04/17/2008 03217 FAX 12583040472 8 BUTLER Ilium-Agency Detention service- -w . .. 003/013 Intergovernmental Agreement - Witness Security Prisoner Operations Division Washington, DC 20530-1000 1. 2. a . acllity Codes) 19-07-0052 July 1, 2007 427 4. Issuing Federal Agency 5..Local Government United States Marshals Service Dakalb County Detention Center 2801 Jordan Road, S.W. Ft. Payne. AL 36968 To; 9. This herein. 6. Appropriation Data 15X 1020 safekeeping, and subsistence of federal prisoners, in accordance with content set forth 7. Local Contact Person Mitchell Dandy, Jail Administrator agreement is for the housing, 3. Tel: (256) 997-3530 8 564 Email: 12. To being provided. Be Used if Prisoner Transportation ls To the 14. Local Government Certification Information submitted In suppert of this agreement is true and correct, this document has been duly authorized by the body governing of the Departmant or Agency and the Department or Agency comply with all provisions set forth herein. best of my knowledge and belief; Title m: Sign (Local) 1 AW?is r150 org/028107 1r Dafe 16. Prisoner Detainee Type Authorized Juvenlie Male Jovenlle Female 17. Signature of Person minimized to Sign (Federal) Signature Adult Male Adult Female Name Title JUNE (6), 0956:3/2008 09229 FAX 1.2583040471 DEKALB DETENTIQN CENTER @004x?013 Agreement Number 19-07-0052 3 Purpose of Agreement and Security Proxiided 3 Period of 4 Assignment and Outsourcing of Jail Operations Medical 4 Receiving 8: Discharge of Federal Detainees 5 Guard/Transportation Services to Medical Facility 6 6 7 8 .b Guard/Transportation Services to 0.5.. Courthouse Special Administrative Orders Agency service Centred: Act .. 8 Per-Diem Rate 8 Billing and Financial 9 Payment Procedures Inspections of .10 Page 2 cf 11 JUNE 2015 regeneration 09:29 FAX 12563340471 BEKALB DETENTION CENTER @0052?013 Authority Pursuant to the authority of Section 119 of the Department of Justice Appropriations Acts of 2001 (Public Law 106-553), this Agreement is entered into between the United States Marshals Service (hereinafter referred to as the ?Federal Government") and Deicaib County, AL (hereinafter referred to as ?Local Government"), who hereby agree as follows: Purpose of Agreement and Security Provided The Federal Government and the Local Government establish this Agreement that allows three (3) Federai'Governrnent counponents, speci?cally, the United States Marshals Servloe (USMS) and the Federal Bureau of Prisons (BOP) of the Department of Justice and the United States . Immigration and Customs Enforcement (ICE) of the Bepartment of Homeland Security (DHS), to house federal detainees with the Local Government at the Dekaib County Betention Center (hereinafter referred to as ?the facility?). For purposes of this Agreement, the term ?Federal Government?, as used herein, shall mean any and all of the three Federal Government components responsible for housing federal detainees, e.g. any notices required to be provided to the Federal Government, including invoices, shall be provided to the speci?c Federal Government component responsible for each federal detainee, or material witness. The population, hereinafter referred to as ?federal detainees," will he 1 individuals sentenced or charged with federal offenses and detained while awaiting trial or sentencing awaiting designation and transport to a BOP facility, a hearing on their immigration status, or deportation. The Local Government shall accept and provide for the secure custody, safekeeping, housing, subsistence and care of federal detainees in accordance with state and local laws, standards and procedures, or court Orders applicable to the operations of the facility, consistent with federal law, policies and regulations. Unless otherwise speci?ed by this Agreement, the Local Government is required, in units housing federal detainees, to perfom in accordance with the most current versions of the mandatory standards of the American Correctional Association (ACA) ?Standards for Adult Local Detention Facilities and the essential National Commission on Correctional Health Care Standards, and the Federal Performance:- based Detention Standards (W. In addition, where ICE federal detainees are housed, the KB federal detainees are to be housed in accordance with ICE Standards . In cases where other standards conflict with policy or standards, policy and standards prevail. Page 3 of 11 JUNE 2015 dogma/2098 d?:29 FAX 12563049471 DEKALB DETENTION CENTER {alone/013 Agreement Number 19~o7~oosz At all times, the Federal Government shall have access to the facility and to the federal detainees housed there, and to all records pertaining to this Agreement, Including ?nancial records, for a period not less than 3 years. This Agreement shall not affect any preexisting, unrelated agreements between the parties or with any other third party or parties. Period of Perionnanoo This Agreement is effective upon the date of signature of both parties, and remains in effect unless terminated by either party with written notice. The Local Government shall provide no less than 120 calendar days notice of their intent to terminate. Where the Local Government has received a Cooperative Agreement Program (CAP) award, the termination provisions of the CAP prevail. Assignment and Outsourcing of Jail Operations Overall management and operation of a facility housing federal detainees may not be contracted out without the prior express written consent of the Federal Government. Medical Services The Local Government is financially responsible for all medical treatment? provided to federal detainees within the facility. The Local Government shall - provide the full range of medical care required within the facility including dental care, mental health care, phemeceuticais, and record keeping, as necessary to meet the essential standards of the National Commission of Correctional Health Care's Standards for Health Services of Jails (current edition). The Local Government will submit to the Federal Government requests for approval of all treatment to be provided outside the facility. The Federal Government shall be responsible for the cost of approved outside medical treatment. In the event of an emergency, the Local Government shall?proceed immediately with necessary medical treatment. In such an ?event, the Local Government shall notify the Federal Government immediately regarding the natare of the federal detainee?e illness or injury, type of treatment provided, and the estimated cost thereof. The Local Government shall forward medical invoices for outsld? medlcal care to the Federal Government within 30 days of receipt. Page 4 of 11 JUNE 2015 ?019/Q3/z2o08 09:30 FAX 12588640471 DEKALB DETENTION CENTER @oowom Agreement Number 19-07-0052 The facility shall have in place an adequate infectious disease control program, which includes testing all federal detainees at the facility for tuberculosis (TB) as soon as possible upon intake (not to exceed 14 days) and read within 72 hours. TB testing shall be accomplished in accordance with the latest CDC Guidelines and the results documented on the federal detainee's medical record. The Local Government shall immediately notify the Federal Government of any cases of suspected or a?ctive TB so that any scheduled transports or production can be delayed until a physician veri?es the federal detainee's TB status. When a federal detainee is being transferred and/or released from the facility, they will be provided with seven days of prescription medication which will be dispensed from the facility. When possible, generic medications should be prescribed. Medical records must travel with the federal detainee. If the records are maintained at a medical contractor's facility, it is the Local Government?s responsibility to obtain them before a federal detainee is moved. Federal detainees may be charged a co-payment for medical services provided by the Local Government. The Local Government shall administer the program in accordance with the Federal Prisoner Health Care (Jo-Payment Act of 2060 (Title 18 401 3d). This statute does not cover ICE federal detainees; col-payments shall not be collected from ICE federal detainees under AM circumstances. Receiving Discharge of Federal Detainees The Local Government agrees to accept federal detainees only upon presentation by a law enforcement officer of the Federal Government with proper agency credentials. The Local Government shall not relocate a federal detainee from one facility under its control to another facility not described in this Agreement without permission of the Federal Government. The Local Government agrees to release federal detainees only to, law enforcement of?cers of the Federal?Gover-nment agency initially-committing the federal detainee DEA, ICE, etc.) or to a Deputy United States Marshal (DUSM). Those federal detainees who are remanded to custody by a DUSM may only be released to a DUSM or an agent speci?ed by the DUSM of the Judicial District. USMS federal detainees sought for a state or local court proceeding must be acquired through a Writ of Habeas Corpus or the Interstate Agreement on Detainers and then only with the concurrence of the district United States Marshal (USN). Page 5 of 11 JUNE 2015 09/03/2008 09:30 FAX 12583040471 DEKALB DETENTION CENTER @008/013 Agreement Number 19-07-0052 ICE federal detainees shall not be released to the custody of other Federal, state, or local of?cials for any reason, except for medical or emergency situations, Without express authorization of ICE. Guardrl?ranaportatlon Services to Medical Facility The Local Government agrees, upon request of the Federal Government in whose custody a prisoner is held, to provide transportation and escort guard services for federal prisoners housed at their facility to and from a medical facility for outpatient care, and transportation and stationary guard services for federal prisoners admitted to a medical facility. Such services will be performed by? qualified law enforcement or correctional of?cer personne emp oyed by the Local Government under their policies, procedures, and practices. The Local Government agrees to augment such practices as may be requested by the USM to enhance speci?c requirement for security, prisoner monitoring, visitation, and contraband control. The Local Government will continue to be liable for the actions of its employees while they are transporting federal prisoners on behalf of the USMS. Further, the Local Government will also continue to provide workers' compensation to its employees while they are providing this service. It Is further agreed that the local Jail employees will continue to act on behalf of the Local Government in providing transportation to federal prisoners on behalf of the USMS. Furthermore, the Local Government agrees to hold hamiess and indemnify the USMS and its of?cials in their of?cial and individual capacities from any liability, including third-party liability or workers' compensation, arising from the conduct of the local jail employees during the course of transporting federal prisoners on behalf of the USMS. The Federal Government agrees to reimburse the Local Government at the rate stipulated on page one (1) of this agreement. Mileage shall be reimbursed in accordance with the current GSA mileage rate. .Guerdrl'raneportation Services to U.8. Courthouse The Local Government agrees upon request of the USM in whose custody a prisoner is held, to provide transportation and escort guard services for' federal prisoners housed at their facility to and from the US. Courthouse. Trans rtatlon and escort guard services will be performed by W. Wuan?ed officers employed by the Local Government un er their Page 6 of 11 JUNE 2015 99fd3{2608 09:30 FAX 12583048471 DEEALB DETENTION CENTER @099/013 Agreement Number 19-07-0052 policies, procedures, and practices, and will augment such practices as may be requested by the USM to enhance speci?c requirements for security, prisoner monitoring, and contraband control. Upon arrival at the courthouse, transportation and escort guard will turn federal prisoners over to Deputy u.s. Marshals only upon prosantation by the deputy of proper law enforcement credentials. The Local Government mm transport federal prisoners to any US. Courthouse without a speci?c request from tho USM who will provide the prisoner's name, the U.S. Courthouse, and the date the prisoner is to be transported. Each prisoner will be restrained in handcuffs, waist chains, and leg irons during transportation. Such services will be performed by quali?ed law enforcement or correctional of?cer personnel employed by the Local Government under their policies, procedures, and practices. Tho Local Government agrees to augment such practices as may be requested by tho USM to enhance speci?c requirements for security, prisoner monitoring, visitation, and contraband control, The Local Government will continue to be liable for the actions of its employees while they are transporting federal prisoners on behalf of the USMS. Further, the Local Government will also continue to provide workers? compensation to its employees while they are providing this service. It is further agreed that the local jail employees will continue to act on behalf of the Local Government in providing tranSportation to federal prisoners on . behalf of the USMS. The Local Government agrees to hold harmless and indemnify the USMS and its of?cials in their official and individual capacities from any liability, including third~party liability workers? compensation, arising from the conduct of the local jail employees during the course of transporting federal prisoners on behalf of tho USMS. The Federal Government agrees to reimburse the Local Government at the rate speci?ed on page one (1) of this agreement. Mileage shall be reimbursed in accordance with the current GSA mileage rota. Special Noti?cations The Local Government shall notify the Federal Government of any activity by a federal detainee which would likely result in litigation or alleged criminal activity. The Local Government shall immediately notify the Federal Government of?an escape of a federal detainee. The Local Government shall use all reasonable Pogo 7 of 11 JUN 2015 bards/2008 09:30 FAX 12563040471 DEKALB DETENTION CENTER [mom/013 Agreement Number 19-07-0052 means to apprehend the escaped federal detainee and all reasonable costs In connection therewith shall be borne by the Local Government. The Federal Government shall have primary responsibility and authority to direct the pursuit and capture of such escaped federal detainees. Additionally, the Local Government shall notify the Federal Government as soon as possible when a federal detainee is involved in an attempted escape or conspiracy to escape from the facility. In the event of the death or assault of a federal detainee, the Local Government shall immediately notify the Federal Government. Administrative Orders 8. Agency Instructions For administrative convenience, the Federal Government may request services not listed in this Intergovemmentai Agreement (IGA) (Le. Guard Service, Transportation, etc). Any individual agency orders with the Local Government shall clearly de?ne the additional services and/or procedures, a reasonable price, if any, and state that all other terms and conditions of this IGA remain In effect. Service Contract Act This Agreement Incorporates the following clause by reference, with the same force and effect as if it was given In full text. Upon request, the full text will be made available. The full text of this provision may be accessed electronically at this address: w. Federal Acquisition Regulation Clause(s): 52.222-41 Service Contract Act of 1965, as Amended (July 2005) 52.222?42 Statement of. Equivalent Rates for Federal Hires (May 1989) 52.222-43 Fair Labor Standards Act and the Service Contract Act - Price Adjustment (Multiyear and Option Contracts) (May 1989) The current local government wage rates shall be the prevailing wages unless notified by the Federal Government. Pen-Diem Rate The Federal Government will use various price analysis techniques and procedures to ensure the per-diam rate established by this Agreement Is considered a fair and reasonable price. Examples of such techniques include, but are not limited to, the following: 1. Comparison of the requested perhdlem rate with the independent government estimate for services, otherwise known has the Core Rate; Page 8 of 11 JUNE 2015 llama/2008 69:30 FAX 12553346471 DEKALB CENTER @011/013 Agreement Number 2. Comparison with per-diam rates at other state or local facilities of similar size and economic conditions; 3. Comparison of previously proposed prices and previous Federal Government and commercial contract prices with current proposed prices for the same or similar items; 4. Evaluation of the provided jail operating expense information: The firm-fixed perwdiem rate for services is $47.00, and shall not be subject to adjustment on the basis of the Dekalb County Detention Center's actsai cost experience in providing the service. The poodlem rate shall be ?xed for a period from the effective date of the Agreement forward for 36 months. The parvdt'em rate covers the support of one federal detainee per ?federal detainee day", which shall include the day of arrival, but not the day of departure. After 36 months, if a rate adjustment is desired, the Local Government shall submit a request through the 91614 area of the Detention Services Network (DSNehyork). All information pertaining to the jail or: DSNeMork will be required before a new per-diam rate can be considered:I The perk-diam rate covers the support of one federal detainee per 1?federal detainee day", which shall Include the day of arrival, but not the day of departure. Billing and Financial Provisions The Local Government shall prepare and submit for certi?cation and payment, original and separate invoices each month to each of the Federal f(:amirlernrnend: components responsible for federal detainees housed at the ac itv. The addresses for the USMS components are: United States Marshals Service Northern District of Georgia 1669 Federal Building Atlanta, GA 30303 (404) 331-6833 To constitute a proper invoice, the name and address of the facility, the name of each federal detainee, their speci?c dates of confinement, the total days to be paid, the appropriate per diem rate as approved in the IGA, and the total amount billed (total days multiplied by the rate per day) shall be listed, along with the name, title, complete address and telephone number of the Local Government of?cial responsible for invoice preparation. Page 9 of 13. JUNE 2015 09:30 FAX 12563040471 DEKALB BETENTIGN CENTER [glow/0:3 Agreement Number 19-07-41052 Nothing contained herein shall be construed to obligate the Federal Government to any expenditure or obligation of funds in excess of, or in advance of, appropriations in accordance with the Act, 31 U.S.C. 1341. Payment Procedures The Federal Government will make payments to the Local Government on a basis, alter receipt of on appropriate invoice. The Local Government shall provide a remittance address below: Del-:er County Detention Center 2801 Jordan Road, S.W. Ft. Payne, AL 36968 Modi?cations and Disputes Either party may initiate a request for modi?cation to this Agreement in writing. All modi?cations negotiated will be effective only upon written approval of both parties. Disputes, questions, or concerns pertaining to this Agreement will be . resolved between appropriate officials of. each party. Both the parties agree that they will use their best efforts to resolve that dispute in an informal fashion through consultation and communication, or other forms of non-s binding alternative dispute resolution mutually acceptable to the parties. inspections of Services The Local Government agrees to allow periodic inspections of the facility by Federal Government inspectors. Findings of the inspection will be shared with the facility administrator in order to promote improvements to facility operations, conditions of confinement, and levels of services. Llabillty The Local Government shall protect, defend, indemnify, save and hold harmless the Federal Government, DHS and its employees or agents, . from and against any and all claims, demands, expenses, causes of action, judgments and liability arising out of, or in connection with the performance or this Agreement by the Local Government, its agents, sub-contractors, employees, assignees or any one for whom the Local Government may be responsible. The Local Government shall also be liable for any and all costs, expenses and attorneys fees incurred as a result of any such claim, demand, Page 10 of 11 JUNE 2015 A normal/races 09:31 FAX BEKALB DETENTION CENTER @013r?013 Agreement Number 19-07-0052 cause of action, judgment or liability, Including those costs, expenses and attomoys fees incurred by the Federal Government, DHS and its employees or agents. The Local Government's liability shall not be limited by any provision or limits of insurance set forth in the resulting agreement. Awarding the Agreement, the Federal Government does not assume any liability to third parties. in awarding and administering this Agreement, the Federal Government does not assume any liability to third parties, nor will the Federal Government reimburse the Local Government for its liabilities to third parties, with moped: to lose dun to death, bodily injury, or damage to property resulting in any way from the performance of the Agreement or any subcontract under this Agreement. The Local Government shall be responsible for all litigation, including the cost of litigation, brought against it, its employees or agents for alleged acts or omissions. The Federal Government shall be notified in writing of all litigation pertaining to this Agreement and provided copies of any pleadings ?led or said litigation within ?ve working days of the filing. The Local Government shall cooperate With the Federal Government legal staff and/or the United States Attorney regarding any requests pertaining to Federal Government or Local Government litigation. Page 11 of 11 JUNE 2015 05798/2009 13:56 FAX 12583040471 DEKALB DETENTION CENTER @003/004 US. De artment of Justice United Sfates Marshals Service Modi?cation of Intergovernmental Agreement 1. MODIFICATION No. 2. REQUEST FOR DETENTION SERVICES NO. 3. EFFECTIVE DATE OF MODIFICATION Once (1) 08-159 See Block 123 . 3.10CKE 0. Nix us. MARSHALS SERVICE Dekalb County Detention Center 19-07-0052 PRISONER OPERATIONS 2801 Jordan Road, SW WASHINGTON. 11c. 205301000 Fort Payne, AL 35968 7. 4Z7 3. ACCOUNTING CITATION 9. ESTIMATED ANNUAL PAY WA IO. EXCEPT AS PROVIDED SPECIFICALLY HEREIN, ALL TERMS AND CONDITIONS OF THE DOCUMENT REFERRED TO IN BLOCK 5. REMAIN TERMS OF THIS MODIFICATION: The purpose of this modi?cation is to: Add the District of Eastern Tennessee a a user District to the eyeement. On page 9 of - Billing and Financial Provisions, add: U. S. Marshals Service District of Eastern Tennessee HOwerd H. Baker, Jr. US. Courthouse 800 Market, Suite 320 Knoxvme, TN 37902 Phone: (365) 545-4182 All other conditions and term are to remain the same in accordance with the terms ofthe current ll . INSTRUCTIONS TO LOCAL GOVERNMENT FOR EXECUTION OF THIS MODIFICATION: A. I B. TO SIGN THIS DOCUMENT TO SIGN THIS DOCUMENT AND RETURN corms no es. MARSHAL B. FEDERAL GOVERNMENT ?Kudzu. Signamrc Grants Specialist /09 DA 0 - 8 HQ USE ONLY (Rev. 3/99) P-ec_t_ or JUNE 2015 wu? .. . I .5. Department of Homeland Sum-rt) .?s?lrl I ?nus! ?iuiac?Hfl-II: 2053.0 {Ef?e} U.S. Immigration and Customs Enforcement Addendum #2 I Hold hannless statement: HOLD HARMLESS AND INDEMNITY AGREEMENT BETWEEN ANDTHE US. DEPARTMENT OF HOMELAND SECURITY, U.S. IMMIGRATION AND CUSTOMS ENFORCEMENT Mint Agreement made this 151% day of 20 betweenmeg?" (referred to herein as "'Contractor?) and the us. Department of Homeland Security. us. Immigration and Customs Enforcement 1. Driver of Vehicle. The ICE Vehicle(s) may be driven only by designated employees of the Contractor. The Contractor shall ensure, and assumes the duty, that all its drivers of ICE Vehicles will meet all medical and legal requirements for driving. including that the driver will: be over 21 years of age. unless a state law prohibits setting an age requirement; be a CDL quali?ed and licensed driver, be a driver whose driver's license. in any state. has not been revoked or suspended within the previous three (3) years. even if he or she now possesses a valid driver?s license; not operate the vehicle under the in?uence of alcohol or other intoxicanls, such as drugs or narcotics, or under any other physical or mental impairment Which adversely affects driver?s ability'to operate the ICE Vehicle; and . not carry more passengers than available seatbelts. 2. Return of Vehicle. The ICE Vehicle shall be returned to ICE, In the same condition as when received, ordinary wear and tear expected. The Contractor will perform any cleaning or repairs necessary to return the ICE Vehicle to the required condition. The determination as to the condition of the vehicle shall be made solely by ICE. The amount of time the Contractor can use an ICE Vehicle shall be determined by ICE. . 3. Self-Insured: The Contractor, DeKalb County. is selhinsured. The Contractor agrees to cover any damages to the ICE Vehicle or to other parties for the negligence of its employees driving ICE Vehicles. The Contractor agrees to cooperate with ICE if any claim is made. and to weperate with ICE in any investigation involving an ICE Vehicle which was driven by a Contractor employee or sub-contractor. 4. Other Liability. The Contractor assumes all risks from the use of the ICE Vehicle. The Contractor is responsible for damages to the Contractor?s property or goods left or stored in the ICE Vehicle. The Contractor agrees not to hold ICE liable for damage from downtime, materials. or other consequential damages resulting from the use of the ICE Vehicle. The Contractor releases and holds ICE. its agents and employees harmless from and against any and all losses, liabilities, damages, injuries. claims. costs, and expenses arising out of the Contractor's use or possession of the vehicle, including, but not limited to, any and all ?nes. penalties. and forfeitures imposed by any governmental entity and, to the extent not Jung?!? ?5 JCF 901 000078 covered by insurance. The Contractor shall additionally hold harmless for all toss, liability, and expense in excess ol the limits of liability provrded tor herein as a result of injury, death. or damage arising out of the Contractor's use of the vehicle Neither the Contractor nor any other driver of the Vehicle shatt be deemed the agent. servant, or employee of for any reason Or any purpose. 5. Accidents. The Contractor will immediately report any accidents or damage to the vehicle and shall deliver to any document received by the ContraCtor relating to any claim, suit. or proceeding connected with any accident or event involving the vehicle. 6 Warranty Disclaimer. disclaims any and all warranties, express or implied. including, without limitation, any implied warranty of merchantability or fitness for a particular purpose or implied warranty arising out of course of performance, course of dealing. or us.er of trade Furthermore speci?cally, does not warrant and speci?cally disdaims any warranty that an Vehicle will always be available for your use and that an Vehicle will be without need of repair or in good working order. does not warrant the actions or omissions of a manufacturer or repairer of the vehicle. 7. indemnification of ICE. The Contractor shall indemnify, defend and hold harmless and its officers, agents, emptoyees, and each of them, from and against any and all third party claims, demands. causes of action. costs, damages, expenses. tosses and liabilities (including reasonable attomeys' fees) incurred or to be incurred, arising out of or resutting from. your operation of the ICE Vehicte. senvrce PROVIDER . I Name i ?jun? I Signature pate; 1 1 l? AND cusroms ENFORCEMENT Name Signature Date: A Front center area of vehicle FLEET l-ront passepger side Passenger side front fender Paswngor side door Rear passenger side tender {quarter panel) Rear passenger side humpcr and light are-:1 AREA 6 Rear center area of vehicle OF Rear driver side bumper and tight area DANIAGE I Rear driver side fender (quarter panel) - Driver side door Front driver side fender I. Front driver side bumper and tight area [op 01' which; [light bar) Under carriage and unknown 0 Otlur (not included .IhtnL] UNRECORDED DAMAGE Mark (X) on photo to identify area of damage. Enter appropriate Letter and note type of damage. REPORT ANY SIGNIFICANT DAMAGE JUNE 2015 05/08/2003 13258 FAX 12583040471 DEKALB DETENTION CENTER 0. 5. Department oi? Justice united States Marshai: Service 4. Modi?cation No. TWO (2) 2. Effective Date See Block 138. 3. Facility Code(s) 1. reement No. A9 427 19-07-0052 002/004 Hudi?catian of Intergovernmental Agreement 5. DUNS No. 6. Issuing Federal Agency 7. Local Government Dekaib County Detention Center 2801 Jordan Road, 5w Fort Payne, AL 35968 United States Marshals Service Prisoner Operations DMsion Denentlon Operations - East DC 20530-1000 9. Per-DIem Rate 47.00 a. Appropriation Data 15X1020 13.00 10. Guard/Transportation Hourly Rate REFERRED TO IN BLOCK 1. REMAIN UNCHANGED. TERMS OF THIS MODIFICATION: AGREEMENT. BILLING AND FINANCIAL PROVISION SHOULD BE SENT TO: u.s. IMMIGRATION CUSTOMS ENFORCEMENT ATTN: (6). (NO 1010 E. WHATLEY - or - OAKDALE, LA. 71453 (318) 335-7493 NO OTHER TERMS OR CONDITIONS OF THIS AGREEMENT ARE AFFECTED. 11. EXCEPT AS PROVIDED SPECIFICALLY HEREIN, ALLTERMS AND CONDITIONS OF THE IGA DOCUMENT THE PURPOSE OF THIS MODIFICATION IS TO ADD IMMIGRATION AND CUSTOMS ENFORCEMENT (ICE) TO THIS AGREEMENT. ICE IS A50 ADDED IN THE SERVICES OF THIS 12. INSTRUCTIONS TO LOCAL GOVERNMENT FOR EXECUTION OF THIS MODIFICTION: A. LOCAL GOVERNMENT IS NOT REQUIRED TO SIGN THIS DOCUMENT u. s. MARSHAL B. LOCAL GOVERNMENT IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ALL COPIES TO OVALS 8. FEDERAL GOVERNMENT . LOOKLG VEWIW . . 3 Signature Signature 05 C) 7 Gama anmm ATE TITLE JUNE 2015 ICE2012FOIA03030.000078 Page of 1 05/38/2008 13:58 FAX 12583040471 DEKALB DETENTION CENTER 003/004 US. Department of Justice United States Marshals Service Modi?cation of Intergovernmental Agreement I. MODIFICATION NO. 2. REQUEST FOR SERVICES No. 3. BFFECTWE DATE OF MODIFICTDON Once (1) 08.159 See Block 123 5. toe/It UUVERNNIEN I 6.1% us. MARSHALS SERVICE Dekalb County Detention Center 19-07-0052 PRISONER 2801 Jordan Road, SW WASHINGTON. DC. 20530-1000 Fort Payne, AL 35968 7. FACILITY 4Z7 CITATION 99'. PAYMENT NM 10. EXCEPT AS PROVIDED SPECIFICALLY HEREIN. ALL TERMS AND CONDITIONS OF THE IGA DOCUMENT REFERRED TO IN BLOCK 5, REMAIN TERMS OF THIS MODIFICATION: The purpose of this modi?cation is to: Add the District of Eastern Tennessee 8 a user District In the agreement. On page 9 of I - Billing and Financial Provisions, add: U. S. Marshals Service District of Eastern Tennessee Howard H. Baker, Jr. U.S. Courthouse 800 Market, Suite 320 Knoxville, TN 37902 Phone: (865) 545-4182 All other conditions and terms are to remain the same in accordance with the terms of the current IGA 11. INSTRUCTIONS TO LOCAL GOVERNMENT FOR EXECUTION OF THIS MODIFICATION: A. I LOCAL GOVERNMENT IS NOT REQUIRED B. LOCAL GOVERNMENT IS REQUIRED TO SIGN THIS DOCUMENT TO SIGN ms DOCUMENT AND RETURN COPIES to us. MARSHAL B. FEDERAL GOVERNMENT Tiffani 22m i Signature Grants Specialist /gf TITLE DATE - a JUNE 2015 HQ USE ONLY (Rev- 3/99) Page 1 of _l U. S. Department of Justice United States Marshals Service Modi?cation of Intergovernmental Agreement 1. Agreement No. 2. Effective Date 3. Facility Code(s) 4. Modi?cation No. 5. DUNS No. 19-07-0052 See Block 13B. 427 3 (Three) 6. Issuing Federal Agency 7. Local Government Dekalb County Detention Center United States Marshals Service 2801 Jordan Road, SW Witness Security Prisoner Operations Fort Payne, AL 35968 Programs Assistance Branch Washington, DC 20530-1000 Tax 8. Appropriation Data 9. Per-Diem Rate 10. Guard/Transportation Hourly Rate 15X1020 $47.00 $13.00 11. EXCEPT As PROVIDED SPECIFICALLY HEREIN, ALL TERMS AND CONDITIONS OF THE IGA DOCUMENT REFERRED TO IN BLOCK 1, REMAIN UNCHANGED. TERMS OF THIS MODIFICATION: A. The purpose of this modi?cation is to: Incarporate special language for Immigration and Customs Enforcement noted on the Proposed Modi?cation (See Attachment p. 2 of 5) Incarporate Addendum 1, Vehicle List 3 of 5). add two (2) ICE Government Owned Vehicles to 19?07-0052. Incorporate Addendum Hold Harmless Statement 4 of 5-), - add Hold Harmless and an Indemnity Agreement to IGA 19-07-0052. All other conditions and terms are to remain the some in accordance 'with the terms of the current 12. INSTRUCTIONS TO LOCAL GOVERNMENT FOR EXECUTION OF THIS MODIFICTION: A. LOCAL GOVERNMENT IS NOT REQUIRED 8. LOCAL GOVERNMENT IS REQUIRED TO SIGN TO SIGN THIS DOCUMENT THIS DOCUMENT AND RETURN ALL 3 COPIES TO U. MARSHAL FPPROVALS A (A. LOCA GOVERN NT . B. FEDERAL MM 4 II 1/ i SiJnature Signature . 03t1 I DATE ITLE DATE JUNE 2015 ICE2012FOIA03030.000080 U. S. Department of Justice United States Marshals Service Modification of Intergovernmental Agreement _I_tgreement Number: 19-07-0052 1 Page 2 of 5 I ATTACHMENT #1 PROPOSED MCDIFICATION When available and as agreed upon by the parties. ICE will provide the SERVICE PROVIDER with a Government Owned Vehicle (GOV) (described in the addendum) for the transportation of ICE detainees in accordance with the terms and conditions of this United States Marshall's Service Agreement (MSA). The SERVICE PROVIDER will contact the designated ICE official to schedule maintenance of the GOV In accordance with the following maintenance requirements: - DRO Vehicle Management Handbook Dated 9/1/09 ICE Personal Property Handbook Dated January 2009 - DHS Management Directive 0510 - Motor Vehicle Fleet Management - Dated 3/1/03 . The SERVICE PROVIDER will provide the COTR with proof thatits guards are properly licensed CDI- operators and insured in accordance with state law to operate the GOV provided. The SERVICE PROVIDER agrees to adhere to all provisions contained within this contract and the above referenced documents. shall be used to transport only ICE detainees to and from locations as directed by or designated ICE of?cial. Under the terms of this MSA. transportation services of detainees to and from the SERVICE facility will be at the negotiated MSA hourly rate tor guard/transportation of?cers. The SERVICE PROVIDER will be reimbursed for fuel and fluids required by the ICE GOV during transportation service and reimbursed in accordance with GSA published rates for meals and lodging required by overnight'transportation routes. but will not be reimbursed for transportation mileage while using the ICE GOV. The SERVICE PROVIDER shall not tamper with any vehicle equipment without the express writtenauthcrization of the COTR. The repair and maintenance of the vehicle will be coordinated and handled through theOakdaIe Of?ce. Primary PCC Marc Gladden at 504 329 9421 Secondary POC Scott Sutter?eid 318-335-7500. The SERVICE PROVIDER agrees to be responsible for any damage incurred to the vehicle as a result of any act or omission on the part of the SERVICE PROVIDER, Its employees and or persons acting on behalf of the SERVICE PROVIDER. In addition. the SERVICE PROVIDER assumes ?nancial responsibility for any related property damage to said vehicle caused by the negligent act or omission of its employees or persons acting on behalf of the SERVICE PROVIDER. The SERVICE PROVIDER accepts responsibility for the negligent acts or omissions on the part of its employees. and or persons acting on behalf of the service provide in the operation or said vehlcie. The SERVICE PROVIDER acknowledges the use of the vehicle. The referenced vehicle remains the property of the Department of Homeland Security, Immigration and Customs Enforcement (OHS-ICE) and will be made available to? the SERVICE PROVIDER for the express purpose of transporting detainees The SERVICE PROVIDER will keep said vehicle in the same condition as received except for normal wear and tea: and mileage. In order for the ICE New Orleans Field Of?m to maintain, accurate ?eet records the SERVICE PROVIDER must complete the following documentation at the end of each month. Copies will be provided to the SERVICE PROVIDER. The SERVICE PROVIDER will sign and date the Hold Harmless Agreement addendum #2 and forward it to the ICE Contracting Of?cer identi?ed in the addendum. JUNE 2015 ICE2012FOIA03030.000081 U. S. Department of Justice United States Marshals Service Modification of Intergovernmental Agreement I Page 3 27 5 Addendum #1 (Vehicle List) Vehicle if ICE i'emceqle) i sea: Year_ ?.ia_ke I venice Mocei i - teens?:? Ngg??Cer/State veggie SEC-meter Reading I E25351 ?ler-? 2V umber I a :22; cede Number 3 LJEDment: Vehicle #2 l: heavernment aned V33 .. . Lieewumbep Year genie Make I iveryaaode? i 2.113135 Coior . hicie (GOV) Descrition ..Number/State xehice Odometer 1 Reading LBadio Serial?uiriei 311: Code Number? Ligiailed Equigrje: JUNE 2015 U.S. Dcpa rtment of Homeland Security SDI I Street, NW, Suite 910-10" Washington, DC. 20636 Addendum #2 harmless statement: HOLD HARMLESS AND INDEMNITY AGREEMENT BETWEEN AND THE U.S. DEPARTMENT OF HOMELAND SECURITY. U.S. IMMIGRATION AND CUSTOMS ENFORCEMENT Agreement made this day of 20 . between (referred to herein as ?"Contractcr?) and the USS. Department of Homeland Security. U.S. Immigration and Customs Enforcement 1. Driver of Vehicle. The ICE Vehicle(s} may be driven only by designated employees of the Contractor. The Contractor shall ensure. and assumes the duty. that all its drivers of ICE Vehicles will meet all medical and legal requirements for driving. including that the driver will: be over 21 years of age. unless a state law prohibits setting an age requirement; be a CD1. quali?ed and licensed driver: to) be a driver whose driver's license, in any state, has not been revoked or suspended within the previous three (3) years, even if he or she now possesses a valid driver?s license; not operate the vehicle under the in?uence of alcohol or other intoxicants. such as drugs or narcotics. or under any other physical or mental impairment which adversely affects driver?s ability to operate the ICE Vehicle; and not carry more passengers than available seatbelts. 2. Return of Vehicle. The ICE Vehicle shall be returned to ICE. in the same condition as when received. ordinary wear and tear expected. The Contractor will perform any cleaning or repairs necessary to return the ICE Vehicle to the required condition. The determination as to the condition of the vehicle shall be made solely by ICE. The amount of time the Contractor can use an ICE Vehicle shall be determined by 3. Self-Insured: The Contractor. DeKalb County. is self-insured. The Contractor agrees to cover any damages to the ICE Vehicle or to other parties for the negligence of its employees driving ICE Vehicles. The Contractor agrees to cooperate with ICE if any claim is made. and to cooperate with ICE in any investigation involving an Vehicle which was driven by a Contractor employee or sub-contractor. 4. Other Liability. The Contractor assumes all risks from the use of the Vehicle. The Contractor is responsible for damages to the Contractor?s property or goods left or stored in the ICE Vehicle. The Contractor agrees not to hold ICE liable for damage from downtime, materials. or other consequential damages resulting from the use of the ICE Vehicle. The Contractor releases and holds ICE. its agents and employees harmless from and against any and all losses. liabilities. damages. injuries, claims, costs. and expenses arising out of the Contractor?s use or possession of the vehicle, including, but not limited to. any and all ?nes. penalties. and forfeitures imposed by any governmental entity and. to the extent not JUNE 2015 rum-u covered by insurance. The Contractor shall additionally hold harmless for all loss. liability. and expense-in excess of the limits of liability provided for herein as a result of iriury. death. or property damage arising out of the Contractor's use of the vehicle. Neither the Contractor nor any other driver of the Vehicle shall be deemed the agent, servant, or employee of for any reason or any purpose. 5. Accidents. The Contractor will Immediately report any accidents or damage to the vehicle and shall de?ver to any document received by the Contractor relating to any claim, suit. or proceeding connected with any accident or event involving the vehicle. .6. Warranty Disclaimer. disclaims any and all warranties, express or 'unpiied. including. without limitation, any implied warranty of merchantability or ?tness for a particular purpose or implied warranty arising out of course of performance. course of dealing, or usage of trade. Furthermore and speci?cally. ICE does not warrant and specifically disclaims any warranty that an Vehicle will always be available for your use and that an ICE Vehicle will be without need of repair or in- good working order. does not warrant the actions or omissions of a manufacturer or repairer oi the vehicle. 7. Indemnification of The Contractor shall indemnify. defend and hold harmless and its officers, agents. employees. and each of them, from and against any and all third party claims. demands. causes of action. costs. damages, expenses. losses and liabilities (including reasonable attomeys' fees) incurred or to be incurred, arising out of or resulting from, your operation of the ICE Vehicle. SERVICE I jimm7 i I oi: i Name Signature Date; - AND. CUSTOMS ENFORCEMENT Name Signature bate: JUNE 2015 000084 covered by insurance. The Contractor shall additionally hold ICE harmless for all loss, liability, and expense in excess of the limits of liability provided for herein as a result of Injury, death, or property damage arising out of the Contractor?s use of the vehicle. Neitherthe Contractor nor any other driver of the ICE Vehicle shall be deemed the agent, serva nt, or employee of ICE for any reason or any purpose. 5. Accidents. The Contractor will immediately report any accidents or damage to the vehicle and shall deliver to ICE any document received by the Contractor relating to any claim, suit, or proceeding connected with any accident or event involving the vehicle. 6. Warranty Disclaimer. ICE disclaims any and all warranties, express or implied, including, without limitation, any implied warranty of merchantability or ?tness for a particular purpose or implied warranty arising out of course of performance, course of dealing, or usage of trade. Furthermore and speci?cally, ICE does not warrant and speci?cally disclaims any warranty that an ICE Vehicle will always be available for your use and that an ICE Vehicle will be without need of repair or in good working order. ICE does not warrant the actions or omissions of a manufacturer or repairer of the ICE vehicle. 7. Indemni?cation of ICE. The Contractor shall indemnify, defend and hold harmless ICE, and its of?cers, agents, employees, and each of them, from and against any and all third party claims, demands, causes of action, costs, damages, expenses, losses and liabilities (including reasonable attorneys? fees) incurred orto be incurred, arising out of or resulting from, your operation of the ICE Vehicle. SERVICE PROVIDER Name Xum7 HARRI Signature Date; \t 1'l? IMMIGRATION AND CUSTOMS ENFORCEMENT dhs. ov Signature Date: JUNE 2015 ICE2012FOIA03030.000085 U. S. Department of Justice United States Marshals Service Modification of Inteaovernmental Agreement 1. Agreement No. I 2. Effective Date 3. Facility Code(s) I 4. Modi?cation NO. 5. DUNS NO. 19-07-0052 See Block 13a._ 1. 427 4 (FOUR) 6. Issuing Federal Agency 7. Local Government United States Marshals Service Dekalb County Detention Center Prisoner Operations Division 2801 Jordan Road, SW 2604 Jefferson Davis Highway Fort Payne, AL 35968 Alexandria, VA 22301-1025 8. ApprOpriation Data 9. Per-Diem Rate 10. Hourly Rate 15X1020 $47.00 $13.00 11. EXCEPT ASPROVIDED SDECIFICALLY HEREIN, ALL TERMS AND CONDITIONS OF THE IGA DOCUMENT REFERRED TO IN BLOCK 1, REMAIN UNCHANGED. TERMS OF THIS MODIFICATION: A. The purpose of this modi?cation is to: l. Incorporate special language tor the Immigration and Customs Enforcement (ICE) as noted on the Statement of Work (See Attachment l) for Government Owned Vehicie (GOV) described In the addendum. All other conditions and terms are to remain the same in accordance with the terms of the current IGA. 12. LOCAL GSVEBNMENT FOR EXECUTION OF nus MODIFICATION: A. LOCAL GOVERNMENT IS NOT REQUIRED B. 8 LOCAL GOVERNMENT IS REQUIRED TO SIGN To SIGN THIS DOCUMENT THIS DOCUMENT AND RETURN ALL 3 COPIES TO U. S. MARSHAL 13. APPROVALS OCAL GOVERNMENT \c 3 @(gicky Signature TITLE DATE JUNE 2015 ICE2012FOIA03030.000086 U. S. Department of Justice United States Marshals Service Modi?cation of Intergovernmental Agreement ATTACHMENT #1 PROPOSED MODIFICATION When available and as agreed upon by the parties. ICE will provide the SERVICE PROVIDER with a Government Owned Vehicle (described in the addendum} for the transportation of ICE detainees in accordance with the terms and conditions of this Inter-Governmental Service Agreement (IGSA) The SERVICE will contact the designated ICE of?cial to schedule maintenance of the GOV in accordance with the following maintenance requirements: - DRO Vehicle Management Handbook Dated erofcu rrentlSigned_Fleet_Ha ICE Personal Property Handbook - Dated January 2009 - DHS Management Directive 0510 Meter Vehicle Fleet Management - Dated 311 I03 if qovi? pol icie all nstructionsl?05?l 0%20lvlotor%20Vehicle %20Fleet% 20Manaqement. pdf) The SERVICE PROVIDER (The County of Dekalb, AL) will provide the COTR with proof that its guards are properly licensed CDL operators and insured in accordance with state law to operate the GOV provided. The SERVICE PROVIDER agrees to adhere to all provisions contained