10/20/2004 Contract
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
December 10, 2004
TO:
Peter Horton, Manager
Monroe County Airports
FROM:
Bevette Moore
Airport Business Administrator
Pamela G. Hanc~
Deputy Clerk rY
ATTN:
At the October 20, 2004, Board of County Commissioner's meeting the Board granted
approval and authorized execution of a Construction Contract between Monroe County and Koch
Corporation for the Noise Insulation Program, Phase 3 construction, for the Key West
International Airport.
Enclosed are three 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 w/o document
County Attorney
Finanfe
File I
THIS AGREEMENT effective 30th day of August , 20 ~between the MONROE
COUNTY, a municipal corporation organized and existing under the laws of the State of Florida (hereinafter referred to as the
"Sponsor") and Koch Corporation (hereinafter referred to as the
"Contractor").
WITNESSETH
WHEREAS, the Sponsor is the sponsor of the Key West International Airport Noise Insulation Program (hereinafter referred to as
the "NIP"); and
WHEREAS, the Sponsor has elected to implement the third phase of the NIP (hereinafter referred to as "Phase 3"); and
WHEREAS, the Phase 3 NIP is managed by the consultant team consisting of the prime manager, architect, acoustician and
construction manager (hereinafter referred to as the Program Manager")
WHEREAS, the Contractor shall perform all necessary work and labor in the Phase 3 NIP (hereinafter referred to as the "Work");
and
WHEREAS, the Work shall be performed in accordance with the approved Phase 3 NIP Construction Drawings dated April 30,
2004 (hereinafter referred to as the "Drawings" and the approved Phase 3 NIP Construction Specifications dated April 30, 2004
(hereinafter referred to as the "Specifications"); and
WHEREAS, the Work shall be completed in accordance with the following Phase 3 NIP Construction Schedule (hereinafter
referred to as the "Schedule"), consisting of the sub-construction construction schedules (1-4) and total construction period
schedule; and
Phase 3 Total Construction Period 120 days Mon 3/21/05 Tue 8/16/05
Sub-Construction Period 1 (9 homes) 30 days Mon 3/21/05 Fri 4/29/05
Sub-Construction Period 2 (10 homes) 30 days Mon 4/25/05 Fri 6/6/05
Sub-Construction Period 3 (10 homes) 30 days Mon 5/31/05 Fri 7/12/05
Sub-Construction Period 4 (10 homes) 30 days Mon 7/6/05 Fri 8/16/05
NOW, THEREFORE, in consideration of the terms, covenants and conditions set forth herein, and other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, the Sponsor and the Contractor hereby agree as
follows:
That the Contractor in consideration of the payment of the Contract price thereof amounting to Two Million Forty Six Thousand
Eight Hundred Eighty Nine Dollars ($2,046,889.00), shall perform all work set forth in the Drawings and Specifications, and
agrees to furnish all materials (except as specified to be furnished by the NIP), together with all necessary to furnish all necessary
equipment, tools, labor, and other means of construction and do and perform all necessary work and labor for the full completion
of the Work under Contract No. THC NO. 04KW13 the Work to be performed in accordance with approved Drawings and
Specifications and for the price and compensation set forth above and as specified in the Bid Form of the Contractor which is
hereto attached and hereby made a part of this agreement. The Work will be performed in accordance with Schedule. Work and
payments will be pursuant to and in accordance with Drawings and Specifications, therein set forth and addenda thereto, all being
incorporated by reference and being a part of this agreement.
The Contractor agrees to utilize the following Disadvantaged Business Enterprises:
Kenmar General Contracting. LLC
CONSTRUCTION CONTRACT/BONDS
00500 - I
Contractor agrees that the Work shall be done and performed in a good and workmanlike manner, that all materials and labor shall
be in strict conformity in every respect with the Drawings and Specifications for the improvement and shall be subject to
inspection and approval of the Sponsor through its duly authorized Program Manager and, in case any material or labor supplied
shall be rejected by the Sponsor as defective or unusable, such rejected material shall be removed and replaced with approved
material, and the rejected work shall be corrected to the satisfaction and approval of the Sponsor through its authorized Program
Manager, at no additional cost or expense to the Sponsor.
Contractor further agrees that he will commence the Work hereunder upon receipt ofthe executed copy thereof and will complete
the Work to the satisfaction and approval of the Program Manager within the time limits specified in Time of Completion
and Schedule sections in the Specifications.
It is further agreed that any delay caused by the elements and other causes over which Contractor has no control or by strikes or
other combined action of workers employed in the construction or in the transportation of materials, in no part caused or resulting
from default or collusion on the part of the Contractor, shall be excused and the time for completion extended to the extent that
Program Manager may fmd and determine such condition to have delayed completion within the time limit through no
fault of the Contractor, but the judgment of Program Manager in respect thereto shall be final and conclusive upon the
parties. Contractor agrees that neither it nor its Subcontractors shall have any claim for damages against the Sponsor
or its agents arising from delays in the Work. Contractor understands that its sole remedy for a delay is an extension oftime.
The Sponsor and the Contractor agree that the damages which would be incurred by the Sponsor in the event of delay of the
Project would be substantial but are not capable of being precisely calculated as of the execution of this Contract. The Sponsor
and the Contractor therefore agree based upon their professional knowledge and experience with projects of this type and their best
estimates ofthe damage associated with delay ofthe Project that the Contractor (and his surety) shall be liable for and shall forfeit
One Thousand Dollars ($1,000.00) from the Contract Sum for each calendar day (Sundays and Holidays included) after the final
Completion Date (8/16/05) that any part of the Work upon any property remains incomplete, herein stipulated as fixed, agreed, as
liquidated damages, and not as a penalty.
It is further understood and agreed that no claim for extra Work done or materials furnished by the Contractor will be allowed
except as provided by the Drawings and Specifications, nor shall the Contractor do any work or furnish any materials not covered
by the Drawings and Specifications and by this Contract unless such work is first ordered in writing as provided in the Drawings
and Specifications. Any extra work done or materials furnished by the Contractor without written order first being given therefore
as in the Drawings and Specifications provided shall be at Contractor's risk, cost and expense, and Contractor agrees in such event
that he will make no claim for compensation for such extra work or materials.
It is further agreed that in no event shall the contracting officers of the Sponsor be personally liable or responsible in any manner
to the Contractor, Subcontractors, suppliers, laborers or to other person or persons whomsoever for claim, demand, damages,
actions, or causes of action or character arising out of or by reason of the execution of this agreement or the performance and
completion of the Work and improvement provided herein.
Contractor certifies to being not disqualified or debarred from entering into or receiving a Florida Department of Transportation
contract, or a municipal State-aid or County State-aid Contract administered by the Department of Transportation as agent of a
municipality or county pursuant to Florida Statutes. Further, Contractor agrees not to utilize either directly or indirectly any
contractor, corporation, partnership, or business however organized, which is disqualified or debarred from entering into or
receiving contract as stated above. This restriction applies regardless of whether the disqualified or disbarred party acts in the
capacity of a Contractor, a Subcontractor, or as an equipment or material supplier.
It is further agreed that the Contractor will abide by the provisions of Title VI of the Civil Rights Act of 1964 and Federal
Regulations of the Department of Transportation, set forth in Section 00210 of the Specifications, will afford opportunity for
Disadvantaged Business Enterprise as set forth in Section 00210 of the Specifications, wi II camp Iy with restrictions on F edera I
Public Works Projects as set forth in Section 00210 ofthe Specifications, will comply with the General Civil Rights Provisions as
set forth in Section 00210 of the Specifications, and will comply with Buy American Steel and Manufactured Products for
Construction requirements as set forth in Section 00210 of the Specifications.
CONSTRUCTION CONTRACT/BONDS
00500 - 2
MONROE COUNTY NOISE INSULA nON PROGRAM
By
STATE OF FLORIDA )
MONROE COUNTY )
) SS
This instrument was acknowledged before me on 8th
day of
December
,20~,by
Murray E. Nelson
........... PAUELA G HANCOCK
~~\if\Y.l'Si~~ ...... .
N~:"1 MY COMMISSION # DO 256075
~. '. ::! EXPIRES: February 7. 2008
,~,;;....., 80ndeli Thru N_N Public UndIIwriIen
'tJi'H~:' v_,
'"'th'au~~NIP.
1\rotary Public Signature
1/
, i
e: I
CON~ At., T
, ~
l '
By . .
C. S ph n Koch
President
(Notarial Seal)
Title
~-'.".,: ,;-.
(..,_._~ ,::....:.
[-~ i ~""-
("".....,
;:".,;.;
C?
Contractor
Individual & Co-Partnership Acknowledgment
.:::;J
-~,/'~
.. ..... -.-...J
:2
"';ir.,
STATE OF FLORIDA )
) SS
MONROE COUNTY )
~1
;-
...,
is;
(.J
I.',,;:
This instrument was acknowledged before me on
day of
,20
by
Notary Public Signature
(N otarial Seal)
Contractor
Corporate Acknowledgment BY
OA
STATE OF KENTUCKY)
) SS
JEFFERSON COUNTY )
This instrument was acknowledged before me on 30th
day of
August
,20 04
, by
C. Stephen Koch
Corporation
(Notarial Seal)
CONSTRUCTION CONTRACT/BONDS
00500 - 3
Monror: County Noise Jnsulation ProgJ1lm (NIP)
PAYMENT AND PERFORMANCE BOND
Part A: Payment Bond
BOOD NO. SBOO85371
KNOW ALL BY THESE PRESENTS, that we, KOCH CDRPORATICfi
Contractor,
as Principal, whose address is
XL SPECIALTY INSURANCE cn<<>ANY
_' and Surety
,whose address is 25 INDEPmDmcE BLVD., WARRm, NJ 07059
duty authorized and licensed to do business in the State of Florid a, as Surety, hereinafter called Surety, are held and finnly bound
unto the MONROE COUNT\' NOISE TNSULATlON PROGRAM NIP as obli ee, hereinafter called OVtner, for the lIse and
benefit of claimants as hereinafter provided in the amount of EJrBr Dollars, for the
payment whereofPrindpal and Surety bind themselves, their heirs, executors, administrators, successors and E1Ssigns, jointly and
severally, firmly by these presents. WHEREAS. Principal bas written llIITeement dated _, 20_, entered
into a contract with Owner for NIP phase 3 CONTRACT. 'lICR).' 0R18 , in accordance with drawings and specifications
prepared by/for MONROE COUNTY NIP wbich contract is by reference made party of hereof and is required by Section
255.05, Florida Statutes. Th~ said written agreemeJJt, drawings, specifications and amendments are hereinafter referred to as the
Contract.
NOW THEREFORE, THE CONDITION OF TillS OBLJGATION, as required by Section 255.05, Florida Statutes, is such
tbat, if the Principal shall faithfully perfonn the said contract and pay every person entitled thereto for all the claims for labor
performed aud materials furnished under the Contract, to be used or consumed in making the public improvements or performing
the publie work as pr.ovided in the Contract, then this obligatioll shall be null and void; otherwise is shall remain in full force and
effect, subject, however, to the following conditions: 1) :No assignment, modification or change of the Contract, or change in the
work covered thereby, or any extension of time for the completion of the Contract shall release the sureties on the bond. 2) Not
later than one year after the completion of the work under the Contract, any party in interest may maintain an action in his own
:name against the Principal and the Surety upOn this bond. for the recovery or any damages he may have sustained by reason ofthe
failure ofthe Principal to comply witb tlle Contract or with the Contract between the Principal and his subcontractors. If the
amount realized on this bond is insufficient to satisfy all claims of'thc parties in full, it shall be distributed among the parties pro
rata.
Signed and sealed this 30th
day of
Au gu s t
,2004,
IN THE PRESENCE OF:
By:
. cipal (Contractor)
(Seal)
XL SPECIALTY INSURANCE c:nwANY
Name of Surety
~,
"""--) L~ ~ By;
Witn s DIANE L. PHELPS
~
STEVEN M. GARRETT, A'l'TORNEY- IN-FAC'I'
(Seal)
CONSTRUCTION CONTRACT160NOS
00500 - 4
"
1\ '....
Monroe County Noise !nsullltiOl1 Pm~am (NlP)
PAYMENT AND PERFORMANCE BOND
Part B: Performance Bond
BCtID NO. SBOO85371
KNOW ALL BY THESE PRESENTS, that we,
KOCH CORPQRATIOO
Contractor,
a5 Principal, whose address is XL SPECIALTY INSURANCE COMPANY .- I and Surety
whose address is 25 INDEPENDENCE BLVD., WARREN, NJ 07059
,. - .. ,II
duly authorized and licensed to do business in the State ofFlorlda, as Surety. hereinafter called Surety, are held and firmly bound
unto MONROE COUNTY NOISE INSULATION PROG er, for the use and
benefit of claimants as hereinafter provided in the amount of Dollars, fur the
payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and
severally. firmly by these presents. WHEREAS. Principal has written agreement dated ,20-, entered
into Ii contract with Owner for NIP CONTRACT ':nc t.U 04RW13 , in accordance with drawings and specifications prepared
by/for MONROE COUNTY NIP which eontract is by reference madE: party ofhercof and is required by Section 255.05, Florida
Statutes. The said written agreement, drawings, specifications and amendments are hereinafter referred to as the Contract.
NOW THEREFORE, THE CONDITION OF THIS OBLIGA TIO~, iftl1e Principal shall faithfully complete the Contract(s)
according to it! tenns and shall save the Monroe County NIP hannless from all cost and charges that may accrue on account of the
doing oftbe Work specified and s1'laJ1 pay all costs of enforcement ofthe tenns of the bond, if action is brought thereon, including
reasonable attorney's fees, C(J$ts and disbursements, in any case in which such action is successfully maintained, or successfully
appealed, and shall comply with the taws ofthe state appertaining to $uch Contract(s), then this obligation s'hall be void but
otherwise it shaH remain in full force and effect pursuant 10 Florida Statutes,
Signed and sealed this
30th
day of
,'\11g11 c:t
, 2004
IN THE PRESENCE OF:
KOCH
100
of Principal (Contractor)
~ IJ;!!;:;een
By:
(Seat)
XL SPECIALTY INSORANCE COMPANY
Name of Surety
~~>c~ By.
ess DIANE L. PHELPS
~
STEVEN M. GARRET.r, AT'l'CRNEY- IN-FACT
(Seal)
CONSTRUCTIONCONTRACTmONDS
00500 - 5
"itdt,ff;L,~;Jjj;~l!i_t:;:;&:i;q;$~~~"'j~ln '1iI1T '~I"~""~~~
~
~~I""~"~--nt
~~jj~~U "'1:1' 1'- ".~~liW"""'",n'''''li'''MlI.liil<Iii;""t,.""",,,:,C''''''''",''''-''''';''''-''""",_"
SURETY DISCLOSURE
NOTICE CONCERNING FEDERAL TERRORISM
RISK INSURANCE ACT
You should know that, effective November 26, 2002, the US Congress enacted
the Terrorism Risk Insurance Act of 2002 (the "Act"). Under the Act, any covered
losses caused by certified acts of terrorism would be partially reimbursed by the
United States under a formula established by federal law. Under this formula, the
United States pays 90% of covered terrorism losses exceeding the statutorily
established deductible paid by the insurance company providing the coverage.
In accordance with this Act, we are providing this disclosure notice for bonds on
which XL Specialty Insurance Company is the surety.
DISCLOSURE OF PREMIUM
The portion of the bond premium attributable to coverage for certified acts of
terrorism under the Act is Zero Dollars ($0.00)
. - .,.._, '....,c '.
.".... ---- ,.
.., . .
>!4:SPEOArry
~~Al,#P:;;;;V:::::::: ,::::::. .:::_::::_ ,::::,::
KNOWi\LL MEN BY THES~PRESENTS<.That ttleXL SP.~CI~LTY INSURANCE COMPANY, a corporation organized and existing by virtue of the laws of the State
of Dela~~("COmpaflY~Q"!;Corporation"}; with 0~.~r25jridependence Blvd.. Suite 103, Warren. New Jersey, 07059, does hereby nominate, constitute and
appoint; Steven M. Garrett, William A.KantJehri~r;.HI, Thomas J. Mitchell, JeffreyA. Brown, Diane L. Phelps, Deborah A. Yates,
its true and lawful Attomey(s)-in.fact to make, execute, attest. seal and deliver for and on its behalf, as surety, and as its act and deed, where required. any and all
bonds, undertakings, recognizances and written obligations in the nature thereof, the penal sum of no one?fwhich is in any ~vent to exce.~~$Unlimi~~.Q()c
Such bonds and undertakings, when duly executed by the aforesaid Attorney(s)-in-fact shall bebindinglJponWesaidComplU')yasfUlIy an<ltoihe$ame~xWntasifsuch
bonds and undertakings were signed by the President and Secretary of the Company and sealed with it'sccirporate~~al.>.. ..........i .................... ..... ... ..
This Power of Attorney is granted and is signed by facsimile under and by the authority of the foJJ()WingRElSolutidn ll<ii:lpted by tile El(jard ofpireclorspfthe Company
on the 5th day of December, 1988: . . .... ,. ... . .. .
THIS IS NOT A BOND NUMBER
UNLIMITED POWER OF ATTORNEY
XlS
84234
., - - .
.. .
. -" ,. , .
.., ".
"RESOLVED, That the President, or any Vice President of the Company or any person desi~n13t~#by anyone qftb~ is herebY,iUthori~~d tOll~llc:~te. Powers
of Attorney qualifying the attorney named in the given Power of Attorney to execute in behalf()fthe CompailY;bonds, undert~!!:ings an(:jcilfppnlTacts of
suretyship, and that any Secretary or any Assistant Secretary of the Company be, and that each or any of them hereby is authorized to atlest the execution
of any such Power of Attorney. and to attach thereto the Seal of the Company.
.. ,.. .,,,' ---. --....'..
. .
. " - " .
" , .. -, - -, '-,..., . -..,. '. ....., ,- -.-,
., --,,' . ......
FP~'rHER RESQI.VE:P, That tl:t~~igriittJf~of~~chpffit:~~and the Seal of the Company may be affixed to any such Power of Attorney or to any certificate
rlllci!irig tI1eret()tly,atSii'rl~e,(ir~any ~i;JctiA()werof Att()~yorcertificate bearing such facsimile signatures or facsimile seal shall be thereafter valid and
............ ~il'1ding~por~ComparyViithrespElct to anybi:>nd, und~rtaking..orcontract of suretyShip to which it is attached."
Bonds eXElcute4un~Qtthis Power of Attbrney may bllElXecuted unqerfacsimile signature and seal pursuant to the following Resolution adopted by the Board of
Director$6f t~ Company onA\l{jiJst7, 19~7. ...
BY
PRESIDENT
Attest:
STATE ()FNEW SECRETARY
COUNT'( OF
On this 20th day of November, 2003, before me personally came Nicholas M. Brown Jr, tome known, who, being duly sworn, did depose and say: that he is President
of the Corporation described in and which executed the above instrument; that he knows the seal of said CClrporation; that the seal affixed to the aforesaid instrument
is such corporate seal and was affixed thereto by order and authority of the Board of Directors of said C?ffiPany; and thathllex~cutedthe~ai(:j .
instrument by like order, .. . . .. . .
REBECCA CLAIRE KOLLHOFF
Notary Public
Stl>le of New Jel'l!ey
My CommiSllion Expires 3/8/2O(y[
STATE OF DELAWARE
COUNTY OF NEW CASTLE
I, Ben M,Llanllta, Secretaryoft~XL SPECIA.LTYINSL!RA~9~c;OMPANY a corporation of the State of Delaware, do hereby certify that the above and forgoing is a
full, tl1.!llan~C9rrectcopYJ>f~o"ffir of Atf9rneYilj~till~bY~idC;ClI1:wany, and that I have compared same with the original and that it is a correct transcript therefrom
and~fth~1MioleClf theprigjnal al"ldlfl<itthe s(iidAo..verpf Attorney is still in full force and effect and has not been revoked.
. ". ,.-.,.
.,. ,...
NOTARY PUBLIC
day of
20_,
This Power of Attorney may not be used to execute any bond with an inception date after Novelfi~r 20. 2()()7 .....
SECRETARY
This document is printed on a blue background
SECTION 00410
BID FORM
BID TO: MONROE COUNTY PURCHASING DEPARTMENT
1100 SIMONTON STREET
ROOM 2.213
KEY WEST, FLORIDA 33040
BID FROM: Koch Corporation
1131 Logan Street
Louisville, KY 40204
The undersigned, having carefully examined the Work and reference Drawings, Specifications,
Proposal, and Addenda thereto and other Contract Documents for the construction of:
Kev West International Airport Noise Insulation Proaram - Phase 3
and having carefully examined the site where the Work is to be performed, having become familiar
with all local conditions including labor affecting the cost thereof, and having familiarized himself
with material availability, Federal, State, and Local laws, ordinances, rules and regulations affecting
performance of the Work, does hereby propose to furnish all labor, mechanics, superintendents,
tools, material, equipment, transportation services, and all incidentals necessary to perform and
complete said Work and work incidental hereto, in a workman-like manner, in conformance with
said Drawings, Specifications, and other Contract Documents including Addenda issued thereto.
The undersigned further certifies that he has personally inspected the actual location of where the
Work is to be performed, together with the local sources of supply and that he understands the
conditions under which the Work is to be performed. The successful bidder shall assume the risk of
any and all costs and delays arising from the existence of any subsurface or other latent physical
condition which could be reasonably anticipated by reference to documentary information provided
and made available, and from inspection and examination of the site.
The undersigned acknowledges that if awarded this contract on the basis of this Proposal, they will
commence pre-work activities within ten (10) days, after the date specified as the "Notice to
Proceed with Pre-Construction Activities." The Bidder and Bidders Surety shall also agree to be
liable for and shall make payment to the Sponsor based on the following:
1. For each day after the Completion Date for the entire Work of the Contract that any part of the
Work upon any parcel remains incomplete the bidder shall incur $1,000.00 per day in liquidated
damages as provided in the Agreement.
I acknowledge receipt of Addenda No.(s) 1, 2
(Check mark items below. as a reminder that they are included.)
BID FORM
00410 - 1
I have included the following items, which have been appropriately executed and notarized:
Section
V 00430
t;;T' 00431
t;- 00450
00451
* 00452
00453
00454
V 00455
V- 00456
77 00457
---v-- 00458
L:::7 /"'00459
V NA
Description
Bid Bond
Performance of Work by Subcontractors
Non-Collusion Affidavit
Lobbying and Conflict of Interest Clause
Drug-Free Workplace Form
Equal Employment Opportunity Report Statement
Disadvantaged Business Enterprise Assurance
Certification of Non-Segregated Facilities
Certification Regarding Debarment, Etc.
Certification Regarding Foreign Participation
Sworn Statement on Public Entity Crimes
Buy American Certification
Copies of Contractor and Subcontractor Licenses
The Bid is broken down into the following categories:
1. Bonds and Insurance:
2. Pre-construction Work: Measurement Visit & Precon. Mtg:
3. General Conditions:
4. Windows:
5. Doors:
6. Storm Products:
7. Hurricane Shutters:
8. Wall Modification:
9. Mechanical:
10. Electrical:
1 IV Q~k)
--hue hlt' r I ft1l.t .frlJy ..fix -MovJ~ ~ fw\:J-t.J. ,
(Total Bid - in words) ~'7 ~'lr f\.A ~'\{
OD ( l.J({i'
$ 2,ot.f(P,8'8Q
(Total Bid - in figures)
Included in the Total Bid above are the following line items:
1. Cost of conducting the duct leakage test (x) the number of homes:
$ Lf 2. 5 (x) 29 homes = $ 1.2 I 4 2- 5"
2. Remediation cost for an estimated 3 hours of sealing (per home):
$ If) (] per hour labor (x) 3 hours (x) 29 homes = $
~70D
,
BID FORM
00410 - 2
Mailing Address:
Koch Corporation
1131 Logan Street
Louisville, KY 40204
Signed by:
President
7/13/04
(Date)
STATE OF:
Kentucky
COUNTY OF:
Jefferson
On this 13th dayof July ,intheyear2004, C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided above.
~~.
SI A URE OF NOTARY BLlC
END OF BID FORM
)
BID FORM
00410 - 3
SECTION 00431
PERFORMANCE OF WORK BY SUBCONTRACTORS
The BIDDER hereby states that he proposes, if awarded the Contract, to use the following subcontractors on this project:
List below ALL proposed subcontractors (including DBE subcontractors) and trade specialties. If type of work to be
performed will be performed by Contractor's own forces, place "NA"in the space provided.Add any additional categories
as needed.
Type of Work,to be Performed Name of Subcontractor
Mechanical (HVAC) Sub-Zero
Electrical FLCRi M K4, S
Window Installation Kenmar General Contracting, LLC
Carpentry 11/4-
Drywall
Masonry 1/1 /It
Painting /Staining t+
Thermal Insulation Sarasota Manatee Insulation
Acoustic Storm Protection
Door Installation 1i 1
Hurricane Shutters Kenmar General' Contracti na, LLC
Estimated Total Cost(f�e/s that I ER states will be performed by Subcontractors: ($ J�1t /0 7 )
/ rl
Signed by: 7/13/04
(Must e same signature as on Bid Form) (Date)
C. Stephen Koch, President
END OF PERFORMANCE OF WORK BY SUBCONTRACTORS
PERFORMANCE OF WORK 00431 - 1
BY SUBCONTRACTORS
SECTION 00450
NON-COLLUSION AFFIDAVIT
I,
according to law on my oath, and under penalty of perjury, depose and say that:
C. Stephen Koch
1.
lam
President
of the firm of Koch Corporation
the bidder making the Proposal for the project described in the notice for calling for bids for:
Key West International Airport Noise Insulation ProQram - Phase 3
and that I executed the said proposal with full authority to do so;
2. the prices in this bid have been arrived at independently without collusion, consultation, communication or
agreement for the purpose of restricting competition, as to any matter relating to such prices with any other
bidder or with any competitor;
3. unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly
disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or
indirectly, to any other bidder or to any competitor; and
4. no attempt has been made or will be made by the bidder to induce any other person, partnership or corporation
to submit, or not to submit, a bid for the purpose of restricting competition;
5. the statements ntained in this affidavit are true and correct, and made with full knowledge that the Sponsor
relies upon the" 0 th~ i1men,s contained In this affidaw In swamlng contn>cts to< said project
Signed by: K. 7 /13/04
ust be s me signature as on Bid Form) (Date)
I'
C \ Stephen KBch~ President
STATE OF: Kentucky
COUNTY OF: Jefferson
On this 13th day of JiJl y ,in the year --2.004 C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
_above. _ ~
SIG&TL,c -
END OF NON-COLLUSION AFFIDAVIT
NON-COLLUSION AFFIDAVIT
00450 - 1
SECTION 00451
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
"
Koch Corporation
(Name of Business)
"
" warrants that he/it has not employed, retained or otherwise had act on his/its behalf any
former County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any
County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or
violation of this provision the County may, in its discretion, 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 ~ ,commission, percentage, gift, or consideration paid to the former County
officer or employee".
~1
7/13/04
(Date)
Signed by:
(Must e ame signature as on Bid Form)
C. Steph n Koch, President
STATE OF:
COUNTY OF:
Kentucky
Jefferson
On this 13th day of JU1Y,intheyear---.1..Q04 C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided abov~
I _
END OF LOBBYING AND CONFLICT OF INTEREST CLAUSE
LOBBYING AND CONFLICT
OF INTEREST CLAUSE
00451 - 1
SECTION 00452
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that
Koch Corporation
"
II
(Name of Business)
1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of
a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees
for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free
workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that
may be impose upon employees for drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the
statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the commodities
or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the
employer of any conviction of, or plea of guilt or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or
of any state, for a violation occurring in the workplace no later that five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if
such is available in the employee's community, any employee who is so convicted.
6. Make a good faith e continue to maintain a drug-free workplace through implementation of this section.
As the pe..on a"Qrize 'n Ih~ l1emenl. I ceMy thai Ihl, fine comp1;e, fully wffh the above requ"emenls.
Signed by: K JA. 7/13/04
(Must be ame signature as on Bid Form) (Date)
C. Stephen Koch, President
STATE OF:
COUNTY OF:
Kentucky
Jefferson
Onthis 13th day of July ,intheyear200~ C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided abo e.
END OF DRUG-FREE WORKPLACE FORM
)
DRUG-FREE WORKPLACE
FORM
00452 - 1
SECTION 00453
EQUAL EMPLOYMENT OPPORTUNITY REPORT STATEMENT
The Bidder shall complete the following statement by checking the appropriate blank spaces.
Failure to complete these blanks may be grounds for rejection of Proposals.
1. The Bidder has X has not developed and has on file at each
establishment Affirmative Action Programs pursuant to 41 CFR 60-14 and 41 CFR 60-2.
2. The Bidder has X has not participated in any previous contract or
subcontract subject to the Equal Opportunity Clause prescribed by Executive Order 11246,
as amended.
3. The Bidder has X has not filed with the Joint Reporting Committee
the annual compliance report on Standard Form 100 (EEO-1 Report).
