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11/17/1996 DV03A2279 O ~, \ I r '~ ' r'\, \ CONTRACT AGREEMENT AGREEMENT, MADE THIS /".?- 0(. day ofNe J;t".)l~C:L 9 96, by and between, Arnold's ("Contractor") , and the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, of the County 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 emergency removal of DV03A2279 for which a derelict vessel report is attached as exhibit A. 2. The work to be performed under this contract shall commence immediat~ly from the date the Liaison provides the Notice to Proceed and shall be completed by October 31, 1996. 3. The work to be performed under the Contract is contingent upon grant funding from the Florida Department of Environmental Protection, Boating Improvement Fund. If this grant is denied, then no compensation is due under this Contract. The Contractor acknowledges the contingent nature of the state funding and agrees that, if the grant is denied, the Contractor may not make a claim for compensation under this agreement or by way of estoppel, detrimental reliance or otherwise. The Contractor understands the rules of the Department of Environmental Protection and shall comply with those rules, along with the rules and procedures instituted by the Board to ensure an orderly progress to the project. ." -. l' .__~ - ..' . - ..' j Both the intent and the requirements of the specifications are Li ~~ J ~. j '~.; ~;~:~ U ~ l; J understood by the Contractor. 4. The Board shall pay the Contractor $750.00 for the removal and legal disposal of derelict vessel DV03A2279. 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. S. The attached Derelict Vessel Report and Specifications tog~ther with this Agreement, form the the Contract. They are fully a part of this Contract as if repeated herein verbatim. 6. The Contractor covenants and agrees to indemnify and hold harmless the Monroe County Board of County Commissioners from any and all claims for bodily injury (includin~"death), personal injury and property damage (including property owned by Monroe County) and other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Contractor or any of its Subcontractor (s) in any tier occasioned by the negligence, errors, or other wrongful acts or omissions of the Contractor, its Subcontractor (s) in any tier, their employees, or agents. The purchase of the insurance required ~n paragraph 13 does not vitiate this indemnification provision. 7. The Contractor agrees to supply the County with a set of photographs of the vessels in all phases of the removal and disposal process. The Contractor will be responsible for the camera, film, and development costs. 8. The Contractor must inform the County and the Florida Marine Patrol prior to initiation of work. 9. The parties agree that timely performance of this agreement is essential due to possible damage to the natural resources, hazards to navigation, or threats to human health and welfare. Therefore, the parties agree that the Contractor shall be liable to the Board for $100 per day of liquidated damages for each day after 12-31-96that any of the Contractor's obligations under this agreement remain unp~rformed. The parties agree that such amount is by the way of compensatory damages and does not constitute a penalty. 10. 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 envlronment. 11. The CONTRACTOR will be responsible for all necessary ... lnsurance coverage as indicated by an "X" on the attached forms identified as INSCKLST 1-4, as further detailed of forms WC1, WCJA, GL1, WL1, & POLl attached Exhibit C. All policies must list Monroe County as additional insured with the exception of the Worker's Compensation policies. 12. A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO ($10,000) for a period of 36 months from the date of being placed on the convicted vendor list. 13. The Board may terminate this agreement with or without cause at anytime upon giving the contractor a minimum of ten days in writing. The contractor, upon receipt of the notice, shall immediately cease work. The Board shall pay the contractor the percentage of the contract sum which is proportional to the amount of work performed by the contractor in a manner satisfactory to the Board up to the date the Contractor received the Notice to Termination. IN WITNESS WHEREOF the parties hereto have executed this Agreement to day and year first writt~.. oveo J /2~ BY: ~(j/ ~ Owner Title Arnold's Firm , (Seal) Attest: -/f7~~ Witness BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA .By:cS',~~1~__Q Mayor Cha' an IV (Seal) Attest: D"-NNY L. KOLHAGE, CIerlj G __'.ft lLc. ~~ Clerk FL MHklN~ ~H1ROL/Dl~ 3 ~ax:~u~-L~~-2326 ...... --'. . ....~- - - uct)l ~b 1~:4d ~.. UL EXHIBIT A INCIDENT REPORT NARRAT!VE CONTINUATION RePO~T. _ DERELICT mSEL 13Ae. (:7 ., ;~-_._.-.... ~..._..__.. .... .~. .,..... '....._...~... .. ~........ .-...... ...... ............ .............. ............ ..... ..... ......... ..... .. 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META~. ..........:::::;;OT~ER.= '" OfllftOtI ( ~O.>/P" I Rt~~~ t\. $ \\..\Cr G~~I' \0 13 \~ Ch.t!on Numb., Nv..-nber Ar,..\-<I 10-31-1996 2:21PM FRCf-1 tMRltC. PROJ~L1S L~';j ~II KEY WEST POUCE gfpARTNBfT I REPORT SIGN"'- " L nM' 0A1 -. /UV.f ivA-f OC...,.~tP p./AS .IS'fUf"/ ~t'/P = ?kIf 1UA;5 ~C"~ v-11-'/r/t rM/t'.-<J~' ~~ aL 011/ Iv ~ tJ r 17k / ~ ~ . "y~~fI'l PI J(,. fL MHKINt. r'HlkuLJLJ1~ !.J t-ax:,)u~)-__ _1---__~I__r_ Ui_ l ..' 1 jQ 1..:> : 4 ( I . V l ~ \ FLORIDA MARINE PATROL DISTRIC1~ THREE 2796 OVERSEAS HIGHWAY SUITE 100 MARATHON, FLORIDA 33050 4. (305) 289-2320 FAX #: (305) 289-~2326 FACSIM~ILE MESSAGE DATE: \0-3 \- ~b TO : ~ \ Y\ \r\ <. G:~.( FROM: a~ ~K\hO V\ \~\~ NUMBER OF PAGES SENT: ~. ____ (INCLUDING COVER SHEET) COMMENTS: ~~f>~0~p \6_R~~S-~_$\( ~~l\C\ ~t. V:rr?~~1J ~U d1.c Exhibit B DERELICT VESSEL REMOVAL CONTRACT SPECIFICATIONS FOR MONROE COUNTY, FLORIDA 1. INTENT: It is intended that these specifications shall cover all aspects of the work. 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 as many derelict vessels on the primary list for which a Florida Marine Patrol Derelict Vessel Report is provided as funding will allow. 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 removal of one or more derelict vessels for less than $25,000 total. 3. PLANS: There are no plans for this project, but copies of the Florida Marine Patrol Derelict V~ssel Report with location Sketches have been bound into these documents for the Contractor's use. The Specifications include a 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 County 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 County has a limited amount of money to effect the removal of these derelict vessels. We have established priorities based on public safety, navigation and traffic hazard, 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. 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 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 possesses a Florida Mar~ne 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 reached by the Florida Department of Environmental Protection, 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 derelict vessel may be replaced and removed without the trig party consent noted in this paragraph. A contractor may suggest a possible replacement vessel but he may not remove it without the appropriate consent above. 5Q SCOPE OF WORK: The Contractor shall be responsible for providing all permits, supervision, labor, eq~ipment, 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. DV Specs--Page 2 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 surrounding 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 removed from the derelict vessel prior to removal from the water. 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 engines. He must dispose of them in any legal manner. Pure used oil will be taken by Monroe County for disposal. Mixture of oil, gas, seawater or any combination of the three must be transported from the Cou~ty 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 found, 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 Marine Patrol. 6. MATERIALS AND WORKMANSHIP: The Contractor shall provide the necessary materials and equipment to safely complete the job. The Contractor agrees that all work shall be performed by competent employees who are experienced and qualified to do the work specified, and that all work will be performed in accordance with the best commercial practices. A list of equipment to be used and a description of the removal and transporting procedures to be followed must be provided to the County at the presswork Conference described below. Precaution shall be exercised at all times for the protection 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 DV Specs--Page 3 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 repair and replace or not receive payment for the unaccomplished work. The Contractor shall 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 governmental agencies such as the Department of Environmental Protection, 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 EXPLOSIVES", and shall be in the complete care of competent watchmen. The Contractor shall secure the proper competent watchmen. The Contractor shall assume all responsibility for damages caused by explosives. 