Install 4 Channel Markers MarathonCONTRACT AGREEMENT
AGREEMENT, MADE THIS L day of / VGVf llb,, 1995, by and
between, Spirit Marine Towing & Assistance ( "Contractor") , and the
BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, of the
County of Monroe, State of Florida ("Board").
The Contractor and the Board, for the consideration named,
agree as follows:
1. The Contractor shall furnish all the materials _,I
and perform all the work as required by the attac-ted--
0
Specifications for the installation of four channel: mar} ers a't
97th Street Canal in Marathon. ti
2. The work performed under the contract shall comrrfence,-
w
immediately from the date the Liaison provides the Notice to
Proceed and shall be completed by January 31, 1996'
4. The work performed under the contract is contingent upon
grant funding from the Florida Department of Environmental
Protection Boating Improvement Fund. If grant funding is
denied,then no compensation is due under this contract. The
Contractoracknowledges the contingent nature of the State
funding and agrees that, if the grant is denied, the Contractor
may not make a claim for compensation under this agreement or by
way of estoppel, detrimental reliance or otherwise. The
Contractor understands the rules of the Department of
Environmental Protection and shall comply with said rules, along
with the rules and procedures instituted by the Board to ensure
an orderly progress to the project. Both the intent and the
requirements of the Specifications are understood by the
Contractor.
5. The Board shall pay the Contractor the total sum of
$5,437.00 for the installation of four channel markers at
97th Street Canal in Marathon. Payment for the work
shall be upon completion by the Contractor and acceptance by the
Board, subject to the terms and conditions of the Specifications
(attached as Exhibit A) and this contract.
6. The attached Specifications, together with this
Agreement, form the contract. They are fully a part of this
contract as if repeated herein verbatim.
7. The Contractor covenants and agrees to indemnify
and hold harmless 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 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, errors, or other wrongful acts or omissions of the
Contractor or its subcontractor(s) in any tier, their employees
or agents. The purchase of the insurance required in
paragraph 13 does not vitiate this indemnification provision.
8. The Contractor acknowledges his/her intention to comply
with the need to coordinate all work with the appropriate
environmental agencies, the U.S. Coast Guard, and the County.
Page 2
9. The Contractor agrees to supply the County with a
set of. photographs of the installed aids to navigation along
with a letter certifying completion of work. The contractor will
be responsible for the camera, film, and development costs. The
Contractor also agrees to provide transportation for the Liaison
to inspect completed project.
10. The Contractor understands and agrees that no payment
will be made for this project without required photographs
and written certification of completion.
11. The Contractor understands and agrees that receipt of
Notice to Proceed from the County does not relieve his
responsibilities to obtain any appropriate permits. The
Contractor must inform and advise the appropriate permitting
authorities prior to the installation of channel markers.
12. Due to the use of heavy equipment and, at times,
dangerous work environment, the Contractor understands and
agrees to maintain an alcohol and drug free work environment.
13. The CONTRACTOR will be responsible for all necessary
insurance coverage as indicated by an "X" on the attached forms
identified as General Insurance Requirements and INSCKLST 1-4,
as further detailed on forms WC1, WCJA, GL1, VL1, & WL1
(attached as Exhibit B). All policies must list Monroe County as
additional insured with the exception of the Workers Compensation
policy.
Page 3
I
14. A person or affiliate who has been placed on the
convicted vendor list following a conviction for public entity
crime may not submit a bid on a contract to provide any goods
or services to a public entity, may not submit a bid on a
contract with a public entity for the construction or repair
of a public building or public work, may not submit bids on
leases of real property to a public entity, may not be awarded
or perform work as a contractor, supplier, subcontractor, or
consultant under a contract with any public entity in excess
of the threshold amount provided in Section 287.017, for
CATEGORY TWO ($3,000.00) for a period of 36 months from the date
of being placed on the convicted vendor list.
15. The Board may terminate this Agreement with
or without cause at any time upon giving the Contractor up to 10
days notice in writing. The Contractor, upon receipt of the
notice, shall immediately cease work. The Board must pay the
the Contractor the percentage of the contract price which is
proportional to the amount of work performed in a manner
satisfactory to the Board up to the date the contractor received
the notice of termination.
