12/15/2004 Contract
CONTRACT FOR JANITORIAL SERVICES
FLORIDA KEYS MARATHON AIRPORT
TillS AGREEMENT, made and entered into this 15th day of December , 2004, A.D" by and
between MONROE COUNTY, FLORIDA, (hereinafter sometimes called the "Owner"), and BIRDS
OF PARADISE CLEANING SERVICE, (hereinafter called the "Contractor").
WITNESSED: That the parties hereto, for the consideration hereinafter set forth, mutually
agree as follows:
1. SCOPE OF WORK, The Contractor shall provide janitorial services at the Florida Keys
Marathon Airport, and perform all of the work described in Specifications for Janitorial Services at
Florida Keys Marathon Airport (Exhibit A) and his Bid (Exhibit A-I) attached hereto and incorporated as
part of this contract document. The Contractor shall ensure that all exterior doors are locked upon their
departure after business hours,
2. THE CONTRACT SUM, The County shall pay to the Contractor for the faithful
performance of said service on a per week in arrears basis. The Contractor shall invoice the County
weekly for janitorial services performed under the Specifications contained herein, The contract amount
shall be as calculated by the Contractor's bid proposal as follows: $250,00 per week.
3, CONTRACTOR'S ACCEPTANCE OF CONDITIONS,
a) All specifications have been read and carefully considered by the Contractor, who understands
the same and agrees to their sufficiency for the work to be done, Under no circumstances, conditions, or
situations shall this Contract be more strongly construed against the Owner than against the Contractor,
b) Any ambiguity or uncertainty in the specifications shall be interpreted and construed by the
Owner, and his decision shall be final and binding upon all parties,
c) The passing, approval, and/or acceptance by the Owner of any of the services furnished by the
Contractor shall not operate as a waiver by the Owner of strict compliance with the terms of this Contract,
and specifications covering the services, Failure on the part of the Contractor, immediately after Notice
to Correct shall entitle the Owner, if it sees fit, to correct the same and recover the reasonable cost of such
replacement and/or repair from the Contractor, who shall in any event be jointly and severally liable to the
Owner for all damage, loss, and expense caused to the Owner by reason of the Contractor's breach of this
Contract and/or his failure to comply strictly and in all things with this Contract and with the
specifications.
4, TERM OF CONTRACTIRENEW AL,
a) This contract shall be for a period of one (1) year, commencing January 1, 2005, and
terminating December 31, 2005,
b) The County shall have the option to renew this agreement after the first year, and each
succeeding year, for three additional one year periods, The Contract amount agreed to herein might be
adjusted annually in accordance with the percentage change in the Consumer Price Index for all urban
consumers (CPI-U) for the most recent twelve (12) months available,
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5, HOLD HARMLESS, The Contractor covenants and agrees to indemnify and hold
harmless Monroe County Board of County Commissioners from any and all claims for bodily injury
(including death), personal injury, and property damage (including property owned by Monroe County)
and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection
with, or by reason of services provided by the Contractor, its agents, or employees while Contractor is
cleaning the Airport facilities. However, Contractor shall not be liable for any claims, actions or expenses
which arise from the negligent or intentional acts or omissions of the County, its agents or employees.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements
contained elsewhere within this agreement.
6, INDEPENDENT CONTRACTOR. At all times and for all purposes under this
agreement the Contractor is an independent contractor and not an employee of the Board of County
Commissioners for Monroe County. No statement contained in this agreement shall be construed so as
to find the contractor or any of his/her employees, contractors, servants, or agents to be employees of the
Board of County Commissioners for Monroe County,
7, ASSURANCE AGAINST DISCRIMINATION, County and Contractor agree that
there will be no discrimination against any person, and it is expressly understood that upon a
determination by a court of competent jurisdiction that discrimination has occurred, this Agreement
automatically terminates without any further action on the part of any party, effective the date of the court
order, County or Contractor agree to comply with all Federal and Florida statutes, and all local
ordinances, as applicable, relating to nondiscrimination, These include but are not limited to: 1) Title VI
of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis ofrace, color or
national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss, 1681-1683,
and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation
Act of 1973, as amended (20 USC s, 794), which prohibits discrimination on the basis of handicaps; 4)
The Age Discrimination Act of 1975, as amended (42 use ss, 6101-6107) which prohibits discrimination
on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended,
relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912,
ss, 523 and 527 (42 USC ss, 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and
drug abuse patent records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s, et seq.), as amended,
relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with
Disabilities Act of 1990 (42 USC s, 1201 Note), as maybe amended from time to time, relating to
nondiscrimination on the basis of disability; 10) Monroe County Code Ch. 13, Art. VI, prohibiting
discrimination on the bases of race, color, sex, religion, disability, national origin, ancestry, sexual
orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination
provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this
Agreement.
