05/15/1991 Contract
r- I L r- n r-- n r."' ..-, ,- I' ,....., 0 r'~
r j t_ I. ,- ," :..-' t J r i ;
CARD SOUND Gp~~~H CANOPY
-91 JUf".J 26 P 3 :4
THIS AGREEMENT., made and entered into this Lth day of /fi!... , 1991,
by and betw~en Monroe County, Florida, party of th~st part
(hereinaftr~~dsometimes ~alled the "Owner"), and Biscayne Awning & Shade,
Inc., party of the second part (hereinafter sometimes called the
"Contractor").
WITNESSED: That the parties hereto, for
hereinafter set forth, mutually agree as follows:
the
consideration
1.01 SCOPE OF THE WORK
The Contractor shall furnish all labor, materials, equipment,
machinery, tools, apparatus, transportation and dump fees; and
perform all the work as stated in the Contractor's Proposal dated
March 8, 1991 and shall do everything required by this Contract.
1.02 THE CONTRACT SUM
A. The Owner shall pay to the Contractor for the faithful performance
of the Contract, in lawful money of the United States, as follows:
B. Based upon the price shown in the Proposal dated March 8, 1991
heretofore submitted to the Owner by the Contractor, a copy of said
Proposal being a part of these Contract Documents, the aggregate
amount of this Contract is the sum of
Nineteen Thousand Five Hundred Thirty Dollars ($ 19,530.00)
C. The Contractor shall invoice the Owner upon completion of the work.
The Owner shall pay the Contractor within 60 days of receipt of the
invoice and acceptance of the work. No other methods of payment
shall be acceptable to the Owner.
1 . 03 COMMENCEMENT AND COMPLETION OF WORK
A. The Contractor shall commence work within Ten (10) calendar days
after issuance of a Notice to Proceed.
B. The Contractor shall prosecute
diligence and shall complete the
calendar days after commencement.
the work with
work not later
faithfulness
than sixty
and
(60)
C. Prior to commencement the Contractor shall submit color samples for
selection by the County.
1
1.04 CONTRACTOR'S ACCEPTANCE OF CONDITIONS
A. The Contractor hereby agrees that he has carefully examined the
site and has made investigations to fully satisfy himself that such
site is correct and suitable for this work and he assumes full
responsibility therefore.
B. It is understood and agreed that the passing, approval, and/or
acceptance of any part of the work or material by the Owner shall
not operate as a waiver by the Owner of strict compliance with the
terms of this Contract, and the Proposal covering said work; and
the Owner may require the Contractor and/or his surety repair,
replace, restore, and/or make to comply strictly and in all things
with the Contract and the Proposal any and all of said work and/or
materials which within a period of one year from and after the date
of the passing, approval, and/or acceptance of any such work or
material, are found to be defective or to fail in any way to comply
with this Contract or with the Proposal. This provision shall not
apply to materials or equipment normally expected to deteriorate or
wear out and become subject to normal repair and replacement before
their condition is discovered. Failure on the part of the
Contractor and/or his Surety to replace defective materials and
workmanship shall entitle the Owner, if it sees fit, to replace or
repair the same and recover the reasonable cost of such replacement
and/or repair from the Contractor and/or his surety, who shall in
any event be jointly and severely liable to the Owner for all
damage, loss, and expense caused to the Owner by reason of the
Contractor's breach of this Contract and/or his failure to comply
strictly and in all things with this Contract and with the
Proposal.
1.05 LIQUIDATED DAMAGES
A. It is mutually agreed that time is of the essence and should the
Contractor fail to complete the work within the specified time, or
any authorized extension thereof, there shall be deducted from the
compensation otherwise to be paid to the Contractor, and the Owner
will retain the amount of Fifty Dollars ($ 50.00) per calendar day
as fixed, agreed, and liquidated damages for each calendar day
elapsing beyond the specified time for completion or any authorized
extension thereof, which sum shall represent the actual damages
which the Owner will have sustained by failure of the Contractor to
complete the work within the specified time; it being further
agreed that said sum is not a penalty, but is the stipulated amount
of damages sustained by the Owner in the event of such default by
the Contractor.
B. For the purposes of this Article, the day of final acceptance of
the work shall be considered a day scheduled for completion.
