Item V2BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: November 22, 2016
Bulk Item: Yes No X
Department: Project Management
Staff Contact/Phone #: Doug Sposito X4416
AGENDA ITEM WORDING: Approval of a change order with Greentech Group Solutions, LLC for
the Key Largo Park Residence Spaliing and Deck Repair project,in the amount of $25,607.16. This is
funded by the one -cent infrastructure tax.
ITEM BACKGROUND: The Key Largo Park duplex building has a large storage space underneath it
that is non - compliant with Monroe County code. The Monroe County Planning Department requested
that the building be brought up to code by adding two legal storage units under the residential building
where the large single space is.
PREVIOUS RELEVANT BOCC ACTION: On June 15, 2016 the BOCC approved a contract with
Greentech Group Solutions, LLC for the Key Largo Park Residence Spatting and Deck Repair.
CONTRACT /AGREEMENT CHANGES: Add two storage units and increase substantial
completion by 21 days.
STAFF RECOMMENDATIONS: Approval as stated above.
TOTAL COST: $25,607.16 INDIRECT COST: BUDGETED: Yes X No
DIFFERENTIAL OF LOCAL PREFERENCE: N/A
COST TO COUNTY: $25.607.16 SOURCE OF FUNDS: Fund 304
REVENUE PRODUCING: Yes _ No X AMOUNT PER MONTH Year
APPROVED BY: County Atty OMB/Purchasinink1k Management,
DOCUMENTATION: , Included X Not Required
DISPOSITION: AGENDA ITEM # V X
Revised 6115
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with:
Contract Purpose/Description:
Contract #
Effective Date:
Expiration Date:
I Contract Manager: Aafitx� i 'j3 '4# ` - aBRri 41
(Name) (Ext (Department/Stop #)
for BOCC meeting on i 11/22/16 Agenda Deadline: rIlOT '
CONTRACT COSTS
Total Dollar Value of Contract: $ ,Q' Current Year Portion: $
Budgeted? Yes® No Q Account Codes:' 304- 24000 - 560620 - COI 505
County Match: $ - - -
ADDITIONAL COSTS
Estimated Ongoing Costs: $ Iyr For:
of included in dollar value above) (e.. maintenance, utilities, janitorial, salaries,
CONTRACT REVIEW
Changes
41 Needed Reviewer
Department Head Yes[] No
Risk Management I jZL1y YesQNoRf
O.M.B./Purchasing 11 �II Yes[] NoQ
County Attorney � YesQ Nol;� r
It
11
Comments:
0MR Fnnn Revised 2127101
il��1111�lp N411011,
PROJECT TITLE:
Key Largo Park Residence Spalling
and Deck Repair
TO CONTRACTOR:
Greentech Group Solutions, LLC
P.O. Box 504422
Marathon, FL 33050
The Contract is changed as follows:
CHANGE ORDER NO: 1
INITIATION DATE: November, 2016
CONTRACT DATE: June 15, 2016
The original (Contract Sum) (Guaranteed Maximum Price) .............. ..............................$ 82,000.00
Net change by previously authorized Change Orders .:.... ............................... ..............$ 0.00
The (Contract Sum) (Guaranteed Maximum Price)_prior to this Change order was .............$ 82,000.00
The (Contract Sum) (Guaranteed Maximum Price) will be increased (decreased)
(unchanged) by this Change Order ....... $ 25,607.16
The new (Contract Sum) (Guaranteed Maximum Price) including this Change Order is ....... $ 107,607.16
The Contract Time will be (increased) (decreased) (unchanged) by ... ............................... 21 days
The date of Substantial Completion as of the date of this Change Order is ............... ..... .January 17, 2017
Detailed description of change order and justification:
Two &g §forage units under residence building added to the scope of work par permitting requirements.
An additional 21 days needed forsubstantial completion forthe delivery of the doors.
This change Order is 31.23% of the original contract,arice.
(SEAL)
Attest: Amy Heavilin, Clerk
By: _
Date:
CONTRACTOR
NTECH GROUP SOL ONS, LLC.
J
Title: -�
Date:
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By:
i
Mayor /Chairman
z
co
WIT SS TO COkXRACTOR
Q <
r
, '
z 8�
U N
By.
RQ
Date:
STATE OF FLORIDA
COUNTY OF
On this day of d , 2016, before m ersonall ap red vt ' L51 . known to me to be the
person whose name is subscribed above or who prod 4 as identification, and acknowledged that he /she is
the person who executed the above contract with Monroe Cou y o'r the Key La n Reside "& ack Repair, for
the purposes therein contained. �'�
MY COtrlhliSSIOPI # FF 229h61 Stamp and Signature of Notary Public � Z `X EXPIRE May 12, 2019
^� o ° Bonded Dru BudcetNalary Services
Change Order Attachment per Ordinance No. 004 -1999
• Change Order was not included in the original contract specifications. Yes ® No ❑
If Yes, explanation: The Monroe County Planning Department requested that the building
residence be brought up to code by adding two legal storage units, under the residential
building, where there existed one large space. Additional time needed for delivery of
materials.
• Change Order was included in the original specifications. Yes ❑ No
If Yes, explanation of increase in price:
• Change Order exceeds $25,000 or 5% of contract price (whichever is greater). Yes ® No ❑
If Yes, explanation as to why it is not subject for a calling for bids: These are changes to the
existing contract with the contractor. To bid these changes would cause more interruptions
and delays to the project
• Project architect approves the change order. Yes ❑ No
If no, explanation of why: The Architect is not responsible for Construction Administration
services.
• Change Order is correcting an error or omission in design document. Yes ❑No
Should a claim under the applicable professional liability policy be made? Yes ❑ No
Explain:
Greentech Group Solutions, LLC
CHANGE ORDER No 01
Project: Spalling Repair and Wooden Deck Replacement - 320 Laguna Avenue - Key Largo
Owner: Monroe County
Contractor: Greentech Group Solutions, LLC
PO# : Contrat Agreement
Original Purchase Order Amount ....................... ............................... $82,000.00
Net Changes from Previous Change Orders ....................... $0.00
Contract Amount prior to this Change Order ....................... $82,000.00
Net Increase / (Decrease) of this Change Order ...... ............................... $ 25,607.16
Contract Amount with all approved Change Orders .............. $107,607.16
Change Order Description
This Change order includes the costs, overhead and profit to cover the additional scope of work not included on original contract scope of work
depicted on provided revision dated 5.16.16 and as it is listed below.
Item Description Quantity Unit Unit Value Total Value
Windows - Material
Impact Windows 36X36 - SGL HUNG Zone 4 pos +46, neg - 50.1
4
Ea
$ 368.00
$ 1,471.98
PT Wood and Hardware (Frame)
1
LS
$ 60.79
$ 60.79
2X4X 12 - $6.87Ea -Needed 7Ea Subtotal (including tax) $51.69
#100 Inc Polymer Coated Exterior Screw 1 Box (Including tax) $9.10
Doors - Material
Steel Frame & Door DP Rating +75/ -75 - 180 mph Zone 5
4
Ea
$ 870.75
$ 3,483.00
PT Wood and Hardware (Frame)
1
LS
$ 82.95
$ 82.95
2X4X12 - $6.87Ea - Needed IOEa Subtotal (including tax) $73.85
#10x3 Inc Polymer Coated Exterior Screw 1 Box (Including tax) $9.10
Smart Vent Hood - Material
Smart Vent Hood - Material
8
Ea
$ 261.22
$ 2,089.72
Paint - Materials
Paint - Primer coat
1
Ea
$ 75.19
$ 75.19
Paint - Gildden Premium
1
Ea
$- 94.46
$ 94.46
SUBTOTAL.'
$,''. " , '1;35&09
Mark -u (10 °la
TOTAL MATERIAL •
S' '' ' %8;093:89
Electrical Scope of Work (SUBCONTRACTOR)
Subcontractor - Galaxy Electric
1
LS
$ 5,750.00
$ 5,750.00
Partitions and Walls (SUBCONTRACTOR)
Subcontractor - GA Contractors
1
LS
$ 1,800.00
$ 1,800.00
SUBTOTAL<
Mark =u '(40 %a ).:
$'•,. °.; 75 :00;
TOTALsMATERIAL.