8. ASSIGNMENT/SUBCONTRACT, The Contractor shall not assign or subcontract its
obligations under this agreement, except in writing and with the prior written approval ofthe Board of
County Commissioners for Monroe County and Contractor, which approval shall be subject to such
conditions and provisions as the Board may deem necessary.
This agreement shall be incorporated by reference into any assignment or subcontract and any
assignee or subcontractor shall comply with all of the provisions of this agreement. Unless expressly
provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon
the Board in addition to the total agreed-upon price of the services/goods of the contractor.
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9. COMPLIANCE WITH LAW, In providing all services/goods pursuant to this
agreement, the contractor shall abide by all statutes, ordinances, rules and regulations pertaining to, or
regulating the provisions of, such services, including those now in effect and hereinafter adopted, Any
violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this
agreement and shall entitle the Board to terminate this contract immediately upon delivery of written
notice oftermination to the contractor. The Contractor shall possess proper licenses to perform work in
accordance with these specifications throughout the term of this contract.
10, INSURANCE, Prior to execution of this agreement, the contractor shall furnish the
Owner Certificates of Insurance indicating the following minimum coverages:
Worker's Compensation in the amount of statutory limits
Vehicle Liability - $100,000 combined single limit
General Liability - $300,000 combined single limit
Employee Dishonesty - $10,000,
11. FUNDING AVAILABILITY, In the event that funds from Airports Contractual
Services are partially reduced or cannot be obtained or cannot be continued at level sufficient to allow
for the purchase of the services/goods specified herein, this agreement may then be terminated
immediately at the option of the Board of County Commissioners by written notice of termination
delivered in person or be mail to the contractor. The Board shall not be obligated to pay for any services
provided by the contractor after the contractor has received written notice of termination,
12, PROFESSIONAL RESPONSIBILITY, The Contractor warrants that he is authorized
by law to engage in the performance of the activities encompassed by the project herein described,
subject to the terms and conditions set forth in these contract documents The provider shall at all times
exercise independent, professional judgment and shall assume professional responsibility for the services
to be provided, Continued funding by the Board is contingent upon retention of appropriate local, state,
and/or federal certification and/or licensure of contractor.
13. NOTICE REQUIREMENT, Any notice required or permitted under this agreement
shall be in writing and hand delivered or mailed, postage prepaid, to the other party by certified mail,
returned receipt requested, to the following:
FOR COUNTY
Airport Manager
Florida Keys Marathon Airport
9400 Overseas Highway
Marathon, FL 33050
FOR CONTRACTOR
Gail Holley-Myrick
Birds of Paradise Cleaning Services
P,O, Box 51856
Marathon, FL 33050
14, CANCELLATION.
a) The County may cancel this contract for cause with seven (7) days notice to the contractor.
Cause shall constitute a breach of the obligations of the Contractor to perform the services enumerated as
the Contractor's obligations under this contract.
b) Either of the parties hereto may cancel this agreement without cause by giving the other party
sixty (60) days written notice of its intention to do so.
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15, GOVERNING LAW, VENUE, INTERPRETATION, COSTS, AND FEES, This
Agreement shall be governed by and construed in accordance with the laws of the State of Florida
applicable to contracts made and to be performed entirely in the State, In the event that any cause of
action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement,
the County and Contractor agree that venue will lie in the appropriate court or before the appropriate
administrative body in Monroe County, Florida,
The County and Contractor agree that, in the event of conflicting interpretations of the terms or a
term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the
institution of any other administrative or legal proceeding,
This Agreement is governed by the laws of the State of Florida, Venue for any litigation
arising under this Agreement must be in Monroe County, Florida, In the event of any
litigation, the prevailing party is entitled to attorney's fees and costs,
a) Severability. If any term, covenant, condition or provision of this Agreement (or the
application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent
by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this
Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of
this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the
enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would
prevent the accomplishment of the original intent of this Agreement. The County and Contractor agree to
reform the Agreement to replace any stricken provision with a valid provision that comes as close as
possible to the intent of the stricken provision,
b) Attorney's Fees and Costs, The County and Contractor agree that in the event any cause
of action or administrative proceeding is initiated or defended by any party relative to the enforcement or
interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, court
costs, investigative, and out-of-pocket expenses, as an award against the non-prevailing party, and shall
include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate proceedings.
