Item D4BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: JANUARY 16, 2014
Bulk Item: Yes X No
Division: TDC
Department:
Staff Contact Person/Phone #: Maxine Pacini
296 -1552
AGENDA ITEM WORDING:
Approval of an Amendment to Agreement with Old Island Restoration Foundation, Inc. for the
Oldest House Museum Lift Station /Restroom Plumbing Upgrades project to revise scope of
services in Exhibit A and reduce project cost.
ITEM BACKGROUND:
District I Advisory Committee approved same at their meeting of November 20, 2013
TDC approved same at their meeting of December 17, 2013
PREVIOUS RELEVANT BOCC ACTION:
BOCC approved original agreement at their meeting of June 19, 2013
CONTRACT /AGREEMENT CHANGES:
Amendment to Agreement
STAFF RECOMMENDATIONS:
Approval
TOTAL COST: $3,600 BUDGETED: Yes X No
COST TO COUNTY: $ SOURCE OF FUNDS: TDC
REVENUE PRODUCING: Yes X No AMOUNT PER MONTH Year _
I S—
APPROVED BY: County Atty X 01VIB E<' C /Purchasing X Risk Management X
DOCUMENTATION: Included X Not Required
DISPOSITION:
AGENDA ITEM #
Revised 11/06
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Old Island Restoration Contract #
Foundation, Inc.
Effective Date:
Expiration Date
1168
6/19/13
3/31/14
Contract Purpose/Description:
Approval of an Ame ndment to Aqreement with Old Island Restoration
Foundation, Inc. for the Oldest House Museum Lift Station /Restroom Plumbing
Upgrades project to revise scope of services in Exhibit A and reduce project
cost.
Contract Manager: Maxine Pacini 3523 TDC # 3
(Name) (Ext.) (Department/Stop #)
for BOCC meeting on 1' Agenda Deadline 10-1
CONTRACT COSTS
Total Dollar Value of Contract: $ $3,600
Budgeted? Yes®
Grant: $
County Match: $
Estimated Ongoing Costs: $_/yr
(Not included in dollar value above)
CONTRACT REVIEW
Changes
Date In Needed Re v'e r
Division Director rr���j/j! Yes❑ No[T
Risk Management [ �q - (,Yes❑ No
E3
ECI-
O.M.B./Purchasing /p /x3113 Yes❑ No[f U L I - 12 -
County Attorney 10 ) 17 113 Yes❑ NoE4 C. Limbert
Comments:
etc.)
Date Out
No ❑
Account Codes :
Current Year Portion:
117- 77040 -5 3 03 40 -TB 3 7 -793 -Y- 5 3 03 40
ADDITIONAL COSTS
For:
OMB Form Revised 2/27/01 MCP #2
AMENDMENT Ost AMENDMENT) TO AGREEMENT
THIS AMENDMENT to agreement dated the day of 2014 is entered into by
and between the Board of County Commissioners for Monroe County, on behalf of the Tourist
Development Council, and Oldest House Restoration Foundation, Inc. ( "Event Sponsor")
WHEREAS, there was an agreement entered into on June 19, 2013 between the parties,
awarding $7,411 to the Oldest House Restoration Foundation, Inc. for the Oldest House Museum Lift
Station /Restroom Plumbing Upgrades project; and
WHEREAS, it has become necessary to revise Exhibit A outlining Scope of Services and
compensation with the agreement due to a portion of the work not being necessary at the time
contractor began work on the project, and
NOW, THEREFORE, in consideration of the mutual covenants contained herein the parties
agree to the amended agreement as follows:
Exhibit A of the agreement shall be revised and attached hereto.
2. Paragraph 3 (1 paragraph) of the agreement will read as follows: AMOUNT OF
AGREEMENT AND PAYMENT. The Grantor shall provide an amount not to exceed $3,600 (TDC
District I funding) (no in -kind funds were noted in the application towards this funding application) for
materials and services used to repair and improve the property. Reimbursement request must show
that Grantee has paid in full for materials and services relating to the segment prior to seeking the
50% (fifty percent) reimbursement from Grantor. Payment shall be 50% (fifty percent)
reimbursement of the total cost of the segment, subject to the cap on expenditures for that segment
as set forth in Exhibit A. Reimbursement can be sought after each segment of the agreement is
completed and signed by the Monroe County Engineering Department as outlined in 3.a. The Board
of County Commissioners and the Tourist Development Council assume 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.
5. In all other respects, the remaining provisions of the agreement dated June 19, 2013 shall
remain in full force and effect.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
Amendment #I
Oldest House Museum Amendment — Restroom Project
ID# 1168
IN WITNESS WHEREOF, the Parties hove est their lands end seal on the day and year ON
above written.
(SEAL)
Attest Amy He"n, Cleric
Do" Cleric
(CORPORATE SEAL)
By.
Boost"
Print Name
Dabs:
Board of County Com W=bnwg
of Monroe County
Oldest Mouse ltooWnitlon Fow aMo -. Inc.
Dabs:
OR TWO WIVES (only InG It tlr Proaldent doss not aiprr)
(1)
(1)
print NOnve
Date:
Am imot fl
01" Ir- Mu� Amy -amw y ptcd t
mo Ito
a �
Print Name
Dabs:
n" 4 r. I'k
REVISED EXHIBIT A
NAME OF ENTITY: Old Island Restoration Foundation Inc
NAME OF PROJECT: Oldest House Museum Lift Station /Restroom Plumbina
Upgrades
NUMBER OF SEGMENTS TO PROJECT: 1
Note County signoff and submission for reimbursement only allowed after completion of
each segment as documented in this exhibit. Grantee must apply for reimbursement
utilizing the 'Application for Payment' form included within the Payment /Reimbursement Kit.
