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1st Amendment 10/17/2018 4p. ° Q ` ' , Kevin Madok, CPA o: ;.• 1 '� ' '/:; Clerk of the Circuit Court & Comptroller — Monroe County, Florida DATE: November 16, 2018 TO: Beth Bergh, Land Steward Planning & Environmental Resources Alison Smith, Executive Assistant Planning & Environmental Resources FROM: Pamela Hanco \a' .C. SUBJECT: October 17 BOCC Meeting Enclosed is a duplicate original of Item I7, Amendment No. 1 to add $95,000.00 to the Contract between Earthbalance Corporation and Monroe County; and, extending the existing contract to May 17, 2019 for removal of invasive exotic plants from County owned land, , for your handling: Should you have any questions, please feel free to contact me at extension 3130. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070 Plantation Key, Florida 33070 305 - 294 -4641, 305 - 289 -6027 305- 852 -7145 305 - 852 -7145 AMENDMENT NO. 1 TO CONTRACT BETWEEN EARTHBALANCE CORPORATION AND MONROE COUNTY, FLORIDA THIS FIRST AMENDMENT TO CONTRACT is made and entered into this 17th day of October 2018, between Monroe County Board of County Commissioners (hereinafter "COUNTY" or "BOCC ") and Earthbalance Corporation (hereinafter "CONTRACTOR "). WITNESSETH: WHEREAS, the COUNTY and CONTRACTOR (hereinafter "Parties ") entered into a Contract (hereinafter "Contract ") on January 17, 2018, for the removal of invasive exotic plant species from Monroe County conservation lands; and WHEREAS, the Parties mutually agree that the scope of work under said Contract was completed on May 18, 2018; and WHEREAS, Section 37 of said Contract authorizes the extension of services by the mutual consent of the undersigned parties and upon the same terms of said Contract for three (3) additional, future funding cycles, whether for a greater or smaller sum, and using a different completion date, contingent upon the County's receipt of funds specifically for the purposes set forth herein; and WHEREAS, the County has received an additional $80,000 in funding for FY 2018 -2019 from the State's Florida Fish and Wildlife Conservation Commission's Invasive Plant Management Section for the removal of invasive exotic plants from Monroe County conservation lands; and WHEREAS, in addition to the aforesaid $80,000 the County has received in State funding, the County is contributing an additional $15,000 to this project from the Monroe County Environmental Land Management and Restoration Fund; and WHEREAS, this Amendment No. 1 to Contract (hereinafter "Contract Extension ") is the first of three extensions authorized under Section 37 of said Contract. NOW, THEREFORE, IN CONSIDERATION of the mutual covenants contained herein the parties agree as follows: 1. The recitals contained herein are true and correct and are hereby incorporated as if fully stated herein. 2. The original Contract between the parties is attached to this Contract Extension and made a part of it as if fully stated herein. 3. The parties mutually consent to exercise the original Contract's Section 37 provision authorizing the extension of services upon the same terms of the original agreement for an additional future funding cycle using a different completion date, based upon the County's receipt of funds specifically for the purposes set forth herein. 1 4. Exhibit "A" (hereinafter "Scope of Services ") to the original Contract is hereby amended to reflect completion of the project work upon the reaching of the maximum amount of $95,000.00, or upon the date of May 17, 2019, whichever occurs first. 5. Section 4.1 of said original Contract is hereby amended as follows: The maximum compensation available to the CONTRACTOR under this agreement is $95,000.00. The COUNTY agrees to pay the CONTRACTOR based on completion of work within the Scope of Services corresponding as Exhibit "A" to this Contract Extension, according to progress reports and other documentation to show the hours expended by each of the CONTRACTOR'S on -site staff. There will be a 5% retainage by COUNTY until the kill rate requirements established in the said work under said Scope of Services are satisfied. Because said work under said Scope of Services must be completed by May 17, 2019, compensation shall be only for the amount of work completed, regardless of the cause of any delay. 6. Section 37 of said original Contract is hereby amended as follows: The work under this Contract is to be completed by May 17, 2019, or upon reaching the maximum amount of $95,000. After May 17, 2019, this Contract may be extended by mutual consent upon the same terms for two (2) additional, future funding cycles, whether for a greater or smaller sum, and using a different completion date, contingent upon County's receipt of funds specifically for the purposes set forth herein. 7. All of the other terms, covenants, conditions, and provisions of said original Contract dated January 17, 2018, except those expressly modified and rendered inconsistent by this Contract Extension, remain in full force and effect and binding upon the Parties. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK SIGNATURE PAGE TO FOLLOW 2 IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed on the 41- d`ay dot ) 2018. a i. ' A . 1 // n 1 0 11 =t(-SEAL)a �� ' �� h�, A,TTLST MADOK, CLERK BOARD OF COUNTY COMMISSIONERS '`°4MONROE COUNTY, FLORIDA OF MONROE COUNTY, FLORIDA By 6 By Deputy Clerk Mayor MO NRON:.COuNTY ATTORNEY /IP VED IOiFQRM N7ariY / j `` w/ (CORPORATE SEAL) ATTEST: EARTHBALANCE CORPORATION W9.44-- 4 By /liN_PA c'1,t--e9-A- By: First Witness re 1 o CZ cca Print Name: L:: '. , _ id • .Lr First Witness Printed Name : V__ Title: VP bQ I"f(1coLZ "� ,d Witness Signature z �== ' t-. C, rn - ` O ..< � rr � C7 Second Witness Printed Name ;`p �. Ste. .. STATE OF �, L� kr, ckrA. - zr..° _ COUNTY OF ) -SO " On this a� day of aL_____ 2018, before me the person whose name is subscribed above, and who produced - f ./]E __ I_ „_ y 1: .I as identification, acknowledged that he /she is the person who executed the above Contract for the purposes therein contained and id swear an oath. _ lk - '_. �•. �� Wit-.. "v ett Notary Public State of Florida Notary Public , :. • h Becky Adams I My Commission GG 035567 VI' • ` _� mo d' Expires 12128/2020 �� V Print Name be) My commission expires: ).-1 Seal 3 EXHIBIT A To Amendment Dated October 17, 2018 SCOPE OF SERVICES REMOVAL OF INVASIVE EXOTIC PLANTS FROM MONROE COUNTY CONSERVATION LANDS — MAINTENANCE TREATMENT PROJECT HISTORY Monroe County currently owns or manages approximately 2,000 acres of conservation lands throughout the Keys. The purpose of the current project is to maintain the County's properties that have been previously treated for invasive plants and to treat small infestations of exotics. Monroe County has received funding from the Florida Fish & Wildlife Conservation Commission, Invasive Plant Management Section, in the amount of $80,000 to fund an invasive exotic plant technician crew to work on County parcels selected by the Monroe County Land Steward. In addition, the County is providing a local match of $15,000, bringing the total funds available for the project to $95,000 (not to exceed). Work must be completed by May 17, 2019. PROJECT LOCATION Lands in this project area consist of public conservation lands located throughout the Florida Keys either owned or managed by Monroe County. Monroe County owns approximately 2,000 acres of scattered conservation lands throughout the Florida Keys. This project will target a portion of those properties in the areas identified below (the majority of the sites are within the Lower Keys area): Upper Keys: Key Largo; Tavernier Middle Keys: Crawl Key; Fat Deer Key Lower Keys: Sugarloaf Keys; Cudjoe Key; Summerland Key; Ramrod Key; Torch Keys; Big Pine Key Most individual parcels are only 0.1 acres in size, but many are contiguous and combine to form much larger management units. The majority of the sites are located in neighborhoods, adjacent to residences, and easily accessed by roads. Work in neighborhoods will require special considerations for safety, noise, and appearance of the property. Level of infestation varies by site, but since most of these sites have been previously treated, most sites will be less than 10% coverage of invasive exotic vegetation. SCOPE OF WORK The project consists of the eradication of invasive exotic plant species occurring on selected Monroe County conservation lands, utilizing herbicide as necessary. The work will be completed by the contractor's ground crew comprised of up to four (4) invasive plant technicians (including the crew supervisor). No more than one crew (composed of one crew supervisor and up to 3 technicians) may work at any one time. The contractor will manage the project including the scheduling, subcontracting as necessary, labor, monitoring and reporting progress. Additionally, the contractor will provide all necessary training, equipment, supervisory and administrative support for the technician crew. All work is to be completed using hand tools (no heavy equipment required). Work must be performed during normal work hours (between 8 am and 5 pm), Monday through Friday. No work may occur on weekends or on holidays observed by Monroe County. The County will supply location maps of project sites, including GIS shapefiles. 