Loading...
03/13/2023 Agreement Monroe County Purchasing Policy and Procedures ATTACHMENT D.5 COUNTY ADMINISTRATOR CONTRACT SUMMARY FORM FOR CONTRACTS LESS THAN$50,000.00 Contract with: CD1 of Monroe, LLC Contract# Effective Date: Expiration Date: Contract Purpose/Description: Daily Lift- tat€on Gleaning for the PK Jail/Government Center and Rath Contract is Original Agreement Contract Amendment/Extension Renewal Contract Manager: Cyan 13enaley 3997 Co re tion 9-E (Name) (Ext.) (Department/Stop #) CONTRACT COSTS Total Dollar Value of Contract: $ Current Year Portion: $ must be less than$50,000 If multiyear agreement then 39,475 requires BOCC approval unless the gos�fl cuwuk e�m,auw d� dess dw ")'5 hIh9'0Ih9') Budgeted? Yes X❑ No ❑ Grant: $ County Match: $ Fund/Cost Center/Spend Categry: CC 20505 530460 SCOORii ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (e.g. maintenance,utilities,janitorial,salaries,etc.) Insurance Required: YES ❑ NO ❑ CONTRACT REVIEW Changes Date In Needed Reviewer Date In Department Head Yes❑No X❑ William DeSantis „,F1= 4/20/23 County Attorney Yes No �/ Digitally signed by Patricia Ea 4/20/23 ❑ /� Patricia EablPiS Date:2023.04.2015:09:35-04'00''00' Risk Management Yes El No❑X �,e�� �°° "° 4/20/23 Lisa Ab re u Digitally signed by Lisa Abreu Purchasing Yes❑No Date 2023.04.20 16 34 12-04'00' Digit OMB Yes❑ ❑X No John Quinn Datea1ly 2023.05 03snedy08 50 54.John 04'00' Comments: Revised BOCC 8/17/2022 Page 85 of 106 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS REQUEST FOR SERVICES FOR PLANTATION KEY GOVERNMENT NT CENTS AND DETENTION FACILITY AND TIME ROTH BUILDING LIFT STATIONS MAINTENANCE AND CLEANING BOARD OF COUNTY COMMISSIONERS w r 4. Mayor Craig Cates, District 1 Mayor Pro Tern 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 Correction Facilities Administrator Kevin Madok Dan Bensley February 2023 PREPARED BY: Correction Facilities Maintenance Department Page 1 of 29 Monroe County Correction Facilities Maintenance General Scope of Work Job Name: PLANTATION KEY GOVERNMENT CENTER AND DETENTION FACILITY AND THE ROTH BUIDING LIFT STATIONS MAINTENANCE AND CLEANING Job Location: Plantation Key Government Center and Detention Facility 88820 Overseas Highway Plantation Key,FL 33070 Roth Building 50 High Point Road Plantation Key,FL 33070 Contact: Correction Facilities Maintenance Dan Bensley benslev-t:a y irionro count -11. rov 305-587-3239 Martina Lake l e- i ra' ec - . oy 305-295-3998 PROJECT OVERVIEW,PROJECT INTENT AND SCOPE,GENERAL REQUIREMENTS 1. Project Overview A) a. Monroe County ('`Owner" or"County") shall enter into a contract with a qualified Contractor to Clean and Maintain the Litt Stations located at the two (2) addresses shown above. The term of this contract shall commence upon the date of issuance to the undersigned by Owner of the Notice to Proceed/Purchase Order/Task Order. Once commenced, the undersigned shall diligently continue performance until final completion of the Project, which shall be a one (1) year term from the date of commencement thereafter. The Contractor shall be required to secure and pay for all required permits and approvals to perform the work which may include: Monroe County Building Department,the Village Page 2 of 29 of Islamorada, and any other permitting or regulatory agencies, if applicable. Contractor shall include those permit fees as a part of the Contractor's bid. B) All quotes are due by February 18,2023 at 3:00 P.M., via email to lake-martina@monroecounty-fl.gov. All Quotes must state they will be good for one hundred twenty (120)calendar days from submittal due date. 2. Project Intent and Scope Scope of Work: The Contractor shall provide the following Scope of Work and provide all labor and materials to clean and maintain the lift stations at the above stated locations: • Daily: 1. Cleaning of a lift out style trash basket. (Debris shall be removed from the Site and properly disposed of daily). Weekly: 1. Visually inspect the station for vandalism. 2. Clean up any trash or debris material. 3. Record pump hours for each pump. 4. Run each pump by hand with manual run switch to ensure pumps are operating properly. 5. Wash down wet well. 6. Place pump controls back in auto position prior to leaving station. 7. Test all panel lights and change as needed to ensure proper operation. 8. Lock up station, including exterior power panels if required,prior to leaving. 9. Complete all required paperwork. Monthly: 1. Open wet well and visually inspect the pumping of each pump. 2. Completely pump down the wet well to its lowest point and make visual inspection. 3. Hose the wet well down during the pump down process. 4. Inspect wet well for excessive grease build up on surface, clean when needed. 5. Check wet well floats for rag build up,clean as needed. 6. Pumps and piping are checked visually for defects. 7. Turn in operations log sheets at end of the month. Quarterly: 1. Clean grit and grease from the wet well using a Vac-con truck. • Other: 1. Emergency pump out service during system failures.(At a price per gallon listed in the contractor proposal). 2. Respond to all lift station alarms. 3. Maintain all required lift station field logs. 4. Report all problems with the lift station to Monroe County. 5. Record all lift station problems or observations in the lift station log. Page 3 of 29 3. Summary of General Requirements A) The Contractor shall coordinate all activities with the Monroe County Correction Facilities Maintenance Department contact: Dan Bensley at 305-587-3239 B) The Contractor is required to provide protection for all existing surfaces including, but not limited to: i. Existing fixtures ii. Personal Items iii. Floors iv. Vehicles and Personal Property v. Landscaping C) The Contractor shall ensure that all non-exempt employees for this effort are compensated in accordance with all State and Local Laws. D) The Contractor shall load,haul,and properly dispose of all construction debris and materials. E) The Contractor shall provide and maintain appropriate (OSHA required) construction warning signs and barriers. F) The Contractor shall furnish all required work site safety equipment. G) The Contractor shall furnish and maintain on-site material safety data sheets (MSDS)for all materials used in the construction. H) Construction work times shall be limited to: Specified by the County I) All materials must be approved by submittal prior to commencement of work. J) The Contractor shall provide a lump sum price by February 18,2023,at 3:00 p.m., via email as noted herein. K) The Contractor needs to be aware of weather and location and plan accordingly. L) The Contractor needs to be aware of the facility,its residents,and staff with unusual schedules and plan accordingly. M) The Contractor shall provide a schedule for all phases of the project. Page 4 of 29 N) The Contractor shall coordinate all activities with concurrent site work being performed, if any. O) Insurance Requirements: Workers Compensation Statutory Limits Employers' Liability $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee General Liability $200,000 per Person $300,000 per Occurrence $200,000 Property Damage or $300,000 Combined Single Limit Vehicle: $200,000 per Person (Owned, non-owned, $300,000 per Occurrence and hired vehicles) $200,000 Property Damage or $300,000 Combined Single Limit Builders Risk Not Required Construction Bond Not Required The Monroe County Board of County Commissioners, its employees and officials, 1100 Simonton Street, Key West, Florida 33040, shall be named as Certificate Holder and Additional Insured on General Liability and Vehicle policies. A"Sample" Certificate of Insurance is attached,which may not be reflective of the insurance amounts required for this project, but is provided for"informational purposes" only. P) The Contractor is required to have all current licenses necessary to perform the work and shall submit the Contractor's License and Monroe County Business Tax Receipt along with its Proposal. If the Contractor is not a current registered Monroe County Vendor, then it shall also submit a properly completed and executed W-9 Form. Q) INDEMNIFICATION, HOLD HARMLESS, AND DEFENSE. Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement. the Contractor shall defend, indemnify and hold the County and the County's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings. appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be asserted against,initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with,(A)any activity of the Contractor or any of its employees,agents. Page 5 of 29 contractors or other invitees during the term of this Agreement, (B) the negligence or recklessness, intentional wrongful misconduct, errors or other wrongful act or omission of the Contractor or any of its employees,agents, sub-contractors or other invitees,or(C)the Contractor's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings,costs or expenses arise from the intentional or sole negligent acts or omissions of the County or any of its employees, agents, contractors or invitees (other than the Contractor). The monetary limitation of liability under this contract shall be equal to the dollar value of the contract and not less than $1 million per occurrence pursuant to Section 725.06, Florida Statutes. The limits of liability shall be as set forth in the insurance requirements included in Paragraph 3 0. herein. Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this Agreement,this section will survive the expiration of the term of this Agreement or any earlier termination of this Agreement. In the event that the completion of the project(to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in the plans and specifications provided by the Contractor,the Contractor agrees and warrants that the Contractor shall hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action on the County's behalf. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this Agreement. This indemnification shall survive the termination of this Contract. Nothing contained in this paragraph is intended to nor shall it constitute a waiver of the County's sovereign immunity. R) NON-COLLUSION.By signing this proposal,the undersigned swears. according to law on his/her oath, and under penalty of perjury, that their firm executes this proposal with prices arrived at independently without collusion, consultation, communication, or agreement for the purpose of restricting competition,as to any matter relating to such prices with and,other bidder or with any competitor. Unless otherwise required by law,the prices which have been quoted in this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed by the proposer prior to proposal opening, directly or indirectly,to any other proposer or to any competitor.No attempt has been made or will be made by the proposer to induce any other person, partnership or corporation to submit, or not to submit a proposal for the purpose of restricting competition. The statements contained in this paragraph are true and correct, and made with the full knowledge that Monroe County relies upon the truth of the statements contained in this paragraph in awarding contracts for this project. Page 6 of 29 S) EMPLOYMENT OR RETENTION OF FORMER COUNTY OFFICERS OR EMPLOYEES. By signing this proposal, the undersigned warrants that he/she/it has not employed, retained or otherwise had act on his/hers/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 0 10-1990 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. T) CODE OF ETHICS. County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313,Florida