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06/15/2022 Agreement Kevin Madok, cpA Clerk of the Circuit Court& Comptroller Monroe County, Florida DATE: July 11, 2022 TO: Rhonda I laag Clilef'Resillence 01licer Lindsey Ballard Aide to (lie County Administrator ]FROM: Pamela G. Hanco�,�k I.C. SUBJECT: June 15di BOCC Meeting Allaclied are copies of the I'011owing items for your handling: 07 Contract with Adventure Environmental, Inc., the top ranked vendor for the construction of the Canal 25 Backfill Restoration Project in Key Largo, in the amount of $1,280,509.00; funded by Florida Department of Environmental Protection Stewardship Grant No. LPA0249. 08 Contract with Adventure Environmental Inc., the top ranked vendor for the Canal 28 Backfill Restoration in Key Largo, in the amount of$2,203,456.00; ftinded by Florida Department of Environmental Protection Stewardship Grant No. LPA0241. Should you have any questions please feel Free to contact me at (305) 292-3550. cc: County Attorney Finwicc File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070 305-294-4641 305-289-6027 305-852-7145 305-852-7145 AGREEMENT Between MONROE COUNTY And ADVENTURE ENVIRONMENTAL, INC. For Canal 28 Backfill Key Largo AGREEMENT Made as of the 15th day of June, 2022 BETWEEN the Owner: Monroe County Board of County Commissioners 1100 Simonton Street The Gato Building, Room 2-205 Key West, Florida 33040 And the Contractor: ADVENTURE ENVIRONMENTAL, INC. 160 Georgia Avenue Tavernier, Florida 33070 For the following Project: Backfill Restoration Water Quality Improvement Projects, Canal #28, Key Largo, Monroe County, Florida This Agreement represents one of the canal restoration demonstration projects approved by the Monroe County BOCC, whose public purpose is to improve the water quality in Monroe County. Scope of the Work 1. Project Overview The Scope of Work for Canal #28 (between Pigeon Drive and Sexton Cove Drive) located in Key Largo, Florida consists of backfilling. The backfilling activities are to be completed so that a natural benthic community can be established. This proven restoration technique was vetted during the demonstration projects and is anticipated to increase the water quality in the canal. 2. General Project Intent and Scope Provide all labor, supervision, engineering, materials, supplies, equipment, tools, transportation, surveying, layout, and protection for the proper execution and completion of all the work in accordance with the Contract Documents. The Work shall include but AGREEMENT 00500-Page 1 of 18 not be limited to that shown on the Drawings and detailed in the Technical Specifications if any included in this Contract. 3. General Requirements A. Construction work times shall be limited to: 8AM to 6PM Mon-Fri, excluding holidays. Saturdays may be added at the mutual consent of both parties. B. Contractor needs to be aware of weather and location and plan accordingly. C. Contractor must remain aware of the community residences and plan accordingly. Coordination of each day's works shall be done in advance with approval from WOOD/Engineer. D. The Scope of Work shall include, but not be limited to, all work shown and listed in the Project Drawings (Exhibit A). The Contractor is required to provide a complete job as contemplated by the drawings and specifications, which are a part of this proposal package. The Contractor shall furnish all labor, supervision, materials, power, tools, equipment, supplies and any other means of construction necessary or proper for performing and completing the Scope of Work, unless otherwise specifically stated. Exhibit B contains the unit price sheet. Monroe County has made all reasonable efforts to obtain the required permits for this project. If the Contractor is aware of another permit that is required, it is up to them to obtain it. SPECIAL PROVISIONS The following Special Provisions are intended to clarify the scope of work, or highlight features of the work, or modify, change, add to, or delete from the General Scope of this Proposal Package. 1. All licenses required in order to perform the scope of work in the specified location, shall be procured and maintained by the contractor and his subcontractors. Contractor shall submit copies to WOOD prior to notice to proceed. Contractor's license shall accompany proposal. 2. Contractor is to review Division 1 General Requirements for additional responsibilities required in order to perform this Work. 3. If in the event of conflicting or overlapping requirements in any area of the proposal documents, technical specifications, or drawings, the most stringent condition shall be proposed and constructed. Notify Sustainability Manager in any event, in order to not compromise the Owner's right to make appropriate decisions. AGREEMENT 00500-Page 2 of 18 4. Contractor shall maintain As-Built Drawings, (Record Drawings per Section 01720), of his work progression. 5. Contractor shall provide suitable storage container and be responsible for disposal off-site of all debris and trash. 6. The Contractor shall coordinate with Owner's representative on available hours for Job Site access. Job site will have limited 8AM-6PM work hours Mon-Friday excluding holidays. Contractor will need to schedule work shifts typically from 8AM-6PM weekly. Any change to the agreed upon schedule must be obtained in writing with a minimum of 72 hrs. advanced notice. 7. Coordination of each day's works shall be done in advance with approval from WOOD / Engineer The Engineer is: WOOD Environment & Infrastructure Solutions, Inc. Greg Corning 5845 NW 158t" Street Miami Lakes, Florida, 33014 314-920-8359 The Owner and Contractor agree as set forth below. ARTICLE 1 The Contract Documents The Contract Documents consist of this Agreement, Conditions of the Contract (General, Supplementary and other Conditions), Drawings, Specifications, Proposal Documents, Addenda issued prior to execution of this Agreement, together with the response to RFP and all required insurance documentation, and Modifications issued after execution of this Agreement. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations, representations or agreements, either written or oral. An enumeration of the Contract Documents, other than Modifications, appears in Article 9. In the event of a discrepancy between the documents, precedence shall be determined by the order of the documents as just listed. ARTICLE 2 The Work of this Contract The Contractor shall execute the entire Work described in the Contract Documents, except to the extent specifically indicated in the Contract Documents to be the responsibility of others, or as follows: N/A ARTICLE 3 Date of Commencement and Substantial Completion AGREEMENT 00500-Page 3 of 18 3.1 The date of commencement is the date to be fixed in a notice to proceed issued by the Owner. The Contractor shall proceed with Work no later than seven calendar days after receipt of the Notice To Proceed. Failure to commence with Work within the 7-day time shall result in a $500.00 fine to the Contractor for each day that work does not commence for the first 15 days, $1,000/day for days 16-30 and $3,500 per day for days 31 and thereafter, as specified below. The Contractor shall accomplish Substantial Completion of the Combined Project within Two Hundred and Forty (240) calendar days from Notice to Proceed. The time or times stipulated in the contract for completion of the work of the contract or of specified phases of the contract shall be the calendar date or dates listed in the milestone schedule. The Owner shall be entitled to liquidated damages as shown below for all work that fails to meet the deadlines shown in the milestone schedule. Liquidated damages will be based on the Substantial Completion Date for all work, modified by all approved extensions in time as set forth by the Sustainability Manager's signature of approval on the Certificate of Substantial Completion. The liquidated damages table below shall be utilized to determine the amount of liquidated damages. FIRST SECOND 31ST DAY & CONTRACT AMOUNT 15 DAYS 15 DAYS THEREAFTER Under $50,000.00 $50.00/Day $100.00/Day $250.00/Day $50,000.00-99,999.00 100.00/Day 200.00/Day 750.00/Day $100,000.00-499,999.00 200.00/Day 500.00/Day 2,000.00/Day $500,000.00 and Up 500.00/Day 1,000.00/Day 3,500.00/Day The Contractor's recovery of damages and sole remedy for any delay caused by the Owner shall be an extension of time on the Contract. ARTICLE 4 Contract Sum 4.1 The owner shall pay the Contractor in current funds for the Contractor's performance of the Contract the Contract Sum of Two Million Two Hundred ThreeThousand Four Hundred Fifty Six/100 Dollars ($2,203,456.00) subject to additions and deductions as provided in the Contract Documents. ARTICLE 5 Progress Payments 5.1 Based upon Applications for Payment submitted by the Contractor to the Sustainability Program Manager, and upon approval for payment issued by the Sustainability Program Manager, and Engineer, the Owner shall make progress payments on account of the Contract Sum to the contractor as provided below and elsewhere in the Contract Documents. 5.2 The period covered by each Application for payment shall be one calendar month ending on the last day of the month, or as follows: AGREEMENT 00500-Page 4 of 18 5.3 Payment will be made by the Owner in accordance with the Florida Local Government Prompt Payment Act, section 218.735, Florida Statutes. Contractor shall submit to Owner invoices with supporting documentation acceptable to the Clerk, on a MONTHLY schedule in arrears. Acceptability to the Clerk is based on generally accepted accounting principles and such laws, rules and regulations as may govern the Clerk's disbursal of funds. Owner's performance and obligation to pay under this agreement, is contingent upon annual appropriation by the Board of County Commissioners. 5.4 Each Application for Payment shall be based upon the Schedule of Values submitted by the Contractor in accordance with the Contract Documents. The Schedule of Values shall allocate the entire Contract Sum among the various portions of the Work and be prepared in such form and supported by such data to substantiate its accuracy as the Sustainability Program Manager may require. This schedule, unless objected to by the Sustainability Program Manager, shall be used as a basis for reviewing the Contractor's Applications for Payment. 5.5 Applications for Payment shall indicate the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.6 Subject to the provisions of the Contract Documents, the amount of each progress payment shall be computed as follows: 5.6.1 Take that portion of the Contract Sum properly allocable to completed Work as determined by multiplying the percentage completion of each portion of the Work by the share of the total Contract Sum allocated to that portion of the Work in the Schedule of Values, less retainage of Five Percent 5%. Pending final determination of cost to the owner of changes in the Work, amounts not in dispute may be included in Applications for Payment. The amount of credit to be allowed by the Contractor to the Owner for a deletion or change which results in a net decrease in the Contract Sum shall be the net cost to the Owner, less Overhead, Profit and Documented Costs incurred prior to the change Request, as indicated in the corresponding line item in the Approved Schedule of Values for that line item as confirmed by the Sustainability Program Manager. When both additions and credits covering related Work or substitutions are involved in a change the allowance for overhead and profit shall be figured based on net increase, if any, with respect to that change. 5.6.2 Add that portion of the Contract Sum properly allocable to materials and equipment delivered and suitably stored at the site for subsequent incorporation in the completed construction (or, if approved in advance by the Owner, suitably stored off the site at a location agreed upon in writing), less retainage; 5.6.3 Subtract the aggregate of previous payments made by the Owner; and 5.6.4 Subtract amounts, if any, for which the Sustainability Program Manager has withheld or nullified a Certificate for Payment as provided in Paragraph 9.5 of the General Conditions. AGREEMENT 00500-Page 5 of 18 5.7 Retainage of 5% will be withheld in accordance with section 218.735 (8) (a), Florida Statutes. 5.8 Reduction or limitation of retainage, if any, shall be as follows: Upon achieving fifty percent (50 %) completion of the Work, and when requested by the Engineer, the Owner may release half of the amount previously retained. Owner reserves the right, at its sole discretion, to further reduce the amounts retained on any subsequent monthly payment request prior to final payment. Provided, however, nothing in this Section shall preclude or limit the Owner's right to withhold payment as otherwise permitted by the terms of the Contract Documents or as permitted by law. ARTICLE 6 Final Payment Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by the Owner to the Contractor when (1) the Contract has been fully performed by the Contractor except for the Contractor's responsibility to correct nonconforming Work as provided in Subparagraph 12.2.2 of the General Conditions and to satisfy other requirements, if any, which necessarily survive final payment, and (2) a final approval for payment has been issued by the Sustainability Program Manager. Such final payment shall be made by the Owner not more than 20 days after the issuance of the final approval for payment. The following documents (samples in section 1027) are required for Final Payment: (1) Application and Certificate for Payment (2) Continuation Sheet (3) Certificate of Substantial Completion (4) Contractor's Affidavit of Debts and Claims (5) Contractor's Affidavit of Release of Liens (6) Final Release of Lien (7) Contractor shall provide two (2) hard copies in tabulated divided binders and one (1) saved electronically tabbed and indexed in Adobe Acrobat file (.PDF) format delivered on a downloadable CD/DVD or flash drive of all the following but not limited to: A .Project Record Documents (As Built Documents). B. Operating and maintenance data, instructions to the Owner's personnel. C. Warranties bond and guarantees. D. Keys and keying schedule. E. Spare parts and maintenance materials. F. Electronic copies of approved submittals AGREEMENT 00500-Page 6 of 18 G. Evidence of payment and final release of liens and consent of surety to final release (includes final release from all utilities and utility companies). ARTICLE 7 Miscellaneous Provisions 7.1 Where reference is made in this Agreement to a provision of the General Conditions or another Contract Document, the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. 7.2 Payment shall be made according to the Florida Local Government Prompt Payment Act and Monroe County Code. 7.3 Temporary facilities and services: As described in Article 34 of the General Conditions 7.4 Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County Commissioners. 7.5 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 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 of real property to public entity, may not be awarded or perform work as contractor, supplier, subcontractor, or consultant 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. 7.6 The following items are included in this contract: a) Contractor shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Records shall be retained for a period of seven years from the termination of this agreement or for a period of three years from the submission of the final expenditure report as per 2 CFR §200.333, whichever is greater. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for seven years following the termination of this Agreement. If an auditor employed by the County or Clerk determines that monies paid to Contractor pursuant to this Agreement were spent for purposes not authorized by this Agreement, the Contractor shall repay the monies together with interest calculated pursuant to Sec. 55.03; FS, running from the date the monies were paid to Contractor. b) Governing Law, Venue, Interpretation, Costs, and Fees: This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. In the event that AGREEMENT 00500-Page 7 of 18 any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the County and Contractor agree that venue shall lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. The Parties waive their rights to trial by jury. The County and Contractor agree that, in the event of conflicting interpretations of the terms or a term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding, pursuant to Section XVI of this agreement. c) Severability. If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The County and Contractor agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. d) Attorney's Fees and Costs. The County and Contractor agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees and court costs as an award against the non- prevailing party and shall include attorney's fees and courts costs in appellate proceedings. e) Binding Effect. The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the County and Contractor and their respective legal representatives, successors, and assigns. f) Authority. Each party represents and warrants to the other that all necessary County and corporate action, as required by law have duly authorized the execution, delivery and performance of this Agreement. Each party agrees that it has had ample opportunity to submit this Contract to legal counsel of its choice and enters into this agreement freely, voluntarily and with advice of counsel. g) Claims for Federal or State Aid. Contractor and County agree that each shall be, and is, empowered to apply for, seek, and obtain federal and state funds to further the purpose of this Agreement; provided that all applications, requests, grant proposals, and funding solicitations shall be approved by each party prior to submission. h) Adjudication of Disputes or Disagreements. County and Contractor agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of 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 arbitration. AGREEMENT 00500-Page 8 of 18 i) Cooperation. In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, County and Contractor agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. County and Contractor specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. j) Nondiscrimination. County and Contractor agree 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 or Contractor 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 VII of the Civil Rights Act of 1964 (PL 88- 352), which prohibit discrimination in employment on the basis of race, color, religion, sex, and national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC §§ 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 § 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC §§ 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, §§ 523 and 527 (42 USC §§ 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 §§ 3601 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 §§ 12101), as amended from time to time, relating to nondiscrimination in employment on the basis of disability; 10) Monroe County Code Chapter 14, Article 11, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination provisions in any federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. k) Covenant of No Interest. County and Contractor covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that only interest of each is to perform and receive benefits as recited in this Agreement. 1) Code of Ethics. County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, 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. AGREEMENT 00500-Page 9 of 18 m) No Solicitation/Payment. The County and Contractor warrant 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 that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than 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 Contractor 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. n) Public Records Compliance. Contractor must comply with Florida public records laws, including but not limited to Chapter 119, Florida Statutes and Section 24 of article I of the Constitution of Florida. The County and Contractor shall allow and permit reasonable access to, and inspection of, all documents, records, papers, letters or other "public record" materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the County and Contractor in conjunction with this contract and related to contract performance. The County shall have the right to unilaterally cancel this contract upon violation of this provision by the Contractor. Failure of the Contractor to abide by the terms of this provision shall be deemed a material breach of this contract and the County may enforce the terms of this provision in the form of a court proceeding and shall, as a prevailing party, be entitled to reimbursement of all attorney's fees and costs associated with that proceeding. This provision shall survive any termination or expiration of the contract. The Contractor is encouraged to consult with its advisors about Florida Public Records Law in order to comply with this provision. Pursuant to F.S. 119.0701 and the terms and conditions of this contract, the Contractor is required to: (1) Keep and maintain public records that would be required by the County to perform the service. (2) Upon receipt from the County's custodian of records, provide the County with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. (3) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the contractor does not transfer the records to the County. (4) Upon completion of the contract, transfer, at no cost, to the County all public records in possession of the Contractor or keep and maintain public records that would be required by the County to perform the service. If the Contractor transfers all public records to the County upon completion of the contract, the Contractor AGREEMENT 00500-Page 10 of 18 shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the County, upon request from the County's custodian of records, in a format that is compatible with the information technology systems of the County. (5) A request to inspector copy public records relating to a County contract must be made directly to the County, but if the County does not possess the requested records, the County shall immediately notify the Contractor of the request, and the Contractor must provide the records to the County or allow the records to be inspected or copied within a reasonable time. If the Contractor does not comply with the County's request for records, the County shall 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 who fails to provide the public records to the County or pursuant to a valid public records request within a reasonable time may be subject to penalties under Section 119.10, Florida Statutes. Contractor shall not transfer custody, release, alter, destroy or otherwise dispose of any public records unless or otherwise provided in this provision or as otherwise provided by law. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY, AT (305) 292-3470, BRADLEY- BRIANa_MONROECOUNTY-FL.GOV, MONROE COUNTY ATTORNEY'S OFFICE, 1111 12th STREET, SUITE 408, KEY WEST, FL 33040. o) Non-Waiver of Immunity. Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the Contractor and the County in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the County be required to contain any provision for waiver. p) Privileges and Immunities. All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or AGREEMENT 00500-Page 11 of 18 employees of any public agents or employees of the County, when performing their respective functions under this Agreement within the territorial limits of the County shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the County. q) Legal Obligations and Responsibilities: Non-Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the County, except to the extent permitted by the Florida constitution, state statute, and case law. r) Non-Reliance by Non-Parties. No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third- party claim or entitlement to or benefit of any service or program contemplated hereunder, and the County and the Contractor agree that neither the County nor the Contractor or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. s) Attestations. Contractor agrees to execute such documents as the County may reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace Statement. t) No Personal Liability. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. u) Execution in Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. v) Hold Harmless and Indemnification. Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement, Contractor shall defend, indemnify and hold the COUNTY and the COUNTY's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of Contractor or any of its employees, agents, contractors or other invitees during the term of this Agreement, (B) the negligence or willful misconduct of Contractor or any of its AGREEMENT 00500-Page 12 of 18 employees, agents, sub-contractors or other invitees, or (C) Contractor's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the COUNTY or any of its employees, agents, contractors or invitees (other than Contractor). The monetary limitation of liability under this contract shall be equal to the dollar value of the contract and not less than $1 million per occurrence pursuant to Section 725.06, Florida Statutes. Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this Agreement, this section will survive the expiration of the term of this Agreement or any earlier termination of this Agreement. In the event that the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor s failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in the plans and specifications provided by the Contractor, the Contractor agrees and warrants that the Contractor shall hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action on the County's behalf. w) Section Headings. Section headings have been inserted in this Agreement as a matter of convenience of reference only, and it is agreed that such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. x) Disadvantaged Business Enterprise (DBE) Policy and Obligation. It is the policy of the County that DBE's, as defined in C.F.R. Part 26, as amended, shall have the opportunity to participate in the performance of contracts financed in whole or in part with County funds under this agreement. The DBE requirements of applicable federal and state laws and regulations apply to this Agreement. The County and its Contractor agree to ensure that DBE's have the opportunity to participate in the performance of the Agreement. In this regard, all recipients and contractors shall take all necessary and reasonable steps in accordance with applicable federal and state laws and regulations to ensure that DBE's have the opportunity to compete and perform contracts. The County, Contractor, and subcontractors shall not discriminate on the basis of race, color, national origin or sex in award and performance of contracts, entered pursuant to this Agreement. y) Agreements with Subcontractors. In the event that the Contractor subcontracts any or all of the work in this project to any third party, the Contractor specifically agrees to identify the COUNTY as an additional insured on all insurance policies required by the County. In addition, the Contractor specifically agrees that all agreements or contracts of any nature with his subcontractors shall include the COUNTY as additional insured. Special Conditions, if any are detailed in Section 00990 of the Project Manual for this Project. AGREEMENT 00500-Page 13 of 18 ARTICLE 8 FEDERALLY REQUIRED CONTRACT PROVISIONS The Contractor and its subcontractors must follow the provisions, as applicable, as set forth in 2 C.F.R. §200.326 Contract Provisions and 2 C.F.R., Appendix II to Part 200, as amended, including but not limited to: 8.1 Clean Air Act (42 U.S.C. §§7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. §§1251-1387) as amended (for contracts and subgrants in excess of $150,000). Contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. §§7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. §§1251-1387) and will report violations to FEMA and the Regional Office of the Environmental Protection Agency (EPA). The Clean Air Act (42 U.S.C. §§7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. §§1251-1387), as amended, applies to Contracts and subgrants of amounts in excess of$150,000. 8.2 Contract Work Hours and Safety Standards Act (40 U.S.C. §§3701-3708). Where applicable, which includes all FEMA grant and cooperative agreement programs, all contracts awarded by the County in excess of $100,000 that involve the employment of mechanics or laborers must comply with 40 U.S.C. §§3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. §3702 of the Act, each Contractor must compute the wages of every mechanic and laborer based on a standard workweek of forty (40) hours. Work in excess of the standard workweek is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of forty (40) hours in the workweek. The requirements of 40 U.S.C. §3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. 8.3 The Contractor shall utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the Contractor during the term of the Contract and shall expressly require any subcontractors performing work or providing services pursuant to the Contract to likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the Contract term. ARTICLE 9 Termination or Suspension 9.1 The Contract may be terminated by the Owner as provided in Article 14 of the General Conditions. AGREEMENT 00500-Page 14 of 18 ARTICLE 10 Enumeration of Contract Documents 10.1 The Contract Documents, except for Modifications issued after execution of this Agreement, are enumerated as follows: a) Drawings: Exhibit A b) Unit Price Sheet Exhibit B c) Project Manual including General Conditions 10.1.1 The Agreement is this executed Standard Form of Agreement Between Owner and Contractor. 10.1.2 The General Conditions are the General Conditions of the Contract for Construction. 10.1.3 The Supplementary and other Conditions of the Contract are those contained in the Project Manual. 10.1.4 The Addenda, if any, are as follows: Number Date Pages 1 03/16/22 1 2 04/05/22 1 3 04/25/22 1-3 10.1.5 The Alternates, if any, are as follows: Alternate No. 1: Not Applicable This Agreement is entered into as of the day and year first written above and is executed in at least four original copies of which one is to be delivered to the Contractor. Execution by the Contractor must be by a person with authority to bind the entity. AGREEMENT 00500-Page 15 of 18 $IGNATURE OF THE PERSON EXECUTINGTHE DOCUMENT MUST BE Ni*RIZED AND WITNESSEDT I " ENTITY (SEAL,): BOARD OF COUNTY COMMISSIONERS Attest: in M d k, Clerk OF MONROE COUNTY, FLORIDA ° ... ° wBy- As i. Cie 7a—yor/Chairman t ...M .. 4— (SEAL,) T Afte By.- .. By- ENT rrr ta � ���� � � rl t mw . .. . � ���� Ise%.��m..... . �� ... Title.-. Thal : . ° ���� ����� ...� Date- 6 AIL. �.� a s .� W � It C 101_. Print Name° - Title- �, � � � � �° ���~µ Date: as, STATE OF FLORIDA, COUINITY Subscribed and sworn t ( r a ur ) -lore Arta, by mearts �f 9/'physical presence,or El online . ,. notarization, t aaat�TM ��arr�all ...bra t one o � date ....mm ... 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Z KKU AP/f1 , O-Om U--W KJ O QiZjU� � — ff/ Q �tNi1O�Ow �O�aOU a w _¢m�Z w w65 �0 AwmKU c, ° w a wOd Z�wO ' i F Q �6 a F F.. w z Q O Z m Z gyp,; _ a a P ➢ 6 enuvs• rn H Z x0<Q Zto J o 3 III/ �V u n Z�wU '�o LL r o , w � w w Y=ate wW ��. o3mo / o 41 i 1) 1 a o E m o o° o° c d oo °w - r C u e H — ° o U(A� a N ° o E W Iooi}J9A o E,.tiea o- w III o ff N O 'Uw .,ZL � � I '1NJ N :x_x N ajoN j0 ,C v � a o s m ....._,.. ,. 3 o o v o o I ........._ _..., O � s I...... c _a 0 - �9 Q O 0 d Exhibit B — Unit Price Sheet BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL UNIT PRICE PROPOSAL SHEET ITEM NO. ESTIMATED UNIT DESCRIPTION UNIT PRICE LINE TOTAL QUANTITY PRICE 1 1 LS Mobilization and Demobilization $200,000.00 $200,000.00 2 1 LS Maintenance of Traffic $50,000.00 $50,000.00 3 1 LS Erosion and Sediment Control $205,000.00 $205,000.00 4 43,836 TON Fill Material $11.65 $510,689.40 5 43,836 TON Trucking of Backfill Material $7.00 $306,852.00 6 33,897 CY Placement of Coarse Fill $15.00 $508,455.00 7 2,633 CY Placement of 1-foot of Sand Fill $15.00 $39,495.00 8 1 LS Construction Surveys $50,000.00 $50,000.00 9 1 LS Labor $280,964.60 $280,964.60 10 1 LS Rehabilitation of Staging Areas to Original Condition $52,000.00 $52,000.00 ............ J Bid Total: $2,203,456.00 Contractor Signature: PROPOSAL FORMS 00110-Page 27 of 218 BA FILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, Mi Ou NROE COUNTY, FL NI -COLLUSION AFFIDAVIT 1, Gregory 'rolpin of the city Tavern k,,,,r -according to law on my oath, and under penalty of perjury, depose and say that: 1 1 am—Vice President/Secretaru of the firm of Adventure Environrnental Inc 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 proposal have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other proposer or with any competitor; 3, Unless otherwise required by law, the prices which have been quoted in this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed by the proposer prior to proposal opening, directly or indirectly„ to any other proposer or to any competitor; and 4 No attempt has been made 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; and 5. The statements contained in this affidavit are true and correct, and made with full knowledge that Mionroe County relies upon the truth of the statements contained in this affidavit in awarding contracts r said project.. ............. . ig n 4i"u-ir,40- Date: 144rt�. , 2 ...................... STATE OF: I to)vv-t cd—L COUNTY OF: 10 9hroc- Subscribed and sworn to or affirmed) before me, by means of or 0 online notarization, 2-gZ) . (date) by (narne of affiint�7 He/She is personally known to m or has produced (type of identification) as identification, XELLY J GRACIE Notary Publfc State of Florida Commission#GG 30,35,88 NOTARY WkR MY Comm,Expires Feb 19,2023 Sanded through Nddondl`Notary Assn. My commission e pires: 'Fe(o 19. D4A-3 INSURANCE REQUIREMENTS AND FORMS 00120-Page 29 of 218 BACKFILL RESTO RATIO N WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL LOBBYING AND CONFLICT OF INTEREST CLAUSE" SWORN STATEMENT UNDER ORDINANCE NO. 010-19,90 MONROE COUNTY, FLORIDA ETH ICS CLAUSE Adver�ture Environmental, lr�c (Com pany) warrants that he/it has not employed, retained or otherwise had act on his/its, behalf any former County officer or employee in violation of Section 2 oftrdinance 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 contract without liability and may also, in its discretion, dedUCt from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentag , gift, or consideration paid to the form er ,;:,jag , m, or considera County officer or employee". igin Date, STATE OF: —C— ,Subscribed and sworn to (or affirmed), before me, by means of Kphysical, presence or 1-1 online notarization, on 2-._ (date) by �-1—0 t P;0 (name of affiant). HelSh s persona�Ily known to me . or has produced (type of identifica identification. "k- KELLY J GRACIE W&TgFZV P N,otary Pub,lic� State of Hor$d�l vLt'y' C - �01�OGG 301SU ;2j DMMM, R My Comm.Exj)ires Feb 19,2023 .....OF My commis sion, expires� feb Bonded through NafionM NiMarV A55fl. RM IN REQUIREMENTS AND FORMS 010120-Page 30 of 218 .......... ....................... BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL DRU'G-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that. k1ve,riture Erv�iironrriental, �nc (Name of Business) I.. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possessions, or use of a controlled!, substance is prohibited in the workplace and specifyingi the actions that will be taken against employees for violations of such prohibition. 2. informs employees about the dangers of drug abuse in the workplace, the business's policy cif 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 proposal a copy of the statement specified in subsection (1), 4. In the statement specified in subsection (1), notifies the employees that, as, a condition of working on the commodities or contractual services that are under proposal, the employee wiII abide by the terms of the statement and will notify the employer of any conviction of, of, plea of guilty or nollo contendere to, any violation of Chapter B93 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later the five (5) days,after such conviction, 51. 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. & Makes a good faith effort to continue to maiintaiin a drug-free workplace through implementation of this section, As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. 7 9 8ign at 0 STATE OF-_jtC)V-t COUNTYt F; Subscribed and sworn to (or affirmed) before me, by means,of 0 physical presence or El online notarization, on (date) by, t jr-s (name of afflant). He/ is personally known t meor has prod c d t i e i ,c 6 n entification. KELLY J GRAClE Nowry Public Stele of FWdda 03; Comm�won 9 GG 303588 My Comm,EMAres Feb $9,2023, Bonded through NlWnM NoLa:ry Assn. INSUFA5CE REQUIREMENTS AND FORMS 120-Page 31 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONO OE COUNTY, FL PUBLIC ENTITY C�RIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime imay 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,supptier,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." AOyu Inc 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 la t 36 months. ii � Date: au ;L ;-0;k� STATE OF: Subscribed and sworn to,(or affirmed) before me, by means of physical presence or 0 online notarization, on VA&q P, 'X0_4- (date) by GWc40AA 'T71f-iP, (name of affiant). He/She is personally known t6 me or,has, produced (type ofi'de on) as identification, /I t LAX, /--NdtW PUBLIC My Commission Expires: -- -fib-- t KELLY J GRACIE T NOWY Public State ol FWrida M599 my Comm,Expim Feb 19,2D23 Z,or "."Fe Bonded WOUVil National Notary Am INSURANCE REQUIREMENTS AND FORMS 0011 20-P,age 32 of 218 . ......................... ........................................ ........ BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS, CANAL#28 KEY LARGIO, MONROE COUNTY, FL VEN ANIS LISTS Project Description(s): backfill Water ()uahL, Wmlrr.z��ts Canal 28, IK� Respondent Vendor Name Vendor FEIN: (35-0768539 Vendc,F's,Aothovized Representative Name and Tiftie: Grp_iLoTy. Tolpm,Vice,, Pres'ident Address: 2 1 f 60 L"13�'�,��('� (Wenue _. .,,orcpa � City: Taverier State: FL Zip- 33070 Phone Email Address Greg_ o�Cg�,4AEI,o ry't Section 287.135, Florida Statutes prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract for goods, or services of any arnount if, at the time of contracting or renewal, the company is on the Scrutinized Companies that Boycott lsrael List, created pursuant to Section 215-4725, FlOtidal Statutes, or is engaged in a Boycott of Israel. Section 287.135,, Florida Statutes, also prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract for goods or services of $1,000,0100 or more, that are an either the Scrutinized Companies with, Activities in Sudan List or the: Scrutinized Companies with Activities in the iron Petvoleum Energy Sector Lists which were created pursuant to & 215,473, Florida Statutes, or is engaged in business operations in Cuba or Syria. As, the person authorizer to sign on behalf at Respondent, I hereby certify that the company identified: above in the Section entitled "Respondent Vendor Name" is not listed on the Scrutinized Companies that Boycott Israel List or engaged in a boycott of Iisrael and for Projects of$1,000,000 or more is not listed on either the Scrutinized Companies with Activities inn Sudan List,the Scrutiruized CompaNes with ActMbes in the Iran Petroleum Energy Sector List, or engaged in business operations in Cuba or Syria. 1 understand that pursuant to Section 287.135, Florida Statutes, the submission of a false certification may subject company to civil penaMes, attorney'z lees, andlor costs. I%irther understand that any contract with the COUNTY may be terminated, at the option of the COUNTY, if the company is found to have submitted a false certification or has been placed on the Scrutinized Companies that Boycott Israel List or engaged an a boycott of Israel or placed on the ScriAinized Companies with,Activities in Sudan List or the Scrutinized Companies,with Activities in the Iran Petroleum Energy Sector List or been engaged in,business operations in Cuba or Syria. Certified By Greg)iry P,.)lpin who is authorized to,sign on behalf of the above referenced company. Authorized Signature:______"" Print Name: Greqory T4edn Title: V ce Note: The List are available at the following Department of Management Services,Site: httr)°//www,dm .nivflo,rida,cofMn/-buisi�ness�oerati�ispate urchasino/vendor information,/convicted, susp ended discrimi,natory complaJots vendor_lists INSURANCE REQUIREMENTS AND FORMS 001120-Page 33 of 218 .........—1.111­11111.111111111111..................... ................ BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL SECTION 00120 - INSURANCE REQUIREMENTS AND FORMS MONROE COUNTY, FLORIDA INSURANCE CHECKLIST FOR PROPOSER WORKERS' COMPENSATION X_Workers' Compensation Statutory Limits Bodily Injury by Accident/Bodily Injury by Disease, policy limits/Bodily Injury by Disease each employee WC1 Employers Liability $100,000/$500,000/$100,000 WC2 Employers Liability $500,000/$500,000/$500,000 WC3 X_ Employers Liability $1,000,000/$1,000,000 /$1,000,000 WCUSLH X_ US Longshoremen & Same as Employers' Harbor Workers Act Liability WCJA X_ Federal Jones Act Same as Employers' Liability INSURANCE REQUIREMENTS AND FORMS 00120-Page 34 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL GENERAL LIABILITY As a minimum, the required general liability coverages will include: • Premises Operations • Products and Completed Operations • Blanket Contractual a Personal Injury • Expanded Definition of Property Damage Required Limits: GL1 $200,000 per Person; $300,000 per Occurrence $200,000 Property Damage or $300,000 Combined Single Limit GL2 $300,000 per Person; $500,000 per Occurrence $200,000 Property Damage or $500,000 Combined Single Limit GL3 _X_ $500,000 per Person; $1,000,000 per Occurrence $100,000 Property Damage or $1,000,000 Combined Single Limit GL4 $2,000,000 Combined Single Limit Required Endorsement: GLXCU Underground, Explosion and Collapse (XCU) GLLIQ Liquor Liability GLS Security Services All endorsements are required to have the same limits as the basic policy. INSURANCE REQUIREMENTS AND FORMS 00120-Page 35 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL VEHICLE LIABILITY As a minimum, coverage should extend to liability for: • Owned; Non-owned; and Hired Vehicles Required Limits: VL1 $50,000 per Person: $100,000 per Occurrence $25,000 Property Damage or $100,000 Combined Single Limit (The use of VL1 should be limited to special projects that involve other governmental entities or "Not for Profit" organizations. Risk Management must approve the use of this form). VL2 $200,000 per Person; $300,000 per Occurrence $200,000 Property Damage or $300,000 Combined Single Limit VL3 _X_ $500,000 per Person; $1,000,000 per Occurrence $100,000 Property Damage or $1,000,000 Combined Single Limit VL4 $5,000,000 Combined Single Limit MISCELLANEOUS COVERAGES WL2 X Watercraft Liability $170007000 BR1 Builders' Limits equal to the Risk completed project. MVC Motor Truck Limits equal to the maximum Cargo value of any one shipment. PRO1 Professional $ 300,000 per Occurrence/$ 5007 OOOAgg. PR02 Liability $ 500,000 per Occurrence/$1,000,000 Agg. PR03 $1,000,000 per Occurrence/$2,000,000 Agg. POL1 Pollution $ 500,000 per Occurrence/$1,000,000 Agg. POL2 X_ Liability $1,000,000 per Occurrence/$2,000,000 Agg POL3 $5,000,000 per Occurrence/$10,000,000 Agg. ED1 Employee $ 107000 INSURANCE REQUIREMENTS AND FORMS 00120-Page 36 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL ED2 Dishonesty $100,000 GK1 Garage $ 300,000 ($ 25,000 per Veh) GK2 Keepers $ 500,000 ($100,000 per Veh) GK3 $1,000,000 ($250,000 per Veh) MED1 Medical $ 300,000/$ 750,000 Agg. MED2 Professional $ 500,000/$ 1,000,000 Agg. M E D3 $1,000,000/$ 3,000,000 Agg. M E D4 $5,000,000/$10,000,000 Agg. IF Installation Maximum value of Equipment Floater Installed VLP1 Hazardous $ 300,000 (Requires MCS-90) VLP2 Cargo $ 500,000 (Requires MCS-90) VLP3 Transporter $1,000,000 (Requires MCS-90) BLL Bailee Liab. Maximum Value of County Property that will be in the Bailee's possession. HKL1 Hangar keepers $ 300,000 HKL2 Liability $ 500,000 H KL3 $ 1,000,000 AIR1 Aircraft $ 1,000,000 AIR2 Liability $ 5,000,000 AI R3 $50,000,000 AE01 Architects Errors $ 300,000 per Occurrence/$ 500,000 Agg. AE02 & Omissions $ 500,000 per Occurrence/$1,000,000 Agg. AE03 $ 1,000,000 per Occurrence/$3,000,000 Agg. E01 Engineers Errors $ 300,000 per Occurrence/$ 500,000 Agg. E02 & Omissions $ 500,000 per Occurrence/$1,000,000 Agg. E03 $ 1,000,000 per Occurrence/$3,000,000 Agg. INSURANCE REQUIREMENTS AND FORMS 00120-Page 37 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR CONTRACT: Backfill Restoration Water Quality Improvement Projects Canal #28, Key Largo, Monroe County, Florida BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $1,000,000 Bodily Injury by Accident $1,000,000 Bodily Injury by Disease, policy limits $1,000,000 Bodily Injury by Disease, each employee WCUSLH US Longshoremen & Harbor Workers Act - Same as Employer's Liability WCJA Federal Jones Act - Same as Employer's Liability- Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. If the Contractor has been approved by the Florida's Department of Labor, as an authorized self-insurer, the County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. INSURANCE REQUIREMENTS AND FORMS 00120-Page 38 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT: Backfill Restoration Water Quality Improvement Projects Canal #28, Key Largo, Monroe County, Florida BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Contractor shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Products and Completed Operations • Blanket Contractual Liability • Personal Injury Liability • Expanded Definition of Property Damage The minimum limits acceptable shall be: $2,000,000 Combined Single Limit (CSL) An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. GL INSURANCE REQUIREMENTS AND FORMS 00120-Page 39 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL VEHICLE LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT: Backfill Restoration Water Quality Improvement Projects Canal #28, Key Largo, Monroe County, Florida BETWEEN MONROE COUNTY, FLORIDA AND Recognizing that the work governed by this contract requires the use of vehicles, the Contractor, prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum, liability coverage for: • Owned, Non-Owned, and Hired Vehicles The minimum limits acceptable shall be: $1,000,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $ 500,000 per Person $1,000,000 per Occurrence $ 100,000 Property Damage The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. VL3 INSURANCE REQUIREMENTS AND FORMS 00120-Page 40 of 218 BACKFILL RESTORATION WATER QUALITY IMPROVEMENT PROJECTS CANAL#28 KEY LARGO, MONROE COUNTY, FL PROPOSER'S INSURANCE AND INDEMNIFICATION STATEMENT INSURANCE REQUIREMENTS Worker's Compensation Statutory Limits Employers Liability $1,000,000 Bodily Injury by Accident $1,000,000 Bodily Injury by Disease Policy Limits $1,000,000 Bodily Injury by Disease, each employee US Longshoremen & Harbor Workers Act—Same as Employer's Liability Federal Jones Act—Same as Employer's Liability General Liability, including $2,000,000 Combined Single Limit Premises Operations Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Expanded Definition of Property Damage Builder's Risk: Not Required Watercraft Liability $1,000,000 Pollution Liability $1,000,000 per Occurrence $2,000,000 Agg Vehicle Liability (Owned, non-owned, and hired vehicles) $1,000,000 Combined Single Limit If split limits are preferred: $ 500,000 per Person $1,000,000 per Occurrence $ 100,000 Property Damage Hold Harmless and Indemnification. Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement, Contractor shall defend, indemnify and hold the COUNTY and the COUNTY's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of Contractor or any of its employees, agents, contractors or other invitees during the term of this Agreement, (B) the negligence or willful misconduct of Contractor or any of its employees, agents, sub-contractors or other invitees, or (C) Contractor's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the COUNTY or any of its employees, agents, contractors or invitees (other than Contractor). Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this Agreement, this section will survive the expiration of the term of this Agreement or any earlier termination of this Agreement. In the event that the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractors failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in the plans and specifications provided by the Contractor, the Contractor agrees and INSURANCE REQUIREMENTS AND FORMS 00120-Page 41 of 218 ADVEN-1 OP ID: GB ,4coRo,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `.�• 01/07/2022 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 504-486-5411 CONTACT Accessible Marine Insurance Accessible Marine Insurance PHONE FAX 1145 Robert E Lee Blvd (A/C,No,Ext): 504�86-5411 (A/C,No):504�82-1475 New Orleans,LA 70124 E-MAIL Eric S.Green ADDRESS:gail@ami-ins.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Capitol Specialty Ins. Company INSURED INSURER B:Great American Ins.Company 22136 Adventure Environmental Inc. Greg Tolpin INSURERC: an StarNet Insurance Company 40045 160 Georgia Avenue Tavernier,FL 33070 INSURER D: 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 DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE Xrl OCCUR EV20190209-04 01/09/2022 01/09/2023 DAMAGE TO RENTED 50,000 X PREMISES Ea occurrence $ APPROVED BY RISK MANAGEMENT MED EXP(Any oneperson) $ 5,000 B`f�. -- = x. .......••_ •.,,„;r'""- PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: DATE 6129/2.•022 GENERAL AGGREGATE $ 2,000,000 X POLICYEl PRO-JJECT1:1 LOC WAVER NIA YES PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER 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 $ C M.E.L. BOOM-A-21-2110 08/15/2021 08/15/2022 M.E.L. 1,000,000 B Hull/P&I Liability OMH841008-10 10/12/2021 10/12/2022 P&I Limit 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County and Florida Department of Environmental Protection,3900 Commonwealth Blvd.Tallahassee, FL 32399 shown as additional insured as respects liabilities hereunder. CERTIFICATE HOLDER CANCELLATION MONRO05 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. Insurance Compliance P. O. Box 100085-FX AUTHORIZED REPRESENTATIVE Duluth,GA 30096 _/y „ 11�9/� ACORD 25(2016/03) ©1988°-'20�15'ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 06/01/2022 Policy number. 03515746 Underwritten by: 41-Progressive Express Insurance Co. NAIC Number: 10193 Certificate of Insurance Cortifieate Holder Insured Aaent Additional Insured Monroe County BOCC Adventure Environmental Inc Butler Buckley Deets Insurance Compliance 160 Georgia Ave 6161 Blue Lagoon#420 PO Box 100085-FX Tavemier, FL 33070 Miami, FL 33126 Deluth,GA 30096 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the periods)indicated.This certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change,alter,modify,or extend the coverages afforded by the policies listed below.The coverages afforded by the policies listed below are subject to all the terms,exclusions,limitations,endorsements,and conditions of these policies. Liability coverage may not apply to all scheduled vehicles. Policy Effective Date: Policy Expiration Date: 06/11/2022 06/11/2023 Insurance covernaefs) Urnits Bodily Injury Property Damage-Combined Single Limits $1,000,000 per occurrence Hired Auto Liability $1,000,000 per occurrence Employer Non-Owned Auto Liability $1,000,000 per occurrence WAVER NA-YE Description of LocationIVehicleslSpecial Items Scheduled autos only 2014 Chevrolet Silverado C2500 VIN 1GC1 CVCG7EF187484 Comprehensive$1,000 Deduct!ble/Collision$1,000 Deductible 2015 Chevrolet Silverado C2500 VIN 1GC2GUEG1FZ541060 Comprehensive$1,000 Deduct!ble/Gollision$1,000 Deductible 2017 Chevrolet Silverado C2500 VIN 1GC1 KUEGOHF207993 Comprehensive$1,000 Deductible/Collision$1,000 Deductible 2018 Chevrolet 2500 HD VIN 1GCIKUEGXJF134539 Comprehensive$1,000 Deduct!ble/Collision$1,000 Deductible 2019 Chevrolet K2500 VIN 1GG1KTEYOKF112991 Comprehensive$1,000 Deduct!ble/Gollision$1,000 Deductible 2002 KW T80 VIN 1NKDLT9X12J894497 Comprehensive$1,000 Deductible/Collision$1,000 Deductible 2014 PTRB 388 VIN 1NPWX4EX5ED226224 Comprehensive$1,000 Deduct!ble/Gollision$1,000 Deductible 2006 INTL 740 VIN 1HTWGAAN16J370901 Comprehensive$1,000 Deduct!ble/Gollision$1,000 Deductible 2009 Chevrolet Silverado C3500 VIN 1GBJC74K99E105480 Comprehensive$1,000 Deductible/Collision$1,000 Deductible 2019 Chevrolet Suburban C1500 VIN 1GNSKJKJ6KR262447 Comprehensive$1,000 Deduct!ble/Collision$1,000 Deductible 2020 Chevrolet Silverado C2500 VIN 1 GC4YPEY7LF1 05587 Comprehensive$1,000 Deduct!ble/Gollision$1,000 Deductible 2020 Chevrolet Silverado C2500 VIN 1 GC4YPEYOLF1 54498 Comprehensive$1,000 Deduct!ble/Collision$1,000 Deductible Certificate number 15222W2E746 Please be advised that additional insureds and loss payees will be notified in the event of a mid-term cancellation. Form 5241(05116) PROMEW E' Adventure Environmental Inc 160 Georgia Ave Tavernier, FL 33070 APPROWD iQY IIH W MAN AGE ENT jig �R ,CIE NA Y WAIVER OF SUBROGATION ENDORSEMENT This endorsement modifies insurance provided under the following: Commercial Auto Policy Motor Truck Cargo Legal Liability Coverage Endorsement Commercial General Liability Coverage Endorsement We agree to waive any and all subrogation claims against the person or organization designated below. Monroe County BOCC Insurance Compliance PO Box 100085-FX Deluth,GA 30096 This endorsement applies to Policy Number: 03515746 Issued to: Adventure Environmental Inc Endorsement Effective: 06/11/2022 Expiration: 06/11/2023 All other terms,limits and provisions of this policy remain unchanged. Form 8610(02/19)M_CL Adventure Environmental Inc. ADVEN-1 PAGE 2 NOTEPAD INSURED'SNAME OP ID: GB Date 01/07/2022 Contractors Pollution Liability: Insurer: Rockhill Insurance Company Policy#: EV20190209-04 Policy Period: 01/09/22 - 01/09/2023 Claims Made Aggregate Limit: 2,000,000 Each Contractors Pollution Condition Limit: 2,000,000 Blanket Additional Insured/ Waiver of Subrogation Professional Liability: Insurer: Rockhill Insurance Company Policy#: EV20190209-04 Policy Period: 01/09/22 - 01/09/2023 Aggregate Limit: 2,000,000 Each Professional Services Incident Limit: 2,000,000 Commercial General Liability Conditions: Deductible Liability Endorsement Exclusion - Testing or Consulting Errors and Omissions Total Pollution Exclusion Endorsement Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization Exclusion-Violation of Statutes that Govern Emails, Fax, Phone Calls or Other Methods of Sending Exclusion - Punitive or Exemplary Damages Amended Waiver of Subrogation Exclusion - Engineers, Architects or Surveyors Exclusion - Exterior Insulation and Finish Systems Exclusion - Professional Services Primary/Non-Contributory Coverage-Blanket - When req. by written contract Additional Insured - Managers or Lessors of Premises Toxic Drywall Exclusion Separation of Insureds Independent and/or Subcontractor Restriction Contractors Pollution Liability (Claims-Made) Conditions: Additional Insured - Owners, Lessees or Contractors (Broad Wording) Amended Waiver of Subrogation Toxic Drywall Exclusion Professional Liability Conditions: War or Terrorism Exclusion Additional Insured - Owners, Lessees or Contractors Hull & Machinery / Protection & Indemnity: Terms and Conditions applicable to All Sections: Severability Terms and Conditions applicable to Hull: A. I. Coastwise and Inland Hull Clauses Deliberage Damage (Pollution Hazard) Engines & Machinery - ACV / Limited Perils Only No Lay Up Warranty No Release to Tower Warranty Seaworthiness Clause Total Loss Hull Premium Earned Clause Vessel Stability Additional Insured as respects P&I Adventure Environmental Inc. ADVEN-1 PAGE 3 NOTEPAD INSURED'SNAME OP ID: GB Date 01/07/2022 Terms and Conditions applicable to P&I: SP-38 Form Collision Clause including Tow & Extended Tower's Liability Collision Liability - P&I Extension Diving & Swimming Exclusion Food & Beverage Exclusion Health Hazard Exclusion Liability Limitation No Release to Tower Warranty P&I Crew Exclusion: Notwithstanding anything contained in the Protection and Indemnity Clauses herein to the contrary, it is understood and agreed that this Company shall not be liable for any loss, expense or claim to employees of the Assured, members of the crew, contractors or subcontractors Punitive/Exemplary Damages Exclusion Special Operations Exclusion Contractor's Equipment: Policy No. : IMP 5305782-05 Policy Period: 01/26/2021 to 01/26/2022 - Owned Equipment $75,000 - Leased/Rented Equipment any one item limit $200,000 - Leased/Rented Equipment all items limit $400,000 M.E.L. -Maritime Employers Liability Coverage Form -Transportation, Wages, Maintenance & Cure -Notice of Cancellation: 30 days (except 10 days of nonpayment of premium) -Death on the High Seas Clause -In Rem Liability -Blanket Waiver of Subrogation This certificate of insurance neither affirmatively nor negatively alters, amends, or extends the coverage afforded by Policy(ies) issued by the Insurer(s) listed on this certificate. Date CERTIFICATE OF LIABILITY INSURANCE 12/7/2021 Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend,extend Holiday, FL 34691 or alter the coverage afforded by the policies below. (727) 938-5562 Insurers Affording Coverage NAIC# Insured: South East Personnel Leasing, Inc. &Subsidiaries Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. InsurerB: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR ADDL Policy Effective Policy Expiration Date Limits LTR INSRD Type of Insurance Policy Number Date (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence Commercial General Liability Damage to rented premises(EA Claims Made ❑ Occur occurrence) ARPRO'VED ipY RMK MANAGEMENT Med Exp General aggregate limit applies per: fri )' ___ Personal Adv Injury Policy Project LOC WAVER NpA—'YES—' General Aggregate ❑ ❑ Products-Comp/Op Agg AUTOMOBILE LIABILITY Combined Single Limit (EA Accident) Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos Hired Autos Bodily Injury Non-Owned Autos (Per Accident) Property Damage (Per Accident) EXCESS/UMBRELLA LIABILITY Each Occurrence Occur ❑Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2022 01/01/2023 x I WC Statu- OTH- Employers'Liability tory Limits ER Any proprietor/partner/executive officer/member E.L.Each Accident $1,000,000 excluded? NO E.L.Disease-Ea Employee $1,000,000 If Yes,describe under special provisions below. E.L.Disease-Policy Limits 1 $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A(Excellent). AMB# 12616 Descriptions of Operations/Locations/Vehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 80-65-323 Coverage only applies to active employee(s)of South East Personnel Leasing,Inc.&Subsidiaries that are leased to the following"Client Company": Adventure Environmental,Inc. Coverage only applies to injuries incurred by South East Personnel Leasing,Inc.&Subsidiaries active employee(s),while working in: FL. Coverage does not apply to statutory employee(s)or independent contractor(s)of the Client Company or any other entity. A list of the active employee(s)leased to the Client Company can be obtained by faxing a request to(727)937-2138 or email certificates@lioninsurancecompany.com Project Name: INCLUDES USL&H. GREGORY J.TOLPIN,LICENSE#CGC1506411 and#CUC1223905,AS QUALIFIER. WAIVER OF SUBROGATION APPLIES IN FAVOR OF MONROE COUNTY BOCC. ISSUE 06-11-21 (PH) Beclin uate:1 IS Colo CERTIFICATE HOLDER CANCELLATION MONROE COUNTY BOCC Should any of the above described policies be cancelled before the expiration date thereof,the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left,but failure to INSURANCE COMPLIANCE do so shall impose no obligation or liability of any kind upon the insurer,its agents or representatives. P.O.BOX 100085-FX DULUTH, GA 30096 " dl„ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE WC 00 03 13 POLICY (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule MONROE COUNTY BOCC INSURANCE COMPLIANCE P.O. BOX 100085 - FX DULUTH, GA 30096 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Insured: South East Personnel Leasing,Inc. Insurance Company:Lion Insurance Co. Countersigned by: Policy 4:WC 71949 Effective: 01/01/2022-01/01/2023 Client: Adventure Environmental,Inc. WC 00 03 13 (Ed.4-84) ©1983 National Council on Compensation Insurance.