02/19/2003 Agreement
Cleltllllhe
Cimul coun
Danny L. Kolhage
Phone: 292-3550 Fax: 295-3663
Memnrantlum
To:
Lynda Stuart, Offzce Manager
Tourist Development Council
Attn:
From:
Maxine Pacini
Isabel C. DeSantis, · .~ )
Deputy Clerkr
Date:
Thursday, February 27, 2003
At the BOCC meeting on February 19, 2003, the Board approved the fOllowing:
Interlocal Agreement for Grant of Funds between Monroe County and the City of
Key West for the Smathers Beach Groin Sand Renourishment project in an amount not
to exceed $49,445, DAC I, FY 2003 Capital Project Resources.
Grant of Funds between Monroe County and Island DOlphin Care, Inc. for the
construction ofIsland DOlphin Care in an amount not to exceed $200,000, DAC V, FY 2003
Capital Project Resources.
Interlocal Agreement for Grant of Funds between Monroe County and the City of
Key West for the White Street Pier Handrail Replacement Phase II project in an amount
not to exceed $120,000, DAC I, FY 2003 Capital Project Resources.
Interlocal Agreement for Grant of Funds between Monroe County and the City of
Marathon for the Phase II project to construct an Amphitheater in an amount not to
exceed $47,200, DAC III, FY 2003 Capital Project Resources.
Grant of Funds between Monroe County and Key West Film Society, Inc. for the
Key West Film Society Theater project in an amount not to exceed $191,845, DAC I, FY
2003 Capital Project Resources.
Grant of Funds between Monroe County and Florida Keys Wild Bird
Rehabilitation Center for the Exhibit Habitat project in an amount not to exceed
$3,860.00, DAC V, FY 2003 Capital Project Resources.
.-.",
Grant of Funds between Monroe County and Upper Keys Community Pool, Inc.
d/b/a Jacobs Aquatic Center for the Audio/Visual Equipment Project in an amount not
to exceed $26,000, DAC V, FY 2003 Capital Project Resources.
Grant of Funds between Monroe County and Old Firehouse Preservation, Inc. for
the Fire Station NO.3 project in an amount not to exceed $119,486, DAC I, FY 2003 Capital
Project Resources.
Grant of Funds between Monroe County and Mote Marine Laboratory covering
the Greenhouse project in an amount not to exceed $61,600, DAC II, FY 2003 Capital
Project Resources.
Grant of Funds between Monroe County and Mote Marine Laboratory covering
the Key West Facility Access and Enhancement project in an amount not to exceed
$10,000, DAC I, FY 2003 Capital Project Resources.
Grant of Funds between Monroe County and Florida Keys Land & Sea Trust for
/the Facelift and Refurbishment project in an amount not to exceed $15,463, DAC III, FY
2003 Capital Project Resources.
Grant of Funds between Monroe County and Dolphin Research Center for the
Replacement of Existing Boardwalks and Docks project in an amount not to exceed
$38,554, DAC III, FY 2003 Capital Project Resources.
Grant of Funds between Monroe County and Mel Fisher Maritime Heritage
Society, Inc. for the Mel Fisher Maritime Museum Repair and Improvement Phase III
project in an amount not to exceed $375,320, DAC I, FY 2003 Capital Project Resources.
Grant of Funds between Monroe County and Marathon Community Theatre, Inc.
for the Green Room/Stage Shop project in an amount not to exceed $13,500, DAC III, FY
2003 Capital Project Resources.
Attached hereto are two (2) duplicate originals of each document above for your
handling. Should you have any questions concerning the above, please do not hesitate
to contact this office.
cc: Finance
County Attorney
File
GRANT OF FUNDS
/ / '.
I . ."
This AGREEMENT dated the It;: day of '.-::cJ:<) 2003, is entered into by and between
the BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY, hereinafter "County," on
behalf of the TOURIST DEVELOPMENT COUNCIL, hereinafter "TDC," and Florida Keys Land &
Sea Trust, a Florida not-for-profit corporation, hereinafter" Contractor".
WHEREAS, the third penny of Tourist Development Tax may be used to acquire, construct,
extend, enlarge, remodel, repair or improve, convention centers, sports stadiums, sports arenas,
coliseums, auditoriums, fishing piers, museums, zoological parks, nature centers and beaches
which are publicly owned and operated or owned and operated by not-for-profit corporations, and
WHEREAS, Contractor has applied for funding for the Facelift and Refurbishment project,
at Crane Point Hammock, hereinafter "the Property"; and
WHEREAS, the County and TDC have determined that it is in the best interest of the
County, for purposes of promoting tourism and preserving the heritage of the community, to
remodel, repair and improve the property for use as a museum and nature center open to the
public;
NOW, THEREFORE, in consideration of the mutual covenants and payments contained
herein, the Contractor and the County have entered into this agreement on the terms and
conditions as set forth below.
1. AGREEMENT PERIOD. This agreement is for the period February 19, 2003 througr. M~rc:h
f5!,2004. This agreement shall remain in effect for the stated period unless one party gives to the
other written notification of termination pursuant to and in compliance with paragraphs 7,12 and 13
below.
2. SCOPE OF AGREEMENT. The Contractor shall provide such services and materials
required for construction of a canvas shade structure over the tropical lagoon, painting of the
museum, repair to museum signage and improvement of outdoor lighting.
The recipient of TDC capital project funding shall designate a project manager if no licensed
architect, engineer or general contractor is involved in the project. If the project is performed by
County or City personnel, the project manager shall be the Engineer, Building Official or
Construction Manager of that local government.
3. AMOUNT OF AGREEMENT AND PAYMENT. The County shall provide an amount not to
exceed $15,463 in reimbursement for materials and services used to remodel, repair and improve
the property. The Board of County Commissioners and the Tourist Development Council assume
no liability to fund this agreement for an amount in excess of this award. Monroe County's
performance and obligation to pay under this agreement is contingent upon an annual
appropriation by the BOCC.
a). Payment for expenditures permissible by law and County policies shall be made
through reimbursement to Contractor upon presentation of invoices, canceled checks and other
documentation necessary to support a claim for reimbursement. Included in said documentation
shall be proof that the Contractor has received and applied to the property matching funds
equivalent to or greater than the amount invoiced to the County. Submission of invoices must be
Florida Keys Land & Sea Trust
Capital Project Funding FY 2003
certified through a statement signed by an officer of the organization and notarized, declaring that
representations in the invoice are true and factual.
b) Application of matching funds requires actual payment of the matching funds, or, in
the alternative, a commitment of said funds and that the portion of the project for which the
matching funds are to be used has been sufficiently completed to require payment of said
matching funds. Mere obligation through execution of a contract or approval of a budget item to
be paid from matching funds will not suffice.
c) Documentation shall be submitted to the TDC Administrative Office to show the
receipt and application of in-kind donations of goods, professional services, and materials. Said
documentation should include invoices, bills of lading, etc., and be verified as received and
applied to the project through a notarized statement of the project architect, engineer, general
contractor or project manager. The receipt and application to the project of volunteer labor are to
be documented and verified by notarized signature of the project architect, engineer, general
contractor or project manager, and said documentation submitted to the TDC Administrative
Office. All submissions should have a proposed schedule of values for phases and indicate the
percentage of completion of the overall project as of the submission. This document should be
signed by the project architect, engineer, general contractor or project manager.
4. REPORTS. The Contractor shall provide financial reports in summary of activity on forms
provided or approved by the TDC, and quarterly narrative reports of activity under the approved
work plan. The Contractor shall keep such records as are necessary to document the
performance of the agreement and expenses as incurred, and give access to these records at the
request of the TDC, the County, the State of Florida or authorized agents and representatives of
said government bodies. It is the responsibility of the Contractor to maintain appropriate records
to insure a proper accounting of all funds and expenditures. The Contractor understands that it
shall be responsible for repayment of any and all audit exceptions which are identified by the
Auditor General for the State of Florida, the Clerk of Court for Monroe County, the Board of
County Commissioners for Monroe County, or their agents and representatives. In the event of an
audit exception, the current fiscal year grant award or subsequent grant awards will be offset by
the amount of the audit exception. In the event the grant is not renewed or supplemented in future
years, the Contractor will be billed by the County for the amount of the audit exception and shall
promptly repay any audit exception.
5. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the terms of this
agreement shall be only amended in writing and approved by the Board of County Commissioners
for Monroe County.
6. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the
Contractor is an independent contractor and not an employee of the Board of County
Commissioners of Monroe County. No statement contained in this agreement shall be construed
as to find the Contractor or any of its employees, contractors, servants or agents to the employees
of the Board of County Commissioners of Monroe County, and they shall be entitled to none of the
rights, privileges or benefits of employees of Monroe County.
7. COMPLIANCE WITH LAW. In carrying out its obligations under this agreement, the
Contractor shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating
the provisions of this agreement, including those now in effect and hereafter adopted. Any
violation of said statutes, ordinances, rules or regulations shall constitute a material breach of this
agreement and shall entitle the County to terminate this agreement immediately upon delivery of
written notice of termination to the Contractor.
Florida Keys Land & Sea Trust
Capital Project Funding FY 2003
8. RESTRICTIONS ON AGREEMENTS ENTERED PURSUANT TO THIS AGREEMENT. The
Contractor shall include in all agreements funded under this agreement the following terms:
a) Anti-discrimination. Contractor agrees that they will not discriminate against any
employees or applicants for employment or against persons for any other benefit or service under
this agreement because of their race, color, religion, sex, national origin, or physical or mental
handicap where the handicap does not affect the ability of an individual to perform in a position of
employment, and to abide by all federal and state laws regarding non-discrimination.
b) Anti-kickback. Contractor warrants that no person has been employed or retained to
solicit or secure this agreement upon an agreement or understanding for a commission,
percentage, brokerage or contingent fee, and that no employee or officer of the Contractor has
any interest, financially or otherwise, in Contractor. For breach or violation of this warranty, the
Contractor shall have the right to annul this agreement without liability or, in its discretion, to
deduct from the agreement price or consideration, the full amount of such commission,
percentage, brokerage or contingent fee. Contractor acknowledges that it is aware that funding
for this agreement is available at least in part through the County and that violation of this
paragraph may result in the County withdrawing funding for the Project.
c) Hold harmless/indemnification. Contractor acknowledges that this agreement is funded
at least in part by the County and agrees to indemnify and hold harmless the County and any of its
officers and employees from and against any and all claims, liabilities, litigation, causes of action,
damages, costs, expenses (including but not limited to fees and expenses arising from any factual
investigation, discovery or preparation for litigation), and the payment of any and all of the
foregoing or any demands, settlements or judgments (collectively claims) arising directly or
indirectly from any negligence or criminal conduct on the part of Contractor in the performance of
the terms of this agreement. The Contractor shall immediately give notice to the County of any
suit, claim or action made against the Contractor that is related to the activity under this
agreement, and will cooperate with the County in the investigation arising as a result of any suit,
action or claim related this agreement.
d) Insurance. Contractor agrees that it maintains in force at its own expense a liability
insurance policy which will insure and indemnify the Contractor and the County from any suits,
claims or actions brought by any person or persons and from all costs and expenses of litigation
brought against the Contractor for such injuries to persons or damage to property occurring during
the agreement or thereafter that results from performance by Contractor of the obligations set
forth in this agreement. At all times during the term of this agreement and for one year after
acceptance of the project, Contractor shall maintain on file with the County a certificate of the
insurance of the carriers showing that the aforesaid insurance policy is in effect. The following
coverage's shall be provided:
1. Workers Compensation insurance as required by Florida Statutes.
2. Commercial General Liability Insurance with minimum limits of $500,000 per occurrence
for bodily injury, personal injury and property damage.
3. Comprehensive Auto Liability Insurance with minimum limits of $300,000 combined
single limit per occurrence.
The Contractor, the County and the TDC shall be named as additional insured, exempt workers
compensation. The policies shall provide no less than 30 days notice of cancellation, non-renewal
or reduction of coverage.
At all times during the term of this agreement and for one year after acceptance of the project,
Contractor shall maintain on file with the County a certificate of insurance showing that the
aforesaid insurance coverage's are in effect.
e) Licensing and Permits. Contractor warrants that it shall have, prior to commencement of
work under this agreement and at all times during said work, all required licenses and permits
whether federal, state, County or City.
Florida Keys Land & Sea Trust
Capital Project Funding FY 2003
9. HOLD HARMLESS/INDEMNIFICATION. The Contractor hereby agrees to indemnify and
hold harmless the BOCC/TDC and any of its officers and employees from and against any and all
claims, liabilities, litigation, causes of action, damages, costs, expenses (including but not limited
to fees and expenses arising from any factual investigation, discovery or preparation for litigation),
and the payment of any and all of the foregoing or any demands, settlements or judgments arising
directly or indirectly under this agreement. The Contractor shall immediately give notice to the
County of any suit, claim or action made against the County that is related to the activity under this
agreement, and will cooperate with the County in the investigation arising as a result of any suit,
action or claim related to this agreement.
10. ANTI-DISCRIMINATION. The Contractor agrees that they will not discriminate against
any of their employees or applicants for employment or against persons for any benefit or service
because of their race, color, religion, sex, national origin, or physical or mental handicap where
the handicap does not affect the ability of an individual to perform in a position of employment,
and to abide by all federal and state laws regarding non-discrimination.
11. ANTI-KICKBACK. The Contractor warrants that no person has been employed or retained
to solicit or secure this agreement upon an agreement or understanding for a commission,
percentage, brokerage or contingent fee, and that no employee or officer of the County or TDC
has any interest, financially or otherwise, in the said funded project, except for general
membership. For breach or violation of this warranty, the County shall have the right to annul this
agreement without liability or, in its discretion, to deduct from the agreement price or
consideration, the full amount of such commission, percentage, brokerage or contingent fee.
12. TERMINATION. This agreement shall terminate on March 15, 2004. Termination prior
thereto shall occur whenever funds cannot be obtained or cannot be continued at a level sufficient
to allow for the continuation of this agreement pursuant to the terms herein. In the event that
funds cannot be continued at a level sufficient to allow the continuation of this agreement pursuant
to the terms specified herein, this agreement may then be terminated immediately by written
notice of termination delivered in person or by mail to Contractor. The County may terminate this
agreement without cause upon giving written notice of termination to provider. The County shall
not be obligated to pay for any services or goods provided by Contractor after Contractor has
received written notice of termination.
13. TERMINATION FOR BREACH. The County may immediately terminate this agreement
for any breach of the terms contained herein. Such termination shall take place immediately upon
receipt of written notice of said termination. Any waiver of any breach of covenants herein
contained to be kept and performed by Contractor shall not be deemed or considered as a
continuing waiver and shall not operate to bar or prevent the County from declaring a forfeiture for
any succeeding breach either of the same conditions or of any other conditions. Failure to provide
County with certification of use of matching funds or matching in-kind services at or above the rate
of request for reimbursement or payment by is a breach of agreement, for which the County may
terminate this agreement upon giving written notification of termination.
14. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties
hereto with respect to the subject matter hereof and supersedes any and all prior agreements with
respect to such subject matter between the Contractor and the County.
Florida Keys Land & Sea Trust
Capital Project Funding FY 2003
15. CONSENT TO JURISDICTION. This agreement, its performance, and all disputes arising
hereunder, shall be governed by the laws of the State of Florida, and both parties agree that the
proper venue for any actions shall be in Monroe County.
16. ETHICS CLAUSE: Contractor warrants that he has not employed, retained or otherwise
had act on his behalf any former County officer or employee in violation of Section 2 or 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 the provision the County may, at its discretion terminate this agreement
without liability and may also, at its discretion, deduct from the agreement or purchase price, or
otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid
to the former or present County officer or employee.
17. 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 an
agreement to provide any goods or services to a public entity, may not submit a bid on a
agreement 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, sub-contractor, or consultant under a agreement 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.
18. AUTHORITY: Contractor warrants that it is authorized by law to engage in the
performance of the activities encompassed by the project herein described. Each of the
signatories for the Contractor below certifies and warrants that the Contractor's name in this
agreement is the full name as designated in its corporate charter (if a corporation); they are
empowered to act and contract for the Contractor, and this agreement has been approved by the
Board of Directors of Contractor or other appropriate authority.
19. LICENSING AND PERMITS: Contractor warrants that it shall have, prior to commencement
of work under this agreement and at all times during said work, all required licenses and permits
whether federal, state, County or City.
20. INSURANCE: Contractor agrees that it maintains in force at its own expense a liability
insurance policy which will insure and indemnify the Contractor and the County from any suits,
claims or actions brought by any person or persons and from all costs and expenses of litigation
brought against the Contractor for such injuries to persons or damage to property occurring during
the agreement or thereafter that results from performance by Contractor of the obligations set
forth in this agreement. At all times during the term of this agreement and for one year after
acceptance of the project, Contractor shall maintain on file with the County a certificate of the
insurance of the carriers showing that the aforesaid insurance policy is in effect. The following
coverage's shall be provided:
1. Workers Compensation insurance as required by Florida Statutes.
2. Commercial General Liability Insurance with minimum limits of $500,000 per occurrence
for bodily injury, personal injury and property damage.
3. Comprehensive Auto Liability Insurance with minimum limits of $300,000 combined
single limit per occurrence.
The Contractor, the County and the TDC shall be named as additional insured, except workers
compensation. The policies shall provide no less than 30 days notice of cancellation, non-renewal
or reduction of coverage.
Florida Keys Land & Sea Trust
Capital Project Funding FY 2003
At all times during the term of this agreement and for one year after acceptance of the project,
Contractor shall maintain on file with the County a certificate of insurance showing that the
aforesaid insurance coverage's are in effect.
21. NOTICE. Any written notice to be given to either party under this agreement or related
hereto shall be addressed and delivered as follows:
For Florida Keys Land & Sea Trust:
Ms. Della Schuler
P.O. Box 500536
Marathon, Florida 33050
For County: Lynda Stuart
Monroe County Tourist Development Council
1201 White Street, Suite 102
Key West, FL 33040
and
Suzanne Hutton, Asst. County Attorney
P.O. Box 1026
Key West, FL 33041-1026
IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed
the day and year first above written.
Y L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By:
,,)~ >n ~
By:
Mayor/Chairman
By:
Florida Keys Land & Sea Trust
Capital Project Funding FY 2003
ACORQM CERTIFICATf ~F LIABILITY INSURP - 'CE I DATE (MM/DDIYY)
02/13/2003
PRODUCER (305)743-0494 FAX (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Keys Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE
Kevin Martin-Vegue
INSURED Florida Keys Land & Sea Trust, Inc. INSURER A: Lloyds of London
P.O. Box 500536 INSURER B: Associated Ind. Insurance Co.
Marathon, FL 33050-0536 INSURER c:
INSURER D:
I INSURER E:
-
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 TYPE OF INSURANCE POLICY NUMBER Pgl-{~~~~~8g;W\E Pg~!fl(~~~~N LIMITS
LTR
~NERAL LIABILITY LJLl70122/02 04/05/2002 04/05/2003 EACH OCCURRENCE $ 1,000,00Cl
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,00Cl
I CLAIMS MADE 00 OCCUR MEO EXP (Anyone person) $ 5,00C
A PERSONAL & ADV INJURY $ 1,000,00Cl
- 2,000,000
- GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $ 2,000,00lJ
h .nPRO-
POLICY JECT LOC
~TOMOBILE LIABILITY APPR~Y I.~ ~~NAGE 4l:N1 COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BY ..... r/I 21 I d BODILY INJURY
- T $
SCHEDULED AUTOS DATE 0 I~ u rp. (Per person)
-
HIRED AUTOS N I A -=::::... -:::::::;:00 BODILY INJURY
- WAIVER (Per accidenl) $
- NON-OWNED AUTOS _YES
PROPERTY DAMAGE $
(Per accident)
RGE LIABILITY AUTO ONLY - EAACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
tJ OCCUR 0 CLAIMS MADE AGGREGATE $
$
1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 2002325126 12/23/2002 12/23/2003 I /t,~~mII~s I IU~IH-
ER
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT 100,00Cl
B $
E.L. DISEASE - EA EMPLOYEE $ 100,00Cl
E.L. DISEASE - POLICY LIMIT $ 500 OOCl
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Monroe County BOCC & TOC ...1!L- DAYS WRmEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn: Maxine BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSSNO OBLIGATION OR LIABILITY
1201 White Street #102 OF ANY KIND UPON THE COMPANY, ITS JNT~ REPRESEI!UTIVES.
Key West, FL 33040 AUTHORIZED REPRESENTATIVE ~
Kevin Martin-Veaue ~~
ACORD 25-S (7/97) FAX: (305)296-0788 ..-'{ "~ACORD CORPORATION 1988
-~
COVERAGES
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (7/97)
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