05/18/2011 AgreementDANNY L. KOLHA GE
CLERK OF THE CIRCUIT COURT
DATE: May 26, 2011
TO: Dent Pierce, Director
Public Works Division
ATTN. Beth Leto, Assistant Director
Public Works Division
FROM: Pamela G. 4k.
At the May 18, 2011, Board of County Commissioner's meeting, the Board granted
approval and authorized execution of Item C 11 Contract with MECO of North Florida, Inc. for
Fuel Piping Replacement at the Monroe County Detention Center, Stock Island, Florida.
Enclosed is a duplicate original of the above -mentioned for your handling. Should you
have any questions please do not hesitate to contact this office.
cc: County Attorney
Finance
File
AGREEMENT
FUEL PIPING REPLACEMENT — MONROE COUNTY DETENTION CENTER
CONTRACT
MONROE COUNTY
MECO OF NORTH FLORIDA, INC.
THIS AGREEMENT made and entered into this 18th day of May 2o11 by and
between MONROE COUNTY, a political subdivision of the State of Florida hereinafter
called "County", whose address is 1100 Simonton Street, Key West, Florida 33040 and
MECO Of North Florida, Inc., a Florida corporation, hereinafter called "Contractor', whose
address is 3626 Phoenix Avenue, Jacksonville, Florida 32206.
WHEREAS, the County is in need of fuel piping replacement at its Monroe County
Detention Center facility; and
WHEREAS, the Contractor is licensed, qualified, properly equipped and is in the business
of performing fuel piping replacement; now, therefore
IN CONSIDERATION of the premises and of mutual covenants and promises hereinafter
contained, the parties hereto do hereby agree as follows:
1. THE CONTRACT
The contract between the County and the Contractor, of which this Agreement is a part,
consists of the contract documents, as specified in paragraph 2.
2. THE CONTRACT DOCUMENTS
The contract documents consist of the Agreement and any amendments hereto executed by
the parties, all Change Orders and any addenda, the Request for Bid together with the
Contractor's response to the RFB and all required insurance documentation. In the event of a
discrepancy between the documents, precedence shall be determined by the order of the
documents as just listed.
Fuel Piping Replacement - MCDC Page 1
3. SCOPE OF THE WORK — — FUEL PIPING REPLACMENT — Monroe County Detention
Center, 5501 College Road, Stock Island, Florida 33040.
A. The Contractor shall perform all of the work required, implied or reasonably inferable
from this agreement. The term "work" shall mean whatever is done by or required of the
contractor to perform and complete its duties under this agreement, including the
following: construction of the whole or a designated part of the project; furnishing of
any required surety bonds and insurance; and the provision or furnishing of labor,
supervision, engineering services, material, supplies, equipment, fixtures, appliances,
facilities, tools, transportation, storage, power, debris disposal, the payment of any
applicable sales and use taxes; procurement and payment of any required permits from
local, state or Federal authorities having jurisdiction, royalties and product license fees;
fuel, heat, light, cooling, and all other utilities as required by this contract. The work is to
not disrupt or jeopardize Detention Center operations. Contractor is to abide by all
security rules and regulations. The work to be performed by the contractor is generally
described as follows:
3.01 DESCRIPTION
A. Provide all labor, material, equipment, and tools as required for:
1) abandonment and closure in place of existing underground supply and return
generator diesel fuel piping in compliance with Chapter 62-761, Florida
Administrative Code (F.A.C.) and acceptance by the Authorities Having Jurisdiction.
Included within this scope is the performance and documentation of a breach of
integrity test of the existing piping secondary containment. Pursuant to Rule 62-
761.800(4)(b)(2) F.A.C, if secondary containment integrity has been maintained, a
closure assessment should not be required.
a. ALLOWANCE: If required, abandonment shall include performing a Storage
Tank System Closure Assessment and reporting in compliance Chapter 62-671
F.A.0 including the Florida Department of Environmental Protection Storage
Tank System Closure Assessment Requirements, and acceptance by the
Authorities Having Jurisdiction. The closure assessment and report is included
within the scope of work, if not conducted, the cost of which is identified on
the Submission Response Form shall be deducted from the contract
amount.
2) installation of approximately 255 lineal feet each of new underground double walled
fiberglass 1" supply and 1 1/4" return diesel fuel lines across existing parking lot and
curbing.
a. Installation shall include all required excavation of the existing 12,000 gallon
underground fuel tank and connections thereto.
Fuel Piping Replacement - MCDC Page 2
b. Installation shall include all required transition sumps and transition piping.
All excavations shall be backfilled with suitable soil and properly compacted.
Parking area and curbing shall be restored to its pre -excavation condition,
inclusive of all asphalt and concrete patching.
d. Installation shall include three (3) 3/4" PVC electrical conduits, full length of
underground fuel piping with transitions to galvanized conduit at tank along
with tank penetration and boots. Opposite end at building, sweep conduits up,
terminate and cap twelve inches above grade. Provide 1/4" braided nylon pull
rope secured at each end of conduit for each conduit run.
3. Installation of approximately 260 lineal feet each of new above ground 1" supply and
1 ''/a" return diesel fuel line. Connection of new piping to existing piping shall occur
at point where existing piping turns up into building.
a. Installation shall include all required pipe hangers and supports
b. All ferrous -metal above ground piping, pipe hangers and supports shall be
coated with not less than one primer and two finish coats of an approved coating
3.02 QUALITY ASSURANCE
A. Contractor shall be a "Certified Contractor" of which means a Pollutant Storage System
Contractor certified by the Department of Business and Professional Regulation in
accordance with Chapter 489, F.S. and shall not have less than three years of experience
as a "Certified Contractor".
