09/16/1992
CON T R ACT
r- , L F,' f..'. r
r- :!;.-
} - -.. ~ i
'.' {';-iP'
THIS AGREEMENT, made and entered into this '9F6tm}V 4~y !iWJf:sg;eptem-
ber, 1992, between Monroe County, Florida (Owner), and ATLANTIC
BUILDERS (Contractor):
WIT N E SSE S: ,
That t;he parties hereto, for the consider~1!JMWit h~~:in~~~er set
forth, mutually agree as follows:
I. SCOPE OF THE WORK
The CC1ntractor shall furnish all labor, materials and equipment
to reinforce and resurface approximately 4000 square feet of roof
at the Marathon Fire Station #2. Work will be in accordance with
the Re~quest for Proposal dated June 26, 1992 and the Contrac-
tor's proposal dated August 18, 1992, all attached hereto and
incorporated as part of this Contract Document.
II. INDEPENDENT CONTRACTOR
At all times -and for all purposes under this agreement the Con-
tractor is an independent contractor and not an employee of the
Board of County Commissioners for Monroe County. No statement
contained in this agreement shall be construed so as to find the
contractor or any of his/her employees, contractors, servants, or
agents to be employees of the Board of County Commissioners for
Monroe County.
III. ASSURANCE AGAINST DISCRIMINATION
The COlltractor shall not discriminate against any person on the
basis of race, creed, color, national origin, sex, age, or any
other characteristic or aspect which is not job related, in its
recruiting, hiring, promoting, terminating, or any other area
affecting employment under this agreement oE~with the provision
of se~vices or goods under this agreement.
\"
IV. ASSIGNMENT
The Contractor shall not assign this agreement, except in writing
and with the prior written approval of the Board of County Commis-
sioners for Monroe County and Contractor, which approval shall be
subject to such conditions and provisions as the Board and Con-
tractor may deem necessary. This agreement shall be incorporated
by refe!rence into any assignment and any assignee shall comply
with all of the provisions of this agreement. Unless expressly
provtded for therein, such approval shall in no manner or event
be deemed to impose any obligation upon the Board in addition to
the total agreed-upon price of the services/goods of the contrac-
tor.
V. COMPLIANCE WITH LAW
In prc)viding all services/goods pursuant to this agreement, the
contractor shall abide by all statutes, ordinances, rules and
regulations pertaining to, or regulating the provisions of, such
services, including those now in effect and hereinafter adopted.
Any violation of said statutes, ordinances, rules and regula-
tions shall consti tute a material breach of this agreement and
shall enti tIe the Board to terminate this contract immediately
upon delivery of written notice of termination to the contractor.
VI. MODIFICATIONS
Any modification, amendment or change to this agreement shall be
in writing and shall become effective only upon the written ap-
proval of the Board of County Commissioners for Monroe County.
VII. LAW GOVERNING
This agreement shall be governed by and construed under the laws
of the State of Florida, and venue for any action arising out of
this agreement shall be in Monroe County.
VIII. INSURANCE
A. General Liability Insurance Requirements:
Prior t.o the commencement of work governed by this contract the
Contrac:tor shall obtain General Liabili ty Insurance. Coverage
shall be maintained throughout the life of the contract and in-
clude, as a minimum:
1. Premises Operations
2. Products and Completed Operations
3. Blanket Contractual Liability
4. Personal Injury Liability
5. Expanded Definition of Property Damage
. ,6. Medical Payments
The minimum limits acceptable shall be:
$500,000 Combined Single Limit (CSL)
$ 5,000 Medical Payments
If split limits are provided, the minimum limits acceptable shall
be:
$250,000 per Person
$500,000 per Occurrence
$ 50,000 Property Damage
$ 5,000 Medical Payments
An Occurrence Form policy is preferred. If coverage is provided
on a Claims Made policy, its provisions should include coverage
for claLims filed on or after the effective date of this con-
tract. In additi~n, the period for which claims may be reported
should extend for a minimum of twelve (12) months following the
acceptance of work by the County.
Monroe County and Monroe County's Board of County Commissioners
shall be named as Additional Insured on all policies issued to
satisfy the above requirements.
B. Vehicle Liability Insurance Requirements:
Prior to the commencement of work governed by this contract, the
Contractor shall obtain Vehicle Liability Insurance. Coverage
shall be maintained throughout the life of the contract and in-
clude, as a minimum, liability coverage for:
1. Owned, Non~Owned, and Hired Vehicles
2. Medical Payments
The Minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
$ 5,000 Medical Payments
If split limits are provided, the minimum limits acceptable shall
be:
$100,000 per Person
. $300,000 per Occurrence
$ 50,000 Property damage
$ 5,000 Medical Payments
Monroe County and Monroe County's Board of County Commissioners
shall be named as Additional Insured on all policies issued to
satisfy the above requirements.
C. Workers' Compensation Insurance Requirements:
Prior "to the commencement of work governed by this contract, the
Contractor shall obtain Workers' Compensation Insurance with
limits sufficient to respond to the applicable state's statutes.
In addition, the Contractor shall obtain Employers' Liability
Insurance with limits of not less than:
$200,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, each employee
$500,000 Bodily Injury by Disease, policy limits
Coverag'e shall be maintained throughout the.,-.~entire term of the
contr~ct.
Coverage shall be provided by a company or companies authorized
to transact busirtess in the State of Florida and the company or
companies must maintain a minimum rating of A-VI, as assigned
by the A.M. Best Company.
If the Contractor has been approved by the Florida's Department
of Labor, as an authorized self-insured, the County shall recog-
nize and honor the Contractor's status. The Contractor shall be
required to submit a Letter of Authorization issued by the Depart-
ment of Labor and a Certificate of Insurance, providing details
on the Contractor's Excess Insurance Program.
If the Contractor participates in a self-insurance fund, a Certif-
icate of insurance will be required. In addition, the Contractor
will be required to submit updated financial statements from the
fund upon request from the County.
IX. INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
The Cc)ntractor covenants and agrees to indemnify and hold harm-
less Monroe County, Florida from any an all claims for bodily
injury (including death), personal injury, and property damage
(including property owned by Monroe County) and any other losses,
damages, and expenses (including attorney's fees) which arise out
of, in connection with, or by reason of services provided by the
contra1ctor or any of its sub-Contractor) s) in any tier, occa-
sioned by the negligence or other wrongful act or omission of the
Contractor or its sub-Contractor(s) in any tier, their employees,
or ageJnts.
The first ten dollars ($10.00) of remuneration paid to the Con-
tractor is for the indemnification provided for above.
The e}(:tent of liability is in no way limited to, reduced, or
lessened by the insurance requirements contained elsewhere within
this a~Jreement.
X. FUNDING AVAILABILITY
In the event that funds from Fire District 1 Capital Outlay Build-
ing and Structure account are partially reduced or cannot be ob-
tained or cannot be continued at level sufficient to allow for
the purchase of the services/goods specified herein, this agree-
ment may then be terminated immediately at the option of the
Board by written notice of termination delivered in person or by
mail to the contractor. The Board shall not be obligated to pay
for any services provided by the contractor after the contractor
has received written notice of termination.
XI. PROFESSIONAL RESPONSIBILITY
The Contractor warrants that it is authorize~~y law to engage in
the performance of the activities encompas~ed by the project
hereiri described, subject to the terms and conditions set forth
and inc:orporated herein as a part of this contract/agreement.
The provider shall at all times exercise independent, profession-
al judgement and shall assume professional responsibility for the
services to be provided. Continued funding by the Board is con-
tingent upon retention of appropriate local, state, and/or feder-
al certification and/or licensure of contractor.
