10/14/1994 DV091626
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 THI S ) 0 -1-J-
day of cOct~tu2j 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 Florida ("Board").
The contractor and the Board, for the consideration named
agree as follows:
1. The contractor shall furnish all the materials and
perform all the work as required by the Specifications for the
emergenc~{ removal of DV091626 for which a derelict vessel report
is attached as exhibit A.
-,.,
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2. The work to be performed under this contra~~_~hall
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commence immediately from the date the Liaison provid~s th~
. - I
-- 0\
Notice to Proceed and shall be completed by NO"llember jJ)~ 1994.-0
~ f"":
3. If the Notice to Proceed has not been giveQ~~on or before
w
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the 21st Day of October, 1994 then this agreement shall be null and
void.
4. The work to be performed under the contract is
contingen.t 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 riull
and void. The contractor understands the rules of the Department
of Environmental Protection and shall comply with 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
$ 1,260.00 for the emergency removal and legal disposal of
DV091626 Payment for the work shall be upon comp~etion by the
contractor and acceptance by the Board, subject to the terms and
conditions of the Specifications (attached as Exhibit B) and this
contractu
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 Clny and all claims, demands, actions, proceedings,
damages, liabilities, costs and expenses, including attorney
fees, ari.sing 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
agreemen1: is essential due to possible damage to the natural
resources, hazard to navigation, or threat to human 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 contractor's obligations under this agreement remain
unperfor~~ed. The parties agree that such amount is by the way of
compensa1:ory damages and does not constitute a penalty.
12. Due to the use of heavy equipment and, at times,
dangerou~; work environment, the contractor understands and
agrees te) 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
liabilit)r, Vehicle Insurance in the amount of $100,000,
Watercraj: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 ~Iriting. The contractor, upon receipt of the notice,
shall ilMlediately cease work. The Board shall pay the
contractc)r the percentage of the contract sum which is
proportic)nal 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.
BY:~ fY ct-P
Owner
Title
Arnold's Towin~
Firm
(Seal)
Attest:
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Wi tness '
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
BY: ~. ~a.)
Mayor/rh~irmaR frc) T€/,,-Y\.
( Seal) AtteR~ L. KotHAGE, CJezt
~!97~)
Clerk
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OFFENSE IN'CIDENT REPORT NARRATIVE CONTINUA liON
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VESSEL ()WNER:
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4. CONDITION: WRECKED ~iJUNKED~;DISMANTLED ____iABANDONED ~~
w . . . .. . .. .. . .. . .. . . . . . .. . .. .. . .. . .. .. .. .. ... .. . ... .. . .. ... .. . .. .., .. . .. .. .. .. ... . . .. .. .. .. . . .. .. .. . . . . . . .. .. . . .. . . . .. . . . .. ... . . . .. . .. .. . .. . . .. .. . .. .. . .. .. . . .. . . . . .. . .. . .. . . . .. . .. . .. .. . . . . .. .. . . .. . . . .. . .. . . . . .. . . . . . . .. . . .. .. .. .. . . .. ... . . ... .... .. ...... ..... . ... .. '" . .. .... ...... .... .. ....
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SUBMERGED ~% CAPSIZED___iLISTING~;IN
(0
FT. OF WATER
AFLOAT \-40
OR ON SHORE,
TOUCHING MEAN HIGII WATER LINE
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....................... ............................... ......................... ............... -.............. ........... ..... .................. '~'t 'e'{~';:""'" .,0...... "60'L~"""""'"'''''' ....................... ..............
6. PROPERTY OWNER: STATE OF FLORIDA
YES
NO .~
OR
............. ..................... .s. t.-) .w.~~~. .... ^-^.AV2.....' N A....................................... .................................................................
9. NAVIGATION THREATENED?
YES ~ NO
10. ENVIRONMENT END~GERED? YES ~ NO
11. TOWED WITHOUT RE~AIR?
YES
NO v-- UNKNOWN
12. RECOMMENDED DISPOSITION: LANDFILL ~;ARTIFICIAL REEF___;OTHER ____
Number Arrestod
DATE 7 8 <1d-
DATE
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Supplement 0
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. ,. ... . .. .. . . .. .. ... .. .. .. .. .. .. .. .... ... .. ... ~ .. .... .. .. .. .. .. .. .. .. .. " . . .. .. .. .. .. .. .. .... .... .. .. .. .. .... . .. . .... .. .... ....... ... ... ...... .... .. ~ .... ..,. ... .. .... . .... .... .... ... .. .. .. . .. ... .. . , ... .. .. .. .. .. .... . .. .... .. . .. . .. ...... -................-......................"......................................, fIo .. .. .. .. .. .. .. . .... . .. .. .. .. .... .. .... ". ~ .. ... . .... .. .... .. .... . .. .. .. .... .. . _. .. .... .... ... .... "" .... .... ........ ... .. .. ... ...... ~.. .. .... ... .. .. .. ....... .. .. .. .
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S-L.f~
OSTS Number
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DNR 2()...()4.6A FMP (8181;l
P~._Of_
TOTAL P.02
(y.. h, bi+ B
DERELICT VESSEL REMOVAL CONTRACT SPECIFICATIONS
FOR MONROE COUNTY, FLORIDA
1. INT1~NT: 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
dOCllInen ts .
2 · BID FORMAT: THE BID MUST BE SUBMITTED ON THE BID
RESl?ONSE 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
com1)ined~ related, linked, or discounted bids. Not
applicable due to emergency contract for removal of one
vessel for less than $25,000.
3 . PLM'rS: There are no plans for this proj ect, but
copi.es of the Florida Marine Patrol Derelict Vessel
Repc)rt with location Sketches have been bound into
these documents for the Contractor's use. The Specifications
include section on instructions to bidders, both
gene~ral and specific, and a copy of each Derelict
Vess:el 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
uponl and subsequently removed.
The County reserves the right to remove any or all vessels
frorrl this contract at any time prior to actual removal from
the water and disposition by the Contractor.
The County has a limited amount of money to effect the
remo,val of these abandoned vessels. We have established
prio,ri ties based on public safety, navigation and traffic
hazard, and environmental considerations. If bids exceed the
Coun.ty' s resources for removal based on these
considerations, we shall limit vessel removal based on the
these considerations and cost effectiveness.
4. VESSEL 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
mus1: be met on each derelict vessel along wi th compliance
wi tll all laws and permi ts for payment to be made.
It is understood that the Contractor has, by personal
ex~~ination 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 l)e reported by the Contractor to the County. The
Courlty 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 Illolested.
It ItLay 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
Prot.ection, Monroe County Administrator of the Derelict
Vessel Program, and the Contractor. This will be applicable
when a contracted derelict vessel can not be located. No
dere:lict 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
remo1ve it without the appropriate consent above.
5. SCOPE 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
environmental permits.
Any vessel which is removed and disposed of shall be
rerno'ved from its present site in such a manner as to do
the least possible damage to the natural environment
surrtDunding the vessel. All debris from the vessel shall be
remo.ved 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
remo~ved from the derelict vessel prior to removal from the
wa te:r .
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
cau.tion 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.
Mix1:ure of oil, gas, seawater or any combination of the
thrE~e must be transported from the County by an approved
haza.rdous 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 1:hose cases where a derelict vessel number can not be
found, i.e. derelict vessel is underwater, the contractor
shall provide marine transportation to the site for the
COUIlty representative to verify the vessel and location
using the original Derelict Vessel Report from the Florida
Marine 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:orrned by competent employees who are experienced and
qualified to do the work specified, and that all work will
be {:)erformed in accordance with the best commercial
prac~tices. A list of equipment to be used and a
description of the removal and transporting procedures to be
foll.owed must be provided to the County at the Prework
Conf:erence described below.
Precaution shall be exercised at all times for the
prot.ection of persons and property. The safety provisions
of the Occupational Safety and Health Act of 1970 (Public
Law 91-596) and other applicable laws, including building
and construction codes shall be observed. Machinery,
equipment and other hazards shall be guarded in accordance
with safety provisions of the "Manual of Accident
Prevention in Construction", published by the
Associated 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 Contract 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
paym1ent for the unaccornplished 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
Natllral 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
dirE~cted the number and sizes of the charges shall be
redllced. All explosives shall be marked clearly "DANGER
EXPI..OSIVES", and shall be in the complete care of compete.nt
watchmen. The Contractor shall secure the proper competent
watchmen. The Contractor shall assume all responsibility for
damclges caused by explosives.
7 . ASSIGNMENT OF CONTRACT AND SUBCONTRACTS: It is expressly
understood that the Contractor is in all respects an
indE~pendent Contractor for this work, not withstanding under
certain conditions he is bound to follow the directions of
the County, and is in no respect an agent, servant, or
empJ.oyee of the County. Nei ther the Contract, nor any part
ther-eof, 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
ei tIler directly or indirectly employed by said
subc~ontractor, as he is for the acts and omissions of
pers:ons directly employed by him. Nothing contained in the
Cont~ract Documents shall create an contractual
rela.tion between any subcontractor and the County.
All subcontractors shall abide by the terms,
cond.i tions, and requirements of this Contract. It is
the responsibility of the Contractor to pay all debt
obli,gations incurred with subcontractors in an
expedient manner.
8 · LEGA.L RESTRICTIONS, PERMITS AND TRAFFIC PROVISIONS: The
Contractor 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
required and should inquire about permit requirements with
the appropriate agencies. The Contractor shall comply with
all the 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
dere~lict vessels which are inhabited at the time
of removal and when another vessel is too close to the
cont:racted derelict vessel to allow safe operations.
Direct confrontations with other boaters should be avoided
and the Florida Marine Patrol should be contacted
irrunE~diately if such confrontations may result from removal
of any contracted derelict vessels.
9 · INSlJRANCE: The Contractor must obtain all insurance
requlired by the County and subrni t proof of same to the
COUI1ty prior to acceptance of bid and contract approval by
Boar'd of County Connnissioners but no later than five
wor~:ing days after notice of low bidder. All insurance
shal.l 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
Division:
Certificate(s) of Insurance which clearly indicates that he
has obtained the insurance coverage required in paragraphs
a,b,c and d below.
The Contractor hereby certifies that no modification or
chan,ge in insurance shall be made without (3) days written
advance notice to Monroe County, c/o the director of the
Risk Management Division.
a.
~?rk~~ '~ C,OInp'e_nsation Insurance as in the amount of .
-51A +e... S ~tl ~tl,iC_~
b.
General Liability Insurance on a comprehensive basis, in an
amount not less than $300,00.00 per occurrence for Bodily
Injury and Property Damage combined, to include contractual
liability.
c.
Pollution Liability Insurance in the Amount of
C' -'_ . .,ii
)l; (j . tc (.-'
!
d.
Water Craft Liability Insurance in the amount of
'St'L), t'{)() .
e. Auto:mobile liability insurance covering all owned,
DV Specs--Page 5
Ilon-.owned and hired vehicles used in connection _~
witll the work, in an amount not less than (DO tV() per
OCCllrrence for Bodily Injury and Property and 'Damage
coml:>ined.
All insurance policies required above shall be issued by
com{:)anies authorized to do business and under the law of the
State if Florida.
10. COlvW[ENCEMENT ,DELAYS AND COMPLETION OF WORK: After'
rece~i ving Board of County Commission approval of the
Contract, and after reconciliation of any details or
cond.i tions which may directly or indirectly interfere or
conf'lict with work of the Contract, the County will issue a
"Not,ice to Proceed wi th Contract worku. officially
authorizing the Contractor to commence. The Contractor shall
cornInence 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
extended upon agreement of 'the County representative.
Requ,ests for extension of time must be subrni tted in wri ting
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
administrative procedures required to obtain action by the
County Commission, a request for time extension must be
received by the County representative at least sixty (60)
calendar days prior to the Contract expiration date.
Liquidated damages resulting from factors beyond the control
of the Contractor which occur too late to allow time for
action by the Board of County Commissioners approving a time
extension may be waived by the County Commission. Such
waiver 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
charged with 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
Department of Environmental Protection changing the
Contractor's approved work schedule;
b. To unforeseeable cause beyond the control and without the
fault or negligence of the Contractor.
c. To a:ny delays of subcontractors or suppliers occasioned by
any ()f the causes specified in subparagraphs (a) and (b)
abov1e .
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
before or after work has begun. Notice of such changes shall
be given in writing to the Contractor; such changes are not
to be grounds for any claim by the Contractor for damages,
nor for the forfeiture of the Contract. It is possible that
a Derelict Vessel could disappear between the time of
inspection by the contractor and the actual effort to remove
it. No 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
records and allow the audit 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]~CT 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. PREWrORK 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. CONTRACT SECURITY: The Contractor agrees to execute and
deliver simultaneously with the executed contract, a
Contractorts 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
County.
16. EXECUTION 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
execution, shall return said documents properly executed
along with any necessary bond and insurance within TEN
WORKING DAYS. With the Contractor's cooperation, if this
period can be reduced, it will assist in acceleration the
execution of the contract documents.
The Contractor, by virtue of signing the Contract,
ackn,awledges that he and all his subcontractors have
satisfied themselves as to the nature and location df 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 e4quipment and facilities needed to perform the work.
Fail~llre on the part of the Contractor to completely or
proplerly evaluate any factors of his costs prior to bidding
shal,l not form a basis for additional compensation if he is
awarded the contract.
If fc:)r any reasons, not acceptable to the County, the
Cont:ractor does not perform, the County shall have the
righ"t to levy liquidated damages against the Contractor.
DV Specs--Page 8
Liquidated damages shall be assessed against the Contractor
for any bid item awarded to him which is not completed and
accepted by the County within the number of calendar days
specified in the Contract. Liquidated damages are
accumulative.
17. NOTI;CE TO PROCEED: The Contractor shall commence work
upon this project on the effective date of the Notice to
Procteed and perform in a continuous manner until
completion and acceptance by the County. For Contracts
wherlein a specified number of days for completion is stated
in tJhe Contract, the effective date of the "Notice to
Proc~~ed with Contract Work" will establish the "beginning
dateH of the project.
18. TERMINATION OF CONTRACT: This Contract may be
term~lnated 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. FINA]~ CLEAN-UP: Upon completion of the work specified
here:Ln and before acceptance and final payment shall be
madel the Contractor shall remove from the sites all
machinery, equipment, surplus and discarded materials and
ternp()rary structures. All disposal of materials, rubbish
and debris shall be made at a legal disposal site.
20. DISP()SAL SITES AND FEES: Contractor is responsible for
disposal of all derelict vessels included in this contract
and nlust make arrangements for legal disposal. It is the
responsibility of the Contractor to pay all disposal fees
incul~red, and such removal related costs should be
consj.dered when bidding on this contract.
The contractor will deliver the derelict vessel to the
dispc)sal site, where staff must be able to verify the
derelict by its Florida Marine Patrol derelict vessel number
or b'}r 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 trle landfill. They must be disposed of inunediately.
A legal disposal site is either the Long Key
Landf'ill-Monroe County, MM 68 1/2, Long Key, Florida 33001,
305-664-9315, other landfills in neighboring countries or
any eIther location for disposal as long as the FDNR
Dispc~sitionCertification Form (attached) is fully
docUlTlented. If a signature cannot be obtained on Florida
Department of Natural Resources Disposition Certification,
the Contractor must contact County Representative for
written approval and instructions.
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 wri t-ten statement wi th a description of what type of
debr.is was transported, dates, times, name, address, and
phon~~ number of si te .
In aejdition to the above information, Contractor must
subm~it three pictures of each vessel removed. The first
photc)graph must be of the vessel at the current location
prior to removal, the second photograph must be of the
vessel after removal but in the same general area preferably
whilE~ 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 cierelict vessel number, when present, must appear in all
photc)graphs.
. The (~ontractor will be responsible for the camera, film,
and cievelopment costs. The photographs should be taken with
a PoJLaroid camera that provides instant photos since this
mininlizes loss of documentation due to camera malfunction or
loss overboard. This camera and film must be provided by the
Contl~actor. The photos must be submi tted on a vessel by
vessel basis according to removal schedule. Without photos
to dc)cument the removal and disposal of the contracted
vessE~ls final payment can not be assured.
The Contractor must notify the Florida Marine Patrol and
the C~ounty 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
multi.party communication for each Derelict Vessel is a
requi.rement of the contract.
22. PAYMENT: All payments for the removal and disposal of
each vessel, shall be for the performance of the work as
stipulated in these specifications and associated
contractual documents. The unit rate of bid shall be totally
inclusive for all phases of the operation. Contractor may
request 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
sign.~d DNR Disposition Certification form, a County
Disposition Affidavit for the vessels for which payment is
beinc;J requested.
The contractor understands and agrees that no payment will
be f()rthcoming for the removal and disposal of any derelict
vessE~l (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 llot been obtained from the Florida Marine Patrol and a
Representative of the disposal site at the time of delivery.
A Florida Marine Patrol officer must certify the complete
rerno""al of each derelict vessel from its location and any
equipment that may have been used to remove the vessel. No
paymE!nt will be made without the Florida Marine Patrol
verij:ication.
In acLdition, property, public or private, if damaged during
the ~lork or removed for ,the convenience of the work, shall
be re~placed at the expense of the Contractor in a manner
acceptable to the County and the OWner, prior to the final
payme~nt for contracted work.
23. PUBLI.C ENTITY CRIMES: Upon entering into the contract, the
ContI~actor agrees to sign and endorse the Public Enti ty
CrimE~s form (attached).
24. NON-C~OLLISION AFFIDAVIT: Upon entering into the contract,
the Contractor agrees to sign and endorse the Non-Collusion
Affidlavit form (attached).
25. ETHIC~S CLAUSE: Upon entering into the contract, the
Contractor 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. DERELICT VESSELS AT ISSUE: The derelict vessels listed on
the D:erelict 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 STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
TIllS FORM l\1UST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUifHORlZED TO ADMINISTER OATHS.
1. This sworn statement is submitted to /~Rt!>F
by
<; ~Url'-//
,
~ [Pri~e ~f the public entity] /
/ C'~(')/.~ '7 /~/ rl'7/f'?T?/ w: "A~~~
I
(print individual's name and title)
/l /,7'n,/Z) k:/ i '(7bt.J/^"'-/
/I?;:>~;? // 5
for
[print name of entity submitting sworn statement)
whose business address is
,5-s-lo :..~~cr A VF" :s.T
/<)F '/ br~r~/r r~ _33c?~
and (if apPI~able) its Federal Employer Identification Number (FEIN) is .~r9 - 22 ?~ f/? z
(If the ~entity has no FEIN, include the Social Security Number of the individual signing this sworn
statemt~nt :
.)
2. I under'stand 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 any public entity or with an agency or political subdivision of any other state or of the IJnited 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~llI subdivision 9f 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 jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.
4. I under'stand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An E~ntity under the control of any natural person who is active in the management of 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 wbo 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 the United States with the legal power to enter into a bindin~
contrac t and which bids or applies to bid on contracts for the provision of goods or services let by a public entity,
or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those
officers, directors, executives, partners, shareholders, employees, members, and agents who are active in
managE~ment of an entity.
6. Based on information and belief, the statement which I have marked below is true in relation to the entity
submittj.Hg this sworn statement. [Indicate which statement applies.)
~either the entity submitting this sworn statement, nor any of its officers, directors, executives, partners,
shareholders, 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.
- 1rhe 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 affiliat(; of
the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989.
- l'he entity submitting 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 beeJI1 a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative
Hearinl~s and the Final Order entered by the Hearing 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 UNDERST ANI) THA TTHE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENT'IFIED ON PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS
FORM IS V AL][D 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, FLORIDAST A TUTES
FOR CATEGOltY TWO OF ANY CIIANGE IN THE INFORMATION CONTAINED IN THIS FORM.
~tf/ ~
[signature]
Sworn to and subscribed before me this
i day of
/t)
,19 9e/
/~.~~
Personally known
/
OR Produced identification
Notary Public - State of ~~
........ flofO!TY 'c!J~: ~~ ~futt1 {Jf ~~crid€J
My Commission expi"" Comm~5~~m' ~:'1..~kt~! ~~~:Yc:' 24, 199!
&~n//f /~ ~~;:;;..C>
(Printed typed or stamped
commissioned name of notary public)
(Type of identifi.~ation)
Form PUR 7068 (Rev. 06/11/92)
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHI CS C~LAUSE ,
/l7?/t"/tI ?
retained or otherwise had
warrants that he/it has not employed,
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, deduct from the contract or purchase price, or
otherwise recover, the full amount of any fee, commission, percentage,
gift, or consideration paid to th~.m~r County O.ffi~. oorr / e e~mployee.
Ld~ tV ~
(signature)
/c ,- j/-- 7~'
Date:
COUNTY C>F
r/~
~N;Roc--
STATE OF'
Subscribed and sworn to (or affirmed) before
me on /?J - 0- yY' ..-(-da te) by
-7~'rlf/l;F~ ~. /l7?.Y"?J/t/ (name of affiant).
Be/She is personally known to me or has produced
as identification.
(type of identification)
// '-7~ ~
./ ( .~. /"). ._~-~-
NOTARY PUBLIC
MCP>>4 RI~V. 2/92
~
NOfory ~ ,_,_
.... . lJoJ:~~ S'Qf, .
"'T Cornnnssion f' 0' Frorl(.~
Bonded Thru Tr~XP:r~s t;'arch 24 11f)l-
Y alf!. fn I 7'i1'
SUrOfl('e (ne,
DRUG-FREE WORKPLACE FORM
The llndersigned vendor i.ll acC()rdallCe wi tll Florida Statllte
287 .087 h~~reby certifies thi:t~ ~ I ~_
d~"r~/& ZC 70u:?I'(
-_._-~---~-- - - -.-,- _. - .- - -.'.._.. _._--~--_:- ...--..., .-. ... ...-. ---,. - -. ..-~ ..- .'-
(Name of Bllsiness)
1 . Ptlb 1 i sh a sta temellt 110ti fyi ng elnp loyees tlla t tIle lInl aWftll
manufact\lre I di stribtl ti on, di spensing, possessi 011, or use 0 f a
controlled substance is prollibited in the workplace and
specifyinc;J the actiollS that will be talt:en against employees for
violatioll:S of stlcll prohibi tioll.
2. Infl:>rm employees abOltt tIle dangers of drllg abtlSe ill the
workplace, tIle b\lsi.l1ess's policy of mai.ntaining a drtlg--free
workplace, any avai 1 able drllg COllnse 1 il1g, rellabi 1 i tati on, and
employee assistance programs, and the penalties that may be "
imposed \t]pon employees for dr\lg ab\lSe violations.
3. GiV1e eacll employee ellgaged ill providillg tile commodi ties or
contract\lal services that are tlllder bid a copy of the statement
specified ill Stlbsection (1).
4. In the statement specified ill sttbsectioll (1), notify the
employees tllat, as a condi tiol1 of working on tIle commod! ties or
contractllal services tllat are tInder bid, tIle employee wi 11 abide
by the terms of the statement and will notify the employer of
any COl1Vi'ction of, or plea of gttilty or 11010 contendere to, any
violation of Chapter 893 (Florida statutes) or of any controlled
s\lbstance law of the Uni ted states or allY state, for a violation
occllring in the workplace 110 later tllC\ll five (5) days after suell
conviction.
5. Impose a sanction on, ()l.' require tIle satisfactory
part! c i pa ti on in a dr\lg abtlSe a SSl. s tallce or rellabi 1. i ta ti on
program if SllC}l is ava! lable in the employee's cerom\11li ty, or any
employee who is so convicted.
6. Malte a good faitl1 effort to COlltilllle to maiIltain a
drltg-free worl{place tllrollg11 lrnplemerltatioll of tllis section.
As the perSOll atttl10rized to 8igl1 tIle statelnetlt, I certify tllat
this firm cOlnplie"s f\llly witll tIle above req\liremellts.
-- / ~ "'- ~~ 77" .
C?;:Z:;~t~~
Date
MCP#S REV. 6/91
I ,
NON-COLLUSION AFFIDAVIT
~'r/;ll~cI r/. /17?/tJIc:T
/Jv% rr-r?t' r
~l/~I/
, of the .ei ty
of
according to law on my oath, and
under perlalty of perjury" 9~pose and say that;
1) I am /l7-f~t1/cf;; -;;:vJ/'-'/7 , the bidder
making thle Proposal for the proj ect desfcribed 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 inl this bid 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 ta,r; and
4) no attempt has been made or will be made by the bidder to
induce an,y 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, and 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
I:-~
4N/?t7~
~W-~
G - (signature of Bidder) ,
/ IJ- Y-f'Y
DATE
COUNTY OF
.____P~S~N1\~L~. ^PPE~;:D BE~c:;~~~e unde~signed authority,
7//,"~/??rc/W.,.1/0 wno, after *first being sworn by me,
(name of individual signing) ~-__"""
""
affixed his/her signature in the space
I(
day of
/?)
provided above on this
, 19 97
~ft~
ftOTlffiY PUBLIC
~- /. " ~ /~
L.p> r~' ,/?//I ,/-1 ~
My commission expires:
Notary puLrrt, SIafe 0' PI ,.... ~,
My c .... norla~
omn]~$~IV;1 E\~;r~ U"",..L 24 ."-
8o"ded Thru Tr: '''r ." b~". tn , 1995'
y 0'11' InSurance Inc.
,Ail' ~ "":l~ J;.;.v~:#,""J ~( .: 4 "\,,\I..~;, ",,4 ir::~i ;-t.liif~~~*~f<~~Y; .
"". ,'. '. . ,. " ..,.. "., '\" :';' ,. ' . - . , . . .'. .. ~ "
NlS NODTU AMERICAN i'L)'
SPECIALTY INSURANCE COMPANY r:',.'
; MANCHESTFR. NEW HAMPSHIRE ;/
~" .~- "'-"", ~...$\\ '" ., ore. . "...~ "'. ". _ '. . ... " . ,.....~
" ".~,{~~~-, ?'" .t~~~~~,:1"~~. -,,\'r.,...,~,"tir' '.)~: Ttq ..l'{~~':pf{'_~~l""'.....~I1.'~t} . ~"'. . . ,..;..., ,,' .'!~,"'~'i' !....
. '. , , " '" . --.oIIIPlrn' "1 I . ..< < .... ; I .u n .' ll. *t · .') . ". u ..:t ~li. &...i ""'-......... ,1r ...... "'''' < " '. A.";". .. ..'.: .. ._ 'C. '
"( lUCY NUMBER POLICY PERIOD 'I"
fl' --------'------., 12:01 AM SIO TIME AT nu: AUUHlSS
(7002CA33224-01 4-30-94 TO 4-30-95 OF THl: INSUREU ASSIbNEU UEKEHI.
-- - ~1n'~~lr;alif~!]I~~~':~~:~~?<:~~.
\_. --''1:::n:~?;;..W r~"iIt '1T~' -:f~ ,.!
--~ -~--, ,~
t J.\rJr f l
'rJ'~I"~rn
l r I r )
','^'I.IrJG
^nr1nr~s
ARNOLD'S TOWING SERVICE
ARNOLD'S AUTO & MARINE REPAIR, INC. NAME
5540 3RD AVE. AND
KEY llEST, FL 33040 ADDRESS
l~~~~~~_~~:~~~~~~~ .~.
A~ENT NO:
17002
INC.
STE. 2
COMMON POLICY OECLARATIONS
BUSINESS DESCRIPTION
TOWINL-_
-.....-.....---~.-.-- --....-..-.....-..... ~--~
IN RETURN fOR THE PAYMENT OF THE PREMIUM, ANO SUBJECT
POLICY. WE AGREE kITH YOU TO PROVIUE THE INSURANC~
nus POLICY CONSISTS OF THE FOLLOWING COVERAGE P
FOR ",tUtU A PREMIUM I S INDICA TEO. THI MIUM
BE SUBJl:CT TO AOJUS TMl:Nl. .~.
CUMMERCIAL
CUMMERCIAl
ClJHHERCIAL
COMMERCIAL
COMMERCIAL
-------
PRf:HIUH SHtJWN
TOTAL
INCEPTION. $________
$--_J.2.12iL___
FUHMS
"~:J1 ~'~'
'--------------------------
----
-----------------
...... ~ ~ ----------..
....---
...b....-.~_____~~
C DUN T ER S 1 G'~f: D___________ i:J Y ____________________________
(OATE) (AUlHORIll::U RlPRE:SE:Nr~TlVeJ
.------' -
f!},/fT' ~CJ;6{ ~~9CJ _ ~~ ;/'<-:/-5 s' Ad///7/;.y--/ c:' /' /OL--L) ~~
-Z:: 4's (J ;~A~(o-' t::.-
--KY..G..2=!.~.!!______________________________________________
~~ --w
S~=~~~ l~
,; . ..;', f:" ~ -1\\\~~';'.J!~;""l. . ~~~~tl~~.~~SIfJ\~ir"~.T~1 .....~~:'!r , -r"~J:lf"'~ !~ ~'T_:r< H~-"1 ...... ,.
N.A ftIv..,,'1 '''', ,j;~.~,~"t"l.a t,Cc1j. 'C . i"
:' I"r 1\Juu rRpy ,- . ~ 'Yr ,", 111}.,
--- DESCRIPTION
,.,. --I " .-----..- Ytar. "Model; /rade Name; Body rype
,~ r 1 28 Z ~CHE ~e~~ iu~;r !~; IV~~~'~ilj"CaljOn Number (Vlffi
~ ~~_. J2~9_.CHEVROLET 11158558
~J_ --J~2J FORD #.A15353
~. ~~". 1 987 INTERN_ATIONAL H 465120
...22_. 1979 LANDOLJL TRAILER 11079998
06 1994 INTERNATIONAL #551465
Olu >-1966 GMC HDL023L
COVERAGES-PREMIUMS, LIMITS AND DEDUCTlBLES IAbSlnce 0' a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding
ITEM TWO column aJ!Phs instead)
PERSOHAlIIWRY PROTECTIOIf AUTO. MfD. PAY. Y lJNDER=~RJ8{ORISTS COMPREHENSIVE ~ ~s
Umit limit Limit
(In Pr@. On Pre. (In
Thou- mium Thou- mium Thou.
w~~ u~~ u~~
r
f
;
,
~
r
r f r------ _ _ "
';/~-
I: ~__
f : ~_._..
r
: I ~ ----...
~-.-
: r------. -__'_
~-
-...-.- t"'--
I Cmred Radius ot Business use
Alrto Op"r at ion : : r:;:~1!
. ~ (In "'11~S) c. commerci.,
~. 50
02 50
J!J_ ._.~Q..._.
I J!!!_. 50
~_ 50
, 06 5G
i 07--'- ----5"0 -_.
i~
,
1 ~ __. "__ ___
,
r
-: ~ -.----.
J
r----- -..__.._...._.
~- ."---
. ~ - '-. .- ..
1-----. - _"__ _.. _
~'-
UABruTY
te.- limit
..... (In
.... Thou. Premium
". Unds)
01 1348
02 999
03 1348
04 2213
05 149
06 1348
,07 1348
"
Total Premium 8 753
v,",,"LLlULC. Ut l.,uvt.t<t.U AUlOS YOU OWN
"l1LCAJJ224-01 EXTENSION OF DECLARATIONS
.,,,IIEDUlE o~ ~~ERED AUTOS YOU OWN (Cont'dH ---------__ PURCHASED ____ _________ ___ _~_.__________
-- _.n~--~=-= AClu3~ TERRITORY: Town & Stale Where Ihe Covered
---- O",lnal Cosl New Cosl & USED (UJ Auto will be principally garaged
39.000 N KEY WEST FT (017)
9...000 NT"
38.000 N "
20..000 N "
20.000 N "
45.000 N "
"
c
s
c
c
C
C
C
CLASSIFICATION Except for Towing all phy~ical damage loss is payabl~ to you and the loss
Size GVW, GCW Primary Rating Second a ry
or V@hicle Ag@ factor Rating Code payee named below as interest may appear at the time of the loss
Seatinr C8pacity Group li.b. Ph,. O.m.re F ae tor
14~500 6 l.35 .95 :13499
6 1.00 1.00 tJ1499
14,500 6 l.35 .95 23499
'26,000 6 ~.IO 1.25 t3649q
6 .15 .65 68499
18.,,500 1 l.35 .95 ~3499
14,500 l.35 ..' . ~3499
COLUSION
TOWING & LABOR
Pre.
mium
limit ·
minus
deductible
shown
below
Premium
Limit
per 0;$' Premium
abrement
Pre.
mium
Limit.
Premium
17 17 170 .101
17 17 4_8 R5
17 17 221 1Qc;
17 17 119 21_1
17 62 I 1 I
17 17 422 7c;7
17 17
~. -
~;..
xxx
119 XXX
XXXXX
XXXX 1864 XXX
.Urnil slattd in ITEM TWO.
102 XXX 1042
Item Sevpn In r; ~: ~ ~e Covm ge r or m - NCln De a ler s" and T I a ilers De alers' Supplementary Schedule
Item Ten in Garap. Covera~e Form -Auto Dealers' Supplementary Schedule. .
, 191 ([ d I' R 7) 1~lf(1lH" f'1I''f''-.r. ~ ~IIN'I' 'He
COMMERCIAL INLAND MARINE COVERAGE PART
MOTOR TRUCK CARGO DECLARA TrONS
I
~
Policy No. 17002CA33224-01
Effective Date 4-30-94
1201 A.M., Standard Time
DESCRIPTION
A. Covered Cargo consists of:
(XJ VEHICLES ANO/or~. CARGO WHilE 1) BEING ATTENDED "ON HOOK"; 2) "UNDER TOW"; 3) "BEING TRANSPORTED."
o OTHER
(Describe Cargo)
LIMITS OF INSURAINCE
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 Vt~hicle:
a.
b.
c.
d.
e.
1.
g.
h.
i.
j.
Trade Name
01
02
03
04
05
06
07
Year Built
Type of Body
Factory or Motor Number
limit of Insurance
$ 50,000
$ NO COVERAGE
$--50 .000__
$ 50.000
$ N() r()VFR~GE
$ 1\0,000
$ EiO,OOO
$
$
$
3. For two or more described vehicles involved in a single "'oss", the most we will pay for this "'oss" is: $100.000
.. ....
...
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 policy)
Forms and Endorsemenls applying to this Coverage Form and made part of this policy at time of issue:
Premium for this Coverage Form $ 1.000
NAS-MTC-DEC (06/93)
THESE DECLARATIONS ARE PART OF THE POlICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POliCY PERIOD
"Incrusion or date optional.
CA 591
(6-92)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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.,.0.00 u
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 $.u
The premium for this endorsement is $....19L..
(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 arl 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) In the Coverage Territory during the Policy
Period.
b. '1\dvertising injury" caused by an offense com-
mitted:
(I) In 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 AIN INSURED
The following are Hinsureds":
....,'~ ...... to ('ll..{:~"
~THENTICn
\'1 1;4'f:,I:~::(I'~:'fJJ,(\('~
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 while acting within
the scope of their duties.
2. COVERAGE EXTENSIONS
Supplementary Payments. In flddition to the Per-
sonallnjury 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., 199]
1
~~
t
t:
,-LECTI~'G NOT TO PURCHASE CERTAIN VALUABLE COVERAGE WHICH PROTECTS
,~,~D YOUR. FAI\11LY OR YOU ARE PURCHASING UNINSURED MOTORIST LIMITS LESS THAN
ruUR BODilY 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 bodily 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 your damages.
Florida law requires thaI 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.t:XX:J each person (enter limit if applicable);
$ ?J). cx:n each accident.
o c. I hereby select Un;nsured 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. Th us, your policy limits would auromatically 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 tin1e, I must let the Company or my agent know in writing.
SigneCi?~ u/ Cl~
(Named Insured)
Signed: ~j~ ~.Jl~
I (Named Insured)
Date:
~<<--'.{ ::J- C;
/79y
ALB859c (r rl 10 87) \ JUIrORM PRINTING 8. SUPPLY, INC
J{c~ollll ion N 191-1991
April 12. I l)() ,
I ~1 Prillt ing
J\rlONROE COUNTY, FLORII)A
Request For Waiver
of
Insurance Requirenlents
Il is rcqut~slcd tllal the insurance requirCJllcnts, as specificd in the Counly's Schedule of Insurance
Rcquirculcnls, be \vaivcd or 11lOdificd on (he rollo\\"ing contract. .
Con Lraclor:
Arnold's Towin~
Conlracl for:
Emergency Remova~ of DV091626
Address of Conlraclor:
5540 3rd Avenue Stock Island
Key West. Fl 33040
Phone:
(305) 296-9182'
Scope of 'Work:
Emergency Removal of DV091626
Reason for Waiver:
Please waive watercraft ins~rance (no vessels used in removal
at shore), pollution insurance (houseboat breaking up, no fuel
on board) and Jones Act cover~~~__ _____
Signature of Conlraclor:
G2~ tV.
Approved ''1/
Nol Approved
~
Dale
( /: ~~"~'~-'-~~'Y) r
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I..
f~.. I (/
Risk ManagclDcnl
/
1--
Counl)' Adlninistralor appeal:
Apl)rov~d :
Nol Approved:
Date:
Board of (~ounly COlluuissioncrs appeal:
Approved:
Not Approved:
Meet; ng Date:
^(LninistTalivc (mdrudion
WAIVER
114709. I
5