Mediation proceedings initiated and conducted
pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and
customary procedures required by the circuit court of Monroe County,
c) Adjudication of Disputes or Disagreements, County and Contractor agree that all
disputes and disagreements shall be attempted to be resolved by meet and confer sessions between
representatives of each of the parties, If no resolution can be agreed upon within 30 days after the first
meet and confer session, the issue or issues shall be discussed at a public meeting of the Board of County
Commissioners, If the issue or issues are still not resolved to the satisfaction of the parties, then any party
shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida
law.
d) Cooperation, In the event any administrative or legal proceeding is instituted against
either party relating to the formation, execution, performance, or breach of this Agreement, County and
Contractor agree to participate, to the extent required by the other party, in all proceedings, hearings,
processes, meetings, and other activities related to the substance of
this Agreement or provision of the services under this Agreement. County and Contractor specifically
agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to
this Agreement.
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16. CONTINGENCY STATEMENT, Monroe County's performance and obligation to pay
under this contract is contingent upon an annual appropriation by the Monroe County Board of County
Commissioners.
17, RECORDS, Contractor shall maintain all books, records, and documents directly
pertinent to performance under this Agreement in accordance with generally accepted accounting
principles consistently applied, Each party to this Agreement or their authorized representatives shall
have reasonable and timely access to such records of each other party to this Agreement for public
records purposes during the term of the Agreement and for four years following the termination of this
Agreement. If an auditor employed by the County or Clerk determines that monies paid to Contractor
pursuant to this Agreement were spent for purposes not authorized by this Agreement, the Contractor
shall repay the monies together with interest calculated pursuant to Sec, 55,03, FS, running from the date
the monies were paid to Contractor.
18. BINDING EFFECT. The terms, covenants, conditions, and proVISIons of this
Agreement shall bind and inure to the benefit of the County and Contractor and their respective legal
representatives, successors, and assigns,
19. AUTHORITY, Each party represents and warrants to the other that the execution,
delivery and performance of this Agreement have been duly authorized by all necessary County and
corporate action, as required by law.
20, COVENANT OF NO INTEREST, County and Contractor covenant that neither
presently has any interest, and shall not acquire any interest, which would conflict in any manner or
degree with its performance under this Agreement, and that only interest of each is to perform and receive
benefits as recited in this Agreement.
21, CODE OF ETIDCS, County agrees that officers and employees of the County
recognize and will be required to comply with the standards of conduct for public officers and employees
as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance
of gifts; doing business with one's agency; unauthorized compensation; misuse of public position,
conflicting employment or contractual relationship; and disclosure or use of certain information,
22. NO SOLICITATION/PAYMENT, The County and Contractor warrant that, in
respect to itself, it has neither employed nor retained any company or person, other than a bona
fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or
agreed to pay any person, company, corporation, individual, or firm, other than a bona fide
employee working solely for it, any fee, commission, percentage, gift, or other consideration
contingent upon or resulting from the award or making of this Agreement. For the breach or
violation of the provision, the Contractor agrees that the County shall have the right to terminate
this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise
recover, the full amount of such fee, commission, percentage, gift, or consideration.
23. PUBLIC ACCESS, The County and Contractor shall allow and permit
reasonable access to, and inspection of, all documents, papers, letters or other materials in its
possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or
received by the County and Contractor in conjunction with this Agreement; and the County shall have the
right to unilaterally cancel this Agreement upon violation of this provision by Contractor.
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24, NON-WAIVER OF IMMUNITY, Notwithstanding the provisions of Sec, 286.28,
Florida Statutes, the participation of the County and the Contractor in this Agreement and the acquisition
of any commercial liability insurance coverage, self-insurance coverage, or local government liability
insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor
shall any contract entered into by the County be required to contain any provision for waiver.
25, PRIVILEGES AND IMMUNITIES, All of the privileges and immunities from
liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers'
compensation, and other benefits which apply to the activity of officers, agents, or employees of any
public agents or employees of the County, when performing their respective functions under this
Agreement within the territorial limits of the County shall apply to the same degree and extent to the
performance of such functions and duties of such officers, agents, volunteers, or employees outside the
territorial limits of the County.
