01/20/1994 Marker Repairs Tavernier Creek
.
and directing the execution of same by the proper authorities for the installation
of nine pile with Idle Speed/No Wake signs in a channel on the southwest side of
Summerland Key.
Enclosed are certified copies of the subject Resolutions for your riles.
6. Contract Agreement between Monroe County and Frank Keevan & Son, Inc., for
the emergency removal of DV091442.
7. Contract Agreement between Monroe County and Captain Dan's Marine Towing &
Salvage for Derelict Vessel removal 1994.
8. Contract Agreement between Monroe County and ASAP Marine Contractors, for the
emergency repair of Channel Markers #6, 7, 8, and 14 in Tavernier Creek.
Enclosed are duplicate originals of the subject Agreements which should be returned to
the appropriate Contractors.
Should you have any questions concerning the above, please do not hesitate to contact
me.
cc: County Attorney
County Administrator, w/o document
Finance
File
-"., : \ ~ (...; ';
CON T R ACT A- G. fiLE 'eM E N't
AGREEMENT, MADE THIS f~ day ot94 :rf$l~ :24 1994, by and between,
ASAP Marine Contractors ("Contractor"), and the BOARD OF COUNTY COMMISSIONERS OF MONROE
- ;
,~ i I _
COUNTY, FLORIDA, of the County of Monroe, State o~~frjFnt~a '("r$..tc:r). L:'
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 attached
Specifications for the repairs of Channel Markers #6, #7, #8, and #14 in Tavernier Creek.
2. The work to be performed under the contract shall commence immediately from the date the
Liaison provides the Notice to Proceed and shall be completed by February 28, 1994.
3. If the Notice to Proceed has not been given by the Liaison to the contractor on or before Januar~
22, 1994 then this Agreement shall be null and void.
4. The work to be performed under the contract is contingent upon receipt of appropriate grant
monies from the State Department of Environmental Protection, Boating Improvement Fund Program. If this
grant is denied, this Agreement shall be null and void. The contractor understands the rules of the
Department of Natural Resources 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 requirements
of the Specifications are understood by the contractor.
5. The Board shall pay the contractor the total sum of $3.675.00 for the repairs to Channel Markers
#6, #7, #8, and #14 in Tavernier Creek. 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
A) and this contract. A final payment will be made when all of the work under the contract is complete.
6. The attached Specifications, Plans, and other documents together with this Agreement, form the
contract. They are fUlly a part of this contract as if repeated herein verbatim.
DV Contract--Page 1
7 · The contractor shall indemnify the Board from and against any and all claims, demands, actions,
proceedings, damages, liabilities, costs and expenses, including attorney fees, arising out of, connected
with, or resulting from this Agreement.
8. The contractor aCknowledges his/her intention to comply with the need to coordinate all work
with the appropriate environmental agencies, the U.S. Coast Guard, and the County.
9. The contractor agrees to supply the County with a photograph of the replaced marker along with
a letter certifying completion of work. The contractor will be responsible for the camera, film, and
development costs. The contractor also agrees to provide transportation for Liaison to inspect completed
project.
1 O. The contractor understands and agrees that no payment will be forthcoming for this project
without required photographs and written certification of completion.
11. The contractor understands and agrees that receipt of Notice to Proceed from the County does
not relieve his responsibilities to obtain any appropriate permits. The contractor must inform and advise the
appropriate permitting authorities prior to the replacement of this channel marker.
12. The contractor understands that he is to repair Channel Markers #6, #7, #8, and #14 in Tavernier
Creek.
13. The work must be completed by February 28. 1994.
14. Due to the use of heavy equipment and, at times, dangerous work environment, the contractor
understands and agrees to maintain an alcohol and drug free work environment.
15. The Contractor will provide general liability insurance in the amount of $300,000, workers
compensation as required by Chapter 440, Florida Statutes, Watercraft Liability in the amount of
$500,000.00 and automobile insurance in the amount of $100,000.
DV Contract--Page 2
16. The Board may terminate this agreement with or without cause at anytime upon giving the
contractor up to 10 days notice 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 notice of termination.
IN WITNESS WHEREOF the parties hereto have executed this Agreement the day and year first
BY:
written above.
(Seal)
Attest:
7~-; ?yC:
Witness
~#r' ~
Firm
a:~~~
Witness
BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNT I ORIDA.
