Item E3 E.3
County f � .�� ��� BOARD OF COUNTY COMMISSIONERS
Mayor David Rice,District 4
Mayor Pro Tem Craig Cates,District 1
The Florida Keys '
Y � �F' Michelle Coldiron,District 2
Vacant,District 3
--' Holly Merrill Raschein,District 5
County Commission Meeting
February 16, 2022
Agenda Item Number: E.3
Agenda Item Summary #10173
BULK ITEM: Yes DEPARTMENT: Tourist Development Council
TIME APPROXIMATE: STAFF CONTACT: Ammie Machan (305) 296-1552
N/A
AGENDA ITEM WORDING: Approval to advertise a Request for Applications for FY 2023
Capital Project Funding Applications.
ITEM BACKGROUND: Attached is a list of revisions and a copy of the FY 2023 Capital Project
Funding Application.
PREVIOUS RELEVANT BOCC ACTION:
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
TDC FY 2023 Capital App 2-8
FINANCIAL IMPACT:
Effective Date:
Expiration Date:
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
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Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
REVIEWED BY:
Maxine Pacini Completed 02/01/2022 9:40 AM
Christine Limbert Completed 02/01/2022 11:51 AM
Liz Yongue Completed 02/01/2022 1:51 PM
Board of County Commissioners Pending 02/16/2022 9:00 AM
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PROJECTCAPITAL SCHEDULE
F. r 2023
TDC APPROVAL TO ADVERTISE: February 8, 2022
BOCC APPROVAL TO ADVERTISE: February 16, 2022
NOTICES SENT TO INTERESTED PERSONS February 9, 2022 (noting pending
BOCC approval)
ADVERTISE RFP: February 23, 2022
DAC WORKSHOPS: March 1st and 2"', 2022 �
64 DAYS
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DEADLINE-- April 77. 7 77
DAC DEADLINE: June 17, 2022
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DAC APPROVAL: June 281h and 291h 2022 `44
TDC APPROVAL: July 19, 2022co
BOCC APPROVAL AFTER OCTOBER 2022
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Revisions to Capital application:
• Not-for-profits allowed to request up to 100% of their total
project cost. This has been incorporated into the
application on pages 2 and 12.
• Page 2 — added procedure for funding projects that request
funding in more than one district
• Page 8 — added auto responder message
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MONROE COUNTY TOURIST DEVELOPMENT COUNCIL
FY 2023 CAPITAL PROJECT (BRICKS AND MORTAR) FUNDING
APPLICATION
EQEU T FOR APPLICATIONS FOR CAPITAL PROJECTS (BRICKS AND MORTAR)
All respondents must use the current application downloaded from the wesite
www.demandstar.com. Use of any other application will result in your application Fein
rejected. All directions within the application must be followed r it will not be accepted.
APPLICATON DEADLINE: Wednesday April 27, 2022
All applications should be received no later than 5:00 p.m. (close of business day)
In response to Covid-19, the Monroe County Purchasing Department has implemented a new electronic
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process for reviewing and opening sealed bids. Monroe County is committed to continuing to receive and 2
process competitive solicitations while maintaining the health and safety of our employees and those who
attend bid openings. Please do not mail or attempt to deliver in person any sealed bids. Mailed/physically
delivered bids/proposal/responses WILL NOT be accepted.
The Monroe County Purchasing Department hereby directs that bids be submitted via email to: O
ID (err�or�roecour�ty- i,cov, no later than 5:00 P.M. on April 27, 2022. Your subject line on both emails
must read as follows:
FY 2023 Brick and Mortar Capital Projects 04/27/2022
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Files that do not contain this subject line WILL BE REJECTED. Please note that the maximum file
size that will be accepted by email is 25MB. Please plan accordingly to ensure that your bid is co
not rejected due to the file size. Should your bid documents exceed 25MB or otherwise be
rejected or undeliverable to OIAB-BIDS1.5monroecouu ty-fU. ov, in advance of the bid opening,
please email: omb-purchasunq@monroecounty-fU.gov so accommodations for delivery of your
bid can be made prior to the bid opening. Please be advised that it is the bidder's sole
responsibility to ensure delivery of their bid and waiting until the bid opening to address or
confirm your bid submission delivery will result in your bid being rejected.
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The bid opening for this solicitation will be held virtually,via the internet, at 9:00 a.m.,on Thursday
April 28, 2022.
Join Zoom Meeting
https://mcbocc.zoom.us/j/4509326156
Meeting ID: 4509326156
Additional ways to access this Zoom meeting can be found in the legal noticed posted on
Demandstar.com
All inquiries and correspondence, other than submission of application, should be made to the
Monroe County Tourist Development Council. Contact Maxine Pacini orAmmie Machan at (305)
296-1552. Email correspondence should be address to AmmieEla®Ke s.com. Questions
regarding permissibility of your project submitted less than 10 business days prior to the deadline
date may not be answered.
Monroe County Tourist Development Council FY 2023 Capital Project Application
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CAPITAL1
This application is intended for applicants whose facility has a primary purpose of promoting
tourism.
The Monroe County Tourist Development Council (TDC) administers the four (4) cent bed tax
collected for the purpose of promoting the Florida Keys as a tourist destination. Each year, the
TDC advertises a Request for Applications (RFA) for Capital Project funding through the TDC.
Projects must be owned and operated by either a governmental entity or non-profit
organization. Individuals and for-profit organizations and companies are not eligible to apply
for Capital Project funds. Applicants must be registered to do business in Florida. All applications
will be reviewed by the appropriate District Advisory Committees (DAC's), who shall make
recommendations on funding the project to the TDC. Upon approval of recommended funding
allocation by the TDC, the administrative office will coordinate with the project manager to
establish an agreement for the project and will present the proposed agreement to the County
for final approval.
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This application may be funded up to one hundred percent 100% reimbursement of funds
expended by any individual non-profit organization and governmental entities. The
applicant must show that all funds (100%) are available for the project at the time of
application so that there is no delay in the progress of the project, and that TDC funding
is not used as "matching" funds.
If an applicant applies for funding in more than one District for their Capital Project, they may co,
either:
Apply for a specific portion of the total funding request in multiple Districts. Each DAC will
be informed of the amount requested in each DAC and will consider only the amount
requested in their specific District. (Preferred method) CD
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or
Only under emergency circumstances, i.e. projects that need to be completed due to
emergency circumstances (an immediate danger to the public health or safety or a danger
of loss of public or private property that requires immediate action), may an applicant
apply for the full funding request across multiple DACs. The Applicant must submit
documentation or a detailed explanation of the emergency circumstances relating to the
project. Each DAC will consider the total funding request and will be informed that the
funding request is across multiple Districts. If the project is partially funded by a DAC, the
funding request for the other DACs will be reduced by that amount, and the DAC members
will be informed of the funding recommendations made by the other DACs. Once a DAC
has approved the final funding allocation recommendation, the funding process does not
allow for that amount to be increased or decreased based upon subsequent funding
allocations made by other DACs.
Monroe County Tourist Development Council FY 2023 Capital Project Application
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IMPORTANT INFORMATION
All information furnished or disclosed as part of the application process is considered public
record by the laws of the State of Florida.
The applicant shall not lobby, solicit or act to influence the advisory committee members and/or
the TDC board members in any way that may have an effect on the outcome of the competition,
discussion or negotiations leading to the allocation of funding, or an award of an agreement as
reviewed and approved by the County Attorney's office. Such action may lead to withdrawal of
the application from consideration.
Commencement of Project: No portion of the project for which you are seeking TDC funding
may commence prior to the approval of an agreement by the Monroe County Board of County
Commissioners. Once your agreement has been approved by the BOCC then the project work
described in Exhibit A must commence before the end of the Fiscal Year in which it is funded.
Example: FY 2022 funding would be October 2021 to September 30, 2022, or between the date
of BOCC approval of your agreement and September 30, 2022. Proof that the project
commenced within the Fiscal Year funded may be requested by the TDC administrative office.
For projects requesting $19,999.99 and under, please see page 7.
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Prior to filling out application, please go to www.sunbiL.org to ensure that your organization is
registered to do business in the State of Florida. Only applicants that are duly registered will be ,
accepted. Print out and attach as Exhibit A.
Cost of preparation and submission of the application is the responsibility of the applicant.
Applicant shall complete, sign (by an authorized officer)and submit the application to the Monroe
County Purchasing Department.
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Completed Application: The application shall be considered complete upon receipt and should >_
stand alone with no other information being provided after-the-fact other than any additional
information that may be requested by the TDC administrative office, or questions from the DAC
at the allocation meeting.
All attachments should be noted as such in the top right-hand corner of each sheet.
Applicants shall familiarize themselves with referenced online materials noted in this application.
A sample agreement can be found at: hop s.Hwww.monroecount�®
fl. ov/ ocumentCenter/i/iew/22010/Sm le®C itl®A reement
Any part of the project for which the applicant wishes to seek reimbursement from the County
must NOT commence prior to the date of County (BOCC) approval.
Be advised that if your organization is awarded funding you will be required to enter into an
agreement which delegates you to maintain accurate and complete documentation of the
project. You will be required to obtain a signed amendment to agreement before making any
Monroe County Tourist Development Council FY 2023 Capital Project Application
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substantive changes to the project or you may nullify the County's obligation to pay. You will be
required to comply with the following reimbursement procedures outlined in the sample
reimbursement packet which can be found at: hops.//www.monroecount
fl. ov/ ocumentCenter/i/iew/1200/Sm le®Reimbursement®®®C itlbidld=
The recipient of TDC capital project funding shall designate a project manager if no licensed
architect, engineer or general contractor is involved in the project. If the project is performed by
County or City personnel, the project manager shall be the engineer, building official or
construction manager of that local government.
Taxes: The TDC/County is exempt from Federal, Excise and State of Florida Sales Tax.
Maintenance: The applicant shall be responsible for all maintenance and operational costs of
the premises improved or constructed with the use of funding from the TDC/County. The
applicant shall be responsible to the TDC/County for the safekeeping and proper use of the
property entrusted to applicant's care, to include any and all insurance for the value of the
equipment and any maintenance or service contracts relating to such equipment for its service
life. Any disposal of assets procured through funding under this agreement shall comply with
chapter 274, F.S. or chapter 617 F.S., dependent upon the type of entity funded under this
agreement.
Permits: Applicant shall be responsible for securing all federal, state and local development
approval and permits necessary to complete the project. Award of funds under this application
does not indicate any development approval by the County and applicant shall be required to
comply with all County concurrency requirements under land use laws of the County and State. CO
The TDC/County shall reimburse not for profits for the cost of permits required to complete the
physical brick and mortar portion of the project as outlined in the scope of services (Exhibit A) of
the final agreement. Applicant shall submit for reimbursement for permits within the last segment
of their proposed project. The TDC/County will not reimburse for permits obtained prior to
approval of a funding agreement by the BOCC.
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Insurance: Applicants requesting $20,000 or more in funding shall complete Exhibit R (pg. 23-
27 of application). Applicant shall provide the TDC/BOCC with current insurance certificates as U-
per the requirements set forth within the funding agreement. The TDC/County shall not
reimburse for the cost of insurance relating to the project for which the applicant is receiving
funding.
Performance Guarantee: A successful applicant shall warrant, by signing this application, that
applicant has the financial capability of completing the project as planned without the need to
request further funding from TDC/County for same. Applicant shall warrant, by signing this
application, and confirm in writing (in the form of bank statements; signed letter from the bank
stating that the funds are in the bank for the specified project; documentation provided by a
financial institution of a line of credit assigned to the specific project within the application) that
applicant has the funds in place at the time of the application for grant funds to be able to
complete the project prior to seeking reimbursement of TDC funds. Applicant may be asked to
provide proof that the funds are available to complete all outstanding TDC grants in addition to
this application. Applicants may also be asked to provide proof that the funds are available if
requesting an amendment to agreement. A governmental applicant shall provide a line item
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budget for the project in application, and proof that the budget has been adopted by governing
board of that entity. The applicant, by signing the application certifies that: applicant, its
principals, and any previously owned business is/are not and have never been in default to
Monroe County under the terms of any contract. (Default means failure to fulfill contractual
obligations where County had to take legal action to obtain remedy or where a bonding company
had to make good for applicant.)
In-Kind Services: Non-Profit Organization's funding obligation shall be 25% or more of the total
project cost with an option of up to 50% of this funding obligation in the form of in-kind services
which relate to the permissible elements of the project. In-kind services mean
donated/free/volunteered labor; materials; goods; and services. Applicant shall provide a
schedule of values for each unit of in-kind services and/or goods at the time of the application.
Volunteered labor, as a component of in-kind services, will be calculated at a reasonable hourly
rate for the type of work/services being performed (e.g. an architect who volunteers to paint will
be able to seek reimbursement for the reasonable rate for the painting work performed not the
professional rate of an architect). Should funding be allocated, County/TDC reserves the right to
deny the application of certain in-kind services and goods and to negotiate a revised schedule
of values for permissible items. For example, County will not accept as in-kind services, the
waiver of governmental fees, or in-kind towards the acquisition of property. The amount of in-
kind services you note within your application shall be entered into your final agreement.
Applicants will be able to request additional allowable in-kind services after submission of
application only if the applicant does not receive the full TDC funding requested in the
application. In-kind services will not be reimbursed to the applicant.
Project Quotes and Bidding Process: co
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Governmental Entities: An applicant which is a governmental entity shall comply with the
procurement regulations and policies to which it is subject. A copy or link to these policies will
need to be submitted as part of your reimbursement request.
Not-for-Profits: Work under $50,000 requires three written quotes or a notarized statement as
to why such written quotes were not obtainable for the work to complete the project. Work
$50,000 or more requires a competitive bid process. This documentation will need to be
submitted as part of your reimbursement request.
Construction and Other Contracts: Applicant, by signing the application, warrants that, if
awarded funds for the project, all contracts, for construction or otherwise, to complete the project
shall be met in compliance with all applicable laws and County purchasing policy and to comply
particularly with F.S. Chapter 255, Chapter 274 and Chapter 287. Applicant further agrees to
provide TDC/County and their designated representatives with:
a) Access to the project premises for inspection of the progress of the project;
b) Documentation including copies of all sub-contractors/Requests for Bids verifying
compliance with purchasing/construction/architectural contract requirements of the
County {Notice to owner: list of sub-contractors must be provided to County}; and
c) Access to all records concerning the project. These records must be retained by
applicant for a minimum of four (4) years after the termination date of agreement.
The requirement may be for a different time period than that required by other
government agencies. All records must be kept in accordance with Generally
Accepted Accounting Principles.
Monroe County Tourist Development Council FY 2023 Capital Project Application
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Termination for Default/Convenience: The TDC/County reserves the right to terminate any
agreement if, in its opinion, there shall be a failure at any time to properly perform faithfully any
portion of the project as funded by TDC/County according to the plan presented within the
application, or as modified and accepted in writing by TDC/County. Further, TDC/County
reserves the right to terminate payments under this agreement should the anticipated funding
become unavailable for any reason. Should termination occur under this provision, TDC/County
shall give the applicant thirty (30) days' notice prior to termination.
Payments: Applicants shall submit all documentation required by the County Finance
Department in accordance with instructions from said department, prior to payment of any funds
awarded. The TDC Application for Payment forms provided in the TDC reimbursement
package shall be used. Ten percent (10%) of every progress payment shall be withheld by
County until certification of completion of project.
Design/Architectural Costs: Final design plans and architectural costs will be paid upon
completion of the physical bricks and mortar portion of the project outlined within the agreement.
Applicant shall submit for reimbursement of final design plans and architectural services within
the last segment of their proposed project (Exhibit A). This is to ensure that TDC dollars are
used for completed projects that are open to the public. No portion of the final design plans or
architectural drawings for which you are seeking TDC funding may commence prior to the
approval of an agreement by the Monroe County Board of County Commissioners. Applicant
may submit a preliminary plan within their application to provide the District Advisory Committee
and TDC with an idea of the proposed plan. U_
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Acquisition of Property: Applications for acquisition of property will only be considered if the
applicant can confirm availability of funding for one hundred percent (100%) of the purchase
price through a bank statement showing that the entity has funding set aside in a line item for
the purchase of the property, or that a loan from a financial institution has been fully approved;
there are no liens on the property; and a clear title of ownership will be held by the entity
requesting funding upon the closing of the purchase of the property. A clear title in the name of
the contracting entity will be required to submit for reimbursement of the TDC funds allocated.
The property shall be used for a minimum of ten (10) years as a tourist facility. The County will
evaluate non-compliance of use as a tourist facility and upon request by the County the applicant U
shall pay a prorated reimbursement of funding allocated. The purchase or down payment of the
property may not commence prior to approval of a funding agreement between the County and
the contracted entity. No in-kind services apply to the purchase of property, and payment will be
made in one reimbursement check upon completion of the requirements set forth within the
funding agreement. A Restrictive Covenant on the property will be required to secure
TDC/County funds.
Acknowledgements: Applicant shall be required to display an appropriate public
acknowledgement of the support of the Monroe County Tourist Development Council in a
publicly prominent area of the project.
Funding Allocations: DAC recommendations on funding allocations shall be limited to
recommending allocations which do not exceed the amount requested by the applicant.
Monroe County Tourist Development Council FY 2023 Capital Project Application
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Funding requests may be denied or reduced to a lesser amount than requested by the applicant.
Projects Requesting $19,999.99 and Under: Projects requesting $19,999.99 and under may
enter into a "Streamlined Process".(this eliminates the requirement for a formal contract to be
entered into with the Board of County Commission which allows for a faster start time for your
project; insurance documentation; and County Engineering Department approval of work
completed) whereby the applicant will swear or affirm that the work will be completed in
accordance with the Streamline Process. Upon approval by the TDC, the administrative office
will provide the applicant with a commencement date; project summary sheet; and
reimbursement packet. Applicant will be required to comply with reimbursement procedures
outlined in the sample Project Summary Sheet, which can be found at:
h ter/View/1 39/S m le®TDC®Pro ect®
Summery®Sheet®for®Projects®1999999®end®Under?bidld=
Public Facilities: TDC Capital funding may be utilized to acquire, construct, extend, enlarge,
remodel, repair, improve, maintain, operate, or finance public facilities, if needed to increase
tourist related business activities and in accordance with the conditions as set forth in F.S.
125.0104(5)(a)(6). These conditions include:
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1) The use must be approved by a vote of at least two-thirds of the BOCC
2) An independent analysis, performed at the expense of the TDC, must demonstrate the
positive impact of the infrastructure project on tourist related business in the county
3) No more than 70% of the cost of the project may be paid by the TDC
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Applicants submitting an application for a Public Facility should complete the section on pg. 13 U_
pertaining to Public Facilities, the application for the project will be submitted as one application CO
with two segments. The first segment of the project should include the request for the
independent analysis "study", including an estimated completion date and funding request
(100%) for the study. The second segment of the project should include the physical portion of
the project. The applicant may request and may be allocated up to 70% of the total project cost
for this segment. Upon approval by the DAC and TDC, an agreement including both segments
will be placed on a BOCC agenda and must receive a two-thirds vote to utilize the funds. Upon
approval by the BOCC, the applicant will be responsible for coordination of the study and will
receive 100% reimbursement of the total cost of the study segment of the project, subject to the
cap on expenditures for that segment as set forth in the agreement. If the study shows a positive
impact of the project on tourist-related businesses, the remaining segments of the project will
move forward as set forth in the agreement. If the study does not show a positive impact of the
project on tourist-related businesses, then the remainder of the agreement will terminate.
Regardless of the outcome of the study, the applicant will be reimbursed for the cost of the study,
subject to the caps on expenditures set forth in the agreement. For more information on the
process please refer to the flow chart located here: htts://www.monroecount ®
fl. ov/ ocumentCenter/i/iew/16271/Public®Pcilities®Ctegory flowchart?bidld=
"Public facilities" means major capital improvements that have a life expectancy of 5 or more
years, including, but not limited to, transportation, sanitary sewer, solid waste, drainage, potable
water and pedestrian facilities.
Public Record: All information furnished or disclosed as part of the application process is
considered public record by the laws of the State of Florida.
Monroe County Tourist Development Council FY 2023 Capital Project Application
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Submission of Application: Applications must be submitted by the deadline date and in the
manor listed on the first page of this application. It is applicants' sole responsibility to ensure that
the application is successfully received prior to the application deadline. Please note if you
submit more than one email only one autoresponder message will be sent. If you do not receive
confirmation of your submission, it is the applicant's responsibility to follow up prior to the
application deadline. Below is the response that you will receive if your submission is
successfully received.
Email Auto Responder:
Your bid/proposal/response was successfully received by the Monroe County Purchasing
Department. The bid opening will occur at the date and time set forth in the Notice of Competitive
Solicitation. Thank you.
Iis r ICE"° ADVISORY Comm, r rEE WORKSHOPS FOR APPLICAN rs
Workshops will be held in each of the districts at the following times via zoom for those applicants
that are interested in applying for funding. Attendance is strongly recommended. Please note
that all dates and times are subject to change and can be confirmed by calling the TDC
administrative office at (305) 296-1552.
District I Wednesday March 2, 2022 3:00 p.m. Zoom Meeting ID: 833 1247 7494
District 11 Tuesday March 1, 2022 6:00 p.m. Zoom Meeting ID: 884 8909 9706 >-
District III Wednesday March 2, 2022 9:30 a.m. Zoom Meeting ID: 897 0796 1489 11,
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District IV Tuesday March 1, 2022 2:00 p.m. Zoom Meeting ID: 874 4022 4835
District V Tuesday March 1, 2022 10.00a.m Zoom Meeting ID: 870 3830 1989
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11 �` 1�Sil III„ Ili F C1T111 + III...�,CT F
This application is intended for applicants whose facility has a primary purpose of promoting
tourism.
All capital projects funded by TDC shall be owned and operated by either a governmental entity
or non-profit organizations and open to the public. Individuals and for-profit organizations
and companies are not eligible to apply for Capital Project funds. Applicant shall provide proof
of property ownership, long term lease, or service contracts for consideration of funding, and
should show sufficient expertise or financial capability to operate such facilities.
Tourist Development Council capital project funds may be used in Monroe County as follows-
1. To acquire, construct, extend, enlarge, remodel, repair, improve, maintain, operate or
promote one or more:
Publicly owned and operated convention centers, sports stadiums, sports arenas, coliseums or
auditoriums within the boundaries of the county or subcounty special taxing district in which the
tax is levied;
Auditoriums that are publicly owned but are operated by organizations that are exempt from
federal taxation pursuant to 26 U.S.C. s. 501(c)(3) and open to the public within the boundaries
of the county or subcounty special taxing district in which the tax is levied; or
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Aquariums or museums that are publicly owned and operated or owned and operated by not-
for-profit organizations and open to the public, within the boundaries of the county or subcounty
special taxing district in which the tax is levied; or
Zoological parks, fishing piers or nature centers which are publicly owned and operated or owned
and operated by non-profit organizations and open to the public; and
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2. To finance beach park facilities, or beach, channel, estuary, or lagoon improvement,
maintenance, re-nourishment, restoration, and erosion control, including construction of
beach groins and shoreline protection, enhancement, cleanup or restoration of inland
lakes and rivers to which there is public assess as those used relate to the physical
preservation of the beach, shoreline, channel, estuary, lagoon, or inland lake or river.
3. To acquire, construct, extend, enlarge, remodel, repair, improve, maintain, operate, or
finance public facilities, if public facilities are needed to increase tourist related business
activities and in accordance with the conditions as set forth in F.S. 125.0104(5)(a)(6.)
Authorized uses of revenue must be in compliance with, l ri 1 Statute 1 5. ,,1 4, as may
be amended from time to time.
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, PP�i `Ti ' > �'�` III OE Ills
This application is to request funding from the following District:
❑ District I: Key West— (shall encompass the city limits of Key West)
❑ District II: Lower Keys — (city limits of Key West to west end of Seven Mile Bridge)
❑ District III: Marathon — (west end of Seven Mile Bridge to Long Key Bridge)
❑ District IV: Islamorada — (between Long Key Bridge and Mile Marker 90.939)
❑ District V: Key Largo — (from Mile Marker 90.940 to the Dade/Monroe County Line and any
portions of mainland Monroe County)
APPLICANT ORGANIZATION: Organizaton Name Here
(Registered business name EXACTLY as it appears on www.sunbiz.org. Attach as Exhibit A �
Type of Applicant: ❑ Non-Profit ❑ Governmental Entity
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Project Title:
FEDERAL EMPLOYER'S IDENTIFICATION NUMBER OF APPLICATIONS ORGANIZATION
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DESIGNATED PROJECT CONTACT PERSON: co
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Please provide a contact for general correspondence for this project. The person listed below
should be able to accept responsibility for receipt of information including agreement and
reimbursement information.
Name and Title-
Telephone/Mobile Number:
Email Address:
Address:
Website for Facility:
LOCATION OR ADDRESS OF PROJECT: Provide physical (postal service) address, RE#
and legal description lot, block, subdivision and attach map.
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WHICH OF THE FOLLOWING APPLIES TO YOUR FACILITY?
❑ Publicly owned and operated ❑ Owned and operated by a non-profit organization
❑ Publicly owned and operated by a non-profit organization
WHICH OF THE FOLLOWING BEST DESCRIBES YOUR FACILITY?
❑ Convention Center ❑ Sports Stadium ❑ Sports Arena ❑ Coliseum
❑ Auditorium ❑ Aquarium ❑ Museum ❑ Zoological Park
❑ Nature Center ❑ Fishing Pier ❑ *Beach or Beach Park Facility, channel,
estuary or lagoon
❑ Public Facilities in accordance with conditions
set forth in F.S. 125.0104(5)(a)(6)
WHICH OF THE FOLLOWING APPLIES TO YOUR PROJECT?
❑ Acquire ❑ Construct ❑ Extend ❑ Enlarge ❑ Remodel
❑ Repair ❑ Improve CD
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*IF YOU CHECKED THE BOX FOR BEACH OR BEACH PARK FACILITY, WHICH OF THE co
FOLLOWING APPLIES:
❑ Improve ❑ Renourishment ❑ Restoration ❑ Erosion Control
❑ Maintenance ❑ Construct ❑ Repair
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If the TDC/County requires a Conservation Easement Deed or mortgage note requiring
repayment of TDC monies in the event of transfer of ownership or change in use of the premises,
would you be agreeable to executing same?
❑ Yes ❑ No E
CODE ENFORCEMENT: Does your organization/property have any outstanding code violations
and/or fines/costs or liens? (please note that pursuant to Section 2-25(e), Monroe County Code, organizations
with outstanding code compliance fines are not eligible to receive grants or contracts from the county until such
time as the fines are resolved through payment or settlement). ❑ Yes ❑ No. I you have answered yes,
please explain below:
Monroe County Tourist Development Council FY 2023 Capital Project Application
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Please only complete the section of raaae 12 or 13 which corresponds to your type of application
Non ProfitQ,[gg!,n,1Zgt1ons
Payment may be up to one hundred percent (100%) reimbursement of the total cost of each segment of
the project, subject to the maximum reimbursement amount of expenditures for each segment (if the
project work is segmented) as set forth in the agreement. Applicant must be prepared to pay the entire
cost of each segment of work in advance of seeking the up to one hundred percent(100%). For purposes
of this application no more than fifty percent (50%) of out of pocket cost for non-profits shall be of in-kind
services and materials, and no in-kind services shall be reimbursed. If the TDC Funds Requested are
allocated at less than 100% of the total project cost, only then may the organization request to allow
additional in-kind services after submission of the application, which must be entered into the final
agreement. The project may be broken down into 2 or 3 segments. When one segment is completed, _
reimbursement of the TDC portion of that completed segment cost can be applied for through the TDC.
For acquisition of property, see importation information on page 6.
0
Total TDC Funds Organizations Confirmed Confirmed/Available Organizations
Project Requested: Out of Pocket In-Kind Hard Dollar Funds: Financial
Cost: (up to Cost: Services: (Total Project Cost Investment: a
100% of (Total Project (Up to Less In-Kind (Out of Pocke
Total Cost less 50% of Services) Cost Less In-Kinc
Project TDC Funds Out of Services)
Cost) Requested) Pocket
Cost)
$ $ $ $ $ $ N
In the space below list all in-kind services and goods and their values. These values are subject
co
to negotiation with the TDC/County Please refer to page 4 of this application.
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o eir r e tal Entities
Payment may be up to one hundred (100%) reimbursement of the total cost of each segment of the
project, subject to the cap on expenditures for that segment as set forth in the agreement. Applicant must
be prepared to pay the entire cost of each segment in advance of seeking up to 100% reimbursement. E
The project may be broken down into 2 or 3 segments. For acquisition of property see important
information on page 6.
Total TDC Funds Requested: Governmental Agency I have highlighted
Project (Up to 100% of total Out of Pocket Cost: the line item(s) in
Cost: Project Cost) (Total Project Cost less budget for this
TDC Funds Requested) specific project.
Enclose portion of
line item budget as
proof of funding for
Exhibit B ❑
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Publici iti
Segment #1 _ Study
Payment will be 100% reimbursement of the total project cost of the study segment of the project, subject
to the cap on expenditures for that segment as set forth in the agreement. Applicant must be prepared to
pay the entire cost of this segment in advance of seeking reimbursement. The project may be broken
down into additional segments. For acquisition of property see importation information on page 6.
Total Study TDC Funds Governmental Agency I have highlighted the
Cost: Requested: Out of Pocket Cost: line item(s) in budget
(up to 100% of (Total Project Cost less for this specific
Total Study Cost TDC Funds project. Enclose
Requested) portion of line item _
budget as proof of
funding for Exhibit B
$ $ $
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Estimated Completion date for study:
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Segment _ Project
Payment will be up to 70% reimbursement of the physical project segment, subject to the cap on co,
expenditures for that segment as set forth in the agreement. Applicant must be prepared to pay the entire
cost of each segment in advance of seeking reimbursement. The project may be broken down into
additional segments. For acquisition of property see importation information on page 6.
Total Project TDC Funds Governmental Agency I have highlighted the
Cost: Requested: Out of Pocket Cost: line item(s) in budget
(not including (up to 70% of (Total Project Cost less for this specific N
study) Total Project Cost TDC Funds project. Enclose U-
Requested) portion of line item
budget as proof of
funding for Exhibit B
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TDC requires confirmation in writing that the project funds are in place at the time of this
application for grant funds (see Performance Guarantee on page 4). Enclose proof of funding
as Exhibit B.
In the space below list the specific items/services, and the estimated dollar amount for each of
those items/services that your requested TDC funds will be spent on (please do not include
contingency fees, warranty fees or items relating to administrative, office or retail space as part
of your budget):
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1. Use:
a) Original use of structure/facility and date of construction:
b) Present Use:
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c) Proposed Use:
d) Attach photograph of existing site as Exhibit C.
e) Historic designation: Indicate whether the property has been listed in the National
Register, is located in a National Register district, is a locally designated historic landmark or is
located in a locally designated historic district. If located within a historic district, provide the
official name of the district. This information is available from the planning agency having
jurisdiction over the property.
2. All Capital projects funded by the TDC shall be owned and operated by a governmental
entity or non-profit organization. Applicant shall provide proof of property ownership, long term
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lease or service contracts for consideration of funding and should show sufficient expertise or
financial capability to operate such facilities (Enclose as Exhibit D).
Ownership or other interest in property by applicant:
a) Official records reference for ownership documentation
b) If not owned by applicant, provide long term lease of property or service contract
and provide notarized consent letter from owner for use of property as outlined in
this application.
3. If proposed project calls for transfer of title of real property to County, at least two (2)
current real estate appraisals and one (1)environmental assessment shall be provided (Enclose
as Exhibit E). The TDC/County shall ascertain, prior to acceptance of any donation or prior to
the purchase, that the property will pose no environmental hazard or liability for same, to County.
The TDC/County must also ascertain permissible governmental interest in the transfer of title. M
Indicate any such proposed title transfers here:
4. This paragraph applies only to an acquisition funding request, but you will still need to
complete items 5-13, whether this is a new construction or renovations, additions, or exhibits.
Indicate the area of the property to be acquired in acres:
In evaluating applications for acquisition funding, an important consideration is the co
appropriateness of the size of the site to be acquired. Determinations of the appropriateness of
the site size will be made on a case by case basis and will depend on the characteristics for
which the property is considered to be significant. Sufficient property should be acquired to
assure that the historic relationship of a structure or archaeological site to its surrounding
environment is preserved. However, it is important that no more property than is necessary to
achieve established preservation objectives be included in the acquisition project application. As
this factor is crucial to favorable consideration of your grant application and will have substantial
impact on the cost of the required application documentation, we encourage prospective
applicants to consult with the staff of the TDC administrative office prior to initiating the required
documentation.
5. Protection of Property: Indicate any type of state or federal protection currently afforded E
the property. It may be that more than one type may be applicable. Provide citations for
applicable local protective ordinances. Include copies of property-specific restrictive legal
instruments in an attachment (Enclose as Exhibit F). By signing and submitting this application,
the proposer warrants that all restrictions are disclosed. Failure to include every restriction on
the property may result in immediate termination of any agreement and demand for return of any
monies paid thereunder.
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6. Is the property threatened by imminent destruction, deterioration or other loss which may
include demolition, vacancy, severe deterioration, loss of structural integrity, encroaching
development, adverse environmental conditions, vandalism, etc.? Be specific regarding the
nature of immediacy of the threat. If so, describe in detail:
7. a) Are there any building restrictions on the site? If so, describe. Attach copies of all
recorded easement and restrictive covenants. By signing and submitting this application, the
proposer warrants that all restrictions are disclosed. Failure to include every restriction on the
property may result in immediate termination of any agreement and demand for return of any
monies aid thereunder Enclose as Exhibit G .
L.
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b) Is the proposed project compatible with the County's and/or the Municipality's >-
Concurrency Requirements under the existing and proposed Land Use Comprehensive Plan?
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❑ Yes ❑ No
Describe below how you have ascertained such compatibility. Note if your description does not
provide information on about existing permits and/or review by the appropriate Planning
Department, your application your application shall be rejected. Please list all permits required
to complete this project.
c) Does the site contain endangered or threatened species of flora or fauna?
❑ Yes ❑ No If yes, attach explanation as Exhibit H
d) Indicate, whether or not the project will be accessible to the handicapped per
Chapter 553, Part V Florida Statutes and the Americans with Disabilities Act of 1990, Public Law
101-336, as amended.
❑ Yes ❑ No If no, attach explanation as Exhibit
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e) Explain how your facility will utilize recycling within the work of your proposed
project:
f) Public accessibility and use: Indicate the extent to which the property is currently
or will be scheduled to be open to the public each year(hours per day, days per week and weeks
per year) upon project completion. Estimate the number of persons who will use or visit the
completed facility annually. Explain how this estimate was derived. For archaeological projects,
if the site will not be accessible to the public, estimate the number of persons annually who will
be exposed to the interpretive materials and reports resulting from the project. How was your 2
estimate derived?
CO
N
g) Is there currently signage for this project/facility on U.S.1?
❑ Yes ❑ No
If No, are there plans to install signage and if so, do you have FDOT approval? Explain below:
N
N
h) If the project/facility is located in a Historical District, is there currently signage for
the project/facility in the Historical District?
❑ Yes ❑ No ❑ Not located in a Historical District
i) Does the project/facility require any parking variances? Explain how this was
determined in the space below.
❑ Yes ❑ No
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8. Describe present physical condition of site (attach legal description per property tax
records). Indicate the present condition of the property by checking the appropriate term below:
❑ Excellent: The property is habitable and occupied; no repairs are needed. All physical
evidence indicates that the property is under continuous maintenance. Application is for
expansion and enhancement.
❑ Good: The property is habitable and occupied; only replacement or cosmetic repairs are
needed (e.g. peeling paint, missing ornamental features, windows, doors, some deteriorated
mortar, etc.) Property is maintained but in need of minor repair.
❑ Fair: The property is habitable but may be vacant. Both the structural integrity (foundation,
framing, etc.) and weather tight integrity of the property (siding, walls, roofing, etc.) are in
jeopardy because of prolonged neglect.
❑ Poor: The property is uninhabitable and vacant. Major structural repairs are needed.
Weather tight integrity has been lost. The property is derelict, abandoned and not habitable
without major rehabilitation work.
List any specific factors or problems which contribute to the present condition of the
property—
CO
N
N
9. Status of project planning: (Any work initiated prior to approval of an Agreement by the
Monroe County Board of County Commissioners will be at applicants' own cost):
N
❑ Not yet initiated ❑ Initiated
❑ Schematics Completed ❑ Design development completed
❑ Construction documents completed ❑ Permits have been obtained (if
required)
10. Name and Address of Project Consultant (architect, engineer, contractor, etc)
Enclose preliminary plans or architectural documents completed to date — 1 set (Enclose as
Exhibit J)
11.Has an Agreement for architectural services or construction services been executed?
❑ Yes (cost will not be reimbursed by TDC) ❑ No
❑ Project does not require architectural services
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12.It is the County's policy not to fund operations and maintenance cost of facilities.
Describe the means by which the structure(s) affected by this project will be maintained
subsequent to restoration/rehabilitation. Include sources and estimated amounts of funding for
such maintenance.
13.How will this project enhance tourism in Monroe County?
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N
N
N
N
Monroe County Tourist Development Council FY 2023 Capital Project Application
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14.Applicant must demonstrate the ability to complete the project as proposed and to
maintain and operate the project as a viable and long-term tourist attraction that is open to the
public. Included in this demonstration should be a proposed operational budget and marketing
program to promote this facility as a tourist attraction. (Attach as Exhibit K).
15.Estimated Project completion date:
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CD
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CD
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Monroe County Tourist Development Council FY 2023 Capital Project Application
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NON-00L,J,,,,,US_0N AFFIDAVIT AND VERIFICATION
(Enclose as Exhibit Q
I, , of the city of according to
law on my oath, and under penalty of perjury, depose and say that:
1) 1 am the applicant making the
application for the project described as follows:
2) The prices in this application have been arrived at independently without collusion,
consultation, communication or contract for the purpose of restricting competition, as to any
matter relating to such prices with any other applicant or with any competitor;
3) Unless otherwise required by law, the prices which have been quoted in this
application have not been knowingly disclosed by the applicant and will not knowingly be
disclosed by the applicant prior to application opening, directly or indirectly, to any other applicant .
or to any competitor;
1) No attempt has been made or will be made by the applicant to induce any other
person, partnership or corporation to submit, or not to submit, a application for the purpose of
restricting competition; and
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 11,
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in awarding contracts for said project.
(Signature)
Date:
STATE OF: `V
cv
COUNTY OF:
Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or ❑ online
notarization, on (date) by (name
of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
Monroe County Tourist Development Council FY 2023 Capital Project Application
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IDRUG FREE WORKPLACE FORM
(Enclose as Exhibit M)
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
(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
maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee 2
0.
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 application a copy of the statement specified in subsection (1).
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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 application, 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 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. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or co
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 person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
(Signature)
Date:
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or ❑ online
notarization, on (date) by (name
of affiant). He/She is personally known to me or has
Produced (type of identification) as identification.
NOTARY PUBLIC
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H01 O HARMLESS/INDEMNIFICATION
(Enclose as Exhibit N)
(herein after"Organization")hereby covenants and agrees to indemnify and
hold harmless the Monroe County Board of County Commissioners and Monroe County Tourist Development
Council (herein after "BOCC/TDC") and the 3406 North Roosevelt Blvd. Corporation or any of its officers and
employees from and against any and all claims, liabilities, litigation, causes of action, bodily injury(including death),
personal injury, and property damage, and another other losses, damages, costs, expenses (including but not
limited to fees and expenses arising from any factual investigation, discovery or preparation for litigation), and the
payment of any and all of the foregoing or any demands, settlements or judgments arising out of, or in connection
with, Project Name (herein after "Project") being funded by the BOCC/TDC. The Organization shall immediately
give notice to the BOCC/TDC of any suit, claim or action made against the Organization that is related to this
Project, and will cooperate with the BOCC/TDC in the investigation arising as a result of any suit, action or claim
related to this Project.
a.) Non-Waiver of Immunity. Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the
participation of the BOCC/TDC in reimbursing/funding any portion of the Project and the acquisition of any
commercial liability insurance coverage, self-insurance coverage, or local government liability insurance
pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any CL
contract entered into by the BOCC/TDC be required to contain any provision for waiver.
b.) Privileges and Immunities. All of the privileges and immunities from liability, exemptions from laws,
ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which
apply to the activity of officers, agents, or employees of any public agents or employees of the BOCC/TDC, CD
N
when performing their respective functions related to this Project within the territorial limits of the County >_
shall apply to the same degree and extent to the performance of such functions and duties of such officers,
agents, volunteers, or employees outside the territorial limits of the County. co
c.) RESTRICTIONS ON AGREEMENTS FUNDED BY BOCC/TDC. The Organization shall include
the following term in all agreements funded by the BOCC/TDC for this Project:
Hold harmless/indemnification. Contractor acknowledges that this agreement is funded at least in
part by the BOCC/TDC and agrees to indemnify and hold harmless the BOCC/TDC and any of its officers
and employees from and against any and all claims, liabilities, litigation, causes of action, damages, costs,
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expenses (including but not limited to fees and expenses arising from any factual investigation, discovery N
or preparation for litigation), and the payment of any and all of the foregoing or any demands, settlements N
or judgments (collectively claims) arising directly or indirectly from any negligence or criminal conduct on
the part of contractor in the performance of the terms of this agreement. The contractor shall immediately
give notice to the BOCC/TDC of any suit, claim or action made against the contractor that is related to the
activity under this agreement, and will cooperate with the BOCC/TDC in the investigation arising as a result
of any suit, action or claim related to this agreement. E
President of Organization/Mayor's Name Typed President's/Mayor's Signature
Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or ❑ online
notarization,on (date)by
name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
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Ethics Statement
(Enclose as Exhibit O)
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
(Company)
"...warrants that he/it has not employed, retained or otherwise had act on his/her behalf any former
County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or 9
employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision 0.
the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion,
deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee."
0.
(Signature)
N
Date:
STATE OF: co
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COUNTY OF:
Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or ❑ online
notarization, on (date) by ca
(name of affiant). He/She is personally known to me or has produced
(type of identification) as identification. cv
NOTARY PUBLIC
My Commission Expires:
Monroe County Tourist Development Council FY 2023 Capital Project Application
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Public Entity Crime Statement:
"A person or affiliate who has been placed on the convicted vendor list following a conviction for public
entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may
not submit a bid on a contract with a public entity for the construction or repair of a public building or
public work, may not submit bids on leases of real property to public entity, may not be awarded or
perform work as a CONTRACTOR, supplier, subcontractor, or CONTRACTOR 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, for CATEGORY TWO for a period of 36 months from the date of being
placed on the convicted vendor list."
I have read the above and state that neither (Respondent's name) nor any
Affiliate has been placed on the convicted vendor list within the last 36 months.
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(Signature)
N
Date:
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STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or ❑ online
notarization, on (date) by >-
(name of affiant). He/She is personally known to me or
has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
Monroe County Tourist Development Council FY 2023 Capital Project Application
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Print off this page complete, and include as part of your application
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Enclose as Exhibit Q
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-NSURANCE CHECKI IST ANDAGENT/BIDDERS STATEMENT
(Enclose as Exhibit R)
Div for amlications reauestinqmore in fundinq
INSURANCE CHECKLIST FOR VENDORS SUBMITTING PROPOSALS OR BIDS FOR WORK
To assist in the development of your proposal,the insurance coverages marked with an "X"will be required in the
event an award is made to your firm. Please review this form with your insurance agent and have him/her sign it
in the place provided. It is also required that the bidder sign requisite form reflecting coverage and submit it with
the proposal.
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
Workers' Statutory Limits
X Compensation
Bodily Injury by Accident/Bodily Injury by Disease, Policy CL
Limits/Bodily Injury by Disease each employee
WC1 Employers Liability $100,000/$500,OOO/$100,000
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WC2 Employers Liability $500,000/$500,OOO/$500,000 CD
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WC3 Employers Liability $1,000,000/$1,000,000;$1,000,000 co
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US Longshoremen &
WCUSLH Harbor Workers Act $1,000,000
WCJA Federal Jones Act $1,000,000
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GENERAL LIABILITY
As a minimum, the required general liability coverages will include:
• Premise Operation • Products and Completed Operations
• Blanket Contractual • Personal Injury
Required Limits:
GL1 $300,000Combined Single Limit
GI-2 x $500,000Combined Single Limit
GI-3 $1,000,000 Combined Single Limit
GI-4 $2,000,000Combined Single Limit
GI-5 $3,000,000Combined Single Limit
GI-6 $4,000,000Combined Single Limit CL
GI-7 $5,000,000Combined Single Limit
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Required Endorsements: co
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GLLIQ Liquor Liability
GLS Security Services
All endorsements are required to have the same limits as the basic policy.
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BUSINESS AUTOMOBILE LIABILITY
As a minimum, coverage should extend to liability for:
• Owned; Non-Owned and Hired Vehicles
Required Limits:
$50,000 per Person:$100,000 per Occurrence
$25,000 Property Damage
Or
$100,000 Combined Single Limit
(The use of VLI should be limited to special projects that involve other
governmental entities or "Not for Profit"organizations. Risk Management
VL1 must approve the use of this form).
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$200,000 per Person; $300,000 per Occurrence
$200,000 Property Damage
or
VL2 X $300,000 Combined Single Limit
$500,000 per Person; $1,000,000 per Occurrence
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$100,000 Property Damage
or
VL3 $1,000,000 Combined Single Limit
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VL4 $5,000,000 Combined Single Limit
Miscellaneous Coveragesco
Builders Risk Limits equal to the
Full Replacement Value of the completed
BR1 project.
CLI Cyber Liability $1,000,000
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Motor Truck Cargo Limits equal to the maximum value of any one `V
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MVC shipment
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PRO Professional Liability $300,000 per Occurrence,$ 500,000 Agg.
PR02 $500,000 per Occurrence/$1,000,000 Agg.
PR03 $1,000,000 per Occurrence$2,000,000 Agg.
POL1 Pollution Liability $ 500,000 per Occurrence $(,000,000 Agg.
POL2 $1,000,000 per Occurrencej$2,000,000 Agg.
POL3 $3,000,000 per Occurrence;'$6,000,000Agg.
POL4 $5,000,000 per Occurrencej$10,000,000 Agg.
EDt Employee Dishonesty $ 10,000
ED2 $100,000
GK1 Garage Keepers $ 300,000 ($25,000 per Vehicle)
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GK2 $ 500,000 ($100,000 per Vehicle)
GK3 $1,000,000 ($250,000 per Vehicle)
MED1 Medial Professional $300,000/$750,000 Agg.
MED2 $500,000/$1,000,000 Agg.
MED3 $1,000,000/$3,000,000 Agg.
MED4 $5,000,000/$10,000,000 Agg.
IF Installation Floater Maximus value of Equipment Installed
VLP1 Hazardous Cargo Transporter $300,000 (Requires MCS-90)
VLP2 $500,000 (Requires MCS-90)
VLP3 $1,000,000 (Requires MCS-90) S
Maximum Value of County Property that will be
BILL Bailee Liab. in the Bailee's possession
HKL1 Hanger Keepers Liability $300,000
H KL2 $500,000 CL
H KL3 $1,000,000
H KL4 $5,000,000
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AIR1 Aircraft Liability $1,000,000 cV
AIR2 $5,000,000
AIR3 $50,000,000 co
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AEO1 Architects Errors &Omissions $250,000 per Occurrence.'$500,000 Agg
AE02 $500,000 per Occurrence/$1,000,000 Agg
AE03 $1,000,000 per Occurrence/$3,000,000 Agg.
AE04 $300,000,000 per Occurrence/$5,000,000 Agg. Uc�
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ARP All Risk Property Full Replacement Value of Structure
EOJ Engineers Errors &Omissions $250,000 per Occurrence '$500,000 Agg.
E02 $500,000 per Occurrence$1,000,000 Agg.
E03 $ 1,000,000 per Occurrence$2,000,000 Agg.
E04 $ 5,000,000 per Occurrence'$10,000,000 Agg. E
WL1 Water Craft Liability $500,000 per Occurrence <
WI-2 $1,000,000 per Occurrence
Monroe County Tourist Development Council FY 2023 Capital Project Application
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INSURANCE AGENT'S STATEMENT
I have reviewed the above requirements with the bidder named below. The following deductibles apply to the
corresponding policy.
Policy Deductibles
Liability policies are ❑ Occurrence —]Claims Made
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Insurance Agency Signature
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APPLICANTS STATEMENT
I understand the insurance that will be mandatory if awarded the contract and will
comply in full with all the requirements.
Applicant Name and Title Signature
Company Name: E
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TT CH EN rS AND CERTIFICATIONS
(Enclose as Exhibit S)
1. The following supporting documents are attached:
a) ❑ Print out from Sunbiz.org "Detail by Entity" (Exhibit A)
b) ❑ Documentation from bank of confirmed project funds (Exhibit B)
c) ❑ If applicable: Insert or attach photograph of existing site (Exhibit C)
d) ❑ Proof of ownership; long term lease or service contract (Exhibit D)
(Include consent of ownership for use of property as described within this application)
e) ❑ If applicable: Enclose at least two (2) current real estate appraisals and one (1)
environmental assessment (Exhibit E)
f) ❑ If applicable: Enclose citations for local protective ordinances (Exhibit F)
g) ❑ If applicable: Enclose copies of all recorded easement and restrictive covenants
(Exhibit G)
h) ❑ If applicable: Enclose description of endangered/threatened species of flora or
fauna (Exhibit H)
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i) ❑ If applicable: Enclose ADA accessibility explanation (Exhibit 1)
j) ❑ If applicable: Enclose preliminary plans or architectural documents — 1 set
k) ❑ Proposed operational budget and marketing plan (Exhibit K)
1) ❑ Notarized Non-Collusion affidavit and verification (Exhibit L)
m) ❑ Signed Drug Free Workplace Form (Exhibit M)
n) ❑ Notarized Hold-Harmless/Indemnification form (Exhibit N)
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o) ❑ Notarized Ethics form (Exhibit O)
p) ❑ Notarized Public Crime Entity Statement (Exhibit P)
q) ❑ Applicant has printed and completed the W-9 Form included within this
application (Exhibit Q)
r) ❑ Applicant has printed and completed the Insurance Worksheet (pg. 27-31) with U
their Insurance Agent (only required if requesting $20,000 or more in funding)
(Exhibit R)
s) ❑ Notarized Attachments and Certifications form (Exhibit S)
t) ❑ I have read the Capital Project Funding Process and Importation Information
provided on pg. 2-9 of this application (not necessary to print and include these pages
with your submission)
President of Organization/Mayor's Name Typed President's/Mayor's Signature
Subscribed and sworn to (or affirmed) before me, by means of ❑ physical presence or ❑ online
notarization,on (date)by
name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
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