Antitrust Certification Statements (Tex Government Code § 2155.005) By submission of this bid or proposal, the Bidder certifies that: I affirm under penalty of perjury of the laws of the State of Texas that: (1) I am duly authorized to execute this contract on my own behalf or on behalf of the company, corporation, firm, partnership or individual (Company) listed below; (2) In connection with this bid, neither I nor any representative of the Company has violated any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15; (3) In connection with this bid, neither I nor any representative of the Company has violated any federal antitrust law; (4) Neither I nor any representative of the Company has directly or indirectly communicated any of the contents of this bid to a competitor of the Company or any other company, corporation, firm, partnership or individual engaged in the same line of business as the Company.
CERTIFICATION STATEMENT Under Section 231.006, Family Code, the vendor or applicant certifies that the individual or business entity named in this contract, bid, or application is not ineligible to receive the specified grant, loan, or payment and acknowledges that this contract may be terminated and payment may be withheld if this certification is inaccurate. The contractor understands that it is the contractor’s responsibility to verify whether a child support obligor who is more than 30 days delinquent is the sole proprietor, partner, shareholder or owner with an ownership interest of at least 25%.
By Non-State Agencies Upon acceptance of Product or as otherwise provided by Contract, Contractor may invoice for payment. The required payment date shall be thirty calendar days, excluding legal holidays, or as mandated by the appropriate governing law from the receipt of a proper invoice. The terms of Article 11-A of the State Finance Law apply only to procurements by and the consequent payment obligations of Agencies. Neither expressly nor by any implication is the statute applicable to Non- State Authorized Users. Neither OGS nor the State Comptroller is responsible for payments on any purchases made by a Non- State Agency Authorized User.
LITIGATION STATEMENT CHECK ONE [ ] The undersigned bidder has had no litigation and/or judgments entered against it by any local, state or federal entity and has had no litigation and/or judgments entered against such entities during the past ten (10) years. [ ] The undersigned bidder, BY ATTACHMENT TO THIS FORM, submits a summary and disposition of individual cases of litigation and/or judgments entered by or against any local, state or federal entity, by any state or federal court, during the past ten (10) years. COMPANY NAME AUTHORIZED SIGNATURE NAME (PRINT OR TYPE) TITLE Failure to check the appropriate blocks above may result in disqualification of your bid. Likewise, failure to provide documentation of a possible conflict of interest, or a summary of past litigation and/or judgments, may result in disqualification of your bid. E VERIFICATION CERTIFICATION Contract No.Y20-1058-MV I hereby certify that I will utilize the U.S. Department of Homeland Security’s E-Verify system in accordance with the terms governing the use of the system to confirm the employment eligibility of the individuals classified below. In accordance with s. 837.06, Florida Statutes, I understand and acknowledge that whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his or her official duties shall be guilty of a misdemeanor in the second degree, punishable as provided in s. 775.082 or s. 775.083, Florida statutes. All persons, including subcontractors and their workforce, who will perform work under Contract No.Y20-1058-MV, Heavy Equipment Parts and Labor, within the state of Florida. NAME OF CONTRACTOR: ADDRESS OF CONTRACTOR: AUTHORIZED SIGNATURE: TITLE: DATE: RELATIONSHIP DISCLOSURE FORM FOR USE WITH PROCUREMENT ITEMS, EXCEPT THOSE WHERE THE COUNTY IS THE PRINCIPAL OR PRIMARY BIDDER For procurement items that will come before the Board of County Commissioners for final approval, this form shall be completed by the Bidder and shall be submitted to the Procurement Division by the Bidder. In the event any information provided on this form should change, the Bidder must file an amended form on or before the date the item is considered by the appropriate board or body. Part I INFORMATION ON BIDDER: Legal Name of Bidder: Business Address (Street/P.O. Box, City and Zip Code): Business Phone: ( ) Facsimile: ( ) INFORMATION ON XXXXXX’S AUTHORIZED AGENT, IF APPLICABLE: (Agent Authorization Form also required to be attached) Name of Bidder’s Authorized Agent: Business Address (Street/P.O. Box, City and Zip Code): Business Phone: ( ) Facsimile: ( ) Part II IS THE BIDDER A RELATIVE OF THE MAYOR OR ANY MEMBER OF THE BCC? YES NO IS THE MAYOR OR ANY MEMBER OF THE BCC THE BIDDER’S EMPLOYEE? YES NO IS THE BIDDER OR ANY PERSON WITH A DIRECT BENEFICIAL INTEREST IN THE OUTCOME OF THIS MATTER A BUSINESS ASSOCIATE OF THE MAYOR OR ANY MEMBER OF THE BCC? YES NO If you responded “YES” to any of the above questions, please state with whom and explain the relationship. (Use additional sheets of paper if necessary) Part III
Mission Statement a. Employees are the most valuable resource in the City’s effective and efficient delivery of services to the public. The parties have a commitment to prevent drug or alcohol impairment in the workplace and to xxxxxx and maintain a drug and alcohol free work environment. The parties also have a mutual interest in preventing accidents and injuries on the job and, by doing so, protecting the health and safety of employees, co-workers, and the public.
Action Steps State scope of practice laws can allow for broad, unre- stricted CPAs between pharmacists and other providers. To build and strengthen collaborative practices, phar- macists can use the following strategies, which were proposed by the APhA Foundation’s expert group: Use simple, understandable terms to describe the patient care services that pharmacists can provide. Educate other health care professionals about the value of including pharmacists on health care teams. Encourage other health professional organizations to work together when proposing changes to scope of practice laws. Set up or participate in interprofessional committees to discuss how scope of practice laws can expand the role of pharmacists and other health professionals in team-based care. Talk with local health care providers about entering into CPAs. Talk with payers about using viable business models to support pharmacists’ patient care services. Share appropriate health information with providers through the use of EHRs. Show relevant stakeholders the value of aligning incentives and reimbursement for all health care team members involved in patient care to improve health and decrease costs. Maintain strong, trusting, and mutually beneficial relationships with patients, doctors, and other providers and encourage those individuals to promote pharmacists’ patient care services. Expanding and promoting pharmacists’ patient care services at the local level can help key stakeholders understand the value of CPAs. Patients, doctors, and other health care pro- viders can share their positive experiences with pharmacists to affirm and promote the value that pharmacists bring to the health care system. They can also champion policies that support collaborative practices.
Construction Standards The Subrecipient and Developer shall ensure that all Approved Projects comply with the following requirements:
Certification Status The Engineer certifies that it is not:
Supplementary Provisions 15.1 This Agreement is executed in two original copies and each Party shall keep one.
SUPPLEMENTARY PREAMBLES For preambles see "Specifications of materials and methods to be used - PW 371" GLAZING TO STEEL WITH PUTTY 4mm Obscure safety glass: 1 Panes not exceeding 0,1 m2 m2 3 Carried Forward to Summary of Section No. 3 R Section No. 3 SMD1 Bill No. 11 GLAZING BVI CONSULTING ENGINEERS Amount Item No SECTION 3 Quantity Rate Amount BILL NO. 12 PAINTWORK SUPPLEMENTARY PREAMBLES For preambles see "Specifications of materials and methods to be used - PW 371" ON FIBRE-CEMENT Prepare and brush to remove all loose contaminations, apply one coat primer and two coats PVA emulsion paint: 1 On fascias and barge boards m2 6 ON WOOD Undercoat and minimum 2 coat gloss enamel: 2 On doors (Internal) m2 3 3 On doors (External) m2 7 ON METAL Undercoat and minimum 2 coat gloss enamel: 4 On door frames m2 1 5 On gates (Measured over the full flat area of both sides) m2 8 6 On gutters and down pipes m 10 Spot prining defects in prime surface with zinc chromate primer and apply one universal undercoat and two coats EPWP, golden brown gloss enamel paint on steel: 7 On windows with burglar bars m2 3 Carried Forward to Summary of Section No. 3 Section No. 3 SMD1 Bill No. 12 PAINTWORK BVI CONSULTING ENGINEERS R SECTION SUMMARY - SMD1 Bill No Page No 1 EARTHWORKS 61 2 CONCRETE,FORMWORK AND REINFORCEMENT 63 3 MASONRY 66 4 WATERPROOFING 67 5 ROOF COVERINGS 69 6 CARPENTRY AND JOINERY 71 7 IRONMONGERY 73 8 METALWORK 74 9 PLASTERING 75 10 PLUMBING AND DRAINAGE 78 11 GLAZING 79 12 PAINTWORK 80 Carried to Final Summary Section No. 3 SMD1 BVI CONSULTING ENGINEERS Amount R Item No SECTION 4 Quantity Rate Amount BILL NO.1 EARTHWORKS (PROVISIONAL) SUPPLEMENTARY PREAMBLES For preambles see "Specifications of materials and methods to be used - PW 371" SITE CLEARANCE 1 Digging up and removing rubbish, debris, vegetation, xxxxxx, shrubs,xxxx and trees not exceeding 200mm girth, etc. m2 73 2 Stripping average 100mm thick layer of top soil and stockpiling on site m2 73 EXCAVATION,FILLING, ETC Excavation in earth not exceeding 2m deep: 3 Trenches m3 18 4 Pit m3 27 5 For aprons thickenning m3 4 Extra over trench and hole excavations in earth for excavation: 6 Soft rock m3 49 7 Hard rock m3 49 Extra over all excavations for carting away: 8 Surplus material from excavations and/or stock piles on site to a dumping site to be alocated by the Contractor m3 35 Carried Forward Section No. 4 MD3 Bill No. 1 EARTHWORKS BVI CONSULTING ENGINEERS R Brought Forward R Risk of collapse of excavations: 9 Sides of trench and hole excavation not exceeding 1,5m deep. m2 82 Keeping excavations free of water: 10 Keeping excavations free of water other than subterranean water Item Earth filling obtained from the excavations and/or prescribed stock piles on site compacted to 93% ModAASHTO density: 11 Under floors, steps, pavings, etc. m3 7 12 Backfilling to trenches, holes, etc. m3 9 Compaction of surfaces: 13 Compaction of ground surface under floors etc including scarifying for a depth of 150mm, breaking down oversize material, adding suitable material where necessary and compacting to 93% Mod AASHTO density m2 25 14 Compaction of ground surface to pits etc including scarifying for a depth of 150mm, breaking down oversize material, adding suitable material where necessary and compacting to 93% Mod AASHTO density m2 20 15 Compaction of ground surface to aprons etc including scarifying for a depth of 150mm, breaking down oversize material, adding suitable material where necessary and compacting to 93% Mod AASHTO density m2 44 Prescribed density tests on filling: 16 Modified AASHTO Density tests No 5 SOIL POISONING Carried Forward R Section No. 4 MD3 Bill No. 1 EARTHWORKS BVI CONSULTING ENGINEERS Brought Forward R Soil insecticide: 17 Under floors etc including forming and poisoning shallow furrows against foundation walls etc, filling in furrows and ramming. m2 25 18 To bottom of concrate aprons m2 44 19 To bottoms and sides of trenches, etc. m2 69 Carried Forward to Summary of Section No. 4 R Section No. 4 MD3 Bill No. 1 EARTHWORKS BVI CONSULTING ENGINEERS R Amount
