12/22/1993rJ
AGREEMENT BETWEEN OWNER AND CONSULTANT
OWNER: Monroe County Board of County Commissioners
500 Whitehead Street
Key West, Florida 33040
CONSULTANT: Professional Service Industries, Inc.
3901 N.W. 29th Avenue
Miami, FL 33142
(305) 633-7555
PROGRAM Morrison-Knudsen/Gerrits
CONSTRUCTION 5090 College Road
MANAGER: Key West, Florida 33040
(305) 292-7845
FOR THE FOLLOWING
SERVICES: Threshold Inspection, Quality Control and Material Testing, and
Geotechnical/Subsurface Investigation services for Monroe County
Capital Improvement Projects
DATED:
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TABLE OF CONTENTS
1.0 General
2.0 Basic Services
3.0 Owner's Representative
4.0 Authorization to Perform Services
5.0 Compensation
6.0 Subconsultants and Subcontractors
7.0 Satisfactory Performance
8.0 Resolution of Disagreements
9.0 Consultant Accounting Records
10.0 Ownership of Project Documents
11.0 Indemnification
12.0 Insurance Coverage
13.0 Equal Employment Opportunity Clause
14.0 Independent Status and Immigration Reform Act Compliance
15.0 Truth in Negotiations
16.0 Successors and Assigns
17.0 Termination of Agreement
18.0 Extent of Agreement
19.0 Governing Law
Attachment "A" - Scope of Services
Attachment "B" - Unit and Hourly Rates
1.0 General
The Consultant is to provide professional Threshold Inspection, Quality Control and
Material Testing, and Subsurface Investigation services for the Board of County
Commissioners (BOCC) of Monroe County for capital improvement projects in accordance
with the scope of work and unit rates detailed in Attachments A and B. Monroe County
reserves the right to solicit any portion or all of the services included in this Agreement
elsewhere, if deemed by the BOCC to be in the best interest of the County.
The term of this Agreement shall be for one year with an option to extend the services for a
period of three years.
2.0 Basic Services
All services to be performed under this Agreement shall be on a job specific basis under
direction of requests by Monroe County. Such requests shall be in written form and shall
specify the exact scope of services required.
Throughout the life of this Agreement, the Consultant shall be responsible on each
assignment for properly coordinating, expediting, and controlling the technical aspects of the
services to be provided under this Agreement to ensure complete technical integrity.
3.0 Owner's Representative
The Owner's designated representative authorized to act on the Owner's behalf with respect
to the Project is the Monroe County Board of County Commissioners (BOCC). The BOCC
meets to consider agenda items approximately once a month for those items scheduled two
weeks in advance. The Owner or such authorized representative shall render decisions in a
timely manner pertaining to documents submitted by the Consultant in order to avoid
unreasonable delay in the orderly and sequential progress of the Consultant's services.
The Owner's Program Construction Manager, Morrison-Knudsen/Gerrits, shall administer
this Agreement, receive inspection/test reports and observe the work at the site.
4.0 Authorization to perform services may be given only by the County Administrator or his
representative as directed by the Monroe County Board of County Commissioners. A
detailed estimate including time frames of all job specific work to be performed for each
project shall be submitted to Monroe County for approval prior to commencement of said
work. Any work exceeding the amount of the original estimate shall require an approval
before commencement.
After Notice to Proceed is received for an individual project estimate, services shall
commence within three (3) days. Final reports shall be delivered to the County within the
specified time frame in each estimate.
The procedure shall be as follows:
1. The scope of work of the desired service shall be determined by the County.
Consultant input may be required in defining the scope of work.
2. The finalized scope of work will be transmitted to the Consultant for pricing and time
frames. The pricing shall be in accordance with Attachment "B".
3. The Program Construction Manager will review the Consultant's proposed price and
time frames for the service and subsequently negotiate or approve the price.
4. The scope and pricing will be presented to the Board of County Commissioners for
approval.
5. Upon BOCC approval, the Consultant will be directed in writing to proceed.
The Consultant shall perform no services contemplated to merit compensation beyond that
provided for in the proposal, unless such services, and compensation therefor, are provided
for by an appropriate amendment which is approved by the BOCC.
