Item P7 P.7
County f � .�� ",�, 1 BOARD OF COUNTY COMMISSIONERS
Mayor Craig Cates,District 1
Mayor Pro Tem Holly Merrill Raschein,District 5
The Florida Keys
Michelle Lincoln,District 2
James K.Scholl,District 3
David Rice,District 4
County Commission Meeting
December 7, 2022
Agenda Item Number: P.7
Agenda Item Summary #11459
BULK ITEM: Yes DEPARTMENT: County Attorney's Office
TIME APPROXIMATE: STAFF CONTACT: Brian Bradley (305) 295-3177
N/A
AGENDA ITEM WORDING: Approval to advertise solicitation for proposals for Pollution
Liability Insurance Coverage.
ITEM BACKGROUND:
The Pollution Liability Insurance Policy issued by Ironshore Specialty Insurance Co. provides
coverage to the County for potential liability associated with an accidental discharge of pollutants
from one of its fuel storage tanks and the potential liability associated with a pollution incident at
other scheduled County locations. County Purchasing Policy requires competitive bids for insurance
every three years, current policy expires May 1, 2023.
PREVIOUS RELEVANT BOCC ACTION:
This policy was last bid in January 2020, and approved by the BOCC on April 12, 2020.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Pollution RFP clean
FINANCIAL IMPACT:
Effective Date: 5/1/2023
Expiration Date: 5/1/2026
Total Dollar Value of Contract: $75,000
Total Cost to County: $75,000
Packet Pg. 1911
P.7
Current Year Portion:
Budgeted: Yes
Source of Funds: Internal Service Fund Primarily Ad Valorem
CPI: N/A
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: No If yes, amount:
Grant: N/A
County Match: N/A
Insurance Required: N/A
Additional Details:
N/A
REVIEWED BY:
Brian Bradley Completed 11/21/2022 3:27 PM
Cynthia Hall Completed 11/21/2022 3:54 PM
Bob Shillinger Completed 11/21/2022 3:57 PM
Purchasing Completed 11/21/2022 4:04 PM
Budget and Finance Completed 11/21/2022 4:08 PM
Lindsey Ballard Completed 11/21/2022 4:09 PM
Board of County Commissioners Pending 12/07/2022 9:00 AM
Packet Pg. 1912
P.7.a
MONROE COUNTY
REQUEST FOR PROPOSALS
FOR
2023 - 2026 Pollution Liability Insurance Prociram
18 23
7P
CL
U
BOARD OF COUNTY COMMISSIONERS
Mayor, Craig Cates, District 1
Mayor Pro Tem, Holly Merrill Raschein, District 5
Michelle Lincoln, District 2
James K. Scholl, District 3
David Rice, District 4
COUNTY ADMINISTRATOR
Roman Gastesi
CLERK OF THE CIRCUIT COURT COUNTY ATTORNEY
Kevin Madok, CPA Risk Management
May 1, 2023
i
Packet Pg. 1913
TABLE OF CONTENTS
NOTICE OF REQUEST FOR PROPOSALS
SECTION ONE - INSTRUCTION TO PROPOSERS
SECTION TWO COUNTY FORMS
2
Packet Pg. 1914
P.7.a
NOTICE OF REQUEST FOR COMPETITIVE SOLICITATIONS
NOTICE IS HEREBY GIVEN that on Wednesday, March 15 2023, at 3:00 P.M., the Monroe County
Purchasing Office will receive and open sealed responses for the following:
2023-2026 Pollution Liability Insurance Program
Monroe County, Florida
Pursuant to F.S. 50.0211(3)(a), all published competitive solicitation notices can be viewed at:
www.floridaDublicnotices.com, a searchable Statewide repository for all published legal notices.
Requirements for submission and the selection criteria may be requested from DemandStar at
www.demandstar.com OR www.monroecounty-fl. ov/bids. The Public Record is available upon
request.
Monroe County Purchasing Department receives bids electronically. Please do not mail or attempt to
deliver in person any sealed bids. Mailed/physically delivered bids/proposals/responses WILL NOT be
accepted.
The Monroe County Purchasing Department hereby directs that bids be submitted via email to:
OMB-BIDSL�monroecounty-fl. ov, no later than 3:OOP.M., on Wednesday, March 15. Please submit
your confidential financial information in a SEPARATE EMAIL from your bid and required a
documents. Your subject line on both emails must read as follows:
0
2023-2026 Pollution Liability Insurance Program 3-15-2023
Files that do not contain this subject line WILL BE REJECTED. Please note that the maximum file size
that will be accepted by email is 25MB. Please plan accordingly to ensure that your bid is not rejected
due to the file size. Should your bid documents exceed 25MB, in advance of the bid opening, please
email: omb- urchasin a)monroecount�-fl.�ov so accommodations for delivery of your bid can be
made prior to the bid opening. Please be advised that it is the bidder's sole responsibility to ensure 2
delivery of their bid and waiting until the bid opening to address or confirm your bid submission delivery 0-
will result in your bid being rejected.
The bid opening for this solicitation will be held virtually, via the internet, at 3:00 P.M., on March
15, 2023. You may call in by phone or internet using the following:
Join Zoom Meeting
httl2sa//mcbocc.zoom.us/i/4509326156
Meeting ID: 4509326156
One tap mobile:
+16465189805„4509326156# US (New York)
+16699006833„4509326156#US (San Jose)
Dial by your location:
+1 646 518 9805 (New York)
+1 669 900 6833 (San Jose)
Publication dates:
Keys Weekly: Thur., 1/26/2023
News Barometer: Fri., 1/27/2023
Citizen: Sat, 1/28/2023
3
Packet Pg. 1915
P.7.a
Monroe County
Board of County Commissioners
REQUEST FOR PROPOSALS
FOR
2023 - 2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
BACKGROUND INFORMATION
The County is a non-chartered county established under the Constitution and the laws
of the State of Florida. The Clerk of the Circuit Court serves as the fiscal agent.
The Board of County Commissioners, constituted as the governing body, has all the
powers of a body corporate, including the powers to contract; to sue and be sued; to
acquire, purchase, hold, lease and convey real estate and personal property; to borrow
money, and to generally exercise the powers of a public authority organized and
existing for the purpose of providing community services to citizens within its territorial
boundaries. In order to carry out is function; the County is empowered to levy taxes to
pay the cost of operations.
0
A full time Risk Manager is employed to oversee the County's Property and Casualty
insurance program. A full time safety manager reports to the County Administrator.
CURRENT PROGRAM
The County's current policy was issued on May 1, 2020 on a three year basis by
Ironshore Specialty Insurance Co. The limits of the policy are $5 million per occurrence
and a $5 million annual aggregate. All claims are subject to a $50,000 deductible. -
The three (3) year premium was $75,000.
The policy extends to the legal obligations of the County that arise out of the discharge,
dispersal, release, seepage, migration or escape of smoke, vapors, soot, fumes, acids,
alkalis, toxic chemicals, liquids, gases, or other similar hazardous materials from
locations scheduled in the policy. The policy will also pay for the expenses incurred for
the investigation, monitoring, removal, disposal, treatment or neutralization of property
contaminated by such incidents. Coverage is provided on a ""Claims Made" basis with a
retroactive date of 7/10/95.
4
Packet Pg. 1916
P.7.a
MONROE COUNTY
BOARD OF COUNTY COMMISSIONERS
REQUEST FOR PROPOSALS
FOR
2023 - 2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
GENERAL INFORMATION AND COVERAGES REQUESTED
COVERAGES REQUESTED
Monroe County, Florida wishes to receive proposals for the following insurance
protection:
❖ Pollution Liability
The County will consider modified proposals to the extent that they provide adequate
coverage and in view of the overall program objectives. Reasonable options are
solicited where the desired coverages cannot be provided as requested. All reasonable
proposals will be eligible for review.
SEPARABILITY OF COVERAGES g
Coverages that must be purchased in combination or as part of other coverages should 0-
be specifically stated in the proposal(s). If different premiums apply to coverages when
purchased separately, they should be specifically stated.
RATING DATA
A schedule of locations to be insured and a schedule of County owned Storage Tanks
(to be included as insured locations) are included below.
0
EVALUATION CRITERIA ;
Award shall be made to the responsible proposer whose proposal is determined to be
the most advantageous to the County, taking into consideration the evaluation criteria
set forth below:
Evaluation Factor Maximum Available Points
Terms and conditions of coverages 30
being proposed
Financial stability of insurers being 15
proposed
Experience of proposing agent with
structuring Pollution Liability 7
insurance
Experience of proposing agent with
governmental entities $
5
Packet Pg. 1917
P.7.a
Location of proposing agent
(including local preference if 10
applicable: 5points)
Price 30
Total points earned are on a scale of 1 — 100 points
1 = lowest 100 = highest
LOSS HISTORY
There have been no known losses during the past five (5) years.
EFFECTIVE DATE OF COVERAGE
The effective date of coverage is May 1, 2023. The County would prefer to purchase a
three (3) year policy with premiums paid on an annual basis. The County will consider
a single year policy if a multi year policy is unavailable.
ASSIGNMENT OF MARKETS g
Due to the limited number of insurers that have the ability and desire to provide �
Pollution Liability insurance, the County will not assign markets for this RFP. However,
if a proposer submits the County's account to an insurer and later elects to pursue a
proposal from that insurer, it is requested that the proposer release the insurer and
waive the standard 10 day waiting period so other proposers will have access to that
insurer.
RFP SCHEDULE CL
The following schedule will apply to the RFP process. Extensions of any of the deadlines
will not be honored.
Date Activity
12/8/22 Posting of bid specifications on
Demandstar
2/16/23 Deadline for requests for additional
information
2/17/23 Posting of Addendum on
Demandstar
3/17/23 Proposal return date and bid
opening
4/19/23 Board meeting and award of
and contract
4/20/23
6
Packet Pg. 1918
P.7.a
5/1/23 1 Effective Date
VALID DATE OF PROPOSALS
Proposals are requested to remain valid until June 1, 2023 in the event that an
extension of the current program is undertaken.
RIGHT TO REJECT PROPOSALS
Monroe County, Florida reserves the right to reject or waive any proposal individually,
including any portion of a proposal for any reason that it deems appropriate.
The County may elect to negotiate or not to negotiate with any individual Proposer.
The County reserves the right to select the proposal(s) that it believes will best serve its 6�
interests. The award of any multi-year contract is subject to an annual appropriation by
the Monroe County Board of County Commissioners.
ADHERENCE TO INFORMATION AND PROPOSAL
All statements contained in written proposals are intended to be relied upon by Monroe
County. All coverages must be issued as proposed unless the County authorizes
individual changes. Any changes authorized by the County will not alter any other
items contained in this Request for Proposal. Policies not issued in conformance
with the submitted proposal will be considered not in compliance and must be
corrected.
CL
SUBMISSION OF PROPOSALS
The proposal submitted in response to this Request for Proposals (RFP) shall be clear
and concise, tabulated, and provide the information requested herein. All proposals
shall be submitted as specified in the Notice of Request for Competitive Solicitations
that is made part of this RFP. Proposals submitted without the required information
will not be considered. Responses shall be organized as indicated below. The Proposer
should not withhold any information from the written response in anticipation of
presenting the information orally or in a demonstration, since oral presentations or
demonstrations may not be solicited. Each Proposer must submit adequate
documentation to certify the Proposer's compliance with the County's requirements.
Proposer should focus specifically on the information requested.
AUTHORITY OF PROPOSERS
An authorized representative of the insurance company underwriting the program
should sign the proposals. If the submitting agent/broker does not have the authority
to sign the proposal, it should be signed by an authorized representative of the
company. Proposals submitted without binding authority will not be given the same
consideration as authorized proposals. Proposals should not be contingent upon any
subsequent inspection after the inception date.
REQUIRED LICENSE
7
Packet Pg. 1919
P.7.a
All agents submitting proposals are required to be currently licensed in the State of
Florida to transact property and related coverages insurance. The County reserves the
right to request verification of such licensing. The agent should be licensed with the
insurer submitting a proposal and have the authority to bind coverage.
STABILITY OF INSURERS
Insurers furnishing coverage should be stable and have a current A. M. Best Company
rating of "A-" or better and be of sufficient financial size to provide security. Insurers
must be currently authorized to transact insurance business in the State of Florida. If
an insurer is proposed that has a Best rating of less than A-, a copy of the insurer's
most recent financial statement should be included for review.
ADDITIONAL INFORMATION/INSPECTION
Every attempt has been made to furnish complete and accurate information to the best
of the County's knowledge. Proposers are encouraged to determine, at their expense,
their own information for underwriting purposes including any inspections and loss
control surveys.
If additional information is required, written requests must be submitted prior to 3:00
pm, February 16, 2023 to:
Brian Bradley RMLO, FCRM
Risk Manager
Monroe County Attorney's Office
1111 12th Street, Suite 408
Key West, FL 33040
Email: bradley-briar: cC onroecoun - 1. ov
Email requests will be honored. 0-
Based upon the requests received, any addendum to the specifications will be prepared
and posted on DemandStar. Oral requests for additional information will not be
entertained.
Payment Terms
The County desires to have the option of interest free, periodic premium payments.
Please indicate any terms available.
SAMPLE POLICIES AND CONTRACTS
Sample forms/endorsements and other coverage information are considered an integral
part of the proposal. If Insurance Services Office (ISO) forms are to be used, reference
can be made to the form numbers and edition dates.
If Manuscript or non-ISO forms are proposed, specimen forms must be attached to the
proposal for review.
8
Packet Pg. 1920
P.7.a
RATE CHANGE/POLICY MODIFICATION
Ninety (90) days written notice is requested to be provided by the insurer prior to
modification resulting in restriction of existing policy terms or provisions required by the
insurer.
TERMINATION/NON-RENEWAL NOTICE
Ninety (90) days written notice is requested to be given by the insurer for termination,
non-renewal or restriction of limits or coverage except for non-payment of premium.
NAMED INSURED
The Named Insured wording of the policy should include the following:
Monroe County Board of County Commissioners and its elected officials,
NOTICE OF CLAIM
Proposers are requested to modify policy language relating to notification to the insurer
following a loss to provide that:
"Notice of loss shall be given to the insurer as soon as practicable
following receipt of notice of the claim by the Risk Manager of Monroe
County, Florida. " CL
CLAIM REPORTING LOCATIONS
Please indicate the address, telephone number and name of individuals to report claims
to and the procedures to be followed in notifying the insurer. Please provide a list of all IL
insurer claim reporting offices, their addresses, telephone numbers and contact persons
who will adjust claims within the limits of the County's operations.
LOSS HISTORY REPORTS
Written loss history reports must be furnished at least quarterly. Reports should be
completed in plain English and should include a detailed description of individual claims
and the amounts paid and reserves for each claim.
WAIVER OF SUBROGATION
The standard policy wording involving subrogation should be modified to remove
subrogation between the County and entities owned, managed, or required to be
removed by agreement, contract or lease including interlocal and other governmental
agreements.
9
Packet Pg. 1921
P.7.a
LOSS CONTROL SERVICES
The County wishes to utilize services of the successful insurer(s). Proposers should
include a statement of the intended loss control activities and the frequency of such
services. Any additional charges not included in normal policy premiums must be
specifically identified by type and frequency of service and specific costs or charges
separately stated.
USE OF PROPOSAL FORMS
Proposers are required to submit their proposal on the forms included in this
reauest. Additional information or proposals may be submitted in addition to the initial
proposal. The general information proposal form must be signed in accordance with
other requirements of this Request for Proposal as well as individual coverage sections.
In addition, if an addendum to this Request is issued, the Proposer must acknowledge
receipt of such addendum by completing and returning, with their proposals, the
acknowledgment forms that will accompany the addendum. However, the failure of the
Proposer to acknowledge receipt of the addendum will not render the addendum invalid.
All sections of the proposal forms must be completed. Responses such as ""See Policy
Form" or ""See Proposal" will not be acceptable. Part of the evaluation process will be
the ability of the proposer to understand and explain the terms and conditions of the
policies. Fully responding to all issues addressed in the proposal forms will demonstrate
the proposer's understanding of the program being submitted and the ability of the
proposer to serve the needs of the County.
CL
COMPLETION OF REQUIRED FORMS
Proposers must complete and submit the required "Drug-free Workplace" "Non-
Collusion Affidavit", ""Sworn Statement Under Ordinance No. 10-1990 Ethics Clause" and 0
""Public Entity Crime Statement" forms in addition to completing the proposal forms.
Required State and Local Clauses
1. Florida Public Records law (F.S. 119.0701).
RECORDS- ACCESS AND AUDITS: Pursuant to F.S. 119.0701, Contractor and its
subcontractors shall comply with all public records laws of the State of Florida, including
but not limited to:
a. Keep and maintain public records required by Monroe County in order to
perform the service.
b. Upon request from the public agency's custodian of public records, provide
the public agency with a copy of the requested records or allow the records to be
inspected or copied within a reasonable time at a cost that does not exceed the cost
provided in Florida Statutes, Chapter 119 or as otherwise provided by law.
c. Ensure that public records that are exempt or confidential and exempt from
public records disclosure requirements are not disclosed except as authorized by law for
the duration of the contract term and following completion of the contract if the
10
Packet Pg. 1922
P.7.a
contractor does not transfer the records to the public agency.
d. Upon completion of the contract, transfer, at no cost, to Monroe County all
public records in possession of the contractor or keep and maintain public records
required by the public agency to perform the service. If the contractor transfers all
public records to the public agency upon completion of the contract, the contractor shall
destroy any duplicate public records that are exempt or confidential and exempt from
public records disclosure requirements. If the contractor keeps and maintains public
records upon completion of the contract, the contractor shall meet all applicable
requirements for retaining public records. All records stored electronically must be
provided to Monroe County, upon request from the public agency's custodian of
records, in a format that is compatible with the information technology systems of
Monroe County.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO
THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS,
BRIAN BRADLEY, AT (305) 292-3470, bradl
- , c/o Monroe County Attorney's Office,
1111 12t" St., Suite 408, Key West FL 33040.
2. F.S. 287.0582, F.S. and Monroe County Purchasing Policy: Monroe County's
performance and obligation to pay under this contract is contingent upon an annual
appropriation by the BOCC.
3. Public Entity Crime Statement (required by F.S. 287.133 and Monroe
County Purchasing Policy): A person or affiliate who has been placed on the
convicted vendor list following a conviction for public entity crime may not submit a
bid on a contract to provide any goods or services to a public entity, may not submit 0
a bid on a contract with a public entity for the construction or repair of a public
building or public work, may not submit bids on leases of real property to public
entity, may not be awarded or perform work as a CONTRACTOR, supplier,
subcontractor, or CONTRACTOR under a contract with any public entity, and may
not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, for CATEGORY TWO for a period of 36 months from
the date of being placed on the convicted vendor list. As used herein, the term
k1convicted vendor list" means a list maintained by the Florida Department of
Management Services, as defined in F.S. 287.133.
By entering in this Agreement, the vendor acknowledges that it has read the above
and states that neither the vendor nor any Affiliate has been placed on the
convicted vendor list within the last 36 months.
4. Ethics Clause (required by Monroe County Ordinance No. 10-1990): By
entering in this Agreement, the vendor warrants that he/it has not employed,
retained or otherwise had act on his/her behalf any former County officer or
11
Packet Pg. 1923
P.7.a
employee in violation 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
Agreement without liability and may also, in 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 County officer or
employee.
5. E-verify requirement (required by F.S. 448.095): Beginning January 1, 2021,
every public employer, contractor, and subcontractor shall register with and use the
E-Verify system to verify the work authorization status of all newly hired employees.
By entering into this Agreement, the vendor certifies that it registers with and uses
the E-Verify system. If the contractor enters into a contract with a subcontractor,
the subcontractor must provide the contractor with an affidavit stating that the
subcontractor does not employ, contract with, or subcontract with an unauthorized
alien. The contractor shall maintain a copy of such affidavit for the duration of the 6�
contract.
6. Scrutinized companies (F.S. 287.135):
a. (Applies to contracts > $1 million): This contract is terminable at the option
of the awarding body if the vendor is found to have submitted a false certification
as defined below, has been placed on the Scrutinized Companies with Activities in
6
Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum P-
Energy Sector List as those terms are defined in F.S. 287.135, or been engaged in
business operations in Cuba or Syria.
i. False certification: At the time a company submits a bid or proposal for a
contract or before the company enters into or renews a contract with an
agency or local governmental entity for goods or services of $1 million or
more, the company must certify that the company is not on the Scrutinized 0
Companies with Activities in Sudan List or the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List and that it does not have OE
business operations in Cuba or Syria. At the time a company submits a bid
or proposal for a contract or before the company enters into or renews a
contract with an agency or local governmental entity for goods or services
of any amount, the company must certify that the company is not
participating in a boycott of Israel. By entering into this agreement, the
vendor certifies that the company complies with these requirements.
b. (Applies to all contracts): This contract is terminable at the option of the
awarding body if the company is found to have been placed on the Scrutinized
Companies that Boycott Israel List as that term is defined in F.S. 287.135 or is
engaged in a boycott of Israel.
7. Payment: Invoices will be paid in accordance with the Florida Local Government
Prompt Payment Act, F.S. 218.70 et seq. Invoices must be submitted to the Clerk
12
Packet Pg. 1924
P.7.a
with supporting documentation acceptable to the Clerk. Acceptability to the Clerk is
based on generally accepted accounting principles and such laws, rules, and
regulations as may govern the Clerk's disbursal of funds.
2 CFR PART 200
If any Federal Funds are used to pay and/or services the vendor will be expected to
comply with the terms and conditions required by 2 CFR part 200, including Appendix
II to 2 CFR part 200 (Contract Provisions for Non-Federal Entity Contracts under
Federal Awards).
Section 30. Federal Contract Clauses. If federal funds are used to pay for these
services, the following federal contract clauses from 2 CFR part 200 are incorporated in
and made part of this Agreement:
a. Debarment and Suspension (Executive Orders 12549 and 12689)—A
contract award (see 2 CFR 180.220) will not be made to parties listed
on the government wide exclusions in the System for Award
Management (SAM), in accordance with the OMB guidelines at 2 CFR
180 that implement Executive Orders 12549 (3 CFR part 1986 Comp.,
p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), ""Debarment and
Suspension." SAM Exclusions contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties
declared ineligible under statutory or regulatory authority other than
Executive Order 12549.
b. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors that
apply or bid for an award exceeding $100,000 must file the required
certification. Each tier certifies to the tier above that it will not and has
not used Federal appropriated funds to pay any person or organization
for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, officer or employee of Congress, or an CL
employee of a member of Congress in connection with obtaining any
Federal contract, grant or any other award covered by 31 U.S.C. 1352.
Each tier must also disclose any lobbying with non-Federal funds that
takes place in connection with obtaining any Federal award. Such
disclosures are forwarded from tier to tier up to the non-Federal award.
c. Americans with Disabilities Act of 1990 (ADA) - Contractor will comply
with all the requirements as imposed by the ADA, the regulations of the
Federal government issued thereunder, and the assurance by the
CONTRACTOR pursuant thereto.
d. Disadvantaged Business Enterprise (DBE) Policy and Obligation - It is
the policy of the COUNTY that DBEs, as defined in 49 C.F.R. Part 26,
as amended, shall have the opportunity to participate in the
performance of contracts financed in whole or in part with COUNTY
funds under this Agreement. The DBE requirements of applicable
federal and state laws and regulations apply to this Agreement. The
13
Packet Pg. 1925
P.7.a
COUNTY and its CONTRACTOR agree to ensure that DBE's have the
opportunity to participate in the performance of this Agreement. In this
regard, all recipients and contractors shall take all necessary and
reasonable steps in accordance with applicable federal and state laws
and regulations to ensure that the DBE's have the opportunity to
compete for and perform contracts. The COUNTY and the CONTRACTOR
and subcontractors shall not discriminate on the basis of race, color,
national origin or sex in the award and performance of contracts,
entered pursuant to this Agreement.
e. The Contractor shall utilize the U.S. Department of Homeland Security's
E-Verify system to verify the employment eligibility of all new
employees hired by the Contractor during the term of the Contract and
shall expressly require any subcontractors performing work or providing
services pursuant to the Contract to likewise utilize the U.S.
Department of Homeland Security's E-Verify system to verify the
employment eligibility of all new employees hired by the subcontractor
during the Contract term.
f. No Obligation by Federal Government. The federal government is not a
party to this contract and is not subject to any obligations or liabilities
to the non-Federal entity, contractor, or any other party pertaining to
any matter resulting from the contract. P-
g. Program Fraud and False or Fraudulent Statements or Related Acts.
The Contractor acknowledges that 31 U.S.C. Chapter 38
(Administrative Remedies for False Claims and Statements) applies to
the Contractor's actions pertaining to this contract.
0
CL
14
Packet Pg. 1926
P.7.a
Monroe County, Florida
2023 - 2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
REQUESTED COVERAGES
FORM
The policy should extend to the legal obligations of the County that arise out of the
discharge, dispersal, release, seepage, migration or escape of smoke, vapors, soot
fumes acids, alkalis, toxic chemicals, liquids, gases, or other similar hazardous
materials from locations scheduled in the policy. The policy should also pay for the
expenses incurred for the investigation, monitoring, removal, disposal, treatment or
neutralization of property contaminated by such incidents. If coverage is provided on a
""Claims Made" basis, the County desires to have full "Prior Acts" coverage; however to
maintain the continuity of the current program, any proposal with a retroactive date
later than 7/10/95 will receive less consideration.
DESIRED LIMITS AND DEDUCTIBLE
Desired Limits $50 million
Desired Deductible $50,000
Alternative limits and deductibles will be considered based on the level of protection
being provided and pricing. LL
UNDERWRITING INFORMATION
Specific underwriting information is provided as attachments.
Additional information regarding the County (to include budgetary information) can be
obtained from the County's Website at fIT gov/.
LOSS EXPERIENCE
There have been no known losses within the past five years.
15
Packet Pg. 1927
P.7.a
Monroe County, Florida
2023 - 2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
Proposal Form
GENERAL INFORMATION
Use of the proposal forms will enable a faster more complete analysis of the proposal(s)
submitted.
Please complete this general proposal form in addition to a separate proposal fc 1
for each coverage proposed. Additional information can be attached to the forms.
Agent/Agency submitting proposal:
Address:
Telephone Number:
Does agent have binding authority? Yes No
If not, state procedure to bind.
Is agent licensed in the state of Florida? Yes No
Are the following coverages proposed?
Legal obligations arising out of the discharge,
disposal, release, seepage, migration or
escape of pollutants Yes No
Payment of expenses incurred for the investigation
monitoring, removal, disposal, treatment or
neutralization of property contaminated
by pollution incidents Yes No
If not, provide specific details of coverages
provided
16
Packet Pg. 1928
P.7.a
Are coverages different from current program? Yes No
If so, state differences
Effective date(s) of coverage(s)
List payment plan, including interest or
service charges
Proposal valid until (date)
Rate Change/Policy Modification
wording included as requested? Yes No
Termination Notice wording included
as requested? Yes No
Named Insured wording included
as requested? Yes No
If not, include actual wording to be used.
Claim reporting location included? Yes No
Will requested claim reporting wording
be used? Yes No
Claim Reports to be provided as requested? Yes No
E
If not, state details
Loss Control services to be provided? Yes No
Details.
17
Packet Pg. 1929
P.7.a
Sample forms and policies included as required? Yes No
The proposer stated below is the authorized agent of the company or companies propose
and is authorized to bind coverages upon acceptance by the County. Deviations from the
requested program have been stated. Coverage will be issued as proposed.
Signature of Authorized Representative Date
CL
CL
18
Packet Pg. 1930
P.7.a
Monroe County, Florida
2023 - 2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
Proposal Form
POLLUTION LIABILITY
Company
Underwriting office used
Address
Telephone Number
Is insurer authorized to transact insurance in the
State of Florida? Yes No
Basis of authorization:
CL
Admitted insurer Yes No
Surplus Lines insurer Yes No
Current A. M. Best Co. rating
Is requested policy form proposed? Yes No
If not, list form(s) used
Coverages Provided
Legal Liability Yes No
Clean Up Yes No
Rates guaranteed for one year? Yes No
Are rating worksheets attached? Yes No
19
Packet Pg. 1931
P.7.a
Term of coverage being proposed
One year? Yes No
Two year? Yes No
Three year? Yes No
Limits/Premiums/Deductibles
One Year Two Year Three
Limit Deductible premium Premium Year
Premium
Legal
Liability
Clean U
If a multi year program is being proposed,
will premiums be payable on an annual basis? Yes No
The proposer stated below is the authorized agent of the company or companies
proposed, and is authorized to bind coverages upon acceptance by the County.
Deviations from the requested program have been stated. Coverage will be issued as
proposed.
Signature of Authorized Representative Date
0
CL
20
Packet Pg. 1932
P.7.a
MONROE COUNTY, FLORIDA
2023 - 2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
SCHEDULE OF INSURED LOCATIONS
FIRE AMBULANCE FIRE STATION
STATION KEY DEER BLVD SENIOR CITIZEN CENTER LIBRARY
23 EMERALD ROAD BIG PINE KEY, FL KEY DEER BLVD 200 KEY DEER BLVD
BIG COPPITT KEY, FL 33043 BIG PINE KEY, FL 33043 BIG PINE KEY, FL 33043
33040
SHERIFF'S AVIATION SHERIFF'S
SUBSTATION LIBRARY LIBRARY OFFICE, 10100
MM21 CUDJOE KEY 2331 OVERSEES HWY MM101.5 OVERSEES HWY OVERSEAS HWY,
CUDJOE KEY, FL 33042 KEY LARGO, FL 33037 KEY LARGO, FL 33037 MARATHON, FL
SENIOR CITIZEN HEALTH DEPARTMENT SUB- SHERIFF'S SUB-STATION
CENTER 3333 OVERSEES HWY
COURTHOUSE/OFFICES OFFICES
33RD STREET - GULF MARATHON, FL 33050 3117 OVERSEES HWY 3103 OVERSEES HWY
MARATHON, FL 33050
MARATHON, FL 33050 MARATHON, FL 33050 g
GOVERNMENT CENTER MARATHON GOV. AIRPORT TERMINAL PUBLIC WORKS OFFICES
ANNEX CENTER/EOC 9480 OVERSEES HWY 10600 AVIATION BLVD
490 63RD STREET 27900 OVERSEES HWY MARATHON, FL 33050 MARATHON, FL 33050
MARATHON, FL 33050 MARATHON, FL 33050
SHERIFF'S SUB- COUNTY
STATION OFFICES/SOCIAL DETENTION FACILITY SHERIFF'S SPECIAL
SERVICES OPERATIONS
88770 OVERSEES HWY HIGHPOINT ROAD 3981 OCEAN TERRACE 85 COCO PLUM ROAD CL
PLANTATION KEY, FL PLANTATION KEY, FL MARATHON, FL 33050 MARATHON, FL 33050
33070 33070
SENIOR CITIZEN
DETENTION FACILITY DETENTION FACILITY PUBLIC WORKS OFFICES CENTER
HIGHPOINT ROAD 5501 COLLEGE ROAD 103 KEY HEIGHTS DRIVE HIGHPOINT ROAD
PLANTATION KEY, FL STOCK ISLAND, FL PLANTATION KEY, FL 33070 PLANTATION KEY, FL
33070 33040 33070
SHERIFF ADMIN.
BUILDING
5525 COLLEGE ROAD
STOCK ISLAND, FL
33040
21
Packet Pg. 1933
P.7.a
MONROE COUNTY, FLORIDA
2023 - 2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
SCHEDULE OF INSURED LOCATIONS
(continued)
FIRE &AMBULANCE COURTHOUSE SPOTTSWOOD BLDG,
STATION 500 WHITEHEAD ANNEX/COURTROOMS 887700 OVERSEAS HWY, �-
MARINE AVENUE STREET 510 WHITEHEAD STREET PLANTATION KEY, FL
TAVERNIER, FL 33070 KEY WEST, FL 33040 KEY WEST, FL 33040 33070
JUSTICE BLDG/RECORD
LIGHTHOUSE MUSEUM STORAGE LIBRARY SENIOR CITIZENS
938 WHITEHEAD NUTRITION CENTER
STREET 530 WHITEHEAD 700 FLEMING STREET TRUMAN AVE. /WHITE ST
KEY WEST, FL 33040 STREET KEY WEST, FL 33040 KEY WEST, FL 33040
KEY WEST, FL 33040CL
a
AIRPORT TERMINAL COUNTY GARAGE GATO BUILDING & ARNOLD AIRPORT
3491 S. ROOSEVELT GENERATOR TERMINAL ANNEX c�
S. ROOSEVELT BLVD. CL
BLVD. 1100 SIMONTON STREET S. ROOSEVELT BLVD.
KEY WEST, FL 33040 KEY WEST, FL 33040 KEY WEST, FL 33040 KEY WEST, FL 33040
g
LONG KEY LANDFILL
AND TRANSFER CUDJOE KEY LANDFILL 0
HOUSE FOR THE AGED FIRE STATION CL
STATION AND TRANSFER 5200 COLLEGE ROAD OVERSEES HWY
MM 68 STATION
LONG KEY, FL 33001 CUDJOE KEY, FL 33042 STOCK ISLAND, FL 33040 CONCH KEY, FL 33050
c�
LIBRARY GOVERNMENTAL HEALTH CLINIC HARVEY GOVERNMENT
3251 OVERSEES HWY CENTER/COURTHOUSE 170901 HIGHWAY #1 CENTER
MARATHON, FL 33050 HIGHPOINT ROAD (REAR) 1200 TRUMAN AVENUE
PLANTATION KEY, FL TAVERNIER, FL 33070 KEY WEST, FL 33040
33070
FLEET MAINTENANCE COUNTY OFFICES/ELLIS STATE ATTORNEY/VOTING
FACILITY BUILDING REGISTRAR 60 HIGH POINT ROAD
10600 AVIATION BLVD 88800 US HIGHWAY #1 302 FLEMING STREET/501 ISLAMORADA, FL 33070
MARATHON, FL 33050 PLANTATION KEY, FL THOMAS STREET
33070 KEY WEST, FL 33040
22
Packet Pg. 1934
P.7.a
KEY LARGO LANDFILL MURRAY E NELSON
AND TRANSFER GOVERNMENT & FREEMAN JUSTICE
STATION CULTURAL BLDG., BUILDING, 302 FLEMING FIRE STATION,6180 2ND
11100 COUNTY RD. 102050 OVERSEAS ST., KEY WEST, FL AVE., STOCK ISLAND
905 HWY, KEY WEST, FL
KEY LARGO, FL
All Listed Tanks are Above Ground Storage Tanks
c�
c�
23
Packet Pg. 1935
P.7.a
Monroe County, Florida
MONROE COUNTY, FLORIDA
2023 -2026 Pollution Liability
Insurance Program
EFFECTIVE DATE: 5/1/23
Underwriting Information
Coverage has not been cancelled, denied or non-renewed.
Monroe County has not been investigated, cited and/or prosecuted for contravention or violation of any
standard or law relating to any release of pollutants.
There have been no pollution claims. Copies of current loss runs are attached.
Monroe County is not aware of any past or present contamination on-site or emanating from any site that could
give rise to a claim.
Monroe County has not received any notices of violation, fine,penalties, complaints etc. within the past 5
years. 0
Monroe County presently complies with statutes, standards, regulation relating to the protection of the a
environment.
There has been no past,present or planned remediation, monitoring or sampling to investigate potential a
contamination.
0
There are no plans to sell or sublease any of the locations listed.
There are no known plans for future development, improvement, betterment, demolition or plans for changes E
in site operations.
Underground storage tanks are in compliance with the 1998 US EPA standards for leak detection, overflow
protection and corrosion protection.
24
Packet Pg. 1936
P.7.a
Information on the County Owned landfills:
Location Lined Size Acres
Mound 1 Top Lined
MM68 but Not 8
Long Key Bottom
Lined
Mound 2 Top Lined
MM68 but Not 6.5
Long Key Bottom
Lined
Key Largo Landfill, Top Lined
Key Largo but Not 7
Bottom
Lined
Cud j oe Key Landfill, Top Lined
Cud j oe Key but Not
Bottom 7
Lined
Ground water monitoring devices and sub surface wells have been installed. They are evaluated 4 times a year
by an independent contractor. No negative reports have been issued.
0
All landfills were opened between 1974 and 1975. They were closed between 1994 and 1995. They are top-
lined but not bottom-lined.
All public waste is transported out of the County and disposed in properly licensed waste disposals sites. The
County has constructed three (3) Transfer Facilities. The disposal of public waste is provided by independent C
contractors with the agreements containing favorable Hold Harmless/Indemnification provisions in favor of the 2
County and appropriate minimum insurance requirements that the contractors must comply with. 2
0-
c�
25
Packet Pg. 1937
E
u-
REQUIRED FORMS
TO BE COMPLETED
BY .2
0
PROPOSER
0
(L
E
26
Packet Pg. 1938
P.7.a
RESPONSE FORM
RESPOND TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
Purchasing Department
GATO BUILDING, ROOM 1-213
1100 SIMONTON STREET
KEY WEST, FLORIDA 33040
I acknowledge receipt of Addenda No. (s)
I have included
0 Response Form
® Lobbying and Conflict of Interest Clause
® Non-Collusion Affidavit
0 Drug Free Workplace Form
® Public Entity Crime Statement
0 Proof of payment of Monroe County business
tax and relevant City business tax, unless
exempted, must be provided within ten days
of award of the contract
® Local Preference form (if applicable) 0
® Proposal Forms (General Information, and
Pollution Liability)
c�
(Check mark items above, as reminder that they are included.)
0
I have included a current copy of the following professional licenses and receipt for business taxes: CL
c�
Mailing Address: Telephone:
Fax:
Date:
27
Packet Pg. 1939
P.7.a
Signed: Witness:
(Print Name)
(Title)
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
0
c�
0
c�
28
Packet Pg. 1940
P.7.a
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
(Company)
"...warrants that he/it has not employed, retained or otherwise had act on his/her behalf any former County
officer or employee in violation 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 Agreement without liability and may also, in its discretion, deduct from the U-
Agreement 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."
0
(Signature)
Date:
CL
STATE OF:
COUNTY OF:
0
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
29
Packet Pg. 1941
P.7.a
NON-COLLUSION AFFIDAVIT
I, of the city of according to law on my oath, and
under penalty of perjury, depose and say that
1. I am of the firm of
the bidder making the Proposal for the
project described in the Request for Proposals for
and that I executed the said proposal with full
authority to do so;
2. The prices in this bid have been arrived at independently without collusion, consultation,
communication or agreement for the purpose of restricting competition, as to any matter relating
to such prices with any other bidder or with any competitor; U-
3. Unless otherwise required by law, the prices which have been quoted in this bid have not been
knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid Z
opening, directly or indirectly, to any other bidder or to any competitor;
4. No attempt has been made or will be made by the bidder to induce any other person,partnership
or corporation to submit, or not to submit, a bid for the purpose of restricting competition; and
0
5. The statements contained in this affidavit are true and correct, and made with full knowledge that
Monroe County relies upon the truth of the statements contained in this affidavit in awarding
contracts for said project.
(Signature)
0
Date:
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to
me or has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
30
Packet Pg. 1942
P.7.a
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
(Name of Business)
1. Publishes 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. Informs employees about the dangers of drug abuse in the workplace, the business' 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. Gives 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), notifies the employees that, as a condition of working on 6
the commodities or contractual services that are under bid, the employee will abide by the terms of the 'W
statement and will notify the employer of any conviction of, or plea of guilty or nolo contenderre to,
any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States ;2
or any state, for a violation occurring in the workplace no later than five (5) days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is so 2
convicted. 0
6. Makes a good faith effort to continue to maintain a drug-free workplace through implementation of this
section.
c�
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
0
(Signature)
Date:
c�
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to
me or has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
31
Packet Pg. 1943
P.7.a
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity
crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a
bid on a contract with a public entity for the construction or repair of a public building or public work, may not
submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor,
supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact
business with any public entity in excess of the threshold amount provided in Section 287.017, for
CATEGORY TWO for a period of 36 months fro the date of being placed on the convicted vendor list."
I have read the above and state that neither (Proposer's name) nor any Affiliate has
been placed on the convicted vendor list within the last 36 months.
(Signature)
Date:
0
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to
6
me or has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
32
Packet Pg. 1944
P.7.a
LOCAL PREFERENCE FORM
Vendors claiming a local preference according to Ordinance 023-2009 must complete this form.
Name of Bidder/Responder Date:
1. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector dated at least one year prior to
the notice or request for bid or proposal? (Please furnish copy.)
2. Does the vendor have a physical business address located within Monroe County from which the vendor operates or performs
business on a day to day basis that is a substantial component of the goods or services being offered to Monroe
County?
List Address:
Telephone Number:
B.Does the vendor/prime contractor intend to subcontract 50%or more of the goods,services or construction to local businesses
meeting the criteria above as to licensing and location?
If yes,please provide:
1. Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the subcontractor dated at least one year prior to
the notice or request for bid or proposal.
2. Subcontractor Address within Monroe County from which the subcontractor operates:
Tel.Number
c�
Print Name:
Signature and Title of Authorized Signatory for
Bidder/Responder
0
CL
STATE OF:
COUNTY OF:
c�
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to me or has produced
(type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
33
Packet Pg. 1945