4 The contractor must have GPS equipment and trained field staff to enable accurate field verification of property boundaries and to provide accurate mapping of areas treated. At the end of the project, the contractor will provide the County with GIS shapefile data indicating the total area surveyed. The contractor will work closely with the County Land Steward to identify sites where only boundary or edge treatments are necessary and sites where a thorough inspection / treatment of the entire site is required. The work requires a knowledgeable crew of technicians who can "sweep" County properties and remove only the invasive exotic plant species found on the sites. The technicians must have demonstrated knowledge in identification of Florida Keys' species, both native and exotic, including closely related species. The contracted crew's priorities will include: maintaining previously treated exotic removal sites free of exotics; conducting sweeps of large conservation areas, looking for new infestations; and the removal of small infestations of exotics from recently purchased conservation lands. The contractor shall notify the County Land Steward when it finds infestations of invasive exotics that are either too large for the crew to handle or trees that may be potentially hazardous to remove (i.e. near power lines or neighbors' structures). The contractor shall provide information to the County on the approximate dimensions of the infestation and the location. Target species include: Brazilian pepper (Schinus terebinth folius); Australian pine (Casuarina spp); lead tree (Leucaena leucocephala); seaside mahoe (Thespesia populnea); scaevola (Scaevola sericea); latherleaf ( Cohtbrina asiatica); Brazilian jasmine (Jasminum fluminense); Guinea grass (Panicum maximum); Washington fan palm (Washingtonia robusta); sapodilla (Manilkara zapota); sea hibiscus (Hibiscus tiliaceus); castor bean (Ricinus communis); wedelia (Sphagneticola trilobata); oyster plant (Tradescantia spathacea); air potato (Dioscorea bulbifera); red sandalwood (Adenthera pavonina); woman's tongue (Albizia lebbeck); tropical almond (Terminalia catappa); green fountain grass (Pennisetum setaceum); asparagus fern (Asparagus aethiopicus); chastetree (Vitex trifolia) and night- blooming cactus (Hylocereus undatus). These and all other invasive exotic species listed by Florida Exotic Pest Plant Council (FLEPPC) will be either hand - pulled, cut and treated, or treated in place with appropriate herbicide. Every effort shall be made to avoid damage to native vegetation and impacts to wildlife. The exotic plant species listed above will be treated according to developed effective control techniques. Depending upon the species treated and the type of habitat, plants may be hand - pulled, treated in place, removed from site, or chipped on site. Decisions regarding specific plant treatment methods on each site will be made by the Land Steward. The contractor is responsible for the treatment and / or removal of all exotic plant species listed, including trees, grasses, groundcovers, and vines, in any life stage (including seedlings). Handpulling shall be the preferred method of removal when feasible. When it is not feasible, vegetation may be treated with herbicide and left standing in areas where standing dead timber does not pose a threat to human safety or is not offensive to adjacent neighbors. When cutting is required, each cut plant will be cut as low to the ground as possible. Cuts will be made level to the ground to minimize herbicide runoff prior to absorption. An appropriate herbicide shall be applied within one (1) minute of stump preparation. Invasive exotic plant species shall be treated with herbicide as follows: Target Species Treatment Method Asiatic colubrina 50% Garlon 3A applied to cut surface immediately after cut or (Colubrina asiatica) 20% Garlon 4 applied to stump's cut surface and sides Australian pine 50% Garlon 3A applied to cut surface immediately after cut or (Casuarina spp) 20% Garlon 4 applied to stump's cut surface and sides Beach naupaka 50% Garlon 3A applied to cut surface immediately after cut or (Scaevola sericea) 10% Garlon 4 applied to stump's cut surface and sides Brazilian pepper 50% Garlon 3A applied to cut surface immediately after cut or 5 (Schinus terebinthifolius) 20% Garlon 4 applied to stump's cut surface and sides Lead tree 30% Garlon 4 applied to stump's cut surface and sides ( Leucaena leucocephala) Seaside mahoe 50% Garlon 3A applied to cut surface immediately upon cutting (Thespesia populnea) Technicians shall utilize quart- sized, chemical resistant spray bottles, such as "Spraymaster" bottles (or similar), for herbicide application. The contents must be clearly labeled on the outside of the bottle. A dye shall be used to facilitate identification of treated stems. Herbicides will be applied using a low - pressure spray to minimize drift and non - target damage. Any additional treatment methods or changes to the methods listed above must be pre - approved by the County Land Steward. All mature (brown) lead tree (Leucaena leucocephala) seeds and air potato (Dioscorea bulbifera) will be bagged and left on the site for disposal by the County. All vegetative material from bowstring hemp (Sansevieria hyacinthoides) and night - blooming cactus (Hylocereus undatus) must be physically removed. Resulting plant material may either be bagged or neatly piled on site (adjacent to the road) for County pick up. The contractor may utilize a chipper (not required). Any mulch created will be disposed of in one of the following ways (as determined by the County Land Steward): 1. Spread evenly across the site; or 2. Removed from the site by the Contractor, at no expense to the County for the removal (if the Contractor wants the mulch for their own purposes); or 3. Neatly piled on the site by the contractor and removed from the site by the County (if Land Steward determines that on -site disposal is not an option). The Contractor will not be required to transport off -site or pay for the disposal of any vegetative waste created by the project, unless the Contractor desires to keep the mulch. The Contractor will provide all necessary equipment to complete the project including (but not limited to) hand tools, chainsaws, chippers (not required), vehicles, sprayers, garbage bags and personal protective equipment. The Contractor will also provide all materials for treatment (including herbicide and adjuvants) and ensure proper disposal of herbicide and adjuvant containers and will strictly adhere to all herbicide label application, precautionary, and safety statements. The Contractor shall be paid according to the hourly rates established in the contract for each type of on -site employee. No compensation shall be paid for travel time to and from the work site. The project is complete when the total cost per hour reaches $95,000 or on May 17, 2019, whichever occurs first. There are no reimbursable expenses. All herbicide treatments shall be at least 95% effective in preventing re- sprout of treated plants. If 95% kill rate is not achieved for any area of the project after two (2) months past initial project completion; one additional treatment of the exotic plants in the problem area shall be the responsibility of the Contractor at no additional cost to the County. The Contractor shall at all times provide an on -site ground crew supervisor that is certified by the Florida Department of Agricultural and Consumer Services and in good standing with that Department, as part of the work force. Ground crew supervisors will be responsible for : 1) coordination with the Monroe County Land Steward on a daily / weekly basis; 2) all control activities and safety on project sites; 3) assuring that all crews are knowledgeable of, and remain within property and treatment boundaries; 4) assuring appropriate herbicide labels and Material Safety Data Sheets (MSDS)are on site; 5) avoiding damage to native vegetation and wildlife; and 6) strict adherence to all herbicide label application, precautionary, and safety statements. Ground crew supervisors shall be certified by the Florida Department of Agriculture and Consumer Services 6 in the Natural Areas category. The County reserves the right to disqualify prospective bidders who have violations of the Rules of Chapter 62C -20, F.A.C., or other state or federal laws or regulations related to pesticide use or aquatic plant control resolved by mediation, Consent Order, or fine within the two (2) previous years. Crew supervisors must meet with the County Land Steward on a regular basis to discuss the progress of the project and to determine priority areas for treatment. The contractor shall complete "Daily Progress Reports for Invasive Plant Control" and "Weekly Progress Reports for Invasive Plant Control" and will submit the completed forms to the County every two weeks at a minimum. The Monroe County Land Steward will submit the permit application for the proposed exotic removal work, however the Contractor is required to pick up the permit from the Monroe County Building Department and keep the permit with the crew while • working on -site. The term "technician" is used to imply specialized knowledge of invasive exotic plant control. All technicians working on the crew must have training in plant identification (specifically Keys' species) and herbicide application methods. The contractor must hold a valid Monroe County business tax receipt and a Monroe County Certificate of Competency for a Landscaping Specialty Contractor. A general contractor may apply if he holds a landscaping specialty contractor certificate of competency in Monroe County or employs a Landscaping Specialty Contractor licensed in Monroe County. The business tax receipt is required for both. Additional plant treatment or removal and nonplant debris removal may be added to the project by mutual agreement as field conditions warrant and funds permit. Such agreements for additional work shall be made in writing and agreed to by signature of both parties. According to the County's formal agreement with Florida Fish & Wildlife Conservation Commission, contractors working on invasive exotic removal projects must adhere to the following protocol: • Mandatory decontamination protocols must be followed for vehicles and equipment prior to entering Monroe County from areas outside of the County. • When moving equipment from site to site within Monroe County, decontamination requirements will be at the discretion of the County and will be dependent upon the exotic species that were treated at the previous site and on the nature of the treatment sites. • If decontamination is required by the County then the contractor must utilize a designated decontamination site within Monroe County. The County shall supply the contractor with a list of designated decontamination sites if necessary. Decontamination protocols: • All equipment including but not limited to vehicles, trailer, ATV's, and chippers must be cleaned with a pressure washer (at a County approved facility). Decontamination protocols include spraying down all equipment surfaces including the undercarriage and tires to insure that mud, vegetative debris and other debris is not transported from the previous treatment site. Special attention will be paid to equipment that has worked at sites where Lygodium, Cogon grass and other exotics specific to the mainland were treated to prevent the spread of these species into Monroe County. • Equipment such as chain saws, loppers, etc. used for cut stump treatment must be wiped down and cleaned so that they are free of debris. Prior to the commencement of the project, the contractor and the County Land Steward shall discuss the necessity for a decontamination plan. If the County requires a plan, then the contractor shall submit a brief decontamination plan in writing, to the County for approval. The decontamination plan shall identity specific decontamination procedures and decontamination sites. Decontamination protocols may vary depending upon the nature of the treatment site, type of treatment conducted at the site, and the exotic species that were treated. Failure to comply with decontamination protocols constitutes reason for contract cancellation and dismissal of the contractor. While notice to proceed will be issued as soon as possible after the contract is final, the project timeframe may be adjusted depending on seasonal conditions. All work must be completed by May 17, 2019. Requirement to Use E- Verify. The Contractor must: (1) utilize the US Department of Homeland Security's E -Verify system to verify the employment eligibility of all new employees hired by the Contractor during the term of the Contract; and, (2) include in all subcontracts under this Contract, the requirement that subcontractors performing work or providing services pursuant to this Contract utilize the E -verify system to verify the employment eligibility of all new employees hired by the subcontractor during the term of the subcontract. 8 ' ACO ® DATE (MMIDD/YYYY) `� CERTIFICATE OF LIABILITY INSURANCE 8/17/2018 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(ies) 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Wallace Welch & Willingham, Inc. PHONE Certificates /Commercial Lines FAX 300 1st Ave. So., 5th Floor INC. No. Ext): 727 - 522 - 7777 INC , No): 727 521 - 2902 Saint Petersburg FL 33701 ADDRESS: certificates @w3ins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: National Trust Ins. Co. 20141 INSURED EARTCOR -01 INSURER B : Homeland Ins Co of New York 34452 EarthBalance Corporation 2570 Commerce Parkway INSURERC: Amerisure Ins. Co. 19488 North Port FL 34289 INSURER D: Monroe Guaranty Ins. Co. 32506 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 774860981 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSD VD POLICY NUMBER IMMIDD/YYYY) IM IY MIDDYYYI A X COMMERCIAL GENERAL LIABILITY Y Y GL00107428 8/23/2018 8/23/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 - .1'c'RG) . 0 8 'I f K M' A 3EMENT MED EXP (Any one person) $ 5,000 X XCU Included - IJH (E. , -- ,IrM u. PERSONAL & ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: WAIVER N/A . ' GENERAL AGGREGATE $ 2,000,000 POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 X OTHER: Primary Non Cont $ D AUTOMOBILE LIABILITY Y CA10000408904 8/23/2018 8/23/2019 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED X SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED X W N ON -ONED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR Y Y UMB10001683701 8/23/2018 8/23/2019 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 10,000,000 DED X RETENTION $ 10 000 $ • c WORKERS COMPENSATION Y WC20964660301 4/1/2018 4/1/2019 X STATUTE OTH- ER U.S.L.H AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR !PARTNER /EXECUTIVE N N / A E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Professional / Pollution Liab 7930075900000 2/18 /2018 2/18/2019 Each Claim/Aggregate 2,000,000/2,000,00 Retro Date 2/18/1997 Deductible 15,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Monroe County BOCC is additional insured with respect to General Liability subject to terms, conditions and exclusions of the policy form and with respect to Auto Liability per Auto Coverage Form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC 1100 Simonton St. Key West FL 33040 AUTHORIZED REPRESENTATIVE . I 814." , © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD