08/21/2002 Agreement
Cled( 01 the
Circul coun
Danny L. Kolhage
Clerk of the Circuit Court
Phone: (305) 292-3550
FAX: (305) 295-3663
e-mail: phancock@monroe-clerk.com
Memnrandum
TO: Dent Pierce, Director
Public Works Division
ATTN: Beth Leto, Administrative Assistant
Public Works Division
FROM: Pamela G. Hanc~.
Deputy Clerk CY
DATE: September 10,2002
At the August 21, 2002, Board of County Commissioner's meeting the Board granted
approval and authorized execution of the following:
Lease Agreement between Monroe County and Florida Keys Children's Shelter to occupy
approximately 510 square feet of useable office space on the second floor of the newly built Department of
Juvenile Justice building on Stock Island, at a rate of $16.68 per s.f.
JLease Agreement between Monroe County and Florida Keys Outreach Coalition to occupy
approximately 396 square feet of useable office space on the second floor of the newly built Department of
Juvenile Justice building on Stock Island, at a rate of $16.68 per s.f.
Enclosed is a duplicate original 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 .I
'.
LEASE AGREEMENT
FOR
NON-PROFIT ORGANIZATIONS
This Lease Agreement ("Lease") is made and entered into this 21 st day of August,
2002, between Monroe County, a political subdivision of the Sate of Florida, whose
address is 1100 Simonton Street, Key West, FI 33040 (Lessor/County), and the Florida
Keys Outreach Coalition, (Lessee).
Whereas, the County and State of Florida, Department of Juvenile Justice, whereby
there was reserved from the property described in Exhibit A, the second story in the
Detention Facility Building, pursuant to a Lease Amendment dated August 15,2001 and
an original Land Lease Agreement dated July 8, 1999 and a Construction and Occupation
Agreement (with a third party, the Monroe County Sheriffs Office) dated November 20,
200 I; and Whereas the story may be utilized by the Lessor (or its designees, contractors
or agents) for any lawful public purpose; and Whereas, Lessee wishes to utilize space for
the purpose of providing the following services to Monroe County: Information and
referral services: intake assessment for a countywide homelessness prevention service
program which provides transitional residential housing for homeless men. single women
and women with children: issuance of Greyhound bus tickets to homeless individuals and
families for the purpose of family unification and for those individuals seeking treatment
programs elsewhere: HUD funded countywide support service program which includes
the payment of transportation. both local and out of county: now therefore,
The County and the Lessee agree as follows:
I. DEMISE AND PREMISES
For good and valuable consideration, the County hereby leases to the Lessee an
area approximately 396 square feet of useable space, located on the second floor
of the Juvenile Justice Building at 5503 College Road, Stock Island, Key West,
Florida. Said area is depicted as the "the premises" on a sketch of the second
floor, said sketch being attached hereto as Exhibit B.
2, TERM
A. Subject to and upon the terms and conditions set forth herein, this Lease
shall continue in force for a term of five years commencing as the ~day
of October, 2002 and ending on the 30th day of September, 2007.
B. The County shall have the option to renew this agreement after the first
term and succeeding term for two additional five-year term periods.
3. RENT
JUL
1:3"'.( : ~._.
A. The Lessee shall promptly pay the County, in advance, the sum of $550.44 per
month on or before the 1st of each month. Rent is calculated by the rate structure
of $16.00 per square foot per year (approved by the Momoe County Board of
County Commissioners at their 7/26/00 meeting) plus the CPI-U of 2.6% for July
2001, and 1.6% as of April 2002, for a current rate of $16.68 per square foot per
year. Rent shall be made payable to Momoe County and paid to the CleIk located
at the Momoe County Courthouse, 500 Whitehead Street, Key West, FL. 33040.
B. The rental amount agreed to herein may 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.
4. UTILITIES AND MAINTENANCE
The rental amount shall be inclusive of utilities, maintenance and janitorial services.
5. COMMON AREAS
A. Elevators, stairs, parking areas within fenced perimeter, grounds within fenced
perimeter, and walkways shall constitute the Common Areas. The Common
Areas of the building are for the joint use of the Department of Juvenile Justice
(DJJ), the MomoeCounty Sheriff's Office (MCSO), and the County, as well as
their officers, employees, agents and invitees including any operator or Lessee of
DJJ, MCSO, or the County. Any and all such persons shall use the common areas
ina reasonable, orderly, and sanitary manner in coopention with all other
occupants and their officers, employees, agents and invitees.
B. Each tenant will conduct itself and will cause its officers, employees, agents, and
invitees to conduct themselves with full regard for the rights, convenience, and
welfare of all other occupants in the facility.
6. UNAUTHORIZED USE
Lessee shall, through its agents and employees, prevent the unauthorized use of the
leased premises or the common areas, or any use thereof not in conformance with this
Lease. The Lessee shall not permit the leased site to be used or occupied in any manner
which will violate any laws or regulations of the applicable governmental authority or
entity .
7. ALTERATIONS
The County or MCSO are allowed by contract to make non-structural alterations,
additions, or improvements to the second floor of the DJJ building after reasonable
advance written notice to DJJ. Therefore, any non-structural alterations, additions, or
2
improvements which Lessee desires to make shall require County permission after
advance reasonable written notice bas been provided to DJJ.
8. MECHANIC'S LIENS
No Operators or Lessees will permit any mechanic's lien or liens to be placed on the
Property or on improvements on them. If a mechanic's lien is filed, it shall be the sole
responsibility of the Operator or Lessee causing the lien to be filed to discharge the lien
and to hold harmless and defend DJJ, MCSO, and the County against enforcement of
such lien. Pursuant to Section 713.01, F.S. the liens authorized in elL 713, F.S., do not
apply to DJJ, the County, or the MCSO. DJJ, MCSO, the County and their Operators or
Lessees shall give notice to all contractors before making improvements on the Property
of this provision of this agreement.
9. RECORDS - ACCESS AND AUDITS
Lessee shall maintain adequate and complete records for a period of four years after
termination of this lease. The County shall have access to the Lessee's books, records,
and documents related to this Lease Agreement upon request The access to and
inspection of such books, records, and documents by the County shall occur at any
reasonable time.
10. RELATIONSHIPOFPARTIES
Lessee is, and shall be an independent contractor and not an employee, agent or servant
of the County. Lessee shall exercise control, direction, and supervision over the means,
manner personnel and volunteers through where it performs the work. Lessee shall have
no authority whatsoever to act on behalf and/or as agent for the County in any promise,
agreement or representation other than specifically provided for in this Lease. The
County shall at no time be legally responsible for any negligence on the part of the
Lessee, its employees, agents or volunteers resulting in either bodily or personal injury or
property damage to any individual, property or corporation.
11. MODIFICATION
Additions to, modifications to, or deletions from the provisions of this Lease shall be
effective only if made in writing and executed by the County. No modification shall
become effective without written approval of both parties.
12. BREACH AND PENALTIES
The parties agree to full performance of the covenants contained in the contract. Both
parties reserve the right, at the discretion of each to terminate this Lease (pursuant to
paragraph #13) for any misfeasance, malfeasance or nonperformance of the terms of this
3
Lease or negligent performance of the Lease terms by the other party. Any waiver of any
breach of covenants herein contained shall not be deemed to be a continuing waiver and
shall not operate to bar either party from declaring a forfeiture for any succeeding breach
either of the same conditions or covenants or otherwise. Payment of the rental amount
shall be prorated if the lease is terminated effective before the end of any month. If the
prorated amount and any penalties imposed for damage to the premises are less than the
amount paid, the County shall return the excess amount to Lessee. Lessee shall pay the
County the cost of any repairs and clean-up (other than regular wear and tear) necessary
to restore the premises to a rentable condition.
13. TERMINATION
Termination of this Lease shall occur at the Natural ending date, or earlier should either
party determine that there has occurred any material breach of any covenants herein
contained, or either party otherwise deems it in their best interest to terminate.
Termination may be with or without cause, and shall require written notice to be given to
the other party as follows:
A In the event either party terminates for breach of contract, termination shall be
effective at such time as the terminating party shall declare in its act to terminate
for cause, with a minimum of fourteen days notice in writing required prior to
effective termination.
B. In the event either party terminates without cause, the termination shall not take
effect until at least sixty days subsequent to written notice to the other party, and
the effective date of termination shall be specified in said notice.
C. In the event funding for the lease payment comes from federal or state grants, the
agency may terminate lease if no or insufficient funds upon non-appropriation
from such sources, upon giving the County thirty days notice prior to termination.
14. INSURANCE REQUIREMENTS
Lessee shall carry, during the term of this Lease, public liability insurance, including
bodily injury and property loss damage to cover an claims, demands or actions by any
person or entity in any way arising from the operation of the Lease. Such liability
insurance shall meet the requirements of the Insurance Requirement Attachments hereto.
Monroe County shall be named as an additional insured under the insurance policy and
such insurance shalt be primary and non-contributing with any insurance carried by the
County. Lessee shall furnish the County with a certificate evidencing the insurance
required by this paragraph at the time of executing this Lease.
15. INDEMNIFICATION AND HOLD HARMLESS
Lessee covenants and agrees to indemnify and hold barmless Monroe County Board of
County Commissioners, tbe Department of Juvenile Justice, and the Monroe County
4
Sheriff s Office, their departments, agencies, officials, employees, agents, servants, from
any and all claims for bodily injury (including death), personal injury, and property
damage (including property owned by Monroe County, DJJ, and the MCSO) and any
other losses, damages, and expenses (including attorney's fees) which arise out of, in
connection with, this Agreement.
In the event the Lessee fails to purchase or maintain the required insurance, the Lessee
shall indemnify the County, DJJ, and the MCSO from any and all expenses resulting
from such failure.
The extent of liability is in no way limited to, reduced, or lessened by the insurance
requirements contained elsewhere within this agreement.
16. PERMITS
Lessee shall secure and maintain all required permits and/or licenses necessary to carry
out any service it provides at the premises.
17. LAWS AND REGULATIONS
A This Lease shall be construed by and governed under the laws of the State of
Florida unless in an area of law pre-empted by federal law. Lessee agrees for
venue of any dispute to lie in Monroe County, Florida.
B. Lessee shall comply with all federal, state and local laws and ordinances
applicable to its activities and use of the premises, and shall not discriminate on
the grounds of race, color, religion, sex, age, or national origin in providing
services or employing staff at the leased premises.
C. Any violation of said statutes, ordinances, rules, regulations and executive orders
shall constitute a material breach of this Lease and shall entitle the County to
terminate this Lease immediately upon delivery of written notice to the Lessee.
18. SEVERABILITY
If any provision of this Lease shall be held by a court of competent jurisdiction to be
invalid or unenforceable, the remainder of this Lease, or the application of such provision
other than those as to which it is invalid or unenforceable, shall not be affected thereby~
and each provision of this Lease shall be valid and enforceable to the fullest extent
permitted by law.
19. DAMAGE OR DESTRUCTION BY FIRE, W A~ OR ACTS OF GOD
In the event that the premises subleased are rendered untenantable in whole or in
substantial part as a result of destruction or damage by fire, acts or war, or acts of God
this lease shall cease, provided, nonetheless, that the lessor shall have the option of
5
rebuilding or repairing the premises if he elects so to do and gives written notice as such
election to rebuild or repair to the sublessor within 10 days after such damage or
destruction. If lessor elects to rebuild or repair the premises and does so without
unnecessary delay, sublessee shall be bound by the terms of this lease, except that during
the period of repairs or rebuilding, the rent under this sublease shall be abated in the same
proportion as the portion of the premises rendered unfit for occupancy by sublessee shall
bear to the whole of the sublease premises. Sublessee shall have the right to declare this
sublease terminated when more than 30 days after the destruction or damaging of the
premises as shall have elapsed without the lessor having elected to repair or rebuild.
20. ASSIGNMENT
Lessee shall not assign, transfer, sublease, pledge, hypothecate, surrender, or otherwise
encumber or dispose of this Lease or any estate created by this Lease, or any interest in
any portion of the same, without first obtaining the written consent of the County. In the
event of such consent, this Lease shall be binding upon the Lessee's successors and
aSSigns.
21. DISCLOSURE
Lessee shall be required to list any or all potential conflicts of interest, as defined by
Florida Statutes Chapter 112, Part III and the Monroe County Ethics Ordinance. Lessee
shall disclose to the County all actual or proposed conflicts of interest, financial or
otherwise, direct or indirect, involving any client's interest which may constitute a
conflict under said laws.
22. CARE OF PROPERTY
Lessee shall be responsible to the County for the safekeeping and proper use of the
property entrusted to the Lessee's care, and to process all documents necessary to
continue, without interruptions, any maintenance or service contracts relating to such
equipment for its service life. Lessee shall ensure that their patrons do not loiter or
congregate on the property. Lessee shall not commit waste on the leased premises, nor
maintain or permit a nuisance on the premises.
23. ETHICS CLAUSE
Lessee warrants that it has not employed, retained or otherwise had act on its behalf any
former County officer or employee subject to the prohibition of Section 2 of ordinance
No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance
No. 010-1990. For breach or violation of this provision, the County may, in its
discretion, terminate this Lease without liability and may also, in its discretion, deduct
from the Lease or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift or consideration paid to the former County officer or
employee.
6
24. NOTICE
Any notice required or permitted under this Lease shall be in writing and hand-delivered
or mailed, postage prepaid, by certified mail, return receipt requested, to the other party
as follows:
To: County
Monroe County Facilities Maintenance
3583 S. Roosevelt Blvd.
Key West, FL 33040
To: Lessee
Fl. Keys Outreach Coalition
P.O. Box 4767
Key West, FL 33040
25. FULL AGREEMENT
This Agreement constitutes the entire and full understanding between the parties hereto
and neither party shall be bound by any representations, statements, promises or
agreements not expressly set forth herein and in duly executed amendments under
paragraph 9 hereof
/~~~~ITNESS WHEREOF, the parties have executed this agreement the day and year
(/,-:,..i:,.:..~~ve written.
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Deputy Clerk
BOARD OF COUNTY COMMISSIONERS
OF MONROE ~OUNTY, FLORIDA
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EXHIBIT" A "
A parcel of land, formerly submerged in the Bay of Florida, and being part of the land
described in Trustees of the Internal Improvement Trust FUnd of the State of Florida
(TIIF) Deed Number 19725, and also being within the boundary of the land of the
Monroe County Detention Center as described in Deed recorded in Official Record Book
1139 at page 2381 of the Public Records of Monroe County, Florida and being described
more particularly by metes and bounds 8:S follows:
COM1ffiNCE at point 29 as described in said Monroe County Detention Center Deed
and thence S3 7~4 '3 7" W for a distance of 51 feet to the POINT OF BEGlNNrN:G of the
parcel herein being described; thence N530l2'53" W for a distance of35.03 feet to a
point; thence N 42017' 13" W for a distance of 60.81 feet to a point; thence N 52004'48"
W for a distance of 59.74 feet to a point; thence N 56017'08" W for a distance of 81.09
feet to a point on the Northeasterly extension of a Southeasterly face of the Detention
Center building; thence S 33007'42" W, along the said Northeasterly extension and the
said Southeasterly face, for a distance of240.50 feet to the point of intersection with a
Northeasterly face of the said building;; thence S Sr18'38" E, along the said
Northeasterly face of the said building and the Southeasterly extension thereof, for a
distance of 174.65 feet to a point; thence N 50018'31"E for a distance of 55.26 feet to a
point; thence N71~6'47" E for a distance of75.48 feet to a point; thence N45~6'47" E
for a distance of 61.81 feet to a point; thence N34039'37" E for a distance of 42.28 feet to
a point; thence NS3012'53" W for a distance of 17.69 feet back to the Point of Beginning.
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1996 Edition
\
f\l\)NROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
Introduction
to
Lease of County-Owned
Property
This section of the manual will apply to OrganizationslIndividuals who lease, or operate
concessions in or on County-owned property. Included in this section are those
OrganizationslIndividuals who lease or rent County-O\vned vehicles.
As a general rule, all agreements will include as a minimum:
· Indemnification and Hold Harmless Provisions
· General Insurance Requirements
· All Risk Property Provisions
and
· General Liability Provisions
If a County-owned vehicle is leased or rented, Vehicle Liability Insurance will be required to
include physical damage coverage.
All agreements must incorporate the "PROP" Indemnification and Hold Harmless agreement.
Questions should be directed to Risk Management at (305) 292-4542.
Administration Instruction
#4709.2
8.
: '9';,,~~~~r..l!>'?~~\"':1'!;
1996 Edition
. .JNROE COUNTY, FLORIDA
RISK l\1:ANAGEl\1ENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
General Insurance Requirements
for
o rganiza tionsflndivid uals
Leasing County-Owned
Property
Prior to the Organization or Individual taking possession of the property ovmed by the County,
or commencing its concessionaire operations, the OrganizationlIndividual shall obtain, at hislher
ovm expense, insurance as specified in the attached schedules, which are made part of this
leaselrental agreement.
111e Organization/Individual will not be pern1itted to occupy or use the property until satisfactory
evidence of the required insurance has been f11rnished to the County as specified below.
The Organization/Individual shall maintain the required insurance throughout the entire term of
tlus leaselrental agreement and any extensions specified in the attached schedules. Failure to
comply \vith this provision may result in the immediate termination of the leaselrental agreement
and the return of all property owned by the County.
The Organization/Individual shall provide, to the County, as satisfactory evidence of the required
insurance, ei ther:
· Certificate of Insurance
or
· A Certified copy of the actual insurance policy.
The County, at its sole option, has the right to request a certified copy of any or all insurance
policies required by this contract.
All insurance policies must specify that they are not subject to cancellation, non-renewal,
material change, or reduction in coverage unless a minimum of thirty (30) days prior notification
is given to the County by the insurer.
The acceptance and/or approval of the Organization/Individual's insurance shall not be construed
as relieving the Organization/Individual from any liability or obligation assumed under this
contract or imposed by law.
The Monroe County Board of County Commissioners, will be included as "Additional Insured"
on all policies. They will also be nan1ed as "Loss Payee" with respect to Fire Legal Exposure.
. Any deviations from these General Insurance Requirements. must be requested in writing on the
County prepared form entitled "Request for Waiver of Insurance Requirements" and
approved by Monroe County Risk Management.
Administration Instruction
#4709.2
9
.'
~.';::'::~~)"W~j~..
, ..~ 1.'1,
1996 Edition
ALL RISK PROPERTY
INSURANCE REQUIREMENTS
FOR
LEASESIRENTALS OF
COUNTY.OWNED PROPERTY
BET\VEEN
MONROE COUNTY, FLORIDA
AND
Prior to the Organization/Individual taking possession of the property governed by this
lease/rental agreement, the Organization/Individual shall obtain All Risk Property Insurance (to
include the perils of Flood and \Vind) with limits no less than the Replacement Cost Value of the
property leased or rented. Coverage shall be maintained throughout the life of the LeaselRental
Agreement and include, as a minimum, liability coverage for:
Fire
Sprinkler Leakage
Windstorm
Civil Commotion
Lightning
Sinkhole Collapse
Smoke
Aircraft and Vehicle Damage
Vandalism
Falling Objects
Explosion
Flood
The Monroe County Board of County Commissioners shall be named as Additional Insured and
Loss Payee on all policies issued to satisfy the above requirements.
Administration Instruction
#4709.2
'10
1996 Edition
GENERAL LIABILITY
INSURANCE REQUlREl\1ENTS
FOR
LEASEIRENT AL OF PROPERTY
OWNED BY THE COUNTY
BET\VEEN
MONROE COUNTY, FLORIDA
AND
Prior to the Organization/Individual taking possession of the property governed by this
lease/rental agreement, the Organization/Individual 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 Dan1age
· Fire Legal Liability (with limits equal to the fair market value of the leased property.)
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
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 termination of the Lease/Rental Agreement.
The Monroe County Board.ofCounty Commissioners shall be named as Additional Insured on
all policies issued to satisfy the above requirements.
Administration Instruction
#/4709.2
11
..".''':'":~~'
1996 Edition
y fHICLE LIABILITY
INSURANCE REQUlRE1\1:ENTS
FOR
LEASESIRENT ALS OF
COUNTY-O\VNED PROPERTY
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the Organizationflndividual taking possession of the property governed by this
leaselrental agreement, the Organizationflndividual shall purchase Vehicle Liability
Insurance. Coverage shall be maintained throughout the life of the Lease/Rental
Agreement and include, as a minimum, liability coverage for:
· Owned, Non-Ov.rned, and Hired Vehicles
· Physical Damage Protection (if the leased property is a County-owned
vehicle)
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
ACV for Physical Damage
If split limits are provided, the minimum limits acceptable shall be:
$ 100,000 per Person
$ 300,000 per Occurrence
$ 50,000 Property Damage
ACV for Physical Damage
The Monroe County Board of County Commissioners shall be named as Additional
Insured on all policies issued to satisfy the above requirements. In addition, if the
leaselrental agreement involves County-owned vehicles, the Monroe County Board of
County Commissioners shall be named as "Loss Payee" with respect to the physical
damage protection.
Administration 'Instruction
#4709.2
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12
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WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
BElWEEN
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 Florida Statute 440.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
$100,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$100,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire tenn of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the State of
Florida and the company or companies must maintain a minimum rating of A-VI, as assigned by the A.M.
Best Company.
If the Contractor has been approved by 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.
Administrative Instruction
1-4709.2
WC1
13
I PRODUCER
\
IS'Ll\ND INSURANCE l\GENCY,
3229 FLAGLER l\VE#112
KEY WEST,FL. 33040
INC.
- ~ -)--:~1:~b~\r~~~~~t~~~~!(!:Q~;)~~:~~~.LFLQ:~~;}S:Z~tltt%a~Llli~701 TJ
I.- THIS CERTIFICATE i's ISSUED AS A MATTER OF INFORMATioN
'I ONLY AND CONFer NO RIGHTS UPON THE CERTIFICATE
I HOLDER. THIS CERL .CATE DOES NOT AMEND, EXTEND OR
! AL TEfllJl~cgYI::RAGE AFFORDED BY "Tl!_EJ~OLJ9!~~ __~ELOW.
COMPANIES AFFORDING COVERAGE
INSURED
COMPANY
A AMERICAN EQUITY INS CO.
. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE13EEN 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.
COMPANY
B
FLORIDl\ KEYS OUTREl\CH COALITION, INC.
P.O. BOX 4767
KEY WEST,FL. 33040
COMPANY
C
I CT~ TYPE OF INSUI1ANCE
--~--------_._----_.-.,---_..-
:. GENERAL LIABILITY
~XX, COMMERCIAL GENERAL LIABILITY
POLICY NUMBER
POLICY EFFECTIVE ! POLICY EXPIRATION
DATE (MM/ODIYY) DATE (MMIODIYY)
LIMITS
l\CC 186264
9/25/01
9/25/02
GENERAL AGGREGATE ! $ 1 ~ 000 1 000
PRODUCTS - COMP/OP AGG : $ 1,000 I 000
PERSONAL & ADV INJURY ,$ 1,000 1000
EACH OCCURRENCE '$ 1,000 I 000
FIRE DAMAGE (Anyone fire) , $ 50 I 000
MED EXP (Any ~n~~r_sonL ,; $ .1.{ 000
CLAIMS MADE
OCCUR
l\'
. OWNER'S & CONTRACTOR'S PROT
___.J-...----.-.--'_________._ ._
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
. SCHEDULED AUTOS
i
.; HIRED AUTOS
NON-OWNED AUTOS
· < f1J~
. jf(~
. ~O'II )dV lo~
%:,.')1
COMBINED SINGLE LIMIT
,$
BODIL Y INJURY
(Per person)
i $
BODILY INJURY
(Per accident)
; $
GARAGE LIABILITY
ANY AUTO
....~;r-' ,-
,
\'.
..vl.
, ,
',>
~......L- .
I
~ \
..~
PROPERTY DAMAGE
$
,/
/
A \.I 10 ONLY Ell, ACCIDENT
<Jl HEll1 HAN AUTO ONL Y
U,CH ACCIDFNT S,
$
EXCESS LIABILITY
UMBRELLA FOI1M
(
/
// ().J\>\)/~/],:.y > 'I.
AGGREGATE So
-,--... ....
l
r ACH OCCURRENCE $
^GGI~EGATr
'5
,_. . __.Q!':l,~~_1.:~j~!~~,f<'II3HEII.A fOHM
: WORKERS COMPENSATION AND
: EMPLOYERS' LIABILITY
$
, THE PROPRIETOHI
PARTNERs/EXECUTIVE
OFFICERS ARE
.-.. -.. -.... .~--.
OTHER
we STATU. DTH.
TOIW LIMITS EA
U EACH ACCIDENT So
INCL
EXCI
n DISFASF POLICY LIMIT S-
F I IlISEASF EA FMPI OYEE 5
! OrSCHlPTlON or OPEI1ATlONS/l OCAIIO'<SNEHICLESISPECIAI ITEMS
NON-PHOFIT.
I
i C~HTIFICATE BOLDEr< IS ADDITIONAL INSURED.
: CERTIFICATE HOLDER
l'ONRROE (DUNTY BOARD OF (DUNTY CDMMISSIONERS
5100 COLLEGE RD
KEY WEST,FL. 33040
CANCELLATION
SHOUlD ANY OF THE ABOVE nr:SCf1IBFO POliCIES or CANC[l.U:O Br:n)HI lHI
I: XPlnA TlON OA TE
.Il,GENTS OR REPRESENTATIVES.
ACORD 25-S (1/l}S)
i 10
\ _ 5)1'.. i\NY KIND
\ AUTHORIZ
, ACORD CORPORA
N1988
PAYCHEX BUSINESS SOLUTIONS, INC.
911 PANORAMA TRAIL SOUTH
ROCHESTER,NY14625
DATEiMMi5ol'VY)
5/27/2002
THIS CERTIFICATE IS ISSUt::O AS A MATTER OF IN FOR :T10N
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AfFORDED BY THE POUCIES BELOW.
COMPANIES AFFORDING COVERAGE
:JAYCHEX AGENCY, INC.
t30 UNDEN AVENUE
SUITE 200
:tOCHESTER, NY 14625
cmFANY
A
HARTFORD CASUAL TV INSURANCE co.
,URED
COMPANY
B
COMPANY
C
cmFANY
D
iVE~cl~!;)n"~Wjt~;i;,n"! '^ c; ";11\'
THIS IS TO CERTIFY THAT THE POlIClES OF INSURANCE lISTED Baow HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING AHY REQUIREMENT. TERM OR CONDITION OF AHY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIACATE MAY BE ISSueD OR MAY PERTMoI. TtE 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 PAl> CLAIMS.
TYPE OF INSURANCE
GENERAL LIABIUTY
POUCY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (IIIIIIIIlIYY) DATE (IIIIIIIIlIYY)
LIMITS
COMPRaENSI\IE FORM
PREMlSESIOPERATJONS
UNDERGROUND
EXPlOSION & COLLAPSE HAZARD
PROOlJCTSIC()MP OPER
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUTOMOBILE LIABILITY
BODILY INJURY ace s
BODILY INJURY AGG S
PROPERlY DAMAGE ace s
PROPERlY DAMAGE AGG S
81 & PO COIlBINED ace s
81 & PO COMBIIED AGG S
PERSONAL INJURY AGG S
EXCESS LIABIUTY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION AND
EMPLOYERS'LIABIUTY
- - -- -,.-
_ .._1lMl1lO2___ _
BODILY INJURY S
(Per pen;on)
BODILY INJURY S
(Per accidlInt)
PROPERTY DAMAGE S
BODILY INJURY &
PROPERTY DAMAGE S
COMBINED
EACH OCCURRENCE S
AGGREGATE S
S
<m'"
s 100000o
.-
EL DISEASE - POLICY LIMIT S 100000o
EL DISEASE - EA EMPLOYEE S 100000o
ALL OWNED AUTOS (PIlvale PMa)
ALL OWNED AUTOS
(Cllher Ihan PriwlIe Passenger)
HIRED AUTOS
APP,.
B'(
O~JE
WANER
:.N't
.-
.----
1 WN Jl19OO___._
06101~ .
TtE PROPRJETORI
PARTNERSIEXECUTl
OFFICERS ARE:
OlllER
X INCL
EXCL
ONLY THOSE EMPLOYEES LEASED TO BUT NOT
UBCONTRACTORS OF: EE RE: BELOW
;CRIPTION OF OPERATIONSILOCATIONSIVEHIClESISPECIAL ITEMS
: FL KEYS OUTREACH COALITION, INC
MONROE COUNTY BOARD 0
COUNTY COMMISSIONERS
ATTN: ANN MYTNIK
5100 COLLEGE ROAD
KEY WEST. FL 33040
,.,..".-..<....i;i'Jil'~~-,...M'~*'~~
()Rt);2:H-t.\'QlI5);Yi%iJ"i'if'%~f!\:~i~ifi~'!:'il'i,,,-,,fff ,
RRrET'TE
JUL 0 5 2002
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
,J]()UL.J ~ ~P.AAJ (fhAL, .%L.
(N of Busmess)
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 dmg 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 that are under bid, the employee will abide by the terms of the
statement and will notify the employer of any conviction of: or plea of guilty or nolo contendere to, any
violation of Chapter 893 (Florida Statutes) or of any controlled substance law of 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
section.
As the person authorized to sign the statement, I certify that this :firm complies fully with the above
requirements.
6?~
Lessee
o~- Z j?! / i 5~-Y ,7UO""C:-
Date
OMB - MCP#5
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETIDCS CLAUSE
'44". ~Lt..J &a,.J~1I{1J..)
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 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, tenninate 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 former County officer or employee.
~<)
Date: O~- ~ >'- 0 z
STATE OF tJ!LwdJ
COUNTY OF Yk d~
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
~. ~~ dJtlJ~ who, after first being sworn by me, affixed hislher
signature (name of individual signing) in the space provided above on this ~4:J-A day of
~ ,20~.
L a-6JtJ
NOTARY PUBLIC
My commission expires: 0 tf - J if - D f
OMB - MCP FORM #4
"~,...~' Gina Pecora
* * My COmmissio
~,,' n CC962932
"'...... Expires September 15
.2004