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Item C19BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: August 17, 2011 Division: Public Works Bulk Item: Yes X No Department: Facilities Maintenance Staff Contact Person: John W. Kin 292-4531 AGENDA ITEM WORDING: Approval to enter into a one-year residential lease agreement with Monroe County Sheriff's Deputy to reside in a Monroe County -owned residence (Location Q. ITEM BACKGROUND: The current lease for the residing Deputy terminates September 30, 2010. The Monroe County Sheriff s Office has again recommended this deputy to continue in Location C. PREVIOUS RELEVANT BOCC ACTION: N/A CONTRACT/AGREEMENT CHANGES: New Residential Lease STAFF RECOMMENDATIONS: Approval TOTAL COST $ N/A INDIRECT COSTS BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: $ N/A SOURCE OF FUNDS: Revenue REVENUE PRODUCING: Yes X No AMOUNT PER MONTH $880.00 Year $10,560.00 APPROVED BY: County Atty. OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # M E M O R A N D U M DATE: July 13, 2011 TO: Dent Pierce, Division Director Public Works FROM: John W. King, Sr. Director Lower Keys Operations RE: Agenda Item —August 17, 2011 BOCC Meeting Deputy Residential Lease — Location C The lease for the Deputy currently residing at Location C terminates September 30, 2011. The Monroe County Sheriff's Office has again recommended this deputy to lease the premises. I hereby request to enter into a one-year residential lease agreement with this Deputy to reside in the home located at Location C. JWK/jbw Enclosures MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Monroe County Contract # Sheriff's Deputy Effective Date: October 1, 2011 Expiration Date: September 30, 2012 Contract Purpose/Description: Residential lease with Law Enforcement Officer for Location C Contract Manager: Jo B. Walters 4549 Facilities Maint/Sto #4 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 08/17/11 Agenda Deadline: 08/02/11 CONTRACT COSTS/REVENUE Total Dollar Value of Contract: $ 10,560 Current Year Portion: $ -0- Budgeted? Yes X No ❑ Account Codes: -_ Grant: $ N/A -_ County Match: $ N/A -_ Estimated Ongoing Costs: $_ (Not included in dollar value above ADDITIONAL COSTS /yr For: CONTRACT REVIEW Changes utilities, to In Needed Reviewer Division Director 1 I Yes❑ NoE� Risk Management ��i Yes❑ No[� O.M B./Purc ng �I l( Yes❑ NoZr 1 County Attorney `1 l� Yes❑ No0�u i Comments: DMB Form Revised 2/27/01 MCP #2 Date Out RESIDENTIAL LEASE WITH LAW ENFORCEMENT OFFICER This Agreement is made and entered into by the parties, MONROE COUNTY, a political subdivision of the State of Flo id whose address 1100 Simonton Street, Key West, Florida 33040, ("County"), and Enforcement Officer(s) of the Monroe County Sheriff's Office, icer WITNESSETH: ani"'commonly the County owns a residential remises " remises" situat d known a Monroe County, Florida and; WHEREAS, the County believes the presence of a law enforcement officer residing at the premises described in this agreement would deter vandalism and theft at the premises, and; WHEREAS, the Officer desires to provide the law enforcement protection required under this agreement and further desires to reside on the premises, and; WHEREAS, the County has decided that at the present time it is in the County's best interest to enter into a lease with the Officer(s) to provide the deterrence described; Now, therefore, the parties agree as follows: 1 • P County leases to the Officer the premises located Nib" Monroe County, Florida. 2. TERM. The term of this agreement is one year commencing on October 1, 2011 and running through September 30, 2012. The tenant shall have the option to renew the lease as long as the terms of the lease are met. There is no automatic renewal of this agreement. In the event that the Officer does not vacate the premises and surrender them to the County upon termination of the Agreement, Officer will be liable for rent at a rate of $20.00 (Twenty Dollars) per square foot per month prorated for the time he/she continues to occupy the property, as well as County's expenses and reasonable attorney fees in obtaining possession of the property. 