Segment #: 1
Description Materials and labor and
permit fees required to complete the
following work:
• Alterations to restroom floor to re-
rough sewer line and tie it into the
sewer system beneath the house.
(In order for this segment to be reimbursed,
acknowledgement of TDC funding must be in place
and proof in the form of pictures provided with
submission for reimbursement of this
segment. This acknowledgement shall not be
covered as part of the TDC reimbursement - see
contract paragraph 2)
Total Cost:
$ 7,200
*No in -kind
funds were
noted within
th*
application
TDC portion:
$ 3,600
Page 1 of 1
From: Cork Tarolee
To: Marine Parini
Subject Re: TDC Funding
Dated Thursday, Odober 17, 201312:06;18 PM
Re: Contract #1168
Dear Maxine:
I am writing to request that the TDC ammend our Grant Award Agreement #1168 "Oldest
House Museum Lift Station /Restroom Plumbing." In short, the reason is that we were able
to avoid having to install a lift station, so the project has been completed with less expense
than anticipated.
To explain in detail: The project was initiated because the sewer system that serves the
public restrooms in the garden of the Oldest House museum were not working properly.
Four licensed plumbing contractor were asked to diagnose the problem and bid on the
solution. All four said that the only solution was to install a lift station. However when the
lowest bidding contractor excavated the piping at the site of the proposed lift station, he
found that the piping could be reinstalled in such a way that the drains would function by
gravity without the lift station. We have, therefore,had the drain pipes replaced in
compliance with all building codes and the problem is installed without the extra expense
(or the perpetual maintenance) of a lift station. The work accomplished is work that was
included in our original agreement. We simply; stopped short of installing the lift station.
Our original contract calls for a total project cost of $14,823 and the TDC's portion to be
$7,411.
We would like the contract to be amrnended to reflect our actual cost of $7,200 and our
request that the TDC's- portion be $3600.
Please let me know if there is any additional information you need.
Very truly yours,
Cork Tarplee
Administrator
Old Island Restoration Foundation, Inc.
Grant Award Aureement
THIS AGREEMENT (agreement) is entered into this Iq da y of
2013 by and between MONROE COUNTY, a political subdivision of the State
o Florida (County or Grantor) and Old Island Restoration Foundation, Inc. a not for
profit organized and operating under the laws of the state of Florida (Grantee).
WHEREAS, the district pennies of Tourist Development Tax may be used to
acquire, construct, extend, enlarge, remodel, repair or improve, convention centers, sports
stadiums, sports arenas, coliseums, auditoriums, aquariums, fishing piers, museums,
zoological parks, nature centers, beach improvements and beach park facilities which are
publicly owned and operated or owned and operated by not - for -profit corporations, and
WHEREAS, Grantee has applied to TDC District I for funding for the Oldest
House Museum Lift Station /Restroom Plumbing Upgrades project; and
WHEREAS, the Grantor and Tourist Development Council (TDC) have
determined that it is in the best interest of the County, for purposes of promoting tourism
and preserving the heritage of the community, to attract tourists, and repair and improve
the property for use as a museum open to the public;
NOW, THEREFORE, in consideration of the mutual covenants and
payments contained herein, the Grantee and the Grantor have entered into this agreement
on the terms and conditions as set forth below.
1. GRANT AGREEMENT PERIOD. This agreement is for the period of June 19, 2013
through to March 31, 2014. 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 or 13 below.
2. SCOPE OF AGREEMENT. The representations made by the Grantee in its
proposal submitted to the TDC are incorporated herein by reference. The Grantee shall
provide the following scope of services: Materials and labor required to complete the
project. Segment(s) of the work is/are more particularly described in Exhibit(s) A, detailing
the work and the cost allocable to each segment, attached hereto, and incorporated herein
by reference. Anything not referenced within exhibit A will not be reimbursed. All
work for which grant funds are to be expended must be completed by the stated
termination date of March 31, 2014 and all invoices pertaining to this project shall be
submitted to the Finance Department of Monroe County no later than March 31, 2014 to
--- - - - - -- ______ _- -__ - -- _ _ be considered for-payment. - AeknowkK[aement: _ Grantee shaWbe- required to permanent.y- _
display and maintain at Grantee's expense, public acknowledgement of the support of the
Monroe County Tourist Development Council in a publicly prominent area of their facility in
the following form: "This project was made possible with the financial support of the
Monroe County Tourist Development Council." If the Grantee has already complied with
this requirement through previous funding, said acknowledgement fulfills this condition. A
FY 2013 Funding
Contract 1DA:1168
photograph of said acknowledgment shall be provided with the final request for
reimbursement outlined in Exhibit A of this agreement.
a.) There shall be a project manager to acknowledge receipt of goods or work
performed. This Project Manager shall be Cork Tarplee, PO Box 689, Key West, FL,
33041, Tel:(305) 294 -9501, oirfO- oirf.oro Should there be a change in the project
manager specified in the Grantee's application, a new project manager shall be
designated, and notice with new contact information shall be provided in writing to
the TDC administrative office.
b.) If, and to the extent that, Grantee contracts for any of the work funded under
this agreement to be performed or completed, Grantee shall give notice to County
of the contractual relationship, provide County with a copy of any and all contracts
and shall require the contractors) to comply with all the terms of this contract.
Should Grantee contract the work and then decrease the scope of work to be
performed by a contractor, Grantee shall provide County with an amended contract
executed by Grantee and its contractor.
(i) A Grantee which is a governmental entity shall comply with the
procurement regulations and policies to which it is subject, and shall provide
Grantor documentation of the procurement requirements applicable to the
project and compliance therewith.
(ii) A Grantee which is a not- for -profit entity shall use procurement
processes for those parts of the project to be contracted (not performed by
the entity's employees) as follows. For work expected to be under $50,000,
the not - for -profit shall document in the file two written quotes or a notarized
statement as to why such written quotes were not feasible for the goods or
services. For work expected to be $50,000 or more, a competitive bid
process must be performed following Monroe County's procurement policies
and procedures must be followed, unless the commodities or services will be
provided by a "sole source" provider, in which case the not - for -profit must
submit a notarized statement with its request for payment explaining why the
vendor is the only source for the commodities or services.
c.) Grantee shall exercise good internal controls to assure that the project as
described in the funding application shall be completed on a timely basis within the
proposed budget and shall provide to County any certifications, including those by
the architect, engineer, contractor or an independent consultant if necessary,
required to establish that materials which are purported to be applied to the project
e in fact so applied. Further verification_ shall be required to show that equipment_
and other fixtures and personal property covered by this agreement are delivered to
and installed in the project site. When any permit is required by any governmental
agency, copies of plans and other documents which are submitted to the applicable
agency shall be submitted to the County Engineering Division to enable verification
that the scope of services under this agreement has been provided.
FY 2013 Funding
Contract ID#.1168
2
3. AMOUNT OF AGREEMENT AND PAYMENT. The Grantor shall provide an
amount not to exceed $7,411 (TDC District I funding) (no in -kind funds were noted in the
application towards this funding application) for materials and services used to repair and
improve the property. Reimbursement request must show that Grantee has paid in full for
materials and services relating to the segment prior to seeking the 50% (fifty percent)
reimbursement from Grantor. Payment shall be 50% (fifty percent) reimbursement of the
total cost of the segment, subject to the cap on expenditures for that segment as set forth
in Exhibit A. Reimbursement can be sought after each segment of the agreement is
completed and signed by the Monroe County Engineering Department as outlined in 3.a.
The Board of County Commissioners and the Tourist Development Council assume 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.
a.) Payment shall be made upon the completion of a specific segment as
outlined in the Scope of Services and Exhibit A. Payment for expenditures
permissible by law and County policies shall be made through reimbursement to
Grantee upon presentation of Application for . Payment Summary, AIA Document
G702 or similar certification as required below for governmental entities and not -for-
profit entities, invoices, canceled checks and other documentation necessary to
support a claim for reimbursement. Included in said documentation shall be proof
that the Grantee has received the property, realty or personally, for each segment of
agreement as outlined in Exhibit A and paid an amount equal to or greater than the
amount invoiced to the Grantor. It shall be necessary for the Grantee to contact the
County Engineering Division and to arrange for inspections upon the completion of
each segment. The documentation needed to support the payment request shall be
in the form necessary for submission and available to the County Engineer at the
time of inspection. All submissions for payment shall have a proposed schedule of
values for segment(s) and indicate the percentage of completion of the overall
project as of the submission. This document should be signed by the project
architect, engineer, general contractor or project manager. Photos of the progress
of the work shall also be submitted with the payment application. It shall be the
responsibility of the project architect, engineer, general contractor or project
manager to initiate the communication with the Monroe County Engineering Division
to facilitate the inspection(s) of the segment of the project. All submissions
requesting payment shall be approved in writing, and signed, by the Monroe County
Engineering Division as to the completion of the segment of the project for which
payment is requested. The application for payment document must be certified
through a statement signed by an officer of the organization and notarized,
declaring that representations in the invoice are true and factual. Grantee shall also
provide paM al releases-- of.liens-_or __certifications of- non - lien -if. applicable--Grantor-
shall retain 10% of any payment on work in progress until the Grantee has provided
a Final Release of Lien for each vendor /Contractor for whom payment is requested.
For projects exceeding $50,000 in TDC funding under this agreement, final payment
will not be made until the following documents are complete and submitted to the
Grantor.
AIA Document G -702 Application for Payment Summary
FY 2013 Funding
Contract /DA 1168
3
AIA Document G -704 Certificate of Substantial Completion
AIA Document G -706 Contractor's Affidavit of Debts & Claims
AIA Document G -706A Contractor's Affidavit of Release of Liens
AIA Document G -707 Consent of Surety to Final Payment (when
applicable)
Final Release of Lien or Affidavit and Partial Release of Lien
For projects for which TDC funding under this agreement is $50,000 or less, the AIA
documentation is not required, but sufficient documentation must be submitted to
County to provide similar assurances that the work has been completed and
contractors/suppliers paid.
All payment requests must be submitted no later than the completion of project of
March 31, 2014. Invoices received after March 31, 2014 will not be considered for
payment.
b.) If in -kind services were noted within your application, and you are applying
them to this project, documentation shall be submitted to the TDC Administrative
Office to show the receipt and application of in -kind donations of goods,
professional services, and materials. Said documentation should include invoices,
bills of lading, etc., and be verified as received and applied to the project through a
notarized statement of the project architect, engineer, general contractor or project
manager. The receipt and application to the project of volunteer labor are to be
documented and verified by notarized signature of the project architect, engineer,
general contractor, or project manager, and said documentation submitted to the
TDC Administrative Office. All submissions shall identify the items included in
Exhibit A and Grantee shall complete the Application for Payment form which is
provided within the payment/reimbursement kit provided to the Grantee, listing the
schedule of values which are sought to be reimbursed and shall indicate the
percentage of completion of the overall project as of the submission. This
document should be signed by the project architect, engineer, general contractor or
project manager.
Photographs showing progress on project shall be included in any payment request.
The Project Manager shall certify delivery to the project site and installation therein
of any goods or services provided other than through an architect, engineer or
contractor. All work performed and goods received on site and incorporated into the
project shall be verged by one of the foregoing. Submission of any documentation
which is untrue, falsified, or otherwise misrepresents the work which has been
completed, paid, or donated shall constitute a breach of agreement, for which
--- -_ -_ -- .- _--- __hrea -c - the_.c ontract_max_4e_ immediatelylerminated_at -the _discretion_of-the_County,._-
whose decision shall be final.
c.) Grantee must submit all documentation for final payment on or before the
termination date of this grant of March 31, 2014. Invoices received after March 31,
2014 will not be considered for payment.
FY 2013 Funding
Contract /D #:1168
4
d.) At any time that the documentation requirement policies of Monroe County
are revised, such as to require annual inventory reports for equipment purchased
under a TDC capital project grant, Grantee shall comply thereafter with such
increased requirements, or further funding under the agreement may be terminated
by County.
e.) Upon successful completion of this Grant agreement, the Grantee may retain
ownership of the real and personal property acquired and /or improved with funding
under this Grant agreement. However, the Grantee shall maintain, preserve, and
operate the property which was acquired or improved under this agreement for the
uses and purposes which qualified the Grantee for tourist development tax funding.
Grantee shall complete and sign a Property Reporting Form (provided within
paymentireimbursement package) for personal property and forward said
completed form with the appropriate invoice to the TDC Administrative Office. Real
property acquired or improved through funding under this agreement shall remain
dedicated for the purposes set forth herein or for other purposes which promote
tourism and ownership of said property shall be retained by the Grantee. The
following terms shall apply:
(i) The Grantee shall have the use of the property, including both realty
and personally acquired with funding under this agreement, at the project site
for so long as the facility is operated by Grantee, open to the public, and has
a primary purpose of promoting tourism. At such time as any of the
conditions in the preceding sentence shall cease to exist, the Grantee shall
transfer ownership and possession of equipment and personal property to a
local government or another not - for -profit organization which is a facility for
which tourist development taxes may be used pursuant to Florida Statute
with prior approval from TDC and BOCC.
(ii) At any time that the Grantee: (a) elects to stop the project or otherwise
decide not to place into service for tourist- related purposes the facility
acquired, constructed, or renovated with tourist development tax funding, (b)
demolishes the project facility or divests itself of ownership or possession of
the real property, or (c) ceases the use of the property with a primary
purpose of promoting tourism, Grantee shall, pursuant to the formula set
forth hereafter, refund to the County the Tourist Development funding. This
provision shall survive the termination date of all other provisions of this
contract for a period of ten years. Should the demolition, transfer of
ownership, or change to a non - tourist related purpose occur after the facility
has been used for tourist - related purposes for at least three (3) years, the
amount of _refund shall ber)ro -rated based . on au f JAI IIf�Q� ten_ 1Q�_yQaL$.
(iii) The Grantee is
maintenance procedures
operating condition.
responsible for the implementation of adequate
to keep the real and personal property in good
FY 2013 Funding
Contract ID #:1168
(iv) The Grantee is responsible for any loss, damage, or theft of, and any
loss, damage or injury caused by the use of, real or personal property or
equipment purchased through funding under this agreement.
4. RECORDS AND REPORTS. The Grantee shall keep such records as are
necessary to document the performance of the agreement and expenses as incurred, and
give access to these records at the request of the TDC, the County, the State of Florida or
authorized agents and representatives of said government bodies. The Grantee shall also
provide such access to the personal property and equipment purchased under this
agreement. It is the responsibility of the Grantee to maintain appropriate records in
accordance with generally accepted accounting principles consistently applied to insure a
proper accounting of all funds and expenditures. The Grantee 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 Cleric of Court for Monroe County, the Board of
County Commissioners for Monroe County, or their agents and representatives. In the
event of an audit exception, the current fiscal year grant award or subsequent grant
awards will be offset by the amount of the audit exception. In the event the grant is not
renewed or supplemented in future years, the Grantee will be billed by the Grantor for the
amount of the audit exception and shall promptly repay any audit exception.
a.) Public Access. The County and Grantee shall allow and permit reasonable
access to, and inspection of, all documents, papers, letters or other materials in its
possession or under its control subject to the provisions of Chapter 119, Florida
Statutes, and made or received by the County and Grantee in conjunction with this
agreement; and the County shall have the right to unilaterally cancel this agreement
upon violation of this provision by Grantee.
5. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the terms of
this agreement shall be only amended in writing and approved by the Board of County
Commissioners for Monroe County. The terms, covenants, conditions, and provisions of
this agreement shall bind and inure to the benefit of the County and Grantee and their
respective legal representatives, successors, and assigns.
6. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
Grantee 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 Grantee 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.
a.) No Personal Liability. No covenant _or_agmoment . contained herei n
deemed to be a covenant or agreement.of any member, officer, agent or employee
of Monroe County in his or her individual capacity, and no member, officer, agent or
employee of Monroe County shall be liable personally on this agreement or be
subject to any personal liability or accountability by reason of the execution of this
agreement.
FY 2013 Funding
Contract 0 1168
6
7. COMPLIANCE WITH LAW. In carrying out its obligations under this agreement, the
Grantee 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 Grantor to terminate this agreement
immediately upon delivery of written notice of termination to the Grantee.
8. RESTRICTIONS ON AGREEMENTS ENTERED PURSUANT TO THIS
AGREEMENT. The Grantee shall include in all agreements funded under this agreement
the following terms:
a.) Anti - discrimination. Contractor agrees that it will not discriminate against any
employees or applicants for employment or against persons for any other benefit or
service under this agreement 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.
b.) Anti - kickback. Contractor 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 Contractor has any interest, financially or otherwise, in County. 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. Contractor acknowledges that it is aware that funding for this
agreement is available at least in part through the County and that violation of this
paragraph may result in the County withdrawing funding for the Project.
c.) Hold harmless /indemnification. Contractor acknowledges that this
agreement is funded at least in part by the County and agrees to indemnify and hold
harmless the County and any of its 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 (collectively claims)
arising directly or indirectly from any negligence or criminal conduct on the part of
Contractor in the performance of the terms of this agreement. The Contractor shall
immediately give notice to the County of any suit, claim or action made against the
Contractor that is related to the activity under this agreement, and will cooperate
_wAK the- _..Co the-_iavestigation_ arising as__a-resuli_of._any -suit, action_or- lain - --
related to this agreement.
d.) Insurance. Contractor agrees that it maintains in force at its own expense a
liability insurance policy which will insure and indemnify the Contractor and the
County from any suits, claims or actions brought by any person or persons and from
all costs and expenses of litigation brought against the Contractor for such injuries
to persons or damage to property occurring during the agreement or thereafter that
FY 2013 Funding
Contract IDA
7
results from performance by Contractor of the obligations set forth in this
agreement. At all times during the term of this agreement and for one year after
acceptance of the project, Contractor shall maintain on file with the County a
certificate of the insurance of the carriers showing that the aforesaid insurance
policy is in effect. The following coverage's shall be provided:
1. Workers Compensation insurance as required by Florida Statutes.
2. Commercial General Liability Insurance with minimum limits of $500,000
per occurrence for bodily injury, personal injury and property damage.
3. Comprehensive Auto Liability Insurance with minimum limits of $300,000
combined single limit per occurrence.
The Contractor, the County and the TDC shall be named as additional insured,
exempt workers compensation. The policies shall provide no less than 30 days
notice of cancellation, non - renewal or reduction of coverage.
At all times during the term of this agreement and for one year after acceptance of
the project, Contractor shall maintain on file with the County a certificate of
insurance showing that the aforesaid insurance coverage's are in effect.
e.) Licensing and Permits. Contractor warrants that it 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.
f.) Right to Audit. The Contractor shall keep such records as are necessary to
document the performance of the agreement and expenses as incurred, and give
access to these records at the request of the TDC, the County, the State of Florida
or authorized agents and representatives of said government bodies.
9. HOLD HARMLESS /INDEMNIFICATION. The Grantee hereby agrees to indemnify
and hold harmless the BOCC/TDC and the 3406 North Roosevelt Blvd. Corporation or any
of its 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 Grantee shall immediately give
notice to the Grantor of any suit, claim or action made against the Grantor that is related to
the activity under this agreement, and will cooperate with the Grantor in the investigation
_ - - -__ adsing_as_a_-resulLof any-suit, action or claim related-to-this-
a.) Non - Waiver of Immunity. Notwithstanding the provisions of Sec. 768.28,
Florida Statutes, the participation of the County and the Grantee in this agreement
and the acquisition of any commercial liability insurance coverage, self- insurance
coverage, or local govemment liability insurance pool coverage shall not be deemed
a waiver of immunity to the extent of liability coverage, nor shall any contract
entered into by the County be required to contain any provision for waiver.
FY 2013 Funding
Contract ID#.1168
8
OWN
WU
b.) Privileges and Immunities. All of the privileges and immunities from liability,
exemptions from laws, ordinances, and rules and pensions and relief, disability,
workers' compensation, and other benefits which apply to the activity of officers,
agents, or employees of any public agents or employees of the County, when
performing their respective functions under this agreement within the territorial limits
of the County shall apply to the same degree and extent to the performance of such
functions and duties of such officers, agents, volunteers, or employees outside the
territorial limits of the County.
10. NONDISCRIMINATION. County and Grantee agree that there will be no
discrimination against any person, and it is expressly understood that upon a
determination by a court of competent jurisdiction that discrimination has occurred, this
agreement automatically terminates without any further action on the part of any party,
effective the date of the court order. County or Grantee agree to comply with all Federal
and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination.
These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88 -352)
which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the
Education Amendment of 1972, as amended (20 USC ss. 1681 -1683, and 1685 - 1686),
which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act
of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of
handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101 -6107)
which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and
Treatment Act of 1972 (PL 92 -255), as amended, relating to nondiscrimination on the basis
of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (PL 91 -616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health
Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd -3 and 290ee -3), as amended,
relating to confidentiality of alcohol and drug abuse patent records; 8) Title VIII of the Civil
Rights Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the
sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42
USC s. 1201 Note), as maybe amended from time to time, relating to nondiscrimination on
the basis of disability; 10) Any other nondiscrimination provisions in any Federal or state
statutes which may apply to the parties to, or the subject matter of, this agreement.
11. ANTI - KICKBACK. The Grantee 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 or TDC has any interest, financially or otherwise, in the said funded project,
except for general membership. For breach or violation of this warranty, the Grantor shall
------- - - - - -__ have-the-nght_ta.annuL this- agreement- - without liaW- or,- in_its..discretion + _ tQ.deduci.fram___.
the agreement price or consideration, the full amount of such commission, percentage,
brokerage or contingent fee.
12. TERMINATION. This agreement shall terminate on March 31, 2014. 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
FY 2013 Funding
Contract IDA1168
9
continuation of this agreement pursuant to the terms specked herein, this agreement may
then be terminated immediately by written notice of termination delivered in person or by
mail to Grantee. The Grantor may terminate this agreement without cause upon giving
written notice of termination to Grantee. The Grantor shall not be obligated to pay for any
services or goods provided by Grantee after Grantee has received written notice of
termination.
13. TERMINATION FOR BREACH. The Grantor 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 Grantee shall not be deemed or
considered as a continuing waiver and shall not operate to bar or prevent the Grantor from
declaring a forfeiture for any succeeding breach either of the same conditions or of any
other conditions. Failure to provide Grantor with certification of use of matching funds or
matching in -kind services at or above the rate of request for reimbursement or payment is
a breach of agreement, for which the Grantor may terminate this agreement upon giving
written notification of termination.
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 Grantee and the Grantor.
15. GOVERNING LAW, VENUE, INTERPRETATION, COSTS, AND FEES. This
agreement shall be governed by and construed in accordance with the laws of the State of
Florida applicable to contracts made and to be performed entirely in the State. This
agreement is not subject to arbitration. Mediation proceedings initiated and conducted
pursuant to this agreement shall be in accordance with the Florida Rules of Civil Procedure
and usual and customary procedures required by the circuit court of Monroe County.
a.) Venue. In the event that any cause of action or administrative proceeding is
instituted for the enforcement or interpretation of this agreement, the County and
Grantee agree that venue shall lie in the appropriate court or before the appropriate
administrative body in Monroe County, Florida.
b.) Severability. If any term, covenant, condition or provision of this agreement
(or the application thereof to any circumstance or person) shall be declared invalid
or unenforceable to any extent by a court of competent jurisdiction, the remaining
terms, covenants, conditions and provisions of this agreement, shall not be affected
thereby; and each remaining term, covenant, condition and provision of this
agreement shall be valid and shall be enforceable to the fullest extent permitted by
law- unless the- enforcement -of- -- the__ remaining -- terms -_- covsnants,__conditions__and-
provisions of this agreement would prevent the accomplishment of the original intent
of this agreement. The County and Grantee agree to reform the agreement to
replace any stricken provision with a valid provision that comes as close as possible
to the intent of the stricken provision.
FY 2013 Funding
Contract IDA I If 68
10
c.) Attorney's Fees and Costs. The County and Grantee agree that in the event
any cause of action or administrative proceeding is initiated or defended by any
party relative to the enforcement or interpretation of this agreement, the prevailing
party shall be entitled to reasonable attorney's fees, court costs, investigative, and
out -of- pocket expenses, as an award against the non - prevailing party, and shall
include attorney's fees, court costs, investigative, and out -of- pocket expenses in
appellate proceedings.
d.) Adjudication of Disputes or Disagreements. County and Grantee agree that
all disputes and disagreements shall be attempted to be resolved by meet and
confer sessions between representatives of each of the parties. If the issue or
issues are still not resolved to the satisfaction of the parties, then any party shall
have the right to seek such relief or remedy as may be provided by this agreement
or by Florida law. This agreement shall not be subject to arbitration.
e.) Cooperation. In the event any administrative or legal proceeding is instituted
against either party relating to the formation, execution, performance, or breach of
this agreement, County and Grantee agree to participate, to the extent required by
the other party, in all proceedings, hearings, processes, meetings, and other
activities related to the substance of this agreement or provision of the services
under this agreement. County and Grantee specifically agree that no party to this
agreement shall be required to enter into any arbitration proceedings related to this
agreement.
16. ETHICS CLAUSE: Grantee 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 or Ordinance No. 10 -1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10 -1990. For breach or violation of the provision the Grantor
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. The County and Grantee warrant that, in respect to
itself, it has neither employed nor retained any company or person, other than a bona fide
employee working solely for it, to solicit or secure this agreement and that it has not paid or
agreed to pay any person, company, corporation, individual, or firm, other than a bona fide
employee working solely for it, any fee, commission, percentage, gift, or other
consideration contingent upon or resulting from the award or making of this agreement.
For the breach or violation of the provision, the Grantee agrees that the County shall have
the right to terminate this agreement without liability and, at its discretion, to offset from
monies owed, or otherwise recover, the full amount of such fee, commission, percentage,
- - - - - -gift, consideratiorr; -- -- - -- --
a.) Covenant of No Interest. County and Grantee covenant that neither
presently has any interest, and shall not acquire any interest, which would conflict in
any manner or degree with its performance under this agreement, and that only
interest of each is to perform and receive benefits as recited in this agreement.
FY 2013 Funding
Contract IDA1168
11
b.) Code of Ethics. County agrees that officers and employees of the County
recognize and will be required to comply with the standards of conduct for public
officers and employees as delineated in Section 112.313, Florida Statutes,
regarding, but not limited to, solicitation or acceptance of gifts; doing business with
one's agency; unauthorized compensation; misuse of public position, conflicting
employment or contractual relationship; and disclosure or use of certain information.
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, Florida Statutes, for
CATEGORY TWO for a period of 36 months from the date of being placed on the
convicted vendor list. By executing this document grantee warrants that it is in compliance
with this paragraph.
18. AUTHORITY: Grantee 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 Grantee below certifies and warrants that the Grantee's name in this
agreement is the full name as designated in its corporate charter (if a corporation); they
are empowered to act and contract for the Grantee, and this agreement has been
approved by the Board of Directors of Grantee or other appropriate authority.
19. LICENSING AND PERMITS: Grantee warrants that it 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: Grantee agrees that it maintains in force at its own expense a liability
insurance policy which will insure and indemnify the Grantee and the Grantor from any
suits, claims or actions brought by any person or persons and from all costs and expenses
of litigation brought against the Grantee for such injuries to persons or damage to property
occurring during the agreement or thereafter that results from performance by Grantee of
the obligations set forth in this agreement. At all times during the term of this agreement
and for one year after acceptance of the project, Grantee shall maintain on file with the
Grantor a certificate of the insurance of the carriers showing that the aforesaid insurance
policy is in effect. The following coverage's shall be provided:
__ -- - -- — ------------- - -1.-_ Workers- CGmpLensatim �- surance-a aq_ired bit Florida Statutes.-- - - - - -- - --
2. Commercial General Liability Insurance with minimum limits of $500,000
Combined Single Limit (CSL) If split limits are provided, the minimum
limits acceptable shall be $250,000 per Person $500,000 per occurrence
$50,000 property damage.
FY 2013 Funding
Contract MAI168
12
r
3. Comprehensive Auto Liability Insurance with minimum limits of $300,000
combined single limit per occurrence.
The Grantee, the Grantor and the TDC shall . be named as additional insured, except
workers compensation. The policies shall provide no less than 30 days notice of
cancellation, non - renewal or reduction of coverage. Grantee shall provide to the County,
as satisfactory evidence of the required insurance, including the insurance policy
application and either:
• Original Certificate of Insurance, OR
• Certified copy of the actual insurance policy, OR
• Certificate of Insurance e- mailed from Insurance Agent/Company to
County Risk Management - Telephone Maria Slavik at (305) 295 -3178 for
details (Certificates can be e- mailed directly from the insurance agency
to: Slavik- MadaD- MonroeCounty- FL.Gov — The e-mail must state that
this is a certificate for a TDC project and should be forwarded to Maxine
Pacini at the TDC administrative office)
An original certificate or a certified copy of any or all insurance policies required by this
contract shall be filed with the Clerk of the BOCC prior to the contract being executed by
the Clerks office. The Insurance policy must state that the Monroe County BOCC and
Monroe County TDC is the Certificate Holder and additional Insured for this contract
(certificate only for worker's compensation coverage). Insurance information should be
mailed to:
Monroe County Board of County Commissioners
c/o Risk Management
P.O. Box 1026
Key West, FL 33041
21. NOTICE. Any notice required or permitted under this agreement shall be in writing
and had delivered or mailed, postage prepaid, to the other party by certified mail, returned
receipt requested to the following:
For Grantee: Cork Tarplee
PO Box 689
Key West
FL, 33041
ForOrantor. -- tynda - - - - -- - - -- -- _ - - -- - ------ -- - -- - - - --
Monroe County Tourist Development Council
1201 White Street, Suite 102
Key West, FL 33040
and
FY 2013 Funding
Contract ID#:1168
13
Cynthia Hall, Asst. County Attorney
P.O. Box 1026
Key West, FL 33041 -1026
22. CLAIMS FOR FEDERAL OR STATE AID. Contractor and County agree that each
shall be, and is, empowered to apply for, seek, and obtain federal and state funds to
further the purpose of this agreement; provided that all applications, requests, grant
proposals, and funding solicitations shall be approved by each party prior to submission.
23. NON - DELEGATION OF CONSTITUTIONAL OR STATUTORY DUTIES. This
agreement is not intended to, nor shall it be construed as, relieving any participating entity
from any obligation or responsibility imposed upon the entity by law except to the extent of
actual and timely performance thereof by any participating entity, in which case the
performance may be offered in satisfaction of the obligation or responsibility. Further, this
agreement is not intended to, nor shall it be construed as, authorizing the delegation of the
constitutional or statutory duties of the County, except to the extent permitted by the
Florida constitution, state statute, and case law.
24. NON - RELIANCE BY NON - PARTIES. No person or entity shall be entitled to rely
upon the terms, or any of them, of this agreement to enforce or attempt to enforce any
third -party claim or entitlement to or benefit of any service or program contemplated
hereunder, and the County and the Grantee agree that neither the County nor the Grantee
or any agent, officer, or employee of either shall have the authority to inform, counsel, or
otherwise indicate that any particular individual or group of individuals, entity or entities,
have entitlements or benefits under this agreement separate and apart, inferior to, or
superior to the community in general or for the purposes contemplated in this agreement.
25. ATTESTATIONS. Grantee agrees to execute such documents as the County may
reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a
Drug -Free Workplace Statement.
26. NO PERSONAL LIABILITY. No covenant or agreement contained herein shall be
deemed to be a covenant or agreement of any member, officer, agent or employee of
Monroe County in his or her individual capacity, and no member, officer, agent or
employee of Monroe County shall be liable personally on this agreement or be subject to
any personal liability or accountability by reason of the execution of this agreement.
27. FORCE MAJEURE. The Grantee shall not be liable for delay in performance or
failure to complete the project, in whole or in part, due to the occurrence of any
contingency beyond its control or the control of its contractors and subcontractors,
including
_war_or_ act of war whether an actual_ declaration thereof is made or not. act _of_____
terrorism impacting travel in the United States, insurrection, riot or civil commotion, act of
public enemy, epidemic, quarantine restriction, storm, flood, drought or other act of God, or
act of nature (including presence of endangered animal species which cannot be timely
removed in a safe manner or any act of any governmental authority which prohibits the
project from proceeding as described in the scope of services and incorporated references
and which the Grantee has exercised reasonable care in the prevention thereof. However,
lack of planning for normal and expected weather conditions for the time of year the project
FY 2013 Funding
Contract IDA1168
14
lallobsessaMdul not or Will an act af God emmieftedeify. Any delay arfilwo
due to to come elmled alml not cormlM a b rfa ch of Use apa hmw,. the
9= dud heve #w rVt to dgKn*w I ftm wo be any reduclon Is the wnow of
bxb due to to Gmrdn aw cm! We Man of al mlwmW fwb and minnin 101r I
wounft the dsWinp ma orf*n to mm w the project vAft t h e aon
pwkA Upon do w of TDO or B= the gmnift mu@t hrf*h evids d #0 =as
of ouch delay arlebm B00C" rat psy fix any goo*r@o*mor aav provided
after ft ddgs) duatod In par ap r rrph I and Scope of Sovba
A EXEMMON IN COUNTERPARTS. JJ* q im g - t may 'be amouted In any
number cfmuftPsft each Of which Mdb@fsgwtW=Mmrth dofvAftWm
loqdw shal 0WWAdm am ud the mm kwbwwt ad any of ft pare hallo ray QNSMADVAINgresi magby Igil arwouch ow*wpart.
A SEICTM WEADINGL 8 roln. I Cl a have bean im IN b ta age I - a a
a matter dmWww"atmull CIO* and it a0 A that auoh esrdlon tw ad h pe am
not a pat Of fft OPumd and YA W be used In to Mstespr of MW pmvkkn of
tft mg wit.
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MONROE COUNTY ATrORNmy
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ASSIS n!NTY ATTORNEY
Dde-
1E
EXHIBIT A
NAME OF ENTITY: Old Island Restoration Foundation, Inc.
NAME OF PROJECT: Oldest House Museum Lift Station /Restroom Plumbing
Upgrades
NUMBER OF SEGMENTS TO PROJECT: 1
Note County signoff and submission for reimbursement only allowed after completion of
each segment as documented in this exhibit. Grantee must apply for reimbursement
utilizing the 'Application for Payment' form included within the Payment /Reimbursement Kit.
Segment #: 1
Description Materials and labor and
permit fees required to complete the
following work:
e Installation of a lift station in back of
public restrooms at the Oldest House
(includes: alterations to restroom floor
to re -rough sewer line and tying into
the sewer system beneath the house).
Total Cost: TDC portion:
14 2 7411
(In order for this segment to be reimbursed,
acknowledgement of TDC funding must be in place
*No In -kind
and proof In the form of pictures provided with
funds were
submission for reimbursement of this
noted within
segment This acknowledgement shall not be
covered as part of the TDC reimbursement — see
the
contract paragraph 2)
agaiicatlon
Page 1 of 1
1E11
IC
c 1 CERT IFICATE OF LIABILITY INSURANCE 3/26/2 13
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: H the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. N SUBROGATION IS WANED, subject to
the terns and conditions of the policy, certain policies may require an endorsement. A ststement on this certificate does not confer rights to the
PRODUCER Barry PAllspson
Southernmost Insurance PIIOIe . (305) 296 -5052 (309)297 -Oi49
1010 Kennedy Drive Barry@ southernmostinsurance.com
Suite 300 INMJREAM AFFOROM COVERAGE NM #
Rey Crest FL 33040 N3UMA:C41ntUrY SUrStY Insurance
INSURED IINSURFA 8:
Old Island Restoration Foundation, Inc. own" C:
PO Box 689 1 _ 0 =10111 0:
Nest
COVERAGES
CERTIFICATE NUMBER 'CLUS`buueua
KftVIwwN n umatn:
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.
81=1 OM su POLICY EM POLICY VIP
LTR
A
TYPE OF 9"ANCE
OENERALLIAMM
COMMERCIAL GENERAL LIM ITY
CLAWS -MADE E] OCCUR
X
Monroe County, BOCC
801243
2/5/2013
2/5/2013
LIMITS
EACH OCCURRENCE
$ 1
E TO RENTED
3 100,000
MED EXP A once anon
3 5,000
PERSONAL 6 ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
3 2,000,000
GEWL AGGREGATE LIMIT APPLIES PER:
X POLICY P Lac
PRODUCTS - COMP/OP AGO
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OI D �� LED
HIRED AUTOS AAU TIOS NED
COMINED SINGLE LIMIT
BODILY INJURY (Per pwaan)
3
SOOILY INJURY (Pw acddwN)
$
R DA
(per A=dwm
3
$
UMBRELLA Lt"
EXCESS LIAR
OCCUR
CLAMS-MADE
/
EACH OCCURRENCE
3
AGGREGATE
$
WORMJI! COMPO4AYMN
AND EMPLOYERS• LIABILITY
TORLPARTNERIECUTIVE YIN
ANY PROPRE XE
OFRCEF MEMBER EXCLUDED?
(M I -- lop"
D OMCION F OPERATIONS below
N/A
ATU" I 10A
E.L. EACH ACCIDENT
$
E.L DISEASE - EA EMPLOYE
3
E.L DISEASE - POLICY LIMIT
DESCMP ION OF OPENATIONS / LOCATIONS / VEHICLES (A Baeh ACORD 101, Add00nal Rwanka eehaeda, B Saw aPaea b M**9Q
Certificate holder is additional insured for TDC projects: plumbing repair and hurricane shutter
installation
nwune, I A n^u
ACONO20(ZIJ1WUD) wivowcuivmu%mwVVnrvnl%fnvn.
INS025 (woo5).o1 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
Monroe County, BOCC
ACCORDANCE WITH THE POLICY PROVISIONS.
Misria Slavic
1100 Simonton Street, Ste 268
AUTNORQEDREPRlSENTATIVE
Key Nest, FL 33040
Barry Philipson /BP
ACONO20(ZIJ1WUD) wivowcuivmu%mwVVnrvnl%fnvn.
INS025 (woo5).o1 The ACORD name and logo are registered marks of ACORD
M Ed1ed
MONROE COUNTY, FLORIDA
Request For Waiver
of
Insurance Requirements
It is requested that the insurance requirements, as specified in the County's Schedule of Insurance
Requirements, be waived or modified on the following contract.
Contractor: Old Island Restoration Foundation, Inc.
Contract for: Oldest Noase
Address of Contractor. 322 Duval Street, Key West, Florida 33040
Ptroax: (305) 294 -9501
Scope of Work; UR Station and Restroom Project and Window and Strutters Project
Reason for Waiver.
Waiver of Auto Insurance requirement and Workers Comp: No Autos and
only 3 employees
Policies Waiver win
apply to: Workers Comp and Auto
Signature of Contractor: d /
AP" Not Appro
Risk Management:
Date: — 1 — I /
County Administrator Appeal:
Approved Not Approved
Date:
Hoard of County Commissioners Appeal:
Approved Not Approved
Meding Dab:
Administration Instruction
94709.2