09/22/1994 Channel Marker Repairs Tavernier Creek
nlannp I.. Itolbagt
BRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
MEMORANDUM
TO: Peter Horton, Director
Division of Community Services
FROM:
Ruth Ann Jantzen, Deputy Clerk P'4J-.
October 31, 1994
DA TE:
------------------------------------------------------------------------------------------------------------------------
On September 22, 1994, the Board of County Commissioners authorized execution
of a C9R~ ~.' Aft" ""aa&l~between MOllJ"oe C,ounty and !I:~= . - . . JI_, for the
emergency repairs of JlLlllUWJI nu:u[{U UU'I'" J1JlJiJ ~~~l~:~L. ~ l..Jo the amount
of $2,370.00.
Enclosed, for return to ASAP Marine Contractors is a fully executed, duplicate
original of the subject contract.
Should you have any questions concerning the above, please do not hesitate to
contact me.
cc: County Attorney
Finance
County Administrator, w/o document
File
CONTRACT AGREEMENT
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AGREEMENT, MADE THIS ).)I,J day of ~ '~4992~1 ~~ C~22
, ~';.
between, ASAp Marine Contractors ("Contractor'''':" and the
l, t. f\ ; it,' .
BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY /f'm~:iDM.J;~!df( Ibhe
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 attached
Specifications for the repair and/or replacement of Channel
Markers 115 &:.#16 in Tavernier Creek
2. The work performed under the contract shall commence
inunediately from the date the Liaison provides the Notice to
Proceed and shall be completed by
October 31. 1994
3. If the Notice to Proceed has not been given by the
Liaison to the contractor on or before Sept:embe~ 23, 1994
then this Agreement shall be null and void.
4. The work performed under the contract is contingent upon
appropriate grant monies from the Florida Department of
Environmental Protection Special Waterway Projects Program. If
this grant is denied, this Agreement shall be null and void. The
contractor understands the rules of the Department of
Environmental Protection and shall comply with said rules, along
with the rules and procedures instituted by the Board to ensure
an orderly progress to the project. Both the intent and the
requirements of the Specifications are understood by the
contractor.
5. The Board shall pay the contractor the total sum of
$ 2.370.00
for the replacement and or repair of channel
markers# 15 & 16
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.
6. The attached Specifications, together with this
Agreement, form the contract. They are fully a part of this
contract as if repeated herein verbatim.
-Y
I ~
-r~!~ ~or! tl ~~ ~or shall iIl.:1eIltl1ifythe Board from and
against any and all claims, demands, accions, proceedings,
cJ.C:a.ii,aye.::. , liabi:i..1. ;...1. eo::., cu.::, ts a.Hd eX'p~nses, including at tor ne y
fees, aris~sing out of, connected with, or resulting from this
Agreement.
B. The contractoI' acknowleJ.ges his/her intention to comply
with the need to cGordinate 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 corrected aid to navigation 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 the Liaison
to inspect completed project.
Page 2
10. The contractor understands and agrees that no payment
will 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 or repair to the channel
marker.
12. The work must be completed by October 31, 1994
13. Due to the use of heavy equipment and, at times,
dangero'us work environment, the contractor understands and
agrees to maintain an alcohol and drug free work environment.
14. The contractor will provide General Liability
insurance in the amount of $ 300,000 Workers
Compensation Insurance as required by Chapter 440, Florida
Statutes and Federal Jones Act (46 U.S.C.A. subsection 688) with
limits not less than those specified for Employer's Liability,
Watercraft Liability in the amount of $ 500,000 , and
automobile insurance in the amount of $ 100,000
15. The Board may terminate this Agreement with or without
cause at any time upon giving the contractor up to 10 days notice
in writing. The contractor, upon receipt of the notice, shall
immediately cease work.
Page 3
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 that is 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 written above.