B. It is the responsibility of the contractor to initiate a Quality Control Program to govern
all aspects of the work. Contractor shall provide inspections, tests and other quality -
control services as required by all Authorities Having Jurisdiction. Costs for these
services are included in the Contract Sum.
C. It is the responsibility of the contractor to insure that all work complies with DEP Rule
Chapter 62-761 and to apply to and receive approval from all Authorities Having
Jurisdiction. This is to include any required engineering, drawings and permit fees.
3.03 PERFORMANCE
A. All storage tank systems shall be installed according to the applicable provisions of
NFPA 30 and 30A, PEI/RP 100-97, API RP 1615 and ASME B31.4
1. Including the latest Amendments and Supplements.
Fuel Piping Replacement - MCDC Page 3
B. A pressure test shall be performed for underground piping before the piping system is
placed into service. Tightness tests for underground small diameter piping connected to
underground tanks are subject to paragraph 62-761.500(2)(d), F.A.C.
C. All piping that is not in contact with the soil shall meet the construction standards in
paragraphs 62-761.500(8)(a)-(d), F.A.C.
3.04 SUBMITTALS - Owner review and approval is required for the following
submittals. When submittals are marked approved by the Owner, that part of the work
covered by the submittal may proceed provided it complies with requirements of the Contract
Documents; final acceptance will depend upon that compliance. Allow sufficient review
time so that installation will not be delayed because of the time required to process
submittals, including time for re -submittals. Allow two weeks for initial review. Four copies
will be required for each submission. One copy will be returned to the Contractor with
appropriate comments.
A. All Contractor submissions to any Authority Having Jurisdiction shall also be submitted
to the Owner
B. All related correspondence, approvals and/or permits from any Authority Having
Jurisdiction to the Contractor shall also be submitted to the Owner.
C. Phased excavation plan indicating how access is to be maintained to the Jail and to the
MCSO Administration Building
D. Product data for all pipe, containment systems, pipe hangers and supports
E. Product data for paint and/or other coatings
3.05 DELIVERY & STORAGE
A. Deliver all materials to the job site in manufacturer's original, unopened containers,
with legible labels and in sufficient quantity to allow for continuity of work.
B. Select and operate material handling equipment in a safe manner, guarding against
damage to existing construction or site and in compliance with Manufacturer's
recommendations of handling and storage.
C. Staging and/or storage areas shall be coordinated with and approved by the owner's
representative
D. Store materials in a manner to protect them from excessive corrosion.
Fuel Piping Replacement - MCDC Page 4
E. Flammable materials shall be stored in a cool, dry area away from sparks and open
flames. Follow all precautions as outlined in manufacturer's Material Safety Data
Sheets.
F. Materials, having been determined by the owner/owner's representative to be damaged
or corroded, shall be immediately removed from the construction site and replaced at no
cost to the owner.
3.06 JOB CONDITIONS
A. Safety
1. Take all necessary precautions regarding worker health and safety.
2. Contractor shall be responsible for all Maintenance of Traffic, plating of open
trenches and securing site to maintain safety for all pedestrian and vehicular traffic.
3. Take necessary precautions when using solvents and adhesives near fresh air intakes.
4. Comply with all OSHA requirements for construction.
5. Daily site cleanup shall be performed to minimize debris and hazardous congestion.
3.07 COORDINATION
A. Prior to commencement of work, a pre -construction conference will be held with the
contractor, MCSO Jail staff and owner/owner's representative(s) to discuss the project,
its proper application and the expectations of all parties involved including any security
measures. The owner/owner's representative shall notify all parties a minimum of ten
days prior to the meeting.
B. Plan and coordinate piping installation in such a manner to safely maintain pedestrian
and vehicular traffic to and from the Jail, MCSO Administration Building and COTTS.
PRODUCTS
3.08 GENERAL
A. All storage tank system equipment shall be approved by the Florida Department of
Environmental Protection
1. PIPING
a. Fiberglass reinforced plastic piping or other non-metallic piping installed, shall
be listed with UL 971, UL 567, certified by a Nationally Recognized Laboratory
that these standards are met, or approved in accordance with subparagraph 62-
761.500(8)(b)3 F.A.C.
Fuel Piping Replacement - MCDC Page 5
b. Coated steel piping shall be constructed in accordance with ASME B31.4
c. Integral piping constructed of other materials or design shall be approved by the
Department of Environmental Protection in accordance with subsection 62-
761.850(2), F.A.C.
2. PAINT/COATINGS
a. Subject to compliance with the specified requirements, provide products by one
of the following manufacturers:
1. Benjamin Moore & Co.,
2. Duron, Inc.,
3. PPG Architectural Finishes, Inc.,
4. (Basis of Design) Sherwin-Williams Company
b. Exterior Ferrous -Metal Primer: Factory -formulated rust -inhibitive metal primer
for exterior application. Sherwin-Williams; Pro-Cryl Universal Primer (1366-310
Series): Applied at a dry film thickness of not less than 2.0 mils per coat
c. Exterior Full -Gloss Acrylic Enamel for Ferrous and Other Metals: Factory -
formulated full -gloss waterborne acrylic -latex enamel for exterior application.
Sherwin-Williams; DTM Acrylic Coating (1366-100 Series -Gloss); Applied at a
dry film thickness of not less than 2.5 mils per coat.
3.09 GUARANTEE
A. All work performed by the Contractor in completing the subject project shall be
guaranteed by the Contractor against all defects resulting from the use of materials,
equipment and workmanship for a period of one year from the date of Final Completion
of the project.
B. If, within any guarantee period, repairs or changes are required in connection with the
guarantee work, which in the opinion of the Owner is rendered necessary as a result of
the use of materials, equipment or workmanship which are defective or inferior or not in
accordance with the terms of the Contract, the Contractor shall, promptly upon receipt of
notice from the Owner and without expense to the Owner, proceed to
Place in satisfactory condition in every particular all of such guaranteed work,
correct all defects therein; and
Make good all damages to the structure or site or equipment or contents thereof,
which, in the opinion of the Owner, is the result of the use of materials, equipment or
workmanship which are inferior, defective or not in accordance with the terms of the
Contract; and
Fuel Piping Replacement - MCDC Page 6
Make good any work or materials or the equipment and contents of structures or site
disturbed in fulfilling any such guarantee.
If the Contractor, after receipt of any such written notice, fails within seventy-two (72)
hours to commence at the job site with performance of the work necessary to remedy all
defects in the work described in such notice so as to provide the Owner with the subject
project completed in accordance with all requirements of the Contract Documents, or
fails to complete the performance of such remedial work with a reasonable time after
commencing same, the Owner shall be entitled to have such defective work remedied on
the account of the Contractor, in which event, the Contractor shall be fully liable for all
costs and expenses reasonably incurred by the Owner in having such defective work
remedied.
4. THE CONTRACT AMOUNT
A. The Owner shall pay the Contractor in current funds for the Contractor's performance
of the Contract per Paragraph 4.13 of which follows, the Contract sum of Forty Nine
Thousand Seven Hundred Ninety-two /100 Dollars ($49,792.00).
B. This paragraph specifies administrative and procedural requirements necessary to
prepare and process Applications for Payment.
Bar -Chart Schedule: Prepare a fully developed, horizontal bar -chart -type,
contractor's construction schedule. Submit to Owner for approval within ten
days after the date of Notice to Proceed.
a. Provide a separate time bar for each significant administrative and
construction activity. Provide a continuous vertical line to identify the
first working day of each week.
b. The time line between the Notice to Proceed and substantial completion is
not to exceed one hundred and twenty days unless approved by the Owner.
2. Application for Payment: Partial progress payments may be issued to the
Contractor with the Owner's approval and with submission of properly executed
invoice and partial release of liens. Ten percent retainage will be withheld on all
progress payments. When the final work is accepted by the owner, the contractor
shall invoice the County for full and final payment.
a. The owner may decline to make payment, may withhold funds, and if
necessary, may demand the return of some or all of the amounts previously
paid to the contractor, to protect the owner from loss because of
1. defective work not remedied by the contractor nor, in the opinion of the
owner, likely to be remedied by the contractor;
Fuel Piping Replacement - MCDC Page 7
2. claims of third parties against the owner or the owner's property;
3. failure by the contractor to pay subcontractors or others in a prompt and
proper fashion;
4. evidence that the balance of the work cannot be completed in accordance
with the contract for the unpaid balance of the contract price;
5. persistent failure to carry out the work in accordance with the contract;
6. damage to the owner or a third party to whom the owner is, or may be,
liable.
In the event that the owner makes written demand upon the contractor for
amounts previously paid by the owner as contemplated in this
subparagraph, the contractor shall promptly comply with such demand.
b. When all of the work is finally complete and the contractor is ready for a
final inspection, it shall notify the owner thereof in writing. Thereupon, the
owner will make final inspection of the work and, if work and all
submissions are complete, in full accordance with this contract and this
contract has been fully performed, the owner will promptly issue a final
certificate for payment certifying that the project is complete and the
contractor is entitled to the remainder of the unpaid contract price, less any
amount withheld pursuant to this contract. Guarantees required by the
contract shall commence on the date of final completion of the work. If
the owner is unable to issue its final certificate for payment and is required
to repeat its final inspection of the work, the contractor shall bear the cost
of such repeat final inspection(s), which cost may be deducted by the owner
from the contractor's final payment.
c. The contractor shall not be entitled to payment unless and until it submits to
the owner invoices with supporting documentation acceptable to the Clerk
of Court of which may include partial and final releases and waivers of
lien; releases and waivers of lien from all subcontractors of the contractor
and of any and all parties required by the owner. Acceptability to the Clerk
is based on generally accepted accounting principles and such laws, rules
and regulations as may govern the Clerk's disbursal of funds. The County
designates the Clerk of Courts as its agent under the Local Government
Prompt Payment Act, Florida Statues Section 218.735
3. Acceptance of final payment by the contractor shall constitute a waiver of all
claims against the owner by the contractor except for those claims previously
made in writing against the owner by the contractor, pending at the time of final
Fuel Piping Replacement - MCDC Page 8
payment, and identified in writing by the contractor as unsettled at the time of its
request for final payment.
C. Final payment, constituting the entire unpaid balance of the Contract Amount, shall be
made by the Owner to the Contractor when the Contract has been fully performed by
the Contractor.
5. WARRANTY
A. The contractor warrants to the owner that all labor furnished to progress the work under
this contract will be competent to perform the tasks undertaken, that the product of such
labor will yield only first-class results, that materials and equipment furnished will be
of good quality and new unless otherwise permitted by the contract, and that the work
will be of good quality, free from faults and defects and in strict conformance with the
contract and warrant same for a period of one year commencing at final completion.