XI. NOTICE REQUIREMENT
After Notice to Proceed, all work to be performed will be coordi-
nated through Public Works FaciIi ties Maintenance Department to
ensure communications wi th the Fire Department. Any notice re-
quired lOr permitted under this agreement shall be in writing and
hand delivered or mailed, postage prepaid, to the other party by
certified mail, returned receipt requested, to the following:
FOR OWNER
Monroe County Public Works
5100 College Road
Key West, Florida 33040
ATTN: Michael Lawn
FOR THE CONTRACTOR
Atlantic Builder
P.O. Box 4464
Key West, FL 33040
ATTN: Robert W. Svetlik
XII.
COMMENCEMENT AND COMPLETION OF WORK
The Cc)ntractor shall commence work immediately upon receipt of
notice to proceed. Prior to commencement of work a pre-confer-
ence meeting shall be established with representatives from the
Monroe County Public Works Department, the Fire Marshal's Office
and the Contractor, to discuss procedural methods and scheduling
of said project. The Contractor shall prosecute the work wi th
faithfulness and diligence and shall complete the work in accor-
dance with following the schedule of completion.
Upon receipt of Notice to Proceed the Contractor shall take no
longer than twenty eight (28) calendar days to complete the work
after which a One Hundred Dollar ($100.00) a day liquidated dam-
age will be assessed. The Owner will, however, take into consid-
eration rain days that are documented.
The Contractor shall be responsible for protection of County
propert~y and project materials from the elements and theft.
Clean up of all debris will be necessary daily, in order to main-
tain a:n orderly facili ty and to minimize impact to the Monroe
County Fire Department and Airport.
Inspect,ions by the Superintendent of Buildings from the Facili-
ties Maintenance Department and a Building Department Representa-
tive s]lall be performed at completion of every major phase of
work to ensure proper building code compliance.
XIII.
, PAYMENT
--~
The County shall pay to the Contractor for invoices paid by the
Contractor for associated building materials stored on site.
Materials must be stored properly to prevent damage by the ele-
ments and will not impact the services of the Marathon Fire De-
partmen't .
The remainder of the contract sum shall be paid in full upon
final acceptance by the Owner. Total contract amount shall not
exceed Twenty One Thousand Seven Hundred Dollars' ($21,700.00).
In witness whereof, the parties hereto have executed this agree-
ment the day and year first above written,
COUNTY OF MONROE, STATE OF FLORIDA
Attest: DANNY L. KOLHAGE, Clerk
~
-- . . ~\
By ~~~;~:;m~~ ~ ~
Attest ::
::~~ ~
Y!!ff.~ ytLJ
WITNESS
~~~06-\_A ~ A.~~
WI~ESS
~\I
r:: ..
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAU,SE
Robert W. Svetlik
warrants that he/it has not employed,
retained or otherwise had act on he/its behalf any former County officer
or employee subject to the prohibition of Section 2 of Ordinance No.
10-1990 or lany County officer or employee in violation of Section 3 of
Ordinance Nc). 10-1990. For breach or violation of this provision the
County may, in its discretion, terminate this contract without liability
and may als(), in its discretion, deduct from the contract or purchase
price, or ot:herwise recover, the full amount of any fee, commission,
percentage, gift, or consideration paid to the former County officer or
.... ";
employee.
Date:
10-30-92
STATE OF :E1lorida
COUNTY OF Monroe
PERSONALLY APPEAI3.ED BEFORE ME, the undersign.e~ authori ty,
FJI(.1II= $/~+'-7'111f-4h(-V?r"~ ~.c. ~. //-Z-r-V~
Robert w. Svetlik who, after first being sworn by me,
affixed his/ber signature (name of individual signing) in the space
provided abolve on thi s 30
day of
10
,19 92.
..~ .
NOTARY PUBLIC
My commission expires:
'!:~~7Y ~Uh~re8 Sf~f~ o~ r-fodda
My ft~tH'.;,h 24, 1995
e
.. 1 ...---- ~;~ ,
..fT
MONROE COUNTY PUBLIC WORKS
BOARD OF COUNTY COMMISSIONERS
MONROE COUNTY, FLORIDA
REQUEST FOR PROPOSAL .
June 26, 1992
PROJEC~r :
Roof rE~pair I Marathon Fire Station #2
8900 O,rerseas Highway.
Marathon, FL 33050
SCOPE:
Reinforce existing truss system. Strip existing roof to trusses
and ref.urface.
SPECIFICS:
1) Truss Reinforcement
a) Reinforce twenty-five (25) trusses' (one every 4') by
installing a 2 x 6 continuous plate across both the top
and bottom cord with 16 penny nails at 18" on center.
b) Install a minimum of four (4) 2 x 6 upright jacks evenly
spaced and nailed with 16 penny nails and install truss
clips top and bottom (~ach jack) nailed with 8 penny
nails.
c) Install three (3) continuous rows of 2 x 4 cats evenly
spaced prior to removal of roof sheeting.
2) Re-roofing
a) Remove existing built-up roofing system and 1/2" plywood
sheeting.
b) Remove and dispose of all debris.
c) Install 5/8" plywood sheeting and nail according to code.
d) Install new drip edge around existing asphalt shingle
mansard as required to accommodate n~~ roof system.
3) The remaining scope of the roof system installation is at the
discretion of the Contractor for proposal. Procedural method
and material types must be presented with clarity.
4) Roofing shall not be applied if it is raining or if any other
conditions exist that will not permit proper application of
roo.fing.
5) Final Cleanup to be done by Contractor
GUARANTEE:
"Contractor should include a five (5) year guarantee against leak-
, .: ing and wind damage on standard certificate forms and shall cover
..,'<.:'.'l:,:r~placelnent/repair.' cost of labor and material.
.
DOCUMENTS:
All work specified herein shall be performed in accordance with
the Standard Building Code, the National Electric Code, and all
State, County, and Local Ordinances.
EXECUTION:
.Proposals to be -c~nsidered shall be submitted to Monroe County
Purchasing Department,. Public Service BUilding, Cross Wing Room
#002, Stock Island, no later than 10:00 a.m. on August 20, 1992.
Work shall be completed within thirty (30) days of proposal accep-
tance and issuance of Notice to Proceed.
PERMITS AND LICENSES:
Prior to the commencement of the work, the Contractor shall ob-
tain all required permits. The Contractor shall furnish copies
of all current licenses as a part of this proposal.
INSURANCE:
The Contractor shall be responsible for all necessary insurance
coverage as indicated by an "X" on the attached forms identified
as INSC:KLST 1-4.
INDEMNIFICATION AND HOLD HARMLESS:
The Contractor shal1 defend, indemriifyand hold harmless the Coun-
ty, its officials, and agents, from any and all claims, liabili-
ties, losses and causes of action which may arise out of the
performance of the Contract except such claims, liabilities,
losses and causes of action which may arise because of the Coun-
ty's n~~gligent actions or omissions. Compliance with the insur-
ance requirements shall not relieve the Contractor from the obli-
gations imposed by this article. ~~
PUBLIC ENTITY CRIMES:
The Contractor shall furnish the attached statement, fully com-
plete and notarized, as required by law, as a part of his propos-
al.
NON-COLUSION AFFIDAVIT: ·
The Contractor shall furnish the attached statement, fully com-
plete and notarized, as a part of his proposal.
