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1st Change Order 09/15/2021
„couAra o-° � o Kevin Madok, CPA •: rwP 4•••. : Clerk of the Circuit Court&Comptroller—Monroe County, Florida °~RoecouN-e4 DATE: October 14, 2021 TO: Stan Thompson, Contract Administrator Project Management Ar FROM: Pamela G. Hanco , t).C. SUBJECT: September 15th BOCC Meeting Attached is an electronic copy of the following item for your handling: C18 1st Change Order to the Contract with Gary's Plumbing and Fire, Inc.,in the amount of$162,400.00, for the installation of the planned fire alarm system for eight of the ten Historic Buildings on Pigeon Key; to be paid by Tourist Development Council Grant No. 2484. Should you have any questions please feel free to contact me at(305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070 305-294-4641 305-289-6027 305-852-7145 305-852-7145 MONROE COUNTY/ENGINEERING/ PROJECT MANAGEMENT CONTRACT CHANGE ORDER PROJECT TITLE: CHANGE ORDER NO: #001 Pigeon Key Fire Suppression System Installation INITIATION DATE:8/27/2021 CONTRACT DATE:08/19/2020 TO CONTRACTOR: Gary's Plumbing and Fire, Inc. 6409 2nd Terrace;Suite 1 Key West, FL 33040 The Contract is changed as follows: The original (Contract Sum)(Guaranteed Maximum Price) $468,000.00 Net change by previously authorized Change Orders $ 0.00 The(Contract Sum)(Guaranteed Maximum Price)prior to this Change order was 1$468,000.00 The(Contract Sum)(Guaranteed Maximum Price)will be(increased)(decreased)(unchanged)by this Change Order : $ 162,400.00 The new(Contract Sum)(Guaranteed Maximum Price)including this Change Order is $ 630,400.00 The Contract Time will be(increased)(decreased)(unchanged)by 272 Days The date of Substantial Completion as of the date of this Change Order is 10/15/2021 Detailed description of change order and justification: The full scope of this project was advertised with bids due on 2/07/2019. The sole respondent's bid price exceeded the available project funding. In an effort to utilize grant funding prior to'its expiration, a reduced scope contract eliminating several work items,including the fire alarm installation, was executed 8/19/2020. Additional grant funding was awarded by the TDC which becomes available 10/01/2021. As such, adding the fire alarm scope which includes complete alarm installation in 8 of 10 buildings and associated electric back into the contract is required to proceed with the work. An additional 272 days will be required to extend contract to current date and allow for completion of the added scope. Change order is 34.7%of original contract price. Not valid until signed by Owner,Architect(if applicable),and Contractor ARCHITECT: -�i - ,. - �yi Thomps. 8 Youngrr; Eng Consult., LLC Date CONTRACTOR: ' e :II-a.::.i O_ :1„a 1 ,:;G4` PI ingl=nd Fire, Inc. Date BOARD OF COUNTY COMMISSIONERS 'i i`- �SEAI): OF MONRO _ if Y,FLORIDA -�. ~� 1-1 ATTEST?IK VIN MADOK,CLERK A4 4 A 'WI.) t-Ncr .471,_:q Vi' l B Mayor Michelle Coldiron - � - As Deputy Clerk 9/15 i 7_ L_- MONROE COUNTY ATTORNEYS OFFICE �APPROVED AS TO FORM _ �C � ����� ,�-`� (r1 vr) .30 �PH.611vD11� 23 � SISTANT COUN Y ATTORNEY '" r` DATE: R_zn_9n i o Change Order Attachment per Ordinance No. 004-1999 • Change Order was not included in the original contract specifications. Yes ® No ❑ If Yes, explanation: The alarm scope was eliminated via a reduced scope contract due to insufficient funding. This change order adds the original scope back into the contract now that additional funding has become available. • Change Order was included in the original specifications. Yes ❑ No If Yes, explanation of increase in price: • Change Order exceeds $50,000 or 5% of contract price (whichever is greater). Yes ® No ❑ If Yes, explanation as to why it is not subject for a calling for bids: The sole respondent's bid price exceeded the available project funding. To utilize grant funding prior to its expiration, a reduced scope contract eliminating several work items was executed. The addition of this change order restores, in part, the original scope reflecting the design plans upon which the original bid of the contractor was based. This scope makes the fire suppression system whole and compliant with applicable fire code. • Project architect approves the change order. Yes ® No ❑ If no, explanation of why: • Change Order is correcting an error or omission in design document. Yes ❑No Should a claim under the applicable professional liability policy be made? Yes ❑ No Explain: N/A St Ate lumbin License N State Fire Marshall License FC1FPC13-000064 r ------ REQUEST August 27, 2021 MonroeCounty Public Works & Engineering Project Management Departmnt via email - ii,.ci., _ nr C; unty-FL, ;oV Fire Sprinkler System : Pigeon Request for Change Order Bames Alann Systems: $ 73,733.18 Sparkehaser electric: $ 72,445.00 Gary's Plumbing and Fire, Inc. - % Management: $ 7,308.90 Bonding: $ 2,106.00 G r 's Plumbing and Fire, hi. Direct Cost: J--k&Q!!92 Respe t ul Submitted, Ga ntornz President Ply i �anid Fire, Inc. r 6409 "'Terrace,Bette t. Key east, on ; ', - tit * Fax tt5 - y t mbi t ya co St' ' BARNES Quotation 5800 Overseas Highway, Suite 30 MARATHON, FL 33050 Quote umber: FA F$1goe,,,,�rk cg0106 r Plumbing F Quote ante: Terrace, West, Suite I 19 Key Customer I Good Thru Payment Terms Sales tee Quantity Descflption Unit Price Extension Quotation nation pr-ovided I's for Pigeon 1(ey Fir.. Alarm based on Drawings FA 0.1, 1.1, 1.2, 1.3 dated 4/2 12317 1 .53 Addressable Fire Alarm Panel rtit)r one (1) SLC 2„15-7.00 ', 2, 557.0O 1„ ;)3 120VAC Surge Protector 69.50 69.50 2.,00 13 p-Hr,. Battery 9 -00 196-00 1 .00 Battery ):aox for 2 bat - 1 180 86.00 ' 86.00 1 .311 tlaatifier 601 Character LLD Annunciator 872.00 872.00 30.00 Addressable ;smoke fret.t_ctur Head, photo, 103.00 3, 090� 01 36.36 Smoke Detector Base :.:. New Style 19.00 570.00 24.00 Addressable Pull Stat bran 119.00 2, 3569. 0 22-00 Horn/Strobe White `75.00 1, 650 00 i 4.00 L,srn/Stro rye, werather ;,;,f 95.00 380.00 20.t'£I Seer°trAlert Multi Candela Strobe, White 60.00 ', 3, 252.6f1 32-36 Mini Monitor Module. 68.00 2,652.00 1=66 Fire-Lite '1'h rrnarTec all arse:at.her Heat 1)a tef:'rrar.. 194 49.00 49A0 deg fixed 1.60 Mini Monitor Module 68.00 681 00 1_ 6 Cable, Connectors an,,1 Hardware 14,000.00 14,6t16 ti L 1,06 Preferred Contractor Discount 10 on Material 3,07 .55 3,079 55 1 .00 Labor to install new fire alarm system leased on 37,65 .6 37,6'ir5.5f Drawings FAA. 1, 1.1, .i.2, 1.3 dame 412()/1°7 program and test Nate: 120VAC Dedicated Breaker to be installed by electrical cont.racor not included in bi,,,re try -iaa Note: All Trenching and conduit with pull string work is to be a.Sx:ne by elec ram. al Con y tlor and is not included in above pricing Note: Permitting fees are not inc'.uded in a ave Subtotal Continued Voice. 1-305-743-m2334 Fax: 1-305-.-728-3 t„ S l x �',ntinuec:7 Freight t Contin uerl Stake Certhed EF20000482 Total Continued V Fh I, S, BAR NES 'f �S Quotation 5800 Overseas Highway, Suite 30 MARATHON, FL 33050 Quote Number: FA Pigeon cg0106 Garys Plumbing Quote Date: 6409 2nd Terrace, it I Feb 6, 2019 Key West, FL 33040 Paqe: Customer i D Good t,.,hru Payment Terrns Sales g rgr l 3181,,19 Net 15 Days globeCOI Quantity Description Unit Price Extension pricing and will be additlonal cost Note; Any Paint or Patch work is excluded in above pricing inn and will be drone by other Note: Transportation to arts from pigeon island i; excluded in above pricing nd will provided by other at no cost to BAS Note- All necc s ry Egpail-sment is to be transporter by other and not iracluded in above pricing Notes Quote is based on Afli aDiorovi l if any additional devices are needed another quote will. be p1rovided Subtotal ' " 0310 0'5 V,;,yice;, 1- 3;:x 1'i3-7l14 Freight 1.1,11 State Certified EF20000482 Total '7 8 ER OF Iyrk I— WiSHUST NUMBER m 10 yP '('41CAE SEROry r sa# c r a atetta�fin rtlta a aad is l and PVC.conduit Irrfrastrra tore for alarm c r aft and controller requirements for project Pigeon Kcy fire pump and sprinkler renovation.This proposal is a° ,'on information and re oluirements contained in drawings provided and numbered job 151365,dated for permit 4/20/2017. This proposal includes.