BIGI & BIGI, LLC 1b F7
Lease#CHS
LEASE AGREEMENT
THIS LEASE AGREEMENT (`Lease) entered into this 24th day of October 2023,
between BIGI & BIGI, LLC, a Florida Limited Liability Company, whose mailing address is 144
Governors Hill Road, Oxford, CT 06478, hereinafter referred to as "LESSOR or VENDOR/
CONTRACTOR," and COLLIER COUNTY, a political subdivision of the State of Florida, whose
mailing address is c/o Real Property Management, 3335 East Tamiami Trail, Suite 102, Naples,
Florida 34112, on behalf of the Collier County Health Department, hereinafter referred as "LESSEE."
WITNESSETH
In consideration of the mutual covenants contained herein, and other valuable consideration,
the parties agree as follows:
ARTICLE 1. Demised Premises
LESSOR hereby leases to LESSEE and LESSEE hereby leases from LESSOR approximately
2,500 square feet of office space located at Court Plaza III, 2671 Airport Road, Naples, Florida 34112,
Suite 202, 204, and 206, hereinafter referred to as the "Demised Premises", for the sole purpose of
operating a government office.
LESSEE covenants and agrees not to use, occupy, suffer or permit said Demised Premises or
any part thereof to be used or occupied for any purpose contrary to law or the rules or regulations of
any public authority.
ARTICLE 2. Term of Lease
LESSEE shall have and hold the Demised Premises for a term to commence on October 24,
2023, and ending June 30, 2028, with automatic annual renewals. LESSEE is granted the option,
provided it is not then in default of any of the terms of this Lease, to renew same automatically for
additional annual terms under the terms and conditions as provided herein.
LESSEE, however, reserves the right to terminate this Lease, with or without cause, upon
ninety (90) days prior written notice of such termination to LESSOR at the address set forth in
ARTICLE 13 of this Lease. Said notice shall be effective upon actual receipt by LESSOR.
LESSEE intends to utilize grant funding for the office space, attached are the requirements for
the grant funding program, described in Exhibit"A".
ARTICLE 3. Rent
LESSEE hereby covenants and agrees to pay as rent for the Demised Premises the sum of Fifty
Thousand and Four Hundred Dollars and 00/100 Cents ($50,400.00) per year, commencing on October
24, 2023, to June 30, 2028, to be paid in equal monthly installments of Four Thousand Two Hundred
Dollars and 00/100 Cents ($4,200.00) each month; the LESSEE is tax exempt. The first month will be
prorated.
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LESSEE shall provide LESSOR with the first month's rent payment, in advance, within ten
days from LESSOR'S execution of this Lease.
All rental payments shall be due and payable in advance on the first day of every calendar
month during the term hereof If the terms of this Lease shall commence on a day other than the first
day of the month, LESSEE shall pay rental equal to one thirtieth (1/30th) of the monthly rental
multiplied by the number of rental days of such fractional month.
ARTICLE 4. Renewal Term Rent
In the event LESSEE elects to renew this Lease, as provided for in ARTICLE 2, the rent set
forth in ARTICLE 3 shall be increased for the ensuing one-year renewal by 3% compounded annually.
ARTICLE 5. Other Expenses and Charges
LESSEE shall pay all janitorial services, electrical utilities, and communications services
pertaining to the Demised Premises.
LESSEE shall be required to procure and pay for an annual air-conditioning maintenance
contract to also include the cost of any Freon required. LESSEE shall also replace the air-conditioning
filters within the Demised Premises at its sole cost and expense.
LESSOR shall be responsible for the cost of any repairs of the air-conditioning system,
plumbing and electrical systems, and pest control at the Demised Premises.
ARTICLE 6. Modifications to Demised Premises
Prior to making any changes, alterations, additions or improvements to the Demised Premises,
LESSEE will provide to LESSOR all proposals and plans for alterations, improvements, changes or
additions to the Demised Premises for LESSOR'S prior written approval, specifying in writing the
nature and extent of the desired alteration, improvement, change, or addition, along with the
contemplated starting and completion time for such project. LESSOR or its designee will then have
sixty (60) days within which to approve or deny in writing said request for changes, improvements,
alterations or additions. LESSOR shall not unreasonably withhold its consent to required or
appropriate alterations, improvements, changes or additions proposed by LESSEE. If after sixty (60)
days there has been no written rejection delivered by LESSOR to LESSEE regarding said proposals or
plans,then such silence shall be deemed as an APPROVAL to such request of LESSEE.
LESSEE covenants and agrees in connection with any maintenance, repair work, erection,
construction, improvement, addition or alteration of any authorized modifications, additions or
improvements to the Demised Premises, to observe and comply with all then and future applicable
laws, ordinances, rules, regulation, and requirements of the United States of America, State of Florida,
County of Collier, and any and all governmental agencies having jurisdiction over the Demised
Premises.
All alterations, improvements, and additions to said Demised Premises shall at once, when
made or installed, be deemed as attached to the freehold and to have become property of LESSOR.
Prior to the termination of this Lease or any renewal term thereof, or within thirty (30) days thereafter,
if LESSOR so directs, LESSEE shall promptly remove all such additions, improvements, alterations,
fixtures and installations which were placed in, on or upon the Demised Premises by or on behalf of
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LESSEE, and which are designated in said notice, and repair any damage occasioned to the Demised
Premises by such removal and in default thereof, LESSOR may complete said removals and repairs at
LESSEE'S expense.
ARTICLE 7. Access to Demised Premises
LESSOR, its duly authorized agents, representatives and employees, shall have the right after
reasonable oral notice to LESSEE, to enter into and upon the Demised Premises or any part thereof at
all reasonable hours for the purpose of examining same and making repairs or janitorial service therein,
and for the purposes of inspection for compliance with provisions of this Lease.
ARTICLE 8. Assignment and Subletting
LESSEE covenants and agrees not to assign this Lease or to sublet the whole or any part of the
Demised Premises, or to permit any other persons, other than another County agency, to occupy same
without the prior expressed written consent of LESSOR. Any such assignment or subletting, even with
the consent of LESSOR, shall not relieve LESSEE from liability for payment of rent or other sums
herein provided or from the obligation to keep and be bound by the terms, conditions and covenants of
this Lease. The acceptance of rent from any other person shall not be deemed to be a waiver of any of
the provisions of this Lease or to be a consent to the assignment of this Lease or subletting of the
Demised Premises.
ARTICLE 9. Indemnity and Insurance
To the extent legally possible, the parties will continue the insurance arrangements in effect at
the time of the commencement of this Lease, adjusted only so far as necessary to account for their
change in legal position vis-à-vis.
ARTICLE 10. Maintenance
LESSEE shall, at its sole cost and expense, keep the Demised Premises clean at all times. If
said Demised Premises are not kept clean in the opinion of LESSOR, LESSEE will be so advised in
writing. If corrective action is not taken within thirty (30) days of the receipt of such notice, LESSOR
will cause the same to be cleaned and corrected and LESSEE shall assume and pay all necessary
cleaning costs and such costs shall constitute additional rent which shall be paid by LESSEE within
thirty (30) days of receipt of written notice of costs incurred by LESSOR.
ARTICLE 11. Default by LESSEE
Failure of LESSEE to comply with any provision or covenant of this Lease shall constitute a
default and LESSOR may, at LESSOR'S option, terminate this Lease after thirty (30) days written
notice to LESSEE, unless the default be cured within that notice period (or such additional time as is
reasonably required to correct such default).
ARTICLE 12. Default by LESSOR
LESSOR shall in no event be charged with default in the performance of any of its obligations
hereunder unless and until LESSOR shall have failed to perform such obligations within ninety (90)
days (or such additional time as is reasonably required to correct such default) after written notice from
LESSEE to LESSOR properly specifying wherein LESSOR has failed to perform any such obligations.
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ARTICLE 13. Notices
Any notice which LESSOR or LESSEE may be required to give to the other party shall be in
writing to the other party at the following addresses:
LESSEE: LESSOR:
Board of County Commissioners Bigi & Bigi, LLC
c/o Real Property Management 144 Governors Hill Road
3335 East Tamiami Trail Oxford, CT 06478
Naples, Florida 34112
cc: Director, Community and Human Services
ARTICLE 15. Surrender of Premises
LESSEE covenants and agrees to deliver up and surrender to LESSOR possession of the
Demised Premises upon expiration of this Lease, or its earlier termination, broom clean and in as good
condition and repair as the same shall be at the commencement of the term of this Lease or may have
been put by LESSOR or LESSEE during the continuance thereof, ordinary wear and tear and damage
by fire or the elements beyond LESSEE'S control excepted.
ARTICLE 16. General Provisions
LESSEE fully understands that the police and law enforcement security protection provided by
law enforcement agencies to the Demised Premises is limited to that provided to any other business or
agency situated in Collier County, and LESSOR acknowledges that any special security measures
deemed necessary for additional protection of the Demised Premises shall be the sole responsibility
and cost of LESSEE and shall involve no cost or expense to LESSOR.
LESSEE expressly agrees for itself, its successor and assigns, to refrain from any use of the
Demised Premises which would interfere with or adversely affect the operation and maintenance of
LESSOR'S standard operations as well as the LESSOR'S right to make improvements upon the
Demised Premises as deemed necessary by LESSOR.
ARTICLE 17. Radon Gas
In compliance with Section 404.056, Florida Statutes, all parties are hereby made aware of the
following:
Radon is a naturally occurring radioactive gas that, when it has accumulated in a building in
sufficient quantities, may present health risks to persons who are exposed to it over time. Levels of
radon that exceed federal and state guidelines have been found in buildings in Florida. Additional
information regarding radon and radon testing may be obtained from your County Public Health
Department.
ARTICLE 18. Effective Date
This Lease shall become effective upon execution by both LESSOR and LESSEE.
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ARTICLE, 19. Governing Law
This Lease shall be governed and construed in accordance with the laws of the State of Florida.
IN WITNESS WHEREOF, the parties hereto have hereunder set l'orth their hands and seals.
AS TO THE LESSEE:
DATED: 0 CT- 211126 2_3
ATTEST:
CRySTAt:r.K1NZEL. Clerk of BOARD OF COUNTY COMMISSIONERS,
The Circuit Court and Comptroller COLLIER COUNTY ELORIDA
BY: BY:
.Attest t6 aitsibnIslY Clerk RICK 1.0CASTRO, Chairman
AS TOTUE LESSOR: BIG! & BIGI. LLC, a Florida Limited ',jab ity
Company
DATED: OCT 2, 2.02.3 BY:
ALI BIGL Manager
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Approved as to form and legality:
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FEDERAL CONTRACT PROVISIONS EXHIBIT"A"
DEPARTMENT OF TREASURY
CORONAVIRUS LOCAL FISCAL RECOVERY FUND PROGRAM
CFDA 21.027
The supplemental conditions contained in this section are intended to cooperate with,to supplement,and to modify the general conditions and
other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shall govern. This is an
acknowledgement that the United States Department of the Treasury financial assistance Sections 501 of Division N of the Consolidated
Appropriations Act,2021 and 3201(a)of the America Rescue Plan Act of 2021 will be used to fund all or a portion of the contract.The contractor
will comply with all applicable Federal law,regulations,executive orders,policies,procedures,and directives.Pursuant uniform requirements of
federal awards(2 CFR Part 200.23)the definition of CONTRACTOR is an entity that receives a Contract/Purchase Order.
Termination for Convenience(General Provision):See Standard Purchase Order and/or Contract Terms and Conditions
Suspension and Debarment:(1)This contract is a covered transaction for purposes of 2 C.F.R.pt. 180 and 2 C.F.R.pt.3000.As such the
contractor is required to verify that none of the contractor, its principals(defined at 2 C.F.R.§180.995),or its affiliates(defined at 2 C.F.R.§
180.905)are excluded(defined at 2 C.F.R.§180.940)or disqualified(defined at 2 C.F.R.§180.935). (2)The contractor must comply with 2
C.F.R. pt. 180,subpart C and 2 C.F.R. pt.3000,subpart C and must include a requirement to comply with these regulations in any lower tier
covered transaction it enters into. (3)This certification is a material representation of fact relied upon by the County.If it is later determined that
the contractor did not comply with 2 C.F.R.pt.180,subpart C and 2 C.F.R.pt.3000,subpart C,in addition to remedies available to the County,
the Federal Government may pursue available remedies,including but not limited to suspension and/or debarment.(4)The bidder or proposer
agrees to comply with the requirements of 2 C.F.R.pt. 180,subpart C and 2 C.F.R.pt.3000,subpart C while this offer is valid and throughout
the period of any contract that may arise from this offer.The bidder or proposer further agrees to include a provision requiring such compliance
in its lower tier covered transactions.