(Seal)
DANNY L. KOLHAGE,Clerk
Attest:
~_C.~~
DV Contract--page 3
SEVENTH COAST GUARD DISTRICT
PRIVATE AIDS TO NAVIGATION STANDARDS
DAYBEACONS (UNLIGHTED BEACONS)
AND LIGHTS (LIGHTED BEACONS)
SHAPE:
Dayboards on lights have the same shapes as those on
daybeacons.
Starboard hand dayboards have a triangular shape.
Port hand dayboards have a square shape.
Safe water dayboards have an octagonal shape.
COLOR OF DAYBOARDS:
Starboard hand, triangular dayboards are red.
Port hand, square dayboards are green.
Safe water, octagonal dayboards are red on the right half and
white on the left half.
see "RETROREFLECTIVE MATERIALS" for colors of letters and
borders.
CHARACTERS:
See "DIMENSIONS" for the correct size and distance from the
base or lower apex of the dayboard.
Red starboard hand triangular dayboards have even numbers.
Green port hand square dayboards have odd numbers.
Safe water dayboards are not numbered but may be lettered for
identification purposes. Letters should be sized and placed in
the same way as numbers. However, letters on safe water
dayboards should be centered in the red, right half.
FLUORESCENT AND RETROREFLECTIVE MATERIALS:
Fluorescent background material and retroreflective numbers,
letters, and borders, although optional, should be used on
dayboards. Retroreflective numbers, letter, and borders should
be the same color but a contrasting darker shade) as the
background material; alternatively, numbers and letters may be
white.
The signal characteristics of paint are relatively poor, but
use of paint is not prohibited. If paint is used, then numbers
and letters are white.
EXI-IIBIT itA"
DIMENSIONS:
OAYBOARDS: The MInIMum acceptable dl..nslons are for a no.lnal range of 1/2 nautIcal _lIe
(nMI). ApplIcants May establiSh larger sizes If ~hey wish. Optional fluorescent background and
re~roreflec~lv. numbers, letters, end borders ere encoureged. All dimensions ere In Inches.
t04l HAL
RAK;E
( n.1 )
TYPE
SIZE
DAYBOARD
· NUK3ER/
LETTER SIZE
(single) (double)
DISTANCE DAYBOAR>
BASE TO NUMBER BASE
(sing I.) (double)
RETROREFLECTIYE
BORDER SIZE
(optional)
PORT
HAt()
1/2 Squere sIde length-IS 8 6
Square side 'ength-36 12 12
2 Squere side length-48 16 16
3 Squere side length-72 24 24
STARBOARD HAND
1/2 Triangle helght-24 8 6
wldth* -24
Tril)r.gie height-46 12 12
width. -48
2 Trlengle helght-72 16 16
wldth* -72
3 Triangle helght-96 24 24
wldth* -96
SAFE WATER
Octogon helgh't..-48 12 8
width.. -48
side length-20
3 Octogon helght..-96 16 12
w'dtf\.. -96
side length-40
. Width at base of the trlengte
.. Width/height from side ~o the opposlt. sid.
... Dlstonce from the lower apex to the letter base
5
4
1.5
12
12
2
16
16
3
24
24
4
5
4
1.5
10
7
2
16
12
3
20
14
4
21... 21*** j
42... 42..* 6
(DIMENSIONS continued)
STRUCTURES: There are not required dimensions" materials,
fastenings, or designs for structures supporting dayboards and
associated lights. No particular height above mean high water is
mandated.
Permitees should insure all aids to navigation are established
consistent with prudent, sound engineering practice and the harsh
nature of the marine environment. The following sketches are
for general reference and should be modified to suit the
circumstances.
LIGHTING EQUIPMENT ON LIGHTS (LIGHTED BEACONS):
COLOR:
Lights on starboard hand lighted beacons are red.
Lights on port hand lighted beacons are green.
Lights on safe water beacons are white.
LIGHT NOMINAL (VISUAL) RANGE:
The minimum visual range of a light is one nautical mile.
Depending on the circumstances a greater range may be permitted,
required, or prohibited.
FLASH CHARACTERISTICS:
Red and green flashing lights are laterally significant and
usually flash (light off longer than on) regularly with a
frequency of not more than 30 flashes per minute. When special
caution is necessary, such as sharp turns, obstructions, wrecks,
etc., quick flashing lights (60 flashes per minute) may be used.
White lights on safe water beacons flash in a Morse Code flA."
rhythm (short-long flash).
~fD D~IONS
These are general reccmrendations and may be adapted to s~cific
circunstances. They should also be modified as necessary to meet the
requirenents of prlXient sound engineering practice am the demands of the
marine envirorrrent.
