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1st Change Order 05/15/2024
MONROE COUNTY CONTRACT CHANGE ORDER PROJECT TITLE: CHANGE ORDER NO: 1 Backfill Restoration Water Quality Improvement Projects, Canal#90 Hammer Point Park, INITIATION DATE: March 4, 2024 Key Largo, Monroe County, Florida TO CONTRACTOR: CONTRACT DATE: January 31, 2024 Adventure Environmental, Inc The Contract is changed as follows: The original (Contract Sum) (Guaranteed Maximum Price)............................................$ 1, 066,000.00 Net change by previously authorized Change Orders...................................................$ 0.00 The ( ) ( ) p i i Change order was.............$ 1,066,000.00 The (Contract Sum) (Guaranteed Maximum Price) will be(„increased„)„(decreased) (unchanged) by this Change Order.......$ 277,500.00 The new (Contract Sum) (Guaranteed Maximum Price) including this Change Order is......$ 1,343,500.00 The Contract Time will be (increased) (decreased) (unchanged) by.................................. The date of Substantial Completion as of the date of this Change Order is......................... July 2, 2024 Detailed description of change order and justification: Additional fill material needed to bring canal to proposed elevaton to achieve proper flushing. The amount of this change order is "not to exeed" to be verified by back up documentation provided by the Contractor and verified by the Engineer and County This change Order is % of the original contract price. 26% Not valid until signed by Owner, Architect (if applicable), and Contractor Corning,Greg (USGC714750) Date:2l02 042917:27:04-04'00'y signed by Corning,Greg(USGC714750) ENGINEER: Date CONTRACTOR: 04/29/2024 Date Digitally signed by Rhonda Haag SUSTAINABILITY PROGRAM MANAGER: Rhonda Haag Date:2024.04.29 17:43:08-04'00' Date COUNTY/DEPUTY ADMINISTRATOR 05.20.2024 Date APPLICATION FOR PAYMENT 01027-Page 82 of 159 Change Order Attachment per Ordinance No. 004-1999 • Change Order was not included in the original contract specifications. Yes X No If Yes, explanation:Same work already being performed, must an increase in amount. • Change Order was included in the original specifications. Yes No x If Yes, explanation of increase in price:See above • Change Order exceeds $25,000 or 5% of contract price (whichever is greater). Yes 0 No ❑ If Yes, explanation as to why it is not subject for a calling for bids: It is more cost effective to continue with backfill work already underway and avoid new mobilization and related construction costs which are anticipated to be much higher. • Project engineer approves the change order. Yes 0 No ❑ If no, explanation of why: • Change Order is correcting an error or omission in design document. Yes ❑No 9 Should a claim under the applicable professional liability policy be made? Yes ❑ No [v7 Explain: CER 1E1CATF QE.S11$STAN11A.I�CQD�PI�TIQIY APPLICATION FOR PAYMENT 01027-Page 83 of 159 PROTRCT- CONTRACT FOR- ADVE E NV-01 DAS B U RY ACORO"° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/6/2023 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 INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificates NAME: Construction Casualty Insurance,LLC PHONE FAX 3637 4th Street North (A/C,No,Ext): (727)502-2190 (A/C,No): IL Suite 310 ADDRESS:certs@cci-ins.com Saint Petersburg,FL 33704 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Progressive Express Insurance Co 10193 INSURED INSURER B: Adventure Environmental Inc INSURER C7 160 Georgia Ave INSURER D: Tavernier,FL 33070 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDD/YYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ APPROVED BY RISK MANAGEMENT MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: DATE GENERAL AGGREGATE $ POLICY JJECT LOC WAIVER N/A_YES _ PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X X 03515746 6/10/2023 6/10/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) When required by written contract,the certificate holder is listed as an additional insured with regard to the Business Auto policy.When required by written contract,a waiver of subrogration applies in favor of the certiifcate holder on the Business Auto policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St,Suite 408 Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADVEN-1 OP ID: GB ACORO CERTIFICATE OF LIABILITY INSURANCE FDATE TE(MM/DD/YYYY) `..-� 01/03/2024 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 504-486-5411 CONTACT Accessible Marine Insurance Accessible Marine Insurance PHONE FAX 1145 Allen Toussaint Blvd (A/C,No,Ext): 504�86-5411 (A/C,No):504�82-1475 New Orleans,LA 70124 E-MAIL Eric S.Green ADDRESS:gail@ami-ins.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Capitol Specialty Ins. Company INSURED INSURER B:Great American Ins.Company 22136 Adventure Environmental Inc. Greg Tolpin INSURERC: an StarNet Insurance Company 40045 160 Georgia Avenue Tavernier,FL 33070 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE 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. INSR TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE Firl OCCUR EV20190209-06 01/09/2024 01/09/2025 DAMAGE TO RENTED 50,000 X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY� jECT1:1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS a "°�'"�' BODILY INJURY Per accident $ PROPERTY DAMAGE AUTOS ONLY AUUTOS ONLY "^^' Per accident $ DAT 1 4 24 GL&pollution - .w,.,,— _ _ m $ UMBRELLA LIAB OCCUR WAWWkX Yft EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C M.E.L. X BOUM-A-23-2110 08/15/2023 08/15/2024 M.E.L. 1,000,000 B Hull/P&I Liability OMH841008-12 10/12/2023 10/12/2024 P&I Limit 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder shown as additional insured with waiver of subrogation in their favor as required by written contract as respects insured's operations. Project: Backfill Restoration Water Quality Improvement ProJ'ects Canal#90 Hammer Point Park, Key Largo, Monroe County, FL CERTIFICATE HOLDER CANCELLATION MONRO05 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of ACCORDANCE WITH THE POLICY PROVISIONS. County Commissioners 1100 Simonton St.,Ste 408 AUTHORIZED REPRESENTATIVE Key West, FL 33040 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Adventure Environmental Inc. ADVEN-1 PAGE 2 NOTEPAD INSURED'S NAME OP ID: GB Date 01/03/2024 Contractors Pollution Liability: Insurer: Rockhill Insurance Company Policy#: EV20190209-04 Policy Period: 01/09/23 - 01/09/2024 Claims Made Aggregate Limit: 2,000,000 Each Contractors Pollution Condition Limit: 2,000,000 Blanket Additional Insured/ Waiver of Subrogation Professional Liability: Insurer: Rockhill Insurance Company Policy#: EV20190209-04 Policy Period: 01/09/23 - 01/09/2024 Aggregate Limit: 2,000,000 Each Professional Services Incident Limit: 2,000,000 Commercial General Liability Conditions: Deductible Liability Endorsement Exclusion - Testing or Consulting Errors and Omissions Total Pollution Exclusion Endorsement Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization Exclusion-Violation of Statutes that Govern Emails, Fax, Phone Calls or Other Methods of Sending Exclusion - Punitive or Exemplary Damages Amended Waiver of Subrogation Exclusion - Engineers, Architects or Surveyors Exclusion - Exterior Insulation and Finish Systems Exclusion - Professional Services Primary/Non-Contributory Coverage-Blanket - When req. by written contract Additional Insured - Managers or Lessors of Premises Toxic Drywall Exclusion Separation of Insureds Independent and/or Subcontractor Restriction Contractors Pollution Liability (Claims-Made) Conditions: Additional Insured - Owners, Lessees or Contractors (Broad Wording) Amended Waiver of Subrogation Toxic Drywall Exclusion Professional Liability Conditions: War or Terrorism Exclusion Additional Insured - Owners, Lessees or Contractors Hull & Machinery / Protection & Indemnity: Terms and Conditions applicable to All Sections: Severability Terms and Conditions applicable to Hull: A. I. Coastwise and Inland Hull Clauses Deliberage Damage (Pollution Hazard) Engines & Machinery - ACV / Limited Perils Only No Lay Up Warranty No Release to Tower Warranty Seaworthiness Clause Total Loss Hull Premium Earned Clause Vessel Stability Additional Insured as respects P&I Adventure Environmental Inc. ADVEN-1 PAGE 3 NOTEPAD INSURED'S NAME OP ID: GB Date 01/03/2024 Terms and Conditions applicable to P&I: SP-38 Form Collision Clause including Tow & Extended Tower's Liability Collision Liability - P&I Extension Diving & Swimming Exclusion Food & Beverage Exclusion Health Hazard Exclusion Liability Limitation No Release to Tower Warranty P&I Crew Exclusion: Notwithstanding anything contained in the Protection and Indemnity Clauses herein to the contrary, it is understood and agreed that this Company shall not be liable for any loss, expense or claim to employees of the Assured, members of the crew, contractors or subcontractors Punitive/Exemplary Damages Exclusion Special Operations Exclusion Contractor's Equipment: Policy No. : IMP 5305782-07 Policy Period: 01/26/2023 to 01/26/2024 - Owned Equipment $75,000 - Leased/Rented Equipment any one item limit $200,000 - Leased/Rented Equipment all items limit $400,000 Inland Marine Coverage Part Declarations Page Commercial Inland Marine Conditions Contractor's Equipment Declarations Scheduled Form Contractor's Equipment Scheduled Coverage Form Contractor's Equipment Equipment Leased or Rented From Others Coverage Florida Changes - Warranties Florida Changes - Loss Payment Crane Exclusion Endorsement Contractor's Equipment Existing Fire Exclusion Blanket Loss Payable Endorsement Marijuana Exclusion M.E.L. -Maritime Employers Liability Coverage Form -Transportation, Wages, Maintenance & Cure -Notice of Cancellation: 30 days (except 10 days of nonpayment of premium) -Death on the High Seas Clause -In Rem Liability -Blanket Waiver of Subrogation This certificate of insurance neither affirmatively nor negatively alters, amends, or extends the coverage afforded by Policy(ies) issued by the Insurer(s) listed on this certificate. Date CERTIFICATE OF LIABILITY INSURANCE 12/12/2023 Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend,extend Holiday, FL 34691 or alter the coverage afforded by the policies below. (727)938-5562 1 Insurers Affording Coverage NAIC# Insured: South East Personnel Leasing, Inc. &Subsidiaries Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. Insurer B: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR ADDL Policy Effective Policy Expiration Limits LTR INSRD Type of Insurance Policy Number Date Date (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence Commercial General Liability Damage to rented premises(EA Claims Made ❑ Occur occurrence) Med Exp Personal Adv Injury General aggregate limit applies per: General Aggregate Policy ❑Project ❑ LOC Products-Comp/Op Agg AUTOMOBILE LIABILITY Combined Single Limit (EA Accident) Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos � - Bodily Injury Hired Autos - - . (Per Accident) Non-Owned Autos q 1 2.24 ,�......., .. �.,«.+-� Property Damage (Per Accident) EXCESS/UMBRELLA LIABILITY M " Ij r- Each Occurrence Occur ❑Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2024 01/01/2025 x I WC Statu- OTH- Employers'Liability tory Limits ER Any proprietor/partner/executive officer/member E.L.Each Accident $1,000,000 excluded? NO E.L.Disease-Ea Employee $1,000,000 If Yes,describe under special provisions below. E.L.Disease-Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A(Excellent). AMB# 12616 Descriptions of Operations/Locations/Vehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 80-65-323 Coverage only applies to active employee(s)of South East Personnel Leasing,Inc.&Subsidiaries that are leased to the following"Client Company": Adventure Environmental,Inc. Coverage only applies to injuries incurred by South East Personnel Leasing,Inc.&Subsidiaries active employee(s),while working in:FL. Coverage does not apply to statutory employee(s)or independent contractor(s)of the Client Company or any other entity. A list of the active employee(s)leased to the Client Company can be obtained by emailing a request to certificates@lioninsurancecompany.com Project Name: INCLUDES USL&H.ISSUE 02-21-22(To).REISSUE 12-20-22(PH) Be in Date:3/15/2010 CERTIFICATE HOLDER CANCELLATION MONROE COUNTY BOARD OF COUNTY Should any of the above described policies be cancelled before the expiration date thereof,the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left,but failure to COMMISSIONERS do so shall impose no obligation or liability of any kind upon the insurer,its agents or representatives. 1100 SIMONTON STREET KEY WEST, FL 33040