10/14/1994 DV091715
Jaann!, 'I.. liolbagt
BRANCH OFFICE
3117 OVERSEAS HIGH'NAY
MARATHON, FLORIDA. 33050
TEL. (305) 289-6027
CLERK OF TI.IE CIRCUIT COURT
MONROE COUNTY
500 \VHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANT A TION KEY, FLORIDA 33070
TEL. (305) 852-7145
MEMORANDUM
TO: Peter Horton, Director
Division of Community Services
Ruth Ann Jantzen, Deputy Clerk ff~).
FROM:
DATE:
January 6, 1995
------------------------------------------------------------------------------------------------------------------------
On {ktober ~O. 1994, the Board of County Commissioners granted approval and
authorized execution of the following documents:
Contract Agreement between Monroe County and Arnold's Towing for the
emergency removal of Derelict Vessel DV091626, located in Stock Island, in the amount
of $1,260.00.
Contract Agreement between Monroe County and Arnold's Towing for the
emergency removal of Derelict Vessel DV09171S, located in Boca Chica Bay, in the
amount of ~~1 ,512.00.
Renewal Agreement between Monroe County and Frigola, DeVane, Wright and
Dorl, P.A.,for a period of six months.
On November 23, 1994, the Board of County Commissioners granted approval
and authorized execution of the following documents:
Contract Agreement between Monroe County and Frank Keev8n & Son, Inc., for
the emergency removal of DV091420, DV091422, DV091423, DV091425 and DV091661.
located in Boca Chica Bay, in the amount of $6,960.00.
Contract Agreement between Monroe County and Arnold's Towing for the
emergency removal or Derelict Vessel DV091779, in the amount of $1,680.00.
CONTRACT AGREEMENT
AGREEMENT, MADE THIS JO~,--
day of c.rJ-~/\. 1994, by
and betwE~en,
Arnold's Towing
("Contractor"), and
the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, of
the Count:y of Monroe , State of Flor ida ("Board").
The contractor and the Board, for the consideration named
agree as follows:
-7 -11
1. The contractor shall furnish all the mater~ls) an~ ,
_'~~' f"'Tl
perform all the work as required by the specificatioIi~'for~he ~
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for which a derelict vessel ~port
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emergenc~{ removal of DV091715
is attached as exhibit A.
c-.:J
.....
..........~
,....J
2 .
The work to be performed under this contract shal~
,- _-:1
commence immediately from the date the Liaison provides the
Notice tC) Proceed and shall be completed by November 30, 1994.
3. If the Notice to Proceed has not been given on or before
the 21st :Oay of October, 1994 then this agreement shall be null and
void.
4. The work to be performed under the contract is
contingent upon approval of appropriate grant monies from the
State Department of Environmental Protection, Boating Improvement
Fund. If this grant is denied, this Agreement shall be null
and void. The contractor understands the rules of the Department
of Enviro,nrnental Protection and shall comply wi th said rules,
along with the rules and procedures instituted by the Board to
ensure an orderly progress to the project. Both the intent and
the letter of the specifications are understood by the
contractor.
5. The Board shall pay the Contractor the total sum of
$1,512.00 for the emergency removal and legal disposal of
DV091712 Payment for the work shall be upon completion by the
contractor and acceptance by the Board, subject to the terms and
conditions of the Specifications (attached as Exhibit B) and this
contract.
6. The attached Derelict Vessel Report and Specifications
together with this Agreement, form the the contract. They are
fully a part of this contract as if repeated herein verbatim.
7. The contractor shall indemnify the Board from and
against any and all claims, demands, actions, proceedings,
damages, liabilities, costs and expenses, including attorney
fees, arising out of, connected with, or resulting from the
Agreement.
8. The contractor acknowledges his/her intention to comply
with the need to coordinate all work with the appropriate
environmental agencies, the Florida Marine Patrol, and the County.
9. The contractor agrees to supply the County with a set of
photographs of the vessel in all phases of the removal and
disposal process. The contractor will be responsible for the
camera, film, and development costs.
10. The contractor understands and agrees that the receipt
of the Notice to Proceed from the County does not relieve his
responsibility to obtain any appropriate permits. The contractor
must inform the appropriate permitting authorities prior to
initiation of work.
11. The parties agree that timely performance of this
agreement is essential due to possible damage to the natural
resources, hazard to navigation, or threat to humah health
and welfare. Therefore, the parties agree that the
contractor shall be liable to the Board for $100 per day of
liquidatE~d damages for each day after November 30, 1994 that any
of the cc)ntractor' s obligations under this agreement remain
unperfornled. The parties agree that such amount is by the way of
compensat:ory damages and does not constitute a penalty.
12. Due to the use of heavy equipment and, at times,
dangerous. work environment, the 'contractor understands and
agrees to maintain an alcohol and drug free work environment.
13. The contractor -will provide General Liability
insurance~ the amount of $300,000, Workers Compensations the
amount of $500,000, Federal Jones Act (46 U.S.C.A. subsection
688) with limits not less than those specified for Employer's
liabilitj~, Vehicle Insurance in the amount of $100,000,
Watercra1:t Liability on the amount of $300,000, and Pollution
insurancE~ in the amount of $500,000.
14. The Board may terminate this agreement with or without
cause at anytime upon giving the contractor a minimum of'ten
days in ~lriting. The contractor, upon receipt of the notice,
shall llmlediately cease work. The Board shall pay the
contractc)r the percentage of the contract sum which is
proportional to the amount of work performed by the contractor in
a mannersatisfactory to the Board up to the date the contractor
received the Notice to Proceed.
IN vvITNESS WHEREOF the parties hereto have executed this
Agreement to day and year first written above.
BYt~~~ a/ (LA/
Owner
Title
Arnold's Towi~
Firm
(Seal)
Attest:
"..
.~;~
Witness
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BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
BY: #. ~~
Mayor'(Ch~irfftan ~rc' e/~
(Seal) AttestDAJ(HY L.lCOLHAG-E. CWtr
~~'P~~~5.h{). JJ~C
Clerk ' ,
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OFFEN'SE INCIDEN1. REPORT NARRATIVE CONTINUA liON
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HULL MA'r~.~IAL: WOOD~ ..~/.~~. f.1~rr~~.~...?~.~.~~...........
MOTOR ATTACHED Yes
NAME
ON VESSEL" ,^,Oc:fOe.~
, ,
; OTHER IDENTIFIERS
~_..hh..vESSEL OWNER: hh~UR.e: L\ 0 ..ABR..E Lt. h hhhhhhhDCJB:hh.'.Z.!?.3/<DO...............h........
.................... ..\.~.\.4. .t?\.NE'. . ...ST~.E ~.T...... ~ . Ke:y. .\NEST..'"\....F L......3 30.4.0.. .. ......... ............ ....................................................
3. EXACT LOCATION: , '
.. ....... .......... .................. .......................................... ..00..... .~. E..6. T.. ... E~.5 T... .o.~.. .....B oY..o .s..... ..~^^ PGt: Q.O.W.N.O...................... ...........
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4. CONDITION: WRECKED ____;JUNKED~iDISMANTLED ____;ABANDONED ~
w . . .. . . .. .. .. .. ... .. . .. .. .. . . . .. . . . . . . .. . .. , .. . . . . .. . .. .. . . . .. .. .. . .. .. . . . . .. .. . .. .. . . . . .. . .. .. . . . . . . . . . . . . . . . . . . .. . .. . . . .. . . .. .. . . .. . . . . . . .. .. . . .. . .. . .. . .. .. . . . .. .. . . .. .. . .. . .. .. . . .. . .. . . . . .. . .. . .. .. ... . .. . .. .. . . . ..... .. .. .. .. . ... ... ...... . .. .. .. ........... .. .. ......... .. ..... . .........