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Witness
A'-~"~/ ~
- - J..,- ,",' 4' - " t!!-
Firm (Seal) Attest:
(Seal)
~OUNTY ':'Oi,Ir..iISSIONERS
OUNTY, FLORIDA
AttestDANNX L. ~OLJlAGEJ Clerk
~LN,I"~/~J
Clerk
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Page 4
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SPECIFICATIONS FOR THE REPAIR/REPLACEMENT OF AIDS TO
NAVIGATION IN TAVERNIER CREEK, MONROE COUNTY, FLORIDA
Specifications for installation of treated wood' piles complete
with U.S Coast Guard approved Daybeacons, in the locations indi-
cated are in the enclosed materials.
A. DAYBEACON PILES:
1. Pile shall be of timber treated with chromated copper
aresenate (C.C.A.).
2. . Pile shall be of timber which will stand the driving for
which they are intended. _ \
3. A straight line drawn from the center of the butt to the
center of ,the tip shall not at any point face further
away from center of the pile than a distance equal to 1%
of the length of the pile.
4. Minimum butt diameter = 12" measured 3' from end.
Minimum tip diameter = 8".
5. Piles to be sufficient length to provide a minimum of
four feet penetration into existing sea floor and the
base of the daybook's must be eight feet above mean high
water.
6. Pile shall be driven or best installation practices used.
B. DAYBEACONS:
Daybeacons to be constructed and erected as indicated on the
enclosed sketches and documents. There are two dayboards per
daybeacon.
1. Construct all daybeacons as noted in the U.S. Coast Guard
Specifications enclosed.
Nav. Aids Specs:--Page 1
SHAPE:
SEVENTH CO~ST GUARD DISTRICT
PRIVATE AIDS TO NAVIGATION STANDARDS
DAYBEACONS (UNLIGHTED BEACONS)
AND LIGHTS (LIGHTED BEACONS}.
DaYboards on lights have the same shapes as those on
daYbeacons.
Starboard ~and dayboards have a triangular shape.
Port hand Qayboards have a square shape.
COLOR OF DAYBOARDS:
Safe water dayboards have an octagonal shape.
\
Starboard hand, triangular daYboard~ 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 ~laced 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.
o I ME NS ION S :
OAY80ARDS: The elnleum acceptable dl..nslons ere for e noslnal range of 1/2 nautical ell.
(nell. Applicants ~y establish larger sizes If ~hey wlah. Optional fluorescent background and
retroreflectlve numbers, letters, end borders ere encouraged. All diMensions ere In Inch.,.
fOCI HAL
RAKiE
( n.' )
TYPE
SIZE
o AYBO,tro
· HUM3ER/
LETTER SIZE
(single) (double)
OISTAN~ DAYBOm>
BASE TO NUfeER BASE
(s'ngle) (double)
RETROREFLECT. WE
BORDER SIZE
(optional)
PORT
tW()
1/2 Squere side l.ngth-18 e 6 5 4 1.5
\
Square S'de length-36 12 12 12 12 2
2 Square S'de length-ti8 16 16 16 16 3
3 Square side length-72 24 24 24 24 4
Sf ARSOARO HAND
1/2 Trlangl. "'lg"t-24 8 6 , 4 1.5
width. ~24
Tr'artgie helgnt-48 12 12 10 7 2
"Idt"- ~8
2 Trlangl. ".lght-72 16 16 16 12 3
wldt"- ~72
3 Triangle "'ght--96 24 24 20 14 ~
width. -96
~- ...-. -.,.....- ....
SAFE WATER
1 Octogon "'8"t..-48 12 . 21... 21... $
.Idt".. -ca
side 'ength-20
~ Octogon "'8"'..-96 16 12 42... 42t1.. 6
.'crf".. -16
side 'engtta-40
. Width .t base of the trlengl. .
.. Wldth/helgh~ from side ~o the opposl~. sid.
... Distance from the lower apex to the 'etter bUe
(!JIMEt{$_.LOJiS 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 1:- \
COLOR:
Lights on starboard hand lighted beacons are red.
