1st Change Order 07/19/2007
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
August 16,2007
TO:
Dave Koppel, County Engineer
Engineering Division
Pamela G. Han~
Deputy Clerk C~7J
FROM:
At the July 19, 2007, Board of County Commissioner's meeting the Board granted
approval and authorized execution of Change Order No. I in the amount of $71,621.00
concerning the Three-Party Contract No. DC646 between Monroe County, Department of
Environmental Protection (DEP) and OTAK Group, Inc. to complete the fishing platforms at the
Tom's Harbor Cut Historic Fishing Bridge.
Enclosed is a duplicate original of the above-mentioned for your handling. Should you
have any questions please do not hesitate to contact this office.
cc: County Attorney
Finance
GMD-T. Schwab
File.l
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Chanee Order
Contract for Construction Services
Contract No.: DC646
01
:Change Order No.
Project No.: 6G023 Otak Group, luc. 1 Aaron ~ato_
FKOHT I Tom's Harbor Cut Historic Bridl!e Fishinl!
Location / P"rk: Platforms 904-225-2588
: Vendor / Contact Person
:Phone No.
chauge order has been approved and will be paid for by the Couuty of Monroe
per the attached letter dated June 12, 2007. The labor and materials have been
by the contractor and approved by FDEPIOGT and Monroe County.
Total Contract Days & Start Date:
February 5, 2007
8/412007
8/4/2007
Original Contract Sum: $
Fixed Price Cost Change: $
Net Change, Add: $
Present Contract Sum: $
New Contract Sum: $
Original Substantial Completion:
210
180
180
o
180
Angust 4, 2007
September 3, 2007 + one year after construction completion
i Present Substantial Completion:
f-----
i This Change:
[New Substantial Completion:
New Final Completion:
30
$
71,621.00 !
658,500.00
71,621.00
71,621.00
658,500.00
730,121.00
This Change .order is an amendml~nt to the Contract Agreement between CONTRACTOR and the DEPARTMENT, and all contract provisions shall apply unless specific~~ exempted. The
amount and lime change designated are the maximum agreed to by both the DEPARTMENT and the CONTRACTOR for this change_ In consideration of:! foregomg adJWJi1ents i~ntract
time and contract sum the CONTRACTOR hereby releases DEPARTMENT from all claims, demands or causes of action arising out of the transactions, Mnts ~occu&s gJvipse to
this Change Order, This wriUen Change Order is the entire agreement between DEPARTMENT and CONTRACTOR WIth respect to this Changz"-Ordd'.:: No . agreert'\'ts or
modifications shall apply to this contract amendment unless expressly provided herein, This Change Order represents final agency action pursuant to Secti~j~~~:fIOrid~tutes (128'))
<'\:>-l.:-",: _ ~
Signatures and Dates: ..~. , (j\ :~J
Samautha Browne or
Jim Wood
.\;ection Neall
-----~ ~--
Signature
~~
___ ... ~n_.~
Slgnalure
tlM(JhV f; ~
S'i!,>r1aIUre
~j(f~
c
Date:
(p.)'...'4 -..n
:',. L',\
--0
:x
r::!
~n
~, ."
r,'")
C.:.
-.:)
2:>
o
Michael Renard
Conlract ManaKa, BD&C, j.DEP
Date:
(:,. r~.()7
Otak Group,}uc.
Date:
&-1 )-()7
('onlroctor
Date:
JUl 1 9 2007
County of Monroe
Cr)nlfiJi.;{/fiillionty -----
---Signature
E PAID BY MONROE COUNTY
1~~,~Gr~~I~,~:\ - m. MONRO~ COUNTY ATTORNEY
~:4.th &ii~;{dntractl. A4ministrator (MS 93) PPROVED S T R~:
I' . the Buteau ~fF'iliance&~ccounting (MS 78)
\' . . ".'
;;:: \, . \.; SUSAN M. GRI LEY
\.<......~. ..... .~/ . L L_(UIIIIl I! Dat~SSISTW~ ~N~YO U;OANEY
,:._,:j\-.'>:\;..r 4""",,,~
IPf-oI
Cl.IM
Total: $
71,621.00
Offtu of the Director
2798 Overseas Highway
Suite #400
Marathon. FL 33050
Voice: (305) 289.2517
FAX: (305) 289-2854
Boud of County Commissioners
Mayor Mario Di Gennaro, DiSl. 4
Mayor Pro Tem Dixie Spehar.Ojst I
George Neugent, Dist 2
Charles Mc-Coy. Oist. 3
Sylvia MlIIJlhy. Oist. 5
We strive to be eaTing, professional and fair
June 12,2007
Mr. Randy Smith, Project Manager
Office of Greenways and Trails
Florida Dept. of Environmental Protection
3900 Commonwealth Blvd.
Tallahassee, FL 32399-3000
RE: ',f;Jn:.~J~M Fishing Platforms-Change Order
Dear ~1itfJ
The County has identified funds to pay for a change order (Amount of $71,621) to complete the Toms
Harbor Cut Fishing Platforms.
In order to execute the change order, approval from the Board of County Commissioners will be
required. VIe are therefore requesting that the Department of Environmental Protection (DEP) proceed
with preparing the necessary paperworlc in order to execute the proposed change order.
Our deadline in order to place the proposed Change Order on the July BOCC agenda is June 20.
If you have any questions, please contact Townsley Sc1'1wab, at 305-289-2506.
\\:~{)
JT~a'l~~
Comprehensive Planning Manager
c. Townsley Schwab, Bicycl~Pedestrian Coordinator
Memorandum
Florida Department of
Environmental Protection
TO:
Luis Tellechea
Florida Department of Transportation
District 6
David Koppel, P.E.
Monroe County Engineer
samantha Browne
Office of Greenways & Trails
Florida Department of Environmental Protection
Michael Schwier, P.E.
The LPA Group, Inc.
FROM:
Ilr
l1J,J
(ff'l,)"
J. Randy Smith
Office of Greenways & Trails
Florida Department of Environmental Protection
DATE:
March 28, 2007
RE:
Florida Keys Overseas Heritage Trail ( FKOHT )
Tom's Harbor Cut Historic Bridge
Construction of Fishing Platforms
FDEP Project No. 6G023 FOOT No. FM 414587-1
FDEP Bid No. BD&C 10-05/06 FDEP Contract No. DC 646
PROJECT:
CONTRACTOR:
Otak Group, Inc
Aaron Kato, President
Request for Change Order
For your review I have attached the Contractors letter of March 5, 2007 requesting a change order in the
amount of $ 71,621.00 and the Contractors documentation of cost increase amounts from the Contractors
supply vendors. As indicated in the letter the cost increase amounts are due the elapsed time from Bid Date to
the issued Notice to Proceed. I questioned the Contractor about the claimed additional contractual condition
requirement not part of the original scope indicated in the letter, Mr. Kato said this is the additional insurance
require by Monroe County not specified within the bid documents.
Project records indicate the project was bid November 10, 2005. The Notice to Proceed was issued January
31,2007 with a begin construction date of February 5, 2007, 15 months after the bid date. The amount of
time that elapsed was due to several factors. This project is funded by Monroe County and through the FOOT
LAP Program with a grant to FDEP, Office of Greenways & Trails. The project was bid prior to the issued
Federal Requirements LAP Checklist fpr Construction Contracts ( phase 58 ). Therefore Monroe County and
FDEP had to rnodify the contracts documents to comply with the checklist requirements and to comply and be
approved by the Monroe County Board of County Commissioners. I had anticipated this process would take
about 90 days and advised the Contractor he could keep his Bid Bond active until a contract was prepared.
After several months passed the contractor advised that since he had limited his bonding ability for so long he
would hold on until the project could be awarded.
During my State Government tenure with the Florida Department Management Services and the FDEP, as a
Design and Construction Manager I have not experienced a significant time lapse from bid to award such as
this. Therefore I don't know if there is a precedent for this type of Change Order, to grant approval for
material cost increase because of lapsed time.
It appears that !the request for cost of Longshore Uability Insurance required prior to contract, but not
specified should be approved. The contractor states that the amount requested is pro-rated from the annual
premium specifically for this project.
I believe the contractors request has merits. After review if the request or portions of the request are judged
to be acceptable, perhaps the partners could co-share with the cost. I believe there are some remaining funds
From the FOOT LAP. Perhaps Monroe County may have unused funds from other FKOHT grants. FDEP could
explore possiblE! available funding.
Please let me know of your comments. As you know this project is currently under construction and there is
need to resolve the request soon. Thanks in advance for you valued assistance and decisions with this matter.
ENCLOSED CONTRACTOR LEITER AND COST DOCUMENTS:
CC: FDEP: Debra Stucki, Mike Renard
MONROE COUNTY: Judy Clarke, P.E., Jose Papa, Townsley Schwab, RLA
~
OTAK GROUP, INC.
~ & GE~AL CONTRACTORS
March S, 2007
HE: SVMJMay OF 'ROII!X."1' CoIn' INcaUI!lEll- Nov/2ll/l5 TO.JANI2OO7
FtoRmA Kml8 OVI:RSIlAIIlERIT AGE TIlAIL_ TOM'! HARIlOR CUT HVlTO...C .8RTOOl! _ F1!hING
I'LAT_II<<._ FDEPBIDNO.Bo.aCl~SI'06
Rand.y,
As dillWSOCd .t tile """"" lefi:.5u...d "",jeer prc COIlSlnx:tiOll c:onferenoc, 0_ Group, IIIc. has jnclImd
addltioml CDSI due 10 lime cIJlpsocl be_ tbe lIC\uaJ Bid Dalc lIDd die Natice-to-Proc:c:ed; also 1I5 duo
- of .cldiliolllll contrwnJal <:oDdition I'eQllimnmb IIDt Jl81I or dte orisiual scope of work.
Below is a&monasyatlllc COCI burden iDcwrcd by 0Iak a. al'llS\/lt ofdeL1)' Novomber, :WOStD J8IIU8Iy
1007, and a.. .. _lilt at additi<lll8l oontr./etuIIl COIIdiIion mqui-..
C1111nge in Dlnoct Casl to 0Iak Novl200S to JB11I2O<17:
AJuIltlsl.....Pedeatriall PldIet ..Hlna................................................ 5 UI,ZIlI.OO
MOIU'DeC",ty accept D III "dull Debri........................................... S fi,.lIlj7100
T.......... Concrete Baa..... ..................................... ..............._. 5 4/....00
StAriIlJeH Steel 8.LP. P................................... .............._........... ..... S 10,260.00
MOO II c..c...l\II:J:........................._..........................................H....... $ 4,307.00
....nrorci... Skcl............. ..... .......... ......... .......... .......... ......., .........$ 1,134.00
1_......, US.....UI........................................................................ 511,041.00
Tata'IHII'I!aIel
$ 52.Z79.1lCl
COlt CIuIac<oo to Otlk Nov/2G115 to J0/1807:
Co.'l' a<:to. ',s Jlhrf<-Up ( 15 %)
5 "~,17UO
S '.JC:z.OO
T...t ~ JlI...ltiVlc tAl .r....nM.,
t .,....JIi:'11W1
By Ihls IelCe1' .IId III tlIs t1_ OlD: Graap, lllC. n:que1ll1bat a cloup order ill tlIe __at of
S 1LAi21.0I1 be -.. ..,.doe.......nIoori.- MId lidded to"'''net _
'~Jk
~&'lGNED
Aaran Kula
President
850022 U.S. HighWllY 17.. Yulee. Florida 32097 Office; (904) 225-2588 F",,: (904) 225-1001
January 8, 2007
Aaron Kato
Otak Group, Inc.
850022 U.S. Highway 17
Yulee, FL 32097
Kenneth Daughtry Welding
67270 Wingate Landing Road
Yulee, FL 32097
Subject: Pedestrian Picket Railing for Tom's Harbor Cut Fishing Platforms
Thank you for your continued interest in our work and authorizing us to start work on the
railing we give you a quote for in October, 2005. However, our price was good for 60
days only.
Due to pricing pressures from our suppliers and our own increase for labor and fuel we
must ask for an additional $ 26.50/per lin ft. installed.
This will add $ 18,285.00 to our October, 2005 quote.
Friel, for fabrication and installation of Pedestrian Picket Railing for Tom's Harbor Cut
Fishing Platforms per plans and specification.......Total: $ 151,770.00
This price is good for 60 days.
Please let us know as-soon-as-possible how to proceed.
We look forward to working with on this project,
February 5, 2007
RE: Monroe County - No Longer Can Accept Demolition Debris from The Tom's
Harbor Cut Bridge
Aaron,
I spoke with Judy Steel from Monroe County today concerning demo debris from Tom's
Harbor. Judy telJs me the site the county had available in November 2005 is no longer
available and the county can not accept any debris from this job.
We where not informed by the county ofthis change and have already started demo.
We will need to find a refuge contractor to take all the debris.
Please advise. . .
