2. 07/21/1994 to 07/20/1995BRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 333050
TEL. (305) 289-6027
'A
10a ntip 1. ftel#nIt
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
SW WHITEHEAD S77 W
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
MEMORANDUM
TO: Reggie Parot
Director of Public Safety
FROM: Ruth Ann Jantzen ,
Deputy Clerk -4"A�
DATE; December 21,1994
BRANCH OFFICE
N8 W OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
At the July 21, 1994 County Commission Meeting, the Board granted approval
and authorized execution of a renewal of a contract between the Board of Governors of
Lower & Middle Keys Fire and Ambulance District and Fire -Tech Repair Service, Inc.,
for maintenance of rwe/rescue vehicles, semi-annual inspections, preventative
maintenance and unscheduled maintenance resulting from malfunction or failure.
At the same meeting, the Board granted approval and authorized execution of a
contract between the Board, acting as the Governing Board for MSTD S and 6, and
Fire -Tad Repair Service, Inc., for maintenance of fire/rescue vehicks, semi-annual
inspections, preventative maintenance and unscheduled maintenance resulting from
malfunction or failure.
Enclosed please find a fully executed duplicate original of each of the above
contracts to be returned to your providers.
If you have any questions regarding the above, please do not hesitate to contact
this office.
Enclosure
cc: County Attorney County AWministrator, w/o document
Finance ire
MAINTENANCE OF FIRE/RESCUE VEHICLES
AGREEMENT, made this 21st day of July , 19 94 between
the Board of Governors of the Lower and Middle Keys Fire &
Ambulance District Monroe County, Florida, hereinafter (DISTRICT),
and Fire -Tech Repair Service, 'inc., P. 0. Box 1570, Key Largo, FL
33037, hereinafter (CONTRACTOR),
RECITALS
A. The DISTRICT advertised a notice of calling for bid for
MAINTENANCE OF FIRE/RESCUE VEHICLES to be opened on the 2nd day of
February, 1993, duly submitted to be published on the 5th day of
January 1993.
B. The successful bidder was Fire -Tech Repair Service, Inc.
and in consideration of the mutual covenants expressed herein it is
agreed that:
1. CONTRACT PERIOD AND RENEWAL - This contract covers a
period of one year from the date on which it is signed by the last
of the two parties to sign. It may be renewed annually by DISTRICT
up to three one year periods, with the approval of (a) the Public
Safety Director, (b) the Office of Management and Budget, and (c)
the Board of Governors of the Lower and Middle Keys Fire and
Ambulance District, Monroe County, Florida. Notice of intention to
renew shall be given at least 60 days before the applicable
anniversary date.
2. CONTRACT TERMINATION - This contract may be terminated
for any reason by either party on 30-day written notice without
cause.
3. SUBJECT MATTER OF CONTRACT -- This contract is for
scheduled semi annual inspections and preventative maintenance of
fire rescue vehicles, annual pump tests and for unscheduled
maintenance and repair resulting from equipment failure or
malfunction.
4. RATES - The hourly rate shall be $45.00 per man-hour
with no travel time or milage charge. Jobs requiring more than one
technician will be charged at the rate of $30.00 per man-hour for
the second man. Semi Annual inspections and annual pump tests are
at quoted flat rates and excluded from hourly rate.
5. OVERTIME AND HOLIDAYS - Rates per man-hour for
emergency repairs called ouk. 1j' ,6NtfLtk*MNGyusiness hours and federal
holidays shall bo one and one h411ftiimlds the normal rate.
0 t: bd lz 330 K
` 6. SEMI ANNUAL INSPECTIONS. - Contractor shall
inspections. duringthe perform two
year (Level I and Level II Preventative
Maintenance Service) of each vehicle at an annual total cost of:
Rescue -type vehicles, without pump $360..00
Pumpers $4.90.00
Aerials $640.00
Exception shall be if a vehicle has been used 1,GOD hours. prior
to yearly preventative maintenance service,. level I and II
Preventative Maintenance Service shall be performed and charged the
above rate.
Level I: 250 Hours or 6 months (whichever comes first)
Full vehicle inspection_ as per attached semi-annual inspection
schedule plus:
- Engine oil and filter change
- Fuel filter change (every 6 months)
- Air filter inspection and replacement if necessary
- Chassis lubrication
- Outboard (forward) impeller shaft lubrication
- Lubrication of all valve control linkages
- Clean or replace air compressor strainer
- Clean engine crankcase breatl4er
- Inspection of generator and service of lubricant system,
full system., and air filter according to its individual
hours of operation (not to exceed 6 months)
Level II: 1000 Hours or one year (which ever comes. first)
Full service performed in Level I plus:
- Replacement of coolant hoses,, filter and coolant as
needed
- Replacement of all drive belts
- Replacement of pump transmission oil and filter
- Replacement of engine transmission fluid and filter
- Replacement of rear axle lube. oil
- Inspection and re -packing or replacement of front wheel
bearing grease
- Inspection. and. clean; ng of relief valve strainer
- Replacement of secondary fuel filters on both engine and
generator
The numher cf vehicles may fluctuate from, time to time due to
new purchases or removal of vehicles from inventory. ins. ,,-.. `--ion!:,`--ion!:,-:hall be preformed at the respective fire stations. The
7. Qfik ffljWUL& - Regularly scheduled semi annual
"OP"ee"ne and preventative maintenance shall be conducted at such
intervals as -are approved by the DISTRICT.
8. PUMP TESTS - CONTRACTOR shall
perform
test at a flat rate cost of $225 each for allehiclesn 1 pump
_ requiring
Page No. 2
such test. In order to, facilitate the passing of the Pump test
minor repairs and adjustments shall be made as needed
includes -clean-up after salt water use. Price
9. PARTS, FLUIDS AND LUBRICANTS - All parts, fluids, and
lubricants used for maintaining and repairing vehicles shall be
supplied by CONTRACTOR and billed to the DISTRICT at cost plus. 25%,
with a copy of original parts supplier invoices for all parts
attached to the bill.
10. ENGINE OIL AND FILTER CHANCE and complete drive train
lubrication and any other fluids and/or filter changes, shall be
performed as recommended by the manufacturer.
11. SEMI ANNUAL INSPECTION SCHEDULE - CONTRACTOR shall
perform the following inspection and, preventive maintenance twice
per year on all vehicles:
( a ) Cooling system.,including: fan. belts.,. radiator supports,
hoses and clamps., and auxiliary cooler;
(b) Exhaust System, including hanger, clamps, muffler, and
Pipes;
(c) Clutch, including freeplay, linkage, and fluid levels;
(d) Manual Transmission, including seals, linkage, and lube
level;
(e) Automatic Transmission, includingfluid level, seals,
modulator adjustment, and linkage;
(f) Drive Train., including U-joints., center support, and
companion flanges;
(9) Rear Axle and Springs, including oil links, spring
hangers, center bolts, and U-bolts
(h) Front End, including steering. box, linkage, kingpins
and bushings, spring hangers, and U-bolts;
(i) Mechanical Brakes, including adjustment and fluid
levels;
(j) Air Brakes, including drain, adjustment, wear, and air
leaks;
(k) Tires, including condition and wear;
(1) Electrical System, including running lights, emerge4cy
lights, battery cables., turn lights., 4-way flasher,
headlights, stop lights, and switches;
(m) Fuel System, including hoses and fittings.,. filters and
brackets, and tank straps; -
(n) Booster Tank, including leaks. and supports;
(o) Prime Pump, including wires, coupling, switch, and
valve discharge;
(P) Plumbing and Gates, including leaks., brackets.., bleed
valves, control arms and knobs, and linkage;
(q) Main Pump, including. vacuum test, pressure test,
packing, clappers -,and mounting;
(r) Pump Transmission, including fluid levels, seals-, shift
motors, and manual override;
(s) Aerial Ladder, including power takeoff, drive shaft and
coupling, p.t.o. activating device, and outrigger
controls;
Page No. 3
(t) Aerial Operation, including engine r.p.m., hydraulic
pressure, operation of all controls, warning devices.,
hoses and fittings, rung covers, ladder locks., and ring
gear;
(u) Aerial Platform, including lubrication, leveling,
electrical system, turntable and platform controls,
communications, and water tube.
The above inspections shall include, at no additional labor
charge the changing of all applicable filters- and fluids
used by the unit being inspected. Air filters shall be
changed on first inspection and then yearly thereafter.
Filters and fluids- shall be billed at cast plus. 25%, as
previously described in Section 10 of this AGREEMENT.
12. WEEKLY MAINTENAN:CE SCHEDULE. - CONTRACTOR shall provide
to the DISTRICT a preventative maintenance schedule that can be
performed weekly by the individual Volunteer Fire Departments
personnel.