5.0 Compensation
All fees will be based on the rate schedules as detailed in Attachment 'B". Overtime is
defined as those hours in excess of 8 hours per day per individual, work on Saturdays,
Sundays and holidays. The limits and application of travel time will be established in the
Consultant's individual project estimate.
All invoices shall be submitted monthly and shall be based on the actual hours expended and
tests performed as detailed in the individual project proposal and shall not exceed the limits
established in the proposal unless approved as detailed in 4.0. All invoices are to be made
out to Monroe County and sent c/o MK/G, 5090 College Road, Key West, FL 33040.
Miscellaneous separate reimbursables will not be considered and must be included in the
rate schedule and individual project proposal.
The County shall endeavor to make payments on account of the Consultant's approved basic
services, as well as any approved additional services, within thirty (30) days upon
presentation of the Consultant's invoice. If there are any questions regarding the invoice
submitted, the County will notify the Consultant.
6.0 Subconsultants and Subcontractors
The County reserves the right to review the qualifications of any and all subcontractors or
subconsultants, and to reject any subcontractors or subconsultants deemed not qualified to
perform, in a proper and timely manner, the services for which it shall have been engaged.
7.0 Satisfactory Performance
All services to be provided by the Consultant under the provisions of this Agreement,
including services to be provided by subcontractors or subconsultants shall be performed to
the satisfaction of the County's representative.
The Consultant shall pay the County all losses, damages, expenses, costs, and attorney's fees,
including appellate proceedings, that the County sustains by reason of any default, any
negligent act or omission, including patent infringements on the part of the Consultant in
connection with the performance of this Agreement. The Consultant shall not be
responsible for occurrences beyond their control, including but not limited to, intangible
losses due to scheduling, conflicts caused by other firms or the County.
8.0 Resolution of Disagreements
The County shall decide all questions and disputes, of any nature whatsoever, that may arise
in the execution and fulfillment of the services provided for under this Agreement. Venue
for any claims or disputes arising under this contract shall be in the Circuit Court of the 16th
Judicial Circuit of the State of Florida.
The decision of the County upon all claims, questions, disputes, and conflicts shall be final
and conclusive, and shall be binding upon all parties to this Agreement.
9.0 Consultant Accounting Records
Records of expenses pertaining to all services performed shall be kept in accordance with
generally recognized accounting principles and procedures.
The Consultant's records shall be open to inspection and subject to examination, audit, an/or
reproduction during normal working hours by the County's agent or authorized
representative to the extent necessary to adequately permit evaluation and verification of any
invoices, payments, or claims submitted by the Consultant or any of his payees pursuant to
the execution of the Agreement.
For the purpose of such audits, inspection, examinations, and evaluations, the County's agent
or authorized representative shall have access to said records from the effective date of the
Agreement, for the duration of work, and until three (3) years after the date of final
payment by the County to the Consultant pursuant to this Agreement.
The County's agent or authorized representative shall have access to the Consultant's
facilities and all necessary records in order to conduct audits in compliance with this section.
The County's agent or authorized representative shall give the Consultant reasonable
advance notice of intended inspections, examinations, and/or audits.
The Consultant shall require their consultants to comply with the provisions of this article by
insertion of requirements of this article in written contract agreements between the
consultant and such payees. Failure to include such provisions shall be reason to exclude
some or all of the related payee's costs from the amount payable to the Consultant pursuant
to this contract.
10.0 Ownership of Project Documents
Copies of all reports, test data, design data, plans, specifications, filed survey notes and any
other documents prepared or obtained by the Consultant under the provisions of this
Agreement shall be the sole property of the County and, together with all data and
reference material furnished by the County in connection with any Project, shall be delivered
to the County upon completion of the scope of work, or upon termination of this Agreement
as provided for herein.
