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08/21/2002 Lease Cled( of lIIe CircuR coun Danny L. KoIhage Clerk of the Circuit Court Phone: (305) 2!J2..S550 FAX: (305) 295-8668 e-mail: phancock@monroe-clerk.com Memnrandmn TO: Dent Pierce, Director Public Works Division ATTN: Beth Leto, Administrative Assistant Public Works Division FROM: Pamela G. Hanc~. Deputy Clerk Q 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. Lease 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 / ,. 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 State of Florida, whose address is 1100 Simonton Street, Key West, FL. 33040 (Lessor/County), and Fl. Keys Children's Shelter, (Lessee/CIN FIN). 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, pmsuant to a Lease Amendment dated August 15, 200 1 and an original Land Lease Agreement dated July 8, 1999 and a Construction and Occup.ation Agreement (with a third party, the Monroe County Sheriff's Office), dated November 20, 2001; 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 non-residential counseling providing services for at risk students and families that seek help (school setting). Residential counseling (up to 35 days). and provides Crisis Intervention Services to help ''walk-thru'' families while experiencing a crises; now therefore, The County and the Lessee agree as follows: 1. DEMISE AND PREMISES For good and valuable consideration, the County hereby leases to the Lessee an area approximately 510 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 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 of the L day of October, 2002 and ending on the 30111 day of September, 2007. B. The County shall have the option to renew this agreement after the first term and each succeeding term for two additional five-year term periods. 3. RENT A. The Lessee shaH promptly pay the County, in advance, the sum of $708.90 per month on or before the 1 It of each month. Rent is calculated by the rate structure of $16.00 per square foot per year (approved by the Monroe County Board of County Commissioners at their 7/26/00 meeting) plus the CPI-U of2.6% for July I 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 Monroe County and paid to the Clerk located at the Monroe 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 Monroe County 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 cooperation 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 pennit 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. ALTERA nONS 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 improvements which Lessee desires to make shall require County permission after advance reasonable written notice has been provided to DU. 8. MECHANIC'S LIENS 2 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 ch. 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. RELATIONSHIP OF PARTIES 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 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 3 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 all 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. Momoe County shall be named as an additional insured under the insurance policy and such insurance shall 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 harmless Momoe County Board of County Commissioners, the Department of Juvenile Justice, and the Momoe County 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 Momoe County, DJI, and the MCSO) and any other losses, damages, and expenses (including attorney's fees) which arise out ot: in connection with, this Agreement. 4 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, WAR, OR ACfS 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 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 5 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 HI 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. 24. NOTICE 6 Any notice required or permitted under this Lease shall be in writing and hand-delivered or mailed, postage prepaid, by certified mai~ 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 Children's Shelter 73 High Point Road Tavernier, FL 33070 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 ~~.... ,...,'''' -,-' (~r\\ ~v"-.",,,, /~:):~;...,~ ./-...;::,~~, WITNESS WHEREOF, the parties have executed this agreement the day and year , . .',~.. ,':'l~] f23 u ~above written. J ( . r . ~ I A.-, ", :Il.." f J!~fl /. I \ A\'~) -),\~:;,-- -; -., , - 'ls'\ ~ " .' t'".. n 1 i'\ ; . .l..__~~ I-~' ~"'\ '_~- ,~,.' ,.:.-rt~..., .,' ,( "f "\ '-., ....., ...----'" \:~.<<,;>" At!t.est'>nA'NNY L KOLHAGE Clerk '~>:'..' .';;2!j// . , (SEAL) Attest: BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA 1') .~ Us ~+'l i "~~ . Mayor/Chairm~ c :z )> ::00 (") ?,=.. r-. 1Tl;l!: B~!'- 0 c: :ii ;;;~ :z: . C) -I roo ~ :<~::r: FL. KEYS CHILDREN'S Sl-:Q!L~R N )> ITl ~ <::::) = ~ U) rrl -0 ." r f"I1 D ." o :::0 ;0 G~ Duty Clerk By III CJ o :::0 CJ r-- By~~",,- Ac-~r~ BY~~ Title ~tO~ TitleCfuc:.. a.c~ Vh . ~'t: 7 ~,~Y" .. t .~. ""~~:'f"!', .. .~ :rr ;l<~':l~'" "t'.":~.."'l:. EXHIBIT "A" A parcel of land, fonnedy 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: COMMENCE 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 BEGINNING of the parcel herein being described; thence N53012'53" W for a distance of35.03 feet to a point; thence N 42017'13" W for a distance of60.81 feet to a point; thence N 52004'48" W for a distance of 59.74 feet to a point; thence N 56017'0811 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 57018'38" 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 N53012'53" W for a distance of 17.69 feet back to the Point of Beginning. 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Q' ..... - ----, ~ 'S": IW >~ ~/ @ ~iaOO,I&'t. \OOrmOOJ @ ,..... r ~ ~ llW :'t ~ ~ ::,;:l:.:;:::~~.:",l.~c ~. _:~l~ --'_, .,,:~ m~.~. 11m.. hoo ~ .1.; ~ ~Im . ~ .~~, ;lm..~ ~ 1'.I:'\.1A\!:\0N~~(i"{~N;{~,~t~~~~'1~H~\Z~,,\~';~'~\i{ '<:i':~.C:.,:,i.,<,\'y',~"~:i'?-~'{,\h\-!(?\\,lJ;\h~'1'~fi.;)i"(':'\iN\S\,\!.;:;",;.,..; ,'i; .',. \.' ,"";.:~'.I;";I:;"',( ",\', .;,',;;' .\' ';"11"'; i'o",\ t' :%~~Z~~)1;\'t.;t~!~~~~~~~.'~~*.~.~~.~{~~;~~g1<':;~~:.:~M+~J0YMft~i.},\~~.~.~:~1t.~;{~~~[~.,;;\~:~;;\..\tt,:~\{t;t}:;~;~;?~',Vi:,,;,;:,,~;;;)'~:<'h:~<~1:i~i,!''J\'~,~'i::.::::<~,,~.,:::.<\:.~;}:;;:/~;~i;"3(/ :,"'\j:.;..1y,,\:4~;,(,;. \l~~~'\'-r",\.~t~ij.~\'J") ", \(. "'liJ..O't~'f~t' (>..~ l.~- ~"~ "-.", .' J( ~.: ;,', 'I, ~ > ,"., l. "!,'."-(~'\~,,"':~\ ','.) 4:,:t," (~~"\\' '. .!.~ i','."" "J.;,'~'\ ,: . . .-' .' -, 'f "," " . "oF ,t"-,. " \'; , ,,", ." ( ','.. I. -.' 1'1 ". "~~ ~ . ..If F. ..:.: . .~~~. ."1 -I ,.', . , .1 ::I . . .. -:..j,' I~oo {~. h~ ~ iW .":<-<'1>( Q '" '".;: .. ,:0: ~ ..~;. ...........ifl ,~ .~: ~! ; ',:::rXl~ . ,.... ~ i ,/~ ,', !CW.... .'.-:.:. ~h' .~". -.:, ~"'~~J-,~:~~W~'4"~~~:,"f~;-"'~.;'I>~". \ 1996 Edition h.JNROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL Introduction to Lease of County-Owned Property 1l1is 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-owned vehicles. As a general rule, all agreements \vill include as a minimum: · Indemnification and Hold Hannless Provisions · General Insurance Requirements · All Risk Property Provisions and · General Liability Provisions If a County-ovmed 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 #14709.2 8 , A~..\", 1996 Edition , ". ,~,~~,:"~:_P'~:':-:\~~r~~~:.~,'~'~::,';' . l,..0NROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION f\1.ANUAL General Insurance Requirements for Organ iza tions/Individ 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 o\\"n expense, insurance as specified in the attached schedules, which are made part of this leaselrental agreement. The Organization/Individual will not be pern1it1ed to occupy or use the property until satisfactory evidence of the required insurance has been furnished to the County as specified below. The Organization/Individual shall maintain the required insurance throughout the entire term of tbis leaselrental agreement and any extensions specified in the attached schedules. Failure to comply with 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, either: · 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 tbis 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 Organizationllndividual's insurance shall not be construed as relieving the Organization/IndividuaJ 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 ~~ '~'f.<~;"1''', -)',._~~J~_.!~--;" '. . -"-';.0-",:', . ":t. 1996 Edition ALL RISK PROPERTY INSURANCE REQUIREMENTS FOR LEAS ESIRENT ALS OF COUNTY-OWNED PROPERTY BET\VEEN MONROE COUNTY, FLORIDA AND Prior to the OrganizationlIndividual taking possession of the property governed by this lease/rental agreement, the OrganizationlIndividual shall obtain All Risk Property Insurance (to include the perils of Flood and Wind) 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 #14709.2 '10 1996 Edition GENERAL LIABILITY INSURANCE REQUIREMENTS FOR LEASEfRENT AL OF PROPERTY OWNED BY THE COUNTY BET\VEEN MONROE COUNTY, FLORIDA AND Prior to the OrganizationlIndividual taking possession of the property governed by this leaselrental 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 LeaselRental 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 ~";-,,,"'::-:-,'I,-.;;I'r:O< ,-. 1996 Edition . EHICLE LIABILITY INSURANCE REQUIREMENTS FOR LEAS ESIRENT ALS OF COUNTY-OWNED PROPERTY BETWEEN MONROE COUNTY, FLORIDA AND Prior to the Organization/Individual taking possession of the property governed by this lease/rental agreement, the Organization/Individual 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-ovmed 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 lease/rental 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 lnstruction #4709.2 "..'."'Y"""'''~.~.''''~. . c' - "';:.~\~:~t~~..~. 12 t "i,f;~;'~~X;<<~ ',,",. WORKERS' COMPENSA nON INSURANCE REQUIREMENTS BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work govemed 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 term 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 14709.2 WC1 13 DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: (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 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 guil1y 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 communi1y, 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. ~ cJ.~. ~ S') ';!'OOJ-. OMB - MCP#5 SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE ~{'fI!e.r1~~11 warrants that helit 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. ~~ (signature) Date~P?S" J 0let::B-. STATE OF ~.-J.. UlA..(,\~ COUNTY OF '---VY\.1,'Y\Jlv-R- PERSONALLY APPEARED BEFORE ME, the undersigned authority, Ko~/V'- -J ~~ who, after first being sworn by me, affixed hislher .... signature (name of individual signing) in the space provided above on this ~ ? day of ~~ , 20 0 ~ ~-:-~~ ~ ~~cSJ-~ NOTARY PUBLIC My commission expires: -.::>. I ~ ;.):?, ~v "(J - 0.....,. 8(".-< LINDA L GONSALVES ~ . C' co.-.-olI 1lU_ ; : CC808530 "'1- ~ II\' COllMlll8lQN EXPIfD OF f\.O FEB. 11,2003 OMB - MCP FORM #4 ACORD.. CEIRTIFI.CATEOF LIABILITY..INSURANGtE@T...oPD:AD ............... o..TEI~ .. ... ... . .. . .... .. .. . ... ..... ... ..... ..... ... .... . .....:.J!'Ll(EYSC .. 09/10/01 . . . - . PRODUCER 'THIS CERTIFICATE IS IssueD AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON 1HE CERTIFICATE Greq Roe Insurance, Inc. HOLDER. lHlS CERTIFICATE DOES NOT AMEND. EXTEND OR 9851 State Road 54 ALTER 1HE COVERAGE AFFORDED BY lHE POLICIES BELOW. New Port Richey FL 34655 COMPANIES AFFORDING COVERAGE Al.vina Davis A062355 COMPANY A Nonprofits Ins. Association Phone"" 727-376-0030 F.."" 727-376-2262 INSIJRe) COMPANY B Zurich Insurance e~y Fl.orida Keys Chi.1.dren ' s COMPANY Shel.ter, Inc. C 73 Hi.ghpoint Road COMPNlY Tavernier FL 33070 D .COVERAGES.: . .::. .:.:.::..... ::.. .:. ::.: .::.. ...:....:-.:.. ..:.:.:::- .::.::...::::: . . . . . , - . . . . . , . . . .. ..... ',....... .. ....... d'" ... THIS 1$ TO CERTIFY THAT THE POLICIES OF INSURANCE LiSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABove FOR lHE POLICY PERIOD INDICATED. NOTWITHSTANDING JW'( REQUIREMENT. TERM OR CONDITION OF N<< CONTRACT OR OTHER 00ClIUENT WITH RESPECT TO lMiICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY llfE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL llfE TERMS. EXCWSIONS AND CONDITIONS OF SUCH POl.ICIES. UUlTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. co TYPE OF INSURANCE POLICY NlJMBER POlICY EFFeCTIIIE POlICY EXPIRATION .......TS LTR o..TE (MMIOOIVY) o..TE(~ CiEJoER.OL !JAEIIJTY _AGGREGATE $ 3,000,000 f-- A ~ COMlolERClAI.. _..-.rrv NIA1814142 09/15/01 09/15/02 PROllUCTS. COMPIOP AGG $ 3,000,000 L--. b CLAIMS MADE [i] OCCUR PERSOtW. &IOIIN.AJRV $1 000,000 I-- ov.oER'S & CONTRACTOR'S PROT EACHOC~ $ 1.,000,000 FIRE Q.WAGE (Any........, s 50,000 I-- lIIIDElCP(Any__, S 5,000 ~Bll.E lIABIJTY COMBN!D SINGlE I.MI' $ 500,000 A ~ ANY >.UTa NIA1814142 09/15/01 09/15/02 I-- . AU.. OWNED .wros BOIlLY lNJJR'( S SCHEC\LEDAUTOS (Per_I I-- A ~ HIREO AUTOS ~~ I B!J9.Y~f1 ~Il~~ s A ~ ~"lJTOS ._~.J:I'( R 8\ I T T}:.71 , A.P, 1\ \ ~ - I-- I'ROPeRTY Q.WAGE S nV J\../ lJo _'\ .:::.- GARAGE lIABIJTY ... J 1/ \ \ 17' -, ....L --=-- AUTO ON.Y - EAACCIDEHT S I-- ANY AUTO OATE - ~. YES OTtER THAN NJrO ONI. Y: .. ..:::::.: . I-- - WANER N/A EACH ACCIlENT S .. AGGREGATE $ ~=FORM .. EACH OCCUPRENCE s 1,000,000 A REL18U047 09/15/01 09/15/02 AGGREGATE s 1,000,000 OTHER 11-IAN UWBREI..I.A FORM S WORI<EPS COMPENSATION AND xl~~ I I~ .. ... ... ~OVEPS' lIAIlIJTY S 500, 000 a. EACH ACCIJENT A THE PROPRIETORJ M~L 0811.00033530 01/01/01. 01/01/02 a. OISEASE . POlICY I.MI' S 500, 000 PARTNERSIElCECVTI\IE OFACEPS .oPa El<CL a. OISEASE - EA~VEE $ 500.000 OTHER A NIA NIA1.814142 09/15/01 09/15/02 ~~ , . $750.,..00.0_---;-_. $109,900 : DESCPPTlON OF CPeRATIONSILOCAT1ONSNEHICl.ESIITE!llS I ,Ii \.1- WORKERS COMPENSATION APPLIES TO FLORIDA OPERATIONS ONLY * WORRERS ~... COMPENSATION 30 DAYS AI.I. OTHER POLICIES 10 DAYS TO CANCEL . CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED UNDER GENERAl. LIABILITY .AND EXCESS LIABILITY. =,..--. . .... CERTlFICATEHOtOER" ..: ... ... .......::.... .... .. CANCELLATIoN.. .:.... .. . ........ ........................ MONRO 0 1 SHOI.U) ANY OF lIE AIIO\'E llESCRIlEO POlJCIES llE CANCElLEO llEFORe lIE MONROE COOlllTY El<PRAllON DATE llEREOF. THE ISSIJIIIC COMPNlYwu..ENlEAVOR TO__ Dace ~ 0.."8 ~ NOTICE TO THE CERTFICATE HOLDER NAMED TO lIE LEFT. ATTN :RISK MANAGEYENT BUT FALURE TO...... SUCH NOTICE SHALL ~ NO OIlIJGAllON OR L.IA8Il..ITY 5100 eOI.I.EGE ROAD KEY WES?:, FL 33040-4399 OF ANYKJND IA>ONlIE COMPANY. n"SAGaITS OF! PEPPESENTATlIIES AUTl-iOPIZEO PEPRESENTATlIIE A1vina Davis A062355 ACORO~(1195) . :. 0: .... .:. . ..' .. 'ACoRD:CORPORATlON 1:* . . :...., v.., ......, ~vv, RODUCER (305)743-0494 FAX C311:.>)743-0532 THIS CERTIFICATE IS 1~"uEO AS A MATTER OF INFORMATION <eys Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE OOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE ISURED Florida Keys Chlldren Shelter Inc y.5 INSURER A:. Hartford Ins Co 73 High Point Road INSURER B: Tavernier, FL 33070 INSURER c: INSURER 0: I INSURER E: OVERAGES 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 CONDmONS OF SUCH POLICIES. AGGREGATE lIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO ClAIMS. PI: TYPE OF INSURANCE POUCYNUMBER ~~ ~~ GENERAL LIABIUTY I-- COMMERCIAL GENERAL LlA8l1:./TY I CLAIMS MADE 0 OCCUR EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one p8I'SOI1) PERSONAl & ADV INJURY GENERAL AGGREGATE GEN1. AGGREGATE LIMIT APPLIES PER: n POLICY n ~~ n LOC AUTOII08ILE lIABIlITY - NlY AUTO - All OWNED AUTOS - SCHEDULED AUTOS PRODUCTS - COMPIOP AGG $ COMBINED SINGlE LIMIT (Ea accident) .,.." .,..... ,., BY MSIl UANaGEM i\OI.~JlLuJ '- r -1:r: lOd- .u NT BOOIL Y INJURY (Per person) - .- HIRED AUTOS - .. BY DATE BOOIl Y INJURY (Per accident) NON-DWNED AUTOS - PROPERTY DAMAGE (Per accidenl) I\I/A -Vl=~ ~\)ft'.(Ou ~ in::i -( LL ~ c;o ~ AUTO ONlY. EA ACCIDENT S GARAGE lIABIlITY ~ NlY AUTO EXCESS lIABIlITY :J OCCUR 0 ClAIMS MADE I DEDUCTIBLE --, RETENTION $ WORKERS COMPENSATION AND 'lWECGD3303 EMPlOYERS' UABIUTY OTHER THAN AUTO ONLY: EACH OCCURRENCE AGGREGATE '9 01/31/2002 01/31/2003 T~mJ.v-S I IU~~' E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPlOYEE $ E.L. DISEASE - POLICY LIMIT $ " OTHER 'ESCRIPTlON OF OPERATIONSlLOCATIONSlVEHIClESIEXClUSlONS ADDED BY ENOORSEIIENTISPEClAL. PROVISIONS ,.... UMITS $ $ $ $ $ $ $ $ $ EA ACC $ AGG $ $ $ $ $ $ 100 , ()()(l 100 , OQ(J 500 , ()()(l \.. - v U 1..0 Z CANCELlATION SHOULD ANY OF lltE ABOVE DE ~.. BE CANCEUED BEFORE THE EXPIRATION DATE THEREOF, THE ~G COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN ~~~Te HOLDER NAIlED 10 lltE LEFT, ;;;;;"URE TO MAlI.. ~~ SHAlL 1M 'NO OBlIGATION OR UA8lUTY OF ANY KINO UPON THE OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE \ \. '\. r-- "----- .~ l".._. --_.-.-~ :ERTIFICATE HOLDER I I AOOITIONAllHSURED; INSURER lETTER: County of Monroe Monroe County Ris~ Management Maria Del Rio / 1100 Simonton Street Key West, FL 33040 ~CORD 25-5 (7/97) @ACORD CORPORATION 1988