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11/18/2009 LeaseDANNY L. KOLHAGE CLERK OF THE CIRCUIT COURT DATE: January 8, 2010 TO: Suzanne A. Hutton County Attorney A TTN. Kathy M. Peters Executive Assistant FROM: Isabel C. DeSantis, D. C. At the November 18 2009 Board of County Commissioner's meeting, the Board granted approval of a Lease Agreement between Monroe County and the Boys & Girls of the Keys Area, Inc. - Version 7 which allows Lessee (B &G) to terminate the lease without penalty if mitigation or re g pair of windstorm or flood damage is unfeasible Enclosed is a duplicate original of the document or your handling Should you have an questions, please feel free to contact this office. cc: Finance File LEASE AGREEMENT BOYS & GIRLS CLUBS OF THE KEYS AREA, INC. MONROE COUNTY THIS AGREEMENT made this 18th day of November, 2009, by and between Monroe County, Florida, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida, 33040 (hereafter "LESSOR~' or ~~County"), and the Boys & Girls Clubs of the Keys Area, Inc., a Florida 501 c-3 not for profit corporation, whose address is 1400 United Street, Suite 108, Key West, Florida 33040 (the ~~LESSEE~~ or "Boys and Girls club"). WHEREAS, the Boys and Girls club provides after school and holiday day care facilities in a safe, supervised environment for chi ldren; and WHEREAS, the community of Big Pine Key IS In need of afterschool and holiday daycare facilities; and WHEREAS, the Boys and Girls desires to lease property from the County to provide daycare facilities on Big Pine Key; and WHEREAS, afterschool daycare facilities where children are cared for In a safe, supervised environment is beneficial to the public, NOW THEREFORE, In consideration of the preInises and the mutual covenants and agreements herein contained, the parties agree as follows: WITNESSETH: 1. Premises and Term: a. LESSOR does hereby lease to LESSEE, according to the terms and provisions herein, the property C~prenlises'~) located on Lot 1 C Big Pine Acres, an unrecorded subdivision on Big Pine Key, Monroe County, Florida 33043; located on property described as follows: Section 23, Township 66, Range 29, Big Pine Key, Big Pine Key Acres Tract IC, as recorded in Official Record Book 797, Page 1839, Official Record Book 936, pages 422-423 Q/C, Official Record Book 1136, page 2053, Public Records Monroe County, Florida Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property Novelnber 2009 - I - b. The initial term will be for five (5) years, beginning the 18th day of November, 2009, and ending on the 17th day of November, 2014. c. LESSEE may also be granted one (1) additional five (5) year renewal terms. The LESSEE must be in compliance with all lease terms and conditions as a prerequisite to exercising the option to renew. The LESSEE tnust provide to the LESSOR a written notice of its intent to exercise said option at least sixty (60) days prior to the expiration of the current Lease term. The re-negotiation of the Lease terms will commence upon receipt of LESEE'S notice and written consent of the LESSOR. d. If LESSOR decides not to extend this lease hereof as per paragraph 1 c above, LESSOR shall allow LESSEE sixty (60) days from the lease ending date to vacate said premises, provided however LESSEE shall be required to pay LESSOR the same equal monthly rent installments during such sixty (60) day period. e. SURRENDER OF PREMISES AT END OF TERM - Upon the expiration of the term hereof or sooner termination of this lease as herein provided, LESSEE agrees to surrender and yield possession of the detnised premises peacefully and without further notice, and in good order and condition but subject to ordinary wear and reasonable use thereof. 2. Rent: The rent to be paid by LESSEE to LESSOR in the first term of this Lease Agreement shall be One Dollar ($1.00) per year in exchange for renovating the building to make it habitable for the Boys and Girls Club intended use, and performing all routine tnaintenance during the term of this lease as more particularly described in paragraphs 3 and 5 below. Upon exercise of the option for additional lease terms, the rent amount may also be re-negotiated pursuant to paragraph 1 c. 3. Use and Condition of Premises: 3. The Boys and Girls Club, has an average daily attendance of 42 children per day ranging in ages frotn 5 years to 12 years old. The children are divided into groups and rotated between inside time, outside time, homework help, field trips, and other activities. The Boys and Girls Club uses a ratio of 10 children per one staff member. LESSEE agrees to use said prelnises only for organized youth activities~ after-school care~ and safe summer programs on a daily basis as follows: Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 2 - 1. The Boys & Girls Club will use the premises otherwise known as the Stiglitz House Monday-Friday during the school year, with hours of operation from 2:30- 6:00 p.m. on normal after school days. When the school district has an early release day, hours of operation will begin at 11 :30 a.m. and end at 6:00 p.m. The director and staff may enter the premises throughout the day prior to the hours of operation to prepare lessons, clean, and set up dai ly activities. During the school year when there is no school, Christmas Break, Spring Break, and during the summer months, the Boys and Girls Club will operate from 8:00 a.m. to 6:00 p.m. There will be NO overnight activities or anyone residing on the property 11. The unenclosed downstairs area shall be used for outside arts and crafts. LESSEE shall provide tables and chairs for use in the downstairs area for the children to paint, color, glue, etc. iii. The rooms located upstairs will be used for a variety of activities, i.e. cOlnputer room, homework rOOln, and a t.v.hnovie rOOln. IV. Play areas will be the public county facility at Watson Park and only the upland, ~~cleared" areas only on the Stiglitz property. LESSEE will keep all children out of the woods and the wetlands. The Boys and Girls Clubs of the Keys area will apply for grants to secure new playground equipment for the existing playground at Watson Field b. Prior to commencement of operations, LESSEE will Inake all repairs necessary for safe day-to-day operations as required by Monroe County Building Departlnent and the Monroe County Fire Marshal. The downstairs enclosure will be locked and secured until funds can be obtained and approvals secured from Monroe County to remove the enclosure. c. LESSEE must maintain the prelnlses In good repair and condition at all times, including the interior and exterior of the prelnises. LESSEE must keep the premises in a clean, sanitary, and safe condition at all tilnes. The plumbing and other facilities must not be used for any other purposes other than that for which they were constructed. No foreign substances of any kind may be deposited in the facilities, and the expense of any breakage, stoppage or damage resulting from the violation of this Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 3 - provision by LESSEE will be borne by LESSEE. LESSEE agrees to observe, cOlnply with, and execute promptly at its sole expense during the term of this lease, all laws, rules, orders, directives, codes, ordinances, regulations, licensure and inspection requirements of governmental authorities and agencies and of insurance carriers which relate to LESSEE'S use or occupancy of the premises. LESSEE must not allow or cause the use of the premises in any way that constitutes either a public or a private nuisance or in any way that unreasonably interferes with any other lessees or neighbors to the premises. d. Upon reasonable notice, LESSOR or its authorized representative may enter the leased premises at any reasonable time for the purpose of inspecting the leased premises or for performing the LESSOR'S duty of care and Inaintenance. 4. Quiet Enjoyment: Upon the payment by LESSEE of the rents provided, and upon the observation and performance of all the covenants, terms and conditions on LESSEE'S part to be observed and performed, LESSEE shall peacefully and quietly hold and enjoy the subject premises for the term hereby demised without hindrance or interruption by LESSOR or any other person or persons lawfully or equitably claiming by, through or under LESSOR, subject, nevertheless, to the terms of the lease. 5. Care and Maintenance of Premises: a. LESSEE takes said premises in its present condition in exchange for rent of $1.00 per year for the term of this lease. b. LESSOR will be responsible for closing shutters at LESSOR's discretion in the event of a storm watch or warning. c. LESSEE'S DUTY OF CARE AND MAINTENANCE- 1. LESSEE shall, after taking possession of said premises and until termination of this lease and the actual removal from the prelnises, at its own expense, care for and maintain said premises in a reasonably safe and serviceable condition, except for structural parts of the building. LESSEE will furnish its own interior decorating. LESSEE will not pennit or allow said premises to be damaged or depreciated in value by any act or negligence of the LESSEE, its agents or employees. Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 4 - 11. LESSEE shall perform and be responsible for the cost of all structural renovations or repairs required for Lessee's intended use. LESSEE shall perform and be responsible for the cost of all repairs and/or maintenance necessary for all ~~mechanicals" including, but not limited to, air conditioning, water, heater, and plumbing, and to keep the demised prelnises in good order, repair and condition during the term of the lease. iii. LESSEE agrees to keep faucets closed so as to prevent waste of water and flooding of the premises and to promptly take care of any leakage or stoppage in any of the water or waste pipes. IV. LESSEE shall have the right during the term of this Lease Agreement to construct, re-construct, re-model, paint, decorate and re-decorate the leased portion of the property; provided however, that all such improvements to the demised premises by LESSEE shall conform to all applicable building codes, regulations, and prior written approval from LESSOR is obtained, written approval by LESSOR shall not be unreasonably withheld. All improvements remaining on the demised premises at the expiration or upon the termination of the Lease Agreement shall becolne the property of LESSOR. If at the expiration or termination of this agreement LESSEE wishes to leave the improvelnents on the property, LESSEE shall obtain written approval from LESSOR. LESSOR has the sole right to reject the leaving of such improvements and require LESSEE to remove improvements from the subject property. If LESSEE fails to remove the improvements that a) LESSEE leaves on site and b) LESSOR requests removal; LESSOR shall have the sole right to remove LESSEE'S improvements from the premises. LESSEE shall be responsible to reimburse LESSOR for all costs and expenses associated with the removal and disposal of LESSEE'S personal property and improvements. v. LESSEE shall secure all windows, doors, and gates of the premises and shall lock all entrances and openings to the premises after normal business hours. In the event of pending storm notifications, LESSEE shall secure all windows, doors, gates, and equipment stored on ground level of the prelnises and shall lock all entrances and openings to the premises before vacating the premises when a Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 5 - ~~Watch" is issued. Further, LESSEE agrees to notify LESSOR that storm preparations have been completed. Failure of the same shall constitute a default of this Lease. VI. LESSEE may attach, affix, or paint or exhibit signs on the fence on the leased premises provided LESSEE has obtained the required permits and the signs describe the services provided and the hours of operation, and do not damage the fence. 6. Taxes: Where applicable, LESSEE agrees to pay all required county property or building taxes, sales taxes, licenses and fees which may occur froln time to time during the term of this Lease. 7. Governmental Requirements: LESSEE shall be required to obtain any and all required permits, variances and/or special exceptions from all authorities having jurisdiction over the operation of this facility. 8. Assignment and Subletting: This lease may not be sold, transferred, or assigned in full or part without the written permission of LESSOR. Any purported assignment without such prior written consent shall be null and void. LESSEE shall not have the right to sublet this lease or any portion of this lease or property. 9. Insurance Requirements: By the sIgnIng of this lease, LESSEE agrees without reservations, to the insurance requirelnents specified herein. a. The insurance provided by LESSEE pursuant to this lease shall apply on a primary basis and any other insurance provided by LESSOR shall be excess of and not contributory to the insurance provided by LESSEE. b. LESSEE shall provide LESSOR with current proof of coverages required, in the form of an original certified Certificate of Insurance properly signed by the authorized agent of the insurance company. The insurance company must be authorized to transact business within the State of Florida. The agent of the insurance company must be licensed to sell the insurance coverages required under this Lease Agreement. c. Commercial Insurance: The insurance shall cover those sources of liability which would be covered by the latest edition of the standard Commercial General Liability Boys and Girls Clubs of the Keys Area. Inc. Stigl itz Property November 2009 - 6 - Coverage Form (ISO Form CG 00-01) as filed for use in Florida without the attachment of restrictive endorsements other than the elimination of medical payments and fire damage legal liability. During the term of this Lease, except as specifically provided herein, LESSEE shall provide and maintain, at his sole cost and expense, the following insurance coverages with indicated limits of liability are mandatory under this Lease Agreement: Workers~ Compensation Employers' Liability Insurance Statutory Limits $100,000 Bodi ly Accident $500,000 Disease, policy limits $100,000 Disease, each employee General Liability, Lease/Rental of Property Owned by the County, $1,000,000 Combined Single Limit including or · Premises Operation $500,000 per person · Blanket Contractual $1,000,000 per person . Products and Complete Operations $100,000 per occurrence · Expanded Definition of Property Damage . Personal Injury Liability . Participant Accident · Fire Legal Liability (with limits equal to fair market value of the leased property) Vehicle Liability (Owned, Non-Owned and Hired Vehicles; Physical Damage $300,000 Combined Single Limit Protection (if leased property is a ACV for Physical Damage County-owned vehicle or (Leases/Rentals of County-owned Property) $100,000 per person $300,000 per occurrence $50,000 Property Damage d. Property: LESSEE will provide LESSOR with evidence of Property, Insurance with limits of coverages based on the current replacement cost of the structure. e. Certificate of Insurance: Before commencing work, LESSEE shall furnish LESSOR with a certificate or certificates of insurance signed by an authorized representative of the insurer(s) evidencing the insurance required. The Certificates of Insurance shall provide that the LESSEE shall endeavor to give notice prior to cancellation or restriction of coverage. f. Additional Named Insured: The Monroe County Board of County Commissioners shall be included as an additional named insured for the coverages above. Boys and Girls Clubs of the Keys Area, Inc. Stiglitz Property November 2009 - 7 - g. The Lessee must keep in full force and effect the insurance described during the term of this agreement. If the insurance policies originally purchased that meet the requirements are canceled, terminated or reduced in coverage, then the Lessee must immediately substitute complying policies so that no gap in coverage occurs. h. The insurance required of the Lessee in this paragraph is for the protection of the County, its property and employees, and the general public. The insurance requirement is not, however, for the protection of any specific member of the general public who might be injured because of an act or omission of the Lessee. The insurance requirements of this paragraph do not Inake any specific injured member of the general public a third party beneficiary under this agreement. Therefore, any failure by the County to enforce this paragraph, or evict the Lessee if the Lessee becomes uninsured or underinsured, is not a breach of any duty or obligation owed to any specific member of the general public and cannot form the basis of any County liability to a specific member of the general public or his/her dependents, or estate or heirs. i. LESSEE shall not be required to obtain Windstonn and Flood insurance coverage for the premises, however, LESSEE shall be solely responsible for any damages to the prelnises occasioned by windstorm or flood. THE LESSOR SHALL NOT BE HELD RESPONSIBLE FOR ANY DAMAGE CAUSED BY A WINDSTORM OR FLOOD EVENT. LESSEE SHALL BE SOLELY RESPONSIBLE FOR ALL COSTS ASSOCIATED WITH MITIGATION OR REPAIR(S) OF DAMAGES CAUSED BY A WINDSTORM OR FLOOD EVENT. AT LESSEE'S OPTION, LESSEE MAY TERMINATE THE LEASE WITHOUT PENALTY IF LESSEE DETERMINES THAT MITIGATION OR REPAIR OF THE DAMAGES IS UNFEASIBLE. 10. Utilities: LESSEE agrees to comply \vith all applicable County codes and proper use of, and to pay for, the installation (if required) and use of electricity, water, sewer, solid waste, and other utilities to the subject premises. LESSOR shall be responsible for the payment of all connection and development fees, sewer lateral installation costs and septic tank decommissioning costs associated with providing a central sewerage connection to the Premises. Other than central sewerage connection fees, LESSEE shall be responsible for any impact fees, associated with utilities. 11. ()bservation of Laws and Ordinances: Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 8 - a. LESSEE agrees to observe, comply with and execute promptly, at their expense, during the term hereof, all laws, rules, requirements, orders, directives, ordinances and regulations and any and all governmental authorities or agencies and of all municipal departments, bureaus, boards and officials due to its use or occupancy of the subject premises, and to obtain and maintain during the term thereof any and all certificates, licenses, and other documents necessary for lawful occupation and operation. b. This agreement shall be governed by and construed in accordance with the laws of the State of Florida. In the event that any cause of action or adIninistrative proceeding is instituted for the enforcement or interpretation of this Lease Agreement, the LESSOR and LESSEE agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. The LESSOR and LESSEE agree that, in the event of conflicting interpretations of the terms or a term of this Agreement by or between any of them, the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding. This Agreement shall not be subject to Arbitration. 12. Defaults: In the event that LESSEE fails, within thirty (30) days after notice, to cure any default of any obligations owed by LESSEE to LESSOR under this Lease Agreement then, in that event, LESSOR shall have the right to terminate this Lease Agreement and to enter upon the leased premises and again have, repossess and enjoy the saIne as if this Lease Agreement had not been made. 13. Attorney's Fees: Should any cause of action or adIninistrative proceeding arise out of this lease in connection with the enforceInent or interpretation of this lease between LESSOR and LESSEE, the prevailing party shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an award against the non-prevailing party. Mediation proceeding initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the Sixteenth Judicial Circuit in and for Monroe County, Florida. 