In return for the acquisition of the drawings and specifications, the County agrees to
acknowledge that the Consultant shall not be responsible for any changes made to the
drawings and specifications by anyone other than the Consultant and agrees to release the
Consultant against any and all costs, damages, losses and liabilities arising out of the
County's use of the drawings and specifications other than such costs, damages, losses and
liabilities resulting from the Consultant's sole negligence. The County acknowledges that the
Consultant drawings, specifications, reports and other similar documents are instruments of
professional services, not products.
11.0 Indemnification
The Consultant covenants and agrees to indemnify and hold harmless Monroe County,
Monroe County Board of County Commissioners, and Morrison-Knudsen/Gerrits from any
and all claims for bodily injury (including death), personal injury, and property damage
(including property owned by Monroe County and Morrison-Knudsen/Gerrits) 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 Consultant or any of its subconsultants in any
tier, occasioned by the negligence, errors, or other wrongful act or omission of the
Consultant or its subconsultants in any tier, their employees, or agents.
In the event the completion of the project (to include the work of others) is delayed or
suspended as a result of the Consultant's failure to purchase or maintain the required
insurance, the Consultant shall indemnify the County from any and all increased expenses
resulting from such delay.
The first ten dollars ($10.00) of remuneration paid to the Consultant is for the
indemnification provided for the above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance
requirements contained elsewhere within this agreement.
12.0 Insurance
Prior to commencement of work governed by this contract (including the pre -staging of
personnel and material), the Consultant shall obtain, at their own expense, insurance as
specified in the attached schedules, which are made part of this Agreement. The Consultant
will ensure that the insurance obtained will extend protection to all subconsultants engaged
by the Consultant. As an alternative the Consultant may require all subconsultants to obtain
insurance consistent with the attached schedules.
The Consultant will not be permitted to commence work governed by the Agreement
(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 Consultant to provide satisfactory
evidence of the required insurance shall not extend deadlines specified in this Agreement
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 Consultant's failure to provide
satisfactory evidence.
The Consultant shall maintain the required insurance throughout the entire term of this
contract and any extensions specified in any 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 required insurance shall not extend deadlines specified in this
Agreement 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 Consultant's failure to
provide satisfactory evidence.
The Consultant shall provide, to the County in care of the Construction Manager, as
satisfactory evidence of the required insurance, either:
o Certificate of Insurance
or
o A certified copy of the actual insurance policy
The insurance certificate form included in this section contains the appropriate language and
is the preferred certificate form.
All insurance policies must specify that they are not subject to cancellation, non -renewal,
material change, or reduction in coverage unless a minimum of thirty (30) days prior
notification is given to the County by the insurer.
The acceptance and/or approval of the Consultant's insurance shall not be construed as
relieving the Consultant from any liability or obligation assumed under this contract or
imposed by law.
The Monroe County Board of County Commissioners, its employees and officials, and
Morrison-Knudsen/Gerrits will be included as "Additional Insured" on all policies, except for
Workers' Compensation.
In addition, the County will be named as an additional insured and loss payee on all policies
covering County -owned property.
Any deviations from these General Insurance Requirements must be requested in writing on
the County prepared form entitled "Request for Waiver of Insurance Requirements" and
approved by the Monroe County's Risk Manager.
CERTIFICATE OF INSURANCE
MONROE COUNTY
In consideration of the premiums charged on the insurance policies shown in this certificate, this certificate is issued to the certificate holder shown below. T1»s
certificate does not amend, extend or alter the coverage afforded by the policies listed below except as shown below.
NAME & ADDRESS OF INSURED
COMPANIES AFFORDING COVERAGES
Compaq Leaer A
Compaq Letter B
NAME & ADDRESS OF AGENCY:
Compaq Ica C
Compaq Letter D
Compaq Letter E
Ibis is to certify that the insurance policies listed below have been issued to the insured and are enforced at this time. It is agreed that none of these policies will be cancelled or changed without providing 30 days
written notice of such cancellation of change to the certificate holder, enoept 30 days for Workers' Compensation.