70 ASSIGNMENT OF CONTRACT AND SUBCONTRACTS: It is expressly understood that the Contractor is in all respects an independent 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 employee of the County. Neither the Contract, nor any part thereof, nor any monies due or to become due tbereunder, 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 persons directly employed by him. Nothing contained in the Contract Documents shall create a contractual relation between any subcontractor and the County. All subcontractors shall abide by the terms, DV Specs--Page 4 conditions, and requirements of this Contract. It is the responsibility of the Contractor to pay all debt obligations incurred with subcontractors in an expedient manner. 80 LEGAL 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 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 immediately if such confrontations result from removal of any contracted derelict vesselso 9. INSURANCE: 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 Board of County Commissioners 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 Division: Certificate(s) of Insurance which clearly indicates that he has obtained the insurance coverage required in paragraphs a,b,c and d below. DV Specs--Page 5 The Contractor hereby certifies that no modification or change in insurance shall be made without (IO) days written advance notice to Monroe County, c/o the Director of the Risk Management Division. a. Worker's Compensation Insurance per Fl. Statutes b. Federal Jones Act Coverage c. 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$500,000. d. Water Craft Liability Insurance in the amount of $500,000. e. Automobile liability insurance covering all owned, non-owned and hired vehicles used in connection- with the work, in an amount not less than $100,000 per occurrence for Bodily Injury and Property and Damage coftbined. All insurance policies required above shall be issued by companies authorized to do business and under the laws of the State of Florida. The Monroe County Board of County Commissioners must be listed as "Additional Insured" on all policies, except for Worker's Compensation. 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" officially authorizing the Contractor to commence. The Contractor shall commence work within one week from the date on the "Notice to Proceed" letter. 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. Requests 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 Contract expiration 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) DV Specs--Page 6 calendar days prior to the Contract expiration date. Provided further that the Contractor shall within ten (10) 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 her 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 arriving 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 Tn accordance with the Specifications. The County may give instructions or directions to supplement the Specifications. These shall be binding upon Lhe 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 right 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 event that this occurs. Except when otherwise specified, the expense of all tests requested by the County will be borne by the County. 12. AUDIT RIGHTS: As a provision of the grant from the State of Florida to the County, and if so requested by the State, DV Specs--Page 7 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. 130 CONTRACT AWARD: The County reserves the right to evaluate the submitted bids to award a contract to the bidders 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 actual number of vessels to be removed will depend on the accepted per foot bid price and the available funds. 14. PRESSWORK 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 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 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, acknowledges 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 equipment and facilities needed to perform the work. Failure 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 DV Specs--Page 8 awarded the contract. If for any reasons, not acceptable to the County, the Contractor does not perform, the County shall have the right to levy liquidated damages against the Contractor. Liquidated damages in the amount of $100 per day 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. . NOTICE TO PROCEED: The Contractor shall commence work upon this project within one week of the date of the Notice to Proceed letter and perform in a continuous manner until completion and acceptance by the County. For Contracts wherein a specified number of days for completion is stated in the Contract, the effective date of the "Notice to