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06/10/2022 Agreement Monroe County Purchasing Policy and Procedures ATTACHMENT D.5 COUNTY ADMINISTRATOR CONTRACT SUMMARY FORM FOR CONTRACTS LESS THAN $50,000.00 Contract with: Affordable Asphalt Contract# N/A Effective Date: 6/712022 Expiration Date: Contract Purpose/Description: Contract to repair court end zones and extend court ends at Blue Heron Pickleball Courts. Contract is Original Agreement Contract Amendment/Extension Renewal Contract Manager: Tom Henry 305-509-0239 Parks and Beaches/#2 (Name) (Ext.) (Department/Stop #) Total Dollar Value of Contract: $ Current Year Portion: $ (must be less than$50,000) 18,000 (If multiyear agreement then 1810, 00 requires BOCC approval,unless the tcwl cagla 16vvc flan `i50.000 00). Budgeted? Yes■❑ No ❑ Grant: $0.00 County Match: $NSA Fund/Cost Center/Spend Category: 147-20503-00062 ADDITIONAL COSTS Estimated Ongoing Costs: $o.00/yr For: N/A (Not included in dollar value above) (e.g. maintenance,utilities,janitorial, salaries, etc.) IInsurance Required: YES 0 NO ❑ CONTRACT REVIEW Changes Date In Needed Reviewer Date In Department Head Yes❑ No■❑ � County Attorney Yes❑ No[ 6/8/2022 Risk Management Yes❑ No® 6/8/2022 O.M.B./Purchasing Yes[:] No® 6/8/2022 Comments: contractor to reach project substantial completicK,ithin 60 days of Notice To Proceed. Revised BOCC 1/21/2022 Pegs 85 of q 06 r IIIUI BOARD OF COUNTY COMMISSIONERS REQUEST FOR SERVICES FOR BLUE HERON PARK PICKLEBALL COURT ASPHALT EXTENSION NON-MAN DATORY/Pre-bid Job Walk will take place on Thursday, March 2022 at w ., at 30451 Lyttons Way, Big Pine Key, FL 33041 I"aM b BOARD F COUNTY COMMISSIONERS Mayor David isDistrict 4 CraigMayor Pro Tern s, District Michelle I it m District District Hollyill Raschein, District COUNTY ADMINISTRATOR Roman Gastesi Clerk of the Circuit it c s and Beaches AllenKevin Madok John March PREPAREDY® Monroe County Project Management Department Monroe County Project Management U1il ��V1u�� 1100 Simonton Street,2-216 JJ Key West,FL 33040 Monroe County Project Management Date: March 1 , 2022 Scope of Work Install two pickleball Hot Mix Asphalt ( ) court extensions to existingcourts as safety zones. Job ® Blue Heron Park Pickleball Court Asphalt Extension Location:Job lug Heron Park, 30451 Lyttons Way, Big Pine Key, FL 33043. Project ana ent Tom Henry (305)509-0239 V PROJECT OVERVIEW, PROJECT INTENT AND SCOPE, GENERAL REQUIREMENTS 1. Project Overview The contractor is responsibleto verify s I Contractora) Base Bid: l install an expandedx Asphalt ( ) safety /c I existing contiguous pickle ball courts. The current length i is approximately tall approximately asphalt over base on both ends of ) asphalt extensionI be added to each contiguousbaseline clearance for a total of approximately1,140 squaret, providing additionall i ts. The Scope of Work includes: I. ) existing court asphalt edges to straighten for qualityjoint. ii® Excavate a minimuminches of existing soil i f soil legally off site. ill® Base Material —fill and grade withminimum '/2 compactedinches of crusheds . iv® Base material(s) must be approvedin writing Project installation. v® Compact base materialsi tandem vibratory minimum i %. Page 2 of 32 .... ...... Monroe County Project Management e 1 1100 Simonton Street,2-216 1, 't O i✓ Key Vilest,FL 33040 vi. Provide four (4) total density tests for compaction of base material, two (2) at each court . vii. Apply SS-1t binding agent as tack ri . viii. Install 1 Y2 compacted inches mix asphalt, 1 lift, and roll to finishexisting . ix. The minimumt thickness for combined rs s will be six ) compacted inches. x. A slope of 0.83%-1% pitch end to end or side to sidef the extension is requiredr water drainage away from courts. A. Water test court extensionto ensure standing low areas undulations are no greaterinches in diameterthan 1/16 inch deep. xii. Backfill, grade, and roll soil to asphalt grade as necessary. All. No court paintings i is required. iv® Cap rocktreatment is not included. b) Alternate#1 Bid: An alternate i is requesteds a separatei item from Base Bid for an expandedIts fety apron/clearance apron/clearance zone at courts as above, using the same mainci is . Install approximately square feet (95 ® t over baset both ends of the courts. One (1) asphalt extensionill be added to eachcontiguous baseline clearance zone for a total of approximatelysquare feet, providing additional to participants. ScopeThe includes: I. Saw cut asphalt on ALL four ( ) court side q newly installed baseline clearance I existing sideline clearance as t straighten clean for a quality butt joint, v ri q and dispose II site. ii. Install a twelve1 ) inch i i ) inch concrete curb, 5,000 psi, light broom finished, around perimeterentire courts system. l v i slope to matchcourt new safety surface. Ill. A slope of %- % pitch end to end or side i xt si . is required for wateri courts. iva Water test court extensionto ensure standinglow areas or undulations are no greaterinches idiameter and no greater than 1/16 inch deep. v. Backfill, grade and rollsi i curb grade as necessary. vi. No court paintings lt sealing is required. vii. Cap rockt is not included. viii. Concrete ribbonill not be installed in front of existing concrete pad (see attachedsketch). Page �ir%�N��J fy1l�P�o Monroe County Project Management �, 1 i 100 Simonton street,2-2 1s They West,Ni^t., 33040 /�lll�rrrfriifrma,„mn/��% c) A job walk is scheduled f a Lyttons Way, Big Pines FL 33043. d) All Quotes are due by Friday, April 8, 2022, at 3:00 ® via ® All Quotes must state they will honored for one hundred twenty ( calendar days from submittal due date. 2. Project Intent and Scope ® The intent of this request for servicest ches are to describe the materials t construction required or f the r 1, it is intended that this request for services attached tcdelineate the detailedextent of the work. Contract documents arec what is required bindings if required ® Contractor shall supply allmaterials and hardware to completethe projectt in the ProjectOverview dispose of debris. 3. Summary of General Requirements ® Contractor is requiredprovide ci existing s® To include, t not limitedto: i® Existing parkfixtures, furniture, features and amenities ii® Vehicles and Personal iiia Landscaping ® The Contractorshall s r t t employees for this effort are compensated in accordancei t te and Local Laws. cn Provide a dumpster, containment bi 9 or similar vic the collection containment f construction generated debris® Load,d. haul, and properlydispose str i is® e. Provide maintain is ire ) construction warning signs and barriers. ® Furnish all required r site y equipment. g. Furnish i ion-site safety data sheets (64 ") for all materials used in the construction. Page 4 of 3 ��r a�I ��I1��11yN'✓ Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 r it h° Construction work times shall be limited to; 8n00 A.M. to 5s00 Pete Monday- i i® All materialsvprior to commencement of r4 j. Contractor shall providei ffi P.M. via inoted herein. Contractork. iaccordingly. L Contractor needs to be awarefacility, its residents, and staff with accordingly.unusual schedules and plan ® Contractor shall provide a safety liftr all crane/hoist work° ® Contractor to provideI l project. Contractoro. r v electronic copies of all original device specifications, warranties, maintenance schedules, drawings, permits, repair and maintenance contacts, information r functionthe proper iequipment. ® Contractor to coordinatectivi i s with concurrent sitebeing signing this agreement, the i terms and conditions t forth by the Monroe County General Requirementsr Construction, I i link fl w w.��.oeCC1w��ii�"lt gi�ilillrl .„LLi s -----lii� �...... .................................. ��.��w...��..........��.........,".......................°:.....................�..... rw. Insurance Requirements: Compensationt Limits Employers' Liability ily Injury by Accident Bodily Injury by Disease, policy i i s Bodily i Monroe County Project Management lla l� ri. 1100 Simonton Street,2-216 Key West,FL 33040 General Liability $300,000 Combined Single Limit Business Vehicle $200,000 per Person $300,000 per Occurrence Property Damage or $300,000 Combined Single Limit Builders Risk Not-required Construction The Monroe County Board of County Commissioners s Additional Insured i i itVehicle is s. The Contractor ll be required c I permits required to perform the work. ® The Contractoris requiredI current lic c ss to perform INDEMNIFICATION,the work. u. HOLD HARMLESS AND Notwithstanding any minimum insurance it ts prescribed elsewhere in this agreement, c I defend, i i the County and the elected i is s and employees harmless from and against i claims, cti causes of action, u) any litigation, administrative c i ss appellate proceedings, or other proceedings relating f injury (including deat ), loss, damage, fine, penalty or business interruption, ii) any costs s s that may be asserted against, inii it respect to, or sustained indemnified party by reason ° or in connection with, ) any activityf Contractor any of its employees, agents, contractors invitees i the term of is Agreement, ) the negligencer recklessness, intentional wrongf l misconduct, errors or otheromission c r any of its employees, agents, sub-contractors or other invitees, r (C) Contractor' default in respect of any of the obligations that it undertakes under the terms of this t, except to the extentclaims, cic ° causes of action, litigation, c i s° costs or expenses arise from the intentional negligentcs or omissions of the County or any of its employees, agents, contractorsor invitees (otherthan Contractor). The monetaryi it ti liability i contract shall be not less than $1 million per occurrence pursuantctiFloridas, Insofar as the claims, ti ° causes of action, litigation, proceedings, costs or expenses relate to events Page 6 of 32 Monroe County Project Management I IGO Simonton Street,2-216 Key Vest,FL 33040 or circumstances that occur during the term of this Agreement, this section will iv the expirationthe term of thist or any earlier termination . In the event that the completionc include others) is delayed or suspended as a resultt c 's failure c or maintain the requiredinsurance, t ct ll indemnify the Countyy and all increased ing from such delay. claimsShould any i t the Countyvirtue deficiency ambiguity in the plans and specificationsprovided Contractor, the Contractor tContractor shall harmlesshold the County shall indemnify it from all losses occurring thereby and shall f claim or cti . The is ( 1 . ) of remunerationi t c is the indemnification prov!ded for the abov The extent of liabilityis in no way limitedt , reduced, or lessened by the insurance requirements c ti iswithin is Agreement. This indemnification shall surviv ! ! this c ® Nothing contained in thisis intended to nor shall it constitute iv r of the (County) Agency's sovereign immunity. v. signing is proposal, the undersigned , according his/hert , and under penaltyr° , that theiris executes !s proposal with pricesiv independently ! t collusion, consultation, is ! , or agreement for the purpose of restricting competition, to any matteri to suchiwith any bidderother i competitor. t ise required by law, the prices is v in this v t been knowingly discloseds will not knowinglydisclosed the proposer prior to proposal opening, directly or indirectly, proposer or to y competitor. No attempti by the proposer to induce s , partnership or corporation to submit, or not to submit srestricting competition. The statements contained in thistrue and correct, with the fullr County relies t statements contai in this in awardingcontracts ! project. w. EMPLOYMENT OR RETENTION OF FORMER COUNTY OFFICERS OR EMPLOYEES. By signing i proposal, the undersignedthat he/she/it has not employed, retained or otherwiseact on his/her/its Page 7 f3 I1G �i �I ,r Monroe County Project Management 1100 Simonton Street,2-216 0 Key West,FL 33040 2faixniNaa�t riyr//llU��"III behalf any former County officer or employee in violation of Section 2 of Ordinance r any County officerviolation Section r inance No. 010-1990. For breach or violation f this provision , in its discretion, terminate thi t without liability , in its discretion, deduct from the Agreement or purchase price, or otherwiserecover, the full amount of any f , commission, c , gift, or considerationi to the former County officer or employee. x® CODE OF ETHICS. County agrees that officersf the County recognize i it comply with conductis officers and employeesdelineated in Section , Floridat s, regarding, but not limited agency;, s lici i c t c of gifts; doing business with ® unauthorized , misuselc position, conflicting I t or contractual relationship; isclosure or use of certain information. y, DRUG-FREE ® By signingi 1, the undersigned certifies that the Contractorc i , and in accordancei Floridattt , Section 287.087, the requirementsfollows: i® They will publish a statement notifyingthe unlawful distribution, i si , possession, controlled substance is prohibitedin the workplacespecify the actionsill be taken against employees for violations c prohibition. ii® Inform employees about the dangers of drug abuse in the workplace, the business'sis i t i i , any available counseling, i i ti , and employees i c programs, and the penalties that may be imposed upon employees for drug abuse vit iii® Give eachproviding commodities contractual servicesi copy of the statement specified in subsectioni)° iv® In the statement specified in subsection (i), notify the employeesthat, as a condition i the commodities contractual is that are under bid, i i terms f the statement and will notify the employerconviction , or plea of guiltycontendere t , any violation (Florida Statutes) or of any controlled substancelaw of the United state,any for a violation c in the workplacethan five (5) days after such conviction. V. Impose a sanctionit tip ctory participation in a drug abuse assistance i i i if suchis available in t 9s community, e is so convicted. Page 8 of 32 j j yl��li�P/w/Wil��ri� f"f lyf Monroe County Project Management 1100 Simonton Street,2-216 u Key ey Test,FL 33040 �it rmrai if i G0" vi® Make a good faithcontinue to maintain workplace through implementation of thiscti ADDITIONAL CONTRACT PROVISIONS I. CONTRACTOR and COUNTY agree that there willi cri i i i st any person, and it is expressly understoodthat upon a determination of competent jurisdiction that ci i i has occurred, this Agreement automatically i at without any further action , effective t the court order. CONTRACTOR or COUNTY agrees to comply with all Federal and Floridastatutes, Il local ordinances, as applicable, relating to nondiscrimination. These include i i 1) Title Vilthe Civil Rights Actis i its discrimination on the bsi c , color or national origin; ) Title IX of the Education t of 1972, as amended (20 USC ss. 1681-1683, and -1 ), which prohibits discrimination on the basis of fSection of the Rehabilitationc . 794), which prohibits discrimination on the bsi is sg 4) The Age Discriminati ss. 1 ) which prohibits discrimination the basis ) The Drug Abuse Office and Treatmentt s amended, relating to nondiscriminationthe basisr m ) The Comprehensive cohol Abuse and AlcoholismPrevention, Treatment Rehabilitation Act of ( ), as amended, relating t nondiscrimination the basis of alcohols i 7) The Public Healthis , s . 523 and 527 ), as amended, relating to confidentiality of alcohol and drug abuspatient records; ) Title Vill of the Civil Rights Act s. 3601 et .), amended,as relating to nondiscriminationin the rental or financing housing; 9) The Americans withDisabilities c 1 Note), as may be amended from timeto time, relating to nondiscrimination the is of disability; 10) Monroe County Code Chapter 14, Article 11, which prohibits discrimination on the basis of race, color, s , religion, national origin, ancestry, sexual orientation, gender identity x ssi , familial status or age; Any other nondiscriminationvi i s in any Federal or state statutes which may apply to the parties t , or the subjectt r , this Agreement. Duringc this Agreement, the CONTRACTOR, in accordance Equalwith Employment Opportunity(30 Fed. Reg. 12319, 12935, , 1964-1965 Comp., p. ), as amended by Executive11375, Amending Executiver 11246 Relatingto 1 Employment Opportunity, and implementing t! a at 41C.F.R. Part 60 (Office of Federal Contract Compliance r s, Equal Employment Opportunity, Department of Labor). Appendix 11, 1 C, agrees as follows- Page Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 ��l�f/O�il�r,�✓/I/�/�`rU` I 1) The contractor will not discriminate against any employee or applicant race,for employment because of c , religion, sex, sexual orientation, gender identity, tional origin. The contractoriaffirmative action to ensure that applicantsI t employees are duringtreated t, without regard to their race, color, religion, x, sexual orientation, r identity, or national origin. Such action shall include, but not be limitedto the following: Employment, upgrading, demotion, transfer, recruitment recruitment advertising; termination; rates t forms of compensation, selection for training, ic i r is i contractor s to posti conspicuous pla , available to employees and applicants for notices to be providedsetting provisions this nondiscrimination clause. 2) The contractor will, in ions or advertisements for employees placedctor, state that all qualifiedapplicants will receiveconsideration for employment without regard to race, color, religion, sex, sexual i ti identity, or national origin. 3) The contractor wi t not dischargein any otheri ci i againstisant for employment becausesuch employee r applicant has inquired , discussed, or disclosed compensation i applicant. This provisionto instances in whis employee who has access to the compensation information employees r applicants as a part of such essential functions discloses the compensation cother applicantsindividuals ise have accessc information, ss such disclosure is in response to a formal complaint or charge, i c investigation, proceeding, hearing, or action, including an investigationconducted the employer, or i consistent it contractor's is information. 4) The contractor wi irepresentative of workers with whichit has a collective i i t or othercontract understanding, ticprovided advising iunion or representative of the contractorscommitments under this section, shall post copiesf the noticein conspicuous I available to employes and applicants for employment. The contractor will comply withI visi s of Executiver 11246 rules,of September 24, 1965, and of the regulations, and relevant Secretaryof the Monroe County Project Management I100 Simonton Street,2-216 r Key West,FL 33040 �ira��rm,�yiu r�arlal�l� ) The contractor will furnish all information and reports required by OrderExecutive 1 , 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permitcc is books, records, and accountsy the administering agency and the Secretary of Labfor purposes of investigation sc in compliance withs, regulations, and ) In the eventnoncompliance i the nondiscriminationclauses this contractit i rules, regulations, orders, this contract canceled, terminated suspended in wholein part and the contractordeclared ineligible for further Government contracts or federally assisted construction c in accordancei c authorized i Executive Order 11246 of September 2 , 1965, and such sanctions imposed and remediesprovided i Executive , or by rule, regulation, or order of the Secretary of Labor, or as otherwiseprovided Contractor8) The it include c immediately precedingr ) and the provisions in everyc rder unless exempted by rules, regulations, or orders of the Secretaryissued section Executive r , 1965, so that such provisionsit be bindingc c vendor. Contractor it take suchi i subcontract purchase i i idirect as a means of enforcing provisions, including sancti non-compliance; provided, however, that in the eventcontractor c involved i , or is threatened with, litigation isubcontractor or vendor as a result of such directiony the administeringagency, the contractor request the Unitedt to enter into such litigationto protect the interests of the UnitedStates. ® In the eventthe CONTRACTOR shall be found to be negligenti aspect of service, v i to terminatei agreement after iv ) days' written notificationto the CONTRACTOR. ® Either of the partiescancel i it cause giving sixty ) days' written tic its intention Page 11 of 32 Monroe County Project Management 1100 Simonton Street,2-216 W Key West,FL 33040 �J9r�7�tr�t� �� c. Termination for Cease and Remedies: In the event of breech of any contract terms, the COUNTY retainsthe rightt terminate this Agreement. The COUNTY may also terminatethis t for cause with CONTRACTOR should CONTRACTOR fall the covenants hereini the time in the manner herein provided. event of such termination, i i , the COUNTY shall provide CONTRACTOR with fivecalendar days' notice and provide CONTRACTOR with an opportunityto cure the breachthat has occurred. If the breachis not cured, the Agreement willterminated for cause. the COUNTY terminates this et with the CONTRACTOR, COUNTY II pay CONTRACTOR the sum due the CONTRACTOR under is agreement priortermination, unI s the costcompletion to the COUNTY exceeds the funds remaining in the contract; however, the reservesCOUNTY i t to assertoffset for damages caused by the breach. x I t in any eventexceed i cap in this Agreement. In addition, reservesthe COUNTY all rights availablerecoup moniesi is Agreement, including the ri t to sue for breachcontract and including the right to pursueclaim r violation 's False Claims Ordinance, located at Art. IX, Section 2-721t al. of the Monroe County d. Termination for Convenience: r i t i Agreement for convenience, time, upon seven ( s" notice CONTRACTOR. If the COUNTY terminates this it the CONTRACTOR, COUNTY shall pay CONTRACTOR the sum due the CONTRACTOR under this agreement prior to termination, s the cost of completion to the COUNTY exc i i in the contract. maximumThe t due to CONTRACTOR shallx the spendingcap in this Agreement. In addition,the COUNTY reserves i t available to recoupis paid under this Agreement, including right breachto sue for contract including the right s claim violation t ®s False Claims i c , located at Art. I , Section - County Code. a. Scrutinized Compa r Contracts of any amount, if the County determines that the Contractor/Consultant s submitted s certification under Secti ( )g Florida Statutes or has been placedScrutinized Companiest Boycott Israel List, or is engaged in a boycott of Israel, the County shall havethe optionterminating the Agr it has given the Contractor/Consultant written noticeopportunity demonstratethe agency'st r i ti f false certification was in error pursuant to Section )(a), Florida Statutes, or (2) maintaining the Page 12 of 32 Monroe County Project Management 1100 darn®ntcass Street,2-2 fl 6 Key West,FL 33040 Agreement if the conditionsSection 7. ( , Florida Statutes, are t. f. For Contracts f $1,000,000 or more, if the County determinesthat the Contractor/Consultant it se certification under Secti ® ( Floridas, or if the Contractor/Consultant placed on the Scrutinizedi i Activities in the Sudan List, the Scrutinized Compai s with Activitiesin the Iran PetroleumSector List, or in businessi in Cuba or Syria, the County shall have the option1) terminating the Agreement after it has giventhe Contractor/Consultant written is i to demonstrate agency'ster i i f false certification was in errorto Section ), Florida Statutes, maintaining the conditions ci . )9 Floridat. III. MAINTENANCE OF RECORDS. TRACTOR II maintain all books, records, and documents directly pertinentce under this Agreement in accordancei accepted accounting i ci s consistently applied. Records shall be retained periodfor a v ) years from the terminationthis for a period iv ) years from the submissionrexpenditure report as 3, whichever is greater. Each party to this authorizedives shall havereasonable and timelycc c recordscother party to this Agreement for public records and audit purposesi v 7 following the termination this t. If an auditorI the County or Clerki t monies paidto this Agreement were spent for purposes not authorizedi t, or were wrongfullyi the CONTRACTOR, the CONTRACTOR shall repay the moniesi interest c t r t to Sec. 55.03 of the Florida Statutes, i t the moniest i y the COUNTY. IV PUBLIC ACCESS. The CONTRACTOR and COUNTY shall allow and permitreasonable access t , and inspection g all documents, papers, letters or other materials in its possessionits control c the provisionster 119, Florida Statutes, and made or received i connection i this the COUNTY shallv the right unilaterallycancel this Agreement upon violation i provision CONTRACTOR. CONTRACTOR shall be referred to hereinalso "Contractor""Contractor" for thisprovision Page 13 of 32 Monroe County Management rsrll �� tv t`l Project 1100 Simonton Street,2-216 yf�r�rarr f/� Key West,FL 33040 Public Records Compliance. Contractor must comply with Florida public records laws, including but not limited Chapter 119, Florida Section Article I of the ConstitutionFlorida. tContractor shall l it reasonable access to, and inspection of, all doc s, records, s° letters or other "public record" materials in its possession under its control subject to the provisionsf Chapter 119, Florida Statutes, and made or received the County and Contractorin conjunction i is contract relatedand contract c . The County shall ve the right to unilaterally cancel this contract violation f this provision Contractor. it f the Contractorto abideterms of thisprovision shall be deemed a material breach of this contract rc terms of this provision in the form of a court proceedingshall, s prevailing it i l tt 's fees and costs associated i i . This provision shall survive termination expiration f the contract. The Contractor is encouraged to consult with its advisors about FloridaPublic Recordsin order to comply withis provision. Pursuantl ., Sec. 119.0701 and the terms and conditions is contract, the Contractoris required t ( maintain ices that would be requiredt t perform the service. receiptthe County'scustodian of records, provide the County with a copy of the requestedrecords or allow the records to be inspected copied it i reasonable time cost t does not exceed the cost provided in this chapter t isprovided } Ensure that publice that are exempt or confidential t from public records disclosure requirementsdisclosed except authorized by law for the durationcontract term and fol i completion of the contract contractor s not transfer the recordst the County. ) Upon completion contract, transfer, at no cost, to the County all public records i sion of the Contractor or keep and maintainpublic records that wouldit the County to perform the service. If the Contractor transfers all public records to the Countycompletion the contract, the Contractors I destroy any duplicatepublic records that are exempt or confidential and exempt from pubIic records disclosure requirements. If the Contractors and maintains publicrc o completion f the contract, the Contractorapplicable requirements for retaining public records. Allrecords stored electronically st be provided County, upon requestt custodian records, in a format that is compatible i the informationc systems of the County. request to inspect or copy public records relatingt contract must be made directly ° but if the County does not possess the requested records, the shall immediately i the Contractor Page t iIJJJUr�I/1 '� , �%i 1�1 Monroe County Project Management / J l P ,. ltoa Simonton Street,2-216 rug Key Vest,FL 33040 ",',,Moth request, and the Contractor must provide the records to the County or allow records o be inspected or copied Rhin a reasonablei a If the Contractor does not comply it the oun 's request for records, the County II enforce the public records contract provisions in accordance with the contract, notwithstanding the County's option and right to unilaterally cancel this contract upon violation of this provision by the Contractor. A Contractor o fails to provide the public records to the County or pursuant to a valid u lic records request within a reasonable time subject to penalties under Section 119.10, Florida Statutes. The Contractor shall not transfer custody, release, It r, destroy or otherwise disposeof anypublic records unless or otherwise provided In this provision or s otherwise provided by law. IF THE CONTRACTOR HAS Tk—PPLICATION OF CHAPTER 119 I FLORIDA CONTRACTOR'STHE I RELATING OF PUBLIC RECORD 292- KEY WEST, FL 33040. V. RIGHT TO AUDIT. �—vailabfflty of Records. The records of the parties tot is Agreement relating o the Project, which shall include but not be limited to accounting records (hard copy, as well as computer readable data if it can made available; subcontract files (including r os Is of successful and unsuccessful bidders, bid recaps, i in instructions, bidders list, c.); original estimates; estimating work sheets; correspondence; files (including docu ntatio covering negotiated settlements); c c r logs and supporting docu n a ion; general ledger entries detailing cash and trade discounts earned, insurance rebates and dividends; any other supporting vs e c deemed necessary by Owner or byte Monroe Countyice of the Clerkof Court and Comptroller (hereinafter referred to as "County Clerk") to substantiate charges related o this Agreement, and all other agree a ts, sources of information at rs that may InOwner's or the County Clerk's reasonable judgment have any bearing on or pertain to any matters, rights, duties or obligations under or covered by anycontract document (all foregoing hereins er referred to as "Records") shall be open to inspection and subject to audit and/or reproduction by Owner's representative and/or agents of Owner or the County Clerk. Owner or CountyClerk a lso conduct verifications such as, but not limited to, Page 15 of 32 J1i✓dl Imisurse(;surety Project Management 1100 Simonton Street,2-216 Key West,FL 33040 I i�icw;Kw r,M011, counting employees at the job site, witnessing the distribution of payroll, verifying l computations, overhead computations, observing vendor and supplier payments, miscellaneous allocations, special charges, verifying information r interviews and wri fir iwith Subcontractors, suppliers, and contractors' representatives. All records r isCompletion. Clerks independent authorityconduct it of records, assets, and activitiesrelating is Project. If an auditoremployed ClerkCounty or i that moniesi to Contractort to this spentAgreement were for purposes not authorizedis Agreement, or were wrongfully retained the Contractor, the Contractorshall repay the monies together i interest of c. 55.03, FloridaStatutes, runningthe datei ! r. The Rightit provisions i termination or expit i f this VI. PAYMENT OF FEES/IMV_OICES Payment ill be made by the Owner, upon receipt of a proper invoice r Contractor, in accordanceit l ri Local Government Act, Section 218.735, Florida Statutes Contractoris to submitto the Owner invoices i idocumentation that are acceptableto the Monroe County OfficeComptroller (Clerk). Acceptability to the Clerkis based upon generally acceptedaccounting principles laws, rules and regulationsdisbursal funds by the ® The Owner is exempttaxes. A copy of the tax exemption certificate itprovided the Owner upon request. Final payment, constituting the entirei ce of the Contract Sum, shall be made by the Owner to the Contractor # r ct has been fully performedrk has been accepted by the Owner. VI 1. E-VERIFY SYSTEM inning , 2021, ! c r ce with Fla. Stat. Sec. 448.095, the Contractorc tor shall registeri Iutilize . HomelandDepartment of c ri 9 E-Verify system to verify authorization t o of allI it the Contractor term c l expressly requiresubcontractors r i work or providingis r c likewise i i the U.S. HomelandDepartment of c rity's E-Verify system to verify authorizationstatus of allit the subcontractorduring Contract term. Any subcontractorprovide affidavit stating that the subcontractor 1 , contract with, or subcontracti unauthorized ! . The Contractor shall comply withsubject to the provisions . Sec. 448.095. Page 16 of 32 MonToe County Project Management f t 1100 Simonton Street,2-216 Key West,FI. 33040 Villa NOTICE REgg[ftlEMENT Any written notices or correspondence given pursuant to this contract shall be sent by United States Mail, certified, return receipt requested, postage prepaid, or by courier with proof of delivery. The place of giving Notice shall remain the same as set forth herein until changed in writing in the manner provided in this paragraph. Notice is deemed received by Contractor when hand delivered b national courier with proof of delivery or by U.S. ail upon verified receipt or Capon the date of refusal or non-acceptance of delivery. Notice shall be sent to the following persons: For Contractors „ .. yrzm ForOwner: Director of Pro'ect Man------' Assistant Couaty Administrator, 1100 Simonton St., Room 2-216 1100 Simonton St. y Westg Florida 33040 Key West,, Florida 33040 Monroe County ttorney's Office 1111 12t" Street, Suite 43 Key West, Florida 33040 IX UNCONTROLLABLE CIRCUMSTANCE. ;�_ny delay or failure of either Party to perform its obligations under this Agreement will be excused to the extent that the delay or failure was caused directly by an event beyond such arty's control, without such arty's fault or negligence and that by its mature could not have been foreseen by such Party or, if it could have been foreseen, was unavoidable: (a) acts of Coda (b) flood, fire, earthquake, explosion, tropical storm, hurricane or other declared emergency in the geographic area of theProject; (c) war, invasion, hostilities (whether war is declared or not), terrorist threats or acts riot, or other civil unrest in the geographic area of the Project; ( ) government order or law in the geographic rea of the Project! (e) actions, embargoes, or blockades in effect on or after the date of thisAgreement; ( action by any governmental authority prohibiting ark in the geographic area of the Project! (each, a "Uncontrollable Circumstance"). Contractor's financial inability to perform, changes in cost or availability of materials, components, or services market conditions or supplier actions or contract disputes will not excuse performance by Contractor under this Sections Contractor shall give County written notice within seven (7) days of any event or circumstance that is reasonably likely to result in an Uncontrollable Circumstance, and the anticipated duration of such Page 17 of 32 Ill �l, ll%✓ar1, Monroe County Project Management fl fl00 Simonton Street,2-216 "'��y✓%rUfw ✓ I{e}+West,FL 33040 �YlfOi ��BREYomiivsM � I Uncontrollable Circumstance. Contractor shall use all diligent efforts to end the Uncontrollable Circumstance, ensure that the effects of any Uncontrollable Circumstance are minimized and resume full performance under this Agreement, The County will not pay additional cost as a result of an Uncontrollable Circumstance. The Contractor may only seek additional time at no cost to the County as theOwner's Representative may determine. The Contractor may only seek a no cost Change Order for such reasonable time as theOwner's Representative may determine. ADJUDICATIONX. { County an ontr ctor agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of eachof the parties. If the issue or Issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. This Agreement Is not subject to arbitrations This rovision does not negate or waive the provisions of Article Il concerning termination or cancellation. Page 18 of 32 Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 PROPOSALFORM PROPOSALTO: Monroe County Project Management Key West, FL 33040 E" &PAS ° ,.... 0 . The undersigned, having l i Drawings, Specifications, thereto and other Cont is for the construction of- BLUE ASPHALT EXTENSION and having examined site is to be performed, having become familiar t local conditions includingi the cost thereof, havingand i i ihimself/herselfi material v i ili y, Federal, State, ordinances,and Local laws, s and regulationsaffecting f the proposeWork, does hereby i , mechanics, superintendents, tools, material, i t, transportation services, l incidentals perform and complete saidincidental r , iworkman-like manner, in conformance with said r i , Specifications, and other Contract Documents including Addenda issued thereto. certifiesThe undersigned further /s inspected the actual location the Work is to be performed, together withsources supply and that he/she s the conditionsi is to be performed. The proposer I assume the riskcosts arising the existencec r other latent physicalcondition whichticipated by reference to documentary information provided v it , and frominspection and exami i i ° The undersigned agrees to r this within ) calendar days after the date of issuance to the undersigned Purchase ® Once commenced, undersigned shall diligently continue performance until i f the Project. The undersignedI is Substantialti f the Project withincalendar days. The undersignedshall accomplishi ti within calendar days thereafter, The Base Proposall shalill be -furnished bellow In words and numbers. If there is an inconsistency between the two, the Proposal in words shaill control. Dollars (Total Base Proposal- words) $ Dollars (Total Base Proposal — inurnbers) I acknowledge Alternates as follows: Alternate #1 ,T%Atewrl FIvE TtI`tusr%+Jt> �R%3F_ IDollars (Alternate #1- words) 1 ,54,c) Dollars (Alternate #1— numbers) I acknowledge receipt of Addenda No.( ): No.—Dated No.—Dated Ai 1 'ew /GUari/%!l , Monroe County Project Management fi'� 77�1969a➢11J� �''1 I100 Simonton Street,2-216 l � r 0/4 Key West,FL 33040 In addition„ Proposer states that he/she has included a certified copy of Contractor's License Monroe County Business Tax Receipt, and Certificate of Liability showing the minimum insurance requirements for this project. Execution by the Conr sperson it ri to bindthe entity. IN WITNESS , the parties have caused this Agreement to be executed by their duly authorized representatives, as follows: Contractor: 1k15I ' ".... silinAddress: II ,,, � t Phone r. I Ia ea ,,,,,,,,,,,,,,,, ,,,m,,,,,,,, ,,,,,,,...,,,,.,,, Email: F-F1 Date.- „/ Signed: ,,,, vv000c , ) „,,,,,,,,,,,,,,,,, t (Title) Contractor's Witness signature: ............................ ,,,,,,,,,,,,,,,,, t Witness name: I Z ate. .. CountyThe t the above proposal: COUNTY,MONROE FLORIDA Digitally signed by Roman Gastesi Roman Gastesi Date:2022.06.10 08:54:48-04'00' Date. y. County Administrator or designee MONAOE COUNTY ATTORNEY'S OFFICE EDpAS TO OHM A 1 1A MLES ASSMT,AN ' , � 2A1"roRNEY QATE: �W Pic 2 t. Of, Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 rrowrie,a71P VENDOR CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS Project esc i do (s): % W &° • ar Respondent Vendor a 1. SP 7- Ve dor I - / Vendor's Authorized Representative Name and Title: H I C444rt.. WLOQLS Address: q4if/1 i' City: -T t 01 State; zip: Phone Numberg 1' ailAddress: .�1 . f �. Section 287.135, Florida Statutes prohibits a company from biddingon, submitting a proposal for, or entering into or renewing a contract for goods or services of any amount i , at the time of contracting or renewal, the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to Section 2 .4725, Florida Statutes, or is engaged in a Boycott of Israel. s the person authorized to sin on behalf of Respondent, I hereby certify that the company identified above in the Section entitled "Respondent Vendor Name" is not listed on the Scrutinized Companies at Boycott Israel List. I understand that urs ant to Section 287.135, Florida Statutes, the submission of a false certification a subject company to civil penalties, a or a 's fees, and/or costs. I further understand that any contract with the COUNTY maybe terminated, at the option of the COUNTY, if the company is found to have submitted a false certification or has been placedon the Scrutinized Companies that Boycott Israel List or engaged in a boycottof Israel. Certified By:: ......................................�.. .. , .........00 o is authorized to sign sig non behalf o the above referenced company. Authorized Siignature:........, _. Print Name: Title: Pub /CN.5N7 Note: The List are available at the following e a ent of Management Services Site: �lfin ° u �!,l�w NwlllNro .IIINII IIlodi!';w u� lines fVq"',� i L. u Nlu 'urr�u urr 'uml N�mN �imW �N � a::ur hNrB �r� ll�:nul�p"� b. Nw��l'I'u!�'ull;a i ��ilu., II Nulmw� �2d "-L1mo'I,NN",t — I h't'll:"nu"' Page 22 of 32 �a r�F�llj f?�0l��r it r Monroe County Project Management agement 1100 Simonton Street,2-216 Key West,FL 33040 l/��1j/rirarr rrI/P��r P NON-COLLUSION Is ofthecityof ... „w according to law on my oath, and r penalty of perjury, deposeand saythat: ® I am - of the firm of the proposer making the Proposal for the projectdescribed In the notice for calling for proposals for: that I executed e said proposal with full authority to do so; 2® The prices In this proposal have been arrived at independently wL out collusion, consultation, communication or agreement for the purpose o restricting competition, as to any matter relating to such rlcee with other proposer or with any competitor; and 3e Unless otherwise required y law, the prices which have been quoted In this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed the proposer prior to proposal opening, Irectl or indirectly, to any other proposer or to any competitor; and ® No attempt has beene or will be made by the proposer to induce any other person, partnership or corporation to submit, or not to submit, a proposal for the purpose of restricting competition; an ® The statements contained In this affidavit are true and corrects and made with full knowledge of said rojec . (Signature of Proposer) (Date) STATEOF: 4 PA COUNTY OF: Subscribed and sworn t (or affirmed) before me, by means of D9 physical presence or 0 online notarization, on I (date) by 1W 1 (name of a i nt)n _ e i personally known to or has produced .11.......m .�._. (type of identification) identification. 9°T I (S EA My commission expires: L:N :ar �QN�BEEVER ublic-5tate o'Florida rs Q "0 GG 25)65. Expires Aq ?, N22 e� � � of 32 �fnamom Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 000 LOBBYING CONFLICT F INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS L (Company) warrants that lit has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance ® 010-1990 or any County officer or employeein violation of Section 3 o Ordinance o. 010-1990. For breach or violation of this provision the County in its discretion, terminate thi contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any , commission, percentage, gift, or consideration paid former my officer or employee". (Signature) Date'. COUNTYSTATE OF. ® -4 �. Subscribed and sworn to (or affirmed) before me, by meansofJK physical presence or 11 online notarization, on I i °w (date) y t (name of afflant). He/She is personally known to me or has produced ( of identification) as identification. NOMYY-PUBLIC (SEAL) My commission expires° . At arc ,,, V r Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 ........r DRUG-FREE WORKPLACE FORM The undersigned vendor in accordanceit lri Statute 287.087 hereby certifies that: r t t.1- ( a sine ) 1 Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, pssio ,or use of a controlled substance is prohibited in the workplace specifyingthe actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drugabuse in the workplace,thebusiness's policy of maintainingdrug-free ork I c , any available drugcounseling, rehabilitation, employee ssi to ce programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives eachto engaged in providingthe commodities r contractual services t are under proposal a copy of the statement specified in subsection (1). . In the statement specified in subsection (1), notifies the employees that, as a condition o working on the commodities r contractual services that r under proposal,the employee ill abide y the terms of the statement an ill notify the employer of any conviction o ,or plea of guiltyr nolo contendere to, any violation of Chapter 893 (Florida Statutes) or o any controlled substance law of thenit tat s or any state, for a violation occurring i the workplace no later than five ( )days after such conviction. 5. Imposes a sanction o , or require the satisfactory participationin s drug abuseassistance or rehabilitation pro r if such is available in the employee's communi ,or any employee who is so convicted. 6. Makes a goodfaith effort to continue ait ! drug-free workplace through implementation of this section. s the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. (Proposer"s Signature -±t °gym ate STATE OF: _I HIV or, Subscribed and sor o(or affirmed) for n is I presence or El online notarization, on (date) o 6 DS (name of a is t). He/She ipersonallyw known o a r produced (type of identification)as identification. .................................... .......... NOTARY LIC ( L) - „ y y commission expires: "' P11111a, e 25 of 32 Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 PUBLIC ENTITY Y GRIME STATEMENT "A person r affiliate who has been placedthe convictedlist following conviction is entity crime t submit a bidcontract to providey goods or services to a public entity, may not submit a bidcontract with a public entity for the construction r repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded perform work as a contractor, lier, subcontractor, or CONTRACTOR under contract wit y public entity, and may not transact business withis entity in excessprovided in Section287.017, Florida Statutes, periodfor CATEGORY TWO for a t from t f being placed the convicted vendor list." I have read the above - (Proposer's name) nor any Affiliate c o convicted vendor list withinthe last thirty-six (Signature) Date: COUNTY OF: NRO STATE OF: Subscribed o I before sic l presence or 0 online a iz ti Q t 2- by 1 i t ® He/She i ,p2rsonally_knqWn,X me or has produced (type of identification) as identification. `'Ojc�®ri J®NI SEEVER w ' / Notary Public a State of FloridaNOTAi(�FE W. Commission a GG 250851 `.'oFrT My Comm,Expires Aug 20,2022 —6oadgd throu h National Notar Assn. w y My commission x it o r f�� Monroe County Project Management 1100 Simonton Street,2-216 �j a dri Key West,FL 33040 INSURANCE REQUIREMENT'S AND FORDS MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES General Insurance Requirements For Other Contractors, Subcontractors and Professional Services As a pre-requisite icy governed, r the goods supplied this ct (including t pre-staging rs i , the Contractor shall obtain, at his/her , insurance as specified schedules, which are made part of thist® The Contractor will ensure that the insurance obtained iextend protection c c the Contractor. Alternatively, t ctor may require all Subcontractorst insurance istent with the attached schedules. ContractorThe ill not be permitted to commence work governed by thiscontract pre-staging rmaterial) until satisfactoryevidence f the required insurance r is specified e Delays in the commencementf work, resulting from the failurethe Contractort provide satisfactory evidence ! insurance, shall not extenddeadlines specified in this contract and any penalties and failure shall be imposed as if the work commencedspecified i for the Contractor'sto provide satisfactoryevidence. The Contractor maintain it insurance throughout the entire this contract x si specified the attachedschedules. Failure comply i provision in the immediate iuntil the requiredinsurance has been reinstatedr replaced. Delays in the completion of work resulting the failureContractor to i i the required insurance xtend deadlines specifiedin this contractpenalties and failure to performt l imposed as if the work had not been exceptr the Contractor'sfailure to maintainrequired insurance. The Contractor i ideductibles self-insured retentions that may be contained in the Cont ct s Insurance lici The Contractor v , to the County, as satisfactoryevidence the required insurance, either: ® Certificate of Insurance Certified copy of the actuali cpolicy. County,The at its sole option, has the rightto request a certified copy of any or all insurance icies required by this contract. PIE. 27 o Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 �1i��rinum��r ul�rOJl�vi� All insurance policies mint specify that they are not subject to cancellation, non- , material change, or reductionin coverage i i thirty priordays i is i is giveninsurer. The acceptance / approval Contractor's insurance t be construed as relievingthe Contractor from any liabilityobligation this contract ori 4 MonroeThe ty Board of County Commissioners, its employees and officials will be included "Additional Insured" on all policies, except for Workers' Compensation. Any deviations l Insurance Requirements must be requested in writing t form entitled "Request Requirements"Insurance and approvedi t 11 e 28 o edu rvan /qi a 1"i o�� Monroe County Project Management Simonton onton Street,2-216 ��Ip`" r�� " Key West,f L 33040 " U f' VE PROPOSER'S INSURANCE AND INDEMNIFICATION STATEMENT Workers' INSURANCE REQUIREMENTS Compensation Statutory Limits Employers' Liability $100,000 BodilyjAccident BodilyInjury i , policy limits $100,000 BodilyInjury each employee General Liability Occurrence$300,000 per $200a Property r CombinediLimit Vehicle , Person (Owned, non-owned, and hired vehicles) $300,000 per Occurrence $200a000 Property r Combinedi it Buildersi t Required Construction t Required CountyThe Monroe i si r I be named as Additional Insuredral Liability and Vehis is s® INDEMNIFICATION, HOLD HARMLESS and DEFENSE. Notwithstanding minimum insurance requirements presci r in this agreement, Contractor , indemnify I ty and the County's elected appointedand isers and employees harmless from and against (I) any claims, actions causes of action, (ii) any litigation, i i tiproceedings, appellate proceedings, r c irelating to any type of injury (including death), loss, damage, fine, penalty or business interruption, (iii)any costs or expenses at may be asserted against, initiated wi respect t , or sustainedby, any indemnified party by reason of, or in connection with, activity Contractor or any of its employees, agents, contractors or other invitees during the term of this Agreement, the negligenceor recklessness, intentional misconduct, errors or other wrongfulomission Contractor it PaRze 29 of 32 red r Monroe County Project Management 1100 Simonton Street,2-216 Key Pest,FT, 33046 employees, agents, sub-contractors or other invitees, ®r(C) Contractor's default in respect of any of the obligations that it undertakes under the terms of this except to the extent the claims, actions, causes of action, litigation, proceedings, costs ise from the intentional sole li omissions of its employees, , contractors or invitees (other than Contractor). i i ion of liability under this contract shall be not less t million c to Section725.06, Florida Statutes. claims, ti s, causes of action, litigation, proceedings, costs or expenses t to eventscircumstances ccduring the term of this Agreement, ti ction will survive xi i term of this Agreement or any earlier termination is Agreement. eventIn the I ti f the project (to includethe work of others) is delayed or suspended as a resultof the Contractor'spurchase maintain it insurance, t c indemnify the County from any and all increased s resulting from suchclaims asserted against the County by virtue deficiency or ambiguityin the plans and specifications provided the Contractor, the Contractors and warrants that the Contractorshall hold the County harmless and shall indemnify it from all losses occurring shall further defendi r action County's behalf. The first ten dollars ( ) of remunerationi the Contractoris for the indemnification provi for the v extentThe of liabilityis in i i , reduced, or lessenedthe insurance requirements contained Iswithin i r PROPOSERe S STATEMENT I understand the insurance that will be mandatory if awarded the contracti comply in full i f the requirementsi ® I fullycc the indemnification harmlessand hold s set out in this proposal. ... Signature t.l e 301 of"3 hAoniro Co unm Pire,➢ sR" zRu ae euuu R1 '+ WQD"usmu uakmu"up a~ , �J1-111,111,111IRANCp: ,�� :p S STAIII" ��:.� �I�'"".i .T p have reviewed the above requirements with the pro poser inarned above. ...p.'h POLICY DEDUCTIBLES following deductiWes app�y to the corresponding pofir.-.Y, I-Jability, policies are ..,,.W .Occurrence Cp lima Made �9 n IIM�OI� � . ..�.,.., w..,..�„..„.,. „,„�a„„ ..�......,.... ......�.,„„ .... � ...�, p' � u,. u' uruirc �u 'u ��u � ��m...............��. �...�....�. m�,o.��.�...��..., , ,�;; : ' Monroe County Project Management 1100 Simonton Street,2-216 Key West,FL 33040 COUNTY,MONROE I WAIVERREQUEST FOR INSURANCE It is requested that the insurance requirements, as specified in the Count 's Schedule of Insurance Requirements, be waived or modified on the following contract. C r cto N o : Project or Service: ContractorNendor Address & Phone Generalcop or : Reason for Waiver or Modification: Policies iv r Modification will apply to: Signature Co r ctor Date: Approved Not Approved Riskana ement Signature: .,_..............................................................................................._......................„................... ..............................._............................__.......................................................... ............................. County Administrator appeal: ................. .......... Approved: Not Approved: - ate:.,,,,,,,,.,, ........................... Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Pa of" i '>a - 1 i l r IP I«/// rrr"/�(>✓�'iXi'%��'i;/� �i', ��i/i s 9G�D�li ,, !y «- %? Flo /1,f' l Bill / 2 I f %ll r lay% � %�/r/�iJl�V�yrrrr✓ all/ «�/u/P>ny/ �j r/« «, '""�Y'�JJ«�Tf« � �' �y✓!re�V �«a f a'�>�"✓Hr>�jII �/s%'% fir' / r o ,n�Ji� a � 'I`✓,3r.; �w;�Jr *ai, rr,, ! r� c�rl F �I� r + ��JM«��r �a i 1r0 /1 1 N dq rrN i l 1 ljjj r 7 pu4r 11�� /��/�J J�r '�I f��i�l ,'�'"�°�� 1i l 1 r e 111Q1 � ha '' C" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/18/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. CONTACT PRODUCER George A Zellner Co NAME: Certificates 4114 Sunbeam Road PHONE (904)356-1492 FAX (904)354-4328 Suite 101 E-MAIL certificates@zellnerinsurance.com Jacksonville FL 32257- INSURERS AFFORDING COVERAGE NAIC# INSURERA:Auto-Owners Insurance Company 18988 INSURED INSURER B:Colony Insurance Company 39993 Affordable Asphalt,Inc. INSURER C 94411 Overseas Highway INSURER D Tavernier FL 33070- INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTRPOLICY NUMBER B X COMMERCIAL GENERAL LIABILITY X X 6000LO204038-00 08/28/2021 08/28/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAPRE MGE TO RENTED $ 100,000 MEDEXP(Any oneperson) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ❑X PRO ❑ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY X X 5155488900 07/20/2021 07/20/2022 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per a—dent) yy $ UMBRELLA LIAB OCCUR �ytl EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION � � 5 ��1 8 . 2 O . '—'"_ $ WORKERS COMPENSATION PERUTF OTH- AND EMPLOYERS'LIABILITY Y/N M 1� f ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Equipment 78366062 07/20/2021 07/20/2022 Limit 140,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required The Certificate Holder is listed as Additional Insured with respects to General Liability and Auto Liability if required by contract. CERTIFICATE HOLDER CANCELLATION AI 024906 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St Key West FL 33040- AUTHORIZED REPRESENTATIVE 'V ir11 00 �d Fax:( ) - @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 05/18/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Krista Scarborough NAME: Caton-Nosey Insurance ACNE. Ext: (386)767-3161 a/c,No): (386)760-1770 3731 Nova Rd. E-MAIL Krista@catonhosey.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Port Orange FL 32129 INSURERA: ICW Group 27847 INSURED INSURER B Affordable Asphalt,Inc,DBA:Affordable Asphalt INSURER C: 94411 Overseas Highway INSURER D: INSURER E: Tavernier FL 33070 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2242528333 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO TED CLAIMS-MADE OCCUR -PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- ❑ LOC Z422 d�' q� PRODUCTS-COMP/OP AGG $ OTHER: t"a, .....9` $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED . AUTOS ONLY AUTOS �,,,_,.,�,�„ BODILY INJURY(Per accident) $ � "" HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY it _ .. Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X1 SPTER EORH AND EMPLOYERS'LIABI LI TY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ AOFFICER/MEMBER EXCLUDED? N/A WFL 5055467 02 O5/08/2022 O5/08/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) License CGC1531764 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Ron DeSantis,Governor Melanie S.Griffin,Secretary bpr ; ;.' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION IdS�TItICENSING BOARD 'J i y' % /% / THE GENERAL Cif T IREII IT[FjED UNDER THE PROVISIOIS� FW�� FL" /STATUTES / fib/ / r /� / ur 1 /� r°✓ / �il� Gi/4 � I r / /If( lJ/ // zY LICE�(S � IIC 531764 EXPIRATION DATE: AUGUST 31,2022 Always verify licenses online at MyFloridaLicense.com 0� 0 Do not alter this document in any form. ■ This is your license. It is unlawful for anyone other than the licensee to use this document. 2021 / 2022 MONROE COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30, 2022 RECEIPT# 30140-122854 Business Name: AFFORDABLE ASPHALT INC Owner Name: MICHAEL WOODS Business Location: TAVERNIER, OVERSEAS H WY Mailing Address: TAVERNIER, FL 330077 0 94411 OVERSEAS HWY Business Phone: 305-853-1189 TAVERNIER, FL 33070 Business Type: CONTRACTOR(CERTIFIED GENERAL CONTRACTOR) Employees 8 STATE LICENSE: CGC1531764 Tax Amount Transfer Fee Sub-Total Penalty Prior Years Collection Cost Total Paid 25.00 0.00 25.00 0.00 1 0.00 1 0.00 25.00 Paid 000-20-00030790 07/01 /2021 25 .00 THIS BECOMES A TAX RECEIPT Sam C. Steele, CFC, Tax Collector THIS IS ONLY A TAX. WHEN VALIDATED PO Box 1129, Key West, FL 33041 YOU MUST MEET ALL COUNTY AND/OR M U N ICI PA LITY PLANNING, ZONING AND LICENSING REQUIREMENTS. MONROE COUNTY BUSINESS TAX RECEIPT P.O. Box 1129, Key West, FL 33041-1129 EXPIRES SEPTEMBER 30, 2022 Business Name: AFFORDABLE ASPHALT INC RECEIPT# 30140-122854 94411 OVERSEAS HWY Business Location: TAVERNIER, FL 33070 Owner Name: MICHAEL WOODS Mailing Address: Business Phone: 305-853-1189 94411 OVERSEAS HWY Business Type: CONTRACTOR(CERTIFIED GENERAL CONTRACTOR) TAVERNIER, FL 33070 Employees 8 STATE LICENSE: CGC1531764 Tax Amount Transfer Fee Sub-Total Penalty Prior Years Collection Cost Total Paid 25.00 0.00 25.00 0.00 0.00 0.00 25.00 Paid 000-20-00030790 07/01 /2021 25 .00