CO LTR
TYPE OF INSURANCE
POLICY f
EFFECTIVE DATE
ExPutATION DATE
ALL LIMITS IN THOUSANDS
General Liability
General Aggregate
f
O Commercial General liability
O Claims Made O Occurrence
Products-Comp/Ops Aggregate
f
O Owner's & Contractors Protective
Personal & Advertising Injury
i
O X. C. U. Coverages
Each Occurrence
f
O Broad Form Property Damage
Fire Damage (any one fire)
f
O Independent Contractors
O Blanket Contractual
Medial Expense
(any one person)
i
AutnmoWe Liability
Bodily Injury
• Any Auto
(Each Person)
f
O Ace owned Autos
(Each Accident)
f
❑ Scheduled Autos
Property Damage
f
O Hired Auta
Bodily Injury and Property
Damage Combined
i
O Non -Owned Autos
Escen Liability
O Umbrella Form
O Other than Umbrella Form
O Claims Made
O Omurence
Bodily Injury and Property
DamW Combined
$
women' Compensation and
Employers' liability
workea' Compensation
Statutory
Employers'Liability
$
Other
=
Comments: Monroe County, Monroe County Board of County Commissionen and Morrison-Knudsen/Cerrits are named as additional insureds, with respect to the General Liability, Vehicle Liability, Professional
Liability and Excess Liability Policies.
Name and Address of the Certificate Holder.
Monroe County
c/o Morrison-Knudserl/Gerrits
5090 College Road
Key West, Florida 33040
Date Issued:
Authorized Representative:
Address:
Telephone:
13.0 Equal Employment Opportunity Clause
In carrying out the contract, the Consultant shall not discriminate against employee or
applicant for employment because of race, color, religion, sex, or national origin. The
Consultant shall take affirmative action to insure that applicants for employment are
employed, and that employees are treated during employment without regard to their race,
color, religion, sex, or national origin. Such action shall include, but not be limited to, the
following:
a. Employment, upgrading, demotion, or transfer.
b. Recruitment or recruitment advertising.
C. Layoff or termination.
d. Rates of pay or other forms of compensation.
e. Selection for training, including apprenticeship.
The Consultant shall place in conspicuous places which are available to employees and
applicants for employment, notices to be provided by the Government setting forth the
provisions of the nondiscrimination clause. The Consultant shall state that all qualified
candidates will receive consideration for employment without regard to race, color, religion,
sex, or national origin.
14.0 Independent Status and Compliance with the Immigration Reform and Control Act of 1986
The Consultant acknowledges that is functioning as an independent consultant in performing
under the terms of this Agreement, and it is not acting as an employee of Monroe County.
The Consultant acknowledges that it is responsible for complying with the provisions of the
Immigration Reform and Control Act of 1986, located at 8 U.S.G. Section 1324, et seq., and
regulations relating thereto. Failure to comply with the above provisions of this contract
shall be considered a material breach and shall be grounds for immediate termination of the
contract.
15.0 Truth in Negotiations
The Consultant shall comply with Florida State Statute 287.055, paragraph 5(a).
By execution of this Agreement, the Consultant certifies to truth -in -negotiations and that
wage rates and other factual unit costs supporting the compensation are accurate, complete
and current at the time of contracting. Further, the original contract amount and any
additions thereto shall be adjusted to exclude any significant sums where the County
determines the contract price was increased due to inaccurate, incomplete, or non -current
wage rates and other factual unit costs. Such adjustments must be made within one (1) year
following the end of the contract.
16.0 Successors and Assigns
The Consultant shall not assign, sublet, or transfer his interest in this Agreement without the
written consent of the County.
17.0 Termination of Agreement
This Agreement may be terminated by either party upon seven (7) days written notice to the
other party should either party fail substantially to perform in accordance with the terms of
this agreement through no fault of the other party.
19.0
In the event that conditions arise, such as lack of available funds, which in the County's
opinion make it advisable and in the public interest to terminate this Agreement, it may do
so upon written notice.
If the project is suspended or abandoned in whole or in part for more than three (3)
months, the Consultant shall be compensated for all services performed prior to receipt of
written notice from the County of such suspension or abandonment. If the project is
resumed after being suspended for more than three (3) months, the Consultant's
compensation shall be equitably adjusted.
Extent of Agreement
This Agreement represents, together with all Attachments, the entire written Agreement
between the County and the Consultant and may be amended only by written instrument
signed by both the County and Consultant.
Governing Law
The Consultant shall comply with all Federal, state and local laws and ordinances applicable
to the work or payment for work thereof. This Agreement shall be governed by the laws of
the State of Florida.
• Professional Service Monroe County Board of County Commissioners
Title
I �
Date
/ Sa c iC L ft v%*% o n
Mayor/Chairman
I�y�g3
Date
Approved as to form and legal sufficiency
County .--f.
ffice
Attest: Danny L. Kolhage, Clerk
CO,00 "4..L PA wrct*
-- I7,1 �13
Date
QC and Material Testing
Scope of Work
1.0 General
1.1 The Consultant will provide all necessary materials, labor and appurtenances required to
perform all required laboratory and field testing and services for assigned capital
improvement projects for Monroe County. These services shall be performed in
accordance with the following criteria:
1.1.1 Testing laboratory shall be authorized to operate in the State of Florida
1.1.2 Testing laboratory staff shall include a full time registered Engineer to supervise
services.
1.1.3 Testing equipment shall be calibrated at reasonable intervals with devices of an
accuracy traceable to either National Bureau of Standards (NBS) Standards or
accepted values of natural physical constants.
1.1.4 The Consultant must meet "Recommended Requirements for Independent
Laboratory Qualification", published by American Council of Independent
Laboratories.
1.1.5 The Consultant must provide qualified personnel at the construction site. Cooperate
with the Architect, Program Construction Manager and the Contractor in
performance of services.
1.1.6 Perform specified inspection, sampling, and testing of products in accordance with
specified standards and Contract Documents.
1.1.7 Ascertain compliance of materials mixes and test results with requirements of the
Contract Documents.
1.1.8 Promptly notify the Program Construction Manager and the Contractor of observed
irregularities or non-conformance of the Work or materials.
1.1.9 Perform additional inspections and tests required by the A/E and Program
Construction Manager.
2.0 Testing Laboratory Reports
2.1 After each inspection and test, promptly submit four properly sealed copies of each testing
laboratory report to the Program Construction Manager.
ATTACHMENT "A"- SCOPE OF SERVICES page 1
2.2 Include:
1. Date issued
2. Project title and number
3. Name of inspector
4. Date and time of sampling or inspection
5. Identification of product and Specifications Section
6. Location in the Project
7. Type of inspection or test
8. Date of test
9. Results of test
10. Conformance with the Contract Documents
2.3 When requested by the Program Construction Manager or A/E, provide interpretation of
test results.
3.0 Limits on Testing Laboratory Authority
3.1 The testing laboratory may not release, revoke, alter, or enlarge on requirements of the
Contract Documents.
3.2 The testing laboratory may not approve or accept any portion of the Work.
3.3 The testing laboratory may not assume any duties of the Contractor.
3.4 The testing laboratory has no authority to stop the Work.
ATTACHMENT "A" - SCOPE OF SERVICES page 2
Geotechnical/Sub-Surface Investigation
Scope of Work
1.0 General
1.1 The Consultant must be capable of providing structural soil bearing analysis, soil borings,
and caisson foundation inspection.
2.0 Qualifications
2.1 All work shall be performed by qualified personnel under the supervision of a registered
Professional Engineer. All reports shall bear the seal of a Registered Professional
Engineer.
ATTACHMENT "A!'- SCOPE OF SERVICES page 3
Threshold Inspection
Scope of Work
1.0 General
1.1 In accordance with Florida Statutes Chapter 553, provide building construction threshold
inspection services as required by an Architect/Engineer's structural inspection plan for
assigned capital improvement projects for Monroe County, including but not limited to the
completion and submittal of required threshold inspection reports to the enforcing agency
signing off the structure.
1.2 The inspector shall be a person certified, licensed, or registered under Chapter 471 as an
engineer or under Chapter 481 as an architect.
