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3rd Amendment 02/19/2020 Z.couRr Kevin Madok, CPA %-'4.4 Clerk of the Circuit Court&Comptroller—Monroe County, Florida ROE 00V�1 DATE: February 28, 2020 TO: Alice Steryou Contract Monitor 1 FROM: Pamela G. Hanco 11.C. SUBJECT: February 19th BOCC Meeting Attached is an electronic copy of the following item for your handling: C6 3rd Amendment to Agreement with Ceiling to Floor Cleaning, Inc. for Upper Keys and Marathon Janitorial Services for a one year renewal and annual CPI-U adjustment with new monthly amount of$21,943.35. Funding is ad valorem. Should you have any questions, please feel free to contact me at (305) 292-3550. cc: Facilities Supervisor 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 THIRD AMENDMENT TO AGREEMENT FOR UPPER KEYS AND MARATHON JANITORIAL SERVICES MONROE COUNTY,FLORIDA This Third Amendment to Agreement is made and entered into this 19th day of February, 2020, between MONROE COUNTY, FLORIDA("COUNTY"), a political subdivision of the State of Florida, whose address is 1100 Simonton Street,Key West,Florida 33040,and Ceiling to Floor Cleaning,Inc.,a Florida Profit Corporation, authorized to do business in the State of Florida, ("CONTRACTOR"), whose principal address is 2732 NW I5th Court, Fort Lauderdale, Florida 33311, and whose physical address for purposes of this Agreement is 2003 NW 55th Avenue,Margate,Florida 33063. WHEREAS, on February 20, 2019, the parties entered into the Agreement for the CONTRACTOR to provide janitorial services for facilities in the Upper Keys and Marathon ("Original Agreement");and WHEREAS, on April 17, 2019, the parties entered into a First Amendment to the Agreement which provided for the CONTRACTOR to perform additional janitorial services for the Roth Building in Tavernier and the State Attorney's Office in Marathon;and WHEREAS, on May 22, 2019, the parties entered into a Second Amendment to the Agreement which provided for the CONTRACTOR to perform additional janitorial services for the Public Defender's Office in Marathon,Florida;and WHEREAS, the COUNTY desires to extend the term of the Original Agreement and provide for an annual adjustment in the contract price pursuant to the terms of the Original Agreement;and WHEREAS, the parties have found the Original Agreement, as amended, to be mutually beneficial;and WHEREAS, the parties find that it would be mutually beneficial to enter into this Third Amendment to the Original Agreement; NOW,THEREFORE,IN CONSIDERATION of the mutual promises and covenants set forth below,the parties agree to amend the Original Agreement as follows: 1. In accordance with Paragraph S.C. of the Original Agreement, the COUNTY exercises its option to renew the Original Agreement for the first of the four(4) one-year terms. The term of the Agreement shall now commence on March 1, 2020, and ends upon February 28, 2021, unless terminated earlier under paragraph 19 of this Agreement. The contract amount may also be adjusted annually in accordance with the percentage change in the U.S. Department of Commerce Consumer Price Index (CPI-U) for all Urban Consumers as.reported by the U.S. Bureau of Labor Statistics and shall thereby be adjusted 2.3% based upon the CPI-U computation at December 31,2019. 2. In accordance with Paragraph 5. B. of the Original Agreement, as amended, the total contract amount for janitorial services is hereby adjusted from Twenty-one Thousand Four Hundred Fifty and 00/100 ($21,450.00) Dollars per month to Twenty-one Thousand Nine Hundred Forty-three and 35/100(S21,943.35) Dollars per month. ,-,mt cci 4'.4,11 F 4:_,,,4_.,,-_g,,t, rf ED FOR RECORD �.y n, v „; .;-_,,-.,„/k(.,z5 ,,. ,.. N0k....i,\, acp. 01\ , cc,no . 2020 FEB 28 PM to 37 '° `° ____G C y ' -c,-) COUNTY. •2 ,g i `sru �MOOROE FLU O `ti n < ` r„ ' \ m C\ z J. h\ 1 C7 Da CA ril trl sW tyj ,--i s .71 .. ��� ` � � � ( � z 11) › . Zr ri A 0 co ° oma GI \ w \ C" a vtU 3 �\I to,, ,ti ��✓� O' �.t •�, ►gyp 0 a m �c U � � z C?�0 . :ti !may No c 0OO2 H ai 0: \.1, gr, R.\ k. c_., a cizs , A ng &i, r, ?:' NJ o ""G -n z '�.t M1� b'''''' . gyp- m -4; NC 0 Si law to Jcs, R ....... p I N g. co ri j !!l n ill ra. z + .41.+Pr. LTH B PAULIN() 43 �]. �� C t� 1 4 ;- :.1�,,. ,.o,ar -.rblit..Stele of I loreda t •-i` ,.).Corn.,.Lxprr.Feeb�5 2072 ' • A�� CERTIFICATE OF LIABILITY INSURANCE DATE(L7RIDDIYYYYI 6/10/2019 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 BYTHE 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: lithe certificate holder is an ADDmONAL INSURED;the policy(ies) to the terms and conditions of the policy,certain policies may require an endorsement,A statement on this certificate does not confer rights tto the certificate holder in lieu of such endorsement(s). PRODUCER • caNIAeT Triton Global NAME• Triton Insurance Group FHONE (866)400-7674 Y200 1FAX 100 N state Road 7 WC.No ° INC N.,11«1657-1i1° Unit 304 Aa0RESS-quo taetritonagency.cons Margate30 FL 33063 INSURERIS)AFFORDING COVERAGE. NAIL I I/ INSURED SURMA:Depositers Insurance company 42507. XI suFLsR a:INTrNiTP.AUTO INSURANCE Ceiling to Floor Cleaning Inc INSURER C:Old Re¢11b11C Surety CO 1431 SR 6 Way INSURERD:. • INSURER S: Deerfield Beach FL 33441 INSURER F: COVERAGES CERTIFICATE NUMBER:C1,1961010943 REVISION NUMBER: THIS IS TO CERTIFYTHAT 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 DER TYPE OF INSURANCE 'Tot.suss POLICY OFF POLICY owINSD VAO POLICY NUMBER {NMino,rvYp IMMJDorrYYYI I LIMITS X I COMMERCIAL GEIJERALUABILITV EACH OCCURRENCE 3 1,000,000 A I CLAIMS-MADE n OCCUR DAMAGE TO RGVTD PREN:$=5(Ea occur•.MICR; S 100.000 Deductible:$500 Per Occ X ACP30078313E4 7/28/2018 7/28/2019 IAED Ext.(Any 0to panon1 5 5,000 - PERSONAL S.ACV INJURY 5 1,000,000 GSNtAOGREOATE UNIT APPLIES PER GENERiLADDC,REGATE S 2,000,000 R POLICY 1 ( n LOC PRCCLCTS-COIJPrOPACG S 2,000,000 OTHER: S 8 AUTOMOBILELIABIuTY 5098:0033119001 04/02/2019 04/02/2020 CEa ardOM81Nf:ert FEC 5nGLE LLII' IS 1,000,000.00 [ �_ANY AUTO BODILY INJURY(Per hereon) S ALL OWNED SCHEDULED AUTOS AUTOS AUTOS X BODILY INJURY(Per acodan) S HIRED AUTOS NONdVMEO PRCF=_RT(DAUSGE I AUTOS (Per o o4e-c: S I5 I umsatLLAune OCCUR __1 _ EACH OCCURRENCE 5 EXCESS LULe — tA� _ Y RISK rR]C�ff L1A3t5-4AOE AGSaFi`eGAT3 s ZED I I RE:EEDCN 5 S r.\ .4 17 - S WCRNERS COMPENSATION '�} 11 I RATJTE I I I ANOEMPLOYERS'LIABILITY YIN DATE . --1�!_(r? .VK PP.OPRiedi,o,FRTNEP1EAEWTTJE n NIA L.EACH,'CCICEN7 S OFRRCER7MEMPA EXa.00EOa (Mandatory In NH) WAIVER NI YES EL.DISEASE-EA eV LOYEE s II Tee,deoene wMer DESCRIPTION OF OP_R:TIONSee(cw EL D EF SEASE-POLICY WET S J BOND X150317805 06/11/2019 1 06/11/2020 EMPLOYEE OGHONEFY $10,000 C I DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLW(ACORD 101,Additional Remarks Schedule,may M attached It roars wee Is ra9ulrs6l Additional Insured Status Afforded where required by written contract with the insured. Certificate Bolder is listed as a Loss Payee in regards to the Bond. - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Board of County CommissionersACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St. Rey West, FL 33040 AI/THORNEDREPRESENTATIVE �n N Michaud/GLOBAL ISOsk7 ©1988-2014 ACORD'CORPORATION. All�Al rights reserved. ACORD 25(2014(01) The ACORD name and logo are registered marks of ACORD INS025(201401) CERTIFICATE OF LIABILITY INSURANCE °"'EI"YfOO^ 7/31/2019 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. IMPORTANfl It the certificate hofdorls anADDITIONALINSURED,the pollcy(ies)must:birondersedi if SUBROGATION 15 WAIVED;:sub)oce to the terms and conditions of the policy,certain policies may require ad endorsement. A statement on thta certificate does not confer rights to the certificate holder In lieu of such endorsomem(s). PROOUCfR t CONTA-Cr HAbi8Triton Global Triton Insurance Group PHOtE (B66)400-7674 X10D 100 N State Road 7 , Ew4ness�.E>tl I iA C Not MO n,-sc,A Unit 304 + :-q uoto?tritonageney.com - _ • Wbihesib)AFFOROLNO COVERAGE tGargatc FL 33063 = IWIG r NeURED wsumaA:DepoSiteis :insurance Company . 42597 LYSURER B.1N:I'INZTY:AUTO:XNSUH.ANNGE Coiling to Floor Cloaning Inc ctsuRER a:Old-t r it1,i i C'Surety to 1431 SW 6 Kay V:SURERe: WSUREH E:I • - _ - • Deerfield Beach FL 13441 WSURERF: . COVERAGES :CERTIFICATE:NUMBER:CL197311137B REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF,INSURANCE LISTED:BELOW HAVE BEEN ISSUED TO'THE INSURED NrtiMED-ABOVH,FOR THE POLICY PERIOD INDICATED NOTWMTHSTANDINGANYs,REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER,DOCUMENTIMTH RESPECT TO VNIICH THIS CERTIFICATE MAY RE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDEQ.By THE POLUCIES'DESCRIBED HEREIN'IB SUBJECT.TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS'SHOWN MAY HAVE:BEEN REDUCED BYPAID CLAIMS. AWL duAk yL7RR 'ryrL'of INS11w CH I IUOUCY Ff POLICY YIIP - - iN�O 5W1 POLICY LAUNDER. IVDOrY1R'1'1 INWOWYYYY}-- :Ll1iiIS. X .COMMERCIAL OBIERAL LIABILITY _ - - - EACH O%CURRE CE S 1,000,000 AJ CWMSJAADE 1-1 OCCURDAt1AGEIOND..EC. - - PREL1iSERIEsccom+tXMI f 100,000, X DoduCt bla:$SOO Erik Oac X. AC93007031364 7/29/2019 7/29/2020 IAETi E7tp (Any 0,0 cmunj S 5,000 PERScIAL3ADVOi:URY S 1,000,000 GEKtAGGfr?QA18 LLIITAPPJL�IES PER. POLICY in r ' 1 LOC GEHE4.iL AGGREGATE ! 2,000,000' PROOLCTS CQUP4004,00 '1 2,000,000 OhfER f B AUTOMO®s$LIABILITY 509820033119001 0l/02/2019 04/02/2020 L` `t91'1bDStt+'CiLEL044 ! 1,000,000.00 ANYAUTO fE7 630Cirt1 ALL OWNED SCHEDULED AUTOS AUTOS X 5001LY INJURY;Ptr pawn) 5 BODILY INJURY Pow ARRRRO f HIRED AUTOS AUUNOTOS � PROPERTYD.IVAC,E n APPR. Y Fil^oKe4C-fill ! _ UMaTae a Lucy _ OCCUR BY a 1.., fJ[CEaa LJAB I £sCft CCCUFi4E4CE a CLA,1IS40ALr' • _ f: "BATE G ^y arrseLla E •! WORKERS alaM xrrae _ •+�.�'—_',1 l;" 4—'i ` ( f ANDfMPLOYIII&Lgell7r rfN WAIVER / YES si UTE.: I I ANY PROPRZTORRARINEWEASCtfrAtE. OFF,CEateusERExctcrvED>' NIA EL EACH ACG:DJ,t7 S tMardaloty In NH) •_ - YYeea rasr.0a.er441 D,.,:A!"E-E4E7.IP,0`tEE 4. DESRIP^.ON CF OPERATIONS baba El_05F.i5E=PC.aCYLJIAT - R130317305 06/11/2019 06/11/2020 BIWLOYEEDSHOFTY C 410,000 OGaT10N of OPERATIONS I LOCATIONS I VEMCE9 µCORD 10t;AOd4Ie i Ranuls Scl 2 IA,'may bo=idglomd If a,o . o Is o s qukld) CRD 1aem tional Insured Statua'Affordad where required ley written contract with the insured. Certificate Holder is listed as a Loos Pays in regards to the Bond. CERTIFICATE HOLDER - CANCELLATION • SHOULDANY:OF THE ABOVE D°B$CRISED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION'DATE THEREOF NOTICE WILL BE D LIVER_ED_IN Board of County Commissioners ACCORDANCEWmi THE POLICY PROVISIONS: 1100 Simonton St, Key West, FL 33040 AUT1lDRlZH1 REPRESENTATIVE I- • • I �i Michaud/GLOBAL v; o Q,1088-2O14 ACORD,CORPORATION. All rights rostrrved ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 R01401) DATE(MMIDDIYYYY) A�D® GA CERTIFICATE OF LIABILITY INSURANCE6/10/2019 . 