CONDITICtNS:
This proposal will include the materials and methods to. be used
to ~emove the existing bitumen-based build up roofin~ system
;and replace with a bitumen-based roofing system as described in
}. the. specifics.' . . Work will include inspection and replacement of
("flashing, counter-flashing, penetrations, pitch pans and drip
. .. edges as required to provide the facility with a water-tight roof
system. Work will include labor, materials, removal of debris
and will meet all current requirements for public safety. Any
.
work which will interfere with no~al County Government opera-
tions will be coordinated in advance with the applicable Depart-
ment Ma,nager.
.'
-t: .
.
. -" '"
GENERAL INSURANCE REQUIREMENTS
FOR ALL
CONTRACTS WITH
MONROE COUNTY, FLORIDA
Prior to the dommencement of work governed by this contract
(including the pre-staging of personnel and material), the _
Contractor shall obtain, at his own expense, insurance as ..
speci1:ied in the attached schedules, which are made part of this
contract. The Contra~tor will also ensure that all
Sub-Contractors, in any tier, have obtained the insurance as
specified in the attached schedules.
The Contractor will not be permitted to commence work governed by
this contract (including pre-staging of personnel and material)
until satisfactory evidence of the required insurance has been
furnished to. the County as specified below. Delays in the
commencement of work, resulting from the failure of the
Contractor to provide satisfactory evidence of the required
insurance, shall not extend deadlines specified in this contract
and any penalties and failure to perform assessments shall be ·
imposed as if the work commenced on the specified date and time,
except for the Contractor's failure to provide satisfactory
evidence.
The Contractor and any Sub-Contractor(s) shall maintain the
required insurance throughout the entire term of this contract
and any extensions specified in the attached schedules. Failure
.to comply with this provision may result in the immediate
suspension of all work until the required insurance has been "
reinstated or replaced. Delays in the completion of work
resulting from the failure of the Contractor to maintain the
requirled insurance shall not extend deadlines..-lipecified. in this
contra~~t and any penalties and failure to' perform assessments
shall' be imposed,as if the work had not been suspended, except
for thE~ Contractor's failure to maintain the required insurance.
I
The Contractor and all Sub-ContractorCs) shall provide, to the
County,. as satisfactory evidence of the required insurance,
ei ther ::
o Monroe County's Certificate of Insurance
or
.
o A Certified copy of the actual insurance policy.
. The County, at ;its-sole option, has the right to request a
certified copy of "any or all insurance policies required by this
contract. If a certificate of insurance "is provided, the County
prepared form must be used. "ACORD ~ORHs" ARE NOT ACC.EPTABLE.
GIR
1
"\ '
All insurance policies must specify that they are not subject to
cancE!llation, non-renewal, material change, or reduction in
coverage unless a minimum of forty-five (45) days prior
notification is given to the County by the insurer. The standard
langu,age of "endeavor to provide notification" is insufficient.
The acceptanc~ and/or approval of the Contractor's and
Sub-Contractor's insurance shall not be construed as relieving
the Contractor or SUb-contractor from any liability or obligation
assumed under ~his contract or imposed by law.
Monroe County, Monroe County Board of County commissi"oners, its
employees and officials will be included as "Additional Insureds"
on all policies, except for Workers' Compensation.
Any deviations from these General Insurance Requirements must be
requested in writing on the County prepared form entitled
"Requ1est for Waiver or Modification of Insurance Requirements"
and approved by Monroe County's Ri~k Manager.
-'~
"~
..
~
GI~
2
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
FOR ALL
CONTRACTS WITH
MONROE COUNTY, FLORIDA
The Contractor covenants and ~grees,to indemnify and hold
harmll~ss Monroe County Board of County Commissioners from any and
all claims for bodily injury (inClUding death),.personal injury,
and property damage (including property owned by Monroe County)
and any other losses," damages, and expenses (including attorney's
fees) which arise out of, in connection with, or by reason of
services provided by The Contractor or any of its
subcontractor(s) in any tier, occasioned by the negligence or
other wrongful act or omission of The Contractor or its
subcontractor(s) in any tier, their employees, or agents.
-"~
..
..
. .
IND.
1
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND .
Recognizing that the work governed by this contract involves
either underground exposures, explosive activities, or the
possibility of collapse of a structure, .the Contractor's General
Liability Policy shall include coverage for the XCU (explosion,
collapse, and underground) exposures with limits of liability
equal to those of the General Liability Insurance policy.
.........-"
~---~
,~ /I
OK~~ETrY ~o~~~~E
(305) 294-4641
REQUEST FOR PROP(:)SAL
bOARD OF COUNTY COMMISSIONERS
MA YOR, Wilhelmina Harvey, District 1
Mayor Pro Tern, Jack london, District 2
Douglas Jones, District 3
A. Earl Cheal, District 4
John Stormont District 5
TO:
Atlantic Builders
THIS IS AN INQUIRY -- NOT AN ORDER.
P.O. Box 4464
Please quote the best price you offer on
the items listed below,.. Note Delivery Re-
Key West, FL 33040
quirements, and state firm Delivery Date.
REPLY DUE BY
8-20-92 lO:OOAM
UNI'I~ I
I
I ROOF REPAIR, MARATHON FIRE
I STATION #2 (REBID)
I
I
I
Bid :1 Include New Mansard Roof lhingles; add
I I
I ,
DATE I
7-22-92 1
QTY I
I
I EACl~
I
I
I
I
I
1 Alte.qnate
I
I
DELIVERY REQUIRED BY
30 Days from N.T.P.
DESCRIPTION
1
I
I 03-00021-03-54
UNIT PRICE AMOUNT
H'.C. SALES TAX EXEMPT fI
$ 21,700.00
$
4,000.00
SPECIAL NOTES: E,ACH RESPONDER MUST SUBMIT TWO (2) ORIGINAL SIGNATURE DOCUMENTS &
ONE (1) COpy OF THEIR BID PROPOSAL. ANY QUESTIONS. SHOULD BE DLRECTED TO 305-292-4431
VENDOR: PLEASE COMPLETE THIS INFORMATIOl~
1. Delivery Promised: ASAP
We offer to furnish you the above. commodities
2. F.O.B. Point:
Marathon, Fl.
or services at the. prices indicated:
1 4
3. Terms: Pavme'nt on completion.
4. Date of Proposal: AUQust 18, 1992
5. Date quoted p:rices w.ill expire:
Octob'er 31, 1~992
-'
ADDRESS REPLY TO:
Monroe County Pu~:hasing
5100 College Road
Cross Wing, Rocm ,'002
Key West, Florida- 33040
PHONE (30S)292-4~54 or 292-4465
FAX (305)292-4515
ALL BIDS MUST BE SUBMITTED IN A
SEALED ENVELOPE MARKED ON THE OUTSIDE
"SEALED PROPOSAL FOR ROQF REPAIR AT
MARATHON FIRE STATION #2 AT lO:OOAM
ON. AUGUST 20, 1992"
~C'~..
"OfJra
~
RECYCLED PAPER
" dllU .(;UflUnlUflS are satiSfactory ana are nereoy accepted. You are authorized ';)'K"dlU'~
n
,,;-
L.
4.~.. .
t "':'
'.".,,"
,.
'\._/
1 .,
~.
o
Lie.
