Item C09
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 2/16/00
2/17/00
DIVISION: COUNTY ADMINISTRATOR
BULK ITEM: YES
DEPARTMENT: AIRPORTS
AGENDA ITEM WORDING: Approval of agreement with ChemTreat, Inc., to provide chemicals and equipment for
maintenance of the Air-conditioning System Chiller, at the Marathon Airport.
ITEM BACKGROUND: Service to be provided by ChemTreat is necessary to insure the proper operation of the Air-
conditioning system. The agreement is for a term of one year.
PREVIOUS RELEVANT BOCC ACTION: None
STAFF RECOMMENDATION: Approval
TOTAL COST: $2,400.00
BUDGETED: Yes
COST TO AIRPORT: $2,400.00
COST TO COUNTY: None
REVENUE PRODUCING: No
AMOUNT PER MONTHIYEAR: N/A
APPROVED BY: County Attorney X
OMB/Purchasing X
Risk Management X
AIRPORT DIRECTOR APPROVAL ~ke: ~t<--
DOCUMENTATION: Included X
To Follow
Not Required
AGENDA ITEM #
DISPOSITION:
/bev
APB
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
Contract with: ChemTreat
CONTRACT SUMMARY
Contract #
Effective Date: 1/1/2000
Expiration Date: 12/31/2000
Contract Purpose/Description: Provide chemicals and equipment for maintenance of the Air Conditioning
System Chiller at the Marathon Airport
Contract Manager: Bevette Moore
(name)
for BOCC meeting on: 1/1~/2000
# 5195
(Ext. )
Airports - Stop # 5
(Department)
Agenda Deadline: 1/5/2000
I
CONTRACT COSTS
Total Dollar Value of Contract: 2,400.00
Budgeted? Yes
Grant: N/A
County Match: N/A
Estimated Ongoing Costs: N/A
(not included in dollar value above)
Current Year Portion: 1,800.00
Account Codes: 403-63501-530-340
ADDITIONAL COSTS
For:
(eg. maintenance, utilities, janitorial, salaries, etc.)
Changes
Needed Reviewer
Yes No ~~
()~~
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Ai '" PL~ (d1i-l~;NJ [e.qwr (' (Hpld:,>. ~ fd' 18 Pd i ~
Date In
A JllPo",T
Director
flJ;~
(2 /1 tf 1 eye/
R~sJs.~anage~t
CjjJ/ \)
O.M.B./Purc' Ing
ll/'1/21-
County Attorney
~_I-
Comments: m(S'5I(\~
CONTRACT REVIEW
Date Out
--:
L/ ~ "'-'
Service Agreement
Effective Date:
ChcmTreat, Inc. agrees to provide services, chemicals incidental to such services and certain items of
equipment to eustomer as described in Exhibit A (which is attached and made a part of this Service
Agreement) for a period of 12 months commencing J / 'I ~..-:~ -t-
Ship To:
Bill To:
Marathon AilPOrt
Same
9400 Overseas Highway Attn: Chiller Room
Attn: Theresa Cook
Marathon, Fl 33050
For this program, Customer agrees to pay ehcmTreat, Inc. the total sum of two thousand four hundred and
00/1 00 Dollars ($2400), in 12 instalhnents at the rate of $200/month, according to invoices rendered by
ChemTreat, Inc.; such invoices to be paid by Customer in arrcllIS. State and local ttxes will bc added to
each invoice unless a tax exemption certificate is submitted to ChemTreat, Inc.
Customer and ChcmTreat, Inc. agree that the ultimate success of any water treatment program provided by
ChemTrcat, Inc. to Customer hereunder is dependent on diligent application of ChemTreat, lne, program
by Customer in full accordance with recommendations made by ChemTreat, Inc. during CbemTrcat, Inc. 's
normal service visits. Failmc of the Customer to diligently follow CbemTrC:Jt, Inc.'s recormneodations
may lead to the failure of such program. ChemTreat, Inc. will accept no responsibility for any failure
caused by whole or part by Customer's lack of diligenee or failure to follow ChemTreat, Inc. 's
recommendations.
ChemTreat, Inc. wiU be responsible (or reasonable diligence and care in providing its program hereunder.
ChemTreat, lne. will not be responsible for failure or delay in providing its program due to any act or
circumstance beyond its control.
Under no circumstances shall either ChemTreat, Inc. or Customer be liable to the other for any incidental or
consequential damages even if advised by the other party of the possibility of the same.
This Agreement may be terminated by either party upon 30 days prior written notice to the other, In the
event of termination of this Agreement, Customer must pay ChemTreat for existing inventory and
equipment delivered to the Customer up to the date of termination. per the tcnns of the service and
equipment agreements,
Customer:
By:
By:
(Signature)
(Printed Name)
f
( rinted Name)
Title:-&-u.A ~IL
Title:
8
'~'~~n ~TTW ~TMnn' ~n~Mnw:wn~~ I~ ~r RR-~~-,qn
COIlI'OIlATE OFFICES PO. BOX 27207
FllCI iMOND, VA 2:l261 . (804) 935.2000
C!~mTreat:Jlnc.
COSTS
Chemtreat will supply all chemicals, test kits, and service necessary to treat the
condenser and chilled water system at Marathon Airport. We will supply day tanks for
the products, Any equipment needed will be purchased off contract. No equipment is
needed at this time.
We will also supply the labor and material needed to relocate the existing bleed-off
solenoid to a suitable location. We would recommend that an inspection of the waterside
of the condenser be done prior to us starting our program to detail conditions for both
parties. In the event this cannot be done during the summer, the chiller service company
detailing the cond~nser approach temperatures will suffice.
Please find attached our service agreement forms in the sum of $2400.00/year I or
$200/month. I hope we are able to provide results for you in the immediate future!
EXHIBIT A
)
@mTreat,lnc.
HI:nmOn: v;. :32E'
18G.:, 9:;S.200C
Product Data
COOLING WATER INHIBITOR
CHEMTREA T CL-1467
GENERAL DESCRIPTION
CHEMTREAT CL-1467 is a synergistic blend of polymeric antiscalents with molybdate
and organo nitrogen corrosion inhibitors, specifically designed to reduce both
corrosion and fouling of heat transfer surfaces. CL-1467 effectively inhibits formation of
calcium carbonate and metal oxide sludge by a combination of crystal modification
and molar sequesteration. The organic corrosion inhibitor effectively minimizes
copper alloy corrosion and galvanic corrosion induced by bi-metallic coupling while
the molybdate enhances carbon steel pitting corrosion inhibition over a wide pH range.
TYPICAL PHYSICAL PROPERTIES
Form ............................................ Amber liquid
ado r ........................... ................. Mil d
pH. ........ ............ .............. ............. 13.4
Density........................................ 9.77 pounds/ gallon
DOSAGE
CHEMTREAT CL-1467 should be fed to the cooling water or makeup water at a rate
sufficient to develop a residual of 100 ppm to 250 ppm in the recirculating water.
FEEDING
CHEMTREAT CL-1467 may be fed directly from the shipping container or bulk tank.
Continuous feeding is preferable and normal materials of feed pump construction will
be suitable. Avoid the use of carbon steel and copper in the feed system.
SAFETY PRECAUTIONS
For specific information on handling, safety and first aid, please review the product's
Material Safety Data Sheet.
SHIPPING
CHEMTREAT CL-1467 is available in 30 and 55 gallon drums,returnable bins, and in
bulk.
Rev. Date 1/98
)
@mTreat,lnc.
R,cnmon<j VA 23261
I B041 935,2000
Product Da ta
COOUNG WATER MICROBIOCIDE
CHEMICAL TREATMENT CL-2150
EPA Reg. No. 1530()..24
GENERAL DESCRIPTION
CHEMICAL TREATMENT CL-2150 is a formulation of two organosuliur
antlITIlcrobials designed to control algae, bacteria, and fungi in recircula tIng coolmf:
water systems. CL-2150 is particularly effective against those sllIne iormIn~
organisms common to conaenser water and air washer systems. CL-2150 is efiectl;'e
at low concentrations and is highly resistant to the inhibitory effects of most orgaruc
and inorganic compounds.
TYPICAL PHYSICAL PROPERTIES
Form ...................................... Green liquid
Odor .. ...................... ............... Mild
pH .......... ...... ........ ................... 3.0-5.0
Density ................................... 8.6lbs./ gal.
DOSAGE
Dosage levels of CHEMICAL TREATMENT CL-2150 and frequency of addition will
depend on nature and severity of contamination. Typical requirements fall within
the range of 50 and 150 ppm,
FEEDING
CHEMICAL TREATMENT CL-2150 may be pumped continuously to the recirculating
water or added intermittently by slug dosage. Please consult ChemTreat technical
staff personnel for all feed system recommendations.
SAFETY' PRECAUTIONS
For specific information on handling, safety and first aid, please review the product's
Material Safety Data Sheet
SHIPPING
CHEMICAL TREATMENT CL-2150 is available in 30 and 55 gallon drums, as well as
bulk quantities,
)
Rev. Date 11/96
@mrreat,lnc.
Rlcnmonc VA 2326'
,80.,935.2000
CHEMTREAT BL-1821
GENERAL DESCRIPTION
CHEMTREAT BL-1821 is a con'centrated, liquid formulation of nitrite-based and organic corroslqn mhibi-
tors with an effective borate buffer system. BL-1821 provides maximum protection for all metals In both
chill water and hot water closed systems and requires no pH adjustment. BL-1821 is authorized for
applications for those plants inspected by the U.S. Department of Agriculture.
TYPICAL PHYSICAL PROPERTIES
Form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Liquid
Color .............................. Blue
Odor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Mild
Density ............................ 9.75 Ibs./ gal.
DOSAGE
Dosages of CHEMTREAT BL-1821 will depend upon conditions of the system and the temperature at
which it is operating. A CHEMTREAT. INC. Representative will determine initial dosages and subsequent
schedules for the addition of BL-1821.
FEEDING
CHEMTREAT BL-1821 may be fed directly into the system by a pot feeder or by pump with reset timer.
SAFETY PRECAUTIONS
For specific information on handling, safety, and first-aid, please review the product's Material Safety
Data Sheet
,SHIPPING
CHEMTREAT BL-1821 is available in 15, 30 and 55 gallon drums, 275 gallon non returnable totes and
300 gallon returnable totes,
)
Rev. Date 11/88
@mTreat,lnc.
Rlcnmonc VA 232E ~
1804,935,2000
Product Data
COOLING WATER MICROBIOCIDE
CHEMTREAT C-2189 TABLETS
EPA REG. NO. 5785-63-'5300
GENERAL DESCRIPTION
CHEMTREA T C-21 89 is a concentrated dry formulation of halogen releasing compound desIgned
to provide effective biocontrol in recirculating cooling water systems. Since both bromine and
chlorine are released, control is eHeeted in the presence of ammonia nitrogen and at elevated pH.
Application of C-21 89 destroys the bio-film which might otherwise impede effective heat transfer.
TYPICAL PHYSICAL PROPERTIES
Form............................ ....... ................... Tablets
Assay, % .............. ...............................96
Active Bromine I wt. %..........................31
Active Chlorine, wt. % .........................14
Solubility @ 250 C, g/100 in water.......0.15
DOSAGE
The amount of CHEMTREAT C-2189 required will vary depending upon system operating
parameters. Dosage and correct method of feed will be established atter a thorough survey by a
CHEMTREAT. INC. Technical Representative.
SAFETY PRECAUTIONS
For specifiC information on handling. safety and first aid, please review the product's Material Safety
Data Sheet.
SHIPPING
CHEMTREAT C-2189 is available in 50 pound plastic pails.
219S (InH)
Program Summary
This contract will provide ChemTreat, Ine. service, chemicals and equipment for those systems
defined below. Any other systems, products, or equipment are not included in the price of this
contract
Boiler Water System
No. of Boilers:
ChemTreat, Ine. Products:
N/A
Mechanical Equipment
Testing Equipment
Solutions (Testing):
Cooling Water System
No. of Towers:
1
ChemTreat Inc. Products: CL-1467,CL-2150,CL-2189
Mechanical Equipment 2 15 gallon Pulsafeeder day tanks
Testing Equipment 1 conductivity meter, 1 Hach low range molybdate test kit
Solutions (Testing):
all needed
Chilled Water System
No. of Chillers:
1
ChemTreat, Inc.. Products: BL-1821
Mechanical Equipment
Testing Equipment
Solutions (Testing):
Closed Water System
Total Gallons (approx.):
Makeup Water/Month (est): N/ A
ChemTreat, Ine. Products:
Mechanical Equipment
Testing Equipment
Solutions (Testing):
)
Customer:
ChemTreat, Inc.:
ITax Exempt (Check One):
Yes
No
COfH'OflAl E OFF ICES PO. BOX 27207
HICHMOND, VA 23261 . (80~) 935,2000
-;I~ .
~ C!!emTreat~/nc.
SURVEY CONDITIONS
I inspected the tower system to get data for our proposal. Upon entering the chiller room,
I found the control system for the tower to be in alarm. The alarm was high conductivity.
Further inspection revealed that even though the tower was calling for bleed off and the
solenoid was energized, no water was coming out. According to the controller, tower
conductivity was 2600 mmhos and it was supposed to be a maximum of 1150 mmhos.
As this condition would cause scaling of the system I I opened a manual bleed-off at the
tower to remove the highly concentrated water and let the conductivity drop into
recommended range. This was done with Cub's knowledge and I informed Barbara that I
had done this, I also recommended that you call your vendor ASAP and get them to
repair the valve.
I then examined the installation. I found that the bleed solenoid was placed on the return
line from the controller to the system, downstream of the chemical injection points. Since
water will follow the path of least resistance, this would allow chemical to go to the drain
before it is injected into the system. This would especially be true if chemical feed was
occurring while bleed -off was occurring.
The current location of the bleed solenoid is also bleeding off cold water, rather than hot
water returning to the tower. A separate tap, on the chiller discharge currently exists for
bleed-off of hot water without being tied into the controller piping.
Inspection of the tower showed significant deposition on the cooling tower fill. Algae was
also present in the sump and on the tower fill.
Scale inhibitor is fed based on a timer, not load conditions. Flow thru the controller
piping was severely restricted( for unknown reasons). A single non-oxidizing biocide was
fed by timer. A pot feeder exists for treatment of the chilled water.
)
COflPOllAT E OF f ICES P.O. E30X 27207
flICIIMONI1. VA 23261' (804) 935-2000
C!.~mTreat:1lnc.
RECOMMENDA TIONS
First and most important, relocating the bleed off solenoid to a different location is
critical. Its current location not only allows chemicals to go to the drain before reaching
the system, but is also bleeding off water that you have spent energy cooling down, The
location exists for this to happen -without any significant work or cost by simply moving
the solenoid to the existing tap on the bottom of the discharge piping.
Secondly, maintaining a conductivity in the tower of only 1150 mmhos is wasting water.
We can safely maintain a conductivity of 1800 mmhos. This will reduce your water
consumption significantly, If you average a load of 60 tons of ale, this will result in a
reduction of over 800 gallons per day or over 290,000 gallons per year. Not only is this a
financial savings, but an environmental benefit.
We would also recommend that a training and on-site testing program be started and
implemented. This would give you the ability to find problems before they cause scaling
of the system, which in turn raises your electrical costs and reduces the system's
efficiency. The estimated time needed for your staff to accomplish these tasks would be
no more than 20 minutes per day'. Recommended frequency is at least twice per week.
We would use a dual biocide program that would include an oxidizing biocide. The
physical location of your tower allows it to receive heavy sunlight exposure during the
AM hours. This increases the potential for algae growth. Using a dual biocide program
prevents bacteria from developing resistance.
Your chilled water system will be treated against corrosion, and the product will contain
a blue dye to aid in leak detection ( should one develop).
All our products are compatible with your current system, are capable of being safely
discharged to your waste treatment system, and are environmentally friendly. They are
currently in use at Hawks Cay, where we provide the treatment for the cooling tower
system.
We are currently providing service to Hawks Cay on a monthly basis, and would do the
same for Marathon Airport. We would make as many visits as necessary during start-up
and training to ensure that your personnel are comfortable with our program
)
There are 4 Chemtreat reps in the South Florida area. and we can provide 8 hour
response time in the event of an emergency. All MSDS sheets are placed on site, and
COW'OI1ATE OFFICES PO. BOX 27207
HICIIMOND, VA 23261. (804) 935.2000
C!~mTreat~/nc.
safety procedures are discussed prior to our program starting. We also have a 24 hour
800 number for chemical emergencies.
All products would be shipped to the chiller room FOB destination. Bill of lading are on
each delivery. We will supply day tanks so as not to feed product from their shipping
containers. Each tank will be clearly labeled as to what is in them.
Product data sheets are enclosed on all products that we would use.
)
1996 Edition
,RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
General Insurance Requirements
for
Other Contractors and Subcontractors
As a pre-requisite of the work governed, or the goods supplied under this contract (including the
pre-staging of personnel and material), the Contractor shall obtain, at his/her own expense,
insurance as specified in any attached schedules, which are made part of this contract. The
Contractor will ensure that the insurance obtained will extend protection to all Subcontractors
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 the 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 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.
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.
Administration Instruction
#4709.3
EXHIBIT B
14
1996 Edition
The Monroe County Board of County Commissioners, its employees and officials will be included
as "Additional Insured" on all policies, except for Workers' Compensation.
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.
Administration Instruction
#4709,3
15
1996 Edition
MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
Indemnification and Hold Harmless
for
Construction Contractors and Subcontractors
The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of
County Commissioners from any and all claims for bodily injury (including death), personal injury,
and property damage (including property owned by Monroe County) and any other losses,
damages, and expenses (including attorney's fees) which arise out of, in connection with, or by
reason of services provided by the Contractor or any of its Subcontractor(s) in any tier,
occasioned by the negligence, errors, or other wrongful act or omission of the Contractor or its
Subcontractor(s) in any tier, their employees, or agents,
..
In the event 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, the
Contractor shall indemnify the County from any and all increased expenses resulting from such
delay.
The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification
provided for above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements
contained elsewhere within this agreement.
ccs
Administration Instruction
#4709.3
95
1996 Edition
. GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BElWEEN
MONROE COUNTY, FLORIDA
AND
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
· Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its
provisions should include coverage for claims filed on or after the effective date of this contract.
In addition, the period for which claims may be reported should extend for a minimum of twelve
(12) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
GLl
Administration Instruction
#4709.3
53
1996 Edition
POLLUTION LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BElWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract involves the storage, treatment, processing,
or transporting of hazardous materials (as defined by the Federal Environmental Protection
Agency), the Contractor shall purchase and maintain, throughout the life of the contract, Pollution
Liability Insurance which will respond to bodily injury, property damage, and environmental
damage caused by a pollution incident.
The minimum limits of liability shall be:
$1,000,000 per Occurrence/$2,000,000 Aggregate
If coverage is provided on a claims made basis, an extended claims reporting period of four (4)
years will be required.
POL2
Administration Instruction
#4709.3
72
1996 Edition
. VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BElWEEN
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:
$100,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 50,000 per Person
$100,000 per Occurrence
$ 25,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirement~.
VLl
Administration Instruction
#4709.3
80
1996 Edition
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT
BElWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers' Compensation Insurance with limits sufficient to respond to Florida Statute 440.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
$100,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$100,000 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.
WCl
PUBLJC ENTITY CRJME 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
I
building or public work, n:ay not submit bids opleases of real property to
public entity, may not be awarded or perform work as a contractor, supplier,
subcontractor, or consultant under a contract with any public entity, and may
not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, for CATEGORY TWO for a period of36
months from the date of being placed on the convicted vendor list."
~igna~
/2,,/06 /11
I #
Date:
STATE OF
\).1 J ," ,;..
I-jp.n r' l. '0
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
9~ 1ho~
o.vho, after first being swam by me, affixed his/fler
sig~ature (name of individual signing) in the space provided above on this 3f) day of
~.~
,19li.
~~p~
OTARY PUBLIC
My commission expires: 911~!J-() fJlJ
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
C~t"",T(. c.+ :r",L.
I
-
warrants that h~as 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. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. 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.
9f1;(1~
~ (signature)
11- jJ6 JOll
, .
Date:
STATE OF
V. ') ,,, I ~ .
I-f p/)I'" ; {,O
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
q~ mL llivv~
who, after first being sworn by me, affixed his/her
sigp,atnre (name of individual signing) h the space provided above on this So
day of
~Cl/V~^--
, 19.!l!l./
~~ t-&~
NOTARY PUBLIC
My commission expires: 'I ('tJ (~{)()
. !::mffi~ffi~I~~~I~!m~l:!:I:!!m1!~l~I~:~I~iml~i~~~~OOffl~~~OO~!~~!~~~~~~~~~i!!ill!!l~l!l!llll!!ll!m!!lmi Issue Date: 01/13/00
Producer
Wilson, Timmons & Wallerstein
P.O, Box 11247
Richmond, VA 23230-1247
TillS CERTIF1CATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
CERTIFICATE 1I0LDER. TI-IIS CERTIFICATE OOES NOT AMEND,EXTEND OR ALTER TilE COVERACE
AFFORDED BY THE POLlCIE.<; BELOW.
nsure
ChemTreat, Ine.
P.O. Box 27207
Richmond, VA
23261
Companies Affording Coverage
COMPANY LETTER A Federal Insurance Company
COMPANY LETTER B Vigilant Insurance Company
COMPANY LETTER C
COMPANY LETTER D
COMPANY LETTER E
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THIS IS 1'0 CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOlWITHSTANDING A..'lY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIlli RESPECT TO WHICH
llilS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY lliE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL lliE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
COI TYPES OF INSURANCE POLICY POLICY LIMITS
LTR POLlCY NUMBER EFF. DATE EXP. DATE
I
GENERAL LIABILITY 35349680 05/01/99 05/01/00 PRODUCTs-COMp / Ors AGG. , ,
A (X) COMMERCIAL GENERAL LIABILITY $3,000,000
( ) CLAIMS MADE PERSONAL & ADVERTISING INJURY $1,000,000
(x) OcCURRENCE EACH OcCURRENCE $1,000,000
( ) OWNER'S & CONTRACTOR'S FIRE DAMAGE (ANY ONE FiRE)
PROTECTIVE MEDICAL EXPENSE (ANY ONE $ 10,000
PERSON)
A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(X) ANY AUTO BAP73235479 ry A) 05/01/99 05/01/00 BODILY INJURY (PER $1,000,000
(X) ALL OWNED AUTOS BAP73235483 (IX) 05/01/99 05/01/00
BAP73235480 (AO) 05/01/99 05/01/00 PERSON)
( ) SCHEDULED AUTOS BODILY INJURY (PER
(X) HIRED AUTOS ACCIDENT)
(X) NON-OwNED AUTOS PROPERTY DAMAGE
( ) GARAGE LIABILITY
A EXCESS LIABILITY 79727700 05/01/99 05/01/00 EACH OcCURRENCE $3,000,000
(x) UMBRELLA FORM AGGREGATE $3,000,000
( ) OlliER lliAN UMBRELLA foRM
B WORKER'S 71644316 05/01/99 05/01/00 STATUTORY LIMITS
COMPENSATION EACH ACCIDENT $ 500,000
AND DISEASE - POLICY LIMIT $ 500,000
EMPLOYERS' LIABILITY DISEASE - EACH $ 500,000
EMPLOYEE
DESCRIPTION OF OpERAT10NS/LOCA TIONS/VEH1CLES/SpEClAL Ill':MS
It is hereby understood and agreed that The Monroe County Board of County Commissioner is named as additional insured with regard to the general
liability policy.
1 CERTIFICATE HOLDER CANCELLATION :
"'................................................................................................................ ..................................................................n............................................................................................
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE lliE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO lliE LEFT, BUT
FAILURE TO MAIL SUCH NOTICE SHALL NOT IMPOSE NO OBLIGATION OR LIABILITY OF
ANY KIND UPON THE COMpANNY ITS AGENTS OR REPRESENTATIVES.
Authorized Representative
Jack A. Wilson, Sr.
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Monroe County Board of County Commissioners
MCBOCC
9400 Overseas Highway
Marathon, Florida 330
A TIN: Barbara Ward
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