•. .. . ";'830500'
Greentech Labor
Based on:
Crew: 1 Foreman 1 Carpenter 2 Labor
Foreman (Salary $1.500 Weekly)
Carpenter (Hourly $16.25)
Labor (Hourly $14.25) X2
Total Hour Cost/Crew: $82.25/Hour
Bourden @ 35 %: $28.80 Hour
Total Direct Cost Crew: $I 11.05
Demolition - Labor
Esitmate time frame to demo additional scope of work 16 Hours
16
Hour
$ 111.05
$ 1,776.80
Windows - Labor
Estimated time frame per crew to install lEa 36X36 Window - 4 Hrs
16
Hour
$ 111.05
$ 1,776.80
Estimated time frame per crew to install lEa 36X36 Window Frame - 4 Hrs
Is -
Greentech Group Solutions, LLC
Door - Labor
Estimated time frame per crew to install 1 Ea Steel Door - 4 Hrs
12
Hour
$ 111.05
$
1,332.60
Estimated time frame per crew to install IEa Door Frame - 4 Hrs
Smart Vent Hood - Labor
Estimated time frame per crew to install IEa Smart Vent (Concrete) - 2 Hrs
8
Hour
$ 111.05
$
888.40
Estimated time frame per crew to install IEa Smart Vent Wood Frame) - 1 Hr
4
Hour
$ 111.05
$
444.20
Paint - Labor
Estimated Time frame to paint the additional scope of work
10
Hour
$ 111.05
$
1,110.50
SUBTOTAL
$
'7;329.30
Mark-up 5 %a
$-
366.47
TOTAL MATERUL
$
7,695:77'
Others
Furnishing ofDum sters
1
Ea
$ 575.00
$
575.00
Furnishing of tools and special equipment (Chipping Hammer, Generator, etc)
I
LS
$ 800.00
$
800.00
SUBTOTAL
$ '-
1,37 §.00
Mark -u . 10 %';
$'
1:3750..
TOTAL'MATERUL
$ `.
5,512:50
TOTAL
.$
2$,607:16
NOTES: ADDITIONAL TIME REQUESTED TO COMPLETE THE LISTED SCOPE OF WORK IS 21 CALENDAR
DAYS
Net Total ..... ...............................
Total
All other Terms and nnditions of the Original Purr-hasp Ord - Remain Unchanged
It is further understood and agreed that all terms and conditions of said Contract as it may herebefore have been modified shall be
and remain the same.
This writing comprises the full and entire agreement between the parties affecting the work provided for herein. No other agreement
or understanding of any nature concerning the same has been entered into or will be recognized. Contractor has made no
inducements or representations to Subcontractor whatsoever except as expressely herein stated . No oral modification of this
Change Order has any force of effect.
This Change Order authorization includes not only all direct costs of the subcontractor such as labor, material, job overhead, and
profit marked but also includes all costs for modifications or changes in sequence of work to be performed, delays, rescheduling,
disruptions, extended direct overhead and general overhead, acceleration, material or other escalation which includes wages,
and other impact costs.
Change Order
$
$
Amount
25,607.16
2 5,607.16
Accepted : Accepted
Greentech Group Solutions, LLC Monroe County
By: Date : By:
Title : Title
Date
FaRESTEK, LLC
38521 OVERSEAS HWY
TAVERNIER, FL 33070
Detailed with Locations
POMGREENTECH
Job Name:
Job Address:
Ouole ff 517914
Ship Date: 0!31/2016
Sales Person'.Renee Barile
Customer Cash "132
Account #
Pthoneff ( 393 -2749 Fax#
Line #
item Description Quantity
Line Pricing
0001 SH700 ALUf,.t SINGLE HUNG 700 ordered:
Lisp Price. $.p Price_
(1.00)
4.00
5487.00 5342.32
Configuration:
36.X36.X .STD.112" FL.W,EQUAL,G,G- 5!16,01R.NO GRID, SGt _.S'r� /f= LP.181oK,1_SILI_,...x.
Certification Type: MIAMI
NOA Selection: 16- 0714.06
?r =fir`; L %' ^ =3
Frame Type:.5FLANGE
Vent Cori figuration: EQUAL
Window Style: STD
Size Selection: CUSTOM
.T,'.
Size Ref: TTT
Width: 36.0000
,:
Height: 36.0000
Actual Size: 36 X 36
Rough Masonry: 36 314 X 36
Wood Frame: 3 114 .5 X 35 114
Egress: 32 112 X 11 314 (2.652 SQFT)
Frame Color: White
Does unit need to meet Turtle Code: NO
Glass Family Laminated
Glass: 5!16" LAMI (!!BAN - .090 PVB- 118 AN)
Interlayer Type: PVB090
Glass Color: GRAY
Low E: NONE
Privacy Glass: NONE
Grid Type: NO Grid
Screen Type: 1816 Charcoal
Stainless Steel Package: N
Anchor Group: C.SH700
Boxing Options: None
Lock Type: Sweep Latch
Decralite: N
I.mtd Sash Stop: N
Vent Ht: 18.2070
CAR #: 16. 0714.0(;
Positive DesignPressure: 64.0000
NegaliveDesignPressure: 80.0000
PANuniber: FL -239
EnergyStar: NONE
CondensationResistance: 13.0000
U F: 1.0700
Sola rHeatGainCoof f : 0.5300
VT: 0.4000
VTCOG: 0.5900
Location:
Notes:
TOTAL LIST AMOUNT: $1948.00
E�Aj P!'tu
S1.369.28
TOTAL SALE AMT: $1,369.28
TOTAL CUSTOMER $102.70
V TAX:
$1,471.98
NET SALE AMOUNT:
Please verify all quantities, sizes and options_ If you would like to place this order please initial each product you are
ordering and sign by the total.
Quote 9 517914
Print Date 912712016
I
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FOREST TEK LUMBER PAGE NO 1
88521 OVERSEAS HIGHWAY
TAVERNIER FL 33070 -2048
www.keysIumber.com
PHONE: (305) 852 -4300
YOUR WINDOW AND DOOR SPECIALIST
GUARANTEED LOW PRICE
CYST NO: JOB NO: PURCHASE ORDER: REFERENCE: TERMS: CLERK: DATE I TIME
"5 000 GREEN TECH SOL HVHZ STEEL DOORS CASH KA 9130116 7:19
TERMINAL: 562
SOLO TO: SHIP TO. EXP. DATE: 2128117 '
CASH
SALESPERSON: KA KEN ARTMANN
TAx: 001 FL STATE•MONROE COUNT
ESTIMATE: 575801/1
LINE
SHIPPED
ORDERED
UM
SKU
DESCRIPTION
LOCATION
UNITS
PRICE/ PER
EXTENSION
1
Steel Frame & Door - HVHZ &
2
4
EA
ZZ001 575801 01 1
Unit 3/0 x 618 FLUSH
SO
4
810.00 /EA
3,240.00
3
Steel Frame & Door - HVHZ &
4
90min
5
OP Rating +75/ -75
6
- Welded - P &D Frame w/
7
Expansion Bolts
8
- Double Bore
9
- T' Bumper Threshold Outswing
10
- Weatherstrip
11
- US 32 BBD Hinges
12
SO
13
LEAD TIME IS 3 +1- WEEKS
SO
°5000575801E31001^
TOT WT: 0.00
TAXABLE 3240.00
NON- TAXABLE 0.00
SUBTOTAL 3240.00
TAX AMOUNT 243.00
TOTAL 3483.00
X
Received By
FOREST TEK LUMBER
88521 OVERSEAS HIGHWAY
TAVERNIER FL 33070 -2048
www.keysiumber.com
PHONE: (305) 852 -4300
YOUR WINDOW AND DOOR SPECIALIST
GUARANTEED LOW PRICE
PAGE NO 1
COST NO: JOB NO:
PURCHASE ORDER: REFERENCE:
TERMS:
CLERK: DATE ( TIME:
15 000
GREEN TECH SOL SMART VENT CONCRETE
CASH
KA 9130116 8:11
PRICE/ PER
EXTENSION
1
2
TERMINAL: 562
SOLO TO:
SHIP TO:
EXP. DATE: 2/28/17
SMART VENT CONCRETE
16 "X8"
' * CASH ""
KIM
242.99 /EA
>>
971.96
SALESPERSON: KA KEN ARTMANN
TAX: 001 FL STATE - MONROE COUNT
ESTIMA TE: 575816/1
LINE
SHIPPED
ORDERED
UM
SKU
DESCRIPTION
LOCATION
UNITS
PRICE/ PER
EXTENSION
1
2
4
EA
SMV
SMART VENT CONCRETE
16 "X8"
40D
40D
4
242.99 /EA
>>
971.96
TAXABLE 971.96
NON - TAXABLE 0.00
SUBTOTAL 971.96
`5000575816E31001\
TOT WT 0.00
TAX AMOUNT 72.90
TOTAL 1044.86
X
Received By
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Proposal Date: 10110C2016
Proposal #: 1452
PROPOSAL
Bill To:
Green Tech P.O. Box 504422
Description
Prov Electrical Control Breaker Panel (Exterio
Provide new wiring for: GF|'s2ea.3 Way Switch Light
4Eo. Smoke Detector 2Eo.
Relocate existing lines tobo wired hnmproposed
Ex Control Breaker Box.
Includes all labor equipment and material
Work hzboperfomedat320 Laguna Av. Key Largo
aa per drawings dated 5-18-18 (rev per Fema)
Engineer Timmins Engnieohng.LLC
Est. Hours/Qty.
Rate . Tota
5,750.00
...... .... ......... .... ...
$5
SIGNATURE
Page I ol'3
Proposal No. 16-1020-01 Rei
Proposal Submitted To:
Greentech Group Solutions LLC
143 Sioux St.
Tavernier, FL 33070
Date: 1110812016
Job Address:,
320 Laguna Avenue
Key Largo, Fl. 33036
Project: Partition and Exterior Plywood Wall Installation to Subject Property:
We hereby propose to furnish the materials and perform the labor necessary for the
completion of the above mentioned project.
Initial
South Florida
CA lhw� soulkIR 1`1-11m�ld"
Page 2 oP3
i
Scope of work:
• Install partitions as per Engineer drawings dated 12th of Feb 2016 (Sheet #2)
• Remove All Partition and Gypsum Board Construction Debris from Job Site.
• Paint by others.
• Electrical work, by others.
• Plumbing work by others.
• A/c work by others.
1:Y'iCY GA Contractors is responsible for only Partition, depicted on Engineer Drawings,
GA is not responsible for any finish (paint, knock clown texture, etc).* * * **
*v .t... ?': .4 T 's " ?E�t (S fF!:}iC'i. E:i jt ?s'i 'Ei i'I ?'f Etl ' ?i � €: ?': ?C'C:; a�EI ?� .. €'ii{ S:+ F,il!? %i E? !'•n: ?:'i' ?ii.,. :k. E =' ...- `.ECi7Ei Ii:Ei� ti!
Is will i.. +i "i .:£ 'i? ; ' - . 1
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All Materials guaranteed as specified by FLBC and the above work performed in
Accordance to the drawings and specifications submitted and completed in a Professional
and Workmanlike manner.
Project Total $1,800.00
Initial
1 3 oP3
Payments to be made as Followed:
1" Payment - 45 %►.upon signing of the contract
2 n ` 1 Payment - 45% to installation of gypsum board
3" Payment — 10% upon completion of job
i' :Y 3� w? i F' .s '.r ;F`: fY, t2 (:. ; yi; ?1 iS!`?:ii " , r i:S=S .`:'i$ • ° . 5 3?..e, i ??..... �:)S � y`.
Signature:
GA Representative.
Date:
The Above prices, specifications and terms are satisfactory to me and are hereby
accepted. You are authorized to complete this contract and
Payment will be made as outlined above.
S ignature:
;authorized Customer
Date:
7539 Gulf Stream Blvd. Marathon F133050
rw
Cell# 305- 440 -2812 Cell # 305 -680 -8000
Jorge Rafael
LICENSED & INSURED
Initial
Bill To
GREENTECH GROUP SOLUTIONS LLC
PO BOX 504422
MARATHON FL 33050
INVOICE
Date Invoice #
10/1912016 38133
I Delivered To (Job Site) I
CURRY HAMMACK STATE PARK
56200 OVERSEAS HWY
MARATHON, , FL 33050
EURANY 305 - 903 -2944 code0636
la derecha ,nadamas que entres
P.O. No.
Terns
Project
VERBAL JUAN
Credit Card
Description
Ordered
S.O. No.
Unit Price / Rate
Amount
EXCHANGE OF 20 -YARD DUTAPSTER
1
15 -21666
575.00
575.00
Phone #
E -mail
Follow Us Online!
Subtotal 5575,00
(305) 743 -5680
accounting @discountrocksand.com
m-tv.DiscountRockandSand.com
Thank You For Your Business!
Sales Tax 50.00
We Accept: Visa. Mastercard, Discover, American Express, Business & Personal Checks.
Total $575.00
Please mail payment to:
Discount Rock & Sand, Inc.
P.O. Box 504484 - Marathon. FL 33050 '; : w <;<> _ , ,...
Payments /Credits $0.00
BALANCE DUE $575.00
����® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
6/24/2016
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()es) must be endorsed. If SUBROGATION IS WAIVED, subject to
tl:e terms and conditions of the policy, certain policies may require an endorsement. A statement on this certifcate does not confer fights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Keys Insurance Services
5800 Overseas Hwy
p .0. BOX 500280
Marathon FL 33050
NAMEACT Angel zzYarbrough
PHONE (305) 743 - 0494 FAX (3057743 - 0582
1M a. Pslh LAIC, Noh
AD O R esS :ayarbrough @keysinsurance.com
INSURER (S) AFFORDING COVERAGE
NAIC It
INSURER A:International Ins Co of Hanover SE
100,000
INSURED
Greentech Group Solutions LLC
P.O. BOX 504422
Marathon FL 33050
INSURERS :Allstate Insurance
I
INSURERC:Florida Citrus Business 6 Ind
`�� / y �ED� Y (S �ANAGLmI 'r' PERSONALBADVINJURY $
GENERAL AGGREGATE I $
INSURER DAmerican Zurich Ins Company
GEN'L AGGREGATE LIMIT APPLIES PER: ,' J'(
X POLICY E] PRO- JECT ❑ LOC EY ) / PRODUCTS - COMP /OP AGG $
/
�j1
INSURER E
OTHER: DATE 'y 11 `10 $
INSURER F:
1
V 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 REDU B Y PAID CLAIMS.
INSR TYPE OF INSURANCE A L I S POLICY NUMBER MMIIODNYW h M tUOCO� LIMITS
LTR
X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE Is
1,000,000
PR MISE� I S
100,000
A CLAIMS -MADE � OCCUR .occu rrence)
IG06C003762 -01 11/2015 11/23/2016 MED EXP (Any one person) $
5,000
`�� / y �ED� Y (S �ANAGLmI 'r' PERSONALBADVINJURY $
GENERAL AGGREGATE I $
1,000,000
2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: ,' J'(
X POLICY E] PRO- JECT ❑ LOC EY ) / PRODUCTS - COMP /OP AGG $
/
�j1
2,000,000
OTHER: DATE 'y 11 `10 $
1
AUTOMOBILE LIABILITY
i t
WAIVER N/
YES_.
-
COMBINED SINGLE LIMIT
(Ea acctdenq
$
1,000,000
BODILY INJURY (Per person)
$
X
B
ANY'AUTO
ALL OWNED SCHEDULED
AUTOS ALTOS
648233553 00
5/2/2016
5/2/2017
BODILY INJURY (Per accident)
$
PROPERTY cAmA.
(Pef aCriden
i s
"ION- OT'NEp
HIRED AUTOS XUTOS
is
10,000
I
UMBRELLA LIAR
I
EACH OCCURRENCE
i s
AGGREGATE
I s
H OCCUR
EXCESS LIAS
CLAIMS -MADE
I
DED I 1 RETENTIONS
I s
WORKERS COMPENSATION
STATUTE I ER
I
'
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
-
EL EACH ACCIDENT
$
5 00,000
,
E.L. DISEASE - EA EMPLOYE
S
500
C
OFFlCERISiEMBER EXCLUDED? I�
(Mandatory In NH)
NIA A
I
10645259
6/3/2015
6/3/2017
E.L. DISEASE - POLICY LIMIT
I S
500
if ' es, describe under
Or5CRIPTION OF OPERATI belovi
II I
D
Builders Risk
ER09349061
6/27/2016
12/27/2016
$82,000
$82,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
Monroe County Board of County Commissioners is an additional insured for General Liability and Automobile
Liability when required by written contract, subject to policy terms, conditions and exclusions.
nULUI=M
Monroe County Board of County Commissione
1100 Simonton St.
Key West, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
David Sheppard /DSHEP b r, 0 `^
n 19RR_2n1d ACORn CORPORATION. All riahts reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (9n1401l