'rnttnsul
ATLANTIC BUILDERS
General & Roofing Contractor
#CG C037715 RC0056192 RR0050962
P.O. Box 4464
KEY WEST, FLORIDA 33040
(305) 294-2726 FAX 296-5294
Page No.
of
Pages
PROPOSAL SUBMITTED TO
Count of Monroe
PHONE
5100 College Road
292-4464
JOB NAME
Marathon Fire station Roof Repair
STREET
CITV, STATE AND ZIP CODE
JOB lOCATION
Key West, Fl. 33040
ARCHITECT DATE OF PLANS
8900 Overseas Hiw
Marathon, Fl. 33050
We hereby submit specifications and estimates for:
RE~.~IRS......rO..BtJIL.DING.. AS. PER ..SPECS.....BY......PURCHASING....DEPT..
i.Reinforce 25 trusses (ea. 4'). install 2x6..top..and....bo.t.tom..plate...
Inst,all 4 upr'Igllt 'J a"cks"e'v'e'nl'y"""'spac'e'd'.-""N"a'f'i' 'securely. .. .... .
Install 3 rows of ~.~.~.s b~~.~.~.~.I)... j9~..~~.~....l;>.~.f.9~~._.....~.h.~.C!thi.ng..I'.emQ.v.al.
2 .R em ()'v e ex isti ng ...:r;.~<?.~.....~~..t..~.~.~..~..~,- . ... s.h.~.~..~h..~..~ g..'-......q..~.~.P9..~.~.......9.f ....m.~.t.e.~..i.~l$...
..' .. o'f'f :premi'ses'~'" ..
3.~......t-ri'sEiiii"iie'w"5'/ffi," cdx ply and new metal drip edge around perimeter
of Jnansard roof.
4. ....~.~~:~..~~.~....1. (..?..".....l?.~..~..~..i te board base sh~.~~.....Qver.... new. plywood ,mechanically.
fasten with 2" wood screws and three inch galvalume washers.
Ins talI .F i~ E! ~.~..q.~.~......~:P.J~M. ...~..~rt g..J~.~.... P.~Y...m.~Il'lP~~..n..~......QY.~.~..... p.e.r l..i.te.....PQ.a rd. ,... .
.........m.e.clh.an.!ca.iiy. fasten each 12" along seam before cement ing seam.
E P DJ\{ i s 4 5 m ~..+..f?.......~.~......~.Q...~........P y.....J..Q.Q...~.......~.9..~.J...f?..t.9......mJ..n..~.m.!.~.~.....~e.g.m.s.......i.n...rOQ f..
......4...~........R.~..!..~~..~ ......~ RP.~......! !.~.h .......?... c 9.~..~..f?.......~h..~.~.~........~.q.:r;.y.~.l q.......:r.9.9..~~.~.J..Q.t....
heat refle~tivity.
..f..9.~.....g.~.e.a..t..e.r.....
..... ........T E.N....yj~.j\.lf. .m'ii't'eI<tii i war ran t y by'! F res ton e".
TWO ".YEl\'l~'" .i..ab.o.r......wiir.rarity. on 'w'o'rkm'a"Ii's'li"i'p'~.
TOTAL INSTALLED PRICE: $ 21,700.00
Itt Jtrrtpnst hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
7.
Twenty'One Thousand Seven Hundred Dollars 21,~0.OO
dollars ($
Payment to.be mad.! as follows:
; l::l
All material is guaran~teed to be as specified. All work to be completed in a workmanlike
manner according to !itandard practices. Any alteration or deviation from above specifica-
tions involving extra c'osts will be executed only upon written orders, and will become an
extra charge over and Ilbove the estimate. All agreements contingent upon strikes, accidents
or delays beyond our l:ontrol. Owner to carry fire, tornado and other necessary insurance.
Our workers are fully Clove red by Workmen's Compensation Insurance.
Authorized t
Signature
Roh~rt W Svetlik, president-
~ote:lfiis proposa' may be
withdrawn by us if not accepted within day!
.Atttpbttttl~ nf 'rnpdsul____ The above prices. specifications
. and conditions are satisfactory and are hereby accepted. You are authorized Signature
. · .A.. -,....:.......- -___.__:6:_..... D..........ft..... 'AlIII hiD rn~rfiD ::It: ~lItlinprf ~bove. _
.
~
.
.. _.~. --.-------. ....---
1'III1in:1217.3~ Inc.. ""'". ..... OWl. I, )h PIOI[ IlU IIIE{ J HOO.Z25.&J!D
PROPOSAL SUBMITTED TO
County of Man.roe
ADDRESS
5100 Jr. COllege Rd.
Jrupusul Page No.
ATLANTIC BUILDERS
f~esidentia' & Rooting Contractor
I.Ic. #RR0050962 RC0056192
P.O. Box... 4464
KEY WEST, FlORIDA 33040
(305) 294-2726
of
Pages
DATE
A u'g . 1 8 , 1 992
PHONE
292-4464
Fl. 33040
DATE OF PlANS
Repair
8900 Overseas Hywy, Marathon, Fl.
ARCHITECT
-.
We hereby submit sPecifications and e'limates. subiect to all terms and Conditions as set forth on both sides. as follows:
J08 PHONE
ALTERNATE BID:
INCLUDE r.
1 .u . Removal of eXisting shingles. and base sheet
on perimete:r mansard roof. Disposeuof debris
. off premi ses .'
2. Install basE! sheet 30 lb. felt and 20 year
aSPhault/fiberglas shingles. Install new
.. . d iIpUedge ..u at. base~. . ... ...u u ....u. .... Uu ..u......u...
TOTAL Iiii8tALLED PRICE:
$' '4'~ OOO"~ 00
.. ...TWENTY YEARMAttkIAL WARRANTY ON SHINGLES ~uu
.u.. TWOuYEARWORKMANSHIP WARRANTY.
~.~
:: (Read Reyerse Side)
., propOSI hereby to furnish mater,'a' and 'abor - complete In lICCllrdance with abOve ~iflcations,
~or the sum f' Four Thousand DOllars . .. 4, uOO. 00
o '-~. dollars ($ .)
Irlot accepted within
Note: This proposal '!"'Y be ...lthdr....n byus If
-. days.
Authorized
Signature
Robert w. Svetlik, pr
president
id.
httptta: · The above Prices, spec'ficatfo~s and
conditions are satlsfactoO)' and are hereby aCcePled. You
are authorized to do the WOrk as Specified. Payment
will be made as outlined above.
SI,nature
Sl~"ature
'.
NON-COLLUSION AFFIDAVIT
I, Robert w. Svetlik, Atlantic B~ilders
I of the city
of Kev West, Fl.
according to law on my oath, and
under penalty of perjury, depose and say that;
1) I am Robert W. Svetlik, Atlantic Builders , the 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 i.n this bid have not been knowingly disclosed by the bidder
and will not knowingly be discla~ed by the bidder prior to bid
opening, directly or indirectly, to any other bidder or to any
competitoriand
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 submi "t:, a bid for the purpose of restricting competi tion;
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.
"~~J~
(Signature O~~Bidder~--' u~
STATE Olr' '. Florida
Auaust 19, 1992
DATE
COUNTY OF Monroe
PERSONALLY APPEARED BEFORE M~, the undersigned authority,
~br..r7- ~I. $\fe+ l.ik. who, after first being sworn by me,
(name of individ~al signing)
affixed his/her signature in the space provided' ~bove on this
Jq~ day of ~.
." . /<~.<,>" . .r
, 19 '1 ~.
....J
, . ~ I'.'J i__
My commission expires: ~o~~. PUbliE'State ofAorid'
My Comm. Exp. Jan. 25, 199~
Bonded thru ~JCHARD Ins. Agency
, """ It'; ~ ~ t,' \
.:. t ,'<' f<:
r-
f.)
FORM MCPffl REV. 1/91
.,
I. .. . I '.
! , ~ 1
, ,..
. , I :'..
SWOltN ST^1"F:Mr~NT rUJlSUAN'r TO 'SECTION' 287.1JJ(J) (n),
F.L.QlIJJ!^ SIATUTKc;~ ~N rUl1ljlC" EN'rl1Y CRIMFS,
TIllS FORf\'1 ~Ius'r ilK SIGNEJ) ANI) S\V()llN TO IN 'rIfF: I)RK()I~NCE 'OF A N01"ARY IlUDLIC OR OTIIER
, OFFICIAl.. AtrrlIOlllZEI) '1"0 AI),.,IINIS1"RR OA1'"IIS. .
o 0" ".
. ,J. '
1l11~ sworn stnlement is ~uhlnitlcd to County .of Monroe
I prlllt nnlne or . he lUlbllc enclty I
by :Hobert W. Svetlik, president t ,"
(print Indlvldunl's nnlne nnd lltle)
ror-1~t 1 ~'1tlc B'li Iders
: '0' , ',. (print nnme or t'IlUty submitting s\"orn sfnternentJ
Ii:
. ;." : t. ;'; . WllO$C bu:dnc~s nddre~s Is
" i ;;. ,JI',;" ',' ." .'~ t .:",
. &. ~. . .
" I ..'
. ,~
~ ~ .. . f . ~ . I
. ~. ': ;!~:::., ..,..,
~,' , " .. ~ . ".'.!' I . f .., . .!.~ I
! .
, . I
.' .:- ..;, '.
.1
~
. ;, . o.
~ ,':"; ,.
P.CI.Box 4464,
826 Terry Lane, KeYIWest~i~ F.l. 33040 .. \,'.1,',::
J ' '
: and ,(IIr., nppllcable) Its Fcdernl Employer Identinc:\tlon Number (FEIN) Is 65-001 341 4 '
.... .. 2; .:
I, ..
s\vorn stntcmcnt:
(tr the entity has no FEIN, Include the Social Security Numbcrofthe Indl~ldual signing this'
".... , .
369-44-6814
, .)
2. I unt1cr~l:lIl(1 thnt :l "public entity ("rime" :l~ defined in Pnrngr:aph 287.133(1)(g), Ji1o.d.d1l Sllltll(es. menns a
violntinll or nny state or federal l:t\v by :1 rer~on \vilh respect to :lnd dltectly relnted to the transaction of
business \vith :lilY public entity or ,vilh nn ngcnt")' or politic:.1 subdivision of nny other state or of the United
Statcs, including, but not limited to, any bid or contmct for goods or services to be provided to any public
entily or an ngcnl.l' or politic:l1 suhdivision of any other ~d3(e or of the United Slntcs nnd involving antitrust,
fraud, theft, hribery, collusion, racketeering, conspJrncy, or rnnterial misrepresentation.
3. I undcrslnncJ Ih31 "convicl<.'d" or "conviction" as defined In Pnrngrnph 287.133(1)(b), r12.rhl!LS1nfllfe~ means
a Iinding of guilt or n convlcllon oC n public entity crime, with or without an ndJudlcatlon of guilt, In any
Ccdem:l or stille trial court of record relnting to chMge!l brought by indictment or InCormation arler July J,
19R9, :~~ n rC~\l11 of a Jury verdict, nonJury (rial, or entry or a pica of guilty or nolo conrendere.
4. I \lndc:r~l:uHI lhat :In -nffiliatc. :as <.Icfin~d in Pnrngraph ~87"lJ3(t)(n), ElgrJdn...s(ntn(e~, means: I
I. A predecc.'I:,;or or successor of l\ perlion convicled of a public en~tl. crime; or
2. An: ,entity under the control oC any nalural person who Is active In- the management of the entity and
who' h:'ls becn convict~d oC n public entity crime. 'llle term "affiliate" includes those orficers, directors,
executives, pMtners, !lhareholders, employec.'I, members, and agents who are active In the manngement of
an affiliale. 11le ownership by one per!lon of share!l constilutlng a controlling interest In another person,
or a pooling oC c<lllipm'e?t or In,ccrne among pers~>ns when not for fair marke~ value undtr an arm's length
agreement, shall be a prima faCIe case Ihnt one person controls another person. A person who knowingly
enters inlo II Joint venture with a person who has been convicted of a public entity crime In florida during
the prlcccdlng 36 nlonths shall be considered an nffiliate.
S. I undc:rsland that a "per:,;on- as defined in Paragraph 287.133(1 ) (e), FJorldn Sfatutes, means any natural
personl or entity Organized under the laws of any state or of the United States with the legal power to enter
into a binding conlract and which bids or applies 10 bid on contracts for the provision of goods or services
let by a public entity, or which otherwL'Ie tmnsncts or applies to transact business with a public entity. The
!erm "pcrson" incl\ldc.~ those onicers, directors, exccutivc.~, partners, shareholders, employees, members, and
agenls who are active in manngemcnt of an entity. . ,
"i~.....il:i,r):;':' ',.' .~~ ):~~rj\'~'\il'j (.\in;!',
I
<< ,..
Dascd on Informalion And bcllef, lhe slnlcmenl which I have markcd below Is lrue In relallon to the entity
subnlltlllf1g this sworn SlalcmcnC. [lndlcnCe ,,.hlch !Cnlenlent nl)plle~.J
- Neither Ihe enUly sub,nitling ,this sworn slntemen~. .nor. any of Its omcers, directors, executlve.'l.
partner~, shareholders, employees. members, or agents who arc active In the management of the entity, nor
any affiliate of the entity has been charged wilh and convicted of a public entity crime subsequent to July
I, 1989. '.
"
'" 6.
I.
- TIle enllty submitting lhis sworn statement. or one or more of its officers, directors, executives,
p:ul,)crs, shareholders, cmpl()yec.~o members, or agents who nre active In the management of the entity, or
nn Arminte or Ihe entily has been chnrged with and convicted of a public entity crime subsequent to Jury
J, 1989. .
,.
- TIle entity submltllng this sworn st:ltement. or one or more of Its omcers, directors, executives,
partners, shareholders, clnploycc.~, nlCnlbcr$, or agents who arc active In the management of the entity, or
an affiliate or Ihe entity has been. charged with and convicted of a publle entity crime subsequent to July
I, 1989. However, there has been a suh~cquent proceeding beCore a He.,rlng Officer of the State of Florida,
Divi~ion of Adntinistrativc "Ic:lring~ :llld the r:inal Ordcr cntcrcd by the I-Iearing Orficer determined thal
it ,vas not in the public intcrest to plncc the cntity stJbrnilling this sworn statement on the convicted vendor
list. [nUneh n cnpy or the nnnl order)
. ..' ;.~~":; ,
I UNI)EltSTANJ:) '-IIAT '.IIE SUBMISSION OF 1-IIIS FORM T() TIlE CONTRACJ1NG OFFICER FOlt TIlE
J'Unl~IC ENPrll1r 11)(t;NPrIFIEI) IN l'AltAGltAPl1 1 (ONE) AIJOVF; IS FOlt TIIAT PUBLIC RNTI1Y ONI...Y AND,
TIIA1. '-1118 FOI:tM IS VALli) 1-llllOUGIIIJECEf\1JJElt Jl (IF '-11& C^I.#I~NJ)^R Yr~R IN \VIIICIIIT IS FILEI).
I AI.-<;O tJNI)Elts;rANI) l-l.tAT I AM REQUIREI) 1-0 INFORM prill!: PUDI..IC ENTI1Y PRIOR .ro ENTERING
IN1-0 ^ C()Nl-ft.r\(:T IN I~XCESS Ol~ prlll~ prllltF.SJIOI..I) AM()UN.r 1)lt()Vll)I~I) IN SI~crION 2'17.017, FI.#ORl.UA
s.r^.ru.rl~ r;()!t C/\.rl~(;()lty lW() OF ANY CIIANGI'; IN .rllJ~ INFOltMATION CON1-AINED IN TIllS FOltM.
~#~
. . . : I . · I [s I gn n t u re 1. .... .: ! ..
.: \ ... :',; , . , .
.. ." (: .
, .
, !
.:\ .... t; ~
;" :t.;.
; .,'" ~ . ' ~ ': :
.', ; .: I .~, l
. f' i.
. 'i'! ~ ,.;..:, · '
~ . :.'
. . - .
. ~ '.' t
t ~ -:~.:. .', I
I .
. ;. .:' . . ~ I ~ . " /'4', .
I', "
. '-.: . ,!
" " .
. .'., .
. ... ;
.. t I
. .L::) ~~, .
.19~'~ "..
, , I .:.
.~~j~~;~~~:~~'.'~~~ S~~~C;I~~~' before- me Ihl~; J 1 ~' d~y of
. i ".~ PI' \ . . t !,': t' t .: .': .: :. ", .. : . ' . ; . : .. i : . \ : . .., . ~
. ' 'i:'." i.'.. ..' . ': ";.
P~rsonaJly knuwn'V
OR Produced idc:nlirication
~ . ~ .
l '
.. Ii. :.'.:. :;\! ~ ~l
" (Type: of identifi<:ation) .: .:....,..':.
'.a. ; , , .:.:'. , . ,. . l "
My commission' expires
. ~ . j . . ; ". ; . f' '
. t. .
. I ~ . . ~ , : ~ .; . + . :.: I. '.' . : :'. ".
\ ,~ ~ ~ r. '. h ..:' I .~ '. ~. .' ,. . It: I . .
, ,'/'.';l ~.. ij,i'; ,~'::'", ;1' .";'. ~.i ,;.1,.,1.:.. '
'. ,.~. .
'I .
. 1
.: . , ! .' .' . ... . \
",.. I.:
., , . " ;./~~'.
,'''''~. I . .:.~..;.~..;...t(Printcd typed or.slamped.....,.q.i.....'.L~.
'~.:.". :~r;:' ~ .:: .,: .<.,commls~Joned.namc oC.nolaljipubllc)'
.:.:' ..',')'. , t.: .:: : '\.'. ': '.~ .~~;. .; t ~ :~. I .!.~ ;.:.;./~.::: ;'J")') If!. .:'~/i i'
},;'If, \,<!:...n~ .~..j,:~;;~..; ...:....:.. ...:.~.,.
\ ,! ~t~ '/1 ')-; .~ .~;.,;.:J ':.( .; t'.'.~ :~J ~ ,.\. :. ~ ._.
,i..~.>'.!i.l;~.~:.,'t~. ~."":'l":'. -"::~~."" . ,':.:,.:
.i ";' ~
t, ;;.! ;// :.:. :. ~', ':' ; ;',
.. ':' J t '. 4'-.
" . ;'. . ~ '" i" .' .'.,...., :. ,
.!~: : " . >'c '. :i :". . ~,' !:.."Hi~;.; '~;'~."':" ~ '.",,~.\',:>
. ~~ ", " f~~'" .; ; ('. f: . .:.=;'. : · :;"f~': ;;iirt } I
~
, ,: i ~ ': ' .' l::.;- ~.. .. <". . ';:; · ,f,! i~ t . '... ~
,,' 'i ~. I .' ,
;~ r:;i:';'l"; r::;) ::. :,' ~I.~ ~, I; 'i :' ~i ... :.:,. .
. ., .' . . , '",' '. . " t . .~. ; ';i &.' '1.'1 ;', ,. :. · ~.' .'
. . " .. . .".' .~ : ': ! ..'.; .; .; i ; . ~ . .1' "
I I . . j~ I., :: ::' ;': :'; I:' " ;..>:,: ,':. ..'i · '. I;".';;''";,'
. ~ I :. ~.; ". :.
\ . '. " ......;~, "1. '. ;. i . l>' . /'~ .
'. . .f':," i. f..\:'\.
Form PUR 7068 (Rev. 06/18192)
: l
.'" ,
MONROE COUNTY, FLORIDA
INSURANCE CHECKLIST
. FOR
VENDORS SUBMITTING
PROPOSALS FOR
WORK
,.
-~ .
To assist in the development of your proposal, the insurance
cover~ages marked with an "XII will be required in the event an
award is made to.you~ firm. Please review this form with your
insurance agent and have him sign it in the place provided. It
is also required that the bidder sign the form and submit it with
each lproposal.
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
x
Workers' Compensation
Employers Liability
Employers Liability
Employers Liability
us Longshoremen &
Harbor Workers Act
Federal Jones Act
wel
WC2
We)
WCUSLI-(
x
WCJA
WCFEL~~
Federal' Employers'
Liability Act (FELA)
-.
-.
INSCKLST
1
Statutory Limits
$100,000/$200,000
$200,000/$500,000
$500,000/$1,000,000
Same as Employers'
Liability
Same as Employers'
Liability
Same as Employers'
Liability
-'~
. -
. ..
GENERAL LIABILIT~
AsIa minimum, the required general liability coverages will
include: .-
o Premises Operations
o Blanket Contractual
o Expanded Definition
of Property_Damage.
Required Limits:
~ GLl
,
GL2
L
GL3
· Required Endorsement:
L
GLXCU
GLLIQ
o Products and Completed Operations
o Personal Injury ,
o Medical Payments
$100,000 per Person: $300,000 per Occurrence
$50,000 Property Damage: $5,000 Med. Payments
or
$300,000 Combined Single Limit; $5,000 Med.
Payments
$250,000 per Person: $500,000 per Occurrence
$50,000 Property Damage: $5,000 Med. Payments
or
$500,000 Combined Single Limit; $5,000 Med.
Payments
$500,000 per Person: $1,000,000 per Occurrence
$100,000 Property Damage: '$5,000 Med. Payments
or
$1,000,000 Combined Single Limit; $5,000 Med.
Payments
Underground, Explosion-and Collapse (XCU)
Liquor Liability'
All endorsements are required to have the same limits as the basic
policy.
:
INSCKLST
2
VEHICLE LIABILITX
As a minimum, coverage should extend to liability for:
o Owned; Nonowned; and Hired Vehicles
o Medic~l Payments
Required Liini ts: .
VLl
VL2
VL3
BRl
MVC, . . '.
PR01
PR02
PR03
POLl
POL2
POL3
ED1
ED2
GKl
GK2
GKJ
L
-'': -
$50,000 per Person: $100,000 per Occurrence
$25,000 property ~amage; $5,000 Medical Payments
or
$100,000 Combined Single Limit; $5,000 Medical
Payments
$100,000 per Person; $300,000 per Occurrence
$50,000 Property Damage; $5,000 Medical Payments
or
$300,000 Combined Single Limit; $5,000 Medical
Payments
$500,000 per Person; $1,000,000 per Occurrence
$100,000 Property Damage; $10,000 MedicalPaymentf
or
$1,000,000 Combined Single Limit; $10,000 Medical
Payments
MISCELLANEOUS COVERAGES
Builders'
Risk
Motor Truck
Cargo
Professional
Liability
Pollution
Liability
Empioyee
Dishonesty
Garage
Keepers
INSCKLST
3
Limits equal to the
completed project.-
----- ~ .
