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7. 10/01/2013 to 09/30/2016AMY REAVILIN, CPA CLERK OF CIRCUIT COURT &COMPTROLLER MoxnoE couxn, FLORIDA DATE: September 27, 2013 TO: Chief James Callahan ATTN: Holly Pfiester FROM: Vitia Fernandez, D.C. At the September 17, 2013, Board of County Commissioner's meeting the Board granted approval and authorized execution of Item F2 Award the Maintenance of Monroe County Fire Rescue Vehicles contract to Fire Tech Repair Service, Inc.; three (3) year contract not to exceed two (2) renewal options, and approval for the Fire Chief to sign all documents as needed to complete transaction. Attached is the electronic copy of the above -mentioned for your handling. Should you have any questions, please feel free to contact our office. cc: County Attorney Finance File 500 Whitehead Street Suite 101, PO Box 1980, Key West, FL 33040 Phone: 305-295-3130 Fax: 305-295-3663 3117 Overseas Highway, Marathon, FL 33050 Phone: 305-289-6027 Fax: 305-289-6025 88820 Overseas Highway, Plantation Key, FL 33070 Phone: 852-7145 Fax: 305-852-7146 CONTRACT BETWEEN THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1 OF MONROE COUNTY, FLORIDA ISO FIRE -TECH REPAIR SERVICE, INC. FOR MAINTENANCE OF FIRE / RESCUE VEHICLES THIS CONTRACT, hereinafter `CONTRACT OR AGREEMENT' made and entered into this 1 St day of October, 2013 by and between the BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1, MONROE COUNTY, with principal offices located at 490 63 Street, Marathon, FL 33050 (hereinafter referred to as the `DISTRICT'), and Fire -Tech Repair Service, Inc., P.O. Box 1570 / 103680 Overseas Highway, Key Largo, FL 33037 (hereinafter referred to as `CONTRACTOR') WITNESSETH: WHEREAS, the DISTRICT advertised a notice of request for Proposals for MAINTENANCE OF FIRE RESCUE VEHICLES WHEREAS, the successful Respondent was Fire -Tech Repair Service. Inc. , and; WHEREAS, this CONTRACTOR represents that it is capable and prepared to provide such services, and; WHEREAS, the DISTRICT intends to enter into an Agreement for Maintenance of Fire Rescue vehicles, semi - annual inspections, Preventative Maintenance, and unscheduled maintenance resulting from malfunction or failure with the CONTRACTOR and; WHEREAS, this Contract is an `Agreement' between both parties, NOW, THEREFORE, in consideration of the promises contained herein, the parties agree as follows: Contract Documents: This Contract consists of the Agreement, the Contractor's response to the RFP, and the documents referred to in the Agreement as a part of this Agreement. In the event of any conflict between any of the Contract documents, the one imposing the greater burden on the Contractor will control. 2. Contract Period and Renewal: The effective date of this Agreement shall be an initial three (3) year term commencing on October 1, 2013 through September 30, 2016. This Agreement may be renewed annually, not to exceed two (2), one -year renewals, subject to approval of the Fire Chief of Monroe County Fire Rescue, the Office of Management and Budget, and the Monroe County Board of Governors of Fire and Ambulance District 1. Contract Termination: This Agreement may be terminated for any reason by either party on thirty (30) day written notice without cause. If the Contractor fails to fulfill the terms of this Agreement, or attachments, properly or on time, or otherwise violates the provisions of the Agreement or of applicable laws or regulations governing the use of funds, the County may terminate the Contract by written notice. The notice shall specify cause. All finished or unfinished supplies or services shall, at the option of the County, become property of the County. The County shall pay the Contractor fair and equitable compensation for expenses incurred prior to termination of the Agreement, less any amount or damages caused by the Contractor's breach. If the damages are more than compensation payable, the Contractor will remain liable after termination and the County shall pursue collection for damages. 4. Subject Matter of Contract: This Agreement is for all fire rescue vehicles described in `Attachment A' to receive: - Level I Preventative Maintenance / Semi - Annual - Level II Preventative Maintenance / Annual - Pump Tests / Annually - Unscheduled maintenance and repair resulting from equipment failure or malfunction 5. Hourly Rate: The hourly rate shall be $ 95.00 per man -hour with no travel time or mileage charge. Level I (Semi- Annual) and Level lI (Annual) Preventative Maintenance, and Pump Tests (Annually) are at quoted flat rates and excluded from hourly rate. 6. Overtime and Holidays: The overtime and holiday rate shall be one and one half times the hourly rate of $ 142.50 (as outlined in Section 5) per man -hour for emergency repairs called outside normal business hours and federal holidays. Inspections: During the year, Contractor shall perform twice per year on all vehicles described in `Attachment A': Semi - Annual Level I Preventative Maintenance Service Annual Level II Preventative Maintenance Service. The number of vehicles on `Attachment A' may fluctuate from time to time due to new purchases or removal of vehicles from inventory. The inspections shall be performed at the respective fire stations. Semi - Annual Level I Preventative Maintenance Service: 250 hours or 6 months (whichever comes first) Full vehicle inspection (to include at a minimum) outlined as follows: - Engine oil and filter change - Fuel filter change (every 6 months) - Air filter inspection and replacement if necessary - Chassis lubrication - Outboard (forward) impeller shaft lubrication - Lubrication of all valve control linkages - Clean or replace air compressor strainer - Clean engine crankcase breather - Inspection of generator and service of lubricant system, full system, and air filter according to its individual hours of operation (not to exceed 6 months) - Cooling system, including fan belts, radiator supports, hoses and clamps, and auxiliary cooler - Exhaust system, including hanger, clamps, muffler, and pipes - Exhaust regeneration system - Diesel exhaust fluid (D.E.F.) - Clutch, including free play, linkage, and fluid levels - Manual transmission, including seals, linkage, and lube level - Automatic transmission, including fluid level, seals, modulator adjustment, and linkage - Drive train, including u joints, center support, and companion flanges - Rear axle and springs, including oil links, spring hangers, center bolts, and u -bolts - Front end, including steering box, linkage, kingpins and bushings, spring hangers, and U -bolts - Mechanical brakes, including adjustment and fluid levels - Air brakes, including drain, adjustment, wear, and air leaks - Tires, including condition, wear, tread depth, year of tire and replacement recommendations - Electrical system, including running lights, emergency lights, battery cables, turn lights, 4 -way flasher, headlights, stop lights, hazards and switches - Fuel system, including hoses and fittings, filters and brackets, and tank straps - Booster tank, including leaks and supports - Prime pump, including electrical wires, coupling, switch, and valve discharge - Plumbing and gates, including leaks, brackets, bleed valves, control arms and knobs, and linkage - Main pump, including vacuum test, pressure test, packing, clappers, and mounting - Pump transmission, including fluid levels, seals, shift motors, and manual override - Aerial ladder, including power takeoff, drive shaft and coupling, p.t.o. activating device outrigger controls, auxiliary power control and - Aerial operation, including engine rpm., hydraulic pressure, operation of all controls, warning devices, hoses and fittings, rung covers, ladder locks, and ring gear - Aerial platform, including lubrication, platform leveling, electrical system, turntable and platform controls, communications, and water tube. Annual Level II Preventative Maintenance: 1000 hours or one year (whichever comes first) Full vehicle inspection performed in Level I, plus at a minimum - Replacement of coolant hoses, filter and coolant as needed - Replacement of all drive belts as needed - Replacement of pump transmission oil and filter - Replacement of engine transmission fluid and filter - Replacement of rear axle lube oil as needed - Inspection of front wheel bearing - Replacement and repacking as needed - Inspection and cleaning of relief valve strainer - Replacement of secondary fuel filters on both engine and generator - Inspection of front wheel bearing The above Level I and Level II inspections shall include, at no additional labor charge, the changing of all applicable filters and fluids used by the unit being inspected. Filters and fluids shall be billed at cost plus 25 %, as described in section 10 of this Agreement. Preventative Maintenance Inspections incorporating Level I (semi- annual) and Level II (annual) shall be conducted at such intervals as are approved by Monroe County Fire Rescue. Upon completion of inspection a computerized report will be forwarded to the logistics support services indicating the status of the items inspected. This will be done for every vehicle when Level I (semi - annual) and Level II (annual) Preventative Maintenance is performed on the vehicle. This report must be emailed to the logistics support services office. The form must either be in Microsoft Word or Excel. 