12/15-27 Baggage Conveyor System 03/13/2018 MASTER AGREEMENT FOR PROFESSIONAL SERVICES
TASK ORDER FORM
Effective Date °lt°" � Task Order No. 12/15-27
Client Project No. GA R.0 0 '- 5,i 1 6 Engineer Project No. E9Y37927
This Task Order is entered into on the effective date noted above pursuant to the "Master
Agreement for Professional Services" between Monroe County, Florida ("Client") and JACOBS
PROJECT MANAGEMENT CO. ("Consultant"), dated February 15, 2017 ("Agreement"). The
Agreement is incorporated herein and forms an integral part of this Task Order.
Services Authorized —Baggage Conveyor System Upgrade—Capacity Study(12/15-11) and
Design Assessment& Construction Phase Services (12/15-15) - Supplemental
Client authorizes Consultant to perform the Services described in Exhibit A attached hereto and
incorporated herein, which Exhibit A is marked with the above noted Task Order No. and
consists of 1 page(s).
Pricing
N/A Time and Expense per Agreement and Appendix B to the Agreement.
X Firm Fixed Price of$ 9,034.00
N/A Other(Describe):
Schedule
Services may commence on Execution
Services will cease by 365 days
Other
(SEAL) BOARD OF COUNTY COMMISSIONERS
ATTEST: KEVIN MADOK, CLERK OF MONROE COUNTY, FLORIDA
By �-Ar
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CONSULTANT:
JACOBS PROJECT MANAGEMENT CO
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File: MSTR APS---Monroe County
Page 1 of 1
Exhibit A(12/15-27)
Scope of Services
Monroe County Airports
Key West International Airport
Baggage Conveyor System Upgrade—Capacity Study (12/15-11) and Design
Assessment& Construction Phase Services (12/15-15) -Supplemental
SCOPE OF WORK
Jacobs sub consultant J.A. Watts, Inc.will provide increased Professional Liability Insurance to
meet the requirements of the `Master Agreement for Professional Services Between Jacobs
Project Management Co. and Monroe County, Florida",dated February 15, 2017.
Page I of I
JACOBS ENGINEERING GROUP
03.05.18
Monroe County
Airport:
Key West International Airport
Project:
Baggage Conveyor System Upgrade—Capacity Study(12/15-11)and Design
Assessment&Construction Phase Services(12/15-15)-Supplemental
FEE SUMMARY
BASIC SERVICES
Hours Fee
Article A:
Total Basic Services Lump Sum Fee 0 $ -
SPECIAL SERVICES
Hours
J.A. Watts, Inc. $ 9,034
Total Special Services Lump Sum Fee $ 9,034
TOTAL LUMP SUM PROJECT FEE 0 $ 9,034
1
J9Airpodst_MONROE COUNTYTSO'st 2017 PSO's(ESY379XX New Contract)\PSO 27-JWI InsurancMAM Supplemental Fee.xlsx
JACOBS ENGINEERING GROUP JOB HOUR AND FEE ESTIMATE
Monroe County
Airport:
Key West International Airport
Project:
Baggage Conveyor System Upgrade—Capacity Study(12115-11)and Design Assessment&Construction Phase Services(12/15-15)-
Article A:
' Sr. Dr. br.
S
Project Sr.Project Mechanical Electrical CARD
ingineer Engineer, Tech Clerical TOTAL
Manager, Architect Engineer
WORK ITEM, , 'Engin'
Supplemental Professional Liability See Attached,J.A.Watts Confirmation of Insurance
Insurance
I ITOTAL HOURS
I IRATE $ 195.00 $ 100.00 $ 175.00 $ 110.00 $ 75.00 $ 130.00 $ 60.00 $ 58.00 -----
I I PAYROLL ESTIMATE $ - $ - $ - $ - $ - . $ - $
Task Subconsultants, TOTAL PAYROLL $ -
Total Subconsultants $ 9,034.00 Subconsultants $ 9,034
Expenses $ -
Lump Sum Fee Total $ 9,034
Task Expenses:
Mileage(214 miles round trip
$0.555/mi)x I
Airfare($500 round trip)x 3 1 TOTAL FEE $ 9,0341
Meals and Per Diem
Reproduction/Misc.
Total Expenses
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TURN
SPECIALTY
CONFIRMATION OF INSURANCE
December 27,2017
Mesirow Insurance Services, Inc.-Chicago
Michael Alesia
353 North Clark Street
Chicago, IL 60654
FROM: Dan Brown for Mason Lee
I am pleased to confirm that your Professional Liability Full Program insurance has been bound pursuant
to your request. The attached Confirmation of Insurance will serve as evidence of coverage until the
insurance carrier issues the policy. This insurance document summarizes the policy referenced above
and is not intended to reflect all the terms and conditions or exclusions of the referenced policy. In the
event of a claim,coverage will be determined by the referenced policy,subject to all the terms,
exclusions and conditions of such. Moreover,the information contained in this document reflects
bound coverage as of the effective date of the referenced policy and does not include subsequent
changes by the insurer or changes in the applicable rates for taxes or governmental fees.
NAMED INSURED: J.R.Watts, Inc.
940 W Adams,Suite 400
Chicago, IL 60607
PRIMARY RISK ZIP CODE: 60607
COVERAGE: Professional Liability Full Program
INSURER: Lloyd's of London-Non-Admitted
POLICY NUMBER:
POLICY TERM: 12/31/2017-12/31/2018
POLICY PREMIUM:
FEES: Policy Fee-Carrier
TOTAL FEES:
SURPLUS LINES TAX: Surplus Lines Tax
TURNERRYAN
RE
SPECIALTY
-=ww"
Stamping Office Fee IMI
TOTAL TAXES:
TOTAL:
SPECIAL CONDITIONS/OTHER COVERAGES:
NO FLAT CANCELLATIONS
ALL FEES ARE FULLY EARNED AT INCEPTION
For R-T Specialty to file the surplus lines taxes on your behalf, please complete the surplus lines tax document and
return with your request to bind. Due to state regulations, R-T Specialty requires tax documents to be completed
within 24 to 48 hours of binding. Please be diligent in returning tax forms.
LIMITS OF LIABILITY:
$2,000,000 Each Claim
$2,000,000 Aggregate
ADDITIONAL LIMIT OPTION:
$3,000,000 each claim and aggregate=$9,034 additional premium, including surplus lines taxes
DEDUCTIBLE:
i Per Claim
— Aggregate
RETRO DATE: 04/27/2004
PROFESSIONAL SERVICES: Program and project management services,at-risk construction management,
construction management agency services and owners representative services for others
TERMS&CONDITIONS:
• Worldwide Coverage
• Definition of Insured—includes Named Insured's interest in Joint Ventures,Independent Contractors, Former
Personnel and Subsidiaries.
•Aggregate Deductible
Innocent Insured Coverage
I' A
TURNERR
IIII1111 SPECIALTY
• Punitive Damages are covered where permitted by law
• Flexible definition for Professional Services
• Waiver of Subrogation where required by written contract
• ADA, FHA,OSHA$25k Defense Expense Sublimit included
• Pre claims Assistance
• No Contractual Liability Exclusion
• One,two and three year ERP Options
FORMS&ENDORSEMENTS:
SLC-3 Cover SLC-3
A&E E&S Declarations WK AE 28 12 15
Schedule of Forms Forms
A&E E&S Primary Policy Form WK AE 30 12 15
Cancellation Clause NMA1331
Nuclear Incident Exclusion Clause-Liability-Direct(Broad) (U.S.A.) NMA1256
Radioactive Contamination Exclusion Clause-Liability-Direct(U.S.A.) NMA1477
Several Liability Notice LSW1001
Service Of Suit Clause(U.S.A.) NMA1998
Asbestos Exclusion WK AE 32 12 15
Amended Settlement Clause Endorsement WK AE 39 1116 (50%/50%)
Construction Management Endorsement WK AE 0912 15
Contingent Pollution Endorsement WK AE 1012 15
Mold Exclusion WK AE 33 12 15
War and Terrorism Exclusion Endorsement NMA2918
Technology and Multimedia Liability Coverage Section WK AE 381116
Line Slip Line Slip A&E E&S 2017
TAX RESPONSIBILITY: RT SPECIALTY(NON-ADMITTED: IL RISK)
Authorized Representative
RTRYAN
TURINIER
SPECIALTY
HOME STATE FOR NON-ADMITTED RISKS
Taxes and governmental fees are estimates and subject to change based upon current rates of the Home
State and risk information available at the date of binding. The Home State of the Insured for a
non-admitted risk shall be determined in accordance with the Nonadmitted and Reinsurance Act of
2010, 15. U.S.0§8201, etc. ("NRRA").Some states require the producing broker to submit a written
verification of the insured's Home State for our records. The applicable law of the Home State
governing cancellation or non-renewal of insurance shall apply to this Policy.
Any amendments to coverage must be specifically requested in writing or by submitting a policy change
request form and then approved by the Insurer. Coverage cannot be affected, amended, extended or
altered through the issuance of certificates of insurance. Underlying Insurers must be rated A- VII or
better by A.M. Best.