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#1st Amendment 02/15/2017KEVIN MADOK, CPA MONROE COUNTY CLERK OF THE CIRCUIT COURT & COMPTROLLER DATE: February 27, 2017 TO: Beth Leto Airport Business Manager FROM: Pamela G. HancoC. SUBJECT: February 15th BOCC Meeting Enclosed is a duplicate original Item C3, First Amendment to Agreement with OAC Action Construction Corp., to add grant condition compliance language to the original agreement for die Key West Airport Customs Facility Phase II project, for your handling. Should you have any questions, please feel free to contact me at ext. 3130. Thank you. cc: County Attorney Finance File I FIRST AMENDMENT TO AGREEMENT BETWEEN MONROE COUNTY AND OAC ACTION CONSTRUCTION, CORP. KEY WEST AIRPORT CUSTOMS FACILITY PHASE II THIS FIRST AMENDMENT to the Agreement is made this 15th day of February, 2017 by and between Monroe County, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West Florida 33040, hereafter "County ", and OAC Action Construction Corp., a Florida Corporation whose address is 12540 SW 130` Street, suite 2 -3, Miami Florida 33186 hereafter "OAC" or "Contractor ". WITNESSETH WHEREAS, on the 9th day of December 2015, the County entered in to a Key West Airport Customs Facility Phase II Construction Agreement (hereafter Original Agreement); and, WHEREAS, the Federal Aviation Administration ( "FAA ") and the Florida Department of Transportation ( "FDOT "') have both provided grant funds for the project; and, WHEREAS, the grant awards contain grant conditions which must be satisfied; and WHEREAS, the parties are entering into this First Amendment to the Agreement to address such grant condition compliance responsibilities; NOW, THEREFORE, in consideration of the mutual promises and covenants set forth below, the parties agree to amend the Agreement as follows: Section 1. Federal Contracting Requirements. Section 00110 of the contract document is amended to include the following subsection; FEDERAL CONTRACTING REQUIREMENTS Provision Dollar Threshold Construction a. Access to Records and Reports $ 0 REQD b. Buy American Preferences $ 0 READ (1) Buy American Statement $ 0 READ (2) Buy American — Total Facility $ 0 REQD (3) Buy American —Manufactured $ 0 REQD Product c. Civil Rights— General $ 0 REQD d. Civil Rights - Title VI Assurances $ 0 REQD (1) Clause - Contracts $ 0 REQD (2) List — Pertinent Authorities $0 REQD Provision Dollar Threshold Construction e. Energy Conservation Requirements $ 0 REQD f. Federal Fair Labor Standards Act $ 0 READ g. Occupational Safety and Health Act $ 0 READ h. Rights to Inventions $ 0 Limited i. Trade Restriction Certification $ 0 REQD j. Veteran's Preference $ 0 READ k. Copeland Anti - Kickback $ 2,000 READ I. Davis Bacon Requirements $ 2,000 READ m. Distracted Driving $3,500 REQD n. Affirmative Action Requirement $10,000 REQD o. Equal Employment Opportunity $10,000 READ (1) EEO Contract Clause $10,000 REQD (2) EEO Specification $10,000 REQD p. Recovered Materials $10,000 READ q. Contract Work Hours and Safety Standards $100,000 REQD r. Clean Air /Water Pollution Control $150,000 READ a. ACCESS TO RECORDS AND REPORTS 2 CFR § 200.333 2 CFR § 200.336 FAA Order 5100.38 The Contractor must maintain an acceptable cost accounting system. The Contractor agrees to provide the sponsor, the Federal Aviation Administration, and the Comptroller General of the United States or any of their duly authorized representatives, access to any books, documents, papers, and records of the Contractor which are directly pertinent to the specific contract for the purpose of making audit, examination, excerpts and transcriptions. The Contractor agrees to maintain all books, records and reports required under this contract for a period of not less than three years after final payment is made and all pending matters are closed. b. BUY AMERICAN PREFERENCE Title 49 USC § 50101 The Contractor agrees to comply with 49 USC § 50101, which provides that Federal funds may not be obligated unless all steel and manufactured goods used in AIP funded projects are produced in the United States, unless the FAA has issued a waiver for the product; the product is listed as an Excepted Article, Material Or Supply in Federal Acquisition Regulation subpart 25.108; or is included in the FAA Nationwide Buy American Waivers Issued list. CERTIFICATE OF BUY AMERICAN COMPLIANCE FOR TOTAL FACILITY The Contractor must indicate how they intend to comply with 49 USC § 50101 by selecting one of the following certification statements. These statements are mutually exclusive. Contractor must select one or the other (i.e. not both) by inserting a checkmark ( ®$ror the 1 .. ❑ Contractor hereby certifies that it will comply with 49 USC. 50101 by: a) Only installing steel and manufactured products produced in the United States; or b) Installing manufactured products for which the FAA has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing; or C) Installing products listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation Subpart 25.108. By selecting this certification statement, the Contractor agrees: 1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product. 2. To faithfully comply with providing US domestic products. 3. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. ❑ Contractor hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but may qualify for either a Type 3 or Type 4 waiver under 49 USC § 50101(b). By selecting this certification statement, the Contractor agrees: 1. To submit to the Owner a formal waiver request and required documentation that supports the type of waiver being requested. 2. To faithfully comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FAA. 3. To furnish US domestic product for any waiver request that the FAA rejects. 4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. Required Documentation Type 3 Waiver - The cost of components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the "facility ". The required documentation for a type 3 waiver is: a) Listing of all manufactured products that are not comprised of 100% US domestic content (Excludes products listed on the FAA Nationwide Buy American Waivers Issued listing and products excluded by Federal Acquisition Regulation Subpart 25.108; products of unknown origin must be considered as non - domestic products in their entirety) b) Cost of non - domestic components and subcomponents, excluding labor costs associated with final assembly and installation at project location. C) Percentage of non - domestic component and subcomponent cost as compared to total "facility" component and subcomponent costs, excluding labor costs associated with final assembly and installation at project location. Type 4 Waiver — Total cost of project using US domestic source product exceeds the total project cost using non - domestic product by 25 %. The required documentation for a type 4 of waiver is: a) Detailed cost information for total project using US domestic product b) Detailed cost information for total project using non - domestic product False Statements: Per 49 USC § 47126, this certification concerns a matter within the jurisdiction of the Federal Aviation Administration and the making of a false, fictitious or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code. CERTIFICATE OF BUY AMERICAN COMPLIANCE FOR MANUFACTURED PRODUCTS The Contractor must indicate how they intend to comply with 49 USC § 50101 by selecting one on the following certification statements. These statements are mutually exclusive. Contractor must select one or the other (not both) by inserting a checkmark ( ET'or the letter ❑ Contractor hereby certifies that it will comply with 49 USC § 50101 by: a) Only installing steel and manufactured products produced in the United States, or; b) Installing manufactured products for which the FAA has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing, or; C) Installing products listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation Subpart 25.108. By selecting this certification statement, the Contractor agrees: 1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product. 