Item F3
BOARD OF GOVERNORS
FIRE AND AMBULANCE DISTRICT 1
AGENDA ITEM SUMMARY
Meeting Date: September 20, 2006
Division:
Emergency Services
Bulk Item: Yes
No~
Department: Fire Rescue
Staff Contact Person: Camille Dubroff
AGENDA ITEM WORDING: Approval to extend the Roy Khanna agreement for maintenance of
Fire Rescue vehicles (Ambulances) including inspections, preventative maintenance, and unscheduled
maintenance and repairs resulting from failure or malfunction, which expires on September 30, 2006,
on a month-to-month basis pending execution of a new agreement.
ITEM BACKGROllND: The original agreement was approved in March 19,2003 for a one year
period, providing for annual renewals for three (3) one year periods with approval of the District's
governing Board. Subsequently each year, the Board approved the one-year renewals, with the final
term expiring on September 30, 2006. Currently, we are in the process of advertising a request for
sealed bids which will result in entering into a new agreement with the successful bidder. In the
meantime, we are requesting approval by the board to extend the existing contract on a month-to-
month basis.
PREVIOUS RELEVANT BOG ACTION: On March 19,2003 the Board approved an agreement
with Roy Khanna for maintenance of Fire Rescue vehicles (Ambulances) including inspections,
preventative maintenance, and unscheduled maintenance and repairs resulting from failure or
malfunction. On September 17,2003, the Board approved a renewal agreement to extend the contract
with Roy Khanna for the first one-year period, effective October 1, 2003 through September 30, 2004.
On September 21, 2004, the Board approved a renewal agreement to extend the contract with Roy
Khanna for the second one-year period, effective October 1, 2004 through September 30, 2005. On
September 28, 2005, the Board approved a renewal agreement to extend the contract with Roy Khanna
for the final one-year period, effective October 1, 2005 through September 30, 2006.
CONTRACT/AGREEMENT CHANGES: Term of agreement extended from September 30, 2006 to
a month-to-month basis.
STAFF RECOMMENDATIONS: All conditions of the contract have been met and services
provided have been satisfactory. Staff recommends extending contract on a month-to-month basis until
sealed bids are opened which will result in entering into a new agreement with the successful bidder.
TOTAL COST: * * see below
BUDGETED: Yes ~ No_
141-13001-530-462
COST TO COUNTY: ** see below
SOURCE OF FUNDS: Ad valorem taxes
**Hourly rate of $65.00 per man hour with inspections performed at $239.00. All parts, fluids and
lubricants used to be billed to the DISTRICT at cost plus 25%.
REVENUE PRODUCING: Yes
No
AMOUNTPERMONTH_ Year
APPROVED BY: County Atty YES OMBlPurchasing YES Risk Management YES
Not Required_
DOCUMENTATION:
DISPOSITION:
Included X
AGENDA ITEM #
Revised 8/06
MEMORANDUM ATTACHMENT TO AGENDA ITEM SUMMARY
Meeting Date: September 20, 2006
Division:
Emergency Services
Bulk Item: Yes
No X
Department: Fire Rescue
Staff Contact Person: Camille Dubroff
AGENDA ITEM WORDING: Approval to extend the Roy Khanna agreement, which expires on
September 30, 2006, on a month-to-month basis pending execution of a new agreement.
ITEM BACKGROUND: Monroe County Fire Rescue must maintain all Fire Rescue vehicles
(Ambulances) to include inspections, preventative maintenance, unscheduled maintenance and
repairs resulting from failure or malfunction. Through the years, these services have been contracted
as the total amount spent on these repairs generally exceeds $25,000.00 annually. The original
contract provides for one (1) year of service with the option to renew for three (3) additional years,
subject to approval by the Fire Chief, the Office of Management and Budget and the Monroe County
Board of Governors Fire and Ambulance District 1.
The original agreement was approved in March 19, 2003 for a one year period, providing for annual
renewals for three (3) one year periods with approval of the District's governing Board.
Subsequently each year, the Board approved the one-year renewals, with the final term expiring on
September 30, 2006. Currently, we are in the process of advertising a request for sealed bids which
will result in entering into a new agreement with the successful bidder. In the meantime, we are
requesting approval by the board to extend the existing contract on a month-to-month basis.
PREVIOUS RELEVANT BOG ACTION: On March 19,2003 the Board approved an agreement
with Roy Khanna for maintenance of Fire Rescue vehicles (Ambulances) including inspections,
preventative maintenance, and unscheduled maintenance and repairs resulting from failure or
malfunction.
On September 17, 2003, the Board approved a renewal agreement to extend the contract with Roy
Khanna for the first one-year period, effective October 1, 2003 through September 30, 2004.
On September 21, 2004, the Board approved a renewal agreement to extend the contract with Roy
Khanna for the second one-year period, effective October 1, 2004 through September 30,2005.
On September 28,2005, the Board approved a renewal agreement to extend the contract with Roy
Khanna for the final one-year period, effective October 1, 2005 through September 30, 2006.
On December 21, 2005 an approval by the board for amendment to the agreement with Roy Khanna
for the maintenance of Fire Rescue vehicles (Ambulances), amending Section 6 in order to
eliminate the requirement for Contractor to provide a copy of original parts supplier invoices for all
parts under $200.00
CONTRACT/AGREEMENT CHANGES: Contract will be renewed and the new expiration date
will be September 30,2007.
STAFF RECOMMENDATIONS: All conditions of the contract have been met and services
provided have been satisfactory. Staff recommends extending contract on a month to month basis
until sealed bids are opened which will result in entering into a new agreement with the successful
bidder.
MONROE COUNTY BOARD OF GOVERNORS
CONTRACT SUMMARY
Contract with: Roy Khanna
Contract #_
Effective Date: 10/01/2006
Expiration Date: Month-to-month
Contract Purpose/Description:
Renewal of agreement dated 3/19/2003 for maintenance of Fire Rescue Vehicles
(Ambulances) including inspections, preventative maintenance, and unscheduled
maintenance and repairs resulting from failure or malfunction.
Contract Manager: Camille Dubroff
(Name)
6010
(Ext.)
Emergency Serviccs / Stop 14
(Department/Stop #)
for BOCC meeting on
09/20/2006
Agenda Deadline: 09/06/2005
CONTRACT COSTS
Total Dollar Value
of Contract: $
**Hourly rate of $65.00 per man hour with
inspections performed at $239.00. All
parts, fluids and lubricants used to be billed
to the DISTRICT at cost plus 25%.
Account Codes: 13001-530462-_-__
Curren t
Year
POliion: $
Budgeted? YeslZl
NoD
Gran t: $
County Match: $
- - -
-----
-
-----
- - -
-----
ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities,janitorial, salaries, etc.)
CONTRACT REVIEW
Date Out
Date In
Division Director 1-5'-0&
1-6-0&
County Attorney
Comments:
OMB Form Revised 2/27/01 Mep #2
RENEW AL AGREEMENT
This AGREEMENT dated the _ _day of ,2006, by and between
the Board of Governors of Fire and Ambulance District 1 of Monroe County, Florida, hcreinafter called the
"District" and Roy Khanna., whose mailing address is 3117 Carol Avenue, Palm Springs, FL 33461,
hereinafter called the "Contractor".
WITNESSETH
WHEREAS, the partics hereto did enter into an agreement dated March 19,2003 for scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting trom equipment failure or malfunction; and
WHEREAS, said agreement provided an option to the District to renew the contract for three additional
one year terms; and
WHEREAS, the DISTRICT has exercise said option for all three renewals for the continuation of
scheduled general and preventative maintenance of all Monroe County Fire Rescue ambulances, and for
unscheduled maintenance and repairs resulting from equipment failure or malfunction;
WHEREAS, the DISTRICT is currently in the process of advertising a request for sealed bids which will
result in entering into a new agreement with the successful bidder.
WHEREAS, the DISTRICT requests approval by the Board to extend the existing contract on a month-to-
month basis with Roy Khanna of said agreement, which expires on September 30, 2006; now therefore
TN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as
follows:
I. The District elects to extend the contract on a month-to-month basis.
2. The effective date of this amendment is October 1,2006 and shall extend on a month-to-month
basis pending execution of a ncw agreement from the successful bidder.
3. All other terms and conditions of the contract dated March 19, 2003 shall remain in full force
and effect.
Attest: DANNY 1. KOLHAGE, CLERK
BOARD OF GOVERNORS,
FIRE AND AMBULANCE DISTRICT I
By:
Deputy Clerk
By:
Mayor/Chairman
ROY KHANNA
WITNESS:
. ~ COUNTY ATTORN[Y
Authonzed R ~ A..S TO FORM:
.
au N M. GRIMSL.EY
D.~SSIST1~Oj~J ~TORNeY
MAINTENANCE OF FlRE/RESCUE VEHICLES
AGREEMENT is made and entered into by the Board of Governors of Fire and Ambulance
District I of Monroe County, Florida, hereinafter referred to as "DISTRICT", and Roy Khanna,
hereinafter referred to as "CONTRACTOR".
