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03/19/2014 AgreementAMY REAVILIN, CPA CLERK OF CIRCUIT COURT &COMPTROLLER MONROECOUNIY,FLORIDA DATE: April 28, 2014 TO: David Hill, Director Project Management ATTN: Ann Riger FROM. • Vitia Fernandez, D. At the March 19, 2014, Board of County Commissioner's meeting the Board granted approval and execution of Item C9 Board granted approval to advertise for Bids to demolish the existing Road Department office trailer located at the Public Works Complex, 3583 S. Roosevelt Blvd., Key West, and replace it with a new modular office including new foundation, stairs, and deck. Enclosed is a duplicate original of the above - mentioned for your handling. Should you have any questions, please feel free to contact our office. cc: County Attorney Financ File V 500 Whitehead Street Suite 101, PO Box 1980, Key West, FL 33040 Phone: 305 -295 -3130 Fax: 305 - 195 -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 Monroe County Art in Public Places Award Agreement This AGREEMENT dated the 19 day of March, 2014, is entered into by and between the BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY, hereinafter "County ", and MAUREEN MELVILLE, hereinafter "Artist ", WHEREAS, the Art in Public Places Ordinance #022 -2001, codified at MCC §2- 322(A), provides for an appropriation of 1% of the construction costs for new construction exceeding $500,000 and renovations exceeding $100,000; and WHEREAS, the Ordinance established an Arts in Public Places (AIPP) Committee to advise the County Commission regarding art to be acquired and installed in each public construction project subject to the AIPP allocation; and WHEREAS, the AIPP Committee has selected and recommended to the BOCC one or more artists for this project; and WHEREAS, the Board of County Commissioners of Monroe County have determined that it is in the interest of the promoting the understanding and awareness of the visual arts to contract for the creation and installation of artwork at the Conch Key Fire Station; NOW, THEREFORE, in consideration of the mutual covenants and payments contained herein, the parties have entered into this agreement on the terms and conditions as set forth below. 1. AGREEMENT PERIOD: This agreement is for a period of ninety (90) days after notice to proceed to execute and complete their work. This agreement shall remain in effect for the stated period unless one party gives to the other written notification of termination pursuant to and in compliance with paragraphs 7, 12, and 13 below. All work for which AIPP funds are to be expended must be completed by the stated termination date. 2. SCOPE OF AGREEMENT: The Artist shall provide Three stained glass windows depicting a commercial fishing vessel, pelicans and lobster traps. The stained glass shall be installed on the upper window area 12 ft. x Oft. Artist shall confer with and coordinate activities with the Deputy Chief, Gary Boswell on the job in order to insure that there is as much cooperation and cohesiveness in the incorporation of the art into the building so that there shall be the least amount of interference between the Artist and the Fire Rescue Personnel. Art in Public Places — Conch Key Fire Station 3. AMOUNT OF AGREEMENT AND PAYMENT: The County shall provide an amount not to exceed $14,000.00 for materials and services used to create and install the project. The Board of County Commissioners assumes no liability to fund this agreement for an amount in excess of this award. Monroe County's performance and obligation to pay under this agreement is contingent upon an annual appropriation by the BOCC. Pursuant to Florida's Prompt Payment Act, upon receipt by County of an Invoice for each of three (3) phases, and documentation to satisfy the Clerk that the appropriate phase has been completed, payment shall be made for the following phases at the referenced rates: 1) Design Phase: 33.3% of total payment; 2) Materials: 33.3% of total when artist submits receipts for materials and eligible costs equal to or greater than 33.3% of the contract total. Travel expenses are included in this phase and shall be paid in accordance to Florida State Statute 112.061, or as described in 2) a below: 2) a Travel: All travel expenses shall be reported on a State of Florida Voucher for Reimbursement of Travel Expenses. If Artist has airfare, the original boarding pass, or equivalent, must be attached to the Voucher. If Artist is in vehicle, mileage must be reported on the Voucher. Mileage is reimbursable at .445 cents per mile. Meals are to be reported as follows: Breakfast — when travel begins before 6 a.m. and extends beyond 8 a.m. for $6.00; Lunch — when travel begins before 12 noon and extends beyond 2 p.m. for $11.00; and Dinner — when travel begins before 6 p.m. and extends beyond 8 p.m. for $19.00. A State of Florida Voucher for Reimbursement of Travel Expenses is attached and made part of this contract. 