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03/17/2004 CONTRACT TO PROVIDE TREES THIS CONTRACT is entered into by MONROE COUNTY, a political subdivision of the State of Florida, whose address is the Marathon Government Center, 2798 Overseas Highway, Marathon, Florida 33050, hereafter the COUNTY, and Keys Landscaping, 5837 S.W. 82 Street, South Miami, Florida 33143, hereafter the CONTRACTOR. Section 1. The CONTRACTOR and the COUNTY, for the consideration named agree as follows: 1. The CONTRACTOR will provide trees in the approximate numbers (516) and size, number of deliveries, and delivery frequency as identified in the COUNTY's bid specifications and the CONTRACTOR's bid as identified in Attachment 1. A. All plant material as determined by the project manager or his designee at time of delivery shall be vigorous, well established, of good form consistent of its species, free of disease and insects, with large healthy root systems and with no evidence of being restricted or damaged. . . B. All plant material shall be well watered immediately prior to delivery. C. The project manager or his designee will inspect for quality assurance and approve plant material at the project location. The County reserves BC040321 ClAP Tree Contract.doc 2/26/2004 4:42 PM the right to reject any and all plant material. The CONTRACTOR shall not leave the project location until the material has been approved by the project manager. The CONTRACTOR will be responsible for replacing any rejected material at his/her expense. 2. The CONTRACTOR will provide the plant material in four to six separate deliveries so as to allow for planting in discrete events during the rainy season of spring and summer 2004. A. The first requested delivery is anticipated to be approximately I April 2004. Subsequent deliveries will occur in approximately one month intervals. All deliveries shall to be completed by the end of September 2004. B. Delivery by the CONTRACTOR must include all off loading and placement of materials at sites located on Big Pine Key as determined by the Director of Marine Resources 3. The COUNTY will provide at least a notice two weeks prior to a requested delivery of plant material. The CONTRACTOR and COUNTY will coordinate the actual delivery date with the U.s. Fish and Wildlife Service that will be excavating holes in which to plant the trees. Section 2. At the time of each delivery, the CONTRACTOR may invoice the COUNTY for trees delivered to date. CONTRACT 2/26/2004 4:42 PM 2 1. Invoicing and payment shall be based on an average cost per tree of $96.89 per tree. 2. In the last InVOICe, the CONTRACTOR may invoice for an additional amount (approximately $5.24 - accounting for the "round-off' of the average cost of trees provided). 3. Upon receipt of an invoice for any individual delivery of trees, the COUNTY agrees to pay the amount invoiced based only on the number of trees delivered and accepted by the COUNTY. The COUNTY will not pay for any trees that are rejected at time of delivery. The CONTRACTOR may replace the rejected trees to the satisfaction of the project manager to earn the entire value of all trees delivered on the date of delivery. 4. The CONTRACT shall no exceed the amount of $50,000.00. Section 3. Either party may terminate this CONTRACT because of the failure of the other party to perform its obligations under the CONTRACT. If the COUNTY terminates this CONTRACT because of the CONTRACTOR's failure to perform, then the COUNTY must pay the CONTRACTOR the amount due for all work satisfactorily completed as determined by the COUNTY up to the date of the CONTRACTOR's failure to perform but minus any damages the COUNTY suffered as a result of the CONTRACTOR's failure to perform. The damage amount must be reduced by the amount saved by the CONTRACT 2/2612004 4:42 PM 3 COUNTY as a result of the CONTRACT termination. If the amount owed the CONTRACTOR by the COUNTY is not enough to compensate the COUNTY, then the CONTRACTOR is liable for any additional amount necessary to adequately compensate the COUNTY up to the amount of the CONTRACT pnce. The CONTRACTOR acknowledges and agrees that public use of any or all reports or other printed materials, videos, audio recordings, films and photographs produced as part of this Plan may not be restricted under the copyright laws of the United States of America. Section 4. Records of the CONTRACTOR's direct personnel payroll and other costs and expenses pertaining to the Plan and records of the accounts between the COUNTY and the CONTRACTOR must be kept on a generally recognized accounting basis and must be available to the COUNTY. The records also must be in form sufficient to permit a grant specific audit to be performed in accordance with the rules of the Auditor General. The CONTRACTOR must keep the records for five years following the completion of the Plan. Section 5. The CONTRACTOR acknowledges that all correspondence between the County and the CONTRACTOR are public records under Chapter 119, Florida Statutes. As a result, they must be made available at a reasonable place and time upon the request of a member of the public. Failure to do so is a CONTRACT 2/26/2004 4:42 PM 4 breach of this CONTRACT entitling the COUNTY to treat the CONTRACT as terminated on the date of the violation of Chapter 119, Florida Statutes, with the COUNTY's obligation to pay extending only to work completed as of that date plus amounts previously retained, if any. Section 6. In the course of the requirements of this CONTRACT, the CONTRACTOR may not discriminate against any employee because of race, age, creed, color, sex or national origin. The CONTRACTOR will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action may include, but need not be limited to, the following: employment upgrading, demotion, or transfer; recruitment or recruitment advertising; lay-off or termination; rates of payor other forms of compensation; and selection for training, including apprenticeships. The CONTRACTOR must insert language similar to this Section in any of the CONTRACTOR's sub-contracts, if any, funded through this CONTRACT except for subcontracts for standard commercial supplies and raw materials. Section 7. In carrying out the requirements of the CONTRACT, the CONTRACTOR must comply with the requirements of the Americans With Disabilities Act and federal regulations issued under that Act. CONTRACT 2/2612004 4:42 PM 5 Section 8. The CONTRACTOR warrants that it has not employed, retained, or otherwise had act on its behalf any former COUNTY officer or employee subject to the prohibition of Section 2 of Ordinance No. 0 10-1990 or any COUNTY officer or employee in violation of Section 3 of Ordinance No. 020- 1990. For breach or violation of this provision, the COUNTY, in its discretion, may terminate this CONTRACT without liability and may also, in its discretion, deduct from the CONTRACT or purchase price, or otherwise recover the full amount of any fee, commission, percentage gift, or consideration paid to the former COUNTY officer or employee. Section 9. 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 a CONTRACT to provide any goods or services to a public entity, may not submit a bid on a CONTRACT with a public entity for the construction or repair of a public building or public work, may not perform work as a CONTRACTOR, supplier, subcontractor, or contractor under CONTRACT with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 of the Florida Statutes, for the Category two for a period of 36 months from the date of being placed on the convicted vendor list. CONTRACT 2/26/2004 4:42 PM 6 Section 10. The CONTRACTOR agrees to maintain adequate Insurance or equivalent as provided in Exhibit 2. Section 11. All communication between the parties should be through the following individuals or their designees: Monroe COUNTY George Garrett, Director Department of Marine Resources 2798 Overseas Highway, Suite 420 Marathon, FL 33050 CONTRACTOR Thomas Meyer Keys Landscaping 5837 S.W. 82 Street South Miami, Florida 33143 Section 12. This CONTRACT is governed by the laws of the State of Florida. Venue for litigation arising under this CONTRACT must be in a court of competent jurisdiction located in Monroe COUNTY, Florida. Section 13. The effective date of this CONTRACT is March 17,2004. THE REMAINDER OF THE PAGE LEFT INTENTIONALLY BLANK CONTRACT 2/26/20044:42 PM 7 IN WITNESS WHEREOF each party hereto has caused this BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By l~(~ Mayor/Chairman (SEAL) Attest: ORGANIZATION ORGANIZATION ORGANIZATION o ._~ By ~I ~~ Title 'f:::..~.0. ~~l!l~~ APPROVED AS TO FORM ~ LECAL SUF1=4TrrRl\TC~ ~~E "-> --rj ::z: c::::o 0 ~ 0 .r- r z :x>- c- fTI ::0 :z c: 0 0('")." r--- Z -rt l'Tl~: ... ("'). r- (:) (:) 0'" :::0 C:-:;:'J<' z?Oc ZM ::;0 -fn. ::x fTI !"'C,....j:I: . . )> c:e C'":! .." C> 0 r- ,." s:- ::::0 ,.. \D 0 CONTRACT 2/26/20044:42 PM 8 ATTACHMENT 1 Material Specifications Appendix A 2/2612004 4:42 PM Material Specifications ~ Plant material should be comprised of the following: Sixty (60%) percent of all plant material shall be comprised from the list of canopy trees below. Of that sixty percent Gumbo Limbo shall comprise at least twenty-five (25%) percent of the canopy trees provided. Common Name Willow Bustic Gumbo-limbo Pigeon Plum Black Ironwood Wild Tamarind Jamaica Dogwood Paradise Tree Scientific Name Bumelia salicifolia Bursera simaruba Coccoloba diversafolia Krugiodendron ferreum Lysiloma latisiliquum Piscidia piscipula Simarouba glauca All Canopy trees provided shall meet the following minimum requirements: Minimum pot size - three (3) gallons Minimum Height - five to six (5 to 6) overall height Forty (40%) percent of all plant material shall be comprised ofthe following native palms. The number of Cabbage I Sable Palms provided shall not exceed twenty- five (25%) percent of all the palms supplied. Common Name Cabbage Palm Keys thatch palm Florida thatch palm Scientific Name Sabal palmetto Thrinax Morrissi Thrinax radiata Palm material requirements for palms are as follows: Cabbage palm Minimum Height-eight (8) feet of clear trunk Maximum Height-ten (10) feet of clear trunk KeyslFlorida Thatch palms Minimum size - two (2) feet of clear trunk Appendix E 4/161200410:45 AM Attachment 2 Insurance Requirements Appendix E 2/26/2004 4:42 PM 1996 Edition GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Contractor shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: · Premises Operations · Products and Completed Operations · Blanket Contractual Liability · Personal Injury Liability · Expanded Definition of Property Damage The minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 per Occurrence $ 50,000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. GLl Administration Instruction #4709.3 50 1996 Edition VEHICLE LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA AND Recognizing that the work governed by this contract requires the use of vehicles, the Contractor, prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum, liability coverage for: · Owned, Non-Owned, and Hired Vehicles The minimum limits acceptable shall be: $100,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $ 50,000 per Person $100,000 per Occurrence $ 25,000 Property Damage The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. VLl Administration Instruction #4709.3 82 1996 Edition WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to Florida Statute 440. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. If the Contractor has been approved by the Florida's Department of Labor, as an authorized self- insurer, the County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self-insurance fund, a Certificate ofInsurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. wel Administration Instruction #4709.3 89 .f. i ,~, 1., ., ,J .'.. STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENl SECUHPr DIVISION OF WORKERS' COMPENSATION . CERTIFICA TE OF EXEMPTION FROM FLORIDA WORKERS' COMPENSA TION LAW CONSTRU2TION INDUSTRY EXEMPTION This ce''rtWies that the individual listed below has elected to be exempt from Florida W'I)rkers' Compensation Law. BUS1NI::SS 07/01/2002 PRENTICE 252-51-6922 651043923 KEYS LANDSCAPING MAINTENANCE & MACHINES INC 3636 DUCK AVE KEY WEST FL 33040 EXPIRATION DATE 06/30/2004 EFFECllVIE PERSON SSN FEIN CHRISTOPHER ---,_..--.j NOTE: Pursuant to Chapter 440 . 1 O( 1) , (g) , 2 , F . S. , a sole proprietor, partner, or an officBf (I,f a corporation who elects exemption from the Florida Workers' CompIE'n!~ation Law may not recover benefits or compensation under Chapter 440. PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFEnENCE ST A 1'E OF PLORlOA . OEI>AlnNIENT OF LABOR AND EMPLOYMENl' SECURITY DIVI51'(IN 'OF WORKERS' COMPENSATION F CON:i'rRl,ICiION INDUSTRY . . 0 L CERTIF1C,I\.iE OF EXEMPTION FROM FLORIDA 0 WOI~II<EIIIS' COMPENSATION LAW BU~;II"E:3S, 0710112002 06/3012004 PRENTICE CHRISTOPHER 252-51-6922 851043923 KEYS LANDSCAPING MAINTENANCE & INC 3636 DUCK AVE KEY WEST Fl 33040 H E R E NOTE: Pursuant to chapter 440.10111 .191.2. F.S. I a sole proprietor I partoer, or officer of an corporation who elects exemption Irom the Florida Woerks' Compensation law may not recover benefIts or compensation under Chapter 440. EFFE;(:TIVE: EXPIFIA'nON: PERI:, ON: 581\11; FEII'I CUT HERE .. Carry bottom portion on the job, keep upper portion for your records. ~~L-~ C:UU d ~~U-l 5V8ES6ZS0E slllldans ll~qW SBppnS-WOJ:i 6S:Zl vO-ZO-Je~ PROGREJ.fIVE@ INSURED/APPLlG~I\IT'S NAME CHRISTOPHER PR.ENTICE EFFECTIVE DATE 10/10/03 POLICY NUMBEI~ 4'0584556 - 1 ~:ERSONAL INJURY PROTECTION (PIP) NOTICE OF COST SAVINGS OPTIONS For persona'! Injury protection insurance, the named Insured may elect a deductible and to exclude co"erage fOil' lOBS of gross income and loss of earning capacity ("work loss"). These elections apply to the named Insull"ld only, or to the named insured and all dependent resident relatives. A premium reduction will result frlwn these elections. You are hereby advised not to elect the "work loss" exciuslon if the named insured or dE!p'i!ndent resident reistlves are empioyedl since lost wages will not be payable in the e"ent of an aocldent. If you wouldlll~;e to change your coverage options, please callus at 1-800-436-7071. PMRWD970212021 605161 00 Form No 6 'I ClO FL {O2l001 98L-~ EOO d 850-1 6v8E96ZS0€ S91 IddnS 9'liiO s9ppnS-WoJ~ 6S:2l vO-20-Je~ i(j 1111",1'" ~0584555.1 , Wy,:)r-I'c~ PI1~NTI(t: Page 5 01 5 Motor Vellllliclli! Policy Endorsement Your policy Is amended as follows: 1 . Jllart I - Liability To Others -he following is deleted from the limit of Li<lbility in Part I: ilf1Y payment to a person under this Part I for bodily injury shall be reduced by: I any payment made to that person for bodily injury under Part III - Uninsured/Underinsured Motorist Coverage: 2, any amounts that are paid or payable to that person as personal injury protection beneiits; and 3, the deductible applicable to the injured person's personal injury protection benefits, ;:lnd replaced by: ,~ny payment to a person under this Part I fDf bodily injury shall be reduced by: 1. any payment made to that person for bodily injury under Part III . Uninsured/Underinsured Motorist Coverage; and 2. any amounts that are paid or payable to that person as personal Injury protection beneiits. 2. Part II(A) - Personal Injury Protection (a) The Additional Definition for "medical benefits" in Part II(A) is deleted and replaced by the 'following: "Medical benefits~ means eighty percent (80%) of the reasonable expenses incurred for medically nemsary medical. surgical. x-ray, dental and rehabilitative services, including prosthetic devices and necessary ambulance, hospital, and nursing services. Medical benefits also include medically necessary remedial treatment and services recognized and permitted under the laws of the State of Florida for an injured person who relies upon spiritual means through prayer alone for healing, in accordance with his or her religious belief. All other terms. limits and provisions of this policy remain unchanged. 'orl11 4870 FL (06/0,) 98L-~ VOO d 890-1 6v8E96Z90E S811 ddnS 8' I no s8ppng-UJOJ ~ OO:EI vO-ZO-Je~ B ... uKI::;IS ~"::I~I '11-- INSLlUNCII,1ibR(IIUP Bankers Insurance Company St Petersburg, Florida 33701 800-627-0000 5000 00000 VEeT GL AMENDED Vector EFFECTIVE: 1/22/04 '.Jj~,i'j OC 1'-'1,1 !hlJ'\ I-S; .1.~;:) .?, UU2/0Lf nECIARATIO:'\S PAGE 2/02/04 ';:I):I.!\;:.c;:;;.+~~tt1!Hoii' ',';' ./J".",Ir."'~ " ,h..,,, ." ...~Ii, 305)294-6677 Agent (:105) 294-6677 THE FUL].EI~S INC 1432 Kl:HN:WY DR KEY WE!;'f FL 33040 KEYS LANDSCAPING MAINTENANCE AND M ACHINES INC 3636 DUCK AVE KEY WEST FL 33040-4412 o Individu~ll o J oint Venture o Partnership Ii] Organization (Other than Partnership or Joint Venture) Business Desl:ripUon; LAWN M,AIN!E:NANCE THIS POLICY CONTAINS A DESIGNATED WORK ENDORSEMENT. DAMAGES RESULTING fROM WORK OR OPERATIONS WHICH ARE, HOT SPECIFIC AND CUSTOMARY TO THE CLASSIFICATION SHOWN OR OTHERWISE LIStED IN tHE ENDORSEl'l,1f,NT AS EXCLUDED ARE NOT COVERED ON THIS POLICY. Kathleen A. Batson COLJn((',,::;lgn~d by Authorized RepF'eSent:;ltlve 1/22/04 Date Copies ::ent To: As Indicated On The Back * ...... "" _ .11 "'" ,., ,.., n 'I n [;J r Q n I 98L-~ 500 d 850-1 nun-;;j':lnnnnn 6~8E96ZS0E SBI Idans B~I+tO sBppn8-woj~ OO:El vO-2Q-Jerl , ~lq(~' .11' '!4w t~~!ij ';.,H9'd ),/f.'2/04 'In_t_ BANKI!:,~~ ,._'" IllSUUNCI"I"IC~UP Bankers Insurance Company St. Petersburg, Itlorida 33701 5000 00000 VEeT GL AMENDED Vecto~ EFFECTIVE: DECLARATIONS PAGE 1/22/04 Page 2 of 2 2/02/04 97047 1 Full-Time Incl. $551. 00 Incl. $551.00 2 P a.rt-rime !ncl . $183.00 Inel _ $366.00 Pri.or Insurance Surcharge 1.5000 Total Ad'/arlced Premium $1,376.00 Total Ch~Dnged Premium $.00 TerrorisllI Premium (Certified Acts) $.00 IMPORT A~"(iT NOTiCE TO POLICYHOLDERS ~ Subcontract Work If you sub:cntract work, you must obtain a Certificate of Insurance showing limits of at least $100,000 or limits whil;:h match those on your policy, whichever is less, Operations performed by subcontractors without adequate ins'Jrance shall be classifIed and rated in the same manner as though work was performed by the insured's I:'W n employees. - ., _.....,.,,.,,.,,, n D r 10I n I n II n ';l ':l n n 11 n n 98L-~ 900 d 850-1 6v8E96Z50E S91 IddnS 9'IJJO s9ppn8-woJ~ OO:El vO-ZO-Jel1 Q 2003- 2004 OCCUPATIONAL TAX r~ 0/1; p DE STA"~ OF FL.O!<IDA MUST BE DISPLAYlOLJ IrJ CONSPICUOUS PLACE ~":'O~'IS SEFS EMI'lOVE"S !.l.C:;:OI..'l'-JT :Of: ,S EXPIRES 30140-0028159 SEP T. 30; 2004 0-5 SUPPLEMENTAL ~I:New~-fc.,=,~E~ NEWTA~_=-~ !;~,.,::;: TRANS~"'"I f"rI~~~ 01'lIGINAL T'IX ;.,,::;:;:=' <a ~.-. _c:::t'4.!!r ...... - C:l_ ~ <=J....... AMOUNT ~=~~ :!: PENALTY ~cn_""""1QI ..g COLI.ECTION COST:;; ::: TOTAL 20.00 ;S MO CrY 00 - COllNTY OF MONROE 30140 l.ANDSCAP! NG C ONT SP /~t~;~~t),;. !f~!k ';H~ I \ 24 - --~\~~~~~ tf~I/(;::;'&:pJ 'il~,. '\~1l ~"", -1'- >'" ~.. V .it C:-'" ::';';" > \ j. ~rJ-,". ~~;~ \. I .';. ~; .,. ~040 ,< , / I 1/1 ~ - '~::r.'. .' _.' 01 '-s- ,~......Q{~ "'%' ~.~~ '~""f1,\ ,..,~l ..;?' :.t~~~~..,.~:td' 20.00 :$ S 5 KEY $ L MI D :; CAr I N G r R E N T1 elf:. C H R I " TOP HE K ~J 3636 ()Un~ AVENUE Kt': Y WE S r F L lAr:DSCAII'ING CONT ~,p 1470 c:cuESA.TA;lt II:~I :. : ,WHENVAUDO."JED . 1w".fSED _ HENRIQUEZ TAX · f BOX 1129, KeY WEST Fl ! I' COLLECTO~ 33041-1129 THIS IS ONLY A TAX. YOU MUST MEET ALL COUNTY PLANNING '- AND ZONING REQUIREMENTS. OOOOOOOO)DO 0000002000 0000301400028159 1001 0 CI'I'Y OF KEY WEST, FLORIDA I Occupational License A City Occupational Licens@ 15 a busin~ss tax. Holder must me~t all City zonin~ and use provisions. P.O. Box 1409. Key west. Florida 33040 (305)292-8131 Busjn'ess name L.oC~ltion actor Lie Nbr/Cla55 Issue date Lie Fee pep:01 ty To 1. ~ J KEYS LANDSCAPING MACHINE & MAl Ctl nbr . 3635 DUCK AVE 04 09842 CONTRACTOR - SPEC COMME~CIAL 9/30/03 Expiration date . 9/30/04 87_50 .00 87.50 4BOO LANDSCAPE KEYS LANDSCAPING ~ACHINE HSG DUCK AVE KEY WEST fL 33040 & MAl prominentlY displayed. . 1 CWftl.l\ER Type: {X; Drower. %p~r: 9/Je/03 '51 Receipt no: 125&7~ CH'R15~;.i~e4" D~lt.ECf' QUilf1~P Ull ,.. 'l fC'OCCl! 1411G1S8 Trans nUlber. 1""4 $87 SO CK CllECK ,,, . Trana date: 9/30/03 na!!: 14:18:41 ThIs license must be --------- __________u CITY Of KEY \\'1:.51' OrCOMPEJENCY CERTIfiCATE S TO CERT1fY JI 856 THIS \ ~her r,entice ~."'__U . , - . , i~ 9BH LOO d 890-1 6v8E96Z90E SB!lddnS ;~ljjO s;ppna-WOJ, 00: E I vO-ZO-JeV( 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: Contract for: Address of Contractor: Phone: Scope of Work: Reason for Waiver: Policies Waiver will apply to: Signature of Contractor: Risk Management Date County Administrator appeal: Date: /< -e.. 'I s L A IU 7:J.s CA PI n (." PRov/ -D ~> -IeEE$ ~ . LV. $' ~ ~ .5TUt:-T \ / m 11::), m / F L t:J 12.. lDIi- I (30iA '3 ~(-6;), II rRDU(DE:.. -rR-EtS $1?37 sov~ 5.~TE E XE:.m PTJDU-- Too P-E:. LV E.. rn plo'l Ef~. u ) t) R \<. E. R So eD i/Yl ro E. i'._n; Y\ \l'{) 10 Approved: Not Approved: Board of County Commissioners appeal: Meeting Date: Administration Instruction #4709.3 Approved: Not Approved: 107 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: Contract for: Address of Contractor: Phone: Scope of Work: Reason for Waiver: Policies Waiver will apply to: Signature of Contractor: Risk Management Date County Administrator appeal: Date: k <:: y S L A ,,_rb~ CA P/~ t.- 7ROV IDL '//2 ~~S ~a7 S. U..J. g>d ~ .sTRE:~~ 5ovt-l: MIAmi J PL c:. 3 DD 2> d.1 -0;).. I " PRO u ir)b ---rR.~fS IJ D ( )-L h I ~ ( -r , " by. (OIU ~~'- \DR.. Q,H~P,IUt. K.<e:Y V E-hlCJ S tv tL l bf: U5.E.tJ iZ' P R. D U I T;:)f "i'"e- E_ ~ <; lD ~TL App<oved - L~ ot App<oved ,1,ld1 ftr mtj~r - +re' ~ d~t,u"r(";) -.Hi S It., t~'1 QIIC)tl.tl'" GO"'f4H.7 Approved: Not Approved: Board of County Commissioners appeal: Meeting Date: Administration Instruction #4709.3 Approved: Not Approved: 107 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: Contract for: Address of Contractor: Phone: Scope of Work: Reason for Waiver: Policies Waiver will apply to: Signature of Contractor: Risk Management Date County Administrator appeal: Date: JL L y..s Lf1IJJ S-CfJPI Iv~ .~i)f) ilJ f:- -tetE-S 5??3 7 .5. W. 8J ~D .s~f-€-I souY-t miAmi. FlofC/D A (30:2) 3;)/-0;;;/ P/21JV /l) S -j-t<.t:es 'S~'f" e.tCeltl,tIGf\ - +00 -CE"W ~~rlo'1ee.s . p~ellldc-.5 tVlII be t/~...d h*-.etJA.>Tk:4k tP I-S C t). IV ne..fiC.fJ. [lJ fJ elJ II )]) ~ r.e ;s ID IE.> i~ p/ IU e.. kEY _ Wdt ~e~' (..()n'\per\So,,~\on tI ~ I'. Approved: Not Approved: Board of County Commissioners appeal: Meeting Date: Administration Instruction #4709.3 Approved: Not Approved: 102