1.3 The special inspector, upon completion of the building and prior to the issuance of a
certificate of occupancy, shall file a signed and sealed statement with the enforcement
agency in substantially the following form:
To the best of my knowledge and belief, the above -described construction of all structural
load -bearing components complies with the permitted documents, and the shoring and re -
shoring conforms with the shoring and re -shoring plans submitted to the enforcement
agency.
1.4 Two (2) copies of all reports shall be submitted to the Owner's representative, one (1)
copy shall be submitted directly to the enforcing agency and one (1) copy shall be
submitted directly to the Architect/Engineer.
ATTACHMENT "A"- SCOPE OF SERVICES page 4
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COST BASIS FOR ESTABLISHING A MOBILE LABORATORY IN THE KEYS
IF REQUESTED BY THE COUNTY
1. Prep work and mobilization $ 1,200.00
2. Fit up, anchoring, attachments, and build ins. $ 450.00
3. Equipment* allowance, calibrations and related incidentals $ 1,350.00
4. De -mobilization and move to home office or alternate project location 950.00
Total $ 3,950.00
*Equipment inventory to include, but not necessarily limited to the following:
• Concrete compression machine
• Concrete specimen curing tanks
• Concrete miscellaneous (slump cones, air meters, thermometers, unit weight bucket).
• Grout cube molds
• Sand cone and nuclear densometers
• Drying oven/stove
• Proctor molds and hammers
• Platform and gram scales
• Telephone
• Nest of soil screen (sieves)
• Sieve shaker
• Microwave (for drying)
• Air conditioner
Notes (Assumptions)
1. County to provide area for laboratory (i.e. trailer).
2. Electricity will be installed to trailer by others.
ATTACHMENT B Page - 5
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FURft MUST BE SIGNED AND 9JMX TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTTER OFFICIAL AUTHORIZED 'TO
ADNINISTIER OATHS.
1. This sworn statement is submitted to Monroe County
(print name of the public entity)
by William N. Phillips, executive Vice President
(print individual's name and title)
for Professional Service Industries Inc.
(print name of entity submitting sworn statement)
whose business address is 3901 N.W. 29th Street, Miami, FL 33142
Oand (if applicable) its Federal Employer Identification Number (FEIN) is 37-0962090
(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 287.1330 )(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 of the United States, including, but not limited to, any bid or contract for goods or
services to be provided to any public entity or an agency or political subdivision of any other
state or of the United States and involving antitrust, fraud, theft, bribery, collusion,
racketeering, conspiracy, or material misrepresentation.
3. 1 understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida
Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an
adjudication of guilt, in any federal or 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.
G. I understand that an "affiliate" as defined in Paragraph 287.133(1)(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 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 hares 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, shalt 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.
S. 1 understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any
natural person or entity organized under the laws of any state or of the United States with the
legal power to enter into a binding contract and which bids or applies to bid on contracts for the
provision of goods or services let by a public entity, or which otherwise transacts or applies to
transact business 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 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.)
X 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, or one or more of its officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the
management of the entity, nor an 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, 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 THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN
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 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, FLORIDA
STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
i
(sign e)
Sworn to and subscribed before me this 27th day of September-----,, 19 93
Personally krawn X Cy\ .ir.% d Q n*
OR produced identification Notary Public - State of p1nrirla
(Type of identification)
Form PUR 7068(Rev. 06/11/92)
My Commission expires
(Printed, typed or stamped commissioned name
of
M-4111S TREAT
gsj Notary Public, State of Florida
A My coax. e:plres May 23, 1995
Com. No CCO97556
I
f�
r
E
The entity submitting this sworn statement, or one or more of its officers, directors,
executives, pertners, shareholders, employees, members, or agents who are active in the
management of the entity, nor an 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, 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 THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN
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 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, FLORIDA
STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
Sworn to and subscribed before me this 2 %t-h day of
Personally known
!1
OR produced identification
(Type of identification)
Form PUR 7068(Rev. 06/11/92)
(slgnat e)
September , 19 93
Notary Public - State of pl nri c3a
My Commission expires
(Printed, typed or stamped commissioned name
of
®. MAVIS TREAT
-' �) Notary Public, State of Flori,a
0
a ' A My caw. expires May 23, 1995
Came. No CCO97556
11
fl
H
Fi
r
f�
11
El
D
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
XONROE COUNTY, FLORIDA
ETHICS CLAUSE
. Professional Service Industries, Inc.
(Company)
«... warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former
County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or
employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the
t 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 forme County officer or employees.
IDate: September 27, 1993
STATE OF Florida
COUNTY OF Orange
Subscribed and sworn to (or affirmed) before me on September 27, 1993 (date)
by William N. Phillips (name of affiant). He/She is personally known to me
or has produced as identification. (type
of identification)
NOTAR PM 1C
M11 I S TREAT
EAT
9 Notary Public, State o. Flcrida
a !r AN My coan. expire; Nay 23, 1995
Cone. No CC0375156
J
MCP 04 Rev 2/92
Ii
I
ISSUE DATE (MM/DD/YY)
�►�:11����. CERTIFICA F INSURANCE
12 / O 1/ 9 3
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
MCCORKLE COMMERCIAL INSURANCE AGENCY
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
909 NE LOOP 410, SUITE 700
POLICIES BELOW.
SAN ANTONIO, TEXAS 78209
COMPANIES AFFORDING COVERAGE
COMPANY
A
LETTER
ZURICH INSURANCE COMPANY
COMPANY 23 4 56 78
B
INSURED
LETTER
APPROVED By RISK MANAGEMENT
PROFESSIONAL SERVICE INDUSTRIES, INC.
COMPANY `/
JAMMAL & ASSOCIATES DIVISION
LETTER
_. BY M- DEC I993
3901 N.W. 29TH AVENUE
COMPANY �f I l � o
LETTER Received)
MIAMI, FLORIDA 33142
pA h"arr(71
on K17Ud
COMPANY _YES -- T��a Gerrits
LETTER N/A
305/633-7555
tiNgVER'_ �,
COVERAGES►
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
HAVE BEEN ISSUED TO THE INSURED NAMED AB ICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH 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 TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
A GENERAL LIABILITY GLO 580471-02
3/1/93 3/1/94 GENERAL AGGREGATE $ 219000,000
X COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGG. $ 2,000,000
CLAIMS MADE X OCCUR.
PERSONAL & ADV. INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT.
EACH OCCURRENCE $ 1,000,000
X BROAD FORM CONTRACTUAL
FIRE DAMAGE (Any one fire) $ 50,000
MED. EXPENSE (Any one person) $ 5,000
A AUTOMOBILE LIABILITY TAP6580473-02 (TX)
3/1/93 3/1/94 COMBINED SINGLE
XANY AUTO MA6580474-02(MA)
$
3/1/93 3/1/94 LIMIT 1,000,000
ALL OWNED AUTOS BAP6580472-02
3/1/93 3/1/94 BODILY INJURY
SCHEDULED AUTOS
(Per person) $
X HIRED AUTOS
BODILY INJURY
$
X NON -OWNED AUTOS
(Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY
EACH OCCURRENCE $
UMBRELLA FORM
AGGREGATE $
OTHER THAN UMBRELLA FORM
A WORKER'S COMPENSATION WC6580470-02 (CA)
3/1/93 3/1/94 STATUTORY LIMITS
WC658028600-02
3/1/93 3/1/94 EACH ACCIDENT $ 1,000,000
AND
WC6668421-02(FL,LA,TX)3/1/93 3/1/94 DISEASE —POLICY LIMIT $ 1,000,000
EMPLOYERS' LIABILITY
DISEASE —EACH EMPLOYEE $ 1 00O 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS,
ITS EMPLOYEES AND OFFICIALS, AND MORRISON-
KNUDSEN/GERRITS ARE NAMED AS ADDITIONAL INSUREDS. PSI PROJECT NO. 395-30197.