4. The Bidder d
x
does not
employ fifty (50) or more employees.
Signed by:
7/13/04
(Date)
STATE OF:
Kentucky
Jefferson
COUNTY OF:
On this 13th dayof July, in the year 200~ C. Stebhen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided ab ve.
END OF EEO REPORT STATEMENT
)
EEO REPORT STATEMENT
00453 - 1
SECTION 00454
DISADVANTAGED BUSINESS ENTERPRISE ASSURANCE
The Bidder shall complete the following statement by checking the appropriate box (check one
only). Failure to complete this statement may be grounds for rejection of Bid.
x
The Bidder assures that he shall meet the requirements of the DBE
Provisions, for the Monroe County's DBE Policy and Program, and shall
utilize not less than the prescribed goal of 15.5% DBE participation (See
Page 00454-2).
The Bidder is unable to assure DBE participation of the prescribed goal of
15.5% in this Contract, but shall provide for a minimum of
percent ( %) participation.
(If this box is checked, Bidder shall fill in the percentage blanks and
document on a separate attachment to this Assurance, his efforts in
attempting to meet the goal as instructed in '~ Means to Ensure that
Competitors Make Good Faith Efforts to Meet the DBE Goal" on Page
00454-2.)
Signed by:
~
7/13/04
(Date)
STATE OF:
(Must be s me signature as on Bid Form)
C. Stephen Koch, President
Kentucky
Jefferson
COUNTY OF:
On this 13th dayof July ,intheyear~~4 C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided above.
~. J !i1/~-
STURE OF N6TARY .PUBLIC
DBE ASSURANCE
00454 - 1
SECTION 00454
A MEANS TO ENSURE THAT COMPETITORS MAKE
GOOD FAITH EFFORTS TO MEET THE DBE GOAL
This solicitation will include a statement that the apparent successful competitor will be required to
submit DBE participation information and that as a condition of receiving the contract, the
competitor must meet the DBE goal or demonstrate to the Sponsor that it made good faith efforts.
The actual clause to be used is:
"The bidder shall make good faith efforts, as defined in Appendix A of 49 CFR Part 26,
Regulations of the Office of the Secretary of Transportation, to subcontract 15.5 percent of the
dollar value of the prime contract to small business concerns owned and controlled by socially and
economically disadvantaged individuals (DBE). In the event that the bidder for this solicitation
qualifies as a DBE, the contract goal shall be deemed to have been met. Individuals who are
rebuttably presumed to be socially and economically disadvantaged include women, Black
Americans, Hispanic Americans, Native Americans, Asian-Pacific Americans, and Asian-Indian
Americans. The apparent successful competitor will be required to submit information concerning
the DBEs that will participate in the contract. If the bidder fails to achieve the contract goal stated
herein, it will be required to provide documentation demonstrating that it made good faith efforts in
attempting to do so. A Bid that fails to meet these requirements will be considered non-
responsive."
The DBE participation information will be required prior to committing the Sponsor to award the
contract to the apparent successful competitor.
A Bidder may not meet the requirements of the bid specification by stating that it will accomplish
all work of the contract using its own employees. It, first, must demonstrate to the Sponsor's
satisfaction, that it made good faith efforts to meet the goal, and despite those efforts, was unable
to subcontract any of the work to DBEs.
DBE ASSURANCE
00454 - 2
SECTION 00454
REQUIRED CLAUSES FOR FAA-ASSISTED CONTRACTS
The following clauses should be included in all FAA-assisted contracts (but not in leases) between
the sponsor and any contractor:
Policv: "It is the policy of the Department of Transportation that disadvantage business
enterprises as defined in 49 CFR Part 26 shall have the maximum opportunity to participate in the
performance of contracts financed in whole or in part with Federal funds under this agreement.
Consequently, the DBE requirements of 49 CFR Part 26 apply to this agreement."
DBE Obliaation: "The recipient or its contractors agrees to ensure that disadvantage business
enterprises as defined in 49 CFR Part 26 have the maximum opportunity to participate in the
performance of contracts and subcontracts financed in whole or in part with Federal funds
provided under this agreement. In this regard, contractors shall take all necessary and reasonable
steps in accordance with 49 CFR Part 26 to ensure that disadvantaged business enterprises have
the maximum opportunity to compete for and perform contracts. Recipients and their contractors
shall not discriminate on the basis of race, color, national origin, or sex in the award and
performance of DOT -assisted contracts."
Section 26.13(b) requires sponsors to advise each contractor and subcontractor who performs on
an FAA-assisted project that failure to carryout the above requirements shall constitute a breach of
contract. The following clause may be used for this purpose:
"All bidders, potential contractors, or subcontractors for this DOT-assisted contract are hereby
notified that failure to carry out the DOT policy and the DBE obligation, as set forth above, shall
constitute a breach of contract which may result in termination of the contract or such other
remedy as deemed appropriate by the recipient and the FAA."
DBE ASSURANCE
00454 - 3
SECTION 00454
SCHEDULE OF DBE PARTICIPATION
'Name and Address of DBE;Subcontractor- Type of Work Subcontracted ;_ Dollar'Value;of Work:;
Kenmar General Contracting Window Installation
1075 Duval St. , C21PMB150 Hurricane Shutters
Key West, FL 33040 333 16�
02/ tit)tar F-t- 33010 l
Total Dollar Value of DBE Subcontracted Work $ 3 S5,
CC
Total Dollar Value of Bid $ O'i C
Total DBE Percentage(ro nded to nearest 1/10 percent) ( r
The undersigned will ent t a form agreement with the DBE Subcontractors identified herein for work listed in this
schedule,condition d up cutio a contract with the Sponsor.
Signed by: 7/13/04
( t be ame signature as on Bid Form) (Date)
C. St phen Koch, President
STATE OF: Kentucky
COUNTY OF: Jefferson
On this 13th day of July in the year 200,4 C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided above
SI A URE OF TARP BLIC
DBE ASSURANCE 00454-4
SECTION 00454
DBE SUBCONTRACTOR 10 ENTIFICA TION AFFIDAVIT
I,
I
V/ ~/
n1 If-t)Jj ()
according to law on my oath, and under penalty of perjury, depose and say that:
lam frLS/Jtl/IAT
of the firrn of j!L/y)~ ~+L (".,^~'1r: ,.r
whose address is I D 7-r JJ /,j VAi-- --!1" e 21 flt11 BIJ(J ~U; /A)j.O; r / 330Y1)
I hereby declare and affirm that I am a Minority (MBE) or ~ Female (WBE) Business Enterprise as
defined by 49 CFR Part 26, and that I will provide information to document this fact.
This firm is interested in bidding on the following categories of work being procured for the Key West International
Airport Noise Insulation Program - Phase 3:
w/;J1ouJ ~~VkL l'{-t1b 7YtJI4Ul1-/~1t /.s/vTI<<S
I
This firm has current DBE 1 MBE / WBE certification from the following agencies:
/6.-; fAiPJ r J;/t.~f1A-1-/c'~ ;h ,efJ&/~r 1-Yi [)
(:-I A) /2.;. ')A ,0 Aj~ ~f1---HM . A-, '(',/)6 ey
DjWv~&!J 7,I.JJi,uJJ uh-il/.k (bEg J )i1~t1rrt
/ I
f DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE CONTENTS OF THE
FOREGOING DOCUMENT ARE TRUE AND CORRECT, AND THAT I AM AUTHORIZED ON BEHALF OF THE FIRM
TO MAKE THIS AFFID VI ,
~!Jh <f
(Date) ,
Signed by:
STATE OF:
{iot/','d4...
NO'll f ce...
COUNTY OF:
On this I o~ day of ~,in the yearZ/l!!1, Vi c..l<, M~rl'r')D
who is personally known to me, or who oroduced satisfactory identification, affixed his/her signature in the space
pro . bove. -
_---';.:.r.tfj:~ Caroline Vazquez
t.~ ':.1 MYCOMMISSION# OD207307 EXPIRES
%:~'" " - April 30, 2007
"~....", . BONDEDTHRUTIlOYFAININSURANCE.INC
DBE ASSURANCE
00454 - 5
_~C:.l.=-.'I:I....t
JJI.r........tI'~.."a'III~~
~t~-..~if.i...J, -:I-.i~"::I:"':I~K"1t
07/12/2004 03:51
502-535-3458
KOCH CORP ACOUSTICAL
PAGE 02/02
seCTION 00454
OBe SUBCONTRACTOR IDENTIFICATION AFFIOAVIT
I, ~(Ylon.d VOt21peL..-
according to law on my oath. and under penalty of perjury, depose and say that:
10m ~ (Y\CS\'\..Cl II G...- 'Z.,r:b U e:7... ,
of the firm of Ft 0 r '( 0\ C<.... ~ ~.1J ~ f' rrl.-lC.-
whoseeddressis 5730 cQ f1d 6ve.
, hereby deelare and affirm that I am a ~ Minority (MBE) or Female (WBE) Business Enterprise as
denned by 49 CFR Part 26, and that r will provide information to document this fact,
This firm Is Interested in bidding on the following categories of worK being procured for the Key West Internatlonel
Airport Noise Insulation Program - Phase 3:
2-~.'~
This firm has current OeE I MBE I WBe certification from the following agencies:
, DO SOLEMNLY OECLARE A
FOREGOING DOCUMENT A
TO MAKE THIS AFFIDAVIT
AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE CONTENTS OF THE
R A D CORRECT, AND THAT' AM AUTHORIZED ON BEHALF OF THE FIRM
Signed by:
7 If 3(0'-(
(Date)
STATE OF:
COUNTY OF:
F{~d~
rn~D-e..
On thIs J'3 dsyor8, in the year EL-t:x:?-4 m{}'rL.(j
who Is personslly known to me, or who produced satisfactory idllntifica!ion, affixed hlslher si
provided abovlI. .
SIGND.1~FJ:1TARY~e:'-
space
,~~.~" .
~~l:'''''.: .-J:i;-~ MISty Leon
~{ Ej MYCOMMISSK>N# 00282721 EXPIRE~
~i",,,,11.:~'; January 20, 2008
"'~Irx,'" 9ONDeO THRU TROY FAIN INSURANCE INC
DBE ASSURANCE
00454 . 5
SECTION 00455
CERTIFICATE OF NON-SEGREGATED FACILITIES
CERTIFICATION TO BE SUBMITTED BY CONSTRUCTION CONTRACTORS AND THEIR
SUBCONTRACTORS (APPLICABLE TO CONTRUCTION CONTRACTS AND RELATED
SUBCONTRACTS EXCEEDING TEN THOUSAND ($10,000.00) DOLLARS (US $) WHICH ARE
NOT EXEMPT FROM THE EQUAL OPPORTUNITY CLAUSE)
The construction contractor certifies that he does not maintain or provide, for his employees, any segregated facilities at
any of his establishments and that he does not permit his employees to perform their services at any location, under his
control, where segregated facilities are maintained. The construction contractor certifies that he will not maintain or
provide, for his employees, segregated facilities at any of his establishments and that he will not permit his employees to
perform their services at any location, under his control, where segregated facilities are maintained. The construction
contractor agrees that a breach of this certification is a violation of the equal opportunity clause in this contract. As used in
this certification, the term "segregated facilities" means any waiting room, work areas. restrooms and washrooms,
restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking
fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are
segregated by explicit directives or are in fact segregated on the basis of race, color, religion, or national origin because of
habit, local custom, or any other reason. The construction contractor agrees that (except where he has obtained identical
certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed
subcontractors prior to tad of subcontracts exceeding ten thousand ($10,000.00) dollars (US) which are not exempt
from the p""",,o,^ of th u OPKJ,1y clause and that he .,11 relaln such ce'"'catlons In his files.
S~nedb~ ~ 7/13/04
(Must be ame signature as on !;lid Form) (Date)
C. Stephen Koch, President
Kentucky
STATE OF:
COUNTY OF:
Jefferson
On this 13th day of July ,in the year 200~ C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
~:~
G ATURE OF<'NOTAR UBUC
END OF CERTIFICATE OF NON-SEGREGATED FACILITIES
)
/
NON-SEGREGATED
FACILITIES
00455 - 1
SECTION 00456
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
INELIGIBILITY, AND VOLUNTARY EXCLUSION - 49 CFR PART 29
(Version 1, 1/5/90)
The bidder certifies, by submission of this proposal or acceptance of this contract, that neither it nor
its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency. It
further agrees by submitting this proposal that it will include this clause with modification in all lower
tier transactions, solicitations, proposals, contracts, and subcontracts. Where the bidder/ offeror/
contractor of any lower tier participant is unable to certify to this statement, it shall attach an
explanation 10 this sol ita .0nIP~lfosar.
Signed b~ ~ 7/13/04
(Must De me signature as on Bid Form) (Date)
C. Step n Koch, President
STATE OF:
COUNTY OF:
Kentucky
Jefferson
On this 13th dayof July ,intheyear 200~ C. Stephen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided above.
END OF CERTIFICATION REGARDING DEBARMENT, ETC.
DEBARMENT, SUSPENSION, ETC.
00456 - 1
SECTION 00457
CERTIFICATION REGARDING FOREIGN PARTICIPATION
The Contractor or subcontractor, by submission of an offer and/or execution of a contract certifies that it:
1. Is not owned or controlled by one or more citizens or nationals of a foreign country included in the list of countries that
discriminate against U.S. firms published by the Office of the United States Trade Representative (USTR);
2. has not knowingly entered into any contract or subcontract for this project with a contractor that is a citizen or national
of a foreign country on said list, or is owned or controlled directly or indirectly by one or more citizens or nationals of a
foreign country on said list;
3. has not procured any product nor subcontracted for the supply of any product for use on the project that is produced
in foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with 49 CFR 30.17, no
contract shall be awarded to a Contractor or subcontractor who is unable to certify to the above. If the Contractor
knowingly procures or subcontracts for the supply of any product or service of a foreign country on this said list for use on
the project, The Federal Aviation Administration may direct, through the sponsor, cancellation of the contract at no cost to
the Government.
Further, the Contractor agrees that, if awarded a contract resulting from this solicitation, it will incorporate this provision for
certification without modification in each contract and in all lower tier subcontracts. This Contractor may rely upon the
certification of a prospective subcontractor unless it has knowledge that the certification is erroneous.
The Contractor shall provide immediate written notice to the sponsor if the Contractor learns that its certification or that of
a subcontractor was erroneous when submitted or has become erroneous by reason of changed circumstances. The
subcontractor agrees to provide immediate written notice to the Contractor, if at any time it learns that its certification was
erroneous by reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when making the award. If it is later
determined that the Contractor or subcontractor knowingly rendered an erroneous certification, the Federal Aviation
Administration may direct, through the sponsor, cancellation of the contract or subcontract for default at no cost to the
Government.
Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in
good faith, the certification required by this provision. The knowledge and information of a contractor is not required to
exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.
This certification conce
a false, fictitious, audu
Section 1001.
Signed by:
c.
STATE OF:
COUNTY OF:
SI
i
,I
FOREIGN PARTICIPATION
00457 - 1
SECTION 00458
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
1. This sworn statement is submitted to the Sponsor
by
C. Stephen Koch
for
Koch Corporation
whose business address is:
1131 Logan Street
Louisville, KY 40204
And (if applicable) its Federal Employer Identification Number (FEIN) is
61-0461707
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement:
2. I understand that a .public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes. means a
violation of any state or federal law by a person with respect to and directly related to the transaction of business
with any public entity or with an agency or political subdivision of any other state or of the United States,
including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an
agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft,
bribery, collusion, racketeering, conspiracy, or material misrepresentation.
3. I understand that .convicted" or .conviction" as defined in Paragraph 287.133 (1 )(b), Florida Statutes, means a
finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or
state trial court of record relating to charges brought by indictment or information after July 1, 1989. as a result of
a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.
4. I understand that an .affiliate" as defined in Paragraph 287.133 (1)(a), Florida Statutes, means:
a, A predecessor or successor of a person convicted of a public entity crime; or
b. An entity under the control of any natural person who is active in the management of the entity and who has
been convicted of a public entity crime. The term .affiliate" includes those officers, directors, executives,
partners, shareholders, employees, members, and agents who are active in the management of an affiliate.
The ownership by one person of shares constituting a controlling interest in another person or a pooling of
equipment or income among persons when not for fair market value under an arm's length agreement, shall
be a prima facie case that one person controls another person. A person who knowingly enters into a joint
venture with a person who has been convicted of a public entity crime in Florida during the preceding 36
months shall be considered an affiliate,
5. I understand that a .person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person
or entity organized under the laws of any state or of the United States with the legal power to enter into a binding
contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity,
or which otherwise transacts or applies to transact business with a public entity. The term .persons" includes
those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in
management of an entity.
PUBLIC ENTITY CRIMES
00458 - 1
6 Based on information and belief, the statement which I have marked below is true in relation to the entity
submitting this sworn statement. [Indicate which statement applies.]
-L Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of
the entity has been charged and convicted of a public entity crime subsequent to July 1, 1989.
- The entity submitting this Sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of
the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989.
- The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity or an affiliate of
the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However,
there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of
Administrative Hearing and the Final Order entered by the Hearing Officer determined that it was not in the public
interest to place the entity submitting this sworn statement on the convicted vendor list. [attach a copy of the final
order]
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS
FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO
UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRACT IN EXCE OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES
FOR CATEGO~Y TW F NY TGE IN THE INFORMATION CONTAINED7/'NIT3H/'OS4FORMO
Signed by: L _ _
(Date)
(Must be"s me.~ignflturepas on.Bid Form)
C. ~tep n KOcn. reSloent
STATE OF:
COUNTY OF:
Kentucky
Jefferson
Onthis 13th day of July ,intheyear 20Q4 C, Sterhen Koch
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided above.
END OF SWORN STATEMENT ON PUBLIC ENTITY CRIMES
PUBLIC ENTITY CRIMES
00458 - 2
SECTION 00459
BUY AMERICAN CERTIFICATION
1. The Contractor agrees that only domestic steel and manufactured products will be used by the Contractor,
subcontractors, materialmen, and suppliers in the performance of this Contract, as defined in (2) below.
2. The following terms apply to this clause:
A. Steel and Manufactured Products. As used in this clause, steel and manufactured products include (1) those
produced in the United States or (2) a manufactured product produced in the United States, if the cost of its
components mined, produced or manufactured in the United States exceeds sixty (60%) percent of the cost of
all its components and final assembly has taken place in the United States.
B. Comoonents. As used in this clause, components means those articles, materials, and supplies incorporated
directly into steel and manufactured products.
C. Cost of Comoonents. This means the costs for production of the components, exclusive of final assembly
labor costs.
By submitting a Bid under this solicitation, except for those items listed by the Bidder below or on a separate and clearly
identified attachment to this Bid. the Bidder certifies that steel and each manufactured product, is produced in the United
States (as defined in the clause Buy American - Steel and Manufactured Products for Construction Contracts) and that
components of unknown origin are considered to have been produced or manufactured outside the United States.
A list of articles, materials, and supplies excepted from this provision is attached in Section 00210 of these Contract
Documents.
PRODUCT
COUNTRY OF ORIGIN
None
Signed by:
Q
7/13/04
(Date)
(Must be ame signature as on Bid Form)
C. Step en Koch, President
STATE OF:
Kentucky
Jefferson
COUNTY OF:
On this 13th dayof July ,intheyear 2001 C. Stephen Koehl
who is personally known to me, or who produced satisfactory identification, affixed his/her signature in the space
provided above.
id - II k
s~ ~y P0BLlC ~
END OF BUY AMERICAN CERTIFICATION
)
BUY AMERICAN
00459 - 1
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
. CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
(850) 487-1395
'R E eEl \/ r: fl
SWANSON I ARTHUR
KOCH CORPORATION
1131 LOGAN ST
LOUISVILLE
JUN 1 4 2004
KY 40204
KOCH CORP,
(
I
I
STATE OF FLORIDA AC# 1 430411
DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION
CRC1327098
06/01/04 030693633
CERTIFIED-RESIDENTIAL CONTRACTOR
SWANSON, ARTHUR
KOCH CORPORATION
IS CERTIFIED under the provisions of ch.489 FS.
l<xpineiol1 d.aee, AUG 31, 2006 L04060101075
.-....~--.-... .., -- ------- -p ,_.u__... .______ ___._n'._'.n _ _'.>_n __.
DETACH HERE
~C# 14 3 0 411
---~--_.----------.--------- --~---._._--------~._-_._-------_._---._---- -_.
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L04060101075
LICENSE NBR
--;.:--.-.,-",-..:. --,
. ..'-- ~ _ -.r -.-
, ,
J6 01 2004 030693633 CRC1327098/>_;~'~~'<:':::---
The' RESIDENTIAL " CONTRACTOR ',' "~ ,,'_un
Named below IS CERTIFIED " ,/~:'r..2::';:X,:.;~". ,. . n' _"
U~der the provisions of Chapt~r,;~*89i:~_FS~--::~ :;;:.-'~~l:--:'::
Expiration date:AUG 31, 2006~~~~~~2i?;~;;.~
SWANSON, ARTHUR
KOCH CORPORATION.
1131 LOGAN ST
LOUISVILLE
,'. ~: :~~~:~;),...
KY 40204
JEB BUSH
~"'Vli'PN'()P
DIANE CARR
~R~PR'J'2l.PV
Key West International Airport Disadvantaged Business Enterprise (DBE)
Office of Small Business Development certifies
January 21, 2004
Mr. Raymond Vazquez
Florida Keys Electric, Inc.
Key West, Monroe County, Florida, 33040
RE: Disadvantaged Business Enterprises Certification
Dear Raymond Vazques,
Please be advised that your firm Florida Keys Electric Inc. has met the required criteria to be Certified as a
Disadvantaged Business Enterprise (DBE). under rules promulgated by the U.S. Department Of Transportation (DOT)
in 49 CFR Part 26.
Commencing January 20,2004 and expiring January 20, 2007
Florida Keys Electric Inc. name will be identified in the Airport's Directory of Certified
Disadvantaged Business Enterprises. Florida Keys Electric Inc. certification status will be effective for
three (3) years from the date of this letter provided there are no dlanges in the organization in the areas of
ownership, control, independence and/or daily operations of the firm during the approved certification
period. Please note that you are required to within fifteen (15) days to notifY the A.irport (DBELO) Director
Jerome Fain Jr., of said dlanges listed above. In addition, it is your responsibility to contact dlis office sixty
(60) days before expiration of this certification letter to initiate your certification renewal. The Key West
International i\irport reserves the right to re-evaluate a your business certification prior to Florida Keys
Electric's participation on an airport project, or at any time the Airport (DBELO) determines dlat such re-
evaluation is warranted for cause. If you have, any questions regarding dle DBE Program of the Airport
please call me at (305) 296-8
Since~r
S~~~
, . ~;,\~" '.1
.,', ':
I,"".
,'11,"
.: :\
,',
"'j
'~ ,~l
. -;:. . " ,~~'I'
.I."
, . ~ " j ~
.- '~._'" ;~ ~':., ,4
.1,.,', .,'
i,
::><:tn'"I1
t'Il--.Jt'"'
o-<wo
0::0
~ H
t'IlNt:!
Ul Z :t-
0-3t:!
::><:
'"I1::C-M
t'"' < ~
rrl Ul
w
w t'Il
o t'"'
~ t'Il
o ()
0-3
::0
H
()
::0
:t-
o-<
:3:
o
Z
t:!
<
:t-
N
.0
c:
t'Il
N
.0
c:
:t-
t'"'
H
'"I1
H
rrl
::0
,'.,
Otn'"I1
<.O~--.Jt'"'
'- wO
....1-'0::0
N N~W H
--..J --..J'-O'\Nt:!
tn tnO.....Z:t-
W......t:!
000 ::><:
000 :t-t'Il
<~
t'Il()t'IlUl
>< 0
'tl Z t'Il
t-' 0-3 I:""
"'l::O . t'Il
OJ:t- ()
rt() 0-3
t-. 0-3 ::0
o 0 H
lj::O ()
0-3'tl
o ctl
rt lj
OJ OJ
..... .....
rt
'<
0-3
::r
....'
Ul
.....
.....
n
ctl
lj
Ul
ctl
a
c:
Ul
rt
t:r
ctl
'tl
"'l
o
!3
t-.
lj
ctl
lj
rt
.....
'<
P-
t-.
Ul
'tl
.....
w
'<
ctl
P-
...',,'-
" '
t'"'H
I- Ul
n Ul
c:
'"I1 Cll
Cll
ctl 0.
OJ
rt
ctl
t'"'l:""ttl
....' 0 c:
n n Ul
Dl t-.
Zrt::l
t:r ..... CD
"'l 0 Ul
'- ::l Ul
()
..... OJ ::l
OJ 0. OJ
Ul 0. !3
Ul "'l CD
c.'
III
rt()
CD t'Il
::0
>-3
.. t'Il
t'"'
t'Il
() ()
<.00-3 rt
'-::0 .....
WH
O() lj
'-:t- t:r
o t'"' "'l
~
N
N
Cl'
'.1.,
o
~
~
~
o
~
o
f@
tO~
~~
4~ ~
~~~tJ:j
~ ;. ~. rn
:: ~ ~
w ::l rUJ .....
o 0. C'D
~ t:r
o ::: c:
Ul Ul
ctl t-,
::l
ro
Ul
Ul
'tl::I:
o
o .....
0. :::-
ro
ttl "'l ()
o t-.
>< i3 rt
c: '<
Ul
rt
......
~
o
<.0 i3
CD
CD
::><: rt
CD
'< QJ
.....
~ .....
CD
Ul ()
rt ....'
W
0'0
tn "'l
o
N ~
<.0 ....' rt
N Ul QJ
I t-. ><
CD 0
...... ::l
W Ul
......
: "
~
~
o
~
~
tJ
>
-. ~ '; ,
-r"':.t"
f;;;
I:~,.,~"~
;.
~
<,~
~
~~
c; CJ
~ en
iiJ
?,'r
.)>
'. -<
,. ..)>
;:cn
:-::0
~. m
'10
:'c
~, -
;:':::0
>,m
.' CJ
i\iCJ
i-<
!' r
",)>
,~ ~
:1.
~
~
"
~-
(~
~
H
a::
tf.lbS
r t>:lH
it n::tl ;ii
J
.
~ tz:J tot
1-3t>:l
~, >t<
, ::tI1
t<to
I:!I
t<
.., t>:l
::tI
I:!Ie:::Z1-3
~ 50; r:
1-'.(1) (I)
11 11 P-I:!I
s>> t'I
rtrttrl:!l
I-'.l:f(l) n
o CD i-' t-3
l:j O::tl
'O~H
P-11 n
S>>OH>
rt<tot'l
(I) 1-"
.. m nn
1-'. tzJ 0
~g ~,~
G:lm;;~
WOHn
.....H1tzJ1-3
.. tlO
n ::tI
t.)l:f
oS>>
0'0
~rt
.:..... ~"~
~,
CD
\O.I .
..
IzJ
to
)>
C")
~
o
CJ1
CO
(J1
, J--l.
o
~
tI
I:!I
I'd
>
::tI
tzJ~
t'l1:!I
~~
t-3
::tIO
HIzJ
n
>bS
t'le:::
to en
nH ~
OZ )>
'~~ ~
~to m
~~ ~
::tI r-
tol'd 0
t'I~ "
HJ:J;l C
ntzJ )>
t>:lto
Zto
toH
HO
5~
t'I
bS
O::tl
>tzJ
::tIG:l
tie:::
t'I
e;
H
o
Z
'"
m
D
=It
t".
o
t.) ."
0"'" ~
-'0'33.
.....~. '
w
0__=-,'-.
~'~;' .
....r ' 'CT'
i:t :;C'~v
::'-~~-"~:--~
. :.," .~
- -' ~ ,...,
~U1t'J;1<
l:!I\Ot'I>'
. Qc..r " t<~ON
, Ol:!l ~ -". O::dlQ
t <:bS ~ He:::
~ l:!I~c~~ I:!Il'dtll:!l
~ ~~.;J: ~~>~
, Oto,.,-,,- H~
',,::tI~",-),2r ~H:i~
e:::to~
S:tzJO
::tI~E3
>n
<:1-3
1:!I:tI
H
#n
J:J;lt-l
t'lt..>H
Z
UJ n
UJ
o
~
o
, ~ .'
'f'"
\ '; ~ \', ".....
;,
Key West International Airport
Florida Keys Marathon Airport
Disadvantaged Business Enterprise (DBE) Program
Kenmar General Contracting, LLC
Ms. Vicki Marino
1075 Duval Street
Key West, Florida 33040
July 1, 2004
RE: DISADVANTAGED BUSINESS ENTERPRISE CERTIFICATION
Dear Ms. Marino:
The Key West International & Florida Keys Marathon Airports are pleased to announce that your company has
been certified as a Disadvantaged Business Enterprise (DBE) which is subject to continued eligibility and also
subject to actions of any other governmental agencies which may affect the DBE status of your firm. This agency's
certification enables the company to compete in work at the Key West International and/or Florida Keys Marathon
Airports as a DBE owned and operated company. It is not a guarantee that the company will receive work.
DBE certification by the Key West International & Florida Keys Marathon Airports shall be for a period of three
(3) years. On each anniversary date during the three (3) year certification period an Affidavit of Continuing
Eligibility must be submitted. If any time there is a change in the ownership and control of the company, a new
Application is to be forwarded without delay to the Key West International & Florida Keys Marathon Airports for
certification at the end of the three (3) year period a new Application must be submitted to the Key West
International and Florida Keys Marathon Airports ninety (90) days prior to expiration of your current certification.
Questions concerning the certification process may be directed to this office at (305)296-8099.
~ince, d ()
~ /"~~
rome Fain Jr.
Disadvantaged Business Enterprise Liaison Officer
CERTIFICATION EXPIRATION DATE:
July 1, 2007
(j) Cf.' ,
Ol7il
.<:~
~ i:di-'
2:C:::
',O'(n ,--
~lI:;
-<
i
mt:!
t:IiIH
~H~
t:IiIt:IiI
1-3
~C1
t<~
::tI
.... ..",'.' .0"
~..,J~~::tI-12il d~1d"~.
'.' :~ig. .~.J~.. ...~... U..,.....l.....-~~....~~~.
I.JiIH~O .' ~<: $lI., .",i.'blI' t\J~>
m Z. .:". ..... L>:IH rr. rr.'tr.-'.Z C.' ;.;.;;
1-3.t:! t;)",..;~t:! ....::r ~,;tz.I ~i:
m t:IiI <,,)tr.lCl 0 (I) l-"~, .~~,
3~".;!jil~liij~ '"
5:.t:"~~ (I)"',~~ GjC;j
g '.' \!.:S:~ ..~m .~i'" ..,;j~"
..~ ";,;Jd'~ '~g~ric; ~".
.~. ~:.,~(j) m ~,~
"JiI C1. '" \~.:.:..~;. (..oJ OI-3::t1::t1
t'l 1-3.:';''0 >' .... Hlt:lil ., (j)
~ "-~~~ :'9~<" ~.I,
<::tIt'lO$ll ....
t" ' '... "',0 0'0 " 0
t'l 9 12 ~ r,t ''''... ~
(') ",,"":!.or;:' AD. ( .....'
, HI:'it"' ."-' . '-, "'"
w
w
o
""
o
;I>
,C')
'*"
,0
.,'W
".".~
,J\)
";'W
Li',:~._~!!;:;: .:~
':ti
"i.~,.,
:::tI
+3
....:3::
fltz.l .
'Oz.
~~L
m'
1-30'
::tIt;I:J
dc.
Otxl
--Hd
Hm.(/)
OH "-1
~~. '>-1
Hm
I~~
0-;08.'"
::tI .r-
t<tt1 0
t"~ ~
H"JiI C
C1tr;!
t:IiIm >
zm
mH
HO
~~
t'l
txl
O::tl
~~
,~
1-3
H
~
en
m
~
t-
o
w
o
01
t.J
W
o
o
t.J
....:I
Ul
t-
o.. .;,:r
...- 0
n 0
co N
0
0 ,
j 0
0 n
.;,:r
..-
0 l-
I"') 0..
W
V)
I-- U)
Z Ul
-, a;
(5 0.:
0 X
0 W
<(
LU
Q
<(
-'
n..
w
=>
0
.....
0
a:
if;
X Z
<C 0
I-- 0
-'J ~
<(
Z<c 0
Qo w
1---
<a: >-
n..O <(
::> -'J -'
0 LL n..
0LL Cf)
00 is
Ul w
!;;: CO
I-- 1-
U) l:r.l
-.
w ~
0
0::
Z
0
~
..;t
o
o
N
I
I'<'")
o
o
N
~
o
o
,0
o
00
~ANIS[.~ HEMRI~UEZ N
TU'COllEClOR
90096i5 ,iOOOI<ofGOO I
DARe/Uf03
Qper .' ~RI
TIll lle
-'J P~id20.00 ,tis
;:1: X 8
tDa;;:1: Z
:2-'JXUl-' 0
Ul<<(LL< -
-'51--(f)~ I--~b
&~$:~g ~-'JUl-'
::>WUla;a: 0~::l;S
cr.;a:ZI--O :2LUOO
<(:0.. 01--
(f) U)
ill Ul
f= ~
::i I
(3a:~
~O:2
I'<'")
o
;1A~f~0r:"~:~.
1....-.".'.....)''''-.._'-~.. ~_.... ,A\.c
l~~f;t rr~ ~'.- \~\\
!;_1! 'h,NV: \"'\'"
11;"::"1''-..1 ~~ .~_.~
"r\.-.I~--,~ :
~'\\','::j', Ii"" -1- I~!
.\<;"..<:\~\ '!u..; ,', , i JI-Jt>
~,\\\"q:,\\ I f~.,;~ .v,. 1~:11
<,.,\p',\\,', '11""""'"'/' ,I! .::::;11-.;
',\~\o'~ \ l J \"\'\S/ .' "o'~
\1(J'\., "-'7/' >, -., c:":'~. //'0/1
~~:::;.:,):"'" I 11 \\:.~ ! / <. /I!
,\~. \0/>':::... \ ( \ ""<~l /<, Iff
"ii~%~~:,~~-' L .. :+~j
-~~~~!J;d;;~}jV;"
z 1I'l0
...... ..-.;,:r
I- 0
U mn
< ~I""l
0:: 0...
I-
Z ..-
o N
U
U
...J-l
< I-
C::_t/)
UJ~ -l
ZU...Ju...
UJ-<
C)>>I-
::) 1/)
C::Oo.UJ
<Z 3
~_lJ'\
ZO::I'-~
w<OUJ
~E"-~
1I'l
I
o
W
ill
UJ
>-
o
-'
!l..
:2'
ill
U)
I--
<
W
(f)
c::
0
!-
U
< I-
0:: V)
I- W
Z CD3
00
U I-~
V)W
-l ~
< .:1:
c:: I-u...
W wO
Z m
UJ <>-
(!;J NI-
--
0 -lU
~ W
~
0
I"') 0"-
1'-0
(f)
:2
o
o
a:
U)
LLU)
OLL!
u.!~
c...U)
~~
U)w
Woo
WUl
~a:
U)O
::>0
CO<(
(I)
C9t3
wZ,..,-
:220
<:<Co
z:2<
l-(.?
(.1)%
:::1-
:;EZ,
zen
:::1<(1-
O..JZ
>Q..W
:;E
X>W
<t....g:
I-Z.:;lt
<(=>o
OW
>Ua:
~..JG
O..JZ
<Z
(Ii 0
-I-N
(l)WQ
:t:WZ
!-:a<e
N
..;t
N
0..
..;t
~
0.. 0
O::N 0
0"- -
I- ,...
wi I'-
w...- ()>.
...J.;,:r -
...Jo f")
01'<'") co
wI'<'") 0
a
x...J a
<u.. ~
I- ..-
I- a
t/) I"")
NUJ a
w3 a
::) 0
a>- 0
-UJ
O::l>! 0
Z a
UJ , a
::::0- N
N a
...- a
0."- a
a
Wx 0
(/')0 0
-co
2 0
<0 0
00.. 0
0 0
Ul a
I-- 0
<C 0
xO
;::~ a
<(> 0
U)Z a
wUl
:2I
05
0,
wO::
(Ow
~()
IW
1--0:
..-
o
0\
~
0...
0..
(") t-3 "0 L' H L' L' to
0 0 /I) t--. 00 t--' 0 c:
:>::: I-' :>::: I:! rl" P n 00 n n 00
t'3 0 t'3 I:! III III c: III ..... 0
>< -..J Z /I) ~ ~ "'1 /I) Z rl" P
lJ1 ~ t:l rl" ll) tT t--" /I)
~ :r:- ("t "< lD 0- ""$ 0 00 ~
t'3 t:1 ::0 Ul III "- t:l 00 "O::x:
Ul c:: rl" (") 0 ~
t-3 <: 0 ll) ~ III P 0 ~
:r:- t'3 Ql 0- III 0- :r:-
"'1 L' Z t-3 00 0- I:! (I) ~ I
L' t'3 ::r 00 ""$ lD to ""$ (")
Ul ::0 t--" 0 1-'
W t-3 :r:- OO >< I:! rl" I
W L' c: "< 0
0 (") ..... I-' 00
.p... N (") fo-' .p... rl" 0
0 I-' 0 n 0 n
Z lD ::x: 0 -..J :>::: ..0 I:! n ~
"0 1-3 t:l 0 0) .p... 0 t'3 ro c:
~ ::0 00 ":;1: '- I-' Z ll) '0
to :r:- t'3 .N I-' ~ :>::: rl" III @
(") N N O.;jl.. t'3 :r:- (I) rl"
t-' 1-3 I:! 0 -..J -..J,-en t:" ::0 "< III t--' 0
lJ1 H c: (") lJ1 lJ10U1 H ..... 0
0 Z 00 (") wen 'NO ~ ..... t:l 0
0 rl" c:: 0 0 0 :r:-:lI1 lD III 0
"0 0 0 0 tt1'Z 00 (") ..... ~
L' tT :r:- t'Jj/trJ rl" t--, ~
L' m t-3 trJ 0 1-3"~ rl" L' "0
0 H >< 0 ::x::r:- "< ..... ~
'0 0 '0 Z L' "'1 n M-
""$ Z t--' t-3 m ..... N /I) .... . ~
0 ""$ ';0 1-30 0 0 P 0
I:! L' III :r:- 0 ""$ t:l 00 ~
1-. H rl"n toZ t--. 1-' lD
t:l (") ....' t-3 '..;J O-P ~
ro t>:l 0 0 ::0 IllIQ 1-' ~ trj
P Z P ::0 :r:- oo toot
rl" Ul (") W III
..... t>:l 0- I t-3 w t:l III ..... W
"< Ql "H 0 0- 0
<: rl" ::0 Z .p... tT CD ~
H 0- ro trJ 0 0 c: c: ::l
0 ..... 0 00 Ul
:>::: 00 ..t'" ro t--" rn v
H '0 0 'L' w t:l CD
..... .. t>:l (") 0'0 ro
~ Ql Z lJ1 ""$ 00 ~
:r:- "< t>:l 0 00
::0 ro ::0 (") N <:
H 0- ..o:r:- rl" ..0 ..... rl" r
Z '-L' ..... N 00 III
0 W I t--, >< 0
0 t:l 0) 0
'- tT I-' t:l
D 0 ""$ W III
c:: .p... I-' ~
:r:-
L'
H ~
"'1
H tj
t>:l
::0 I-'
.... >
0)
en
N
i
THE AMERICAN INSTITUTE OF ARCHITECTS
.
AlA Document A31 0
Bid Bond
BOND # KOCH071304
KNOW ALL MEN BY THESE PRESENTS, that we
KOCH CORPORATION
1131 LOGAN STREET LOUISVILLE, KY 40204
(Here insert full name ,and address or legal title of Contractor)
as Principal, hereinafter called the Principal, and
XL SPECIALTY INSURANCE COMPANY
25 INDEPENDENCE BLVD. WARREN, NJ 07059
a corporation duly organized under the laws of the State of Delaware as Surety, hereinafter called the Surety, are held and firmly
bound unto MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
PURCHASING OFFICE, 1100 SIMONTON ST, RM 2-213, KEY WEST, FL 33040
(Here insert full name ,and address or legal title of Owner)
as Obligee, hereinafter called the Obligee, in the sum of Five Percent (5%) of the Amount of the Bid ($--------), for the
payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors,
administrators, successors and assigns, jointly and severally, fIrmly by these presents.
WHEREAS, the Principal has submitted a bid for
PHASE 3 - NOISE INSULATION PROGRAM
KEY WEST INTERNATIONAL AIRPORT, AlP #3-12-0037-2504
CONTRACT NO. THC NO. 03KW20
(Here insert full name, address and description of project)
NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee
in accordance with the terms of such bid and give such bond or bonds as may be specifIed in the bidding or Contract Documents with
good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in
the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the
Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specifIed in said bid and such
larger amount for which the Obligee may in good faith contract with another party to per orm the Work covered by said bid then this
obligation shall be null and void, otherwise to remain in full force and effect.
Signed and sealed this 13th day of Julv. 2004.
(Seal)
~~~.
(Witness) L i sat. Gr e.n
(Title)
President
AlA DOCUMENT A310 BID BOND AlA @ FEBRUARY 1970 ED THE AMERICAN
INSTITUTE OF ARCHITECTS, 1735 N.Y. A VB" N,W. WASHINGTON, D.C, 20006
WARNING: Unlicensed photocopying violates U,S, copyright laws and is subject to legal prosecution,
1
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE
TM 11/30/2004
PRODUCER Garrett-Stotz Company THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
6011 Brownsboro Park Blvd HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite B ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Louisville KY 40207-1292 INSURERS AFFORDING COVERAGE
INSURED Koch Corporation INSURER A: Amerisure Companies
P. O. Box 4398 INSURER B: Amerisure Companies
Louisville KY 40204 INSURER c:
INSURER 0:
INSURER E:
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,
POLICY EFFECTIVE POLICY EXPIRATION
COVERAGES
I~~:
A
TYPE OF INSURANCE
POLICY NUMBER
~NERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE [2[] OCCUR
CPP 1322729
12/31/2003
12/31/2004
f---
-
~'L AGGRE~E LIMIT AP~S PER:
I POLICY I X I ~~R; I I LOC
B
CA 1322730
12/31/2003
12/31/2004
:~OMOBILE LIABILITY
'_ ANY AUTO
~ ALL OWNED AUTOS
Jf- SCHEDULED AUTOS
~ HIRED AUTOS
~ NON-OWNED AUTOS
f--,
i i
RARAGE LIABILITY
I ANY AUTO
i
--- --
~( IA "",,"[JM:I~-i
A, 0 ~ d~ ~\,/i1~tt];Y7
BY - I~ '-~I-)ThI (1
__ I\rl--.l,""\ I (~'f -
U,...Il- - -r-.,T
WAIVER Nti\ >...J....--_.
B
~ESS LIABILITY CU 1322731
~ OCCUR D CLAIMS MADE
12/31/2003
12/31/2004
~ DEDUCTIBLE
---1 RETENTION $
B WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC 132177002
12/31/2003
12/31/2004
I OTHER
i
B !EQUIP.FLOATER
CPP 1322729
12/31/2003
12/31/2004
LIMITS
EACH OCCURRENCE $
FIRE DAMAGE IAnv one fire) $
MED EXP IAnv one nersonl $
$
$
$
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
AUTO ONLY - EA ACCIDENT $
$
$
$
$
$
$
$
OTHER THAN
AUTO ONLY:
EA ACC
AGG
EACH OCCURRENCE
AGGREGATE
X I WC STATU- I IOJ~-
E.L EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E,L DISEASE - POLICY LIMIT $
1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000
$
1.000,000
$
$
$
5,000,000
5,000,000
100,000
100,000
500,000
$80,000 PER ITEM & AGGREGATE
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
ALL WORK INCLUDING MONROE COUNTY NOISE INSULATION PROGRAM (NIP) PHASE 3 CONTRACT THC
NO. 03KW20
NAMES MONROE COUNTY BOARD OF COUNTY COMMISSIONERS AS ADDITIONAL INSURED AS THEIR
INTEREST MAY APPEAR.
CERTIFICATE HOLDER I X I ADDITIONAL INSURED' INSURER LETTER: A
CANCELLATION
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS
1100 SIMONTON STREET
KEY WEST FL 33040
I
ACORD 25-5 (7/97)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRET"",,E 1'\
//y ,
L./<lV -
!/J/!LA
."" C
CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies} must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s}.
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}.
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s}, authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (7/97)
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE
TM 12/30/2004
PRODUCER Garrett-Stotz Company THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
6011 Brownsboro Park Blvd HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite B ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Louisville KY 40207-1292 INSURERS AFFORDING COVERAGE
-------. ~--~
INSURED Koch Corporation J.llii.URER A Amerisure Companies
.-----.-----
P. O. Box 4398 INSURER B: Amerisure CO.!!ll'an!~~_____~_____________
Louisville KY 40204 INSURE8~_'_______~._._~__._~._________
Jl'!~URER D~ ._~_._-_.._~
INSURER E:
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.
POLICY EFFECTIVE POLICY EXPIRATION
COVERAGES
'~~:
k\
TYPE OF INSURANCE
POLICY NUMBER
n.Q!'lI ERAL LIABILITY
__ X CO_MMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR
CPP 1322729
12/31/2004
12/31/2005
~N'LAGGRE_Q~E LIMIT APPLIES PER:
POLICY X ~~,9,: LOC
B -Al!JOMOBILE LIABILITY
_ ANY AUTO
X ALL OWNED AUTOS
X SCHEDULED AUTOS
~_ HIRED AUTOS
X NON-OWNED AUTOS
CA 1322730
12/31/2004
12/31/2005
APP~ trff~IISf"'(' i' '.J'I} "',')1 n'MENT
BY_~_L\~~'~~
~-O-O<"
DATE __<<.'."'__'_' -:....d..__
"-
WAIVER N/A __~____.
_g~RAGE LIABILITY
ANY AUTO
B _EX~ESS LIABILITY -- CU 1322731
X OCCUR CLAIMS MADE
-
-
- DEDUCTIBLE
RETENTION $
B WORKERS COMPENSATION AND WC 132177002
EMPLOYERS' LIABILITY
12/31/2004
12/31/2005
12/31/2004
12/31/2005
OTHER
B EQUIP. FLOATER
CPP 1322729
12/31/2004
12/31/2005
LIMITS
EAc;):i OCCURRENCE ~$_. 1,000,000
FIRE.[)AMAG~(~ny one fi!~~$ 100,000
...ME:QJ:XP (Any .2.n~~rs-""J-----.l...~.~QQ
.J'I"B.~9NAL & ADV INJURY $ 1,000,000
GENERAL.AGGREGATE $ 2,000,000
.J:.80DUCTS -,--COME'LOP AGG n~--.bQOO,OOQ
COMBINED SINGLE LIMIT $ 1.000,000
(Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
--...
PROPERTY DAMAGE $
(Per accident)
AUTO Qlli1LEA ACCIQI;NT $
EA Ac;C $
AGG $
EACH OCCURRENCE __,$
$
$
$
$
LT~J,~~ OJ~-
_E,L EACH ACClQEN~_J-.~ 100,000
EL. DISEASE - EA EMPLOYEE $ 100,000
EL. DISEASE - POLICY LIMIT $ 500,000
OTHER THAN
AUTO ONLY:
AGGREGATE
5,000,000
5,000,000
$80,000 PER ITEM & AGGREGATE
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
ALL WORK INCLUDING MONROE COUNTY NOISE INSULATION PROGRAM (NIP) PHASE 3 CONTRACT THC
NO. 03KW20
NAMES MONROE COUNTY BOARD OF COUNTY COMMISSIONERS AS ADDITIONAL INSURED AS THEIR
INTEREST MAY APPEAR.
CERTIFICATE HOLDER
X ADDITIONAL INSURED' INSURER LETTER: A
CANCELLATION
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS
1100 SIMONTON STREET
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
KEY WEST
FL
33040
ACORD 25-S (7/97)
CL"~
/ ,..~/..(k......~. / ., /1.
I 1""t.f.~~ ,V/
@AC D CORPORATION 1988