FY2004 01/21/2004
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
March 15, 2004
TO:
Lynda Stuart, Office Manager
Tourist Development Council
ATTN:
FROM:
Maxine Pacini
Administrative Assistant
Pamela G. Hane&-
Deputy Clerk ~
At the January 21, 2004, Board of County Commissioner's meeting the Board granted
approval and authorized execution of an Agreement between Monroe County and Island Dolphin
Care Center, Inc. for construction of the facility (building) in an amount not to exceed $130,000 _
DAC V, FY 2004 Capital Project Resources.
Enclosed are two duplicate originals of the above-mentioned for your handling. Should
you have any questions please do not hesitate to contact this office.
cc: County Administrator wlo document
County Attorney
Finance
File;
Grant In Aid Award Agreement
This AGREEMENT dated the 21st day of January 2004, is
entered into by and between the BOARD OF COUNTY COMMISSIONERS FOR
MONROE COUNTY, hereinafter "County" or "GRANTOR." on behalf of the
TOURIST DEVELOPMENT COUNCIL, hereinafter "TDC" and Island Dolphin
Care, Inc., a Florida not-for-profit corporation, hereinafter "Grantee".
WHEREAS, the third penny of Tourist Development Tax may be
used to acquire, construct, extend, enlarge, remodel, repair or improve.
convention centers, sports stadiums, sports arenas, coliseums, auditoriums.
fishing piers, museums, zoological parks, nature centers and beaches which are .
publicly owned and operated or owned and operated by not-for-profit
corporations. and
WHEREAS, Grantee has applied for Grant in Aid funding for the
Island Dolphin Care Center project to construct the center, hereinafter "the
Property"; and
WHEREAS, the Grantor and TDC have determined that it is in
the best interest of the County, for purposes of promoting tourism and preserving
the heritage of the community, to acquire, construct, repair and/or rehabilitate the
property for use as a zoological park and nature center open to the public;
NOW, THEREFORE, in consideration of the mutual covenants
and payments contained herein, the Grantee and the Grantor have entered into
this agreement on the terms and conditions as set forth below.
1. GRANT AGREEMENT PERIOD. This agreement is for the period
January 21, 2004 through December 31, 2004. This agreement shall remain in
effect for the stated period unless one party gives to the other written notification
of termination pursuant to and in compliance with paragraphs 7,12 and 13 below.
All work for which grant funds are to be expended must be completed by the
stated termination date.
2. SCOPE OF AGREEMENT. The Grantee shall provide such materials
and services as are required to construct a new therapy and learning facility
(building) which will become the Island Dolphin Care Center. The center shall
include class rooms, two elevators, therapy rooms, central hall for workshops,
interactive wall, library room, exhibit space and a large conference room.
This project shall be completed and invoices submitted to the County Finance
Department no later than December 31, 2004. The Grant in Aid funds must be
expensed in the fiscal year ending September 30, 2005. No funds will be
available for use for this project agreement after September 30, 2005.
The Grantee shall designate a project manager if no licensed architect, engineer
or general contractor is involved in the project. If the project is performed by
County or City personnel, the project manager shall be the Engineer, Building
Official or Construction Manager of that local government agency. This
designation must be made and notice pursuant to paragraph 20 provided to
TDC/County prior to commencement of work covered by this agreement.
Documentation of said notice shall be submitted in the first payment application.
Should any signage be erected acknowledging the development of the project,
said signage shall acknOWledge the Tourist Development Council of Monroe
County.
If the amount of award exceeds $25,000, the Grantee agrees to dedicate the
project property for a period of ten years, absent any acts not in control of the
Grantee such as hurricane or terrorist damage, to the public purpose for which
the funds are hereunder to be paid by County. If, project does not encompass
structural improvements to real property and for any reason the project property
ceases such public purpose use before the expiration of the ten years, the
personalty (property other than realty) acquired under this agreement shall be
delivered to the County or a not-for-profit organization which shall use the items
for purposes which are related to the promotion of tourism in Monroe County.
3. AMOUNT OF AGREEMENT AND PAYMENT. The Grantor shall provide
an amount not to exceed $130,000 for materials and services used to construct
the property. The Board of County Commissioners and the Tourist Development
Council assume no liability to fund this agreement for an amount in excess of this
award. Monroe County's performance and obligation to pay under this agreement
is contingent upon an annual appropriation by the BOCC.
a) Payment for expenditures permissible by law and County policies shall be
made through reimbursement to Grantee upon presentation of Application for
Payment Summary- AlA Document G702, invoices, canceled checks and other
documentation necessary to support a claim for reimbursement. Included in said
documentation shall be proof that the Grantee has received and applied to the
property matching funds equivalent to or greater than the amount invoiced to the
Grantor. The application for payment document must be certified through a
statement signed by an officer of the organization and notarized, declaring that
representations in the invoice are true and factual. Grantee shall also provide
partial releases of liens if applicable. Grantor shall retain 10% of any payment on
work in progress until the Grantee has provided a Final Release of Lien for each
vendor/Contractor for whom payment is requested. Final payment will not be
made until the following documents are complete and submitted to the Grantor.
AlA Document G-702 Application for Payment Summary
AlA Document G-704 Certificate of Substantial Completion
AlA Document G-706 Contractor's Affidavit of Debts & Claims
AlA Document G-706A Contractor's Affidavit of Release of Liens
AlA Document G-707 Consent of Surety to Final Payment
Final Release of lien
?
Affidavit and Partial Release of Lien
All payment requests must be submitted no later than 60 days after the
completion of project
b) Matching funds in an amount no less than the funds provided under this
agreement are required to be applied to the project. Application of matching
funds requires actual payment of the matching funds. Mere obligation through
execution of a contract or approval of a budget item to be paid from matching
funds will not suffice. In order for funds to be deemed matching, they shall have
been expended for the services and materials required for the specific project
described in the Scope of Services paragraph. Any funds applied to any use on
the real property other than the project shall not be used as matching funds
required under this agreement. In order to be considered matching funds for the
project funded by grant under this agreement, the matching funds must be
applied to the project during the tenn of this agreement.
c) Documentation shall be submitted to the TOC Administrative Office to show
the receipt and application of in-kind donations of goods, professional services,
and materials. Said documentation should include invoices, bills of lading, etc.,
and be verified as received and applied to the project through a notarized
statement of the project architect, engineer, general contractor or project
manager. The receipt and application to the project of volunteer labor are to be
documented and verified by notarized signature of the project architect, engineer,
general contractor or project manager, and said documentation submitted to the
TDC Administrative Office. All submissions shall identify the items included in
the schedule of values attached hereto and incorporated herein as Exhibit A
which are sought to be reimbursed and shall indicate the percentage of
completion of the overall project as of the submission. This document should be
signed by the project architect, engineer, general contractor or project manager.
Photographs showing progress on project shall be included in any payment
request.
d) Funding granted under this Grant in Aid Agreement must be expended by
the County no later than September 30, 2005. Any amount of the grant funds not
expended by County by that date shall no longer be available to Grantee, unless
prior to December 31,2004, an amendment extending this agreement has been
approved in writing and executed by both parties.
4. REPORTS. The Grantee shall provide financial reports in summary of activity
on fonns provided or approved by the TOC, and quarterly narrative reports of
activity under the approved work plan. The Grantee shall keep such records as
are necessary to document the performance of the agreement and expenses as
incurred, and give access to these records at the request of the TOC, the County,
the State of Florida or authorized agents and representatives of said government
bodies. It is the responsibility of the Grantee to maintain appropriate records to
insure a proper accounting of all funds and expenditures. The Grantee
understands that it shall be responsible for repayment of any and all audit
1
exceptions which are identified by the Auditor General for the State of Florida,
the Clerk of Court for Monroe County, the Board of County Commissioners for
Monroe County, or their agents and representatives. In the event of an audit
exception, the current fiscal year grant award or subsequent grant awards will be
offset by the amount of the audit exception. In the event the grant is not renewed
or supplemented in future years, the Grantee will be billed by the Grantor for the
amount of the audit exception and shall promptly repay any audit exception.
5. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the
terms of this agreement shall be only amended in writing and approved by the
Board of County Commissioners for Monroe County.
6. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder,
the Grantee is an independent contractor and not an employee of the Board of
County Commissioners of Monroe County. No statement contained in this
agreement shall be construed as to find the Grantee or any of its employees,
contractors, servants or agents to the employees of the Board of County
Commissioners of Monroe County, and they shall be entitled to none of the
rights, privileges or benefits of employees of Monroe County.
7. COMPLIANCE WITH LAW. In carrying out its obligations under this
agreement, the Grantee shall abide by all statutes, ordinances, rules and
regulations pertaining to or regulating the provisions of this agreement, including
those now in effect and hereafter adopted. Any violation of said statutes,
ordinances, rules or regulations shall constitute a material breach of this
agreement and shall entitle the Grantor to terminate this agreement immediately
upon delivery of written notice of termination to the Grantee.
8. RESTRICTIONS ON AGREEMENTS ENTERED PURSUANT TO THIS
AGREEMENT. The Grantee shall include in all agreements funded under this
agreement the following terms:
a) Anti-discrimination. Contractor agrees that they will not discriminate against
any employees or applicants for employment or against persons for any other
benefit or service under this agreement because of their race, color, religion, sex,
national origin, or physical or mental handicap where the handicap does not
affect the ability of an individual to perform in a position of employment, and to
abide by all federal and state laws regarding non-discrimination.
b) Anti-kickback. Contractor warrants that no person has been employed or
retained to solicit or secure this agreement upon an agreement or understanding
for a commission, percentage, brokerage or contingent fee, and that no
employee or officer of the Contractor has any interest, financially or otherwise, in
contractor. For breach or violation of this warranty, the Contractor shall have the
right to annul this agreement without liability or, in its discretion, to deduct from
the agreement price or consideration, the full amount of such commission,
percentage, brokerage or contingent fee. Contractor acknowledges that it is
aware that funding for this agreement is available at least in part through the
4
County and that violation of this paragraph may result in the County withdrawing
funding for the Project.
c) Hold harmlesslindemnification. Contractor acknowledges that this agreement
is funded at least in part by the County and agrees to indemnify and hold
harmless the County and any of its officers and employees from and against any
and all claims, liabilities, litigation, causes of action, damages, costs, expenses
(including but not limited to fees and expenses arising from any factual
investigation, discovery or preparation for litigation), and the payment of any and
all of the foregoing or any demands, settlements or judgments (collectively
claims) arising directly or indirectly from any negligence or criminal conduct on
the part of Contractor in the performance of the terms of this agreement. The
Contractor shall immediately give notice to the County of any suit, claim or action
made against the Contractor that is related to the activity under this agreement,
and will cooperate with the County in the investigation arising as a result of any
suit, action or claim related this agreement.
d) Insurance. Contractor agrees that it maintains in force at its own expense a
liability insurance policy which will insure and indemnify the Contractor and the
County from any suits, claims or actions brought by any person or persons and
from all costs and expenses of litigation brought against the Contractor for such
injuries to persons or damage to property occurring during the agreement or
thereafter that results from performance by Contractor of the obligations set forth
in this agreement. At all times during the term of this agreement and for one year
after acceptance of the project, Contractor shall maintain on file with the County
a certificate of the insurance of the carriers showing that the aforesaid insurance
policy is in effect. The following coverageJs shall be provided:
1. Workers Compensation insurance as required by Florida Statutes.
2. Commercial General Liability Insurance with minimum limits of
$500,000 per occurrence for bodily injury, personal injury and property damage.
3. Comprehensive Auto Liability Insurance with minimum limits of
$300,000 combined single limit per occurrence.
The Contractor, the County and the TOe shall be named as additional insured,
exempt workers compensation. The policies shall provide no less than 30 days
notice of cancellation, non-renewal or reduction of coverage.
At all times during the term of this agreement and for one year after acceptance
of the project, Contractor shall maintain on file with the County a certificate of
insurance showing that the aforesaid insurance coverage's are in effect.
All insurance certificates should be mailed directly to:
Monroe County Board of County Commissioners
C/O Risk Management
,
1100 Simonton Street
Room 2-277
Key West, FL 33040
Re-imbursement shall not move forward until the above insurance certificates
have been received and approved by the County Risk Management Department.
e) Licensing and Permits. Contractor warrants that it shall have, prior to
commencement of work under this agreement and at all times during said work,
all required licenses and permits whether federal, state, County or City.
9. HOLD HARMLESS/INDEMNIFICATION. The Grantee hereby agrees to
indemnify and hold harmless the BOCCITDC and any of its officers and
employees from and against any and all claims, liabilities, litigation, causes of
action, damages, costs, expenses (including but not limited to fees and expenses
arising from any factual investigation, discovery or preparation for litigation), and
the payment of any and all of the foregoing or any demands, settlements or
judgments arising directly or indirectly under this agreement. The Grantee shall
immediately give notice to the Grantor of any suit, claim or action made against
the Grantor that is related to the activity under this agreement, and will cooperate
with the Grantor in the investigation arising as a result of any suit, action or claim
related to this agreement.
10. ANTI-DISCRIMINATION. The Grantee agrees that they will not discriminate
against any of their employees or applicants for employment or against persons
for any benefit or service because of their race, color, religion, sex, national
origin, or physical or mental handicap where the handicap does not affect the
ability of an individual to perform in a position of employment, and to abide by all
federal and state laws regarding non-discrimination.
11. ANTI-KICKBACK. The Grantee warrants that no person has been employed
or retained to solicit or secure this agreement upon an agreement or
understanding for a commission, percentage, brokerage or contingent fee, and
that no employee or officer of the County or TOC has any interest, financially or
otherwise, in the said funded project, except for general membership. For
breach or violation of this warranty, the Grantor shall have the right to annul this
agreement without liability or, in its discretion, to deduct from the agreement price
or consideration, the full amount of such commission, percentage, brokerage or
contingent fee.
12. TERMINATION. This agreement shall terminate on December 31, 2004.
Termination prior thereto shall occur whenever funds cannot be obtained or
cannot be continued at a level sufficient to allow for the continuation of this
agreement pursuant to the terms herein. In the event that funds cannot be
continued at a level sufficient to allow the continuation of this agreement
pursuant to the terms specified herein, this agreement may then be terminated
immediately by written notice of termination delivered in person or by mail to
(,
Grantee. The Grantor may terminate this agreement without cause upon giving
written notice of termination to Applicant. The Grantor shall not be obligated to
pay for any services or gOOds provided by Grantee after Grantee has received
written notice of termination. If the Agreement does not receive an approved
extension beyond the grant agreement period, as defined in-paragraph 1, the
grant in aid funds will expire on the fiscal year ending date of September 30,
2005.
13. TERMINATION FOR BREACH. The Grantor may immediately terminate this
agreement for any breach of the terms contained herein. Such termination shall
take place immediately upon receipt of written notice of said termination. Any
waiver of any breach of covenants herein contained to be kept and performed by
Grantee shall not be deemed or considered as a continuing waiver and shall not
operate to bar or prevent the Grantor from declaring a forfeiture for any
succeeding breach either of the same conditions or of any other conditions.
Failure to provide Grantor with certification of use of matching funds or matching
in-kind services at or above the rate of request for reimbursement or payment by
is a breach of agreement, for which the Grantor may terminate this agreement
upon giving written notification of termination.
14. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of
the parties hereto with respect to the subject matter hereof and supersedes any
and all prior agreements with respect to such subject matter between the
Grantee and the Grantor.
15. CONSENT TO JURISDICTION. This agreement, its performance, and all
disputes arising hereunder, shall be governed by the laws of the State of Florida,
and both parties agree that the proper venue for any actions shall be in Monroe
County.
16. ETHICS CLAUSE: Grantee warrants that he has not employed, retained
or otherwise had act on his behalf any former County officer or employee in
violation of Section 2 or Ordinance No. 10-1990 or any County officer or
employee in violation of Section 3 of Ordinance No. 10-1990. For breach or
violation of the provision the Grantor may, at its discretion terminate this
agreement without liability and may also. at its discretion, deduct from the
agreement or purchase price, or otherwise recover, the full amount of any fee.
commission, percentage, gift, or consideration paid to the former or present
County officer or employee.
17. PUBLIC ENTITY CRIME STATEMENT: A person or affiliate who has
been placed on the convicted vendor list following a conviction for pUblic entity
crime may not submit a bid on an agreement to provide any goods or services to
a public entity, may not submit a bid on a agreement with a publiC entity for the
construction or repair of a public building or public work, may not submit bids on
leases of real property to public entity, may not be awarded or perform work as a
contractor, supplier, sub-contractor, or consultant under a agreement with any
public entity, and may not transact business with any public entity in excess of
7
the threshold amount provided in Section 287.017, for CATEGORY TWO for a
period of 36 months from the date of being placed on the convicted vendor list.
18. AUTHORITY: Grantee warrants that it is authorized by law to engage in
the performance of the activities encompassed by the project herein described.
Each of the signatories for the Grantee below certifies and warrants that the
Grantee's name in this agreement is the full name as designated in its corporate
charter (if a corporation); they are empowered to act and contract for the
Grantee, and this agreement has been approved by the Board of Directors of
Grantee or other appropriate authority.
19. LICENSING AND PERMITS: Grantee warrants that it shall have, prior to
commencement of work under this agreement and at all times during said work,
all required licenses and permits whether federal, state, County or City.
20. INSURANCE: Grantee agrees that it maintains in force at its own expense a
liability insurance policy which will insure and indemnify the Grantee and the
Grantor from any suits, claims or actions brought by any person or persons and
from all costs and expenses of litigation brought against the Grantee for such
injuries to persons or damage to property occurring during the agreement or
thereafter that results from performance by Grantee of the obligations set forth in
this agreement. At all times during the term of this agreement and for one year
after acceptance of the project, Grantee shall maintain on file with the Grantor a
certificate of the insurance of the carriers showing that the aforesaid insurance
policy is in effect. The following coverage's shall be provided:
1. Workers Compensation insurance as required by Florida Statutes.
2. Commercial General Liability Insurance with minimum limits of
$500,000 per occurrence for bodily injury, personal injury and property damage.
3. Comprehensive Auto Liability Insurance with minimum limits of
$300,000 combined single limit per occurrence.
The Grantee, the Grantor and the TDC shall be named as additional insured,
except workers compensation. The policies shall provide no less than 30 days
notice of cancellation, non-renewal or reduction of coverage.
At all times during the term of this agreement and for one year after acceptance
of the project, Grantee shall maintain on file with the Grantor a certificate of
insurance showing that the aforesaid insurance coverage's are in effect.
All insurance certificates should be mailed directly to:
Monroe County Board of County Commissioners
C/O Risk Management
1100 Simonton Street
R
Room 2-277
Key West, FL 33040
Re-imbursement shall not move forward until the above insurance certificates
have been received and approved by the County Risk Management Department.
21. NOTICE. Any written notice to be given to either party under this
agreement or related hereto shall be addressed and delivered as follows:
For Grantee:
Deena Hoagland
Executive Director
31 Corrine Place
Key Largo, FL 33037
For Grantor:
Lynda Stuart
Monroe County Tourist Development Council
1201 White Street, Suite 102
Key West, FL 33040
and
Suzanne Hutton, Asst. County Attorney
P.O. Box 1026
Key West, FL 33041-1026
ITNESS WHEREOF, the parties hereto have caused this agreement
the day and year first above written.
K:;.C;fi/.
.. ...... :.:: ~~ l. KOLHAGE, CLERK
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By. ~
/Deputy Clerk
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
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EXHIBIT A
PART V:
PROJECT B~DGET ~D TIMETABLE - ALL PR~EC-m
1. Coet Estimates; Uat all major work items and the estimated COIta of
each. If the projectla phased. segregate cIear1y those ooata for the phase to be
8S8i8ted by the TDC funds requested. All phases and total estimated cost of the
entire DIDiect must be listed heAt.
Project Budget ATTACHMBNT #4
P ase 1 - Property Aqu s t on & Perm tt ng
ase - onstruct on Pa to ate 16,98
Phase 2 - Construction Contract 706,471
Phase 2 - Construction Non-Contract 381,134
Total cost of phaaelproject for which funds are 18QUested: (not to exc8ed
50% of the total project cost:
a)Phase
b)Project
1,104,588
Percentage of TDC funds requested of Total Budget (not to 8XCssd 50%
of the IataI project CCllIt) 18%
a) Phase
b)Project 1] . 8~
2. Confirmation that signed. sealed bid prnces. W88 utilized for acquiring
architectural servfcea. or that project does not require an:hitectural services.
3. MslctIing FuncIe. Uet the IClUR:es and amountlI of confInned matching
funds. (For items involving personnel. include the number of hours to be &pent
on the PfOject 8Ctivitfes and their P81'-hour Value). These funds must not be
expended beb'8 execution of a Capital Project AQI'88ment. Prior donated
S8IVicea or expenditu... are not acceptable as match for grant funda. No more
than fifty (50%) percent of matching funde or Iw8nty-five (25%) percent of the
tot8J project shall be in-kind services.
Jewish Communal Fund-18,000; Blizabeth Hanes-IO,ooO
Singing For Change (Jimmy BUffett)-IO,OOO;
a ce Famil, Foun-SO,o
William J & Dorothy K O'Neill Foundation-IOO,ooO ATTACHHBNT # I~
b) In-Kind (SO%) limit
1.~~n.lqn
Total confirmed matching Hard-dollar funds:
Totsl confirmed matching In-kind funds:
238,000
This amount should equal or exceed TDC Funds requested.
?1
Page 1 of 2
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4. Outline of expansion opportunity for acquiring further match grants.
Island DOlphin Care
thru rant-writin.
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to reach man otential donors. Durin_ 2003 alone ISland
Care haa baen on the TODAY Show. CNN Headline Newe, BB~
and J'panee~ Televi~fnn. _
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Page 2 of 2
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ACORD:.. CERTIFICATE OF UABIllTY INSURANC~ nt DATE ~1Y't)
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WORKERS COIII'St&ATJDIl AlfIJ
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6FR13OE 781K269003
07/29/03
07/29/04
~ UISI:I\SI: POI.lCY UWI
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De!ICfIIPFI(]ff OFOPERATIDH!IILOCATIDN!JI_lCLE!III!XCUJSf ADDED BY ~BIIElfTI5I'ECIAL PJrOVI!IlDN!I
Ce~t;i.fi.cate- ac.lder ls' named as ackUt~l .insw:ed with respects.
coverage. a.fforded above-
to. the-
CEATlf'lCATE HOLDER
y. ADDIFIONAL III!IURED; IHSUBERLETTER>
1IQImO-4
Kon~oe County -Boa~d: .ofCounty
COmmi:eei.onere 5 Monroe Ci;)unty
Tourist Dev:e1opment Counci1
1.100 .S:Lmonton .Street
Key Jfeet FL 33040
I
ACORD ~ (7197)
~ACORD CORPORA nON 1988
UIIIF!I
~1,000,OOO
5300,000
$ 5, 000
$1,000,000
$0
$ 5, 000. 000
1$ 1,000,000
...
f~
Is
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Al3G $
$
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is
$100,000
$100,000
s 500 000
1
I
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
Great American Ins Co
~ ~EE.~~}~BPI....... ......'>!I~~~~F~P. c.".,:~...:.....€Jf1.i'~fil'f'N~HnN~~..
PRODUCER (3Q'5r8S2!?2~li rlJF~I:3t55852~3703
Regan Insurance Agency, Inc.
90144 Overseas Hwy.
Tavernier, FL 33070
Attn
. INSURED
COMPANY
A
Ext
COMPANY
B
Citizens
Island Dolphin Care Inc
POBox 1288
Key Largo, FL 33037
COMPANY
C
National Flood
CO
LTR
THIS IS E POliCIES OF INSURANCE LISTED B W HA THE INSURED NAMED ABOVE FOR THE POLICY P RIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF AIW 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.
. _...,,-_.._-~ -....- -
TYPE OF INSURANCE POUCY NUMBER I POLICY EFFECTIVE I POUCY EXPIRATION COVERED PROPERTY
I DATE (MMlDDIYY) I DATE (MMlDDIYY)
PROPERTY
~~OHO"
rc
BROAD
C ~:=-
I Xj FLOOD
f....
,---..-"
X INLAND MARINE
TYPE OF POLICY
A ~nst/Builders Risk
CAUSES OF LOSS
NAMED PERILS
I OTHER
CRIME
TYPE OF POLICY
I BOILER & MACHINERY
I
,
L)(; OTHER
B ~indstrom
i
870927738332003
X BUILDING $
PERSONAl PROPERTY $
BUSINESS INCOME $
EXTRA EXPENSE $
BLANKET BUILDING $
BlANKET PERS PROP $
09/12/2003 09/12/2004 BLANKET SlOG & PP $
$
$
09/12/2004 X Building $
ded $1000 $
$
$
$
S
$
$
S
S
$
09/12/2003 09/12/2004 :BUl lng
1#1371430
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,lMP1740671
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LOCATION OF PREMlSESlDESCRlPTlON OF PROPERTY
: story joisted masonry office/school located at 150 Lorelane, Key Largo, Fl
SPECIAL CONDmONSfOTHER COVERAGES
:ertificate holder is shown as an additional insured
DATE (MM/DDfYY)
02/18/2004
LIMITS
500,000
~67..900
1,000,00
SHOUlD ANY OF THE ABOVE DESCRIBED POlICIES BE CANCELlED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
......lL DAYS WRITTEN NOTICE TO THE CER11ACATE HOlDER NAMED TO THE LEFT,
BlIT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABIUTY
OF ANY KIND UPON TH~.cOMPANY,lTS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESEN}'ATIVE
Monroe County BOCC & TOC
1100 Simonton Street
Key West, FL 33040
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