Lights on port hand lighted beacons are green.
LIGHT NOMINAL (VISUAL) RANGE:
Lights on safe water beacons are white.
The minimum visual range of a light is one nautical mile.
Depending on the circumstances a greater range may be permitted,
required, or prOhibited.
~LASH CHARACTERISTICS:
Red and green flashing lights are laterally significant and
Usually flash (light off longer 'tl.1an onl..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 Horse Code .A"
rhythm (short-long flash).
"
~ED D~IOOS
These are ge~ral rec0Tm2ndations and may be adapted to 6p?cific
circunstances. They should also be modified as necessary to meet the
requir~nts of prOOent sound engineering practice am the demands of the
marine environment.
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MATERIAL LIST
Item _Quent I tv ,
Moterlels , Size
lll-1 2 606, Aluminum el.oy bolts, nuts, & weshers 1/2- X 22"
ll'-2 1 (opt lone I) Concre1e, prestr8sed '.~fh es r~u'red 10" )( 10"
l f C-J 2 ~_boord Size es needed
II f-4 2 --~~~!._~~~~~~~~_bollS l-~~_& ,,"shers 1/2u X 1~ ct
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II 1-5 I __~ _~<:XJ<1. ~~- cssure 1,..eI.)1edf~1h cs reQufreo 12ft die.
Not.., I:
A tIe I urn In um l>o f 1!. "'''01 '.. "09'01 red 5.1 endl)' d!. f 0' ..er I ne use.
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f' ( f"l (#1 f"l / ., 'Y ~... f I I "., ... I " I
Port
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PORT AND STARBOARD MARKERS
(nominal range, 1 nmi)
2U GREEN .
(OPTIONAL RETROREFLECTIVE)
BORDER . C
12U GREEN
(OPTIONAL RETROREFLECTIVE)
NUMBER
GREEN 2" REO
(OPTIONAL (OPTIONAL RETROREFLEC'rvE)
FLUORESCENT BOROER .
FILM)
Starboard
f nl'~ Y Of' .r :.
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RED
12" RED
(OPTIONAL RETROREFLECTIVE)
· NUMBER
r--.,J:' -.'! ~!':CLI~T
2-' GREEN
(OPTIONAL RETROREFLECTIVE)
BORDER
:....... GREEN (OPTIONAL
: FLUORESCENT FILftJ
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~tbPTIONAL RETROREFLECTIVE)
. I I1UKBERS
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2" RED
(OPTIONAL RETROREFLE~IVE)
BORDER
REO
(OPTIONAL
f'Lll(\" ESCFNT
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12-' REO
(OPTIONAL RETROREFLECTIVE)
NUMBERS
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1711 nurllbers at a height of 1214 off base~
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NON-COLLUSION AFFIDAVIT
I, fit r?$/? ' of the city
of -rhv€"7'rrl"/r1 according to law on my oath, and
under penalty of perjury, depose and say that;
1) I am /I?/IP d??/~~ ~rl"''//7ff" ~~ ~ bidder
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 discloseg 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
contra~ts for. said project.
COUNTY OF
~.,..., 7=?~J e:--
/:/'
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DATE /
~/j
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STATE OF
r /~ T--?, 'C/;;
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
~/ F7?/..v-~ who, after first being swotn by me,
(name of individual s gning)
affixed his/her signature in the space provided above on this
,;( 5 day of /lJyV;S r- , 19 9~
My commission expires:
L: /c ?J / ..", / -{. r -/5 /,4"),.,....- ~ u
DRUG-FREE WORKPLACE FORM
The llndersigned vendor ill acc()rdatlce wi tll Florida Stattlte
287.087 hereby certifies that:
_ /l2!-t-r ___&/1 E5/~,.yr~ ~c; ~ ~~/j~ 10/7 / -
(Name of Bllsiness) .
