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LEHIGH ACRES MUNICIPAL SERVICES IMPROVEMENT DISTRICT BOARD OF COMMISSIONERSREQUEST FOR PROPOSALS – ANNUAL FINANCIAL AUDIT SERVICESINTRODUCTIONLehigh Acres Municipal Services Improvement District (“LA-MSID”) is requesting qualification proposals from certified public accounting firms duly licensed under Chapter 473, Florida Statutes, and qualified to conduct audits in accordance with government auditing standards as adopted by the Florida Board of Accountancy to audit its financial statements on an annual basis beginning with the fiscal year ending September 30, 2018. These annual audits are to be performed in accordance with generally accepted auditing standards including the following (as they may be amended from time to time):Section 218.39, Florida StatutesRules of the Florida Department of Financial ServicesRules of the Florida Auditor General (Chapter 10.550, Local Government Entity Audits)AICPA Audit and Accounting Guide - Audits of State and Local Governmental UnitsFederal and Florida Single Audit Acts (if applicable)Government Auditing Standards issued by the Comptroller General of the United StatesCFR Title 2: Grants and Agreements, Chapter II Part 200, Executive Office of the President, Office of Management and Budget, Washington D.C. (if applicable)Written questions regarding this Request for Proposals (RFP) are to be addressed to the designated Contact Person:Kathryn O’Brien, Finance DirectorLehigh Acres Municipal Services Improvement District601 East County LaneLehigh Acres, FL 33936 Telephone: (239) 368-0044 x 29Fax: (239) 368-5412Email: kobrien@la- Each firm should carefully examine the RFP and may make a written request to LA-MSID’s Finance Director for interpretations or corrections of any ambiguity, inconsistency or error ("Requests for Information" or "RFIs") no later than April 5, 2018, at 12:00 p.m. E.S.T. Only written responses issued by the Finance Director in the form of Addenda to this RFP should be relied upon. LA-MSID will make reasonable efforts to distribute all Addenda issued by the Finance Director to everyone who is issued an RFP. However, each firm is responsible to assure that it has the most recent Addenda. LA-MSID does not accept responsibility for or guarantee that Addenda will be received.Once the RFP is advertised, no applicant or individual acting on behalf of the applicant shall lobby the LA-MSID’s personnel or LA-MSID Board members. Lobbying LA-MSID Board members or LA-MSID personnel will result in disqualification of the offending firm’s Proposal. For purposes of this RFP, “lobbying” is defined as any action taken by an individual, firm, association, joint venture partnership, syndicate, corporation and all other groups who seek to influence the governmental decision of a Board member or LA-MSID personnel after publication of the RFP and prior to time that an award recommendation is posted.To be considered, Proposals in response to this RFP must be delivered to the above address no later than 12:00 p.m. E.S.T. on April 9, 2018. Ten (10) signed copies of the Proposal shall be submitted in one sealed package, clearly marked on the outside "Proposal for Independent Financial Auditing Services", the firm’s name; the name, address, telephone number and email address of the contact person; and the date of the proposal. Proposals must be prepared exactly according to the outline specified in Section 7, below (which will be provided electronically to firms for their convenience). Proposals not submitted in the order required by the outline may be considered Non-Responsive to the RFP, disqualified and not considered. Proposals must be typed or printed in ink. A single digital (CD or USB Flash Drive in PDF format) of the entire transmittal should also be included with the Proposal Package. Proposals received after the deadline will be considered Non-responsive to the RFP, disqualified and returned to the proposer unopened. All costs incurred by the responding firms in preparing Proposals in response to this RFP will not be reimbursed by LA-MSID.LA-MSID reserves the right to reject any or all Proposals, including without limitation, nonconforming, nonresponsive, unbalanced, or conditional Proposals. LA-MSID further reserves the right to reject the Proposal of any Responder whom it finds, after reasonable inquiry and evaluation, to not be responsible. LA-MSID may also reject the Proposal of any Responder if LA-MSID believes that it would not be in the best interest of the LA-MSID to make an award to that Responder, whether because the Proposal is not responsive or the Responder is unqualified or of doubtful financial ability or fails to meet any other pertinent standard or criteria established by LA-MSID. LA-MSID