Contract No. M-002 AGREEMENT BETWEEN OWNER AND CONSULTANT
OWNER: Monroe County Board of County Commissioners
500 Whitehead Street
Key West, Florida 33040
CONSULTANT: Petsche & Associates, Inc.
2581 Metrocentre Boulevard #6
West Palm Beach, FL 33407
(407) 640 - 3800
PROGRAM Morrison - Knudsen/Gerrits
CONSTRUCTION 5090 College Road
MANAGER: Key West, Florida 33040
(305) 292 -7845
FOR THE FOLLOWING
SERVICES: Surveying Services for Monroe County Capital Improvement Projects
DATED: May 17, 1994
CONTRACT NO. M -002
8S: trd 9- Nflr 176.
03-11d
TABLE OF CONTENTS
1.0 General
2.0 Basic Services
3.0 Owner's Representative
4.0 Authorization to Perform Services
5.0 Compensation
6.0 Subconsultants and Subcontractors
7.0 Satisfactory Performance
8.0 Resolution of Disagreements
9.0 Consultant Accounting Records
10.0 Ownership of Project Documents
11.0 Indemnification
12.0 Insurance Coverage
13.0 Equal Employment Opportunity Clause
14.0 Independent Status and Immigration Reform Act Compliance
15.0 Truth in Negotiations
16.0 Successors and Assigns
17.0 Termination of Agreement
18.0 Extent of Agreement
19.0 Governing Law
Attachment "A" - Scope of Services
Attachment "B" - Unit and Hourly Rates
1.0 General
The Consultant is to provide professional Surveying services for the Board of County
Commissioners (BOCC) of Monroe County for capital improvement projects in accordance
with the scope of work and unit rates detailed in Attachments A and B. Monroe County
reserves the right to solicit any portion or all of the services included in this Agreement
, C b.
The elsewhere term of if this deemed Agreement by the shall BO C be to for be one in year the west ith interest an option of the to extend County the services for a
period of three years.
2.0 Basic Services
All services to be performed under this Agreement shall be on a job specific basis under
direction of requests by Monroe County. Such requests shall be in written form and shall
specify the exact scope of services required.
Throughout the life of this Agreement, the Consultant shall be responsible on each
assignment for properly coordinating, expediting, and controlling the technical aspects of the
services to be provided under this Agreement to ensure complete technical integrity.
3.0 Owner's Representative
The Owner's designated representative authorized to act on the Owner's behalf with respect
to the Project is the Monroe County Board of County Commissioners (BOCC). The BOCC
meets to consider agenda items approximately once a month for those items scheduled two
weeks in advance. The Owner or such authorized representative shall render decisions in a
timely manner pertaining to documents submitted by the Consultant in order to avoid
unreasonable delay in the orderly and sequential progress of the Consultant's services.
The Owner's Program Construction Manager, Morrison - Knudsen /Gerrits, shall administer
this Agreement, receive inspection /test reports and observe the work at the site.
4.0 Authorization to perform services may be given only by the County Administrator or his
representative as directed by the Monroe County Board of County Commissioners. A
detailed estimate including time frames of all job specific work to be performed for each
project shall be submitted to Monroe County for approval prior to commencement of said
work. Any work exceeding the amount of the original estimate shall require an approval
before commencement.
After Notice to Proceed is received for an individual project estimate, services shall
commence within three (3) days. Final reports shall be delivered to the County within the
specified time frame in each estimate.
The procedure shall be as follows:
1. The scope of work of the desired service shall be determined by the County.
Consultant input may be required in defining the scope of work.
2. The finalized scope of work will be transmitted to the Consultant for pricing and time
frames. The pricing shall be in accordance with Attachment "B ".
3. The Program Construction Manager will review the Consultant's proposed price and
time frames for the service and subsequently negotiate or approve the price.
4. The scope and pricing will be presented to the Board of County Commissioners for
approval.
5. Upon BOCC approval, the Consultant will be directed in writing to proceed.
The Consultant shall perform no services contemplated to merit compensation beyond that
provided for in the proposal, unless such services, and compensation therefor, are provided
for by an appropriate amendment which is approved by the BOCC.
5.0 Compensation
All fees will be based on the rate schedules as detailed in Attachment "B ". Overtime is
defined as those hours in excess of 8 hours per day per individual, work on Saturdays,
Sundays and holidays. The limits and application of travel time will be established in the
Consultant's individual project estimate.
All invoices shall be submitted monthly and shall be based on the actual hours expended and
tests performed as detailed in the individual project proposal and shall not exceed the limits
established in the proposal unless approved as detailed in 4.0. All invoices are to be made
out to Monroe County and sent c/o MK/G, 5090 College Road, Key West, FL 33040.
Miscellaneous separate reimbursables will not be considered and must be included in the
rate schedule and individual project proposal.
The County shall endeavor to make payments on account of the Consultant's approved basic
services, as well as any approved additional services, within thirty (30) days upon
presentation of the Consultant's invoice. If there are any questions regarding the invoice
submitted, the County will notify the Consultant.
6.0 Subconsultants and Subcontractors
The County reserves the right to review the qualifications of any and all subcontractors or
subconsultants, and to reject any subcontractors or subconsultants deemed not qualified to
perform, in a proper and timely manner, the services for which it shall have been engaged.
7.0 Satisfactory Performance
All services to be provided by the Consultant under the provisions of this Agreement,
including services to be provided by subcontractors or subconsultants shall be performed to
the satisfaction of the County's representative.
The Consultant shall pay the County all losses, damages, expenses, costs, and attorney's fees,
including appellate proceedings, that the County sustains by reason of any default, any
negligent act or omission, including patent infringements on the part of the Consultant in
connection with the performance of this Agreement. The Consultant shall not be
responsible for occurrences beyond their control, including but not limited to, intangible
losses due to scheduling, conflicts caused by other firms or the County.
8.0 Resolution of Disagreements
The County shall decide all questions and disputes, of any nature whatsoever, that may arise
in the execution and fulfillment of the services provided for under this Agreement. Venue
for any claims or disputes arising under this contract shall be in the Circuit Court of the 16th
Judicial Circuit of the State of Florida.
The decision of the County upon all claims, questions, disputes, and conflicts shall be final
and conclusive, and shall be binding upon all parties to this Agreement.
9.0 Consultant Accounting Records
Records of expenses pertaining to all services performed shall be kept in accordance with
generally recognized accounting principles and procedures.
The Consultant's records shall be open to inspection and subject to examination, audit, an /or
reproduction during normal working hours by the County's agent or authorized
representative to the extent necessary to adequately permit evaluation and verification of any
invoices, payments, or claims submitted by the Consultant or any of his payees pursuant to
the execution of the Agreement.
For the purpose of such audits, inspection, examinations, and evaluations, the County's agent
or authorized representative shall have access to said records from the effective date of the
Agreement, for the duration of work, and until three (3) years after the date of final
payment by the County to the Consultant pursuant to this Agreement.
The County's agent or authorized representative shall have access to the Consultant's
facilities and all necessary records in order to conduct audits in compliance with this section.
The County's agent or authorized representative shall give the Consultant reasonable
advance notice of intended inspections, examinations, and /or audits.
The Consultant shall require their consultants to comply with the provisions of this article by
insertion of requirements of this article in written contract agreements between the
consultant and such payees. Failure to include such provisions shall be reason to exclude
some or all of the related payee's costs from the amount payable to the Consultant pursuant
to this contract.
10.0 Ownership of Project Documents
Copies of all reports, test data, design data, plans, specifications, filed survey notes and any
other documents prepared or obtained by the Consultant under the provisions of this
Agreement shall be the sole property of the County and, together with all data and
reference material furnished by the County in connection with any Project, shall be delivered
to the County upon completion of the scope of work, or upon termination of this Agreement
as provided for herein.
In return for the acquisition of the drawings and specifications, the County agrees to
acknowledge that the Consultant shall not be responsible for any changes made to the
drawings and specifications by anyone other than the Consultant and agrees to release the
Consultant against any and all costs, damages, losses and liabilities arising out of the
County's use of the drawings and specifications other than such costs, damages, losses and
liabilities resulting from the Consultant's sole negligence. The County acknowledges that the
Consultant drawings, specifications, reports and other similar documents are instruments of
professional services, not products.
11.0 Indemnification
The Consultant covenants and agrees to indemnify and hold harmless Monroe County,
Monroe County Board of County Commissioners, and Morrison - Knudsen /Gerrits from any
and all claims for bodily injury (including death), personal injury, and property damage
(including property owned by Monroe County and Morrison - Knudsen/Gerrits) and any other
losses, damages, and expenses (including attorney's fees) which arise out of, in connection
with, or by reason of services provided by the Consultant or any of its subconsultants in any
tier, occasioned by the negligence, errors, or other wrongful act or omission of the
Consultant or its subconsultants in any tier, their employees, or agents.
In the event the completion of the project (to include the work of others) is delayed or
suspended as a result of the Consultant's failure to purchase or maintain the required
insurance, the Consultant shall indemnify the County from any and all increased expenses
resulting from such delay.
The first ten dollars ($10.00) of remuneration paid to the Consultant is for the
indemnification provided for the above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance
requirements contained elsewhere within this agreement.
12.0 Insurance
Prior to commencement of work governed by this contract (including the pre- staging of
personnel and material), the Consultant shall obtain, at their own expense, insurance as
specified in the attached schedules, which are made part of this Agreement. The Consultant
will ensure that the insurance obtained will extend protection to all subconsultants engaged
by the Consultant. As an alternative the Consultant may require all subconsultants to obtain
insurance consistent with the attached schedules.
The Consultant will not be permitted to commence work governed by the Agreement
(including pre - staging of personnel and material) until satisfactory evidence of the required
insurance has been furnished to the County as specified below. Delays in the
commencement of work resulting from the failure of the Consultant to provide satisfactory
evidence of the required insurance shall not extend deadlines specified in this Agreement
and any penalties and failure to perform assessments shall be imposed as if the work
commenced on the specified date and time, except for the Consultant's failure to provide
satisfactory evidence.
The Consultant shall maintain the required insurance throughout the entire term of this
contract and any extensions specified in any attached schedules. Failure to comply with this
provision may result in the immediate suspension of all work until the required insurance has
been reinstated or replaced. Delays in the completion of work resulting from the failure of
the Contractor to maintain the required insurance shall not extend deadlines specified in this
Agreement and any penalties and failure to perform assessments shall be imposed as if the
work commenced on the specified date and time, except for the Consultant's failure to
provide satisfactory evidence.
The Consultant shall provide, to the County in care of the Construction Manager, as
satisfactory evidence of the required insurance, either:
o Certificate of Insurance
or
o A certified copy of the actual insurance policy
All insurance policies must specify that they are not subject to cancellation, non - renewal,
material change, or reduction in coverage unless a minimum of thirty (30) days prior
notification is given to the County by the insurer.
The acceptance and /or approval of the Consultant's insurance shall not be construed as
relieving the Consultant from any liability or obligation assumed under this contract or
imposed by law.
The Monroe County Board of County Commissioners, its employees and officials, and
Morrison - Knudsen /Gerrits will be included as "Additional Insured" on all policies, except for
Workers' Compensation.
In addition, the County will be named as an additional insured and loss payee on all policies
covering County -owned property.
Any deviations from these General Insurance Requirements must be requested in writing on
the County prepared form entitled "Request for Waiver of Insurance Requirements" and
approved by the Monroe County's Risk Manager.
1a Pt,n",F
MONROE COUNTY, FLORID
INSURANCE CHECKLIST
FOR
VENDORS SUBMITTING PROPOSALS
FOR WORK
To assist in the development of your proposal, the insurance coverages marked with an "X" will
be required in the event an award is made to your firm. Please review this form with your
insurance agent and have him/her sign it in the place provided. It is also required that the bidder
sign the form and submit it with each proposal.
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
X Workers' Compensation Statutory Limits
WC 1 Employers Liability S 100,000 /5500,000 /S 100,000
WC2 ___X__ Employers Liability $500,000/$500,000 /$500,000
WC3 Employers Liability S1 ,000,00041,000,000 41,000,000
WCUSLH US Longshoremen & Same as Employers'
Harbor Workers Act Liability
WCJA Federal Jones Act Same as Employers'
Liability
Admini4ntive lnanktion INSCKLST
x4709.01 6
IA Prwinc
GENERAL LIABILITY
' As a minimum the required general liability coverages will include:
• Premises Operations • Products and Completed Operations
• Blanket Contractual • Personal Injury
• Expanded Definition
of Propert Dama
Required Limits:
GL1 5100,000 per Person; 5300,000 per Occurrence
550,000 Property Damage
or
5300,000 Combined Single Limit
GL2 __X_ 5250,000 per Person; 5500,000 per Occurrence
550,000 Property Damage
or
5500,000 Combined Single Limit
GL3 5500,000 per Person; 51,000,000 per Occurrence
5100,000 Property Damage
or
51,000,000 Combined Single Limit
Required Endorsement:
GLXCU Underground, Explosion and Collapse (XCU)
GLLIQ Liquor Liability
All endorsements are required to have the same limits as the basic policy.
Admmictratn InstruQioq INSCKLST
N4709.01 7
IA I•nrr,n
VEI [ICLE LIABILITY
As a minimum, coverage should extend to liability for:
• Owned; Nonowned; and Hired Vehicles
Required Limits:
VL 1 550,000 per Person: $100,000 per Occurrence
$25,000 Property Damage
or
$ 100,000 Combined Single Limit
VL2 X $100,000 per Person; 5300,000 per Occurrence
$50,000 Property Damage
or
$300,000 Combined Single Limit
VL3 $500,000 per Person; $1,000,000 per Occurrence
$100,000 Property Damage
or
$ 1,000,000 Combined Single Limit
MISCELLANEOUS COVERAGES
13R 1 Builders' Limits equal to the
Risk completed project.