26, LEGAL OBLIGATIONS AND RESPONSIBILITIES: Non-Delegation of
Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as,
relieving any participating entity from any obligation or responsibility imposed upon the entity by law
except to the extent of actual and timely performance thereof by any participating entity, in which case
the performance may be offered in satisfaction of the obligation or responsibility, Further, this
Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional
or statutory duties of the County, except to the extent permitted by the Florida constitution, state statute,
and case law.
27, NON-RELIANCE BY NON-PARTIES, No person or entity shall be entitled to rely
upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third-party claim
or entitlement to or benefit of any service or program contemplated hereunder, and the County and the
Contractor agree that neither the County nor the Contractor or any agent, officer, or employee of either
shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of
individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart,
inferior to, or superior to the community in general or for the purposes contemplated in this Agreement.
28. ATTESTATIONS, Contractor agrees to execute such documents as the County may
reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free
Workplace Statement.
29, NO PERSONAL LIABILITY, No covenant or agreement contained herein shall be
deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in
his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be
liable personally on this Agreement or be subject to any personal liability or accountability by reason of
the execution of this Agreement.
30, EXECUTION IN COUNTERPARTS, This Agreement may be executed in any
number of counterparts, each of which shall be regarded as an original, all of which taken together shall
constitute one and the same instrument and any of the parties hereto may execute this Agreement by
signing any such counterpart,
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31, SECTION HEADINGS, Section headings have been inserted in this Agreement as a
matter of convenience of reference only, and it is agreed that such section headings are not a part of this
Agreement and will not be used in the interpretation of any provision of this Agreement.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLOIDA
By:
~~;u >n ~~
Mayor/Chairman
Date:
Deputy Clerk
~ I$, Zoo 0,-/
(SEAL)
BIRDS OF PARADISE CLEANING
SERVICE -jJid ~
"~ .~
BYi W..../ ~ f J-t
(4 Gail HOlleY~
Attest:
7:1ES . . I
Md J Ja.J
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EXHIBIT A
SPECIFICATIONS FOR JANITORIAL SERVICES
AT FLORIDA KEYS MARATHON AIRPORT
With reference to the Florida Keys Marathon Airport terminal, 9400 Overseas Highway,
Marathon, Florida 33050, provide janitorial services for the entire terminal building inside and
under the canopies outside, as follows:
DAILY INSIDE
. Clean 1 st floor bathrooms twice a day, before 10:00 a,m. and after 2:00 p,m,
. Empty and clean as necessary, all trash cans (1 st floor and manager's office).
. Sweep the entire 1 st floor.
. Clean 2nd floor bathrooms once a day before opening hours.
. Mop floors as needed for spot clean-up.
. Wipe off and clean lounge furniture as needed.
. Wipe walls as needed.
DAILY OUTSIDE
. Empty and clean all trash cans.
. Empty ash stands.
. Pick up litter as necessary on walk-way in front of Airport,
. Sweep and clean up walkways and curbs as needed (front).
. Wipe off benches, mailboxes, courier box, etc" as needed.
WEEKLY INSIDE
. Mop entire 1 st floor.
. Wipe off and polish wood benches as needed,
. Wipe off and polish wood handrails.
. Wipe off and polish stainless steel items.
. Vacuum all chair cushions and lounge seats as needed,
. Dust and clean advertising brochure racks, pay telephone, mounted fish, display cases, etc,
8
WEEKL Y INSIDE (continued)
.
Vacuum stairs, 2nd floor hallway and manager's office suite,
Clean, dust and sweep out elevator.
Dust and clean all window sills 1 st and 2nd floors.
Dust and clean furniture in manager's office suite,
Vacuum all chair cushions in manager's office suite,
.
.
.
.
WEEKLY OUTSIDE
. Sweep 2nd floor outside back deck.
. Sweep and hose down walkways and curbs in front of terminal.
. Wash 1 st floor glass at front two entry doors, and at both departure gates.
MONTHLY
. Wash all 2nd floor glass windows and doors inside and out.
. Hose down 2nd floor outside back deck.
. Wash inside of all glass windows with Bahama storm shutters.
. Dust and clean baseboards in manager's office suite.
OTHER
. Maintain inventories of cleaning supplies. Coordinate ordering with manager's office,
. Wash windows outside and accordion storm shutters every 6 months,
. Shampoo 2nd floor carpets and stairway as needed.
. Dust and clean overhead soffits as needed,
. Water indoor plants and oversee their care,
SPECIAL EVENTS
. Police and clean-up as needed during and after Airport Terminal special events,
9
o
EXHIBIT A-I
BID FORlVI
BID TO:MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
C/O PURCHASING DEPARTMENT
GA TO BUILDING ROOM 2-213
1100 SIMONTON STREET
KEY WEST, FLORIDA 33040
BID FROM: P)lil~"S 0(1 fP;eJ lC,if ()! '(/}jr1Ji ~.s
BID PRICE: u~.noc),
I
(fI. r1/Sh. Iv t'f'f! J '\
I~
The undersigned, having carefully examined the work, specifications, proposal, and addenda
thereto and other Contract Documents for the services of:
JANITORIAL SERVICES AT FLORIDA KEYS MARATHON AIRPORT
The Contractor, in submitting the foregoing bid, agrees to comply with all contract specification
documents.
I acknowledge receipt of Addenda No. (s)
(Check mark (vi) items below, as a reminder that they are included.)
I have included pages 3cO-33 of the Bid Proposal which entails the Bid Form ~ the Non-
~. -'
Collusion Affidavit~, the Lobbying and Conflict of Interest Clause ~, and the Drug Free
Workplace Form ~/, In addition, I have included a current copy of Monroe County
Occupational License ~, Insurance Agents Statement \/""", and all requirements as stated
in Section One, Article 1.04 Paragraphs A throu~ D. ,
r;] OJ . Z ~ ~ll.j 6 A go Le: - ./'
191+/ /-fa I. e -I I iZt (/ l OLUAJeJ'L
(Print Name) &- ( - fh.. J'. (Tit~) j t. . ,. .
Mailing Address: 13, flO S 0 fJ ICA / sf:!: I '('1M) / A:)Telephone: ~S -./ 7if3.- t( 97,
p~o ,/3!) X- 51 B~ b Fax: ,-305 -iY.3.::!/jC/ ()
jf)/Jf{lJI//;o~ ,-:::/ ,~~Date:
Signed:
Witness:
(Seal)
30
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list following a
conviction for public entity crime may not submit a bid on 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 submit bids on leases of real property to public entity, may not be awarded or
perform work as a contractor, supplier, subcontractor, or consultant under a
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, for
CATEGORY TWO for a period of36 months from the date of being placed on the
convicted vendor list."
8
NON-COLLUSION AFFIDAVIT
I, (]A / / liD 11 eV- fI1 Y /Z:e/< of the oi'y of (J1// e 4/},.; A)
according to law on my/oath, and under penalty of perjury, depose and say at:
o c
1. lam
of the firm of
the bidder making the Proposal for the project described in the Notice for Calling for bids for:
(! ( UIIO tfll S 01' fY) fJ /l;;/lvj'IJ iN) /2fo-e.J--
and that I executed the said proposal with full authority t do so:
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;
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
no attempt has been made or will be made b 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 contained in this affidavit are true and correct, and made with full
knowledge that Monroe County relies upon the truth of the statements contained in
this affidavit in aw rding contracts for said p. oject.
co!.:1 /0 ~
COUNTY OF:
~{~ ~~~
hO/7eO~
STATE OF:
PERSON ALL Y APPEARED BEFORE ME, the undersigned authority, C q , - L /1. ~V/f; 4f
who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided
above on this / day of Abt/eh/~ 2~
~-~~
~T PUBLIC /
My Comm'ssion Expires:
JUUA LYNN GRAY
MY COMMISSION # DO 132731
EXPIRES: October 16. 2006
Bonded Thru NQlary Public UndelY/riters
31
SWORN STATEMENT UNDER ORDINANCE NO.1 0-1990
MONROE COUNTY. FLORIDA
warrants that he/it has not employed, retained
or otherwise had act 0 his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No.1 0-1990. 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 fee,
STATEOF ;:'U/!;IOCL-
COUNTYOF Jtt {)/JLo~
PERSONALL Y APPEARED BEFORE ME, the undersigned authority,
GD/L
/I, d ~;t/'(J.A'
.
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this
/'
day of
lto!/eHA1~
,20,CJj!:
~ afr fft
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
JUUA LYNN GRAY
MY COMMISSION # DO 132731
EXPIRES: October 16, 2006
Bonded Thru Nolary Public UndeIWrlters
32
DRUG-FREE WORKPLACE FORM
.-----' -" ,--- -_.-,----_.. -- ----- .--..------.-- "..-- --~. _.~.------_.,._-
The und:;ign ,vendor in accordance ,WIth FIo}id;,Statute ~l( R7 hereby certities that. , q ,
dIS$-- . ~~SoJrfi<t!.-<L-
I. 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 \vill be taken against
employees for violations of such prohibition.
2. Infonn employees about the dangers of drug abuse in the workplace. the business's policy of maintaining a drug-
free work,1Jlace, any available drug counseling. rehabilitation, and employee assistance programs. and the penalties
that may be imposed 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 specitied in subsection (I).
4. In the statement specified in subsection (I). 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 tenns of the statement and
will notify the employer of any conviction of. or plea of guilty or nolo contendere to. any violation of Chapter 893
(Florida Statutes) or of any controlled substance law of the United States or any state. for a violation occurring in the
\vorkplace no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program
ifsuch is available in the employee's community. or any employee who is so convicted.
6. Make a good faith effort to continue to maintain a drug-free \vorkplace through implementation of this section.
As the person authorized to sign the statement. I certify that this tirm complies fully with the above requirements.
O(J>/ll~
Date
MB - Me!'
ACOBQ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
. ~ _.. TM 11/18/2004
PRODUCER (305) 743-0494 FAX (05) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Marathon, FL 33050-0280
INSURERS AFFORDING COVERAGE NAIC#
INSURED Gail Holley INSURER A: Penn America Ins. Co.
PO Box 501856 INSURER B: Old Republic Surety Co.
Marathon, FL 33050 INSURER C:
INSURER 0:
INSURER E:
COVERAGES
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.
INSR DO'
TYPE OF INSURANCE
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 00 OCCUR
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION LIMITS
11/19/2005 EACH OCCURRENCE $ 100,00
DAMAGE TO RENTED $ 50,00
MED EXP (Anyone person) $ 5,00
PERSONAL & ADV INJURY $ 100,00
GENERAL AGGREGATE $ 200,00
PRODUCTS - COMP/OP AGG $ 100,00
COMBINED SINGLE LIMIT $
(Ea accident)
BODILY INJURY $
(Per person)
.BOOIL Y INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EA ACCIDENT $
BINDER ATTGN-S 11/19/2004
A
LOC
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON,OWNEO AUTOS
EXCESS/UMBRELLA LIABILITY
OCCUR 0 CLAIMS MADE
OTHER THAN
AUTO ONLY:
GARAGE LIABILITY
ANY AUTO
EACH OCCURRENCE
EA ACC $
AGG $
$
$
AGGREGATE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERlMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
Oll:\EI\. .
lUe 11ty Bond
$
$
$
BINDER 041118 11/19/2004
$
EL. DISEASE - EA EMPLOYE $
EL. DISEASE. POLICY LIMIT $
11/19/2005 $10,000
B
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ertifcateholder is additional insured with respect to liability as their interest may appear
Monroe County Board of County Commissioners
1100 Simonton St. Rm 268
Key West, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOT E TO THE C TIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUC NOTICE S L IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE I SURER, I GENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA E ~
ACORD 25 (2001/08) FAX: 295-4342
@ACORD CORPORATION 1988
I q<)ti Edition
MONROE COUNTY, FLORIDA
Request For Waiver
of
Insurance Requirements
It is requested that the insurance requirements, as specified in the County's Schedule ofInsurance Requirements,
be waived or modified on the following contract.
G) I~ f I J-h IL eJ,
f'J /t?(~ S of ,t'p/((licS I ~L~ r /yale) ) tuJ
Address of Contractor: /<'~ '- ()- f!J () ,-I- C; () J 8 _ c; (-)
!VJ /l /J / / --I ':2...-,. e-
(! ,ff f-f fcll /7 ()/l) J ~ . ~/ ~50,.,,) (j
?)D ~- 7tf3- t/9'1()
(l/, J9 iL" "j fJ1/li(dlw""
Contractor:
Contract for:
Phone:
Scope of Work:
1l-/1~.1l1-
Reason for Waiver:
.~ h ;+ Ii t..:r
Policies Waiver
will apply to:
Risk Management
Not Approved
Date
County Administrator appeal:
Approved:
Not Approved:
Date:
Board of County Commissioners appeal:
Approved:
Not Approved:
Meeting Date:
Administration Instruction
#4709.5
102
111l)/i 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
9tE~
~ /)JrljA6
s~u -(D6;P!c~(J
11 ) D/l t p;"J ~ (!~ /1fe II 1 <t;/UJAJ
-(}1 fA) 9~lb 9w 4~~ ~e'~
Approved Not A r ed a
County Administrator appeal:
Date:
Approved:
Not Approved:
Board of County Commissioners appeal:
Approved:
Not Approved:
Meeting Date:
Administration Instruction
#4709.5
102