14. Entire Agreement: This lease sets forth all covenants, promIses, agreements and understandings between LESSOR and LESSEE concerning the subject premIses. No Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 9 - modification or waiver of terms of this Agreement shall be binding, unless in writing, and signed by a duly authorized representative of LESSOR and LESSEE. 15. Partial Invalidity: If any term, covenant or addition of this lease or the application thereof to any person or circumstance shall, to any extent, be inval id or unenforceable, insofar as is reasonable the remainder of this lease, or the application of such term, covenant or condition to persons or circumstances other than those as to which it is held invalid or unenforceable, shall not be affected thereby and each term, covenant or condition of this lease shall be valid and be enforced to the fullest extent permitted by law. 16. Hazardous Materials: a. No petroleum products or other potentially hazardous materials including, but not limited to, oil-based paints, solvents, cleaners, or other chemicals, shall be used or stored on the leased property. LESSEE is not responsible for the presence of, removal, disposal, or clean up of the existing petroleum storage tank located on the property. b. Construction and industrial activities that may cause soil, water, or air contamination are prohibited. Any uses, other than those stated herein, lTIUSt be approved by LESSOR, in writing, prior to commencing such activities on the leased property. c. Solid Waste: No solid waste is allowed to accumulate on the leased property. A distinction between storage of usable materials and accumulated solid waste will be mutually agreed upon by LESSEE and LESSOR. LESSEE, at its own expense, will maintain on the property a solid waste container, with an active disposal schedule, which is large enough to handle any day-to-day refuse. 17. Manner of Payment and Giving Notice: As to LESSOR: As to LESSEE: Boys & Girls Clubs of the Keys Area, Inc. Daniel R. Dombroski, Executive Director 1400 United Street, Suite 108 Key West, Florida 33040 Public Works Division Director Monroe County, Florida 1100 SilTIOnton Street, Suite 2-231 Key West, Florida 33040 And Monroe County Attorneys Office 1111 12th St. Suite 408 Key West, FI. 33040 Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 10 - 18. INDEMNITY AND HOLD HARMLESS: Notwithstanding any mInImum Insurance requirements prescribed elsewhere in this agreement, LESSEE shall defend, indelTInify and hold the LESSOR and the LESSOR's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, and (i i) any I itigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of LESSEI~ or any of its employees, agents, contractors or other invitees during the term of this Agreement, (B) the negligence or willful misconduct of LESSEE or any of its employees, agents, contractors or other invitees, or (C) LESSEE's default in respect of any of the obligations that it undertakes under the terms of this lease., except to the extent the clailTIs, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the LESSOR or any of its employees, agents, contractors or invitees (other than LESSEE). Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this lease, this section will survive the expiration of the term of this lease or any earlier termination of this lease 19. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. LESSEE and LESSOR agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If no resolution can be agreed upon within 30 days after the first meet and confer session, the issue or issues shall be discussed at a public lTIeeting of the Board of County Commissioners. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such reI ief or remedy as may be provided by this Agreement or by Florida law. 20. COOPERATION. In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, LESSEE and LESSOR agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. LESSEE and LESSOR Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 11 - specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. 21 NONDISCRIMINATION. LESSEE agrees that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. LESSEE agrees to cotnply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685- 1686), \vhich prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patent records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 120 1 Note), as maybe atnended from time to time, relating to nondiscrimination on the basis of disability; 10) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. 22. COVENANT OF NO INTEREST. LESSEE and LESSOR covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that the only interest of each is to perform and receive benefits as recited in this Agreement. Boys and Girls Clubs of the Keys Area. Inc. Stigl itz Property November 2009 - 12 - 23. CODE OF ETHICS. LESSOR agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts~ doing business with one's agency~ unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. 