8. Rates: Contractor shall charge Level I (semi- annual) and Level II (annual) Preventative Maintenance Service at flat -rate annual total cost of- RESCUE-TYPE VEHICLES (Without Pump) $ 225.00 PUMPERS $ 300.00 AERIALS $ 425.00 TANKERS $ 300.00 SQUADS $ 300.00 9. Pump Test Rate: Contractor shall perform an annual pump test at a flat rate cost of: PUMP TEST RATE (All vehicles requiring such test) $ 300.00 In order to facilitate the passing of the pump test, minor repairs and adjustments shall be made as needed; price includes clean -up after salt water use. The Contractor shall provide documentation of performance to Monroe County Fire Rescue. The documentation must be in the form of an electronic version report that is emailed to the logistics support services office within ten (10) days of completion of the test. The form must either be in Microsoft Word or Excel. 10. Parts, Fluids and Lubricants Rate: Contractor shall supply all parts, fluids, and lubricants used for maintaining and repairing vehicles to Monroe County Fire Rescue at: Cost + 25 % For any individual parts, or if total of all parts for an individual repair, is $400.00 or over, a copy of original parts supplier invoices shall be attached to the bill. Contractor will be required to keep all original parts supplier invoices available at request by Monroe County Fire Rescue for spot checking and auditing purposes. 11. Engine Oil and Filter Change: Complete drive train lubrication and any other fluids and/or filter changes, shall be performed as recommended by the manufacturer. 12. Weekly Maintenance Schedule: Contractor shall also provide to Monroe County Fire Rescue a Weekly Preventative Maintenance Schedule which can be performed by the individual fire stations' personnel. The Contractor shall provide in- service training to the Lieutenants on all three (3) shifts at all of the stations at no extra cost This will be scheduled by the Contractor with the on -duty Lieutenants and can be done during Level I and Level II Preventative Maintenance visits. 13. Maintenance Log: Contractor shall maintain an inspection and maintenance chart on each vehicle containing at least the following information: - Date of Performance - Apparatus Serviced - Service Performed - Parts Used - Name of Service Person(s) - Total Downtime of Vehicle 14. Maintenance Chart: A copy of chart outlined above shall be supplied to the fire rescue office within ten (10) days of the service. 15. Response Email: Contractor shall respond to all original emergency field repair forms by emailing the original document to the logistics support services office with documentation of repairs made, parts used and any other miscellaneous information that is applicable. 16. Communication Device: Contractor shall maintain a telephone, cell phone, email or paging device such that prompt notification of request for service is possible twenty -four (24) hours a day. 17. Response Time to Service Request: Contractor shall maintain a state of readiness during normal working hours defined as 8:00 am — 5:00 pm Monday thru Friday, and shall acknowledge and respond within two (2) hours to Monroe County Fire Rescue's initial notification during normal working hours; Contractor then has twelve (12) regular working hours to either make repairs, or respond to Monroe County Fire Rescue with a Repair Plan; Response(s) can be by phone or email. Contractor shall be available 24 -hours a day per Item 16 of Contract; Contractor shall acknowledge and respond within four (4) hours to the Monroe County Fire Rescue's initial notification outside of normal working hours; Contractor then has thirty -six (36) hours to either make repairs, or respond to Monroe County Fire Rescue with a Repair Plan; Response(s) can be by phone or email. 18. Staffing: Contractor shall maintain adequate staff to ensure compliance. 19. Certification: Contractor shall provide evidence satisfactory to Monroe County Fire Rescue that its personnel who perform maintenance work are certified - EVT (Emergency Vehicle Technicians) - Pump Mechanics - General Mechanics - Repair Mechanics or personnel who are not certified, are overseen by certified personnel. 20. Qualifications of Maintenance Personnel: All personnel performing maintenance, repairs, adjustments and related work on Monroe County Fire Rescue equipment shall be a certified fire apparatus mechanic, or otherwise certified for the work to be performed. Personnel performing work who are not certified or experienced in such work shall be directly supervised (in person) by an individual with such certification. 21. Indemnification: Contractor shall indemnify and hold Monroe County harmless for all actions of Contractor's negligence as well as faulty or improper workmanship, for all work performed under this Contract, including all costs of collection, reasonable attorney fees, claim costs, and as per `Attachment G'. All property or equipment being directly maintained or repaired by Contractor shall be considered in its care, custody, and control while such work is in progress and until physical control of such property or equipment is restored to the County. 