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HomeMy WebLinkAbout08/20/2025 Agreement GVS COURTq° o: A Kevin Madok, CPA - �o ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida �z cooN DATE: August 22, 2025 TO: Kevin Wilson Assistant County Administrator William DeSantis, Director Facilities Maintenance Chrissy Collins Executive Administrator Tina LoSacco Senior Engineering Technician FROM: Liz Yongue, Deputy Clerk SUBJECT: August 20, 2025 BOCC Meeting The following item has been executed and added to the record: C14 Site Access Agreement for BTEX Engineering, Inc. to access monitoring wells on the Tavernier Fire Station (Station 22)to sample groundwater and contamination from a discharge on the neighboring property at 151 Marine Ave; Tavernier, FL. Should you have any questions please feel free to contact me at(305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY 500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070 PERMISSION TO ENTER PROPERTY-NON-SOURCE 1. The Parties. The undersigned real property owner, Board of Commissioners Of Monroe County ("Owner"), hereby give(s)permission to the State of Florida, Department of Environmental Protection ("Department") and it's Contractor, subcontractors, and vendors ("Contractor"),to enter the Owner's property ("the Property") (see next paragraph). 2. The Property. Owner owns the certain parcel(s) 00478980-000000 of real property located at vacant Land Tavernier , Florida 3. The Source: The suspected source of the contamination is located at 255 Tavernier Street, R. parcel number#00478900-000000 and FDEP Facility/Project# is 448626406 4. Permissible Activities. This Permission to Enter Property("Permission") is limited to activities which may be performed by the Department or its Contractors pursuant to Chapter 62-780 or 62-730, Florida Administrative Code, without cost to the Owner to locate contamination, determine contamination levels and, when necessary, remove and remediate contamination which may be performed by the Department and its Contractor. Specifically, to collect soil, groundwater(including the installation of wells) surface water and sediment samples; removal and treatment of contamination on the Property; installation of a treatment system (as necessary), and monitoring of contamination until completion of remediation. 5. Work Performed during Business Hours. The Department and Contractor may enter the Property during normal business hours and may also make arrangements to enter the Property at other times after agreement from the Owner. 6. No Admission. The granting of this Permission by the Owner is not intended, nor should it be construed, as an admission of liability on the part of the Owner for any contamination discovered on the Property. 7. Activities Comply with Applicable Laws. The Department and Contractor agree that any and all work performed on the Property and in association with this Permission shall be done in a good, safe,workmanlike manner, and in accordance with applicable federal and state statutes, rules and regulations. 8. Well Permits. The Owner authorizes the Department and its Contractor to act as its agent in signing all required forms and documents necessary for obtaining applicable permits related to well construction, repair, maintenance, modification, and abandonment pursuant to Chapter 373, Florida Statutes. 9. Equipment Ownership. The monitoring wells and remedial equipment installed pursuant to this agreement are the property of the Department.The Owner is responsible for replacing any Department property that may be damaged or lost due to any actions by the owner. 10. Property Restoration. The Department shall pay the reasonable costs of restoring the Property as nearly as practicable to the conditions which existed before activities associated with contamination assessment or remedial action were taken. Page 1 of 2 PRPOffSiteAccessAgreement 04042016 • : : 1.1.. •Injurv:to.Department.: The Owner shall not be liable:for any.injury,damage or loss on the:Property suffered ••. : • : : : • : by the Department,:Department•employees or Contractors not caused by the•negligence or intentional acts of.the •• • • • 'Owner's agents or employees, • :. : ' : :. z • : . ' : : • :• : :12.• Sovereign.Immunity,.The:Department acknowledges and.accepts•its responsibility under:applicable law' : • : • : (Section:768:28,:'Florida Statutes)for damages caused by•the.acts of its employees'while on the Property.: : . • : : • .: • : . 1I Public Records. All documents created or received associated with the Permissible activities area:public•: : • : • • :• :. - • :• record•pursuant to Chapter 11.9,Florida Statutes'..The:Owner may.retrieve any documents or•other information : - '• : : : : : •: = related.to.the Permissible Activities:online.usi.ng the facility or project number referenced above in:paragraph.4. •: - • . . . ittp.: epe ms. .e:state.:nius/Oculus/setvlet/loain?action=loaiii.: . : . • • : . : • • .: : : : 1 •: : H ' . .. • . • . - • • ••• • i : •• • • 1 • :• . - • . • • .i :• . - 'ii . ' - .. . . . . — . " . . -. OOGYY .I.(Ail. •• . .."• : . • . .f.. " : . , ......:•..• ." • : • .. ' H.': : • 1 : : . . . ,. . .• . 0 .... . r. • ' . • . ••:- .. :K 4ii : :. -: : .. . .- • .-g: =ture of,each Property Owner. .. . r . Sign-4...re..of Witness.* . •• :• • ' James.Scholl;..Mayor : t. : . 0•. . . • : .. ' . ' Print Name : ' Date : •Print Name . : • 7,. . • • • - . • Dade. . : 1100:Simton Street.Ke :West FL 33040 - ' : • • • • • '.;-, ::/. +ti~ ....:4'+'Att•. st'•-..,.,...:::,...,, v in Madok,Clerk . ••• Mailing •Addres•s •• •• • • ,re,,..., ,:} • n ,;•e �r 3 ,I' '°•4 lad�?,:ice�‘'�wrieen*.\ey.‘i,. : • 305-292-4441 • . • : : .• . . .. . scholl-James@monroecounty-tl.gtw! °;�. '., y,:�..;..z,,,:7;..,,�..�'ts.. .. . . .• :•Telephone or Cell Phone Number. • . : . l''',71-::j.4•!5•:-Itz-,,,;],":::i.'!'i,--1Va4-?•,_: E-mail Address - • 3rs`Deputy Clerk • : • ::•. ,-,,,,0,,,,\\'':-,,,,,,::- ",,,,,,r;,',1..YL-,./., 0.:.F•-•-•':,,,,i,i,t,,,,,,_•;_.,-_-7"Fp•t:/• .• •" .* . • Y,�•.e.'A.s^y�" y.l git5';',4y ... �. v,�... `'J� ' .. A•ccepted• by:C•ontrac•tor ors behalf of t•he State of Florida�epartment••of•Envi•ronmental:: rotection• • : ' * • .. " • ' &i•;".. ''•' A.......,.. . . • • • • • .k,. .:ram . ... : Sign ure of.Contractor:• : : : Signature of witness: .• : '_ ,.: :. .:. : : . .V ..X. CA' I. . . . .eallir •1 : it • . ej,;,:• •• • - • •• -i . /... .1.• clen.: ::-- i.H.,.., .. 7n .,: H ... - .. - . • i • 00, . • : •• 14'C... ... • : .: .. .. . . .. . . i . .. : . . ...„ .. . : 114::-. ..:: t3.. : -Print Name of Contractor: Date: : Print Name. : • Date : : : : s�3 • • : •.. : . . : • . : s . •..:. 6TEX Engineering,Inc.: • .• . . • .. . • .. . • .:` : •1j /IJ.. C .• ta. j 0 : . , •,"' : • . .. : •C.ontractor-Company name - : . .. �Contractor'.s:Contact name � � • ' '. • 601 N:.Congress.Ave.:.Suite 103.. . • . ' : ' :. • :..btexengineering@gmail.com • . . • : :. : : . • :Contractor Mailing Address : :: : • : :Contractor Contact email.address:*: • • •• • : • . : Delray'Beach,FL 33445. .. . • :.. . ' :. .. •.561-272-8644 • : .. . • 1 • :• _ :.. . . Contractor:Company City and:zip code .: : •Contractor Contact's:phone number • • • : • : . • : • ' .: • •. • Ap ROVEu ATTORNEY • ti 0 FORM . < •� age °f 2•� . .. �z •.PRPO.ffSiteAccessA•reement 04042016: P -OJ. . . g . ASSIS weNTY ArrORNEY Date • 8L14125 .. . 7/24/25,2:04 PM gPublic.net-Monroe County,FL-Report:00478980-000000 Monroe County, FL **PROPERTY RECORD CARD** Disclaimer The Monroe County Property Appraiser's office maintains data on property within the County solely for the purpose of fulfilling its responsibility to secure a just valuation for ad valorem tax purposes of all property within the County.The Monroe County Property Appraiser's office cannot guarantee its accuracy for any other purpose.Likewise,data provided regarding one tax year may not be applicable in prior or subsequent years.By requesting such data,you hereby understand and agree that the data is intended for ad valorem tax purposes only and should not be relied on for any(ther purpose. By continuing into this site you assert that you have read and agree to the above statement. Summary Parcel ID 00478980-000000 Account# 1585530 Property ID 1585530 Millage Group SOOP Location Address VACANT LAND,TAVERNIER Legal Description TAVERNIER SUB PB1-105 KEY LARGO BK 3 LOT 15&PT 10'ALLEY J1-142 G6-92 OR881-17/18 OR1259-1860 (Note:Not to be used on legal documents.) Neighborhood 10021 Property Class VACANT EXEMPT(8000) Subdivision TAVERNIER Sec/TWp/Rng 34/62/38 Affordable Housing No Owner FSOARD OF COUNTYCOfNMISSIONFRS OF MONROE COUNTY 1100 Simonton St Ste 205 Key West FL 33040 Valuation 2024 Certified Values 2023 Certified Values 2022 Certified Values 2021 Certified Values _.. . ....__..___.___ _,_.... .___ _._,._�....___. ___._...__. .__.__ + Market Improvement Value $0 $0 $0 $0 _,-_._.._,__,. + MarketMiscValue $0 $0 $0 $0 + Market Land Value $24,083 $24,083 $24,083 $24,083 = Just Market Value $24,083 $24,083 $24,083 $24,083 _.._____..____.__..._ �.,_ _....._..___.....__.,.._.---_---._._-----.- = Total Assessed Value $24,083 $24,083 $24,083 $24,083 School Exempt Value ($24,083) ($24,083) ($24,083) ($24,083) = School Taxable Value $0 $0 $0 - - ---- $o_ Historical Assessments Year Land Value Building Value Yard Item Value Just(Market)Value Assessed Value Exempt Value Taxable Value Maximum Portability 2024 $24,083 $0 $0 $24,083 $24,083 $24.083 $0 $0 2023 $24,083 $0 $0 $24,083 $24,083 $24,083 $0 $0 2022 $24,083 $0 $0 $24,083 $24,063 $24,083 $0 $0 2021 $24,083 $0 $0 $24,083 $24,083 $24,083 $0 $0 2020 $24,083 $0 $0 $24,083 $24,083 $24,083 $0 $0 2019 $24083 $0 $0 $24,083 $24,083 $24,083 $0 $0 2018 $24,083 $0 $0 $24.083 $24,083 $24,083 $0 $0 The Maximum Portability is an estimate only and should not be relied upon as the actual portability amount.Contact our office to verify the actual portability amount. Land Land Use Number of Units Unit Type Frontage Depth (8600) 6,660.00 Square Foot 0 0 (8600) 750.00 Square Foot 5 150 https://gpublic.schneidercorp.com/Application.aspx?AppI D=605&Layerl D=9946&PageTypeI D=4&Pagel D=7635&KeyValue=00478980-000000 1/2 7/24/25,2:04 PM gPublic.net-Monroe County,FL-Report:00478980-000000 View Tax Info View Taxes for this Parcel Map v� l a r 4 / 7u i` No data available for the following modules:Buildings,Yard Items,Sales,Permits,Sketches(click to enlarge),Photos,TRIM Notice. nrCrum',,i'rulriyntUpr "i aiin malnl:uu.,l'r:lorpirrJ,i!,y 111'11nth< < 'only (a,n r (1; 1). (I by ol,r H III,rl irri)0""c,1 illm-,il ii., nrn';ihilfiv I n iust .Al( l', il k'l Idv''Im ni i SCHNEIDER ,>,ulursaialllir.rin;rty iin `hel nn ;.v.Th llmrr7� fnunivFir,IiilyP,,lriii,u';in(�CC. omo�.nnTin� �.ruu''i rirnni 11 r.1 '"or n; uLfnI rMI,,r Li., do irr ;.irrlin.rn ,r;; '.:,:u ni n mi h: gpphk. hl ui prior r ulr r:r,{u nl ;,tra t,' i qnc lk ;uch ri lI You I lod i,i.mrl mi �i,c lh t°'k User Privacy Policy I GIOPR Privacy Notice Last Data Ooacl.7/24/202.5,1:2 :05 AM https://gpublic.schneidercorp.com/Application.aspx?ApplD=605&LayerlD=9946&PageTypelD=4&PagelD=7635&KeyValue=00478980-000000 2/2 A DATE(MM/2025 Y) CC)II L � L/ CERTIFICATE OF LIABILITY INSURANCE 05/15/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 Lauren McDonald NAME: PCF Insurance Services of the West,LLC PaHic°NNo Ext: (904)646-0310 a/c,No: (904)646-1143 dba The Della Porte Group E-MAIL Imcdonald@dellaportagroup.com ADDRESS: 7807 Baymeadows Road,Suite 301 INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32256 INSURER A: Admiral Insurance Company 24856 INSURED INSURER B BTEX Engineering,Inc. INSURER C: 601 N Congress Avenue INSURER D: Suite 103 INSURER E Delray Beach FL 33445 INSURER F: COVERAGES CERTIFICATE NUMBER: CL24111883745 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYY MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3.000,000 DAMAGE TO CLAIMS-MADE OCCUR PREMISES SES Ea occurcDence $ 50,000 MED EXP(Any one person) $ 5,000 A Y Y FEI-ECC-11432-12 12/15/2024 12/15/2025 PERSONAL&ADV INJURY $ 3,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY❑PRO JEC 3,000,000 T LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability& Each Occurrence $1,000,000 A Pollution Liability FEI-ECC-11432-12 12/15/2024 12/15/2025 General Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is additional insured as respects general liability including ongoing&completed operations,on a primary-noncontributory basis, including waiver of subrogation,when required by written contract. APPROVED BY RISK MANAGEMENT BY `t;¢a. DATE '/05.15.25 CERTIFICATE HOLDER CANCELLATION WAIVER N/A RYES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 torw^- blr"�dt ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Aca® CERTIFICATE OF LIABILITY INSURANCE r ATE(MMIDD/YYYY) k.r�►/ 5/15/2025 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 The Insurance Butler PHONAME: Ha den Dudley 2233 NW 41st St A/CN No,Ext:941-704-0585 A/C,No: AIL Suite 500 ADss: dudle camelot.com an Gainesville FL 32606 INSURERS AFFORDING COVERAGE NAIC# License#:W004920 INSURERA:Security National Insurance Company 1952 INSURED BTEXENG-01 INSURER B: BTEX Engineering, Inc. 601 N.CONGRESS AVE. INSURERC: Suite 103 INSURER D: Delray Beach FL 33445 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:2054131078 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 EFF POLICY EXP LTR POLICYNUMBER MM/DDIYYYY MMIDDIYYYY LIMITS COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENT DPREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY E PRO- JECT LOG PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY Y Y M00 0045071 02 5/4/2025 5/4/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED X BODILY INJURY SCHEDULED AUTOS ONLY AUTOS (Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? NIA (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 I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) APPROVED BY RISK MANAGEMENT BY ,sa_ DATE "'05.15.115 WAIVER NIA XYES CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners 1100 Simonton Street Key West FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC"R" CERTIFICATE OF LIABILITY INSURANCE r ATE(MM/DD/YYYY) 5/15/2025 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 NAME: GMS WC Certificates Team SUNZ Insurance Solutions, LLC ID:(GMS-SUNZ) PHONE o Ext: 330-659-0100 a No: 330-659-0555 c/o Group Management Services Inc E-MAIL PO Box 21933 ADDRESS: wccerts rou m mt.com Eagan, MN 55121 INSURERS AFFORDING COVERAGE NAIC# INSURER A: SUNZ Insurance Company 34762 INSURED INSURER B: Group Management Services, Inc.PO BOX 21933 INSURERC: Eagan MN 55121 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 85322088 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. INS RI ADDL SUB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVDI POLICY NUMBER MMIDD/YYYY) (MM/DD1YYYY1 LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO- JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ 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$ $ A WORKERS COMPENSATION WC041-00001-024 10/1/2024 10/1/2025 �/ STATUTE OERH AND EMPLOYERS'LIABILITY Y/N - ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 O00 000 OFFICER/MEMBEREXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1If QO 0 QQ DESCRIPTION OF OPERATIONS below yes,describe under E.L.DISEASE-POLICY LIMIT $1 000 000 D DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage provided for all leased employees but not subcontractors of:BTEX Engineering,Inc. MANAGEMENT Effective:6/25/2023 APPROVED BY RISK MANAGE BY bH 2d DATE 05.15. 5 WAIVER NIA XYES CERTIFICATE HOLDER CANCELLATION 005640 Monroe Count Board Of Count Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Key West FL 33040 AUTHORIZED REPRESENTATIVE Rick Leonard ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 85322088 1 Group Management Services PEO 041 RASTER I Certificate Department 1 5/15/2025 10:43:06 AM (EDT) I Page 1 of 1