24. NO SOLICIT A TION/P A YMENT. LESSOR and LESSEE warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gi ft, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the LESSEE agrees that the LESSOR shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. 25. PUBLIC ACCESS. LESSOR and LESSEE shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the LESSOR and LESSEE in conjunction with this Agreement; and the LESSOR shall have the right to unilaterally cancel this Agreement upon violation of this provision by LESSEE. 26. NON-WAIVER OF IMMUNITY. Notwithstanding the prOVISIons of Sec. 768.28, Florida Statutes, the participation of the LESSOR in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the LESSOR be required to contain any provision for waiver. Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 13 - 27. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the LESSOR, when performing their respective functions under this Agreement within the territorial I imits of the County shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the County. 28. LEGAL OBLIGATIONS AND RESPONSIBILITIES: Non-Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance Inay be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the LESSOR, except to the extent permitted by the Florida constitution, state statute, and case law. 29. NON-RELIANCE BY NON-PARTIES. No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third- party claim or entitlement to or benefit of any service or program contemplated hereunder, and the LESSOR and LESSEE agree that neither the LESSOR nor the LESSEE or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. 30. ATTEST A TIONS. LESSEE agrees to execute such documents as the LESSOR may reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug- Free Workplace Statement. Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 14 - 31. NO PERSONAL LIABILITY. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of LESSOR in his or her individual capacity, and no member, officer, agent or employee of LESSOR shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. 32. SECTION HEADINGS. Section headings have been inserted in this Agreement as a matter of convenience of reference only, and it is agreed that such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. 33. MUTUAL REVIEW. This agreement has been carefully reviewed by LESSEE and LESSOR, therefore this agreement is not to be construed against either party on the basis of authorship. TI-IE REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLNAK. Boys and Girls Clubs of the Keys Area, Inc. Stiglitz Property November 2009 - 15 - IN WITNESS WHEREOF, the parties hereto have been executed this Agreement as of the date first written above. Attest: DANNY L. KOLHAGE, CLERK By: s:b, l,~QC~ Ddta~,d;-;a Deputy/Clerk WITNESS J:1aLlt~.~ Signature Vakle~ ~e4efS Print Name WITNESS: Ck""-L ~ ~ Signature ELa.;\\j\.Q ~trdC\ Print Name ' BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY ORIDA By: ~. Mayor BOYS & GIRLS CLUBS OF THE KEYS AREA, INC. ~ , ~j0/~ ~= ~gnature ~tA ti /) A Y /Vl t1 d (' 1/ J e-.... Print Name J-- ' rreJld2~.-L Title tDo Q L\J IJ ~ '// ~ (..i (/') ~ _ Y.L r:L ~ r) \J"~ ~ r);,{ 4 l.- Address --- {JO{) tJdj> -tjiYW- Phone ~ (-=', .~,..- .. .'.1 '2 tci '. J1' >...."., . '/-'I/IJi ) J' ' ; ,;) ", I ,I JJ^--L[V~ C . ~....L,.'." /,."...7. ....f... -~--_.__...__.__..- '--v . \J (...__ ~..w . ....:'....- / "."."....~' .",r..._:.~:'~;':~"~'~' .' / .' . . r: / ' t ( Z ~I u 7 ! C~ !:;-:t ;1'J Boys and Girls Clubs of the Keys Area, Inc. Stigl itz Property November 2009 - 16 - ~ <:::) -- c;:) ~ :;e , 0'\ 2] r- I'"T1 o ." a ;;0 .::0 rr'1 CJ o ::u o l:.. ::c ~ c.n N ACQRQT,, CERTIFICA._ - OF LIABILITY INSURAI.°CE DATE(MM/DD/YYYY) 12/15/2009 PRODUCER (305)294-2542 FAX (305)296-7985 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Porter Allen Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 513 Southard Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West, FL 33040 Frank McPherson INSURERS AFFORDING COVERAGE NAIC# INSURED Boys & Girls Club of the Keys Area, Inc INSURER A: Markel Insurance Company 1400 B United Street INSURER B: Key West, FL. 33040 INSURERC: INSURER D: INSURER E: COVERAGES THE POLICIES OF.INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR (NSRp DATE IMM/DD/YYI DATE ftNM/DD/YY) LIMITS ' GENERAL LIABILITY 8502CY263142 - 5 03/25/2009 03/25/2010 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100 000 PRFMIRFS(Fa nrcurenca) $ , CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5,000 A X PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 nPOLICY n JECT n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO $ (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS . „ BODILY INJURY NON-OWNED AUTOS : (Per accident) PROPERTY DAMAGE $ �(• (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR n CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY TORY I IMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED AT: 30150 South Street, Big Pine Key, FL 33043 