10/25/1991 Contract
CONTRACT
THIS AGREEMENT, made and entered
ber, 1991, between Monroe County,
ING MAINTENANCE (Contractor):
WIT N E S
That the parties hereto, for the
forth, mutually agree as follows:
into this 30th day of
Florida (OWner), and ACE
FILED F OF Rrr~ow
Octo-
BU~fD'NOV 14 A 8 :52
S E S:
consideration
hereinafter D~~C~r\ LiR' L
MONROE CDUN 1 Y FLt
I.
SCOPE OF THE WORK
The Contractor shall provide janitorial services, including all
necessary supplies and equipment required in the performance of
same, for the Key West Courthouse, located in Key West, Monroe
County, Florida. The Contractor agrees to furnish janitorial
services in accordance with the Public Works Manual entitled
"Standard Janitorial Specifications and Requirements, Key West
Courthouse", attached hereto and incorporated as part of this
contract document. The manual shall serve as minimum contract
standards, and shall be the basis of inspection and acceptance of
all the work. The Contractor shall insure all exterior doors are
locked upon their departure.
II. INDEPENDENT CONTRACTOR
At all times and for all purposes under this agreement the Con-
tractor 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.
III. ASSURANCE AGAINST DISCRIMINATION
The Contractor shall not discriminate against any person on the
basis of race, creed, color, national origin, sex, age, or any
other characteristic or aspect which is not job related, in its
recruiting, hiring, promoting, terminating, or any other area
affecting employment under this agreement or with the provision
of services or goods under this agreement.
IV. ASSIGNMENT
The Contractor shall not assign this agreement, except in writing
and with the prior written approval of the Board of County Commis-
sioners for Monroe County and Contractor, which approval shall be
subject to such conditions and provisions as the Board and Con-
tractor may deem necessary. This agreement shall be incorporated
by reference into any assignment and any assignee 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 contrac-
tor.
V.
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 regula-
tions shall constitute a material breach of this agreement and
shall entitle the Board to terminate this contract immediately
upon delivery of written notice of termination to the contractor.
VI. INSURANCE
Upon execution of this agreement, the
the OWner Certificates of Insurance
minimum coverage limitations:
Contractor
indicating
shall furnish
the following
Commercial General Liability including completed operations
and contractual liability, with minimum limits of
$500,000.00 per occurrence.
Comprehensive Auto Liability with minimum combined single
limits of $300,000.00 per occurrence.
Worker's Compensation - as required by Florida Statutes.
Dishonesty bond with minimum limits of $5,000.00 per occur
rence.
Monroe County is to be named additional insured on both the Gener-
al Liability and Auto Liability Policies. The minimum coverage
limitations must be maintained throughout the contract term.
VII.
HOLD HARMLESS
The Contractor shall defend, indemnify and hold the County, its
officials, employees and agents harmless, from any and all
claims, liabilities, losses and causes of action which may arise
out of the performance of the Contract except such claims, liabil-
ities, losses and causes of action which may arise because of the
County's negligent actions or omissions. Compliance with the
insurance requirements shall not relieve the Contractor from the
obligations imposed by this article.
VIII.
TERM OF CONTRACT
This contract shall be for a period of one (1) year, commencing
on the day in which it has been executed by both parties. This
Contract term shall be renewable in accordance with Article X.
2
IX. CANCELLATION
Either of the parties hereto may cancel this agreement with or
without cause by giving the other party sixty (60) days written
notice sent certified mail of its intention to do so.
X.
RENEWAL
The OWner shall have the option to renew this agreement after the
first year, and each succeeding year, for a maximum of two (2)
years. The contract amount agreed herein may be adjusted annually
in accordance with the percentage change in the Consumer Price
Index (CPI) for Wage Earners and Clerical Workers in the Miami,
Florida area index, and shall be based upon the annual average CPI
computation from January 1 through December 31 of the previous
year.
XI. FUNDING AVAILABILITY
In the event that funds from Facilities Maintenance 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 termi-
nated immediately at the option of the Board by written notice of
termination delivered in person or by 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 no-
tice of termination.
XII.
PROFESSIONAL RESPONSIBILITY
The Contractor warrants that it 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 the Public Works Manual entitled "Standard Janitorial Specifi-
cations and Requirements, Key West, Courthouse", which is at-
tached hereto and incorporated herein as a part of this con-
tract/agreement. The provider shall at all times exercise inde-
pendent, professional judgement and shall assume professional
responsibility for the services to be provided. Continued fund-
ing by the Board is contingent upon retention of appropriate
local, state, and/or federal certification and/or licensure of
contractor.
XIII.
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
Monroe County Public Works
P.O. Box 1029
Key West, FL 33041
ATTN: Mike Lawn
FOR CONTRACTOR
ACE BUILDING MAINTENANCE
P. o. Box 2763
Key West, Fla. 33045
3
XIV. PAYMENT
The County shall pay to the Contractor for the performance of
said service on a per month in arrears basis on or before the
15th day of the following month in each of twelve (12) months.
The Contractor shall invoice the County monthly for janitorial
services performed under the Specifications contained herein.
The Contract amount shall be as stated by the contractors propos-
al as follows: Twenty One Thousand Three Hundred Sixty Dollars
($21,360.00) to be paid One Thousand Seven Hundred Eighty Dol-
lars ($1,780.00) per month.
In witness whereof, the parties hereto have executed this agree-
ment the day and year first above written,
COUNTY OF MONROE, STATE OF
FLORIDA
By ~~;~:;;;::i~~ ~
Attest: DANNY L. KOLHAGE, Clerk
./!
ACE BUILDING MAINTENANCE
B~~
Attest:
.~
WITNESS
-HI~
By
4
NOTICE OF CALLING FOR BIDS
NOTICE IS HEREBY GIVEN TO WHOM IT MAY CONCERN that on the
10th day of October, 1991 at 10:00 a.m., at the Office of
the Director of Purchasing, a Committee consisting of the
Director of Purchasing, the County Administrator, the County
Attorney, and the requesting Department Head or Division
Director, or their designees, will open sealed bids for
JANITORIAL SERVICES CONTRACT
KEY WEST COURTHOUSE
All proposals must be received by the Office of the
Director of Purchasing, 5100 West College Road, Public Service
Building, Wing II, Stock Island, Key West, Monroe County,
Florida 33040 on or before 10:00 a.m. on October 10, 1991.
All bids, inclUding the recommendation of the County
Administrator and requesting Department Head or Division
Director, will be referred to the Board of County Commissioners
for final awarding or otherwise.
The Board will automatically reject the bid of any person
or affiliate who appears on the convicted vendor list prepared
by the Department of General Services, State of Florida, under
Sec. 287.133 (3)(d), Fla.Stat. (1989).
Four (4) copies of each bid shall be submitted in a sealed
envelope marked on the outside, "Sealed Bid for Janitorial
Services Key West Courthouse". All bids must remain valid for a
period of ninety (90) days.
Specifications and/or further information may be obtained
by contacting the Office of Facilities Maintenance, 5100 West
College Road, Stock Island, Florida, 33040, (305) 292-4431.
The Board also reserves the right to separately accept or
reject any item or items of a bid and to award and/or negotiate
a contract in the best interest of the County.
DATED at Key West, Florida, this 6th day of September,
1991.
R.M. COFER
Director of Purchasing
for Monroe County, Florida
PUBLIC WORKS MANUAL
FACILITY MAINTENANCE
STANDARD
JANITORIAL
SPECIFICATIONS
AND
REQUIREMENTS
MONROE COUNTY COURTHOUSE - KEY WEST
MONROE COUNTY PUBLIC WORKS DEPARTMENT
BOARD OF COUNTY COMMISSIONERS
MONROE COUNTY, FLORIDA
PUBLIC WORKS SPECIFICATION MANUAL
JANITORIAL
KEY WEST COURTHOUSE
TWO DAYS PER WEEK SERVICE/OFFICES
FIVE DAYS PER WEEK/HALLWAYS & RESTROOMS
TABLE OF CONTENTS
TITLE
PAGE
A. DESCRIPTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2
B . WORK HOURS .............................................. 2
C . GENERAL CLEANING ........................................ 2
D. RESTROOM SANITATION ..................................... 2
E. FLOOR TREATMENT ......................................... 3
F. PERIODIC SERVICES ....................................... 3
G. COORDINATION OF THE WORK ................................ 3
H. PAPER PRODUCTS AND SUPPLIES ............................. 4
I . RECYCLING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4
J. INSPECTION OF THE WORK .................................. 4
K. INSURANCE/INDEMNIFICATION/HOLD HARMLESS ................. 4
L. PUBLIC ENTITY CRIME AFFIDAVIT ........................... 5
M. NON-COLLUSION AFFIDAVIT ................................. 5
A. DESCRIPTION
1. The Contractor shall furnish janitorial services, includ-
ing all necessary supplies and equipment required in the
performance of same, for the Key West Courthouse.
B. WORK HOURS
1.
The Contractor shall clean all required
nights per week, Tuesday and Friday, each
required restrooms and public hallways
per week, Monday through Friday. Work
formed between the hours of 5:00 p.m. and
offices two (2)
week, and all
five (5) nights
shall be per-
7:00 a.m.
C. GENERAL CLEANING
General cleaning shall include the following:
1. All tile floors are to be dust mopped and/or damp mopped
as necessary.
2. All furniture and furnishings dusted and spot cleaned.
3. All walls and woodwork spot cleaned to a height of six
(6) feet monthly.
4. Low ledges, sills, rails, and baseboards dusted and/or
spot cleaned.
5. All ashtrays emptied, damp cleaned, and polished.
6. All cigarette burns cleaned and debris removed.
7. Clean and polish all drinking fountains.
8. All trash receptacles emptied, trash can liners changed.
9. All glass entrance doors shall be washed and polished
inside and outside.
10. All other glass partitions, interior doors, mirrors,
windows, etc., to be washed and polished as needed.
11. Vacuum all upholstered furniture.
12. Carpets in all traffic areas are to be vacuumed each
night, complete area also to be vacuumed each night.
13. All carpeting will be regularly inspected and spot
cleaned.
D. RESTROOM SANITATION
Restroom sanitation shall include the following:
1. All floors swept with a straw broom, loose dirt removed.
2. Wash and disinfect floor and upon completion, floor is
to be mopped to a damp dry condition.
3. Stall partitions damp cleaned.
4. All commodes, urinals, basins and vanities shall be
scoured and disinfected.
5. All urinal traps shall be specially cleaned and disin-
fected.
6. All sanitary napkin receptacles will be cleaned, waste
disposed, and disinfected.
7. All supplies shall be replaced.
2
8. All slop sink closets to be cleaned completely each
week, and mops, buckets, etc., removed to storerooms
after usage.
9. All other work necessary to maintain a clean and sani-
tary condition in these restrooms shall be accomplished,
whether it is specifically noted in these specifications
or not.
E. FLOOR CLEANING
1. Buildings with floors requiring stripping, refinishing,
and buffing shall receive this treatment on a regularly
scheduled basis, so as never to allow a build-up of old
finish to accrue anywhere on the floors of the complex.
2. Treatment of these floors shall be performed a minimum
of one (1) time per month.
3. All other flooring shall be cleaned as described in
Sections Band E of this specification.
F. PERIODIC SERVICES
8.
9.
10.
The services below shall be included and shall be performed
at the frequency indicated as ~ollows:
1. All door vents cleaned weekly.
2. All high dusting (i.e. pictures, door frames, air vents,
etc., shall be cleaned monthly.
All walls dusted monthly
All interior windows washed bimonthly.
All janitor rooms and closets to be cleaned at all times.
Clean/Shampoo all carpeted areas a minimum of once every
six (6) months.
Sweep all stairs, landings, breezeway area, and brick
area once a week.
Pressure clean breezeway twice a month.
Pressure clean entrance area and walls once a
All air conditioner filters shall be replaced
month. Filter material shall be supplied
County Public Works as required.
3.
4.
5.
6.
7.
month.
once a
by Monroe
G. COORDINATION OF THE WORK
1. Contractor shall provide maximum amount of Janitorial
Services with the minimum amount of interference to
building tenants.
2. Coordination of the work with the County area representa-
tive shall be the responsibility of the Contractor. The
Contractor shall perform the work during hours and times
as specified.
3. Keys shall be issued to the Contractor by the area repre-
sentative at the start of the Contract. Written confir-
mation of receipt of keys shall be signed by the Contrac-
tor. The Contractor shall return all keys as issued
upon expiration of the Contract or termination.
3
4.
The Contractor shall be responsible for
changing locks, etc., for all keyed secured
which the Contractor does not return the keys.
the cost of
areas for
H. SUPPLIES
1. The Contractor shall provide all supplies necessary for
the cleaning performance of his work under the con-
tract. All supplies, including but not limited to, hand
soap, sanitary napkins, paper towels, toilet paper, and
trash can liners, shall be supplied by the Contractor.
2. The Contractor shall maintain stock in each facility in
a minimum amount sufficient to last through the next
cleaning day.
I . RECYCLING
1. The Contractor shall be required to participate in the
recycling program on a per office basis. County offices
recycling office paper, aluminum, and newspaper shall
have receptacles indicating specific use. The Contrac-
tor shall be responsible for emptying receptacles to
designated dumpsters in all County Offices covered by
the Contract in which the tenants participate in recy-
cling programs.
J. INSPECTION OF THE WORK
1. The tenants of each facility shall be the deemed the
County's representative on a daily basis, and shall
determine if deficiencies exist.
2. Random inspections shall be performed by County Represen-
tatives from the Public Works Division administering the
contracts.
3. Deficiencies shall be corrected within a twenty-four
(24) hour period of notification to the Contractor.
Failure of the Contractor to correct such deficiencies
shall result in prorated deduction from the monthly
invoice.
K. INSURANCE/INDEMNIFICATION/HOLD HARMLESS
1. The successful proposer will be required to indemnify,
defend, and hold-harmless the County from any and all
claims, liabilities, costs, including attorney fees,
etc., that the County may incur due to the negligent
acts, errors, or omissions of the janitorial service
company.
2. Minimum insurance requirements:
a) Commercial General Liability including completed
operations and contractual liability, with minimum
limits of $500,000.00 per occurrence.
4
b) Comprehensive Auto Liability with minimum combined
single limits of $300,000.00 per occurrence.
c) Workers Compensation as required by Florida Stat-
utes.
d) Dishonesty bond with minimum limits of $5,000.00
per occurrence.
Monroe County is to be named additional insured on both
the General Liability and Auto Liability policies.