2
1.06 INSURANCE
The Contractor shall furnish all
County Code, Monroe County Public
Federal Statutes.
insurances as required by Monroe
Works Manual, and all State and
Prior to the execution of this Contract, the Contractor shall
furnish the Owner with Certificates of Insurance indicating current
coverage in the minimum amounts herein stated and name Monroe
County as an additional insured.
Minimum limitations of required insurances are:
Public Liability
Property Damage
Worker's Compensation
$ 500,000.00
$ 500,000.00
statutory
1.07 INDEMNIFICATION AND HOLD HARMLESS
The Contractor shall defend, indemnify and hold harmless the
County, its officials, employees and agents, from any and all
claims, liabilities, losses and causes of action which may arise
out of the performance of the Contract except such causes of action
may which may arise because of the County's negligent actions or
omissions. Compliance with the insurance requirements shall not
relieve the Contractor from the obligations imposed by this
article.
1.08 PAYMENT
In accordance with the prOV1S1ons fully set forth herein, and
subject to additions and deductions as provided, the Owner shall
pay the Contractor as follows:
Lump sum for full contract price upon one hundred percent (100%)
completion and acceptance by the Owner. All written warranties,
manufacturer's data, and operational manuals shall be furnished by
the Contractor to the owner prior to final acceptance and payment.
1.09 PUBLIC ENTITY CRIMES
A. The Contractor shall complete the attached sworn statement and
shall return it with the executed contract.
1.10 ETHICS CLAUSE
A. The Contractor shall complete the attached sworn statement under
Ordinance No. 010-1990 and shall return it with the executed
contract.
3
IN WITNESS WHEREOF the parties hereto have executed this Agreement
on the day and date first above written in four (4) counterparts,
each of which shall, without proof or accounting for the other
counterparts, be deemed an original Contract*
By
MONROE COUNTY
Party of the First Part
By: \.k:).~.tvv~~~ ~
Attest:
DANNY L. KOTflHAGE, Clerk
(Seal)
.
Singed, Sealed and Witnessed in
the ~esence, of: ** .
L'c~ iP-c;
cY~/r<~~..;_)
BISCAYNE AWNING & SHADE, INC.
Party of~the Second ~rt
By: ~'LP' ~ //~-'(
T'-~: ~€ ~"l>e.~J,J
Attest:
(Seal)
(*) In the event that the Contractor is a Corporation, there shall be
attached to each counterpart a certified copy of a resolution of
the Board of Directors of the Corporation, authorizing the officer
who signs the Contract to do so in its behalf.
(**) Two witnesses are required when Contractor is sole ownership or
partnership.
4
:~;~:'j -~---- .
'f · :~ ':
. I .
i!
~; 1 .
-_~ iropusu '_..._.__u.. .N.~' 9'" ._ ..._...~~~~~_~.~::-_2.__,_~__~.
. h~ ."d~"l$cayne
~.WNIN,*' &~S"ADE COal .!NCa
242 S. W. 5th Street, l\"iami~Ffor;(ja .33'130
(305) 856-0701 (Dade) / 523-0203 (Brov-Jarcj .i (Fax) 854-1 ()7!..l I
--PRQj;{;$ACSu8t.m-mTO----------.------------J; s t:. t~:F l~{ - 2 45"..92 (:ia _. ..., OATf---- ------~-.---- '. ----.--~
__!.Os_~__~!.~KLE..!~..9.l:!Q.~~lE~I~~~~--.____..______._ ,~9131:~q~.__~~:~!J2Q.___ ._____fr.31 08191 I
STREf T JOB NAME ... . -- -- -.. - ..... -------. '-"1
