Item Q4 Q.4
County f � .�� ��� BOARD OF COUNTY COMMISSIONERS
Mayor David Rice,District 4
The Florida Keys Mayor Pro Tem Craig Cates,District 1
Y F' Michelle Coldiron,District 2
Vacant,District 3
--' Holly Merrill Raschein,District 5
County Commission Meeting
February 16, 2022
Agenda Item Number: Q.4
Agenda Item Summary #10158
BULK ITEM: Yes DEPARTMENT: Risk Management
TIME APPROXIMATE: STAFF CONTACT: Brian Bradley (305) 295-3177
N/A
AGENDA ITEM WORDING: Approval to advertise a request for proposals (RFP) for Airport
Owners and Operators Liability insurance policy.
ITEM BACKGROUND: The County wishes to receive proposals for Airport Owners and
Operators Liability Insurance for the operations of its airport facilities located in Key West,
Florida and Marathon, Florida. While the County's current program is provided on a first dollar
basis and does not contain a deductible or retention and the County prefers to continue to
purchase its coverage without deductibles or retentions, consideration will be given to programs
that contain such provisions. The County wishes to maintain the airport liability program
separate from its other non-airport liability exposures. The County will consider modified
proposals to the extent that they provide adequate coverage and meet the overall program
objectives.
These policies were renewed three times since the last procurement. Pursuant to County
purchasing policy chapter 10 this solicitation must be issued to obtain new quotes.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval to advertise.
DOCUMENTATION:
2022 Airport Liability RFP 1.12.2022
Monroe County BOCC (N00985004) Loss Runx
FINANCIAL IMPACT:
Effective Date (of policy): July 27, 2022
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Q.4
Expiration Date: July 27, 2023 (+ option to renew for three 1-year terms)
Total Dollar Value of Contract: N/A
Total Cost to County: Advertising, TBD
Current Year Portion: Advertising
Budgeted: Yes
Source of Funds: Internal Service Fund/Primarily Ad Valorem
CPI: N/A
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: No If yes, amount:
Grant: N/A
County Match: N/A
Insurance Required: N/A
Additional Details:
REVIEWED BY:
Brian Bradley Completed 01/17/2022 4:47 PM
Cynthia Hall Completed 01/17/2022 6:36 PM
Bob Shillinger Completed 01/18/2022 1:55 PM
Bob Shillinger Completed 01/18/2022 1:55 PM
Cynthia Hall Skipped 01/17/2022 4:45 PM
Purchasing Completed 01/18/2022 2:21 PM
Budget and Finance Completed 01/31/2022 10:22 AM
Liz Yongue Completed 02/01/2022 11:24 AM
Board of County Commissioners Pending 02/16/2022 9:00 AM
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MONROE COUNTY
REQUEST FOR PROPOSALS
FOR
AIRPORT OWNERS AND OPERATORS LIABILITY INSURANCE
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BOARD OF COUNTY COMMISSIONERS
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Mayor, Michelle Coldiron, District 2
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Mayor Pro Tern, David Rice, District 4
Vacant, District 3
Craig Cates, District 1
Holly Merrill Raschein, District 5
COUNTY ADMINISTRATOR
Roman Gastesi
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CLERK OF THE CIRCUIT COURT CD
Kevin Madok, CPA RISK MANAGEMENT
Bid Opening Date: May 3, 2022
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NOTICE OF REQUEST FOR COMPETITIVE SOLICITATIONS
NOTICE IS HEREBY GIVEN that on May 3, 2022, at 3:00 P.M., the Monroe County Purchasing Office will receive
and open sealed responses for the following:
REQUEST FOR PROPOSALS
FOR
AIRPORT OWNERS AND OPERATORS LIABILITY INSURANCE J
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Pursuant to F.S. § 50.0211(3)(a), all published competitive solicitation notices can be viewed at: www.floridapublicnotices.com, a
searchable Statewide repository for all published legal notices. Requirements for submission and the selection criteria may be requested R
from DemandStar by Onvia at www.demandstar.com OR www.monroecountybids.com. The Public Record is available upon
request.
In response to Covid-19,the Monroe County Purchasing Department has implemented a new electronic process for reviewing
and opening sealed bids. Monroe County is committed to continuing to receive and 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. e(
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The Monroe County Purchasing Department hereby directs that bids be submitted via email to: OMB-BIDSLa monroecountyCL
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fl.gov,no later than 3:00 P.M.on May 3,2022. Please submit your confidential financial information in a SEPARATE EMAIL
from your bid and required documents. Your subject line on both emails must read as follows: cu
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Airport Owners and Operators Liability Insurance 5/3/2022
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 not rejected due to the file size. Should
your bid documents exceed 25MB or otherwise be rejected or undeliverable to OMB-BIDS(c�monroecounty-fl.gov, 0
in advance of the bid opening,please email: o -purc asin (c� onroecounty-f1. ov 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 CN
in your bid being rejected.
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The bid opening for this solicitation will be held virtually,via the internet, at 3:00 P.M., on 5/3/2022. You may call
in by phone or internet using the following: LL
Join Zoom Meeting
https:// cbocc.zoo .gLi/4509326156
Meeting ID: 4509326156
One tap mobile:
+16465189805„4509326156#US (New York) _
+16699006833994509326156#US (San Jose)
Dial by your location:
+1 646 518 9805 US (New York) N
+1 669 900 6833 US (San Jose)
Publication Dates: E
Key West Citizen:Sat.,
Keys Weekly: Thur.,
News Barometer: Fri.,
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TABLE OF CONTENTS
SECTION ONE - INSTRUCTIONS TO PROPOSERS
SECTION TWO — GENERAL INFORMATION
SECTION THREE — REQUESTED COVERAGES
SECTION FOUR — PROPOSAL FORMS
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A. GENERAL INFORMATION
B. PROPOSAL SPECIFICS
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SECTION FIVE — UNDERWRITING INFORMATION
SECTION SIX — REQUIRED COUNTY FORMS
ATTACHMENTS — CURRENTLY VALUED LOSS RUNS (SEPARATE DOCUMENT)
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SECTION ONE: INSTRUCTIONS TO PROPOSERS
Objective of the Request for Proposals (RFP).
Monroe County is seeking insurance agent(s) duly licensed in the State of Florida to provide the County
with insurance coverages in accordance with the specifications outlined in this Request for Proposals.
The County anticipates that the contract will be awarded for an effective date of July 27, 2022. The
initial policy term will be for 1 year and the County may elect to renew for up to three (3) additional
consecutive 1-year terms, dependent upon acceptability of cost, coverage, service, provider
stability and market conditions, with Board of County Commission review.
The County is requesting proposals for the following coverages:
➢ Airport Owners and Operators Liability
Proposers are required to submit their proposals on the proposal forms included within this
RFP.
Background Information
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Monroe County is a non-charter county and a political subdivision of the State of Florida. The County
population is approximately 82,847 as of the last census. The Board of County Commissioners,
constituted as the governing body, has all the powers of a body corporate, including the powers to
contract; to sue and be sued; to acquire, purchase, hold, lease and convey real estate and personal
property; to borrow money and to generally exercise the powers of a public authority organized and
existing for the purpose of providing community services to citizens within its territorial boundaries. In
order to carry out this function, the County is empowered to levy taxes to pay the cost of operations.
Monroe County is the southernmost county in the United States. It is comprised of the Florida Keys
and a portion of the Florida Everglades. The Florida Keys are an archipelago of islands stretching W
from Key West, only 90 miles from Cuba, up to the mainland. In addition to the unincorporated county,
there are five municipalities in the Florida Keys: Key West, Marathon, Key Colony Beach, Layton, and N
Islamorada. Further information about the demographics of the County can be found here-
http://www.monroecounty-fl.gov/index.aspx?NID=27.
Approximately one-third of the population is situated in the City of Key West, which is the county seat; LL
however, the County offers services throughout the Keys, and has government buildings throughout
the Lower Keys (primarily Big Pine Key), Middle Keys (primarily Marathon), and Upper Keys (primarily
Plantation Key and Key Largo) in addition to Key West, with employees stationed in all locations.
The Board of County Commissioners, constituted as the governing body, has all the powers of a body
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corporate, including the powers to contract; to sue and be sued; to acquire, purchase, hold, lease and _
convey real estate and personal property; to borrow money, and to generally exercise the powers of a
public authority organized and existing for the purpose of providing community services to citizens
within its territorial boundaries. In order to carry out is function, the County is empowered to levy N
taxes to pay the cost of operations.
The County has a full time Risk Administrator who oversees a Self-Insured Liability Fund and the
property and casualty insurance program.
The County owns and operates two airports located in Key West and Marathon. The Key
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West International Airport has scheduled commercial flights while the Florida Keys/Marathon
International Airport only serves private and chartered flights. All of the servicing of aircraft (including
fueling) is performed by Fixed Base Operators (FBOs) through separate contracts with the County
being named as an "Additional Insured" on their General Liability insurance. In addition, the FBOs
are required to indemnify and hold the County harmless for all claims arising out of their operations.
To support the indemnification and hold harmless provision of the contracts, the FBOs are also
required to maintain the following types of insurance with the noted limits.
Coverage Type Minimum Required Limits
Workers' Compensation Statutory
General Liability Ranging from $1 million to $5 million
depending on the services provided
Hanger Keepers Legal Liability Ranging from $1 million to $5 million
depending on the services provided
Automobile Liability Ranging from $1 million to $5 million
depending on the services provided
Pollution/Environmental Liability (if fueling
services or maintenance of fuel tanks is Consistent with Florida Statute § 376.3072
provided)
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SECTION TWO -GENERAL INFORMATION
MONROE COUNTY, FLORIDA
REQUEST FOR PROPOSALS
AIRPORT OWNERS AND OPERATORS LIABILITY _
INSURANCE
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GENERAL INFORMATION AND COVERAGES REQUESTED
Monroe County, Florida wishes to receive proposals for Airport Owners and Operators Liability
Insurance for the operations of its airport facilities located in Key West, Florida and Marathon, Florida.
While the County's current program is provided on a first dollar basis and does not contain a deductible
or retention and the County prefers to continue to purchase its coverage without deductibles or
retentions, consideration will be given to programs that contain such provisions.
The County wishes to maintain the airport liability program separate from its other non-airport liability
exposures, which are self-insured and are not included within this RFP.
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The County will consider modified proposals to the extent that they provide adequate coverage and
meet the overall program objectives.
COVERAGES REQUESTED
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At a minimum, the following coverages are desired by the County:
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➢ Premises and Operations Liability
➢ Products/Completed Operations
➢ Personal Injury N
➢ Hangar Keepers Legal Liability
➢ Non-Owned Aircraft Liability
➢ Fire Damage Liability
➢ Medical Expenses
➢ Contingent Liquor Liability
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CURRENT PROGRAM
Owners and Operators Liability
The County's Owners and Operators Liability Insurance is currently provided by Ace Property and
Casualty Insurance Company. The following limits are currently in effect:
✓ Premises and Operations Liability $100 million
✓ Products/Completed Operations $100 million
✓ Personal Injury $50 million
✓ Hangar Keepers Legal Liability $100 million
✓ Non-Owned Aircraft Liability $100 million
✓ Fire Damage Liability $250,000
✓ Medical Expenses $25,000
A restaurant that serves alcoholic beverages is located in the Key West International Airport. The liquor
license for the restaurant is owned by the County. The operations of the restaurant have been
subcontracted to a third party vendor who is required to maintain appropriate Liquor Liability Insurance.
The County's policy has been endorsed to provide Liquor Liability Insurance in excess of the coverages .
provided by the restaurant's operator. The limits of the restaurant owner's Liquor Liability policy are
$1,000,000. The County views this extension as being critical and proposals that do not provide such
coverage will not be given full consideration.
The current program contains no deductible.
The County's current annual premium for its Airport Owners and Operators Liability policy is $52,240.
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EFFECTIVE DATE OF COVERAGE
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The effective date of the coverage will be July 27, 2022 to July 27, 2023. The County anticipates that
coverages will be placed with the successful proposer for a minimum of one (1) year with the possibility
of extensions for an additional three (3) years. However, the County reserves the right to terminate theCD
coverage at each anniversary date without penalty. This purchase is subject to annual appropriation
by the Board of County Commissioners.
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RFP SCHEDULE
The following schedule will apply to this RFP. To allow ample time to evaluate the proposals received
and to obtain County Commission's approval, no extensions of deadlines will be granted.
Date Activity
3/1/22 Distribute RFP
4/1/22 Deadline for Requests for Additional Information
5/3/22 Proposal Return Date and Bid Opening
6/15/22 Presentation to Board of County Commissioners
7/27/22 Effective Date
ORDERLY MARKET APPROACH
No market assignments will be conducted for this RFP.
SUPPLEMENTAL INFORMATION REQUESTS AND DISTRIBUTION OF RESPONSES
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Every attempt has been made to furnish complete and accurate information to the best of Monroe
County's knowledge. Proposers are encouraged to determine, at their own expense, their own
information for underwriting purposes including any inspections and loss control surveys. 0.
The Proposer is solely responsible for all costs of preparing and submitting their response, regardless
of whether the County purchases insurance through this RFP process or not. The proposer is It
responsible for knowledge of the content of all parts of this RFP package, including the statement of
the coverage expected to be provided by the successful proposer.
If additional information is required, please contact:
Mr. Brian Bradley
Risk Manager
Monroe County
1111 12t" St. Suite 408
Key West, Florida 33040 CL
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Re: Monroe County Airport Owners and Operators Liability Insurance
Email: Brad ley-Brian@Monroecounty-FI.Gov
All requests for additional underwriting or rating information must be in writing and received by 2.00
Pm April 1, 2022 The County's responses will be issued in writing at one time and distributed via an It
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addendum on DemandStar. No further requests for additional information will be considered. Oral _
requests will not be entertained or answered.
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While appropriate applications will be completed for the successful proposer, requests to complete CN
individual applications during this RFP process will not be honored.
RATING DATA
Included as an attachment is an underwriting rating sheet for both the Key West and Florida
Keys/Marathon International Airports.
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Additional information regarding the County, to include current and past budgets, is available on the
County's web site at www.monroecounty-fl.gov. Interested proposers are encouraged to visit this site.
A number of links have been established that will provide an overview of the County's operations.
REQUESTED PROPOSAL DATE
All proposals are required to be received no later than 3.00 pm, May 3, 2022. A formal opening of
sealed proposals will be held at that time. Interested proposers are welcome to attend. Details
regarding the proposals will be released only after all proposals have been reviewed by the County's
Risk Management Consultant.
SUBMISSION OF PROPOSALS
NUMBER OF COPIES OF PROPOSALS REQUIRED; BID OPENING DATE; DELIVERY LOCATION
Proposals must be submitted electronically in accordance with the instructions in Notice of
Request for Competitive Solicitations. Proposals received after the deadline will not be
considered
MODIFICATION OF RESPONSES
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Written modification will be accepted from Proposers if submitted in accordance with the instructions
in Notice of Request for Competitive Solicitations and received prior to Proposal due date and time.
Any modifications submitted must have the word "Modification" in the subject line, to read as follows:
MODIFICATION--Airport Owners and Operators Liability Insurance 7/27/20221
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PROPOSAL RETURN ADDRESS
Proposals must be submitted in accordance with the instructions in the Notice of Request for
Competitive Solicitations.
VALID DATE OF PROPOSALS
Proposals must remain valid until July 27, 2022 to provide additional time for clarification in the event
that an extension of the current program is undertaken.
EVALUATION CRITERIA
Award shall be made to the responsible proposer whose proposal is determined to be the most
advantageous to the County, taking into consideration the evaluation criteria set forth below:
Evaluation Factor Maximum Available Points
Terms and conditions of coverages being 35
ro osed
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Financial stability of insurers being 15
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ro osed
Experience of proposing agent with
governmental entities with emphasis 15
placed on experience with airport
operations
Price 35
Total Available Points 100
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In accordance with County Ordinance 023-2009, preference is given to local vendors. A maximum of N
5 bonus points will be awarded to firms that have a valid Monroe County Tax Collector's receipt
and/or have a physical business address located in Monroe County or intend to subcontract at least
50% of the services to such a firm. A maximum of 5 points will be added to the above "Total
Available Points" bringing the total possible points to 105.
RIGHT TO REJECT PROPOSALS
The Board reserves the right to reject any or all proposals, to waive irregularities and informalities in It
any or all proposals, and to re-advertise for proposals.
The Board also reserves the right to separately accept or reject any item and/or items of a proposal cN
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and to award and/or negotiate a contract that is viewed as being in the best interest of the County.
ADHERENCE TO INFORMATION AND PROPOSAL
Monroe County will assume that all information submitted by proposers is accurate and complete.
Information presented in this Request for Proposal and all statements contained in the written proposals
received are intended to be relied upon by Monroe County, Florida. All coverages must be issued as
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proposed unless individual changes are authorized by the County. Any changes authorized by the
County will not alter any other items contained in this Request for Proposal. Policies not issued in
conformance with the submitted proposal will be considered not in compliance and must be corrected.
AGENT/BROKER QUALIFICATIONS
All proposing Agents or Brokers must be currently licensed in Florida for the appropriate type of
coverage proposed. Evidence of current license status may be required.
INSURER QUALIFICATIONS
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All proposing insurers must be currently authorized to transact business in Florida in accordance with
the Florida Department of Insurance rules and regulations and be acceptable to the County. The
County prefers to have all of its insurers maintain an A.M. Best rating of A- or better. Proposals from
insurers that do not currently have a Best rating of A- or better must include the insurers most recent
audited financial statements.
AUTHORITY OF PROPOSERS
Proposals should be signed by an authorized representative of the insurer underwriting the program.
If the submitting Agent/Broker does not have the authority to sign the Proposal, it should be signed by
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an officer or other authorized representative of the insurer. Proposals submitted without binding
authority will not be given full consideration.
SAMPLE FORMS OR POLICIES
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Sample forms/endorsements and other coverage information are considered an integral part of
proposals made. If Insurance Services Office (ISO) forms are to be used, reference can be made to
the form numbers and edition dates. If manuscript or non-ISO forms are proposed, specimen forms
must be attached to the proposal for review. W
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RATE CHANGE/POLICY MODIFICATION
Ninety (90) days written notice is required from the insurer prior to any increase in rates or modification
resulting in restriction of existing policy terms or provisions required by the insurer.
TERMINATION/NON-RENEWAL NOTICE
Ninety (90) days written notice is required from the insurer for termination, non-renewal or restriction
of limits or coverage except for non-payment of premium.
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NAMED INSURED
The Named Insured wording on the policy is to be as follows: E
Monroe County Board of County Commissioners
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The following must be included in the definition of an insured:
All elected or appointed officials and officers including employees, volunteers, licensees, permittees
and any individual or organization required by statute, agreement, contract or lease or other
circumstances including all existing or newly created boards, committees and their members.
NOTICE OF CLAIM
Proposers are requested to modify policy language relating to notification to the insurer following a loss
to provide that:
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Notice of loss shall be given to the insurers as soon as practicable following receipt of notice of the
claim by the individual responsible for Monroe County's Insurance and Risk Management affairs.
CLAIM REPORTING LOCATIONS
Please provide a list of all insurer claim reporting offices, their addresses, telephone numbers, and
contact persons who will adjust claims for the County.
CLAIM REPORTS
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Claim reports should be furnished quarterly. Reports should be completed in plain English and received
by the County within twenty (20) days following the end of each quarter. The reports should include a
detailed description of individual claims and the amount paid for each claim and any open reserves that
are assigned. Individual allocations by operating location may be necessary. The total claims (both
number and amount) should be included for each coverage.
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Claim reports must be continued to be furnished without charge until the last open claim is closed, even
if coverage has been terminated.
WAIVER OF SUBROGATION N
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The standard policy wording involving subrogation should be modified to remove subrogation between cN
the County and entities required to be removed by agreement, contract or lease. T-
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LOSS CONTROL SERVICES
The County wishes to utilize the loss control services of the successful insurer(s). Proposals should
include a statement of the intended loss control activities and the frequency of such services.
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PAYMENT TERMS
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The County prefers the ability to pay premiums on a quarterly basis. Please indicate any terms N
available, particularly down payments, finance charges, service fees or others.
The provider shall submit to the County an invoice with supporting documentation acceptable to the
Clerk. Acceptability to the Clerk is based on generally accepted accounting principles and such laws,
rules and regulation as may govern the Clerk's disbursal of funds.
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Upon receipt of the provider's invoice in the proper form as stipulated above and upon acceptance by
the Clerk, Monroe County will make payment in accordance with the Florida Local Government Prompt
Payment Act, Section 218.70, Florida Statutes which indicates that the County has 45 days to pay after
the receipt of a proper invoice.
RESPONSIBILITY FOR RESPONSE
The Proposer is solely responsible for all costs of preparing and submitting the response, regardless
of whether a contract award is made by the County.
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USE OF PROPOSAL FORMS
Proposers must submit their proposal on the forms included in this RFP. Additional information
regarding the insurer, coverage, loss control services, or other modifications or information may be
submitted in addition to the Proposal Forms. All items must be completed. Responses such as "See
Policy Form" will not be acceptable.
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In addition, if an addendum to this request is issued, the Proposer must acknowledge receipt of such E
addendum by completing and returning with their proposals the acknowledgment forms that will
accompany the addendum.
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COMPLETION OF REQUIRED FORMS
Proposer shall complete and execute the forms specified below and included as attachments to this
RFP, as well as providing copies of all business licenses and receipts for business tax and shall
include them within their proposals
Required Forms
➢ Acknowledgement of Addenda & Forms Checklist
➢ Proposal Forms N
➢ Lobbying and Conflict of Interest Ethics Clause
➢ Non-Collusion Affidavit
➢ Drug Free Workplace Form
➢ Public Entity Crime Form
➢ Any Proposer claiming a local preference as defined in Monroe County Ordinance 023-2009
must complete the Local Preference Form and attach it to their Proposal.
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DISQUALIFICATION OF PROPOSER
A. NON-COLLUSION AFFIDAVIT: Any person submitting a proposal in response to this E
invitation must execute the enclosed NON-COLLUSION AFFIDAVIT. If it is discovered that collusion
exists among the Proposers, the proposals of all participants in such collusion shall be rejected, and
no participants in such collusion will be considered in future proposals for the same work.
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B. PUBLIC ENTITY CRIME: A person or affiliate who has been placed on the convicted vendor
list following a conviction for a 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 work, may not submit Proposals on leases
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 F.S., for CATEGORY TWO for a period of 36 months from the date of
being placed on the convicted vendor list. Category Two: $25,000.00
C. DRUG-FREE WORKPLACE FORM: Any person submitting a bid or proposal in response to
this invitation must execute the enclosed DRUG-FREE WORKPLACE FORM and submit it with
his/her proposal. Failure to complete this form in every detail and submit it with the bid or proposal
may result in immediate disqualification of the bid or proposal.
D. LOBBYING AND CONFLICT OF INTEREST ETHICS CLAUSE: Any person submitting a bid E
or proposal in response to this invitation must execute the enclosed LOBBYING AND CONFLICT OF
INTEREST CLAUSE and submit it with his/her bid or proposal. Failure to complete this form in every
detail and submit it with the bid or proposal may result in immediate disqualification of the bid or
proposal. B
CONFLICT OF INTEREST
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The officers and employees of Monroe County are required to comply with the standards of conduct
for public officers and employees as delineated in Section 112.313, Florida Statutes (Florida's Code
of Ethics), regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's
agency; unauthorized compensation; misuse of public position, conflicting employment or contractual
relationship; and disclosure or use of certain information.
The Proposer warrants that, in respect to itself, it has neither employed nor retained any company or
person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and W
that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than cN
a bona fide employee working solely for it, any fee, commission, percentage, gift, or other
consideration contingent upon or resulting from the award or making of this Agreement. For the
breach or violation of the provision, the Proposer agrees that the County shall have the right to
terminate this Agreement without liability and, at its discretion, to offset from monies owed, or
otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration.
F.S. 448.095 (E-VERIFY)
Beginning with 1/l/2021, every public employer, contractor, and subcontractor doing business with
the State of Florida and local governments are required to register with and use the E-Verify system
to verify the work authorization status of all employees hired on or after that date. If the vendor who N
issues a proposal is selected to issue a policy, by issuing the policy, the vendor warrants that has
registered with and is using the federal E-Verify system. Any knowing violation of this provision will
result in immediate termination of any contract between the parties.
PROPOSED PRICING
All proposed pricing must include all taxes, fees and assessments. Monroe County is not subject to
any sales or use tax.
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NON DISCRIMINATION
The County will not do business with any entity that discriminates. By submitting this proposal, and by
issuing a policy (if applicable), the vendors warrant that there will be no discrimination against any
person, and it is expressly understood that upon a determination by a court of competent jurisdiction
that discrimination has occurred, this Agreement automatically terminates without any further action on
the part of any party, effective the date of the court order. County and vendors agree to comply with
all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination.
These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88-352) which
prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the Education
Amendment of 1972, as amended (20 USC ss. 1681- 1683, and 1685-1686), which prohibits
discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20
USC s. 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act
of 1975, as amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5)
The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of .
1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of
alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.),
as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans
with Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to time, relating to
nondiscrimination on the basis of disability; 10) Any other nondiscrimination provisions in any Federal
or state statutes which may apply to Monroe County and vendors with regards to the subject matter of,
this Agreement.
0
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SECTION THREE — COVERAGES REQUESTED
MONROE COUNTY, FLORIDA
REQUEST FOR PROPOSALS _
FOR
AIRPORT OWNERS AND OPERATORS LIABILITY
INSURANCE
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FORMS
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Coverage is requested on an Occurrence Basis to pay for liability arising out of all operations of the
County-owned airports.
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It is desired that contractual coverage be extended to all County contracts which apply to airport
operations. The County has a Risk Management Polices and Procedure Manual to which it strictly
adheres. Coverage should include all necessary and required agreements between the County and
Federal Aviation Authority, Fixed Base Operators, and others and should include:
➢ Premises and Operations
➢ Products Liability
➢ Completed Operations
➢ Blanket Contractual Liability
➢ Personal Injury Liability (employee and contractual exclusions removed)
➢ Premises Medical Payments
➢ Contingent Hangar Keepers Liability W
➢ Contingent Liquor Liability
N
N
Currently all Hangar Keepers Liability operations are subcontracted with the Fixed Base Operator
required to maintain appropriate insurance with minimum limits of liability of $1 million. The County
believes it has limited, if any, exposure in this area and is seeking protection only if the subcontractor's
insurance is deficient. The Key West airport contains a restaurant/lounge (the Conch Flyer) and has
subcontracted its operations to a third party. The County maintains the liquor license for the lounge
and requires the operator to purchase the liquor liability insurance and name the County as an insured.
The Marathon airport also contains a restaurant/lounge with the County maintaining the liquor license. 00.
The Marathon restaurant/lounge is not currently active.
N
N
N
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DESIRED LIMITS AND DEDUCTIBLES
Proposals are requested for the following limits and deductibles. If a separate Excess or Umbrella
policy is utilized to achieve the desired limits, the terms and conditions of the policy must be no more
restrictive that the underlying coverage.
DESIRED LIMITS
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0
Coverage Desired Limits
Premises and Operations Liability $100 Million
Products and Completed Operations $100 Million
Personal Injury $50 Million
Hangar keepers Legal Liability $100 Million
Non Owned Aircraft Liability $100 Million
Fire Damage Liability $250,000
Medical Expenses $25,000
Alternative limits will be considered based on the extent of protection being provided and the overall
objectives of the County CL
DESIRED DEDUCTIBLES
None
0
Alternative deductibles will be considered based on the extent of protection being provided and the
overall objectives of the County
RATING DATA --
cv
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Number of Commissioners 5
Total number of Airport
Employees 23 (19 EYW and 4 MTH) T-
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Total number of Volunteers 0
$18,212,594 plus an additional $5.1 million capital construction
Current Fiscal Year Budget budget funded by Passenger Facilities Charges (EYW);
$275947765 (MTH)
Total County Population 827847
Please refer to the Underwriting Data that is included as an attachment regarding further information
regarding Monroe County's Airport operations.
N
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Loss EXPERIENCE
Currently valued loss runs are included as an attachment to this RFP.
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SECTION FOUR — PROPOSAL FORMS
MONROE COUNTY, FLORIDA
REQUEST FOR PROPOSALS _
FOR
AIRPORT OWNERS AND OPERATORS LIABILITY
INSURANCE
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PROPOSAL FORM
PART I --GENERAL INFORMATION
Use of the proposal forms will enable a faster more complete analysis of the Proposal(s) submitted.
Please complete this general proposal form in addition to a separate proposal for each coverage
proposed. Additional information can be attached to the forms.
r-
0
Proposers must provide clear and concise responses. Responses such as "See Policy Form, I=B
or "Per Policy Terms" may not be given full consideration.
0
0.
Agent/Agency submitting proposal:
Address:
0
Telephone & Fax Number:
2
N
Does agent have binding authority? Yes No
N
If not, state procedure to bind.
Is Agent/Broker licensed in the State of Florida
for the type of coverage proposed? Yes No
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Are coverages different from requested program? Yes No
N
N
If yes, state differences
Effective date(s) of coverage(s)?
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Describe payment plan, including down payment terms,
interest or service charges:
Proposal valid until (date)?
Rate Change/Policy Modification wording included
as requested? Yes No
Termination Notice wording included as requested? Yes No
c
Named Insured wording included as requested? Yes No
c
If not, include actual wording to be used.
0
Does the Named Insured include the County's
officials, employees and leased employees? Yes No
If not, specify exceptions
N
N
N
N
Is the requested claim reporting wording
being offered? Yes No
Claim reports to be provided as requested? Yes No
If not, state details.
c
Provide details on specialized loss control services
to be provided (attach additional sheet if necessary):
N
N
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Sample forms and policies included? Yes No
Information required by Monroe County Code section 2-347:
Has the person, principals, entity, or any entity previously owned,
operated or directed by any of its officers, major shareholders or Yes No
directors, ever failed to complete work or provide the goods for
which it has contracted? If yes, provide details.
Are there any judgments, claims, arbitration proceeding or suits
pending or outstanding against the person, principal of the entity,
or entity, or any entity previously owned, operated or directed by Yes No
any of its officers, directors, or general partners? If yes, provide
details.
Has the person, principal of the entity, entity, or any entity
previously owned, operated or directed by any of its officers,
major shareholders or directors, within the last five years, been a
party to any lawsuit, arbitration, or mediation with regard to a Yes No
contract for services, goods or construction services similar to 0.
those requested in the specifications with private or public
entities? If yes, provide details.
Has the person, principal of the entity, or any entity previously
owned, operated or directed by any of its officers, owners,
partners, major shareholders or directors, ever initiated litigation
against the county or been sued by the county in connection with Yes No
a contract to provide services, goods or construction services? If
yes, provide details.
Has the person, principal of the entity, or any entity previously
owned, operated or directed by any of its officers, owners,
partners, major shareholders or directors, ever initiated litigation Yes No
against the county or been sued by the county in connection with
a contract to provide services, goods or construction services? If
yes, provide details.
Whether, within the last five years, the owner, an officer, general
partner, principal, controlling shareholder or major creditor of the
person or entity was an officer, director, general partner,
principal, controlling shareholder or major creditor of any other Yes No
entity that failed to perform services or furnish goods similar to
those sought in the request for competitive solicitation.
The Proposer stated below is the authorized agent of the company or companies proposed, and is
authorized to bind coverages upon acceptance by Monroe County, Florida. Deviations from the
requested program have been stated. Coverage will be issued as proposed. The insurer agrees to
deliver a policy(ies) to the insured within forty-five (45) days after inception of coverages. It is agreed
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that policy premiums will be payable upon receipt by insured of complete policy conforming with the
accepted proposal.
Signature of Authorized Representative Date
0
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0
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N
N
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Q.4.a
MONROE COUNTY, FLORIDA
REQUEST FOR PROPOSALS
FOR
AIRPORT OWNERS AND OPERATORS LIABILITY INSURANCE
PROPOSAL FORM
PART II—CARRIER INFORMATION
Proposers must provide clear and concise responses. Responses such as "See Policy Form"
or "Per Policy Terms" may not be given full consideration.
0
Proposing Company
Underwriting office used
Address
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Telephone number
Current A.M. Best Co. rating?
Is policy form and all endorsements included Yes No
for review?
Are the following coverages included?
Premises and Operations Yes No
N
Independent Contractors Yes No
Products/Completed Operations Yes No
Medical Expense payments Yes No
Blanket Contractual Yes No
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(all related contracts included?) Yes No
N
N
(any reporting requirements?) Yes No
Personal Injury Liability Yes No E
(employees and contractual exclusions
removed) Yes No
Contingent Hangar Keepers Liability Yes No
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Contingent Liquor Liability Yes No
Are all Coverages provided on an Occurrence
Basis? Yes No
If not, please provide details
Are defense costs included in the aggregate limit of
liability? Yes No
Is requested Named Insured wording used? Yes No
If not, stated wording to be used
Will the policy contain any COVID/Communicable
Disease Exclusions/Limitations? Yes No
If so, please provide full details
0.
Please provide a list of all insurer claim reporting offices, their addresses, telephone numbers, and
0
contact persons who will adjust claims for the County:
N
N
N
N
LIMITS, DEDUCTIBLES AND PREMIUMS
LIMITS DEDUCTIBLE PROPOSED
PREMIUM
Requested Program $100,000,000 None
Optional Proposal
Optional Proposal
U
M
The Proposer stated below is the authorized agent of the company or companies proposed, and is
authorized to bind coverages upon acceptance by Monroe County. Deviations from the requested
program have been stated. Coverage will be issued as proposed. The insurer agrees to deliver a
policy(ies) to the insured within forty-five (45) days after inception of coverages. It is agreed that policy
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premiums will be payable upon receipt by insured of complete policy conforming with the accepted
proposal.
Signature of Authorized Representative Date
0
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0
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SECTION FIVE— UNDERWRITING DATA
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MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
AIRPORT LIABILITY UNDERWRITING INFORMATION
Florida Keys/Marathon Key West International Airport
International Airport
9400 Overseas Hwy 3491 South Roosevelt Blvd.
Physical Address Marathon, FI. 33050 Key West, FI. 33040
Interest Owned Owned
Occupancy Entire Entire
Airport Manager Michael Legere Richard Strickland
Mr. Legere has over 31
years of Aviation Mr. Strickland has over 24 years of
Manager's Experience experience and has Airport Management experience and has
served as Marathon's served as the Director of Airports since
Manager for the past 2 2018.
ears.
FAA Classification Part 139 — Non Hub Part 139 Approach Category C
Design Group III
Is Airport Completely Yes Yes
Fenced
Heading — 7/25 Heading — 9/27
Length — 5008' Length — 4801' (5,075' TODA, RWY 9)
Runways Width — 100' Width — 100'
Surface —Asphalt Surface —Asphalt (Crowned and
Crowned and Grooved Grooved
Fueling All fueling operations are All fueling operations are the
the responsibility of FBO responsibility of FBO
All fueling operations are All fueling operations are the
Fuel Storage the responsibility of FBO responsibility of FBO0.
County does not perform County does not perform any aircraft
any aircraft maintenance;
Aircraft Maintenance any maintenance is done maintenance; any maintenance is done
b the FBO by the FBO
Rental/Lease of Hangars Yes Yes
or Tie Downs
Aircraft Hangaring Through FBOs Through FBOs
Aircraft Operations None None
Control Tower Operations No Control Tower Operations — Leased to FAA.
Subcontracted by FAA to Private Firm
Operations of Unicom Through FBO None
Operations of Navaids,
PAPI, Windshear PAPI, Rotating Beacon Navaids, PAPI, Rotating Beacon, and
Detectors or Aviation and Windsock Windsock
Communication Equip
Ownership/Operations of The County has installed an Engineered
runway anti-skid or other None Material Arresting System on the west
similar items and east ends of KWIA's runway.
Rental/Lease of land or Yes Yes
buildings
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Marathon Airport Key West Airport
Rental of Premises for Yes Yes
Retail Operations
Other Aviation Activities None None
Animal Control, Sewer
Treatment Facility and
Public Works Garage The County owns and operates a Public
(owned and operated by Works Garage that is located on Airport
the County). Also the Property (One remaining PW office will be
Non-Aviation Activities County is in the process of relocated off Airport property in Feb.
constructing a new 2022. The County also owns a structure
Emergency Operations that a third party vendor operates as a
Center, to be located on public museum (East Martello Tower) that
the southwest corner of is located on Airport Property.
the Airport property-
Who is responsible for Airport operations and
inspection/maintenance of maintenance staff inspect. Airport Firefighters inspect.
ramps, taxi ways and Repairs are performed by Repairs are performed by subcontractors
runways subcontractors
Largest type of airplane G-6 A319
using airport facility on a (Corporate) (American, Delta and Allegiant Airlines)
regular basis
City of Marathon Fire
Rescue. 13 Full time Monroe County Fire Rescue
Who provides fire/crash Monroe County Fire personnel. City of Key West Fire Rescue
operations Rescue provides provides additional support through
additional support through mutual aid agreement.
mutual aid agreement.
Describe Police Security County Sheriff County Sheriff Who provides Misc. Provided by sub-
Provided by sub-contractor
Services such as janitorial contractor
Airport Manager, Fire Chief, Security
Are vehicles used off Vehicles are not normally Chief and rotating Airport Maintenance
premises used off premises. staff take vehicles home as they are on
call.
Any parking services Free Parking Paid parking, with operations
provided subcontracted to Republic Parking Inc.
Airport maintains FAA
Describe emergency and Airport Certification Airport maintains FAA Airport Certification B
crash plans in place manual and FAA Airport manual and FAA Airport Security Manual
Emergency Plan
Describe fuel tank None — all operations None — all operations performed by FBOs
operations performed by FBOs
Elevators One Five
Escalators None One
Moving Sidewalks None None
Electric Doors Two sets Six sets
Passenger Trams None None
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Insurance requirements Varies depending on
for vendors and services provided. Varies depending on services provided.
contractors Ranges from $300,000 to Ranges from $300,000 to $50 million
$50 million
0
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Number of 2021 2022 estimated 2023 estimated
Commercial
Airline
Passengers
Key West 1,400,000 1,500,000 1,600,000
Marathon 0 0 0
0
Number of 2021 2022 estimated 2023 estimated
Landings
Key West 55,500 57,500 60,000
Marathon 41,056 45,500 50,550
Both Key West and Marathon have on-site fire support. In Key West, the City provides backup from a
station located approximately 1 mile from the airport.
0
There are no military aircraft that land at either airport on a regular basis. Occasionally military planes
will use the airport facilities in the case of emergency.
0.
There have been no air meets, contests or exhibitions conducted at either airport within the past five
(5) years. None are scheduled for the foreseeable future.
All fueling is performed by FBOs and the County requires the FBOs to maintain appropriate insurance.
All fueling is performed by truck. There are two above ground fuel storage tanks that are controlled
and maintained by the FBOs. The FBOs are required to maintain appropriate pollution liability
insurance.
N
There is no control tower at Marathon. The air traffic control at Key West is subcontracted by the FAA
to a firm named RVA with its corporate offices located in Oklahoma City.
Marathon does not charge for parking at its facility. Key West subcontracts the parking operations to
USA Parking Inc.
Planned structural alterations-
0
KWIA (EYW):
1. The taxiway is being extended; it will be connected to the western end of the runway. Construction
is underway. Estimated completion date: first quarter 2023.
2. The roadway leading to the fuel farm (near the General Aviation section) is being relocated.
Construction is underway, and is expected to be complete in approximately 6 months. E
3. The terminal at KWIA is undergoing an $80 million construction project, for construction of"New
Concourse A and Terminal Improvements." Planning and design have been underway for
approximately a year. Construction is expected to begin in second quarter 2022 and will continue
for approximately 18-24 months.
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Florida Keys/Marathon International Airport (MTH):
1. The entire length of the runway will be shifted 40 feet to the north. Construction is planned to begin
in 2024 and will continue for approximately two years.
Key West Airport has 10 pickup trucks, 1 van, 2 fire suppression units and 3 SUVs.
The FBOs at both Key West and Marathon have fuel trucks and the FBO at Key West has a courtesy
van. FBOs are required to maintain appropriate insurance.
0
The Monroe County Sheriff's Office owns 1 fixed wing and 2 rotary aircraft that are separately insured
a.
and are not part of this RFP. The County does not own any other aircraft and does not charter aircraft
on a regular basis. It is believed that the County's non-owned aircraft exposure is minimal, if any.
The County has developed a manual entitled Risk Management Policies and Procedures / Contract
Administration Manual ("Manual") that specifies the types and amounts of insurance that will be
required for each category of contract issued by Monroe County. The Manual utilizes a matrix system It
that establishes the requirements based on the scope of work to be performed and the projected size
of the project. The Manual specifies particular requirements for contracts dealing with airport
construction and all types of airport/aircraft activities (i.e., activities occurring at the airports), in
addition to other types of contracts. Contracts of a unique nature that are not addressed in the manual
or those that have a high projected cost (normally in excess of$1 million) are referred to the County's
Risk Management department for special handling.
The Manual has specific indemnification and hold harmless language that must be included in each
contract. The County requires all vendors to indemnify, defend, and hold the County harmless for all
claims arising out of the services being provided. Where permitted, the County also requires the
County to be named as an "Additional Insured" on the vendors' respective insurance policies, and also
"Loss Payee" on builder's risk policies.
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SECTION SIX E
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REQUIRED COUNTY FORMS AND LICENSES
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RESPOND TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
I acknowledge receipt of Addenda No. (s)
I have included:
• Lobbying and Conflict of Interest Clause
• Non-Collusion Affidavit
• Drug Free Workplace Form
• Public Entity Crime Statement
• Local Preference Form (if applicable)
In addition, I have included a current copy of the following professional licenses and business tax
receipts:
(Check mark items above, as reminder that they are included)
0
Mailing Address: Telephone-
0
Fax: CL
Date:
Signed: Witness:
2
(Print Name)
(Title)
STATE OF:
N
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on
(date) by (name of affiant). He/She is personally
known to me or has produced (type of
identification) as
identification.
0
N
NOTARY PUBLIC
My Commission Expires:
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LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
c
(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 employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this
provision 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." B
0
0.
(Signature)
0
Date:
STATE OF:
N
COUNTY OF:
N
N
Subscribed and sworn to (or affirmed) before me on
(date) by (name of affiant). He/She is personally
known to me or has produced (type of
identification) as identification.
0
NOTARY PUBLIC
CD
My Commission
Expires:
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NON-COLLUSION AFFIDAVIT
I, of the city of according to law on my
oath, and under penalty of perjury, depose and say that
1. 1 am of the firm of
the bidder making the Proposal for the
project described in the Request for Proposals for
and that I executed the said proposal with full
authority to do so;
2. The prices in this bid have been arrived at independently without collusion, consultation,
communication or agreement for the purpose of restricting competition, as to any matter relating to
such prices with any other bidder or with any competitor;
3. Unless otherwise required by law, the prices which have been quoted in this bid have not
been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid
opening, directly or indirectly, to any other bidder or to any competitor;
4. No attempt has been made or will be made by the bidder to induce any other person
partnership or corporation to submit, or not to submit, a bid for the purpose of restricting competition;
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 in awarding
contracts for said project.
(Signature)
0
Date:
2
N
STATE OF:
N
N
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on
(date) by (name of affiant). He/She is personally
known to me or has produced (type of
identification) as identification.
0
NOTARY PUBLIC
CD
My Commission
Expires:
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Q.4.a
DRUG-FREE WORKPLACE FORM
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' policy of
maintaining 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 bid 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 bid, 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 B
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.
0
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
N
N
N
(Signature)
Date:
STATE OF:
c
COUNTY OF:
N
N
Subscribed and sworn to (or affirmed) before me 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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My Commission
Expires:
CL
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0
2
N
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CL
N
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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."
0
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)
Date:
CL
STATE OF:
c
COUNTY OF:
2
Subscribed and sworn to (or affirmed) before me 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-
0
N
N
N
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Q.4.a
LOCAL PREFERENCE FORM
A. Vendors claiming a local preference according to Ordinance 023-2009 must complete this form.
Name of Bidder/Responder Date:
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? (Please furnish
copy. )
0
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?
List Address:
Telephone Number:
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0
B. Does the vendor/prime 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?
0.
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
N
N
N
Print
Name:
Signature and Title of Authorized Signatory for
Bidder/Responder
c
STATE OF:
N
COUNTY OF:
Subscribed and sworn to (or affirmed) before me 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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