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Item D14C ounty of M onroe {f `° " rel BOARD OF COUNTY COMMISSIONERS n Mayor David Rice, District 4 The FlOnda Key y m 1 �� Mayor Pro Tem Sylvia J. Murphy, District 5 Danny L. Kolhage, District 1 George Neugent, District 2 Heather Carruthers, District 3 County Commission Meeting July 18, 2018 Agenda Item Number: D.14 Agenda Item Summary #4436 BULK ITEM: Yes DEPARTMENT: Project Management TIME APPROXIMATE: STAFF CONTACT: Johnnie Yongue (305) 292 -4429 none AGENDA ITEM WORDING: Approval to seek additional documentation„ which was left out by the lowest bidder, A -1 Property Services, for the Tavernier Fire Station Roof Replacement and enter into a contract if sufficient documentation is provided. A -1 Property Services bid is for $119,500.00. If documentation is not sufficient, staff seeks approval to award to the higher bidder, Roofing By Ruff, Inc., who submitted a bid of $272,000.00. The contract is to replace the roof on the Tavernier Fire Station which was partially removed during Hurricane Irma. ITEM BACKGROUND: The roof of the Tavernier Fire Station was severely damaged by Hurricane Irma, and is in dire need to be replaced. On June 19, 2018, County staff opened the two proposals in response to the Request for Proposals. The low bidder did not provide the financial information and answer the legal questions required in the procurement process for sealed bids. In lieu of rejecting and re- advertising the project due to the severe condition of the roof, Monroe County staff is asking for approval to ask for the missing documentation and enter into a contract with the lowest bidder, or reject his bid for being incomplete and award to the higher bidder. PREVIOUS RELEVANT BOCC ACTION: On September 7', Monroe County declared a state of emergency due to the threat of Hurricane Irma. CONTRACT /AGREEMENT CHANGES: New Contract STAFF RECOMMENDATION: Approval as stated above DOCUMENTATION: A -1 property Services Proposal Roofing by Ruff Proposal FINANCIAL IMPACT: Effective Date: 7/18/18 Expiration Date: Substantial completion of the work not later than ninety (90) days after commencement of issuance of a Notice to Proceed. Total Dollar Value of Contract: $119,500 or $272,000.00 Total Cost to County: $119,500 or $272,000.00 Current Year Portion: $119,500 or $272,000.00 Budgeted: Source of Funds: 125 - 0459110- IRMONREI CPI: Indirect Costs: None Estimated Ongoing Costs Not Included in above dollar amounts: none Revenue Producing: No Grant: No County Match: NA Insurance Required: Yes Additional Details: None If yes, amount: Bid price from A -1 Property Services $119,500, Bid price from Roofing by Ruff $272,000. Hurricane Irma damage repairs. To be spent in FY 2018 07/18/18 125 - 0459110 -HURRICANE IRMA IRMONREI $272,000.00 REVIEWED BY: Ann Mytnik Completed 07/03/2018 3:01 PM Kevin Wilson Completed 07/03/2018 3:03 PM Patricia Eables Completed 07/03/2018 3:32 PM Budget and Finance Completed 07/03/2018 3:35 PM Maria Slavik Completed 07/03/2018 4:59 PM Kathy Peters Completed 07/03/2018 5:05 PM Board of County Commissioners Pending 07/18/2018 9:00 AM W V Q N LL z Q W 00 z W H Q a W D w V a W W O w Q J m x IL O O M Q 00 O N G1 W n n W a 0 Z W IL O V �I �I O O O W J H w H A w H O W O In N U L L O L CL Q a L z 72 a 0 N S } } y a C3 N � S U U � N p� N } C3 � s c3 > N Cf � N � 7 U S L a � � o a a rn � o — • .' F .W. � Q a O .� U — } L U O L� U > a � 0- C) U') fn -6 s � } U a � C3 } •L L O U LL O L 01 N 4 S } H U') m O L S a a J m N N Q O m z O O O O O Q O O 0 O Lr I� ri N ,-I 0 0 o 0 m 0 m Y L z 0 D � ) U z C° O CL o p d C1 z Q } L O_ N N } U m N U L L O L CL Q a L z 72 a 0 N S } } y a C3 N � S U U � N p� N } C3 � s c3 > N Cf � N � 7 U S L a � � o a a rn � o — • .' F .W. � Q a O .� U — } L U O L� U > a � 0- C) U') fn -6 s � } U a � C3 } •L L O U LL O L 01 N 4 S } H U') m O L S a a J m N N Q O m I acknowledge Alternates as follows: 10 1150 mi- Unit prices, if any, are as follows: I acknowledge receipt of Addenda No.(s) No. Dated FP No. Dated No. Dated No. Dated Proposer, states by his/her check mark in the blank beside the form and by his/her signature that he/she has provided the following requirements (located in Section (30120): 1. Proposal Form 2. Proposal Security (Bid Bond) 3. Non-Collusion Affidavit 4. Lobbying and Conflict of Interest Clause 5. Drug-Free Workplace Form 6. Public Entity Crime Statement 7. Subcontractor List Form & Proposer's Insurance and Indemnification Statement 9. Insurance Agents Statement (signed by agent) 10. Answered Required Questions 11. Provided three (3) Customer References and three (3) Credit References 12, Provided three (3) years of Financial Statements in separate envelope 13, Certified copy of Valid Florida Contractor's License 14. Current Monroe County Occupational License 15. Minority Owned Business Declaration 16. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion Business ki C6 Name: t sew, ca- DBA: 0 01 PROPOSAL FORM 00120- Page 25 of 229 14M M N Business EIN # Business Address: C !S VJ Mailing Lj() Address: City ' State, Zip 'N66Mi F� City, State ZiPAM Phone: Local Phone: j Email: The physical business address must be regist Florida Department of State for at least one (1 proposal. Date: I Signed: as its principal place of business with the r prior to thp notice of request for bid or N Title: Witness: ec'm PROPOSAL FORM 001 20- Page 26 of 229 1:112501060.1 0 M.11 PROPOSALTO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS c/o PURCHASING DEPARTMENT 1100 SIMONTON STREET ROOM 2-213 KEY WEST, FLORIDA 33040 PROPOSAL FROM: The undersigned, having carefully examined the Work and reference Dr8vvngs. GpgcificatioRs, Proposal, and Addenda thereto and other Contract Documents for the construction of: and having carefully examined the site where the Work is to be performed, having become familiar with all local conditions including labor affecting the cost thereof, and having familiarized himnoeWYhomaelfvvi{h material availability, Fadere|. State, and Lnoo| |evvs, ordinances, m|ea and regulations affecting performance of the VVodr does hereby propose to furnish GM labor, mechaDUcS, superintendents, tools, material, equipment, transportation Gen/ioe6, and all incidentals necessary 10 perform and complete said Work and work incidental haretu, in m workman-like manner, in conformance with said Dnyvings. Opeuifioat|ona, and other Contract Documents including Addenda issued thereto. The undersigned further certifies that he/she has personally inspected the mttOe| |oCBtk}n of where the Work is to be performed, together with the |ooe| ouuro*a of supply and that he/she understands the conditions under which the Work |otobeperformed. The successful proposer shall assume the risk of any and all costs and delays arising from the existence of any subsurface or other latent physical condition which could be reasonably anticipated by reference to documentary information provided and made available, and from inspection and examination of the site. The Base Proposal shall be furnished below in words and numbers. If there is an inconsistency between the two, the Proposal im words shall control. \ ~ dL O> (Total Base Proposal- words) 1 M (Total Basd Proposal — numbers) PROPOSALFORM 00 120- Page 24 of 229 KNOW ALL MEN BY THESE PRESENTS, that we A-1 Property Services Group, Inc. 890 SW 69th Ave., Miami, FL 33144 (Here insert name and address or legal title of Contractor) as Principal, hereinafter called the Principal, and FCCI Insurance Company 6300 University Parkway, Sarasota, FL 34240 (Here insert full name and address or legal title of Surety) a corporation duly organized under the laws of the State of FL as Surety, hereinafter called the Surety, are held and firmly bound unto Monroe County Board of County Commissioners 1100 Simonton St., Key West, FL 33040 (Here insert full name and address or legal title of Owner) as Obligee, hereinafter called the Obligee, in the SUM of Five Percent of Bid Amount Dollars ($ 5% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Tavernier Fire Station ReRoofing (Here insert full name, address and description of project) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with a other party to perform the Work covered a other pa th erw� by said bid, then this obligation shall be null and vo' , otherwise to remain in full force and I effect. Any action instituted by a claimant under thi Lbond mustke i accordance with 'the notice and time limitations provisions in Section 255.0 2), Florida St tut (Witngs 0 ne t '�S)' wip (Sea,') Po? �)'i V) (Title) (Su rety) (Sea[) Tina Shannon, Attorney-in-Fact (Title) PROPOSAL FORM 001 20- Page 27 of 2129 I INSURANCL 'FCC GROUP More than a policy. 4\s Know all r State of F C I Ins lei :1 :4 9 1 09 I organized\nd existing Under F,CCI,ln.sur,a,,nlcleCom,Any,. 11 11 11 1111 111 11 1 1 1111111111111 1 W SECTION 00120 NON-COLLUSION AFFIDAVIT . . cit VA | the 8ocdrdingto law ' on 0y oath, dnd under penalty of pe depose and say that: 1. |o the proposer making tHe Proposal forflie project described in the notice for calling for proposals for: and that | executed the said proposal with full authority to do so; 2. The prices in this proposal have been arrived at independently without collusion, oonau|bation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other proposer or with any competitor; and 3. Unless otherwise required by |avv, the prices which have been quoted in this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed by the proposer prior to proposal opening, directly or indirectly, to any other proposer or tO any competitor; and 4. No attempt has been made or will be made by the proposer to induce any other person, rt not to mubnm[t, g proposal for the purpose of 5. The co tai d in this affidavit are true and oorreot, and made with full (Si#4 re of Proposer) (Date) STATE OF: r �� `~ COUNTY OF: PERSONALLY APPEARED BEFORE ME c�� . undersigned / who, after first being sworn bv me, (name of individual signing) mffix*dhks/her signature inthe space prov above. PROPOGALR]RM O012O- Page 28of22B SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE Al " warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer oremployee in violation of Section 2 Of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach nr violation nf this provision the County may i its discreton terminate this contract without liability and may also, in its discretion, deduct from the contra purChase price or otherwise recover, the fo|| amount of any fee, commission, percentage gift, or consi erat paid to the former County officer or employee". il I Date STATE OF: I V COUNTY OF: bAbQ Subscr and sworn to (or affirmed) before nnao n mta\ or has produced as identification, (T y, ide ification) NOTARY PUBLIC Wy commission expires ES A _022 y COMMISSION 9 W222037 (SEAL) EXpIRF,S: August 03, 2022 OF PROPOSALFORM 001 20- Page 29 of 229 NO WTUTIMM-A' � 1111111J 11 '' III � 1 The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: jj (N me of Business) I Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under proposal a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under proposal, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Makes a good faith effort to continue to maintain a drug-free workplace through implementation of this section. I As the person authorized to sign the statement, I certif that this fir c Lmplies fully with the above requirements. Proposer's Signature PROPOSAL FORM 001 20- Rage 30 of 229 "A person m affiliate who has been placed onthe convicted vendor list following a conviction for public entity crime may not submit a bid on e contract to prov any goods or services to a public entity, may not submit a bid 000 contract with e public entity for the construction orrepair of public building or public work, may not submit bids on leases of nao| property to public entity, may not be awarded or perform VV0Fk as o oontrmotVr. supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." I have read e above and stat that neither (Proposer's kame) nor an i e has been placed on the 'convicted ndor list within the last thirty-six (36 onths, T (Si Date: STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before n1eonthe day _AS by lj(�504W M e/�,'he is person, Cn�wL��tm--Wor Aas produced _(name of affiant). C ---- Tty — pe of identification) as identification. PROPOSAL FORM 00 1 20- Page 31 of 229 1 !11 [��7111111111111 1111111111,�illillil x* \?vililill 11111111 111111111111 ;;;1;;1 10 Division Subcontractor Contact Person Ph # Warea code Fax: Cell: Address m CER TIFICATE I ILI INSURANCE Date 6/812018 Producer: Plymouth Insurance Agency This Certificate is Issued as a matter of information only and confers no 2739 U,S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend, extend Holiday, FL 34691 or alter the coverage afforded by the policies below. (727) 936 - 5562 Insurers Affording Coverage NAIL # Insured; South East Personnel Leasing, Inc. & Subsidiaries Insurer A: Ilion Insurance Company 11075 2739 U.S. Highway 19 N. Insurer H: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: i ne poricies or insurance asteo neiow nave peen issueo to the ensuran named above for the riwey penoa inaicacea. ntonunnstanatng any requirement,: term or conaiuon or any contract or Omer 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 Stich policies, Aggregate limits shown may have been reduced by paid claims. INSK AODL P©licy Effective Policy Expiration Limits LTIR INSRD Type of Insurance Policy Number Date Date (MM /DD/YY) (MM /DDPYY) GENERAL LIABILITY Each Occurronce 3 Commercial General Liability Damage to rented premises (EA Claims Made Occur occurrence) oral aggregate limit applies per: Policy Project LOC E LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non - Owned Autos Mind Exp Personal Adv Injury General Aggregate Products - Comp/Op Agg Combined Single Limit. (EA Accident) (Per Person) Bodily Injury (Per Accident) Property Damage (Per Accident) EXCESS /UMBRELLA LIABILITY Each Occurrence Occur Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/0112018 01101/2019 X WC Statu CfTH- Employers' Liability to Limits ER Any proprietorlparinerlexecutive officer /member E.L. Each Accident $1,aoo,aa0 excluded? NO E.L. Disease - Ea Employee $1,000,000 If Yes, describe under special provisions below. E.L. Disease - Policy Limits 1 $1,000,000 Other f Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 1 Descriptions of Operations /Locations /Vehicles /ExcIus ions added by Endorsement/Special Provisions: Client ID: 91 -67 -687 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company ": A -1 Property Services Group, Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc, & Subsidiaries active employees„ while working in: FL. Coverage does not apply to statutory employees) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by fax a request to (727) 937 - 2138 or by calling (727) 938 - 5562, Project Name: ISSUE 10 -26 -17 (RK). REISSUE 01 -09 -18 (SS). REISSUE 06 -08 -18 (PH) 5houid any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to OUR VALUED p® V do so shall impose no obligation or liability of any kind upon the insurer,. its agents or representatives.. MLe! C �� G � 4s ACC>Rbr CERTIFICATE OF LIABILITY INSURANCE €3AtE(IdMft)ONYYYI TYPE OF W SURANON THIS CERTIFICATE IS 188LIED 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 CONS`l`ITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESEN OR PRODUCER, AND THE CE RTIFICATE HOLDER. IMPORTANT; If the certificate holder Is on ADDITIONAL INSUPLO, tho polfcy(les) In€ISt bo endorsed, If SUBROGATION 15 WAIVED, Subject to the terms and conditions of tine policy, certain policies may rc quire an endors©ment, A statomOnt 01) this oertlf ato doss not Confer rights to the Certificate holder In If of s € €ch endersemant(s), PRODUCER er�I�TAQT O'a1} ret LaRu9 HFtA9C; Vxa,nk KX Sux- maak., Xna. PnO�N I, l'9S£) 943 -5054 Aq Nat ( 5943 Sd a - la .•V` MAlL 1314 3 ast: ,pitlant:�O' Blvd, ALtI)RESSa �3 €TTkd aC3�iis 7ika71�T1811��YICft, C16ri! ... fNSl3RERi9lA COVER __ NAPO tf ._ P. 4. Box ID27 Pompano Heaeli Pt 33061 p__.._�� INSURrart� I$rarplun GRI3TdX& � a 26G20 INfiUICSI) INSORERtl. CR�u�7.{~, �tktG Co tsf 7.9446 INSURERC tCominOYce &• :Cn us Iry lla r."k^Anoo CID 19420 A-1 P 7oVerb..y Sozv oeo Group, Xno 090 MW 69th Ave INS URER ll _..._.� INSURER @; uiaini FL 337.4 A INSURERF: LIABILITY' ANY AUTO ALI.OVMEO SCHEDULED AUTOS L qilTOS NON O4VNELa HIRED AUTOS AUTOS COVERAGES OfiRTIFICATE NUMBER :B t 203-7 OL /AU /Um IREViSInN NtllUit PP! ICATED.. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY COWrRACT OR OTHER DOCUMENT WITH RESI TO WHICH THIS RTIFICATE MAY SE ISSUER OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, L'R' S IS TO CERTIFY THAI" rHE POLICIES OF INSURANCE LISTED 13FLOW HAVE 13FEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CLU SIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY-HAVE BEEN REDUCO;D I3Y PAID CLAIMS, TYPE OF W SURANON aR POLI4YN€lMMR. AG Y EFF IMWQpIYYYY Pr;LICY EYtP (tlhht3l} LIMITS It 3C cOMMERCIA€.GHNCRAL LIABILITY CIAIMS•I Agt'' OCCUR NLOLNO3029AX 9/30/200.7 9/30/201.0 EACHOOCURRENCr _ S 3"00 Pffeh10SES Eg oCCU a ae S 1.40, 000 MED_r:XP Any QnaParson) S 5,000 PERSGNAI_ KAOVI S 1 ,00 0, 0 0 0 GERL AGGREGATE LIMIT APPLIES KR: POLICY 171 ": i y I_t7G - OENERALAGGRCGATE $- 2 _ PRODUCTS - C;]MPK)PAGt3 TS 2, 000, OGO AUTAMosILE LIABILITY' ANY AUTO ALI.OVMEO SCHEDULED AUTOS L qilTOS NON O4VNELa HIRED AUTOS AUTOS DMR6290b4 8/17/203,7 a/17/201a CO al Bq S RE LIMIT 9 cct enl 5 11 004, 404 BODILY 1NJUItY (I er pergoA) $ BODILYINSUTtY � PROPERTY DAMAGQ Pa nc and .a.__ 9 'S c [XI UMBMI.LALIAB OCCUR CXOESS M13 4LAIMS•MAtIE 13NU23 Over 01+ Only 9/3a/2p17 1 9/30/2010 EACH OCCURRENCE S AGGREGATE _ .q000,000 $ 5 000, 000 UED ETENTIUNS WORKERS cOWKIISATiON AND EMPLOYBRS'LtABILITY Y l N ANY PROPRIETORIPARTNERfMCUTIVE OFFICEWMEMBFREXOLUI El (Mandatary In NH) Ifni rfiaWhoundar DC98RIPTtON OE opr.RATIONS halaW N/A PER O STA[UT r,L.>=ACHACOIgEN7 .. s E.1- DISEASE - LA I MI'LOYE 9 - -T. F.L. DISEASE POLICY LIMIT — ... S 01 "RIPWON Or OPMAVONS I LOCATIONS VEHICLES IACORO 401, Atldlllonal Romarks Schedule, may be Atlauhu(3lr atdre apsaue IS ragvlred) SHOULD ANY OF THE ABOVE LDE801118ED POLICIES 132 CANCELLED BEFORE THE GXPIRATIQN DATE THERE 0' NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVIVONS, A UT H O R I z L 0 IIrP R E %i NTATi VE UeL7ox1g/8D 0 1988 -2014 AC ACORD 26 (2014/01) Tf €e ACORD t1ama and logo are regfstamd marks of ACORD INS026 pawl) RD CORPORATION, All rights reservod. I Packet Pg. 1 511 Prop F 890 SIN 69th Ave Miami, FL 3344 0: (305) 473 -7353 Fxt 303 F: (305) 471-3702 www.a 3.roofingcontractors.com State Certified Roofing Contractors License STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CCCi02 &328 f ' �( The ROOFING CONTRACTOR Named below IS CERTIFIED Under the provisons of Chapter 489 FS. Expiration dale AUG 31, 2018 MADRUGA, YOSVANY F A -1 PROPERTY SERVICES GROUP INC a r 841 SW 69TH AVENUE MIAMI FL 33144 r MUM 09 14 DiSPL4YAS REOIIIRFD BY t AW fiCi}a I trna�annnt yta STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1 1 CGC1523132 a The GENERAL CONTRACTOR ' Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 MADRUGA, YOSVANY F @ ' M A•1 PROPERTY SERVICES GROUP INC. 89DSW69THAVENUE , MIAMI FL 33144, ISSUED, 0911412018 DISPLAY AS REQUIRED BY I AW crux Page 1 of 1 =: x - WATCH US ON You F EC.1K'1 TE 6�� h flyy irk w� i� «N'T rX g, �r ��ryryig 1111111 r 1 11111111111111111 11!1! PROPO8ER'S INSURANCE AND INDEMNIFICATION STATEMENT INSURANCE REQUIREMENTS Worker's Compensation Employers Liability General LiobU0v. including Premises Operations Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Statutory Limits $5UQ.O0O Bodily Injury bvAood*Dt $508.O8O Bodily Injury bv[Uoem8e Policy Limits $5OO Bodily Injury bvDisease. each employee $50D Combined Single Linmit Vehicle Liability (Omxled, mon-ovvoed and hired vehicles) $300,000 Combined Single Limit If split limits are preferred: 020O.000 per Person $0]O.00Q per Occurrence $200,000 Property Damage The contract shall require a Public Construction bond equal to the contract cost, The bond must be issued by an A rated surety company doing business in the State of Florida. Hold Harmless and Indemnification. Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement, Contractor oheU defend, indemnify and hold the COUNTY and the COUNTY's elected and appointed officers and employees harmless from and against (i) any C]ainnn, actions or causes of action, (ii) any litigation, administrative proceedings, appellate pnJcoedings, or other proceedings relating to any b/p8 of injury (including death), loss, do[Bage, fine, paDe|b/ or business interruption, and h0 any costs nr expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of. or in connection with, (A) any activity cfContractor or any of its employees, agentn, contractors or other invitees during the term of this Agreement, /13\ the negligence or recklessness, intentional wrongful rnieomnduct, errors or other wrongful act or omission of Contractor or any of its ennp|nyees, agents, sub-contractors or other invitees, or (C) Contractor's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the o|ainne, oo1iono, causes of action, litigation, pruoeedim88, nonin or expenses 8dge from the intentional or sole negligent ootG or omissions of the COUNTY nr any 0f its employees, agents, contractors or invitees /other than Contractor). The monetary limitation of liability under this contract shall be not |een than $1 million per occurrence pursuant to F. S. 725.06. Insofar as the claims, actions, causes ofaction, litigation, proceedings, costs or expenses xa|mha t8 events or circumstances that occur during the term of this Aoreerngnt, this section will survive the expiration of the hemn of this Agreement or any earlier termination mf this Agreement. In the event that the completion of the project (to include the work of is delayed mr suspended as a result of the Contractor s failure to purchase or maintain the required insurance, INSURANCE REQUIREMENTS AND FORMS 00130- Page 38 of 229 the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in the plans and specifications provided by the Contractor, the Contractor agrees and warrants that the Contractor shall hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action on the County's behalf. The first ten dollars ($10.00 of remuneration paid to the Contractor is for the indemnification provided for the above. The extent ofliability is in no vvuy limited to, reduced or haee8ned by the insurance requirements contained elsewhere within this AGREEMENT. FDEK0Indemnification To the fullest extent permitted by Kovv the Contractor shall indemnify and hold honnkeso the Agency, the State ofFlorida, Department 0fEmergency K0onaQemment, and its officers and employees, from liabilities, damages, |88Ses and costs, ino|udimg, but not limited to. reasonable attorney's fees, to the extent caused by the neg0genma, recklessness or intentional wrongful misconduct of the Contractor and persons employed or utilized by the Contractor in the performance of this Contract. This indemnification shall survive the termination of this Contract. Nothing contained in this paragraph is intended to nor shall it constitute o waiver of the State of Florida and the (County) Agency's soverign immunity. PROPOSER'S STATEMENT | understand the insurance that will be mandatory if with all of the requirements herein, |fully accept the to defend as set out in this proposal. ud the contract and will comply infull PR POSER I Sig nification and hold haroless and duty INSURANCE REQUIREMENTS AND FORMS 00 130- Page 39 of 229 INSURANCE AGENT'S STATEMENT | have reviewed the above requirements with the proposer named above. The follow deductibles apply 0O the corresponding policy. POLICY DEDUCTIBLES I q q 9 4 2, 5 CIO L-^\ --t 2-� f5 0 0 �� }� _} ��/1 �` �� ' � `� t') _�� Signature INSURANCE REQUIREMENTS AND FORMS 00 130- Page 40 of 229 Minority Owned Il'Susiness Declaration , A A �f Y0 } , a sub- contractor engaged by Monroe County during the completion of work associated with he below indicated project (Check one) is a minority business enterprise, as defined in Section 288.703, Florida Statutes or is not a minority business enterprise, as defined in Section 288.703, Florida Statutes, F.S. 288.703(3) "Minority business enterprise" means any small business concern as defined in subsection (6)(see below) which is organized to engage in commercial transactions, which is domiciled in Florida, and which is at least 51- percent -owned by minority persons who are members of an insular group that is of a particular racial, ethnic, or gender makeup or national origin, which has been subjected historically to disparate treatment due to identification in and with that group resulting in an underrepresentation of commercial enterprises under the group's control, and whose management and daily operations are controlled by such persons. A minority business enterprise may primarily involve the practice of a profession. Ownership by a minority person does not include ownership which is the result of a transfer from a nonminority person to a minority person within a related immediate family group if the combined total net asset value of all members of such family group exceeds $1 million, For purposes of this subsection, the term "related immediate family group" means one or more children under 16 years of age and a parent of such children or the spouse of such parent residing in the same house or living unit. F.S 288.703(6) "Small business" means an independently owned and operated business concern that employs 200 or fewer permanent full -time employees and that, together with its affiliates, has a net worth of not more than $5 millio or any firm based in this state which has a Small Business Administration 8(a) certification. As applicable to sole 4prietorships, the §5 million net worth requirement shall include both personal and business investments. Sub - Recipient: Monroe County Sign r Signature Print O VAIA Ot (u� printed Narne: Title: ' iJ .� , Title/ OMB Department: Verified via: httths: /Zosd.dms. flo rida.r_o ldirectories Address: I S �,, G c AT DEM Contract: 20002 City /State /Zip ft d L Date: l FEMA Project Number: INSURANCE REQUIREMENTS AND FORMS 00130- Page 41 of 229 Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion Contractor Covered Transactions (1) The prospective contractor of the Rec certifies by submission of this document, that neither it nor its principals is presently debarred, suspended, proposed for debmmnent, declared ine|igib|o, or voluntarily excluded from participation inth|atransaction by any Federal department or agency. C8 Where the unable to certify to the above statement, the prospective . contractor shall attach an explanation to this form. a Sic gnar� CIA ) I Name and Title Q / 4oe Street Address City, State, Zip End of Section 00120 Recipient's Name Division Contract Number FEMA Project Number INSURANCE REQUIREMENTS AND FORMS 00 130- Page 42 of 229 Tavernier Fire Station ReRoofing SECTION 00120 PROPOSALFORM The Proposal shall be submitted on the forms included in this section of the Proposal Documents as previously instructed herein. Item Description 1. Proposal Form 2. Bid Bond (Proposal Security) 3. Non - Collusion Affidavit 4. Lobbying and Conflict of Interest Clause 5. Drug -Free Workplace Form 6. Public Entity Crime Statement 7. Subcontractor Listing Form 8. Insurance Requirements and Checklist 9. Workers Compensation and Employers' Liability 10. General Liability 11. Vehicle Liability 12. Proposer's Insurance and Indemnification Statement 13. Insurance Agent's Statements 14. Minority Owned Business Declaration 15. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion 16. Contractor License: A Current Copy to be submitted with Proposal. Subcontractor Licenses to be Submitted Prior to Award of Notice to Proceed. INFORMATION REQUIRED TO BE PROVIDED Pages 24 27 28 29 30 31 32 33 34 35 36 37 40 41 42 1. In order to determine if the persons or entity submitting proposals are responsible, all Proposals for contracts to be awarded under this section must contain the following information: A. A list of the entity's shareholders with five percent (5 %) or more of the stock or, if a general partnership, a list of the general partners; or, if a limited liability company, a list of its members; if a solely owned proprietorship, names(s) of owner(s). A copy of documentation demonstrating that the entity is a legally viable entity shall be attached. PROPOSAL FORM 00120- Page 21 of 229 Tavernier Fire Station ReRoofing B, A list of the officers and directors of the entity. C. Relevant Experience: The number of years the person or entity has been operating and, if different, the number of years it has been providing the service, goods, or construction services called for in the proposal specifications (include a list of similar projects). D. The number of years the person or entity has operated under its present name and any prior names. E. Answers to the following questions regarding claims and suits= a. Has the person or entity ever failed to complete work or provide the goods for which it has contracted? (If yes, provide details of the job, including where the job was located and the name of the owner.) YES F NO b. Are there any judgments, claims, arbitration proceeding or suits pending or outstanding against the person, principal of the entity, or entity, or its officers, directors, or general partners (this specifically includes any present or prior entities in which the person, principal, entity, officer, director or general partner of the proposing entity has been involved as a person, principal, entity, officer, director or general partner in the last five (5) years)? (If yes, provide details, include enough information about the judgment, claim, arbitration or suit so that the Owner will able to obtain a copy of the judgment or claim or locate the suit by location and case number.) YES F NO ] c. Has the person, principal of the entity, entity, or its officers, major shareholders or directors within the last five (5) years, been a party to any law suits or arbitrations with regard to a contract for services, goods or construction services similar to those requested in the specifications with private or public entities? This specifically includes any present or prior entities in which the person, principal, entity, officer, director or general partner of the proposing entity has been involved as a person, principal, entity, officer, director or general partner in the last five (5) years. (If yes, provide details, include enough information about the judgment, claim, arbitration or suit so that the Owner will able to obtain a copy of the judgment or claim or locate the suit by location and case number.) YES NO d, Has the person, principal of the entity, or its officers, owners, partners, major shareholders or directors, ever initiated litigation against Monroe PROPOSAL FORM 00120 - Page 22 of 229 Tavernier Fire Station ReRoofing County or been sued by Monroe County in connection with a contract to provide services, goods or construction services? This specifically includes any present or prior entities in which the person, principal, entity, officer, director or general partner of the proposing entity has been involved as a person, principal, entity, officer, director or general partner. (If yes, provide details, include enough information about the judgment, claim, arbitration, or suit so that the Owner will able to obtain a copy of the judgment or claim or locate the suit by location and case number.) YES [:] NO e. Whether, within the last five (5) years, the Owner, an officer, general partner, controlling shareholder or major creditor of the person or entity was an officer, general partner, controlling shareholder or major creditor of any other entity that failed to perform services or furnish goods similar to those sought in the request for bids. (If yes, provide details and information about the failure to perform services or furnish goods that will enable the Owner to thoroughly consider the matter.) YES F] NO °"` Customer references (minimum of three), including name, current address and current telephone number. Credit References (minimum of three), including name, current address and current telephone number. g. Financial statements for the prior three (3) years. Please provide in a separate sealed envelope for the Contractor's confidentiality, and clearl label the envelope "CONFIDENTIAL" one (1) original copy. ( "Any financial statement that an agency requires a prospective bidder to submit in order to prequalify for bidding or for responding to a bid for a road or any other public works project is exempt from F.S. 119.07(1) and s.24(a), Art. 1 of the State Constitution. ") PROPOSAL FORM 00120- Page 23 of 229 Tavernier Fire Station ReRoofing SECTION 00120 PROPOSAL FORM PROPOSAL TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS c/o PURCHASING DEPARTMENT 1100 SIMONTON STREET ROOM 2 -213 KEY WEST, FLORIDA 33040 PROPOSAL FROM: 1 j(4 'bA (ZU In(_ i� The undersigned, having carefully examined the Work and reference Drawings, Specifications, Proposal, and Addenda thereto and other Contract Documents for the construction of: TAVERNIER FIRE STATION REROOFING and having carefully examined the site where the Work is to be performed, having become familiar with all local conditions including labor affecting the cost thereof, and having familiarized himself /herself with material availability, Federal, State, and Local laws, ordinances, rules and regulations affecting performance of the Work, does hereby propose to furnish all labor, mechanics, superintendents, tools, material, equipment, transportation services, and all incidentals necessary to perform and complete said Work and work incidental hereto, in a workman -like manner, in conformance with said Drawings, Specifications, and other Contract Documents including Addenda issued thereto. The undersigned further certifies that he /she has personally inspected the actual location of where the Work is to be performed, together with the local sources of supply and that he /she understands the conditions under which the Work is to be performed. The successful proposer shall assume the risk of any and all costs and delays arising from the existence of any subsurface or other latent physical condition which could be reasonably anticipated by reference to documentary information provided and made available, and from inspection and examination of the site. The Base Proposal shall be furnished below in words and numbers. If there is an inconsistency between the two, the Proposal in words shall control. Ad Dollars. (Total Base Proposal- words) $ _ - 1 2 - w 'o c),,, -, (Total Base Proposal — numbers) PROPOSAL FORM 00120- Page 24 of 229 Tavernier Fire Station ReRoofing I acknowledge Alternates as follows: None Unit prices, if any, are as follows: I acknowledge receipt of Addenda No.(s) No. Dated No. Dated No. Dated No. Dated Proposer, states by his /her check mark in the blank beside the form and by his /her signature that he /she has provided the following requirements (located in Section 00120): 1. Proposal Form 2. Proposal Security (Bid Bond) 3. Non - Collusion Affidavit 4. Lobbying and Conflict of Interest Clause 5. Drug -Free Workplace Form 6. Public Entity Crime Statement 7. Subcontractor List Form 8. Proposer's Insurance and Indemnification Statement 9. Insurance Agents Statement (signed by agent) 10. Answered Required Questions 11. Provided three (3) Customer References and three (3) Credit References 12. Provided three (3) years of Financial Statements in separate envelope 13. Certified copy of Valid Florida Contractor's License 14. Current Monroe County Occupational License 15. Minority Owned Business Declaration 16. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion Business Name: .. �, Qcp DBA: e PROPOSAL FORM 00120- Page 25 of 229 Tavernier Fire Station ReRoofing Business EIN # 7 `1 Business Mailing Address: Address: The physical business address must be registered as its principal place of business with the Florida Department of State for at least one (1) year prior to the notice of request for bid or proposal. Date: i Witness; PROPOSAL FORM 00120- Page 26 of 229 Tavernier Fire Station ReRoofing SECTION 00120 NON - COLLUSION AFFIDAVIT I, k .., y t 9, U of the city — , 1 according to law on my oath, and under penalty of perjury, depose and say that: of the firm of L� j the proposer making the Proposal for the project described in the notice for calling for proposals for: and that I executed the said proposal with full authority to do so; 2. The prices in this proposal have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other proposer or with any competitor; and 3. Unless otherwise required by law, the prices which have been quoted in this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed by the proposer prior to proposal opening, directly or indirectly, to any other proposer or to any competitor; and 4. No attempt has been made or will be made by the proposer to induce any other person, partnership or corporation to submit, or not to submit, a proposal for the purpose of restricting competition; and 5. The statements contained in this affidavit are true and correct, and made with full knowledge of said project. ) (Signature df Proposer) (Date) STATE OFI � a COUNTY OF: '. PERSONALLY APPEARED BEFORE ME, the undersigned authority,_ -� eliz 14 who, after first being sworn by me, (name of individual signing) affixed his /her signature in the space provided above, on this day of 20 lam... NOTARY PUBLIC My commission expires: „ 2 1 3 1 (SEAL) PROPOSAL FORM 00120- Page 28 of 229 Tavernier Fire Station ReRoofing LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010 -1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE mpany) "... warrants that he /it has not employed, retained or otherwise had act on his /its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 010 -1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010 -1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee ". �4,T--- - (Signature) Date: C � "< t STATE OF: COUNTY OF: Subscribed and sworn to or affirmed before me on �M1 ( ) � r �' � I .'�' (date) by TI �,�_� � (name of affiant). He /She is personally known to me or has produce ",.t _ as identification. (Type of identification) $ .k NOTARY PUBLIC My commission expires: (SEAL) PROPOSAL FORM 00120- Page 29 of 229 Tavernier Fire Station ReRoofing DRUG -FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: 2 Y . ' -. f (Name of Business) 1. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under proposal a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under proposal, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Makes a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. Proposer's Signature Date PROPOSAL FORM 00120- Page 30 of 229 Tavernier Fire Station ReRoofing 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 a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." 4 have read the above and state that neither 0 tj ' (Proposer's name) nor any Affiliate has been placed on the convicted ven r list within the last thirty -six (36) months. (Signatu Date: V STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me on the day of 7 k 20 , , by F k4w known to me or has produced identification) as identification. name of affiant). He /She is personally (type of My Commission Expires: ) LL k NOTARY PUBLIC (SEAL) PROPOSAL FORM 00120- Page 31 of 229 Tavernier Fire Station ReRoofing SUBCONTRACTOR LISTING FORM Division Subcontractor Contact Person Ph # w /area code Fax: Cell: Address N o iU E PROPOSAL FORM 00120- Page 32 of 229 Tavernier Fire Station ReRoofing SECTION 00130 INSURANCE REQUIREMENTS AND FORMS MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES General Insurance Requirements for Construction Contractors and Subcontractors Prior to the commencement of work governed by this contract (including the pre- staging of personnel and material), the Contractor shall obtain, at his /her own expense, insurance as specified in the attached schedules, which are made part of this contract. The Contractor will ensure that the insurance obtained will extend protection to all Sub - Contractors engaged by the Contractor. As an alternative, the Contractor may require all Subcontractors to obtain insurance consistent with the attached schedules. The Contractor will not be permitted to commence work governed by this contract (including pre- staging of personnel and material) until satisfactory evidence of the required insurance has been furnished to the County as specified below. Delays in the commencement of work, resulting from the failure of the Contractor to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the Contractor's failure to provide satisfactory evidence. The Contractor shall maintain the required insurance throughout the entire term of this contract and any extensions specified in any attached schedules. Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced. Delays in the completion of work resulting from the failure of the Contractor to maintain the required insurance shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work had not been suspended, except for the Contractor's failure to maintain the required insurance. The Contractor will be held responsible for all deductibles and self- insured retentions that may be contained in the Contractor's Insurance policies. The Contractor shall provide, to the County, as satisfactory evidence of the required insurance, either: Certificate of Insurance or A Certified copy of the actual insurance policy. The County, at its sole option, has the right to request a certified copy of any or all insurance policies required by this contract. All insurance policies must specify that they are not subject to cancellation, non - renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. INSURANCE REQUIREMENTS AND FORMS 00130- Page 33 of 229 Tavernier Fire Station ReRoofing The acceptance and /or approval of the Contractor's insurance shall not be construed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on all policies, except for Workers' Compensation. In addition, the County will be named as an Additional Insured and Loss Payee on all policies covering County -owned property. Any deviations from these General Insurance Requirements must be requested in writing on the County prepared form entitled "Request for Waiver of Insurance Requirements" and approved by Monroe County Risk Management. INSURANCE REQUIREMENTS AND FORMS 00130- Page 34 of 229 Tavernier Fire Station ReRoofing WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR CONTRACT: TAVERNIER FIRE STATION REROOFING BETWEEN MONROE COUNTY, FLORIDA AND L iL QED Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes and the requirements of Florida Statutes, Chapter 440. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than $500,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $500,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. If the Contractor has been approved by the Florida's Department of Labor, as an authorized self- insurer, the County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self- insurance fund, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. INSURANCE REQUIREMENTS AND FORMS 00130- Page 35 of 229 Tavernier Fire Station ReRoofing GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT: TAVERNIER FIRE STATION REROOFING BETWEEN MONROE COUNTY, FLORIDA AND R . Prior to the commencement of work governed by this contract, the Contractor shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: Premises Operations Products and Completed Operations Blanket Contractual Liability Personal Injury Liability The minimum limits acceptable shall be: $500,000 Combined Single Limit An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. INSURANCE REQUIREMENTS AND FORMS 00130- Page 36 of 229 Tavernier Fire Station ReRoofing VEHICLE LIABILITY INSURANCE REQUIREMENTS FOR Tavernier Fire Station ReRoofing BETWEEN MONROE COUNTY, FLORIDA AND Recognizing that the work governed by this contract requires the use of vehicles, the Contractor, prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum, liability coverage for: • Owned, Non - Owned, and Hired Vehicles The minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $200,000 per Person $300,000 per Occurrence $200,000 Property Damage The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. INSURANCE REQUIREMENTS AND FORMS 00130- Page 37 of 229 Tavernier Fire Station ReRoofing PROPOSER'S INSURANCE AND INDEMNIFICATION STATEMENT INSURANCE REQUIREMENTS Worker's Compensation Employers Liability Statutory Limits $500,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease Policy Limits $500,000 Bodily Injury by Disease, each employee General Liability, including Premises Operations Products and Completed Operations Blanket Contractual Liability Personal Injury Liability $500,000 Combined Single Limit Vehicle Liability (Owned, non - owned, and hired vehicles) $300,000 Combined Single Limit If split limits are preferred: $200,000 per Person $300,000 per Occurrence $200,000 Property Damage The contract shall require a Public Construction bond equal to the contract cost. The bond must be issued by an A rated surety company doing business in the State of Florida. Hold Harmless and Indemnification. Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement, Contractor shall defend, indemnify and hold the COUNTY and the COUNTY's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of Contractor or any of its employees, agents, contractors or other invitees during the term of this Agreement, (B) the negligence or recklessness, intentional wrongful misconduct, errors or other wrongful act or omission of Contractor or any of its employees, agents, sub - contractors or other invitees, or (C) Contractor's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the COUNTY or any of its employees, agents, contractors or invitees (other than Contractor). The monetary limitation of liability under this contract shall be not less than $1 million per occurrence pursuant to F. S. 725.06. Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this Agreement, this section will survive the expiration of the term of this Agreement or any earlier termination of this Agreement. In the event that the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor s failure to purchase or maintain the required insurance, INSURANCE REQUIREMENTS AND FORMS 00130- Page 38 of 229 Tavernier Fire Station ReRoofing the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in the plans and specifications provided by the Contractor, the Contractor agrees and warrants that the Contractor shall hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action on the County's behalf. The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification provided for the above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this AGREEMENT. FDEM Indemnification To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the Agency, the State of Florida, Department of Emergency Management, and its officers and employees, from liabilities, damages, losses and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness or intentional wrongful misconduct of the Contractor and persons employed or utilized by the Contractor in the performance of this Contract. This indemnification shall survive the termination of this Contract. Nothing contained in this paragraph is intended to nor shall it constitute a waiver of the State of Florida and the (County) Agency's soverign immunity. PROPOSER'S STATEMENT I understand the insurance that will be mandatory if awarded the contract and will comply in full with all of the requirements herein. I fully accept the indemnification and hold harmless and duty to defend as set out in this proposal. INSURANCE REQUIREMENTS AND FORMS 00130- Page 39 of 229 PROPOSER Signature Tavernier Fire Station ReRoofing INSURANCE AGENT'S STATEMENT I have reviewed the above requirements with the proposer named above. The following deductibles apply to the corresponding policy. POLICY DEDUCTIBLES Workers Cammsation N/A General Liability_ R i.cinac.c Al An (,i nhi 1 i�7 Liability policies are / occurrence M Insurance Associates, Inc. Insurance Agency N/A 160 -1 i"ITiNTSIR I' A r 'nst�'r INSURANCE REQUIREMENTS AND FORMS 00130- Page 40 of 229 tis„3 fi Minority Owned Business Declarat a sub - contractor engaged by Monroe County during the completion f^ of work associ tdd with the below indicated project (Check one) is a minority business enterprise, as defined in Section 288.703, Florida Statutes IZ'is not a minority business enterprise, as defined in Section 288.703, Florida Statutes F.S. 288.703(3) "Minority business enterprise" means any small business concern as defined in subsection (6)(see below) which is organized to engage in commercial transactions, which is domiciled in Florida, and which is at least 51- percent -owned by minority persons who are members of an insular group that is of a particular racial, ethnic, or gender makeup or national origin, which has been subjected historically to disparate treatment due to identification in and with that group resulting in an underrepresentation of commercial enterprises under the group's control, and whose management and daily operations are controlled by such persons. A minority business enterprise may primarily involve the practice of a profession. Ownership by a minority person does not include ownership which is the result of a transfer from a nonminority person to a minority person within a related immediate family group if the combined total net asset value of all members of such family group exceeds $1 million. For purposes of this subsection, the term "related immediate family group" means one or more children under 16 years of age and a parent of such children or the spouse of such parent residing in the same house or living unit. F.S 288.703(6) "Small business" means an independently owned and operated business concern that employs 200 or fewer permanent full -time employees and that, together with its affiliates, has a net worth of not more than $5 million or any firm based in this state which has a Small Business Administration 8(a) certification. As applicable to sole proprietorships, the $5 million net worth requirement shall include both personal and business investments. Contractor may refer to F.S. 288.703 for more information. Contractor Signature ,, Print Name: 4 1 Title: 4 _ .,.. 1 .. Address: City /State /Zip =/ ¢ Date: r, Sub - Recipient: Monroe County Signature Printed Name: Title/ OMB Department:. Verified via: https:ZZosd.dms.mvflorida.com /directories DEM Contract: Z0002 FEMA Project Number INSURANCE REQUIREMENTS AND FORMS 00130- Page 41 of 229 Tavernier Fire Station ReRoofing Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion Contractor Covered Transactions (1) The prospective contractor of the Recipient _ ° 1°' certifies, by submission of this document, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the Recipient's contractor is unable to certify to the above statement, the prospective contractor shall attach an explanation to this form. CONTRACTOR By 4 , 7 t 7l Signature � r 816 - ( Name and Title Street City, Date End of Section 00120 Recipient's Name Division Contract Number FEMA Project Number INSURANCE REQUIREMENTS AND FORMS 00130- Page 42 of 229 CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDNYYY) 6/18/2018 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(tes) must have ADDITIONAL INSURED provisions or 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 riahtls to the certificate holder in lieu of such endorsement(s). PRODUCER �X "'�' HMS Insurance Associates, Inc. P NAM E__ Darlene Placek 20 Wight Ave Suite 300 •443 -33E Hunt Valley MD 21030 EMS d bacek hens INSURED Roofing by Ruff Inc. 937 Fleming Street Key West FL 33040 Fire Insurance Cc Fire COVERAGES CERTIFICATE NUMBER: 69027136 REVISI NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _.. _.. INSR LTR TYPE OF INSURANCE ADDL WSD SUBR WVD .. POLICY NUMBER POLICY EFF f Do POLICY' EXP 1MAVbDfYYYy1 . -. -.- LIMITS A X - COMMERCIAL GENERAL LIABILITY '.6056631877 5/112018 5/112019 EACH OCCURRENCE $ 1,000,000 D AMAGE REN'�O i CLAIMS -MADE � OCCUR PI�� @,F,ISES {ca otxraarencp) $ SOO MED EXP (Any one person (, $ 1 00000 PERSONAL & ADV INJURY $ 1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GEN ERAL AGGREG $ 2,000,000 I T 7 LOC POLICY PE PRODUCTS - COMP /OPAGG $2000,000 i s OTHER: I E AUTOMOBILE LIABILITY 6056631829 5/1/2018 5/112019 COMBINED SINGLE LIMIT a od MI $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ! °- I OWNED SCHEDULED H AUTOS ONLY ___ ___ AUTOS BODILY INJURY (Per accidant) Y $ PROPERTY DAMAGE _rPa t9 $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $ B X UMBRELLA LIAB X p_n OCCUR 6056714953 12/1/2017 51112019 EACH OCCURRENCE -._ $ 10,000,000 AGGREGATE $ 10 000,000 __ ...., EXCESS LIAB CLAIMS -MADE DEL) I X I RETENTION$ $ C F _ j g gQg WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN 6056631846 5/1/2018 5/1/2019 X STATUTE ER FL ANYPROPRIETOR/PARTNER(EXECUTIVE E.L. EACH ACCIDENT _ ,000,000 - - -- _ -- -- OFFICERIMEMBER EXCLUDED? N ! A "` _ ""�"'— (Mandatory In NH) E.L. DIS EASE - EA EMPLOYEE - - $ 1,000,000 __n_ E.L. DISEASE- POLICY LIMIT $1L000.000 If yes, describe under DESCRIPTION OF OPERATIONS below _: C Professional Liability (PROF) CPLUS307785 11/21/2017 11/21/2018 ProfAgreggate $3,000,000 D Pollution Liability (POLL) 6056966007 12/12017 511/2019 Poll Aggregate $3,000,000 Leased/Rented Equipment ( Leased /Rented Equip $150,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is additional insured with respects to the general liability, automobile liability and umbrella policies when required by a written contract. Waiver of subrogation in favor of the additional insured included under the general liabilty, automobile and workers compensation when required by a written contract. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Insurance Verification AUTHORIZED REPRESENTATIVE ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD LU u UJ X r4 0 Oo Lu UJ ca Z N, m U) CO M Lu Z LLJ 0 CL U x uj lu 0 0� z 0 FE o C9 z o M U- 0 0 (.9 LL o C o 0 b M w LU _j �: 0) r� u LL P Ln u rl N } Ln Z u 00 m LLJ 00 0) N� fn U di Lf) Z 6 C: LU U C) fo u M 0 CL r- >. w 3 CL - Q) Ln (A (A Lf) Ln .2 W in V) =1 = :3 E no ED co LU U LL LU LL > < n C( LLLI- >- D co C� u nf (D >- LU z 0 z m LL 0 0 0 N E @u fu z E Ln Z < m OE 0 (D UJ 0 5' (N Ui ru cy ro a. LU 9 0 o - a Ln O z Z-iz 0 O �- <<— U U) 7- o LI) Z) 0 2: z U N W u =) D Z 0 o 0 D z U 2: < U 0 O 0 O W T) u 0 o mm o 0 U. U y o 0 C� aNi C lu .27 c C) o C\d 0 1- rA N 0 •2 CG m 0 in IL 0 ti 0 V) C\l 10 (L) o C) a. C) w C) u lu 1 0 LU V) C: C) cl' LO p x 0 0 < UJ U) �- ui < 0 E M 0 < u < x ui > co z Ln Lu IL 2£ y < »«2 � < <ef �� :0d2 » <fff 2227 #< ;» y < »©� .xa. � © - fa� < :2� # » *.f ?y�a <a» �. w ::� »d�. at■t :■ :� : : <�,t+ 2« \/ » »� %2 ■! ! \ ©m \ * ° ©!4 »\9 2\ -,■. ? ^�; �� \: : \ <�.a: <,.. -..,. w - < .e — Credit References ABC Supply Company 3924 Vero Rd. Baltimore, MD 21227 Phone (410) 247 -2424 Fax (410)247 -5476 Account : 273900 Contact: Joe Mauk Bradco Supply Company 1303 W. Hamburg Street Baltimore, MD 21230 Phone (410)332 -1134 Fax (410)752 -4736 Account : 788820 Contact: Joe Mauk 1010 Kennedy Dr., Suite 201 Key West FL 33040 P (305) 296 -1000 F (305) 296 -1001 info @ruffroofers.com The Roof Center 1321 Western Ave. Baltimore, MD 21230 Phone (410)265 -1426 Fax (410) 636 -8197 Account: 50663 Contact: Nancy Staten Morris Ginsberg 7495 Race Rd. Hanover, MD 21076 Phone ( 410)732 -3200 Fax(410)732 -4804 Account: RUF50 Contact: Denise Campbell RESIDENTIAL • INDUSTRIAL • COMMERCIAL • INSTITUTIONAL ROOFING & SIDING • SHEET METAL WORK www.ruffroofers.com Member: National Roofing Contractors Association ......:..: I References Monroe County Project Management Johnnie Young (305) 292.4439 Bender & Associates David Salay (305) 296 -1347 AECOM Michelle Garland (512) 454.4797 1010 Kennedy Dr., Suite 201 Key West FL 33040 P (305) 296 -1000 F (305) 296 -1001 info @ruffroofers.com RESIDENTIAL • INDUSTRIAL • COMMERCIAL • INSTITUTIONAL ROOFING & SIDING • SHEET METAL WORK www.ruffroofers.com Member: National Roofing Contractors Association ......:..: WE 1010 Kennedy Dr., Suite 201 Key West FL 3304 P (305) 296 -1000 F (305) 296 -100 info @ruff roofers. cor QUALIFICATIONS INFORMATION COMPANY INFORMAITON Roofing by Ruff, Inc. 1010 Kennedy Dr.; Suite 201 Key West FL 33040 P (305)296 -1000 F (305)296 -1001 Established in 2005 S Corporation in FL MANAGEMENT President: Timothy Ruff 20 years in roofing and supervision 13 years with Roofing by Ruff, Inc Vice President: Robert Ruff 21 years in roofing, supervision, estimating 13 years with Roofing by Ruff, Inc RESIDENTIAL • INDUSTRIAL • COMMERCIAL • INSTITUTIONAL ROOFING & SIDING - SHEET METAL WORK www.ruffroofers.com Member: National Roofing Contractors Association MUDEMM co cQ m CC) tl- co E 0 0 0 0 0 0 0 CN (N CN cq (q m 0 0 0 0 0 0 0 0 0 E 6 9 6 C? 9 CC) U) 0 0 0 0 0 0 0 0 y .... 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