@
DAY~ ,ttw ~ll.a
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MATERIAL LIST
Item QU8ntlty ~terl8ls Size
L 11-1 2 6061 Aluminum alloy bolts, nuts. & washers 172- X 22"
lll-2 1 (opt I on~d) Concrete, prestresed re_~th es required 10" X 10"
L 11-3 2 O~ybo~rd Size es needed
L I '-4 2 6061 A I um i nurn 8' loy bol1s l. nuts, & w~shers 1/2" X 14"
L 11-5 1 ~ Wood , pressure tre~ted, length as required 12" d18.
Note 1:
A,II e I um I num bot ts meet recogn I zed standards for Iftar I ne use.
Hote 2:
Piece e 2" X." filler will be pieced between deymerks end the pile
et the upper bolt connection ~o provide e five degree outbo8rd ~llt.
,"
PORT AND STARBOARD MARKERS
(nominal range, 1 nmi)
Port
r ~~1~1:-it~r~-
~~~r ~1'" .~~~;~ ~.~--
f . "~S:~.' :~. . -;j~~:l
H ;~~.:~:~;#l~~~:(~' .
1- 3' -I
2" GREEN
(OPTIONAL RETROREFLECTIVE)
BORDER
12" GREEN
(OPTIONAL RETROREFLECTIVE)
NUMBER
GREEN 2" RED
(OPTIONAL (OPTIONAL RETROREFLECTIVE)
FLUORESCENT BORDER .
FILM)
Starboard
t J. Lh)
! ~-~ :, -.' ~ ~ S .: 1: l ~ T
4'
12" REO
(OPTIONAL RETROREFLECTIVE)
NUMBER
(nT"'~r()r~~ ~.
RED
4'
....,
., .
2" GREEN
(OPTIONAL RETROREFLECTIVE)
BORDER
. ..,
~...- .;'~.:7'1!~' .~:.~ .:.~..".;'. .~.
:~~t1~t1~(1':~-~:; .:
::~.. ;..:~ ~ .: .,:;~.~~:'
;---- GREEN (OPTIONAL
': FLOORESCENT FIL"'
f---3'
k ~'.' GREEN
(OPTIONAL RETROREFLECTIVE)
. I NUMBERS
*For 2 numerals.
**For 3 numerals,
;:'~:'~'" .'
.~.. :.'"
.i:J%-i: t-.
. ". . .... -. - . .
..~~ii:.~::;. ~~:~. ..~: 4'
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. ,,~.=..... . . . ~.... . ..
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1- 4' · I,
..
use 12" numbers at a height of 12" off base.
use 81t numbers at a height of 1211 off base.
2" RED
(OPTIONAL RETROREFLECTIVE)
BORDER
.
12" RED
(OPTIONAL RETROREFLECTIVE)
NUMBERS
SEVENTH COAST GUARD DISTRICT
PRIVATE AIDS TO NAVIGATION STANDARDS
DAYBEACONS (UNLIGHTED BEACONS)
AND LIGHTS (LIGHTED BEACONS)
(SPECIAL PURPOSE SUPPLEMENT)
SHAPE:
Special purpose dayboards have a diamond shape.
COLOR OF DAYBOARDS:
Special purpose dayboards are yellow.
See "RETROREFLECTIVE MATERIALS" for colors of letters and
borders.
CHARACTERS:
Special purpose dayboards are not numbered but may be
lettered for identification purposed. Letters should be sized
and placed as described for numbers. \
See "DIMENSIONS" for the correct size and distance from the
lower apex of the dayboard.
RETROREFLECTIVE MATERIALS:
Retroreflective letters and borders, although optional,
should be used on dayboards. They should be the same color, (but
a contrasting darker shade) as the background material; letters
may be white.
The signal characteristics of paint are relatively poor, but
the use of paint is not prohibited. If paint is used, then
letters are black.
DIMENSIONS:
DAYBOARDS: The minimum acceptable dimensions are for a
nominal (visual) range of 1/2 nautical (nmi). Applicants may
establish larger sizes if they wish. Optional retroreflective
letters and borders are encouraged. All sizes are in inches.
DIMENSIONS (continued):
N:)M I NAL.
IWGE
eM' )
TYPE
SIZE
OAYBOIRl
IllteERI
LEnER SIZE
(.'ngle) (doubC.)
DISTNCE O~~
8ASE TO ~~ BASE
(.Ingle) <<double)
RET'ROREFLECTIVE
8(R)ER SIZE
(OPtion..)