1..~-~(r~{TH KI{OivlE AVE'NUE . H'EIGH ~Tp.'~CION(C^'~Os(),J"'O) . t
.'--wr:~:TAn:.~'No~~~pcGDe.-'----._.-------....----.-.----..... ._-" JOBlO~A~'~~" ,_u "-"'--'" ,,_... -.. --- -.'-- ......-..--.----.--..- -.--------i
HOHESTEAD, FL 33030 __ MOl'ill:Qf;J::_QtJ1~JX__ ._____ I
'CCN. T ^. CT f'fRSON: ..~.__..~._...--.--._.--.-.-I..-s. A.f..'€S7AE?', ..----. ""FAA/.IE'::};,_ v'$C;jCOl;Lf."~' .- ... "1 ~;~0:;~A'- '".- --.~-..::..==:~:;..::.~.--;;.-~',;.:.;;;:::;.:---:-==--'. -- ._.~
_.....J.~.:..J!..~~'-~'"~.,(~K~..~-~--.-R .;..",,'3:'\ R'<::~..~ NT. ~_ ... . g TF!<:L Ji,W L II F D 'P -~ TT 0 SOO V 11'iYL 16 (; i:, I
We tl61 "'by au bmlt lipacifications and filtl:: for. _ ..__......__.___ _ ___ _._ _........ _ _ _"_ _ _" __ ..__ ___.. ______ I
- ---...-.-... '--"~~=1
_~===~..~Z~~~~~~!~1i~....~~~.:..-....: .._":-" .:'''~ :-. ..- ... ..-..~..:=--~=.-.~~..=-.~~..=..~=-J
. 2 .___!:~~~
1
. .to'-a'
-~IIM l- ~I"'--'" l1..TllT pi' ...__ iII'-' ..w,.,,~.--~..~~r.'<:I~'.~o;.-,..;.."t;..;...:7':_.(,~~;.:;;r~ii;:.,'...~>1...,....;;:.&"'~~ '--'--.- - .---~---_.--
._._-._..___.__ ~,_,_,___ u_A______... ..._ ...__. .~~tIfQ,tIf~....,.-~- ~"'T l' ....,..-
--------- ---.-----..--...-..---... -..-----....-. ....- - . -.. :"- :..---..-..=~-[tr=~-.~--~-.==-j
--. - ""'-'''- --- _ --I !~,------..---1
, ;
-[-_.__...~._.. . ---...-.. !
tf-i
I - 11 -.- - ---- --- .
I . -t .1... --.. -- ---
I'" . ".. --..~.-, rf' .~-.. y ~ -,~"'--~...._~j
..... ...:....~u~,.,....__.............- ........-.., .6.........~--..._....__-.-.Jl i
!~--- --........ -- .-. - -. \.------------ ----- '---"'- "-rlTT 1 .... -...' .. -" . (. I '\ - - --- .. --I1i"Y - - '" ---- ----. '
~----.'----.- d-~ -----..-.--~.-l.....- -- -0 - ..-,------.-.L::J. ,------. ..- ..'
~ ~~ ~~~~~~J
Pa)'nent to b~ tn~de as foHows: (i 8 % ~nterest (/:'1 ~ate pay~'ne?)ts) ~
112 Deposit and Balance t)n the day of CCfnpierr.:;n. ~
------..--- ---- .....-..-- ----.... ----------.- .. -----_..- - --'-'- "-~l-" -'---'''---' . .... ..... - ". .-. ....... - ......- .-.. -..--..::::----- - ------1
PRI.~!:___S1;;_~_1J\s.zLL_._...._____...._____... I. /'1 /'C- .i I
-. .,_._..T A~_;__...__ -..- --'--'. ----------.------~--.. ~"~ '-' ..----~-.-. ,. ._--,~ I ~~l~~~ii;~d .-{~-<.:i./J./.::.-;.,-;/.~t'-;::- _j~"~/:'~"/~-' "_ '_'__"~:l.
_TOTA~___ -......--.. .-.------....--.----.,---.---.--.- r J'~ :
DEPOSIT: ..----.---.- eK Q-...- CAS~1 .P II. ~=,.". '.,,-~ ."".. ..-_.~....-.,". . "-.'-'-'=. =--c",;::;::''-'.. -- ...~..,.;.."."=. '''=''''i
Le.~..~.c_~_: _...,.._-.. ...._____..._......_~-.___.._...... _ .,,+.,_..____ O;tt~, ct .!',:~((l)i..~;.<~0 ..._. .....__..... __.. ....
I II Si'Jn.,r::.!;l "'''_'. ...._._.... .-.---..---- .....-..-...-.....
I II -- ---. ---...-.. .. .
--6" ppe----..---
.". -- - --.--
~. - 2 1:-:1 - - .:;:::-, ..or
L.J E D
';a : -3 ....:t
:r;:= :;.': c:. .:;3. Y ,--, e
:'-. t '..d ';-'a r's -~ ' c.. '::.1
I t-, '::.. f--=' W;::~ ::-~
r- -'.-:---...-
",
B;:~;y~-e _~.____....~!~~~J~:__-l_.?!___~_~ paS$1
AWNING & SHADE CO., INC. 1
242 S.W. 5ttl Street, Miami, Florida 3.3130 ,
(305) 856-0701 (Dade) I 523-02Q3 (Braward) / (Fax! ~;54.1 074 J
Est!t 1924 ,
PROPOSAUMiMillli;T()"-----.--..--.-.---- .PHONE FAX-Z45-':'9' 20S"-.1.c,AfE...._- .-- -...--. -'-...- -""., ...-!
_--.l'O~'L.!!y_t';K~Y SCHUH. JERNIGA::{._.______ J-~.._~_.Ht:47.;)Q..J__.._-'~)jQfll1 . . :
STREET JOe NWAMEeIG"ll ..... '[' ^'T 'r (". --'-- -....- ... -- ......_~. "
~.__.!._~i?J<.Tt!.,_~~~.O~AV.[lliIE ---__'_4___.~_______ :rM " .'7L L t~~
C'T'(. Sf... Tf ANC l,P C1:lOEJOe L~ no-;;~_L_...~ ..... . -"'---.- .--.... ..-.... .-.....-.-.-.'1
H.Oi'"r~::: ~T.EAD.r FL 330 3q ---...r---.--------- .,.-.... ~,. MO.. r~R0Ji---:~<;9::..~t.~~ll~;,:=~~;-~~..::;:.-=~':;.~~=:.=~----. ...-. -.--____ ..__,._.~"_. ,--~-.l
ce.. : ~~ - " SAl(S/REF FRAME GALV SCrjEOULE -4U I ~OVe:A .----~.-------..~- .----.. i
, . ,
· i ~:':1 . '1:, R GARGAN"'A S""FEl \'4~t.~I '"'En .) t T 1 r'i f:)(1 U '-Y'Vl "." .~\.~ ~
~___. ':-'__-':":'~".' . '~_'_ ___..:-=-~ - _.w__"__.:..:.;.....:..:. ~~ .1_'.1 r~...J -,--', J..) . .i: ^'\ .J.'. .jl · ~!..;.v;.~ i ')'--;,~, i
f~~ h6fOOy e[.;~'r' ., ,:,......:i11caiionund estimate for. THIS PROPOSAL / CONTRACT VO m:::; PR\.!POSAL DArED 01;' 29/5,1 j
~-__:c:~~,gl~ _ I~~ C.~JfD ~ S A~~__~L ~.~J..~I CA~..1:):;,\r.ll?:~~ .~::rr~~~.fp.r-9- X~:."J{t:' _... ._._... ..__~ ...______.__....__. .
t....-..!=;~~E.~~1<~~;~c JiQ 9J\...UP .. AT ..1.. OIL S I T;..JiJ.!-_L2~ .&'L@D 11:.H: K~L ..P, ~ s.r.:; t'1;:: ;~:r~.._..____...___. ..~
..--..-..... .r~OH!FH-f.-B9l-'JTH-FILEVA1:'{ONS....H. . '-'" . ..... ...... ..---............----.........--..-.1
. . . '.'W .... ......... '____"_ .._ "'" _.. ..__.1
-=~==~---,...-.-.. .- ......=.. ..=--~-._~,~.....- ..~::~:~:=-~~~=~:~._#.~~"~,-..-..~==~~--.. t~~='~=--=
..-.--...-..-..---.-..-.-.-.-----..?J;;-~~t - '" . --.--- --'''-'''-.''f~- -..... --i
--.-------..-----... .. ~~~~~~l~ ~~~~~
-.~~--'".-~.-...-~--.. -- ~~r'IJ ~ .".. -_...~~,.....<"t~....,.."'-:~'j'-~__.,~.. ......;ra.....-..~-"-~:Jt- .tf--'~-- .-- ~. --.~ -,'
-.... ~.. _10_ _.~---..I.-.-;'.. ..........1 ~~...r..................-.~...;,.ft......;-.~A,-...... .. ... ..~.._.___lII[, .1IIl................_.................~...~ _
~.\P e'y r'n[l> ~;
------.. ~-..~~..-.;iI~ ~f.~~t----. --~"",ii.4~.,..h;.,,,~;;,..".~_.. . it- ----'--'-1
.=~==__~1:tiil1-Tar-~~~.-.=~~~....~-_~..~.:~.~-...-. .... . '-' ..._~.~.~~~. JI~~~~....~~._..~~
--m..---__~t'..~=~==__-...-.~~.-...:-.~___......=_.._...: ..~-. ----' -- . ----. . "I'~---'" "'__'___1
. _. -- -- - -.. ... -...... I " - ~ .. .. .. ". . .. . __ . . ".. .~ .. ...... .. . .... r"~'-'-'" ........ .-.. i
,I 'h'~.,.,.. -, 'I' r ~~~)-. ~ ..~...,~ ,.I~.,;,,,~ ~l..!._a.."p;.:.~ll' . . .! . . .
!......---.--... ...rUi~~te--iootini ..............-- :~~~~S~~~~:i~ ~~~~~::~~~~~~;~=~-........C:J. ... ....' . r
. ..--. ..- -laee"detailJ'" '- -.'.. -..._.. --.... '''' ..... . .... ....... ---- .... . . .... . .. ... .... -.....-.- - -....-. - ---. . .. '-i
.::.~:;r-=C'..;.;:::.--:-,--;..:-:... ...::.:::.;:.-..;;;:.=--===-===-='::O:::'==-.:.x::---=.:.-~...:.~~"";:O._===...~.,.-'-~,::,;-.;_=:';;.:._'7.~.;...."w...~~~;;:,=:'.:~::-':; ",:.-;-~.---:::;~- - "- .~. ::--'-'- ,.'. '~:...:..-...w-;-~,:. ;...:.- ':~.:,:;.::;:~.:-_...:-~:..;:;---;:~..~-..;.:::-:.-:;:':..,~:;::.:;,; .~~:l
)
;
--.---..---..---...--.-.---..---------~....-~....--..--------.--. -...,-...-....-- .-... ~-.----- ~- - -....~ . rlc-t't!ir~ ($ _ _ ...... _.__._..___._.._.__~________...,.
I Payment to be made a~: follows' (1 Z % jntaresr on rate pairne'~s~ .
{' t 12 Deposit anrj 8.a!a!1ce on the ~h3.:I d .:;;:yr,r..l,3! L.):'.
r .....~;~~:~~~-9 ~.;.;~-~_-oo_=~=~--.--~~~.~~~-= .----r..----.. .... /1 .... .......- ..>;-.... ..--.-....-.j
r AX ~ 1-" t- -&\7 T \X l""l ,r R ~ T tJ i ~; " .! ._(_-,._::.,..~_~..'..::_.~_:~._".~_.:',...~~j'"...'<.P..:..'. _.!"~.__.~'-";'-'_.
; . . ..___...:.__...:::.t:.C.!::-!.._.-'::... .~A~"d_--'- .. l~ '~!J~roO"U'11 · .-; { "'. , ~. .' .
: . ~ ,.., ~ ,... .. ~ ~. 1 Q ~ 30 00 (Cl)) !; S ll~;-' ..ih,~ tP. d. ~ \..- _...-~ \,..A,".' ~_ ,-'r .!. ~_..:... -' .. _... _.. . _..._ _~...
! D €j~~:~._. :~~=; ...~ :; .i.~..:..~~~. ~_...:~~~- 0" jl .,~ ~'7.7' ,. c.-c. ...... ..~,~7.~C ~.. .c-~.~ . .". (~/...,.~ '..~ .c,.' ~ . j
Gl ~t dt.JCE: ~-t)~~Y~0~.~~~---'---"t ,il C;;:e'A '\'''(~;:,l'',).", I
:'::)~:~~':-'''-~.'''' .. -'0:'" ."({) dftC""'-- -- .--....- il · . '. . .... . -. -. ...-. u. '.
i !. I ~ 1 l :~ ,1' iJ, :,5.' 3D........ oj. ... - < :~.. - \Jr'''' c..o..., It. ~!J~ ~ !i ':;';,. . .
't' !).', =-. l i ~ , . - ,
l(
NON-COLLUSION AFFIDAVIT
I, Co.w(L..^P~
~r --
Efl-/c ~
, of the city of
AJI," """- " (-" (6.. according to law on my oath, and under penalty
'of perjurt, depose and say that;
1) I am rp(U~-5 il)~f of the firm of
!3,-SLNy,vG ~,J"f--X~ c,' Si~c,I~/, the bidder making the Proposal for the
project described as follow~ :
2) the prices in this bid have been arrived at independently
without collusion, consultation, communication or agreement for the
purpose of restricting competition, as to any matter relating to such
prices with any other bidder or with any competitor;
3) unless otherwise required by law, the prices which have been
quoted in this 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 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;
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.
STATE OF FLORIDA
COUNTY OF DADE
June 11, 1991
DATE
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
Co/V~/));> ,PE/(E2 who, after first being sworn by me,
(name of individual signing)
Affixed his/her signature in the space provided above on this //
day of d<'~ , 19 ?/ ·
a~1a~ /l#
NOTARY PUBLIC
My Commission expires
NOT A RY PUB(IC t .ST ATE OF FCORII1KJ
MV COMMISSION EXPIRES: AUG. 24, 199 f.
IONDE.D THRU NcnAItY puaLIC UNOEftWJltIT"R",
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
f31>C^'fr-'2-At.V~I;.v1~,(Lk--O<-G'/J~~arrants that it has not employed,
retained or otherw se had act on its behalf any former County office or
employee subject to the prohibition of Section 2 of Ordinance No.
010-1990 or any County officer or employee in violation of Section 3 of
Ordinance No. 010-1990. 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 of purchase
price, or otherwise recover, the full amount of any fee, commission,
percentage, gift, or consideration paid to the former County office or
employee.
////{b ~-{ P-'t{
~ (signature)
Date: 0~/;(?~
./ /
STATE OF FLORIDA
COUNTY OF DADE
PERSONALLY APPEARED BEFORE ME, the undersigned authority, ~~~/.rI9L> ;?~~~~
who, after first being sworn by me, affixed his/her signature (name of
individual signing) in the space provided above on this
~ ~{A./~L/ , 19 7/ .
(/
1/
day of
;l' /,/
a~d~~qj tl'f/7/If ^
NOTARY PUBLIC
My commission exoires:
NOTARY PUBLIC, STATE 0' FLl)IftU.:
MY COMMISSION EXPIIES: AUG. 24, 19.r.
.OND&O THRU NeTAIIY pua...lC UNO&a.aIT&"'"
5
. A.~..ltl.. CERTIFICATE OF INSURANCE
ISSlJt OA Tf U..1"A."(,,\ '
(~(. / ~, \ ~.~. J ,~,
I~ 0 u I tOT". A 9 e l'l C y, I n C r
THis-'ce-RTIFicATE "islSs'UEO AS-AMA TT-E'ri-OF'.'N'FORMA T~'or' 'ONi.." A" .u'.
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTt~ICA rl t
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 0 ':' 'rHL-~. I
POLlel! BELOW. __ _.~
COMPANIES AFFORDING COVERAGE !
I
I
I
COMPANY A
LETTER
~1 c:H- y r ,':! n d Cas U a I -L y <:: c. m p f~ n y
PAODUCfA
1. ~.~ (~ 0 0 1:1 i b L. ~~ Y n ~~ Ii I v d.. ... E; ~~ ~?
t1 i a rn i, F L. 3~:l J B:t .... 2"7 ,~ ~:l
INSURED
COMPANY B
LET1ER
F II <:; . C . I II
r'und
fs i !:. cay n ,~ Awn i n U & ~i had f~ C I:J I n r.:
2 4 ~? S ~Il r. ~ L , I f:) t J'- f~ f:~ t
t-1 i a In i F'L.
:'1 :~ 1 3 ,,)
COMPANY C
Lt: TTFR
COMPANY D
LETTER
COMrANV E
LETf!R
"'COVERAGeS ._.J ~......... ,..---...------" "'-1
THIS IS TO CERTIFY THAT TH~ POLIC'ES OF fNSURANCE USreOBELOW HAVE BEEN tSSUED TO THE tNSURED NAMeD ABOVE FO~ THE POLICY PEH.Jt)
tNOICATEO, NOTWITHSTANDJNG ANY REQUIREMENT, TEAM OR CONOtTION OF ANY CONTRACT OR OiHER DOCUMENT WITH ~ESPECT :0 ~!H:CH ....;.~.
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANce AFFORDED BY THE POL.fCIES DESCRIBED HEREIN IS SU6JECT TO A.LL T;-.E T':~"",~,
EXCLUSIONS AND CONOITIQNS OF SUCH POLICiES. LlMfrs SHOWN MAY HAVE BEeN REDUCEO BY PAID C1.AIMS. '
AUTOMOBILE LIABILITY'
A X ANY AUTO
X Al.l.. OWNEO AUTOS
X &CHCDULED AUTOS
X HIRED AUTOS
X NON. OWNED AuTOS
GARAGI:i LIABILITY
1 ~1P:L 2(,) 4 "139 5~?0 0R
'~5/251 '/1
I
1
i
I
GENERAL AGGREGATE $600 v ()(1~1
0~j 12~; / (} 2 P~OD1JCTS.COMPjOP AGO ~ f.~ ,~{a 'i ,) ,~~j ,
PERSONAl. & AD\/. INJUFiY $ ::I'~ (~ \' ',-:J'10 1
EACH OCCURRENCE $ 300 , (~q.0 I
FIRE DAMAGE iAny O~8 flr~) $ ~'i0 y 0~ Y) I
MEO, EXPENSE (A:',y onli per5<>'-'.l $ 5 t 0 () '!' --1
COMBINED SINGLE $ "
0~. I 'JC':"/9 .., liMIT ~, ..". ~ '\':-- f.~ t
'-' .A., ,., ..... .., YJ t..' .".. '. !
L'M'T&
CO
LTR
TVPE OF INSURANCE
POLICY NUM'E."
POLICY EFFeCTive 'OI.ICV I:xPtnA TlON
DATE (MM/DD/VY) DAT' (MM/DO/VY)
GEN~R"L LIABILITY
A X COMMERCIAL GENERAL LtABII..ITY
ClAtMS MADE X OCCUn
OWNER'S & CONTRACTOR'S P~OT.
1 MP 126 4 "1:~tCJ520(~H
05/:1.5/91
B
WOAK!R'S COMP!NSATION
AND
Eft' PLOY EAS' liABILITY
.., '-<I. B -12:2 9 6 .)(,
I
i
I
I
I
I
I
-----1
,
01/0 t /91 01. /01 /92 EACH ACCI:)ENT ,:t "0 '! ~'t'~;"(~ I
DISEASE-POLICY LIMIT ~ 500 l (700 \
D1SEA85-. EACH EMP-'LOYEE ~ 'J 0\1 '1l~(;- 1
. ~_:..J' ...:"_ ...-1_ --1
!
BODIL v I~JJURY
(Per PoriOr\)
$
BOOI L Y INJ un y
(PEt, accident)
$
PROPE:OTV DAMAGe
,
EXCESS LIABILITY
UMBRE l.I..A F'OnM
01 H~k THAN UMClRELLA FORM
EACH OCCURRENCE
ACiGAEGA TE
$
S
STATUTOfiY lfMITS
OTHER
I
,
I
,
,
~---l
DESCRIPTION OF OPERA TIONS/L.OCA TlON9iV!HICLES/SPfCIA'- ,TIMB
-1(. 3 0 d {"it Y not ice 0 -r r.: d 1") eel I a t ion a p p I j c; a b let 0 W 0 t'" k e I'" 's Com p n
t: 0 vel"" d t1 E .,
;
r
I
I
i
.~
,. - . _. - u_ __ ____-._
CERTIFICA TE HOLDER
CANCELLATION
SHQULO ANY OF THE ABOVE DESCRIBED PO~lCfES ee CANCfLLEU BEF~f~t T"e;
EXPfRATION DATE THEREOF, THE ISSU1NG COMPANY ~.'ILL ~NtJEAVj~ T,)
MOnl" oe CO~Ant Y MAIL 1(" DAYS WRITTEN NOTice TO TME CERT'FICATE HOl..DER N:~~I/~O i/) iHE
p\J tJ I i r.: Wo r- k LEFT, BUT FAILURe TO MAlt. SUCH NOTICE SHALL IMPOSE NO 06L1CATI')1\ ~)R I
At tn: Bt~th Seto LIABILITY OF ANY K'ND UPON Tt-iE COMPANY, ITS AGENTS O~ ~EPRESt:. IftTI.'f:S
P.O" Box 10:?9 AUTtt~I.~ED"I!""E9E~IV.E \.~). _, .-------.-~~.,I'.
Key "~e5 t FL 33041,--1029 I (I~,. ~\. (" \" ~\ \~~ 1
\ )\\jJ~_.i ~~ . \.:(j~ I ~
ACORD 25-9 (7/90) ACORD OOAPOAATiO~ 1890 ,
'.___.. .........___,-__......__. .___' ... ~__."........____..~__-.....r....-._~...-._-....---.........-.--- J"--- _.. --_._...~-_..__. . ,"-. --.. .--~_..-----_..- --"
.,
; "
S\\'ORN STATEl\IENT UNDER SECTI0~ 287.133(3)(a),
FLORIDA STATUTES. ON PUBUC ENl"ITI' CRIMES
THIS FO~f ~1UST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER
AUTHORIZED TO ADMINISTER OATHS.
1. This sworn statement is submitted with Bid, Proposal or Contract No. 5' q- 0 C, (, ~ '>'2 3>
for---ALAf~',./! A-' t-\j~dH s-IA.II~# C,,^-- (l/tOJR0eCbL)..:fj.
. B'? .'. ,r J, , ,-J < C ~ L11rV- C-a lA-lL,
This sworn statement is submitted by . / J CA 1~ t::- /\ vJ IV I ~.. '"t. r
[name of entity submi ng sworn statement]
(') t'
7- '-{- L- ::>, {;c J SO S> r
..
2.
whose business address is
;ilj I It ,AA- , ' , r:: eL-_,
/
-SS f 3 0
and
(if applicable) its Federal Employer Identification Number (FEIN) is 59- 0668 5 2 3
. ,
(If the entity has no FEINt include the Social Security Number of the individual signing this sworn
statement:
.)
3.
c- 0 tJ f--~ 0 Q ~s.~ -:c
[please print name or individual signing]
entity named above is -'Pe ~ .s I P C: ~1--
and my relationship to the
My name is
4. I understand that a Bpublic entity crimeB 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 with the United States, including, but not limited to, any bid or contract for goods or
services to be provided to any public entity or an agency or political subdivision of any other state
or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering,
conspiracy, or material misrepresentation.
5. 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 Slate trial coun 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.
6. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes. means:
1. .~ predecessor or successor of a person convicted of a public entity crime: or
2. An entity under the control of any natural person who is active in the management of the _
entity and who h~ been convicted of a public entity crime. The term naffi1iateB includes those
officers, directors, executives, partners, shareholders, employees, members, and agents who are active
in the management of an affiliate. The ownership by one person of shares constituting' a controllliig
interest in another person, or a pooling of equipment or income among persoDSwhen 'not'for fair
marker 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
affilia tee
7. .1 understand that a .person" as defined in Paragraph 287.133(1)(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 binding contract 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
",ith a public entity. The term "person" includes those officers, directors, executives, partners,
shareholders. employees, members, and agents who are active in management of an entity.
8. Based on information and belief, the statement which I have marked below is true in relation to the
entity submitting this sworn statement. [Please indicate which statement applies.]
/ Neither the entitv submitting this sworn statement, nor any officers, directOrs, executives, <
partners, shareholders, e"mployees, members, or agents who are active in management of the entity,
nor any affiliate of the entity have been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
~
_ The entity submitting this sworn statement, or one or more of the officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in 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, ~ [Please indicate which additional statement applies.]
_ There has been a proceeding concerning the conviction before a hearing' officer of
the State of Florida, Division of Administrative Hearings. The final order entered by the
hearing officer did not place the person or affiliate on the convicted vendor lisL [Please
attach a copy or the final order.]
_ The person or affiliate was placed on the oonvicted vendor list. There has been a
subsequent proceeding before a hearing officer of the State of Florida, Division of
Administrative Hearings. The final order entered by the hearing officer determined that it
was in the public interest to remove the person or affiliate from the convicted vendor lisL
[Please attach a copy of the Onal order.]
___ The person or affiliate has not been placed on the convicted vendor list. [please
describe any action taken by or pending with the Department or General Services.]
~/~~ ()~3
[signature]
Date: ~~ ~/j? /
STATE OF
FLORIDA
COUNTY OF DADE
N PERSONALLY APPEARED BEFORE ME, the undersigned authority,
UJ A/ R /11> /'E/f S Z
[name of individual signing]
who, after first being sworn by me, affixed his/her signature
in the space provided above on this
II
,<< ., 19 7/ .
'~0?74:~ Pd'/
NOTARY PUBLI(;
My commission expires:
NOTARY PUBlIC_ STA1E OF FlORIDA'l .
MY COMMISSION EXPIRES: AUG. 24, 1991.
aONDCQ ,..utu NQTAfty J'u8LIC UNDE"WftIT.......
For~ PUR 7068 (Rev. 11/89)