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Home My WebLink AboutItem F1 2892 2893 2894 2895 2896 2897 2898 2899 289: 28:1 28:2 28:3 28:4 28:5 28:6 28:7 28:8 28:9 28:: 2911 2912 2913 2914 2915 2916 2917 2918 2919 291: 2921 2922 2923 2924 2925 2926 2927 2928 2929 292: 2931 2932 2933 2934 2935 2936 2937 2938 2939 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 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). CONTACT PRODUCER NAME: FAX PHONE (A/C, No): (A/C, No, Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGESCERTIFICATE 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ DAMAGE TO RENTED CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY$ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS NON-OWNED HIREDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANYP ROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD 293: AGENCY CUSTOMER ID: LOC #: Page of ADDITIONAL REMARKS SCHEDULE AGENCYNAMED INSURED POLICY NUMBER CARRIERNAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 2941 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 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). CONTACT PRODUCER NAME: FAX PHONE (A/C, No): (A/C, No, Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGESCERTIFICATE 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ DAMAGE TO RENTED CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY$ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS NON-OWNED HIREDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANYP ROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD 2942 AGENCY CUSTOMER ID: LOC #: Page of ADDITIONAL REMARKS SCHEDULE AGENCYNAMED INSURED POLICY NUMBER CARRIERNAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 2943 2944 2945 2946 2947 2948 2949 294: 2951 2952 XPSLFST!DPNQFOTBUJPO!BOE!FNQMPZFST!MJBCJMJUZ!JOTVSBODF!QPMJDZXD!11!14!24 )Fe/!5.95* XBJWFS!PG!PVS!SJHIU!UP!SFDPWFS!GSPN!PUIFST!FOEPSTFNFOU Xf!ibwf!uif!sjhiu!up!sfdpwfs!pvs!qbznfout!gspn!bozpof!mjbcmf!gps!bo!jokvsz!dpwfsfe!cz!uijt!qpmjdz/!Xf!xjmm! opu!fogpsdf!pvs!sjhiu!bhbjotu!uif!qfstpo!ps!pshboj{bujpo!obnfe!jo!uif!Tdifevmf/!)Uijt!bhsffnfou!bqqmjft!pomz! up!uif!fyufou!uibu!zpv!qfsgpsn!xpsl!voefs!b!xsjuufo!dpousbdu!uibu!sfrvjsft!zpv!up!pcubjo!uijt!bhsffnfou!gspn! vt/* Uijt!bhsffnfou!tibmm!opu!pqfsbuf!ejsfdumz!ps!joejsfdumz!up!cfofgju!bozpof!opu!obnfe!jo!uif!Tdifevmf/ Tdifevmf +Cmbolfu!Xbjwfs!pg!Tvcsphbujpo!Bqqmjft+ Uijt!foepstfnfou!dibohft!uif!qpmjdz!up!xijdi!ju!jt!buubdife!boe!jt!fggfdujwf!po!uif!ebuf!jttvfe!vomftt!puifsxjtf!tubufe/ Ebuf!Qsfqbsfe;Nbz!8-!3135 Dbssjfs;Csjehfgjfme!Fnqmpzfst!Jotvsbodf!Dpnqboz Fggfdujwf!Ebuf!pg!Foepstfnfou;Kvmz!33-!3135 Qpmjdz!Ovncfs;941.668:5Dpvoufstjhofe!cz; Jotvsfe;B,!Fowjsponfoubm!Sftupsbujpo-!MMD XD!11!14!24)Fe/!5.95* #Jodmveft!dpqzsjhiu!nbufsjbm!pg!uif!Obujpobm!Dpvodjm!po!Dpnqfotbujpo!Jotvsbodf-!Jod/!vtfe!xjui!jut!qfsnjttjpo/!Dpqzsjhiu!2:95!ODDJ# 2953 2954 2955 Page 2 / 2 FWC Contract No. 23007; Task Assignment FK-188. 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Note, not all parcels within each unit will be treated: UNIT KEY Approx # of NATURAL COMMUNITIES TO BE Acres to be TREATED WITHIN UNIT* Treated 3 Cudjoe Key Cudjoe 55.6 Hardwood hammock; buttonwood Acres saltmarsh 4 Cudjoe Key 19.6 Hardwood hammock; buttonwood Cutthroat Harbor saltmarsh 6 Ramrod Key 32.3 Hardwood hammock; buttonwood saltmarsh; freshwater wetlands 7 Little Torch Key 22.6 Hardwood hammock; buttonwood saltmarsh 11 Big Pine Key -Drs 7.75 Hardwood hammock; buttonwood Arm saltmarsh 12 Big Pine Key - Sands 33.7 Hardwood hammock; buttonwood saltmarsh; pine rockland 13B Crawl Key 52.2 Hardwood hammock; buttonwood saltmarsh 13C Long Key 8.1 Cactus hammock; buttonwood saltmarsh 15 Key Largo Bay 34.6 Hardwood hammock; buttonwood Haven saltmarsh 18 Key Largo Pamela 33.1 Hardwood hammock; buttonwood Villa saltmarsh 20 Key Largo Largo 13.3 Hardwood hammock City TOTAL 313 2972 2973 or Gallons Applied the name % Rate enter : maintenance (any pri or controlled species % never treated) 100Herbicide site - target 95 = each 6 initial ( or of the herbicide used, the % rate of herbicide applied, and for . F 95% type - once 75 = 5 enance traversed Class Cover Click here to enter text. 75% - : Choose an item.Maint # 50 acres = using FWC dollars only 4 /PCL INVOICE REPORTING FORM Invoice (per below), the chemical unit 50% Acres - Traversed 25 Maintenance acres CONTRACT NO. = 3 required. Treatment Cost number of FWC Initial PCL Class Initial Cover 25% - total TASK ASSIGNMENT 5 and/or = the 2 . ____________________________ Individual Enter Initial Acres 5% . - Traversed 1 = 1 Maintenance enter the applied for PCL) <1% = 0 (using FWC funds): $ (not mix) cover class Click here to enter text. Cost the , | RANGE(%) __________________________________________ Plant Controlled : Treatment treatments (a single unit cannot be both) PCL Name Public Conservation Land ( PCL COVER CLASS common or scientific) Task Assignment Number:This form must be submitted with each invoice. All data fields are For each (the total quantity of herbicidetreatment) FirstIndividual Use additional sheets if necessary. 2974 GallonsGallons AppliedApplied % % RateRate HerbicideHerbicide ClassClass CoverCover Maintenance Maintenance AcresAcres TraversedTraversed Maintenance Maintenance ClassClass Initial Initial CoverCover __________ _________________________________________________________ $$ Initial Initial Acres Acres TraversedTraversed ______ _______________________ : __________________________________________ : Plant ControlledPlant Controlled Name Name PCL PCL Use additional sheets if necessary. SecondIndividual PCL Treatment Cost (using FWC funds): ThirdIndividual PCL Treatment Cost (using FWC funds):