Contractors placed on the State of Florida convicted vendor list following a conviction for a public entity crime or on the State of Florida
discriminatory vendor list may not submit a bid on a contract to provide any goods or services to a public entity,may not submit a bid on a contract
with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public
entity,may not be awarded or perform work as a contractor,supplier,subcontractor,or consultant under a contract with a public entity,and may
not transact business with any public entity in excess of$25,000.00 for a period of thirty-six(36)months from the date of being placed on the
convicted vendor list or on the discriminatory vendor list.
Access to Records and Reports(2 CFR§200.337):The contractor/vendor agrees to maintain all books, records, accounts and reports required
under this contract for a period of not less than three years after the date of termination or expiration of this contract, except in the event of
litigation or settlement of claims arising from the performance of this contract, in which case the Contractor agrees to maintain same until the
Purchaser,the Grantor Administrator,the Comptroller General,or any of their duly authorized representatives,have disposed of all such litigation,
appeals,claims or exceptions related thereto.
Affirmative Socioeconomic Steps If subcontracts are to be let,the prime contractor is required to take all necessary steps identified in 2 C.F.R.§
200.321(b)(1)-(5)to ensure that small and minority businesses,women's business enterprises, and labor surplus area firms are used when
possible.Contractors may seek opportunities with minority businesses,women's business enterprises,and labor surplus area firms using the
Dynamic Small Business Search tool:http://dsbs.sba.00v/dsbs/search/dso dsbs.cfm
Byrd Anti-Lobbying Amendment(31 U.S.C.§1352(as amended)($100,000 or more): Contractors who apply or bid for an award of$100,000 or more
shall file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any
person or organization for influencing or attempting to influence an officer or employee of any agency,a member of Congress,officer or employee
of Congress,or an employee of a member of Congress in connection with obtaining any Federal contract,grant,or any other award covered by
31 U.S.C.§1352. Each tier shall also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal
award.Such disclosures are forwarded from tier to tier up to the recipient."
Domestic Preference for Procurements 2 CFR§200.322: As appropriate and to the extent consistent with law,the non-Federal entity should,to the
greatest extent practicable under a Federal award,provide a preference for the purchase,acquisition,or use of goods,products,or materials
produced in the United States(including but not limited to iron,aluminum,steel,cement,and other manufactured products).The requirements
of this section must be included in all subawards including all contracts and purchase orders for work or products under this award. For purposes
of this section:"Produced in the United States"means,for iron and steel products,that all manufacturing processes,from the initial melting stage
through the application of coatings,occurred in the United States."Manufactured products"means items and construction materials composed
in whole or in part of non-ferrous metals such as aluminum; plastics and polymer-based products such as polyvinyl chloride pipe;aggregates
such as concrete;glass,including optical fiber;and lumber.
Procurement of Recovered Materials(§200.323)(Over$10,000): In the performance of this contract,the Contractor shall make maximum use of
products containing recovered materials that are EPA-designated items unless the product cannot be acquired—Competitively within a timeframe
providing for compliance with the contract performance schedule; Meeting contract performance requirements; or at a reasonable price.
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FEDERAL CONTRACT PROVISIONS EXHIBIT"A"
Information about this requirement,along with the list of EPA-designated items,is available at EPA's Comprehensive Procurement Guidelines
webpage: https://www.epa.gov/smm/comprehensive-procurement-guideline-cpg-program. The Contractor also agrees to comply with all other
applicable requirements of Section 6002 of the Solid Waste Disposal Act.
Prohibition on certain telecommunications and video surveillance services or equipment(Reference 2 CFR§200.216): The Federal awarding agency
prohibits the County to enter into a contract to procure or obtain equipment,services or systems that uses covered telecommunications equipment
or services as a substantial or essential component of any system,or as critical technology as part of any system.As described in Public Law
115-232,section 889,covered telecommunications equipment is telecommunications equipment produced by Huawei Technologies Company
or ZTE Corporation(or any subsidiary or affiliate of such entities). (i)For the purpose of public safety,security of government facilities,physical
security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment
produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company,or Dahua Technology Company(or any
subsidiary or affiliate of such entities). (ii)Telecommunications or video surveillance services provided by such entities or using such equipment.
(i)(iii)Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in
consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an
entity owned or controlled by,or otherwise connected to,the government of a covered foreign country.(b)In implementing the prohibition under
Public Law 115-232,section 889,subsection(f),paragraph(1),heads of executive agencies administering loan,grant,or subsidy programs shall
prioritize available funding and technical support to assist affected businesses, institutions and organizations as is reasonably necessary for
those affected entities to transition from covered communications equipment and services,to procure replacement equipment and services,and
to ensure that communications service to users and customers is sustained.(c)See Public Law 115-232,section 889 for additional information.
Rights to Inventions Made Under a Contract or Agreement(37 CFR§401.2): Not applicable.
Statutes and Regulations prohibiting Discrimination include, without limitation, the following: The sub-grantee, contractor, subcontractor,
successor,transferee,and assignee shall comply with Title the Civil right Act of 1964,which prohibits recipients of federal financial assistance
from excluding a program or activity,denying benefits of,or otherwise discriminating against a person on the basis of race,color,or national
origin(42 U.S.C.§2000d et seq.),as implemented by the Department of Treasury's Title VI regulations,31 C.F.R. Part 22,which are herein
incorporated by refenced and made a part of this contract(or agreement). Title VI also includes protection to persons with "Limited English
Proficiency"in any program or activity receiving federal financial assistance,42 U.S.C.§2000d et seq.,as implemented by the Department of
the Treasury's Title VI regulations,31 C.F.R.Part 22,and herein incorporated by reference and made a part of this contract or agreement.
Publications:Any publications produced with funds from this award must display the following language"This project[is being][was]supported,
in whole or in part,by federal award number STL-1155 awarded to Collier County by the U.S.Department of the Treasury."
Increasing Seat Belt Use in the United States:Pursuant to Executive Order 13043,62 FR 19217(April 8,1997),the County as a federal assistance
Recipient should encourage its contractors to adopt and enforce on-the-job seat belt policies and programs for their employees when operating
company-owned,rented or personally owned vehicles.
Reducing Text Messaging While Driving:Pursuant to Executive Order 13513,the County as a federal assistance Recipient should encourage its
and contractors to adopt and enforce policies that ban text messaging while driving.
Contract Work Hours and Safety Standards Act (CWHSSA)
(1)Overtime requirements.No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment
of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of
forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all
hours worked in excess of forty hours in such workweek.
(2)Violation;liability for unpaid wages;liquidated damages.In the event of any violation of the clause set forth in paragraph(1)of this section the
contractor and any subcontractor responsible therefor shall be liable for the unpaid wages.In addition,such contractor and subcontractor shall be liable to the
United States(in the case of work done under contract for the District of Columbia or a territory,to such District or to such territory),for liquidated damages.Such
liquidated damages shall be computed with respect to each individual laborer or mechanic,including watchmen and guards,employed in violation of the clause set
forth in paragraph(1)of this section,in the sum of$10 for each calendar day on which such individual was required or permitted to work in excess of the standard
workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph(1)of this section.
(3)Withholding for unpaid wages and liquidated damages.The(write in the name of the Federal agency or the loan or grant recipient)shall upon its
own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld,from any moneys payable on
account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor,or any other
federally-assisted contract subject to the Contract Work Hours and Safety Standards Act,which is held by the same prime contractor,such sums as may be
determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set
forth in paragraph(2)of this section.
(4)Subcontracts.The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph(1)through(4)of this section and
also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts.The prime contractor shall be responsible for compliance by any
subcontractor or lower tier subcontractor with the clauses set forth in paragraphs(1)through(4)of this section."
For contracts that are only subject to Contract Work Hours and Safety Standards Act and are not subject to the other statutes in 29 C.F.R.§5.1
"Further Compliance with the Contract Work Hours and Safety Standards Act.
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FEDERAL CONTRACT PROVISIONS EXHIBIT"A"
(1)The contractor or subcontractor shall maintain payrolls and basic payroll records during the course of the work and shall preserve them for a
period of three years from the completion of the contract for all laborers and mechanics,including guards and watchmen,working on the contract.Such records
shall contain the name and address of each such employee,social security number,correct classifications,hourly rates of wages paid,daily and weekly number
of hours worked,deductions made,and actual wages paid.
(2)Records to be maintained under this provision shall be made available by the contractor or subcontractor for inspection,copying,or transcription
by authorized representatives of the Department of Homeland Security,the Federal Emergency Management Agency,and the Department of Labor,and the
contractor or subcontractor will permit such representatives to interview employees during working hours on the job.
Certification
On behalf of my firm, I acknowledge, the grant requirements identified in this document.
Vendor/Contractor Name ALI BIGI
Signature Date
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FEDERAL CONTRACT PROVISIONS EXHIBIT"A" 1 6 F 7
COLLIER COUNTY
Certification Regarding Debarment,Suspension,and Other Responsibility Matters
Primary Covered Transactions
(1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its
principals:
(a) Are not presently debarred, suspended,proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by any Federal department or agency;
(b) Have not within a three-year period preceding this proposal been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or
contract under a public transaction;violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements,or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State or local)with commission of any of the offenses enumerated in paragraph(1)(b) of
this certification; and
(d) Have not within a three-year period preceding this application/proposal had one or more public
transactions(Federal, State or local)terminated for cause or default.
(2) Where the prospective primary participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Ali Bigi
Name Project Name
Manager
Title Project Number
Bigi& Bigi, LLC 81-0867234
Firm Tax ID Number
DUNS Number
144 Governor Hill Rd, Oxford, CT 06478
Street Address, City, State,Zip
Signature
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FEDERAL CONTRACT PROVISIONS EXHIBIT"A"
COLLIER COUNTY
Certification Regarding Lobbying
The undersigned certifies,to the best of his or her knowledge,that:
(1)No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or employee of an agency,a Member
of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract,the making of any Federal grant,the making of
any Federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress,
an officer or employee of Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers(including subcontracts, subgrants, and contracts under grants,
loans, and cooperative agreements)and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure
Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty
of not less than $10,000 and not more than $100,000 for each such failure.
The Contractor, Ali Bigi, certifies or affirms the truthfulness and accuracy of each statement of its
certification and disclosure, if any. In addition, the Contractor understands and agrees that the
provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any.
In addition, the Contractor understands and agrees that the provisions of 11.062, Florida Statutes.,
apply to this certification and disclosure, if any.
Signature of Contractor's Authorized Official
ALI BIGI,Manager Name of Authorized Official and Title
Date
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FEDERAL CONTRACT PROVISIONS EXHIBIT"A" 1 6 F 7
COLLIER COUNTY
Conflict of Interest Certification
Collier County Solicitation No.
I, Ali Bigi, hereby certify that to the best of my knowledge, neither I nor my spouse, dependent child,
general partner, or any organization for which I am serving as an officer, director, trustee, general partner
or employee,or any person or organization with whom I am negotiating or have an arrangement concerning
prospective employment has a financial interest in this matter.
I further certify to the best of my knowledge that this matter will not affect the financial interests of any
member of my household. Also, to the best of my knowledge, no member of my household; no relative
with whom I have a close relationship; no one with whom my spouse, parent or dependent child has or
seeks employment; and no organization with which I am seeking a business relationship nor which I now
serve actively or have served within the last year are parties or represent a party to the matter.
I also acknowledge my responsibility to disclose the acquisition of any financial or personal interest as
described above that would be affected by the matter,and to disclose any interest I,or anyone noted above,
has in any person or organization that does become involved in,or is affected at a later date by,the conduct
of this matter.
Ali Bigi
Name Signature
Manager
Position Date
Privacy Act Statement
Title I of the Ethics in Government Act of 1978 (5 U.S.C. App.), Executive Order 12674 and 5 CFR Part
2634, Subpart I require the reporting of this information. The primary use of the information on this form
is for review by officials of The Justice Department to determine compliance with applicable federal
conflict of interest laws and regulations. Additional disclosures of the information on this report may be
made: (1)to a federal, state or local law enforcement agency if the Justice Department becomes aware of a
violation or potential violation of law or regulations; (2) to a court or party in a court or federal
administrative proceeding if the government is a party or in order to comply with a judge-issued subpoena;
(3) to a source when necessary to obtain information relevant to a conflict of interest investigation or
decision; (4)to the National Archives and Records Administration or the General Services Administration
in records management inspections; (5) to the Office of Management and Budget during legislative
coordination on private relief legislation;and(6)in response to a request for discovery or for the appearance
of a witness in a judicial or administrative proceeding, if the information is relevant to the subject matter.
This confidential certification will not be disclosed to any requesting person unless authorized by law. See
also the OGE/GOVT-2 executive branch-wide Privacy Act system of records.
Page 6 of 9
GvO
FEDERAL CONTRACT PROVISIONS EXHIBIT"A" 1 b F 7 '
COLLIER COUNTY
ANTICIPATED DISADVANTAGED, MINORITY, WOMEN OR VETERAN PARTICIPATION STATEMENT
Status will be verified. Unverifiable statuses v,YI requ re tie PP ME to either prc,•de a revised statement or provide scurce documentation that va'idates a
status.
A. PRIME VENDOR/CONTRACTOR INFORMATION
PRIME NAME PRIME FED NUMBER CON--5ACT DO-L;F.AMOUNT
IS THE PRIME A FLORIDA-CERTIFIED DISADVANTAGED. VETERAN y N !S THE ACTIVITY OF THIS CONTRACT...
MINORITY OR WOMEN BUSINESS ENTERPRISE? DBE? N CONSTRUCTION? Y t;
+DBEJMBErViBE)OR HAVE A SMALL DISADVANTAGED
BUS NESSSA CERTIFICATION FROM THE SMALL BUSINESS MBE? Y N CONSULTATION? Y
ADMINISTRATION? A SERVICE DISABLED VETERAN? WBE? Y N OTHER? Y
SOB BA? N
IS TH'SSUBMISSION A REVISION? N F 1'ES,RE''SION NUMBER
B. IF PRIME HAS SUBCONTRACTOR OR SUPPLIER WHO IS A DISADVANTAGED MINORITY,WOMEN-OWNED,SMALL
BUSINESS CONCERN OR SERVICE DISABLED VETERAN,PRIME IS TO COMPLETE THIS NEXT SECTION
DBE P/WBE SUBCONTRACTOR OR SUPPLIER TYPE OF WORK OR ETHNICITY CODE SUB/SUPPLIER PERCENT OF CONTRACT
VETERAN NAME SPECIALTY {See Below) DOLLAR AMOUNT DOLLARS
C. SECTION TO BE COMPLETED BY PRIME VENDOR/CONTRACTOR
NAME OF SUBMITTER DATE TITLE OF SUBMrTTER - I111
EMAIL ADDRESS OF PRIME[SUBMITTER) TELEPHONE NUMBER FAX NUMBER
NOTE:This information is used to track and report anticipated DBE c-MBE participation in federally-funded contracts.The anticipated DBE or
MBE amount is voluntary and.will not become part c'the cantractua'terms. This form must be submitted at time of response to a
solicitation. rf and when awarded a Count,contract,the prime v.ill be asked to update the information for the grant compliance files.
ETHNICITY CODE
Black American BA
hispanic American hA.
Native American NA
Subcont.Asi an American L 4..
Asian-Pacific American APA
Non-Mincrity Women
Other:not of any other group listed 0
D. SECTION TO BE COMPLETED BY COLLIER COUNTY
DEPARTMENT NAME COWER CONTRACT e I IFBJRF P o•'0't t G GRANT PP OG RAM/CONTRA..C—
ACCEPTED BY: DATE
Page 7 of 9
FEDERAL CONTRACT PROVISIONS EXHIBIT"A" 1 6 F 7
COLLIER COUNTY
Acknowledgement of Terms, Conditions and Grant Clauses
Flow Down of Terms and Conditions from the Grant Agreement
Subcontracts: If the vendor subcontracts any of the work required under this Agreement, a copy of the
signed subcontract must be available to the Department for review and approval. The vendor agrees
to include in the subcontract that (1) the subcontractor is bound by the terms of this Agreement, (ii)
the subcontractor is bound by all applicable state and federal laws and regulations, and (iii) the
subcontractor shall hold the Department and Recipient harmless against all claims of whatever nature
arising out of the subcontractor's performance of work under this Agreement, to the extent allowed and
required by law. The recipient shall document in the quarterly report the subcontractor's progress in
performing its work under this agreement. For each subcontract,the Recipient shall provide a written
statement to the Department as to whether the subcontractor is a minority vendor as defined in Section
288.703,Fla. Stat.
Certification
On behalf of my firm, I acknowledge, and agree to perform all of the specifications and grant
requirements identified in this provisions document(s).
Vendor/Contractor Name Bigi&Bigi,LLC Date
Authorized Signature
Address 144 Governor Hill Rd, Oxford,CT 06478
Solicitation/Contract#
Page 8 of 9
16F74
FEDERAL CONTRACT PROVISIONS EXHIBIT"A"
Page 9 of 9