09/21/1995
ADDENDUM TO AGREEMENT
~ (Central Air Conditioning Repair Contract - Upper Keys Facilities)
THIS ADDENDUM TO AGREEMENT is made and entered into this 21st
..
day of Septemb_er, 1995, betw. =n ) the COUNTY OF MONROE and AMERICAN
ENERGY & SHEETMETAL CORP. in order to amend that certain agreement
between the parties dated October 20, 1994, as follows:
1. In accordance with Article 2.06B of aforementioned agreement,
the County hereby exercises its option to renew said Agreement and
hereby amend Article 2.06B and Article 2.02A to read as follows:
"2.06B The Owner shall have the option to renew this agreement
after the second year .for one addi tional year. The contract amount
agreed to herein may be adjusted annually in accordance with the
percentage change in the Consumer Price Index (CPI) for Wage Earners
and Clerical Workers in the Miami, Florida area index, and shall be
based upon the annual average CPI computation from January 1 through
December 31 of the previous year, or by the actual increase in cost
and labor, whichever is less. Increases in the contract amount during
each option year period shall be ex~ended into the succeeding years."
"2.02A The actual cost of parts and materials plus 35% used by
the Contractor to fulfill the obligations of the Contract. Request
for payment. for any part over $100.00 must be documented with sales
slips, invoices, or other acceptable proof of purchase."
2. Payment by the County to American Energy & Sheetmetal Corp.
for the performance of said service remains as set forth in Article
2.02 of the Contract Agreement dated October 20, 1994, as amended on
September 21, 1995.
3. The term of this amended agreement shall commenc~ on October
20, 1995, and terminate on October 19, 1996. 3:. :51 ::!
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4. In all other respects, the agreement between the 'p'aJ:'fie~at@.
October 20, 1994 remains in full force and effect. . -'-..,
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IN WITNESS WHEREOF, the parties have hereunto set their
the day and year first written above.
seal,
Seal)
Attest: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF M~u;.~RIDA
By: Aft ..,....1lI".v
By: 4'nr~)~.,f~i"-)
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AMERICAN ENERGY &
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SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES. ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
I.
Tbis sworn statement is submiUed to
Monroe County Board Of Commissioners
[print oame of Ihe public entil)')
by To~__Vi~rgutz
[prinllndh'idual'. name and title]
for
American^Energy & ~heetmetal Corp.
[print name of entil)' .ubmllllng ...-om .Iat.ment)
~
whose business address is
101 N.E. Third Road
Homestead Fl. 33030
and (if ap'plicable) ils Federal Emplo)'er Identification Number (FEIN) is
S'l-11'lR711
(If the enlity has no FEIN, include the Social Security Number of Ihe individual signing Ihis sworn
statement:
.)
2. I understand tbat a "public entity crime" as delined in Paragraph 287.133(I)(g), Florida Statutes. means a
,iolation of any state or federal law by a person with respect to and directly related to the transaction of business
witb any public entity or with an agency or political subdh'ision oCany other state or oftbe United States, including,
but not limited to, any bid or contract for goods or senices to be pro,ided to any public entity or an agency or
political subdivision !If any other stale or of lhe United States and involving antitrust, fraud, theft, bribery,
collusion, rackeleerint, conspiracy, or material misrepresentation.
3. I understand that"co",ictcd" or "conviction" as dcfined in Paragraph 287.J33(IXb), Florida Slatutes, means a
linding of guilt or a conviction oca public enlity crime, ..ith or 1'Iithout an adjudication ofguill, in any federal or
slate trial court ofrecord relating to charges brought by indictment or information after July I, 1989, as a result
of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo conlendere.
4. I understand that an "affiliale" as delined in Paragraph 287.133(I)(a), Florida Statutes, means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An entity under tbe control of any natural person who is active in tbe managemenl of Ihe enlity and who has
been convicted oca public enlity crime. The term "affiliate" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in Ibe management oCan affiliate. The ownership
by one person of shares constituting a controlling interest in anotber person, or pooling of equipment or income
among persons whim not for fair market value under an arm's lengtb agreement, sball be a prima facie case Ihat
one person controls anotber person. A person whq kn01'lingly enters into a joint venture 1'Iith a person who has
been convicted of a public entity crime in Florida during tbe preceding 36 months shall be considered an arliliate.
S. I understand that a "person" as defined in Paragraph 287.133(lXe), Florida Statutes, means any natural person
or entity organized under Ihe laws of any slate or o/'the United States 1'Iilh the legal power to enter into a binding
contract and which bids or applies to bid on contracts for the pro,ision of goods or services let by a public entity,
or which otherwise transacts or applies to transact business 1'Iilh a public entity. The term "person" includes tbose
officers, directors, execullves, partners, sharebolders, employees, members, and agents who are active in
management of anenllty. .
6". Based on inCormalion and belieC, Ihe slalemenl which I have marked below is Irue in relalion 10 Ihe enlity
submilling Ihis sworn slalemenl. [Indicale whicb slalemenl applies.)
...KL Neilher Ihe enlity submilling Ihis sworn slalement, nor any oC ils officers, direclors, execulives, parlners,
shareholders, employees, members, or agents who are active in Ihe managemenl orlhe enlity, nor any affiliale or
Ibe entity bas been cbarged wilb and co",ided or a public enlity crime subsequent 10 July I, 1989.
_ The enlity submilling Ihis sworn slalemenl, nor any or its officers, diredors, execlulives, parlners,
shareholders, employees, members, or agents who are acth'e in Ihe management Drlbe entity, nor an affiliale or
the entity has been charged with and con\icted or B public entity crime subsequent to July I, 1989.
_ The entity submilling this sworn statement, or one or more or its officers, directors, executives, parlners,
sbarebolders, employees, members, or agents wbo are acth'e in tbe manage"ment or tl\e entity, or an affiliale or
Ibe entity has been cbarged "ith and con\ided or a public entil)' crime subsequent to July I, 1989. However,lbere
has been a subsequent proceeding beCore a Hearing Officer or tbe State or Florida, Di\ision or A~ministralive
Hearings and tbe Final Order entered by Ihe Hearing Officer determined tbat it was not in tbe public interest 10
place the enlity submilling Ihis sworn slalement on Ibe co",ided vendor list. (allacb a copy or tbe final order)
I UNDERSTAND THA TTHE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENTIFIED ON PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS
FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO
UNDERSTAND THAT I AM REQIDRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION287.017, FLORIDAST A lUTES
FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION tONTAINED IN THIS FORM.
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Sworn 10 and subscribed berore me Ihis ao
day or
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Personally knOW~~
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.
OR Produced idenlification
Notary P Iic - Slate or
My Commission eXPi;es~~I3. 9<6
(Type or identification)
(Prinled typed or stamped
commissioned name or notary public)
...,~\'IiJ!... MARCIA R. MCCORMICK
lfl":':_ MY COMMISSION' CC 884391
~~. ~J "EXPIRES: AugUlt 15, 1998
"i,~.R'r",,~ol' Bonded ThIu Notary Public UndarWl1tera
Forni PUR 7068 (Rev. 06111/92)
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Sep. 28 1995 10:26AM P02
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lIINTON CH1LES
I. QOVE~NOI1
BI\TCH NO
94006232
THE YEAR
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8Ee ETAAVI . .P.R~
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1995-1996
MONROE
FACILITIES
OR
MACHINES
OCCUPATIONAL TAX
STATE OF FLORIDA
MUST BE DISPLAYED IN CONSPICUOUS PLACE
EMPLOYEES 0 - 5
ROOMS
SEATS
~~~N~~S 30140 C ONT RAC TO R S I A I R CON D IT I~?~N.'~;~r;'if.'':"".,
BUSINESS . ~};~~~i}_~j :~~: L:,;"OC:~'<~~~~~;:~_\1;.
ADDRESS 1 0 9 N E 3 R D R 0 A D 1i,i-iJ' (.C....' '."'-'. ,. '"'i~'
00 - COUNTY OF MONROE Jl!},~,'::'\~,',l8fj iNi)"l \~J';l~,
~~~~ICAN ENERGY & SHEETME.mA~~ (Z~< I': "l\\~\~.
VIERGUTZ TOM PRES ~I'\ ,-- '~\ ~ rlil
VIERGUTZ TAMMY SEe ,';, I ; 1/
POBOX 901295 ,S / ,~i/!
HOME STEAD F l 33090 '('.' 7;)01
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C us TOME R R EQU E S TE D "'<l;":". /~."p
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THIS BECOMES A TAX HARRY F KNIGHT,. CFC, TAX COllECTOR
RECEIPT WHEN VALIDATED P 0 BOX 1 1 29, ~ E Y W ~ S T F l 3 304 1 - 1 1 29
NAME
MAILING
ADDRESS
0000000000 0000002000 0000301400063680 1001 6
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ACCOUNT
EXPIRES
30140-0063680
SEPT. 30, 1996
SUPPLEMENTAL
RENEWAL
NEW TAX
TRANSFER
ORIGINAL TAX
20.00
AMOUNT
PENALTY
COLLECTION COST
TOTAL
20.00
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THIS IS ONLY A TAX. YOU MUST
MEET ALL COUNTY PLANNING
, AND ZONING REQUIREMENTS.