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FY2003 02/19/2003 RemodelGRANT OF FUNDS This AGREEMENT dated the Lt day of _�'�� `�..-l�= the BOARD OF COUNTY COMMISSIONERS FOR NROE 2003, is entered into by and between behalf of the TOURIST DEVELOPMENT COUNCIL,,hereinafter COUNTY,' DCheand KeyWest reinafter on Society, Inc., a Florida not -for -profit corporation, hereinafter " Contractor". Film WHEREAS, the third penny of Tourist Development Tax may be used to acquire, construct, extend, enlarge, remodel, repair or improve, convention centers, sports stadiums, sports arenas, coliseums, auditoriums, fishing piers, museums, zoological parks, nature and which are publicly owned and operated or owned and operated by nofor-pro it corporations, ons,and beaches t WHEREAS, Contractor has applied for funding for the Key West Film Society Theater project to remodel, repair and improve the theater property hereinafter "the Property"; and WHEREAS, the County and TDC have determined that it is in the best interest of the County, for purposes of promoting tourism and preserving the heritage of the community, to remodel, repair and improve the property for use as an auditorium open to the public; NOW, THEREFORE, in consideration of the mutual covenants and payments contained herein, the Contractor and the County have entered into this agreement on the terms and conditions as set forth below. 1. AGREEMENT PERIOD. This agreement is for the period February 19, 2003 through March 15, 2004. This agreement shall remain in effect for the stated period unless one party gives to the other written notification of termination pursuant to and in compliance with paragraphs 7,12 and 13 below. 2. SCOPE OF AGREEMENT. The Contractor shall provide such materials, services and equipment as is necessary to renovate and equip an 8,000 sq. ft. vacant space for use as a multi- purpose cultural auditorium with two theater spaces. Included within the renovation will be lighting; finishes (tile, carpet, wall covering, painting, ceiling); signage; art work; ticket booth; counters; concession systems; storage shelving; projection screen and sound systems; theatre lighting; seating; window treatments; legal architectural and consulting services related to all above items. The recipient of TDC capital project funding shall designate a project managerarchitect, engineer or general contractor is involved in the project. If the projects no bd County or City personnel, the project manager shall be the Engineer, Building Official or Construction Manager of that local government. 3. AMOUNT OF AGREEMENT AND PAYMENT. The County shall provide an amount not to exceed $191,845 in reimbursement for materials and services used to acquire, improve, rehabilitate, repair and renovate the property. The Board of County Commissioners and the Tourist Development Council assume no liability to fund this agreement for an amount in excess of this award. Monroe County's performance and obligation to pay under this agreement is contingent upon an annual appropriation by the BOCC. Key West Film Society FY 2003 Capital Project Resources a). Payment for expenditures permissible by law and County policies shall be made through reimbursement to Contractor upon presentation of invoices, canceled checks and other documentation necessary to support a claim for reimbursement. Included in said documentation shall be proof that the Contractor has received and applied to the property matching funds equivalent to or greater than the amount invoiced to the County. Submission of invoices must be certified through a statement signed by an officer of the organization and notarized, declaring that representations in the invoice are true and factual. b) Application of matching funds requires actual payment of the matching funds, or, in the alternative, a commitment of said funds and that the portion of the project for which the matching funds are to be used has been sufficiently completed to require payment of said matching funds. Mere obligation through execution of a contract or approval of a budget item to be paid from matching funds will not suffice. c) Documentation shall be submitted to the TDC Administrative Office to show the receipt and application of in -kind donations of goods, , professional services, and materials. Said documentation should include invoices, bills of lading, etc., and be verified as received and applied to the project through a notarized statement of the project architect, engineer, general contractor or project manager. The receipt and application to the project of volunteer labor are to be documented and verified by notarized signature of the project architect, engineer, general contractor or project manager, and said documentation submitted to the TDC Administrative Office. All submissions should have a proposed schedule of values for phases and indicate the percentage of completion of the overall project as of the submission. This document should be signed by the project architect, engineer, general contractor or project manager. 4. REPORTS. The Contractor shall provide financial reports in summary of activity on forms provided or approved by the TDC, and quarterly narrative reports of activity under the approved work plan. The Contractor shall keep such records as are necessary to document the performance of the agreement and expenses as incurred, and give access to these records at the request of the TDC, the County, the State of Florida or authorized agents and representatives of said government bodies. It is the responsibility of the Contractor to maintain appropriate records to insure a proper accounting of all funds and expenditures. The Contractor understands that it shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General for the State of Florida, the Clerk of Court for Monroe County, the Board of County Commissioners for Monroe County, or their agents and representatives. In the event of an audit exception, the current fiscal year grant award or subsequent grant awards will be offset by the amount of the audit exception. In the event the grant is not renewed or supplemented in future years, the Contractor will be billed by the County for the amount of the audit exception and shall promptly repay any audit exception. 5. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the terms of this agreement shall be only amended in writing and approved by the Board of County Commissioners for Monroe County. 6. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the Contractor is an independent contractor and not an employee of the Board of County Commissioners of Monroe County. No statement contained in this agreement shall be construed as to find the Contractor or any of its employees, contractors, servants or agents to the employees of the Board of County Commissioners of Monroe County, and they shall be entitled to none of the rights, privileges or benefits of employees of Monroe County. Key West Film Society FY 2003 Capital Project Resources PA 7. COMPLIANCE WITH LAW. In carrying out its obligations under this agreement, the Contractor shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provisions of this agreement, including those now in effect and hereafter adopted. Any violation of said statutes, ordinances, rules or regulations shall constitute a material breach of this agreement and shall entitle the County to terminate this agreement immediately upon delivery of written notice of termination to the Contractor. 8. RESTRICTIONS ON AGREEMENTS ENTERED PURSUANT TO THIS AGREEMENT. The Contractor shall include in all agreements funded under this agreement the following terms: a) Anti -discrimination. Contractor agrees that they will not discriminate against any employees or applicants for employment or against persons for any other benefit or service under this agreement because of their race, color, religion, sex, national origin, or physical or mental handicap where the handicap does not affect the ability of an individual to perform in a position of employment, and to abide by all federal and state laws regarding non-discrimination. b) Anti -kickback. Contractor warrants that no person has been employed or retained to solicit or secure this agreement upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, and that no employee or officer of the Contractor has any interest, financially or otherwise, in Contractor. For breach or violation of this warranty, the Contractor shall have the right to annul this agreement without liability or, in its discretion, to deduct from the agreement price or consideration, the full amount of such commission, percentage, brokerage or contingent fee. Contractor acknowledges that it is aware that funding for this agreement is available at least in part through the County and that violation of this paragraph may result in the County withdrawing funding for the Project. c) Hold harmless/indemnification. Contractor acknowledges that this agreement is funded at least in part by the County and agrees to indemnify and hold harmless the County and any of its officers and employees from and against any and all claims, liabilities, litigation, causes of action, damages, costs, expenses (including but not limited to fees and expenses arising from any factual investigation, discovery or preparation for litigation), and the payment of any and all of the foregoing or any demands, settlements or judgments (collectively claims) arising directly or indirectly from any negligence or criminal conduct on the part of Contractor in the performance of the terms of this agreement. The Contractor shall immediately give notice to the County of any suit, claim or action made against the Contractor that is related to the activity under this agreement, and will cooperate with the County in the investigation arising as a result of any suit, action or claim related this agreement. d) Insurance. Contractor agrees that it maintains in force at its own expense a liability insurance policy which will insure and indemnify the Contractor and the County from any suits, claims or actions brought by any person or persons and from all costs and expenses of litigation brought against the Contractor for such injuries to persons or damage to property occurring during the agreement or thereafter that results from performance by Contractor of the obligations set forth in this agreement. At all times during the term of this agreement and for one year after acceptance of the project, Contractor shall maintain on file with the County a certificate of the insurance of the carriers showing that the aforesaid insurance policy is in effect. The following coverage's shall be provided: 1. Workers Compensation insurance as required by Florida Statutes. 2. Employer's Liability insurance with minimum limits of (aggregate): $500,000 bodily injury by accident, $500,000 bodily injury by disease aggregate, $500,000 bodily injury by disease per person. 3. Commercial General Liability Insurance with minimum limits of $500,000 per occurrence for bodily injury, personal injury and property damage. Key West Film Society FY 2003 Capital Project Resources 3 4. Comprehensive Auto Liability Insurance with minimum limits of $300,000 combined single limit per occurrence. The Contractor, the County and the TDC shall be named as additional insured, exempt workers compensation. The policies shall provide no less than 30 days notice of cancellation, non -renewal or reduction of coverage. At all times during the term of this agreement and for one year after acceptance of the project, Contractor shall maintain on file with the County a certificate of insurance showing that the aforesaid insurance coverage's are in effect. e) Licensing and Permits. Contractor warrants that it shall have, prior to commencement of work under this agreement and at all times during said work, all required licenses and permits whether federal, state, County or City. 9. HOLD HARMLESS/INDEMNIFICATION. The Contractor hereby agrees to indemnify and hold harmless the BOCC/TDC and any of its officers and employees from and against any and all claims, liabilities, litigation, causes of action, damages, costs, expenses (including but not limited to fees and expenses arising from any factual investigation, discovery or preparation for litigation), and the payment of any and all of the foregoing or any demands, settlements or judgments arising directly or indirectly under this agreement. The Contractor shall immediately give notice to the County of any suit, claim or action made against the County that is related to the activity under this agreement, and will cooperate with the County in the investigation arising as a result of any suit, action or claim related to this agreement. 10. ANTI -DISCRIMINATION. The Contractor agrees that they will not discriminate against any of their employees or applicants for employment or against persons for any benefit or service because of their race, color, religion, sex, national origin, or physical or mental handicap where the handicap does not affect the ability of an individual to perform in a position of employment, and to abide by all federal and state laws regarding non-discrimination. 11. ANTI -KICKBACK. The Contractor warrants that no person has been employed or retained to solicit or secure this agreement upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, and that no employee or officer of the County or TDC has any interest, financially or otherwise, in the said funded project, except for membership. For breach or violation of this warranty, the County shall have the right to annulgeneral this agreement without liability or, in its discretion, to deduct from the agreement price or consideration, the full amount of such commission, percentage, brokerage or contingent fee. 12. TERMINATION. This agreement shall terminate on March 15, 0 thereto shall occur whenever funds cannot be obtained or cannot be continued at a level sufficiient to allow for the continuation of this agreement pursuant to the terms herein. In the event that funds cannot be continued at a level sufficient to allow the continuation of this agreement pursuant to the terms specified herein, this agreement may then be terminated immediately by written notice of termination delivered in person or by mail to Contractor. The County may terminate this agreement without cause upon giving written notice of termination to provider. The County shall not be obligated to pay for any services or goods provided by Contractor after Contractor has received written notice of termination. 13. TERMINATION FOR BREACH. The County may immediately terminate this agreement for any breach of the terms contained herein. Such termination shall take place immediately upon receipt of written notice of said termination. Any waiver of any breach of covenants herein Key West Film Society FY 2003 Capital Project Resources 4 coritained to be kept and performed by Contractor shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the County from declaring a forfeiture for any succeeding breach either of the same conditions or of any other conditions. Failure to provide County with certification of use of matching funds or matching in -kind services at or above the rate of request for reimbursement or payment by is a breach of agreement, for which the County may terminate this agreement upon giving written notification of termination. 14. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the Contractor and the County. 15. CONSENT TO JURISDICTION. This agreement, its performance, and all disputes arising hereunder, shall be governed by the laws of the State of Florida, and both parties agree that the proper venue for any actions shall be in Monroe County. 16. ETHICS CLAUSE: Contractor warrants that he has not employed, retained or otherwise had act on his behalf any former County officer or employee in violation of Section 2 or Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of the provision the County may, at its discretion terminate this agreement without liability and may also, at its discretion, deduct from the agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former or present County officer or employee. 17. PUBLIC ENTITY CRIME STATEMENT: A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on an agreement to provide any goods or services to a public entity, may not submit a bid on a agreement with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a Contractor, supplier, sub -contractor, or consultant under a agreement with an y public entity, ad may not transact business with any public entity in excess of the threshold amount provided nn Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 18. AUTHORITY: Contractor warrants that it is authorized by law to engage in the performance of the activities encompassed by the Each signatories for the Contractor below certifies and warrants cthat the Cont at hereinbctor's name of this agreement is the full name as designated in its corporate charter (if a corporation); they are empowered to act and contract for the Contractor, and this agreement has been approved by the Board of Directors of Contractor or other appropriate authority. 19. LICENSING AND PERMITS: Contractor warrants that it shall have, prior to commencement of work under this agreement and at all times during said work, all required licenses and permits whether federal, state, County or City. 20. INSURANCE: Contractor agrees that it maintains in force at its own expense a liability insurance policy which will insure and indemnify the Contractor and the County from any suits, claims or actions brought by any person or persons and from all costs and expenses of litigation brought against the Contractor for such injuries to persons or damage to property occurring during the agreement or thereafter that results from performance by Contractor of the obligations set Key West Film Society FY 2003 Capital Project Resources M forth in this agreement. At all times during the term of this agreement and for one year after acceptance of the project, Contractor shall maintain on file with the County a certificate of the insurance of the carriers showing that the aforesaid insurance policy is in effect. The following coverage's shall be provided: 1. Workers Compensation insurance as required by Florida Statutes. 2. Employer's Liability insurance with minimum limits of a re ate injury by accident, $500,000 bodily injury by disease a (gg g ) nury b00 bodily aggregate, per person. , $500,000 bodily injury by disease 3. Commercial General Liability Insurance with minimum limits of $500,000 per occurrence for bodily injury, personal injury and property damage. 4. Comprehensive Auto Liability Insurance with minimum limits of $300,000 combined single limit per occurrence. The Contractor, the County and the TDC shall be named as additional insured, except workers compensation. The policies shall provide no less than 30 days notice of cancellation, non -renewal or reduction of coverage. At all times during the term of this agreement and for one year after acceptance of the project, Contractor shall maintain on file with the County a certificate of insurance showing that the aforesaid insurance coverage's are in effect. 21. NOTICE. Any written notice to be given to either party under this agreement or related hereto shall be addressed and delivered as follows: For Key West Film Society, Inc.: George Cooper C/O Key West Film Society Box 1283, Key West, FL 33041 For County: Lynda Stuart Monroe County Tourist Development Council 1201 White Street, Suite 102 Key West, FL 33040 and Suzanne Hutton, Asst. County Attorney P.O. Box 1026 Key West, FL 33041-1026 IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed the day and year first above written. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK (SEAL) ATTEST: Deputy Clerk Secretary Key West Film Society FY 2003 Capital Project Resources BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By: � �6 u. Mayor/Chairman Key West Film ociety, Inc. By: esident 'APNO Y AS TO_FO. ,` 4 Feb 05 03 08:00a Wa9ne Robertson 305.292.4364 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, aived or modified on the following contract. w I� C ,.0 w6 S z F ((_ PN S nC C E T tr I -VC- Contractor: '1) C Contract for: Address of Contractor: 1� (,Ues� Fc. 33o�u 3os- 2Ct-4- ON 1-,.k o Phone: Scope of Work: "o Up';- c 4- E Q j A Tr ✓t Reason for Waiver: p.I Policies Waiver <Nv R K e its Cc)hl Sri Yt D will apply to: ►'` Q LO `r0n S' 1, i A� {'lL 17LI Au T6 C,(Pr�lL_l"f Y Signature of Contractor: Approve Not Approved _ Risk Management Date Q 3 County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date, Administration Instruction .102 #d7093 Feb 05 03 08:00a Wayne Robertson 305.292.4364 p.2 There are no employees. A volunteer board operates in an advisory capacity only. All work on the project will be completed by contractors hired by us. We recognize that insurance will be required for all Contractors and Sub- contractors.We accept responsibilityorensuring cont all tract. contractors meet all of the insurance requirementsspecified C-08D CERTIFICATE OF LIABILITY INSURANCE OPID DATE(MM/DDIYY) YW-23 02/14/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Key West Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 5487 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33045-5487 Phone: 305-294-1096 Fax: 305-294-8016 INSURERS AFFORDING COVERAGE INSURED INSURER A: Century Surety INSURER B: Key West Film Society INSURERC: PO BOX 1283 INSURERD: Key West FL 33041 INSURER E: rnVFPAnFS 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. INS TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY E DATE (MCY /D EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑X OCCUR CCP233312 03/19/02 03/19/03 EACH OCCURRENCE $ 1000000 FIRE DAMAGE (Anyonefire) _$._ 50000 MED EXP (Any one person) $ excluded PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ Included AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY HANY AUTO A P B, I9K6�6NEMENT AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ DATE WAIVER EACH OCCURRENCE $ AGGREGATE $ /A $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TATU TORSY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS certificate holder is additional insured L:tK I II-IL:A It MULUtK Y I ADDITIONAL INSURED; INSURER LETTER: 1_,AN1,CLLH I IUIV MONROEC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Board of County Commissioners NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL for Monroe County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO Box 2666 Key West FL 33045 RE ^^ ENTATIVES. f t Insurance, Inc. A(t()Rn 9A_R 17/Q71 ©ACORD CORPORATION 1988 AC-ORD. CERTIFICATE OF LIABILITY INSURANCE OPID DATE(MMIDDIYY) YW-23 02/14/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Key West Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Bo5487 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. x Key West FL 33045-5487 Phone:305-294-1096 Fax:305-294-8016 INSURED Key West Film Society PO Box 1283 Key West FL 33041 COVERAGES INSURERS AFFORDING COVERAGE INSURER A: Century Sure INSURER B: INSURER C: INSURER D: INSURER E: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY POLICY EXPIRATION DATE MM/DD/YY) LIMITS A GENERAL LIABILITY I X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑X OCCUR CCP233312 - — 03/19/02 03/19/03 EACH OCCURRENCE $ 1000000 FIRE DAMAGE (Any one fire) $ 50000 MED EXP (Any one person) $ excluded PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ Included AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY JOTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS certificate holder is additional insured L;LK I It-JUA I t HULUtK Y ADDITIONAL INSURED; INSURER LETTER: I.AIVI+t LLA I IkJN TOURIST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County Tourist NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Developoment Council IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1201 White Street Key West FL 33040 REPRESENTATIVES^ t I'nsurance . Ific . ArOP11 95_C 17/Q71 ©ACORD CORPORATION 1988 Feb 05 03 08:00a lda~ne Robertson 305.292....36... p. 1 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in tbe County's Schedule of Insurance Requirements. be waived or modified on the following contract. Phone: ke'\' The &>\t" \~ 305"" - 20\ 4 - 5'"<6 S"\ \A..lt: ~ '\ F I (.. t"\ SoC,.