Statutes,regarding,but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. U) DRUG-FREE WORKPLACE.By signing this proposal,the undersigned certifies that the contractor complies fully with, and in accordance with Florida Statute, Section 287.087,the requirements as follows: 1) They will publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specify 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 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, for 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. ADDITIONAL CONTRACT PROVISIONS I) Nondiscrimi atiun/:I ua.l Employment Opportunity. Page 7 of 29 The Contractor and County agree that there will be no discrimination against any person,and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred. this Agreement automatically terminates without any further action on the part of any parry,effective the date of the court order. Contractor agrees to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race;color or national origin;2)Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended,relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcohol ism; 7)The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3). as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. 3601 et seq.), as amended. relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 12101 Note), as may be amended from time to time,relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 14, Article II, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression. familial status or age; and 11) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. II) Termination Provisions. A. In the event that the Contractor shall be found to be negligent in any aspect of service, the County shall have the right to terminate this agreement after five (5) days' written notification to the Contractor. B. Either of the parties hereto may cancel this Agreement without cause by giving the other party sixty (60)days' written notice of its intention to do so. C. Tennination for Cause and Remedies: In the event of breach of any contract terms, the County retains the right to terminate this Agreement. The County may also terminate this agreement for cause with Contractor should the Contractor fail to perform the covenants herein contained at the time and in the manner herein provided. In the event of such termination, prior to termination, the County shall provide Contractor with five (5) calendar days' notice and provide the Contractor with an opportunity to cure the breach that has occurred. If the breach is not cured, the Agreement will be terminated for cause. If the County terminates this agreement with the Contractor, County shall pay Contractor the sum due the Contractor under this agreement prior to termination, unless the cost of completion to the County exceeds the funds remaining in the contract; however, the County Page 8 of 29 reserves the right to assert and seek an offset for damages caused by the breach. The maximum amount due to Contractor shall not in any event exceed the spending cap in this Agreement. In addition, the County reserves all rights available to recoup monies paid under this Agreement, including the right to sue for breach of contract and including the right to pursue a claim for violation of the County's False Claims Ordinance, located at Section 2-721 et al. of the Monroe County Code. D. Termination for Convenience: The County may terminate this Agreement for convenience, at any time, upon seven (7) days' notice to Contractor. If the County terminates this agreement with the Contractor,County shall pay Contractor the sum due the Contractor under this agreement prior to termination, unless the cost of completion to the County exceeds the funds remaining in the contract. The maximum amount due to Contractor shall not exceed the spending cap in this Agreement. In addition, the County reserves all rights available to recoup monies paid under this Agreement, including the right to sue for breach of contract and including the right to pursue a claim for violation of the County's False Claims Ordinance, located at Art. IX, Section 2-721 et al. of the Monroe County Code. E. Scrutinized Companies: For Contracts of any amount, if the County determines that the Contractor/Consultant has submitted a false certification under Section 287.135(5), Florida Statutes or has been placed on the Scrutinized Companies that Boycott Israel List, or is engaged in a boycott of Israel, the County shall have the option of (1) terminating the Agreement after it has given the Contractor/Consultant written notice and an opportunity to demonstrate the agency's determination of false certification was in error pursuant to Section 287.135(5)(a), Florida Statutes, or(2) maintaining the Agreement if the conditions of Section 287.135(4), Florida Statutes, are met. III)Maintenance of Records.. The Contractor shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Records shall be retained for a period of seven(7)years from the termination of this agreement or for a period of three (3) years from the submission of the final expenditure report as per 2 CFR §200.33, whichever is greater. Each party to this Agreement or its authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for seven (7) years following the termination of this Agreement. IV)Fight to Audit. Availability of Records. The records of the parties to this Agreement relating to the Project,which shall include but not be limited to accounting records(hard copy,as well as computer readable data if it can be made available; subcontract files (including proposals of successful and unsuccessful bidders, bid recaps, bidding instructions. bidders list, etc.); original estimates; estimating work sheets; correspondence; change order files (including documentation covering negotiated settlements); back charge logs and supporting documentation; general ledger entries detailing cash and trade Page 9 of 29 discounts earned, insurance rebates and dividends, any other supporting evidence deemed necessary by Owner or the Monroe County Office of the Clerk of Court and Comptroller(hereinafter referred to as"County Clerk") to substantiate charges related to this agreement, and all other agreements, sources of information and matters that may in Owner's or the County Clerk's reasonable judgment have any bearing on or pertain to any matters, rights, duties, or obligations under or covered by any contract document (all foregoing hereinafter referred to as "Records") shall be open to inspection and subject to audit and/or reproduction by Owner's representative and/or agents of Owner or the County Clerk. Owner or County Clerk may also conduct verifications such as,but not limited to, counting employees at the job site, witnessing the distribution of payroll, verifying payroll computations, overhead computations, observing vendor and supplier payments, miscellaneous allocations, special charges, verifying information and amounts through interviews and written confirmations with employees, subcontractors, suppliers, and contractors' representatives. All records shall be kept for ten (10) years after Final Completion. The County Clerk possesses the independent authority to conduct an audit of records, assets, and activities relating to this Project. If an auditor employed by the County or Clerk determines that monies paid to Contractor pursuant to this Agreement were spent for purposes not authorized by this Agreement,or were wrongfully retained by the Contractor,the Contractor shall repay the monies together with interest calculated pursuant to Sec. 55.03 of the Florida Statutes,running from the date the monies were paid to Contractor. The right to audit provisions survive the termination or expiration of this Agreement. V) Paayment of Fees/Invoices. County shall pay pursuant to the Florida Local Government Prompt Payment Act. Fla. Stat., Sec.218.70,upon receipt of a Proper Invoice from the Contractor. Payments due and unpaid under the Contract shall bear interest pursuant to the Florida Local Government Prompt Payment Act. The Contractor is to submit to the County invoices with supporting documentation that are 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. Invoices shall be submitted to Correction Facilities Maintenance Department,Attention Martina Lake,via email at lake-martin 6lni0111-0eCOL11E!) -ll . The County is exempt from sales and use taxes. A copy of the tax exemption certificate will be provided upon request. Final payment shall be made by the County, as the Owner, to the Contractor when the Contract has been fully performed by the Contractor and the work has been accepted by the County. VI)]Public Records Compliance. The Contractor must comply with Florida public records laws,including but not limited to Chapter 119, Florida Statutes and Section 24 of article I of the Constitution of Page 10 of 29 Florida. The County and Contractor shall allow and permit reasonable access to, and inspection of, all documents, records,papers, letters or other"public record"materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the County and Contractor in conjunction with this contract and related to contract performance. The County shall have the right to unilaterally cancel this contract upon violation of this provision by the Contractor. Failure of the Contractor to abide by the terms of this provision shall be deemed a material breach of this contract and the County may enforce the terms of this provision in the form of a court proceeding and shall, as a prevailing party, be entitled to reimbursement of all attorney's fees and costs associated with that proceeding. This provision shall survive any termination or expiration of the contract. The Contractor is encouraged to consult with its advisors about Florida Public Records Law in order to comply with this provision. Pursuant to Fla. Stat., Sec. 119.0701 and the terms and conditions of this contract, the Contractor is required to: (1) Keep and maintain public records that would be required by the County to perform the service. (2) Upon receipt from the County's custodian of records,provide the County 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 this chapter or as otherwise provided by law. (3) 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 contractor does not transfer the records to the County. (4) Upon completion of the contract, transfer, at no cost, to the County all public records in possession of the Contractor or keep and maintain public records that would be required by the County to perform the service. If the Contractor transfers all public records to the County 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 the County, upon request from the County's custodian of records, in a format that is compatible with the information technology systems of the County. (5) A request to inspect or copy public records relating to a County contract must be made directly to the County, but if the County does not possess the requested records, the County shall immediately notify the Contractor of the request, and the Contractor must provide the records to the County or allow the records to be inspected or copied within a reasonable time. If the Contractor does not comply with the County's request for records, the County shall enforce the public records contract provisions in accordance with the contract, notwithstanding the County's option and right to unilaterally cancel this contract upon Page I I of 29 violation of this provision by the Contractor. A Contractor who fails to provide the public records to the County or pursuant to a valid public records request within a reasonable time may be subject to penalties under Section 119.10, Florida Statutes. The Contractor shall not transfer custody, release, alter, destroy or otherwise dispose of any public records unless or otherwise provided in this provision or as otherwise provided by law. 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 PHONE NO. 305- 292-3470 BRADLEY-IIRIANkMONROECOUNTY-FL.GOV MONROE COUNTY ATTORNEY'S OFFICE 1111 12TH Street SUITE 408, KEY WEST FL 33040. VII) E-VerifyS stern. Beginning January 1, 2021, in accordance with Fla. Stat., Sec. 448.095,the Contractor and any subcontractor shall register with and shall utilize the U.S. Department of Homeland Security's E-Verify system to verify the work authorization status 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 work authorization status of all new employees hired by the subcontractor during the Contract term. Any subcontractor shall provide an affidavit stating that the subcontractor does not employ, contract with, or subcontract with an unauthorized alien. The Contractor shall comply with and be subject to the provisions of Fla. Stat., Sec. 448.095. VIII) Notice Requirement. Any written notices or correspondence given pursuant to this contract shall be sent by United States Mail, certified, return receipt requested, postage prepared, or by courier with proof of delivery. Notice is deemed received by Contractor when hand delivered by national courier with proof of delivery or by U.S. Mail upon verified receipt or upon the date of refusal or non-acceptance of delivery. The place of giving Notice shall remain the same as set forth herein until changed in writing in the manner provided in this paragraph. Notice shall be sent to the following persons: Page 12 of 29 For Contractor: L. m ✓ r„, ° _. .. For Owner: Administrator of Correction Facilities Attention: Dan Bensley 5501 College Road Key West, Florida 33040 And Monroe County Attorney's Office 1111 12`h Street Suite 408 Key West, Florida 33040 IX) lincontrol:lable Circumstance. Any delay or failure of either Party to perform its obligations under this Agreement will be excused to the extent that the delay or failure was caused directly by an event beyond such Party's control, without such Party's fault or negligence and that by its nature could not have been foreseen by such Party or, if it could have been foreseen, was unavoidable: (a)acts of God: (b)flood,fire,earthquake, explosion,tropical storm. hurricane or other declared emergency in the geographic area of the Project. (c) czar. invasion, hostilities (whether war is declared or not), terrorist threats or acts. riot, or other civil unrest in the geographic area of the Project; (d)government order or lwv in the geographic area of the Project: (e) actions, embargoes. or blockades in effect on or after the date of this Agreement; (f) action by any goverrunental authority prohibiting work in the geographic area of the Project,(each, a "Uncontrollable Circumstance"). CONTRACTOR'S financial inability to perform, changes in cost or availability of materials, components, or services, market conditions, or supplier actions or contract disputes will not excuse performance by Contractor under this Section.Contractor shall give County written notice within seven (7) days of any event or circumstance that is reasonably likely to result in an Uncontrollable Circumstance. and the anticipated duration of such Uncontrollable Circumstance. Contractor shall use all diligent efforts to end the Uncontrollable Circumstance, ensure that the effects of any Uncontrollable Circumstance are minimized and resume full performance under this Agreement. The County will not pay additional cost as a result of an Uncontrollable Circuumstance. The Contractor may only seek a no cost Change Order or Amendment for such reasonable time as the Owners Representative may deternine. Page 13 of 29 X) Adjudication of Disputes or Disagreements. County and Contractor agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. This Agreement is not subject to arbitration. This provision does not negate or waive the provisions of Sections I,Nondiscrimination, or Section II, concerning termination or cancellation. Page 14 of 29 PROPOSAL FORM. PROPOSAL TO: Monroe County Correction Facilities 5501 College Road Key West,FL 33040 ,r PROPOSAL FROM: 0 r,�t1 � " e 3L,70 The undersigned, having carefully examined the Work and reference Drawings, Specifications, Proposal, and Addenda thereto and other Contract Documents for the construction of: PLANTATION KEY GOVERNMENT CENTER AND DETENTION FACILITY AND THE ROTH BUILDING LIFT STATIONS MAINTENANCE AND CLEANING and having carefully examined the site where the Work is to be performed,having become familiar with all local conditions including labor affecting the cost thereof, and having familiarized himself with material availability, Federal, State, and Local laws, ordinances, rules and regulations affecting performance of the Work, does hereby propose to furnish all labor, mechanics, superintendents, tools. material, equipment, transportation services, and all incidentals necessary to perform and complete said Work and work incidental hereto,in a workman-like manner,in conformance with said Drawings, Specifications,and other Contract Documents including Addenda issued thereto. The undersigned further certifies that he/she has personally inspected the actual location of where the Work is to be performed,together with the local sources of supply and that he/she understands the conditions under which the Work is to be performed. The proposer shall assume the risk of any and all costs and delays arising from the existence of any subsurface or other latent physical condition which could be reasonably anticipated by reference to documentary information provided and made available, and from inspection and examination of the site. The undersigned agrees to commence performance of this Project within Ten (10) calendar days after the date of issuance to the undersigned by Owner of the Notice to Proceed/Purchase Order/Task Order. Once commenced, undersigned shall diligently continue performance until completion of the Project. The undersigned shall accomplish Final Completion of the Project, which shall be a one(1)year term after commencement. thereafter. Page 15 of 29 The Base Proposal shall be furnished below in words and numbers. If there is an inconsistency between the two,the Proposal in words shall control. mq 'i� wk"y .". 17oilal'F.:. (Total base Proposal-words) (Total Base P��Oposal—numbers) I acknowledge Alternates as follows: N/A I acknowledge receipt of Addenda No.(s) or None No. Dated No. Dated Page 16 of 29 In addition, Proposer states that he/she has provided or will provide the County. along with this Proposal, a certified copy of Contractor's License. Monroe County Business Tax Receipt. and Certificate of Insurance showing the minimum insurance requirements for this project. Execution by the Contractor must be by a person with authority to bind the entity. By signing this agreement below,the Contractor has read and accepts the terms and conditions set forth by the Monroe County General Requirements for Construction found at the link on the Monroe County web page: htt :8fl-monroecounl .ci vicp I us.corn/Bids.as x?Cat,ID=18. AND accepts all of the terms and conditions and all Federal required contract provisions herein. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their duly authorized representatives, as follows: Contractor: JAN Gl q 1-4 ... ....... . .. _ Mailing Address: ` €! Phone Number: q 3 ct q & c f E.I.N.: Email: _ � L �vl�"c :.:_ �'__ �..� .. �e.....—.— cr- r Date: :�,2 f Signed: Name Title Contractor's Witness signature. Witness name: Date: 2 3,> )�`► The County accepts the above proposal: MONROE COUNTY, FLORIDA Roman as S Digitally signed by Roman Gastesi 1 Date:2023.05.03 10:21:33-04'00' Date: B County Administrator or Designee MoNpZE COUNTY AT TORNEVS OFFICE FS��"6O� Page 17 of 29 PATMOtAEABLES ASMS AN7,, � A 0 1 DATE; NON-COLLUSION AFFIDAVIT I r e-ot co of the city of Te-'(! ' - m,) according to law on my oath, and under penalty of perjury, depose and say that: 1. I am � W ,) of the firm of the proposer making the Propos I for the project described in the notice for calling fo roposals for: c. and that I executed the said proposal with fu authority to do so; Z The prices in this proposal 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 proposer or with any competitor; and 3. Unless otherwise required by law, the prices which have been quoted in this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed by the proposer prior to proposal opening, directly or indirectly, to any other proposer or to any competitor; and 4. No attempt has been made or will be made by the proposer to induce any other person, partnership or corporation to submit, or not to submit, a proposal for the purpose of restricting competition; and 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 of Proposer) (Date) STATE OF: -Eloyli�& COUNTY OF: fl Subscribed and sworn to (or affirmed) before me, by means of 2 physical presence or ❑ online notarization, on -4 - (date) by r CIJ f- (name of affiant). He/She is personally known to me or has produced M L (type of identification) as identification, yLl41hYIII1ArN,,rr kQJAK y PUBLIC My commission expires: � , WW N j 8 of 29 LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE YS �F1 fi.y^ 'mm.w°"" fl ft (Company) warrants that he/she/it has not employed, retained or otherwise had act on his/her/ its 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 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 ploye". (Signature) Date.- STATE OF: COUNTY OF: Subscribed and sworn to (or affirmed) before me, by means of sical presence or online notanz ion, on 20a� (date) by (name of affiant). He/She is personally knowb to me or has produced as identification. (Type of identification) hGTATtYPUBLIC My commission expires: o " (SEAL); Paae 19 of 29 DRUG-FREE WORKPLACE FORM Fhe L1rldel-sk�,Teed %' .�. �-� ..� . ...' ..�..� � �^�..�� ��.— ��4 ...�mm... ..mm.� that: endo�r c�'�, .irr c4"rd"Inc v601 [Iorida Statute. Sec, 287 087 hereby certifies � (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. ?. Informs 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. Gives each employee engaged in providing the commodities or contractual services that are under proposal 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 the commodities or contractual services that are under proposal, 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, Imposes a sanction on, or requires the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, for any employee who is so convicted. 6o Makes 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 fi i complies f y r ith the above requirements. Proposer's Sionat.ure 1� Date STATE OF: r I O COUNTY OF: y 1 or El online Subscribed and sworn to (or affinne before me, b means o �hysica�esei ce notarization, on (name affiant He/She is ersonall known date b to me or has produced ) Y ( ) p • y rod uced (type o` tle ti "'tion) ; identification. NOTARY - (SEALS < Mrc°Tm.ExpreS My Commission Expires: March 14,2023 i N° GG 312179 Page 20 of 29 OF V_ �� �JIVOW,IPVLO64KK OO 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, proposd; or reply on a contract to provide any goods or services to a public entity, may not submit a bid, proposal, or reply 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 a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of thirty-six (36) months from the date of being placed on the convicted vendor list." I have rid th above and state that :either C C)L W( /0 oK [ , Proposer's name) nor any Affiliate has been place n the convicted v dor list within the last thirty-six (36) months. a (Si ature) Date �7 _ �- STATE OF W COUNTY OF: "; Subscribed and sworn to (or affirmed) before me, by means of EI physical presence or y of W►'CM❑0 online by to ization, on the . da (name of affiant). He/She is Maply known to me or as produced (type of identification) as ation. My C sion Expire NOTARY MBILIC ry o (SEAT. .,, Page 21 of 29 VENDOR CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS . .-,--'_--_.~-~.`~'Respondent Vendor Name: Vendor's Authorized Representative Name ano Title: t c,", t e- Phone Number 'Q Email Address: 8aoUon 287.135, Florida Statutes prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract for goods or services of any amount if, at the time of contracting or renewal,the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to Section 215.4725. Florida Statutes, orisengaged in 8oycoftofIsrael. As the person authorized to sign on behalf of Respondent, ! hereby certify that the company identified above in the Section entitled "Respondent Vendor Name" is not listed on the Scrutinized Companies that Boycott Israel List. I understand that pursuant to Section 287.135, Florida Statutes, the submission of a false certification may subject company to civil penalties, attorney's fees, and/or costs. I further understand that any contract with the COUNTY may be terminated, at the option of the COUNTY, if the company is found to have submitted afa|se certification or has been placed on the Scrutinized Companies that Boycott Israel List orengaged ina boycott nfIsrael. Certified BY 0° "^~ Pee,?C-0 C who is authorized to sign on behalf of the above refermt ompanyw Authorized Signature: Print Name- Note: The List are available at the following Department of Management Services Site: ended discriminatoa complaints vendor lists Page 22of%9 INSURANCE REQUIREMENTS AND FORMS MONROE COUNTY,FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES General Insurance Requirements For Other Contractors, Subcontractors and Professional Services As a pre-requisite of the work and services governed, or the goods supplied under this contract (including the pre-staging of personnel and material), the Contractor shall obtain, at his/her own expense, insurance as specified in any attached schedules, which are made part of this contract. The Contractor wi 11 ensure that the insurance obtained will extend protection to all Subcontractors engaged by the Contractor. Alternatively, the Contractor may require all Subcontractors to obtain insurance consistent with the attached schedules. The Contractor will not be permitted to commence work governed by this contract (including pre- staging of personnel and material) until satisfactory evidence of the required insurance has been furnished to the County as specified below. Delays in the commencement of work,resulting from the failure of the Contractor to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the Contractor's failure to provide satisfactory evidence. The Contractor shall maintain the required insurance throughout the entire term of this contract and any extensions specified in the attached schedules.Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced. Delays in the completion of work resulting from the failure of the Contractor to maintain the required insurance shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work had not been suspended,except for the Contractor's failure to maintain the required insurance. The Contractor will be held responsible for all deductibles and self-insured retentions that may be contained in the Contractor's Insurance policies. The Contractor 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 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 Contractor's insurance shall not be construed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law. Page 23 of 29 The Monroe County Board of County Commissioners, its employees and officials, at 1100 Simonton Street, Key West, Florida 33040, will be included as "Additional Insured" on all policies. except for Workers' Compensation. 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 Department. Page 24 of 29 PROPOSER'S INSURANCE AND INDEMNIFICATION STATEMENT INSURANCE REQUIREMENTS Workers Compensation Statutory Limits Employers Liability $100,000/$500,000/$100.000 Bodily Injury by Accident/Bodily Injury by Disease,policy limits/Bodily Injury by Disease each employee General Liability $200,000 per Person $300,000 per Occurrence $200,000 Property Damage or $300.000 Combined Single Limit Vehicle $200,000 per Person (Owned,non-owned, and hired vehicles) $300,000 per Occurrence $200,000 Property Damage or $300,000 Combined Single Limit Builders Risk Not Required Construction Bond Not Required The Monroe County Board of County Commissioners,its employees and officials, 1100 Simonton Street, Key West. Florida 33040, shall be named as Certificate Holder and Additional Insured on General Liability and Vehicle policies. INDEMNIFICATION,HOLD HARMLESS,AND DEFENSE.Notwithstanding any minimum insurance requirements prescribed elsewhere in this agreement,Contractor shall defend,indemnify and hold the County and the County's elected and appointed officers and employees harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death),loss,damage,fine,penalty or business interruption,and(iii)any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of Contractor or any of its employees, agents. contractors or other invitees during the term of this Agreement, (B)the negligence or recklessness,intentional wrongful misconduct, errors or other wrongful act or omission of Contractor or any of its employees, agents, sub-contractors or other invitees, or(C) Contractor's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the County or any of its employees, agents, contractors or invitees (other than Contractor). The monetary limitation of liability under this Page 25 of 29 contract shall be equal to the dollar value of the contract and not less than$1 million per occurrence pursuant to Section 725.06, Florida Statutes. The limits of liability shall be as set forth in the insurance requirements included in Paragraph 3.0. herein. Insofar as the claims. actions. causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this Agreement, this section will survive the expiration of the term of this Agreement or any earlier termination of this Agreement. In the event that the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in the plans and specifications provided by the Contractor,the Contractor agrees and warrants that the Contractor shall hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action on the County's behalf. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this Agreement. PROPOSER'S STATEMENT I understand the insurance that will be mandatory if awarded the contract and will comply in full with all of the requirements herein. I fully accept the indemnification and hold harmless and duty to defend as set out in this proposal. e° m.,. PROPOSER ;signature Page 26 of 29 INSURANCE AGENT'S STATEMENT I have reviewed the above requirements with the proposer named above The ;ollowing deductibles apply to the corresponding policy. POLICY DEDUCTIBLES � u 1 , Liability policies are Occurrence Claims Made r�ce.A. enc " '� nature , lnsu� Agency . __�. Page 27 of 29 Page 28 of 29 MONROE COUNTY, FLORIDA REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS It is requested that the insurance requirements,as specified in the County's Schedule of Insurance Requirements.be waived or modified on the following contract. C ontr iL�[ yr,'V dog r 0 Project Service: X.... J - G ? vz C ontractorNendt�r Addre:sw& Phone 0 4 G tV ' � ," �p _ __ General Sof of Work: dd Reaso � � . for .... ry . Modification:ation:Waiver� r r��t......_ e�c�. _......._ ��.. Politics Waiver or Modification will apply to: — - — Signature of ContractorNendor r . Date: 4 . 10 . 2 3 Approved , _X mITmm Not Approved Jaclyn Hatt 9a"" Risk Management Signature: Date: County Administrator appeal: Approved: _mw Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Page 29 of 29 ... . ......... ......... ... . . . .......... ............ . .................... .... ....... ....... .. ... ... ..... . ... ...... .. ...... ................. .. AC" CERTIFICATE OF LIABILITY INSURANCE 7EO4120/23 (MMIDDIYYYY] THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: BUYSMART INSURANCE INC PHCN o E 305 246-2114 FAX No): 305 247-7057 190 N Homestead Blvd ADDRIESs: buysmart@bellsouth.net Homestead, FL 33030-7426 INSURERS AFFORDING COVERAGE NAIC# INSURER A: COVINGTON SPECIALTY INSURANCE COMPANY INSURED INSURERS: PROGRESSIVE CDI OF MONROE LLC INSURER C: 239 TARPON ST INSURER D: TAVERNIER, FL 33070 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 APFORDFD 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MMIDD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 CLAIMS-MAOE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 _ MED EXP(Any one person) $ 5,000 A Y Y VBA826138 09/14/22 09114/23 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 0A O00 JECT POLICY❑ PRO ❑ LOG PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY (CEO,.B3denDtSINGLE LIMIT $ 300,000 ANY AUTO BODILY INJURY(Per person) $ OWNED B AUTOS ONLY AU-HcosDLED Y 03085532 12/30/22 12/30/23 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ '.. EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ ", -� 7 $ WORKERS COMPENSATION 'I - PER OTH- AND EMPLOYERS'LIABILITY YIN .,. � � STATUTE ER ANY PROPRIETORIPARTNERIEXEGUTIVE ❑ E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA .... — (Mandatory in NH) "'" E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below r. E.L.DISEASE-POLICY LIMIT $ ............... DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached If more space is required), 97222-MACHINERY OR EQUIPMENT INSTALLATION,SERVCING OR REPAIRS 98482-PLUMBLING COMMERCIAL&INDUSTRIAL ALSO ADDITIONAL NAMES INSURED&WAIVER OF SUBROGATION ON POLICY,BLANKET ENDORSEMENT APPLIES FOR GENERAL LIABILITY& ADDITIONAL INSURED APPLIES TO THE COMMERICAL AUTO CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THERME, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLI RO ISIONS, 1100 Simonton St. Key West, FL 33040 DUORIMSENTATIVE CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of A 2022 / 2023 MONROE COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30, 2023 C)I 10 N R 0 L t,I F10 C 1 y Owrief Nmnit, DONAt 0 H'ACOC K 1AVCAMIrR, H, J'j 01 0 �39 TAU'IPON St Um'Ow", Phlmv"� T AV I RN I'll 11, H 330M M0011f (�,,4014tl ORAIN OTANINC, W101 VA( IHOCK) ............ ........ ............Tox Ao'ioun C!i, C()St ToUfl 00 2 S .. ...... 2 oo 0,00 000 2em 7 50 Paid 316-22-0100,001,07 10/14/2022 27. 5,0 THIS HCOMH A TAX RECEIPT Sam C. Steele, CLC, Tax Collector, T1 11S 15 ON[Y A TAX, WHEN VA[,[DATED PO Box 1129, Key West, FL 33041 Y 0 U M U S r M(,"t:'T A L L, COUNTY AN()/OR MUNICIPALITY PLANNING, ZONING AND [ACENSING REQUIREMEN-M MONROE COUNTY BUSINESS TAX RECEIPT P.0, Box 1129, Key West, Fl- 33041-1129 EXPIRES SEPTEMBEfl 30, 2023 businer,s Name: C01 OF MONROE LIC REMP14 29240-128404 N10 cly BUSHIOSSIXGAIOW TAVLRNIER, FL 33070 Owner Nanw! DONALD PEACOCK Madmg AddresS: ffioiness Phorw 239TARPON ST 13u"i'Nrle"s lype. MOB11 17 (STORM DRAIN CLEANING WITH VAC TAVERNIER, FL 33070 MUCK) 7 T ............................. ............... arrAmount Transfer fee Sub-Totait Penalty ........... 25,00100 25ko 2. 0 010 11-111 11 ................. Paiid 3116-22-00000107 10/14/2022 27 . 50