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SUBMERG~ED &::L% CAPSIZED_;LISrrING~iIN
"3
FT. OF WATER
.......,.............. ..4." ~4""""""'."" ...~...,.. ......4... ...... ..... .......... ................... ....... .......................4........................................ ............
AFLOAT
OR ON SIIORE,
TOUCHING MEAN HIGH WATER LINE
............... .......4.... ..... .....4.4........... ....4. ...... ......... ....... ....... ........ ......4..............."....... "4....... .......... ... ..... ... .".'''' "......... ... .....4.. ....... .... ..........4.... ..... ............................................................ ..............
6. PROPERTY OWNER: STATE OF FLORIDA
YES~ NO
,........................ 4. ~.. . ."..... . . ",. ..... .."..". ........ .........".....".."..... . "....... .".... '.' . .. . . . . . . . . "... ... . ............."... ..... ..........................."..............................................."....... ~..................................... ..................................................
OR
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9. NAVIGATION THREATENED?
YES ~ NO
.................................................."....... ...... ........ ...................... ............ .... .... . . ..... ........................... ...............................".... .................................. .... -0........................................................ ...............4..... ......
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10. ENVIRO!lMENT END~GERED? YES ~ NO_
.. ....................... ..................... ...... ...._............ ....... ....... ...... .... ........... ........ .......... ._.. ............. ............ .......... ... .............. .P'O:'T~~~6..l-....aL\..-....S.e.'.l-'--....................................
................. ............. ................ .... ............ .... ..' ...... ..... ....... ........ ..... ....................... ...... .......................... ..... .... ...... .....-........................... ".... .... ......... .......................................................................................
11. TOWED WITHOUT REPAIR?
YES
NO ~ UNKNOWN
............... ~.."...".""" 4.......................' ...................".............. '.. ........................................... ....... . ... ..... . .............. ... . ..... .. ........ ........ ................................... ...................................................................... ... ................. ........................... .......
12. RECOMM]~NDED DISPOSITION: LANDFILL ~;ARTIFICIAL REEF___iOTHER ____
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DERELICT VESSEL REMOVAL CONTRACT SPECIFICATIONS
FOR MONROE COUNTY, FLORIDA
1. INTENT: It is intended that these specifications shall
cover all aspects of the work explicit provisions. The
purpose of this section is to provide specific coverage for
conditions applicable to this contract, where such coverage
is not provided for in other portions of the contract
documents.
2. BID FORMAT: THE BID MUST BE SUBMITTED ON THE BID
RESPONSE FORM ENCLOSED IN THIS PACKAGE. A dollar amount
per foot must be submitted for the removal of all derelict
vessels on the primary list for which a Florida Marine
Patrol Derelict Vessel Report is provided. Any
deviation from this format will result in an unaccepted
bid. A contract will not be granted on the basis of
combined, related, linked, or discounted bids. Not
applicable due to emergency contract for removal of one
vessel for less than $25,000.
3. PLANS: There are no plans for this project, but
coples' of the Florida Marine Patrol Derelict Vessel
Report with location Sketches have been bound into
theste documents for the Contractor's use. The Specifications
inclllde section on instructions to bidders, both
general and specific, and a copy of each Derelict
Vessel Report from the Florida Marine Patrol. Only
those derelict vessels for which a report is included
and listed on the Bid Response Form are to be bid
upon and subsequently removed.
The (:ounty reserves the right to remove any or all vessels
from this contract at any time prior to actual removal from
the water and disposition by the Contractor.
The (~ounty has a limi ted amount of money to effect the
rerno'val of these abandoned vessels. We have established
priorities based on public safety, navigation and traffic
haza:rd, and environmental considerations. If bids exceed the
County's resources for removal based on these
considerations, we shall limit vessel removal based on the
these considerations and cost effectiveness.
4. VESSJEL IDENTIFICATION AND LOCATION: Each of the vessels
have been given a derelict vessel identification number,
which is shown with the location in the Florida Marine
Patrol Derelict Vessel Report, included herewith.
Each bidder is responsible for his own identification of
each derelict vessel as to location, description and
condition. If a Derelict Vessel cannot be (1) located, (2)
removed, (3) verified and (4) disposed of, as specified in
these procedures, then no payment will be made forthcoming
to the Contractor for that vessel. Those four conditions
must be met on each derelict vessel along with compliance
with all laws and permits for payment to be made.
It is understood that the Contractor has, by personal
examination and inquiry, if necessary, satisfied himself as
to the local conditions of each derelict vessel and as to
the meaning, requirements and reservations of the
specifications; for after contract letting, no deviation
will be allowed. In case errors are discovered, they are
to be reported by the Contractor to the County. The
County assumes no responsibility should there be any
discrepancies in what is stated in these documents and what
the bidder evaluates.
A contractor should take special care to remove only those
derelict vessel's on his contract and for which he possessed
a Florida Marine Patrol Derelict Vessel Report. Other
derelict vessel's in the area but not under contract, cannot
be molested.
It may be possible to replace a derelict vessel of like
kind, for the same or less money, when mutual agreement can
be r,eached by the Florida Department of Environmental
Protlection, Monroe County Administrator of the Derelict
Vess1el Program, and the Contractor. This will be applicable
when a contracted derelict vessel can not be located. No
derelict vessel may be replaced and removed without the
tri party consent noted in thisparagraph. A contractor
may suggest a possible replacement vessel but he may not
remo've it wi thout the appropriate consent above.
5. SCOP:E OF WORK: The Contractor shall be responsible for
providing all permits, supervision, labor, equipment, tools,
fees and taxes required to complete this project to the
satisfaction of the County.
The Contractor's procedure and methods of removal may be of
his own selection provided they secure results which satisfy
the requirements of the Specifications and any necessary
envi:ronmental permits.
Any vessel which is removed and disposed of shall be
removed from its present site in such a manner as to do
the least possible damage to the natural environment
surrc)unding the vessel. All debris from the vessel shall be
removed and the site left in a reasonably clean condition.
No oil or fuel shall be permitted to be dumped or spilled
into or unto the water or land. All pollutants shall be
rerno',ed from the derelict vessel prior to removal from the
wa te]::- .
DV Specs--Page 2
The Contractor shall be responsible for making any and all
arrangements for access to the vessel to be removed. If
private property has to be traversed, then written
permission of the owner is necessary. In removing a derelict
vessel that may lie on or near grass or sponge flats extreme
caution must be used to do the least possible damage.
Prior to delivery of derelict vessels to the disposal site,
the Contractor must remove all oil, gas and metal (including
engines). He must dispose of them in any legal manner. Pure
used oil will be taken by Monroe County for disposal.
Mix,ture of oil, gas, seawater or any combination of the
three must be transported from the County by an approved
hazardous waste handler. The names of those firms will be
supplied by the Monroe County Environmental Management
Department. Metal becomes the property of the Contractor.
In those cases where a derelict vessel number can not be
foun,d, i.e. derelict vessel is underwater, the contractor
shall provide marine transportation to the site for the
County representative to verify the vessel and location
using the original Derelict Vessel Report from the Florida
Mari,ne Patrol.
6 . MATE~RIALS AND WORKMANSHIP: The Contractor shall provide
the :necessary materials and equipment to safely complete
the job. The Contractor agrees that all work shall be
perf()rmed by competent employees who are experienced and
qualified to do the work specified, and that all work will
be p1erformed in accordance wi th the best commercial
prac"tices. A list of equipment to be used and a
description of the removal and transporting procedures to be
follc)wed must be provided to the County at the Prework
Conf~erence described below.
