Loading...
06/05/2020 Agreement ATTACHMENT DA COUNTY ADMINISTRATOR CONTRACT SUMMARY FORM FOR CONTRACTS LESS THAN$50,000.00 Contract with: Cummins Sales$ Service Contract# Effective Date: June 5,2020 Expiration Date. June S 2021 Contract Purpose/Description: Full Service Maintenance Axrwmcat and lummAim for Aug2020,to Feb 2021 Contract is Original Agreement Contract Amendment/Extension Renewal Contract Manager: Tyler Bethel X5214 rt_ . (Name) (Ext.) (Department/Stop#) CONTRACT COSTS Total Dollar Value of Contract: $ 4095AR Cunent Year Portion:$ (mast bc Irss d=S50.000) (Ifrriwfil ear air then mvirm BaCC approval.unless du: Budgeted?Yes[ No❑ Account Codes: 4o 4 5304o- Grant:$ County Match: $ - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: Not included in dollar value above e. .mainunzwx,utilities 'anitor salari etc. CONTRACT REVIEW Changes 01 Date Out Date In Needed vi Department Head ��a YesO No[f 6 # p Risk Management 06-18-2020 yeSO No® 06-18-2020 O.M.B./Purchasing 6/23/20 yes0 Na© j14. -i,ytq,B�t,�-, j,�, 6/23/20 County Attorney F23426 YesO Nog Comments: MIAMI FL BRANCH ut� 6350 NW 167TH STREET FL REG MV#95746 MDMVR#10169 MIAMI LAKES,FL 33014 Phone:305-8214200 PLAMD MAINTFNANCF AGREEMENT Customer Address Customer Contact cote Information KEY WEST INTL AIRPORT Contact: Chris Hawks Quote Date: 05-JUN-20 CHRIS HAWKS Phone: 305 360-793 3491 S R005EVELT BLVD Quote Expires: 05-JUN-21 2ND FLOOR Fes' Quote Num: 102552 Key West, FL 33040 Cust Id: 361168 Quoted By: Martin E Delmas Quote Term: I Year(s) Site Information 1 KEY WEST INTERNATIONAL 100 ROOSEVELT BLVD KEY WEST FL 33040 Site Unit Number Manufacturer Model Prod Model Serial Number Type 1 UNIT#i ONAN 750.ODQFAA-59 750.ODQFAA-5938798A080144119 STDBY Site Unit Number Service Event Qty Sell Price Extended Price I UNIT#1 FULL SERVICE 1 2,849.52 2,849.52 PM INSPECTION 1 1,245.96 1,245.96 This renewal proposal covers two(2)service visits annually:one(1)Full Maintenance Service and one(1)Maintenance Inspection. This proposal does not include replacement of batteries,air filters or coolant over two gallons.All services must be performed during normal business hours,unless otherwise specified. Services to be scheduled as follows:Full Service-August 2020;Inspection-February 2021.. This is a one(1)year proposal,running from Ol August 2020 through 31 July 2021,which will be automatically renewed unless cancelled by either party. Preventive maintenance customers receive a 10%discount on all unscheduled repairs as well as a guaranteed four hour response time 24 hours a day. Thank you,we appreciate your business! Please feel free to contact us with any questions or comments. Ann Mason,Inside Sales Coordinator-PG (804)297-1636-Office/(404)765-9568-Fax margaret.mason@cummins.com or SouthPMQacummins.com �16-d A/jV Standard Agreement Amount S4,095.48 Proposal Total S4,095.48 -r THERE ARE ADDITIONAL CONTRACT TERMS AND a ing oun mints ra or CONDITIONS ON THE REVERSE SIDE OF THIS h/2-912ZZ0 Page 1 of 2 PLANNED MAINTENANCF,ACzREEMENT Customer-Address Customer Contact Ouote Information KEY WEST INTL AIRPORT Contact: Chris Hawks Quote Date: 05-JUN-20 CHRIS HAWKS Phone: 305 360-7935 Quote Expires: 05-JUN-2 I 3491 S ROOSEVELT BLVD Fax: Quote Num: 102552 2ND FLOOR Cust Id: 361168 Quoted By: Martin E Delmas Key West, FL 33040 Quote Term: I Year(s) DOCUMENT, INCLUDING LIMITATIONS OF WARRANTIES AND LIABILITY,WHICH ARE EXPRESSLY INCORPORATED HEREIN. CUSTOMER ACKNOWLEDGES THAT THE CONTRACT TERMS AND CONDITIONS HAVE BEEN READ, FULLY UNDERSTOOD,AND ACCEPTED. Customer Approval CUMMINS INC Signature: Signature: _... c i g oun mints or Date: 1 -Q&f2Q20 _ Date: 77/30/2020 E(MM/DDYYY) A�" CERTIFICATE OF LIABILITY INSURANCE /Y 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). CONTACT PRODUCER Aon Risk Services Central Inc. NAME: A.I.King Insurance Agency, Inc. 200 E Randolpph St., Suite 0900 aC"No,Ext: 317-841-6004 Fvc,No: Chicago, IL 26r01 E-MAIL ADDRESS: cummins@aikinginsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Old Republic Insurance Company 24147 INSURED INSURERB: AlllanZ Global Risks US Insurance Co 35300 Cummins Inc. INSURERC: Ace American Insurance Company 22667 500 Jackson Street Mail Code 91676 INSURER D7 Columbus IN 47201-6258 INSURER E7 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD A / COMMERCIAL GENERAL LIABILITY / / MWZY302202-19 12/1/2019 12/1/2020 EACH OCCURRENCE $1,000,000 DA CLAIMS-MADE 11/1 OCCUR PREM SESOEa