— apply and installation of all conduit,boxes,conductors,disconnects,and associated fittings to complete the lime voltages ..�,e. tmrumar rMumim.-f OnhVflnlrpUMp78� ------ Supply and installation of all PVC conduit,bo es,ra ud fangs,pull string,and associated fittings to facilitate Install of alarm cables and devices by fire alarm contractor. needed.All conduits to be PVC.fill large voltage ho its to comply with ra ings provided,2011 N E C.,and cmunty retired building modes. All low voltage,fiber optic,signal,control wares or cables for fire alarm%ystern or fire pump,control nels,power supplies devices,or detectors to be provided and installed by firs alarms contuictor _ ---------..........._.................. ............ ........................ ........ . _ All trenching,compacting,and backfiffing to be provided by others. T'Pata r6PoSat des arb�fffa ii —_ Any and all fees from permitting,utility,engineering,state or county entities, Any parts,labor,or repairs to any part of this project or property not specified on provided drawings .�.._ .. .. . r .. . .:..... 81 Key Deer Blivd, Big Pine Key, FL 33043 9 State Plumbing License# E State Fire Marshall License ° 1425735 FPC13-000064 PROPOSAL April 20,2021 Monroe Counts, Public Works & Engineering rr e t Management Department rtment via email: linoer-Jor ra=_sa 0 n rq&poix:u_t, Attn: Jordan Salinger-.Project Manager Ref. Fire Alarm Installation Saar 's Plumbing and Fire, Inc.shall provide all labor, material and equipment ne essar to install tlr I°�sllar irrrl�as �.. plans b "�l"'Iraaaral�s;a�:n oungrasss Engineering, Ira .,,,jab number 1 136,dated / i 1 7a . Provide and install aal:arrra system for the 8 buildings slar°inkled under previous scope Classroom Bridge e Tender's Mouse Pint F remaan's House General Storage Guest I-louse Museum Staff Housing A Staff Housing 1u Electrical scope includes the following: Provide and install all above ground 3/4" cb 80 PVC conduit infrastructure for Ere,alarin in tl stni tore sa Install all required conduit, boxes, pull string, fasteners and associated fittings, Route all interior conduits on surface and/or above drop ceiling with gAlvanized fasteners.. Route all exterior conduits carder,structures with SS fa sterierrs, Provide 120 vac circuits for FACIA Fire, Alarm Control Panel), Alarm system will include the following: tlalresssable lire aalaarrra panel with I SIX 120 volt sane protector 18 as p-hr battery aatt r t'box for 2 ba tl ries [ a tilaer°80 character cter LCD Annunciator Smoke e Detector d r°a.ssa ble gall Station Weatherproof Flora/Strobe pear lert multi candela strobe Mini monitor mavrdulc Firs-lite th rm tec all weather heat detector Cable, connectors and hardware ,espearttt ly toed, r� Gaga Cen .nze, lea° si ent iaar 's PIcrr abin i' Fire, Inc. 6409 "d Terrace,Suite 1 Key West,FL 33040 Phone( 5) 6- 013 * Fax( 05)2 2-4 7 * rys lrt bin l,,' aol.eo Client#: 66814 GARPL DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1 10/13/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Amanda Lisenbey Acrisure dba Gulfshore Ins-SF PHONE 239 659-8867 FAX 239 213-2803 4100 Goodlette Rd N -MA Lo,Ext: (A/c,No): ADDRESS: Alisenbey@gulfshoreinsurance.com Naples, FL 34103 INSURER(S)AFFORDING COVERAGE NAIC# 239 261-3646 Obsidian Specialty Insurance Company 16871 INSURER A: p Y P Y INSURED INSURER B:Commerce&Industry 19410 Gary's Plumbing and Fire, Inc. The Travelers Insurance Company 36137 INSURER C: p Y 6409 2nd Terrace, Suite 1 INSURER D Key West, FL 33040 INSURER E 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY X X PTCGL00000007800 08/13/2021 08/13/2022 EACH OCCURRENCE $1,000,000 CLAIMS-MADE [*OCCUR PREMISESOEa occur°nce $100,000 X BI/PD Ded:2,500 Approved Risk Managemetit MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE $2,000,000 PRO- POLICY X JECT LOC 10-13-2021 PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY X X BA4S5617752142G 08/13/2021 08/13/202 C Ea aOMBINEDccidentS INGLE LIMIT $1 