Precaution shall be exercised at all times for the
protection of persons and property. The safety provisions
of tJhe Occupational Safety and Health Act of 1970 (Public
Law 91-596) and other applicable laws, including building
and construction codes shall be observed. Machinery,
equi];Jment and other hazards shall be guarded in accordance
with safety provisions of the "Manual of Accident
Prev'=ntion in Construction", published by the
Asso<:iated General Contractors of America, to the extent
that such provisions are not in contradiction of applicable
law.
The Contractor shall store materials and shall maintain
partly or wholly finished work during the continuance of
the (~ontract and until the final acceptance. If any
materials or part of the work become lost, damaged, or
destroyed by any cause or means whatsoever, the Contractor
shall satisfactorily repair and replace or not receive
payment for the unaccomplished work. The Contractor shall
DV Specs--Page 3
maintain suitable and sufficient guards and barriers, and
at night, suitable and sufficient light or other
appropriate security or protection for the prevention of
accidents.
Use of explosives is discouraged in carrying out the
project. No blasting with explosives shall be done except
under prior approval by the County and as permitted by all
relevant government agencies such as the Department of
Natural Resources, Department of Environmental
Regulation, U.S.Army Corps of Engineers, u.s. Fish and
Wildlife Service and the u.s. Coast Guard. When the use of
explosives is approved the Contractor shall use the utmost
care so as not to endanger life or property and whenever
directed the number and sizes of the charges shall be
reduced. All explosives shall be marked clearly "DANGER
EXPL10SIVES", and shall be in the complete care of competent
watc'hrnen. The Contractor shall secure the proper competent
watc'hrnen. The Contractor shall assume all responsibility for
damages caused by explosives.
7 . ASSI'GNMENT OF CONTRACT AND SUBCONTRACTS: It is expressly
understood that the Contractor is in all respects an
inde:pendent Contractor for this work, not wi thstanding under
certain conditions he is bound to follow the directions of
the County, and is in no respect an agent, servant, or
employee of the County. Neither the Contract, nor any part
ther1eof, nor any monies due or to become due thereunder, may
be assigned by the Contractor without the prior written
approval of the County.
The Contractor is fully responsible to the County for the
acts and omissions of his subcontractors and of persons
either directly or indirectly employed by said
subcontractor, as he is for the acts and omissions of
pers()ns directly employed by him. Nothing contained in the
Cont~ract Documents shall create an contractual
relation between any subcontractor and the County.
All ;subcontractors shall abide by the terms,
conditions, and requirements of this Contract. It is
the responsibility of the Contractor to pay all debt
oblicJations incurred with subcontractors in an
expedient manner.
8. LEGAJ~ RESTRICTIONS, PERMITS AND TRAFFIC PROVISIONS: The
Cont:ractor shall comply with all applicable local, State and
Federal requirements pertaining to the terms of this
Contract. The Contractor will be responsible for obtaining,
at his own expense, any licenses or permits that may be
requ~Lred and should inquire about permi t requirements wi th
the a.ppropriate agencies. The Contractor shall comply wi th
all 1:he requirements of the Federal Pollution Control Act.
The Contractor shall conduct his operations so that he shall
DV Specs--Page 4
not close any thoroughfare nor interfere in any way with
traffic on highways, or on water, without the written
consent of the proper authorities. Work shall be done at
any time that shall not interrupt or disturb members of the
public.
Off-loading sites (water to land for transport to the
landfill or other disposal site by vehicle) must have
written approval of the land owner.
The Florida Marine Patrol should be contacted to
initiate eviction proceedings for contracted
derelict vessels which are inhabited at the time
of removal and when another vessel is too close to the
contracted derelict vessel to allow safe operations.
Direct confrontations with other boaters should be avoided
and the Florida Marine Patrol should be contacted
imme,diately if such confrontations may result from removal
of any contracted derelict vessels.
9. INSU:RANCE: The Contractor must obtain all insurance
required by the County and submit proof of same to the
county prior to acceptance of bid and contract approval by
Boar(! of County Conunissioners but no later than five
working days after notice of low bidder. All insurance
shall be maintained until work has been completed and
accepted by the County.
The Contractor shall furnish the following certificates of
insurance for review by the County's Risk Management
Di vi,sion:
Certificate(s) of Insurance which clearly indicates that he
has ()btained the insurance coverage required in paragraphs
a,b,c and d below.
The Contractor hereby certifies that no modification or
change in insurance shall be made without (3) days written
advance notice to Monroe County, c/o the director of the
Risk Management Division.
a. WQrk4=r is Compensation Insurance as in the amount of
S+-v\~ .lc: S"t-Z\_t-l.\-.-te' 5
b. Gene:ral Liability Insurance on a comprehensive basis, in an
amount not less than $300,00.00 per occurrence for Bodily
Inju:ry and Property Damage combined, to include contractual
liab~Lli ty.
c. Polll1tion Liabili ty Insurance in the Amount ofSZ>Ll i (;()()
,
d.
WateJC Craft Liability Insurance in the amount of
"~x)() ~ L;()() ·
r
e. Autornobile liability insurance covering all owned,
DV Specs--Page 5
non-owned and hired vehicles used in connection
with the work, in an amount not less than 1006 ODD per
occurrence for Bodily Injury and Property and amage
combined.
All insurance policies required above shall be issued by
companies authorized to do business and under the law of the
State if Florida.
10. COMMENCEMENT,DELAYS AND COMPLETION OF WORK: After
receiving Board of County Commission approval of the
Contract, and after reconciliation of any details or
conditions which may directly or indirectly interfere or
conflict with work of the Contract, the County will issue a
"Notice to Proceed with Contract work" officially
authorizing the Contractor to commence. The Contractor shall
commence work on said date.
If the Contractor should be delayed in the progress of the
work included in the Contract by unforeseeable causes beyond
his 'control, the time for the completion of the work. may be
exte:nded upon agreement of the County representa ti ve .
Requ'ests for extension of time must be submitted in writing
to the County representative. Extensions of time cannot
legally be approved unless the written request is submitted
in the time to permit it to be acted upon before the
Contractexpiration date. To allow sufficient time for the
adrni:nistrative procedures required to obtain action by the
Coun.ty Conunission, a request for time extension must be
received by the County representative at least sixty (60)
calendar days prior to the Contract expiration date.
Liqu.idated damages resulting from factors beyond the control
of the Contractor which occur too late to allow time for
actic:)n by the Board of County Commissioners approving a time
exte:nsion may be waived by the County Commission. Such
waivc~r shall be granted only when the County representative
determines that the delay is beyond the control of the
Contractor, and in this event the Contractor shall not be
charc;Jed wi th the liquidated damages or any excess cost when
the delay in the completion of the work is due:
a. To any duly issued order by the County or the State
Depa:rtrnent of Environmental Protection changing the
Contractor's approved work schedule;
b. To ul:1foreseeable cause beyond the control and without the
fault or negligence of the Contractor.
c. To allY delays of subcontractors or suppliers occasioned by
any of the causes specified in subparagraphs (a) and (b)
abovE~ .
Provided further that the Contractor shall within ten (10)
DV Specs--Page 6
from the beginning of such delay notify the County, in
writing, of the causes of the delay. The County
representative will ascertain the facts and the extent of
the delay and notify the Contractor within a reasonable
time of his decision in the matter.
If the Contractor fails to complete the work within the time
limit, and if the County should nevertheless permit the
Contractor to continue and complete the same without
official extension of time in writing, such permission
shall not modify nor waive any liability of the Contractor
for damages arising from non-completion of work within
the time limit, but such liabilities shall be subject to
continuation in full force against the contractor.
11. CHANGES AND INSPECTION: The vessels herein considered are
to be removed for the County by the Contractor in accordance
with the Specifications. The County may give instructions or
directions to supplement the Specifications. These shall be
binding upon the Contractor and upon all his subcontractors,
employees and agents of every kind.
All 'work and every process and operation shall be subject to
inspection at all times, and the County and their
representatives shall have free access to all aspects of
the work. The Contractor shall remove and make good, as may
be directed, without charge, any defective work. Oversight
or error of judgement of inspectors, or previous acceptance,
shall not relieve the Contractor from the obligation to make
good any defect whenever discovered.
The rights is reserved to change the Specifications
consistent with regard to the general intention of the
Contract for any part of the work or materials, either
befo:re or after work has begun. Notice of such changes shall
be given in writing to the Contractor; such changes are not
to bc~ grounds for any claim by the Contractor for damages,
nor for the forfeiture of the Contract. It is possible that
a De~relict Vessel could disappear between the time of
inspc~ction by the contractor and the actual effort to remove
it. ]~o payment will be forthcoming in the case.
Except when otherwise specified, the expense of all tests
requested by the County will be borne by the County.
12. AUDI~r RIGHTS: As a provision of the grant from the State
of Florida to the County, and if so requested by the State,
the successful bidder agrees to provide access to all
recoJrds and allow the audi t of any books, documents and
papers related to this project for a period of up to one
year and during and after termination of the contract.
13. CONT]~ACT AWARD: The County reserves the right to evaluate
the submitted bids to award a contract to the bidders
DV Specs--Page 7
submitting the lowest per foot bid for the derelict vessels
listed in the bid package as one project and for which a
Florida Marine Patrol Derelict Vessel Report is included.
One bid will be accepted and a contract issued for the total
removal of all listed derelict vessels as one project, up to
the limit of available funds.
The vessels are to be removed in the order listed and the
per foot bid estimates should reflect this removal order.
The actual number of vessels to be removed will depend on
the accepted per foot bid price and the available funds.
14. PREWORK CONFERENCE: A meeting will be necessary
involving a representative of the County, the Contractor and
other parties with direct involvement prior to the signing
of the contract. The time and place of this conference will
be set by the County representative. At this time the
Contractor shall provide the County with a schedule as to
the order in which he proposes to remove the vessels awarded
to him.
15 . CONT:RACT SECURITY: The Contractor agrees to execute and
deli'ver simultaneously with the executed contract, a
Contractor's Performance and Payment Bond. The contractor
is expected to act and deliver in good faith all work, at
the agreed price, in the allowed time. Failure to do so,
could jeopardize the contractor's reputation with the County
and potentially influence any future contracts with Monroe
Coun'ty.
16. EXEC'UTION OF CONTRACT DOCUMENTS: Due to the time frame
involved with this project, the Contractor upon notification
that he is to be awarded the contract documents for
exec"lItion, shall return said documents properly executed
alonl;J wi th any necessary bond and insurance wi thin TEN
WORKING DAYS. With the Contractor's cooperation, if this
period can be reduced, it will assist in acceleration the
execlltion of the contract documents.
The Contractor, by virtue of signing the Contract,
ackn()wledges that he and all his subcontractors have
satisfied themselves as to the nature and location of the
work, the general and local conditions, including, but not
restricted to, those bearing upon transportation, handling,
access to the pick-up and disposal sites; and the character
of e(~uiprnent and facilities needed to perform the work.
Faill1re on the part of the Contractor to completely or
properly evaluate any factors of his costs prior to bidding
shall not form a basis for additional compensation if he is
awar(ied the contract.
If f()r any reasons, not acceptable to the County, the
Contractor does not perform, the County shall have the
righi: to levy liquidated damages against the Contractor.
DV Specs--Page 8
Liqu.idated damages shall be assessed against the Contractor
for ,any bid item awarded to him which is not completed and
acce:pted by the County wi thin the number of calendar days
specified in the Contract. Liquidated damages are
accUJmulative.
17. NOTI'CE TO PROCEED: The Contractor shall conunence work
upon this project on the effective date of the Notice to
Proc1eed and perform in a continuous manner until
completion and acceptance by the County. For Contracts
wher,ein a specified nwnber of days for completion is stated
in t:he Contract, the effecti ve date of the "Notice to
proc.eed with Contract Work" will establish the "beginning
date" of the project.
18. TERMINATION OF CONTRACT: This Contract may be
terminated by the County, giving up to ten (10) days
written notice to the Contractor; said notice shall be
sufficient if delivered to the party personally or mailed
by certified mail to his mailing address as specified on
the accepted Bid.
19. FINAL CLEAN-UP: Upon completion of the work specified
herein and before acceptance and final payment shall be
made, the Contractor shall remove from the sites all
machinery, equipment, surplus and discarded materials and
temporary structures. All disposal of materials, rubbish
and debris shall be made at a legal disposal site.
20. DISPOSAL SITES AND FEES: Contractor is responsible for
disposal of all derelict vessels included in this contract
and must make arrangements for legal disposal. It is the
responsibility of the Contractor to pay all disposal fees
incurred, and such removal related costs should be
considered when bidding on this contract.
The contractor will deliver the derelict vessel to the
disposal site, where staff must be able to verify the
derelict by its Florida Marine Patrol derelict vessel number
or by some other means. It is the intent of this contract to
remove derelict vessels from their present sites a legal
present site a legal disposal site. Upon receipt of vessels
at the landfill. They must be disposed of immediately.
A legal disposal site is either the Long Key
Landfill-Monroe County, MM 68 1/2, Long Key, Florida 33001,
305-664-9315, other landfills in neighboring countries or
any other location for disposal as long as the FDNR
Disposi tion Certificati()n Form (attached) is fully
documented. If a signat'ilre cannot be obtained on Florida
Department of Natural R~~sources Disposition Certification,
the Contractor must con":act County Representative for
written approval and in,5tructions.
DV Specs--Page 9
21. PROOF OF PROPER DISPOSAL AND NOTIFICATION TO MARINE
PATROL: Contractor must submit prior to receiving any
payment: A receipt for each vessel including the date of
disposal, the Florida Marine Patrol Derelict Vessel Number,
disposal site location, and the telephone number, title and
signature of person at disposal site verifying delivery of
said derelict vessel. A County Disposition Affidavit is to
also required to be signed by the Contractor. If vessel is
not identifiable and/or if the derelict vessel number is not
visible. Recipient of debris should provide detailed receipt
showing type and description of debris received. if person
delivering vessel to disposal site is other than contractor
a written statement with a description of what type of
debris was transported, dates, times, name, address, and
phon.e number of si te.
In addition to the above information, Contractor must
submit three pictures of each vessel removed. The first
photograph must be of the vessel at the current location
prior to removal, the second photograph must be of the
vesslel after removal but in the same general area preferably
whil'2 in tow, and the third photograph must be of the vessel
at the disposal site with sufficient background to depict of
disposal (i.e., building or sign identifying disposal site).
The .jerelict vessel number, when present, must appear in all
phot()graphs.
The (:ontractor will be responsible for the camera, film,
and development costs. The photographs should be taken with
a Polaroid camera that provides instant photos since this
minilnizes loss of documentation due to camera malfunction or
loss overboard. This camera and film must be provided by the
Cont~ractor. The photos must be submitted on a vessel by
vessel basis according to removal schedule. Without photos
to dc:>cument the removal and disposal of the contracted
vess4=ls final payment can not be assured.
