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Item C05BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: May 15, 2013 Division: Emergency Services Bulk Item: Yes _ No X Department: Fire Rescue Staff Contact Person: Mary Napoli ext. 6010 AGENDA ITEM WORDING: Approval of the Renewal Agreement between the Board of County Commissioners of Monroe County and J. A. LaRocco Enterprises, Inc. for the installation of fire hydrants in unincorporated Monroe County using Ad Valorem taxes, Impact Fees, and other funding sources such as grants, private donations, etc. ITEM BACKGROUND: The original Agreement between the parties provided for a three year term from June 16, 2010 through June 15, 2013 with the option renew once for three (3) additional years, with the approval of the District's governing Board. Staff is requesting approval to exercise the renewal clause for three additional years, commencing on June 16, 2013 and ending on June 15, 2016. PREVIOUS RELEVANT BOCC ACTION: On May 6, 2010 sealed bids were opened for the installation of fire hydrants in unincorporated Monroe County. There were four bids. From the four bidders, J. A. Larocco Enterprises Inc. was the successful bidder with the lowest overall pricing. On June 16, 2010 the County entered into a new service agreement with J. A. LaRocco Enterprises, Inc. with a term beginning June 16, 2010, for the installation of fire hydrants in unincorporated Monroe County using Ad Valorem taxes, Impact Fees, and other funding sources such as grants, private donations, etc. This contract provides for the installation of hydrants in District 1 for $9,975.00 per hydrant, in District 2 for $7,975.00 per hydrant, in District 3 for $7,000.00 per hydrant and in Key Colony Beach for $7,975.00 per hydrant. CONTRACT/AGREEMENT CHANGES: Contract will be extended and the new expiration date will be June 15, 2016. STAFF RECOMMENDATIONS: Staff recommends approval as written. TOTAL COST: $9975.00/hydrant District 1 INDIRECT COST: X BUDGETED: Yes X No $7975.00/hydrant District 2 $7000.00/hydrant District 3 $7975.00/hdrant Key Colony Beach DIFFERENTIAL OF LOCAL PREFERENCE: Yes COST TO COUNTY: See above SOURCE OF FUNDS: Ad Valorem Taxes, Impact Fees, other Funding sources such as grants, donations, etc. REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year 5-1- APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 07 09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: J.A. LaRocco Enterprises Inc. Contract # Effective Date: Expiration Date: Contract Purpose/Description: Installation of fire hydrants in unincorporated Monroe County. Contract Manager: Mary Napoli (Name) for BOCC meeting on 05/15/2010 06/ 16/2013 06/15/2016 6010 Emergency Services / Stop 14 (Ext.) (Department/Stop #) genda Deadline: 04/3012010 CONTRACT COSTS Total Dollar Value of Contract: $ $9975.00/hydrant District 1 Current $7975.00/hydrant District 2 Year $7000.00/hydrant District 3 $7975.00/hydrant Key Portion: Colony Bch. $ Budgeted? Yes® No ❑ Account Codes: Impact Fee funds: 31501-560-630.31502-560-630.31503- 560630 31504-560-6503 and other fundine sources such as Ad Valorem taxes, ¢rants. private donations, et. Grant: $ County Match: $ ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out Date In Needed Division Director- 15 Yes❑ No[�]-- Risk Management 1-Ay Yes❑ No� 7- O.M.B./Purchasing Jq-J4/!3 Yes❑ NoEf County Attorney *1L+ 1-n13 Yes❑ No[� �4 ao Comments: OMB Form Revised 2/27/01 MCP #2 RENEWAL AGREEMENT 1 his RENEWAL, AGREEMENT is dated the _ __ day of _ 2013, by and between the Board of County Commissioners of Monroe Count}. Florida, and J. A. LaRocco Enterprises, Inc., hereinafter called the "Contractor". WIT-NESSETH WHEREAS. the parties hereto did enter into an agreement dated June 16, 2010 for the installation of fire hydrants in unincorporated Monroe County using Ad Valorem taxes, Impact Fees, and other funding sources such as grants. private donations, etc. ("Agreement"'). the term of which runs from June 16, 2010 to June 15, 2013: and WHEREAS, said Agreement provided an option to the Count) to renew the contract for one additional three year term: and WI IEREAS, the County has elected to exercise said option for the continuation of the installation of fire hydrants in unincorporated Monroe County: not therefore IN CONSIDERATION of the mutual covenants and obligations contained herein, the parties agree as follows: 1. The County elects to reneNN the Agreement for the three additional }ears pursuant to Article 2 of the Agreement. 2. The effective date of this amendment is June 16. 2013 and shall extend through June 15. 2016. under the same terms and conditions of the Agreement. 4. All other terms and conditions of the Agreement shall remain in full force and effect. Attest: AMY HLAVILIN, CLERK Deputy Clerk WITNESS: BOARD OI COUNTY COMMISSIONERS OF MONROE COUNTY. FLORIDA By: Mayor/Chairman J.A. LAROCCO ENTERPRISES. INC. Print Name: S e care Print Title MONROE COUNTY ATTORNEY AP OVE AS TO F R HIA L. AL ASSIST T OUNTY ATTORNEY Date - .� —.Z0 Client#: 65951 IALAR1 ACORD_ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 04/24/2013 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 Advanced Insurance Und. (Estero) CONTACT NAME: PHONE 239-949-1888 Alc No): 29-949-1388 AIC No Ext 10600 Chevrolet Way Ste. 200 Estero, FL 33928 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 239 949-1888 INSURER A: FCCI Insurance Company 10178 INSURED J. A. LaRocco Enterprise, Inc. dba All Keys Concrete 743 Largo Road Key Largo, FL 33037 INSURER B : INSURER C INSURER D INSURERS: 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 CONTRACTOR 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 INSR WVD POLICY NUMBER MMIDDIYYYY MMIDD A GENERAL LIABILITY GLOO130472 D2113/2013 02/13/201 $1 000000 MMERCIAL GENERAL LIABILITY -EACH q�OCCURRENCE PREMISES EaENurrence S50O OOO MED EXP (Any one person) $1O 000 CLAIMS -MADE L ^JOCCUR PERSONAL & ADV INJURY $1 000 000 rGEWLA( GENERAL AGGREGATE s2,000,000 GREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 $ ICY E O LOC D211312013 A AUTOMOBILE LIABILITY CA00203452 02/13/201 (Ea accideDtSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ $ ALL OWNED SCHEDULED _ AUTOS AUTOS NON OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident X UMBRELLA LIAB X OCCUR UMB00138462 2/13/2013 $ A 02113/2014 EACH OCCURRENCE $1 OOO 000 AGGREGATE S1,000,000 EXCESS LIAB CLAIMS-MADEi --- $ DED X RETENTION $10000 _ WORKERS COMPENSATION 001 WC12A68081 AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? a N / A (Mandatory in NH) A 2/25/2013 02/25/201 TOTH- X ` O sT LIMIS ER E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEEI $1 000 000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 4-a5+ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) ** Workers Comp Information ** USLH ** Supplemental Name ** First Supplemental Name applies to all policies - J. A. LaRocco Enterprise, Inc. (See Attached Descriptions) I:[0]U14V Monroe County Board of County Commissioners 490 63rd Street, Suite 170 Marathon, FL 33050 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,c7 19RR-2nln ACI6RD CORPORATION. All riahts reserved ACORD 25 (2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S981604/M981603 SAB DESCRIPTIONS (Continued from Page 1) 1 First Supplemental Name applies to all policies - dba All Keys Concrete SAGITTA 25.3 (2010105) 2 of 2 #S9816041M981603 CONTRACT BETWEEN THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA AND J. A. LaROCCO ENTERPRISES INC. FOR INSTALLATION OF FIRE HYDRANTS IN MONROE COUNTY THIS CONTRACT, hereinafter "CONTRACT or AGREEMENT" is made and entered into this -J-(- day of June, 2010 by and between the Board of County Commissioners of Monroe County, Florida, hereinafter referred to as "COUNTY", and J. A. LaRocco Enterprises Inc., hereinafter referred to as "CONTRACTOR'. WITNESSETH: WHEREAS, the COUNTY advertised a notice of request for proposals for INSTALLATION OF FIRE HYDRANTS IN MONROE COUNTY; and WHEREAS, the successful Contractor was J.A. LaRocco Enterprises Inc., and; WHEREAS, this CONTRACTOR represents that it is capable and prepared to provide such services, and; WHEREAS, the COUNTY intends to enter into an agreement for the INSTALLATION OF FIRE HYDRANTS IN MONROE COUNTY with the CONTRACTOR and; WHEREAS, this contract is an "Agreement" between both parties, NOW, THEREFORE, in consideration of the promises contained herein, the parties agree as follows: 1. CONTRACT DOCUMENTS - This contract consists of the Agreement, the CONTRACTOR'S response to the RFP, and the documents referred to in the Agreement as a part of this Agreement. In the event of any conflict between any of the contract documents, the one imposing the greater burden on the CONTRACTOR will control. 2. CONTRACT PERIOD AND RENEWAL - The effective date of this Agreement shall be June 16, 2010 through June 15, 2013. This Agreement may be renewed once for three (3) additional years, subject to approval of the Fire Chief of Monroe County Fire Rescue, the Office of Management and Budget and the Monroe County Board of County Commissioners. 3. CONTRACT TERMINATION - This Agreement may be terminated for any reason by either party on 30-day written notice without cause. If the CONTRACTOR fails to fulfill the terms of this Agreement, or attachments, properly or on time, or otherwise violates the provisions of the agreement or of applicable laws or regulations governing the use of funds, the County may terminate the contract by written notice. The notice shall specify cause. All finished or unfinished supplies or services shall, at the option of the County, become property of the County. The County shall pay the CONTRACTOR fair and equitable compensation for expenses incurred prior to termination of the agreement, less any amount or damages caused by the CONTRACTOR'S breach. If the damages are more than compensation payable, the CONTRACTOR will remain liable after termination and the County shall pursue collection for damages. 4. SUBJECT MATTER OF CONTRACT — This contract is for the installation of Fire Hydrants in unincorporated Monroe County in the following areas: a. District 1 Lower Keys — The area of Monroe County South of the Seven Mile Bridge (MM40), excluding the City of Key West. b. District 2 Middle Keys — The area of Monroe County and including Fiesta Key south to the Seven Mile Bridge. (MM40). c. District 3 Upper Keys — The area of Monroe County north of Fiesta Key, excluding Layton. d. Key Colony Beach — The area of Key Colony Beach. 5. QUALIFICATION OF THE CONTRACTOR: a. The Contractor shall be responsible for obtaining all necessary permits and approvals for the installation of the hydrants, including permits from the FKAA, Monroe County Growth Management (Building Department), and FDOT. b. 'The Contractor performing installation, maintenance, repairs, adjustments and related work shall be properly certified by the State of Florida for the work to be performed. c. Personnel performing work who are not certified or experienced in such work shall be directly supervised (in person) by an individual with such certification. - d. Within 90 days after award of the Contract, the Contractor shall supply Monroe County with a monthly schedule of the time frame when each fire hydrant will be installed. 6. SERVICES TO BE PERFORMED BY CONTRACTOR: a. The CONTRACTOR shall begin the permitting phase for each requested hydrant within 30 days of notification by the Monroe County Fire Marshal of the location(s) of the hydrant(s). The hydrant(s) shall be installed within 45 days after the issuance of the last required permit (such date shall be transmitted in writing to the Fire Marshal's Office). b. The CONTRACTOR shall ensure that all installations, maintenance and repairs are performed in a timely manner in accordance with operational needs. c. The CONTRACTOR shall describe the approach and methodology he/she will take to accomplish the services defined herein. This shall include information on time for installation, schedule and availability, staffing, whether sub -contractors are used, whether the Contractor owns the equipment used, and any other relevant information explaining how the delivery of the product and the provisions of services is accomplished. d. The CONTRACTOR shall conform to the standards set forth by the Florida Keys Aqueduct Authority's (FKAA) Minimum Construction Standards and Specifications when connecting to an FKAA water source. Standards are available at fkaa.com. e. The CONTRACTOR shall be responsible for performing the installation of fire hydrants. f. The CONTRACTOR shall, within 30 days after completion of each fire hydrant installation, forward a computerized report to Monroe County Fire Rescue indicating the status of the hydrant and GPS coordinates. This will be done for each hydrant when completed. This report must be emailed to the Assistant Fire Marshal. The form must either be in Microsoft Word or Excel. g. The CONTRACTOR shall be licensed in fire hydrant installation by the State of Florida. h. The CONTRACTOR agrees to indemnify and hold harmless Monroe County for all actions of contractor's negligence as well as faulty or improper workmanship for all work performed under the contract including all costs of collection, reasonable attorney fees, claim costs and others. It is agreed that all property and equipment being directly worked on by the contractor is considered to be in its care, custody and control while such work is being performed. i. The CONTRACTOR shall supply all materials and labor for the installation of specified fire hydrants including but not limited to: the hydrant itself (acceptable hydrants are specified in the FKAA construction standards document), labor, pipes, joints, valves, taps, thrust blocks, restraining clamps, backfill material, excavation, asphalt, temporary paving, repair of pavement removed as a result of installation, tools, cutting, barricades, traffic and warning devices and any and all required permits. 7. RATES -The following rates shall be per hydrant installation with no travel time or mileage charged. District 1 — Lower Keys $9975.00 / per hydrant. District 2 — Middle Keys $7975.00 / per hydrant. District 3 - Upper Keys $7000.00 / per hydrant. Key Colony Beach $7975.00 / per hydrant. 8. INSURANCE - During the term of this contract, the CONTRACTOR must keep in force and effect the insurance required by Attachments F. Attachment F is attached and incorporated into this contract. 9. ADDITIONAL REQUIRED STATEMENTS/VERIFICATIONS/AFFIDAVITS. Attached hereto in Attachments A, B, C, D and E are Non -Collusion Affidavit, Public Entity Crime Statement, Drug -Free Workplace Form, Conflict of Interest Clause, and Indemnification to Hold Harmless. 10. PAYMENTS — The COUNTY shall pay CONTRACTOR within 30 days of the completion of the rendered services on each hydrant and after proper invoicing by the CONTRACTOR. All payments will be made in accordance with the Florida Local Government Prompt Payment Act. 11. STANDARD OF CARE — CONTRACTOR shall exercise the same degree of care, skill, and diligence in the performance of Services as is ordinarily provided by a professional CONTRACTOR, offering services for local governments in South Florida, under similar circumstances and CONTRACTOR shall, at no additional cost to the COUNTY, re - perform services which fail to satisfy the foregoing standard of care. 12. Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County Commissioners of Monroe County, Florida. 13. Venue for any litigation arising under this contract must be in a court of competent jurisdiction in Monroe County, Florida. This Agreement is not subject to arbitration. IN WITNESS WHEREOF, each party hereto has caused this contract to be executed by its duly authorized representative. BOARD OF COUNTY COMMISSIONERS s - of MO OE C TY, FL (SEAL)- Mayor/Chairman Attest: Danny L. Kolhage, Clerk Clerk WITNESS: Name and Address of Contractor MON E COUNTY ATTORNEY ` � V,_,=��q OVEp AfSU R , % iorized Representative Signature YNTHIA L. HALL ASSIS NT COUNTY ATTORNEY ess se Date-as-aoi0 SECTION FOUR: FORMS Attachment A Attachment B Attachment C Attachment D Attachment E Attachment F Attachment G Non -Collusion Affidavit Public Entity Crime Statement Drug Free Workplace Form Lobbying & Conflict of Interest Clause- (Ethics Clause) Indemnification and Hold Harmless Insurance Documents Local Preference Form (if applicable) tltrtychnient + UO- D& CQ LUSION AFMAVEF I, John LaRocco of the city of Key Largo according to law on my oath, and under penalty of peijury, depose and say that; 1) Iam J.A. LaRocco Enterprise. Inc. the respondent making the Proposal for the project described as follows: Installation of Fire Hydrants in Monroe County 2) The prices in this proposal 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 respondent or with any competitor; 3) Unless otherwise required by law, the prices which have been quoted in this proposal have not been knowingly disclosed by the respondent and will not knowingly be disclosed by the respondent prior to proposal opening, directly or indirectly, to any other respondent or to any competitor; and 4) No attempt has been made or will be made by the respondent to induce any other person, partnership or corporation to submit, or not to submit, a proposal for the purpose of restricting competition; and .11 5) The sta_tements contained in this affidavit are true and correct, and made with full knowledge that Monroe County relies upon the of stet Lt-inedin this affidavit in awarding contracts for said project. STATE OF Florida �- (Signature of Respondent) COUNTY OF Monroe 0 4 / 1 6 / 10 Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, John LaRocco who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this 16th day of April , 20 10 My commission expires: A BRIAN KEITH CONOVER NOTARY PUBLIC •" MY COMMISSION # D0907044 ���,.' iEXPIRES July 14, 2013 OMB - MCP FORM # 1 ox) 39e ws� ��+ogdeeloto ervloaoom R Attachment B FUBLIC ENTITY CRMM, STATE si NT "A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a proposal on a contract to provide any goods or services to a public entity, may not submit a proposal on a contract with a public entity for the construction or repair of a public building or public worts, may not submit proposals on leases of real property to public entity, may not be awarded or perform worts as a bidder, supplier, subbidder, or RESPONDENT under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." By executing this form, I acknowledge that I/my company is in compliance with the above. _ STATE OF —El —Or I —da � (l, / % ( (Signature of Respondent) COUNTY OF Monroe _ 04 / 16 / 10 Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, John LaRocco who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this 16t:h _day of April , 20 10 My commission expires: , 4,� NOTARY PUBLIC <�RIAN KEITH a;oNov�+R •O? My COMMISSION # DD907544 EXPIRES July 14, 2013 4 39&0753 poridallotery5embe,com tlttaclunent C DRUG -FREE WOREFLACE FORM The undersigned Respondent in accordance with Florida Statute 287.087 hereby certifies that: J.A. LaRocco Enterprise, Inc. (Name of Business) 1. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of maiutainipg a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under proposal a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under proposal, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendre 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. Imposes 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. Makes a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the nerson Authoriz (f-I gn the statement, I certify that this firm complies fully with the ab a emen . !ti Respondents Signature 04/'16/10 Date OMB - MCP FORM #5 W AttaChmet2t D ]Li,OBBiYII1 G AND CONIFUCT OF, INTEREST CLAUSE' SWORN STATEMENT UDDER ORDINANCE NO. 1.0-1990 MONROE COUNTY, FLORSDA ETEJFCS CLAUSE John LaRocco warrants that helit has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discr 'on, deduct from the contract or purchase price, or otherwise re v r, r9full am any fee, commission, percentage, gift, or consideration paid to th fo unty or employee. Date: 04/16/10 STATE OF (Signature) Florida COUNTY OF Monroe PERSONALLY APPEARED BEFORE ME, the undersigned authority, John LaRocco his/her who, after first being sworn by me, affixed signature (name of individual signing) in the space provided above on this 1 6th day Of April .20 1 0 . NOTARY PUBLIC __��pVbll� . EITH CONOVER My commission expires: A MY COMMISSION It DD907544 EXPIRES July 14, 2013 4f 407)398-0153 Rlor{deNo4+M3ory wm OMB - MCP FORM 04 :9 Attachment E Ii/i101 ROE COUNTY, F LOR DA RISK MANAG EAd[E 1T POLICY AND PROCEDURES CONTRACT ADMMSTRATION B AWAL Indemnification and Hold Harmless for Other Bidders and Subbidders The Bidder covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners AND Board of Governors for District I, its servants, agents and employees 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 �incluchng attorney's fees which arise out of, in connection with, or by reason of services provided by the Bidder or any of its Subbidder(s) in any -tier, occasioned by the negligence, errors, or other wrongful act or omission of The Bidder or its Subbidders in any tier, their employees, or agents. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Bidder's failure to purchase or maintain the required insurance, the Respondent shall indemnify the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Respondent is for the indedinification-provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. Respondent's Signature 04/16/10 Date TCS I0 Attachment F (1 of S) INSURANCE REQUIREMENTS FOR CONTRACT INSTALLATION OF HYDRANTS IN MONROE COUNTY, FL BETWEEN MONROE COUNTY, FLORIDA AND J.A. LaROCCO ENTERPRISE, Inc. Prior to the commencement of work governed by this contract, the Contractor shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Products and Completed Operations • Blanket Contractual Liability • Personal Injury Liability • Expanded Definition of Property Damage The minimum limits acceptable shall be: $500,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $250,000 pefPerson $500,000 per Occurrence $ 50,000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all liability policies issued to satisfy the above requirements. GL2 Attachment F (2 of S) GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT INSTALLATION OF FIRE HYDRANTS IN MONROE COUNTY, FL BETWEEN MONROE COUNTY, FLORIDA AND J.A. LaROCCO ENTERPRISE, Inc. Recognizing that the work governed by this contract involves either underground exposures, explosive activities, or the possibility of collapse of a structure, the Contractor's General Liability Policy shall include coverage for the XCU (explosion, collapse, and underground) exposures with limits of liability equal to those of the General Liability Insurance policy. GLXCU 12 Attachment F (3 of S) VEHICLE LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT INSTALLATION OF HYDRANTS IN MONROE COUNTY, FL BETWEEN MONROE COUNTY, FLORIDA AND J.A. LaROCCO ENTERPRISE, Inc. 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: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 per Occurrence $ 50,000 Property Damage The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. VL2 13 Attachment F (4 of S) WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR CONTRACT INSTALLATION OF HYDRANTS IN MONROE COUNTY, FL BETWEEN MONROE COUNTY, FLORIDA AND J.A. LaROCCO ENTERPRISE, Inc. 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 shall obtain Employers' Liability Insurance with limits of not less than: $500,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $500,000 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 from the County. WC2 14 Attachment F (S of S) MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: Contract for: Address of Contractor: Phone: Scope of Work: , Reason for Waiver: Policies Waiver will apply to: Signature of Contractor: Approved Not Approved Risk Management Date County Administrator appeal: Approved: Date: Board of County Commissioners appeal: Approved: _ Meeting Date: Not Approved: Not Approved: 15 Attachment 6 LOCAL PREFERENCE FORM A. Vendors claiming a local preference acoording to Ordinance 023 -2009 must complete this form Name of Bidder/Responder J e A o LaRocco Ent. Inca Date: 0 4/ 1 6/ 1 0 1. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector dated at least one year prior to the notice or request for bid or proposal? yes (Please furnish copy. ) 2. Does the vendor have a physical business address located within Monroe County from which the vendor operates or performs business on a day to day basis that is a substantial component of the goods or services being offered to Monroe County? Yes List Address: 743 Largo Rd, Rey Largo, FL 33037 Telephone Number. (305) • 453-0368 B. Does the vendor/prune contractor intend to subcontract 50% or more of the goods, services or construction to local businesses meeting the criteria above as to licensing and location? If yes, please provide: 1. Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the subcontractor dated at least one year prior to the notice or request for bid or proposal. 2. Subcontractor Address within Monroe County from which the subcontractor operates: Tel. Number Print Name: John LaRocco Predident STATE OF Florida COUNTY OF Monroe Oa this 1 6th day of ARK-1.1 201 0 , before me, the undersigned notary public, personally appeared John LaRocco , known to me to be the person whose name is subscribed above or who produced persona y nowrb identification, and acknowledged that he/she is the person who executed the above Local Preference Form for the purposes therein contained. Notary Public Brian Ka Conover Print Name My commission expires: Seal - 011� NWH CONOVET4 16 w• , ;°? MY COMMISSION it 00901644 EXPIRES July 14, 2013 NotArAGrvtoe.� 407 39 p153 Florida C( #:65951 t JALARI ACORM CERTIFICATE OF LIABILITY INSURANCE DATEIMMWOIYYYY) 06/28/2010 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(les) 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 Adv. Ins. UM - ESTERO NAME: 10600 Chevrolet Way Ste. 200 WMAIL "0 H Eat 954 963-6666 A/C No ; 9549641438 Estero, FL 33928 ADDRESS: 239 949-1888 CU,11QMER ID a: INSURER(S) AFFORDING COVERAGE NAICS INSURED INSURER A: FCC[ Insurance Company J. A. LaRocco Enterprise, Inc. ------- 743 Largo Road INSURER 0: Key Largo, FL 33037 INSURERC: INSURER D : INSURER E INSURER F: COVERAGES CFRT1Ctfnerr .,crrarvr`% iwmocn: 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 CONTRACTOR 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 CLAIMS.. TYPE OF INSURANCE POLICY NUMBER pPAID M LI 0/1'YY P M�OYpl ;V LIMITS A GENERAL LIABILITY GL000�3 44 i r ; . f ,1 j , 0 3/2010 Q2/13/2011 EAcHoccuRRENCE $1 000 000 D� X COMMERCIAL GENERAL LIABILITY -..� G CLAIMS -MADE aOCCUR 3{�` - PREMISES Ea ou nes $100 000 MEDEXPAnyonsporaon) $10000 -- - • / (j�t4� y � (4 �w PERSONAL A ADV INJURY 51,000,000 GENt AGGREGATE LIMIT APPLIES y •' � i�j GENERALAGGREGATE S2 00O 000 PRODUCTS • COMP!°PAGG s2 OOO 000 PER: PRO- tit:; l , -------µ`r +=�..................... $ POLK:Y LOC q AUTOMOBILE LIABILITY TCA00086464 02/13/2010 02/13/2011 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) 51,000,000 BODILY INJURY (Pet person) S ALL OWNED AUTOS BODILY INJURY (Per acodem) 5 SCHEDULED AUTOS PROPERTY DAMAGE S X HIRED AUTOS X NOR -OWNED AUTOS War acddont) 5 S A UMBRELLALUIB X OCCUR UMS00060993 02/13/2010 02/13/2011 EACH OCCURRENCE 51 000 000 EXCESS LIAR CLAIMS -MADE AGGREGATE 51 00O 000 DEDUCTIBLE S RETENTION 5 S A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY OO1 WC1 OA63744 02/25l2010 02/25/2011 X I WC STATU' OTH• Y/NrR 0 FICERAAAEMMaEOR EXCLUDE EED? ECUTIVEFE NIA ILL EACH ACCIDENT $1 000 OOO (Mandatory In NIA E.L. DISEASE • EA EMPLOYEE S11,000,000 E.L DISEASE - POLICY LIMB S1 00O 000 0yyeea,dsacrlt 4under OESC IPTK)N OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, AddlUonal Remark! Schadule, It more space Is required) Monroe County Board of County Commissioners - Additional Insured (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non -Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN of ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street, Room 1-213 AUTHORIZED REPRESENTATIVE Key West, FL 33040 ACORD 25 (2009109) 1 Of 2 dS651429/M651428 0199a-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SAB DESCRIPTIONS (Continued from Page 1) '• General Liability Information'• Job#; 1 •• Workers Comp Information •• Proprietors/Partners/Executive Officers/Members Excluded: John LaRocco, President G VI G #S651429/M651428 2009 / 2010 MONROE COUNTY BUSYNESS TAX RECEIPT EXPIRES SEPTEMBER 30, 2010 Business Name: LAROCCO J A ELATE Owner Name: J A LAROCCO Mailing Address: 743 LARGO R KEY LARGO, J Rooms COMP CARD RECEIPT# 30 t40-60562 743 LARGO RD KEY LARGO, FL 33037 305-453-0368 '�\CONTRACTORS(CONT ENGINEERING ENG 1245) rl' .�ku.ni�0%7.ti � YrINrIMr +v.M ,I PAID-105-aa-001J07049 0 i THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX -RECEIPT Danise D. Henriquez, CFC, Tax Collector WHEN VAUDATED -• PO Box 1129, Key West, FL 33041 THIS IS ONLY A TAX. YOU MUST MEET ALL COUNTY AND/OR MUNICIPALITY PLANNING AND ZONING REQUIREMENTS. MONROE COUNTY MONROE COUNTY RECEIPT N0, 128230 CC: ENGI THIS IS TO CERTIFY THAT ISSUE DATE: 11/04/2009 FEE DUE 200.00 LAROCCO, JOHN A COUNTY LIC# ENG 1245 FEE PAID 200.00 QUALIFIES AS A ENGINEERING CONT I THIS CERTIFIES THAT THIS CERTIFICATE EXPIRES ON LAROCCO, JOHN A 10/31/11 QUALIFIES AS A ENGINEERING CONT I UNLESS REVOKED IN GOOD STANDING AND THIS CERTIFICATE ACCORDING TO OF COMPETENCY IS VALID AND IN FORCE UNTIL 10/31/11 P BUILDING OFFICIAL LAROCCO, JOHN A J A LAROCCO ENTERPRISE INC 424 SUNSHINE BLVD TAVERNIER FL, 33070 CERTIFICATE OF COMPETENCY