3. USE. The premises shall be used solely for the purpose of residential premises. If the premises are used for any other purpose, the County shall have the option of immediately terminating this agreement. The Officer shall not permit any use of the premises in any manner that would obstruct or interfere with any County function or duties. The Officer will further use and occupy said premises in a careful and proper manner, and not commit any waste thereon. The Officer shall not cause, or allowed to be caused, any nuisance or objectionable activity of any nature on the premises. The Officer will not use or occupy said premises for any unlawful purpose and will, at the Officer's sole cost and expense, conform to and obey any present or future ordinances and/or rules, regulations, requirements and orders of governmental authorities or agencies respecting the use and occupation of said County -Owned Property Residential Lease 1 2011- 2012 (Law Enforcement) premises. The Officer acknowledges that if he or she ceases to be employed as a law enforcement Officer during the term of the lease, for any reason whatsoever, the lease is terminated. Officer covenants and agrees that he or she will, during the term of the Lease, keep the premises in a good state of repair and in the current condition, and that upon the expiration of the lease he or she will return the premises to the same good state of repair as when he or she moved into the premises. The Officer agrees that only his or her immediate family or an approved non -law enforcement roommate shall occupy the premises. The Officer agrees to clean the premises at the end of the lease and to return it to the same condition that it was in when the Officer accepted the house. The Officer agrees to pay any fees that the County incurs to clean the premises if necessary after the officer vacates the premises. 4. RENT AND SECURITY DEPOS nqv the County the current rent of month, said paymenV onthe first day of the month. The Officer shall pay a security osit in the amount equal to one months rent to the County prior to occupancy. The monthly payment shall be remitted to the Monroe County Clerk of Courts, Finance Department, 500 Whitehead Street, Key West, FL 33040. 5. UTILITIES. The Officer shall pay for the utilities including water, sewer/septic, electricity and solid waste collection. The cost of connections for the above described utilities shall be at the expense of the County. The Officer shall arrange for and provide residential electric service, telephone service, and cable television service, at his or her own expense. The cost of connections for residential telephone service and cable television service shall be paid for by the Officer. 6. QUIET ENJOYMENT. Upon the payment by LESSEE of the rents provided, and upon the observation and performance of all the covenants, terms and conditions on LESSEE'S part to be observed and performed, LESSEE shall peacefully and quietly hold and enjoy the subject premises for the term hereby demised without hindrance or interruption by LESSOR or any other person or persons lawfully or equitably claiming by, through or under LESSOR, subject, nevertheless, to the terms of the lease. 7. ASSIGNMENT AND SUBLETTING. This lease may not be sold, transferred, or assigned in full or part without the written permission of LESSOR. Any purported assignment without such prior written consent shall be null and void. LESSEE shall not have the right to sublet this lease or any portion of this lease or property. CONDITIONS. The Officer further agrees that, during the term of this agreement: a) the Officer is and will remain certified as a regular, fulltime law enforcement Officer by the Florida Criminal Justice Standards and Training Commission; b) the Officer is and will remain a Deputy employed by the Monroe County Sheriff's office and empowered to make arrests under the laws of the State of Florida; County -Owned Property Residential Lease - 2 - 2011- 2012 (Law Enforcement) c) he or she will not sub -lease the premises nor assign any obligation, benefit or duty created under this Agreement, without written consent of the County. d) he/she shall have a letter of permission from his/her Agency Head permitting Officer to execute Agreement which shall be attached to this Agreement as Exhibit "A". 