within this contract and the above referenced documents. The GOV shall be used to transport only ICE detainees to and from locations as directed by the COTR or designated ICE official. Under the terms of this MSA. transportation services of detainees to and from the SERVICE PROVIDERS facility will be at the negotiated MBA hourly rate for officers. The SERVICE PROVIDER is authorized to utilize the DHS Fleet Card provided with each vehicle to pay for fuel and ?uids necessary to conduct transportation of ICE detainees; use of the DHS Fleet Card shall be conducted in accordance with all provisions contained within this contract and the above referenced documents. The Fleet Card shall only be utilized to pay for the fuel and fluids of the vehicle to which it is assigned. The SERVICE PROVIDER will be reimbursed for transportation services in accordance with GSA published rates for meals and lodging required by overnight transportation routes. but will not be reimbursed for transportation mileage while using the ICE GOV. The SERVICE PROVIDER shall not tamper with any vehicle equipment without the express written authorization of the COTR. All vehicle repair and maintenance shall be coordinated and approved through the New Orleans Field Of?ce Field Of?ce. POC Marc Gladden. The SERVICE PROVIDER agrees to be responsible for any damage incurred to the vehicle as a result of any act or omission on the part of the SERVICE PROVIDER. its employees and or persons acting on behalf of the SERVICE In addition, the SERVICE PROVIDER assumes ?nancial responsibility for any related property damage to said vehicle caused by the negligent act or omission of its emptoyees or persons acting on behalf of the SERVICE PROVIDER. The SERVICE PROVIDER accepts responsibility for the negligent acts or omissions on the part of its employees. and or persons acting on behalf of the service provide in the operation of said vehicle. The SERVICE PROVIDER acknowledges the use of the vehicle. The referenced vehicle remains the property of the Department of Homeland Security. Immigration and Customs Enforcement (DHS-ICE) and will be made available to the SERVICE PROVIDER for the express purpose of transporting detainees The SERVICE PROVIDER will keep said vehicle in the same condition as received except for normal wear and tear, and mileage. In order for the ICE New Orleans Field Of?ce to maintain accurate ?eet records the SERVICE PROVIDER must complete the following documentation at the end of each month. Copies will be provided to the SERVICE PROVIDER. The SERVICE PROVIDER will sign and date the Hold Harmless Agreement addendum #2 and forward it to the ICE Contracting Officer identi?ed in the addendum. Page 1 of JUNE 2015 SOLICITATIONICONTRACTIORDER FOR COMMERCIAL ITEM ?mum'o? NWBER PAGE OFFEROR To COMPLETE BLOCKS 12. 17. 23, 24CONTRACT NO. 8. . ORDER NUMBER 5. SOLICITATION WMBER . 8. SOLICITATION EFFECTIVE DATE 7? FOR scum-mug" 3 NAME - a TELEPHONE NUMBER (No commas) a. OFFERDUE DATEILOOAL TIME INFORMATION CALL: 9. ISSUEDBY CODE I ICE 10. THIS ACQUISITION UNREOTRICTED OR SET 9s FOR ICE/Detent Mngt/Detent Contracts-DC Euam Immigration and Customs Enforcement 88?? ?amass Baas?: Office of Acqu151tion Management ?ms: DHUBZONE SHALL DSOLEWE 801 I Street NW, Suite 910 BUSINESS . ST A 8'2 RD USERVICE-DISABLED VETM UNA) SMALL WES i1. DELIVERY FOR F09 12. DISCOUNT Tm 130. RATING TION WLESS BLOCK IS Net 3 0 D138. THIS CONTRACT ISA mo ER WOO or SOLICITATION DSEE SCHEDULE DREO EIIFE RFP DELIVER To 10.ADMINISTERED BY CODE IICE DC- DC ICE/Detent Mngt/Detent Contracts-DC Immigration and Customs Enforcement Office of Acquisition Management 801 I Street NW Suite930 Attn: Washington DC 20536 . I CODE FACILITY 16D. BE MADE BY CODE 17' [0820565990000 I cowl . IICE OAQ DE KALB COUNTY OF DHS, ICE 111 GRAND AVE SW Burlington Finance Center SUITE 200 . P.0.BOX 1620 FORT PAYNE AL 359671991 Attn: ICE-OAQ Williston VT 05495?1620 TELEPHOIE NO. 13m. CHECK IF Is DIFFERENT Am PUT SUCH ADDRECE IN OFFER sueurr INVOICEs TO SHOWN IN BLOCK 18a UNLESS BLOCK BELOW Is CHECKED DSEE ADDENDUM 19. . 20. 21. 22. 23. 24. ITEM NO. SCHEDULE OF - QUANTITY UNIT UNIT PRICE AMOUNT DUNS Number: 082056599 Program Office POC: (6). Contracting Officer: 202?736 Contract Specialist (6). he purpose of this is to add an existing . Marshals Services Agreement to PRISM so that funded task orders can be created using a G?5i4. All other terms and conditions remain the same. (Use Reverse and/or Attach Additional Sheets as Necessary) 25. ACCOUNTING AND APPROPRIATION DATA 2. TOTAL AWARD AMOUNT (For Govt Use 00M See schedule 00 C1273. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212?1. 52212-4. FAR 52212-3 AND 52212-5 ARE ATTACHED. ADDENDA ARE ARE "or Armcaeu I21 279. CONTRACTIPURCHASE ORDER INCORPORATES av REFERENCE FAR 52212.4. FAR 522:2.5 Is ATTACHED. AODENDA ARE [31 ARE NOT ATTACHED. [325. Is REQUIRED To SIGN THIS DOCUMENT AND RETURN :21 29. AWARD or CONTRACT REE. OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES To FURNISH AND DELIVER ON (BLOCK 5), ALL ITEMS SET FORTH 0R OTHERINISE IDENTIFIED ABOVE AND. ON ANY ADDITIONAL ICH ARE SET FORTH SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN. soa' SIGNATURE OF OFFERORIOONTRACTOR 30b. NAME AND TITLE OF SIGNER {Typo orpn'n!) 306. DATE SI Daze?"Wu FOR REPRODUCTION . PREVIOUS EDITION IS NOT Preac?hed by GSA - FAR (48 53.212 JUNE 2015 ICE2012FOIA03030.000088 20f 2 19. . - . 21. 22. 23. 24. ITEM NO. SCHEDULE OF QUANTITY UNIT UNIT PRICE AMOUNT Exempt Action: .Y 0001 Bed Day Rate at $47.00 - EA 47.00 0.00 Product/Service Code: 3206 Product/Service Description: GUARD 0002 I Transportation and Guard SerMices at $13. 00 HR 13.00 Product/Service Code: S206 Product/Service Description: GUARD-- The 'Obligated amount of award: $0.00. The total for this award .is shown in box 26. 0.00 32a. QUANTITY IN COLUMN 21 HAS BEEN RECEIVED ACCEPTED, AND CONFORMS TO THE CONTRACTI EXCEPT AS INSPECTED I: 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32a. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE - 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE 329. EMAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE 33. SHIP NUMBER 4. VOUCHER NUMBER 35. AMOUNT VERIFIED '36. PAYMENT CHECK NUMBER CORRECT FOR . COMPLETE a PARTIAL FINAL - PARTIAL FINAL 38. SIR ACCOUNT NUMBER 39_ SIR VOUCHER NUMBER 40. PAID BY 413. CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 41 b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE 42a. RECEIVED BY {Print} 42b. RECEIVED AT (Location) 426. DATE - 42d. TOTAL CONTAINERS JUNE 2015 STANDARD FORM 1449 (REV. $2005} BACK