FY2012 10/19/2011 Agreement DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: October 24, 2011
TO: Lynda Stuart, Office Manager
Tourist Development Council
ATTN: Maxine Pacini
Administrative Assistant
FROM: Pamela G. Hanc ck, !b. C.
At the October 19, 2011, Board of County Commissioners meeting, the Board granted
approval and authorized execution of the following
DI Dolphin Research Center, Inc. in an amount not to exceed $44,647, DAC III, FY
2012 Capital Resources.
D2 Key West Film Society, Inc. for the Tropic Cinema Phase Seven: Conversion to
Digital Projection project in an amount not to exceed $150,000, DAC I, FY 2012 Capital
Resources.
D5 Florida Keys History of Diving Museum, Inc. in an amount not to exceed
$11,531, DAC IV, FY 2012 Capital Resources.
D6 Pigeon Key Foundation, Inc. in an amount not to exceed $14,415, DAC III, FY
2012 Capital Resources.
D7 Florida Keys Wild Bird Rehabilitation Center, Inc. in an amount not to exceed
$7,000, DAC V, FY 2012 Capital Resources.
D8 Instituto Patriotico Y Docente San Carlos, Inc. covering the San Carlos minor
repairs project in an amount not to exceed $2,500, DAC I, FY 2012 Capital Resources.
D9 Key West Half Marathon LLC covering the Key West Half Marathon in 2012 in
an amount not to exceed $10,000, DAC I, FY 2012 Event Resources.
D10 Premiere Racing, Inc. for the Key West Race Week 2012 in an amount not to
exceed $120,000, DAC I, FY 2012 Event Resources.
D11 Lower Keys Chamber of Commerce, Inc. covering the Big Pine & Lower Keys
Nautical Flea Market in 2012 in an amount not to exceed $10,000, DAC II, FY 2012 Event
Resources.
D12 MRM Key West LLC for the Key West Food and Wine Festival in 2012 in an
amount not to exceed $25,000, DAC I, FY 2012 Event Resources.
D13 Domestic Abuse Shelter, Inc. covering the No Name Race in 2012 in an amount
not to exceed $7,500, DAC II, FY 2012 Event Resources.
D14 Bauer Restaurant, Inc. covering the Key West Songwriters' Festival in May, 2012
in an amount not to exceed $75,000, DAC I, FY 2012 Event Resources.
D16 Keys Area Interdenominational Resources, Inc. covering Sombrero Beach Run in
2012 in an amount not exceed $20,000, DAC III, FY 2012 Event Resources.
D18 Super Boat International Productions, Inc. covering Key West World
Championship Race in November, 2012 in an amount not to exceed $120,000, DAC I, FY 2012
Event Resources.
D19 Shoot for the Moon covering Battle in the Bay Dragon Boat Festival in May 2012
in an amount not to exceed $30,000, DAC III, FY 2012 Event Resources.
D20 Hawk's Cay Resort covering Conchtoberfest 2012 in an amount not to exceed
$40,000, DAC III, FY 2012 Event Resources.
D21 218 Duval Street Corp. covering Fight Night in the Keys V in an amount not to
exceed $50,000, DAC I, FY 2012 Event Resources.
D22 Lower Keys Chamber of Commerce, Inc. covering the Big Pine & Lower Keys
Island Art Festival in 2012 in an amount not to exceed $10,000, DAC II, FY 2012 Event
Resources.
D23 Greater Marathon Chamber of Commerce, Inc. covering the Original Marathon
Seafood Festival in 2012 in an amount not to exceed $50,000, DAC III, FY 2012 Event
Resources.
D24 Key Largo Merchants Association, Inc. covering the Key Largo Stone Crab and
Seafood Festival in 2012 in an amount not to exceed $30,000, DAC V, FY 2012 Event
Resources.
D25 Key West Business Guild, Inc. covering Tropical Heat Key West in August, 2012
in an amount not to exceed $17,000, DAC I, FY 2012 Event Resources.