Limits equal to the maximum
value of anyone shipment.
$500,000 per Occurrence
$1,000,000 per Occurrence
$2,009,000 per Occurrence
$500,000 per Occurrence
$1,000,000 per Occurrence
$2,000,000 per Occurrence
$100,000
$200,000
$ 300,000 ($25,000 per Veh)
$ 500,000 ($100,000 per Veh)
$1,000,000 ($100,000 per Veh)
.[ :" ...
, , ....:.
fft"
j
'v'
I
~
HEOl
MED2
MEDJ
I~
VLPl
VI,P2
VLPJ
, BL'L
'''''~~.:~'
. .
Medical $ 500fOOO
Protessional $1,000,000
$5,000,000
Installa10n Maxi~um value of Equipment
Floater . Install~d .
.
liazardous
Cargo
Transportar
$100,000 (Requires, MCS-gO)
$500,000 (Requit'8s, MOS-90)
~1,000,OOO'(RequireS:MCS-90)
'I; 0'
Bailee Liab. Maximum Value of Pt~perty
IN~URANCE ^GEN~'S ST^T~ME~
I have reviewed the above ~equlrem~nts with the bidder na~ed btlow.
The following deductibles apply to the eorrespondin9 polioy.' ,
\
POLICY
. .
.. G L:?_:
GL,2-
If!.EOUCTIBLES
rgJO .
~ l,/lhSlt/i)' /S tIJ m; /91'1 ~S'
'I- fll,ql',~~ L/Alr( qA1Af~ ~~JJ- M/ILL>>fT"
l!Ki.ltDri' r"t/,l. W17tILl M~ ~ht. . rlf1~'
... ~
Liabllity polioies are . ~. Occurrence
h...
, · ,.Jj;t/JlL(OtlS 2IN~f)(Llt-pa 11je.e(
Insurance A9~ncy
IUQPERS ~T^TEMP.:~
I Understand the insurance that will bQ mandatory if awarded'the
c(),htX'act and will compl.y in fall with all the requirornonta.
, ,;;rLA/t)f7tj 64!Lo.$~ ~~ggp//(/
Bidder ' SignaturG .
'tl
. .~~: ':
"J. '. . .
~ . II
.
" .
:. i -- - , '
I c.
,"c ~~': ' ,; \('
.~
PRODUCER
. .. ...... ............. . ......, ..
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..,... '............ '................... ...." '. -.. ..... ... -..... ............ -,. ........ .......... ".... -, ..,... ...... ...... ...... ................ ........ -,. ...... . .......... ................. '................ ......... '.. '.. ...... -, ..........
.-.................. -.... .......... .... '.... ......... ....... ... ............. ...... ........ .... ....,.. '. .,. ,-.... ................. ......... ..... ....... ....... .. ........... ..................., ,...........,... ....... '..................,... .....,
..........,.........,.,........... ..... .......,... ...... ...... .,... .... ...............,..... ......... ... ... ...... ... ............ ................... ............ ... . .............. ,.................. '......
:<i~"Q"fi:'11I. <i1'I:' '.:~.::~\~"Q\/~~<':I:' .:;,t~~:::T:Q}:~}~~f~"Q:~iU:;/.!/U:<::))::: :::::::::::::::::::::::::':.:::::::<::::.:::.:i::::-:-i::::::::::'.:::.::::::: ISSUE DATE (MMIDDIYY)
i""JJ.i.lX:I.. .:J1.. .. "".:i':\;::lJJ.i"J?:... .1~O\)~:a:;I,~""JJ.i ..... 10 3 0 9 2
"':':"':':"':"':':::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::;::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.:.:........
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.
THE JOHNSONS INS AGCY
PO BOX 2346
MARATHON ~)HORES FL 33052
COMPANIES AFFORDING COVERAGE
~'tY A
ATLANTIC I~UILDERS
P.Oe BOX 4464
KEY WEST FL 33041
. . . . . . . . . . . . . . . . . .. ................ .......................................... .~.. . . . . . . . . . . . . . . . .
....~~~...~.......Wl'~'l'~....f~...... ...........1....
~~y c ... . . ....~IP j ... .}, \ Ll..t(AVhf .. . ..
..~~y..~ .... ...O;fL...,..0\? ~OCD")... .... v.. ..... ...............
~'tY E
INSURED
1HIS IS TO CERTIFY mAT'1HE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO 1HE INSURED NAMED ABOVE FOR mE POUCY PERIOD
INDICATED, N01WI1HSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OlliER DOCUMENT WITII RESPECT TO WHICH nns
CER'I1FICATE MAY BE ISSUED OR MAY PERTAIN, lHE INSURiu~CE MrORDED BY THE POliCIES DESCRIBED HEREiN IS SiIillECT TO All. TIlE TERlvfS,
EXCLUSIONS AND CONDrllONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
........................................................................................................................................................
CO
LTR
TYPE OF INSURANC.E
POLICY NUMBER
POLICY EFFECTIVE: POLICY EXPIRATION
DATE(MMIDD/YY): DATE(MMIDDIYY):
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUf OS
SCHEDULED AUf OS
HIRED AUTOS
APPLIED FOR
: GENERAL AGGREGATE : S
...............................................................
: PRODUCTS-COMP/OP AGG. : 5
................................................
: PERSONAL & ADV. INJURY S
........................................ .................
: EACH OCCURRENCE : 5
............................................................
: FIRE DAMAGE (Any one fuel 5
.............................................. ....................
MED. EXPENSE (Any one person) : 5
:10/ 06 / 9 2 :10/ 0 6 / 9 3 COMBINED SINGLE
LIMIT
CLAIMS MADE
OCCUR.
OWNER'S Ie CONTRACTOR'S PROT.
BODILY INJURY
(Per person)
5100 000
. . . - . . . .. . . . .. . . . . - . . .. .1.. . .. . . . _ . . . . . . .
-'0 ....
X NON-OWNED AUTOS
GARAGE LIABILITY
BODILY INJURY
(Per accident)
;5300 000
. . . . . . .. . . . . . . . .. . . .. . . , . . . .. . . . . . . . . . . . .
550 000
:$
S
PROPERTY DAMAGE
WORKER'S COMPENSATION
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
AND
EACH ACCIDENT 5
DISEASE--POLICY LIMIT S
DISEASE--EACH EMPLOYEE 5
EMPLOYERS' LIABILrrv
OTHER
DESCRIPfION OF OPERATIONSILOCATIONSNEIDCLESISPECIAL ITEMS
ROOFING
MONROE COUN,]~Y BOARD OF COUNTY
COMMISSIONE:F~S & MONROE COUNTY
5100 COLLEGE ROAD
STOCK ISLANr) KE FL 33040
SHOUID ANY OF mE ABOVE DESCRIBED POUCIES BE CANCEllED BEFORE TIlE
EXPIRATION DATE mEREOF, mE ISSUING COMPANY WIll ENDEAVOR.. TO
MAIL~ DAYS WRIITEN NOTICE TO mE CERTIFICATE HOIDER N~~' TO TIlE
LEFT, BUT ,fAILURE TO UCH NOTICE SJ-IALL IMPOSE NO OBUGATION OR
UABIUTY OF ANY KIND E COMPANY, ITS AGENTS OR P ENTATIVES.
XA ".
:}:{::)..)i}(::}}}}://){::::):}///:://~:A:cOR)liC:ijROOR*TION::ir~(j<
... ,,~.~' .. ~ .../ttP...."... .~
COMPANIES AFFORDING COVERAGES
NAME AND ADDRESS Of INSURED
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
L E TT E R
Earth Star Ent.rpri.... Ine. 0
dba Atlantic Builders f~~~~NY
P. O. Box 4464
COMPANY E
Key W..t. FL 33041 LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement. term or condition
of any contreet 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.
The John8ODs Insurance Agency
P. o. Box 2346
Marathon Shores. FL 33052
TYPE or INSURANCE
POLICY NUMBE R
PO LIe Y
EXPIRATION DATE
BODIL V t NJURV S S
PROPERTY DAMAGE S S
4/23/93
BODIL Y INJURY AND
PROPERTY DAMAGE S 500 s 500
COMBINED
PERSONAL INJURY S
BODIL Y INJURY S
(EACH PERSON)
BODll Y INJURY S
(EACH ACCIDENT)
PROPERTY DAMAGE S
BODll Y INJURV AND
PROPERTV DAMAGE S
COMBINED
BODtL v INJURV AND
PROPERTY DAMAGE S
COMBINED
GENERAL LIABILITY
A
~COMPREHENSIVE FORM
~ PREMISES-OPERATIONS
EXPLOSION AND COLLAPSE
HAZARD
o UNDERGROUND HAlARD
~."'~OMPlE'rED
T NS HAZ,~RD
~ CONTRACTUAL INSURANCE
!BROAD FORM PROPERTY
DAMAGE
INDEPENDENT CONTRAC TORS
PERSONAL INJURV
GLA 164033
AUTOMOBILE LIABILITY
o COMPREHENSIVE FORM
DOWNED
o HIRED
o NON-OWNED
EXCESS LIABILITY
o UMBRELLA FORM
o OTHER THAN UMBREl.LA
FORM
WORKERS' COMPENSATION
and
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONSIlOCATIONSNEHlClES
Effective 4/23/92
lfom:oe County Board of County Commi8s1oners &
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof. the issuing com-
pany will endeavor to mail --4S- days written notice to the below named certificate holder. but failure to
mail such notice shall impose no obligation or liability of any k,nd upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER:
Public Works Dept.
5100 College Road
Key West. FL 33040-4399
DATE ISSUED:
.....,.~ .~. . """--.,,
THE JOHNSONS INS AGCY
PO BOX 2346
MARATHON f;HORES FL 33052
, ... '" . . .. """. '''''' . "" "" "'" ","" '" '" , , , '" "" '"'' , " , " " ".". , ". ". '" "
,...,.,..,'""""""""", ,'." ,." ,......."..,.". '.",'., ,., '.. """ '., """"" .,., '.. '.., "'" '. """"" "" """ .., .......... ""'" .." """ '."", ",.".,"',.,.,..,.,',.,.."""""""".."".,.,. '.
",......"""""", "", """""'" ...." ".......". '.", """" ..,..,....".."."., ,.... '., ...... ..... ..., ..... ........".. ..... .... ...... ...................,.,... ,..,..,....,....,...,....,..,...",...."."." ,., ,.. """
...,......,. '..,..,'....,.. ,.,.,'..... '.,.,.....,.. ...... ..... ... .... ,..,..,..,.,..,." '" .,.." '..,'. ....'....... '....,., .., ....... ,.. '.. ,.,.. ,'." .,'.,'.... """" """"'" "',.".,.,',.".,",.,"""""""".""."."."" '. ,.
"',.."".""""" '.." ......"" .....,.."., "..,.. '.... .,." '.,.. '.....". ,., ... """ '" .,.......... ,.......", ....,.. ..., ""'" ,.. ..... "'" .... ... '.. ...,..".. '.,.,....., ....., ,.... ..,...
....,..,.,.....,., '.."...... ,.,.,.., ,...,..... "" ..., ""'" '. ............. ....., .......,...,.. """ ... .... ....,... ... """" "" ... ......., ....,.., ..,.... '.,......,... . ..,......,'... ,.
..~;mR.l'fll~lIi1;mil1fI:NSHlI:N~;mnn>}................. ........... ....................... ISSUE DATE (MMIDD/YY)
.........:..:>....:...>.......................................................................................:.:.............................................................................. . . 1 0 3 0 9 2
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.
PRODUCER
.................. .. .............". .. ... ...... .......................
COMPAMffiSAFF~COVERAGE
HHHHHHHHHHHHHHO ~~::H 0 c~~~ 'H .0 . 0 H. 00 H H OH .
. . .. . . . . . .. . . . . .. . .. .. . . .. . .. . . .. .. . . .. . . . . . . . .. . .. . .. .. . . ), .. . .. . .. J . . . . . .
r~1rY A
INSURED
ATLANTIC E.UILDERS
P.O. BOX 4464
KEY WEST
FL 33041
~~YD
TRAVELERS INS CO
................................................................................................
~~YE
.................. .................................................
nns IS TO CERTIFY THAT 1HE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO 1HE INSURED NAMED ABOVE FOR 1HE POUCY PERIOD
INDICATED. NOTWI1HSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR 01HER DOCUMENT WI1H RESPECT TO WHICH nns
CERTIfICATE MAY BE ISSUED OR MAY PERTAIN. 1HE INSURANCE Al<"FORDED BY THE PUUCIES DESCRIBED HEREiN IS SUBJECT TO AIL THE rclWS.
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
DATE (MMIDDIYY): DATE (MMIDDIYY) :
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE
OCCUR.
GENERAL AGGREGATE
PRODUcrS-COMP/OP AGG.
PERSONAL &; ADV. INJURY
EACH OCCURRENCE
FIRE DAMAGE
MED. EXPENSE (Any one person)
OWNER'S &; CONTRAcrOR'S PROT.
AUfOM081LE LIABILITY
ANY AurO
ALL OWNED AurOS
SCHEDULED AurOS
HIRED AurOS
NON-OWNED AurOS
GARAGE LIABILITY
COMBINED SINGLE
LIMIT
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA I~ORM
EACH OCCURRENCE
AGGREGATE
WORKER'S COMPENSATION
UB449K349692
3/04/92
3 /04/9 3 ~.....:.~~!~.~~~.~~~~....................,...........................'.'...................
:. .~.~~~.~~~.~~~... ................... ~ .? 9.9. f.. .9. 9.9.....
.:. .I?~~~~~~~~~~~ .~~...... ...... ~.~. Q. q. f.. .9. Q. q....
: DISEASE-EACH EMPLOYEE : S 5 0 0 0 0 0
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPfION OF OPERATIONSILOCATIONSIVEIDCLESISPECIAL ITEMS
CONSTRUCTION
MONROE COUNT~l BUILDING &
ZONING
5100 COLLEGE ROAD STOCK ISLAND
KEY WEST FL 33040
SHOUID ANY OF mE ABOVE DESCRIBED POliCIES BE CANCElLED BEFORE THE
EXPIRATION DATE 1HEREOF, ISSUING COMPANY WIll ENDFAVOR TO ,.
MAIL~ DAYS WmTfEN NO' 111HE CERTIfICATE HOlDER NAMED TO lHE
LEFr, BUT FAILURE TO L OTICE SHAlL IMPOSE NO 0 UGATION OR
liABIliTY OF ANY KIN PO E COMPANY, ITS GENTS 0 P TIVES.
XA
.... . . .- .. -'. "".cY '</t.. .. . ~ ~ .A....,... p' '....~. ".. "..J-.,~ ~..... .-: