Item C23
Revised 2/95
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: July 26,2000
Bulk Item: Yes [8J No 0
Division: Management Services
Department: O.M.B.
AGENDA ITEM WORDING: Approval of contract amendment with Diamond Detective
Agency to adjust the hourly rate to reflect the change in the consumer price index.
ITEM BACKGROUND: None
PREVIOUS RELEVANT BOCC ACTION: Discussion of contract and approval of
appointees at the June 2000 meeting.
STAFF RECOMMENDATION: Approval
TOTAL COST: $52,940.16
BUDGETED: Yes ~ No 0
COST TO COUNTY: $52,940.16
REVENUE PRODUCING: Yes 0 No [8J
AMOUNT PER MONTH
YEAR
APPROVED BY:COUNTY A TTY 0 OMB/PURCHASING ~ RISK MANAGEMENT 0
DIVISION DIRECTOR APPROVAL: - ~~I-
James L. Roberts, County Administrator
DOCUMENTATION: INCLUDED: ~ TO FOLLOW: 0 NOT REQUIRED: 0
DISPOSITION: AGENDA ITEM #: ~~
t
MONROE COUNTY BOARD OF COUNTY COl\IMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: -J'- a fit c:)YJ d 7>.c.r-/-e cl- (' cI e. ~~ c '1 Effective Date: ~/ ~/ u D
Expiration Date: ; z. / ~I fio
Contract Purpose/Description: A-rrt ~ J tt1 <:~,-i -(-0 uM fy-q c: t ~ r
U V C-!L lery ~-ec v,r; -/y ,-/0 V'e H -ccf c It Ct /1 q-L {' "
C 6Y} S U 14I -e.r- ;J r (' c.. ~ /'17 d &;t- .
,
Contract Manager: '[), () bt.,/ en s
(Name)
44.77-
(Ext.)
o J'11 ...3>
(Department)
for BOCC meeting on -..:L./ 2--& /6 D
Agenda Deadline:
/
/
CONTRACT COSTS
Total Dollar Value of Contract: $ !; 2.1'10./" Current Year Portion: $ 1:. 31) 70J-, uO
Budgeted? Yes X No Account Codes: I $2 - tJf..(w( - 5303i./O -
Grant: $
County Match: $
ADDITIONAL COSTS
Estimated Ongoing Costs: $ () I t1 /yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date In Needed Reviewer
Division Director '1-IQJ.!!..!! ~e~ ~ ~O-
-...;:a
R~anagement ~/J.~/.E.E. (~) a. w~
o'ir'~.IPurchaSing7113ID':">( ,;' ,u{~ tI ~
[County Attorney ?lcJ ~/f!J:J. (~ )
Comments: -
)/~~~~
Date Out
7 In I"!!'y
2-1 ~ E-O
'7 /3 I Vu
---
(
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) OMB Form Revised 8/30/95 Mep #2
CONTRACT AMENDMENT
This Amendment to Agreement is made and entered into this day
of , 2000, between the BOARD OF COUNTY COMMISIONERS OF
MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and
Diamond Detective Agency, Inc., hereinafter referred to as "Contractor."
WHEREAS, County and Contractor entered into an agreement on January 1,
1999 for the purpose of providing security patrols and services for the Duck Key Security
District;
IN CONSIDERATION of the mutual promises and covenants contained herein, it
is agreed as follow:
1. Article 8 of the agreement dated shall be amended by adding the following
sentence:
As of January 1, 2000, the annual amount shall be $52,940.16, in consideration
of 3,744 hours of security services at an hourly rate of $14.14, which reflects the original
agreement price with an adjustment for the rise in the Consumer Price Index
IN WITNESS WHEREOF, the parties hereto have caused these presents to be
executed as of the day and year first written above.
(SEAL)
ATTEST: DANNY L KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
By
Deputy Clerk
Mayor/Chairman
DIAMOND DETECTIVE AGANCY, INC.
By
Name
Title
I
CONTRACT AGREEMENT
THIS AGREEMENT is set forth as of the c;lJf day of b € c e/I{ 5'6L 199 L
between the Board of County Commissioners of Monroe County, Florida, as the governing
body of the Duck Key Security District, hereinafter "Owner" or "County" and the following
Contractor:
Nmne:Diamond Detective Agency, Inc.
Address: 1651 s. Halsted, P.O. Box 750
Chicago-Heights, Illinois 60411
Phone: (708) 754-988~
hereinafter "Contractor" for the purpose of performing all of the services required by the
Contract Documents for the following:
SECURITY PATROLS AND SERVICES
Duck Key Security District
Monroe County, Florida
The Owner and the Contractor agree as set forth as follows:
Article 1 - The Contract Documents
The Contract Document consist of this Agreement, the Request for Bids, the Non-Collusion
Affidavit, the Insurance Documents, the Sworn Statement under Ordinance No. 10-1990, the
Drug-Free Work Place Form, the Specifications and Modifications issued after execution of
this Agreement. These form the Contract and all are as fully a part of the Contract as if
attached to this Agreement or repeated herein. An enumeration of the Contract Document
appears in Article 5.
Article 2 - Term
A. The contract shall have a term of 2 4 months commencing at 12:01 a.m.
January 1 , 1999 through 12:00 midnight, December 31 ,2000.
B. At the end of the second year the County shall have an option of extending this agreement for
an additional one year term, which option shall be exercised by written notice at least thirty
(30) days prior to December 31, 2000, and shall be documented by agreement amendment
executed by both parties. At the end of the additional one-year term, County shall have one
more option for an additional one-year term under the smne conditions, thus providing that
this agreement shall be for two years with two one-year extension options. The contract
mnount agreed to herein may be adjusted annually in accordance with the percentage change
in the Consumer Price Index (CPI) for Wage Earners and Clerical Workers in Miami, Florida
area index and shall be based upon the annual average CPI communication from January 1
t
.
through December 31 of the previous year. Increases in the contract amount during each
option year period shall be extended into the succeeding years. Again 90 days on or before
end of 2 year extension.
C. The County may cancel this contract for cause with seven (7) days written notice to the
Contractor. The Contractor may terminate this contract for cause with fifteen (15) days
written notice to the County. Cause shall constitute a breach of the obligations that either
party is required to perform under this contract.
Article 3 - Specifications
A The Contractor must submit to the owner a copy of its Class "B" operating license as defined
and required under FS 493.
B. All Security Personnel must have a Class "0" license as defined and required under FS 493.
Security Personnel must be screened for drug usage via a standard pre-employment urine drug
test. The Duck Key Security District reserves the right to require periodic random drug
testing of Security Personnel.
An examination of each Security Person's driving record from every state where he or she has
resided is required. A satisfactory driving record is required of all Security Personnel (not
more than three tickets and/or accidents in the past five years and no instances ofDUl or
OWl).
C. Security Personnel are specifically prohibited from carrying weapons of any sort to include but
not be limited to firearms, batons (nightsticks), stun guns and chemical weapons (i.e. mace).
D. Security Personnel do not have arrest or detention authority and must refrain from any action,
which may jeopardize a "legal" arrest by qualified law enforcement officers.
E. Security vehicles (automobiles required) must be equipped with driver's side spotlight, with
amber flashing light, distinct logo prominently displayed preferably indicating "Duck Key
Security" as allowed under present state licensing parameters, cellular telephone and two-way
radio communication equipment allowing immediate communication with the Contractor's
base station.
F. In no case shall security vehicles be operated at speeds beyond the local posted limits.
Security vehicles are specifically prohibited from engaging in pursuit driving and/or high-speed
response to emergencies.
G. All security personnel will wear uniforms of a design that resemble a police uniform.
. t
H. Reflective, adhesive stickers will be provided by the Contractor for identification of vehicles
- of residents of the Duck Key Security District. The contractor shall also make available to
residents guard hours and phone numbers for: guard, supervisors and sheriffs office.
Article 4 - Scope of Operations
The contractor will provide on-site security services on the following schedule:
A. Daily 9:00 PM to 5:00 AM Monday through Friday, unless otherwise agreed by the parties.
B. Saturday and Sunday 9:00 AM to 5:00 PM and 9:00 PM to 5:00 AM, unless otherwise
agreed by the parties.
C. Holidays - Thanksgiving, Christmas, New Year's Day, Memorial Day, 4th of July and Labor
Day - 9:00 AM to 5:00 PM and 9:00 PM to 5:00 AM.
D. A minimum of four (4) drive through circuits of the entire Duck Key Security District will
be provided each eight (8) hour shift.
E. Door checks of all unoccupied residences will be made at least once every thirty (30) days
with a minimum of twenty (20) random door checks provided each eight (8) hour shift. All
door checks will be noted in the daily patrol report, unless otherwise agreed by the parties.
F. Daily patrol reports will be in duplicate. One copy to be retained by the Contractor. One
copy be provided to a designate of the Duck Key Security District Advisory Board.
G. Security Personnel will be expected to report any unusual activity, remove trespassers, quiet
noisy parties, direct emergency vehicle and/or traffic and questions suspicious activity.
Contact with the Sheriffs office will be made anytime situations occur which, in the
judgment of Security Personnel, fall outside these outlines parameters, or when obvious
illegal activity has taken place.
H. Excess water usage notifications found at unoccupied residences will be forwarded directly to
the property owner by the Contractor.
I. Additional security services may from time to time be requested by the Duck Key Security
District Advisory Board. Any such additional security requests shall be billed at the normal
hourly rate as specified in the contract.
The Duck Key Security District reserves the right to contract with other vendors or agencies
from time to time for additional security services (ie. off-duty Sheriffs Deputies, Marine
Patrol Officers or other private security service providers). Individual residents of the Duck
Key Security District may also contract for additional security services directly with the
Contractor or any other vendor of their choice.
~ )
1. Security Personnel will not enter an unoccupied residence without an accompanying Sheriff's
Deputy.
Article 5 - Contract Documents
The Contract Documents which comprise the entire agreement between the Owner and the
Contractor consist of the following:
1. This Agreement
2. Request for Proposals
3. Non Collusion Affidavit
4. Insurance Documents
5. Sworn Statement under Ordinance No. 10-1990
6. Drug Free Workplace Fonn
There are no Contract Documents other than those listed above in this Article. The Contract
Documents may only be amended, modified or supplemented as provided in the Request for Bid.
Article 6 - Miscellaneous
No assignment by a party hereto of any rights under or interests in the Contract Documents will
be binding on another party hereto without the written consent of the party sought to be bound;
and specifically but without limitation moneys that may become due and moneys that are due may
not be assigned without such consent (except to the extent that the effect of this restriction may
be limited by law), and unless specifically stated to the contrary in any written consent to an
assignment no assignment will release or discharge the assignor from any duty of responsibility
under the Contract Documents.
Owner and Contractor each binds itself, its partners, successors, assigns and legal representatives
to the other party hereto, its partners, successors, assigns and legal representatives in the respect
of all covenants, agreements and obligations contained in the Contract Documents.
Article 7 - Other Provisions
In cases of conflict within the described Contract Documents in Article 5 of the Fonn of
Agreement, the order of precedence shall be as follows:
1. This Agreement
2. Request for Bids
3. Scope of Operations
4. Specifications
. '
Article 8 - Contract Price
The Owner shall pay the Contractor for security services as described in the Form Agreement in
current funds in the amount of
_Fifty One Thousand Six Hundred Twenty Nine
And _76 /100 dollars ($ 51,629.76 ) per annum. Such sum is in
consideration of 3,744 hours of security services at an hourly rate of
$_13.79_ per hour.
Article 9- Payment Procedures
The Contractor will submit a monthly invoice for security services provided during the preceding
month. Upon submittal of said invoice the Owner shall pay the total amount invoiced as
recommended by the Owner's designated representative.
Article 10 - Indemnification and Hold Harmless Agreement
The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of
County Commissioners from any and all claims for bodily injury (including death), personal injury,
and property damage (including property owned by Monroe County) and any other losses,
damages, and expenses (including attorney's fees) which arise out of, in connection with, or by
reason of services provided by the Contractor occasioned by the negligence or other wrongful act
or omission of the Contractor's liability to indemnify employees, or agents. The Contractor's
liability to indemnify the County shall extend to intentional acts of the Contractor. The extent of
liability is in no way limited to, reduced, or lessened by the insurance requirements contained
elsewhere within this agreement.
. J
IN WITNESS WHEREOF, the Owner and Contractor has signed this Agreement in triplicate,
one counterpart each has been delivered to the Owner, Contractor and the Duck Key Security
District Advisory Board. All portions of the Contract Documents have been signed or identified
by the Owner and Contractor.
r. .. A~r~ementwill be effective 12:01 AM, 1st January, 1999.
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L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
ByJ2~~ .
Deput erk
t,~.."~&J... -:---_~-
By - ..., . - . ~. '\
Mayor/Chairman
CONTRACTOR
~ li2a1ft
~
~-Donna
Witness
Jim Wall
Diamond Detective Agency, Inc.
Potts
. )
DRUG-FREE WORKPLACE FORM
-nlC undersigncd vendor in accordance with Florida Statutc 287.087 herehy ccrtilics that:
Diamond Detective Agency, Inc.
(Name of Business)
I. Publish a statement notifying employees thaI the unlawful manufacture. distribution, dispensing.
possession, or use of a controlled subslance is prohibitcd in Ihe workplace and specifying the actions that
will bc taken against employees for violatiuns of such prohibition.
2. Infurm employees about the dangers of drug abuse in the workplace. the business's policy of
maintaining a drug-free workplace, any available drug counseling, rehabilitation. and t:mployee assislance
programs, and the penalties that may be imposed upon employees for drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services that are under bid a
copy of the statement specified in subsection (I).
4. In the statement specified in subsection (I), notify the employees that, as a condition of working on the
commodities or contractual services that are under bid, the employee will abide by the tenns of the
statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any
violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any
state. for a violation occurring in the workplace no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation
program if such is available in the employee's community, or any employee who is so convicted.
6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this
section.
As the person authorized to sign the statement, I certify that this finn complies fully with the above
requirements.
. )
NON-COLLUSION AFFIDAVIT
I,
John J. Jordan, Jr.
of the city
of Frankfort, Illinois
according to law on my oath, and under
penalty of perjury, depose and say that;
1) lam Director/C.E.O.
Proposal for the project described as follows:
, the bidder making the
2) The prices in this bid have been arrived at independently without collusion,
consultation, communication or agreement for the purpose of restricting:competition, as
to any matter relating to such prices with any other bidder or with any competitor;
3) Unless otherwise required by law, the prices which have been quoted in this bid
have not been knowingly disclosed by the bidder and will not knowingly be disclosed by
the bidder prior to bid opening, directly or indirectly, to any other bidder or to any
competitor; and
4) No attempt has been made or will be made by the bidder to induce any other
person, partnership or corporation to submit, or not to submit, a bid for the purpose of
restricting competition;
5) The statements contained in this affidavit are true and correct, and made with
full knowledge that Monroe County relies upon the truth of the statements contained in
this affidavit in awarding contracts for said project.
COUNTY GF
Cook
DATE
STATE OF
Illinois'
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
::lJhY\ .:y- ~\ dQ V\ 3( who, after first being sworn by me, (name of
individual signing) affixed his/her signature in the space provided above on this
J/~J.... dayof'1J~h.....
~~
NOTARY PUBLIC
,19Qg
My commission expires:
.OFFICIAL SEAt:
JERI L. O'BRIEN
Notary Public, State of Illinois ~
~ My Commission Expires 6114/99 ~
OMB - MCP FORM #1
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SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
John J. Jordan, Jr.
warrants that he/it has not cmployed, rctained
or otherwise had act on his/its behalf any formcr County officer or cmployee in violalion of
Section 2 of Ordinancc No. 10-1990 or any County officer or employec in violation of
Section 3 of Ordinance No. 10-1990. For brcach or violat ion of this provision thc COllnty
may, in its discrction. terminate this contract without liability and mel)' also. in its discretion.
deduct from the contract or purchase price. or otherwise recovcr, the full amoun~ of any fec,
commission, percentage, gift, or consideration paid to the former County officer or emplo)'ee.
STATE OF Illinois
COUNTY OF Cook
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
~~f' 3 :&cJa~I:R.
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this 17~ day of
1J~()..... , 1612.
~~~
NOTARY PUBLIC
My commission expires:
"OFFICIAL SEAt:
JERI L. O'BRIEN
Notary Public, State of Illinois
My Commission Expires 6/14/99 .
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Doe,=,f'ler Insurance Agency I be
P. O. Box 919
BamawQod XL 60430-0919
ONLY AND CONFERS NO RIGHTS uPON THE CSRnRCATE
HOLDER. THIS c:smRCATE DOES NOT AMEND. EXTEND OR
AlTER THE COVERAGE AFFORDED BY THE POUClES saOW.
COMPANIES AR=ORrIWG COveRAGE
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708-798-2009
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P.O. Box 750 COMP/IN'f
ChJ.cago KlUgh::' II. 60411 D
....!=. .!J.,~~......."..~"....'......'" ...... w....:.;,..*:::~..:;:s.....:::;.:..~.:s:~:^.:.,.:o:I..'~::i"..,,~.:~.: .... ". '~" ,... ...:.........w.~'..',"'''!..~.::.~....'':.....,.....'..,.,''~.<.":":"::.'~.'~:.'.".;m:'.:~'*::~.;..'.:."" ........... ....... .. ..... ""m<:;;:;,<,..."..,.< . , ."',:<,.."...... '_
. ..'!.~.. ," . "." "'""<":'~ . '''''''~-~:*'~'~'~ ... "T:~""~:;"~~::~~~M:::i.)~~:f::i::;:::@hiiC
'THIS IS TO c:emJ=Y THAT THE POUClES OF INSURANCE LISliD BELOW HAVE BEEN ISSUED TO lHE INSURED NAMED ABOVE FOR 'THE POUCY PSUOD
INDICA lED. NOlWmiSTAND/NG ANY REQUIREMiNT. TERM OR CONDmON OF ANY CONTRACT OR O'THEft DOCUMENT wmt RESPECT TO WH/Qi 'THIS
c:smFICAiE MAY BE ISSUED OR MAY PERTAIN. 'THE INSURANCI: AFFORDED BY 'THE POUClES DESQU8ED HEREW IS SUBJECTTO ALL. 'THE iCftMS.
EXCLUSIONS AND CONDmONS OF SUQi POUCIE5. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
~ I .......-- I .......- I,=,-= '== f __
TGINaw. UMIU1'Y GlHERAL AGGltEGA'n I .
n CClMM!ftCIAL GlNIKAL UA8IlJ1Y 1'ftOOuc:rs. CCMPIOP AGO I .
1m I CLAIMS MADr 0 OCCUR - I'BlIONAI.. N)V INJUIn' .
OWNBI'S II CONlMCTOR"S PftOT IACH oc:::tllIII'lINCI I .
I--
I'IftI DAMAGE lAnF _ IlnII I.
Mm IXIt lAnF _ ......., I.
COMIIHID IlHGU UMrT /. 1, COO, COO
04/25/99
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~UMIU1'Y
A '-- NI'f AUTO
_ AU. OWNEl AlIfOS
..!. SCHElUL!D AlIfOS
..!. HIRID AUTOS
..!. NONoOWNID AUTOS
I8107S7T2134~ZL98
04/25/98
BODILY IIUUftY
... ,....,
.
I
I
I
IOCILY IN.IUII'f
.. ........,
/.
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/IN'f AUTO
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UMIRB.LA I"ORM
OTHIft THAN UMBl'I!U.A PORM
waRICIIIa c:aMPINaA'I1ON AIIID I
-.....a~ UMIUTY
R=. ..
THE MO.....ITOIV
l"NlTHIRSIIXECUTNI
O"'CIftS Aft!:
On.l
MCII'!InY DAMAGr
.
Auro OHLY.IA ACCIDENT .
OTHfft THAN AUTO ONLY: -.~ft"MlW=?j:::j:~'~(
EACH ACClDENT .
AGGIWIA'n .
IACH oc=JIlMNcr I .
AGGRIGAT! .
,.
I STATUTOin'" UMITS ~ttiit!fi~::::;:;>
EACH AC::DIHT I .
DISIASI. POUC't UMIT .
0ISIASt . fAOt EMPLOYe .
DUCNPTlON O~OPli'AnOIUADCAnO~D J "Lnw&
LDa~S A:r PCI.IC% Dla:P.rIax
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, - aHOUI,D IW't OfIlM1.uova IlDCNUD l'aUCID .. CNlC"D , - 88'0"'",
$ ~11ON DA1T1MIIla:NI. n......... -IW'tWlU.INDIAVOR TO MAIL
~ DA"aWIInWN 1II01ICETO 1MIC8ft'IIIC.\'nHOLDIIl HAMID TO TltEl.8"T.
IU'I" 'Al&.UWTO llIAIL aUCH IIIOnca aHAU. NI'aA Il1O oaua.r.noN OR UAaIU1"'I'
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DATE (UJ.l.tJDIYY)
11f1~8
nlls CERT1F1CAlE IS ISSUED AS A MAlTER OF INFORMA110N
ONlY AND CONFERS NO RIGHtS UPON lHE CERllACAlE
HOLDER. nus CER11FJCAlE DOES NOT AMEND, EXTEND OR
AllER lHE COVERAGE AFFORDED BY lHE POUCIES Baow.
COMPANIES AFFORDING COVERAGE
....
Ac~.~nlt~
CERTIFICATE OF LIABILITY INSURANCE
t)
PRODUCER
1ZZ0 INSURANCE SERVICES INC.
7234 WEST NORTIi AVENUE
ELMWOOD PARK
IL 60707-4200
COMPANY
A
GENESIS INDEMNITY INS.
INSURED
DIAMOND DETECTIVE AGENCY, INC.
1651 SOUTH HAl..SlED STREET
P. O. BOX 750
CHICAGO HBGHTS, IL 60411
COMPANY
B
roMPANY
C
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE POlICIES OF INSURANCE LISTED BaOW HAVE BEEN ISSUED TO 1HE INSURED NAMED ABOVE FOR THE PO\.JCY PERIOD
INDICATED, NOlWJTHSTANolNG ANf REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTlACATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POucrES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS.
EXClUSIONS AND CONDmONS OF SUCH POlICIES. UMITS SHOWN MAY HAVE BEEN REDuCED BY PAID CLAIMS.
co lYPE OF INSURANCE POUC'f NUIIBER POI.JCY EFFECnVE POLICY EXPNllON
LTR DAn: (IoIMIDO/'(Y) DAle (IAMlM'Y)
i A GENERAl UAIlIUTY ex 00000052 05/31/98 05131199
X COMMERQAL GENERAl UABIUTY
ClAIMS MADE 0 OCCUR
OWNER'S & CX>NTRACTOR"S PROT
EFlR:m & o.t I 55 I eN;
GENERAl. AGGREGATE
PROOuCTS . COMPIOP AGG
PEIlSCHAl & NJV INJURY
EAQt OCCURRENCE
FIlE DAUAGE (Any _ h'
lED EXP (AnJ _ pellllftl
AUTOMOBILE I..IASIUTY
ANY AUTO
AU OWNEO AUTOS
SOlEDUlED AUTOS
HIRED AUTOS
NON-owNED AUTOS
CDIlIINED SINGlE LIIIT
IIOOI.Y tWRY
,.. PIIDI
(C(Q)DY
IlODLY IIUIlY
,.. aidIaI)
PIU'ERTY DAMAGE
GARAGE I..IASIUTY
ANY AUTO
'.
AlIJO OtI.Y . EA ACalENT
OllER tHAN AUTO ONlY:
EAQf ACalENT
AGGREGATE
EAQt OCCURRENCE
AGGREGATE
EXCESS UABlurY
UUSRalA FORM
OTHF.R THAN llUIlREW FORM
WORKERS CX>UPENSATlON AND
EMPlOYERS' UAIlIUTY
THE PROPRETOAI INCI.
PARTNERSaECUTIVE
OFFICERS ARE: EXa.
OTHER
::SCRIPTION OF OPERATlONS1.OCATIONSlVEHlCUSlSPECIAI. ITEUS
:ERl1ACATE HOLDER
UIIITS
s 2,000,000
s 1,000,000
S 1,000,000
$ 1,000,000
S 50,000
s 5,000
$
S
S
S
$
S
S
S
$
S
$
$
S
CANCBlA110N
SHOWl ANY OF THE ABOVE DESCRIBED POUCIES IE CANCEllED BEFORE THE
EXPlRATION DATE THEREOF, THE ISSlJlNG CXlIolPAHY WlL EHOEAIIOR TO MAlL
--1!! DAYS WRITTEN NOTICE TO THE CERTFlCATE IIOl.DER NAMED TO ~ LEF.T.
BUT FAIlURE TO MAIl SUQI NOTICE SHAU. IMPOSE NO OBl.IGATION OR LIA8lJTY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR AEPAESENTATNES.
AIITHORI2ED REPRESEHl'ATIVE 0
A~~.C~...... ~Jt7-
/V(.. e' ACORD ~ORA-riON-1988
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. .. . .:..... ....:".-..~~:1:-::=-~... . ". ..
II~~U rtAN\,;C I ....,&~
-- - ...--...-.... -.""'11...' I I 09/24/98
""CCiUcIIi THIS CER1l7=IC.lrc &I I8IUED AS A MTTEJIt Of' IHI=ORllATlON
A ~ Gallaghe= & Oo-Chgo Metro ONLY AHD CCN~ NO RJlJJm UPON THE ~TC
1iOl 31st'Street HOLeER. nos C!RT'IFJ::ATE DCI!S NCT AIIEHD, EXTEND OR
ALTER 'THE CQ\'ERAGE AF=FORcID BY 'THE PCXJCmIIIB.CW.
P. o. Box 579 I I
Downers Greve, IL 60515 IHSUAERsAJlFORClNG CC\IEIUCIE
I
I~ IHSUlt!RA: Clarendor. Nat=.onal Insuranc:e Cornoa
Diamond Detective Ag~cy, !ne. INSURIR 1: I
1651 South Halsted Street NtM!lt c:
P.O. Box 750 lNSUR;R0: i
Chicagc;:J Heights, IL 60411 11H8UIt!1t!:
I
COVERAGES
THE POUClESOFINSUfWfCC LJS1"E) BaCW HAVE lIEN ISSUED TO TH!! IH.SUItl!D NAMED AIIOVE 'OR'nlEPaJc'fPERlCOINDJC,I.'T1!D. NOlWrHSrANOW::;
ANY REQUIREMENT. law Olt COHOmoH OF NlY CONnACi Ollt ontER OOCUUENT \\nM llESPS:T TO \\tlICH nos camFlCAT! MAY II /$SUED OR
1M" PERTAIN. 'niE INSURANCE AFFORDED In' 'nfl PCuCES DiSCRI8ED HIR!IN IS SU8JECT TO ALl. THE laMS. EXCUISlONS AHD COHDmcHs OF SUCH
POUClES. AGGREGA1E LIMJTS SHOWN~" ""~ BEEN R!OUCEl8Y PAID CUIIIS.
~i 'rtn 0Jr1lllUMNCZ I PCIUCT IIIllIrIIP ,~~...~ '~C;Y~1\CfIti UIInS
~IMLUAIIu'rr * I UCHoeetlllaNa I. I
I I
~==-o":: Pla!DIIl1IG;___J I.
M&D .CMp_.... fa
I I'!ISCrPL &AIN IN.IUln" I.
I .
-rhe1mlLt r;I iabIly shawn tl&!=the IimiIa at ~ ~AGCM!~ft I.
Cl!Jn.AGGRIGIo~ LIMIT AJtIIU!e P!It Artu J. GIlII;nr &. CQ. dcIs .taonassum. any f ~.CCIIPICPAGO ! I
. '11"aJCY n ~ n t.CC I k7 r.cIfficallcn In h ewnt C:I d of the ~ r I
FUAIRm , I.
I CCIBlm SDIGl.5 LMr
lI!a-.
AU. ClWNEDNn'Os ICICr.T IICJUIrt /,
b~~ ,..,....,
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Hlll!DAInOS I IIGCllLT IUllIt\'
I ~AUTOa , G"Ir~
,...., I ,.
I l=,twNI
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HUAIRm · I I I I Nm)CNLY.!AACC:DeIr ,.
M'f Al1fQ I I I cmet'blM MACe: /.
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e-. I I iiolCH~ I'
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A I---CCIIPDaA1IClNANO /QLT<ROOl3867 109/15/98 109/15/99 IX1wc.rA'nJ. I I~i
I ~UUUTT I !.LUCHACCID!NT 1.1,000,000
I I .J I!.LDIS!AU.ulllN:l'te/s1, 000 000
I IUllllUa.~1.IMn" 1.1 000.000
. one... I I I I
I
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CIISCllPftoNClFOI'UAnoJIM.CC&"7DIStIJrI ~UIICIii ADam 1IT1NDaIl:I8II~~
For Verification of Workers COmpensation Coverage Only. Coverage provided
for IL, IN, FL, U':' ana leY. T~s certificate indicates C".lrrent coverage.
Perscnalized cert~ficate car. be issued upor. =equest.
CERTlFtCATI! HOLDI!R
$8,' .
,- ~_.: .,- . .
--... .....~ '.. . - -
. . :.'-~-." -.. -:~.. .~~. ',:
. -. ....:::.. '10"_ - - _'
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CAN~'T1aN
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DATI"....". 'nil ~ IIIIUIlQ WlU.lNDUvanDIUIL ~ DA'\"I w.nwN
IICl'rIC: '"'".. ~TI IIOUlIIt IlAIIID TO". UPT. 8VrF.&/L&aE '"' ClO lID IIW.L.
, ; ~ Il1O ~1DII OR U&IIIUTr Of' IWrllllllO&.-cIIl':Ma....... IrSACalnWCft
:i~In...~
I i A -7:7:.ATrn
ADW e AcaRD CORP'QRATlON ,..
............ ,oO ..
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... .."")~..-
1996 Edilioll
The Monroe County Board of County Commissioners, its employees and officials will be
included as "Additional Insured" on all policies, except for Workers' Compensation.
Any deviations from these General Insurance Requirements must be requested in writing on the
County prepared form entitled "Request for Waiver of Insurance Requirements" and
approved by Monroe County Risk Management.
::
Administration Instruction
fl4709.2
~ I
15
1996 Ediliull
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
General Insurance Requirements
for
Other Contractors and Subcontractors
As a pre-requisite of the work governed, or the goods supplied under this contract (including the
pre-staging of personnel and material), the Contractor shall obtain, at his/her own expense,
insurance as specified in any attached schedules, which are made part of this contract. The
Contractor will ensure that the insurance obtained will extend protection to all Subcontractors
engaged by the Contractor. As an alternative, the Contractor may require all Subcontractors to
obtain insurance consistent with the attached schedules.
The Contractor will not be permitted to commence work governed by this contract (including
pre-staging of personnel and material) until satisfactory evidence of the required insurance has
been furnished to the County as specified below. Delays in the commencement of work,
resulting from the failure of the Contractor to provide satisfactory evidence of the required
insurance, shall not extend deadlines specified in this contract and any penalties and failure to
perform assessments shall be imposed as if the work commenced on the specified date and time,
except for the Contractor's failure to provide satisfactory evidence.
The Contractor shall maintain the required insurance throughout the entire term of this contract
and any extensions specified in the attached schedules. Failure to comply with this provision
may result in the immediate suspension of all work until the required insurance has been
reinstated or replaced. Delays in the completion of work resulting from the failure of the
Contractor to maintain the required insurance shall not extend deadlines specified in this contract
and any penalties and failure to perform assessments shall be imposed as if the work had not
been suspended, except for the Contractor's failure to maintain the required insurance.
The Contractor shall provide, to the County, as satisfactory evidence of the required insurance,
either:
· Certificate of Insurance
or
· A Certified copy of the actual insurance policy.
The County, at its sole option, has the right to request a certified copy of any or all insurance
policies required by this contract.
All insurance policies must specify that they are not subject to cancellation, non-renewal,
material change, or reduction in coverage unless a minimum of thirty (30) days prior notification
is given to the County by the insurer.
The acceptance and/or approval of the Contractor's insurance shall not be construed as relieving
the Contmctor from any liability or obligation assumed under this contract or imposed by law.
Administration Instruction
114709.2
:. )
14
J 996 Edition
VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract requires the use of vehicles, the Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for:
· Owned, Non-Owned, and Hired Vehicles
The minimum limits acceptable shall be:
$1,000,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 500,000 per Person
$1,000,000 per Occurrence
$ 100,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on
all policies issued to satisfy the above requirements.
=
VLJ
Administration Instruction
#4109.2
83
, )
1996 Edition
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers' Compensation Insurance with limits sufficient to respond to the applicable state
statutes.
In addition, the Contractor shaH obtain Employers' Liability Insurance with limits of not less
than:
$1,000,000 Bodily Injury by Accident
$1,000,000 Bodily Injury by Disease, policy limits
$1,000,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the
state of Florida.
If the Contractor has been approved by the Florida's Department of Labor, as an authorized self-
insurer, the County shall recognize and honor the Contractor's status. The Contractor may be
required to submit a Letter of Authorization issued by the Department of Labor and a Certificate
of Insurance, providing details on the Contractor's Excess Insurance Program.
If the Contractor Participates in a self-insurance fund, a Certificate of Insurance will be required.
In addition, the Contractor may be required to submit updated financial statements from the fund
upon request fipm the County.
WC3
Administration Instruction
#4709.2
)
~
90
. . ""'(J"E' R'lliJ'E. .1'~""'rN."""illE. "'0"E'''l],''''''J'7Jl'/ .;;;.B.J.I2'.;."I......,.:...:.:..I.~'.'.. .:s..m.... ..... "'m' .....
:'.' ACOin", .:.,.' .... ......... '.. .... :., .... ...::",,:: .'. :.'::' .:. ..:.:.... ...... .,:.:.,. '.:. '. ,.:.: ,.' :.: '.:. ~. m:I;;;:'ciRr'Blr:.:.:.:.:.:.;.:.:.:.......... -.-,--...
..... ......... .".....~~~..:.::.:.;.:..::::;i.:L/:\::::).:::::.:::?.:.,).."'....i:::.i.,:::::,..:.......:.::.i::::::..<:::::::..::,.,:::.::I\.:::::.'::)\.:..::;:\.::',:::::::t::.;;:::,h::::J::::J!!thDHo;j;::::;;;I;:;:;:;:;;:; 06/02/00
PRODiJCER" ............ . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE -
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND eR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW"
COMPANIES AFFORDING COVERAGE
Doe%f1ezo XDauranae AgaDcy lIne
P. O. Box 919
Homewood IL 60430-0919
PlIaMNo. 708-798-2009 Fa No. 708-798-2077
IN8UAED
ct:JIIIPANY
A P~..i.v. Ina. Co.
ct:JIIIPANY
B
Di..,-...d Det:ect:i.v. AgaDay CCIIIPANY
1651 S. Ba1.t:ecl Sb:eet C
P.O. Box 750 CCIIIPANY
Chi.c:ago Bei.qhta :tI. 60411 D
ntS IS TO CERTFY THAT llE PClUCIES OF INSURANCE LISTED BELOW HAve BEEN ISSUED TO THE INSURED NMED NfKNE FOR THE POUC'f PERIOD
INDICATED, N01WITHSTANDING NIY REQUIREMENT, TERM QR caNDITION OF NIY CONTRACT QR OTHER DOCt IEHTWITH RESPECT TO wtICH ntS
~ I rlCATE MAY BE ISSUED QR MAY PERTAIN, THE INSURANCE AFFORDED 8'f llE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCl}""'" N<<J caNDI110NS Of'SUCH PQIJCIES. LMTS SHOWN MAY HAVE BEEN REDUCED 8'f PAID CLANS.
PCLIC'I EFFECI1VE PCLIC'I EXPIRA11CN
DAle (MMDOIYV) DAle (MMarN)
co
LTR
1YPI! OF INaJRANCE
PC1JCY NUMBER
UMII'S
AUTQMCB.E LJA8LrIY
I-
A..!.ANYAUTO
_ ALL C7NNED AUTOS
_ SCHEDl UP AUTOS
~ HlEDAUTOS
~ NQN.OWNEDAUTOS
044721510
05/15/00
OEtERALAGGREGAlE I
PRCDJCI'S. CDIII'IC1P AGO I
PER8CINAL & IDIINJURV I
EACHOCCl~ I
FIRE DAMAGE (Any-In) I
MED EXP (Any_.......1 I
05/15/01 CCIBE) SlNGLELMI' I 1000000
BODILY INJURV I
(Pw ........
BCDLY INJURV .
(Pw ..-...0
.--EfU," DAMAGE I
GENERAL LJA8LrIY
~~~GENERALUAIIIUTY
~ Q.AlMSMADE 0 OCCUR
~ OWNER'S & CQNJRACl'CR'S PROf
~LJA8LrIY
I-ANYAUTO
,(7.\ .,- """.:. '.~.
, - ~... ,,-,. .;....., ,
~ ' t :, lI\ II: J
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=r=~FORM
WORKERS CQlFENSA11CN AHD
EMPLOYERS'LJA8LrIY
~R::
OFFICERS ARE; --
OTHER
/./.....--
-'-
(G~~
v L, -"J l.-~Jh
. "
\.. ( [\~ l!
" AUTO ONLY . lOA ACClDEN1' I
'. 4 V'u OTHERlHANAUTOClNLY: ~
. \ ~~ EACHACClDENI' I
\ :) AGGREGAlE I
EACH oa:uRRENCE I
AGGREGAlE I
s
~~~I~
EL EACH ACClDEN1' I
EL ClSEASE. PCLIC'I LMI' .
EL ClSEASE. lOA BFLOYEE S
0ESCRPJlCIN OF 0PERA1lClHSILClCAl1ONSIV&lICLESIITEMS
I.DIITS AT POI.IC% INCEPTION.
County of Monroe
lU..k ~t
5100 Co11~ Haad
z.y ...t F.L 33040
~Cf)
.:}}}}I:t{:::::r:I}}:\,gtl~F.!. g.1JOff-I:?M:ttl:1Itttttt:t::r:}}:t:}fIff}::::}f::,?::rif??:f?mm::?ltiI:::m:?\
MONROEC SHClUl..D ANY OF'nE AIIO\/E CE8{"'-F' PCUClES BE CANCELLED IIEF'ClRE 'nE
EXPIRA11CN DAlElHEREDF. lHE JS&UINQ CCII/PAN'fWLL ENDEAVOR 10 MAIL
~ DAYSWRIT1EN NCmCE10lHE CERTFlCAlE HOlDER NAMED10lHE LEFT.
BUT FALURE 10 MAIL SUCH NOTICE SHALL IMPOSE NO 08UGA11CN OR L.IA8I.ITY
A
OF ANY I<IND UPON THE COtIIPANY, (rS AGENTS OR REPRESENl'A11VJiiIl
AUTHORIZEDREPRESENTAllVE ....' -~....// ..".
*' _---.. .:' _____? .,. -...r
f '.i..__ ..
::,:::,:,;.'. . .::::::m::::l:}:::::rrt:r:::::(':m:mm:Ad.... ":coRPORAi10N .1988'
G~F~lAAP;Jj9Y;?~?::?:{It,?::?:::{::::::::tII:::IfI:tr:::::::
t
ACORI)"2SS(il95Jit:t:'r::\f\I::):rn:nt:r:'/rir::m:::
PROGREI1lVEe
aa_...a............. ''-''''110&
ADDITIONAL INSURED
The person or organization named below is a person insured with respect to such liability coverage as is afforded
by the policy but this insurance applies to said insured only as a person liable for the conduct of another insured and
then only to the extent of that liability. We also agree with you that insurance provided by this agreement will be
excess insurance over any other valid and collectible insurance.
NAME OF PERSON OR ORGANIZATION:
MONROE COUNTY Boee
5100 COLLEGE RO
KEY WEST
FL 33040
LIMIT OF LIABILITY
Bodily Injury
each person!
each accident
each accident
s 1 .000,000 each accident
Property Damage
Combined Uability
All other parts of this polley remain unchanged.
This endorsement changes Policy No.: 04472151-0
Issued to (Name of Insured): DIAMOND DETECTIVE AGENCY
Endorsement Effective: 08/01/00
Expiration: 05/15/01
Form No. 1198 (4-97)
CVFL0415971607L119801
PROG/1EII1IIE3
.
CI lalM~_~
ADDITIONAL INSURED
The person or organization named below is a person insured with respect to such liability coverage as is afforded
by the policy but this insurance applies to said insured only as a person liable for the conduct of another insured and
then only to the extent of that liability. We also agree with you that insurance provided by this agreement will be
excess insurance over any other valid and collectible insurance. .
NAME OF PERSON OR ORGANIZATION:
MONROE COUNTY IDce
5100 COLLEGE RO
KEY WEST
FL 33040
LIMIT OF LIABILITY
Bodily Injury
Property Damage
Combined Uability
each person!
each accident
each accident
$1 ,000,000 each accident
.;_,'~!,"r:- Q'~ ~
,.v~ _ (fD
f'~'E ~'r ,
~"~
CC '. cl1b
off1b ;~
All other parts of this policy remain unchanged.
This endorsement changes Policy No.: 04472151-0
Issued to (Name of Insured): DIAMOND DETECTIVE AGENCY
Endorsement Effective: 08/28/00
1,,11' ".~(~:
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Expiration: 05/1&/01
)
Form No. 1198 (4-97)
CVFL0415971607L119801
1
A4!Htlllte CERTIFICATE OF LIABILITY INSURANCE DATE (MMIIlDIYYJ
05I31AJO
'DUCER THIS CERTlRCATE IS ISSUED AS A MATTER OF INFORMAJ1ON
ONLY AND CONFERS NO RIGHTS UPON THE CERllRCATE
IZZO INSURANCE SERVICES INC. HOLDER. THIS CEFmFICATE DOES NOT AMEND, EXTEND OR
7234 WEST NORTH AVENUE ALTER THE COVERAGE AFFORDED BY THE POUCIES BaoW.
COMPANIES AFFORDING COVERAGE
ElMWOOD PARK IL 60707-4200
COMPANY
A GENESIS INDEMNITY INS.
JI1EL' COMPANY
DIAMOND DETECTIVE AGENCY, INC. B CASUALTY RECIPROCAL
1651 SOUTH HALSTED SlREET COMPANY
P. O. BOX 750 C
CHICAGO HSGHlS, IL 80411
COMPANY
D
:OVERAGES
iHIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTEO BaOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
:~.JDICATEO. NOTWITHSTANDING Atf'f REQUIREMENT. TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
:[RTlACATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUClES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
:::<CLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'1 TYPE OF INSURANCE POUCY NUII8ER POLICY EFFEC'T1VE POLICY EXPlRAllON UUlTS
'n DATE (MMIODNY) DATE fMMIOD,YVl
GENERAL UASlllTY ex 00006004 05/31/00 05131 01 GE~ERAL AGGREGATE S 2.000,000
1-:0:-
X COMMERCIAl GENERAL UABIUTY PRODUCTS - COMP,op AGG S IN,CLU,DED
I aAlUS MADE [!] OCCUR PERSONAl & ADV INJURY S
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE S 1.000.000
T ERFmS & CMISSIOO ARE DAMAGE (Any one tile) S 50,000
MED EXP (Any one peIIllIII S 5.000
AlJTOMOBlE UA8ILITY
- COMBINED SINGLE LIMIT S
ANY AUTO
-
All OWNED AUTOS '(~"~n;m .. ,:l;~" ~ BODILY INJURY
- . . ..r . .. . S
SCHEDULED AUTOS 'J~. JI' j (per peISlIIll
-
HIRED AUTOS .. v BODIlY INJI./RY
- I lQl ft ) (per accidenl) S
NON.owNED AUTOS rq:__ 1(\"( I
-
-
./ PROPERTY DAMAGE S
,
GARAGE UA8lJTY '1", I'~. . "Y-' , AUTO ONlY. EA ACCIDENT S
- ({b ,'1
ANY AUTO ~ OTHER THAN AUTO ONlY:
- " "W
EACHACCIOENT S
t' ~ ,'1 AGGREGATE S
EXCESS UABllITY C(~ ':-4 1 Vi; EACH OCCURRENCE S
" ."
R UMBRELlA FORM atfi .6 AGGREGATE S
OTHER THAN UMBRELlA FORM S
WORKERS COMPENSATION AND X IT~Y~ I jU~f
EMPLOYERS' UA8ILITY WCP 0739374,11 09/15:00 EL EACH ACCIDENT 1.000.000
,~ 09/15/99 S
THE PROPRIETOR! R'NCl EL DISEASE . POLICY LIMIT S 1.000.000 I
PARTNERS~XECUTNE
orFICERS ARE: EXCl EL DISEASE . EA EMPLOYEE S 1,000,000 i
CHHER !
. :iCRIPTIONl~ OPFRATION~f1't!Etm~ StfJ I bJAL I ~ED TO GENERAL ,
;:RT I F ICA to..DER I I L i
:ABllITY POLICY CX-00006004 AS RESPECTS THE LIABILITY CREATED BY THE
n,lI GENT ACTS. ERFmS rn 0.1 ( SS I OOS OF NNAED I NSURED HERE I N (DUCK KEY) !
("flKERS CCMPENSATI~ COVERAGE PIDIIDED IN: FL. IL. IN, KY, MO
'ECAJH TY GLJAFI) AID I NVESTI GA TI VE SERV ICES. I
r
~ERTlFlCATE HOlDER CANCElLATlON !
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEUED BEFORE THE .'
t
COUNTY OF UONROE-COUNTY BOARD OF COMMISSIONERS EXPIRATION DATE THEREOF. THE ISSUING COMPANY Will ENDEAVOR TO MAIL t
RISK MNGMT-WING 11, RM 207 PSB ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. >.
f
5100 COLLEGE ROAD 33IMO ~ D - '"' "."" TO ... '""' "'.." '"'"- "",)S, '" "'"""'" 0' ...., !
KEY WEST FL i( )OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES i
I
) AUTHORIZED REPRESENTATIVE ~
d n! f
.\CORD 25-S (1195) ~/~,~j) @ ACORD CORPORATlON 1988
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