The (;ontractor must notify the Florida Marine Patrol and
the County Representative in writing as to the work schedule
of removal. This should be done after the prework
conference with the County representative. Notification is
to be made before doing any work on each vessel. This
muI t~iparty communication for each Derelict Vessel is a
requ~irement of the contract.
22. PAYMENT: All payments for the removal and disposal of
each vessel, shall be for the performance of the work as
stiplllated in these specifications and associated
contJractual documents. The unit rate of bid shall be totally
inclusive for all phases of the operation. Contractor may
requE~st four partial payments by submitting an invoice for
the number of vessels removed up to the date of the invoice,
providing the Contract agreement does not explicitly
prohibit partial payments. Photographs, disposal receipts,
DV Specs--Page 10
signed DNR Disposition Certification form, a County
Disp,osition Affidavit for the vessels for which payment is
bein,g requested.
The ,contractor understands and agrees that no payment will
be forthcoming for the removal and disposal of any derelict
vessel (1) not listed on this contract nor (2) for any
derelict vessel on this Contract for which a written
certification verifying the removal of the subject vessel
has :not been obtained from the Florida Marine Patrol and a
Representative of the disposal site at the time of delivery.
A Fl('jrida Marine Patrol officer must certify the complete
remo'val of each derelict vessel from its location and any
equi:pment that may have been used to remove the vessel. No
paym1ent will be made without the Florida Marine Patrol
veri:fication.
In addition, property, public or private, if damaged during
the work or removed for the convenience of the work, shall
be replaced at the expense of the Contractor in a manner
acce:ptable to the County and the OWner, prior to the final
paym1ent for contracted work.
23. PUBLIC ENTITY CRIMES: Upon entering into the contract, the
Cont:ractor agrees to sign and endorse the Public Enti ty
Crimes form (attached).
24. NON-(~OLLISION AFFIDAVIT: Upon entering into the contract,
the Contractor agrees to sign and endorse the Non-Collusion
Affidavit form (attached).
25. ETHICS CLAUSE: Upon entering into the contract, the
ContI"'actor agrees to sign and endorse the Ethics Clause form
(atta.ched) .
26. DRUG FREE WORK PLACE FORM: Upon entering the contract, the
Contractor agrees to sign and endorse the Drug Free Work
Place form (attached).
27. DERE:LICT VESSELS AT ISSUE: The derelict vessels listed on
the Derelict Vessel Bid Response Form shall be removed and
disposed of by the Contractor in accordance with the
provisions of these Specifications.
H:\A\BIF\-DV\DV-1993\SPECS.NEW
DV Specs--Page 11
SWORN ST ^ TEl\1EN'r PURSUAN'r l~O SECTION 287.133(3)(a),
FLORlDA~'rATUTE~--l ON PUBLIC ENTITY CRIMES
TIllS FORM ~vlUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AlTTHORIZED TO ADMINISTER OATHS.
1. This sworn statement is submitted to.4.-o~?t:?[ ~>) ~/Y
I
___.___,; " _ [prh~.~,!)oIIme of the public entity]
/ 5> .~ ,174 X C/ /1 /'~-r::, /c/
(print individual's name and title]
//7~,/C7 /c/ ,5. '-7~ . .,..-'/"
[print name of entity submitting sworn statement]
by
for
whose business address is /~
/::;- 3- /0, :::s /5 c,;// 4 ;/.r~.
-~ 7{ ~~ /
-----L.~ ~}/ t~;;.s:-/ /~-
/
. . . ,~
~ / .,-.,/}}" -r-c~, /,_~-/
~--~ / ~) r 4 ,_-;...~-=~q:"y c::
'.33dm
and (if applicable) its Federal Employer Identification Number (FEIN) is ~cZ2 Cf t; -<t12
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
sta tem len t:
.)
2. I undelistand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes. means a
violation of any state or federal law by a person with respect to and directly related to the transaction of business
with alllY public entity or with an agency or political subdivision of any other state or orthe United States, including,
but not limited to, any bid or contract for goods cr services to be provided to any public entity or an agency or
politic=lI subdivision ~f any other state or of the United States and involving antitrust, fraud,.theft, bribery,
collusion, racketeerint, conspiracy, or material misrepresentation.
3. I understand that"convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a
finding: of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or
state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result
of a ju."y verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.
4. I undel"stand that an "affiliate" as defined in Paragraph 287.133(I)(a), Florida Statutes, means:
1. A plredecessor or successor of a person convicted of a public entity crime; or
2. An 4~ntity under the control of any natural person who is active in the management ~f the entity and who has
been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership
by one person of shares constituting a controlling interest in another person, or pooling of equipment or income
among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that
one person controls another person. A person who knowingly enters into a joint venture with a person who has
been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.
s. I understand that a "person" as defined in Paragraph 287.133(l)(e), Florida Statutes, means any natural person
or entity organized under the laws of any state or of tlie United States with the legal power to enter into a bindin~
contra<:t and which bids or applies to hid on contracts for the provision of goods or services let by a public entity,
or which otherwise transacts or applies.o transact business with a puhlic entity. The term "person" includes those
officers:, directors, executives, parfners, shareholders, employees, members, and agents who are active in
mana~t~ment of an entity.
6. Based em infor-mation and helief, the statl'n1l'nt which I hal'e mar-ked helow is tr-IIe in r-e1ation to the entity
suhmiHin~ this sworn statement. (Indicate ,,'hich statement applies.)
~ Neither the entity suhmiUing this sworn statement, nor any of its o.fficers, directors, executives, partners,
~-holders, employees, members, or agents who are active in the management of the entity, nor any affiliate of
the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989.
- ll1e entity submitting this sworn statement, nor any of its officers, directors, exectutives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor an affiliatE: of
the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989.
- "'he entity suhmitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of
the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there
has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative
Hearin1~s and the Final Order entered by the llearing Officer determined that it was not in the public interest to
place the entity submitting this sworn statement on the convicted vendor list. (attach a copy of the final order)
I UNDER~T ANI) THA TTIIE SUBMISSION OF THIS FORM TOTHE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENl'IFIED 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 REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES
FOR CA TEGOllY TWO OF ANY CIIANGE IN THE INFORMATION CONTAINED IN THIS FORM.
l~W:~
[signature]
Sworn to and subscribed before me this x: ~ of
Personally known
~
<;;:'~;.r7k/l'7 bE .-~ ,19 9~
/;?2:'-~. :~~C::--
Notary Public - State of /'/,-~,
.. .' flofory'IIMit, Stoff! of FToriltf --"
My Commission explrcIIJ Con,mi<liQR h",i, (1 ':1 .
~ d d 2.~~~~L' .J, '4oJ 199,)
,e: ~ ,T-?,;". /--?: e~74~'c;
(Printed typed or stamped \
commissioned name of notary public)
OR Produced id4entification
(Type of identifi4~ation)
Form PUR 7068 (Rev. 06/1 1/92)
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHI CS CLAUSE / __________.
~'7j>l'C/{f,5. /c:t//..-y-9 warrants that he/it has not employed,
~ //
retained or otherwise had act on his/its behalf any former County officer
or employee in violation of Section 2 of 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 this provision the County may, in
its discretion, terminate this contract without liability and may also,
in its discretion, ~educt from the contract or purchase price, or
otherwise recover, the full amount of any fee, commission, percentage,
gift, or consideration paid to t~~~~ ~q~r employee.