Proceed with Contract Work" will establish the "beginning date" of the proj ect . -" 18Q TERMINATION OF CONTRACT: This Contract may be terminated ~ the County, giving up to ten (10) days written notice to the €ontractor; 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 vessels to the disposal site. It is the intent of this contract to remove derelict vessels from their present site and legally dispose of them. Upon receipt of vessels at the landfill, They must be disposed of immediately. There are several Monroe County disposal sites, Cuddle Landfill, MM 21 (vessels must be 26' and under to be delivered in tact, over 26' they must be broken up), Long DV Specs--Page 9 Key Landfill MM 68, and Card Sound Road aka SR905 other landfills in neighboring counties or any other location for disposal as long as the site is a legal licensed disposal site. Prior to transportation of vessels out of County the County representative must approve. Vessels being disposed of at County Landfill sites must be free of pollutants and engines. 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. 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 phone number of site. This information must accompany billing. .-" 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 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 derelict vessel number, when possible, must appear in all photographs. The Contractor 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 minimizes loss of documentation due to camera malfunction or loss overboard. This camera and film must be provided by the Contractor. The photos must be submitted on a vessel by vessel basis according to removal schedule. Without photos to document the removal and disposal of the contracted vessels final payment can not be assured. The Contractor 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 pre-work conference with the County representative. Notification is to be made before doing any work on each vessel. This multiparty communication for each Derelict Vessel is a requirement of the contract. 22. PAYMENT: All payments for the removal and disposal of DV Specs--Page 10 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 two 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, signed FDEP Disposition Certification form for the vessels for which payment is being 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. 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 acceptable to. the County and the Owner, prior to the final payment for contracted work. 23. NON-COLLISION AFFIDAVIT: Upon entering into the contract, the Contractor agrees to sign and endorse the Non-Collusion Affidavit form (attached). 24. ETHICS CLAUSE: Upon entering into the contract, the Contractor agrees to sign and endorse the Ethics Clause form attached) . 25. 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 Derelict Vessel Working List for 1996 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 EXHIBIT C ,\pril 22. 1 <Jc).l 1 ~ I'rint ing J\10NROE COUNlY, FLORIDA INSURA~CE CI-IECKLIST FOR' VENDORS SUBi\11TTING PROPOSALS FOR \VORK To assist in the development of your proposal, the insurance coverages nlarked \vilh an "XII \vill be required in the e\'ent an award is made to your firm. Please review this form with your insurance agent and have himlher sign it in the place provided. It is also required that the bidder sign the form and submit it v.,ith each proposal. " \\'OJtKERS' COMPENSATION ,~ND E~1PLOr'ERSt LIABILITY X \\' C J \\7C2 \\'C3 WCUSLH \\'CJA X \\!orkers' Compensation Emp)ojJcrs Liabilit)7 EmpJoyers Liability Employers Liability 4. US Longshoremen & Harbor \\'orkers Act Federal Jones Act Statutory Limits $100,000/$500,000/$100,000 $500,000/$ 500,000/$ 5 00 ~ 000 $1 ,OOO~OOO/$l ,000,000/$1 ,000,000 Same as Employers' Liabilit y Sanle as Employers' Liability ^dmini~1rative ]rNn.csion fl4709.01 INSCKLsrr () April 22. )<)<).1 11':1 I'rinl ing GENE~~L LIABILITY As a minimum, the required generalliabiuty coverages will include: · Premises Operations · Blanket Contractual · Expanded Definition of Property Damage . Products and Completed Operations Personal Injury . Required Limits: GLl x $100,000 per Person; $300,000 per Occurrence $50,000 Property Damage or $300,000 Cornbined Single LiInit $250,000 per Person; $500,\ 000 per Occurrence $50,000 Proper1)' Dalnage or $500,000 Combined Single Limit ~~ GL2 GL3 $500,000 per Person; $1,000,\000 per Occurrence $100,000 Property Damage or ~ J, 000, 000 CQmbined Single Limit Required Endorsement: GLXCU GLLIQ Underground, Explosion and Collapse (XCU) Liquor Liability All endorsements are required to have the same limits as the basic policy. ^dmini~Tl'Jtj\.c Jnst.ruc1ton ft4709.01 INSCKLS1' 7 .\pril 22. I <)(r1 1~ I'rinfin[: VEl-UCLE LJABLLITY As a minimum, coverage should extend to liability for: · O\\'ned; Nonowned; and Hired \'chicles Required Limits: VLl x VL2 , , VL3 BRl MVC PROl PR02 PR03 POLl POL2 POL3 EDI ED2 GK1 GK2 GK3 MEDI MED2 1\1 ED 3 ^d",ini~rati\'c JrN.ruc1ion ff4709.0 I $50,000 per Person: $100,000 per Occurrence $25,000 Property Damage or $100,000 Combined Single Limit $100,000 per Person; $300,,000 per Occurrence $50,000 Property Darnage or $300,000 Combined Single L.,imit $500,,000 per Person; $1,,000,000 per Occurrence $100,000 Property Damage or $1,000,000 Combined Si ngle Limit ..M1SCELLANEOUS COVERAGES Builders' Risk Limits equal to the completed project. Motor Truck Cargo Professional Liability Limits equal to the maxirnum value of anyone shipment. $ 250,000 per Occurrencel$ 500,000 Agg. $ 500,000 per Occurrence/$l ,000,000 Agg. $1'1000,000 per Occurrencel$2~OOO,000 Agg. $ 500,000 per ()ccurrenceJ$J,OOO,OOO Agg. $1,000,000 per Occurrence!$2,OOO,OOO Agg. $5,000,,000 per Occurrenc~$l 0,,000,000 Agg. Pollution Liability Employee Dishonesty $ J 0,000 $100,000 $ 300,000 ($ 25~OOO per \'eh) $ 500,000 ($] 00,000 per Veh) $1,000,000 ($250,000 per Veh) $ 500,000/$ ] ,000,000 Agg. $1,000,000/$ 3,000,000 Agg. $5,000,000/$ r 0,000,000 Agg. Garage Keepers f\1edicaJ Professional JNSCKLs.r x IF VLPI VLP2 VLP3 BLL HKLI HKL2 11KL3 AIRl AIR2 AIRJ ~, AEOl AE02 AE03 WL X ,'\pr it 22. I C)tj.1 ) ~ I 'rint ing Installation Floater I\1axirnum value of Equiprnent I nstaHed Hazardous Cargo Transporter $ 300,000 (Requires t\1CS-90) $500,000 (Requires MCS-90) $1,000,000 (Requires MCS-90) Bailee Liab. Maxirl1uln Value of Property Hangark eepers Liability $ 300,000 $ 500,000 $ 1,000,000 i\ircrafi Liability $25,000,000 $ 1,000,000 $ 1,000,000 Architects Errors $ 250,000 per Occurrence/$ 500,000 Agg. & Omissions $ 500,000 per Occ.urrence/$I,OOO,OOO Agg. $ J ,000,000 per Occurrencel$3,OOO,000 Agg. Watercraft Liability $500,000 INSU'MNCE AGENT'S ST A.fEMEN'r 1 have reviewed the above requirements with the bidder named below. The following dcductibles apply to the corresponding poOCy. POLICY DEDUCTIBLES Liability policies are _ Occurrence Claims Made Insurance Agency Signature BIDDERS STATEMENT ( understand the insurance that will be mandatory ifawarded the contract and will comply in full with all the requirements. Ad m i n i stra t i vc 1 rt."ct ru<..1 ion #4709.01 Bidder Signal urc INSCKLs.r t) :'\ pl i J 2 2. r <J~ J J sf l'ril11 ;ng \VORKERS' C01\1PENSA l~ION INSURANCE REQUIREl\1EN.rs FOR CONTRACT BET\\'EEN l\10NI~OE COUNTY, FLORIDA AND Prior to the conlmencement of 'W.ork governed by this contract, the (~onlractor shall obtain \Vorke~~' Compensation Insurance \.\,ilh limits sufficient to respond to Plorida Statute 440. I n addition, the Contractor shall obtain Employers' Liability Insurance \vith limits of not less than: $1 OO~OOO Bodily Injury by Accident $500,000 Bodily I~jury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies auth~.Hized to transact business in tbe state of Florida and the company or comparu.es must maintain a nlinimum rating of A- VI, as assigned by the A.M. Best Company. · If the Contractor has been approved by the Florida.s Department of Labor, as an authorized self- insurer, the County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of I nsurance, providing details on the Contractor's Excess Insurance Program. [fthe Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. Administrati\'e lnstructicm f/47091 \\' C J ~ I \\IORKERS' COlV1 PENSA TI01\T INSLJRAr\CE REQUIREJ\1EN1'S FOR CONTRACT BEn\'EEN MONROE COUNTY, FLORIDA AND Re~gnizing that the work governed by this contract involves Maritime Operations, the Contractor's Workers' Compen<.>ation Insurance Policy shall include coverage for claims subject to the Federal Jones Act (46 U.S.c.A. subsection 688) with limits not less than those specified for Employer's Liability. The Contractor shall be pelmiUed to provide Jones Act Coverage tllrOHgh a~parate Protection and Indemnity Policy, in so far as the coverage provided is no less restrictive than would have been provided by a Workers' Compensation policy. ^dmini.~aJj vc I ns1.ru cti on WCJA /(4709. J X4 /\prif 22. 1(}'J.l 1 ~ ('ri"ting GENERAL LIAlllLlll' INSURANCE REQUIREl\1ENTS FOR CONTRACf n Err\VEEN i\10NROE COlINTY, FLORII)A AND Prior to the commencement of\v0rk 1!ovemed bv this contract, the Contractor shall obtain General Liability 1 nsurance. Coverag~ shall be n;aintained throughout the life of the conI ract and include, ,as a minimum: ,~ · Premises Operations · Products and Completed Operations · Blanket Contractual Liability · Personal Injury Liability · Expanded Definition of Property DaJnage rrhe minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) ..... I f split limits are provided, the minimum limits acceptable shall be: $100,,000 per Person $300,000 per Occurrence $ 50)000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after thc effective datc of this contract. In addition, the period for which claims may be reponed should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shaIl be named as Additional r nsured on all policies issued to satisty the above requirements. ^dmin;~t i\'c J~1nK1'()n GLl 114 709. J 5.t April 22. I (}().1 1st l\rinlill~; VEIJICLE LIABILITY INSURANCE REQUIREr\1ENTS FOR CONTRACT llE'l,\'EEN J\10NROE COUNTY, FLORIDA AND Recognizing that the \\'ork governed by this contract requires the use of vehicles, the Contractor" prior t~,the commcncetncnt of work, shall obtain VchlcJc L.iability Insurance. Coverage shall be rnamtained throughout the life of the contract and include, as a minin1u~ liability coverage for: . O\\lned, Non-O\\'ned, and I {ired \' ehicles The minimum limits acceptable shall be: $100,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: .. $ 50,000 per Person $100,000 per Occurrence $ 25,000 Property Damage The t\1onroe County Board of Coun!)' Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. Administnlti vc In.c;tn Ic110n YLl 1i4709 1 75 /\pril 22. 19<).1 1 st Print ing \\'ArrtER CRAFT I.JIAllll.,JT\' INSURANCE REQUIRE1\'lEN1'S FOR CONTRACT BErr\\.'EEN 1\'10NROE COUNTI', FLORIDA AND Prior tcHhe commencement of work governed by this contract, the Contractor shall obtain Water Crafl Liability Insurance vvith (Cfrns no less restrictive th(ln those round in the standard" American" Institute Hull Clauses" (June 2, 1977 edition). Coverage shall be maintained throughout the life of the contract and include, as a (nininllJln: · Injury (including death) to any Person · Damage to Fixed or tv1~vablc Objects · Costs Associated ~'ilh the Removal of\\!reckcd \lesse!s · Contractual Liabilit), with Respect to this Contract If the policy oblained slates tRat coverage applies for the "Acts or Omissions ofa Vessel", il shall be endorsed to provide coverage for tne legalliabilily of the shipowner. The minimum limits acceptabJe shall be: $500,000 Combined Single Limit (CSL) Coverage provided by a Protection and Indemnity Club (P&I) shall be subject to the approval of the County. The l\1onroe County Board of County C0J11nlissioners shall be named as Additional Insured on all policies issued 10 satisfy the above requirenlenls. ^dmini~r111 ivc )n~nJc1 ton \\! L I #4709.1 xc) SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE ~l71 N'cJ / J..i 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 Ord inance 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, comm ission, percentage, gi ft, or consideration paid to the former County officer or employee. (;{~~ cu- ~ (signature) ~ Date: //- r-7~ STATE OF ~~ COUNTY OF ~ #n{,,>€,' PERSONALLY APPEARED BEFOR~ Mrhc undersigned authority, ~ r /1" ( A n/e> ~/ who, after first being sworn by me, affixed his/her I ~i/'IA signature (name of individual signing) in the space provided above on this 7' ~day of ~ c:; _ L'JY€/Yl6U/,19 7'0 ~~ ~. /i': -Z?~ NCYTARY PUBLIC My con1nl ission expires: ()MB - ~1CP FOl{M #4 .:oii\r;.~'r~~ Gloria K. McGee ~*{ }*} MY COMMISSION # CC529329 EXPIRES ~~.. .Ht~ March 24,1999 ""'R~,fh'\\\" BONDED THRU TROY FAIN fNSURANCE,INC. DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: A 7I'/yt;) leis (Name of Business) I. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is p.rohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Infonn employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be impo~ed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (I). 4. In the statement specified in subsection (I), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the enlployee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's comrTIunity, or any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. tX~Ci/- ~_ Bidder's Signature /1- y~ ?~nn Date OMB - MCP#5 of ~~(;d/{/ of the Gfty-, / according to law on my oath, and under penalty of perjury, depose and say that; .. 1) I am A 7?';YC:) /t:/ S Proposal for the project described as follows: c/J?~ M 9(;-if t' j - /1f:---.4 t',,4 / ~ l/cJ.3/i .2 ~ 7 7 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; , the bidder making the 3) Unless otherwise required by law, the prices which have been quoted in 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 competitor; 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; STATE OF 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 contracts for said project. /7~ cA/. (jLL( - ( ignature of Bidder) r/~ COUNTY OF /T;,f~~ /1//5t:)E /1'- Y--7~ DATE ~ERSONALL Y APPEARED B~/ME, the undersigned authority, /7f1r /? i /Ix fftJ/o who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this eyt( day of ,~;/€4~c'~7,19 7G. ~ '~. ~~ My commission expires: NOTARY PUBLIC OMS - MCP FORM #1 "\"'';..~ff~,,,, ~..~~...~~ Gloria K. McGee ~"r@.()"i MY COMMISSION /I CC529329 EXPIRES ~~it March 24, 1999 II "Hr..n\" BONDeD THRu TROY FAIN INSURANCE, INC. DONATO INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERtiFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. o. BOX 607518 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ORLANDO FL 32860-751 COMPANIES AFFORDING COVERAGE 407-889-7525 COMPANY A CONNECTICUT INDEMNITY INSURANCE GROUP INSURED ARNOLD'S TOHING SERVICE 5540 3RD A VENUE KEY WEST FL 33040 COMPANY B COMPANY C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI110N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR ~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION OA TE (MM/DOIYY) DA TE (MM/DO/YY) UMITS GENERAL LIABILITY 1 COMMERCIAL GENERAl UABIUTY ~_ ~_J CLAIMS MADE CJ OCCUR OWNER'S & CONTRACTOR'S PAOT h-J IiI,"! i o___/~- --__~___ _0..._ ~.. __...._._ .__ ~_.."_ C- GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PE RSONAL & ADV INJURY R ece i " cd l _ .--'.i r ,,':: L .:, ;~:'~ ~ :;~.~~( EACH OCCURRENCE iNI'J'li~.J" __ ~.__ FIRE DAMAGE (Anyone fire) - - ,., --~ MED EXfT(Any one person) AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS A X HIRED AUTOS X NON-OWNED AUTOS COMBINED SINGLE LIMIT $ - . - - - -~-~Qq ! qQq- BODIL Y INJURY (Per person) $ TT100291 04/30/96 04/30/97 GARAGE LIABILITY ANY AUTO A X X --_._~~.,._- --------- EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FOAM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR! INCL PARTNERSIEXECUTIVE OFFICERS ARE: EXCL OTHER RAGEKEEPfRS LEGAL LIAB A ON HOOK TT100291 04/30/96 04/30/97 AUTO ONLY - EA ACCIDENT $ r;TH-~~-~~~ AUTO ~NL Y: EACH ACCIDENT $ AGGREGA TE $ EACH OCCURRENCE 500,000 500,000 500,000 AGGREGA TE $ ---~ By O~Tf ?-I;;-~? I. _________ _._____ IY'" '~q: ":,'A /" VC" I'!. . ______.._ STATUTORY LIMITS EACH ACCIDENT DISEASE" POLICY LIMIT $ $ DISEASE - EACH EMPLOYEE $ TT100291 04/30/96 04/30/97 $1,000. DEDUCTIBLE $1,000. DEDUCTIBLE 50,000.00 50,000.00 DESCRIPTION OF OPERA TIONS/LOeA TIONSNEHICLES/SPECIAL ITEMS MONROE COUNTY BOARD OF COUNTY COftffISSIONERS IS INCLUDED AS ADDITIONAL INSURED. CERTIFICATE HOtOER\>>::: " . . ...................... .. ................ ... . . ,', ............. ,0 . .0... ... .... ... .' -::::::::~: ~:~: ~: ~::: ~: ~: ~: ~: ~:~: ~: ~:~: ~ ~ ~:::::::.' . . ".:::CANC:EttAfio:N}>:".:: MONROE COUNTY BOARD OF COUNTY COftffISSIONERS A TTN : 16 . KIM BLANCO 5100 COLLEGE ROAD KEY WEST FL 33040-4399 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r Yi,1j] --r .lli}j/]m _____ f_.._____ ""._____.u~_~~~_~~_.C~APOf1ATION 1993 ACOR~_~~~~__<!~~_ - - ~ .~= . - -=C" -:=:." -"'.~_--;;:. .:..: -=-- :: ", '. . _'-'''' _, " _ ~........ . _ ,__ , ,,",'. ,,......,.., , , _ _ - --- ...~ r- _____ _ __. __ , -. '.,.,'. "~""f'"C~ "1!{it': ".;r."~"~ (l1.J~. ~t ~. 6h (.1' f.fil~b)~}i.~, 'I,l1!Rf.' !"~F:~'.. IttUf cAl1! p...:;r.;r;,~' '''M". . ,~~.. 'II' ~ · ~'~d,*~- .;' ,m: . · , , . '!~ ~~~ n ). ;','" "".e....:"".~-..u.k.~~~ ':tq~~ · " m . ..... _, , II.N .1;_-LI 0 8 / 1 e; L~_._. . THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON mE REVERSE SIDE OF' THIS FOAM. ~OOUC(n SU~CE 2765 Ins f\&.Ir' J 12;0' AM I NOON ~ndQn rntern~tional Group .600 Koger Blvd., ~225 t. PetQ~Sburg, Fl 33702 (813) 57B-2800 J..M P~J 10/19/96 I c.u~, ~~-!~- , (\rnold/g Towing p540 3rd AVenu~ ~(ey WGS t :( 3 0 5 ) 2 9 6 - J 8 ) 2 ~lS eIN~R JS [SSVEt) m ~o COvt1\.l.Q e fN 'TrE A8{)VC r'^ME D (X)MPANY ~ EXPiRl~ POUCY NU: FL 3:1040 I.L owing cervice. Insured will be towing stranded boats o shore with a 1994 16' Carolina kiff, powered by a 25 horGepowe~ ngine. Service r-t:::rro DATE FOR etAlMe MAD6~ GENffiAL ,,~~~~ V' PP=ODUCTs . CC'IP(:)f> AGO. . i PEAS~l &. MN, lNJlAT ~ ~, . fAC.t1 OOYJAAEN~ ~----4L-_ ________ ___ rlPE DI\MAGE (My OM n~ I I MfD F:XI'ENSf rA~yo~ ~- ~ COMO IN~ S 1r..;Q LE U lA rT S ___ _ 6CO'L yLt\l J URY :p Q r P9"'- rOIl) i~ A.,",'Y ALJ~O , I N_ L () ~.w''' 2D AU i 00 r~ 5O--iEeu f C ALrT ~ .__ HlhED Io.Ul~ NCN-ONNS) ^UiOO G AP....t..(} ~ UN) I U fY OOD<l Y Q.J JL.fR)' ., .aC'd.d.fT\) ~ rflOPffil"Y o..v~ E I ~ . AUTO P'tfyt!O^L OAUI.OC :"'~C'IIO~ "~ COLtJ&IC'N: I Oil-1m 1;W-/ eOL ;' &Ci~l'-~I-UrY----- AU Vf~lC':US ~HEDULf.O ~s Iv: E(),CI.~ rA, Yl.<e."T:!I+ _ _ PE;.RSON.AJ... NJURY P~T. It Vr-;[t~"(D M010A~T -----~l-~ ---- - ------r---.- ,S ur'<OfiLlLA FORJ., on-4(~ n<-^J.J U~OF<UA Fon,.~ RZmO Q..\ n: ~ ~r.l~ ~~ I\<...IUJ..L CASti VA.lUt: --- LS~~~'!"L__; , f --1~~_ -__ _ j _ ~~~~~~'CF .._--+~_ a&FNS-Uf<;D~ONi;---- ~01~;;~~~~MI~ ='T~T~~~~_~-~~~~" DIS::WE-POLr.:r ~1/..-1IT t j - - - -~ --~--t --- - - ---- DISu..sf EAC-H nt.P'<...QYLE ; I -~- ----------- -~ ~ ------ rv (1 ~ I'( r- H e C 0 td , rN..o to. no t-4 AHO .. ... P l 0 Y{ Fn:J l r ~ l ("f'y 31>tcl"-l. CON ", n<>wc./OTH ell GOVERA.Qrt\ ~'y p e : & !nd\3rnnity InsIJranc;~ ~' I n' ,< ( I," n T ...' ,. ~ \ \, J .. '~--~/:"~' ^l ~~., ~ _", -r - j .-. I. '~', ' L99L/ cn~'-II.//9 Ycs.t Mn.-ufacrurcr '-" , -~ A ~~. · &.:..1"-7, ~.. ~ t'1.... . ...., ~ A t. '-".....! . ... A 'V ) . & ~ ~ A." . _. ~ , _. .... ... .... . _ . I DESCRIPTION dr.-W A TERCRAFT (H Rental, compldc the~tal Vt:sscl Schedule) T L~ I [ .:neth ~S Motor/engine year Manufacturer TOlal Horsepower Single or Twin? Max Boat Speed BO<lt Type: ~ Outboard 0 lnbollfd 0 In/Ouldrive 0 Sail 0 Jct 0 Air 0 MlJIuaJ 0 House 0 Pontoon 0 Personal Watercraft 0 Sass Boat Material: 0 FibtrglMs (1) 0 Aluminum (5) 0 Wood (2) 0 Sfeel/Mefal 0 Other s,e I;C:P Model Weight Hull 10 /I I Current Actual Cash Value of W.tercraft & Fquip,uent? .6--; t9 V ~ Purchase Dare Purchase Price -- -..-... LIMlTS OF NA VIGA TI<.JN - Coverage appnes only to terrItory selected below. Chcck ALL that '?pl)' Covcrege always includes: Inland lalccs, r"lus and waterways of the USA illCluding rhl JlliracoaJral Waterway, ~cep( (hl Great Laks, lAic.( Mead. lAke Tahoe and Lak Powell or the Fo~ Rivlr/Chaill o/Lakes. Illinois a Ukc MCAd 0 LAke Tthoc 0 Lake Powell o ~ La.k~ It tributAries Incl~di:lg the St Ww'rtn~ Rivc( not below Quetx,c D Al~\cM Co3Stal: 25 miles off-~ho~ o Fox RivcrlCh&in of Lak~, IllinoIs o CAtladlan InlAnd lakes and walerways a A(!a..'ltic 00eJltl from 13~tpo[l, M:ainc to Kty Wcst. FJorida o Pacific Ocun from Cape FI~"cry. Washington to lmJXtidl D~ct.. CA o E MamM Cru ising . Wa~trcraft Uability Watercraft Llability Including Crew Watercraft & Equipment (HuH) Medical Payments Tn fler ------- Persona I Effects Waterski Lirtbility ---- S100 $250 $250 If m bn/itfing (0 bUId, ifldicau aI{ illrcltargt':S _ % N:lVigalion _ % MVR _ % ll\expcrien~ Op<<ator _ %Dcductiblc OM eudia uu.J W UJ!C/I{au prr.millm: _ % 15% CQf1ln.tulll-Owncr _'/" Ifl(.TUSro Haurd _10% Addil;onAllu((rCSI Is thue a: LIE~lIOLDER, ADDITIONAL INTERFSrs & PREMIUM FINANCEINFORMA nON o Licnholde; ~ditiona1lntcres.( !P;plain iPt..en:st) /7",-'-'" 0 Premium Finance Company ~/770,A/~L /p.,r-..Su/~ /J?()~~C L5(),t:;/4i:) ~F ~7Y ~//7(...s-.s/~N~ ~/ t/ 0 CLJ,-~~ /Zo~ / CY N~rl F L- ..3...3 d VO - 1/...39'7 I~SURED'S STATEMENT &. STGNATURE Nunc & Conl pi ctc IV-aifing Ad dress Th is notic" Is r.1vcn ,<I wmpi lM<X witt the Federal fair Credi( Reponing Aet (public UI,\' 91.508). I ufldenl.1nd that Il." ~ pan of the Company'~ undcrwflting procedure, .. routine inquIry m~y be m~de which will jlfQvidc applicablc In (0 mull ion coll<xming chlLt1l.cler. general replllarion, pcnon~1 characlUlstle~. modc o( living and driviag ((COld Upon wr.n.cn reqUCSt, additional i,,(omWlon 8.5 to the ~pc o( the report, If one is made, will be provided. J uada-.t..ad and I ar.rcr l~ abide by allltrm( ,"od c.ondilions or (he po"'y. I underHand Ihat rhe maximum limit or lialJlIlIy for hull coverage Is Ihe acfu.I CI~b vafu< (ACV) ar rbt lime ofloi.S or rht sUttcd ACV .boy~, wilkhcycr Is le1R. The f0~&oing staU.mr IllS m,ld, llI1d signcd by thc owner(s) WatlatlU the InfonnBtion G( t (OM as corrc.cllUld " (rue l>~is on whIch io<;uran<x may l>c grantcd bUl ;1 in no way binds me a.'pliUOI to arcept quotation or iruurcrs 10 -CCCpl risk. RfNT ALS ONLY: I understllud that I may jcopardiu my covcrntc i(l do /lO1 obt.a.in A.I1d CX(Q1lC witll thr Ic'\s(( lj \ignrd rcnud nt~tOlcn( which CQn(nln$ all approved hold hMTnlcss d.1uSC Appl'C.lt\('S \'I'.nnro" ~:{.~ ~~ Title _~~Y.{<} D.lIr _I/)~ Pt<)ducer - ------ --- - .-..- ----- ..~--_.______._u__. _ _-.--___ ...------------- -----________ -4-- _ __ ____-__-_____--___-______ __ ___. Donato Insurance Agency, Inc. INSURED NAME ~ Effective Date 08/21/96 /' P.o. Box 60751 R · Orlando. FL 32X60-75I R (407) X89-7525 · Wals 800-227-74H6 · Fax (407) XX9-t}44I INVOICE All premIums payable on or before effective date of po/icy_ ARNOLD'S TOWING SERVICE/KEY WEST 5540 3RD AVENUE KEY.WEST, FL 33040-0000 00128 ACCOUNT NO. DATE 08/22/96 ARNOLD'S TOWING SERVICE/KEY WE PLEASE DETACH AND RETURN 1HIS PORTION WITH YOUR REMITTANCE PLEASE RETURN THIS PORTION TO INSURE PROPER CREDIT. THANK YOU! Insures To Policy Number Description 08/21/97 , 10619-02 Miscellaneous-Renewal AMOUNT DUE AGENCY POLLUTION INSURANCE 262.1.. PA YMENT ENCLOS[ Amount 262.11 262.11 ~ 'L f I I'" I i {/'I.liI. ll;'/-'~l" ; {-I'~ I'-'I--:;'()UI fit,. -;;,~~'