22. Location of Work: This Contract is for maintenance of fire rescue vehicles located at the following sites: - Stock Island — STATION 8 - Big Coppitt — STATION 9 - Sugarloaf— STATION 10 - Cudjoe — STATION 11 - Big Pine — STATION 13 - Crawl Key — MONROE COUNTY FIRE ACADEMY - Conch Key — STATION 17 - Layton — STATION 18 Tavernier — STATION 22 23. Insurance: During the term of this Contract, the Contractor must keep in force and effect the insurance required by `Attachment H' which is attached and incorporated into this Contract. 24. Additional Required Statements / Verifications / Affidavits: Attached hereto: Attachment C Non - Collusion Affidavit Attachment D Public Entity Crime Statement Attachment E Drug Free Workplace Form Attachment F Lobbying & Conflict of Interest Clause (Ethics Clause) Attachment G Indemnification and Hold Harmless Attachment H Insurance Requirements and Request for Waiver — Workers Comp Attachment I Local Preference Form (if applicable) 25. Payments: All payments will be made in accordance with the Florida Local Government Prompt Payment Act. All unscheduled maintenance and repair resulting from equipment failure or malfunction requiring service shall be billed by the Contractor at the applicable rates as specified in contract. The Contractor upon notification by Monroe County Fire Rescue of an equipment failure or malfunction requiring unscheduled maintenance, shall in a timely manner investigate the problem and provide to Monroe County Fire Rescue an estimate of the cost for repair and vehicle downtime. The Contractor upon receiving authorization to proceed from Monroe County Fire Rescue shall effectuate such repair; upon completion of same the Contractor shall notify Monroe County Fire Rescue of the outcome and actual cost. Monroe County Fire Rescue shall issue a separate purchase order for each occurrence of unscheduled maintenance and repair. 26. Monroe County's performance and obligation to pay under this Contract is contingent upon an annual appropriation by the Board of County Commissioners of Monroe County, Florida. 27. Venue for any litigation arising under this Contract must be in a court of competent jurisdiction in Monroe County, Florida. This Agreement is not subject to arbitration. IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first above written. By: Deputy Clerk �ILIN, BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1 OF MONROE COUNTY, FL B y: 1 Mayor / Chairman FIRE -TECH REPAIR SERVICE, INC.: Date: MONROE COUNTY ATTORNEY PROVED AS O F RM: CYNTHIA L. ALL ASSIS ANT COU�NTa 0(3 ORNEY Date Attachment A SCOPE OF WORK MONROE COUNTY FIRE RESCUE VEHICLE LIST _. L()CATI ©N . VEHICLE DE .. „.. _ _ . „„ _._ � ... Stock Island 2003 Pierce Pumper Big Coppitt .... ............. _._ ... t 1999 Southern Coach American Tanker _ _. 2007 Pierce Ladder ! Sugarloaf _ _ 1986 Chevrolet Rescue Pumpe ._.._._ ._ .. _....._..._._. _..___..___.._. _ __..___._.. T2007 Pierce Pump 2010 Ferrara Tanker Pumper Cudjoe 2007 Pierce Pumper „ .. ...... ........ B Pi ne Key _ 2005 Pierce m Pu er 1996 Dodge Brush Truck 200 Hall mark Tanker Pumper Monroe County Fire Academy 1990 E- One Pumper _ 1981 Saulsbury Tanker Pumper _ s Conch Key ......... .. .. _ _._._w _. ............. l 2005 Pierce Pumper L ayton 2010 Ferrara Pum per _ j 1994 Navist Intern ational Tan Pum per 1992 Ford E -One Air Utility Tavernier 1 1992_Saulsbury Hose Reel Truck i 1988 Spartan Rescue/Purn per 1988/20 E -O ne Aerial Plat 2001 Pierce Pumper i ! E .... ..... _......_ _ ...... . _ ........ ................ .. ............ ....__. .. _............. ....._..._.... ......._...... _ ,............. ...... ........_ .,.............. i i ....,. _._. ' i Attaclunent B Maintenance of Monroe County Fire Rescue Vehicles Respondent's Name and Mailing A 611"111 C _7� Ad dress: nife, 732 Telephone and Fax Numbers: 6 Email Address All amounts must be written AND in number fon In case of a conflict between the amount in words and the amount in numbers, the amount in words shall control. Per vehicle price and hourly rate to be inclusive of travel, mileage, etc. Regularly scheduled semi-annual inspection and maintenance as specified on all apparatus. Cost per vehicle Rescue Type Vehicle without pump Pumpers Aerials Tankers Squads Annual Pump Test $ (70 Total Cost Per Year Per Vehicle oo Cost per vehicle Unscheduled Maintenance — Service resulting from equipment malfunction or failure Hourly Rate Parts I have included: Proposal Submission Response Form Non Collusion Affidavit Public Entity Crime Statement Lobbying and Conflict of Interest Clause Form Drug Free Workplace Form tridernnification and Hold Hanuless. Local Preference Form (if applicable) (Check mark items above, as a reminder that they are included), I state that I am authorized to submit this Proposal. STATE