2. To faithfully comply with providing US domestic product 3. To furnish US domestic product for any waiver request that the FAA rejects 4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. ❑ The Contractor hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but may qualify for either a Type 3 or Type 4 waiver under 49 USC § 50101(b). By selecting this certification statement, the Contractor agrees: 1. To submit to the Owner a formal waiver request and required documentation that supports the type of waiver being requested. 2. To faithfully comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FAA. 3. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. Required Documentation Type 3 Waiver - The cost of the item components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the "item ". The required documentation for a type 3 waiver is: a) Listing of all product components and subcomponents that are not comprised of 100% US domestic content (Excludes products listed on the FAA Nationwide Buy American Certificate of Buy American Compliance for Manufactured Products The Contractor must indicate how they intend to comply with 49 USC § 50101 by selecting one on the following certification statements. These statements are mutually exclusive. Contractor must select one or the other (not both) by inserting a checkmark ( ❑) or the letter ". ❑ Contractor hereby certifies that it will comply with 49 USC § 50101 by: a) Only installing steel and manufactured products produced in the United States, or; b) Installing manufactured products for which the FAA has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing, or; C) Installing products listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation Subpart 25.108. By selecting this certification statement, Contractor agrees: 1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product. 2. To faithfully comply with providing US domestic product 3. To furnish US domestic product for any waiver request that the FAA rejects 4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. ❑ The Contractor hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but may qualify for either a Type 3 or Type 4 waiver under 49 USC § 50101(b). By selecting this certification statement, the Contractor agrees: 1. To submit to the Owner a formal waiver request and required documentation that supports the type of waiver being requested. 2. To faithfully comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FAA. 3. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. Required Documentation Type 3 Waiver - The cost of the item components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the "item ". The required documentation for a type 3 waiver is: Listing of all product components and subcomponents that are not comprised of 100% US domestic content (Excludes products listed on the FAA Nationwide Buy American) c. GENERAL CIVIL RIGHTS PROVISIONS 49 USC § 47123 The Contractor agrees to comply with pertinent statutes, Executive Orders and such rules as are promulgated to ensure that no person shall, on the grounds of race, creed, color, national origin, sex, age, or disability be excluded from participating in any activity conducted with or benefiting from Federal assistance. This provision binds the Contractor and subtier contractors from the bid solicitation period through the completion of the contract. This provision is in addition to that required of Title VI of the Civil Rights Act of 1964. d. TITLE VI ASSURANCES 49 USC § 47123 FAA Order 1400.11 During the performance of this contract, the Contractor, for itself, its assignees, and successors in interest agrees as follows: 1. Compliance with Regulations: The Contractor (hereinafter includes consultants) will comply with the Title VI List of Pertinent Nondiscrimination Acts And Authorities, as they may be amended from time to time, which are herein incorporated by reference and made a part of this contract. 2. Non- discrimination: The Contractor, with regard to the work performed by it during the contract, will not discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. The Contractor will not participate directly or indirectly in the discrimination prohibited by the Nondiscrimination Acts and Authorities, including employment practices when the contract covers any activity, project, or program set forth in Appendix B of 49 CFR part 21. 3. Solicitations for Subcontracts, Including Procurements of Materials and Equipment: In all solicitations, either by competitive bidding, or negotiation made by the Contractor for work to be performed under a subcontract, including procurements of materials, or leases of equipment, each potential subcontractor or supplier will be notified by the Contractor of the Contractor's obligations under this contract and the Nondiscrimination Acts And Authorities on the grounds of race, color, or national origin. 4. Information and Reports: The Contractor will provide all information and reports required by the Acts, the Regulations, and directives issued pursuant thereto and will permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the sponsor or the Federal Aviation Administration to be pertinent to ascertain compliance with such Nondiscrimination Acts And Authorities and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to furnish the information, the contractor will so certify to the sponsor or the Federal Aviation Administration, as appropriate, and will set forth what efforts it has made to obtain the information. 5. Sanctions for Noncompliance: In the event of a Contractor's noncompliance with the Non - discrimination provisions of this contract, the sponsor will impose such contract sanctions as it or the Federal Aviation Administration may determine to be appropriate, including, but not limited to: a. Withholding payments to the Contractor under the contract until the Contractor complies; and /or b. Cancelling, terminating, or suspending a contract, in whole or in part. 6. Incorporation of Provisions: The Contractor will include the provisions of paragraphs one through six in every subcontract, including procurements of materials and leases of equipment, unless exempt by the Acts, the Regulations and directives issued pursuant thereto. The Contractor will take action with respect to any subcontract or procurement as the sponsor or the Federal Aviation Administration may direct as a means of enforcing such provisions including sanctions for noncompliance. Provided, that if the Contractor becomes involved in, or is threatened with litigation by a subcontractor, or supplier because of such direction, the Contractor may request the sponsor to enter into any litigation to protect the interests of the sponsor. In addition, the Contractor may request the United States to enter into the litigation to protect the interests of the United States. Title VI List of Pertinent Nondiscrimination Acts and Authorities During the performance of this contract, the Contractor, for itself, its assignees, and successors in interest agrees to comply with the following non - discrimination statutes and authorities; including but not limited to: • Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits discrimination on the basis of race, color, national origin); • 49 CFR part 21 (Non- discrimination In Federally- Assisted Programs of The Department of Transportation— Effectuation of Title VI of The Civil Rights Act of 1964); • The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal -aid programs and projects); • Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended, (prohibits discrimination on the basis of disability); and 49 CFR part 27; • The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), (prohibits discrimination on the basis of age); • Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as amended, (prohibits discrimination based on race, creed, color, national origin, or sex); • The Civil Rights Restoration Act of 1987, (PL 100 -209), (Broadened the scope, coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms "programs or activities" to include all of the programs or activities of the Federal -aid recipients, sub - recipients and contractors, whether such programs or activities are Federally funded or not); • Titles II and III of the Americans with Disabilities Act of 1990, which prohibit discrimination on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131 — 12189) as implemented by Department of Transportation regulations at 49 CFR parts 37 and 38; • The Federal Aviation Administration's Non - discrimination statute (49 U.S.C. § 47123) (prohibits discrimination on the basis of race, color, national origin, and sex); • Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low - Income Populations, which ensures non- discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low- income populations; • Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of limited English proficiency (LEP). To ensure compliance with Title VI, you must take reasonable steps to ensure that LEP persons have meaningful access to your programs (70 Fed. Reg. at 74087 to 74100); • Title IX of the Education Amendments of 1972, as amended, which prohibits you from discriminating because of sex in education programs or activities (20 U.S.C. 1681 et seq). e. ENERGY CONSERVATION REQUIREMENTS 2 CFR § 200, Appendix II(H) Contractor and Subcontractor agree to comply with mandatory standards and policies relating to energy efficiency as contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6201et seq). f. FEDERAL FAIR LABOR STANDARDS ACT (FEDERAL MINIMUM WAGE) 29 U.S.C. § 201, et seq All contracts and subcontracts that result from this solicitation incorporate by reference the provisions of 29 CFR part 201, the Federal Fair Labor Standards Act (FLSA), with the same force and effect as if given in full text. The FLSA sets minimum wage, overtime pay, recordkeeping, and child labor standards for full and part time workers. The Contractor has full responsibility to monitor compliance to the referenced statute or regulation. The Contractor must address any claims or disputes that arise from this requirement directly with the U.S. Department of Labor — Wage and Hour Division. g. OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 20 CFR part 1910 All contracts and subcontracts that result from this solicitation incorporate by reference the requirements of 29 CFR Part 1910 with the same force and effect as if given in full text. Contractor must provide a work environment that is free from recognized hazards that may cause death or serious physical harm to the employee. The Contractor retains full responsibility to monitor its compliance and their subcontractor's compliance with the applicable requirements of the Occupational Safety and Health Act of 1970 (20 CFR Part 1910). Contractor must address any claims or disputes that pertain to a referenced requirement directly with the U.S. Department of Labor — Occupational Safety and Health Administration. h. RIGHTS TO INVENTIONS 2 CFR § 200, Appendix II(F) 37 CFR §401 Contracts or agreements that include the performance of experimental, developmental, or research work must provide for the rights of the Federal Government and the Owner in any resulting invention as established by 37 CFR part 401, Rights to Inventions Made by Non - profit Organizations and Small Business Firms under Government Grants, Contracts, and Cooperative Agreements. This contract incorporates by reference the patent and inventions rights as specified within in the 37 CFR §401.14. Contractor must include this requirement in all sub -tier contracts involving experimental, developmental or research work. TRADE RESTRICTION CERTIFICATION 49 USC § 50104 49 CFR part 30 The Contractor certifies that with respect to this contract, the Contractor - a. is not owned or controlled by one or more citizens of a foreign country included in the list of countries that discriminate against U.S. firms as published by the Office of the United States Trade Representative (U.S.T.R.); b. has not knowingly entered into any contract or subcontract for this project with a person that is a citizen or national of a foreign country included on the list of countries that discriminate against U.S. firms as published by the U.S.T.R; and c. has not entered into any subcontract for any product to be used on the Federal on the project that is produced in a foreign country included on the list of countries that discriminate against U.S. firms published by the U.S.T.R. This certification concerns a matter within the jurisdiction of an agency of the United States of America and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code, Section 1001. The Contractor must provide immediate written notice to the Owner if the Contractor learns that its certification or that of a subcontractor was erroneous when submitted or has become erroneous by reason of changed circumstances. The Contractor must require subcontractors provide immediate written notice to the Contractor if at any time it learns that its certification was erroneous by reason of changed circumstances. Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with 49 CFR 30.17, no contract shall be awarded to a Contractor or subcontractor: (1) who is owned or controlled by one or more citizens or nationals of a foreign country included on the list of countries that discriminate against U.S. firms published by the U.S.T.R. or (2) whose subcontractors are owned or controlled by one or more citizens or nationals of a foreign country on such U.S.T.R. list or (3) who incorporates in the public works project any product of a foreign country on such U.S.T.R. list; Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by this provision. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. The Contractor agrees that it will incorporate this provision for certification without modification in in all lower tier subcontracts. The Contractor may rely on the certification of a prospective subcontractor that it is not a firm from a foreign country included on the list of countries that discriminate against U.S. firms as published by U.S.T.R, unless the Offeror has knowledge that the certification is erroneous. This certification is a material representation of fact upon which reliance was placed when making an award. If it is later determined that the Contractor or subcontractor knowingly rendered an erroneous certification, the Federal Aviation Administration may direct through the Owner cancellation of the contract or subcontract for default at no cost to the Owner or the FAA. j. VETERAN'S PREFERENCE 49 USC § 47112(c) In the employment of labor (excluding executive, administrative, and supervisory positions), the Contractor and all sub -tier contractors must give preference to covered veterans as defined within Title 49 United States Code Section 47112. Covered veterans include Vietnam - era veterans, Persian Gulf veterans, Afghanistan -Iraq war veterans, disabled veterans, and small business concerns (as defined by 15 U.S.C. 632) owned and controlled by disabled veterans. This preference only applies when there are covered veterans readily available and qualified to perform the work to which the employment relates. k. COPELAND "ANTI- KICKBACK" ACT 2 CFR § 200, Appendix II(D) 29 CFR Parts 3 &5 Contractor must comply with the requirements of the Copeland "Anti- Kickback" Act (18 U.S.C. 874 and 40 U.S.C. 3145), as supplemented by Department of Labor regulation 29 CFR part 3. Contractor and subcontractors are prohibited from inducing, by any means, any person employed on the project to give up any part of the compensation to which the employee is entitled. The Contractor and each Subcontractor must submit to the Owner, a weekly statement on the wages paid to each employee performing on covered work during the prior week. Owner must report any violations of the Act to the Federal Aviation Administration. DAVIS -BACON REQUIREMENTS 2 CFR § 200, Appendix II(D) 29 CFR Part 5 1. Minimum Wages (i) All laborers and mechanics employed or working upon the site of the work will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by the Secretary of Labor under the Copeland Act (29 CFR Part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalent thereof) due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of paragraph (1)(iv) of this section; also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in 29 CFR Part 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided, that the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional classification and wage rates conformed under (1)(ii) of this section) and the Davis -Bacon poster (WH -1321) shall be posted at all times by the Contractor and its subcontractors at the site of the work in a prominent and accessible place where it can easily be seen by the workers. (ii)(A) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (1) The work to be performed by the classification requested is not performed by a classification in the wage determination; and (2) The classification is utilized in the area by the construction industry; and (3) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination. (B) If the Contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, D.C. 20210. The Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30 -day period that additional time is necessary. (C) In the event the Contractor, the laborers or mechanics to be employed in the classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Administrator for determination. The Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30 -day period that additional time is necessary. (D) The wage rate (including fringe benefits where appropriate) determined pursuant to subparagraphs (1)(ii) (B) or (C) of this paragraph, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. (iii) Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the Contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. (iv) If the Contractor does not make payments to a trustee or other third person, the Contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, That the Secretary of Labor has found, upon the written request of the Contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the Contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. 2. Withholding. The Federal Aviation Administration or the sponsor shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld from the Contractor under this contract or any other Federal contract with the same prime Contractor, or any other Federally- assisted contract subject to Davis -Bacon prevailing wage requirements, which is held by the same prime Contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the Contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of work, all or part of the wages required by the contract, the Federal Aviation Administration may, after written notice to the Contractor, sponsor, applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. 3. Payrolls and basic records. (i) Payrolls and basic records relating thereto shall be maintained by the Contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in I (b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in section l (b)(2)(B) of the Davis -Bacon Act, the Contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual costs incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. (ii)(A) The Contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the Federal Aviation Administration if the agency is a party to the contract, but if the agency is not such a party, the Contractor will submit the payrolls to the applicant, sponsor, or owner, as the case may be, for transmission to the Federal Aviation Administration. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead the payrolls shall only need to include an individually identifying number for each employee (e.g. , the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH -347 is available for this purpose from the Wage and Hour Division Web site at http: / /www.dol.gov /esa /whd /forms /wh347instr.htm or its successor site. The prime Contractor is responsible for the submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them upon request to the Federal Aviation Administration if the agency is a party to the contract, but if the agency is not such a party, the Contractor will submit them to the applicant, sponsor, or owner, as the case may be, for transmission to the Federal Aviation Administration, the Contractor, or the Wage and Hour Division of the Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements. It is not a violation of this section for a prime Contractor to require a subcontractor to provide addresses and social security numbers to the prime Contractor for its own records, without weekly submission to the sponsoring government agency (or the applicant, sponsor, or owner). (B) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the Contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (1) That the payroll for the payroll period contains the information required to be provided under 29 CFR § 5.5(a)(3)(ii), the appropriate information is being maintained under 29 CFR § 5.5 (a)(3)(i) and that such information is correct and complete; (2) That each laborer and mechanic (including each helper, apprentice and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations 29 CFR Part 3; (3) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (C) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH -347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph (3)(ii)(B) of this section. (D) The falsification of any of the above certifications may subject the Contractor or subcontractor to civil or criminal prosecution under Section 1001 of Title 18 and Section 231 of Title 31 of the United States Code. (iii) The Contractor or subcontractor shall make the records required under paragraph (3)(i) of this section available for inspection, copying or transcription by authorized representatives of the sponsor, the Federal Aviation Administration or the Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the Contractor or subcontractor fails to submit the required records or to make them available, the Federal agency may, after written notice to the Contractor, sponsor, applicant or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. 4. Apprentices and Trainees. (i) Apprentices. Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Bureau of Apprenticeship and Training, or with a State Apprenticeship Agency recognized by the Bureau, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Bureau of Apprenticeship and Training or a State Apprenticeship Agency (where appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the Contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a Contractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the Contractor's or subcontractor's registered program shall be observed. Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Bureau of Apprenticeship and Training, or a State Apprenticeship Agency recognized by the Bureau, withdraws approval of an apprenticeship program, the Contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (ii) Trainees. Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration. The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate that is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the Contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (iii) Equal Employment Opportunity. The utilization of apprentices, trainees and journeymen under this part shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR Part 30. 5. Compliance with Copeland Act Requirements. The Contractor shall comply with the requirements of 29 CFR Part 3, which are incorporated by reference in this contract. 6. Subcontracts. The Contractor or subcontractor shall insert in any subcontracts the clauses contained in 29 CFR Part 5.5(a)(1) through (10) and such other clauses as the Federal Aviation Administration may by appropriate instructions require, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime Contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR Part 5.5. 7. Contract Termination: Debarment. A breach of the contract clauses in paragraph 1 through 10 of this section may be grounds for termination of the contract, and for debarment as a Contractor and a subcontractor as provided in 29 CFR 5.12. 8. Compliance With Davis -Bacon and Related Act Requirements. All rulings and interpretations of the Davis -Bacon and Related Acts contained in 29 CFR Parts 1, 3, and 5 are herein incorporated by reference in this contract. 9. Disputes Concerning Labor Standards. Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR Parts 5, 6 and 7. Disputes within the meaning of this clause include disputes between the Contractor (or any of its subcontractors) and the contracting agency, the U.S. Department of Labor, or the employees or their representatives. 10. Certification of Eligibility. (i) By entering into this contract, the Contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the Contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). (ii) No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). (iii) The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001. M. DISTRACTED DRIVING Executive Order 13513 DOT Order 3902.10 In accordance with Executive Order 13513, "Federal Leadership on Reducing Text Messaging While Driving" (10/1/2009) and DOT Order 3902.10 "Text Messaging While Driving" (12/30/2009), the FAA encourages recipients of Federal grant funds to adopt and enforce safety policies that decrease crashes by distracted drivers, including policies to ban text messaging while driving when performing work related to a grant or sub - grant. In support of this initiative, the Owner encourages the Contractor to promote policies and initiatives for its employees and other work personnel that decrease crashes by distracted drivers, including policies that ban text messaging while driving motor vehicles while performing work activities associated with the project. The Contractor must include the substance of this clause in all sub -tier contracts exceeding $3,500 and involve driving a motor vehicle in performance of work activities associated with the project. n. NOTICE OF REQUIREMENT FOR AFFIRMATIVE ACTION to ENSURE EQUAL EMPLOYMENT OPPORTUNITY 41 CFR part 60 -4 Executive Order 11246 1. The Contractor's attention is called to the "Equal Opportunity Clause" and the "Standard Federal Equal Employment Opportunity Construction Contract Specifications" set forth herein. 2. The goals and timetables for minority and female participation, expressed in percentage terms for the Contractor's aggregate workforce in each trade on all construction work in the covered area, are as follows: Timetables Goals for minority participation for each trade: 30.4% Goals for female participation in each trade: 6.9% These goals are applicable to all of the Contractor's construction work (whether or not it is Federal or federally- assisted) performed in the covered area. If the Contractor performs construction work in a geographical area located outside of the covered area, it shall apply the goals established for such geographical area where the work is actually performed. With regard to this second area, the Contractor also is subject to the goals for both its federally involved and non - federally involved construction. The Contractor's compliance with the Executive Order and the regulations in 41 CFR Part 60 -4 shall be based on its implementation of the Equal Opportunity Clause, specific affirmative action obligations required by the specifications set forth in 41 CFR 60- 4.3(a), and its efforts to meet the goals. The hours of minority and female employment and training must be substantially uniform throughout the length of the contract, and in each trade, and the Contractor shall make a good faith effort to employ minorities and women evenly on each of its projects. The transfer of minority or female employees or trainees from Contractor to Contractor or from project to project for the sole purpose of meeting the Contractor's goals shall be a violation of the contract, the Executive Order and the regulations in 41 CFR Part 60 -4. Compliance with the goals will be measured against the total work hours performed. 3. The Contractor shall provide written notification to the Director of the Office of Federal Contract Compliance Programs (OFCCP) within 10 working days of award of any construction subcontract in excess of $10,000 at any tier for construction work under the contract resulting from this solicitation. The notification shall list the name, address, and telephone number of the subcontractor; employer identification number of the subcontractor; estimated dollar amount of the subcontract; estimated starting and completion dates of the subcontract; and the geographical area in which the subcontract is to be performed. 4. As used in this notice and in the contract resulting from this solicitation, the "covered area" is Monroe County Florida. o. EQUAL OPPORTUNITY CLAUSE 2 CFR 200, Appendix II(C) 41 CFR § 60 -1.4 41 CFR § 60 -4.3 Executive Order 11246 During the performance of this contract, the Contractor agrees as follows: (1) The Contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, sexual orientation, gender identify or national origin. Such action shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The Contractor will, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive considerations for employment without regard to race, color, religion, sex, or national origin. (3) The Contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (4) The Contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. (5) The Contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (6) In the event of the Contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (7) The Contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The Contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, That in the event a Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the Contractor may request the United States to enter into such litigation to protect the interests of the United States. P. PROCUREMENT OF RECOVERED MATERIALS 2 CFR § 200.322 40 CFR part 247 Contractor and subcontractor agree to comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, and the regulatory provisions of 40 CFR Part 247. In the performance of this contract and to the extent practicable, the Contractor and subcontractors are to use of products containing the highest percentage of recovered materials for items designated by the Environmental Protection Agency (EPA) under 40 CFR Part 247 whenever: a) The contract requires procurement of $10,000 or more of a designated item during the fiscal year; or, b) The Contractor has procured $10,000 or more of a designated item using Federal funding during the previous fiscal year. The list of EPA - designated items is available at www.epa.gov/epawaste/conserve/tools/cpg/products/. Section 6002(c) establishes exceptions to the preference for recovery of EPA - designated products if the Contractor can demonstrate the item is: a) Not reasonably available within a timeframe providing for compliance with the contract performance schedule; b) Fails to meet reasonable contract performance requirements; or c) Is only available at an unreasonable price. q. CONTRACT WORKHOURS AND SAFETY STANDARDS ACT REQUIREMENTS 2 CFR § 200, Appendix II(E) Overtime Requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic, including watchmen and guards, in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one -half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. 2. Violation; Liability for Unpaid Wages; Liquidated Damages. In the event of any violation of the clause set forth in paragraph (1) of this clause, the Contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such Contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph (1) of this clause, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (1) of this clause. 3. Withholding for Unpaid Wages and Liquidated Damages. The Federal Aviation Administration (FAA) or the Owner shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the Contractor or subcontractor under any such contract or any other Federal contract with the same prime Contractor, or any other Federally- assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime Contractor, such sums as may be determined to be necessary to satisfy any liabilities of such Contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph 2 of this clause. 4. Subcontractors. The Contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraphs (1) through (4) and also a clause requiring the subcontractor to include these clauses in any lower tier subcontracts. The prime Contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1) through (4) of this clause. r. CLEAN AIR AND WATER POLLUTION CONTROL 2 CFR § 200, Appendix II(G) Contractor agrees to comply with all applicable standards, orders, and regulations issued pursuant to the Clean Air Act (42 U.S.C. § 740- 7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. § 1251- 1387). The Contractor agrees to report any violation to the Owner immediately upon discovery. The Owner assumes responsibility for notifying the Environmental Protection Agency (EPA) and the Federal Aviation Administration. Contractor must include this requirement in all subcontracts that exceeds $150,000. Section 2. All other provisions of the December 9, 2015 original Key West Airport Customs Facility Phase II Construction Agreement not inconsistent herewith, shall remain in full force and effect. IN WITNESS WHEREOF, each party has caused this 1st Amendment to the Sewer ,struction Agreement to be executed by its duly authorized representative. UK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By 5 Mayor /Chairman Witnesses for COXTRACTOR: Signature 6 1" 6YU L Print Name Date: /�� 2 V/ 7 Signs re , 7 Print Name Date: /� l CO ! T : TOONEY - cv OAC ACTI0yU STRUS,<ON Corp. Signatur" person authorized to legally bind Corporation L. PN47LVEi� raS>fn - Deputy Clerk �'► CERTIFICATE OF LIABILITY INSURANCE 12A2 %2oi6 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 endorsement(s). PRODUCER MICHAEL GEE INC 411 S Pineapple Avenue Sarasota, FL 34236 AuUL INSD CONTACT MICHAEL C GEE PHONE FAX [ Alr. N ( 907 -0914 A N : (941) 907 - 0916 ron verizon.net INSURERS AFFORDING COVERAGE NAIC# INSUR INSURANCE COMPANY OF THE WEST 27847 INSURED OAC ACTION CONSTRUCTION CORP 12540 SW 130TH STREET, SUITE 2 -3 MIAMI, FL 33186 (305) 256 -6655 INSURER B: INSUR INSURER D: $ INSURE : INSURER F: CCIVFRA(;FR CFRTII= 1('ATF All IKAPr:D• o 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. INSR LTR TYPE OF INSURANCE AuUL INSD I UUUK WVD POLICY M ER POLICY EFF MM DD YY POLICY EXP MM DD/YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ $ CLAIMS -MADE 1:1 OCCUR MED EXP (Anyone p erson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO - R POLICY JECT [D LOC GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ $ OT HER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT E acciden $ BODILY INJURY (Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE P r n $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB D I I RETENTION WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1 000 , 000 $ i A ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? N (Mandatory in NH) If y es, DESCRIPTI b OF OPERATIONS beI N/A WFL 5028312 02 12 E.L. DISEASE - EA EMPLOYEE $ / E DI DISEASE I LIMIT 1, 000,000 DESCRIPTIONOF OPERATIONS /LOCATIONS /VEHICLES (ACORD101, Additional Remarks Schedule, maybe attached if more space is required) RE: KEY WEST INTERNATIONAL AIRPORT CUSTOMS FACILITY PHASE II APP V By I NAPEMENT BY WAI R N/A YES rFRTIFIrGTF Pr11 r1F0 rAnrno 1 A-- MONROE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BOARD OF COUNTY COMMISSIONERS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 SIMONTON STREET, RM #2 -213 ACCORDANCE WITH THE POLICY PROVISIONS. KEY WEST, FL 33040 FX# (3 05) 2 92 -4 487 AUTHORIZED REPRESENTATIVE -J�-� C .tom ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD `�.y /7CCMi CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY ) 12/22/2016 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 endorsement(s). PRODUCER MICHAEL GEE INC 411 S Pineap Avenue pP Sarasota, FL 34236 N C GEE PHONE (941 907 -0914 FAX ) A N : (941) 907 -0916 E -MAIL i zon .net A DRE ron ver INSURERS AFFORDING COVERAGE NAIC# INSURER A: INSURANCE COMPANY OF THE WEST 27847 INSURED OAC ACTION CONSTRUCTION CORP. 12540 SW 130TH STREET, SUITE 2 -3 MIAMI, FL 33186 (305) 256 -6655 INSURER B: INSU RER C: INSURER D: INSU $ INSURER F COVERAGES CFRTIFICATF NI IMRFR- RMnslnnl NII ISARR} 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. LTR TYPE OF INSURANCE INSD WV P LI YN M R PO LICY DDNYYY MM /DD YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ $ CLAIMS -MADE D OCCUR MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO D LOC JECT GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ $ O THER: AUTOMOBILE LIABILITY CO MBINED SINGLE LIMIT E n $ BODILY INJURY (Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE P r i n $ $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE R E.L. EACH ACCIDENT 1 000 000 $ I I A ANV PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) DES R descri N u r OPERATIONS N/A WFL 5028312 02 12/21/1612/21/17 E.L. DISEASE - EA EMPLOYEE $ r 000 r E.L. DI DISEASE -POLICY LIMIT 1, 000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) GC LICENSE: CGCO61561 t 4DA D SKI EMEN1 /A S _ CFRTIFI('ATF Hni nr=R r^nnlrl =l I nrinnl MONROE COUNTY BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2798 OVERSEAS HWY. SUITE 300 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN , MARATHON, FL 33050 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ^nr ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ,a► o® EVIDENCE OF PROPERTY INSURANCE DATE 02 /01 /01/ 20 17 / THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY q /C l • (305) 265 -0112 COMPANY Entrust Insurance Certain Underwriters at Lloyd's of London 1431 Ponce De Leon Blvd Coral Gables, FL 33134 F AX C No) (305) 265 -0101 A info @agencyentrust.com CODE: SUB CODE: AGENCY C ID #: INSURED LOAN NUMBER POLICY NUMBER OAC Action Construction Corporation Pending CSN0000291 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 12540 SW 130 Street #2 -3 Miami, FL 33186 02/01/2017 06/30/2017 ❑ TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION /DESC RI PTIO N 3491 S. Roosevelt Blvd Key West, FL 33040 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 EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAI COVERAGE INFORMATION COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Wind -Only Coverage Form Renovations and Improvements $1,000,000 $100,000 All Covered Property at all Locations $1,000,000 $100,000 Flood Zone VE 10 Coverage Form $1,000,000 $100,000 REMARKS (Including Special Conditions) Project Name: Key West International Airport Customs Facility Phase II APPRO D B GEMENT Additional Insured: Monroe County BOCC BY WAIVE /A g CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NAME AND ADDRESS ❑ MORTGAGEE ❑ ADDITIONAL INSURED Monroe County BOCC ❑ LOSS PAYEE ❑ LOAN # 1100 Simonton Street, #2 - 284 Key West, FL 33040 AUTHORIZED REPRESENTATIVE AGVRD 27 (2009 /12) QF @ 1993 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EVIDENCE OF PROPERTY INSURANCE DATE(MM /DD/YYYY) 02/01/2017 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY I PHONE COMPANY Entrust Insurance 1431 Ponce de Leon Blvd Coral Gables, FL 33134 C enc AIC N. I: info a entrust.com ADDRESS: @ 9 Y CODE: D080744 I SUB CODE: INSURED OAC Action Construction, Corp. 12540 SW 130 Street, #2 -3 Miami, FL 33186 American Zurich Insurance Company LOAN NUMBER POLICY NUMBER ER09099617 EFFECTIVE DATE EXPIRATION DATE I 02/01/2017 06/30/2017 CONTINUED UNTIL TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: LOCATION/DESCRIPTION 3491 S Roosevelt Blvd Key West, FL 33040 1 IUN 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 EVIDENCE OF PROPERTY INSURANCE 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. COVPRA[:P INFORMATInN COVERAGE /PERILS /FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Coverage Form ADDITIONAL INSURED $5,000 Renovations and Improvements p $1,000,000 Ex -Wind Ex -Flood All Covered Property at all Locations $1,000,000 1100 Simonton Street V 64.141 VVIIYI \IVI1� Project Name: Key West International Airport Customs Facility Phase II AY PRO QMENT D WAI R CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTFRFST NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED LOSS PAYEE LOAN # Monroe County Board of County Commissioners 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 r+wrcv If tcuum IZ) (9 1993 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD a� 0610 n 016 7o1s °® CERTIFICATE OF LIABILITY INSURANCE DAT 1 Y) o6ro 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 h1 on ADDITIONAL INSURED, the policy(les) 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 endorsementisi. PRODUCER CONTACT Entrust Insurance P E ( 305)265-0112 1 FAX : (305 ) 265 -0101 1431 Ponce De Leon Blvd DDRE Info®agencyentrust,com COfat Gables, FL 33134 INSURE S AFFORDING COVERAGE N= Phone (305)265-0112 Fax (305) 265-0101 INSURER A : Kinsale Insurance Compan INSURED °-• _ -- _ OAC Action Construction Corporation 12540 SW 130 Street #2 -3 Miami FL 33186 CERTIFICATE NUMB I IIID IJ 1 U urn I Ir I nA I I nt rUUL;ItS U1 IV5URANGE L15TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. Key West, FL 33040 I LTR TYPE OF INSURANCE R POLICY NHAIBER M�Lt1LDD EFF MMI YYY LIMITS CObtMERCUILGENERAL W181lITY EJICHOCCURRENCE S 1,000,000.00 ❑ CLAIMS-MADE © OCCUR T RE S 100,000.00 PREMIS a « A ❑ Y 0100039458 -0 06/0412016 06/04/2017 MED EXP (Any one p enen S PERSONAL a ADV INJURY S 1,000,000.00 G AGGREGATE LIMIT APPLES PER GENERAL AGGREGATE S 2,000,000.00 U POLICY ❑ JECT ❑ LOC PRODUCTS- COMP/OPAGG s 2,000,000.00 OTHER $ AUTOMOBILE LIABILITY BINEO SINGLE LIMIT as st, ❑ ANY AUTO BODILY INJURY (Per person) $ ❑ AUTOS NEO ❑ AUTOS BODILY INJURY (Per aaldentl S ❑ HIRED AUTOS El A N O NEO DOPER E S $ ❑ UMBRELLA LIAB ❑ OCCUR EACH OCCURRENCE S EXCESS UAa C3 CLAIMS -MADE AGGREGATE S DED D RETENTION $ s WORKERS COMPENSATION PER OTH- AND EM RS' PLOYE LIABILITY YIN 0 TUrr E. E.L. EACH ACGDENT S ANY PROPRETORIPARTNERIEXECUT1yEI�—�' OFfICER1MEMBER EXCLUDED? [:] NIA A E.L. DISEASE - EA EMPLOYE S (Mandatory In NH) a yes, desenbe under E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddMonal Remarks SdueWapace General Contractor AYPRO ENT WAI UcR I IriCA i a nvLDER CANCELLATION Q 1988-2014 ACORD CORPORATION. AI rW is reserved. ACORD 25 (2014101) OF The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Stmet ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE Q 1988-2014 ACORD CORPORATION. AI rW is reserved. ACORD 25 (2014101) OF The ACORD name and logo are registered marks of ACORD Aco ® CERTIFICATE OF LIABILITY INSURANCE �`1 /2312016 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 endorsement(s). PRODUCER NAMEA LOURDES MENDOZA THOMAS LEDWIDGE INSURANCE AGENCY - StateFarm 6177 MIAMI LAKES DRIVE E MIAMI LAKES, FL 33014 INSURED -- OAC ACTION CONSTRUCTION CORP (10260) 12540 SW 130TH ST STE 2 MIAMI FL 33186-6266 _ L OURDES @L EDWIDGEAGENCY.C OM INSURERIS) AFFORDI COVERAGE __ A ; State Farm Mutual Automob Insurance Company NAIL K 25178 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, EXCLU AND C ONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tNSR �(Mw �Mw POLICY LIMITS L7R TYPE OF INSURANCE 7�� POLUICYBER , COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ DA A ENT CLAIMS-MADE � J OCCUR ( PREMISES MED EXP (Any one Person 1 - PERSO 8 AD V INJURY j GEN'L AGGREG LIMIT APPLIES PER: ! GENE REG ATE POLICY (_.� EC J LOC PR ODUCTS- COMP JOPAGG — - -- — S OTHER: t COMBINED SINGLE LIMIT S A AUTOMOBILE LIABILITY Y N C87 0586 E22 11122/2016 05/2712017 _LEa accaderrti _ - - - - -- BODILY INJURY (Per person} $ 1,000,000 ANY AUTO G171524- C07 -59 09/07/2016 03/07/2017 — _—___- _- ALL OWNED SCULED BODILY INJURY (Per accident) S 1,000,000 HED _ AUTOS � AUTOS j C87 0587 E22 59 1 1112212016 0512212017 PROpERTII DAMAGE _ 1,000,000 rr NON -OWNED per accident S t IRED AUTOS X AUTOS G17 1523 C07 - 09/07/2016 0310712017 BRELLALIAB ;OCCUR EAC OCCURRE _ S -_i_ ESS LJAB CLAIMS -MADE A GGREGATE __ - -_ S S RETENTIONS PER OTH- WORKERS COMPENSATION STATUTE AND EMPLOYERS' LIABILITY - YIN � I E.L. EACH ACCIDENT S ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA I I E.L. DISE EA EMPLO S ,(Mandatory In NH) - ...- -- If yyes, describe under E.L. DISEASE - POLICY LIMIT $ i DESCRIPTION OF OPERATIONS below I N N 948 1859 - E22 - 59A 08122!2016 02122/2017 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it Aare space Is required) 14 Ford F150 Pickup VIN: 1FTFWICF7EFA90329 16 FORD F150 PICKUP VIN: 1FTMFIC83GKD92199 14 Ford F150 Pickup VIN: 1FTMF1CM7EFB57405 16 Ford F150 Pickup VIN 1FTMFIzw Key West Airport Customs Project BY CGCQ61561 Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE _ r1 j i r r _ c ir ®1988 -2014 ACOFW COIRfORATION. All rights reserv` ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02 04 2r3 DATE(MlWDDIYYYY) AC<> CERTIFICATE OF LIABILITY INSURANCE 11/23/2016 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 iieu of such endorsement(s). NAME L OURDES MENDOZA PRODUCER — ----- - -- --- THOMAS LEDWIDGE INSURANCE AGENCY PHON 30 822 -2424 J — aCMot. 8 -2558 StafeFarm 6177 MIAMI LAKES DRIVE E E -MAIL Lourdes@ledwidgeagenc AopRESS:. - MIAMI LAKES, FL 33014 INSURER(5)AfF NGCOYERAGE 51 * S tate Farm Mutual Aut omobile Insurance Company I 25178 INS A : - - -- - _.— — � t l — — INSURED OAC ACTION CONSTRUCTION CORP (10260) INSURER B_ -- - - -- -- 12540 SW 130TH ST STE 2 INSURER C _,__ — MIAMI FL 33186 -6266 INSURERD. 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, EXC LUSION S AN CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEE REDUCED BY PAID CLAIMS. INSR _ A -- 1 -- POLICY EFF POLICY EXP LIMITS IN SR TYPE OF INSURANCE I POLICY NUMBER M COMMERCIAL GENERAL LIABILITY ! EACH OCCURRENCE $ IS 1=10F�N'tEb —... PREMI {Ea occunencel _ b 3 CLAIMS -MADE L OCCUR MFD EXP (Any One person $ A Y I N I 447 7958 -E22 59F 6$94492 E22 - 59F 927 4908 - E22 - 59D 945 4338 - E22 - 59C i i 11/22!2016 (0512212017 11!2212016 1112212016 I 1 11!2212016 05/22/2017 ; 05/22/2017 05122/2017 P ERSONAL & AD INJURY G ENERAL AGGREGATE E 3 - _ hGE'L AGGREGATE LIMIT APPLIES PER POLICY � PRO- LOC E OTHER: ! AuTOMOe1LE LIABILITY - ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS - P RODUCTS- C OMP/OPAGG $ - --- ' - --._ BINED SINGLE LIMIT _ (Ea acadena BODILY INJURY (Per person) $ $ _— _ -- $ 1,000,000 -- -- nt) BODILY INJURY (Per accide S 1,000,000 -- _ — -- PROPERTY DAMAGE Per $_ _ 1,000,000 $ UMBRELLA LIAR EXCESS LIAB j OCCUR CLAIMS -MADE j 4 I E AC H OCCURR — $ _._. _. $___ _ _. AGGREGATE - -_� WORKERS COMPENSA I K.M AND EMPLOYERS' LIABILITY Y j N E.L. E ACH AC CIDENT _ $ ANY PROPRIETOR/PARTNER/FXECUTIVE - - OFFICERIMEMBER EXCLUDED? �i NIA I E1. DISEA - EA EMPLO $ (Mandatory in NH) 1111 _ u— describe under E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 9 more space is requi red) 2008 CHEVROLET C1 5W VIN: 2GCEC13J281158461 2014 ACURA MDX SPORT WG VIN: 5FRYD3H47EB019569 2013 CADILLAC SRX SPORT WG VIN: 3GYFNDE39DS597275 2011 FORD F250 SO PICKUP VIN: 1FT7W2BT1BE652505 Key West Airport Customs Project CGCO61561 Monroe CountyBoard of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 A RED REPRESENTATIVE n ©1988 -2014 C D WOO TION. Ali rights reserieb. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04 -2014 R CERTIFICATE OF LIABILITY INSURANCE DATE (MWDWYYM 11/23r2016 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 pol'ic'ies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c NTA T LOURDES MENDOZA PRODUCER NAME: --� � - - - - -- THOMAS LEDWIDGE INSURANCE AGENCY Statefar►n 6177 MIAMI LAKES DRIVE E 0 • MIAMI LAKES, FL 33014 i IN SU RED ACTION CONSTRUCTION CO 12540 SW 130TH ST STE 2 MIAMI FL 33186 -6266 INSURER(S NASA RER A : State Farm Mutual Automobile Insurance Company 25178 INSU . - --- - INSURER B: — -- - - - - - -- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: cwornn THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR IS TO CERTIFY THAT THE POLICIES NOT4MTHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY AND CO OF SUCH -- TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY ---. CLAIMS -MADE _�] OCCUR OF INSURANCE PERTAIN, POLICIES I � LISTED BELUVV HAVt tsttN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN REDUCED -- 'T -- - POLICY POLICY NUMBER waucv I CONTRACT THE POLICIES BY EFF MMID I-, nw,•.w OR OTHER DESCRIBED PAID CLAIMS. POLY EXP MMND .• �•� •• — • •• — - -- DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS. -- _ —_ LIMITS EACH OCCURRENCE $ — DA`1i AZi€ TO RENTED PRER SES (Ea o ccurtence MED EXP (Any one person) ._ $ ' i PERS 8 ADV INJURY GENER AGGREG $ _ S GEN'L AGGREG LIMIT APPLIES PER: POLICY C J PRO- LOC JECT PRODUCTS - COMP/OP AGG $ A OTHER: AUTOMOBILE LIABILITY Y N G17 1522 C07 59 09/07/2016 j 03/0712017 COM accid SINGLE LIMIT BODILY INJURY (Per person) $ $ 1,000,000 ANY AUTO - -� X ALL OWNED SCHEDULED ? AUTOS AUTOS NON -OWNED HIRED AUTOS _ AUTOS ! ! � r tODILY INJURY (Per accident) — Pf20PERTY DAMAGE Per acadwA �_�. __l._ — .- _ -.. -- $ g __ - - -- - - - - - - -- 5 'Ir UMBRELLA LIAR EXCESS LIAB _ OCCUR CLAIMS-MADE EACH OCCURRE 5 _. — AGGRE b _ 5 f RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN; ANY PROPRIETORIPARTNERIEXECUTIVE ❑NIA OFFICER/MEMBER EXCLUDED? i I I , PER OTH- STATUTE ER UEL. ACCI DENT E _ E.L. DISEASE - EA EMPLOYE S E.L. — (Mandatory in NH) If Yes, descriON OF OPERATIONS below be under DESCRIPTI i E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more apace Is aired) 16 FORD F150 Pickup VIN: 1FTEWlCFXGFB22009 APP ED GEMENT BY Key West Airport Customs Project WAI A ES_ CGCO61561 Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AU RIZED REPRESENTATIVE ©1988 -2014 ACORD' O kTN. All rights rese ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04- 14