This one-year warranty is inclusive of all labor, transportation, equipment and material
cost with no cost to the owner. All work not conforming to these requirements may be
considered defective.
6. CHANGES IN THE WORK
A. Changes in the work within the general scope of this contract, consisting of additions,
deletions, revisions, or any combination thereof, may be ordered without invalidating
this agreement, by change order or by field order.
B. Change order shall mean a written order to the contractor executed by the owner,
issued after execution of this agreement, authorizing and directing a change in the
work or an adjustment in the contract price or the contract time, or any combination
thereof. The contract price and the contract time may be changed only by change
order.
C. Any change in the contract price resulting from a change order shall be determined as
follows: (a) by mutual agreement between the owner and the contractor as evidenced
by (1) the change in the contract price being set forth in the change order, (2) such
change in the contract price, together with any conditions or requirements related
thereof, being initialed by both parties and (3) the contractor's execution of the change
order, or (b) if no mutual agreement occurs between the owner and the contractor, then
the change in the contract price, if any, shall then be determined by the owner on the
basis of the reasonable expenditures or savings of those performing, deleting or
revising the work attributable to the change, including, in the case of an increase or
decrease in the contract price, an allowance for direct job site overhead of 5%, and
profit 5% will be utilized.
D. The execution of a change order by the contractor shall constitute conclusive evidence
of the contractor's agreement to the ordered changes in the work, this agreement as
thus amended, the contract price and the contract time. The contractor, by executing
Fuel Piping Replacement - MCDC Page 9
the change order, waives and forever releases any claim against the owner for
additional time or compensation for matters relating to or arising out of or resulting
from the work included within or affected by the executed change order.
7. CONTRACTOR'S ACCEPTANCE OF CONDITIONS
A. This Agreement and the provision of the services at the location listed have been fully
considered by the Contractor, who understands the same and agrees to their sufficiency
and suitability. Under no circumstances, conditions, or situations shall this Contract be
more strongly construed against the County than against the Contractor.
B. The passing, approval, and/or acceptance by the County of any of the services
furnished by the Contractor shall not operate as a waiver by the County of strict
compliance with the terms of this Contract, and specifications covering the services.
Failure on the part of the Contractor, immediately after Notice to Correct shall entitle
the County, if it sees fit, to correct the same and recover the reasonable cost of such
replacement and/or repair from the Contractor, who shall in any event be jointly and
severally liable to the County for all damage, loss, and expense caused to the County
by reason of the Contractor's breach of this Contract and/or his failure to comply
strictly and in all things with this Contract and with the specifications.
8. INDEMNIFICATION/HOLD HARMLESS
Notwithstanding any minimum insurance requirements prescribed elsewhere in this
agreement, Contractor shall defend, indemnify and hold the COUNTY and the COUNTY's
elected and appointed officers and employees harmless from and against (i) any claims,
actions or causes of action, (ii) any litigation, administrative proceedings, appellate
proceedings, or other proceedings relating to any type of injury (including death), loss,
damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be
asserted against, initiated with respect to, or sustained by, any indemnified party by reason of,
or in connection with, (A) any activity of Contractor or any of its employees, agents, sub-
contractors or other invitees during the term of this Contract, (B) the negligence or willful
misconduct of Contractor or any of its employees, agents, sub -contractors or other invitees,
or (C) Contractor's default in respect of any of the obligations that it undertakes under the
terms of this Contract, except to the extent the claims, actions, causes of action, litigation,
proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions
of the COUNTY or any of its employees, agents, contractors or invitees (other than
CONTRACTOR). Insofar as the claims, actions, causes of action, litigation, proceedings,
costs or expenses relate to events or circumstances that occur during the term of this
Contract, this section will survive the expiration of the term of this Contract or any earlier
termination of this Contract.
In the event that the service is delayed or suspended because of the Contractor's failure to
purchase or maintain the required insurance, the Contractor shall indemnify the County from
any and all increased expenses or lost revenue resulting from such delay.
Fuel Piping Replacement - MCDC Page 10
The first ten dollars ($10.00) of remuneration paid to the Contractor is for the
indemnification provided for above. The extent of liability is in no way limited to, reduced,
or lessened by the insurance requirements contained elsewhere within this agreement. The
provisions of this section shall survive the expiration or earlier termination of this agreement.
9. INDEPENDENT CONTRACTOR
At all times and for all purposes under this agreement the Contractor is an independent
contractor and not an employee of the Board of County Commissioners for Monroe County.
No statement contained in this agreement shall be construed so as to find the Contractor or
any of his/her employees, contractors, servants, or agents to be employees of the Board of
County Commissioners for Monroe County.
10. ASSURANCE AGAINST DISCRIMINATION
The Contractor shall not discriminate against any person on the basis of race, creed, color,
national origin, sex, age, or any other characteristic or aspect which is not job related, in its
recruiting, hiring, promoting, terminating, or any other area affecting employment under this
agreement or with the provision of services or goods under this agreement.
11. ASSIGNMENT/SUBCONTRACT
The Contractor shall not assign or subcontract its obligations under this agreement, except in
writing and with the prior written approval of the Board of County Commissioners for
Monroe County, which approval shall be subject to such conditions and provisions as the
Board may deem necessary. This paragraph shall be incorporated by reference into any
assignment or subcontract and any assignee or subcontractor shall comply with all of the
provisions of this agreement. Unless expressly provided for therein, such approval shall in
no manner or event be deemed to impose any obligation upon the board in addition to the
total agreed -upon price of the services/goods of the Contractor and compensation to County.
12. COMPLIANCE WITH LAW
In providing all services/goods pursuant to this agreement, the Contractor shall abide by all
statutes, ordinances, rules and regulation pertaining to, or regulating the provisions of, such
services, including those now in effect and hereinafter adopted. Any violation of said
statutes, ordinances, rules and regulations shall constitute a material breach of this agreement
and shall entitle the Board to terminate this contract immediately upon delivery of written
notice of termination to the Contractor. The Contractor shall possess proper licenses to
perform work in accordance with these specifications throughout the term of this contract.
Fuel Piping Replacement - MCDC Page 11
13. INSURANCE
Prior to execution of this agreement, and maintained throughout the life of the contract, the
Contractor shall furnish to the County Certificates of Insurance indicating the minimum
coverage limitation as listed below:
A. General Liability — 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 $1,000,000 Combined Single Limit
If split limits are provided, the minimum limits acceptable shall be: $500,000 per
person; $1,000,000 per Occurrence; and $500,000 Property Damage.
An Occurrence Form policy is preferred. If coverage is changed to or provided on a
Claims Made Policy, its provisions should include coverage for claims filed on or after
the effective date of this contract. In addition, the period for which claims may be
reported should extend for a minimum of twelve (12) months following the final
acceptance of work by the County.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS MUST BE NAMED
AS ADDITIONAL INSURED ON ALL POLICIES ISSUED TO SATISFY THE
ABOVE REQUIREMENTS.
B. Vehicle Liability — include as a minimum:
• Owned, Non -Owned, and Hired Vehicles
The minimum limits acceptable shall be $1,000,000 Combined Single Limit
If split limits are provided, the minimum limits acceptable shall be: $500,000 per
Person; $1,000,000 per Occurrence; and $100,000 Property Damage.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS MUST BE
NAMED AS ADDITIONAL INSURED ON ALL POLICIES ISSUED TO
SATISFY THE ABOVE REQUIREMENTS.
C. Pollution Liability:
The minimum limits of liability shall be $1,000,000 per Occurrence/$2,000,000
Aggregate
Fuel Piping Replacement - MCDC Page 12
If coverage is provided on a claims made basis, an extended claims reporting period of
four (4) years will be required.
D. Workers Compensation — limits sufficient to respond to Florida Statute 440.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not
less than:
$500,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$500,000 Bodily Injury by Disease, each employee
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 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 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.
14. CONTRACTOR'S RESPONSIBILITY
The Contractor warrants that it is authorized by law to engage in the performance of the
activities encompassed herein, subject to the terms and conditions set forth in these contract
documents. Contractor shall at all times exercise independent judgment and shall assume
responsibility for the services to be provided.
15. NOTICE REQUIREMENT
Any notice required or permitted under this agreement shall be in writing and hand delivered
or mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to
the following:
FOR COUNTY
Director, Middle Keys Operations
Monroe County Facilities Maintenance
5501 College Road
Key West, Florida 33040
Fuel Piping Replacement - MCDC Page 13
AND
Monroe County Administrator
1100 Simonton Street
Key West, FL 33040
FOR CONTRACTOR OR REPRESENTATIVE AT JOBSITE
FOREMAN
Tony Richardson
3626 Phoenix Avenue
Jacksonville, FL 32206
Notice shall be deemed received when hand delivered, delivered by mail, or when deemed
undeliverable by the U.S. Postal Service.
16. CANCELLATION
A) In the event that the Contractor shall be found to be negligent in any aspect of
installation, stocking, maintenance, repair, or service, the County shall have the right
to terminate this agreement after five days written notification to the Contractor.
B) This contract may be terminated for convenience by County upon ten
(10) days written notice to contractor delivered by hand or certified mail, return
receipt requested, of intent to terminate and the date on which such
termination becomes effective. Contractor shall cease work as directed. In such
case, Contractor shall be paid for all work executed and termination expenses,
and expenses incurred prior to termination. No payment shall be made for profit
for work, which has not been performed.
17. GOVERNING LAWS, VENUE, INTERPRETATION, COSTS, FEES
This Agreement shall be governed by and construed in accordance with the laws of the State
of Florida applicable to contracts made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of the agreement, the County and Contractor agree that venue
shall lie in the appropriate court or before the appropriate administrative body in Monroe
County, Florida. This Agreement shall not be subject to arbitration.
Mediation proceedings initiated and conducted pursuant to this Agreement shall be in
accordance with the Florida Rules of Civil Procedure and usual and customary procedures
required by the circuit court of Monroe County.
Fuel Piping Replacement - MCDC Page 14
18. RECORDKEEPING
Contractor shall maintain all books, records, and documents directly pertinent to
performance under this Agreement in accordance with generally accepted accounting
principles consistently applied. Each party to this Agreement or their authorized
representatives shall have reasonable and timely access to such records of each other party
to this Agreement for public records purposes during the term of the Agreement and for four
years following the termination of this Agreement. If an auditor employed by the County or
Clerk determines that monies paid to Contractor or not paid to County pursuant to this
Agreement were spent for purposes not authorized by this Agreement or wrongfully retained
by Contractor, the Contractor shall repay the monies together with interest calculated
pursuant to Sec. 55.03, FS, running from the date the monies were to have been paid.
19. SEVERABILITY
If any term, covenant, condition or provision of this Agreement (or the application thereof to
any circumstance or person) shall be declared invalid or unenforceable to any extent by a
court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of
this Agreement, shall not be affected thereby; and each remaining term, covenant, condition
and provision of this Agreement shall be valid and shall be enforceable to the fullest extent
permitted by law unless the enforcement of the remaining terms, covenants, conditions and
provisions of this Agreement would prevent the accomplishment of the original intent of this
Agreement. The County and Contractor agree to reform the Agreement to replace any
stricken provision with a valid provision that comes as close as possible to the intent of the
stricken provision.
20. ATTORNEY'S FEES AND COSTS
The County and Contractor agree that in the event any cause of action or administrative
proceeding is initiated or defended by any party relative to the enforcement or interpretation
of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, court
costs, investigative, and out-of-pocket expenses, as an award against the non -prevailing
party, and shall include attorney's fees, court costs, investigative, and out-of-pocket
expenses in appellate proceedings.
21. BINDING EFFECT
The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to
the benefit of the County and Contractor and their respective legal representatives,
successors, and assigns.
22. AUTHORITY
Fuel Piping Replacement - MCDC Page 15
Each party represents and warrants to the other that the execution, delivery and performance
of this Agreement have been duly authorized by all necessary County and corporate or
individual action, as required by law.
23. CLAIMS FOR FEDERAL OR STATE AID
Contractor and County agree that each shall be, and is, empowered to apply for, seek, and
obtain federal and state funds to further the purpose of this Agreement; provided that all
applications, requests, grant Bids, and funding solicitations shall be approved by each party
prior to submission.
24. ADJUDICATION OF DISPUTES OR DISAGREEMENTS
County and Contractor agree that all disputes and disagreements shall be attempted to be
resolved by meet and confer sessions between representatives of each of the parties. If no
resolution can be agreed upon within 30 days after the first meet and confer session, the
issue or issues shall be discussed at public meeting of the Board of County Commissioners.
If the issue or issues are still not resolved to the satisfaction of the parties, then any party
shall have the right to seek such relief or remedy as may be provided by this Agreement or
by Florida law. This provision does not negate or waive the provisions of Paragraph 16
concerning cancellation.
25. COOPERATION
In the event any administrative or legal proceeding is instituted against either party relating
to the formation, execution, performance, or breach of this Agreement, County and
Contractor agree to participate, to the extent required by the other party, in all proceedings,
hearings, processes, meetings, and other activities related to the substance of this Agreement
or provision of the services under this Agreement. County and Contractor specifically agree
that no party to this Agreement shall be required to enter into any arbitration proceedings
related to this Agreement.
26. NONDISCRIMINATION
County and Contractor agree that there will be no discrimination against any person, and it
is expressly understood that upon a determination by a court of competent jurisdiction that
discrimination has occurred, this Agreement automatically terminates without any further
action on the part of any party, effective the date of the court order. County or Contractor
agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable,
relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil
Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race, color or
national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss.
1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section
504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits
discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as
amended (42 USC ss. 6101-6107) which prohibits discrimination on the basis of age; 5) The
Fuel Piping Replacement - MCDC Page 16
Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616) as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism;; 7) The Public
Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as
amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII
of the Civil Rights Act of 1968 (42 USC s. et seq.) as amended, relating to
nondiscrimination in the sale, rental or financing of housing; 9) The Americans with
Disabilities Act of 1990 (42 USC s. 1201 NoteO, as maybe amended from time to time,
relating to nondiscrimination on the basis of disability; 10) Any other nondiscrimination
provisions in any federal or state statutes which may apply to the parties to, or the subject
matter of, this Agreement. Monroe County Code Ch. 13, Art. VI, prohibiting discrimination
on the basis of race, color, sex, religion, disability, national origin, ancestry, sexual
orientation, gender identity or expression, familial status or age. 11) Any other
nondiscrimination provisions in any Federal or state statutes which may apply to the parties
to, or the subject matter of, this Agreement.
27. COVENANT OF NO INTEREST
County and Contractor covenant that neither presently has any interest, and shall not acquire
any interest, which would conflict in any manner or degree with its performance under this
Agreement, and that only interest of each is to perform and receive benefits as recited in this
Agreement.
28. CODE OF ETHICS
County agrees that officers and employees of the County recognize and will be required to
comply with the standards of conduct for public officers and employees as delineated in
Section 112.313, Florida Statues, regarding, but not limited to, solicitation or acceptance of
gifts; doing business with one's agency; unauthorized compensation; misuse of public
position, conflicting employment or contractual relationship; and disclosure or use of certain
information.
29. NO SOLICITATION/PAYMENT
The County and Contractor warrant that, in respect to itself, it has neither employed nor
retained any company or person, other than a bona fide employee working solely for it, to
solicit or secure this Agreement and that it has not paid or agreed to pay any person,
company, corporation, individual, or firm, other than a bona fide employee working solely
for it, any fee, commission, percentage, gift, or other consideration contingent upon or
resulting from the award or making of this Agreement. For the breach or violation of the
provision, the Contractor agrees that the County shall have the right to terminate this
Fuel Piping Replacement - MCDC Page 17
Agreement without liability and, at its discretion, to offset from monies owed, or otherwise
recover, the full amount of such fee, commission, percentage, gift, or consideration.
30. PUBLIC ACCESS
The County and Contractor shall allow and permit reasonable access to, and inspection of,
all documents, papers, letters or other materials in its possession or under its control subject
to the provisions of Chapter 119, Florida Statues, and made or received by the County and
Contractor in conjunction with this Agreement; and the County shall have the right to
unilaterally cancel this Agreement upon violation of this provision by Contractor.
31. NON -WAIVER OF IMMUNITY
Notwithstanding the provisions of Sec. 768.28, Florida Statues, the participation of the
County and the Contractor in this Agreement and the acquisition of any commercial
liability insurance coverage, self-insurance coverage, or local government liability
insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability
coverage, nor shall any contract entered into by the County be required to contain any
provision for waiver.
32. PRIVILEGES AND IMMUNITIES
All of the privileges and immunities from liability, exemptions from laws, ordinances, and
rules and pensions and relief, disability, workers' compensation, and other benefits which
apply to the activity of officers agents or employees of any of any public agents or
employees of the County, when performing their respective functions under this Agreement
within the territorial limits of the County shall apply to the same degree and extent to the
performance of such functions and duties of such officers agents, volunteers, or employees
outside the territorial limits of the County.
33. LEGAL OBLIGATIONS AND RESPONSIBILITIES
Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to,
nor shall it be construed as, relieving any participating entity from any obligation or
responsibility imposed upon the entity by law except to the extent of actual and timely
performance thereof by any participating entity, in which case the performance may be
offered in satisfaction of the obligation or responsibility. Further, this Agreement is not
intended to, nor shall it be construed as, authorizing the delegation of the constitutional or
statutory duties of the County, except to the extent permitted by the Florida constitution,
state statute, and case law.
Fuel Piping Replacement - MCDC Page 18
34. NON -RELIANCE BY NON-PARTIES
No person or entity shall be entitled to rely upon the terms, or any of them, of the
Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit
of any service or program contemplated hereunder, and the County and the Contractor agree
that neither the County nor the Contractor or any agent, officer, or employee of either shall
have the authority to inform, counsel, or otherwise indicate that any particular individual or
group of individuals, entity or entities, have entitlements or benefits under this Agreement
separate and apart, inferior to, or superior to the community in general or for the purposes
contemplated in this Agreement.
35. ATTESTATIONS
Contractor agrees to execute such documents as the County may reasonably require, to
include a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace
Statement.
36. NO PERSONAL LIABILITY
No covenant or agreement contained herein shall be deemed to be a covenant or agreement
of any member, officer, agent or employee of Monroe County in his or her individual
capacity, and no member, officer, agent or employee of Monroe County shall be liable
personally on this Agreement or be subject to any personal liability or accountability by
reason of the execution of this Agreement.
37. EXECUTION IN COUNTERPARTS
This Agreement may be executed in any number of counterparts, each of which shall be
regarded as an original, all of which taken together shall constitute one and the same
instrument any of the parties hereto may execute this Agreement by signing any such
counterpart.
38. SECTION HEADINGS
Section headings have been inserted in this Agreement as a matter of convenience of
reference only, and it is agreed that such section headings are not a part of this Agreement
and will not be used in the interpretation of any provision of this Agreement.
Fuel Piping Replacement - MCDC Page 19
39. CONTINGENCY STATEMENT
Monroe County's performance and obligation to pay under this contract is contingent upon
an annual appropriation by the Monroe County Board of County Commissioners.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and date
first written above in four (4) counterparts, each of which shall, without proof or accounting for the
other counterparts, be deemed an original contract.
a L
(SEAL).
Attest: DAN 48
By:
' D
L. KOLHAGE, CLERK
Clerk
Date: a" 2011
(SEAL)
Attest:
By:
WITNESA
Title: - - 6�U-AP`,�11
By: JL- )qC
WI SS
Title:
Fuel Piping Replacement - MCDC Page 20
BOARD OF COUNTY COMMISSIONERS
OF MONROE CO TY, FLORIDA
By:
ay hairman ,
CONTRACTOR
Title: 2cr'A-Su
H—IUQ—� I c-
Date:
rn
N
�
_
—v
-
--
C
-
O
C)
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO.010-1990
MONROE COUNTY, FLORIDA -
ETHICS CLAUSE
" Lamar W. Scott
(Company Officer/Partner/Individual)
" warrants that heht has not employed, retained or otherwise had act on hisfits 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 County may, in its discretion, terminate this Agreement without liability and may also, in its discretion,
deduct from the Agreement 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".
(Signature)
Date: April 4. 2011
STATE OF: Fl on da
COUNTY OF: Duval
Subscribed and swom to (or affirmed) before me on April 4 - 2011
(date) by _ Lamar W. Scott (name of affiant). He/She is personally
known to me or has produced _ (PQ as
identification. (type of identification)
KIMBERLY D MCCOY
NOTARY PUBLIC -SMITE' *tOR+DA
�S90$ tG21
EXPIRES 8/1
BONOE0TMRU�,ag✓?_;•u'�ty-
17 Fuel Piping Replacement - MCDC
NON -COLLUSION AFFIDAVIT
1, Lamar W. Scott of the city of Jacksonville, FL
according to law on my oath, and under penalty of perjury, depose and say that:
1. I am Secretary / Treasurer
of the firm of MECO of North Florida, Inc.
making the Bid for the services/work/project described in the Request for
Bids for.
Monroe County - Fuel Piping Replacement
and that I executed the said Bid with full authority to do so:
2. The prices in this bid/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 and percentage of return which have
been quoted in this bid/Bid have not been knowingly disclosed by the responder and
will not knowingly be disclosed by the responder prior to bid/Bid opening, directly or
indirectly, to any other bidder/responder or to any competitor.
4. No attempt has been made or will be made by the bidder/responder to induce any
other person, partnership or corporation to submit, or not to submit, a bid/Bid for the
purpose of restricting competition.
5. The statements contained in this affidavit are true and correct, and made with full
knowledge that Monroe County relies upon the truth of the statements contained in
this affidavit in awarding contracts for the project/services/work.
re�� kApril 4, 2011
(Signature of Bidder) (Date)
STATE OF: Fl on da
COUNTY OF: Duval
PERSONALLY APPEARED BEFORE ME, the undersigned authority, Lamar W. Scott
who, after first being sworn by me, (name of individual signing) affixed his/her signature in the
space provided above on this 4th day of April 20 11 .
KtMLt',:[` p IIAcCOY U1
NOTARY PUBLIC r "-OF FLORIDA NOTARY PUBLIC
COMMISSIOP` 'r-83021
EXPIRE
BONDED THRUt-Wibr....ttRYI
$ My Commission Expires:
18 Fuel Piping Replacement - MCDC
DRUG -FREE WORKPLACE FORM
The undersigned Contractor/bidder/responder in accordance With Florida Statute 287.087
hereby certifies that:
NECO of North Florida, Inc.
(Name of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, 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. Informs 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. Gives 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 specked 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. Imposes a sanction on, or requires 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.
�Lr/. rit0� , �/CJ:
Bidder's Signature
April 4, 2011
Date
KIMBERLY D, MCCOY
NOTARY PUBLIC -STATE OF FLORIDA NOTARY PUB IC
COMMISSIONEXPIRES8#1912011
�8�21
1ja BONOEDTHRu t-8WNOTARYI
My Commission Expires:Lv l
19 Fuel Piping Replacement - MCDC
,4co CERTIFICATE OF LIABILITY INSURANCE DATE DYY1
5/20/2011
FmPPOB
RODUCER (770) 447-6547 FAX: (770) 447-8353 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
etro Commercial Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2647 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Norcross GA 30091 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERA:Mid Continent
Meco of North Florida, Inc. INSURER B:National Trust Insurance Co.
Axis Insurance Company--
P O BOX 3871 INSURER C:
INSURER D:
Jacksonville FL 32206 INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
- _---- _-- -- - - - -- - POLICY EFFECTIVE POLICY EXPIRATION
INSRADD'L
LTR INSIPID TYPE OF INSURANCE POLICY NUMBER
LIMITS
GENERAL LIABILITY
..
EACH OCCURRENCE.-_ - $__
1,000,000
}[ COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED I
PREMISES (Ea occurrence) $
50,000
_
A CLAIMS MADE X 'OCCUR
- -
04GL794311 6/30/2010 6/30/2011
MEDEXP(Anyoneperson) $ _
- 1
_ 0
PERSONAL & ADV INJURY 1 $ _ _
_ 1 L000, 000
X 1 Pollution
GENERAL AGGREGATE_ $-
2, 000, 000_
I
PRODUCTS - COMP/OPAGG $_
2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO 'jECT LOC
_AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident) $
1,000,000
X ANY AUTO
1
B ALL OWNED AUTOS
ICA0001716 9 6/30/2010 6/30/2011
BODILY INJURY
$
(Per person)
SCHEDULED AUTOS
` --_
HIRED AUTOS
BODILY INJURY -, $
,I NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE $
(Per accident)
LIABILITY
AUTO ONLY - EA ACCIDENT.I
$.
_GARAGE
ANY AUTO
( _
C-1
EA ACC
OTHER THAN
_$_
-- - -- ----
1
1 AUTO ONLY: AGG
$
EXCESS / UMBRELLA LIABILITY '�'
EACH OCCURRENCE
2 OOO, OOO_
X ! OCCUR CLAIMS MADE
AGGREGATE $
2,000,000
$
C _ DEDUCTIBLE 'XAU718545012010 6/30/2010 6/30/2011
__-- , $
X 1, RETENTION $ 10, 000
$
B WORKERS COMPENSATION
X WC STATU- 01-B
TORY LIMITS X_ F�E
Y
ANDEMPLOYERS'LI Y/ N I,,
ANY PROPRIETOR/PARTNER/EXECUTIVE
_
E L EACH ACCIDENT $-
- -
11000,000
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory In NH) 026WC07A56600 6/30/2010 6/30/2011
�E.L.DISEASE EA EMPLOYE $-
-
1�000,000
If yes, describe under 1
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT ''. $
1,000,000
A OTHER Bailee/Cargo 04I1439141 6/30/2010 6/30/2011
Limite $100,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is named as Additional Insured on the above General Liability policy
& Vehicle Liability
policy if
required by written "Insured Contract"
GLK I IFIGA 1 t HULUtFf L.i MIME -m r rwrll
SHOULD ANY OFTHEABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EXPIRATION
Monroe County Board of County Commissione DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
1100 Simonton Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Room 1-213
Key West, FL 33040 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ( l
Richard Johnson/MS ' x 9-
ACORD 25 (2009/01) U 19SS-ZUU9 AGUFIU GUKt'UKAI IVN. AH rlgrlms reserves.
INS025 (200901) The ACORD name and logo are registered marks of ACORD
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endamement(a).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
rm-wnw w J'"Mmu,I
INS025 rAosm)