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO E LEFT, Monroe County Board of County Commisioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIG ON LI BILITY 1100 Simonton Street OF ANY KIND UPON THE INSURER,ITS AGE OR PRESE TAT E . Key West, FL 33040 AUTHORIZED REPRESENTATIVE FRANK MCPHERSON A174739 R ACORD 25(2001108) ©ACORD CORPORATION 1988 ACORDTM CERTIFICATE OF LIABILITY INSURANCE RPM DATE TM P4SA 01-05-2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PAYCHEX AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 210705 P: () - F: (8 8 8) 443-6112 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 33015 SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED INSURER A:Twin City Fire Ins Co INSURER B: BOYS & GIRLS CLUBS OF THE KEYS INC INSURER C: 1400 UNITED ST STE 108 INSURER D: KEY WEST FL 33040 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITSLTR DATE(MM/DD/YY/ DATE(MM/DD/YYJ GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) S CLAIMS MADE OCCUR MED EXP(Any one person) S PERSONAL&ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S POLICY n PRO- POLICY LOC T AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS ;;RY HIRED AUTOS 'j �,, S NON-OWNED AUTOS -- - _,_2.....--• PROPERTY DAMAGE-- ;�„' i "' - (Per accident) __._. GARAGE LIABILITY ._ X_ _ AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESS LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S DEDUCTIBLE S RETENTION $ _ S WORKERS COMPENSATION AND X WC STATU- OTH- TOflY LIMITS ER A EMPLOYERS'LIABILITY 76 WEG K00211 05/29/09 05/29/10 E.L.EACH ACCIDENT $500, 000 E.L.DISEASE-EA EMPLOYEE $5 0 0, 0 0 0 E.L.DISEASE-POLICY LIMIT $5 0 0, 0 0 0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured' s Operations . CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Monroe County Board of 30 DAYS WRITTEN NOTICE(10 DAYS FOR NON-PAYMENT)TO THE CERTIFICATE County. Commissioners HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 1100 S IMONTON .ST REPRESENTATIVES. KEY WEST, FL 33040 AUTHORIgeREPPRESENTATIVE ES n ,• /A/�� / ACORD 25-S (7/97) ©ACORD CORPORATION 1988 FULLERS INS AGCY PROGREIl/YE° 1432 KENNEDY DRIVE KEY WEST,FL 33040 305-294-6677 Policy number: 02545341-5 Underwritten by: gi Progressive Express Ins Company January 5,2010 Page 1 of 2 Certificate of Insurance Certificate Holder Insured Agent Additional Insured BOYS&GIRLSCLUB INC FULLERS INS AGCY MONROE COUNTY 1400 UNITED ST#108 1432 KENNEDY DRIVE BOARD OF COUNTY COMMISSIONERS KEY WEST, FL 33040 KEY WEST, FL 33040 1100 SIMONTON KEY WEST, FL 33040 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies. Policy Effective Date: Feb 26,2009 Policy Expiration Date: Feb 26,2010 Insurance coverage(s) Limits Bodily Injury/Property Damage $1,000,000 Combined Single Limit Uninsured Motorist $1,000,000 CSL Non-Stacked Personal Injury Protection $10,000 w/$0 Ded -Named Insured Only Description of Location/Vehicles/Special Items Scheduled autos only 2005 CHEVROLET EXPRESS G3500 1GAHG39U551110493 Comprehensive $500 Ded Collision $500 Ded 2006 FORD ECONOLINE E350 1 FBNE31 L46HA16394 Comprehensive $500 Ded Collision $500 Ded NI Continued (Policy Provisions: WC 1-�)0 00 A) , 02 KO INFORMATION PAGE WEG WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INSURER: TWIN CITY FIRE INSURANCE COMPANY HARTFORD PLAZA, HARTFORD, CONNECTICUT 06115 NCCI Company Number: 14974 .`- Company Code: 7 THE HARTFORD • Suffix LARS RENEWAL �_..c POLICY NUMBER: 76 WEG K00211 01 Previous Policy Number: 76 WEG K00211 N HOUSING CODE: 76 0 1. Named Insured and Mailing Address: BOYS & GIRLS CLUBS OF THE KEYS INC (No., Street, Town, State, Zip Code) Lo N 0 1400 UNITED ST #108 FEIN Number: 650678071 KEY ,WEST, FL 33040 State Identification Number(s): UIN: The Named Insured is: NOT FOR PROFIT Business of Named Insured: PHYSICAL FITNESS FACILITY NO P Other workplaces not shown above: 1400 UNITED ST #108 • KEY WEST FL. 33040 2. Policy Period: From 05/29/09 To 05/29/10 12:01 a.m., Standard time at the insured's mailing address. Producer's Name: PAYCHEX AGENCY INC 308 FARMINGTON AVE FARMINGTON, CT 06032 Producer's Code: 210705 Issuing Office: THE HARTFORD 308 FARMINGTON AVE FARMINGTON CT 06032 (877) 287-1312 • _ • Total Estimated Annual Premium: $3,746 Deposit Premium: Policy Minimum Premium: $341 FL (INCLUDES INCREASED LIMIT MIN. PREM. ) Audit Period: ANNUAL Installment Term: The policy is not binding unless countersigned by our authorized� representative. 