occurrDence $1,000,000 AP DRCVED RISK MANAGEMENT with attachm nts MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 ✓ POLICY PRO JECT F � LOC PRODUCTS-COMP/OP AGG $18,000,000 OTHER: 7-31-2020 $ A AUTOMOBILE LIABILITY ✓ ✓ MWTB 314312-19 12/1/2019 12/1/2020 C(EaOMBINED SINGLELIMIT $5,000,000 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE✓ $AUTOS ONLY ✓ AUTOS ONLY Per accident Phy Damage $Self Insured B / UMBRELLA LAB / OCCUR USL00126119 12/1/2019 12/1/2020 EACH OCCURRENCE $25,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $25,000,000 DED RETENTION$ $ A WORKERS COMPENSATION ✓ MWC 314311-19 12/1/2019 12/1/2020 V STATUTE EERH AND EMPLOYERS'LIABILITY Y/N OFFICE R/MEMBEREXCLUDED? I PER ECUTIVE ❑N N/A E.L.EACH ACCIDENT $1,000,000 (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 C Property FAZD38486275 8/1/2020 8/1/2021 Limit:$10,000,000 Special Form including Earthquake&Flood Leased/Rented Equipment FAZD38486275 8/1/2020 8/1/2021 Limit:$25,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Monroe County BOCC 1s named as Additional Insured regarding the General L1ab1 hty.Auto Liability as required per written contract.agreement Crime:Old Republic Insurance Co;#MWML 314309; 12/1/2019-12/1/2020;Limit: $2,000,000 Claim/Aggregate 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 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West FL 33040 AUTHORIZED REPRESENTATIVE /) Richard Trakimas ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 19/20 GL AU UMB WC 20/21 PROP (Custom-Merged) Bev Baxter 17/30/2020 3:48:13 PM (PDT) I Page 1 of 8 Cummins Inc. 12/01/2019 to 12/01/2020 POLICY NUMBER: MWZY 302202-19 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All persons or organizations as required by written contract or On File With Company agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III —Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 19/20 GL AU UMB WC 20/21 PROP (Custom-Merged) I Z`Y 2021`9/2020 Ctiftrrhin1.­lrJdDT) I PfMI/2019-12/01/2020 Cummins Inc. 12/01/2019 to 12/01/2020 POLICY NUMBER: MWZY 302202-19 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations as required by contract or agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 19/20 GL AU UMB WC 20/21 PROP (Custom-Merged) IN JVzSK 202J_'9/2020 Wftfrbin1.­1rJdDT) I PfM1/2019_12/01/2020 MWTB 314312-19 Cummins Inc. 12/01/2019 to 12/01/2020 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SCHEDULE Name of Person or Organization: Only those Persons or Organizations for whom you are required to waive your rights of recovery under the terms of a written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The Transfer Of Rights Of Recovery Against Others To Us Condition is changed by adding the following: We waive any right of recovery we may have against the person(s) or organization(s) shown in the Schedule because of payments we make for injury or damage. This waiver applies only to the person or organization shown in the Schedule. PCA 024 10 13 Page 1 of 1 19/20 Oz Au UMB WC 20/21 PROP (custom-Merged) IWNFS M3�G111/2020 ttfffirftlnelridDT) I P#2701/20f9-12/01/2020 Transfer of Rights of Recovery Against Other to Us USL00126119 Cummins Inc. 12/01/2019to12/01/2020 Allianz 4. The "first named insured" must keep records of the information we need for premium computation, and send us copies at such times as we may request. N. Representations or Fraud By accepting this policy, you agree 1. The statements in the Declarations are accurate and complete: 2. Those statements are based upon representations you made to U& 3. We have issued this policy in reliance upon your representations; and 4. This policy is void in any case of fraud by you as it relates to this policy or any claim under this policy. 0. Retained Limits Provisions 1. The "retained limits' listed in the Schedule of Retained Limits will apply whether or not there is any available'scheduled underlying insurance"or'other insurance". a. If there is "scheduled underlying insurance" or "other insurance" applicable to a 'loss", amounts received through such "scheduled underlying insurance" or "other insurance' for payment of the loss' may be applied to reduce or exhaust the"retained limit", b. If the applicable -retained limit" is specifically designated in the Schedule of Retained Limits as including "defense expenses", then amounts received through "scheduled underlying insurance" providing coverage to the "insured for the payment of"defense expenses" shall reduce the"retained linnit", c. If the applicable "retained limit is not specifically designated in the Schedule of Retained Linnits as including "defense expenses' then amounts received through "scheduled underlying insurance' for the payment of"defense expenses" shall not reduce the'retained limit' 2. insofar as an endorsement attached to this policy indicates that coverage afforded by the terms of the endorsement apply in excess of a specific'retained limit' or "self-insured retention', with respect to any coverage afforded by Such endorsernent, the provisions of the endorsement with respect to "retained limit"or'self-insured retention"wiH apply, P, Separation of linsureds Except with respect to the Limits of insurance, and any rights or citifies specifically assigned in this policy to the 'firs', named it sureeni this insurance applies 1. As if each narned insurec were the only narned inswed", an,,,,; 2, Separately to each insured. against whom claim is rnade or"suit' is brOUght, C. Transfer of Rights of Recovery Against Others to Us 1� if the "insurec" has rights to recover all or part of any payment we have made under this policy those rights are transferred to us The 'visured" rnust do notharg after loss to impair thews A' our request, the snSUred' will bring 'suit' or transfer those rights to us and 6P us enforce there, 2 Any amount recovered will be apporti()ned in the inverse order of payment of "loss' to the extent of actual payrnert The expenses of all such recovery pmceedings w0l be apportioned in the ratio of respectwe recwver.es 3, lf prior to the fin-)e of an 'occurrence" you waive any right of recovery against a specific person or organization for injury or dam aqe as required Linder an 'mSL-ired contracf, we will also waive any rights we may have against SUch person or organization R. Transfer of 1W our Rights and Duties Under Thls pofl,,y Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individUal'named insured". 1- you die, your rights and dWoes will be firansferred to yew legal representative but only while acting within the scope of duties as your legal representative, Until your legal representative is appointed, anyone having AGR-CU 2005 (07-16) Page 19 of 20 19/20 GL AU UME WC 20/21 PROP (Custom-Merged) I Bev Baxter 1 7/30/2020 3:48:13 PM (PET) I Page 5 of 8 MWC 314311-19 Cummins Inc. 12/01/2019 to 12/01/2020 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) POLICY NUMBER: MWC 314311 19 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS OR ORGANIZATIONS WHERE REQUIRED BY WRITTEN CONTRACT (NOT APPLICABLE IN TEXAS AND UTAH) DATE OF ISSUE: 10/01/19 WC 00 03 13 (Ed. 4-84) ©1983 National Council on Compensation Insurance. 19/20 GL AU UMB WC 20/21 PROP (Custom-Merged) I Bev Baxter 17/30/2020 3:48:13 PM (PDT) I Page 6 of 8 MWC 314311-19 Cummins Inc. 12/01/2019 to 12/01/2020 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B (Ed. 6-14) TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( )Specific Waiver Name of person or organization (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL TX OPERATIONS 3. Premium: The premium charge for this endorsement shall be 0 percent of the premium developed on payroll in connection with work performed for the above person(s)or organization(s)arising out of the operations described 4. Advance Premium: INCLUDED This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12/01/2019 Policy No. MWC 314311 19 Endorsement No. Insured CUMMINS INC. Premium INCL. Insurance Company OLD REPUBLIC INSURANCE COMPANY Countersigned By WC 42 03 04 B (Ed 6-14) ©Copyright 2014 National Council on Compensation Insurance,Inc.All Rights Reserved. 19/20 GL AU UMB WC 20/21 PROP (Custom-Merged) I Bev Baxter 17/30/2020 3:48:13 PM (PDT) I Page 7 of 8 MWC 314311-19 Cummins Inc. 12/01/2019 to 12/01/2020 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 43 03 05 POLICY NUMBER: MWC 314311 19 UTAH WAIVER OF SUBROGATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Our waiver of rights does not release your employees' rights against third parties and does not release our authority as trustee of claims against third parties. Schedule ALL PERSONS OR ORGANIZATIONS WHERE REQUIRED BY WRITTEN CONTRACT. DATE OF ISSUE: 10/01/19 ©2000 National Council on Compensation Insurance,Inc. 19/20 GL AU UMB WC 20/21 PROP (Custom-Merged) I Bev Baxter 17/30/2020 3:48:13 PM (PDT) I Page 8 of 8