13. MAINTENANCE LOG. -
inspection and maintenance chart
least the following information:
( a ) Date of performance,
(c) service performed,
(e) name of service person(s),
CONTRACTOR shall maintain an
on each vehicle containing at
b)
(d)
(f)
A copy of thischart shall be supplied
within 30 days of the service.
apparatus.serviced,
parts used,
total downtime of
vehicle
to the -Fire Marshal's Office
14. COMMUNICATION - CONTRACTORS shall maintain a telephone
or paging device such that prompt notification of request for
service is possible at all times.
15. RESPONSE TO SERVICE_ REQUEST - CONTRACTOR shall maintain
itself in a- state of readiness such that it can be on the way
within twelve hours of receiving a- request.
16. CERTIFICATION - CONTRACTOR shall provide evidence
satisfaction to the DISTRICT that its personnel who perform maintenance work are certified in pump mechanics, general mechanics
and repair.
17. QUALIFICATIONS OF MAINTENANCE PERSONNEL. - All personnel
performing maintenance, repairs, adjustments. and, related work on
the DISTRICT'S equipment shall be certified nor experienced in the
work to be performed.
18. INDEMNIFICATION - CONTRACTOR shall indemnify and hold
the DISTRICT and Monroe County harmless for any negligence on its
part, or faulty or improper workmanship., for all work performed
under this contract, including all costs of collection, reasonable
attorney fees, claim costs, and others. All property or equipment
being directly maintained or repaired by CONTRACTOR shall be
considered in its care, custody,. and control while such work is in
Page No. 4
progress and until physical control of such property or equipment
is restored to the DISTRICT.
19.
located at
(a)
(c)
(e)
(g)
LOCATION. OF
the following
Stock Island
Sugarloaf
Marathon (twi
Layton
WORK - This
Fire Stations:
(b)
(d)
stations) (f)
(h)
contract covers vehicles
Big Coppitt
Big Pine Key
Conch Key
Islamorada
20. INSURANCE - CONTRACTOR shall provide public liability
insurance for bodily injury, personal injury, and property damage
in the amount of $300,000.00 for each occurrence. Coverage shall
include products and completed operations, contractual liability,
operation of independent contractors, and other coverages as the
DISTRICT may designate. Coverage shall be at least as broad as the
coverage in the current commercial liability occurrence form. in use
by the Insurance Services. Office.
21. NO-FAULT COVERAGE - CONTRACTOR shall. provide vehicle
liability insurance for bodily injury, property damage, apd
required no-fault coverages- in the amount of at least $300,000.00
per occurrence. Coverage shall be at least as broad as. the
coverage in the current business automobile form in use by the
Insurance Services Office and shall include
garage keeprers'
liability on a direct primary basis for property in CONTRACTOR'S
care, custody, or control while such property is being repaired or
tested.
22. CERTIFICATE OF INSURANCE - Coverage for all exposures
shall be underwritten by an insurer rated at least "A" or higher by
the A.P. Best Company insurance rating organization. The DISTRICT
shall be provided with a certificate of insurance requiring
notification of at least 30 days for termination for any cause.
Coverage shall remain in effect for the full term of this contract.
23. PAYMENTS Payments for semi annual inspection,
preventative maintenance and pump tests shall be made by the
DISTRICT within 30 days of the completion of the rendered services
on each vehicle and proper invoicing by the CONTRACTOR. All
unscheduled maintenance and repair resulting fr= equipment failure
or malfunction requiring service shall be billed by the CONTRACTOR
at the applicable ratesas specified in Section four and five of
this AGREEMENT*. The CONTRACTOR upon notification by the DISTRICT
of an equipment failure or malfunction requiringunscheduled
maintenance shall, in a timely manner investigate the problem and
provide to. the DISTRICT an estimate of the cost for repair and
vehicle downtime. The CONTRACTOR upon receiving authorization to
proceed from the DISTRICT shall effectuate such repair; upon
completion of same the contractor shall notify the DISTRICT of the
out come and actual cost. The DISTRICT shall issue a separate
purchase order for each occurrence of unscheduled maintenance and
repair.
Page No. 5
'a IN WITNESS WHEREOF, the parties, hereto have executed this
contract the day and year first above written.
(SEAL)
Attest: Danny L. Kolhage, Clerk
k. /i,V-1 R m"
WITNESS:
BOARD OF GOVERNORS, LOWER AND
MIDDLE KEYS FIRE AND AMBULANCE
DISTRICT, MONROE COUNTY,
FLORIDA
Mayor
FIRE-T S VICE, INC.
Aut ori7ed Representa
'Ca rected. si-nature -,':or .q.vor; si^ne:l in error_ by "ayor T'ro Tel-i Cne-d.
Page No. 6
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR
OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATH-S.i This sworn statement is submitted
to MONROE COUNTY
[print name of the public entity]
by ROBFJ?P D. BLESER PRESIDENT
(print individual's name and title]
for FIRE —TECH REPAIR SERVICES INC.
. [print name of entity submitting sworn statement]
whose business address is
a 64� I `70
and (if applicable)'its Federal Employer Identification Number (FEIN) is 6a _0;LS"SZ)
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement:
I understand that a "public entity crime" as defined in Paragraph 287.133(i)(g), Florida Statutes means a
violation of any state or federal law by a person with respect to and directly related to the transaction of business
with any public entity or with an agency or political subdivision of any other state or 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.
I 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.
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 ofa public entity crime. The term "affiliate" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership
by one person of shares constituting a controlling interest in another person, or pooling of equipment or income
among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that
one person controls another person. A person who knowingly enters into a joint venture with a person who has
been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.
I understand that a "person" as defined in Paragraph 287.133(I)(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.1.2.3.4.5.
Based on information and belief, the statement which I have marked below is true in relation 10 the entity
submitting this sworn statement. [Indicate which statement applies.]
-K Neither the entity submitting this sworn statement, nor any of its officers, directors, executives partners, shareholders, employees, members, or agents who are active in the management of the entity, nor
any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July
1, 1989.
The entity submitting this sworn statement, nor any of its officers, directors, 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]
6. I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER
FOR THE PUBLIC ENTITY IDENTIFIED ON PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC
ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR
YEAR IN WHICH IT IS FILED. I ALSO 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 STA_ TUTEFOR CATEGORY TWO OF ANY
CHANGE IN THE INFORMATION CONTAINED IN THIS FORD
signature]
Sworn to and subscribed before me this day'of
,191?,
Personally known
OR Produced identification Notary Public - State of�gl
(Type of identification)
Form PUR 7068 (Rev. 06/11/92)
My Commission expires /gq�
�a /1---� S
(Printed typed or stamped
commissioned name of notary public)
AN/V,9 iii
`��,t�.•�N,ISSiONF f ii
26,
p #CC 289914
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SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY; FLORIDA
ETHICS CLAUSE
BQBERT D. BLESER 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 Count cer or employee.
_ignature
Date: �Z�9�
STATE OF��/�
COUNTY OF
Subscribed and sworn to (or affirmed) before
me on /, IC/— ( date) by
f lD %fsF ►� ( name of of f iant) .
He/She is personally known knoto me or has
� - _ produced
as identification.
(type of identification)
MCP#4 REV. 2/92
\�`tpltturrrU���
140T
26,
's o #CC 289914 : 04
i�/�`AFain-Insu���, •� tn' ��
�4 ,8(IC,
DEC-16-94 14:25 FROM: M C PUBLIC SAFETY ID: 2896013 PAGE
CERTIFICATE OF:
1AAN: 11 2 5 9 4
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. TT418 CERTIFICATE DOES NOT AMEND, EXTOND OR
MART;N ,T DARLOW & ASSOCIATES ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW.
7 219 SW 48 ST
_ COMPANIES AFFORDING COVERAGE
MIAMI FL 33155-5518 f COMPANY LLc�YOs OFr,cNDOr1
-- - —
--�- A---- A DMFW�p AU Plc YANASF!Af T - -
INSURED
COMPANY
B i ry
FIRE TECH REPAIR SVC
f oOMPAHY
//-� �° 14;
P 0 BOX 1570
C DATE M f- 0 -
K E Y LARGO FL 33037
i COMPANY
WAIVFI' NSA YfS ��
D
COVERAAEO
THIS 16 TO CERTIFY THAT THE PGLICIFS OF INSURANCE USTED
BELOW HAVE BEEN 1$SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NCITWITHSTANDNG ANY F4FOUIREMEN1. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WrrH RESPECT TO WHICH THIS
CERTIFICAIE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
HAVE BEEN REDUCED BY PAID CLAIMS
EXCLUSIONS AND CONDIT)ONS OF SUCH POLICIES. UMfFS SHOWN MAY HAVE
I -- - - —
POLICY EPmCTI'IV[ POLICY WIIMATION�
COI
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DOWNER S A CUNTAACTOR 6 PRO"'!
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--
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MEO EXP (Any mr p~) I
--------
AUTOMOSILS LIABILITY
COMBINED SINGLE LIMIT /
it i ANY AUTO
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WONKLRt COwIPdN8AT10N AND
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DESCRIPTION OF OPLPATTON/4.00ATION&YLWCLat4poCILL rmme
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CEMITIFIC,47E "OLDER
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OANCELLATION
SHOULD AMY OP THE ASOVQ 0E80AIYED POLJCIES K CAIICSLLAD BEFORE Tw
1 SNDEAYOR TO MA
W ",nON DATE THEREOF, THE MLSUMLO COMPANY WILL
MONRO E CO UNI' Y
1
I �.Q._ DAYS W14MMU NOTICE TO n* CERTIFICATE MOLDER NAMED TO YK tM.
RISK MANAGEMENT
I elrT rAtol TO MAD SUCH NOTICE SHALL IMPOSE NO OSILIOATION OR LMISKM
5100 COLLEGE RD
Or 40 Kop UPON THE COMPANY, fW AORM S OR REPRplNTATRIl/•
KEY WEST Fl, 3-3040
aUTNi IrATM
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ACORO 26 6 t93
6 .. 8
DEC-16-94 14:26 FROM: M C PUBLIC SAFETY ID= 2896013 PAGE 3
• r
ENWRSEMENT
NUMBER 2
ATTACHING TO AND FORMING PART OF CERTIFICATE 022014_11_.,,�,,;�;
NAMED OF INSURED: ]FIRE TECH REPAIR SERVICFS, INC.
IT IS HEREBY NOTED AND AGREED THAT:
A.S PER LN'DORSLMENT 01, MONROE COUNTY CID MCMZ COUN77Y FIM MARSHALS
OFF ICE. Iv A�U�AS �iDilIT�ON�►I. xN�i1Rm �Id(l I�S��AYEEr _�.� _ .—. _ _ _._ _ _
Retched
Risk Nlt;lill. %�. 1.w,%%L_-r}11IU1
_. cf�L -
b/t `" e
ENDORSEMENT EFFECTIVE DATE: 11/9/93
-.----ALL OTHER TRRMS AND CONDITIONS REMAIN UNCHANGED-- —
SECURITY: 100% UNDERWRITERS AT LLOYDS, LONDON
RUEiWIG-FLOOD & ASSOCIATES, INC.
DATE SIGNED: 8/1/94
p9an N�mt J C' VilkLIPM FLOOD JR.
tn�Tlcr Jn'3
03
Lich [ },�•� W 4t
k.l�IA.6,0j'IVLOKZDA 33155
STATE F*LL Q 1866--93
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7 TtiN:. c2uAa•
of KF.
pWTI A,'I I
Vr.t caL„p .14yJath
APPROVED p� R SK MANArFMENT
RY
DATE
WA'UtR; N/A YES
DEC-16-94 14:27 FROM: M C PUBLIC SAFETY
ID: 2896013
PAGE 4
,1iKcl 22. I �N'
iNt Nri«mi1q;
MONROE COUNTY, V LORIDA,
Resluent Igor Waiver
of
1"ouritave Requit•cments
It is rvxlwcctt that the iostitarwe rCgtlirC1 %Cnt5, na specified ill 111C Cotiilty's icW1 lc of
Requircll,ctits, ba wnivod or u,odiflod oil the WHOWiug colttraot.
contractor. FIRE VCH REPA'Ctt
Contract rov FURS '1RUGK REPAIR AND rtAINTENANCR
kldrs54 Uf contrilctof. P.O. BOX 1570 »• �TY� ___- _�
KEY LARGO, FL .1 1017
Phol,c. 305) 451-4730
Scopcof Work MFlintent#flce of llr� truckri
keason for Waiver. Reduce limit of CaraAekeeper's Liabillty to $100,OQO
$300,000, in curt prohi.lsitivc fox amoiugc of cont:-Cri —
Approver!
lb sk M w Relticnt
D Ztc
Coonlr Adinimstrator„pix-j.11:
Approved
Board of C'omay C*ojnuushioncris appeal:
Approved'
NICCtlhb D'41C. -.
Not ApptrovW
Not Approval:
Not Approved:
WAIVLK
DEC-1B-94 14:29 FRC)M= M C PUBLIC SAFETY ID: 2896013 PAGE 5
ialrii CERTIFICATEOFISAN DATLT(MMIDD/1Yy
mil' / 09/94�
PRODUCT n I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
_ I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
- !" �+'^ '� ti HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW.
COMPANIES AFFORDING COVERAGE —
(`t'.'f'1 i �•I' .._ FYI 33070 I COMPANY
A ����pp,, �!1� ��jj II��,,��� r'
INeunEa ---- ITT b"'�R�'N�R'iti9►D#kt`flaFidfi _-- _ --
�COMPANY CAS
iNIC
COMPANY.
x C -7I C_ DATE _ .1.� y -- --
;';! : FL 33027 COMPANY
COVERAGES
IHI:; r, ':I i"I rr.r; IHAr 'HE a':' ICIL% OF INSU1iANCF LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEL) ABOVE 'HE POLICY PERIOD
l�dv1CA'i ` '+:11V IIN�TA.'vC""'+G ANY HEQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEvT TO WHICH THIS
CL'IT'l I( A:L MAY OV IS:,.a ;. (�R h^Av Pitr,TA,N, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
LX LUSIC)N'D Or PCLICIES LIMITS SHOWN MAY HAVE SEEN PEDUCFJ 9Y PAID CLAIMS
._
J
CO TVPt Ui I►/�UnArrC•L POLICY NUMBERPOuCY ItFFECTtVE POLICY EXpIRATLON' LIMITO
LIH(MMtbtYV, DATE (MMMCIYY)
--LOATE
T` Qr NLI-AL LIA81ltTV------ --'-- - �•t'�;-, i% Ct y� �'1 F�f_� ---
�. .: E' _ .- 3 J 6FNEg4l A:iGRECA'E S-
r• 0
r 1
3 0 G1 0
.7LtMFru".'n, C,EI,iERAL �.AhT+' PRODUCTS COMP.'OP AGG 6
1 G 0 o c 0
PERSONAL 3 ADV INJURY 6
300, 000
"tot 1, A (0NI r+k,"1+:, PROTEACH OCCURRENCE 6
3 l,1 V r 003-
---
FIRF nAMAAF (Any orw nnl 6
300 000
-------'�'------ ---- -.__._�.— ----- ----- ---- MED EXP (Ally Ira De ooni ,'P �.
1 o coo
--
AL'TUMURILE I IARII ITY--
+ I I COMBINED SINGLE LIMIT , 6
All .tiNl (1 N1Ti:, ' I BODILY INJURY
..,PCI, A.ITI BODILY INJUFIY 6
-,(+ {P1rAedOentY---
INCtir,wNEDACT,-S - ----
-----
GAPAGE LIABILITY
A n I
I I PROPERTY DAMACIE 3
I_AUTO ONLY - EA ACCIDENT 6
OTHER THAN AUTO ONLY:
EACH AC(;IDEN7_--
_ AflIiHLEAATE 6
CNCC93 UARILrrr-f-------- "_-~---_ I— � -_-- EACH OCCURRENCE
.IMRRFit a F�-,RM AGGREI',ATE _.
`1IIrf, T,AN �IMHrIELLA FOAM I --
-
WORKI III, !'GMPCNSATtON Ann _ 8!ATU77RV LIM'TS
VMPLUYLkB' LIABILITY
/i'' MY 1 �t' I EACH ACC.IDEN' _
7r+ I v-,,rlr.C'Oi:: ( I O�.�1.I 1 ; r--- ----- ---
r'Arlrr+, r,:: ; MI GL ,Tlvt.�'.' D_tSEAS_E PQUG`r LIM,T III_—{ -
t+1' ,V' -I-' 1"A r x, , I _ � �I i I DISEASE EACH EMPLOYEE! S
DTHEn NOV 14 1994
I MUNhJr. Y. T 8i7�. DL�T.
VE FICnIP T1ON Ur OPfnATIONS LOCH t.0491VEHIC.EWSPECIAL ITEMB
---
A k
CERTIFICATE HOLDER CANCRU AT11ON
SHOULD ANY OF THE AAOVE DESCRIBED FOUCIEB BE CANCELLED DErORE THE
,'R.' r`�I',�.�_i..• .�',-�i::-._' '.:F '.��.7�'T�?^!"1f I EXPIRATION GATE THEREOF. THE 18BUINQ COMPANY WILL ENDEAVOR TOMAIL
; : i7 ETr S FCC ) L i CV ,C; LJRE CI OATS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THC LEFT,
L L r�',� E" T*_ , j SLIT FAILL+RET_O MAL SUCH NOTICE OHA" IMPOSE NO OBUGATTON OR UABLFr'
tiN �'. �� Fis .' OF ANY A ) UPON THE COMVAAY, ITB AOewt UR REPREEENTATTVNII.
AUTHaRI� R lBEKPATIv� ---
ROBMT SF A
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