04/17/2002 Agreement
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
BRANCH OFFICE
MARATHON SUB COURTHOUSE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
FAX (305) 289-1745
MONROE COUNTY COURTHOUSE
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
FAX (305) 295-3663
BRANCH OFFICE
PLANTATION KEY
GOVERNMENT CENTER
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
FAX (305) 852-7146
MEMORANDUM
DATE:
April 30, 2002
TO:
Dent Pierce, Director
Public Works Division
ATTN:
Beth Leto, Administrative Assistant
Public Works Division
Pamela G. Hanc~
Deputy Clerk "CY
FROM:
At the March 20, 2002, Board of County Commissioners (BOCC) meeting the Board
granted approval and authorized execution of a Contract Amendment between Monroe County
and Mowery Elevator Service, Inc. to include the elevator located in the common area and the
dumbwaiter, located in the Property Appraiser's Office, at the Key West Courthouse for monthly
maintenance and biennial inspections.
) At the April 17, 2002, BOCC meeting the Board granted approval and authorized
execution of Contracts between Monroe County and L & N Dependable Janitorial, Inc. for
Janitorial Services for the following locations: Big Pine Key Library, George Dolezal Library in
Marathon, Islamorada Library, and the Key Largo Library.
Enclosed are duplicate originals of each of the above mentioned for your handling.
Should you have any questions please do not hesitate to contact this office.
Cc: County Administrator w/o documents
County Attorney
Finance
File ,/
CONTRACT
THIS AGREEMENT, made and entered into this 17th day of April, 2002, A.D., by and between
MONROE COUNTY, FLORIDA, (hereinafter sometimes call the "owner"), and L & N
Dependable Janitorial. Inc. , (hereinafter called the "Contractor").
That the parties hereto, for the consideration hereinafter set forth, mutually agree as follow:
1.01 THE CONTRACT
The contract between the owner and the contractor, of which this agreement is a part,
consists of the contract documents.
A. THE CONTRACT DOCUMENTS
The contract documents consist of this agreement, the specifications, all change orders,
and any addenda issued hereafter, any other amendments hereto executed by the parties
hereafter, together with the bid proposal and all required insurance documentation.
1.02 SCOPE OF THE WORK
The Contractor shall provide janitorial services, including all necessary supplies and
equipment required in the performance of same, and perform all of the work described in
the Contract Specifications entitled:
JANITORIAL SERVICES
ISLAMORADA LmRARY
MONROE COUNTY, FLORIDA
And his bid dated March 13. 2002, each attached hereto and incorporated as part of this
contract document. The specifications shall serve as minimum contract standards, and
shall be the basis of inspection and acceptance of all the work. The Contractor shall
insure all exterior doors locked upon their departure.
1.03 THE CONTRACT SUM
The County shall pay to the Contractor for the faithful performance of said service on a
per month in arrears basis on or before the 30th day of the following month in each of
twelve (12) months.
The Contractor shall invoice the County monthly for janitorial services
Performed under the Specifications contained herein. The Contract amount shall be
as stated by the contractors proposal as follows: $6.300.00 per year, $525.00 per
month.
1.04 CONTRACTOR'S ACCEPTANCE OF CONDITIONS
A. The Contractor hereby agrees that he has carefully examined the site and has made
investigations to fully satisfy himself that such site is correct and a suitable one for this
work and he assumes full responsibility therefore. The provisions of the Contract shall
work and he assumes full responsibility therefore. The provisions of the Contract shall
control any inconsistent provisions contained in the specifications. All specifications
have been read and carefully considered by the Contractor, who understands the same
and agrees to their sufficiency for the work to be done. Under no circumstances,
conditions, or situations shall this Contract be more strongly construed against the Owner
than against the Contractor.
B. Any ambiguity or uncertainty in the specifications shall be interpreted and construed by
the Owner, and his decision shall be final and binding upon all parties.
C. The passing, approval, and/or acceptance by the Owner of any of the janitorial services
furnished by the Contractor shall not operate as a waiver by the Owner of strict
compliance with the terms of this Contract, and specifications covering the services.
Failure on the part of the Contractor, immediately after Notice to Correct shall entitle the
Owner, if it sees fit, to correct the same and recover the reasonable cost of such
replacement and/or repair from the Contractor, who shall in any event be jointly and
severally liable to the Owner for all damage, loss, and expense caused to the Owner by
reason of the Contractor's breach of this Contract and/or his failure to comply strictly and
in all things with this Contract and with the specifications.
1.05 TERM OF CONTRACT/RENEW AL
A. This contract shall be for a period of one (1) year, commencing May 1. 2002 and
terminating April 30. 2003.
B. The Owner shall have the option to renew this agreement after the first year, and each
succeeding year, for two additional one year periods. The Contract amount agreed to
herein might be adjusted annually in accordance with the percentage change in the
Consumer Price Index for all urban consumers (CPI-U) for the most recent twelve (12)
months available.
1.06 HOLD HARMLESS
The Contractor covenants and agrees to indemnify and hold harmless Monroe County
Board of County Commissioners from any and all claims for bodily injury (including
death), personal injury, and property damage (including property owned by Monroe
County) and any other losses, damages, and expenses (including attorney's fees) which
arise out of, in connection with, or by reason of services provided by the Contractor or
any of its Subcontractor(s) in any tier, occasioned by the negligence, errors, or other
wrongful act of omission of the Contractor or its Subcontractors in any tier, their
employees, or agents.
In the event 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.
The first ten dollars ($10.00) of remuneration paid to the Contractor IS for the
indemnification provided for above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance
requirements contained elsewhere within this agreement.
1.07 INDEPENDENT CONTRACTOR
At all times and for all purposes under this agreement the Contractor is an independent
contractor and not an employee of the Board of County Commissioners for Monroe
County. No statement contained in this agreement shall be construed so as to find the
contractor or any ofhis/her employees, contractors, servants, or agents to be employees of
the Board of County Commissioners for Monroe County.
1.08 ASSURANCE AGAINST DISCRIMINATION
The Contractor shall not discriminate against any person on the basis of race, creed, color,
national origin, sex, age, or any other characteristic or aspect which is not job related, in
its recruiting, hiring, promoting, terminating, or any other area affecting employment
under this agreement or with the provision of services or goods under this agreement.
1.09 ASSIGNMENT/SUBCONTRACT
The Contractor shall not assign or subcontract its obligations under this agreement, except
in writing and with the prior written approval of the Board of County Commissioners for
Monroe County and Contractor, which approval shall be subject to such conditions and
provisions as the Board may deem necessary. This paragraph shall be incorporated by
reference into any assignment or subcontract and any assignee or subcontractor shall
comply with all of the provisions of this agreement. Unless expressly provided for
therein, such approval shall in no manner or event be deemed to impose any obligation
upon the board in addition to the total agreed-upon price of the services/goods of the
contractor.
1.10 COMPLIANCE WITH LAW
In providing all services/goods pursuant to this agreement, the contractor shall abide by
all statutes, ordinances, rules and regulation pertaining to, or regulating the provisions of,
such services, including those now in effect and hereinafter adopted. Any violation of
said statutes, ordinances, rules and regulations shall constitute a material breach of this
agreement and shall entitle the Board to terminate this contract immediately upon delivery
of written notice of termination to the contractor. The contractor shall possess proper
licenses to perform work in accordance with these specifications throughout the term of
this contract.
1.11 INSURANCE
Prior to execution of this agreement, the contractor shall furnish the Owner Certificates of
Insurance indicating the minimum coverage limitations as indicated by an "X" on the
attached forms identified as INSCKLST 1-5, as further detailed on forms WCI, GLI,
ED 1, and VL 1, each attached hereto and incorporated as part of this contract document,
and all other requirements found to be in the best interest of Monroe County as may be
imposed by the Monroe County Risk Management Department.
1.12 FUNDING AVAILABILITY
In the event that funds from Facilities Maintenance ContractuaI Services are partially
reduced or cannot be obtained or cannot be continued at level sufficient to aIlow for the
purchase of the services/goods specified herein, this agreement may then be terminated
immediately at the option of the Board of County Commissioners by written notice of
termination delivered in person or be mail to the contractor. The Board shall not be
obligated to pay for any services provided by the contractor after the contractor has
received written notice of termination.
1.13 PROFESSIONAL RESPONSffilLITY
The Contractor warrants that it is authorized by law to engage in the performance of the
activities encompassed by the project herein described, subject to the terms and
conditions set forth in these contract documents The provider shall at all times exercise
independent, professional judgment and shall assume professional responsibility for the
services to be provided. Continued funding by the Owner is contingent upon retention of
appropriate local, state, and/or federal certification and/or licensure of contractor.
1.14 NOTICE REQUIREMENT
Any notice required or permitted under this agreement shall be in writing and hand
delivered or mailed, postage prepaid, to the other party by certified mail, returned receipt
requested, to the following:
FOR COUNTY
Monroe County Facilities Maintenance
3583 S. Roosevelt Blvd.
Key West, FL 33040
FOR CONTRACTOR
L & N Dependable Janitorial, Inc.
P.O. Box 2546
Key Largo, FL 33037
1.15 CANCELLATION
A) The County may cancel this contract for cause with seven (7) days notice to the
contractor. Cause shall constitute a breach of the obligations of the Contractor to
perform the services enumerated as the Contractor's obligations under this
contract.
B) Either ofthe parties hereto may cancel this agreement without cause by giving the
other party sixty (60) days written notice of its intention to do so.
1.16 GOVERNING LAWS
This Agreement is governed by the laws of the State of Florida. Venue for any litigation
arising under this Agreement must be in Monroe County, Florida.
1.17 CONTINGENCY STATEMENT
Monroe County's performance and obligation to pay under this contract is contingent
upon an annual appropriation by the Monroe County Board of County Commissioners.
IN WITNESS WHEREOF the parties hereto have executed this Agreement on the day and date
,0~~~~n above in four (4) counterparts, each of which shall, without proof or accounting for
1.(:f;:':'):~,}1f~~~nterparts, be deemed an original contract.
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. ":Deputy Clerk
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BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLOIDA
By (J 1J
Mayr;&haITman
(SEAL)
Attest:
By:
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PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit a
bid on a contract with a public entity for the construction or repair of a public
building or public work, may not submit bids on leases of real property to
public entity, may not be awarded or perform work as a contractor, supplier,
subcontractor, or 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 of36
months from the date of being placed on the convicted vendor list."
SECTION lWO
CONTRACT SPECIFICATIONS
2.01 DESCRIPTION
The Contractor shall furnish janitorial service, including all necessary supplies,
equipment, and safety devices required in the performance of same for the Islamorada
Library, located at 2331 Overseas Highway, Islamorada Florida, consisting of
approximately 5,699 s.f
1. Restroom Sanitation shall include the following on a daily basis:
a. All Floors swept, loose dirt removed.
b. Wash and disinfect floor
c. StaII partitions damp cleaned.
d. All commodes, urinals, basins and vanities shall be scoured and disinfected.
e. All urinal traps shall be specially cleaned and disinfected.
f All sanitary napkin receptacles will be cleaned, waste disposed, and disinfected.
g. All supplies shall be replaced (paper goods, soap, etc.).
All other work necessary to maintain a clean and sanitary condition in these
restrooms shall be accomplished, whether it is specifically noted in these
specifications or not.
NOTE: Islamorada Library has 1 male public restroom with 2 toilets and 1 urinal, and 1
female public restroom with 3 toilets.
2. All sinks and water fountains outside the restroom areas are to be cleaned daily. Water
fountains are to be polished periodically.
3. General Cleaning shall be completed daily, and should include the following:
a. All tile floors are to be dusted and mopped.
b. All furniture and furnishings to be dusted and spot cleaned.
c. Low ledges, sills, rails, tables, shelving, baseboards, etc. to be wiped with a damp
cloth to reduce the amount of dust in the building.
d. All trash receptacles emptied, and trash can liners replaced.
e. All upholster furniture to be vacuumed.
f All carpeting shall be vacuumed with a powerful HEP A vacuum, such as the
Orik.
3. Weekly janitorial services to include:
a. All glass partitions, doors, mirrors, windows, etc. to be cleaned and/or polished.
b. Obvious scuff marks shall be removed from resilient flooring.
c. All door vents cleaned.
4. Monthly janitorial services to include:
a. All high dusting (i.e. pictures, door frames, air vents, tops of book shelves, etc.)
b. All walls dusted monthly
c. All air conditioning vents, supply and return air grilles cleaned.
5. The Contractor shall insure all exterior doors are locked while they are servicing the
building and upon their departure.
6. Janitorial services will be 5 days a week, Monday thru Friday (excluding holidays),
anytime between the hours of8:00 p.m. and completion before 10:00 a.m.
7. Coordination of the work with the County area representative shall be the responsibility
of the Contractor. The Contractor shall perform the work during hours and time as
specified.
8. Keys shall be issued to the Contractor by the area representative at the start of the
Contract. Written confirmation of receipt of keys shall be signed by the Contractor. The
Contractor shall return all keys as issued upon expiration of the contract or termination.
9. The contractor shall be responsible for the cost of changing locks, etc., for all keyed
secured areas for which the Contractor does not return the keys.
10. The Contractor shall report any problems regarding open doors and/or vandalism to the
Facilities Maintenance Department.
11. The Contractor shall provide all supplies necessary for the cleaning performance of his
work under the contract. All supplies, including but not limited to, hand soap, paper
towels, toilet paper, and trash can liners, shall be supplied by the Contractor.
12. Additional Services: (To be performed once in every three month period, and shall be
included in the bidding price.)
A. Resilient Flooring shall be swept/dust mopped and stripped. After application of
three coats of wax, areas shall be buffed sufficiently for maximum gloss and
uniform sheen from wall to wall, including corners. The waxed floor shall
present a clean appearance free from scuff marks or dirt smears. Furniture and/or
other equipment moved during floor stripping and waxing shall be returned to
their original positions.
B. Dry Cleaning, Steam Cleaning, or Shampooing Carpets and Rugs shall be
vacuumed of all loose soil and debris prior to cleaning, and shall be free of
streaks, stains and spots, and shall have a bright uniform color upon completion of
dry cleaning, steam cleaning or shampooing.
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JANITORIAL SERVICES:
AlA Y IfILL RUSSELL LIBRARY
BIG PINE KEY LIBRARY
GEORGE DOLEZAL LIBRARY - MARATI10N
ISLAAIORADA LIBRARY
KEY LARGO LIBRARY
ADDENDUM NO.1
February 2, 2002
The information contained in this Addendum modifies, supplements or replaces
information contained in the Bid and is hereby made a part of the Contract Documents
1. SECTION ONE - Article 1.04, paragraphs Band C, if Certificates of Competency
and the Monroe County Occupation License cannot be obtained by the bid opening
date, it must be obtained prior to contract execution, if awarded.
2. BID FORM - Page 3, delete from checklist the second sentence that requires the
inclusion of a copy of the Contractor's License.
All other items renl2.in as caIled for III the documents
End of AddendulIl No I
J n W. King, Acting Sf. DiH..'CIOI
ublic Facilities Maintenance
r 1:./3 G 8 2002
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P.O. BOX 2546
KEY LARGO, FL. 33037
305-248-0826
305-242-9274IFAX
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The following is a list of some of our customers, you may call them
for a recommendation.
FLORIDA KEYS AQUEDUCT
FLORIDA KEYS ELECTRIC
FBG/BELL SOUTH
C~ITY BANK/KEY LARGO
COMMUNITY BANK/TAVERNIER
COMMUNITY BANK/OCEAN REEF
REPUBLIC BANKs
TIB BANKS
SEIMENS TECH
305-852-8068
305-852-2431
904-805-9282
305-451-5733
407-933-3338
305-451-4660
305-260-8520
contact Debbie
contact C. Russell
contact Ramona
contact Laurie
contact Marge
contact D. Johnson
contact Jay
Insurance certificates furnished upon signed contract.
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NOTICE IS HEREBY GIVEN TO PROSPECnvE BIDDERS that on March 13, 2002 at U:oo AM the
Monroe County Purchasing Office will open sealed bids for the fallowing:
Spedflcations and Bid Documents may be Obtained from DemandStar by Onvia at
WWW.demandstar.com/suDolier or call toll free at 1/800-711-1712.
JANITORIAL SERVICES FOR UBRARIES IN
KEY WEST, BIG PINE KEY, MARATHON, ISlAMORADA AND KEY LARGO
All bids must be received by the County PUrchasing Office before 11:00 AM, March 13, 2002. Any
bids received after this date and time will be automatically rejected.
Bidders must submit two (2) signed originals and one (1) complete copy of each bid in a seared
envelope,marked QIl_UJ.~_Q~~iff~,:Sealed BId Janitori~L.Servjc~.Jor _. ___!ibrary" addressed
and delivered to: __ _____'____.___.___
Purchasing Office
. . - . - .. ... 1100 SlmonfOn'Street "Roori" 2-213- ,.. , - .... -:
. ,
.Key West, FL 33040
All bids must remain valid for a periOd of ninety (90) days. The Board wiJI automatically reject the
bid of any person or affiliate who appears on the convicted vendor list prepared by the Department
of General Services, State of Ronda, under Sec. 287.133(3)(d), FS (1997).
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Dated at Key West this 31st day of Janua~, 2.002.
Publication ~t~
Reporter
Keynoter
Key West Citizen
2/8-15
2/9-16
2/10-17
Monroe County Purchasing Department
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BID PROPOSAL
The Bid PropOsal shall be submitted on the forms included in this section of the Bidding Documents as
previously instructed therein.
Item
Description
Pages
1. Bid Form 2-3
2. Non-Collusion Affidavit 4
3. Lobbying and Conflict of Interest Clause 5
4. Drug Free Workplace 6
5. Contractor License
(Current copy to be submitted with bid)
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BID FORM
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BID TO:
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
C/O PURCHASING DEPARTMENT
GA TO BUILDING, ROOM 2-213
1100 SIMONTON STREET
KEY WEST, FLORIDA 33040
BID FROM:
The undersigned, having carefully examined the work, specifications, proposal, and addenda thereto
and other Contract Documents for the services of:
.
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JANITORIAL SERVICES - MONROE COUNTY ISLAMORADA LffiRARY
And having become familiar with all local conditions including labor affecting the cost thereof, and
having familiarized himself with material availability, Federal, State, and Loca1laws, ordinances, rules
and regulations affecting performance of the work, does hereby propose to furnish labor, mechanics, t
tools, material, equipment, transportation services, and all incidentals necessary to perform and
complete said work in a workman-like manner, in conformance with said specifications, and other
contract documents including addenda issued thereto.
MONTIIL Y FEE FOR JANITORIAL SERVICES k k..,dI/ il:z4.d;, '1M I ~o^----'
Q..O (J In words
$5~5
ANNU AL FEE FOR JANITORIAL SERVICES /lLfiy .f.Iuu..!w-ttv Ilr! ~~
$ 0300~ In words
I acknowledge receipt of Addenda No. (s)
2
I have included pages 2 through 6 of the Bid Proposal which entails the Proposal Form a.--:1IiC Non-
Collusion Affidavit ~ and the Lobbying and Conflict of Interest Clause ~ the Drug Free
Workplace Fo'rm ~ In addition, I have included copy of Contractor's License--, Monroe
County Occupation License v--: Insurance Agents Statement ~ and all requirements as stated in
Section One, Article 1.04 Paragraphs A through D.
Check mark items above as a reminder that the are included.
Telephone: .JtJS - ~ Vi .tJ!d"
Fax:.JaS~ t7l V~ -9 d ~V
Mailing Address:
Signed:
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I/tJ~1I- ~-IP'7
(Name)
DtOlI.f! ~
(Title)
Date: ~
Witness: -7fj; /l't:'( 1-. - - -
(Seal) .
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NON-COLLUSION AFFIDAVIT
1.--A0.e;1 flff'7 of the city of -4om~S/M1),;:: I
law on my oath, and under penalty of perjury, depose and say that:
lam NotA- OslfJrt I bUJlltL-
oflhefirmof ~y-I/ Y(J~{Jn.J> /J-:2/e .1AN'~~ ,'I)L
according to
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the bidder making the Proposal for the project described in the Notice for Calling for bids for:
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and that I executed the said proposal with full authority t do so:
2. the prices in this bid have been arrived at independently without collusion, consultation, communication or
agreement for the purpose of restiicting competition, as to any matter relating to such prices with any other
bidder or with any competitor,
3. unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly
disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or
indirectly, to any other bidder or to any competitor, and
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4. no attempt has been made or will be made b the bidder to induce any other person, partnership or corporation
to submit, or not to submit, a bid for the purpose of restricting competition;
5. the statements contained in this affidavit are true and correct, and made with full knowledge that Monroe
County celi upon the tru f the statements contained in this affidavit in awarding contracts for said project
c:2 -/3 -0.2.
(Date)
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STATE OF:
COUNTY OF:
>L 1/2/1
/1;:1/9-111/ - .tJt~~
PERSONALLY APPEARED BEFORE ME, the undersigned authority, II).,Vl 1'27G.JJ who,
after first being SWorn by me. (name of illdi~dual signing) affixed hi~'her s~gnature in the space provid~d aho'~is
/.3 nt day of -EJ:? 13 20~.
My Commission Expires: ~-/,~..:. oLZo:z.
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SWORN STATEMENT UNDER ORDINANCE NO. 10.1990
MONROE COUNTY. FLORIDA
Enncs CLAUSE
U~j)~n~1k JA-H,'toR.,/J r,J::,
warrants that he/it has not employed, retained
or otherwise had act on hislits behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. 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, percentage, gift, or consideration paid to the fo er Co
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Date:
,2-/3-02
STATEOF &/;/1
COUNTYOF /!1/1J11/ - A/5'&
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
,IlJOJ! 14 ObT~,u who, after first being sworn by me, affixed IUs!her
signature (name of individual signing) in the space provided above on this /.d nr day of
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NOTARY PUB
My commission expires: ~I ,tJ..!lj ~ a..
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DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
,L",- J/. j) p(J:f /I ,p ,4- J3 if' ::f ,41{ · 'f. ~ " 41.. I .r ~ .
(Name of Business)
1_ Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing,
poSsession, or use of a controlled substance is prohibited in the workplace and specifying the actions that
will be taken against employees for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of
maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance'
programs, and the penalties that may be imposed upon employees for drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services that are under bid a
copy of the statement specified in subsection (1)-
4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the
commodities or contractual services thai are under bid, the employee will abide by the terms of the ..
statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any
violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any
state, for a violation occurring in the workplace no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is so
convicted.
6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this E'
section.
As the person authorized to sign the statement, 1 certify that this finn complies fully with the above
requirements.
~
Date
OMB - MCP#5
6
__a . . II .,,". I;;; ur IN~UHANCE
SUCH INSURANCE AS RESPEcrs THE INTEREST OF THE CERTIFICAlE HoLbER WILL NOT BE CANCaED OR OTHE....
TEAll/HAleD WITHOtiT GIVING 10 DAYS PRIOR WRITTEN NOnCE TO THE CERTlFICATEHOUlER NAMED BELOW, BUT IN
EVENT SHAll. THlS CERTlAcATE BE VALID IIORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSU_
DOES NOT CHANGE THe CoveRAGe PROVIDED BY ANY POLICY DESCRIBED BELOW.
/
This <;Ortjfies that: G STATE.FARM MlfTUAl AUTOMOBIlE INSl-"ANcECOMI'At/v of --.. _. '"
o STATE FAJ:lM AFle AND CASUAlTY COMPANY of Bloonllngton.11IInols
has coverage. in force ,for the following Named IllSured as shown below:
E'.,' - /' ... /;'" <l./ /, }; ".) _/ f,.'/,~.,/
Named Insured l..- .~, /'f..; 1[/ "'.. ,-<- l ~, (...,.. "..,f- ~", .:/".. "~'.).~_~: /.".. , ~. L
;
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Address or Nc,moo Insured /j /' ,
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POUcy NUMBER :;~~: ~~ '~/. .. --', ~ ;:~) L)
:~..:~/ :.<"~-.: -. r;'~: /~/ -
EfFECTIVE DATE "/,,/
OF POucY ::) .. r" ,
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DESCRIPTION OF :;.i";, .
VEHICLE --". , , .-'. A")-( t....
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" - .'
ByES .' 0
UABlUTY COVERAGE 0 NO 0 YES 0 NO 0 YES D NO 0 YES NO
UMlTS OF lIABlUTY
a. Bodily /I1ury
Each ~
fact! ~
b. I'roperty 0amag8
~A~
Co ~~~ I
~_/. /1", / ""',0"
Each ~ ~l...,. i
PHYSICAL DAMAGE BYES 0 NO DyES ON<> DyES DNO 0 YES 0 NO
COVERAGES
a. S ~~;;!.~:::;i ~ $ QeductilIe $ ~ S Dec:b:tible
DyES 0 NO DyES DNO DYES DNO 0 YES 0 NO
b. CoIIsIon $ -:.-;} :.:-{;.: Deductible $ Deductible $ ~ S Deductible,
EMPlOYER'S DYES [2JNO DYES ONO DyES
NoN-owNERSHIP DNO 0 YES 0 NO
CO~E
HIRED CAR COVERAGE . DYES [~J NO DyES DNO DYES ONO 0 YES D NO
,
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f
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. , T- ...,. ,J J':-- ,/ ,",,.:". ....::: ' ./
SignatuftJ .of - Date'
R --.. TItle Agent's Code Number
r
Name and ~_ or Certfficate Holder
t:: -if ,,/' c:i LLl.-l( ,'. H/I/' ./~' t:" ~'.,~: i :'./
t:? <"/, r
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Name and Address of Agent
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~
AGILITIES
'R
IACHINES
YPE OF
USINESS
USINESS
DDRESS
lAME
tAILING
DDRESS
" .
G
2001-2002
OCCUPATIONAL 'IAX
STATE OF FLORIDA
M.O.N.ROE
ROOMS
SEATS
MUST BE DISPLAYED IN ~ONSPICUOUS PLACE
EMPLOYEES
90029:: :OCO Ou VJ :NT:Y :: :OF5 R 1M AHo: YNR S EOE R V [ C E 4f~71~~q~:~'11~,
{f/"~;:; 'h\< ;--'" I if' - (,;,:,~
f',...1. .--' ;e:-">t. '!/, y-., ..",
L&N DEPENDABLE JANITORIAL~~~:{.i/C;.':~~, i !-,,(J -Yr"~,
os TE N NORA A PRE S ~' '" --1;:=-:-=-.: ~:?~'I~'" "',:fi
POBOX 2546 '.,' ' . f, ....h
KE Y LARGO F L 33037 ":;c .J '," :;~!j
"" -. " if
}~';"''''40 .;'~...Q..fs.
'&::0...;,. \'t<?:>).'r
.........,..., ~..... , ... ''i.;\ -~~~!:
'<l)"""OVI<r.\ r'-~ / .,"
~~;;;,;jJ. .""",11'
HIS BECOMES A TAX DANISE D. HENRIQUEZ TAX COLLECTOR
lECElPTWHENVAlIDATEO PO BOX 1129, KEY WEST FL 33041-1129
~L."""U\Ji'J I
29240-00103
SEPT. 3D" 200
EXPIRES
SUPPI.E:MEN-, AL
FiENEWAL
X NEW TAX
Tf,ANSFEH
ORiG!NAL TAX
25.
AMOUNT
PENAL 1Y ~ D
COI j E'C""ON r-,QST ""1:> --t '~ '= f-o. ><:
.. " -' , OI~' :X> I"~
T"'''Al 1-" 1-' ( ......j L71 c-:
,,,I , L:l..~-. n'~
O;);gc-::
r,.;) l::l ...... ~
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8 ':0-- I- ........
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-rUle:: I~ n",~ v ~, "")i 'j!' VOU M
(;)
- - --- -. -- -.~,.,'. . ..._-.~..-- , 037U12002
PROO\ICEft (05)247-5121 FAX (305)24&-&543 THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
T. R '. Jones. It CQq)any ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1780 North K~ome Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Homestead, Fl 33030
INSURERS AFFORDING COVERAGE
INSURED L & N Dependable Janltorial, Inc INSURER A Hartford Insurance Company
PO Box 2546 INSURER B Bridgefield Employers Ins. Co.
Key Largo, FL 33037-2546 INSURER C Security Bond Associates Inc:
INSURER D:
I 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.
I~i~ TYPE OF INSURANCE POLICY NUMBER P6'}+%~,;~i6g~~r
GENERAL LIABILITY ;) lEUCLI2622 11/22/2001
X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE 0 OCCUR
Pgi!f:,~~mf~!gN
11/22/2002
LIMITS
EACH OCCURRENCE
1,000,000
300,000
10,000
1,000,000
1,000,000
1,000,000
FIRE DAMAGE (Anyone fire)
A
-
-
GEN'L AGGREGATE LIMIT APPLIES PER.
I POLICY n ~~T n LOC
~TOMOBILE LIABILITY
ANY AUTO
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMPIOP AGG $
-
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
-
-
f--
f--
NON,OWNED AUTOS
BODILY INJURY
(Per person)
APPI10V'\-L ";tlI ~~EN1 ~((1a rP~~~~~'~;n~r
BY , '._, A (,'\' I\A' ;<;IA , J,ROPERTY DAMAGE
I ~ .J.., I\VU U Q. ,Peracc,dent)
DAlt: - - ~ .( D.~
WAIVER N/A__YES G~. ~
~'I
AUTO ONLY, EA ACCIDENT
$
-
GARAGE LIABILITY
R ANY AUTO
EXCESS LIABILITY
tJ OCCUR 0 CLAIMS MADE
RDEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
OTHER THAN
AUTO ONLY:
EA ACC $
AGG $
$
$
$
$
$
EACH OCCURRENCE
AGGREGATE
P39901
03/28/2002
03/28/2003
OTH;R .
~mp oyee 01shonesty
C ~ond
PBS-460042
10/30/2001
10/30/2002
X 1-ro~{L~Ns 110m:
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEI $
E.L. DISEASE, POLICY LIMIT $
$25,000
Contains Conviction
500,000
500,000
500,000
B
Clause
DESCRIPTION OF OPERATlONSJLOCATlONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
~O Day Notice of Cancellation Applies for Workers Compensation
~onroe County Board of County Commissioners is named as Add'l Insured for
CERTIFICATE HOLDER
I I ADDITIONAL INSURED; INSURER LETTER
CANCELLATION
Gen~ra 11~~;;;002
'., -"---
Monroe County, Board
Attn: Maria del Rio
51 Coll ege Road
Key West, FL 33040
of County Commissioners
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHAl.lIMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE -rY L
Thomas Jones Jr./JM '1)--
ACORD 25-5 (7/97)
<C>ACORD CORPORATION 1988