07/11/2023 SHIP Contractor Agreement MONROE COUNTY STATE HOUSING INITIATIVES PARTNERSHIP PROGRAM
(SHIP) INDEPENDENT CONTRACTOR AGREEMENT
Gregory Splichal — 1225 Ashby Street, Key West, FL 33040, Job#: 04-0532-22 SHIP
Rehabilitation. This Independent Contractor Agreement is made this 113day of July, 2023,
by and between Monroe County, a political subdivision of tile State of Florida, (hereafter
"County") and Keys Home and Investments Inc. (hereinafter referred to as the
"Contractor"), for services described in the Contractor's Bid.Proposal/Job#: 04-0532-22, this
Independent Contractor Agreement, the Work Write-Up/Scope of Work, the Award of Bid, and
the Notice to Proceed, attached hereto and made a part hereof. The parties agree as follows:
I RelationsljjLi. Nothing contained in this Agreement shall be deemed or construed as creating
any other business relationship, partnership or joint venture between Contractor and Monroe
County Board of County Commissioners/Monroe County and/or the Monroe County State
Housing Initiatives Partnership (SHIP) Program (hereinafter referred to as the "County").
1 Services to be Performed, The Conti-actor shall provide a proposal containing the services
listed in the l3idProposaUJob#: 06-9715-22 including pricing, to the County, The bid proposal
shall be reviewed by the County's SHIP coordinator and be in accordance with the Pre-Work
Order Agreement, the SHIP, Local Housing Assistance Plan (L"AP), and the SHIP Program
Overview and Procedures Manual. All SHIP Program measures to be provided to Homes governed
by this Agreement must also be in accordance with the Work Write-Up/Scope of Work,
3. Manner of Performance; Warranties and Representations. Contractor shall do, perform, and
L ----p_
carry out in professional and proper manner the services described in the proposal and Work
Write-Up/Scope of Work. Contractor shall properly supervise and direct completion of
rehabilitation measures on all units assigned under this agreement. Contractor shall be solely
responsible for coordinating all work conducted under the Agreement. Contractor shall
provide and pay for all labor, materials, equipment, tools, equipment/machinery,
transportation, and services necessary for the proper completion of work. Cotitractor shall
comply with all laws, ordinances, rules, regulations, and orders of ally governmental
authority bearing on the performance of the work, including adhering to all local building
codes, and obtaining and paying for permits. Contractor shall be responsible for the acts and
omissions of employees and subcontractors. Contractor, at all times, shall keep the premises
free from aCCUmulatiou of waste materials or rubbish caused by the operation. At completion,
Contractor shall remove all waste and surplus materials and rubbish from and about the
premises, and if applicable, shall clean all glass surfaces and shall leave the work "broom
clean."
Contractor warrants that it is authorized by law to engage in the performance of the activities
herein described, subject to the terms and conditions set forth in these Agreement documents.
The Contractor shall, at all times, exercise independent, professional judgment and shall
assume professional responsibility for the services to be provided. Contractor shall provide
services using the following standards, as a minimum requirement:
A. The Contractor shall maintain adequate staffing levels to provide the services required
tinder this Agreement.
B. To the extent that Contractor uses employees, Subcontractors or independent
contractors, this Agreement specifically requires that the employees, subcontractors and
C. independent contractors shall not be an employee of or have any contractual
relationship with County.
D. All personnel engaged in performing services under this Agreement shall be Fully
qualified, and, if required, to be authorized or permitted Linder State and local law to
perform such services.
E. The Contractor shall maintain all necessary licenses, permits or other authorizations
necessary to act as a Contractor.
4. Confidentiality. Contractor agrees to keep confidential all client information provided to
Contractor and/or Contractor's employees by the County, except such information as is
already known to the public, and not to release, use, disclose same, directly, or indirectly, to
any other person or business,, except with prior written permission of County.
5. Non-Exclusive Relationship. Neither Contractor nor County has an exclusive relationship
with the other. Contractor is free to perform the above-described services, for any other person
or business, so long as this does, not interfere with Contractor's satisfactory and timely
performance of services for COLInty under this agreement.
6. Subcontracts. Contractor shall not enter into any subcontract with any subcontractor who has
been debarred from performing work by any Agency of the United States Government or by
the State of F'Iorida. Conti-actor shall be fully responsible for the acts or omissions of
Subcontractors, and of persons either directly or indirectly employed by them. At no time
shall any contract or agreement between Contractor and a subcontractor be construed as a
relationship, formal or informal, between the subcontractor and County.
7, Contractor's Guarantee, Contractor guarantees all work performed for a period of one (1) year
from the date of final acceptance of all work required by the bid proposal and Work Write-Up/Scope
of Work. Contractor warrants to the owner and County that all materials and equipment used in the
work will be new and free of defects, unless otherwise specified, and approved in advance by an
authorized representative of County. All manufacturers' and suppliers' written guarantees and
warranties covering such materials and equipment shall be furnished to the owner or SHIP prQj'ect
household. Contractor agrees to correct any defects due to faulty workmanship, materials or
equipment and shall pay for or repair any damage to other work resulting there from for a period of
one year from the date of final acceptance of the permitted work.
S. Commencement of Work. Contractor warrants good title to all materials, supplies and equiptrient
incorporated in the work and warrants that it is free froin any claims, liens, or charges, and that
Contractor nor any other person, firm, or corporation, shall have any right to put a lien upon the
premises or materials, supplies or equipment. Contractor must contact the homeowner within five
(5) days of receiving a Notice to Proceed and must complete all work within 180 days of receiving
2
said Notice, Contractor shall contact the SHIP Project Manager upon notice of the event giving
rise to the need for additional days beyond 180. Additional days, may be granted upon mutual
written agreement between Contractor and County via a change order,
9. Protection of Work and Property. Contractor shall be responsible for initiating, maintaining, and
supervising all safety precautions and programs, in connection with the work and complying with
all applicable laws, ordinances, rules, regulations, Contractor shall take all reasonable precautions
for the safety of, and shall provide all reasonable protection to prevent damage, injury,, or loss to
(1) all employees on the work site and other affected persons, (2) all work and materials and
equipment at the site, and (3) other property at the site. Any damage or loss to any property caused
in whole or in part by Contractor, Subcontractor, or employees, shall be remedied by Contractor
and County shall be held harmless,
10. Change: O,rders/Waivers. Any change orders must be approved in writing by the homeowner,
occupant if applicable, Contractor, and SHIP Project Manager with review and sign off by the
SHIP Program Director, prior to the commencement of such work. Any change order or work
waiver commenced prior to authorization shall be considered unauthorized work and will not be
reimbursed by County. If final invoice from Contractor exceeds the Proposal amount, and no
change order was approved, the invoice will be approved for only the amount quoted in the
Proposal.
I I. Compensation. Upon issue of permit, Contractor, at their discretion,can submit invoice for twenty-
five percent (25%) of approved price as stated in the accepted bid proposal and confirmed in the
Award of Bid and Notice to Proceed. This initial invoice will be deemed a progress payment. A
copy of the issued permit and any material receipt(s) must accompany invoice. Contractor, at
their discretion, can submit invoice for fifty percent (50%) of contract price upon delivery of all
required job materials to jiob site. Verification of material delivery, good condition of materials,
and assurance that all materials are secured at job site will be determined and documented by the
County's SHIP Project Manager. Upon completion of the work, Contractor shall submit final
invoice for twenty-five percent (25%) of approved price as stated in the accepted bid proposal and
confirmed in the Award of Bid and Notice to Proceed. Any increases to the original bid proposal
must be submitted in writing via a change order and require advanced approval by the SHIP Project
Manager and SHIP Program Director, The SHIP Project Manager, Contractor, and Owner shall
inspect, and approve in writing, the work prior to final completion. A final closed permit will be
required with final invoice. The Contractor shall deliver to the Owner a complete release of all
claims for labor and material arising out of this Agreement and a final closed permit will be
required with final invoice.
Contractor invoices will be processed for reimbursement upon verification that all conditions
under the agreement have been inet. Payments will be made according to the Florida Local
Government Prompt Payment Act, Sections 218.70-218.8C1, Florida Statutes. Contractor shall
submit to the County an invoice with supporting documentation in a form acceptable to the Clerk.
Acceptability of the invoice 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
3
sent to the County's Social Services Department who will review the documents and route them
to appropriate County Staff for approval. Upon receiving all required approvals, the invoice(s)
will be forwarded to the County Clerk's office for payment. After the prime contractor has
received payment, they must release payment to their subcontractors and suppliers within 30 days
of either when payments became due after furnishing labor or materials, or after the request for
paynient was received; whichever is later.
12. Indemnification. Contractor agrees to be solely responsible, and shall hold harmless the County,
its officers, directors, and ernployees, for any and all claims brought against either Contractor or
County, or for liabilities incurred by County as a result of actions or omissions by the Contractor,
whether under Workers' Compensation laws, or under any other federal, state, or municipal laws,
rules or regulations which may be applicable, or any other set of circumstances not specifically
addressed herein.
13. Insurance. The Contractor shall obtain insurance as specified and maintain the required insurance
at all times that this Agreement is in effect. 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 frorri any and all
increased expenses resulting from such delay.
The coverage provided herein shall be provided by an insurer with all A.M. Best rating of VI or
better, that is licensed to do, business in the State of Florida and that has an agent for service of
process within the State of Florida. The coverage shall contain an endorsement providing sixty
(60) days' notice to the County prior to any cancellation of said coverage. Said coverage shall be
written by an insurer acceptable to the County and shall be in a form acceptable to the County.
Contractor shall obtain and maintain the following policies:
A. Workers' Compensation insurance as required by the State of Florida, sufficient to respond
to Florida Statute 440�.
B. General Liability Insurance with limits of$300,000 combined single limit
C. Con-ipreherisive Business Automobile and Vehicle Liability Insurance covering claims for
injuries to members of the public and/ or damages to property of others arising from use of
motor vehicles, including onsite and offsite operations, and owned, hired or tion-owned
vehicles, with $200,000 per person, $300,000 per Occurrence, $ 200,000 Property Daniage
or $300,000 cornbined single limit.
D. Commercial General Liability Insurance, including Personal Injury Liability, covering
claims for injuries to members of the public or damage to property of others arising out of
any covered act or onlission of the Contractor or any of its employees, agents or
subcontractors or subcontractors, including Premises and/ or Operations, Products and
Completed Operations, Independent Contractors; Broad Form Property Damage and a
Blanket Conti-actual Liability Endorsement with limits of$300,000 combined single limit.
E. County shall be named as an additional insured with respect to Contractor's liabilities
hereunder in insurance coverages identified in Paragraphs Cand D.
F. Contractor shall require its subcontractors to be adequately insured at least to the limits
prescribed above, and to any increased limits of Contractor if so required by County during
the term of this Agreement, County will not pay for increased limits of insurance for
subcontractors.
4
U Contractor shall provide to the County certificates of insurance or a copy of all insurance
policies including those naming the: County as an additional insured. The County reserves
the right to require a certified copy of such policies upon request.
1-1� If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be
required. In addition, the Contractor may be required to submit updated financial
statements from the ftitid upon request from the County.
14. Nondiscrimination. 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 party, 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 discriminatioll
in employment on the basis of race, color, religion, sex or national origin; 2) Title IX of
the 1--ducation Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-168,6),
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
disability; 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 (('L 92-255), as amended, relating to nondiscrimination on the basis
of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention,
on,
Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relatitiv, to
nondiscrimination on the basis of alcohol abuse or alcoholism; 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 11, which prohibits diserlinination on the basis of race, color, sex, religion,
national origin, ancestry, sexual orientation, gender identity or expression, familial status
or age; and I I) Any other nondiscrimination provisions in any Federal or state statutes
which may apply to the parties to, or the subject matter of, this Agreement.
15, Florida Public Records Law (Florida Statute 119.0701). 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 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 tinder its control subject to the
provisions of Chapter 119, Florida Statutes, and made or received by the County and
Contractor in conjunction with this Agreement and related to Agreement performance, The
County shall have the right to unilaterally cancel this Agreement upon violation of this
provision by the Contractor. failure of the Conti-actor to abide by the terms of this provision
shall be deemed a material breach of this Agreement and the County may enforce the terms
of this provision in the form of a court proceeding and shall, as a prevailing party, be
5
entitled to reimbursement of all attorney's fees and costs associated with that proceeding.
This provision shall survive any termination or expiration of the Agreement.
The Contractor is encouraged to Consult with its advisors about Florida Public Records
Law in order to comply with this provision.
Contractor shall maintain all books, records, and documents directly pertinent to performance
under this Agreement in accordance with generally accepted accounting principles consistently
applied. Each party to this Agreement and their authorized representatives shall have reasonable
and timely access to such records of each other party to this Agreement for public records and
auditing purposes during the term of the Agreement and for five(5)years following the termination
of this Agreeirient. If an auditor eiriployed by the County or Clerk determines that monies paid to
Contractor pursuant to this Agreement were spent for purposes not authorized by this Agreement,
the Contractor shall repay the monies together with interested calculated pursuant to Section 55,03
the Florida Statutes, running from the date the monies were paid to Contractor.
Pursuant to F.S. 119,070 1, Contractor and its subcontractors shall comply with all public records
laws of the State of Florida, including but not limited to:
a. Keep and maintain public records required by Monroe County in order to perform the service.
b. Upon request from the public agency's Custodian of public records, provide the public agency
with a copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in Florida Statutes, Chapter 119
or as otherwise provided by law,
c. Ensure that public records that are exempt or confidential and exempt from public records
dISCIOSUre requirenients are not disclosed except as authorized by law for the duration of the
Agreement term and following completion of the Agreement if the contractor does not transfer the
records to the public agency.
d. Upon completion of the Agreement, transfer, at no cost, to Monroe County all public records
in possession of the contractor or keep and maintain public records required by the public agency
to perform the set-vice. If the contractor transfers all public records to the public agency upon
completion of the Agreement, 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 Agreement, the contractor shall meet
all applicable requirements for retaining public records. All records stored electronically triust be
provided to Monroe County, upon request from the public agency's custodian of records, in a
format that is compatible with the information technology systems of Monroe County.
If the contractor does not comply with the County's request for records, the County shall enforce
the public records Agreement provisions in accordance with the Agreement notwithstanding the
County's option and right to unilaterally cancel this Agreement upon violation of this provision
by the Contractor. A Contractor who fails to provide the public records to the County or pursuant
6
to a valid public records request within a reasonable time may be subject to penalties under Section
11 9.10, Florida Statutes,
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 AGREEMENT, CONTACT THE
CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY, AT (30�5) 292-3470"bradim -
briaw"a inonroecumirk 41jp,�, C/o Monroe County Attorney's Office, 1111 12111 St., Suite 408,
Key West FL 33040.
16. Disagreements and Ibis u�tcs. In the event that either Contractor or County commence all action
for damages, i11jUDCt1ve relief, or to enforce the provisions of this agreement, and either party
prevails in any such action, the prevailing party shall be entitled to an award of its reasonable
attorneys' fees and all costs incurred in connection therewith as determined by the court in any
such action,
17. Governing-Law, This Agreement shall be governed by and construed in accordance with the
laws of the State of Florida applicable to Agreements made and to be performed entirely III
the State. In the event that any cause of action or administrative proceeding is instituted for-
the enforcement or interpretation of this Agreement, C01.111ty and Contractor agree that venue
shall lie in the 16"' Judicial Circuit, Monroe County, Florida.
18� Assignment. This agreement may not be assigned without prior written consent of both parties.
This agreement will be binding upon, and will inure to the benefit of, each party's permitted
successors and assigns,
19. Severabilit . The parties agree that the covenants of this agreement are severable and that if any
single clause or clauses shall be found unenforceable, the entire agreement shall not fail but shall
be construed and enforced without any severed clauses in accordance with the terms, of this
agreement.
20. Duration and Termination. If the SHIP Project Manager finds the materials furnished, work
performed, or the finished product are not in reasonably close conformity with the plans and
specifications and have resulted in an unacceptable finished product, the affected work or
materials shall be removed and replaced or otherwise corrected by and at the expense of
the Contractor in accordance with the SHIP Project Manager 's written orders. If Contractor
defaults or neglects to carry Out any work in accordance with this agreement or fails to perforril or
comply with any provision of this agreement, the County may, after written notice to Contractor,
make good such deficiencies and may deduct the cost incurred from the payment due to Contractor
and/or County may terminate the contractor's services and take possession of the site and of all
materials, equipment, tools and construction equipment,, and machinery owned by Contractor,
which were purchased with SHIP program funds, and may finish the work. If the expense of
finishing the work exceeds the unpaid balance to Contractor, Contractor shall be liable for payment
of the difference to County. Contractor and County can terminate the services contemplated this
agreement at any time for any reason upon 7 calendar day notice to either party. Contractor shall
7
be required to satisfactorily finish all work in progress prior to termination of the services. Failure
to do so by Contractor shall result in forfeiture of payment for any work in progress,
21. Notices. Any notice required or permitted under this agreement shall be in writing and hand-
delivered or mailed, postage prepaid, to the other party by certified mail, returned receipt
requested, to the following:
To the County: Roman Gastesi, Monroe County
Administrator
1100 Simonton Street, Room 2-205
Key West, Florida 33040
And: Monroe County Attorney's Office
I I 11 12"' Street, Suite 408
Key West, Florida 33040
And: Monroe County Social Services
1100 Sirnonton Street, Room 1-190
Key West, Florida 33040
For the Contractor: Keys Horne and Investments LLC
1107 Keys Plaza - Mailbox #289
Key West, FL 33040
22. Examination and Retention of Contractor's Records, Contractor shall retain records relating to this
Agreement for four years after final payment is made this agreement. If an audit, litigation, or other
action involving the records is started before the end of the four-year period, records must be
retained until all issues arising out of the action are resolved, or until the end of the four-year period,
whichever is later. County, or any of its authorized representatives, shall have access to Contractor
records.
23. Headings. The headings contained in this agreement are for ref��rence purposes only and shall not
- - y
affect the meaning or interpretation of this agreement,
24.Agreement DOCUMentS. This agreement consists of this Independent Contractor Agreement
(ICA), the Work Write-Up/Scope of Work, the bid proposal from the Contractor, the Award
of Bid, and Notice to Proceed. In the event of a conflict in terms between the ICA, Work
Write-Up/Scope of Work, and the bid proposal, the terms of this Agreement shall prevail.
25. Miscellaneous.
a. Force Majeure. Due performance of any duty or obligation hereunder by either party shall be
excused if prevented by acts of God, information providers or other service providers, public
enemy, war, terrorism, any accident, explosion, fire, storm, earthquake, flood, strike, computer
outage or virus, telecommunications failure, or any other circurnstance beyond that party's
reasonable control.
8
b. Waiver or Consent. Any failure by either of the Parties to comply with any obligation,
covenant, condition, or agreement contained herein may be waived in writing by the party
entitled to the benefits thereof, but such waiver or failure to insist on strict compliance with
such obligation, covenant, condition, or agreement shall not operate as a waiver of or estoppel
with respect to any subsequent or other failure. To be effective, any consent must be in writing
and signed by an authorized representative of that party.
c. Independent Pat-ties. Nothing in this Agreement shall be construed as creating a partnership,
joint venture, fiduciary, or agency relationship between the parties, or as authorizing either
party to act as an agent for the other. The parties to this Agreement are independent parties.
26. Attestations. Contractor agrees to execute such documents as the County ri-iay reasonably require,
including, but not being limited to, a Public Entity Crime Statement, all Ethics Statement and a
Vendor Certification Regarding Scrutinized Companies.
27. E-Verity. Beginning January 1, 2021, in accordance with F.S. 448.0951, 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 erliployees hired by tile
Contractor during the term of the Agreement and shall expressly require any subcontractors
performing work or providing services pursuant to the Agreement to likewise utilize the U.S.
Department of I lorneland Security's E-Verify system to verify the work authorization status of
all new employees hired by the subcontractor during the Agreement 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 F.S. 448.095.
"THE REST OF THIS PAGE WAS LEFT' INTENTIONALLY LEFT BLANK**
9
IN WITNESS WHEROF, County and Contractor have executed this Independent Contractor
Agreement as of the date first written above.
COOT CTO,R: Ike s 11ome and Investments Inc.
By:
'mature
m�
print Name & Title
STATE OF FLORIDA
COUNTY OF MONROE
Subscribed and sworn to (or• affirmed) before�01nee, by means of physical presence or 0 online
notarization, on (Date) by (Name) I V..
c herrh is (are) pe "°onally known to me or has/have produce.
N " . (Type of Identification)as identification.
a� ."a+,�f
Mal
TAR PUBLIC My
M �x rY�'V4 01 ,r iti7,�",^-�b{ 103597
'rt't,
M'(. NROE COO TY:
i
By: Sheryl L Graham
Monroe County SHIP Program Administrator
STATE OF FLORIDA
COUNTY CP MONRO
Subscribed and sworn to (or of tuned) before me, by means of In physical presence or 0 online
notarization, on 1 (Date) by SI BERYL L. GRAI-IAM.
he is (are) ersonall known to me or has/ham produced.
Type of Identification) as identification.
NOTAR PUBLIC � � e oa ri �1a
NEE
:H 103597
5
LEGAL:
10
�IGEICID Tel: 1-800-841-300�O Declarations Page
geico.com This is a descripttior of your coverage.
GEICO General Insurance Company Please retain for your records.
One GEICO, Center Policy Number: 4257-11-96-87
Macon, GA 31295-0001 Coverage Period:
O8-03-23 through 02-03-24
12:01 a.m.localfirne at the address of the named insured.
Date Issued; June 17, 2023
APPROVED BY RISK MANAGEMENT
DON CHRISTOPHER MILLER BY
291 GOLF CLUB DR DATE 8,3-2023
KEY WEST FL 33040-7941 WAIVER NIA YES
Email Address: DMIILLER@IHBFL.COM
Nlamed Insured Additional Drivers
Don Christopher Miller None
Vehicles VIN Vehicle Location Finance Company/
Lienholdler
1 2006 Ford F-250 1 FTSX21526ECO2067 KEY WEST FL 33040-7941
2 2022 GMC Sierra 1GT49PEYXNF107866 KEY WEST FL 33040-7941
Coverages* Limits and/or Deductibles Vehicle 1 Vehicle 2
Bodily Injury Liability
Each Person/Each Occurrence $250,000/$500,000 $574.20 $534-50
Property Damage Liability $100,000 $100.70 $86,10
Personal Injury Protection Non-Dedklnsd&ReI $52.70 $57.60
Uninsured Motorist/Stacked
Each Person/Each Occurrence $250,000/$500,000 $857.10 $728.60
Comprehensive (Excluding Collision) $250 Ded - $578.60
... ..... ......
Collision $500 Ded - $237.00
Emergency Road Service ERS FULL - $3.00
Rental Reimbursement $50 Per IDay
$1,500 Max - $11&90
Mechanical Breakdown $250 Ded - $31 50
Six Month Premium Per Vehicle $1,584,.,70 $2,275.80
Total Six Month Premium, $3,860.50
T-4 Continued on Back
DEC-PAGE(06-16) (Page 1 of 4) Renewal Page 7 of 11
*Coverage applies where a premium or$0.00 is shown for a vehicle.
If you elect to pay your premium in installments, you maybe subject to an additional fee for each installment. The fee
amount will be shown on your billing statements and is subject to change.
Discounts
The total value of your discounts is $949.90
Seatbelt(All Vehicies) ..................... ... .................................... .......$15.70
Passive Restraint/Air Bag (All Vehicles) ................ .....$59.50
Multi-Car(All Vehicles) .................... .. ................. ...................................................... ............................$204.50
5 Year Good Driving (All Vehicles) ............. ......... ................................. ..............,................ ..................$525.00
Anti-Lock Brakes (All Vehicles) ................... .................... ......... .................... ......... .............. ..... .........$81.70
Anti-Theft Device(Veh 2) .... ........... ............................................................... .$63.50
Contract Type: A30FL, FAMILY AUTO INSURANCE POLICY
Contract Amendments; ALL VEHICLES -A3OFL(05-22) SIGPGCW(07-20)
The following forms for your policy are available to review online at geico.com/express:
Form Name Form Number(Revision Gate)
Fee Schedule Endorsement M608 (03-21)
Coverage Descriptions U337FL (03-18)
Notice of Change M700FL (09-22)
Family Auto Policy Contract A30FL (05-22)
You may view, save and print the forms listed above on our website. You will not receive a paper copy of the forms unless
you request that we mail you a paper copy of any of the forms listed above at no cost by calling us at 1-800-841-3000,
Countersigned by Authorized Representative
Important Policy Information
- If you have any questions about this policy, about the insurance services we offer, or if you need assistance resolving
a complaint please contact GEICO at 1-800-841-3000. We can assist you with your personal insurance needs.
- Please review the front and/or back of this page for your coverage and discount information.
- 'Subject to the policy carrying Comprehensive and/or Collision Coverage, if a non-owned auto, in operation while
leased or rented for a fee, has a Manufacturer Suggested' Retail Price above $100,000, the limits of liability for fuss
to the non-owned auto is the highest of the actual cash value of any owned auto shown on the Declarations
page,
Continued on Next Wage
DEC—PAGE(06-16) (Page 2 of 4) Renewal Page 8 of 11
DATE(11AMIDOffYYY)
CERTIFICATE OF LIABILITY INSURANCE 07/31/2023
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 INSUIRER(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 SUIBROG,ATIION 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 eindorsement(s).
PRODUCER NACONTMEACT Todd George
_
Bouchard Insurance for WBS-TG PHONE, (866)293-3600 ext.623 FAX
PC Box 6094 (AIC,No EM): (AC,No):
E-MAIL
Clearwater, FL 33758-6090 ADDRESS; .... ...................
INSURER(S)AFFORDING COVERAGE ---NAIL-9
INSURER A: American Zurich Insurance Company,,,,, 40142
INSURED
INSURER 8
Workforce Business Services,Inc AIL Enip:Keys Home and Investments Inc.
1401 Manatee Ave West Ste.600 INSURER C,:..........
Bradenton,FL 34205.6708 INSURER D
INSURER E.:
I INSURER F:
COVERAGES CERTIFICATE NUMBER;22FI_079934540 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 WffH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSIR R FbLICYEFF 'PdLJtYEkP
LTR TYPE OF INSURANCE SXp POLICYNUMBER (MMODrYYYY) (MM0DNYYY) LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $
DAMAGE 1`0 4ENTEI7 , I
CLAIMS-MADE 0CM)R PREMISES dEa,cqcqrrercal
MEP EXP(Any one perscnl
PERSONAL.A.ADV INJURY S
GEN'L AGGREGATE LILL[APPLIES PER APPROVED BY RISK MANAGEMENT GENERAL AGGREGATE S
PRO-
POLICY JFCT LOD ,By PRODUCTS-COMPiOP AGG S
OTHER i DATr=_ Sa2k)23_
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
WAIVER NIA YES (Ea accident)
ANY AUTO
BODILY INJURY Epee person) s,
OWNED SCHEDULED
AUTOS ONt,Y AUTOS BODILY INJURY Per acceenu S
HiRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (P&accident)
UMBRELLA UAB OCCUR EACH OCCURRENCE S
EXCESS LIAR
CLAIMS-MADE AGGREGATE
DED RETENTIONS
WORKERS COMPENSATION x PER i OTH-
-AND EMPLOYERS'LIABILITY YIN STATUTE ER
ANYPROPiRIE'fOR(PAR"rtwEp' xEcu�FivE E.L
NIA WC 90-00-818-12 12�31/2022 12/31/2023 .EIACHACCIDENT $ 1,000,000
OFFGERJIVIEMBEREXCLUDED'' LA
(Mandatory in NH) E.I. DISEASE_EA EMPLOYEE, 1,000,000
If yes describe Under _
'DESCRIPTION OF OPERATIONS below EA.DISEASE-POLICY LIMIT $ 1,000,000
Location Coverage Period: 12/31/20,22 12/31/2023 Client# 054616
DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is requiired)
Coverage is provided for Keys Home and Investments Inc.
only those co-employees 1107 Key Plaza#289
of bot not subcontractor,-, Key West,FL 33040
to
CERTIFICATE HOLDER CANCELLATION
Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Su to 1.190 ACCORDANCE WITH THE POLICY PROVISIONS.
Key West,FL 33040
AD rH:ORIZED REPRESENTATIVE
I" _° . t
.......................... ......__ Y, - __1.........
({)1988-2015 ACORD CORPORATION. All rights reserved
ACORT)25(2016103) The ACORD name and Ioric,arn rocflsterr4d marks of ACORD
CERTIFICATE F LIABILITY INSURANCE
DATE(MhI1DD(YYY}
07131I2023
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 INSUIRE'R(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate Solder is an ADDITIONAL INSURED,the policy ies must 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 endorsement(s).
PRODUCEIR
NAME: Amanda Katvlich
PGI of West Central Florida,LLC A G�M,Ext): 941-242 9619 1_( ,No): 941 242-9621_. _
IE.NAAIL _._.... _.....
3809 E SIR 64 ADDRESS: arnanda@pglofwestcentraftlorida.cam
........
INSURER(S)AFFORDING COVERAGE. j NAIC N
Bradenton FL 34208 INSURER A: Atlantic Casualty Insurance Coonlaany 42a46
INSURED ._ .._. _ ._. ,. _.
INSURER B _. _.. ..
........ ....
.
Keys Haat�e .investments,Inc. INSURER C 1
1107 Key Plaza INSURER D
4+rMadtaox 9289 INSURE R E:
..... .. .,,,,,,,,, ...............
Key West FL 33040 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER;
THUS 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 AFFORDED 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.
IN SR" ADDLISUBR ,,,,,,,, ...... -POLICY.EFF,,, POLICY EXP
LTR I, TYPE OF INSURANCE
INSD NN'd'D POLICY NUMBER (MMfDDI'fYYY) (MMIDDIYYYY) LIMITS
x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE. $ 1,000,000
DAMAGE 1.0...RENTEC7..._.... _ _. .
q CLAIMS-MADE ,, X OCCUR � PREMISES IEa occurrence $ 100,000
j t _
j ME D EXP(Any one p ersor 1 $ 5,000
A Y L335000051-1 05/31/2023 05/31/2024 PERSONAL&AtDV INJURY s 7,0
__. 00,000
GEN`L AGGREGATE LIMIT APPLIES PIER. APPROVED BY RISK MANAGEMENT -GENERAL AGGREGATE 's 2,000,000
'JC PRO, F
POLICY JECT LOG � PRODUGTS-OOMPtJPAGG $ 2,000000
OTHER: .. DATE 8.3,2023
AUTOMOBILE LIABILITY $
WAIVER N/A „YES .(COMBINED F.a accident
g
ANY AUTO Bt.10'DILY INJURY(Per person) $
ALL G4"t^NE:D l SCHEDULED BODILY TNJlJRY(Per accident)I $
AUTOS AUTOS PRDPFRTYDAMIAGE
` NON-OWNED I _
HIRED AtF'IC)S AUTOS j (Per aerrdentl '$
.....
I
$
UMBRELLA LIAR I000IUIT. ] EACH OCCURRENCE I $ 1
EXCESS LIAR
CLAIMS-MADE! I I AGGREGATE
$
..._ I
DIED RETENTIONS ! $
WORKERS COMPENSATION j 1 i - �
AND EMPLOYERS'LIABILTTY Y I N: I STATUTE � JR 1
(Mandatory
t= in NH)
li EA. EACH ACCIDENT $
ANY PROPRIETOR PARTNEREXECUTIVP
GI�FICEs�rrveLMBER EXCLUDED'? NIA
) F.L DISEASE-EA EMPLOYEE $
If O SCRTPTION OF OPERATIONS below E.L DISEASE-POLICY L,IMTT I S
I 1 I
i I
DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule„may be attached if more space is required)
MonroeCount,y BOCC Is included as an additional insured as regOred by written contract For general liability.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WALL BE DELIVERED IN
ACCORDANCE WITH THE POLICY'PROVISIONS.
N�Ipnrire�County Board al'County Commissioners
1100 Simonton St
AUTHORIZED REPRESENTATIVE
Suute 1-190
Key West FL 3:30407J?fC.� Ea
@ 19188-2014 ACORID CORPORATION. All rights reservedl.
ACORD 25(201'4t01) The ACORD name and logo are registered marks of ACORD
a `.e BOARD OF COUNTY COMMISSIONERS
County of MonroeMayor Craig,Cates,Distria 1
'rhe Florida e � �: Mayor
yPr Lincoln,Holly District Merrill Rasch in,L)istrict 5
Michelle
James N,. Scholl. District 3
David Vice, [,)jstrict 4
Monroe County
State Housing Initiatives Partnership (SHIP) Program
Award of Hid
Date: 29 June 2023
Job umber: 04-0532-22
Client: Gregory Splichal
Client/Job Address: 1225 Ashby Street, They West, FL, 33040
ContractorNendor: Keys I-Jorre and Tnvestrrrents Inc. / S-00524
Late and Amount of Hid: 16 June 2023 /$33,500.00
Comments:
An email was sent on 05/30/23 to approximately 20 contractors. C➢ne (1) note was received on 06/1 Ei/23.
The price quoted for all work listed in the Scale of Work was $33,500 and included the cast of a portable
restroorn and ternporary ,shower enclosure.
- A - °�.
Steven Becker Date
Protect Manager 111
mm �/&
Kim es-VWean Date
Sr Administrator Programs and Compliance
-'22 -7�13 /202,3
Sheryl Graham Hate
NIC SHIP Administrator
County of Monroe BOARD OF COUNTY COMMISSIONERS
Mayor David Dice,District 4
The Florida Keys Mayor Pro Tern Craig Cates, District I
Michelle C oldirtan, District,2
,. James K.Scholl, District 3
I folly Merrill Raaschein (District 5
August 9, 2022
Mr. Gregory Splichal.
1.225 Ashby
Key West, FL 33040
Lear Mr. Splich,al:
This letter is to certify that you qualify to participate in Monroe County's State -lousing Initiative
Partnership Program under the Homeowner ner Rehabilitation Strategy.
Lased on the information you have provided, you qualify 11or a deferred payment SHIP Loan in the
amount of$15,000.00 at zero percent interest 17car a term of twenty (20) years. The total amount of
the award is $35,000.00( .
The first $20,000.011 of exppenses will be a grant. The balance of$15,001,00 wil l be forgiven on the
maturity date. No payments are rewired on this Lien.
Sincerely,
Sheryl L. Graham
Monroe County SHIP Adaiinistrator