4 Countersigned by 04/04/09 Authorized Representative Date Form WC 00 00 01 A (1) Printed in U.S.A. Page 1 (Continued on next page) Process Date: 04/04/09 Policy Expiration Date: 05/29/10 ORIGINAL ORMATION PAGE (Cc . nued) Policy Nurr _ 76 WEG K00211 3.A. Workers Compensation Insurance: Part one of the policy applies to the Workers Compensation Law-of the states listed here: FL Rrn irrtera nn Premium B. Employers Liability Insurance: Part Two of the•policy applies to work in each state listed in Item 3.A.. The limits of our liability under Part Two are: Bodily injury by Accident $500,000 each accident Bodily injury by Disease $500,000' policy limit Bodily injury by Disease $500, 000 each employee =corn C. Other States Insurance: Part Three of the policy applies to the states, if any , listed here: - o ALL STATES EXCEPT ND, OH, WA, WY, AND STATES DESIGNATED IN ITEM 3 .A. OF THE INFORMATION PAGE. D. This policy includes these endorsements and schedule: WC 00 03 08 WC 00 04 21C WC 00 04 22A WC 09 04 02 WC 09 04 03A N WC 00 04 14 WC 00 04 19 WC 09 06 06 t4 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. • Premium Basis ,ten Classifications Total Estimated Rates Per Estimated Code Number and Annual $100 of Annual Description Remuneration Remuneration Premium 9063 302,300 1.21 3,658 EXERCISE OR HEALTH INSTITUTE & CLERICAL • gmg INCREASED LIMITS PART TWO (9807) .80 PERCENT 29• TO EQUAL INCREASED LIMITS MINIMUM PREMIUM (9848) • 21 555 TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 3,708 FL - INTRA EXPERIENCE MODIFICATION 090000000 (CONTINGENT) .940 PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION `3,486 TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 3,486 EXPENSE CONSTANT (0900) 200 TERRORISM (9740) 302,300 .020 60 TOTAL ESTIMATED ANNUAL PREMIUM 3,746 • Total Estimated Annual Premium: $3,746 Deposit Premium: Policy Minimum Premium: $341 FL (INCLUDES INCREASED LIMIT MIN. PREM.) Interstate/Intrastate Identification Number: / 090000000 NAICS: 713940 Labor Contractors Policy Number: SIC: 7991 UIN: NO. OF EMP: 000022 Form WC 00 00 01 A (1) Printed in U.S.A. Page 2 Process Date: 04/04/09 Policy Expiration Date: 05/29/10 • FULLERS INS AGCY PROGREIJ/UE 1432 KENNEDY DRIVE KEY WEST,FL 33040 Named insured Policy number: 02545341-5 Underwritten by: Progressive Express Ins Company October 30,2009 BOYS&GIRLSCLUB INC Policy Period:Feb 26,2009-Feb 26,2010 1400 UNITED ST#108 Page 1 of 3 KEY WEST,FL 33040 p rogressiveage nt.com Online Service Make payments,check biling activity,print Policy documents,or check the stalls of a Commercial Auto da1m. 305-294-6677 Insurance Coverage Summary FULLERS INS AGCY Con:act your agent for personalized service This is your Declarations Page 800-444-4487 • Your coverage has changed For customer service if your agent is unavailable or to report a claim. Your coverage began on February 26,2009 at 12:01 a.m. This policy expires on February 26,2010 at 12:01 a.m. This coverage summary replaces your prior one.Your insurance.policy and any policy endorsements contain a full explanation of your coverage.The policy limits shown or an auto may not be combined with the limits for the same coverage on another au:o, unless the policy contract allows the stacking of limits.The policy contract is form 6912(03/05).The contract is modified by forms Z435FL (12/06),Z228(07/05), 1652FL (08/06),2852FL (10/04),4852FL (10/04),4881FL (10/04)and 1198(01/04). The named insured organization type is a corpora on. Policy changes effective October 29,2009 Premi.im change: • $0.00 Changes: The driver information has changed. The changes shown above will not be effective prior to the:ime the changes were requested. Outline of coverage Description Limits Deductible Premium • Liability To Others $4,992 Bodily Injury and Property Damage Liability $1,000,000 combined single limit Uninsured Moto'ist Non-Stacked $1,DUC,000 comhined single limit 966 Basic Personal Injury Protection- 458 Without Work Comp-Named Insured Only $10,000 each person $0 Comprehensive 231 See Auto Coverage Schedule Limit of liability less deductible Collision 1,223 See Auto Coverage Schedule Limit of liability less deductible Subtotal policy premium $7,870.00 Florida Hurricane Catastrophe Fund Assessment 78.70 Fees SC.0D Total 12 month policy premium $8,028.70 Fonr 6489 FL(05/96) Continued Policy nurnocr: 02545341-5 BOYS&GIRLSCLUE INC Page 2 of 3 Rated drivers 1. DANIEL DOMBROSKI 2. SUSAN KENT 3. CECELIA WILLIAMSON 4. T=RRY WOOD 5. MARY BRANTLEY • 6. ANNE BRESNICKY 7. SCHELLA CEARC 8. DONNA BETHEL 9. PAUL MEADOR Auto coverage schedule 1. 2005 Chevrolet Express G3500 Stated Amount: $18,337 VIN: 1GAHG39U551110453 Garaging Zip Code: 33040 Radius: 50 Liability Liability UMNIM El PIP Premium $2,186 $483 $205 Comp camp Collision Collision Physical Damage Deduable Premium Deductible Premiurr Auto Total Premium $500 $112 $500 $640 • $3,626 2. 2006 Ford Econoline E350 Stated Amount: $16,7776 • VIN: 1FBNE31L46HA16394 Garaging Zip Code: 33040 Radius: 50 Liability Liability • UMNIM El PIP Premium $2,806 $483 $253 Comp Camp Collision Collision Physical Damage Mud ble Premium Deductible Premium Auto Total Premium $500 $119 $500 $583 $4,244 Premium discounts Policy C2545341-5 Renewal Vehide 2005 Chevrolet Express G3500 ABS and Air Bag 2005 Ford Econolire E350 Air Bag Additional Insured information 1 . Additional Insured MONROECOUNIY 1100 SIMONTON KEY WEST,FL 33040 • 2. Additional Insured DONORS FORUM OF SFL • 200SBISCAYNE BL MIAMI,FL 33131 Fonr 6489 FL(05/961 Continued . t_ Policy numocr: 02545341-5 BOYS&GIRLSCLUE INC Page of Agent signature Company officers Secretary - Four 64.9 FL(05/06f