Date: (s~~;;? 9Y
STATE O]~
F~:;?7 / C~
~/?:fCJ~
COUNTY ()F
Subscribed and swo~n to~g(or affirmed) before
me on Y - Ar-Y _/ (date) by
'- ~~- / L ;r LJ;P../: /
~//~//I'?/~C/ I"ya/')'u/c:-"' (name of affiant).
~e/She is personally known to me or has produced
-~
as identification.
(type of identification)
-- flOf~ .ftu6fTt, ~hff, 0' nor'. -
My Commlsswli fxpirc. March 24 19"" fI'
Sol'\ded Th ru T ro F " I;)
Y am - Insurance Inc.
~,. '~7:' ~
.,.... i._.. /7._._._......~.....
c.~ ~ ----. .
//~jZ;'A~<" '" ,/ ~/"....~"'
NOTARY PUBLIC
L~/t:7?<~ /~~ ~()
MCP>>4 R18V. 2/92
NON-~ION AFFIDAVIT
I , --.7.j; -<: ~An; 47y~/f//
/,,;7
,~/)'/?1 ('1&"
,
, of the city-
of
ac~cording to law on my oa th, and
under penc:ll ty of per jury, dEJ_pose and say tha t;
/. ~ -
1) I am - ?j'/Y'{;/c/'?--r'c-;t<-7//f,/C:;- , the bidder
making the Proposal for the project de ribed as follows:
2) the prices in this bid have been arrived at independently
without collusion, consultation, communication or agreement for the
purpose of restricting competition, as to any matter relating to such
prices with any other bidder or with any competitor;
3) unless otherwise required by law, the prices which have been
quoted in this biq have not been knowingly disclosed by the bidder
and will not knowingly be disclosed by the bidder prior to bid
opening, directly or indirectly, to any other bidder or to any
competi tOl:-; and
4) no attempt has been made or will be made by the bidder to
induce any other person, partnership or corporation to submit, or not
to submit" a bid for the purpose of restricting competition;
5) the statements contained in this affidavit are true and
correct, clnd made with full knowledge that Monroe County relies upon
the truth of the statements contained in this affidavit in awarding
contra~ts for said project.
STATE OF
'-/ /
r/ t} 7-;;'/ C'~.&j,
./ _"1./,.~;;7 ..' _'_'~
/' /.;//c~,r /~J&
(/~~ U/, ~~
(Signature of Bidder
?'7.~2-.. 2~'f/' 9
/1... t l
DATE
COUNTY OF
__~~~SON~LY _~PP~~e BEF~/'ME, the undersigned authori ty ,
/'/.. /]/-J/1c/ /971.,y;;/( who, after first being swotn by me,
(name of i.ndi vidual signing)
affixed hi.~ner signature in the space
V' C
,J day of 7
prOVide.d..y.ove on this
~.
, 19 .
~fg:;7~~-..'
NOTARY PUBLIC
My commis~;ion expires:
-- Wofery PlIbrie, Sfqfe of Floricfu --
at, CommissFJt1 E}:phaJ fI1~r,h 241 199 ~
u Ionded Thru Troy fain. lnsuronce (oe"
I)RUG- FREE WORKPLACE FORM
The tlndersigned velldor ill acC()rdallCe wi tll Florida Stattlte
287.087 hereby certifies that:
dftr:/~~,~~~~?; /
1. Ptlblisl1 a statemellt ,loti fying elnployees tIlat tIle \lnlawftl1
mantlfacttlre, distrib\ltion, dlsperlsing, possessiol), or llse of a
controlledl substance is prollibi ted in tIle workplace and
specifyin~r the actiollS that will be talten against employees for
violatiollE~ of stich prohibition.
2. Infc)rm employees abO\lt tIle dangers of drllg abllse il1 the
workplace, tIle btlSil1ess's policy of malntaining a drtlg-free
workpl ace, any ava i 1 ab le d rtlg COllnse 1 i 11g, rel1abi 1 i ta ti on, and
employee assi stance programs I and the pena 1 ties that may be .
imposed tlI>on employees for drttg abtlSe violations.
3. GiVE~ eacll employee ellgaged ill providil1g tIle commodities or
contracttlCll services that are tlllder bid a copy of tile statement
specified in subsection (1).
4. In the statemellt specified ill stlbsectioIl (1), notify the
employees tllat, as a condi tiol1 of working on tlle commodi ties or
contractual services that are tInder bid, the employee will abide
by the terms of the statement and will notify the employer of
any COl1viction of, or plea of gtlilty or 11010 contendere to, any
violation of Chapter 893 (Florida statutes) or of any controlled
8tlbstance 1 aw of the Uni ted sta tes or allY s ta te, for a vi 0 1 a ti on
occllring in the workplace 1"10 later t.11Clll five (5) days after such
convictio~n .
5 . I mpose a sanction on, or reqll ire tIle sa ti s factory
part! C i pa ti on in a dr\lg ab\lSe a ssi statlCe or rellabi 1 i ta tion
program if stlC}l is available ill the employee's commllllity, or any
employee who is so convicted.
6. Malte a good faitll effort to COlltitllle to maiIltain a
drug-free workplace tllrO\lgll irnplementatioll of tllis section.
As the persoll atltllorized to aigll tIle statelnetlt, I certify tllat
this firm cOlnplie's ftllly witl\ tlle above reqlliremellts.
, 'l-~~7._-
Date
MCP#5 REV'. 6/91
I .' .~', '. ", ;. '.i 'V. ~,.~. . :'.i!-'.~AA.r;/&" ~!)'~' L" I,
~~fl>l..t>'1' ~..~ firl;".~::.i~~--::~.:;..:"~.,,.} tit - .,:,.t'..l(!"I\'.VJI .~;4~. '/~r 4(.J'~ t.' "$~-B~'~~~". tf c .r... ','
· .." '. ~(?'~"'.' ", .' ..." ~ d
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I .' . . · J . 'It . OJ I . "' .". .,..,.' JI. <Ii'f. . ~ u" u' ill: .. .It..Jio ""...:.4>.... ... ...... -..,' I" 'o.U.i'. . . ... '.. '.o
: 1'( lIY':;Y NUMAER POLICY PERIOD ~ .,
( l' ;~ 12:01 AM SIO TIME AT nH: AUUHlSS
(7002CA33224-01 4-30-94 TO 4-30-95 ,OF. THl: INSUREU ASSlbNEO Ul:KEHI.
_h, ~1l~li\~~-;wK>;~~~!\/ (.~l':;;~ ..' .. '.. ,:r..<.;>. :-' ;.oJ.\"':~':~:'~~:;'~~!..~; "': v ~ r~;:;;) ..
l~ AGENT NO: 17002
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ARNOLD'S TOWING SERVICE
ARNOLD'S AUTO & MARINE REPAIR, INC. NAME KBK INSURANCE GROUP, INC 0
5540 3RD AVE. AND 990 N. CORPORATE DR. STE. 2
KEY WEST, FL 33040 ADDRESS HARAHAN, LA 70123
T ...'" ~~~";;"i'~'W~~D ' ,~; . .' ;. ...... .: .' ~ ',. ..... .';
t , ' ;; 1rl !ff~ iJDjjn\.~\~ :.il;.o, :'~;-~~~,,~,!:~\~ ,_,-':: -,-'~3E<'~_":~.::.~~; ... '., ~~~)~; ~:.L..__'..t ., MUtti.'fttltli~tk
CUMMON POLICY UEClARATIONS
BUSINESS DESCRIPTIUN
TOWING
~~~-._~~--------..-.~
Ir~ RETURN fOR THE PAYMf.NT OF THE PREMIUM, AND SUBJECT
POLICY. WE AGREE klTH YUU TO PROVIDE THE INSURANCt:
HU S POLICY CONSl STS OF THE FOLLOWING COVERAGE P
FOR ,",IUCU A PREMIUM IS INDICA fEO. THI . 'UUM
BE SUBJi:CT TO AOJUSTMt.:Nl. ,~.
CUMMERCIAL
CUMHERCl^L
ClJHHERCIAL
CUMMERCIAl
COMMERCIAL
----
4-____
------
PRtMIUH SHOWN
TUTAL
INCEPTION. $________
$ ----lj..!.ll.L___
FUKMS
'l>~.1'
.qfj,.."'...... . ------------------------
C OV [RAG E PAR T S : ---~Ii.It~!!.4.qI]Q_______________
(SHUW NUt-1Bl:RS)
-----
----------------
...... ---..- ~ .- ~.....-..
---
-------------
c aUNT ER S I Gr~t 0___________ 8 Y _____________________________
(OATE) (AU1HORIlEO RLPRE:SE:N~JIVt)
~ --
f!'j JfT c-#e, 0/--)' ~.n 90 - ~ '" y"?-;zs s' A d /;//7/,.y.--/, cJ / / 0 ~-0 h'~
..:z::: ~s (J nA.....-Y'......C
--K'LG..2.::1.~j____________________________________________________
. ~Mh~O~gY~l~
' 1" . .:, .?, ~ j .:;~~ ,1i;:~f.l ' ; " ~~J~!f}tt'~.~~fi!:IfJ\~~~.T~l ..It:l;''''.;.' ,',r I~,ftf~ 'I~:, .rll'"P"'.l"".''I '117~7 6"-
,,' ,. 'NA-1000 fRf)V:'1 ~.~, " '~'~vt"~.fJfw.~... '\.T,t:~. . 'C :t 't . .
""",LUULL ut l.,uvt.t<t.u AUTOS YOU OWN
,,<lLCA33224-01 EXTENSION OF DECLARATIONS
.JLHEDULf OF COVERED AUTOS YOU OWN (Cont'd)t
.- -- -,- -DESCRIPTION _---==-=-- PURCHASEO------_u "
- - t-- rea;, Model, Trade Name; Body type N Actual
"'~~~ j ~~ Z ~HE~~~l~u~~r(i1V~~;'~itification Number ~IN) Original Cost ew Cosl &
, Jll_ J 2136cH~VROLET 11158558
,. JlJ_ -_122.L FORD #.A15353
~ 04 1987 INTERNATIONAL 11465120
I :N=~ --I 979 LANDOLL TRAILER 1I07~298
I Jl2.-_ 1-1994 INTERNATIONAL 11551465
! ,~. 1966 GMC IIDL023L
t;f--
i~
~
, .
fIr----. - ----. _
; I
. '-----.. .- ------
COYERACES-PREMIUMS. LIMITS AIID DEDUCTlllES (Absence of a deductible or limit entry in any column below means that the limit or deductible entry In the correspondinl
ITEM TWO column ap'p~s instead)
PERSOHAlINJURY PROTECTION AUTO. MED. PAY. lINDER=~g~fORISrs COMPREHENSIVE ~. ~SE:S
l.imit limit limit
(I" Pre. (In Pre- (In
Thou. mium Thou- mium Thou.
unds) sands) s.nds)
r
- --.--
r-_. _._. "__. _.
-.-.--p----
,.' COYtred Radius of Business us~
, Alto OP"f a f ion : : ,~:(~
: ~ (tn "'il~S' C _ commerci.,
01 50 C
02 50 S
03 50 C
, 04- --50-- C
05--50 -- C
, 06 50 C
j 07-- ----50 -- C
i r----
, r--- .... __ ____
f r--- _._ __ _ __ _"
f
,.
..; r--- -._____ _
)
r------ _____ __ _ ._. _ .
r---- -"'_
r------- _ _.__ _ ... .
LlABIUTY
e.,. Limit
. "". Un
.... Thou Premium
... sands'
01 1348
02 999
03 1348
04 2213
i05 149
06 1348
07 1348
.'
- r-----.-,
-- '-.-- ------..------ --------
------
39.000
--- ~DOO
38 000
20.000
.20 000
45.000
NEW.fN) TERRITORY: Town & State Where the Covered
USED {UJ _ _ Auto will be principally garaged
N KEY JYF:~T AFT (017 )
N" "
N" "
..N" "
_N" "
N" "
"
"
CLASSIFICATION Except for Towing all phy$ical damage loss is payabl~ 10 you andlhe loss
Sile GVW, GCW Primary Rating Secondary
or V~h;cle Ale F tetor Rating Code payee named befow as interest may appear at the time of the loss
Seatin, Capacity Group li.b. Phy. D.m.re Factor
14,500 6 I .35 .95 ~3499
6 l.OO 1.00 014.9 9
14..t500 6 .35 .95 ~3499
26..1000 6 ~ .10 1.25 36499
6 .15 .65 513499
18,500 1 · .35 ..95 ~34.99
14.1500 l.35 . ,. . ~3499
COLLISION
TOWING & LABOR
Pre-
mium
limit ·
minus
deductible
shown
below
Premium
limit
per Dis.
ablement Premium
Pre.
mium
limite
Premium
17 17 170 .101
17 17 48 R5
17 17 2_21 _1 q .1)
17 17 119 21.1
17 _62 111
17 ". 17 422 .75J
17 17
-
Tolal Premium --S753t-XXX- 119 XXX
xxxx.x
102 XXX I1t42
XXXX 1864 XXX
.Umit st.ttd in ITEM TWO.
lIem Sevpn in r> ~ r,e Covel age for m - Non De aler s' and Trailers De alers' Supplement ary Schedule
Item Ten in Garap. Coverag~ rOlm -Auto Dealers' Supplementary Schedule. .
, 19 J ([ d J J n 7) l!Ill/ntH, rQIJj"~ I. );!!'f'I' ,~
~:
COMMERCIAL INLAND MARINE COVERAGE PART
MOTOR TRUCK CARGO DECLARA TrONS
\
i
.
r
Policy No. 17002CAJJ224-01
Effective Date. 4- 30-94
12:01 A.M., Standard Time
DESCRIPTION
A. Covered Cargo consists of:
(XJ VEHICLES AND/OR CARGO WHilE 1) BEING ATTENDED "ON HOOK"; 2) "UNDER TOW"; 3) "BEING TRANSPORTED."
o OTHER
(Describe Cargo)
LIMITS OF INSURANCE
1. Each vehicle that is covered must be described below or on a schedule that is a part of this policy. A limit of Insurance
must be shown for each vehicle. This is the most that we will pay for a loss to cargo carried in or on the vehicle.
2. Description. of V,ehicle:
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Trade Name
01
02
03
04
05
06
07
Year Built
Type of Body
Factory or Motor Number
Limit or Insurance
$ 50,000
$ NO COVERAGE
$--50.000__
$ t}O.OOO
$ NO rOVFR !GE
$ c;O,OOO
$ 1)0 ,000
$
$
$
3. For two or more described vehicles Involved in a single "loss", the most we will pay for this "loss" is: $ J 00 .OOQ
....
It-.
DEDUCTIBLE
The deductible amount of $ 1 , 000 will apply to each loss after all other adjustments have been made.
RA TE AND PREMIUM
Rate S VARIOUS
FORMS AND ENDORSEMENTS (other than applicable Forms and Endorsements shown elsewhere In the polley)
Forms and Endorsements applying to this Coverage Form and made part of this policy at time of issue:
Premium for this Coverage Form $ 1,000
NAS.MTC -DEe (06/93)
THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POliCY PERIOD
"'nclusion of date optional.