SPECIAL PURPosE
112 OJ .-ancJ- sIde leng11t-18 8 6 r. 9 1.'
D I.flend- sId. . eng 'tt\- 36 12 12 20" 20 2
2 Diamond- sid. leng",,-ca 16 16 26.. 26 3
3 o la.-end- side . eng'th-72 24 24 ~O" ~O 4
. All .ngres 900
.. Olst.nee from the Cower .pex to the letter bese
STRUCTURES:
There are not required dimensions, materials, fastenings, or
designs for structures supporting dayboards and associated
lights. No height above mean high water is mandated.
Permittees should insure that all aids to navigation are
established consistent with prudent, sound engineering practice
and the harsh nature of the marine environment. The enclosed
sketches are for general reference and should be modified to suit
the circumstances.
LIGHTING EQUIPMENT ON LIGHTS (LIGHTED BEACONS):
COLOR:
Lights on special purpose beacons are yellow.
LIGHT VISUAL RANGE:
The minimum visual range of a light is one nautical mile.
Depending on the circumstances a greater range may be permitted,
required, or prohibited.
FLASH CHARACTERISTICS:
Yellow lights on special purpose beacons are fixed or flash
(light off longer than on) regularly with a frequency of not more
than 30 flashes per minute.
Regan Insurance Agency, Inc.
90144 Overseas HIghway
Tavernier, Fl 33070
"CERTIFIQ~J~:9,~.~f~~~pRA~~~" 'SSI0D;7i9~IDDIYYI
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
Af:ftillt~
P~ODUCER
COMPANIES AFFORDING COVERAGE
~~T~~~NY A
Proforma c/o Hull & Company
INSURED
~~T~~~NY B
A.S.A.P., Inc.
PO Box 804
Tavernier, Fl 33070
~~T~~~NY C
~~T~~~NY 0
~~T~~~NY E
COVERAGES
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 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DA TE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE :K: OCCUR.
OWNER'S & CONTRACTOR'S PROTo
93 HA 34015
8/31/93
8/31/94
GENERAL AGGREGATE
PRODUCTS-COMP/OP AGG.
PERSONAL & ADV. INJURY
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
$ 600,000
$ 300,000
$ 300, 000
$ 300,000
$ 50,000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
MED. EXPENSE (Anyone person) $
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
COMBINED SINGLE $
LIMIT
BODIL Y INJURY $
(Per person)
BODIL Y INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $
AGGREGA TE $
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
Received
Risk Mgmt. & Loss Control
DATE
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
OTHER
Il\'!TlAL
~
DESCRIPTION OF OPERA TIONS/LOCA TIONS/VEHICLES/SPECIAL ITEMS
Wharf Building
Project: Emergency repair of channel marker #5, Tavernier Creek, Tavernier, Fl
CERTIFICATE HOLDER
CANCELLA rlON
Monroe County Board of County
Commissioners/Additional Insured
5100 College Rd
Key West, Fl 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL -1CL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT. BUT FAILURE TO AIl..SUGH. NOT.LCE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KI '~fHt~OMPA 'ITS AGENTS OR REPRESENTATIVES.
,., t.'./
: ~."'.'; ; /'
~)ACORD CORPORATION 1990
AUTHORIZED REPRES
ACORD 25-5 {7/90}
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""'j~ftCA. ~ ''tlhw Of IllUdlflCld Dq .1Ie fofJowillIC ClVuUItC
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,1[.-1 J. i~..~L_,..j, ,'i CONSTRUCTION 'INDUSTRY .
l J-.- .i .. . J .
, NOTICE OF ELECTION TO BE EXEMPT FROM
THE PROV1SIONS OF THE FLORIDA WORKERSJ CO^fPENSATION LAW
MAIL TO: Depanmcnt ()f Llihor & &lpjOy~~ . .-"?~ ' t- q j-- :. - · 'STATR US&ONLY- ',.... .
Buteau or w.e. CompU~lU ' ACKNOWLEOGEb T -. POSTMARK DATB ~I '-.-
2728 Ccnlllr\'iow Dli\'c, 100 FunuAltMeR ',' 'lblt nol1oe IhaIl be in efiocl tor two (21t.. i'f. the
ThllabauOCl, FJoddn 323~.QMj AGENT ctrCC\i~ dw 01 M - ) . {(l . UIlIiI ), . Cj j
PLF."'S~tfRINT: :iJR J( [1 t1 0: until K\~"'od, wflicOOvcr comcs r.l'llt,
',.