D26 Key West Business Guild, Inc. covering Key West Pride in June, 2012 in an
amount not to exceed $35,000, DAC I, FY 2012 Event Resources.
D27 Key West Business Guild, Inc. covering Womenfest in September 2012 in an
amount not to exceed $35,000, DAC I, FY 2012 Event Resources.
D28 2011 Key West Gator Club Dolphin Derby Agreement to correct name of event
sponsor to University of Florida Alumni Association, Inc. dba Key West Gator Club.
D29 Mad Dog Mandich Fishing Classic, LLC covering the Publix Mad Dog Mandich
Fishing Classic in October 2012 in an amount not to exceed $10,000, DAC IV, FY 2012 Event
Resources.
D30 2011 Key West Half Marathon Agreement to correct name of event sponsor to
University of Florida Alumni Association, Inc. dba Key West Gator Club.
D31 Marine Mammal Conservancy, Inc. for the Marine Mammal Conservancy Phase 1
project to extend completion date to December 31, 2011.
D32 Phil Peterson's Key West Poker Run, LLC covering Phil Peterson's 40` Key West
Poker Run in September 2012 in an amount not to exceed $50,000, DAC I, FY 2012 Event
Resources and $7,500, DAC II, FY 2012 Event Resources.
D33 Agreement with TRIKW, LLC covering the Key West Triathlon and Expo in
November /December 2012 in an amount not to exceed $25,000, DAC I, FY 2012 Event
Resources.
D35 Upper Keys Community Pool, Inc. covering Orange Bowl Winter Training and
Swim Classic in December 2012 in an amount not to exceed $50,000, DAC V, FY 2012 Event
Resources.
D36 Ragnar Events, LLC covering Ragnar Relay Florida Keys in January 2012 in an
amount not to exceed $82,500, FY 2012 Event Resources.
D17 Monroe County Commercial Fisherman, Inc. for the Florida Keys Seafood
Festival in 2012 in an amount not to exceed $25,000, DAC I, FY 2012 Event Resources. The
•
agreement is being returned as the signature is not an original. Please have signed and
return to our office for follow through.
Attached is the electronic copy of each of the above - mentioned for your handling.
Should you have any questions, please feel free to contact me.
cc: County Attorney w/o documents
Finance
File
Turn Key Events Agreement
THIS AGREEMENT (Agreement) is entered into this day of _0rV , 2011,
by and between MONROE COUNTY, a political subdivision of the state of Florida (County)
and Shoot for the Moon a For Profit business organized under the laws of the state of Florida
(Event Sponsor).
WITNESSETH:
In consideration of the mutual covenants contained herein the parties agree as follows:
1. Payment: The COUNTY agrees to pay $30,000 (Thirty Thousand Dollars) for:
Battle in the Bay Dragon Boat Festival in May, 2012 from tourist development tax funds
provided Event Sponsor meets all of its obligations under this agreement.
2. Scope of Services The Event Sponsor agrees to provide the County with an
event as specified in the Scope of Services below (Event):
a). Pre -race party on night prior to event
b). A one (1) day Dragon Boat Race
c). Food and beverage vendors
d). Post event party
e). National TV coverage or nationwide national sponsor marketing or national or
international unpaid marketing exposure
3. Payment: Upon receipt from Event Sponsor of documentation, reviewed and
verified by the Tourist Development Council (TDC) Administrative Office, proving that event
has been produced and promoted through marketing literature, advertising program /publication
ads, television coverage, publicity and on -site advertising, and that the required insurance was
obtained no less than twenty days prior to the event, COUNTY shall pay the sum in Paragraph
1.
Monroe County's performance and obligation to pay under this contract is contingent
upon an annual appropriation by the COUNTY.
4. Accounting Financial records of Sponsor pertaining to this project shall be kept
according to generally recognized accounting principles and shall be available to the COUNTY
or to an authorized representative for audit. Records shall be retained a minimum of three
years after contract has been performed.
Battle in the Bay
Tumkey Funding
FY 2012
ID #: 978
1
5. Modification Any changes to this contract may be made only by written mutual
agreement, recommended by the TDC and approved by the COUNTY.
6. Termination This Agreement terminates on September 30, 2012. All invoices
must be submitted prior to September 30, 2012.
7. Non Occurrence of Event The Event Sponsor shall give written notice to the
Monroe County Tourist Development Council if it is found necessary to cancel an event. The
notice shall contain the following specifics: 1) reason for cancellation, 2) documentation of the
reason for cancellation and 3) person authorized to cancel including title and stated affiliation.
8. Indemnification and Hold Harmless The Event Sponsor covenants and agrees
to indemnify and hold harmless and defend Monroe County, its officers, employees and agents
including the Tourist Development Council and Visit Florida Keys from any and all claims for
bodily injury (including death), personal injury, and property damage (including property owned
by Monroe County) and any other losses, damages, and expenses (including attorney's fees)
which arise out of, in connection with, or by reason of the services provided, event sponsored,
or other activities and funding associated with this agreement, except those losses or damages
caused by COUNTY or its agents.
9. Insurance Requirements Event sponsor as a pre- requisite of the Special Event
governed by this Agreement, shall obtain, at its own expense, insurance as specified in this
section.
Event sponsor shall furnish the County with a certificate evidencing the insurance
required by this paragraph not later than twenty (20) days prior to the event
Please have your insurance agency e-mail your certificates of insurance directly to Maria
Slavik in the Monroe County Risk Management Department. Slavik- Maria(a Mon roeCounty_
FL.Gov — The e-mail must state that this is a certificate for a TDC event (state name of
event as written within your contract) and should be forwarded to Maxine Pacini at the
TDC administrative office. Your certificate must state that the Monroe County Board of
County Commissioners is a "Certificate Holder" and that Monroe County, its employees
and officials will be included as "additional insured ". If you or your insurance agency
need to speak with Maria regarding the insurance requirements, she can be contact by
telephone at (305) 295 -3178, or by e-mail at the address stated above.
It is the event sponsor's responsibility to confirm that your insurance has been received and
approved. You can do this by contacting Maxine Pacini at AdminAsst(a keys.com or by
calling (305) 296 -1552.
Event sponsor will not be permitted to commence work associated with the Event (including
pre- staging of personnel and material) until satisfactory evidence of the required insurance has
Battle in the Bay
Turnkey Funding
FY 2012
ID #: 978
2
been furnished to the county as specified below. Event sponsor shall maintain the required
insurance throughout the entire duration of the Special Event and any extensions specified in
any attached schedules. Failure to comply with this provision may result in the immediate
suspension of the Event until the required insurance has been reinstated or replaced. Event
sponsor shall provide, to the County, as satisfactory evidence of the required insurance, either:
Original certificate of Insurance
or
Certified copy of the actual insurance policy
A certified copy of any or all insurance policies required by this contract shall be filed with the
Clerk of the COUNTY prior to the Event.
All insurance policies must specify that they are not subject to cancellation, non-
renewal, material change or reduction in coverage unless a minimum of thirty (30) days prior
notification is given to the County by the insurer.
Acceptance and /or approval of event sponsor's insurance shall not be construed as
relieving event sponsor from any liability or obligation assumed under this contract or imposed
by law.
Any deviations from these General Insurance Requirements must be requested in
writing on the County form titled "Request for Waiver of Insurance Requirements" and must be
approved by Monroe County Risk Management.
Prior to commencement of work governed by this contract, event sponsor shall obtain
General Liability Insurance. Coverage shall be maintained through out 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:
$1,000,000.00 combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
` $500,000.00 per person
$1,000,000.00 per Occurrence
$100,000.00 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 effective
date of this contract. In addition, the period for which claims may be reported should extend
Battle in the Bay
Tumkey Funding
FY 2012
ID #: 978
3
for a minimum of twelve (12) months following the acceptance of work by the County.
Recognizing that the work governed by this contract involves the sales and /or distribution of
alcoholic beverages, the Contractor's General Liability Insurance policy shall include Liquor
Liability with limits equal to those of the basic coverage.
A separate Liquor Liability policy is acceptable if the coverage is not more restrictive
than the contractor's General Liability policy.
A Workers Compensation insurance is required by Florida Statutes.
10. Permits The Event Sponsor will secure all required permits and licenses and
shall pay all appropriate business taxes.
11. Laws and Regulations Any and all services, materials and equipment shall
comply fully with all Local, State and Federal laws and regulations.
12. Taxes The COUNTY and TDC are exempt from Federal Excise and State of
Florida Sales Tax.
13. Finance Charges The COUNTY and TDC will not be responsible for any
finance charges.
14. Relation of COUNTY/TDC It is the intent of the parties hereto that the Event
Sponsor shall be legally considered as an independent contractor and that neither it nor its
employees shall, under any circumstances, be considered servants or agents of the COUNTY
and TDC, and the COUNTY and TDC shall at no time be legally responsible for any
negligence on the part of said Event Sponsor, its employees or agents, resulting in either
bodily or personal injury or property damage to any individual, firm, or corporation.
15. Disclosure The Event Sponsor shall be required to list any or all potential
conflicts or interest, as defined by Florida Statutes Chapter 112 and Monroe County Code.
The Event Sponsor shall disclose to the COUNTY and TDC all actual or proposed conflicts of
interest, financial or otherwise, direct or indirect, involving any client's interest which may
conflict with the interest of the COUNTY and TDC.
16. Assignment The Event Sponsor shall not assign, transfer, convey, sublet or
otherwise dispose of this agreement, or of any or all of its right, title or interest therein, or his or
its power to execute such agreement to any person, company or corporation without prior
consent of the TDC and COUNTY.
17. Compliance with laws - Nondiscrimination The Event Sponsor, shall comply
with all federal, state and local laws and ordinances applicable to the work or payment for work
thereof, and shall not discriminate on the grounds of race, color, religion, sex, age, or national
origin in the performance of work under this Agreement. This Agreement shall be subject to
all federal, state, and local laws and ordinances.
Battle in the Bay
Tumkey Funding
FY 2012
ID #: 978
4
18. Security Protection: The Event Sponsor agrees to provide adequate security
for the event.
19. Ethics Clause The Event Sponsor warrants that it has not employed, retained
or other wise had act on its behalf, any former County office or employee in violation of Section
2 or 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 the provision the County may, at its
discretion terminate this agreement without liability and may also, at 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 or present County officer or employee.
20. Media rights The TDC shall have the right to broadcast, rebroadcast, use,
reproduce or transmit for any purpose whatsoever, radio, television, pictures, sound, film and
tape motion pictures and still photographs paid for by the COUNTY and TDC under this
agreement.
21. Logo All promotional literature and display advertising with the exception
of generic advertising must display the "The Florida Keys - Marathon" logo /trade mark (as per
attached logo sample — Exhibit A). This logo /trade mark was adopted by the TDC and
County in April 2010.
22. Severability If any provision of this Agreement shall be held by a Court of
competent jurisdiction to be invalid or unenforceable, all remaining provisions shall not be
affected thereby; and each provision of this Agreement shall be valid and enforceable to the
fullest extent permitted by law.
23. Authority Each of the signatories for the sponsor below certifies and warrants
that:
a) The Sponsor's name in the agreement is the full name as designated in its corporate
charter, and b) they are empowered to act and execute the agreement for the Sponsor and c)
this Agreement has been approved by the Sponsor's Governing Board.
24. Public Entity Crimes: "A person or affiliate who has been placed on the
convicted vendor list following a conviction for public entity crime may not submit a proposal on
a contract to provide any goods or services to a public entity, may not submit a proposal on a
contract with a public entity for the construction or repair of a public building or public work,
may not submit proposals on leases of real property to public entity, may not be awarded or
perform work as a contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36
Battle in the Bay
Tumkey Funding
FY 2012
ID #: 978
5
months from the date of being placed on the convicted vendor list ". By execution of this
Agreement, Sponsor warrants that it is in compliance with this requirement.
25. Governing LawNenue 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
Sponsor 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.
26. Notice Any notice required or permitted under this agreement shall be in writing
and had delivered or mailed, postage prepaid, to the other party by certified mail, returned
receipt requested to the following:
For Grantee: Karen Bowers
Shoot for the Moon
P.O. Box 430095
Big Pine Key, FL 33043
For Grantor: Lynda Stuart
Monroe County Tourist Development Council
1201 White Street, Suite 102
Key West, FL 33040
And
Cynthia Hall, Asst. County Attorney
P.O. Box 1026
Key West, FL 33041 -1026
27. Entire Agreement The parties agree that the Agreement above constitutes the
entire agreement between the COUNTY and Event Sponsor.
Battle in the Bay
Tumkey Funding
FY 2012
ID #: 978
N
WHEREOF, the parties hereto have executed this agreement the day and
Clerk
(CORPORATE SEAL)
Attest:
Clerk
By.
Secretary
Print Name
Date:
OR TWO WITNESSES
(
Print Name:
Date:
Board of County Commissioners
of Monroe County
* 4k--
Mayor /Chaff an
Shoot for the Moon
President
Print Name N -,
Date: - y �
n
(2)
Print Name:
Date:
MON E COUNTY ATTORNEY
A OV AST F R
j
A L. HALL
Date NT OI}NT�ATTORNEY
_�f O(f
Soft in the Bay
Turnkey Fundng
FY2012
ID A 978
7
EXHIBIT A
In- County Logo
The below logo that includes the "Monroe County Tourist Development Council' designation is
to be utilized in all approved in- county print newspaper ads, magazine ads, street banners,
posters and other approved signage efforts. Radio commercials should include "Brought to
you by The Monroe County Tourist Development Council ". To seek approval, clarification
and /or logo in electronic format (eps or jpg file), contact Sharon Joseph or John Underwood
with Tinsley Advertising at 305 - 856 -6060.
Th M iEon
orida Keys
MONROE COUNTY TOURIST DEVELOPMENT COUNCIL
Out -of- County Logo
The below logo that does NOT include the "Monroe County Tourist Development Council'
designation is to be utilized in all other efforts including any approved out -of- county print
newspaper ads, magazine ads, television commercials, internet advertising (banners, buttons,
e -mail blasts), direct mail promotions (brochures and pamphlets) and any approved
promotional items including programs, T- shirts, hats, jackets and koozie cups. Radio
commercials should include "Brought to you by The Monroe County Tourist Development
Council'. To seek approval, clarification and /or logo in electronic format (eps or jpg file),
contact Sharon Joseph or John Underwood at Tinsley Advertising at 305 - 856 -6060.
md,a€�i�on "=
Battle in the Bay
Tumkey Funding
FY 2012
ID #: 978
AXIS 8000(08/10) CERTIFICATE OF INSURANCE 1 04/05/2012
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY
American Specialty Insurance 81 Risk Services, Inc. OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT
142 North Main Street BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND
Dn. -l— I -Ai— AR72Q THE CERTIFICATE HOLDER.
INSURED
National Paddling Committee
601 East Boulevard
Charlotte, NC 28203
SHOOT FOR THE MOON
POB 430095
BIG PINE KEY, FL 33043
COVERAGES
Inc. dba USA Canoe/Kayak dba USA Canoe/Kayak Team
INS. C:
CERT NUMBER: 1001027323
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING 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.
INS
LTR
POLICY
TYPE
POLICY NUMBER
POLICY
EFFECTIVE
POLICY
EXPIRATION
LIMITS
A
GL
AXGL03100340-11
07/01/2011
12:01 a.m.
07/01/2012
12:01 a.m.
General Aggregate
5,000,000
Products -Completed Operations Aggregate
2,000,000
Personal and AdvertisingIn'u
1,000,000
Each Occurrence
1,000,000
Damaae to Premises Rented to You An One Premises)
300,000
Medical Expense Limit (Any One Person
Excluded
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The Cerfificateholder is only an additional insured with respect to liability caused by the negligence of the Named Insured as per Form AXIS 1003-Additional Insured-Certificateholders,
but only with respect to BATTLE IN THE BAY DRAGON BOAT FESTIVAL from May 05, 2012 through May 12, 2012.
Liquor Liability is provided under the General Liability: $1,000,000 Each Common Cause, $2,000,000 Aggregate
CERTIFICATE HOLDER CANCELLATION
ATTN: MARIA SLAVIK, MONROE COUNTY RISK MANAGEMENT DEPT
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES
BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AXIS 8000(08/10) CERTIFICATE OF INSURANCE
1 03/09/2012
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
American Specialty Insurance & Risk Services, Inc.
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY
OR NEGATIVELY AMEND,EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
142 North Main Street
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT
BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND
Roanoke, Indiana 46783
THE CERTIFICATE HOLDER.
INSURED
INSURERS AFFORDING COVERAGE
National Paddling Committee, Inc. dba USA Canoe/Kayak dba USA Canoe/Kayak Team
INS. A: AXIS Insurance Company
601 East Boulevard
INS. B:
Charlotte, NC 28203
1 INS C-
SHOOT FOR THE MOON
POB 430095
BIG PINE KEY, FL 33043
CERT NUMBER: 1001022628
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING 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.
INS
LTR
POLICY
TYPE
POLICY NUMBER
POLICY
EFFECTIVE
POLICY
EXPIRATION
LIMITS
A
GL
AXGL03100340-11
07/01/2011
12:01 a.m.
07/01/2012
12:01 a.m.
General Aggregate
5,000,000
Products -Completed Operations Aggregate
2,000,000
Personal and AdvertisingIn'u
1,000,000
Each Occurrence
1,000,000
Damage Premises Rented to You (Any One Premises)
300,000
Medical Expense Limit (Any One Person
Excluded
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
- The Certificateholder is only an additional insured with respect to liability caused by the negligence of the Named Insured as per Form AXIS 1003-Additional Insured-Certificateholders,
but only with respect to BATTLE IN THE BAY DRAGON BOAT FESTIVAL from May 05, 2012 through May 12, 2012.
{
1
CERTIFICATE HOLDER CANCELLATION
ATTN: MARIA SLAVIK, MONROE COUNTY RISK MANAGEMENT DEPT
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES
BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
03/23/2012 15:19 3055152916 MEYER PAGE 02/02
19M UN"
MONROE COUNTY, FLORMA
Request For Waiver
of
Insurance Requirements
It is cequamd that the insnnnce requirements, as specified in the Countyl Schedule of Insumnee
Requirements, be waived or modified on the followinj contract
coatraesor. 9Mgju Al a Sumr a —I tI6 Jlleao+`l
Contract few. &f jj9 ► N-ak-:;1- 6NAt Qg&c& 6QA i - VAd_- - -
Adana of Contractor: VC7 'T3oo 6—
330�L3
Phone: 305 , wp& -106 3
Scope of Work: �- ► wr:7. T cBff .E I N Tw &A/
—rwm eoAT resTi q& -.)
Rees" far Waiver. _Az.,r_ No pia i _b rl
PoHciM Waiverwill .. I _ , .. _ . . _ t I — n n_ _ . , . — _ . t
apply to
Sigoatui
Risk Ms
Date:
County Administrator Appeal:
Approved
Dett:
Hoard of County Commiaionen Appeal:
Approved
Meetiuhs Ante:
Adieisastratim Imtruction
1i *.2
Not Approved
Not Approved