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Home My WebLink AboutAgreement_Regular_02/08/2018_Fire Safety Magnets ��,�VMRG�r�� Q �� FHP � �� `�'� � �'s`��liaRcf�tl�U�m�pc�� 'ks�s�nEss��' 2450 Maitland Center Parkway Sui#e 303 Maitland, F!3275Z Phone:407.990.1600 Fax Completed Form to 309.215.2327 or Emai!to tammy@firesafetymagnets.com Distribution Agreement The Information provided below is for Ehe use of the Fve Safery Magnet Program only.All Information provided is confidential and will not be maAceted to any other individual or organiza6on urtless othervvise authorized by the fire department listed below.The below signed states ihey undersNand that the fire magnets will be shipped to the flre departmern s#ated below FREE OF CHARGE,Signature below also states that they will distribute the Rre Safety Magnets to the communiiy as they see fit to enhance fire safery.The below signed also state that they undeistand that community businesses will pay a fee to be pmmoted on the Fire Safety Magnets.The fee pald by these businesses enables the Fre Safeiy iVlagnets to be supplied to the below signed�ire department FREE OF CHARGE. Denartment Information De arcment Name: v i - U� � e �'S �l�C� �s C�� P � Contatt Name: l S _ _ ,�.�� Please Check ane: Address: �� u �S� ��l U � �OK for Community to ,I Contact Me To Verify This Crty: I�j(A�S��. State/Province: _� Z'ip: j3'i" b� Program 1 Pflorte: S�(l�'��D� �� Fax: � iv l-� ��0 �� Email: J.,JTL I I�.S � y l �,STO` • t,'�� Have Communiiy Contact Name: StGNATURE for Dist:ibution A¢�eement To Verify This Program Prini: _�!C{'1(.�2L. I� � �(,( zZ p . J 2. Title: Authorized Signature: -� rtfe: � ��1 (u ct�� e r ��-' �,�.� J �,� ��I N �'j'' j� : � r:,j � _ L'-l��`�� G�,C�n i��r C�\L�. 1��, l�'�._ ._�.� ..y'_B ° 0~_' B F ._ �� , .. �---- --- ° p '��;�� . 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Bethesda,vID 2081�i 301-802-4182 cell E I.ECTR l€O M PANY ' 240-497-1700 officc Q� INC. ; 240-497-0350 fAs , -� , 742 East Gude Drive• Rockville, MD 20850 �f �v�vw.Nttdhfomcln fi�.com :?'P ubtp:�7CaryuG�rdiru:r.LNE�rom �� ' (301) 279-7233 � _ Caryn.C�rdinc r+lun�andfostcr.rnm �� www.TievyElectric,CORI EMERGENCY NUMBERS Emergency 9� � Emergency Contact Doctor Dentist Hospital Electric Company Gas Company Phone Company Cable Company �,�;,v;,., Water Company �"`��_ - �r'" Mom's Work ~?�'! � ��'�� m Mom's Cell Dad's Work FIRE SAFEN AWARENESS BOARD Fire Safety Tips on Baek Side DadrS Ci@�� Distributed by Your Local Fire Department&Provided by the Listed Sponsors We Also Make Individual Boards. Ernail Inquiries to adeopyQfirehousepromotionsinc.com ALL RIGHTS RESERVED. FIREHOUSE PROMOTIONS,INC. PUBLIC RECORDS. In accordance with Sec. 119.0701, Florida Statutes, CONTRACTOR must keep and maintain this Agreement and any other records associated therewith and that are associated with the perFormance of the work described in the Proposal or Bid. Upon request from the vllage's custodian of public records,CONTRACTOR must provide the Vllage with copies of requested records, or allow such records to be inspected or copied, within a reasonable time in accordance with access and cost requirements of Chapter 119, Florida Statutes. A CONTRACTOR who fails to provide the public records to the Village,or fails to make them available for i�spection or copying, within a reasonable time may be subject to attorne�s fees and costs pursuant to Sec. 119.0701, Florida Statutes,and other penalties under Sec.119.10,Florida Statutes. Further, CONTRACTOR shall ensure that any exempt or confidential records associated with this Agreement or associated with the performance of the work described in the Proposal or Bid are not disclosed except as authorized by law for the duration of the Agreement term, and following completion of the Agreement if the CONTRACTOR does not transfer the records to the Village. Finally, upon completion of•the Agreement, CONTRACTOR shall transfer, at no cost to the Vllage,all public records in possession of the CONTRACTOR, or keep and maintain public records required by the Vllage. If the CONTRACTOR transfers all public records to the vllage upon completion of the Agreement, the CONTRACTOR shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the CONTRACTOR keeps and maintains public records upon completion of the Agreement, the CONTRACTOR shall meet all applicable requirements for retaining public records. Records that are stored electronically must be provided to the VILLAGE, upon request from the Vllage's custodian of public records, in a format that is compatible with the Village's information technology systems. • IF CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, PLEASE CONTACT THE VILLAGE CLERK, RECORDS CUSTODIAN FOR THE VILLAGE, AT (561) 76&0685, OR AT Imcwilliams@teauesta.or�. OR AT 345 TEQUESTA DRtVE,TEQUESTA, FLORIDA 33469.