1. Pllblish a statemellt 110tifying elnployees tllat tIle \lnlawflll
manllfactllre, distrib\ltion, dispensing, possessioll, or llse of a
controlled substance is prollibited in the workplace and
spec i fyi ng the actiot18 tha t wi 11 be talten agai nst employees for
violatiolls of stIch prohibi tion.
2. Inform employees abO\lt tIle dangers of drllg abllse in the
workplace, tl1e b\lSitleSs's policy of malntaining a drtlg-free
workplace I any avai 1 able dr\lg CO\lnSe 1 i tlg, rellabi 1 i ta ti on, and
em~loyee assistallce programs, and the penalties that may be .
imposed llpon employees for drllg abllse violations.
3. Give eacll employee ellgaged ill providillg tIle commodi ties or
contractltal services that are llllder bid a copy of the statement
specified in subsection (1).
4. In the statement specified in subsection (I), notify the
employees tl1a t, as a condi tioll of working on tIle commodi ties or
contractual services that are \Inder 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
Btlbstance law of the Uni ted states or allY state, for a violation
occ\lring in the worltplace 110 1 a tel" tllCltl fi ve (5) days after such
conviction.
5 . Impose a sanction on I or reqll ire tIle sa ti sfactory
participati on in a dr\lg abtlSe assi stsl1ce or rellabi 1 i tation
program if StlC)l is available ill the employee's commllllity, or any
employee who is so convicted.
6. Malte a good faitll effort to COl1titllle to mailltain a
drug- free workpl ace tllrollgll irnplemen ta tiOll of tlli s secti on.
As the persoll 8tltllorized to aigl1 tIle statemetlt, I certi fy tllat
this firm compIle's ftllly witll tIle above req\liremellts.
- - - ..
Bidders Signature
· r-- ?.>-~r-
Date
MCP#5 REV. 6/91
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETI1I CS CLAUSE
~V ~11'~;; warrants that he/it has not employed,
r ( f
retained or otherwise had act on his/its behalf any former County officer
or employee in violation of Section 2 of Ordinance No. 10-1990 or any
County officer or employee in violation of Section 3 of Ordinance No.
10-1990. For breach or violation of this provision the County may, in
its discretion, terminate this contract without liability and may also,
in its discretion, 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 c~ o~'
Da t e ': .,..~ _25
or employee.
STATE OF
r /cn'~c//9
,~orrno~-
COUNTY OF
Subscribed and sworn to~(or affirmed) before
on Y~;'s- Cj~
(date) by
me
(name of affiant).
~l!e/She is pers~ly known to me or has produced
as identification.
(type of identification)
I
t~oforv 'ublic, StQte of fk~dfJ1J
'. p. ~III! '-, .. " r: t"'. ~
My Cc~!' -;.~ I:xpar~$ ;,i::5"i:1:1 . "'t', ; "t oj;,)
Bo",.: . -'oy Foin. Insurance Inc.
NOTARY PUBLIC
L::"/c,;;r/~ /-5.' .254ror~d
MCP#4 REV. 2/92
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORJDA STATUTES, ON PUBLIC ENTITY CRIMES
TIllS FORM MUST BE SIGNED. AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
~~'?i(Jt;- ~ O(j",/-//
,.
(print name of the public entity]
1.
This sworn statement is submitted to
by
~;AI y
/: 7?""' .~~.
C/
~~~.
/ r-Ji1 E/'1"~ ·
.
for
(print individual's name and title)
/f?/f~ /71~'?f"~
[print name of entity submitting sworn statement]
~o/r7!/I"~~/??
,
whose business address is
:::::r=: O. 3cJ I{
.~
/ AV€"'7<tV/ E1'1 I
~~
r=A.., 33070
and (if applicable) its Federal Employer Identification Number (FEIN) is S tj - ~ 3 ~ - .3S0 '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(I)(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 oftbe United States, including,
but not limited to, any bid or contract for goods er 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"convicted" or "conviction" as defined in Paragraph 287.133(I)(b), Florida Stahltes, 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
of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.