3) Completion: 33.3% final payment due when installation is deemed complete and contractual agreement specifications are verified by the Monroe County Project Management Department or designee. Eligible costs and expenditures for the project and the total award include, but are not limited to: A. Artist's design fee B. Labor, materials, contracted services required for production and installation C. Artist's operating expenses related to the project D. Travel related to this project, pursuant to statutory limitations (see above paragraph 3, item 2) a.) E. Transportation of the work to the site (see above paragraph 3, item 2) a.) F. Installation to the site G. Permits and fees necessary for the installation (applicable for exterior projects which also require HARC review) H. Legal costs directly related to the project I. Liability costs of artist 2 Art in Public Places — Conch Key Fire Station Payment shall be made upon presentation of an original invoice and documentation necessary to support the completion of the work. Artist shall also provide a release of lien if applicable. Final payment request must be submitted no later than 60 days after the completion of the project. 4. OWNERSHIP and RIGHTS: Upon the installation of the artwork, County shall own the artwork and all rights related thereto fully and completely. RECORDS: The Artist shall keep such records as are necessary to document the performance of the agreement and give access to these records at the request of the County, the State of Florida, or authorized agent and representative of said government bodies. The Artist understands that it shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General for the State of Florida, the Clerk of Court for Monroe County, the Board of County Commissioners for Monroe County, or their agents and representatives. 6. MODIFICATIONS AND AMENDMENTS: Any and all modifications of the terms of this agreement shall be only amended in writing and approved the Board of County Commissioners for Monroe County. 7. INDEPENDENT CONTRACTOR: At all times and for all purposes hereunder, the Artist is an independent contractor and not an employee of the Board of County Commissioners of Monroe County. No statement contained in this agreement shall be construed as to find the Artist or any of its employees, contractors, servants or agents to the employees of the Board of County Commissioners of Monroe County, and they shall be entitled to none of the rights, privileges or benefits of employees of Monroe County. 8. COMPLIANCE WITH LAW: In carrying out its obligations under this agreement, the Artist shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provisions of this agreement, including those now in effect and hereafter adopted. Any violation of said statutes, ordinances, rules or regulations shall constitute a material breach of this agreement and shall entitle the County to terminate this agreement immediately upon delivery of written notice of termination to the Artist. 9. HOLD HARMLESS /INDEMNIFICATION: The Artist hereby agrees to indemnify and hold harmless the BOCC Florida Keys Council of the Arts, AIPP Committee and Monroe County and any of their officers and employees from and against any and all claims, liabilities, litigation, causes of action, damages, costs, expenses (including but not limited to fees and expenses arising from any factual investigation, discovery or preparation for litigation), and the payment of any and all of the foregoing or any demands, settlements or judgments arising directly or indirectly under this agreement. The Artist shall immediately give notice to the 3 Art in Public Places — Conch Key Fire Station County of any suit, claim or action made against the County that is related to the activity under this agreement, and will cooperate with the County in the investigation arising as a result of any suit, action or claim related to this agreement. 10. ANTI - DISCRIMINATION: The Artist agrees that they will not discriminate against any of their employees or applicants for employment or against persons for any benefit or service because of their race, color, religion, sex, national origin, or physical or mental handicap where the handicap does not affect the ability of an individual to perform in a position of employment, and to abide by all federal and state laws regarding non - discrimination. 11. ANTI - KICKBACK: The Artist warrants that no person has been employed or retained to solicit or secure this agreement upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, and that no employee or officer of the County has any interest, financially or otherwise, in the said funded project, except for general membership. For breach or violation of this warranty, the County shall have the right to annul this agreement without liability or, in its discretion, to deduct from the agreement price or consideration, the full amount of such commission, percentage, brokerage or contingent fee. 12. TERMINATION: This agreement shall terminate pursuant to Paragraph #l. Termination prior thereto shall occur whenever funds cannot be obtained or cannot be continued at a level sufficient to allow for the continuation of this agreement pursuant to the terms herein. In the event that funds cannot be continued at a level sufficient to allow the continuation of this agreement pursuant to the terms specified herein, this agreement may then be terminated immediately by written notice of termination delivered in person or by mail to Artist. The County may terminate this agreement without cause upon giving 90 days written notice of termination to Artist. The County shall not be obligated to pay for any services or goods provided by Artist after Artist has received written notice of termination. 13. TERMINATION FOR BREACH: The County may immediately terminate this agreement for any breach of the terms contained herein. Such termination shall take place immediately upon receipt of written notice of said termination. Any waiver of any breach of covenants herein contained to be kept and performed by Artist shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the County from declaring a forfeiture for any succeeding breach either of the same conditions or of any other conditions. 14. ENTIRE AGREEMENT: This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the County and the Artist. 4 Art in Public Places — Conch Key Fire Station 15. CONSENT TO JURISDICTION: This agreement, its performance, and all disputes arising hereunder, shall be governed by the laws of the State of Florida, and both parties agree that the proper venue for any actions shall be in Monroe County. 16. ETHICS CLAUSE: Artist warrants that he has not employed, retained or otherwise had act on his behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10 -1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10 -1990. For breach or violation of 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. 17. PUBLIC ENTITY CRIME STATEMENT: A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on an agreement to provide any goods or services to a public entity, may not submit a bid on an agreement with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, sub - contractor, or consultant under an agreement with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. Artist represents that Artist is not on the Convicted Vendor list. 18. AUTHORITY: Artist warrants that it is authorized by law to engage in the performance of the activities encompassed by the project herein described. Each of the signatories for the Artist below are authorized to contract Artist's services. 19. LICENSING AND PERMITS: Artist warrants that he or she shall have, prior to commencement of work under this agreement and at all times during said work, all required licenses and permits whether federal, state, County or City. 20. INSURANCE: Artist agrees that it maintains in force at its own expense a liability insurance policy which will insure and indemnify the Artist and the County from any suits, claims or actions brought by any person or persons and from all costs and expenses occurring during the agreement or thereafter that results from performance by Artist of the obligations set forth in this agreement. At all times during the term of the agreement and for one year after acceptance of the project, unless the requirement is waived by the Monroe County Risk Manager, Artist shall maintain on file with the County a certificate of the insurance of the carriers showing that the aforesaid insurance policy is in renewal, material change or reduction'in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. 5 Art in Public Places — Conch Key Fire Station Acceptance and/or approval of Artist's insurance shall not be construed as relieving Artist from any liability or obligation assumed under this contract or imposed by law. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Inured" on all policies except worker's compensation. 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. The following coverages shall be provided prior to commencement of work governed by this contract: I . Workers Compensation if, and as required by Florida Statutes 2. 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: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 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. 21, NOTICE: Any written notice to be given to either party under his agreement or related hereto shall be addressed and delivered as follows: For Artist For Count: Maureen Melville Florida Keys Council of the Arts 1909 Massachusetts Avenue 1100 Simonton Street 6 Art in Public Places — Conch Key Fire Station McLean, Virginia 22101 Key West, FL 33040 and County Attorney P.O. Box 1026 Key West, FL 33041 -1026 22. PUBLIC RECORDS: The Artist agrees to comply with all requirements of Chapter 119 of the Florida Statutes and specifically: (a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the service. (b) Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. (d) Meet all requirements for retaining public records and transfer, at no cost, to the public agency all public records in possession of the artist upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. Remainder of this page left intentionally blank. Signature page to follow as page 8. 7 Art in Public Places — Conch Key Fire Station IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed the and year first above written. BOARD OF COUNTY COMMISSIONERS AMY HEAVILIN, CPA, CLE K OF MONROE COUNTY, FLORIDA By: Deputy Clerk Ma or /Chairman W SSES: ARTIST: MAUREEN ELVILLE STATE OF COUNTY OF On this day of M G(O , 208 ]4, before me, the undersigned notary public, personally appeared ft nl known to me to be the person whose name is subscribed above or who produced N Pt DL as identification, and acknowledged that he /she is the person who executed the above contract with Monroe County for the artwork at the CONCH KEY FIRE STATION # 17 for the purposes therein contained. Notary Public -&�'j Name My Commission Expires (3q I to1gor) CD M G: ...+ t3 u >" CC C) coo O N —J c C DESIREE MARIA TROCHE Notary Public Commonwealth of Virginia 7556859 My Commission Expires Sep 30, 2017 MONROE COLINTY ATTORNEY AP ROVED AS TO F 7V � � � NATILEENE W CASSEL ASSISTANT COUNTY ATTORNEY Date Art in Public Places — Conch Key Fire Station .... # , •„• ir-11114, • D W • 0 ''N. 1111,AhrOlf , 1111 0 0 a , iiir ..44 . ,.,„,...: , :,,,:,•,., ,,, ..441,1/4 ) .., ,. . IS , a ID iiia Maureen Melville Conch Key Fire Station Public Art PROPOSAL I am an architectural glass artist. I have made many stained glass windows and fused glass murals for public art projects. My proposal is for stained glass windows for site 1, the upper windows of the fire station. I have attempted to design windows that reflect the location and character of Conch Key. The left hand window depicts a commercial fishing vessel and a tuna, the center window two pelicans with a suggestion of water behind them and the third window a lobster trap and lobster with a few small fish. Since the windows will be very visible to the passing traffic I chose to make them very graphic and readable from a distance. This is why they each have a different color background and why the images are very large and simple. It is also why the color is so bold. I would describe my work as a colorful, joyous mix of the abstract and the recognizable. It's very difficult to depict stained glass in a rendering since it's impossible to show the transparency of the glass. These windows would have strong color but also be able to be seen through. Changing weather, passing birds, time of day and year will all affect the look of the windows. Stained glass would be very vibrant in this location during the day and lit up on the exterior of the building at night and thus highly visible to the passing traffic. I would make these windows with handmade colored glass from Germany that would be painted with black glass paint. I also acid etch or sandblast the glass for additional detail. It requires no maintenance aside from an occasional cleaning. The color is in the glass and all paint is fired on in the kiln and permanent. The stained glass would be laminated to pieces of plate glass with optically clear, non - yellowing RTV silicone that expands and contracts with extreme temperatures. This is a much more modern look than traditional stained glass. The stained glass is installed inside the building against the exterior windows so it is not exposed to the weather. I have had experience working with many different committees and communities. Some projects required ongoing communication and adjustments to the design and other commissions went from design approval to installation without any changes. I have worked successfully with both groups. All my projects have been completed on time and on budget and I fabricate all my own work. This is a great location for stained glass and I believe it would be beautiful both in the interior of the fire station and for the passing traffic. I hope you will give me this opportunity to work in Conch Key. LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010 -1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE (may) "... warrants that hdit has not employed, retained or odierwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 010 -1990 or. any County officer or employee in violation of Section 3 of Ordinance No. 010 -1990. For breach or violation of this provision the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gib, or coasideratioa paid to fire County officer or employee'. r . ( `mature / Daito: A Z { ( 3 STATE OF: COUNTY OF: Subscribed and sworn to (or affitnued) before me on .1 v . .,42 c 2 (date) by Hiud et, AN e ( 4 11 L C - 1/ _ j�e of �). He/She is personally known to me or has produced A L� r ens f) 0 as identification. (type of identification) F1IREEEM ,IIW IIKtilW Notary Pukk CORM M I M* of 1 OWN 7514117 My comm%%ion Exp1me Sep 3!. 2015 i OTARY My commission expires: / 3 0 ZGl b NON - COLLUSION AFFIDAVIT M mg jxit.l of the city of A 1 ' and sa t: Wording to law on my oath, and under penalty of P�1mY Y that 1. I am t' t,�F' k � fi , LLX _ of the firm of ! rWA k fiw ! the bidder making the Proposal for the project described in the Request for thjallfications for: 1?22M( AWr C& QQh1QH and that I executed the said proposal with W authority to do so: 2. the prices in this bid have been arrived at independently witbout collusion, consultation, commwication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor; 3. unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or indirectly, to any other bidder or to any competitor, and 4, no attempt has boar made or will be trade by the bidder to induce any other person, pip or txsrporation_ to submit, or not .ta submit, a bid for the purpose of restricting competition; 5. the statements coaWned iii this affidavit are'true:and correct, and made with full knowledge that Monroe County relies upon the truth of the statements contain -A . this affidavit in for said project. // t � (Signature of ) (Date) STATE OF: _ U (� /cS) it t • i Mal M PERSONALLY AppEARED BEFORE ME, the undersigned authority, Malv: ( _ who, after first tieing sworn by me, (name of individual signing) affixed his/her signature in the space provided above o n 2- day of Deze'`1 Lu FAREE0A JAN AKRAM Notary Pmbk CommoewuMh of N"We 751"17 My Commistton Ex OM . 2016 4TARY P IC MY .Expires. DRAG FREE WORKPLACE FORM The undersigned vendor In accordance with Florida Statute 287.087 hereby oertifies that Of J. Publish a statement notifying employees that the unlawful manufacture, distribution, dispeasing,..possession, or use of a controlled substanoe je prohibited in t e ce . and specifying the actions that be taken agairwt employees for prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon empbyaes for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are wider bid a copy of the sh", ent specified in subsection (1). 4. in the statement specified in subsection (1), notify f the employees that, as a oondltion of working on the commo or oontrach* services that are under bid, the employee YAP abide by the terns of the statement and will notify the smpioyw of any conviction of, or pies of guilty or nob contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United Stetas or any state,. for a violation occurring In the workplace no later than tive (5) days alter such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse aesistanoe or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug*ee workplace through i n of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. 4 ,, . "A person or affiliate who has been placed on the convicted vendor list following a conviction f public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids 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 is Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." I have rea and acknowl the Public Entity Crime Stat rent Signat me Date: MAURE -2 OP ID: KH ACO ,RQ " CERTIFICATE OF LIABILITY INSURANCE 704110712014 E (MMIDDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endors PRODUCER Long 8r Foster Insurance Agency 14501 George Carter W Chantilly, VA 20151 Kelsi Pophin NAME CT Kelsi Po hln PHONE FAX (4 1C. No Ell: 703 - 877 - 7600 A /c No) 703 263 - 1704 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Hartford 11000 ❑ PRO- ❑ POLICY JECT LOC INSURED Maureen Melville 1909 Massachusetts Av McLean, VA 22101 INSURER B : 'f7Cl(i$?e�S 7,, ls- Qmen? INSURER C $ AUTOMOBILE LIABILITY INSURER D : INSURER E C E OMBINED SINGLE LIMIT a accident INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUB LTR POLICY NUMBER MM/DD EFF MM/DD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE 0 OCCUR X 42SBARU7337 03/26/2014 03/26/2015 G O R N 1 000 00 $ PREMISES a occurrence r X Business Owners MED EXP (Any one person) $ 10,00 PERSONAL 8 ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 ❑ PRO- ❑ POLICY JECT LOC Mon cOU11fti PRODUCTS - COMP /OP AGG $ 2,000,00 'f7Cl(i$?e�S 7,, ls- Qmen? OTHER: $ AUTOMOBILE LIABILITY C E OMBINED SINGLE LIMIT a accident $ n ( ANY AUTO - ° BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS PROPERTY DAMAGE $ NO OWNED HIRED AUTOS AUTOS rri'����lf;��•.�� eraccident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- STATUTE I I ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ NIA E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Monroe County Board of Commissioners is listed as additional insured per form SS 00 08 04 05. APPR < 7 T R ��� ' � u � / DA WAIV R LEM CERTIFICATE HOLDER CANCELLATION ACORD 26 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of Commissioners AUTHORIZED REPRESENTATIVE 1100 Simonton St. Key West, FL 33040 ACORD 26 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT Coverage and Premium accordance with the federal Terrorism Risk Insurance Act (as amended "TRIA "), we are required to make coverage available der your policy for "certified acts of terrorism." The actual coverage provided by your policy(ies) will be limited by the terms, nditions, exclusions, limits, and other provisions of your policy(ies), as well as any applicable rules of law. portion of your premium attributable to this terrorism coverage is shown in the premium section(s) of this quote proposal or of Certified Act of Terrorism A "certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism under TRIA. The criteria contained in TRIA for a "certified act of terrorism" include the following: I . The act results in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to TRIA; and 2. The act results in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of an United States mission; and 3. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals acting as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. of Federal Share of Terrorism Losses to United States Department of the Treasury will reimburse insurers for 85% of that portion of insured losses attributable to rtified acts of terrorism that exceeds the applicable insurer deductible. However, if aggregate industry insured losses under TRIA ceed $100 Billion in a Program Year (January 1 through December 31), the Treasury shall not make any payment for any portion the amount of such losses that exceeds $100 billion. The United States government has not charged any premium for their rticipation in covering terrorism losses. ip on Insurer Liability for Terrorism Losses aggregate industry insured losses attributable to "certified acts of terrorism" under TRIA exceed $100 Billion in a Program Year rnuary 1 through December 31), and we have met, or will meet, our insurer deductible under TRIA, we shall not be liable for the yment of any portion of the amount of such losses that exceed $100 billion. In such case, your coverage for terrorism losses may reduced on a pro-rata basis in accordance with procedures established by the Treasury, based on its estimates of aggregate 3ustry losses and our estimate that we will exceed our insurer deductible. In accordance with the Treasury's procedures, amounts id for losses may be subject to further adjustments based on differences between actual losses and estimates. )te to Producer on TRIA: The premium for terrorism coverage and the TRIA disclosures above must be provided to the insured prospect at the time of quoting. If you are not using this quote proposal, you can use Hartford's stand -alone TRIA disclosure rm for quotes and binders, which is available on EBC or from the company. Acknowled d and Accepted By (Signature of e Insu d) (Date Reference Number: 42SBA7864LC - 002 Total Estimated Annual Premium for Spectrum: $500