A certificate of insurance indicating the above insur-
ance coverages are to be submitted upon recommendation
to the Board of County Commissioners from the Facilities
Maintenance Department of award of bid. All insurance
coverages are subject to review by Risk Management, and
the County retains the right to request any changes, or
clarification of coverage forms, that may be in its best
interest.
L. PUBLIC ENTITY CRIME AFFIDAVIT
1. Any person submitting a bid or proposal in response to
this invitation must execute the enclosed Form PUR
7068, SWORN STATEMENT UNDER SECTION 287.133(3) (A),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES, including
proper check(s), in the space(s) provided, and enclose
it with his bid or proposal. If you are SUbmitting a
bid or proposal on behalf of dealers or suppliers who
will ship commodities and receive payment from the re-
sulting contract, it is your responsibility to see that
copy(s) of the form are executed by them and are includ-
ed with your bid or proposal. Corrections to the form
will not be allowed after the bid or proposal opening
time and date. Failure to complete this form in every
detail and submit it with your bid or proposal will
result in immediate disqualification of your bid or
proposal.
M. NON-COLLUSION AFFIDAVIT
1. Any person submitting a bid or proposal in response to
this invitation must execute the enclosed NON-COLLU-
SION AFFIDAVIT. If it is discovered that collusion
exists among the bidders, the bid or proposals of all
participants in such collusion will be rejected, and no
participants in such collusion will be considered in
future proposals for the same work.
5
SWORN STA:a.EMENT UNDER ORDINANCE NO. ..j-1990
MONROE COUNTY, FLORIDA
ETHI C~ (",J.~USE
~~ Eo'o~t..At.
\
warrants that he/it has not employed,
retained or otherwise had act on he/its behalf any former County officer
or employee subject to the prohibition of Section 2 of Ordinance No.
10-1990 or any County officer or employee in--violatlon of Section 3 of
Ordinance No. 10-1990. 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, commission,
percentage, gift, or consideration paid to the former County officer or
Date:
~
employee.
STATE OF
'--
_T- \cr\ aCA
\'-\Qn-rQ e
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
.:Il.l~~Obl'c.Ac..
affixed hisjher signature (name of individual signing) in the space
above on this ~ct ~ day of
who, after first being sworn by me,
p~
, 19~.
My commission expires:
NOTARY PUBL
NOTARY PUBLIC STATE Of FlOlttDA
MY COMMISSION EXP. JUly 30. 1993
BONDED THRU GENERAl INS. UNO.
~
NON-COLLUSION AFFIDAVIT
I,
, of the city of
on my oath, and under penalty
of the firm of
making the Proposal for the
2) the prices in this bid have been arrived at
ly without collusion, consultation, communication
for the purpose of restricting competition, as to
relating to such prices with any other bidder or with
tor;
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 competi-
tion;
independent-
or agreement
any matter
any competi-
5 )
correc;t,
upon the
awarding
the statements contained in this affidavit are true and
and made with full knowledge that Monroe County relies
truth of the statements contained in this affidavit in
contracts for said project.
STATE OF
/':::::.-L~
-fl1 (}t/U~
COUNTY OF
--fERS~NALLY ~APPEjARED BEFORE ME, the undersigned authority,
, ,yo(: '-~- ~ .')'ot'--Lf.lC- who, after first being sworn by me,
(name of . dividual signing)
affi1ed his/her Sign~ture i~_the space provided above on this
t( I' day of ""'.j-a-,j..:(_ , 19 <1 I .
.'
"-
'~~
My commission expires:
r - - ':)" ~,""l ,,. <<:1 ~...~ ~.r ~~n"!~tH{'
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_ . ;..;-.:..1 r....;.r",.-"r f...."....C '-'N...a.;'h'f'RITIi.Ua.
SWORN STATEMENT PURSUANT TO SECrION 287.133(3}(a),
FLORIDA STATUTES. ON PUBlJC EN1T1Y C1UMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUB1JC OR
OTHER OffiCIAL AUTlIORIZED TO ADMINIS'IER OATHS.
This swom statcment is submitted to ~\ ,~,-,.:.:. . \, ~ ~~;.~, -;'".t')~.::, (,,; \;;,~\.:~
-r;- L '. 11"/J.' - J: (priDCDlllleoftapubllcllldtyJ
by ~( ~ l~:::t. CJ<'"
[prim. dlrid'11'S ~, 8Dd title), J,' ,
for r\l?\'::.{ , U I ~L1 ." L~ 7 ),)4, ~~t/ll\/CE.
~ [pru.t r.!!!~~ aC;ae:17'l:"':~' ":!'!!"!!!'!! ~,-!!!!!! ".
whose business address is I :) () () ',) (j q1J 7l-'(.z~.1 c~
kty Wf:s-r A fr 3.~OY ()
and (if applicable) Its Federal Employer Identf1lc:aUon Number (fEIN) fs0 ~', .~, ~.t
1.
, '
,
(If the entity bas no FEIN, indude the Social Secarity Number of the individual sipiDg this swam
statement:
.)
2. I undentand that a -public entity crimea as <leaDed ill Paragraph 287.133(1)(&), Florida Statutes.
means a violation of .any state or federa1law by a penon with respec:l to and directly related to
the uamacdon of business with any publfc entity or with an agency or polidca1 subdivisfon of my
other state or of the United States. mdudfng, bill DOt limited to, my bid or conuact for goods or
services to be provided to any pubUc entity or an agency or poJitica1 subcUvision of any other state
or of me United States and involving antitrust, fraud, theft, bribery, collusion, racketeering,
conspiracy, or material misrepresentation.
3. 1- undentand that .convicted. or .conviction. as defined in Paragraph 281.133(1)(b), Florida Statutes.
means a finding of guilt or a conviction of a public entity crime. with or without an adjudicnion of
guilt, in any federal or state trial court of ~rd relating t~ ~es brought by indictment, or
information after July 1, 1989, as a result of a JUlY verdict, non)wy trial, or enuy of a plea of'gullty
or nolo contendere.
4. I understand that an -affiliate- as defined in Paragraph 287.133(1)(a). Florida Statutes. means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An entity under the conuel of any natural pCllOD who is active in the management of the entity
and who has been conviClec1 of a public entity crime. The term -aftll1ate. includes those officers,
directors, executives, panners, shareholders, employees, memberS, and agents who are active in the
management of an affiliate. The ownenhip by one person of sl1arc:s constituting a conuolling
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 conuols ~.
another person. A person who knowingly enten into a joint venture with a penon who has been "-
convicted of a public entity crime in Florida during the preceding 36 months stl311 be considered
an aff1liate., .
5. I understand that a -person- as defined in Paragraph 287.133(1)(e), Florida Stntutes. means any
'7 natural person or entity organized under the laws of any sUlte or of the United SUltes 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 "person" includes those officers, directors, e."Cecutives, panners,
shareholders, employees, members, and agents who are active in management of an entity.
, .
i
. 6. Based aD information and beIfa( die SIIteIDCDt whfcb I have m_rb.d bebr fluue ill relptfnll to
the entity submitting 1bis swam 11I~ [ladlcaae wbIda "I~II~I!IlI. appiIa.l
..L NeItlter the eDdty sUb_i this swam statement, nor any ofilS ofllcers, directors, c=cutives,
panners, shareholders, employees, mer1'hms. or apnIS who are aaive in tile III8IUlgement of the
enuty, nor any atmialc of tile entity bas been dIarpd widl aud CXJnvicted of a public entity crime
subsequcnt to July 1, 1989.
-
_ The entity submin1Dg this swam 11af~~ or ODe or mora offiS offfcea. dfrecmrs, cacu1ives,
parmers, shareholders, employees, mambas, or apnss who are acdve in the III8IUlgement of the
entity, or an atmialC of the endty bas been daaIJed widl ~ COJlYiacd of a public endty c:rfme
subsequent to Jufy 1, 1989.' . , .
--- -_.~-----.. .-~l~ ;>e.!_, ---~-_ "" ...~ --.~ .~!"""""'~N ~, -
--":.;;....:;...;.l~.. OMl,,u,llUIUWlLu.IIlS'U&Y i'iiftJiii_.....,'Ol'1HIe-OI"I:iIGnJOllllS .~ u.u~.... ezecu...,,-,- ---~- h_.
panners, shareholders, employees, mambas, or apms who are aaive in the DI8II8pD1CDt of the
entity, or an atmialC of the CDIity bas been dIarpd widl aud convicted of a public _lily crime
subsequent to Jufy 1, 1989. HcJwever, dun bII beeA a subseq1lCll1 ~I before a Hearing
Officer at tile Slale of Florida, DMsfoD of AdmiDfsualive Hearinp aDd tho PfJUiJ Order entered by
the HC:lring Omcer determined that it was DOt fa the pubUc in1Crat to pJacc tile endty submitting
this sworn statement on the mDYicted veador Ifst. [attach a CDPJ or the fImIj onIw)
.
I UNDERSTAND THAT TBE SUBMISSION 01' THIS FORM TO THE CON'l'RACTJNG omcm FOR.
THE PUBUC ENTITY mEl'l UIfIJW IN 'PARAGRAPH 1 (ONE) ABOVE IS FOIl THAT PUBLIC EN"lTlT
ONLY AND, THAT THIS FORM IS VALID TBllOUGB DECEMBEll31 01' THE CALENDAR YEAR IN
WInCH IT IS FILED. I ALSO UNDERSTAND THAT I AM KEQUIRED TO INFORM TBE PUBIJC
ENl11Y PRIOR TO ENTERING INTO A CONTRAcr IN EXCESS 01' THE TJlBESBOLD AMOUNT
PROVIDED IN SECIION 287.017, FLORIDA STATU lmi FOR. CATEGORY TWO 01' ANY CHANGE IN
THE INFORMATION CONTAINED IN THIS FORM.
9d'~ &/;itL/
[s tare)
~/;(jfi /
date)
STATE OF
,q U(<J',itt-
/}JON" ~~
COUNIT OF
..
'\ PERSONALLY APPEARED BEFORE ME, the undersigned autllority,
\' j~ /
L>.J. (-, ',' /t. UA.
-- ..J! -:-J. '- -<-- who, after first being swom by me, afffxed hislher signature
ytame at. dividWlJ signing) -
in the space provided above on this
f tM day of {It(/1~.J:19 'f I.
..
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My commission expires:
'~.\~'/ "':~"'., ST,~rr: OJ:' t[,Nn9.
..,',. ;.",',::~':~f..r;. 3, 1!l91.
. . ....:" ~ l,. ;-1..:,; i.:NO.e:.r::WRITEilS.
Form PUR 7068 (Rev. 04/10/91)
, .
; A~~.III..
CERTIRCAn. ~F INSURANCE
ISSUE DATE (MMIDDIYY)
08/16/91
THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONi: Y AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
AODUCER
THE PORTER ALLEN COMPANY
513 SOUTHARV STREET
KEY WEST, FLORIVA
(305) 294-2542
33040
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
CIGNA INSURANCE COMPANY
.SURED
COMPANY B
LETTER
JUVY EAVY VBA ACE BUILVING AND
MAINTENANCE
PO BOX 2763
KEY WEST, FLORIVA 33040
COMPANY C
lETTER
COMPANY D
!.ETTER
COMPANY E
LETTER
;OVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
;)
R
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRAnON
DATE (MM/DD/YY) DATE (MMlDDIYY)
LIMITS
. .-GENERAL AGGREGATE S 1,000,000.
PRODUCTS-COMPIOP AGG, S 1 , 000, 000 .
09/30/92 PERSONALAADV, INJURY S 1,000,000.
EACH OCCURRENCE S 1,000,000.
FIRE DAMAGE (Anyone lire' S SO, 000 .
MEO, EXPENSE(Anyone~' S ~I.QOO ~_
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROTo
SVP V19993814
09/30/91
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
COMBINED SINGLE
LIMIT
S
BODILY INJURY
(Per person)
S
BODILY INJURY
(Per accidenl)
S
PROPERTY DAMAGE
S
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
S
S
.-..-.'.- -I
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
STATUTORY LIMITS
EACH ACCIDENT S
DISEASE-POLICY LIMIT S
DISEASE-EACH EMPLOYEE S
EMPLOYEE VISHONESTY
COVERAGE
SVP V1992814
09/30/91
09/30/92
EMPLOYEE VISHONELTY
LIMIT: $5,000.
I
I
I
j
I
,
OTHER
ESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
ERTIFICA TE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL ---111.. DAYS WRITTEN NOTICE T CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE AIL 0 CE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF A IN P PANY, ITS AGENTS OR REPRESENTATIVES,
MONROE COUNTY
>>ING 11, PUBLIC SERVICE VEPT.
STOCK ISLANV
KEY WEST, FLORIVA 33040
AUTHORIZED
\~~RD 25-S (7/90)
@ACORD CORPORATION 1990
~ Cl:JJP1Ht OF ~ NIf:f/O.
Q ~ Cc:rl1XrI'f
"...'., - .'. ......... ...""".. ...... ,
CIGNA
PR I OR COMPANY CODE t I NA
BUSINESS AUTO DECLARATIONS
. RENEWAL' ~
PRIOR POLICY: H01079311
POLlCV NUMBER: HO 1 079311
PRODUCER NUMBER: POO 19"
PRODUCER BILLED
Ii
ITEM ONE - POLICY INFORMATION
Named IUlured: JUOY rAOY DBA
ACE BUILDING MAINTENANCE
Address:
POBOX 2763
KEY WEST
FL 33040
form or Busiaess: I ND I VI DUAL
!'lamed IDSured's Business: OFF I CE MA I NTENANCE
Policy Period: Policy covers from 10/03/91 to 10/03/92 12:01 am standard time at the named insured's
address stated above.
Audit Period; NON-AUD I TABLE
rtimated Tocal Premium: S
t
1,419.00
In return for the payment of premium and subject to alllhe lerms of this policy we agree with you to provide the
insurance as stated in this policy. _,__._
"'----'
P"OLlCY NUMBER:HO 1079311 l
ITEM TWO - SCHEDULE OF COVERAGES AND COVERED AUTOS I
,
This policy provides only those coverages where a charge is shown in the premium column below. Each of these
coverages will apply only to those "Autos" shown as covered "Autos" by the entry of one or more of the symbols !
from the COVERED AUTO Section of the Business Auto Coverage form next to the name of the coverage.
COVERAGES UMT
COveReD AUTOS fHE toAOST we WIU. PAY FOR AH'f 0tE PREMIuM
ACCIDENT OR l.OSS
lIABIUTY 1 , 300, QOO $ 1,145
PEJ:ISONAL INJURY PROTECTION SEE ENDORSEMENT ATTAC~EO
(or equl/a1enl No-fault coverage) 7 $ ~2
ADOEO ~ERSONAL INJURY
PROi'ECTION (or eqvivalMI added
No-fault coverage)
PAOPEIlTY PROTE.CTION
INSUflANCE (Micnlgan OI'lIy)
AUTO MEDICAL PAYMENTS 7 , !,OOO $ 4
U,.,.N$UREO MOTORISTS 7 S 300,000 s 60
UNOeRINSUREO MOTORISTS
(When no! included i~ Uninsl#ed
motCti$IS Coverage)
PHYSICAL DAMAGE ACTUAL CASH VALUE OR COST OF REPAIR, WHICHEVER IS
COMPREIolENS1VE COVERAGE LESS M1~S THE OECUCTIBI.E SHOWN IN THE. SCHEDULE OF
7 COVEAEO AUTOS FOR EACH COVERED AUTO, BUT NO $ 62
DEDUCTIBLE APPLIES TO LOSS CAUSED BY FIRE OR
UGHT....NG. S~ ITeM FOUR FOR HIReD OR BOf'ROweo
. AUTOS.,
PHySICAL OAMAGE SPECIFIED ACTUAL CASH VALUE OR COST OF REPAIR. WHlCIiEVEA IS
CAUSES OF LOSS COVERA~ LESS MIlIUS S25 ceo. F~ EACH COVeRED AUTO FOR LOSS
CAUSED BY MISCHIEF OR VAIIOAUSM. SEE ITEM FOUR FOR
HIRED OR SORROweo .AUTOS., .
PHYSICAL DAMAGE COLUSION ACTUAL CASH VALUE OR COST OF REPAIR, WHICHEVeR IS
COVERAGe LESS MIlIUS THE OEOUCTIBLE SHOWN IN THE SCHEDULE OF
1 COV~EO AUTOS FOR EACH COVERED AUTO. SEE ITEM S 136
FOUR FOR HIRED OR SORROWED .AuroS..
PHYSICAL DAMAGE
TOWING AI\C) LABOR
(Not Available in Call1ornia)
I ESTlMA TED TOTAL PREMUW S 1.419
... ". -:,
t)A.3K'5 (W.Ol/ln (CONTlMJEO NEXT P'G()
COPrlS OJ TMS 00QMI(1' HAVlIIIN SINT TO: INSUAED PROOUCER COMPANY
INSUREO'S ~OPY '~24e CAU-3328
TBS GC
PAGE 2
~ 01t
lPOUCY NUMBER: Hoto79311 l
FORMS AND ENDORSEMENTS A TT ACHm TO POLICY AT INCEPTION
CA00010187 8USINfSS AUTO COVERAGE FOR~
CA22101190 FLORIDA PERSONAL INJURY PROTECTION ENDORSE~ENT
CA00291288 BUSINESS AUTO AND TRUCKERS COVERAGE FORMS - INSURED CONTRACT
CA01280690 FLORIDA CHANGES
CA02670'90 FLORIDA CHANGES ~ CANCELLATION AND NONRENEWAL
CA21720691 FLORIDA UNINSURED ~OTORISTS COVERAGE - NON-STACKING
CA99030187 AUTO KEDICAL PAYMENTS COVERAGE
CA99t70187 INDIVIDUAL NA~EO INSURED
ILOOJ7118S CO~ON POLICY CONDITIONS
IL00211185 NUCLEAR ENERGY LIABILITY EXCLUSION !NDORSEMENi (BROAD FORM)
.
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.... (m. 01117) ( CONn I<<Jro NIXT ~AGE)
)ii$o.r ntSl)(')Q.MH1HAYlIUNSIHT TO: lNsuAED PAODUClA COM'ANY
INSURED'S COpy .1241 CAU~3228
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res
GC ',04,1,0"
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I POLICY NUMBER: H01079311
lITEM TIfREE . SCHEDULE OF COVERED AUTOS VOl) OWN
1-
rEM
VAN
s
On~r\II
CQ,I.......
10.000
TeRRITORY
'-'l , ~I.I. WIW. IPIt eo.ertd
A"lIe ",111M pIIN:lllllly ~rt~
fer!
Cod.
-
rlABIL
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fL
COvWO
.lUTO He
, 198'7
OESQIPnON
y...., UOIl... 'rid' NI/llI,
'..II..,.... /II \/lIhClt ldtrlll'OC.ltClrI ....,.. IVIHI
CHEVY
07158.
KEY WEST
FL.
032
,
cu.S$IFICA nON
'",IIIMI III' $lit (#I'll l\alll'lg l'IelClt EilCtCll 1<< 1l7WlfWi. .'1 Ohy$1(11 dll'll.llgl IOU " Plyabl. to YllU
eOv~ AM'''' . . l.-viet Cil:W 01 "011 Clan
"UTO He 01 u.e , . ...111 VlhClt '.."n; ~ COcIt 1/IIl I.... Iou Illy" IIIINd ~ .. ,nl...U rilly IIl(lNr I'
e . CQl'tW'fl..e111 CiIMC"Y ~'Ml ""y OJ'" I"' I.IM 01 tl\t 1ClI',
1 L. S 0-10,000 6 1.00 , .00 01'99
.
..
-
COVERACZS.pAEMIMS. UMlTS AM) omUCT1Bl.S (Absence of I decSuctlble or limit entfy In any coI\J'M below me.". that the limit Of
dedl.Ctlbie entry In the corrMpordlng 1TEJ.t TWO colum 1JlI)ll. lnstNd).
ost c
torro'
:or se
UA8IUTY PERSONAl. INJURY PAOTECTlON ADDeO PIP PROP PJlOT OAlch- Or'M
covEllm I,JmII 1111 ell III uc:l'I ~""l slat.. In .ac:n limIl $'.1-' In PPI
...u'o NO ~~I ~ I'M" ~ ~ ~ .lodtld ~ End End ""1M .tcl ".".\111
Hd JPlllWt'I MI\)II ~l'tIft\lIII ll'oOWn ~ -
1 S :300.000 S 1.061 S 12 -
OTHE
. SOCl
f----
rEM
AUTO WED PAY l.NNSURED MOTORISTS UI\DEAINSlIRED MOTORISTS
COVEllEC ~IPl'II ,,'tMllotrI ~.,., ....,. \Ill "'~
AUTO HO I.lIIlil -
1 , 1.000 S 4 $ 300.000 S 60 nIS
"'OF
-
.
SPEOAED
CONPREHENSlVE CAUSES COWSION TOWlN3 & LABOR
OF LOSS TOT AL PREMIuM
coviR!O ~lrllilllI1" In ~,,,,., SlIl" In IT~ L'nlll IIlle1l ,n ITiM ;"1f""'Nl p., PEA VEHCU
AUTO HO T~ TWO rn1'l\,l' ,"_\Ill TWO TWO ....~ dtcl "t_um Ooubl.' ,"'-""um
b. ._IMIOW "'-...... ,_ belOW "'.,.1
1 S 100 S 62 S 2'0 , 136 S 1. 3~5 OPV~
-
.Jl(SoI
)PI~S '
Dl'~ (EO. 01/11') (CONTlNUEO NEXT PAGE)
_...:_ _ /'~. "-'''-..::.!'~ ~~:"'~':':';:-T:':""""'t ~.;:.'-~ ~!"~~ I!"'....~~!'!'!~ !~!~U!=!~~ ~D~r'''Y'....t:~ rnMDlNY
PAGE "
-'..' _:.
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. - -' .. - ..... - .........'~
.
. [POLICY NUMBER: H01079311 I
] rEM FOUR. SCHEDULE OF IIIRED OR BORROWED AUTO COVERAGE ASD PREMIUMS
-
,
I<
-- lABILITY COVERAGE.AA TING BASIS COST OF HIRE
2
STATE ESTIMA TED COST OF HIRE RATE peR EACH SlOO FACTOR (If liab. PREMIUM
FOR EACH STATE COST OF HIRE coy. is primary)
L EXCESS I F ANY 1 .81 S 42MP
....--'
I .
-
II I TOTAL I'IlEMIlAI I $ 4211P
tost of hire means the total amount you incur Cor the hire of "autos" you don't own (not including "autos" you
J1rrow or renllrom your partners or employ... or ,heir lamily members). Cost 01 hire does not Include charges
. or services performed by motor carriers of property or passengers.
_ rEM FIVE. SCHEDULE fOR NON-OWNERSHIP LIABILITY
-'
I
I
- Nam<<lI....ed.S BUIlnell R.Un; Bull /'Unber Preni""
OTHER THAN A NUMBER OF EMPLOYEES 1 S '+2
SOC I AL S.ERV ICE AGENCY
I $ 42
_I
~!
-!
- rHIS DECLARATION AND THE BUSINESS AUTO POLICY AND Ei'IDORSEMENTS,IF ANY,ISSUED
ro fORM A PART THEREOF. COMPLETE THE ABOVE NUMBERED POLICY. .
I 'I~r_-
-
~ . COUNTERSIGNED BY -
AUT ORlZEO AGENT
1M
D\VID W J;REEMAH CPaI
-' OPYAIGHT IN PART. INSURANCE SERVICES OFFICe. INC..
35 1987
-
- .31<5' (ED. 0111" (CONTINUED NEXT PAGE) PAGI ,
ii1ES OJ TMS ooc:u.tINT NAVE KIH $(Nl' 10: I~SURID ~.ODUCIR COMPANY
INSURED'S copy 112.' CAU.33Z1 TIS GC 04l Ot t