4. I understand that an "affiliate" as defined in Paragraph 287.133(I)(a), Florida Statutes, means:
I. A 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 has
been convicted of a public entity crime. The term" affiliate" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership
by one person of shares constituting a controlling interest in another person, or pooling of equipment or income
among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that
one person controls another person. A person who knowingly enters into a joint venture with a person who has
been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.
5. I understand that a "person" as defined in Paragraph 287.133(l)(e), Florida Statutes, means any natural person
or entity organized under the laws of any state or of tlie United States with the legal power to enter into a 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 with 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.
6. Based on infonnalinn and helief, the statement which I have marked below is true in rdalion 10 the enlity
submitting this sworn statement. (Indicate which statelnent applies.J
-----A- 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 heen 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 are active in the management of the entity, nor an affiliatt; of
the entity has heen charged with and convicted of a public entity crime subsequent to July 1, 1989.
- The entity suhmitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of
the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there
has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative
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 THE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENTIFIED ON PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONL Y AND, THAT THIS
FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO
UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDAST A TIffES
FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
/'
I /,/
/j '--_."/
. ~[S~~-
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Sworn to and subscribed before me this
/"
7---
7~
day of
~ ,19 7~
~, ~~--
C ~)ff,~ /{. ~ ~/"~o
Notary Public - State of r ~
Personally known
OR Produced identification
My Commission unireaubr-c Sf I , F' .d
ftOfUry f" J, u ~ U .OJ! II
My Commissio~, [}~~k~:; rJ:~ldi 24, 1995"
(Type of identification)
(Printed typed or stamped
commissioned name of notary public)
BondF'rl ThrlJ Trt'l)' I=niC'l _ r'H"~""'~~ .~.
Form PUR 7068 (Rev. 06/1 1/92)
I '1 1'1 f lilli, I ~
l\' I ( ) N 1(( ) J(~ (.' .": ) t. , N " ',-' ~ 11' I J ( ) f ~ II) ^
J ~ r CJ II r s t I~' () I' \\1 n i \' C r
of
InSIlt':tlltc Itcquirelurnfs
~
II is reCjllested Ihal the iusurance rCQuirclllcflls, as sJ)(:cj[icd ill fhe Cmlllty's Schedule or IlIsufHncc
Rcquirc.jnCfllS. be \vnivoo or lI\odincd 011 IlIe foJJu\\'iug conlfH(;l. '
CUIII Hlc;(or:
_ ._A.S.A_.P~ Hn~.inc ~~ntrl!c.~_~.:~_....,. _____...
Addll':ss or CUIII mcCor: ---.rQ . ~g~_~04. :rave T_n.!~! L.!.!_.1.30 7~_ _"_
CO/l(IlK( for: Emerg~~~L.~~..irB to ..Channel ~rkerl!...I~.!., '17~. , '18 T.verneir
Creek
--.....-.-.. ,.--.- ....---.--. .-.-.-........--. '--..---
. -.. -. - ---... .. ..~--I- . -
.',. - -----.. --- .
Phone:
85~~4~5.L-_. ._._.____ .____.- ~.___.__.
ScOJ)C of Work:
-.cbanne.l.Ka.r.k.~,L_11J._QJ.aJlli.t,..~._. ....._____.. _____.. '.__.__
- ----... ----~~
..----. - 1'-__-.--, __
Reason for Wai\~c(:
~vn~\e;~.~-on~_.~:: ~~~.~oyees~-~. .~J."~:tfij~~~~.. /, (),
r~~~..kJ '- · . i!,(tSl.
-Vehicle InGI'Y'.rith'i''':,,:,Vl\te:J:-BDa~d-Dp.em~.9.nlY._._.._ ~'J .t..o '.
Signal urc of Contrn~'Ior:
T/2~~" -
~? X '.. No( ^')fUl)VOO :f...-1_/~
U .JU\A-~. .., t.;J cn..,.L~ .L-:.b'")'~.
- - (-- -~ ~y>~) , . U
_ %is/U.. .~.~_~~~ /t_r{j~ ___.__.__..__._.
Risk MahagcltlCnl
Date
COUflt)' Adulinisfralor appc.a':
^I)pro\'~d:
Nol ^pP"ov~;
I) a Ie:
--- . .. ------ . ----
..-.... . -_. '. . ----.. . - ..- .-
UOiU d of CUllufy C:o"ullissjOUCI~ ilpp~ill;
A,lprOVl"-tl ~
Not ^pproved "_ __. .
M t:(,: 1 ; fIg r) a t (~ ~
1\ r I. "" I;',l/ :d f n: 'H',',,, d 1'111
\~I ^ I \'LH
II" .'0'1 1
.)
S r.:- H E [) t..' 1- C: 0 r~~ :J: N S lJ I~ r.- N (,~ E
~~1' 40\
~ ~ "L\
~. , ~".'
~
B
o ~ t f.. :
Act' ca I ..... '\, :
FI t. 0 f', Q ;
7/1~/9~
ASAF'50 RR
8~2-21?1
A S 0 I.f(~ .t
A B A fI :TNt
t;i 0 X 0 0 1
l A V E t~ NIt: I~
FL.. ~13070
RECAN INSURANCE AGCY
'90141 OVERSEAS H~V
TAVERNICR FL 33070
'~iiE-E5~~~ijifi------~._----------i~~;~~I~~---i?ii7i~--~~~~;r--~-------5G;----~
I r' 0 11 (:1 Y t H A () (> ;1 7 e: x p J r ~ Iii hI] 7 I ~ r:, Pre If I hllTl A g .,~ n C y
I I
-1-"'-i:-[i~Bi[fY~-~~~~P-~Di[~i~ij-~2-i5~i-E;;;;;-i~~;.~~i5-~~~-----------*-------
t COYDragQst lI500/1000 PC500 02500
l F=' " l1' IT.J I.' If, I 5 2 11 2 5 95 2. 66 . a 5 ~H 6 ('\.If . 0 0 ~J r1 S, 9 . B S
(
I j'otau :5. ~O.lf. 00 3, U. 11.85
I -.......- ~....... --........... __ _ _ __... _ M. _ -... _ -.. -.. _ -... ........... __.... _..._....._ _.. ___... __ _ _ _ _ _____... _ _ _. __ _ ___ I
- - - i;- c; E: Ei(.; r.' 30 ~... BAR r.F. Ow c5i ;;-9L 30" ci ~ 0 "iF L7682Hfi" A 9;J'" ........~... - - - -- &, ~.... - - - -.. ... M.O. .. ---
CDV~~~9&': HUaO 02500
FI t' ~ tf, 1. u ., t :i 2 2 5
3~Z2S.00
2~.OO
iI. LIAB PROTECTION & INDMEN:tTY Fa BL:30 F'J:'N
COY~~~Sou: LI500 D5000
P r , If, )4 t..J't :
0.00
0.00
lotal:
3,Z2~.OO
?5.00
- .. - -. .. - - - .... ..., .... .... ... ...... - - - ... .... .. .... ." - .... ... - .... -. - ... -... - - - - - - - .,... ..... .. .. till ... ... .. .. .. _ _ _ _ _ .t..... ,.. ".1 _It .... _ ._ _ _ _ _ _ _ _ _ _. .... ..' ., ....