also reserves the right to waive all informalities in a Proposal not involving price, schedule, or changes in the proposed Work and to negotiate contract terms with the Successful Responder.At the discretion of the Audit Committee, firms submitting Proposals may be requested to make oral presentations as part of the evaluation process.LA-MSID reserves the right to retain all Proposals submitted and to use any ideas in a Proposal regardless of whether that Proposal is selected. Submission of a Proposal indicates acceptance by the firm of the conditions contained in this RFP, unless clearly and specifically noted in the Proposal submitted and confirmed in the contract between LA-MSID and the firm selected.Firms submitting Proposals may subcontract portions of the engagement. If this is to be done, the name of the proposed subcontracting firms must be clearly identified in the Proposal. Subcontractors will be held to the same standards and evaluation criteria as the principal. Following award of thecontract, no additional subcontracting will be allowed without the express prior written consent of LA-MSID's Board of Commissioners (the "Board").The Audit Committee will rank in order of preference and recommend to the Board no fewer than three (3) firms deemed to be the most highly qualified to perform the required services. (If fewer than three firms respond to the RFP, the Audit Committee may rank and recommend the firms it deems to be responsive to the RFP and the most highly qualified.) The Board will award a contract to the firm recommended by the Audit Committee as being most qualified and initiate negotiation of a contract in accordance with Section 218.391, Florida Statutes. It is anticipated that the Board will enter into a contract with an initial term of one (1) year starting with the fiscal year ending September 30, 2018. The contract will include an option to extend the contract on an annual basis for additional one (1) year periods. If the Contract is to be awarded, the LA-MSID will award the Contract to the firm whose Proposal is in the best interests of the LA-MSID.In accordance with Section 218.391, Florida Statutes, if the Board is unable to negotiate a satisfactory contract with the firm initially ranked most qualified, negotiation will be terminated and commence with the firm ranked next most qualified, continuing in order of ranking until agreement is reached.ANTICIPATED RFP CALENDARMarch 24, 2018Request for Proposals to be advertisedApril 5, 2018Deadline for written questions related to RFP by 12:00 p.m. E.S.T.April 9, 2018Responses to RFP due by 12:00 p.m. E.S.T. April 9, 2018Audit Committee receives proposalsApril 16, 2018Audit Committee meeting to discuss proposals and preliminary ranking of firmsMay 21, 2018Audit Committee finalizes rankings and recommends firms May 21, 2018Board selects certified public accounting firmMay 22, 2013Selected firm notified to prepare contract or engagement letter June 18, 2018Board of Commissioners approve contract with selected firmNATURE OF SERVICES REQUIRED/SCOPE OF WORK:The LA-MSID is requesting proposals for each of two options shown below. Each year the LA-MSID will determine prior to the issuance of the engagement letter the option chosen for that particular audit year. All requirements and conditions set forth in this RFP shall be incorporated into the contract between LA-MSID and the selected firm unless otherwise specified in the contract.OPTION 1:The Auditor shall: Conduct an audit of and render an opinion on the basic financial statements of LA-MSID. Perform certain limited procedures in accordance with auditing standards generally accepted in the United States of America involving management’s discussion and analysis (MD&A) and the required supplementary information other than MD&A required by accounting principles generally accepted in the United States of America and the Governmental Accounting Standards Board (GASB). Provide an "in relation to" opinion based on the auditing procedures applied during the audit of the financial statements to the individual fund financial statements, the schedule of expenditures of state financial assistance and the schedule of expenditures of federal awards. Perform the audit in accordance with the Rules of the Auditor General, Chapter 10.550 and; OMB Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) or s. 215.97, F.S., the Federal and Florida Single Audit Acts (if applicable); Government Auditing Standards issued by the Comptroller General of the United States; and the AICPA Auditing Standards. Following completion of the audit for each fiscal year's financial statements, the auditor shall issue:A report on the fair presentation of the financial statements in conformity with generally accepted accounting principles.A report on compliance and on internal control over financial reporting.A report on bond compliance (if applicable).Reports on compliance with specific requirements applicable to Federal awards and State financial assistance programs (if applicable).The auditor shall communicate in a letter to management any significant deficiencies or material weaknesses found during the audit. Provide assistance and guidance in implementing changes in governmental accounting standards. If LA-MSID issues debt during any contract term, the official statement of which contains basic financial statements and a report of independent auditors, the auditor shall be required to issue a "consent and citation of expertise" as auditor and any necessary "comfort letters" at no additional cost to LA-MSID. Make an immediate, written report of all irregularities and/or illegal acts identified to the District Manager, the Board of Commissioners and LA-MSID’s General Counsel.Provide additional professional services, upon written request. LA-MSID may request additional professional services during any term of the contract. Upon receipt of such written request from the District Manager, the auditor shall perform such additional services. The auditor must be able to provide, at a minimum, extended audit services or special audits. Such services will be billed according to the negotiated rates in the contract. The total amount for additional services shall be separately negotiated at the time of engagement for a not-to-exceed amount calculated using the rates of the contract.OPTION 2:In addition to items in Option 1 the Auditor will also prepare the following exhibits, schedules and notes to the financial statements and reports:Statement of Net AssetsStatement of ActivitiesBalance Sheet – Governmental FundsReconciliation of the Balance Sheet – Governmental Funds to the Statement of Net PositionStatement of Revenues, Expenditures and Changes in Fund Balance – Governmental FundsNotes to the Financial StatementsRequired Supplementary Information Other than MD&ANotes to the Required Supplementary InformationCombining and Individual Fund Statements and SchedulesFinal Audit Report – Final audit report consolidation, printing, binding and delivery shall be the responsibility of the auditor and will include:Fifteen (15) bound copies and one (1) unbound copy shall be delivered to the LA-MSIDOne bookmarked PDF copy of the Final Audit Report to be made available on the LA-MSID’s website.DESCRIPTION OF LA-MSID AND RECORDS TO BE AUDITEDLehigh Acres Municipal Services Improvement District is on the west coast of Florida, located in the eastern portion of unincorporated Lee County known as Lehigh Acres and the extreme western portion of Hendry County. LA-MSID encompasses approximately 110 square miles. LA-MSID is an independent special district authorized and empowered by Chapters 189, 197, and 298, F.S., and Chapter 2015-202 and Chapter 2017-216, Laws of Florida. LA-MSID is governed by a five (5) member Board of Commissioners elected at-large serving staggered four (4) year terms.For reporting purposes, the Basic Financial Statements (Audited Financial Statements) will include the General Fund, Debt Service and Capital Project funds. LA-MSID has no component units.Accounting records for the Board include the general fund, a debt service fund and three (3) capital projects funds (infrastructure, land acquisition and equipment repair and replacement). The FY 2018 total adopted budget is approximately $6.53 million dollars.As of the date of this RFP, the LA-MSID has no bond issues, but does have six (6) State Revolving Fund (SRF) loans, one (1) bank loan and one (1) capital installment purchase outstanding. The total principal of debt issues outstanding is approximately $10-million as of September 30, 2017.LA-MSID’s main source of revenue consists of non-ad valorem assessments. These assessments are collected by the Lee and Hendry County Tax Collectors at the same time as all other governmental entities' non-ad valorem assessments and ad valorem taxes. Parcels within the LA-MSID are assessed based upon their acreage size.All accounting records are maintained on the modified accrual basis with adjustments made to accrual basis for financial statement purposes.Budgets are integrated with the accounting records.LA-MSID is progressive in its attitude toward new accounting standards. Early implementation is practiced when recommended.LA-MSID does not have an internal audit department.LA-MSID is currently utilizing AccuFund Accounting Software.Copies of prior year financial statements can be found at la-.SCHEDULE FOR THE FY 2018 AUDITEach of the following shall be completed by the auditor no later than the dates indicated unless special arrangements have been made.Interim Work – The auditor shall complete all interim work by September 20, 2018.Detailed Audit Plan – The auditor shall work with the Finance staff (Finance Director, Controller, Accountant, Accounting Clerk) to develop a detailed audit plan by September 20, 2018, which shall include a final list of all schedules to be prepared by LA-MSID staff before field work begins.Field Work – Field work will commence December 3, 2018 and must be completed by December 6, 2018.Final Reports – Audit reports and recommendations of auditor by January 3, 2019. Conference and Progress Reports:Entrance conference with the District Manager, Finance Director and Controller immediately after execution of contract.Exit conference with the District Manager, Treasurer of the Board of Commissioners and Finance staff immediately prior to monthly board meeting in which the Audit is presented by Auditor to the Board of Commissioners.Presentation to the Board of Commissioners at the January board meeting or, in the case of a delay in the FRS reporting, the February board meeting.ASSISTANCE TO BE PROVIDED TO THE AUDITORLA-MSID will have all necessary management personnel available to meet with the selected firm’s personnel upon execution of the auditor’s contract. The LA-MSID's Finance staff and responsible management personnel will be available during the audit to assist the firm by providing information, documentation and reasonable explanations.The LA-MSID's Finance staff will provide the following statements and schedules for the auditors as requested:Bank, Investment, Revenue and Attorney ConfirmationsDebt ComplianceAccrued Payroll SummaryReceivable SchedulesAccounts Payable ReconciliationsBank Reconciliation SummaryInvestment Reconciliation SummaryAccounts Payable Subsidiary LedgerRetainage Payable Subsidiary LedgerFixed Assets SchedulesCIP SchedulesDesignated/Reserve SchedulesSchedule of Expenditures of Federal Awards and State of Florida Financial AssistanceLA-MSID will provide the auditor with reasonable work space, tables and chairs. The auditor will also be provided with access to one telephone line, photocopying facilities, and access to WiFi for communications and transmission of files.If Option 1 is chosen: LA-MSID staff will be responsible for the preparation, printing and distribution of the Basic Financial Statements.LA-MSID’s Staff will perform the year-end closing of the books.LA-MSID’s Staff will prepare the financial statements.LA-MSID’s Staff will submit the Annual Financial Report as required by the Florida Department of Financial Services.LA-MSID’s Staff will prepare work schedules, notes and related materials as requested by the selected firm.LA-MSID’s Staff will provide paid invoices, canceled checks and other supportive documentation as requested by the firm.PROPOSAL SUBMITTAL FORMAT REQUIREMENTSThe firm's Proposal must include the following information, IN THE FORMAT AND EXACT ORDER OUTLINED BELOW. One (1) original (clearly marked as “Original”) and ten (10) complete copies of the Response shall be submitted on 8 ? x 11 inch paper, paginated and separated by tabs to identify each required section. Please also submit one (1) complete scanned electronic copy on CD or USB Flash Drive in PDF format. Please be concise in all responses. If any category is not applicable, so expressly state.In order to facilitate review, Responses shall be organized in the following sequence and under the following headers:TAB A)LETTER OF INTEREST.TAB B)TITLE PAGE showing the RFP subject, the name of the firm, address, telephone number, the name of the contact person, and the date.TAB C)TABLE OF CONTENTS, clearly identifying the enclosed material by section and by page number, following this outline.TAB D)PROFESSIONAL LICENSES. Evidence the firm is a certified public accounting firm duly licensed under Chapter 473, Florida Statutes, and qualified to conduct audits in accordance with government auditing standards as adopted by the Florida Board of Accountancy.TAB E)PROFESSIONAL MEMBERSHIPS. Evidence the firm is a member of the American Institute of Certified Public Accountants and the Florida Institute of Certified Public Accountants for a period of no less than five (5) years.TAB F)STATE OR FEDERAL REVIEWS. Describe the results of any State or Federal reviews during the past three (3) calendar years of the firm’s governmental client audit work.TAB G)DISCIPLINARY ACTIONS. Indicate any disciplinary actions that have been instituted during the last three (3) calendar years against the firm or any of the firm’s professionals, and their resolution or current status.TAB H)LAWSUITS. List all lawsuits in which the firm has been named as a defendant in the past three (3) calendar years.TAB I)PEER REVIEW. The firm should indicate its approach to peer review and attach a copy of the most recent peer review. Indicate whether the peer review included a review of local government client activities.TAB J)KEY PERSONNEL. Provide the names and positions of each professional to be assigned to this audit. Resumes for each person assigned to the audit should be submitted and include the following information (please be concise):Formal educationSupplemental education relative to governmental accounting and auditingExperience in public accounting in generalExperience in private business or governmentExperience in auditing governmental unitsMembership in various national and state governmental accounting boards, committees, or associationsProfessionalrecognition,suchasCertifiedPublicAccountantlicenses, awards, etc.TAB K)TECHNICAL EXPERTISE. Demonstration of technical expertise: Describe up-to- date administrative, spreadsheet (Excel) and database (Access) expertise, as well as training and staff expertise with each type of software. Technological expertise may be tested or require verification satisfactory to LA-MSID.TAB L)GOVERNMENTAL AUDIT EXPERIENCE. Describe the firm's experience in preparing governmental financial statements.TAB M) CURRENT PUBLIC CLIENTS. List Florida counties, municipalities and special districts for which the firm is currently providing or within the last five (5) years has provided audit services, including contact names and phone numbers.TAB N)UNDERSTANDING AND COMMITMENT. A statement setting forth the proposer's understanding of the work to be done and make an affirmative commitment to perform the work within the specified time period and budget constraints, considering the firm’s current and projected workload.TAB O)WORK PLAN. Set forth a work plan, including an explanation of the audit methodology to be followed in order to perform the services required in Section 3 (Services Required/Scope of Work) of this RFP.TAB P)AUDIT APPROACH. Provide the following information on the firm's audit approach:Proposed segmentation of the engagementLevel of staff and number of hours to be assigned to each proposed segment of the engagementSample size and the extent to which statistical sampling is to be used in the engagementExtent of use of EDP software in the engagementType and extent of analytical procedures to be used in the engagementApproach to be taken to gain and document an understanding of the internal control structureApproach to be taken in determining laws and regulations that will be subjectto audit workApproach to be taken in drawing audit samples for purposes of tests of complianceIndicate percentage of the audit that can be completed remotely (All LA-MSID financial records, statements and schedules are retained electronically.TAB Q)PROOF OF INSURANCE. Each response should contain a statement regarding the amount of the firm’s general liability insurance and errors and omissions (i.e. professional) insurance.TAB R)INDEPENDENCE. The Firm should provide an affirmative statement that it is independent of Lehigh Acres Municipal Services Improvement District as defined by generally accepted auditing standards. The firm should also list and describe any relationships involving LA-MSID for the past five years.TAB S)FIRM ETHICS. Disclose firm policies and procedures to prevent ethical violations. Discuss specific staff responsibilities and management commitment.TAB T)OTHER DISCLOSURES: Proposers must answer the following question:“Has the firm ever been asked to resign, voluntarily resigned or withdrew from a project, contract or agreement within the past five (5) years?If the answer is yes, please explain the circumstances.TAB U)ANTI-KICKBACK AFFIDAVIT. The attached affidavit must be completed, signed and included in each applicant’s submittal (see attached Form U).TAB V)NON-COLLUSION AFFIDAVIT. The attached affidavit must be completed, signed and included in each applicant’s submittal (see attached Form V).TAB W) PUBLIC ENTITY CRIMES. Sworn Statement under Section 287.133(3)(a), Florida Statutes, Public Entity Crimes. The attached sworn statement must be completed, signed and included in each applicant’s submittal (see attached Form W).TAB X)DRUG-FREE WORKPLACE CERTIFICATION. Section 287.087, FloridaStatutes, provides that in the event two or more competitive solicitations that are equal with respect to price, quality, and service are received, a response received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. This preference will only be awarded in the event of a tie in scoring and if the other firm has not implemented a drug-free workplace program. In order to receive the preference, the attached certification must be completed, signed and submitted with the Response to this RFP (see attached Form X).TAB Y)COMPENSATION: FEES AND COSTS. For information purposes only, and stated separately for Option 1 and Option 2, the dollar cost for provision of audit services during the first year of the Contract and estimates for each projected contract year up through the potential first five (5) years of the Contract.Total all-inclusive maximum annual priceHourly rates by partner, specialist, supervisory and staff-level, times estimated hours anticipated for each, with estimated rates and costs for:Reimbursement of out-of-pocket expenses and disbursementsAdditional professional servicesExpected manner of paymentTAB Z)SUPPLEMENTAL INFORMATION: Firm promotional material may be included as supplemental information. Please be brief.ORAL PRESENTATIONSThe Audit Committee reserves the right to require that the highest ranked Respondents make an Oral Presentation, of no more than 15 minutes in length, explaining and/or demonstrating their proposal. Oral Presentations shall be scheduled at a public meeting at the convenience of the LA-MSID. Additional copies of the original proposal may be requested and supplied at no cost to LA-MSID. If an Oral Presentation is required by the Audit Committee, a Respondent’s failure to make the presentation for any reason shall be deemed Non-Responsive to the Solicitation requirements.PROPOSAL EVALUATION PROCEDURES & CRITERIAAll Proposals will be reviewed and evaluated by the Audit Committee using the following criteria. Firms meeting the Mandatory Criteria will have their Proposals evaluated and ranked according to their Technical qualifications. Firms may also be evaluated based on their performance in an oral presentation. The following criteria will be considered during the evaluation process.Mandatory CriteriaWhether the firm adheres to the instructions in this RFP on preparing and submitting the proposal in required formWhether the firm is licensed under Chapter 473, Florida Statutes, to practice in Florida and a member of the American Institute of Certified Public Accountants and the Florida Institute of Certified Public Accountants for the required periods.Whether firm is independent of LA-MSID.Whether the firm has any conflicts of interest with regard to any work performed or to be performed by the firm for LA-MSIDWhether the firm submits a copy of its last external peer review report and has a record of quality audit work.Technical Quality CriteriaGeneral government audit experienceSpecial district audit experienceDemonstrated understanding of LA-MSID’s requirementsAudit approachQualifications of individuals assigned to auditTechnological proficiency of individuals assigned to auditIn the event of a tie in ranking the most qualified firms, one (1) “bonus” point will be awarded to any firm that certifies that it has established a drug free workplace program, pursuant to sec. 287.087, F.S.Performance in Oral Presentation (if required)Compensation will be negotiated and will not be considered as a factor in evaluating Proposals or award of the contract.WORKING PAPER RETENTION AND ACCESS TO WORKING PAPERSAll working papers and reports must be retained, at the auditor’s expense, for a period of three (3) years after completion of any services identified herein unless the firm is notified in writing by LA-MSID of the need to extend the retention period. LA-MSID’s management and its representatives shall be entitled at any time during the contract period to inspect and reproduce such documents as deemed necessary.In addition, the firm shall respond to the reasonable inquiries of successor auditors and allow successor auditors to review working papers relating to matters of continuing accounting significance. As requests for copies of working papers are fulfilled, the auditors will be required to notify the Finance Director of the request, as appropriate.FORM "U"ANTI-KICKBACK AFFIDAVITSTATE OF FLORIDA)) ssCOUNTY OF )I, the undersigned, hereby duly sworn, depose and say that no money or contributions have or will be paid to any officer(s) or employee(s) of the Lehigh Acres Municipal Services Improvement District as a commission, kickback, reward of gift, directly or indirectly by me or any member of my firm or by an officer of the firm, as a result of or in connection with my Firm’s submittal of its affixed submittal.By: Name – SignaturePrint Name133540517462500TitleSworn and subscribed before me this day of , 20 91440018986500NOTARY PUBLIC, State of Florida at Large“OFFICIAL NOTARY STAMP”THIS PAGE IS TO BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE.FORM "V"NON-COLLUSION AFFIDAVITSTATE OF FLORIDA)) ssCOUNTY OF ) , being first duly sworn, deposes and says that:He/She isof(the "Firm"), which(Title)(Name of Firm)has submitted the attached Qualifications Package:He/She is fully informed respecting the preparation and contents of the attached Qualifications Package and of all pertinent circumstances respecting such submittal;The Qualifications Package is genuine and is not a collusive or sham Qualifications Package;Further, neither the Firm nor any of the Firm’s officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or indirectly with any other qualifier, firm or person to submit a collusive or sham Qualifications Package in connection with the Annual Auditor position for which the attached Qualifications Package has been submitted or to refrain from bidding in connection with such Annual Auditor position, or has in any manner, directly or indirectly, sought by agreement or collusion or communications or conference with any other qualifier, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the Lehigh Acres Municipal Services Improvement District.By: SignaturePrint Name133477017589500TitleSworn and subscribed before me this day of , 20 91440018923000NOTARY PUBLIC, State of Florida at Large“OFFICIAL NOTARY STAMP”THIS PAGE IS TO BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR FORM "W"PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE. SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES89535018161000THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS.This sworn statement is submitted to Lehigh Acres Municipal Services Improvement District by onbehalfof ,whosebusinessaddressis and whose Federal Employer Identification number (FEIN) is .I understand that a “public entity crime: as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United states and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.I understand that “convicted” or “conviction” as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.I understand that an “affiliate” as defined in Paragraph 287.133(1)(a), Florida Statutes means:A predecessor or successor of a person convicted of a public entity crime; orAn entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term “Affiliate” includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm’s length agreement, shall be prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. [Please indicate which statement applies.] Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, nor any affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one of more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, oran affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list (attach a copy of the final order).I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.320040018542000Name and TitleBefore me personally appeared , to me well known and known to me to be the person described in and who executed the foregoing instrument, and acknowledged to and before me that he/she executed said instrument for the purposes therein expressed.WITNESS my hand and official seal, this day of , 20 .320040022098000Notary Public, State of FloridaMy Commission Expires:THIS PAGE IS TO BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE.FORM "X"DRUG-FREE WORKPLACE CERTIFICATIONPreference shall be given to businesses with drug-free workplace programs. Pursuant to Section 287.087, Florida Statutes, whenever two or more competitive solicitations that are equal with respect to price, quality, and service are received by the State or by any political subdivision for the procurement of commodities or contractual services, a response received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie responses will be followed if none of the tied providers has a drug free workplace program. In order to have a drug-free workplace program, a business shall:Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such rm employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations.Give each employee engaged in providing the commodities or contractual services that are under proposal a copy of the statement specified in Subsection (1).In the statement specified in Subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under proposal, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 894, Florida Statutes, or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction.Impose a sanction on any employee who is so convicted or require the satisfactory participation in a drug abuse assistance or rehabilitation program as such is available in the employee's community.Make a good faith effort to continue to maintain a drug-free workplace through implementation of applicable laws, rules and regulations.As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements.91440020510500411480020510500BUSINESS NAMEPROVIDER'S SIGNATURE ................
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