John Kato
JOHN,
THE COST OF YOUR BEAMS PRESENTLY UNDER CONTRACT (JANUARY 2007) IS
$72.50/U= ,
WE HAD PRICED THESE SAME BEAMS IN NOVEMBER OF 2005 APPROXIMATELY
$66.61/U=
THE INCREASE IN PRICE OVER 14 MONTHS IS DUE TO CONCRETE PRICE INCREASES,
LABOR INCREASES, AND FREIGHT INCREASES.
THANK YOU,
Billy Craig
Chief Estimator
Gate Cl:>ncrete Products Company
Jacksonville, Florida 32226
P 904-7'57-0860 F 904-751-5435
Jan 18 07 ll~ lOa
~AMES RIVER STEEL
804 285 0780
p.2
JAMES RIVER STEEL. INC.
P.O. Box 11498
Richmond. Virginia 23230
Phone: 80'1-285.0717
fAX: 804.285-0780
IZJ ACKNOWLEDGEMENT
JRS#:0117.107
TO,
OTAK GROUP. 1Ne.
850022 US HWY 17
YULEE, FL 32097
Fu: 904.225-1001
Phone: 90<1-225-2588
SHIP TO:
IUS HWY I (OVERSEAS HWYj
MILE MARKER 61-7
MARATHON, FL 33050
DATI ltEOVlRED
I ASAP
-nu.....!'\IllIT
Joe
j
TERMS
DATI:
101118/07
roo
I Veroal-Erin Kato I
FRrCE
$ 16.05/SF I
UESCRIP1'ION
16 GA. ASTM-A240 1"304 STAINLESS STEEL TYPE "N" DECK
24" COVER X THE FOLI.OWING:
NOTES:
1. FOB SHIPPING POINT
2. CONFIRMING TO JOHN KA TO.
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SV:CAROLBUCHANAN
Jam~ Rhoer SteeI.lllc_CI P.o. BOX t 1498.. RICHMOND, V1RQlN1A. 232)0.{S04)285-Q717
I
Arr 18 06 OS:54a
JAMES RIVER STEEL
804 285 0780
p.2
JAMES RIVER STEEL, INC.
po. BOX 11498
R:ichmond, Virginia 23230
Phone: 604-285.0717
FAX: 804-285-0780
o QUOTE
OTAKGROUP
AT'1'N: JOHN KATO
FAX: 904-225.1001
PHONE: 904-225-2588
DI\TI;Ite.OUllll'D
~S
IOU
I
TeRMS
I TEA
1)A.if:
I 02/15106
AAP PRICE
UANTITY uESCRIPTlON
16 GA. ASTM-A240 '1'304 STAINLESS STEEL TYPE "W DECK 513.20/S,
24" COVER X crL
NOTES:
1. FOB SHIPPING POINT
2. PRICES QUOTED ARE BASED ON CtJRRENT STEEL COSTS AS
OF THIS DATE. ADDITIONAL PRICE INCREASES AND ANY
SURCHARGES INSTlruTED BY ll~E STEEL PRODUCERS WILL
RESULT IN PRICE INCREASES.
3 CONFIRMING TO JOHN KA TO.
C.....",....~lJft'I.d,,1l oJol1.lf:,,"IU..-ldlllll boo \\"..,'....b1..,lCI ""....Nc<l", ,ewnbo", ........"" 13.... ",fll>c C_.._ 01""",1:\."
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Vi~llh~"'CllIi!Uj.lllllOo"r'(1~I~<:qIIlIal"eu...,;..I'OlI''''ll~lIlmo:o ""d _Ki,~S_, J_ ("_ Ri_.-~ .._en..I'-""...""n,,,;. in ;>O'~ ~.}'",I_"",
IhiS~"I"'~
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01 "8".I;lIIy~' ""li'l' ..~tIlrm.b 1Ol0i0;1I )lII~ ll.iOQ"lIIipl be llIejlldic.:d, 1'q\aodlos IlfwlK:\twrNd, o;o$C;'; in \illY 1<:11 n:laIeclll" lhis o;&l'tCnlCU\. wiU" l11<>i1 io\ dlc.C~
",odl.,..w..c.JdICJlCIII"il(QRC1wIkd.
CIIIlOonC:r:lll_ ilia Ihr pr<<o:Q:kll d;III$Q du 0101 P'<'fndice J..,,,,,, lIw...." riSh! ... fill! """ mlO<1:l! ~ lion. inel""",, ~ U1C()'aIlics' Ii.,. ()r ma:rl:llllliJl'$' 1I~d, Ill'
1JI11Q"OIi50:: ~K1\ lII'l mkttSl in ~ in WIt j~ris"ididn purn:Dll \0 viltinla C"Dlk !U11.l62, oclli:l' a!lPliallk' Ia'< oflhc Olrml1Ollw~1II oi Vir-j;in.... atIdflll' lIoc ~pplfalMc
I'.... of..,~. ....,....."'1.0' j....d;".....
C'_1Cl"..,6 "ll~ ;lIlaulSlZdillg bol!:Il>cd \H'lllI~I,lriny (10) d;i)'llII.~wdl:~ ofllltinllOlCl:. CIG_IIJ'= _. fi""...~ "'-1;c will"" ,,"',,"'.... ~Il
""lll.IIlIl",~noLp;lii...ul,irllhiny(lOl"'"mlk"n"\.,,, "r 1_:l'Y_pcr"",,~btl(lb(~owaI, c..._ftu1ha"l'C(5~~IKClll'lrcfwlr.:~lio". il!l:llldi"l1
l~'ll<l":1bIo:"'lO'II~yrrc:s.wto:rnC<"IlI'_:III'IOionbllkll.
BY; CARQl. Bl,.lCHANA.N
J:.unl'S tliVt'I' Stn!l.llLc. w P.O. BOX 11.498 . R1CHMONU. VUU.1N1A. 23230 'l804) 285--0111
Mar 28 07 09:07a
Mar 27 07 10:07a
Aaron Kato
Cemex Of Tile FI Keys
904-225-1001
l;;'UOf'iJLf'l
Tc'7
/ /
.'~/./ CI5l1\E.X
OTAK Group
John Kato
March 22, 2007
John.,
The current price for ready mix concrete going to the Toms Harbor Bridge is as follows;
1. $289.00 per cubic yard
2. $ 1.00 per cubic yard mitigation fi:e
3. Fuel adjustment charge per truck (changes monthly March $12.50)
The price ]'eflects a $25.00 per cubic yard increase since first quoted in 2005 and start of
project in 2007.
Please call me if I can be of further assistmce.
Sincerely,
a~,
f John Cberrybon
305-360-7924
5325 E. ~~ale Read 54, 6r'looroon. Florida 34208. US~.. Phole: (94'~ 3ra-aeoo. fax: (941} 379..t,4r,
p.2
~I
II GERDAU AMERISTEEL
February 13,2007
Dear Valued Customer,
The following ~~ves you our chronology of price adjustments 1hat took effect from August 2005 up to 1he
most recently announced or pending price moves to date:
August 12,2005
- Announced $45 per ton increase, effective September 1, 2005.
September 11, 2005 - Announced $20 per ton increase effective October 1, 2005.
October 10, 2005
- Announced $20 per ton decrease effective October 10, 2005.
April 17, 2006
- Announced $15 per ton increase, effective May 1, 2006.
May 17,2006
- Announced $20 per ton increase, effective June 1, 2006.
June 15, 2006
- Announced $8 per ton increase, effective July 3, 2006.
September 26, 2:006 - Announced $20 per ton decrease on #4 and #520' effective immediately.
October 12,2006
- Announced $15 per ton decrease effective immediately.
January 15,2007
- Announced $15 per ton increase effective February 1,2007.
February 12,2007
- Announced $30 per ton increase effective March 1, 2007.
From August 12, 2005 to February 12,2007 we have announced $208 per ton increase.
As discussed before, 1he outlook for fur1her price volatility for 1he future is highly probable given 1he global
events 1hat continue to put extreme demand pressure on all metal related commodities integral to the
production of tlle steel products we produce. These are extremely difficult times for our industry, and we
will do our best to advise you in as timely a manner as possible of events or occurrences 1hat continue to add
pressure to our I~OSt.
Sincerely,
r5)y"
I
Mat1hew Schewe
Sales Manager-Rebar Products Sou1h
l..r'\KKIEK: J:SnagenelO .tmplOYers Insurance LOmp(lny
P.O. Box 988
Lakeland, FL 33802-0988 (863)665-6060
AGENCY: Insurance Office of America- 605
PHONE NUMBER: (904)448-9777
Page I of 1
EXTENSION OF ENDORSEMENT WC 8904 15 ITEM4
FLORIDA
T,
ESTIMATED PREMIUM SUMMARY STATEMENT
Form no. WC 99 04 06A (I
CLIENT:
Otak Group, Inc.
85663 Avant Rd.
Yulee, FL 32097
Client Numb...: 830 340980000
Policy Period: 4/01105 - 4/01106
Plan: 010
RATING PERIOD 4101105
to 4/01/06
WORK
CODE CLASSIFICATION
5221 CONCRETE WORK-FLOORS DRlVEWAYS
56C6 CONTRACTOR-EXECUTIVE SUPERVISO
6217 EXCAVATION/GRADING NOC & D
8810 CLERICAL NOCIDRAFTSMEN
9807 INCREASED E.L. 500/500/500
PAYROLL
22,041.00
43,800.00
73,344.00
34,390.00
.00
PRO
RATA
1.000
1.000
1.000
1.000
.000
Total Manual Premium
Increased Limits Amount
Workplace Safety Credit
Drug Free Workplace Credit
Experience Mod
Standard PremilUll
Discount
Expense Constant
Terrorism - Certified Acts
Policy Grand Total
RATE F
12.25
4.36
12.77
.64
.80
14,195.83
113.57
14,309.40
286.19
701.16
13,322.05
.95
12,655.95
834.50
11,821.45
200.00
52.07
12,073.52
12,073.52
Minimum Premium: $l,OeJO.Oo
TOTAL PREMIUM IS SHOWN ON THE LAST PA<
OF THE PREMIUM SUMMARY STATEMENT
vjy/FLORIDA
Date Prepared: 4/23/05
Time Prepared: 08:30:39
CAP,MON
~ ~i'!ii" .........-.
'':l.. ,,: ; .. jo; [ntern~t'onllr
q::; '''"'!r Group, Inc_
For BillIng InCluir~s
Tel~phone: 18001 645.2.259
Fax: (973) 3~11-8512
EF.l2il: s.....C1iIJPl'lOn@aig.co:Tl
AlVIt:Krt;AN IN I t:Ki\lA TIUNAL COMPANIES
Spedahy Workers Compensation Group
Worl(.ers Coml'ensl!I1ion and/or longshore Liability
Payment Schedule
Customer tD.: 2338588
Policy Number: VIJC 00295489700
Policy ?eri,~d: 01/22/2007 to 01;'22/2008
.
Date; 01/31/2007
Insured
OT AK GROUP, INC
850022 US HIGHVvAY 17
YUlEE FL 320970000
Producer PS3652
LlG MARINE MANAGERS INC
9800 KOGER BL VO NUMBER 225
5T PETERSBURG, FL 33702
YOUR INSURANCE PREMIUM SCHEDULE FOR THE 12-MONTH PERIOD BEGINNING 01/22107 i$ SHOWN BELOW
YOUR ESTIMATED PREM1UM IS SUBJECT TO AUDIT ADJUSTMENT UPON EXPIRATION OF THE POLICY AND MAY RESULT
IN AN ADD;TIONAl PREMIUM OR RETURN PREMIUM. PLEASE REFER TO j'HE TERMS AND CONDITIONS OF YOUR POLICY
lEA YM~f\h SQHJ;DUl;.E I
PAY PLAN
25% Dcwnpay
PAYMENT DUE DATE
01-22-07
02-22-07
03-22-07
04.22-07
05-22-07
06-22_07
07.12-07
6M Installments
PREMIUM AMOUNT
$
7,840.00
3,920.00
3,920_00
3,94:0.00
3,920.00
3,920.00
3,921.00
$
$
$
$
$
$
OR ?A Y IN FULL
$
31,:361.00
A separate iinvolc.e '!NiII follow fDr downPllIvment and instl!lllment premium 03 reflected above in the Payment Schedule. If you
wish to submit paymont, please send a chect( pey.eble to AIG noting your pOlicy number to: AmeriCl!n International Compl'nies,
22427 Netllll"orK. Piece, Chicego. IL 60673-1224
. An tnstallrnem fee v..i11 be added to each inVOice where applicable.
~ Protec: yCUf insurance by mailing payment to arrive on or before its due dale.
... If p~yment is nOl r~ceived on time. the non-payment provisions of your policy will appfy, which may result in loss of
in~t<lllment payment privilflgAS and/or cancel!atior: of your coverage.
. AOlY C:h,:lnHeS to y~ur policy terms should be directed to your producer lisn:::d C)bove.
. ?Iease notify uS Immediately of any changes of addr';;l!Is, it will h<!!lp us serve you bCHer.
Visit .~.aigswc.~.2.!!l with YOl,Jr policy nS$rby to manage your relationship with us, educate your employees.
and access the AIG RiskTool SystemSM which can assist you in Joss prevention and risk control.
[l5002{;
Insured Copy