CERTIFICATE HOLDER
CANCELLATION
MORRISON KNUDSEN/GERRITS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
A JOINT VENTURE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
POST OFFICE BOX 5283
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
KEY WEST, FLORIDA 33045-5283
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
ATTN: MARTELL KARR
AUTHORIZED REP SENTATIV
ACORD 25-S (7/90)
-CORPORATION `1990
ACHNUP.
(PRODUCER
Mack and Parker, Inc.
55 East Jackson Boulevard
Suite 600
Chicago IL 60604-4187
KJT I COMPANY A
LETTER
CODE SUBCODE
i
—-------------------_ _ _
- _.. -._ J COMPANY B
INSURED
LETTER
PROFESSIONAL SERVICE
COMPANY
C
INDUSTRIES, INC.
LETTER
510 EAST 22ND STREET
COMPANv
D
LOMBARD , I LLI NO I S 60148
LETTER
COMPANY C
LETTER C
SEE ATTACHED SCHEDULE
APPROVED BRISK MANAGEMENT
BY `
DATE 13
WAIVER: N/A YES _
THIS IS TO CERTIFY THAT 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.
'COI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS
LTR DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY
GENERAL AGGREGATE
S
! COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OPS AGGREGATE
S
MS MADE OCCUR
CLAIM
PERSONAL & ADVERTISING INJURY
S
8
OWNER'S CONTRACTORS S PROT
,
j 3 (,� a9 �O
EACH OCCURRENCE
5 -
%
FIRE DAMAGE (Any one fire)
S
Ni'
MEDICAL EXPENSE
S
(Any one person)
AUTOMOBILE LIABILITY
DECi99�
COMBINED
�iI
I
ECI-
S
ANY AUTO
M
deceived
LIMIT
AUTOS
N
BODILY
'ALLOWNED
SCHEDULED AUTOS
(A t'R"orrison Knudsen V
INJURY $
Person),
i-
l�l
Gerrits
(Per
r
HIRED AUTOS
G3310 �,�
(�
BODILY
INJURY S
! NON -OWNED AUTOS
(Per Accident)
GARAGE LIABILITY
PROPERTY S
j,
! !i
DAMAGE
............
EXCESS LIABILITY
EACH
AGGREGATE
OCCURRENCE
OTHER THAN UMBRELLA FORM
STATUTORY !
WORKER'S COMPENSATION--•--•�•-•-�-••
S (EACH ACCIDENT)
AND - -.
EMPLOYERS' LIABILITY $ (DISEASE -POLICY LIMIT)
$ (DISEASE -EACH EMPLOYEE)
OTHER'DEFENSE INCL IN LIMIT
A PROFESSIONAL F932017000 7/01/937/01/941INCL CLAIMS EXPENSE
(LIABILITY i$1,000 PER CLAIM
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
PSI/JAMMAL PROJECT NO. 395-30197
SCHEDULE A
INSURANCE COMPANY PARTICIPATION
COVERAGE: Professional Liability Insurance
INSURED: Professional Service Industries, Inc.
POLICY NO.. F932017000
TERM: 07/01/93 to 07/01/94
CARRIER NAME
St. Paul Reinsurance Company
Limited, London . . . . . . . . . . . . . . . . . . . . .
Compagnie D'Assurances Maritimes
Ariennes et Terrestres per Camomile
Underwriting Agencies Limited, London . . . . . . . . . .
Anglo American Insurance Company
Limited, London . . . . . . . . . . . . . . . . . . . . .
Aegon Insurance Company (UK)
Limited, London . . . . . . . . . . . . . . . . . . . . .
Assicurazioni Generali Spa,
London . . . . . . . . . . . . . . . . . . . . . . . . .
Certain Underwriters at Lloyd's,
London . . . . . . . . . . . . . . . . . . . . . . . . .
PERCENT
20.00%
20.00%
20.00%
12.50%
10.00%
17.50%
TOTAL loo.00%
4703D
M—K; GE Pp T a
1 i 194 11 TO No .003 P.01
10 - a
mill
ELI
7
20 t' 0 003 P 02
In d u
73