(e T'r'. ~Vc. ~~\.c.\t~ +- ~~TjI\-f\ CRAPr Contractor: Contract for: Address of Contractor: \1.~ 5 UJe S-"T Fl- -:s 5 o'f <..) (J' ~ 'tCl - '). 'l. \ 0 Scope of Work: ~ufi)....e ~ CG;)\.JIP T l4 E A Tt" (~ Reason for Waiver: ~ c.- -t\c..... c~ r c.\Ao. '\ ""eo. f\"'. Signature of Contractor: VJe) ~ ~ € \\5 eo,",,' e fJ J'r:: Tl o/..J eV\.tLO""reC\.S' hlA ~ILIIl.t /l- ~y--- ) , Au T0 L\A-f:>, L\'T Y Policies Waiver will apply to: Date Not Approved Risk Management County Administrator appeal: Approved: Not A-pproved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Admlnistnstlon )nstJuction #-(709.3 102 Feb 05 03 08:008 laIa~ne Robertson 305.292.4364 p.2 There are no employees. A volunteer board operates in an advisory capacity only. All work on the project will be completed by contractors hired by us. We recognize that insurance will be required for all Contractors and Sub- contractors.We accept responsibility for ensuring that all contractors meet all of the insurance requirements specified in the contract. ACORI). CERTIFICATE OF LIABILITY INSURANC~~~~~ ..~ DATE (MM/DDIYY) 02/14/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Key West Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 5487 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Key West FL 33045-5487 INSURERS AFFORDING COVERAGE Phone: 305-294-1096 Fax:305-294-8016 I INSURED INSURER A Century Surety i INSURER B Key West Film Society i INSURER c: PO Box 1283 INSURER 0 Key West FL 33041 1 INSURER E: 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 IrT~' TYPE OF INSURANCE POLICY NUMBER LIMITS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..l.Q...... DAYS WRITTEN NOTICE TO THE CERTIFICATE 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 COVERAGES A GENERAL LIABILITY X (COMMERCIAL GENERAL LIABILITY ~ CLAIMS MADE I X OCCUR Ii I 03/19/02 i 03/19/03 CCP233312 i GEN'L AGGREGATE LIMIT APPLIES PER i I ,.., PRO- . POLICY JECT I LOC AUTOMOBILE LIABILITY I ANY AUTO I ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO I CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS certificate holder is additional insured CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER: CANCELLATION MONROEC Board of County Commissioners for Monroe County PO Box 2666 Key West FL 33045 ACORD 25-S (7/97) EACH OCCURRENCE ' $ 1000000 I FIRE DAMAGE (Anyone fire) I $ 50000 MED EXP (Anyone person) I $~xcl uded - 1 PERSONAL & ADV INJURY $ 1000000 I GENERAL AGGREGATE $ 2000000 . PRODUCTS - COMP/OP AGG i $ I ncl uded I I COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) 1$ , BODILY INJURY (Per accident) i $ I 1 , I PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT I $ I OTHER THAN ! AUTO ONLY EA ACC $ AGG $ EACH OCCURRENCE AGGREGATE i$ i $ I i $ @ACORD CORPORATION 1988 ACORDN CERTIFICATE OF LIABILITY INSURANC~~~~~ ~ DATE (MM/DDlYYl 02/14/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Key West Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 5487 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33045-5487 INSURERS AFFORDING COVERAGE Phone: 305-294-1096 Fax:305-294-8016 I INSURED I INSURER A Century Surety INSURER B ------- Key West Film Society INSURER C --- ._---~-----~,._~---_..- PO Box 1283 INSURER D Key West FL 33041 ------ . INSURER E: TOURI ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 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 I~T~ TYPE OF INSURANCE POLICY NUMBER I GENERAL LIABILITY EACH OCCURRENCE A CCP233312 03/19/02 03/19/03 I FIRE DAMAGE (Anyone fire) , MED EXP (Anyone person) \- PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG I I COMBINED SINGLE LIMIT i (Ea accident) BODILY INJURY (Per person) BODILY INJURY I (Per accident) I r PROPERTY DAMAGE I (Per accident) AUTO ONLY - EA ACCIDENT $ i GARAGE LIABILITY I ANY AUTO I- OTHER THAN AUTO ONLY: i EACH OCCURRENCE I__EXCESS L1ABILlTY_ OCCUR CLAIMS MADE AGGREGATE ~ I I I DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS i " E.L EACH ACCIDENT E,L DISEASE - EA EMPLOYEE $ EL DISEASE - POLICY LIMIT $ \ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS certificate holder is additional insured CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER: CANCELLATION Monroe County Tourist Developoment Council 1201 White Street Key West FL 33040 LIMITS $ 1000000 $ 50000 I $ excluded $ 1000000 i $ 2000000 $ Included 1, $ 1$ : $ $ EA ACC $ AGG! $ $ $ 1$ i$ $ ACORD 25-S (7/97) @ACORD CORPORATION 1988