OF ( of Respon ent) COUNTY OF k7 6 — ' 0 Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, 72.o,.4, rt P,-, who, after first being sworn by me, (name of individual signing) affixed his/her signature in the" space provided above on this day of J-1i > 20 My commission expires: [ -711 Notary Public State of Florida NOTARY PUBLIC Debra S N ailer * COMMiuion EE 182 Expfts ()4/07/2016 489 E E I Attachment C NQN- COLLUSION AFFIDAVIT iyzlf 1ez te , of the city of \1 8r tr, according to law on my oath, and under penalty of perjury, dep'o'se and that; --- 1) 1 am pt ee_ 1O/ = ___ " ory the Respondent making the 2) The prices in this solicitation 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 Respondent or with any competitor; 3) Unless otherwise required by law, the prices which have been quoted in this solicitation have not been knowingly disclosed by the Respondent and will not knowingly be disclosed by the Respondent prior to solicitation opening, directly or indirectly, to any other Respondent or to any competitor; and 4) No attempt has been made or will be made by the Respondent to induce any other person, partnership or corporation to submit, or not to submit, a solicitation for the purpose of restricting competition; and 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 said project. STATE OF Oqig6attfre of ­ RespondeZt) COUNTY OFD il ro Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, � Q �t - C , 4f, , 6- who, after first being sworn by me, (name of individual signing) dmid his/her signature in the space provided above on this day of_ _D_"' ka My commission expires: q1 - 71;6- NOTARY PUBLIC Notary Public Stat o f Fl OMB - NACP FORM #1 Debra S Naiser OF V My Commission EE 182489 EXPWOS 04/07/2016 Attachment D PUBLIC ENTITY CRIME STATEMENT I `A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a solicitation on a contract to provide any goods or services to a public entity, may not submit a solicitation on a contract with a public entity for the constriction or repair of a public building or public work, may not submit solicitations on leases of real property to public entity, may not be awarded or perform work as a bidder, supplier, subbidder, RESPONDENT or subRespondents 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 months from the date of being placed on the convicted vendor list.' By executing this form, I acknowledge that Ilmy company is in compliance with the above. STATE OF s%r�� �- �, ure of Respon t COUNTY OF aWLf — t") P c Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, n who, after first being sworn by me, (name of individual signing) affixed hislhe�ignature in the space provided above on this day of ��c j rid , 20 . — . a_ t «:, { "+ Notary public State of Florida My commission ex pires�jrG Debra S Na o E My Commission EE 182489 of Expires 0V0712016 NOTARY PUBLIC Attachment E DRUG -FREE WORKPLACE FQRINT The undersigned Respondent in accordance with Florida Statute 287.087 hereby certifies that; Date (Name df 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 busii-iess'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 cormodities or contractual services that are under solicitation a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under solicitation, 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 contendre 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 require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Makes 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. Respondent's Si;natur ONIB - MCP FORM #5 Attachment F LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETIUCS CLAUSE 7 eri that he/it has not employed, retained or otherwise had act on his; its behalf any fbrmer?�ounty officer or employee in violation of Section 2 of Ordinance No. 10 -1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10 -1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. re-11 Respondent's Si Date STATE OF —F fi COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, tC 14 �- who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of - -'J :2 NOTARY PUBLIC Notary Public Stat o f Fl Debra 6 Naiser My Commission e S' My C ommission 182489 , E , �pire . Expires 04/071201 61 RR 6 01MB - TACP FORN4 #4 Attachment G MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT AD-MINISTRATION MANUAL Indemnification and Hold Harmless for Other Respondents and subProposers The Responder covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners AND Board of Governors for District 1, its servants, agents and employees 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 consultant's fees) which arise out of, in connection with, or by reason of services provided by the Bidder or any of its subRespondents (s) in any tier, occasioned by the negligence, errors, or other wrongful act or omission of The Responder or its sub-Responder 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 Responder's failure to purchase or maintain the required insurance, the Respondent shall indemnify the County fToiii any and all increased expenses resulting from such delay. The first ten dollars ($ 10.00) of remuneration paid to the Respondent 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. / Respondent's Si Date Attachment H (.1 of 4) GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT MAINTENANCE OF MONROE COUNTY FIRE RESCUE VE111CLES BETWEEN MONROE COUNTY, FLORIDA AND Prior to the conuiiencement of work- governed by this contract, the Respondent shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Products and Completed Operations • Blanket Contractual Liability • Personal Injury Liability • Expanded Definition of Property Damage The minimum limits acceptable shall be: $500,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $250,000 per Person $500,000 per Occurrence $ 50,000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the 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 acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. Attachment H (2 of 4) VE111CLE LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT OF MONROE COUNTY FIRE RESCUEV'EIHCLES BETWEEN TMONROE COUNTY, FLORIDA AND Recognizing that the work governed by this contract requires the use of vehicles, the Respondent, prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum, liability coverage for: ® Owned, Non-Owned, and Hired Vehicles The minimum limits acceptable shall be: $100,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $50,000 per Person $300,000 per Occurrence S 25,000 Property Damage The Monroe County Board Of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. Attctchinent H (3 of 4) WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR CONTRACT MAINTENANCE ENANCE OF MONROE COUNTY FIRE RESCUE VEHICLES BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Respondent shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the Respondent 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 maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. If the Respondent has been approved by the Florida's Department of Labor, as an authorized self - insurer, the County shall recognize and honor the Respondent's status. The Respondent may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Respondent's Excess Insurance Program. If the Respondent participates in a self - insurance fund, a Certificate of Insurance will be required. In addition, the Respondent may be required to submit updated financial statements from the fund upon request froth the County. Attachtnent H (4 of 4) MONROE COUNTY, FLORIDA Request for Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Respondent: fV i C'� Contract for: Address of Respondent: Phone: Scope of Work: Reason for Waiver: Policies Waiver will apply to: Signature of Respondent: Tot . ............... 71 It (jf - 4� C9 b1A. Ven- Jzwoi�. Approved Risk Management Date County Administrator appeal: Approved: Date: Board of County Commissioners appeal; Approved: Meeting Date: NoTt Approved Not Approved: toe- Not Approved: i1irtachment I LOCAL PREFERENCE FORM Vendors claiming a local preference according to Ordinance 023.2009 must complete this form. Name of Bidder/Responder Date:. 1. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector dated at least one year prior to the notice or request for bid or solicitation? _P`ts_ (Please furnish copy. ) 2, Does the vendor have a physical business address located within Monroe County from which the vendor operates or performs business on a day to day basis that is a substantial component of the goods or services being offered to Monroe County?— V 51 List Address: `reiephone Number: B. Does the vendor/prime Respondent intend to subcontract 50% or more of the 20 ds, services or construction to local businesses meeting the criteria above as to licensing and location? ff yes, please provide: 1. Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the subRespondent dated at least one year prior to the notice or request for bid or solicitation. 2. SubRespondent Address within Monroe County from which the subRespondent operates: Tel. Number Signature and Title pMuthorized Sign ory for Bidder/Responder STATE OF k( - _2y'tL' COUNTY OF. I C r0 Print Name c), On this 7 day of 2_Q�, before me, the undersigned notary public, personally appeared - _own to me to be the person whose _name is subscribed bove or who produced ­ �_47 — p-d – as id e nti?Fication. an acknowe ge t at Cietshe is the person who executed the above Local Preference Form for the purposes therein contained. Notary Public AV P_U& Notary Publ State of Florida Print Name My commission expires; Y_/7 kf Debra S Naiser My Commission EE 182469 av'j Expires 04/07/2018 .Seal