Item C41
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 12/16/09
DIVISION: COUNTY ADMINISTRATOR
DEPARTMENT: AIRPORTS
BULK ITEM: YES
STAFF CONTACT PERSON: Peter Horton
Phone: 809-5200
AGENDA ITEM WORDING: Approval to rent two double retail spaces at the Key West International Airport on a month to
month basis until a formal rental agreement can be drafted and approved by the BOCC.
ITEM BACKGROUND: Both vendors were found responsive to the advertised RFP for retail space. Both vendors have
expressed a desire to start their businesses as soon as possible,
PREVIOUS RELEVANT BOCC ACTION: Approval to advertise an RFP for retail space, 4/15/09.
CONTRACT/AGREEMENT CHANGES: n/a
STAFF RECOMMENDATION: Approval
TOTAL COST: None INDIRECT COST: n/a BUDGETED: n/a
DIFFERENTIAL OF LOCAL PREFERENCE: n/a
COST TO AIRPORT: None SOURCE OF FUNDS: n/a
COST TO PFC: None
COST TO COUNTY: None
REVENUE PRODUCING: Yes AMOUNT PER YEAR: -$67,300.00
APPROVED BY: County Attorney n/a
OMB/Purchasing n/a
Risk Management n/a
DOCUMENTATION: Included X
Not Required
AGENDA ITEM #
DISPOSITION:
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BID PROPOSAL FORM
TO:MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
C/O PURCHASING DEPARTMENT
GA TO BUILDING ROOM 1-213
1100 SIMONTON STREET
KEY WEST, FLORID 33040
FROM:
Bid Price for Airport Concession space will be paid to Monroe County at the
following rate: $_._ per sq. ft. (minimum $35.89) plus _ percentage of Gross Taxable
Sales. Minimum annual guaranteed rent and percentage of sales shall be $
The undersigned, having carefully examined the work, spe9ifications, proposal, and addenda
thereto and other Contract Documents for the services of:
AIRPORT CONCESSION AT KEY WEST INTERNATIONAL AIRPORT
The Contractor, in submitting the foregoing proposal, agrees to comply with all contract
specification documents.
I acknowledge receipt of Addenda No. (s)
(Cheek mark (,J) items below, at reminder that they are ineluded.)
[ have included the Bid Proposal bich entails: Bid Proposal Form ;;:~jX>Sed sample list of
items to be offered for sale J ' ; the Non-Collusion Affidavit.or ; the Lobbying and
Con1Iict Of+:: Clause i-.; and the Drug Free Workplace Form . In addition, I have
included a copy of Monroe County Occupational License ; Insurance Agents
Statement _; and all requirements as stated in Section One, Article 1.04 Paragraphs A
through D.
Print Name C, /1/2 '1' .If, L rctl r f rJ S it I" Title () (IV (V lA/l. / OrcJf..J ((J rc
I
Mailing Address: OU VA L s'f! Telephone: 3 ()~- )';.3 - 1117
liST j:'c };D D Fax: J....J-.17'1~ g,jty
Date: III) h9
/ I
Signed: 9 ,:UC~'" .' Witness:
\Do I 111 gJ"" vi. t~ ~ 21 <> {, Jl (Seal
XJAMJ;l'iy <; \vt!!IO ~ S<f>()(1)~' CfY
t i
30
NON-COLLUSION AFFIDAVIT
of the firm of
projeft 4c;scribed in the Notice fi r Calling for bids
}71 orr \0 0ClC~ 101 ('
and that I executed the said proposal with fuU authority to do so:
the prices in this bid have been arrived at independently without collusion,
consultation, communication or agreement for the purpose of restricting competition,
as to any matter relating to such prices with any other respondent or with any
competitor; ,
unless otherwise required by law, the prices which have been quoted in this bid have
not been knowingly disclosed by the respondent and will not knowingly be disclosed
by the respondent prior to bid opening, directly or indirectly, to any other respondent
or to any competitor, and
no attempt has been made or will be made b the respondent to induce any other
person, partnership or corporation to submit, or not to submit, a bid for the purpose of
restricting mpetition;
5.
15 contained in this affidavit are true and correct, and made with full
t Monroe County relies upon the truth of the statements contained in
~ awuding contracts fur said project. ~j
J) D cr
(Date)
COUNTY OF:
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by IDett{name O~iYidual))igning) affixed his/her
signature in the space p. "d above on this ~ day of dVt..tf.{. f( . 20~"
N
~y CommissIOn Expires:
1-i~iI
~~ OSCAR RODRIGUeZ
!.:iJ'.\ MY COMMISSION # DO 658646
~;.. :1 EXPIRES: June 24, 2011
"'IJ,iif.;r.l Bonded Thru NoIary POOIIc Undelwrtters
~
JUIVL
.II
To: Mr. Peter Horton
Key West International Airport
Re: Retail Concession Proposal
Kennedy Studios Seaport Gallery
Dear Mr. Horton,
Please consider the following as my primary proposal for concession space at the beautiful
new Key West International Airport. To be located in the secured departure lounge area and
utilize the natural traffic pattern of the airport. Two large exit doors exist to the "beach
area"creating a flowing space for a small" carry on" gallery. Space #126- 138 sq. ft. together
with space #127-167 sq. ft. combine to 305 sq. ft. would become semi-enclosed by attached
folding louvers and glass dividers, a very attractive shop-gallery would form.
Items available at this attractive little gallery would include: Canvas artwork, framed
artwork, sculpts, objects de art, prints, etched glass, furnishings, ceramics, shirts, hats, mugs,
licence plates, jewelry, furniture, RTW, art pens, art cards, memorabilia, tipicala of Key West
and other creative gifts.
Kennedy Studios Seaport Gallery has the experience to market to an extremely diverse
clientele, with a cross section of merchandise in broad priced spectrums. Tuning in on the most
effective areas while always striving to improve by introducing and marketing new products.
Space limitations are among the biggest challenges.
Kennedy Studios Seaport Gallery has been pleasing quality and valued conscious travelers
for many years. People return year after year to see what is new for their home, their collections
and for gifts.
Having Kennedy Studios Seaport Gallery or perhaps if you prefer Kennedy International
Artport as a whimsical "tie in" name, would make a marvelous uc essful addition for visitors
and travelers to Key West's International Airport.
nstein
Kennedy Studios Seaport Gallery
State of Florida
County of Monroe :J 'I
Signed before me on this day
of~, 20 iJ~ by IU' L I <./of fl:.f'JSrt.,,,,/
Notary Public
fI' ~ OSCAR RODRIGUEZ
!,.. ~~ MY COMMISSION # DO 65864Q
~" .~i EXPIRES: June 24, 2011
...'I.,iff.:~'(,.,. Bonded Thru Notary Public Undtrwrtltrt
2009 / 2010
MONROE COUNTY BUSINESS TAX RECEIPT
EXPIRES SEPTEMBER 30, 2010
RECEIPTII 48210-99056
Business Name: SEAPORT GALLERY
Owner Name: GARY LICHTENSTEIN
f'1ililing Address: 419 C DUVAL ST
KEY WEST, FL 33040
Business Location:
419 C DUVAL ST
KEY WEST, FL 33040
305-293-1119
RETAIL SALES (ART
GALLERY)
Business Phone:
Business Type:
Rooms
Seats
Employees
.1
Machines
Stalls
/
Number of 1V1achines :
T..lX Amounl Tr..lnsrer Fee
:130,00
For vending Business Only
Vending Type: M
Sub- folal Penally Pnor Years Collecllon Cost
$30,00 $3..00 '1>0,00
Tolal P..lld
~;33,OO
PAID-108-09-000D0088
10/29/2009 3J.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
fH1S BECCf'lES A TAX RECE1PT
',')HEfl VAUDi\TED
Danise D. Henriquez, CFC, Tax Collector
PO Box 1129, Key West, FL 33041
fH1S 15 OrJU A 1-,\;\, YOU r'1lJ':;T
l'lEET l\l_L CCUflTY MJD/OR
:,IUrJlClPALlTY PL'/IWIHIG MiD
;~OfJjfJCj FECUIREf'1FflTS,
.."'..n"'... rn""'TV uIIc;rI\JF<:;C;; T.6)( RFC':FTPT
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
warrants that he/it has not employed, retained
had act on hislits behalfany former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without . bility and may also, in its discretion,
,
i
deduct from the contract or purchase price, or othe . ecover, the full amount of any fee,
STATE OF -Ur.l oA
COUNTY OF ~
commission, percentage, gift, or consideration paid t e former County officer or employee.
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
CA (l., 'r
A.I-llH/<;.tlSTf,J/V
who, after first being sworn by me, affixed hislher
I ~}~ day of
signature (name of individual signing) in the space provided above on this
!ih~ btr<.. · 20 s4
My commission expires:
NOTARY PUBLIC
OSCAR RODRIGUEZ
MY COMMISSION # DO 658646
EXPIRES: June 24, 2011
Bonded ThI1J Notary Publlo UndelWliters
OMB - MCP FORM #4
32
AS
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 281.0811tereby certifies that
l-mvf ~TiJ D/<x., S {APocr (f" U( Cj
(Name of Business)
I. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or
use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against
employees for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a dmg-
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 tbe 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 o~ or plea of guilty or nolo contendere to, any violation of Chapter 893
(Florida Statutes) or of any controlled substance law oftbe United States or any state, for a violation occurring in the
workplace no Jater than five (5) days after such conviction.
5. 1m pose a sanction on, or require the satisfactory participation in g abuse assistance or rehabilitation program
if such is availabJe in the employee's community, or any employee is so convicted.
6. Make a good faith effort to continue to maintain a drug-free w ace through implementation of this section.
COUNTY OF
~<:"
As the person authorized to sign the statement, I certify that this compJies fully with the above requirements.
STAlE OF ~
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
C.4 fL,Y t I (1-1 l"f w ...frt. ,rI who, after first being sworn by me, (name of
individual signing) affixed hislher signature in the space provided above on this
13 day of
/Pylll
N() v.
,2oof.
My commission expires:
OSCAR RODRIGUEZ
. MY COMMISSION # DO 658646
~j EXPIRES: June 24, 2011
..' Booded Thru Notary PubIc Undelwrilllll
33
INSURANCE CHECKLIST
FOR
VENDORS SUBMI'ITING PROPOSALS
FOR WORK
To assist in the development of your proposal, the insurance coverage's marked with an "X" will
be required in the event an award is made to your firm. Please review this form with your
insurance agent and have himIher sign it in the place provided. It is also required that the
respondent sign the form and submit it with each proposal
WORKERS' COMPENSATION
AND
EMPLOYERS'LUW~TY
WCl
x
Workers' Compensation
Employers Liability
StStutory Limits
$100,0001$500,0001$100,000
GENERAL LUWILITY
As a minimum, the required general liability coverage will include:
. Premises Operations
. Blanket Contractual
. Expanded Definition
Of Property Damage
.
Products and Completed Operations
Personal Injury
.
Required Limits:
GLl
x
$100,000 per Person; $300.000 per Occurrence
$50,000 Property Damage
or
$300,000 Combined Single Limit
VEmCLE LIABD..ITY
As a minimum, coverage should extend to liability for:
Owned; Non-owned; and hired V chicles
27
Required Limits:
VLl
x
$50,000 per Person; $100,000 per Occurrence
$25,000 Property Damage
or
$100,000 Combined Single Limit
INSURANCE AGENTS STATEMENT
I have reviewed the above requirements with the respondent named below. The following
deductibles apply to the corresponding policy.
POUCY
Wor'r..e~ CoMf
6~rCA\ L'io.\o',\~
V u,^- r c.'\'<. L "b'. h +--1
Liability policies are / Occurrence
DEDUCTIBLES
01~
N \ (\
wl~
Claims
--........,-~
::L"~\~~d. ::CV\surOl.V\c..<. A.oeV\~
IDluraDee AgeDey \
RESPONDENTS STATE
I understand the insmance that will be mandatory if awarded
with all the requireme ts.
A
Signato, I ~
Do I \A.l{ ~v"\~G s<; b - k'.GV\V\'. <:rJcW\i)$
\ \~Q\'>(& ~vnC(1
28
* Bidders Note;
Kennedy Studios Seaport Gallery is bidding on (2) two side by side booths to create one
shop-gallery .
It is our belief that the space will be better utilized in this manner. The ability to be
successful and create a larger revenue stream will far greater.
Also, this will be very aesthetically pleasing to the eye due to the existing column
separation in that area..
Our original intent was to bid on what has now become the departure lounge gift shop but
it is no longer available to bid.
If in the event that it is unacceptable to bid on joined booths, please consider my offer for
space #127-167 sq. ft. at $36.00 per square foot total $6,012.00 plus 10 percentage. Totaling an
annual guaranteed rate of$12,012 will all other stipulation intact, or space #217 with the same
provisions.
Thank you for your consideration and looking forward to working with the Key West
International Airport.
ary Lichtenstein
Kennedy Studios Seaport Gallery
State of Florida
County of Monroe
Signed b~fore me on tbls l)"day
of~. 2007 by
NOI8ty~~/.'LtJn.'OTi'1 ,J
~. " 'M:It.. OSCAR RODRIGUEZ
I" :~ MY COMMISSION # DO 658646
S*:, : EXPIRES: June 24, 2011
~ , Bonded Thru Notary Public Underwriter.
Green Parrot Bar
601 Whitehead Street
Key West, FL 33040
(305) 294-6133
December 1,2009
Monroe County Board of County Commissioners
C/O Purchasing Department
Gato Building Room 1-213
1100 Simonton Street
Key West, FL 33040
To Whom It May Concern:
It is our pleasure to bid on the retail space at Key West International Airport, We
look forward to the opportunity to serve the airport and its patrons. Please find the
attached documents requested in good order. If there are any questions or concerns
regarding the contents of the bid documents, please contact us directly.
Thank you,
~\r
~agnOni,
Vice President/General Manager
Green Parrot, Inc.
Green Parrot Bar
60 I Whitehead Street
Key West, FL 33040
(305) 294-6133
Table of Contents
2. Business Plan
3. Item List
4. Bid Proposal form
5. Non-Collusion Affidavit
6. Ethics Clause
7. Drug Free Workplace Form
8. Insurance Checklist
9. County Business License
Green Parrot Bar
601 Whitehead Street
Key West, FL 33040
(305) 294-6133
Business Plan
The Green Parrot Bar has made its reputation in Key West by entertaining both
tourists and locals alike with the widest assortment of liye entertainment in town. Over
the last 35 years the Green Parrot has established itself as an original Key West brand
synonymous with the lifestyle and culture of the island.
Driven by demand, in 2002 the Green Parrot opened its stand alone retail outlet,
Parrotphenalia located at 609 Whitehead Street. The success of Parrotphenalia led to an
expansion into internet sales at greenparrot.com where guests can purchase souyenirs,
watch and listen to live webcasts, or plan their next trip to Key West around our
continuous stream of live entertainment and eyents.
Successful retail sales in both the Whitehead Street location and greenparrot.com
haye allowed us to explore other retail and marketing opportunities. We see the retail
space at the airport as a natural extension of a successful retail mix that fits in with the
entire Key West experience. The products that we will offer are more diverse than the
typical souvenir shop that one would come across in other major airports. We achieye
this eclectic product mix by sourcing merchandise primarily from local vendors to insure
a one-of-a-kind shopping experience. We intend to sell apparel, books, music, artwork,
and other miscellaneous items (all conforming to airport regulations).
To compliment our product selection, we bring a competent and experienced staff
and management. Helene Shanley has been our retail manager since our venture into
retail began in 2002. She manages a staff that is personable, professional, and has a
thorough knowledge of our products.
We believe that airport patrons represent a market uniquely suited to the product
mix that we will offer. Specifically, the post security area will place guests in a position
to shop. We will offer a last chance to our precious guests to pick up an item or two to
help remember their time spent on our island. Our retail space will provide airport
patrons a storefront that will capture what we belieye to be the best that Key West has to
offer.
Green Parrot Bar
601 Whitehead Street
Key West, FL 33040
(305) 294-6133
Proposed Item List:
T-Shirts
Tank Tops
Ladies Shirts
Children's Wear
Artwork
Jewelry
Glassware (subject to tsa approval)
Books
Bumper Stickers
Golf Balls
Dog Collars
Key Chains
Magnets
Coasters
Hats
Visors
Book Marks
BID PROPOSAL FORM
TO:MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
C/O PURCHASING DEPARTMENT
GATO BUILDING ROOM 1-213
1100 SIMONTON STREET
KEY WEST, FLORIDA 33040
Gre~ mrD::~~J
!iZ' Uh~ .
Y L 0
FROM:
Bid Price for Airport Concession space 116 ' I J..1 will be paid to Monroe County at the
following rate: $~5" .n per sq. ft. (minimum $35.89) plus iJL percentage of Gross Taxable
Sales. Minimum annual guaranteed rent and percentage of sales shall be $12. J 9'16' "S::
The undersigned, having carefully examined the work, spe9ifications, proposal, and addenda
thereto and other Contract Documents for the services of:
AIRPORT CONCESSION AT KEY WEST INTERNATIONAL AIRPORT
The Contractor, in submitting the foregoing proposal, agrees to comply with all contract
specification documents.
I acknowledge receipt of Addenda No. (s) I W\ d J...
(Check mark t-V) items below, as a reminder that they are included.)
I have included the Bid Proposal which entails: Bid Proposal Form with proposed sample list of
items to be offered for sale/,_'/ ; the Non.Collusion Affidayit -1L...; the Lobbying and
Conflict of Interest Clause~; and the Drug Free Workplace Form ./'. In addition, I haye
included a curr~nt copy of Monroe County Occupational License ~; Insurance Agents
Statement ~; and all requirements as stated in Section One, Article 1.04 Paragraphs A
through D.
Title V\~ P\<1.I~~
TelephoneWDSJ 2.14:1JIJ
Fax(J OS-) )...94 -((( t 2.
Date:/#~.. ~
Witness:' ~
(Seal)
f
PrmtName ~~/It
Mailing Address: h' J"J .st.
J~1' W(~+ J ~L 110L{O
-e~
'-I
'^ Signed:
30
NON-COLLUSION AFFIDAVIT
I, io~1' V~12{\" of the city of ~ We"':!:) ~L
according to law n my oat~ and under penalty of perjury, epose and say that:
~O~V' \l~m()l\;
(Dfeell Pc..{fO~ L,Pri>OrJCLJ
,
1.
Jam
of the firm of
the Notice for <;a~~g for bids
and that I executed the said proposal with full authority to do so:
the prices in this bid have been arrived at independently without collusion,
consultation, communication or agreement for the purpose of restricting competition,
as to any matter relating to such prices with any other respondent or with any
competitor; ,
unless otherwise required by law, the prices which have been quoted in this bid have
not been knowingly disclosed by the respondent and will not knowingly be disclosed
by the respondent prior to bid opening, directly or indirectly, to any other respondent
or to any competitor; and
no attempt haS been made or will be made b the respondent 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 affid vit in awarding contracts for said project.
/~Date)
STATE OF:
o espondent)
(lool
;VI 011/0-<..
COUNTY OF:
I
PERSONALL Y APPEARED BEFORE ME, the undersigned authority, J{;'A 1"1 1/ q 9,..p (v J
who, after first being sworn by me, (name of individual signing) affixed his/her
signature in the space provided ab,!ve on this /s f day of ])eCe"r"\.b<f . 2009 .
tZ:7?/~ ..cf
NOTARY PUBLIC 0
~' CHRIS'rIAN M, lU~LeH
~'t~' ..,~~'" MY COMMISSION #DD498231
( ) EXPIRES: DEe 30, 2009
@ "'""" ""'g' '" SW, I~".~'
My Commission Expires:
1;)/50/09
,
31
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETIDCS CLAUSE
~ () ~ 1\ ~..litf' 0 II 'I
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, 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 or employee.
~
(signature)
I1fJOI
~l~j ~~
MOld O~
STATE OF
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
To It ('oJ V c, S "V~:) (V ,.
~
who, after first being sworn by me, affixed his/her
signature (name of indiyidual signing) in the space provided above on this /5 t day of
----.Del C M bt>1'
, 20..Q!L.
/i6r~/J:;J
y
NOTARY PUBLIC
, CHRISTIAN M, MkCH
~~t MY COMMISSION #00498231
, , EXPIRES: DEC 30, 2009
~o.~ Bonded through 1 sl State Insurance
My commission expires:
/ )/Jflj;~I~ r
OMB - Mep FORM #4
32
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
(,reM Pc.rrof1A III 'f,...JJ
(Name of Business) -
1. Publish a statement notitying employees that the unlawful manufacture, distribution, dispensing, possession, or
use of a controlled substance is prohibited in the workplace and specifying tbe actions that will be taken against
employees for violations ofsucb 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, 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.
STATE OF
(fir, ~
/IIM/fJ~
1
s~?)~spondent)
/ te
COUNTY OF
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
Jo h,.., II (1 C rll P r'I/ ,. who, after first being sworn by me, (name of
individual signing) a'il:b::ed hislher signature in the space provided above on this
/5+ day of "iXceMb('R
~~{~-=,fl/e
NOTARY PUBLIC/
,200.!.
My commission expires:
33
11130/2029 MON 12: 15 FAX 30.5 743 0562_k_=x~..ins_~,rance
HOV-30-2009 MOH 12:47 PM PRIBRAMSKY & ZUELCH
FAX NO. 3052941872
INSlYRANCm CHlCClCLTST
POll
VJ';NDORS SUBMTI'1'ING PROPOSALS
FOR WORK
To 3.~sist in the dcvolopluont of your propo~1. the IDsl1r8neC coverage's marked with an ~X" win
be 1'C'ql1ircd in tho event atl award is nJadc to your fil'm. Plous~ reviow (his form with your
Insu!'t\lIco agent and have l1Jmlhcr 1l1gn it in the place provided. It is also fC(lulrod loot the
respoodonl sign the f'Orm and submit it witb each proposal.
WORKERS' COMPENSATION
AND
EMPLOYER.S. LlABlLlTV
we)
Work<<s' Compr.msaUoll
Employers Linbl1ity
Statutory LImits
$100.0001$500,000/$100,000
_2L-
GENERAl, LlABll..1TV
A.. n min'i1nUI)\I the required gcnert\lliabilily CQVCl11gc will include:
. Premi:les Opem.tions
. nl~nkct Cotll1'Oc1ual
. )],}.-p.pnded Daruution
Of Properly Damflgl'S
'Products and Completed Operations
PcraoJ.'lallnjury
.
.
Required Limils:
OLI
$100,000 per Person; $300.000 per OccurrElDCC
$SOIOOO Property Damage
or
$300.000 C.ombfncd Single Limit
_'Y.._
VEII1CL~ LJAUJl.1TY
As a minimLllJ1. covclagt,; should CxlCIlll to lia.bility for:
Owned; Non-owtled~ and hired Vehicles
27
1lI002/003
P, 02
!ill003/003
KON 12: 15 FAX 305 743 ~582 keys in5ur~n~e_u___ 'u,__....---
11.130/2009
FAX NO. 3052941872
P, 03
NOV-30-2009 MON 12:48 PM PRIBRAMSKY & ZUELCH
R e''luircd Limits:
VI.1
$50,000 pot Person; $100,000 pf'of OCC1.UTeace
$25,000 l'roperty Thunago
or
~100.000 Combined Singlo Limit
_x~
iNSURANCE AGENTS STATEMF.Nr
r have rcvl.cwt:.'d tho above requiremenls with tbo respondont tlMlOO below. The following
d\ldnctiblcs apply to the corresponding policy.
l'OLleY
(0 \- ~c;!!Q~LJ2Q~~ ':)Ql_
\N~ ~j1~'6 L~~__
Y.J.Q.-..~_J...O~~<a~
DEDUCTmLES
~\ COO
~ .\
.
..,--
,-
Liahility J)olioic$ a.cc _L Occnrr~ncC:l ~'.~'_ Claim$ Mado
L-~
~l(gy.s.1ns~ra1J~. Serv.ic{s, Inc.
IUl'.rv.c_l5f)0280
Marathon, FL 33050
RES.PONJ)ll:~rs S'f A TEMENT
I llfuJcrSIMtl tho itlSUlaUCe j]~t will be nlMdat.ory ifawarrlcd the COIltract and will comply in 1i.lll
wilh aU tho requirements.
_~~_~~Uvt\ ~_._
UO:lpondcnt
(j~
Signnture
2S
2009 I 2010
MONROE COUNTY BUSINESS TAX RECEIPT
EXPIRES SEPTEMBER 30, 2010
RECEIPT# 40110-78237
Business Name: GREEN PARROT BAR
Owner Name: BEAN JAMES PRES
Mailing Address:601 WHITEHEAD ST
KEY WEST, Fl33040
Business location: 601 WHITEHEAD ST
KEY WEST, FL 33040
Business Phone: 305-294-6133
Business Type: MISCElLANEOUS BUSINESS
(MISC ENTERTAINMENT)
Rooms
Seats
Employees
Machines
f
Stalls
.. -,-,.-
Tax Amount
j225.Q9
-~_.' -
jTransfer Fee
i
I
_ For Vending Buslne~sOnly
Vendin T e:
iSub- Total Prior Years Collection Cost
$225.00 $0.00
Number of Machin s :
PAID-103-09-000001b2
Effective: 10/30/2009 Posted: 11/05/2009 247.50
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT Danise D. Henriquez, CFC, Tax Collector THIS IS ONLY A TAX, YOU MUST
WHEN VAUDATED PO Box 1129, Key West, FL 33041 MEET AU. COUNTY AND/OR
MUNICIPAUTY PLANNING AND
ZONING REQUIREMENTS.
~. -'.:->-,-00,''''""7:'" -"-'-:-~':'-O-'~-~-'="--:-'--';O7-""-'''~~:-;:=,:,. :-:,:'-' ,-:-=-:'~";~~..."..,.""'='~~-,- ..;-,,_..-.~_.-._-.__....-_._-~~~"~- :-..:. --..--;:--_-=----=-:-:.-_:':"'"""""'=':__::;:,:....~;~~', -~.._-~..r..,.::::'-, '_,.oJ _ __," ~.- .
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