9. DUTIES AND REPORTING. The Officer shall, at least twice each 24 hour period, conduct an inspection and walk through of the property, and shall check for any signs of theft, vandalism, and shall question, and if necessary remove, any unauthorized or suspicious persons found on site. The Officer shall also note in writing any damage, safety hazards, civil or criminal activity observed during his or her inspection and shall inform the Division Director of the County's Public Works Department of any such hazards in writing within 2 days or immediately if the inspection reveals a criminal act, or possible danger to a member of the public. In addition to the above, a regular report on the inspections shall be forwarded to the Officer's suverior and to the Division Director of Monroe County Public Works on the last day of each mpnth or within 5 days thereof. The report shall contain the date and time of the inspection, what the inspection found, whether a citation or arrest report, or Notice to Appear or any other instrument was issued, a copy of any document issued shall be attached to the report, a notation as to the action taken by the Officer, and when remedied, a notation of what was done. 10. TERMINATION BY COUNTY. This Agreement may be terminated before the expiration of a one year term, with or without cause and in the sole discretion of the County, upon a) 60 days written notice by the County to the Officer, b) 30 days written notice by the County to the Officer when; i) The Officer has left the employee of the Monroe County Sheriff's Office; ii) The Officer is no longer certified as required by this agreement; iii) The Officer fails to timely pay the County the amount described in this Agreement or fails to obtain or to keep telephone service as required under this Agreement; iv) The Officer fails to conduct the walk around inspections required by this Agreement or fails to inform Monroe County Public Works of any observed safety hazards as required under this Agreement; v) The Officer leases the premises or assigns any interest without the required consent under this agreement; c) 15 days notice by the County to the Officer in an emergency situation. 11. DEFAULTS. In the event that LESSEE fails, within thirty (30) days after notice, to cure any default of any obligations owed by LESSEE to LESSOR under this Lease Agreement then, in that event, LESSOR shall have the right to terminate this Lease Agreement and to enter upon the leased premises and again have, repossess and enjoy the same as if this Lease Agreement had not been made. County -Owned Property Residential Lease - 3 - 2011- 2012 (Law Enforcement) 12. TERMINATION BY OFFICER. The Officer may terminate this Agreement upon 30 days written notice to the County if he or she transferred to a substation whose location would make it impractical to continue to reside at the residence or if the Officer leaves the employ of the Monroe County Sheriffs Office; or upon 15 days notice by the Officer to the County in an emergency situation. 13. INSURANCE AND HOLD HARMLESS. The Officer agrees to carry $10,000 (Ten Thousand Dollars) in personal liability coverage on the premises and shall provide evidence thereof by Certificate of Insurance. Officer will notify County upon receipt of any notice of reduction or termination of such insurance, and shall immediately obtain replacement insurance. Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement and except for such claims as may occur due to the Officer's performance of duties under section 7 of this Agreement, Lessee shall defend, indemnify and hold the County and the County's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of Lessee or any of its employees, agents, contractors or other invitees on the Premises during the term of this Agreement, (B) the negligence or willful misconduct of Lessee or any of its employees, agents, contractors or other invitees, or (C) Lessee's default in respect of any of the obligations that it undertakes under the terms of this lease, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the County or any of its employees, agents, contractors or invitees (other than Lessee). Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this lease, this section will survive the expiration of the term of this lease or any earlier termination of this lease. 14. DAMAGE TO ANIMALS OR PLANTS BY PET(S). The Officer shall have sole responsibility for any damage, harm, nuisance, claim or other liability which arises as result of the Officer(s) keeping pets or other animals on the premises, including the parking area upon which the rental premises is situated. This provision especially applies to the taking of endangered or threatened species of animals as a result of the action of the Officer's pet(s). Officer shall maintain proper restraint safeguards to ensure against takings and shall be solely liable for takings which occur; regardless of the degree of care the Officer has exercised to prevent any takings. Any repairs shall be paid for by the deputy within thirty (30) days of being given notice by the County of the cost of the damages. 15. ALTERATIONS AND/OR MODIFICATIONS. If the Officer wishes to make any modifications or alterations to the premises he/she must first make the request in writing to the County, and receive written permission from the Division Director of Monroe County Public Works prior to making any alterations and/or modifications. 16. NOTICE. Notices in this Agreement, unless otherwise specified, must be sent by certified mail to the following: County -Owned Property Residential Lease - 4 - 2011- 2012 (Law Enforcement) For the County: Dent Pierce Division Director Public Works 1100 Simonton Street Key West, FL Telephone: 305-292-4560 17. ATTACHMENTS. The following documents are required to be attached to this Agreement: a) EXHIBIT A: Letter from Officer's Agency Head permitting Officer to execute Agreement. b) EXHIBIT B: Certificate of Liability Insurance c) EXHIBIT C: Copy of Officer's CJATC Certificate This Agreement shall not be effective until signing by all parties and by attaching all fully completed Exhibits to the Agreement. 18. OFFICER NOT AN AGENT OR EMPLOYEE OF THE BOARD: It is specifically agreed that the Officer is not an agent or employee of the Board of County Commissioners; that the Officer agrees that he/she is not entitled to worker's compensation coverage, unemployment compensation, health or life insurance, retirement benefits, or social security benefits because of this Agreement; and that any acts performed under this Agreement by the Officer are strictly in his/her capacity and under his/her authority as a law enforcement Officer. This provision is not meant to limit the Officer's authority to make arrests, investigate alleged or actual crimes, or to enforce the state laws, and County Ordinances. 19. WHOLE CONTRACT AND WAIVER. This Agreement is the whole Agreement between the parties, and no prior or contemporaneous oral or written communications are part of the Agreement. If the County waives any breach of the contract, that waiver shall not waive the covenant or conditions breached nor any later breach of any or part of the contract. 20. MODIFICATIONS. If the Officer wishes to make any modifications or alterations to the premises, he/she must first make the request in writing to the County, and receive permission from the Division Director of Public Works prior to making any alterations. 21. GOVERNING LAWS/VENUE. This Agreement shall be governed by the laws of the State of Florida and the United States. Venue for any dispute arising under this agreement must be in Monroe County, Florida. The County and Officer specifically agree that neither the provisions of Chapter 733, Florida Statutes (Mobile Home Park Lot Tenancies) nor the provisions of Chapter 513, Mobile Home and Recreational Vehicle Parks) are to be applied as governing this Agreement or use as constructing provisions of this Agreement. 22. ATTORNEY'S FEES. Should any cause of action or administrative proceeding arise out of this lease in connection with the enforcement or interpretation of this lease between LESSOR and LESSEE, the prevailing party shall be entitled to reasonable attorney's fees, court costs, investigative, and out -of. -pocket expenses, as an award against the non -prevailing party. County -Owned Property Residential Lease - 5 - 2011- 2012 (Law Enforcement) Mediation proceeding initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the Sixteenth Judicial Circuit in and for Monroe County, Florida. 23. MEDIATION. The parties agree to mediate any disputes under this agreement, and further agree that they will not arbitrate any disputes. 24. SEVERABILITY. If any term or provision of this Agreement shall to any extent be held invalid or unenforceable, the remainder of this Agreement shall not be affected thereby, and each remaining term and provision of this Agreement shall be valid and enforceable to the fullest extent permitted by law. 25. ABANDONMENT. If at any time during the term of this Agreement Lessee abandons the Premises or any part thereof, County may, at County's option, obtain possession of the Premises in the manner provided by laws without becoming liable to Lessee for damages or for any payment of any kind whatever. County may, at County's discretion, as agent for Lessee, relet the Premises, or any part thereof, for the whole or any part thereof, for the whole or any part of the then unexpired term, and may receive and collect all rent payable by virtue of such reletting, and, at County's option, hold Lessee liable for any difference between the rent that would have been payable under this Agreement during the balance of the unexpired term, if this Agreement had continued in force, and the net rent for such period realized by County by means of such reletting. If County's right of reentry is exercised following abandonment of the Premises by Lessee, then County shall consider any personal property belonging to Lessee and left on the Premises to also have been abandoned, in which case County may dispose of all such personal property in any manner County shall deem proper and County is hereby relieved of all liability for doing so. 26. INSPECTION OF PREMISES. County and County's agents shall have the right at all reasonable times during the term of this Agreement and any renewal thereof to enter the Premises for the purpose of inspecting the Premises and all buildings and improvements thereon. And for the purposes of making any repairs, additions or alterations as may be deemed appropriate by County for the preservation of the Premises or the building. County and its agents shall further have the right to exhibit the Premises and to display the usual "for sale", "for rent" or "vacancy" signs on the Premises at any time within forty-five (45) days before the expiration of this Lease. The right of entry shall likewise exist for the purpose of removing placards, signs, fixtures, alterations or additions; that do not conform to this Agreement or to any restrictions, rules or regulations affecting the Premises. 27. RADON GAS. Notice to prospective lessee: Radon is a naturally occurring radioactive gas that, when it has accumulated in a building in sufficient quantities, may present health risks to persons who are exposed to it over time Levels of radon that exceed federal and state guidelines have been found in buildings in this state. Additional information regarding radon and radon testing may be obtained from a County public health department. 28. SECTION HEADINGS. Section headings have been inserted in this Agreement as a matter of convenience of reference only, and it is agreed that such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. i County -Owned Property Residential Lease - 6 - 2011- 2012 (Law Enforcement) 29. MUTUAL REVIEW. This agreement has been carefiilly reviewed by LESSEE and LESSOR, therefore this agreement is not to be construed against either party on the basis of authorship. IN WITNESS WHEREOF, the parties hereto have been executed this Agreement as of the date first written above. Attest: DANNY L. KOLHAGE, CLERK Deputy/Clerk WITNESSES for DEPUTY: e Signature Print Name Signature i }� v ,,-Print Name County -Owned Property Residential Lease (Law Enforcement) BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Mayor Print Name COUNTY l ORIj � TIED k ly t�`S IYI� ..ASSISTANT CO r AT"i"t3'cNE'', EXHIBIT "A" Sheriff SI DSTA77ON5 Freeman Substation 20950 Overseas I lwx. Cudjoe Key. FL 33042 1305)745-3194 FAX (305) 745-3761 Monroe County Sheriff's Of (Rpbert T. (Peryam, Sheriff -5525 Coffege kgad -Kry •GVesi, F(orida 33040 305) 292-7000 T A V� (305) 292-7070 1-800-27 Marathon Substation May 2S, 2011 .1103 Oversea_% I Itv% Marathon. I; 1. ?3030 (305) 289-243(t FAX (305) 289-2497 John King, Senior Director Lower Keys Islamgrada Substation MC Public Works Islarn f),a. 1:1. 303 1 100 .Simonton Street — Gato Building Islamorada. fl: 33()3(� 1305) 664-648(1 Key West, FL 33040 FAX (305) 852-3234 Roth Building Re: County Housing 30 High Point Road Tavernier. FL 33070 (305) 853-3211 Dear John: FAX (305) 853-3205 DETENTION CENTERS Please be advised tha s requested and been Ke) West Det. Center a roved to remain the tenant a ounty ouWa ocated 3501 Colleee Road Key West. FL 33040 (305) 293-7300 FAX (303) 93-7353 If you should have any questions or require additional information, Marathon Nt. Facilit_N feel free to contact me at your convenience. 