r 000r 000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ B UMBRELLA LIAB N OCCUR X X BE049327143 08/13/2021 08/13/2022 EACH OCCURRENCE s5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE IER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Pigeon Key Fire Suppression System Certificate Holder(s)are included as Additional Insured in regards to General Liability, including ongoing operations, per form CG2010 0413 and completed operations per form CG2037 0413 on a Primary non-contributory basis per form CG2001 0413 and Waiver of Subrogation per form CG2404 0509. Additional Insured in regards to Auto Liability only as required by written contract per form CAF079 0817 including Waiver of Subrogation. Umbrella follows forms. CERTIFICATE HOLDER CANCELLATION Monroe County Board of County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street, Suite 2-216 AUTHORIZED REPRESENTATIVE Key West, FL 33040 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1736558/M1718211 AHL18 AC" CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) Ill09/30/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Amanda Harvin PGI of West Central Florida,LLC PHONE 941-242-9619 PHONE Ext): (A/C,No): 941-242-9621 3809 E SR 64 ADDRESS: amanda@pgiofwestcentralflorida.com INSURER(S)AFFORDING COVERAGE NAIC# Bradenton FL 34208 INSURERA: Bridgefield Employers Insurance Company 10701 INSURED INSURER B Gary's Plumbing and Fire,Inc INSURER C: 6409 2nd Terrace INSURER D: Ste 1 INSURER E: Key West FL 33040 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ Approved Risk Management MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: #G( Cr, GENERAL AGGREGATE $ POLICY PRO- El JECT ❑ LOC 1 PRODUCTS-COMP/OP AGG $ OTHER: 10-13-2021 $ AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED $ HIRED AUTOS AUTOS (Per accident) UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER STATUTE EURIH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? ❑N N/A Y 830-52315 02/06/2021 02/06/2022 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) A Waiver of Subrogation is in favor of Monroe County Board of County Commissioners in regards to Workers Compensation. USL&H$1,000,000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners 2798 Overseas Highway AUTHORIZED REPRESENTATIVE Suite 300 Marathon FL 33050 { prr @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD DATE(MMIDDIYYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 10/06/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Christina Smith NAME: NSI Insurance Group LLC AICONN0 Ext: (305)556-1488 AIc,No): (305)556-3680 5875 NW 163 Street E-MAIL christinas@nsigroup.org ADDRESS: Suite 207 INSURER(S)AFFORDING COVERAGE NAIC# Miami Lakes FL 33014 INSURERA: Clear Spring Prop&Casualty INSURED INSURER B: Paradise Divers Inc. INSURER C: INSURER D: 31243 Ave E INSURER E: Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2192227746 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I POLICY IYYYY EFF POLICY EXP ( ) ( DD LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM MMIDD LIMITS IYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ See Below O CLAIMS-MADE DOCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ A X YACHT CSRYP/200719 02/23/2021 02/23/2022 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑JECT PRO ❑ LOC Approved Risk Management PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS 10-13-2021 HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ Hyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 1988 30'Island Hopper'Paradise Diver IV"HUIIID:AXA17200A888;Hull:$50,000 Ded:$5,500 Wind Ded:$11,000;Non-Emergency Tow:$500; Liability:$1,000,000 Ded:$2,500;Crew Liability Extension:$1,000,000 Ded:$2,500;Commercial Passenger Liability Extension:$1,000,000 Ded:$2,500; Limited Pollution Extension:$1,000,000 Ded:$2,500;MedPay:$10,000 Ded:$100;Uninsured Boater:$100,000. "Certificate Holder Hereby Listed as Additional Insured" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 OSL S @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD