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1st Change Order 11/10/1993 ..RIIl' I. ...U,11t BRANCH OFFICE 3117 OVERSEAS HIGHWAY MARATHON, FLORIDA 33050 TEL. (305) 289-6027 CLERK OF THE CIRCUIT COURT MONROE COUNTY 500 WHITEHEAD STREET KEY WEST, FLORIDA 33040 TEL. (305) 292-3550 BRANCH OFFICE 88820 OVERSEAS HIGHWAY PLANTATION KEY, FLORIDA 33070 TEL. (305) 852-7145 MIiMQBAH~YH TO: Dent Pierce, Director Division of Public Works fI- Isabel C. DeSantis, Deputy Clerk~.~. FROM: DATE: November 29, 1993 On November 10, 1993, the Board authorized execution of Change Order No. 2 to Sombrero Boulevard Bike Path in the amount of $4,193.08 and Change Order No.1 to D & J Industries, Inc., in the amount of $3,500.00 for the Marathon Library Roof. Attached for return to the proper individuals are duplicate originals of the subject Change Orders. Should you have any questions concerning the above, please do not hesitate to contact me. cc: County Attorney Finance Director County Administrator, w/o document File CHANGE O~DER NO. 1 BOCC 11/10/93 Project Title: Job No. N/A Replace the Roof System @ Marathon Library Contractor: D & J INDUSTRIES Contract Date: July 28, 1993 Nature of the Change: 1. Clay tiles were removed from the gable roof in four places to remove unanticipated rotten wood. 2. An additional area of the roof which was not previously included in the original scope of work was added to the project based on a field inspection by the Director of Facilities Maintenance, Divi- sion Director of Community Services and the Contractor. The changes result in the following: Increase of $3,500.00, revising the contract amount to $25,350.00. Prepared and Approved: B~ rJ t--.. ~~ector 0 Facilities Maint. DATE: Approvl3d and Form: BY: ~~ DATE: ~ Z,S; j'J Date: /0 ( ',- cd (7) By: ~ .u U) -Tl The above changes are accepted: Attest:b~ w -- . A- ..... ~c~: :z: c::: -c:::: -.,., ':::J By: N \0 -~ ~, , \\-\L-~~ Title: -0 - w Repres~ntativei co ~~/c7l?1- . -........ ,.. A_ n Date: ApprOVE!d : BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Attest: DANNY L. KOLHAGE, Clerk ~ ~~ C. ~/J~ CLERK , I , , , i\ SWORN'STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS.. CLAUSE iJ:r 5- Y:,ud t{, 5 f~/ ~? . .'- ..".-- <-J :_~ warrants that he/it has not employed, retained c1r otherwise had act 'on he/i ts behalf any former County officer .. or employee subject to the prohibition of Section 2 of Ordinance No. '. .. . -". ; . -." '. . . .".... . . . . . . 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. , .. . . .. County may, in its di~cretion.'. _t~r~-ina~~<_~i~:9~n.fra~t..witho';t liability and may all3o,in its discretion, deduct: fr6m..~~ 'co~tract o.r. purchase : ~.~. ",,:,". .~ :. .... ...". . ~~. . price, or ()therwise recover_, the full amount o f'- any ~ee, commis~ion, percentage, gift, or' c'onsideration paid to.the. form.er County officer or employee. STATE OF '"1 Lo7Jd4: ll1iJ1il02 .~A(Si~a~~.:e).... Date:.7!.E1J/93 . . ..' . I . . .. . . ~ 1 ~..:l)r _...~.-:s (j, 35- 'J ~-~? -L/CJ8-o COUNTY OF PERSONALLY APPEARED BEFORE ME, ~( ~~O(({ Xocr1 An affixed his/her signature (name above on this 3o~. the undersigned authority, who, after first beinq sworn by me, provided ~1Af of indiyidualsiqninq) in the space: day of hjlJlla. 4-~o~ NOTARY PUBL~ ~ My commission expires: .-----------..----. " 1993 . OFFICIAL NOTARY SEAL sn VIA] PEREZ NOTARY PtJBLIC STATE OF FLORIDA COMMISSION NO. C032377 . ~Ii N SEPT 29 1996 ..... . Af:O I~ I'. ...(~..f;:B'fIEfCATEb EIN SU RA NeEC GC()()2.55/<\'~;~~D~~~MID:)NY) ;:::::::'::":.;:::.:::::::;:::::;:,:.:: :::::::::::::::::::\:'::}:::::.:::\::<:}~:::::::::::::;.;.". .".;-".,:.:.;-:.:.:.:.:.;".;- ::..-;.;.;.;.:.;.;.;.:.;.:.:.:.:.:" I'RODUCER EYS I NSURANCE i~GE~'EO BY RISK MANAGrME~'T . 0 . BOX 500080 I. D. JJ1 / 1ARATHON FL 330_)~ '/ ,j U OAiE 7. '-1/ q;. COMFA1>.'Y A AISLIC l..:;I'7ER IHSURED :;;1>.'Y 8 AIG ,Jc~"\J ~~"-' ~ & J INDUSTRIES, INC COMFA1>.'Y C FLORIDA H011E BUItE~S'~ f' 638 OVERSEAS HIGHWAY LEiiER .<iskMgmt.&LossContro} RATHON, FL 33050 COMFA1>.'Y D D.".7E 7-/'5i,-~ LEiiER COM?A"'Y E 1. .." -~-!.. LEiiER ::P9XgB,A9..~Jt:;::./gg;:::g:t':;Ui/t ......... :........;....:.:.:.:.:.:.:.::... .... . ... ... .:. ........ .... .. ..........:.;:....:. ........ :}':\':';;:';;:"":;';':';:::{::;; ......;.;.,:{.;:;.,.,:;.;.;..:;.;.,.::,.,.;.::;.;:;.:.:,::::,::';';':':"': .:.:.::...:.:.:.:.:.:......::.,.:.....;;.:..::::,...:.:'. j THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDrTlON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS : CERTIFICAtE MAY BE ISSUED OR MAY PERT AJt~ THE INSURANCE AFFORDED BY THE POLICIES DESCRiBED HEREIN 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDrTlClNS OF SUCH POLl..-IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, =0 POWCY EFFECTIVE POWCY EXPIRATIOH TYPE OF IHSUAAHCE POWCY HUMBER WMITS .TR ATE (MMIDONY) DATE (MMlDDNY) A OEHEAAL UAB/WTY CMP557704651 7/02/93 7/02/94 GENERAL AGGREGATE $ 1 000 MMEAClAl. GENERAL UASILITY PRODUCTS-COMPIOP AGG, $ 1 000 LAlMS MADE [iJOCCUR. PERSONAL & AOV. INJURY $ 50 OWNER'S & CONTRACTOR'S PROT, EACH OCCURRENCE $ 1 000 FIRE DAMAGE (Anyone fire) $ 50 MED.EXP. (Anyone person) $ 1 3 BA1457513 7/14/93 7/14/94 COMBINED SINGLE IV AUTO UMrT $ 1 000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per ac:cidenl) $ GARAGE UABIUiY PROPERTY DAMAGE $ EXCESS WABIUTY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WOI!KER'S COMPENSATION 24540 3/01/93 3/01/94 EACH ACCIDENT AHD OISEASE-POUCY UMrT $ EMPLOYERS' UABIUTY DISEASE-EACH EMPLOYEE $ OTHER 'ESCRIPTION OF OPEAA TIONSIlOCA TION'SNEHICLESISPECIAL ITEMS :ONROE COUNTY BOARD OF COUNTY COMMISSIONERS LISTED AS AN ADDITIONAL INSURED IN THE LIABILITY POLICY o DAYS NOTICE FOR WORKER'S COMPENSATION' 10 DAYS NOTICE ALL OTHER COVERAGES.. :ERTf.F!9~.TEHOlOER?};:::;.: ;'iW;:::\W.:?f;::::::':::'.. ........ ... };.;.,::2::;.:U:J::i;::::::::::::::.9~ggH~TI9N::::':ll:t:J:::Jfif';.:i:::i;lWJ:::/f!:U:i::;:;:{'J'tt::tJ;:':::::':ffJ::::':l:::::::::!;:fJ;::{t;:;:{::::tt{:ff:U:.. ;::::; SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE " EXPIRATION DATE THEREOF, THE ISSUING COMPANY WilL ENDEAVOR TO .. MAil DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE .. lEFT, BUT FAILURE TO MAIL SUCH NO ICE SHALL IMPOSE NO OBLIGATION OR ABILITt OF KIND PON THE .IPANY, ITS AGENTS OR REPRESENTATIVES. 1>10NROE COUNTY BOARD OF COUNTY COMHISSIONERS 5100 W. COLLEGE ROAD KEY WEST FL 33040 ,cOFl"P~$'(i/90f'::Jn:nn::::H'm:;;:-=: .:.:.:.:.:.:.;.:.:.:.;.;.;.;.:.: :;:::::::::::::::::;::::;:::::::;:;::::::':= . - .... ............. ...... ..........-,...,'..........................-.. .. .:.:.;::.;.;.::::;:::;:;:;:;: ;';';'-'';''''::>:;:;:<:;';';;:::::;:;:::\;. .'.---.--'-- * er-i ~ ES. ~. ';.":' ...........~ >. :-.- . . ,_. '1:,..... ~ ; '" "!l"':l! "'..... rril" ,,1-1=-~::.1Tlt..;.,.. ~..:;..';,(.~ .' ..ee~~mf!l.:.;~~F.~:.'?f.\:.:.:.~ :.' ~~~~~~J,~~~....~' i:I;~~\"i . ~~h1.c) ~l~O ".:~..m<>t".' . ::;:; ~t'-. ....!"'IOU ..r:'gj ......' C ,. .... '-. ..\.-., ...;. ..' . ...... '-1.' b . '. ~~r::~~o.~..,.}~.~ Nt:. .=. ~.<;.: N~ ., !:CZ~. 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