3981 Ocean Terrace Marathon. FL. 33050 (305) 299-2420 Sincerely, FAX (305) 2x9-242.1 Plantation Det Facili(i 53 )Itgh Point Road Plantation Ke). 11 (305) 953-3206 Robert P. Pery. am FAX (305) 853-3270 - Sheriff of Monroe County SPECIAL OPERATIONS RPR/vam P.O Bo. 300971 cc: HRD Marathon. FI 33-050 (305)289-2410 FAX (305) 289-2498 VIAr1O.N ]VISION 10100 Overseas HK,%. Marathon. Fl- 33050 (305) 289-2 777 FAX (305) 289.2776 COMMUNICATIONS 2796 Cherseas 1Iw}. y� Marathon. FL 3303(; s (305) 289-2351 ' -2493 FAX (305) 289 nm.srm fmrL.tm ACORD' EXHIBIT "B" I OPI �-� EVIDENCE OF PROPERTY INSURANCE DATEIM THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS/3 PO THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND, EXTEND OR ALTER THE COVE GE AFFORDED BY THE_ POLICIES BELOW. _ AGENCY PHONE 305-294-6677 __...------------ — The Fullers, Inc`"O �M1=-- - COMPANY — _ _ — First Community Insurance Co. 143Z Kennedy Drive 11101 Roosevelt Blvd N Key West, FL 33040 St Norman Fuller . Petersburg, FL 33716-2334 FAX 305-4641 E-MAIL-MAILjA/C _Nol:.-...._.__- ... — i - . ADDRESS: CODE: _ - —_._....__..._.-._._...._- i ' SUB CODE: AGENCY - - CUSTOM R_..-i__—___ LOAN NUMBER _--_------ i POLICY NUMBER I----- �� -- 1090011413984701 EFFECTIVE DATE j EXPIRATION DATE II 10/01/10 I ; CONTINUED LINT 10/01N l j ( i TERMINATED IF HE D THIS REPLACES PRIOR EVIDENCE DATED: - — 'ROPERTY INFORMATInN fire and liability THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INCIICA QED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHI H I EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED H1'REI , ISS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C IMS, i :OVERAGE INFORMATION i ---___._._ _ COVERAGE !PERILS /FORMS �FOrm: 04 `------------- _-_--.___`___ AMOUNT OF INSURANCE DED c-n ER Personal Property Amount L 1,L Loss of Use Amount i 250 00 Per Liab Ea Occ Amount 000 I Mad Pay Ea Per Amount 350000 5000 i t` CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDE MAIL 10 DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ADDITIONAL INTEREST NAME AND ADDRESS _. MORTGAGEE A ADDITIONAL INSURED LOSS PAYEE i MONROE COUNTY BOARD OF LOAN# COUNTY COMMISSIONERS 1100 SIMONTON ST ;AUTHORIZED REPRESENTATIVE .. __..._—.-.. KEY WEST, FL 33040-3110 Norman Fuller ACORD 27 (2006/07) © ACORD CORPORATION 1993-2006. All rights The ACORD name and logo are registered marks of ACORD TO MKE"D O IMSURAWN OROY► s 09 0011413984 7 02 EXHIBIT "B" BHO 99.002 1005 0106 First Community Insurance Company 00-0082990 St. Petersburg, Florida 33733 9/30/10 All Inquiries call 800-627-0000 3000 00000 HO H04 RENEWAL DECLARATIONS DECLARATIONS Homeowners Form - H04 Pagel of 2 Bate of Issue 9/30/10 0/01 / 10 To: 10/01 / 11 12:01 am Standard Agent (305)294-6677 THE FULLERS INC 1432 KENNEDY DR KEY WEST FL 33040 Section I Property C Personal Property D Loss of Use / / 0082990 (305) 12 mos 10 O1 08 12:01 am 00 Section II Liability E Personal Liability F Medical Payments to Others Section I Deductibles Deductible applied to all other perils (Except if noted under Special Provisions) EMPA Trust Fund $2.00 MGA Fee $25.00 Total Assessment Fees $8.00 *See Assessment Fee Detail Notice $1,000 $25,000 $5,000 $300,000 Per Occurrence $5,000 Per Person TOTAL PREMIUM TOTAL FEES Please see the reverse side of this document for additional important inf 1A 05 (005 ( 105 i Frame Deborah S Brcka Countersigned by Authorized Representative cc: As indicated on the back. 03 1 -6% 1 2001 1 001 St -Petersburg, Florida Date: 9/30/10 Company 77 312 EXHIBIT "C" �... �-.n�'-Y tiV: ti�t��RtS`A: a�'-x ..':'�=.4� .��^,.�CM�`i �.it: ... ...., P',:.:' �.;'$...:-'tw�.:-R�•++.�.� 1b1� u P JEB BUSH GUY M. TUNNELL GOVERNOR COMMISSIONER FLORIDA DEPARTMENT OF LAW ENFORCEMENT STATE OF FLORIDA THE COMMISSION ON CRIMINAL JUSTICE STANDARDS AND TRAINING Hereby awards to BASIC RECRUIT'CE,RTIFICATE CERTIFICATE OF COMPLIANCE LAW ENFORCEMENTOFFICERS 672 HOURS For having fulfilled the requirements for training as prescribed in Chapter 943 of Florida Statutes DOR.RIS SEIBERT, CHAIRMAN CRIMINAL JUSTICE STANDARDS AND TRAINING COMMISSION November 20, 2001 419-11-6043 MICHAEL D. CREWS, PROGRAM DIRECTOR CRIMINAL JUSTICE PROFESSIONALISM PROGRAM 199856