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'(~L-..l AddnwI. I~~l . .' ~
M (€?R. RA- ~~3D2.Q
(QIJ) (SI<Ilt) /ZIp) (l\ldcnl Br.1JlIC)'ClIcl.lnli/;""liot\ Noonobor)
Natulll of 8Ui~r.Cllli or 'f)'lde': ... rn ~AJi? ~),~ii. .', ~ .~... · Q 00(" G 0 t~,1 ~
As of 12:01 8. m. ~ dl'.)'s (ollowll1&t the date of themallingofthi~form.you.li.th " 'clor,
PlIUler or COJpOT81t OmCL'1' of the abovt IUlttled business d(~~ elect to be ell III . '
CoIJ'.pcnICBtion Law. J understand Ihat b>, this I Cfioll I 8m not .ntitled lO bene h
rom'll ba\le not eXceeded the exempilon 11mb of lhn:e Partners or throe Corp .
bUlilncsS named .lIhove Are covered by wOttm' cumpenllation inaunmco. .
The followin a~ the ~i ed nr ~sJstcred licoRIICI; held by me pUT5uant to chapter 489 FlorldaStllluto5 ar l'lO~t,~"lltfltiCt)!"
(1) 'Jype: · · Numbct: ~~ (2) lYpe; 13 Number:.
/;~~^J/~{~ ~1l<..J7. O~ {,)/AS(~ IT
~
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JNStJRANCIt CA~RIER iNFORMATION (If Applicable): A cons!nIction industJy employer with one (I) l~r '>>.DJe'o.nployee, RlU"
malnta," Wnrlcers' Compcnfjj&t1on COYerasc. FltIlure 10 comply will l'Ciull in a flve-hundtecl dollar ($500) (me and a one-hundRld
dollar ($/00) fine for each day of noncurnp1imce (soe fleCtlou 440.43, F.S.).
s:.~e ft"{r'/iC/tft').
~amc (Jf CUTler _
:lJTier Addres$ _._
Policy Nllrnb~r
JOlurance Alent (Alene)')
"..ncy Add,.,., .....
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-::: Proprlelt'l -lPMnner ~nrKXficu (nlle) ,<) e e. I 7Re~ · · · · · : . · . : ~ · ·
MPOIrr4NTt Individual exetnption 11111" feo, pursuant 10 Soction 440.05, F.S" is &even dClI!ar6 and 11ft}. cents ($1.50> and is
"Yllble only by money ordu Or c.hler', chock, to w.e. Administrative 1TU$1 Fund. Pailu~ to enclose fee wiH texult in return ~f'
.sqUesllIld delay of oertj(jcltIOll. sl-
.WOltN 10 AND SUBSCRrBUV BEFORE ME nus "3 { - DAY OF ~ t I' cr3 , !
\T ~,,~.. ~...s. , FLORIDA ~ ~ I
8.waGuoAf~.~l~p1": ~;~~ DfIIJRAHSHfpp~ - ~"bUc,.~aflbidt -- '
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l.l .\ MY~'CC2122&2
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t ~'~'THisCEFftIFJcATE-is..-s7UEifASA--PI'ATTER'OF-iNFORMATJON ONLY AND' ('~
I- . CONF~RSi NQ RlG~Tst UPO,N' TJ.t. C&A'TIFICA T~'."'~LO~'R.. ,T"" C"'RT'':ICA T~
I DOES t-IOT AMEND, EXrENO OR ALTER THE COVER'AGE AFFORD.ED BY THe
' POLICI.ES BELOW.' : ' :. I
! · --. ., F----~-COMPANIES AFFOR~ING"~~VeRAGe' ,To
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LETTeR ~ : ,
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'i 'COMPA~Y' 0
.! LETreA':'
l coopmvE '
!.: I ': i LETTER i' I ;
(COVERAGES-' ~ '--'-'--', , .: " ,', ' +- -r~-'-:-',' , '~H'
i THIS IS TO CER'!'FY~HA T THE POLicIES OF INSLlRANCE jS1'~" BeLOW H~Ve eee:N ISS~EO TO THE IHSUREO NAMED ABove FOA THE POLICY PERf~ : i!
J INOICATEO. NOtvllTHSTANOING ANY REQUIREMeNT. TE M 0 ONorrlON OF ANY CONTRAOT OR OTHER COCUMENT WfTH RESPECT TO WHICH THtS .
I CERTIFICATE MAY BE fSSUED '~R MAY PERTAIN. THE IN URA "..'rE AFFORQEO BY THE POLICIES DESCRIBED HEREIN I~ SUBJECT TO ALL THE TERM'S,
i eXCLUStO~S ANO OONOJTIONS OF SUCH POLICies. LIM S S awr~ MAY HAve seeN AEouceo BY PAID CLAIMS,
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; co I r poL.cv U~CTtVE POUCY DPIMTIOH
~UR nilE Of.' rsUfWtCli , "O&,ICV,., SR : ll~TI! (MMipOIVVI: DATI! (MWOOJVYI
.LL :J..:J .LU'(.,f
Ae..e.t6 i CERTifiCATE (j
"AOOU~ft
.,
Regan Insurance Agency. Inc. .
90144 Ov~~~~ HIghway
Tavernier,rF~'330.iO
INSUREC'
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A. S " A.. P ., t :fnc .
PO Box 804 .
Tavernier, r ~ 33070
GENERAL UA8IU-rr. .; . ,
A 'x COMMEAC~'GENErw.. LIA8IUTV ,
, CLAlusjMAOe x' ocCUR. " 93' HA. 3401
OVlNeR'S ~ <fNTRACTOA'.S,PRO~.
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ANYALiro ...r
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j' ,~barf Bui+~ing, : . '
Pro jAc:t: "~8ency repair, of
· Waterdrut . exclusion on ... 11
ce"TIF'CA TE HOfER - ; , ,',
Monroe C~ty Board of COur,tty:
Coomission~r;sl Addi ti~l In~ed
5100 Colleie ;:Rd '
Key West; ,n 33040
'ACORD 25..S 7/90 ..
t-' . c:
Proforma c/o Hull & Company
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PAOOuOTS-COMPIOPAGG. ~', ,3OO,@
8131/94 PERSONAL & AOV,ltwRY . 300 t 000 !.
EACH OCCURRENCe · ~~,OOO', ,j:
FIAH,+.MAGE !Anyone flrtl' ,50, 000 ' I
Mm. EXPeNSe (NTyGnlD<<;OO)"S' 11:, fVV\, ',' i':1
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(Pet ~idont)
PROpeRTY OAWAGf .
EACH OCCURReNCe $,
'MGRE~^T~ .
aTAnn'OAv -LIMf..,:J
EACH ACCDENT $
DC:se~-~ouey Ll~I'r .'
DiSEASE-EACH EMPLOYEE I
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CANCelLATiON' .'
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SHOJLO AN~ OF THE ABOVE DESCRISEO POLICIES BE CANCElLED BEf'OAe 'T:HE j i
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EXPl~TION :"QAT~ THeAeOf~ !He fSSU~NG ~MPANY W'lL ENOEAV~R.''-O ~ ! 1
MAlt;.llL OA VS WRITTEN NOTICE TO THE CERTIFICATE HOl.DeR NAMED TO THE; .1
lEFT,: BUT FAI(URE,TO l)I~t!O,~E~HAU. IMPOSE NO OBLIGATION ()f;' .1
uAe.~I'Tv ,OF :AN.Y KI ~!~PA 15 AGENTS OR RePREs~NTA-nve~,! ~ I
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PLANTATION KEY.
TAVERNIER: (305) 852-
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44 6,eRSEAS HIGHWAV, TAVERNIER', FLORIDA 33070 .
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M~.NtI~.. · CERTIFICATE
P.2
. Regan'InSjtIrance Agency, Inc.
90144 . Ov~seas HIgm.r:oty
Tavernierl, ;Fl .33070, .
ISsue OAT! (MMjCDIYY;
. ,1017/93'
lTHiSCeRT,'CATE'-,S iSSUED' AS X-iiA ITER OF INFO.RMA Tl9H ONLY AND' ...
CONF~R$ P R'CWTS urON rue: CEATIFICA Te .HQLQefl. THU:i 'CI;HT.~ICA TE
DOES NOT MENO. EXTEND Of! ALTER THE COV~RAGeAFFORDED BY THE
POLICIES. LOW.: _...._._ . ___~""
COMPA~IIES AFFORDING :CQVERAGE
: PROOUCER
,COMPANY A i::,
lETTER ::
Proforma cl 0 ~l & Company
'~SURfl)
COMPANY B
lemA ,
A.S.A.P.,ilnc.
,PO Bn~~,
Tavern=l.er ~ 'fl 33070:
COMPANY C
LfliTS~
QOMPANV D
LETTeR
COMPANY E
lenER '
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' COVa\AGfS I. . '.
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THIS IS TO CERTIFY T/o1AT THE POLICIES OF IN$URANC . LIST;: . aELoW HAVE seeN ISSUEO TO THE INSURED N.uA!!lo AROVF. FOR THE POLICV PERIOD
INOICATED, NOIl'WrTJ.lST ANDINO A~'Y l'lEQUIAeMeNT. T M Qf1' (jUNDITION OF /tt:4Y CONTRACT OR OTHE~ OOCUUI;NT WITH RI;SPECTTOWHICH THIS
CERTIFICATE MAY BE Issueo OF! MAY FERTAIN. THE I UR CE AFFORDEO ey, THE POLICIES oeSCFlIBED HEFlelN IS SUBJECt TO Af..L TIoIE TERMS,
eXCLUSIONS ~D CONOlTIONS OF SUCH POL'CIES. La S I. WN MAY HAVE B~eN REOUCEO 8YPAlO CI.AIMS.; .. ...
· co 'l'y'Pl o~ IHIUAAHcE . poucv eAicc:nvl' POLICY EXPIIlAT.IOH
!UR B~ i . . . D-'TI(W~O/YY) '. tAlE (NU/!)PlYV) UMITS '
QUEM!.. UAI'~r .'
A X COM"&RC~ GENEfW. 1,.1A811..trV
ctJJ...~ . MADE X OCCUR. ,
OWNERt,S & fONTAAC'tOR'S PA9T.
: 8/31/93
8/31/94
',BeNeRA!r,AGGAiG~TE ' $' 6OO,0Q0
:p~oueT~~O~I'/~~ ~.G~, C.. 300,000,
. PIASONAl . AOV. 'NJU~V J. 300,000
fiA,~W oeCURRENo.e , 300,,000
, ,"AE ~OE (Any ,one f'r~) ... 50,~: ,
Ml!;O. EXPaU (Any an. ~~I) .
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COW8I-JED S~~
LINn
$
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{Ptlt per's(Jn}
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8001'" v INJURY.'
(~~t 1.It.':'C'id4lnt) , :
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DATE
PROPeFlTY D~GE
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AC;i(jH.EQA TE
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OJSeA8e-POUCY LJMIT S
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~ Whail Builq~g "
1. PrOject: Ernergeney repair of ~h....
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CSATlFICAY~ HOU>>ER:
z.tlnroe ~ty. Board of ('.()1.1nty
CoaJni.ssiat~a/.Add.i tional Insured
5100 Collegle Rd
Key West t F!I. )3Q4()'
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CANCfLLA TIQN ,
SHOULO ANY;OF TIiEASOVE DESCAIBFO POl'r."JI<S 8E CANC5LLSD BE"'OI'lETHE
E.XPIRAlION DATE THE~ioF, THE ISSUING COMPANY WILL ENO!AVOA TO
.MA;i..1Q... OAYS WRITT!!lN NOTle.!: TO YHE C!;RTI':ICA~ HOI.OEA NAMeD TO Till::
lEFT, SU.T FAILURe TO AtkS~...'iP~e' .SHAll IMFtOSE' NO OBLJaATION OR
LIA8IL1TY OF ANY Ie ~l@~~ TS ACEN'l18 On ACPAEaENTA'TIVC~, I
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AU1HORlZlD RErRf
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FAX
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NUMBER OF PAGES'
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PLANTATION KEY, 44 ciJERSEAS HIGHWAV, TAVERNIER. FLORIDA 33070'
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SWORN STATEMENT PURSUANT TO SECTION 287. 133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUfHORIZED TO ADMINISTER OATHS.
4~~F L::<<.f~/Y
(print name of the public entity]
1.
This sworn statement is submitted fo
by
? /?~~c/~c/
for
/J"?
.~
T--J/4- ~4/7?/?r"~/
[print name of entity submitting sworn statement]
whose business address is
c/-: 0 · Z5o{"
77!YF71d/~ I
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r~ 330.30
and (if applicable) its Federal Employer Identification Number (FEIN) is
51 -..z3~ -350 7
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement:
.)
2. I understand- that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes. means a
,riolation 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 or any other state or or the United States, including,
but not limited to, any bid or contract for goods cr services to be provided to any public entity or an agency or
political subdivision ~f any other state or of the United States and involving antitrust, fraud,.theft, bribery,
collusion, racketeerint, conspiracy, or material misrepresentation.
3. I understand that"convicfed" or "conviction" as defined in Paragraph 287.133(I)(b), Flori~3 Statute$, means a
finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any Cederal or
state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result
or a jury verdict, nonjury trial, or entry or a plea or gui,lty or nolo contendere.
4. I understand that an "affiliate" as defined in Paragraph 287.133(I)(a), Florida Statutes, means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An entity under the control or any natural person who is active in the management or the entity and who has
been convicted or a public entity crime. The term "affiliate" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in the management or an affiliate. The ownership
by one person or shares constituting a controlling interest in another person, or pooling or 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 oC a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.
5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person
or entity organized under the laws or any state or or the United States with the legal power to enter into a bindin~
contract and which bids or applies to bid on contracts ror the provision or goods or services let by a public entity,
or which otherwise transacts or applies to transact business with a public cntity. The term "person" includes those
officers, directors, executivcs, partners, shareholders, employecs, mcmbers, and agents who are active in
mana~ement of an entity.
'6. Based on information and belief, the statement which I have marked below is true in relation to the entity
submitting this sworn statement. [Indicate which statement applies.)
/ Neither 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.
- The entity submitting this sworn statement, nor any of its officers, directors, exectutives, partners,
shareholders, employees, members, or agents who ar~ 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.
- The 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 enC:ity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However" there
has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative
Hearings 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 UNDERSTAND THA TTHE SUBMISSION OF THIS FORM TO TilE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENTIFIED ON PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS
FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO
UNDERSTANI) THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRACT IN EXCESS OF THE THRESHO LD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES
FOR CATEGORY lWO OF ANY CIIANGE IN THE INFORMATION CONTAINED IN THIS FORM.
. .
,
/:.1 day of C' ~rrc~.6~ 7 ' 19 r ~
,A~'~~
Notary Public - State of F~ 79'/ e-4
Sworn to and subscribed before me this
Personally known y/
OR Produced identification
(Type of identification)
, My Commission expires
Notary PubH~1 State cf n~rida
IItrCnmm:l"d!\n r.l(~;"if ~"'''Lt.J 21,199.
(PrintiWJ~cIJ Grust..ped~u(ance Inc.
commissioned name of notary public)
~ 4 ;'9//4 ,.q' ;-/s4/rD
Form PUR 7068 (Rev. 06/11/92)
NON-COLLUSION AFFIDAVIT
I, 'lAy F~/~?
~" /
~dnt7E:
..c-~#y
, of the ei ty-
of
according to law on my oath, and
under penalty of perjury, depose and say that; ~;S
1) I am //? ,4 ~ /7/4n/~ ~4"/n~~~;~dder
making the Proposal for the project described as follows:
2) the prices in this bid have been arrived at independently
without collusion, consultation, communication or agreement for the
purpose of restricting competition, as to any matter relating to such
prices with any other bidder or with any competitor;
3) unless otherwise required by law, the prices which have been
quoted in this 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;
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
r~ 7~u' ct;
~ff'?9~ ~-
/~ -:30- 93
DATE
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
~;/ /--75> ~> who, after first being sworn by me,
(name of individuaL/signing)
affixed his/her signature in the space provided above on this
30
day of ~~r~.-?/b~7 ' 19 93.
~.??: ~z::::-
NOTARY PUBLIC
My commission expires:
NOfary Pl!b~i~l' State. of ncr;ci~
My (ornmiJ!7~n t~pirfS tt~{;.;-~J~ 24, t 97 r
80flded Thru T{(j~' [f!.in - fr.~vr{!nce Inc,.
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute
287.087 hereby certifies that:
~ -7",4 c?: d~,,~ ~~/~/lr,(?5
(Name of Business) ~
1. Publish a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for
violations of such prohibition.
2. Inform 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
imposed 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 (1).
4. In the statement specified in subsection (1), notify the
employees that, as a condition of working on the commodities or
contractual services that are under bid, the employee 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
occuring 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 community, 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 re irements.
-
.~._-----
ders Signature
_______~~_~ - 7'...3
Date
MCP#5 REV. 6/91
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
3Af FM/4j;;
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retained or otherwise had act on his/its behalf any former County officer
warrants that he/it has not employed,
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 the former
or employee.
Date:
signature)
/~ -~9-Y3
STATE OF'
/~?3/~
A~"e
COUNTY OF
Subscribed and sworn to (or affirmed) before
/2::.. -~9-?3
~I ~;q/7
He/She is personally known to me or has produced
-- ---
me o'n
(date) by
(name of affiant).
as identification.
(type of identification)
I
Notary Pub!t!, Stete of F!~rtda .'
M Commission E~pires M~iCh 24, t 99)
Y knded Theu Tlo)' fain. lnsurance Inc.
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Ch~/,4 ~.~~
NOTARY P BLIC ~
/Z -2-7 -73
MCPD4 RE\'. 2/92