16. This contract is governed by the laws of the State of
Florida. Venue for any litigation arising under this contract
must be in Monroe County. -
Page 4
I
IN WITNESS WHEREOF the parties hereto have executed this
agreement the day and year first written above.
BY: A,,"I
Title: Owner
Firm: Spirit
(Seal)
Attest:
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
BY:
Mayor/Chaman
(Seal) '
Attest: DANNY L. KOLHAGE, Clem
C, �yj6Lrlw���o%
Clerk
Page 5
Exhibit k
SPECIFICATIONS FOR THE REPAIR/REPLACEMENT/
OR INSTALLATION OF AIDS TO
NAVIGATION , MONROE COUNTY, FLORIDA
Specifications for installation of treated wood piles complete
with U.S Coast Guard approved Daybeacons, in the locations indi-
cated are in the enclosed materials.
A. DAYBEACON PILES:
1. Pile shall be of timber treated with chromated copper
arsenate (C.C.A.).
2. Pile shall be of timber which will stand the driving for
which they are intended.
3. A straight line drawn from the center of the butt to the
center of the tip shall not at any point face further
away from center of the pile than a distance equal to to
of the length of the pile.
4. Minimum butt diameter = 12" measured 3' from end.
Minimum tip diameter = 811.
5. Piles to be sufficient length to provide a minimum of
four feet penetration into existing sea floor and the
base of the dayboard must be eight feet above mean high
water.
6. Pile shall be driven or best installation practices used.
B. DAYBEACONS:
Daybeacons to be constructed and erected as indicated on the
enclosed sketches and documents. There are two day boards
per daybeacon.
1. Construct all daybeacons as noted in the U.S. Coast Guard
Specifications enclosed.
0
SEVENTH COAST GUARD DISTRICT
PRIVATE AIDS TO NAVIGATION STANDARDS
DAYBEACONS (UNLIGHTED BEACONS)
AND LIGHTS (LIGHTED BEACONS)
(SPECIAL PURPOSE SUPPLEMENT)
SHAPE•
Special purpose dayboards have a diamond shape.
COLOR OF DAYBOARDS:
Special purpose dayboards are yellow.
See "RETROREFLECTIVE MATERIALS" for colors of letters and
borders.
-CHARACTERS•-
Special purpose dayboards are not numbered but may be
lettered for identification purposed. Letters should be sized
and placed as described for numbers.
See "DIMENSIONS" for the correct size and distance from the
lower apex of the dayboard.
RETROREFLECTIVE MATERIALS:
Retroreflective letters and borders, although optional,
should be used on dayboards. They should be the same color, (but
a contrasting darker shade) as the background material; letters
may be white.
The signal characteristics of paint are relatively poor, but
the use of paint is not prohibited. If paint is used, then
letters are black.
DIMENSIONS•
DAYBOARDS: The minimum acceptable dimensions are for a
nominal (visual) range of 1/2 nautical (nmi). Applicants may
establish larger sizes if they wish. Optional retroreflective
letters and borders are encouraged. All sizes are in inches.
S
DIMENSIONS (continued):
WMIMAL TYPE
SIZE
1U06ER/
0ISTANCE DAT0,0AF0
RETROREFLECTIYE
RANGE
DAYBOMU LETTER SIZE
BASE TO W4tCER BASE
BORDER SIZE
(not)
(single)
(double)
(single) (double)
(optional)
SPEC 1 AL PURPOSE
1/2
OJaaond•
side
length -le 1S
6
re 9
1.5
•
i
Diamond*
side
length-36 12
12
20 N 20 -
2
2
Diamond•
side
length-48 16
16
26•6 26
3
3
Diamond'
side
length-72 24
24
40 " 40
4
All angles-900
a� DIStanCe from tnp lower apex to the letter base
STRUCTURES:
There are not required dimensions, materials, fastenings, or
designs for structures supporting dayboards and associated
lights. No height above mean high water is mandated.
Permittees should insure that all aids to navigation are
established consistent with prudent, sound engineering practice
and the harsh nature of the marine environment. The enclosed
sketches are for general reference and should be modified to suit
the circumstances.
LIGHTING EQUIPMENT ON LIGHTS (LIGHTED BEACONS):
COLOR:
-
Lights on special purpose beacons are yellow.
LIGHT VISUAL RANGE:
The minimum visual range of a light is one nautical mile.
Depending on the circumstances a greater range may be permitted,
required, or prohibited.
FLASH CHARACTERISTICS:
Yellow lights on special purpose beacons are fixed or flash
(light off longer than on) regularly with a frequency of not more
than 30 flashes per minute.
a
DIMENSIONS:
DAYBOARDS: The
minimum acceptable dimensions are for a nominal
range of 1/2
nautical wile
(nml).
Applicants may
establish larger sizes
If they
wish. Optional
fluorescent
background and
retroreflective numbers,
letters, and borders
are encouraged. All dimensions are
in Inches.
NOMINAL
TYPE
SIZE • NUMBER/
DISTANCE DAYBOARD
RETROREFLECTIYE
RANGE
DAYBOARD LETTER SIZE
BASE TO NUMBER BASE
BORDER SIZE
(nm1)
(single)
(double)
(single)
(double)
(optional)
PORT
HAND
1/2
Square
side length-18 8
6
5
4
1.5
1
Square
side length-36 12
12
12
12
2
2
Square
side length-48 16
16
16
16
3
3
Square
side length-72 24
24
24
24
4
STARBOARD
HAND
1/2
Triangle
height-24 8
6
5
4
1.5
width` -24
1
Triangle
heignt-48 12
12
10
7
2
wldtn• -46
2
Triangle
height-72 16
16
16
12
3
width• -72
3
Triangle
height-96 24
24
20
14
4
width• -96
SAFE WATER
1 Octogon height••-48 12 8 21•" 21•" 3
width`• -48
sloe length-20
3 Octogon height••-96 16 12 42••• 426" 6
width•• -96
side length-40
e Width at base of the triangle
" Width/helght from side to the opposite side
`•• Distance from the lower apex to the letter base
(bIMENSIONS continued)
STRUCTURES: There are not required dimensions,, materials,
fastenings, or designs for structures supporting dayboards and
associated lights. No particular height above mean high water is
mandated.
Permitees should insure all aids to navigation are established
consistent with prudent, sound engineering practice and the harsh
nature of the marine environment. The following sketches are
for general reference and should be modified to suit the
circumstances.
LIGHTING EQUIPMENT ON LIGHTS (LIGHTED BEACONS):
COLOR•
Lights on starboard hand lighted beacons are red.
Lights on port hand lighted beacons are green.
Lights on safe water beacons are white.
LIGHT NOMINAL (VISUAL) RANGE:
The minimum visual range of a light is one nautical mile.
Depending on the circumstances a greater range may be permitted,
required, or prohibited.
FLASH CHARACTERISTICS:
Red and green flashing lights are laterally significant and
usually flash (light off longer than on) regularly with a
frequency of not more than 30 flashes per minute. When special
caution is necessary, such as sharp turns, obstructions, wrecks,
etc., quick flashing lights (60 flashes per minute) may be used.
White lights on safe water beacons flash in a Morse Code "A"
rhythm (short -long flash).
a
These are general recanTendations and may be adapted to specific
circumstanoes. They should also be modified as necessary to meet the
requirements of prudent sound engineering practice and the demands of the
marine environment.
! eOLT� fttY L!-1
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V:
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vAYw.re.c TTt�aI.E•f
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O� •ILC � ,
--�
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i �
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_ • DAVLtARK 'KCLi L L
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PILE ITEM LL -S. OK. �'
♦ r•,t ttn ►Tc•9(ort�0ul)
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VIEW
rr
WOTTOM
MATERIAL LIST
Item
QuantIt
Materiels
Size
1,II-1
2
6061 Aluminum alloy bolts nuts d washers
1%2" X "
L11-2
LII-3
1 (optional)
2
Concrete prestrosed Is_noth as r "a lred
Da board
10" X 10"
Size as needed
1-II-4
2
6061 Aluminum alloy bolts, nuts.& washers
2" X 14"
All
LII-5
I
Mood pressure treated Ion th as required
dia.
Note 1: All aluminum bolts meet recognized standards for marine use.
Note 2: Place a 2" X 4" filler w I I I be placed between daymarks and the pile
at the upper bolt connection to provide a five degree outboard tilt.
Port
-3'--�"`
PORT AND STARBOARD MARKERS
(nominal range, 1 nmi)
2" GREEN -
(OPTIONAL RETROREFLECTIVE)
BORDER
12" GREEN
(OPTIONAL RETROREFLECTIVE)
NUMBER
GREEN
(OPTIONAL
FLUORESCENT
FILM)
Starboard
2" RED
(OPTIONAL RETROREFLECTIVE),
BORDER
12" RED
(OPTIONAL RETROREFLECTIVE)
NUMBER
RED
�nrT♦ii�� .. ��. ��., �iT 4'
i ILM)
2" GREEN
(OPTIONAL RETROREFLECTIVE)
BORDER
GREEN (OPTIONAL
FLUORESCENT FILM)
I
B" GREEN
(OPTIONAL RETROREFLECTIVE)
NUMBERS
2" RED
(OPTIONAL RETROREFLECTIVE)
BORDER
12" RED
(OPTIONAL RETROREFLECTIVE)
NUMBERS
RED
(OPTIONAL
FILM) -�-- T
4'
*For 2 numerals, use 12" numbers at a height of 12" off base.
"For 3 numerals, use 8" numbers at a height of 12" off base.
,4,r
April 22, 1993
Isi 1`rinling
MONROE COUNTY, FLORIDA
INSURANCE CHECKLIST
FOR
VENDORS SUBMITTING PROPOSALS
FOR WORK
To assist in the development of your proposal, the insurance coverages marked with an "X" will
be required in the event an award is made to your firm. Please review this form with your
insurance agent and have him/her sign it in the place provided. It is also required that the bidder
sign the form and submit it with each proposal.
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
X
Workers' Compensation
WC]
Employers Liability
WC2
Employers Liability
WC3
Employers Liability
WCUSLH
US Longshoremen &
Harbor Workers Act
WCJA
Federal Jones Act
Statutory Limits
$100,000/$500,000/$100,000
$500, 000/$500, 000/$500, 000
$1,000,000/$1,000,000/$1,000,000
Same as Employers'
Liability
Same as Employers'
Liability
Administrative Irminiclion INSCKLST
#4709.01
Ap i1 22. 199.1
1st Printing
GENERAL LIABILITY
As a minimum, the required general liability coverages will include-
• Premises Operations Products and Completed Operations
• Blanket Contractual Personal Injury
• Expanded Definition
of Property Damage
Required Limits:
GLI $100,000 per Person; $300,000 per Ocairrence
$50,000 Property Damage
or
$300,000 Combined Single Limit
GL2 $250,000 per Person; $500,000 per Occurrence
$50,000 Property Damage
or
$500,000 Combined Single Limit
GL3 $500,000 per Person; $1,000,000 per Occurrence
$100,000 Property Damage
or
$1,000,000 Combined Single Limit
Required Endorsement:
GLXCU Underground, Explosion and Collapse (XCU)
GLLIQ Liquor Liability
All endorsements are required to have the same limits as the basic policy.
Administrative ]nAmction
N4709.01
INSCKLST
0
FA
April 22. 1991
Im Printing
VEYHCLE LIABILITY
As a minimum, coverage should extend to liability for:
• Owned; Nonowned; and Hired Vehicles
Required Limits:
VLl $50,000 per Person: $100,000 per Occurrence
$25,000 Property Damage
or
$100,000 Combined Single Limit
VL2 $100,000 per Person; $300,000 per Occurrence
$50,000 Property Damage
or
$300,000 Combined Single Limit
VL3 $500,000 per Person; $1,000,000 per Occurrence
$100,000 Property Damage
or -
$1,000,000 Combined Single Limit
MISCELLANEOUS COVERAGES
BRI
Builders'
Limits equal to the
Risk
completed project.
MVC
Motor Truck
Limits equal to the maximum
Cargo
value of any one shipment.
PRO
Professional
$ 250,000 per Occurrence/$ 500,000 Agg.