CA 591
(6-92)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
~,~.
f~
CA 25 14 06 92
BROADENED COVERAGE-GARAGES
This endorsement modifies insurance provided under the following:
GARAGE COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Endorsement effective Policy No.
at 12:01 A.M. standard time
Named Insured Countersigned by
SCHEDULE
(Authorized Representative)
Personal Injury and Advertising Injury limit of Insurance $500~1100_____
The FIRE LEGAL LIABILITY COVERAGE Limit of Insurance is $50,000 for anyone fire unless another limit is shown below:
Fire legal liability limit of Insurance $ .--___n___n~.
The premium for this endorsement is $--___19.1___
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as ap-
plicable to this endorsement.) .r
SECTION I-PERSONAL INJURY AND ADVERTISING IN-
JURY liABILITY COVERAGE
A. COVERAGE
We will pay all sums the "insured" legally must pay as
damages because of:
a. "Personal injury" caused by an offense committed:
(1) In the conduct of your business; ,fnd
(2) I n the Coverage Territory during the Policy
Period.
b. ':t\dvertising injury" caused by an offense com-
mitted:
(1) I n the course of advertising your goods, prod-
ucts or -services; and
(2) In the Coverage Territory during the Policy
Period.
We have the right and duty to d~fend any "suit" asking
for these damages. However, we have no duty to de-
fend "suits" for "personal injury" or "advertising injury"
not covered by this Coverage Form. We may investigate
and settle any claim or "suit" as we consider appropri-
ate. Our duty to defend or settle ends when the Per-
sonallnjury and Advertising Injury Limit of Insurance
has been exhausted by payment of judgments 'or set-
tlements.
1. WHO IS A,N INSURED
The follOWing are uinsureds":
..",,,,,,,.-'''''''' (-11.":'",
OAUTHE NTICn
'~{t "....:r'~;.!';:.(A'()tJ
a. You and your spouse.
b. Your partners and their spouses, if you are a
partnership. None of your partners or their
spouses is an "insured" for "personal injury"
or "advertising injury" resulting from the con-
duct of any other partnership.
c. Your employees, executive officers, directors
and stockholders but only white acting within
the scope of their duties.
2. COVERAGE EXTENSIONS
Supplementary Payments. In rlddition to the Per-
sona Injury and Advertising Injury Limit of Insur-
ance" we will pay for the "insured":
a. All expenses we incur.
b. The cost of bonds to release attachments in
any "suit" we defend, but only for bond
amounts within the Personal Injury and Ad-
vertising Injury Limit of Insurance.
c. All reasonable expenses incurred by the "in-
sured" at our request, including actual loss of
earnings up to $100 a day because of time off
from work.
d. All costs taxed against the "insured" in any
"suit" we defend.
e. All interest on the full amount of any judgment
that accrues after entry of the judgment in any
Copyright, Insurance Services Office, Inc., 1991
1
L..LECTlr~G NOT TO PURCHASE CERTAIN VALUABLE COVERAGE WHICH PROTECTS
,~,~D YOUR FAMILY OR YOU ARE PURCHASING UNINSURED MOTORIST LIMITS LESS THAN
ftJUR BODflY INJURY LIABILITY LIMITS WHEN YOU SIGN THIS FORM. PLEASE READ
CAREFUllY.
Uninsured Motorist coverage provides for payment of certain benefits for damages caused by owners or operators of unin-
sured motor vehicles because of bodiry injury or death resulting therefrom. Such benefits may include payments for cer-
tain medical expenses, lost wages, and pain and suffering, subject to limitations and conditions contained in the policy.
For the purpose of this coverage, an uninsured motor vehicle may include a motor vehicle as to which the bodily injury
limits are less than youlr damages.
Florida law requires that automobile liability policies include Uninsured Motorist coverage at limits equal to the Bodily
Injury Liability limits in your policy unless you select a lower limit offered by the company, or reject Uninsured Motorist entirely.
Please indicate whether you desire to entirely reject Uninsured Motorist coverage, or, whether you desire this coverage
at limits lower than the Bodily Injury Liability limits of your policy:
o a. I hereby reject Uninsured Motorist coverage.
'KI b. I hereby select the following Uninsured Motorist limits which are lower than my Bodily Injury Liability limits:
$ 3O,fXX:) each person (enter limit if applicable);
$ ?J). c:x::t:) each accident.
o c. I hereby select Uninsured Motorist limits equal to my Bodily Injury Liability limits. (If you select this option dis-
regard the bold face statement above.)
ELECTION OF NON-STACKED COVERAGE
(Do not complete if you have rejected Uninsured Motorist)
You have the option to purchase, at a reduced rate, non-stacked (limited) type of Uninsured Motorists coverage. Under
this form if injury occurs in a vehicle owned or leased by you or any family member who resides with you, this policy
will apply only to the extent of coverage (if any) which applies to that vehicle in this policy. If an injury occurs while occupy-
ing someone else's vehicle, or you are struck as a pedestrian, you are entitled to select the highest limits of uninsured
motorist coverage available on anyone vehicle for which you are a named insured, insured family member, or insured
resident of the named insured's household. This policy will not apply if you select the coverage available under any other
policy issued to you or the policy of any other family member who resides with you.
If you do not elect to purchase the non-stacked form, your policy limit(s) for each motor vehicle are added together (stacked)
for all covered injuries. Thus, your policy limits would automatically change during the policy term if you increase or decrease
the number of autos covered under the policy.
~ I hereby elect the non-stacked form of Uninsured Motorist coverage.
I understand and agree that selection of any of the above options applies to my liability insurance policy and future renew-
als or replacements of such policy which are issued at the same Bodily Injury Liability limits. If I decide to select another
option at some future tinle, r must let the Company or my agent know in writing.
SigneQ~~ u/ {/~
(Named Insured)
Signed: kj~ ~Jl~
i (Named Insured)
Date:
~d.{ ;+r;
/79y
ALB859c (En 1087) UNlrORM PRINTING & SUPPLY. INC
Hcsolu1 ion If] 91-1991
April 1. 2. I f)<)'
I ~1 Prillt ing
I\lONROE COUNTY, FLORII)A
Request For Waiver
of
Insurance Requirenlcnts
It is requested Lllallhe insurance requircJllcl11S, as specificd in fhc Coullly.s Schedule of Insurance
Rcquircnlcnls, be \vaivcd or IIlOdificd 011 lhe rollo,.,..ing contract. .
Con lrac (0 r:
Arnold's TawiD~
Conlracl for:
Rmprgency ReDlo.yal of DV091715.
Address of Contraclor:
5540 3T~ Avp ~~ork Island
Key We9~, Fl 33040
Phone:
(30-;) 'Q6-Q182,
Scope of 'Work:
RmPTePnry R~moval of DV091715
Reason for Waiver:
Pleage v~ivp W~~PTrT~f~ insurance~ked up with lines
and pulled out by truck), pollution insurance (FMP-had fuel
ext:rac'ted prior to r~mov~ 1 )~-B.I1d_~e.sAct cover~.__
Signature of Conlraclor:
(~U/~
Approved ''JZ
Nol Approved
[' :...- / . :}:"') L'L,..k}/-
,,: ,.",. ~,
I -~J--l' ,~-l '/ <-(
Count)' Achninislralor appeal:
Risk Marulgclllcnt
Dale
ApI}rov~d:
Nol Approved: _______
Date:
Board of C~ouJlly COlllluissioncrs appeal:
Approved:
Nol Approved:
Meeting Dale:
Adrninistrative Instruction
W A'VER
114709. ,
5