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 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 Triton Global NAME Triton Insurance Group PHONE LAIC No Ex(}; (866)400-7674 x100 FAX No): re6 61 6 57-3 61& 100 N State Road 7 ADDRESS:quote@tritonagency.com Unit 309 INSURERS)AFFORDING COVERAGE NAIC A Margate FL 33063 INSURER A:Deposi tars Insurance Company 42587 INSURED INSURER a:INFINITY AUTO INSURANCE Ceiling to Floor Cleaning Inc INSURER C Old Republic Surety Co 1431 SW 6 Way INSURERD: INSURER E: Deerfield Beach FL 33441 INSURER F COVERAGES CERTIFICATE NUMBER:CL1961010943 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 W1TH 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 ADOL SUER LTR TYPE OF INSURANCE INSD WVO POLICY NUMBER POLICY EFF POLICY EXP (MMIODIYYYY) (MMIDOlYYYY} LIMITS X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE IS 1,000,000 A CLAIMS-MADE 'X I OCCUR PREEMISE-5/OEa occurrence) $ . 100,000 X Deductible:$500 Per Occ X AC1,3001831364 7/29/2018 7/28/2019 MED EXP(Any one parson) S 5,000 PERSONAL a ADV INJURY 9 1,000,000 GvEN''L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 ' PR POLICY EOOT LOC PRODUCTS-COMP/OP AGG S 2,000,000 I OTHER: S B AUTOMOBILEUABIUTY 509820033119001 04/02/2019 04/02/2020 COMBINED SINGLE LIMIT `S 1,000,000.00 (Ea aBIJdert) -ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED ,AUTOS R AUTOS X BODILY INJURY(Per accident) S NON-OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS (Per-auS Fn� � CS APO! 0 I9�i.A _ ME I EACH OCCURRENCE S ' EXCESS LIAR CLAIMS-MADE Y - fn�II t - AGGREGATE S •• DED I RETENTION S 14_(VFR 1V 1. -u-,., S WORKERS COMPENSATION - {{{{''''���� ; l ' AND EMPLOYERS'LIABIUTY YIN O�� � 1 STATUTE OER • ANY PROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED/ N IA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS bets E.L.DISEASE-POLICY LIMIT S . • BOND W150317805 06/11/2019 06/11/2020 EMPLOYEE OISHONETY $10,000 C DESCRIPTION OF OPERATIONS/LOCATIONS;VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached if more space Is required) , Additional Insured Status Afforded where required by written contract with the insured. • Certificate Bolder is listed as a Loss Payee in regards to the Bond. I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St. Key West, ET, 33040 AUTHOEI700 REPRESENTATIVE N Michaud/GLOBAL I . ©1988-2014 ACORD CORPORATION. All rights reserved. ; ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) ®ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MM)DDIYYYY) kii.....----- 08/26/2019 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 NAME AP INTEGO INSURANCE GROUP PHONE — — - FAX — 375 Woodcliff Drive JAIC,No- --- — 1(AMC•No): E-MAIL — Suite 103 ADDRESS; _ Fairport, NY 14450 INSURER(S)AFFORDING COVERAGE NAICti INSURERA: NorGUARD Insurance Company ' 31470 INSURED INSURER B: Ceiling To Floor Cleaning, Inc. - INSURER C: . _ PO Box 880 INSURERD: Fort Lauderdale,FL 33302 INSURER E: 1 INSURER F: COVERAGES -CERTIFICATE NUMBER: . . REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES 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 AU.THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSe �---------- _--- ....:ADDL'SUBR? POLICY EFF1 POLICY EJ(P• ---- --- ---------- LTR 1 TYPE OF INSURANCE 1INSD MI I WVD 1 POLICY NUMBER j(MDDIYYYY) JMMIDD/YYYY1 I LIMITS COMMERCIAL GENERAL LIABILITY I I EACH OCCURRENCE S 0 I DAMAGE-TO RENTED I I I CLAIMS-MADE II OCCUR S 0 PREMISES(Ea occurrence) �_� _ MED CP(Any one person) I S 0 ,__i -__ _ PERSONAL&ADV INJURY _ I S _ _ 0 I GEN.AGGREGATE LIMIT APPLIES PER: ,GENERAL AGGREGATE I S 0 I_1 POLICY I`1 PRO -CT i--I LOC I I PRODUCTS-COMPIOPAGO I S 0 I OTHER: I I I s 1 AUTOMOBILE UABIUTY I I I COMBINEDS!NGLEUMIT i s LEA as dentl ANY AUTO I i OWNED ��..CHEDULED BODILY INJURY(Per person) ,S EMENT AUTOS ABLY I AUTOS APPROV aD9I I BODILY INJURY(Per accident)j S HIRED \ON-O\VNEO BY 'I PROPERTY DAMAGE I - AUTOS ONLY I AUTOS ONLY DATE I I I(Per as tlentl ' I I WAI ER N/A is I Is j ;UMBRELLA UAB 1 OCCUR I 1 EACH OCCURRENCE I S - EXCF.,.�S` LWB I :CLAIMS-MADE{ I I I i AGGREGATE 15 I DEO I I RETENTIONS I i I , I S IWORKERS COMPENSATION j I f I MUTE t 1OTH- I AND EMPLOYERS'LIABILITY YIN UT= —l-ER, fANYPROPRIETORJPARTNER/EXECUTI'JE I I EL.EP,CH ACCIDEKI s 500,000 A OFFICE PRIEBEREXCLUDED? n'N/AI CEWC078556 �07/11/2019 07/11/2020 I I(Mandatory in NH) I • I E.L.DISEASE-EA EMPLOYEE 5 500,000 'f yyeess,,�desc ibe under 1DESCRIPTION OF OPERATIONS below I I _ _ - I EL,DISEASE•POLICY LIMIT S 500,000 I I i DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) • Governing Class Description:JANITORIAL SERVICES BY CONTRACTORS. Exclusions: AISHA STYLES; BRICE BENNETT,Vice President; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE Ceilingto Floor Cleaning,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 880 Fort Lauderdale, FL 33302 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD er'.. .'.."14:-..';. JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW** NON-CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 6/4/2019 EXPIRATION DATE: 6/3/2021 PERSON: BRICE BENNETT EMAIL: BRICEBENNETT@YAHOO.COM FEIN: 463081997 BUSINESS NAME AND ADDRESS: CEILING TO FLOOR CLEANING, INC. 10155 SW 170TH TERRACE - A EVj i 56 id MIAMI,FL 33157 Vi, t��,rl SCOPE OF BUSINESS OR TRADE: wi\VER NIA E ..- Janitorial Services By . Contractors-No Window Cleaning Above Ground Level &Drivers IMPORTANT:Pursuant to Chapter 440.05(14),F.S..an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt..apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shalt be subject to revocation if.at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES ' DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW** NON-CONSTRUCTION INDUSTRY EXEMPTION • This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 8/16/2018 EXPIRATION DATE: 8/15/2020 PERSON: AISHA A STYLES EMAIL: AISHA.STYLES99@GMAIL.COM FEIN: 463081997 BUSINESS NAME AND ADDRESS: CEILING TO FLOOR CLEANING,INC. P.O.-BOX 880 NAGS tEN� FORT LAUDERDALE, FL 33302 APP Y -71,04 SCOPE OF BUSINESS OR TRADE: WAVER NIA Janitorial Services By Contractors-No Window Cleaning Above Ground Level 8 Drivers IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by fling a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12).F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13).F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the fling of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609