PR02
Liability
$ 500,000 per Occurrence/$1,000,000 Agg.
PR03
$1,000,000 per Occurrence/$2,000,000 Agg.
POLL
Pollution
$ 500,000 per Occurrence/$1,000,000 Agg.
POL2
Liability
$1,000,000 per Occurrence/$2,000,000 Agg.
POL3
$5,000,000 per Occurrence/$10,000,000 Agg.
ED I _
Employee
$ 10,000
ED2
Dishonesty
$100,000
GK 1
Garage
$ 300,000 ($ 25,000 per Veh)
GK2
Keepers
$ 500,000 ($100,000 per Veh)
GK3
$1,000,000 ($250,000 per Veh)
MED I
Medical
$ 500,000/$ 1,000,000 Agg,
MED2
Professional
$1,000,000/$ 3,000,000 Agg.
MED3
$5,000,000/$10,000,000 Agg.
Admini%lrstivc Irntmelion
INSCKLST
94709.01
1 $
AI)Til 22. 11193
I.M 1'rinting
IF
Installation
Maximum value of Equipment
Floater
Installed
VLP1
Hazardous
$ 300,000 (Requires MCS-90)
VLP2
Cargo
$ 500,000 (Requires MCS-90)
VLP3
Transporter
$1,000,000 (Requires MCS-90)
BLL
Bailee Liab.
Maximum Value of Property
FiKLI
Hangarkeepers
$ 300,000
HKL2
Liability
$ 500,000
I I lu-3
$ 1,000,000
AIR]
Aircraft
$25,000,000
A1R2
Liability
$ 1,000,000
AI R3
$ 1,000,000
AEO1 Architects Errors $ 250,000 per Occurrence/$ 500,000 Agg.
AE02 & Omissions $ 500,000 per Occurrence/$1,000,000 Agg.
AE03 $ 1,000,000 per Occurrence/$3,000,000 Agg.
ego
INSURANCE AGENT'S STATEIXT
I have re,. iewed the above requirements with the bidder named below. The following deductibles
apply to the corresponding policy.
POLICY DEDUCTIBLES
Liability policies are _ Occurrence _ Claims Made
Insurance Agency
Signature
BIDDERS STATEMENT
I understand the insurance that will be mandatory if awarded the contract and will comply in full
with all the requirements.
Bidder
Signature
Administrativc lrtstruction 1NSCKLS'('
04709.01 1
9
April 22. 1993
I s1 I'ri n1 i ng
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers' Compensation Insurance with limits sufficient to respond to Florida Statute 440.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
$100,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$100,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract
Coverage shall be provided by a company or companies authorized to transact business 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 -
insurer, the County shall recognize and honor the Contractor's status. The Contractor may be
required to submit a Letter of Authorization issued by the Department 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 Certificate of insurance will be required.
In addition, the Contractor may be required to submit updated financial statements from the fund
upon request from the County.
Administrative Imimclion WC, 1 1
#4709.1
WORKERS' CONIPENSATIO,N
INSURANCE REQUIREMENTS
FOR
CONTRACT
BE'11VEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract involves Maritime Operations, the
Contractors Workers' Compensation Insurance Policy shall include coverage for claims subject to
the Federal Jones Act (46 U.S.C.A. subsection 688) with limits not less than those specified for
Employers Liability.
The Contractor shall be permitted to provide Jones Act Coverage through a separate Protection
and Indemnity Policy, in so far as the coverage provided is no less restrictive than would have
been provided by a Workers' Compensation policy.
Administrativc Instruction WCJA
44709.1 1 84
April 22. 1993
let Printing
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
General Liability Insurance. Coverage shall be maintained throughout the life of the contract and
include, as a minimum:
• Premises Operations
• Products and Completed Operations
• Blanket Contractual Liability
• Personal Injury Liability
• Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its
provisions should include coverage for claims filed on or after the of ective date of this contract.
In addition, the period for which claims may be reported should extend for a minimum of twelve
(l 2) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
Administmlive )mirudicm G L I
#4709.1
54
April 22. 1993
lst Priiuing
VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract requires the use of vehicles, tile Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for:
• Owned, Non -Owned, and hired Vehicles
The minimum limits acceptable shall be:
$100,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 50,000 per Person
$100,000 per Occurrence
$ 25,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
Administralivc Ircclnldion V L I
94709.1 75
April 22. 1993
1st 14inling
WA'I'ER CRAFT LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Water Crafl Liability Insurance with terms no less restrictive than those found in the
standard "American Institute Hull Clauses"(June 2, 1977 edition). Coverage shall be
maintained throughout the life of the contract and include, as a minimum:
• Injury (including death) to any Person
• Damage to Fixed or Movable Objects
• Costs Associated with the Removal of Wrecked Vessels
• Contractual Liability with Respect to this Contract
If the policy obtained states that coverage applies for the "Acts or Omissions of a Vessel",
it shall be endorsed to provide coverage for the legal liability of the shipowner.
The minimum limits acceptable shall be:
$500,000 Combined Single Limit (CSL)
Coverage provided by a Protection and Indemnity Club (P&I) shall be subject to the
approval of the County.
The Monroe County Board of County Commissioners shall be named as Additional
Insured on all policies issued to satisfy the above requirements.
Adminititwive Irntniction WL I
N4709.1 86
A
NON -COLLUSION AFFIDAVIT
of the
trtq of according to law on my oath, and
under penalty of perjury, depose and say that;
1) 1 am
the Proposal for the p
described as follows:
the bidder making
2) The prices in this bid have been arrived at independently without collusion,
consultation, communication or agreement for the purpose of restricting competition, as
to any matter relating to such prices with any other bidder or with any competitor;
3) Unless otherwise required by law, the prices which have been quoted in this
bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed
by the bidder prior to bid opening, directly or indirectly, to any other bidder or to any
competitor; and
4) No attempt has been made or will be made by the bidder to induce any other
person, partnership or corporation to submit, or not to submit, a bid for the purpose of
restricting competition;
5) The statements contained in this affidavit are true and correct, and made with
full knowledge that Monroe County relies upon the truth of 7thetements contained in
this affidavit in awarding contracts for said project.
STATE OF
ignature of Bi der)
ell -
COUNTY OF
DATE
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, (name of
individual signing) affixed his/her signature in the space provided above on this
day of '1'e 19
NOTARY PUBkIJIt
My commission expires:
OFFICIAL NOTA O'
I l6i F:N 9h(X?iCS YANIZ
FCNCTARY P�_�P.1,IC STATE G: i-LO;IOA
OMMISSION NO. C 04215?
MCP #1(-)r,(PATS510r: F.XP. FEB. 15,19Q8
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
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. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
O '
(si ature)
Date: �/.-3
STATE OF `l 73 "��'`
COUNTY OF ./� .�/ ��o c�
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
--r
signature (name of individual signing) in the space provided above on this 3'P day of
'(: d (& oohs
NOTARY PUBLIC U �Ij
My commission expires:
OFFICIAL NOTARY SEAL
HELEN BROOKS YANIZ
MCP#4 N(7rARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC342357
MY COMMISSION F)CP. FFB. 15,1998
DRUG -FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
(Name of Busi
1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispens-
ing, possession, or use of a controlled substance is prohibited in the workplace and specifying the
actions that will be taken against employees for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of
maintaining a drug -free workplace, any available drug counseling, rehabilitation.. and employee
assistance programs, and the penalties that may be imposed upon employees for drug abuse
violations.
3. Give each employee engaged in providing the commodities or contractual services that are
under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a condition of working
on the commodities or contractual services that are under bid, the employee will abide by the terms
of the statement and will notify the employer of any conviction of, or plea of guilty or nolo
contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law
of the United States or any state, for a violation occurring in the workplace no later than five (5)
days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is
so convicted.
6. Make a good faith effort to continue to maintain a drug -free workplace through implementation
of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
Bidder's Sign ture
Date
MCP#5 REV. 6/91
ROGERS ATKINS GUNTER & ASSOC LP6UC= OEM -
FOREHAND INSURANCE AGENCY INC COMPANIES AFFORDING COVERAGE
P0 BOX 25598 . . ........... . . .......... ...... ...........
TAMPA FL 33622-5598 cOmpAw A
LEM" PROGRAM UNDERWRITERS .INC .... ................
. .... . . .. ...........
.............
....... . ....... .... . ...... ....... ......... cOmp8my
UvTm
....... ............... ............. . . .............. . .......... . .
SEA TOW FLORIDA KEYS COMPAW C
DUKE H PONTIN SPIRIT TOWING ......... . ....... ... . . .... .......... .. ....................
P 0 BOX 244 BIG PINE KEY COMPAW
wrren D
KEYWEST FL 33043 ... ............. .... . .. ......... .......... . ......... I-- ..... . . .....
COMPAW E
Lf"sm
SHMM ANY OF THANOVE DESCMED P0LX= BE CANCEUED SEFORE THE
E
SSUNG OOMPANY WILL ENDEAvon TO
EXPIPATMN DATE THMEW. T14E
WMED
MONROE COUNTY BOARD OF COUNTY MAL 1-0- DA'ys WNTTOd WT'cE To Tpe WmF*&-m mm To TmG
COMMISSIONERS KIM BLANCO -...! LEFT RUT F;ARMM To MAL SUM NoTjoE SKmj j&#%oa No 0BUCAMN OR
5100 COLLEGE ROAD U"L" OF ANY K= UPON THE =*AW, US AGO= OR
KEY WEST FL 33040
"rlV7"tRMM6N# JR
DD(B)
,Tpw: ♦•y1r..✓YI r1aH-�("iU.t'�'a
A1:/1159. E ql NS
RODUCER.
NC ►�} y DATE (MM/DD/Y1p
1..." . �r 11/29/94
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Alan R. Mott Agency, Inc.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
184 East Main Street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
PO Box 995
Huntington, NY 11743
-- -- - APPROVE-
VSURED
COMPANY ��11
Y�tISK-MANkRW- Insurance Co_ of America
COMP
Spirit Marine Towing & Assist. BY
COMPANY
C �2
o
d/b/a Sea Tow Florida Keys
911 West Indies Drive DATE
Ramrod Keys, FL 33043
WAIVER: N
COM Y
A YES
COVERAGES W1
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE POUCY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL
LIABILITY
GENERAL AGGREGATE
$
PRODUCTS-COMP/OP AGG
$
COMMERCIAL GENERAL LIABILITY
I
CLAIMS MADE F—JOCCUR
PERSONAL & ADV INJURY
$
$
OWNER'S d CONT PROT
EACH OCCURRENCE
FIRE DAMAGE (Any one fire)
$
MED EXP (Any one person)
$
AUTOMOBILE
LIABILITY
•
COMBINED SINGLE LIMIT
$
ANY AUTO
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
=
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY
ANY AUTO
R1SkIv�gTrLt.dt
DATE
�ssControl
!�
EACH ACCIDENT
$
AGGREGATE
S
EXCESS UABILITY
LNML
EACH OCCURRENCE
$
AGGREGATE
$
UMBRELLA FORM
$
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
STATUTORY LIMITS
EACH ACCIDENT
$
EMPLOYERS' LIABILITY
DISEASE - POLICY LIMIT
S
THE PROPRIETOR/ 04CL
PARTNERSIEXECUTIVE
OFFICERS ARE: EXCL
DISEASE - EACH EMPLOYEE
S
OTHER
Protection &
Indemnity
ROYALAP789
11/10/94
11/10/95
$500,00.0.
DESCRIPTION OF OPERATKINS/LOCA CIAL LTEMS
1
'75 Spacecraft 25' #SPA02753M75L
174 Thunderbird 24' #TNR23086M75C
'80 Spirit 34' DOC# 639586
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Monroe County Board of County
Commissioners
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn : Kim Blanco
5100 College Road
Key West, FL 33040
BUT FAILUR O MAIL SUCH NOTICE SHAL IMPOSE NO OBLIGATION OR LIABILITY i
OF AN KIND THE P Y, S AGENJ OR REPRESENTATIVES.
AUTHOR DR
I
ACORD 25-S (3/93) ":`' '" -'_a 6 ACORD"CORPORATION 1993