REeIT ALS
A. The DISTRlCT advertised a notice of calling for bids for MAINTENANCE OF
FIRE/RESCUE VEHICLES, which were opened on the ih day of January 2003;
B. The successful bidder was Roy Khanna;
C. The initial contract provides for a renewal of the contract for three additional one-year
terms.
D. This contract is an agreement between parties.
NOW, therefore, the parties agree as follows:
1. CONTRACT PERIOD AND RENEWAL - The first contract term is a period from the
date on which it is signed by the last of the two parties and will expire on September 30,
2003. This contract may be renewed, at the option of the DISTRlCT, upon giving at least
30 days notice to CONTRACTOR. The option for renewal shall be for three additional
one-year terms conditioned upon annual appropriation of funds.
2. CONTRACT TERMINATION - This contract may be terminated for any reason by either
party on 3D-day written notice without cause.
3. SUBJECT MATTER OF CONTRACT - This contract is for performing scheduled
general and preventative maintenance of all Monroe County Fire Rescue ambulances, and
for unscheduled maintenance and repairs resulting from equipment failure or malfunction.
4. RATES -The hourly rate shall be $65.00 per man-hour with no travel time or mileage
charge. Jobs requiring more than one technician will be charged at the rate of$35.00 per
man-hour for the second man. The charge for conducting an ambulance inspection with
each preventative maintenance performed will be $239.00.
5. WORK SCHEDULE - Regularly scheduled inspections and preventative maintenance
shall be conducted at such intervals as are approved by the DISTRlCT and by the Ford
Scheduled Maintenance Guide using '.Special Operating Conditions" as the guide for the
Ford Maintenance. The modular portion of the vehicle shall be maintained in accordance
with the manufacturers recommendations.
6. P ARTS, FLUIDS AND LliBRlCAl"lTS - AIl parts, fluids, and lubricants used for
maintaining and repairing vehicles shall be supplied by CONTRACTOR and billed to the
DISTRlCT at cost plus 25%, with a copy of original parts supplier invoices for all parts
attached to the bill.
P:lge I of3
7. ENGINE OIL AND FILTER CHANGE - CONTRACTOR shall complete drivetrain
lubrication and any other fluids and/or filter changes shall be performed as recommended
by Ford.
8. WEEKLY MAINTENANCE SCHEDULE - CONTRACTOR shall provide to the
DISTRICT a preventative maintenance schedule that can be performed weekly by
Monroe County Fire Rescue personnel.
9. MAINTENANCE LOG - CONTRACTOR shall maintain an inspection and maintenance
chart on each vehicle containing at least the following information:
(a) date of performance,
(b) apparatus serviced,
(c) service performed,
(d) parts used,
(e) name of service person(s),
(f) total downtime of vehicle
A copy of this chart shall be supplied to the Fire Rescue Office within 30 days of the
service.
A computerized ambulance inspection form shall be developed by the Contractor and _
approved by the Monroe County Fire Rescue Support Services Manager. This form will
be completed by the Contractor and forwarded to the office of the Support Services
Manager so that it can part of the service record of the vehicle.
10. COMMUNICATION - CONTRACTOR shall maintain a telephone or paging device such
that prompt notification of request for service is possible at all times.
11. RESPONSE TO SERVICE REQUEST - CONTRA.CTOR shall have 120 hours to
respond if one ambulance goes off line. If a second ambulance goes off line, the
Contractor must respond within 48 hours of notification to repair both vehicles. If a third
ambulance goes off line, the Contractor must respond inunediately to get a minimum of
two ambulances back on line.
12. CERTIFICATION - CONTRACTOR shall provide evidence satisfactory to the
DISTRICT that its personnel who perform maintenance work are certified in general
mechanics and repair.
13. QUALIFICATIONS OF MAINTENANCE PERSONNEL - All personnel performing
maintenance, repairs, adjustments, and related work on the DISTRICT'S equipment shall
be certified or experienced in the work to be performed.
14. INDEMNIFICATION - CONTRACTOR shall indemnify and hold the DISTRICT and
Monroe County harmless for any negligence on its part. or faulty or improper
workmanship, for all work performed under this contract, including all costs of
collection, reasonable attorney fees, claim costs, and as per "Attacrunent A". All
property or equipment being directly maintained or repaired by CONTRACTOR shall be
considered in its care, custody, and control while such work is in progress and until
physical control of such property or equipment is restored to the DISTRICT.
PJge 2 of3
15. LOCATION OF WORK - This contract covers ambulances located at the following
stations:
a. Big Coppitt
b. Cudjoe
c. BigPine
d. Conch Key
e. Tavernier
16. INSURANCE - As per Attachments "B" and "C".
17. PA ThIENTS - Payments shall be made by the DISTRICT within 30 days of the
completion of the rendered services on each vehicle and proper invoicing by the
CONTRACTOR. All unscheduled maintenance and repairs resulting from equipment
failure or malfunction requiring service shall be billed by the CONTRACTOR at the
applicable rates as specified in Section four of this AGREEMENT. The CONTRACTOR
upon notification by the DISTRICT of an equipment failure or malfunction requiring
unscheduled maintenance shall. in a timely manner investigate the problem and provide
to the DISTRICT an estimate of the cost for repair and vehicle downtime. The
CONTRACTOR upon receiving authorization to proceed from the DISTRICT shall
effectuate~uch repair; upon completion of same the contractor shall notify the DISTRICT
of the outcome and actual cost. The DISTRICT shall issue a separate purchase order fur
each occurrence of unscheduled maintenance and repair.
18. This contract takes effect on the date of the last party to sign.
19. Monroe County's performance and obligation to pay under this contract is contingent
upon an annual appropriation by the B.O.C.C.
20. Venue for any litigation arising under this contract must be in a court of competent
jurisdiction in Monroe County, Florida.
IN WITNESS WHEREOF, each party hereto has caused this contract to be executed by its duly
authorized representative.
i /"
Attest: DANNY L. KOLHAGE, CLERK
By:~cJ'LLQ. ~~~ By:
Deputy Clerk APPROvED AS TO FOR~1a)'6r/Chairman
AND 1--, l Sij"i' _'~ C
~ ~ '
[/ 5,'0 ~Nr-.E :c., HUTTON
;j,,~~ ~ /~f'3 '_
R Y KHA.~~A
BOARD OF GOVERNORS,
FIRE AND AMBULANCE DISTRICT 1
't~ --- J1t-U-
','dT?\<cSS: ~t~ 7h,---e/L
---
1 'l9lj Edition
MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
Indemnification and Hold Harmless
for
Other Contractors :lnd Subcontractors
The Contractor covenants and agrees to indeII1I1i.tY and ho ld harmless Monroe County Board of
County Commissioners from any and all claims for bodily injury (including death), personal injury,
and property damage (including property owned by Momoe COlUlty) and any other losses.
damages. and expenses (including anorney's fees) which arise out of, in connection with., or by
reason of services provided by the Contractor or any of its Suocontractor(s) in any tier,
occasioned by the negligence, errors, or other \vrongful act or omission of The Contractor or its
Subcontractors in ~y tier, their employees. or agents.
In the event 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.
The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification
provided for above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements
contained elsewhere within this agreement.
TCS
Administration [nstruction
)j~709.5
ATTACffi1E~T A
96
~
10)96 E<.Iilion
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTR..\..CT ADMINISTRATION
MANUAL
Generallosurance Requiremen-ts
for
Other Contractors and Subcontractors
As a pre-requisite of the work governed, or the goods supplied under this contract (including the
pre-staging of personnel and material), the Contractor shall obt3~ at hislhc:r own expense,
insurance as specified in any attached schedules, which are made part of this contract. The
Contractor will ensure that the insurance obtained will extend protection to all Subcontractors
engaged by the Contractor. As an alternative, 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) lUltil satisfactory evidence of the required insurance has been-
furnished to the COWlty as specified below. Delays in the commencement ofwork, 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 fuilure 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 fuilure to perform assessments shall be imposed as if the work bad not been
suspended, except for the Contractor's failure to maintain the required insurance.
The Contractor shall provide, to the County, as satisfactory evidence of the required insurance,
either:
. Certificate 0 f Insurance
Of
. 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.
Administration Instruction
#4709.5
I~
ATTAC~E~T B (Page 1 of 2)
1'l'l6 EdiliQn
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN ..
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
General Liability Insurance. Coverage shall be maintained throughout the Life of the contract and
include, as a minimum:
. Premises Operations
. Products and Completed Operations
. Blanket Contractual Liability
. Personal Injury Liability
. Expanded Definition of Property Damage
The minimwn limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimwn limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
.-
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its
provisions should include coverage for claims filed on or after the effective date of this contract.
In addition, the period for which claims may be reported should extend for a minimwn of twelve
(12) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfY the above requirements.
GLI
Administration Cnstruction
IJ4709.5
48
ATTACHMENT C (Page 1 of 3)
1996 Edition
VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract requires the use ofvehicles, the Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum. liability coverage for:
. Owned, Non-Owned, and Hired Vehicles
.-
The minimum limits acceptable shall be:
$100,000 Combined Single Limit (CSL)
If split limits are provided, the minimwn limits acceptable shall be:
$ 50,000 per Person
$100,000 per Occurrence
$ 25,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
VLI
Administration Instruction
"4709.5
80
ATTACHME~T C (Page 2 of 3)
1996 Edilion
GARAGE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract involves the servicing and/or repair of
County-owned vehicles, the Contractor will be required to purchase and maintain a Garage Policy
"to include Garage Liability Insurance extending to vehicles. owned or leased by the County, left
with the Contractor for servicing, repair, storage, or safekeeping. Coverage should include, as a
minimum: .'
. Premises and Operations Liability
. Vehicle Liability
. Contractual Liability
. Products and Completed Operations Liability
. Garage Keepers' Legal Liability, to include:
Comprehensive and Collision
The Garage Keepers' Legal Liability shall extend to all County-ownedlleased vehicles in the care,
custody, and. control of the Contractor.
The Contractor's insurance shall be primary to any coverage maintained by the COlll1ty.
The minimwn limits acceptable shall be:
$300,000 Combined Single limit (CSL) for liability
$ 25,000 Garage Keepers' Legal Liability
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
GKl
AdmiruStr.llion [nslruClion
1;\4709.5
46
ATTACHMENT C (Page 3 of 3)
1996 Edition
MONROE COUNTY, FLORIDA
Request For Waiver
or
Insurance Requirements
It is l'equested that the insurance requirements, as specified in the County's Schedule oflnsurance Requirements,
be waived or modified on the following contract.
Contractor:
Contract for:
Address of Contractor:
Phone:
Address:
Scope of Work:
Reason for Waiver:
Policies Waiver
will apply to:
Signature of Contractor:
Risk Management
Date
County Administrator appeal:
Date:
Roy Khanna
Maintenance of Fire Rescue Ambulances including inspections
preventative maintenance and unscheduled maintence and repairs
resulting from failure or malfunction.
561-312-9792
3117 Carol Avenue. Palm Springs. FL 33461
State4above.
T 'yP/l f~fl~ IL-IPI,,-teA/Je/t'e )1"0 /2P~.-9;/l..J
o IV Ii /V\t VI [Pi ;-.C p( cD/'---..sf ~ 0/'+11.. m{e LI flgr C /'7 /;J .4 1....&2 J
Agreement dated 3/19/2003 between BOG and Roy Khanna
and all renewals.
\J~'
AP~~
f() ~, ,
\d-~ &' ~U5
Not Approved
Approved:
Not Approved:
Hf:~ " ~i ~ t,.
Ut' {,
v dC5
B03rd of County Commissioners appeal:
Meding Date:
Administration InslrUctiOll
1#4709.5
Approved:
Not Approved:
". .......- --- '~:"~I:.'::-''''-
t~I,~'.. ..
-
102
MONROE COUNTY FIRE RESCUE
AMBULANCES
VEHICLE LOCATION VEAR/MAKEI MODEL VIN NUMBER COUNTY 10 Prime 0
Backup
BIG COP PITT 2002 FORD AMBULANCE 1 FDXF46F22ED 14878 1416-215 Prime
BIG COP PITT 1995 FORD AMBULANCE 1 FDLF47FOSEA6071 5 1416.54 Backup
CUDJOE 2001 FORD AMBULANCE 1FDXF46F6tEC33364 1416-207 Prime
BIG PINE 2001 FORD AMBULANCE 1 FDXF46F61 EC33365 1416-208 Prime
BIG PINE 1997 FORD AMBULANCE 1 FDLF47F8VEA7393 1416-059 Backup
CONCH KEY 2001 FORD AMBULANCE 1 FDXF46F41EC33363 1416-206 Prime
CONCH KEY 1997 FORD AMBULANCE lFDLF47FBVEA18040 1 416-080 Backup
TAVERNIER 1999 FORD AMBULANCE 1 FDWF46F9XEB99283 1 416-120 Prime
TAVERNIER 1984/94 FORD AMBULANCE 1 FDLF47M8REA52323 1417-151 Backup
/........
. .
. "J! .
/ .
,'f;:
/.
/'
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
:ilot 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 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, for CATEGORY TWO for a period of 36 months from the date of being placed on
the convicted vendor list. "
NON-COLLUSION AFFIDAVIT
I, Roy IChAI--,vA- ,of the city
of }(p i t_fl-I'L b-O P L. according to law on my oath, and under
penalty of perjury, depose and say that;
l) I am_R.D] (L(\.4~"'t7-
the project described as ollows:
f)L
/. ~
, the bidder making the Proposal for
(~TelV F(O~T(j)N$ Fot\.. (oNQoe rOo...;J""T F'Ule;: Re.sCL/c
u e h ('e e.s
2) The prices in this bid have been arrived at independently without collu~ion, 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; --
3) UnJess 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
opening, directly or indirectly, to any other bidder or to any competitor; and
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;
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.
ST ATE OF fi8t""i:>A
COUNTY OF 1J1~ 11 ~
/ J -Ie- C -7-
Date
PERSONALLY APPEARED BEFORE ME, the undersibrned authority,
fflrNJ/ who, after tirst being sworn by me, (name ofindividuaJ
affixed his/her signature in the space provided above on this
/~ d day of ])~eQ1ll3tL
,~ /;tf7
, 2 <X:?..;2,.
My commission expires: I' _ " "
IJ"'
OMS - MCP FORM #1
.f'6..... Elizabell1 EI Kowy
*if*My Commission CC7a7:l97
1\..::.1 ~s December 11. 2002
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
, MONROE COUNTY, FLORIDA
ETHICS CLAUSE
Ko'j l<:''''''",,^,f>-- ~
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10- L 990 or any County officer or employee in violation of
Section 3 of Ordinance No.1 0-1990. For breach or violation of this provision the Counry
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contmct or purchase price, or otherwise recover, the full amount of any fee,
commission, per.centage, gift, or consideration paid to the former County officer "or employee.
9d~~
" (signature)
Date: /,) -J 0 -02-
I
COUNTY OF
n~ L/7J1t
.
rn~/J~
STATE OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
KtJ'j KHHAJ~ A who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this / ~ ct day of
,])~~ .20~
~~kry
My commission expires:
/~ . 1/' ();;h
OMS - MCP FORM #4
/,' ~.. Ellzabelt1 EI KoulV
*fif*My Commission CC787397
'\a;..~ Expires December 11, 2002
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
Rt}1 Kit ~V'-,v A-
(Name of Business)
l. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance is prohibited in the workplace and specifying the actions
that will be taken against employees for violations of such prohibition.
2. Infonn employees about the dangers of drug abuse in the workplace, tl!e business's policy of
maintaining a drug-free workplace, any available drug counseling, rehabiiitation, 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 ( I), 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 Jaw of the United States or any
state, for a violation occurring in the workplace no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is so
convicted.
6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of
this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
(){t -~~
Bidd~r"'S Signature
/ J.. -.)7-0 A
Date
OMB - Me? FORM #5
FROM : JOf-tSON ~D MILLER
PHONE NO.
561 6413 8514
NOV. 313 2004 04:06PM P1
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. -l_ . . .. "
ROY KHANNA
DATI! IMMIDDIVV)
11/30/2004
ONL. V AND CONFER8 NO RIGHTS UPON THE CERTIFI
HOLDER. THIS CERTIFICATE DOE:S NOT AMENDJ. J;XTEN
AL. TER THE COVERAGE AFFORDED BY THE POLICIES B
_._,_,~OMPANIE~ AFFOR"-ING COVERAGE
CO""~Y
A HERMITAGE INSU~ANCE ~O.
COMPANY
B
JOHNSON & MILLER IN5URANC~
1225 N MILITARY TRAIL ~2
WEST PALM BEACH, FL 33409
561-640-~ll.L,_
INS' iD
CO'!ANY
FL 33461
T IS IS 0 T OF I U He! ISTED L E B N I S ED I R NA D A fOR'1'H
INDICATED NOlWlTHSTMlDING ANV REQUIRaAENT, TERM OR CONDITION OF ANY CONTRACl' OR OTHeR DOCUMENT WITH ReSPECT TO
CERTIFICAte MAY BE ISSUI!D OR MAY PERTAIN, THe INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
nl'l!! Of INWMNCI .' I'OUCY ~"'I!" POL;;'~ IFFICTlVtllOl.lCY IXP';''' ~~~.. .. .
M Ti (MN/OllNYl DATI (NMIDCIYYI
eo
~T"
lllN!UL LIA~
X cOMMERCIAL GENERAL ~iA8ILI
ClAlMSMADE['] OCCUR
A O\'IIN&R'SI. eONTRACTOln PR T . HGL 4 4 35 01
12/01/04
I
12/01/05
GI!loIeftAL AGGRIQ.\TC
.P!'ODUCTS - COMPloP A
PlIRsONAl.. & />DV INJURY
I.,.
..iA~H OCCURRENCe
FIRIi ~C! (An, one In
!.Iell E)(f' (My 011. persall)
11 MILLION
.iXCLUDED
11 MILLION
.1 MILLION
I 50,000
S 5,000
AUTOMOIlIU LIAIIIUn'
ANY AlI'fO
AU. O'I\tIED AUTC$
SCHIOI./L!O AUTOS
HlftlD .o.uTOS
IoION-OWI\IED AUTOS
COMBINED SINGL. LIMIT S
BOOM.Y "'J~V
IP. "',.llI\)
s
!lOOILV INJURY
(Pet acaId.....)
.
INCL
I!!XCl
PROPUlY DAMAGE S
AUTO ONLY - !A ACCIOEN .
OTHI!~ THAN AUTO ONL. V:
EACH ACCIDIN
AGGRaOll
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AGGREGA"T&
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GAIIlAGII LIA"UTY
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UMBRELLA I'OfIM
OTl1l!R 'TlfAN UMIRII.LA 'ORM
WORM'" COU'ENSATION AND
IMPlOV!..s' LIAIlIUT'f'
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS SHALL BE LISTED AS ADDITIONAL
INSURED.
'''~.,_:'~ ~I-'~: -" ~E ::~, . '~", ~:,)" ,r~'j,.;i~:'.' :1..:1, 'h',l!:4~-~~_IJ~C\=-1 ' I';."-;~~I l r< \ . "~:I~':' '~l ~'l~'~: ~'."'1' ~ '-;---:. jl
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS
ATTN RISK MANAGEMENT
1100 SIMONTON STREET
KEY WEST, FL 33040
FAX; 305-289-6336
RENEW AL AGREEMENT
This AGREEMENT dated the /7 ~day of ~J"R,/~l'f;.rve ,2003, by and between
the Board of Governors of Fire and Ambulance District 1 of Monroe County, Florida, hereinafter calleu the
"District" and Roy Kbann~., whose mailing address is 3117 Carol Avenue, Palm Springs, FL 33461,
hereinafter called the "Contractor".
WITNESSETH
WHEREAS, the parties hereto did enter into an agreement dated March 19, 2003 for scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; and
WHEREAS, said agreement provided an option to the District to renew the contract for three ~Qditional
one year terms; and
WHEREAS, the DISTRICT has elected to exercise said option for the continuation of scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; now therefore
IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as
follows:
1. The District elects to renew the contract for an additional year pursuant to paragraph 1 of the
agreement entered March 19,2003.
2. The effective date of this amendment is October 1, 2003 and shall extend through September
30, 2004, under the same terms and conditions of the contract dated March 19, 2003.
3. All other terms and conditions of the contract dated March 19,2003 shall remain in full force
and effect.
Attest: DANNY L. KOLHAGE, CLERK
BOARD OF GOVERNORS,
FIRE AND AMBULANCE DISTRICT I
BY:~~C.~%~
Deputy Clerk
X--. )1t~
By:
Mayor/Chairman
WINESS: A~ t-InYfL
epresentative
RENEWAL AGREEMENT
This AGREEMENT dated the~/$day of ..c'J.. ~ ,2004, by and between
the Board of Govemors of Fire and Ambulance District 1 of Monroe County, Florida, hereinafter called the
"District" and Roy Khanna.. whose mailing address is 3117 Carol Avenue, Palm Springs, FL 33461,
hereinafter called the "Contractor".
WITNESSETH
WHEREAS, the parties hereto did enter into an agreement dated March 19,2003 for scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; and
WHEREAS, said agreement provided an option to the District to renew the contract for three additional
one year terms; and
WHEREAS, the DISTRICT has elected to exercise said option for the continuation of scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; now therefore
IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as
follows:
1. The District elects to renew the contract for an additional year pursuant to paragraph 1 of the
agreement entered March 19,2003.
2. The effective date of this amendment is October 1. 2004 and shall extend through September
30.2005, under the same terms and conditions of the contract dated March 19,2003.
3. All other terms and conditions of the contract dated March 19,2003 shall remain in full force
.. .an9. effect.
-?-~--~;~
,r '<'I~"
Att,i~J-,~A:i. "I L. KOLHAGE, CLERK
.. ! l(\.-~:!~~-:;..~
;' 'I
.::;
BOARD OF GOVERNORS,
FIRE AND AMBULANCE DISTRICT 1
By: M~ c. /.SJv~~
Deputy Clerk
By: _
r~)t~
Chairman
WITNESS: ~-'.( llJ2fl
~
A onzed Representatl ve
~--#
- ...... \ . ......
(;i~i
RENEWAL AGREEMENT
This AGREEMENT dated the ,). 8 +1'\ day of &f'k~ ,2005, by and between
the Board of Govemors of Fire and Ambulance District I of Monroe County, Florida, hereinafter called the
"District" and Roy Khanna., whose mailing address is 3117 Carol Avenue, Palm Springs, FL 33461,
hereinafter called the "Contractor".
WITNESSETH
WHEREAS, the parties hereto did enter into an agreement dated March 19, 2003 far scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; and
WHEREAS, said agreement provided an option to the District to renew the contract for three additional
one year terms; and
WHEREAS, the DISTRICT has elected to exercise said option for the continuation of scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; now therefore
IN CONSIDERATION of the mutual canvenants and obligations contained herein, the parties agree as
follows:
1. The District elects to renew the contract for an additional year pursuant to paragraph 1 of the
agreement entered March 19,2003.
2. The effective date of this amendment is October 1,2005 and shall extend through September
30, 2006, under the same terms and conditions of the contract dated March 19, 2003.
3. All other terms and conditions of the contract dated March 19,2003 shall remain in full force
and effect.
-- '..-- "
/;::::;::~';' c' .c,,,.~.
(.l:rA~;I~Y L. KOLHAGE, CLERK.
!(....:.' ','; L:il '2j-0 ,:';"
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\::~<,:c'C,.:., c:~"...' /.J .
<~~4Q(J. ~aJ;0
~~~Clerk
BOARD OF GOVERNORS,
FIRE AND AMBULANCE DISTRICT 1
By:
~ "- J1t-U.
'Chairman
ROY~~NNA
'/:~
It . ,- ...
f - ~
Xuthorized Representatii ~
O~%
:~lONROE COUNiV ATTORNEY ~~~
^P. VED AS RM' 0(")'
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WITNESS: JJza.fc~_~~_.
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AMENDMENT NUMBER 1
TO THE AGREEMENT BETWEEN
BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1
OF MONROE COUNTY FLORIDA
AND ROY KHANNA
This Amendment Number 1 is made and entered into this 1./~f day oh..:_'-4'-V" ,2005, by and
between the Board of Governors of Fire and Ambulance District 1 of Monroe County, Florida, hereinafter
referred to as "District" and Roy Khanna, hereinafter referred to as "Contractor".
WITNESSETH:
WHEREAS, the parties hereto did enter into an agreement dated March 19, 2003 for scheduled
general and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled
maintenance and repairs resulting from equipment failure or malfunction; and
WHEREAS, the parties desire to amend the Agreement to revise Section 6 in order to eliminate the
requirement for Contractor to provide a copy of original parts supplier invoices for all parts under $200.00
and attach to each bill.
NOW THEREFORE, the parties agree as follows:
1. The foregoing provision is included as if fully set forth herein.
2. Section 6 shall now read as follows:
PARTS, FLUIDS AND LUBRICANTS- All parts, fluids and lubricants used for maintaining and
repairing vehicles shall be supplied by CONTRACTOR and billed to the DISTRICT at cost plus
25%. For parts $200.00 and over, a copy of original parts supplier invoices shall be attached to
the bill. Contractor will be required to keep all original parts supplier invoices available at
request by County for spot checking and auditing purposes.
3. In all other respects, the Agreement between the parties dated March 19, 2003, remains in full
force and effect.
IN WITNESS THEREOF, the parties have executed this Agreement the day and year first written
above.
(S-EAL )
BOARD OF GOVERNORS FIRE AND
AMBULANCE DISTRICT 1 OF
MT~~.:u
Mayor/Chairman
WITNESS:
~Clerk
D.c...
Clerk
Roy Khanna