MVC Motor Truck Limits equal to the maximum
Cargo value of any one shipment.
PROI Professional $ 250,000 per Occurrence/$ 500,000 Agg.
PRO2 X Liability $ 500,000 per Occurrence/$I,000,000 Agg.
PRO3 $ I ,000,000 per Occurrence/$2,000,000 Agg.
POLL Pollution $ 500,000 per Occurrence/$I,000,000 Agg.
POL2 Liability $1,000,000 per Occurrence/$2,000,000 Agg.
POL3 55,000,000 per Occurrence/$ 10,000,000 Agg.
ED 1 _ Employee $ 10,000
ED2 Dishonesty $100,000
GK 1 Garage $ 300,000 ($ 25,000 per Veit)
GK2 Keepers $ 500,000 (5100,000 per Veh)
GK3 $1,000,000 ($250,000 per Veh)
MEDI Medical $ 500,000/5 1,000,000 Agg.
MED2 Professional $1,000,000/5 3,000,000 Agg.
MFD3 $5,000,000310,000,000 Agg.
nd,c-ltitniisc Iraiuction INSCKLSI
M4709 01 • 8
13.0 Equal Employment Opportunity Clause
In carrying out the contract, the Consultant shall not discriminate against employee or
applicant for employment because of race, color, religion, sex, or national origin. The
Consultant shall take affirmative action to insure that applicants for employment are
employed, and that employees are treated during employment without regard to their race,
color, religion, sex, or national origin. Such action shall include, but not be limited to, the
following:
a. Employment, upgrading, demotion, or transfer.
b. Recruitment or recruitment advertising.
c. Layoff or termination.
d. Rates of pay or other forms of compensation.
e. Selection for training, including apprenticeship.
The Consultant shall place in conspicuous places which are available to employees and
applicants for employment, notices to be provided by the Government setting forth the
provisions of the nondiscrimination clause. The Consultant shall state that all qualified
candidates will receive consideration for employment without regard to race, color, religion,
sex, or national origin.
14.0 Independent Status and Compliance with the Immigration Reform and Control Act of 1986
The Consultant acknowledges that is functioning as an independent consultant in performing
under the terms of this Agreement, and it is not acting as an employee of Monroe County.
The Consultant acknowledges that it is responsible for complying with the provisions of the
Immigration Reform and Control Act of 1986, located at 8 U.S.G. Section 1324, et seq., and
regulations relating thereto. Failure to comply with the above provisions of this contract
shall be considered a material breach and shall be grounds for immediate termination of the
contract.
15.0 Truth in Negotiations
The Consultant shall comply with Florida State Statute 287.055, paragraph 5(a).
By execution of this Agreement, the Consultant certifies to truth -in- negotiations and that
wage rates and other factual unit costs supporting the compensation are accurate, complete
and current at the time of contracting. Further, the original contract amount and any
additions thereto shall be adjusted to exclude any significant sums where the County
determines the contract price was increased due to inaccurate, incomplete, or non - current
wage rates and other factual unit costs. Such adjustments must be made within one (1) year
following the end of the contract.
16.0 Successors and Assigns
The Consultant shall not assign, sublet, or transfer his interest in this Agreement without the
written consent of the County.
17.0 Termination of Agreement
This Agreement may be terminated by either party upon seven (7) days written notice to the
other party should either party fail substantially to perform in accordance with the terms of
this agreement through no fault of the other party.
0 0
In the event that conditions arise, such as lack of available funds, which in the County's
opinion make it advisable and in the public interest to terminate this Agreement, it may do
so upon written notice.
If the project is suspended or abandoned in whole or in part for more than three (3)
months, the Consultant shall be compensated for all services performed prior to receipt of
written notice from the County of such suspension or abandonment. If the project is
resumed after being suspended for more than three (3) months, the Consultant's
compensation shall be equitably adjusted.
18.0 Extent of Agreement
This Agreement represents, together with all Attachments, the entire written Agreement
between the County and the Consultant and may be amended only by written instrument
signed by both the County and Consultant.
19.0 Governing Law
The Consultant shall comply with all Federal, state and local laws and ordinances applicable
to the work or payment for work thereof. This Agreement shall be governed by the laws of
the State of Florida.
Consult . Petsche so ., Inc. Monr • • • unty BAard of C nt Commissioners
i atu
"ture
i2 J ` t,q0 - 11
Title Mayor /Chh'airman
4 -2 9I rn [ 1 (619'q
Date Dat
Appr v as form and legal sufficiency Attest: Danny L. Kolhage, Clerk
County Attorney's Office „In," ✓' ,
i NH .s /ir /44
Date Date
•
Surveying
Scope of Work
1.0 General
1.1 All work shall be performed by qualified personnel under the supervision of a
Licensed or Registered Land Surveyor, and the document(s) submitted shall bear the
Surveyor's seal and certification to that effect.
2.0 Drawing requirements
2.1 Drawings shall note all dimensions and elevations in equivalent U. S. measurement.
2.2 Drawing sheets shall be 24 x 36.
2.3 Use scale 1" = 30' unless otherwise authorized by the County.
2.4 Include legend of symbols and abbreviations used on the drawing(s).
3.0 Land (Boundary) Survey Requirements
3.1 Show boundary lines, giving length and bearing (including reference or basis) on each
straight line; interior angles; radius, point of tangency and length of curved lines.
Where no monument exists, set permanent iron pin (monument) or other suitable
permanent monument at property corners; drive pin into ground adequately to
prevent movement, mark with wood stake; state on the drawing(s) where corners
were found or set and describe each.
3.2 Confirm or furnish a legal description which conforms to the Record Title
Boundaries. Prior to making this survey, the Surveyor shall, insofar as possible,
acquire data including, but not limited to, deeds, maps, certificates or abstracts of
title, section line and other boundary line locations in the vicinity.
3.3 Give area in square feet if less than one acre, in acres (to .001 acre) if over one acre.
3.4 Note identity, jurisdiction and width of adjoining streets and highways, width and type
of pavement. Identify landmarks.
3.5 Plot location of structures on property and on adjacent property within 0.1 feet.
Dimension perimeters in feet and inches to nearest 1/2 ". State the character and
number of stories. Dimension to property lines and other buildings. Vacant parcels
shall be noted VACANT.
3.6 Show visual encroachments, including cornices, belt courses, etc., either way across
property lines.
3.7 Describe fences and walls. Identify party walls and locate them with respect to
property lines.
3.8 Show recorded or otherwise known easements and rights -of -way; state the owner of
right of each.
3.9 Note possibilities of prescriptive rights -of -way and the nature of each.
3.10 Note anticipated street widenings.
3.11 Show zoning of property; if more than one zone, show the extent of each. Show
zoning of adjacent property and property across the street(s) or highway(s).
3.12 Show building line and setback dimensions, if any.
3.13 Give names of owners of adjacent property.
3.14 Reconcile or explain any discrepancies between the survey and the recorded legal
description.
ATTACHMENT "A" - SCOPE OF SERVICES page 1
4.0 Topographical Survey Requirements
4.1 All lines of levels shall be checked by separate check level lines or on previous
turning points or benchmarks.
4.2 Minimum of one permanent benchmark on site for each four acres; description and
elevation to nearest .01'.
4.3 Contours at 1 foot intervals; error shall not exceed one half contour interval.
4.4 Spot elevation at each intersection of a 25 foot square grid covering the property.
4.5 Spot elevations at street intersections and at 25 feet on center on curb, sidewalk and
edge of paving including far side of paving. If elevations vary from established
grades, state established grades also.
4.6 Plotted location of structures, above and below ground, man -made and natural
features; all floor elevations and elevations at each entrance of buildings on the
property.
4.7 Location, size and depth of water and gas mains, central steam and other above
ground and underground utilities including, but not limited to buried tanks on the
property. Locations, size and depth of underground utilities not visible to be obtained
by Consultant from as -built drawings if available.
4.8 Location of fire hydrants available to the property and the size of the main serving
each.
4.9 Location and characteristics of power and communications systems above and below
grade.
4.10 Location, size depth and direction of flow of sanitary sewers, septic tanks, septic
fields, combination sewers, storm drains, culverts and wells serving, or on, the
property; location of catch basins and manholes, and inverts of pipe at each.
4.11 Name of the operating authority of each utility.
4.12 Mean elevation of water in any excavation, well or nearby body of water.
4.13 Flood plain, flood level of adjacent bodies of water and analysis of site for potential
flooding.
4.14 Trees of 6" diameter and over (caliper 3' above ground); locate within 1' tolerance
and give species in English and botanical terms.
ATTACHMENT "A" - SCOPE OF SERVICES page 2
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■
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
' FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST i!E SIGNED AND SLK*N TO iN THE PRESENCE OF A NOTARY PUBLIC OR OTNER OFFICIAL AUTHORIZED TO
1 ADMINISTER OATHS.
1. This sworn statement Is subnttted to The Board of County Commissioners t i of MonLoe name of 1 Florida
by Mr. Peter J. Petsrhe - President /Ser•retary
(print individual's name end title)
for PET .1 . . • L
1 (print name of entity submitting sworn statement)
•
whose business address is 2581 Metrocentre Boulevard, Suite 6
1 West Palm Beach, FL 33407
end (if applicable) its Federal Employer Identification Number (FEIN) is 59-2738041
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
1 statement: .)
2. I understand that a "public entity crime" es defined in Paragraph 287.133(1)(g), Florida Statutes,
means a violation of any state or federal law by a person with respect to and directly related to
1 the transaction of business with any public entity or with en agency or potiticet 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 en agency or political subdivision of any other
state or of the United States and involving antitrust, fret.d, theft, bribery, collursion,
racketeering, conspiracy, or material misrepresentation.
3. 1 understand that "convicted" or "conviction" es 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
l adjudication of guilt, In any federal or state trial court of record relating to charges brought by
indictment or information after July 1, 1989, es a result of a jury verdict, nonJury trial, or entry
of a plea of guilty or noto contendere.
4. 1 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
1 and who has been convicted of a public entity crime. The term "affiliate" includes those
officers, directors, executives, partners, shareholders, employees, members, and agents who are
active in the management of en affiliate. The ownership by one person of hares constituting not
controlling interest in another person, or pooling of equipment or income among persons
for fair market value under en arm's length agreement, shall be a prime facie case that one
I person controls another person. A person who knowingly enters into e Joint venture with a
person who has been convicted of a public entity grime in Florida during the preceding 36 months
shell be considered an affiliate.
1 5. I understand that a "person" as defined in Paragraph 287.133(1)(e),
Florida Statutes, means any
natural person or entity organized under the laws of any state or of the United States with the
legal power to enter into a binding contract end 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. l o hestefrm ers an" inc n c l ude s w tho see f of
executives, partners, shareholders, emp y
en entity.
6. entity on information applies.)
In relation to the ) trte
X Neither the entity submitting this sworn statement, nor any of its officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the
1 management of the entity, nor any affiliate of entity has been charged with end convicted of
e public entity crime subsequent to Y 1,
1
0
The entity submitting this sworn statement, or one or more of its officers, directors,
exec tuto vas, partners, shareholder*, employees, members, or agents who are active to the
management of the entity, nor an affiliate of the entity has been charged with and convicted of
• pazlic entity crime subsequent to July i, 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 end convicted of a
public entity crime subsequent to July 1, 1989. However, there has been • subsequent proceeding
before a Nearing Officer of the State of Florida, Division of Adnlnistrative Hearings and the
Final place Officer that it was not ndor list. (attach interest
aCOPY
of the final order)
1 UNDERSTAND THAT THE SUBMISSION OF THiS FORM 10 THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN
PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM 1S VALID THROUGH DECEMBER 31 OF
THE CALENDAR YEAR iiiWHICH 11 IS :SLED. i ALSO UNDERSTAND THAT 1 AN REQUIRED TO INFORM THE PUBLIC ENTITY
PRIOR 10 ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
STATUTES FOR CATEGORY TVO OF ANY CHANGE iN THE mammal CONTAINED IN THIS FORM.
signature)
Sworn to and subscribed before me this 27TH day of SEPTEMBER , 1993 .
Personally known X I .
OR produced Identification Notary Pubtie - State of FLORIDA
My Commission expires JUL. 1, 1997
(Type of identification) MARY KATHLEEN FRASER
(Printed, typed or stamped commissioned name
of Notary Public)
tom eR MARY KATb�.EENI FRASEIR
r t My Co.. riabn CC200040
'r M.S.@ .4. 01, 1007
b • s . d b Bonded y FIAT
44 ornse 800- 422 -1566
•
Form PUR 7068(Rev. 06/11/92)
LOBBYING AND CONFLICT OF'INTE CLAUS$
SWORN STATEMENT UNDER ORDINANCE ER NO . 010 -1990
MONROE COUNTY, FLORIDA
I ETHICS CLAUSE
i
• PETSCHE & ASSOCIATES, INC. M
(Company)
" warrants that he /it has not employed, retained or otherwise had act on his /its behalf any former
I County officer or employee In violation of Section 2 of Ordinance No. 010 -1990 or any County officer or
1 Cotrtye�in in terminate this contract O without liabitityh violation of
in its
t deduct from the o� Pd the fo otherwise
county ofticer the
oruemplamount ",of any fee, commission,
percentage, 9
;"af---1., ,
(Signature)
i
i Date: SEPTEMBER 27, 1993
I
STATE OF FLORIDA
1 COUNTY or PALM BEACH
Subscribed and sworn to or affirmed before me on SEPTEMBER 27, 1993
b PETER J. PETSCHE,
(date)
PrRESI /SEC. (name of attient). He /she is� r to pe
er�#mes- 4116
tt1dettt1t1tsti•om
i MARY KATHLEEN FRASERN 011 Ices 40.A 1.✓
NOTARY PUBLIC
I ........ • Q MARY KATHLEEN FRASER
Ay Commission CCaYY0a0
'• +. Expire. Jul. 01, 1907
•
.d' nb' i Bonded by HAI
�',.. ...0. 000. 422 -1665
1
1
MCP 1/4 Rev 2/92 •
i
M'Mtl. ,rvar�r.
""'�" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
moucin Samuel W. Irvine Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT (WEND, EXTEND OR
1920 Palm Beach Lakes Blvd. #101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
West Palm Beach, Fl. 33409 COMPANIES AFFORDING COVERAGE j
COMAANY Association Employers Ins. Co.
- - _ —'
COMPANY Florida Retail Federation SIF
Petelche & Associates �.
2581 Mertocebtre Blvd. #6 COMPANY C
West Palm Beach, F].. 33407 _ __... _.
COMPANY
D ,
- 4,; �� ,; rf -
THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT; TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS -
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TEFMIS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,
CO LTII
TYPE Of INSURANCE POUCY D prilD YY) �Y(1LiMQ70/YY) WITS
fiE11Fy.AL LUIBpJ7Y . . , . , .., . _ .. _ .. - - - -. _ .. . , . . _, ... - . .
�MER AOGREGATL 1 _ 000 000
A , COMMtERCIAL GENERAL LIABILITY PHODUCT5 G0 PPOP Asa i 2 000 _
cLAIMs MADE [l OccUR CPP 511,9 0042 4/12/93 4/12/94 Pa u rate $3.,...--..
S ADY r "'
0 OWNER'S 4 CONT PROT EACH OCCURRENCE i .000.044
1. .. V. FIRE MOM nnr Ms) Ii . .. .
• �' MED EXP ma k on. • . 1 .M i . I
A AUTOMOBILE amo uTY COI/ MO SINGLE LIMIT $ 300 • ow
NI AN Y AUTO N.
saNEDULE CA 149001 9/25/93 9/25/94 m P 1 i
HIRED AUTOS S K INJURY , $ NON -OWNED AUTOS IPB
III
_ PROPERTY DAMAGE $
III ouIRAOELUrMm
R eive I - AUTO ONLY • EA ACGIDEHT $ 1 ANY AUTO _ Risk Mgrn t. Loss Con . OMER THAN AUTO ONLY ; Y ,,, , „ :. {
DATE .2 / _ 9 7 EAGI ACCIE!$!! it
y A$ $ATE $
�L « � E A C H OGCUFWENCE $
MAW UAINUTY III UMBRELLA FOAM *ammonia -- i
OTHER THAN UMBRELLA FORM 1
STATUTORY L NTZ ..... , .: !1.T'�.:'
=MUM COMPENSATION AND _ ,
.-••.;: it
B rMPtorai LIABILm — 52006375 1/1/94 1/1/95 AOLIDENT $1•`1 470 •
THE PROPRILETORI DISEASE POLICY Lan i W.
PARTNERNEXECUTIVE ••^
OFFICERS ARE: EXCL EX04 DISEASE •EACH EMPLOYEE i 1110 T i
oTNBR 9 /5/93 9/5/9h 500, 0000 SL
C Professional Liab. AA 61J,1�C�1�'
Ossclur ION OF 0PERAT ,ONBILOCATION$NE !MSS Q Central
State of Florida
2hgineering k Surveying
* 10 day notice of cancellation applies to liability *30 day notice to workers comp.
t�, p'OULD ANY OF THE WYE P PAS SE CANCELLED BEFORE THE
Morrison '^ [�111a seT1 County � EYMAA71 * DATE THEREOF. 'ME 1 COMPANY WILL ENDEAVOR TO MAIL
Monroe County Bd. of GtYUnty Commissioners –iF OAFS WRITTEN NOTICt TO THE ATE HOLDER NAMED TO THE LET,
}'O Box 5253 BUT FAS.uRE To wuL sum Nome MAU, IMPOSE NO OSUGATION OR LIAMLITY
Key Nest, Fl. 33045 AvTOTIFOI}ANNY • KM UPON 'ME COWART m AGENTS OR REPRESENTA IVE&
r • ..¢.. ',. ,f7 rs "Y' . ,,,.'K A ...4Y ',1:1 . ; . •... -n=.. ~': i.: �; :.__"i' • Arm "Air.J.4., 6,4 •.'� 7 ::,4.14.4' !I!v'
ACORN). .CERTiFICAllh Ull• INbUIPIAIVOC .
.,:;•4 iii.:..-! >1..., ,,... .. 4/19/94 '
. ' , ' • ,..:, ,. ,oi ....,,...._. .. :,,...- ": .• f i
PRODUCER 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND I
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 1
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 1
Samuel W Irvine Associates POLICIES BELCWt_________ 1
1920 Palm Beach Lakes Blvd #101 COMPANIES AFFORDING COVERAGE .
WestPalm Beach,PL 33409
. .. ,
COMPANY A Association Employers Ina. Co.
LETTER ri 1
COMPANY v
I.
INSUR LETTER ED . .. . . . _.. . . . . . ,
Petsche & Associates COMPANY C
2581 Metrocentre Blvd #6 Los , ... i
_ ..
West Palm Beach,FL 33407 COMPANY n
LETTER *0 ,
_ .. .. ... • • • • ---••- •- • _, i
COMPANY
W T r J . . •.• • : l'..:4,:-i3g•ri:.::'.:.;:n\c„44, •%7`; ...":,..: .•, 4 ,.'.4 ',.,'':-. 71: ,,, ..
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERtoo i
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 1
1
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 SY PAID CLAIMS. I
CO EFFECTIVE POUCY ExPIRATIOT I
Moe OF iNSURANcE poucy NuMBER Lucre
LTR : DATE (mLuDD/YY) DATE (ABA/DONY)
■•■-._ .114■... -
A GENERAL LIAsILITY ' GENERAL AGGREGATE ; 6 2 , WU ,130tf I
I-- .,., .,, Am , ,.. i
X COMMERCIAL GENERAL LIABiLrn 1 I PROOUCTS-cOMP/OP A0G. i $ - L . 1
. _ }•••• -
. CLAIMS MADE X , OCCUR. ; CPP 5149 00 42 4/12/94 4/12/95 ' PERSONAL & ADv. INJURY • 1,000,000
, .
:owtem.o $ CONTRACTOR'S PROT. .1EAM.IHOOLIRREHOE :1,000 • 1
FIRE DAMAGE (Any on* Ur) - $ 5 ,000 1
, . . .. . .. MED. EXPENSE (My On. pirion) $ 5,000
,.
--- 414uiososILE LIABILITY ' _ . - OomBINED SINGLE
1
, 1 1
ANY AUTO • ,4025201V umM $
_A_V 1 q b__%
ALL OWNED AUTOS Sr 4 'a? B (Pe ODILY ForamINJURY
, A
. r )
SCHEDULED AUTOS kr tt
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS
(Per acc1c4n0 E
GARAGE LIABILITY 0 ReCei
7 c.P.O!fiS.OITIOteS931 1421 . . ... . . . ..... .. .
PROPERTY DAMAGE t 1
c,,ritt A - I
ExCESI LIABILITY i. (.1310
svg:' • EACH OCCURRENCE $
UMBRELLA FORM ; AGGREGATE $ f
OTHER THAN UMBRELLA FORM °11110t6 1
1 WORKER'S COMPoosATION . .8TATuTOITY LIMITS . 1
AND
ZNIPLoYERS' LIABILITY
-- .-- EAcH ACCIDENT $
DISEAsg—POLICY LIMIT $
1
DISEASE—EACH EMPLOYEE 8
. ...---......-------.--..................---..-.... 1
OTNEm I
i
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPEDIAL ITEMS I
State of Florida,Engineering and Surveying
Contract: Quality Control i
CERTIFICATE HOLDER
CANCEP-Ar.ON -;' ....' . .. , ... • .: L. ,.,.. . ..' .1; ,
Monroe County Board of County CommissionOrsHouLo ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 1
c/o Morrison,Knudsen & Gerritts ' txpiRATooN DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
5090 College Road k MAIL A.Q.._ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1
Key West,FL 33040 I, LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR i
LIABILITY OF ANY • D - 4. THE OMPANY, ITS AGENTS OR REPRESENTATIVES.
,
ATTN:Debbie AUTHoRizED RE. 'En IATIVE Iv , 1
,
Aro' i / i
--77 -
, ..._
*CORD 254 7/60 '. .,': ''' - ' ' 1 ' ''!. ;::' 1 r ' • '' '‘ . %. . ...., Cl o • Ro tho I