I ~ili L. i: .. i .- f: (1 M f' ANY - iN C ... .. - - - h... .. .. - .. - .. - i t. e; ;; t i' ~ ;. .. .... i i i i i i 3 - .. A r; ;; u ;; i - .... - - - ... ... - - 0 uP. - - ... ~. -
If' 0 li c:: y t 9 3HA 310 1 ~j EXF'1l" e $ 1/01/71 Pro &!If. i IJII'I A gent.' y
I ~. _ ..... ...... O. 0.. ". .- _ .. .. .. _ ... ... .. _ _ _ .. ... .. .. .. ... .. .. .. .. .. .. ... .. ... _. .. _ _.. _ .. .. .. _ _ _ .. _ _ _ _ .. ..... ... ...., ... .. .. _ _ _ ... .. _ _. _ _ ... ~. ... ... .. .. ... I
I 1. L I ASH. r T Y CGL Fe l' 006 BU 1 E:R 150 f' PF.iO I
1 t, (:t v e r' ,;. S .:~ <]): L J ~I 0 0 I 6 0 () P e i.. 0 0 PI:; () 0 l. t. ~ 0 M F' 1 [) ~! 5 0 0 .
I Pro~iu~: -388.00
I
I Total: 0.00 ..'~ao.oo
I ... ....., .... ... _ ..' ..... _ _ _ _ _ _ _ ... ... _' _ _ _ _ _ _ woo _ .. ~. fP ... .... .... It, I
... - - ... - ... .. - ..' ..... .., .... .... .... ... .. ... .... ".. ..~ ... ... _ M _ .... - _ _ _ _ _ _ _ _ _ _ ... _ ... _ ... ... _.. ,_ _ __
A e c.' 0 IJ l' I t Tot a 1 t
D,O~9.00
~~ r ~~~'.~6. e~
,
APPROVED BY RISK MANAGEMfNT
::T~J~~1:r ~
WA1VrR: N/A ~ VES ~
10/20/94
13:47
REGAN INSURANCE ~ 3052924417
NO. 486 ~2
30 S - ~ S'~ -'~ "'0,3
T<lVel-n icr
(305) 852-3234
ID 33070
A.S.A.P., Inc
P.O_ Box 804
CXMWfY
AI.I.E.
aJW#Jttt
.
Underwriters Inc.
.......-0
~,."
c
~avernier FL 33070~ ~NW
(, ) - tl D
c~~~.:.~~' .:i'~:~~~!~~~~~ .~,
THIS IS TO C[PTIFY TtiAf nil PQJCIES Of IH$UfWtQE USTEO ea.ow ..YellIN IS8UID TO tHllNSURED......, AIOYI 'OR nc ItGLICY ~ I
IfIIOtCATEO. ~TWfThSTNrKIfHC; IM(~. UAM CM cONOmON or NN e~ ~OfHD 00CUMEHf WITH RESPECT TO WHICH 1N8
~ICATE ~t ec I~~O OM _V'iRTAIH. 1ME INSUMNCE AHORUIiD Il'flMi POUCID ~......... --..cT 'to ALL 'n4E TEAM&
iXC~~~._.!,_"',?_~~OP10~S 0# SUCH POuCIE& UMITS SHOWN IMY MOUeID BY PAID~.
co
Io!ll
nP( 01' ....-..cc
NIUOY .....
~1fftCIM ............
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.......
A
D0077
06/11/94 06/17/95
/IHf MJ10
ALL o.8)~TOI
SOEtU.E.D At.I'mS
HND MItQ&
NQN.OMCD~
. -'-"1 APPP(\VEO IW RISK MAN~GE
, 8Y~~
OATE /0 --<." -,
~f' .1MiI\m
\','f, rV~R: N/A ~ YES
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~""'.IV" OII~"'~OCAftON~__
tmerqency Derelict Vessel Removal.
.~~~.:.-~>~~ll*~
Monroe Count.y Board Of
COllJlissioners
5100 C~l:.ge ~o~d
,,"""~~~"tr, ~~S~~"t7,~1~-~~~....t. '--=.,'~1 ~~' -~::::;-~:-':
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1ft ..- ... -.& ... .... ......... .. .....__ .. UMIUh
." MIll .... ...... .. .....
AU1JIDIIIIID~~--J
LondOn tnrfIIrtQTICJIU
Key We~~t
FL 33040
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t~:91 t661'6t'et
SSSl868rl8 1~HOIlijN~31NI HOONOl WO~j
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