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2017-005B
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2017-005B
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Last modified
2/17/2017 11:18:39 AM
Creation date
2/17/2017 11:18:12 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
01/17/2017
Control Number
2017-005B
Agenda Item Number
8.E.
Entity Name
Timothy Rose Contracting
Subject
Contract and Specifications
43rd Ave, Sidewalk Improvements
Area
Aviation Blvd. to Airport Drive West
Project Number
1123
Bid Number
2017013
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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 275M-13 <br /> CERTIFICATION OF NON SEGREGATION & EQUAL OPPORTUNITY OFFICE <br /> 07105 <br /> NON DISCRIMINATION <br /> SECTION 1: PROJECT IDENTIFICATION <br /> 1.Financial Project No. 2.F.A.P.No. 3.FDOT LAP Contract No. 4.county 5.District or Name of Local A enc <br /> 6.Prime Contractor's Name <br /> l <br /> 7.Com an Na of Contractor,,,Supplier,Rental Com or A enc Rfihmifflnq this certification 8.FEID No of Co.in Box 7 <br /> SECTIO 2: CERTIFICATION STATEMENTS <br /> i <br /> CERTIFICATION OF CERTIFICATION OF <br /> NONSEGREGATED FACILITIES NON DISCRIMINATION <br /> As a federally assisted construction contractor, I As a contractor, sub recipient or subcontractor on a <br /> hereby certify:the following for t his company: Federally funded Contract, this company certifies that it <br /> A. This company does not maintain or provide shall not discriminate on the basis of race, color, national . <br /> any segregated facilities for employees at <br /> origin,or sex in the performance of such contracts. <br /> any of our establishments and we do not The contractor shall carry out applicable requirements of <br /> permit our employees to perform their 49 CFR Part 26 in the award and administration of DOT <br /> services at any location, under our control, assisted contracts. The company agrees that a failure to <br /> where segregated facilities are maintained. carry out these requirements is a material breach of <br /> B. Agreement that a breach of this certification contract,which may result in the contract's termination or <br /> is a violation of the equal opportunity clause such other remedy as the recipient deems appropriate. <br /> In this contract Each subcontract, rental agreement and or material <br /> supplier agreement this company subsequently enters <br /> C. We will obtain and retain identical into for this contact will require this same Certification. <br /> certifications from proposed subcontractors <br /> prior to the award of subcontracts exceeding It is the policy of this company to assure that applicants <br /> $10,000 which are not exempt from the are employed, and that employees are treated during <br /> provisions of the equal opportunity clause. employment, without regard to their race, religion, sex, <br /> As used in this certification,the terms "segregated color, national origin, age or disability. Actions include: <br /> facilities" means any waiting rooms, work areas, employment, upgrading, demotion, or transfer; <br /> restrooms and washrooms, restaurants and recruitment or recruitment advertising; layoff or <br /> termination; rates of pay and other .forms of <br /> fountains, recreation or entertainment area, compensation; and selection for training, including <br /> transportation, and housing facilities provided for <br /> employees which are segregated by explicit apprenticeship, pre apprenticeship, and/or on-the-job <br /> directives or are in fact segregated on the basis of training. <br /> race, color, religion or national origin because of This certification extends to the project identified above <br /> habit,local custom,or any other reason. and affirms our commitment to insure nondiscrimination <br /> and to take affirmative action to assure equal <br /> opportunity as set forth under laws, executive orders, <br /> rules, regulations (28 CFR 35, 29 CFR 1630 and 41 CFR <br /> 60) and orders of the Secretary of Labor as modified by <br /> the provisions of FHWA-1273. <br /> Compliance with Title VI of the Civil Rights Act and the <br /> provisions of the American Disabilities Act of 1990 are <br /> inco orated in this certification. <br /> 9.Name first/last of corporate Official signing Certification 10.Job Title of person named in Box 9 <br /> 11.Signature of Cetg&q <br /> Officlal 12.Date of Si <br /> gnature <br /> -� Lam` �-�-•-----..-__ Y G b� Cr �� <br /> i <br /> j <br /> I <br /> 00490-1 <br /> I <br />
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