03/24/1994 Agreement
SECTION THREE
CONTRACT
THIS AGREEMENT, made and entered into this 24th day of March,
1994, A.D., by and between MONROE COUNTY, FLORIDA, party of the
first part (hereinafter sometimes called the "OWNER"), and ACE
BUILDING MAINTENANCE, party of the second part (hereinafter some-
times called the "CONTRACTOR").
WITNESSED: That the parties hereto, for the consideration
hereinafter set forth, mutually agree as follows:
3.01
SCOPE OF THE WORK
The CONTRACTOR shall provide janitorial services, including all
necessary supplies and equipment required in the performance of
same, and perform all of the work described in t~ Spec1fica~ion
entitled: 2: A ;--
."?2 (" ";2" :~
:J::>
\:)
:::0
I
co
PUBLIC WORKS SPECIFICATION MANUAL
JANITORIAL
600 WHITEHEAD STREET
z'"
_' u
and his bid dated March 2, 1994, each attached h&reto a~d i~or-
porated as part of this contract document. T)le man~l snaIl
serve as mipimum contract standards, and shall be the basis of
inspection ~nd acceptance of all the work. The CONTRACTOR shall
insure all exterior doors are locked while they are servicing the
building and upon their departure. The CONTRACTOR shall insure
individual interior doors are locked at all times except the
interior door to the office they are servicing at that time.
3.02
THE CONTRACT SUM
The County shall pay to the CONTRACTOR for the faithful perfor-
mance of said service on a per month in arrears basis on or be-
fore 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 contrac-
tors bid as follows: One Hundred Eighty-Five Dollars ($185.00)
per month.
3.03 CONTRACTOR'S ACCEPTANCE OF CONDITIONS
A. The CONTRACTOR hereby agrees that he has carefully examined
the sites and has made investigations to fully satisfy him-
self that such sites are correct and suitable ones for this
work and he assumes full responsibility therefore. The provi-
sions of the Contract shall control any inconsistent provi-
sions contained in the specifications. All Specifications
3-1
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 and his Surety.
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 of any part of the
work or material by the OWNER shall not operate as a waiver
by the OWNER of strict compliance with the terms of this
Contract, and Specifications covering said work. Failure on
the part of the CONTRACTOR, immediately after Notice to Cor-
rect workmanship 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 fail-
ure to comply strictly and in all things with this Contract
and with the Specifications.
3.04 TERM OF CONTRACT/RENEWAL/CANCELLATION
A. This contract shall be for a period of one (1) year, commenc-
ing on the day first written above. This Contract Term shall
be renewable in accordance with Article 3.04 B.
B. The OWNER shall have the option to renew this agreement after
the first year, and each succeeding year, for two additional
one year periods. The contract amount agreed to herein may
be adjusted annually in accordance with the percentage change
in the Consumer Price Index (CPI) for Wage Earners and Cleri-
cal 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. Increases in the
contract amount during each option year period shall be ex-
tended into the succeeding years.
C. Either of the parties hereto may cancel this agreement with
or without cause by giving the other party sixty (60) days
written notice of its intention to do so.
3.05 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.
3-2
3.06
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.
3.07
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.
3.08
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 OWNER 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 OWNER in addition to
the total agreed-upon price of the services/goods of the contrac-
tor.
3.09
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 OWNER to terminate this contract immediately
upon delivery of written notice of termination to the contractor.
3.10
INSURANCE
Upon execution of this agreement, the CONTRACTOR shall furnish
the OWNER Certificates of Insurance indicating the minimum cover-
age limitations as indicated by an "X" on the attached forms
identified as INSCKLST 1-4, as further detailed on forms WCl,
GLl, VLl, EDl, GIRl & GIR2, each attached hereto and
incorporated as part of this contract document.
3-3
3.11
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 OWNER by written notice of
termination delivered in person or by mail to the contractor.
The OWNER shall not be obligated to pay for any services provided
by the contractor after the contractor has received written no-
tice of termination.
3.12
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 "Public Works Specification
Manual/Janitorial / 600 Whitehead Street", which is attached
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 OWNER is contingent upon retention of appropriate
local, state, and/or federal certification and/or licensure of
contractor.
3.13
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
Monroe County Public Works
5100 College Road
Key West, FL 33040
FOR CONTRACTOR
Ace Building Maintenance
1200 20th Terrace
Key West, FL 33040
3-4
IN WITNESS WHEREOF the parties hereto have executed this Agree-
ment on the day and date first above written in four (4) counter-
parts, each of which shall, without proof or accounting for the
other counterparts, be deemed an original Contract*
COUNTY OF MONROE, STATE OF
FLORIDA
By
Mayor/Chairman
Attest: DANNY L. KOLHAGE, Clerk
Clerk
ACE BUILDING MAINTENANCE
By
/1
CJ&xij
&~~L--- ,/
1--
Attest:
Corporate Seal if Corporation
./}f!WITNrd' t ~~
I,
C~~A ~~____
WrcrNESS
=~ k:~~FOR'"
ANjt;(J:.c:ENcr
At"'l j ..., ,; .)iiicl'
3-5
1. 01
1. 02
A.
SECTION ONE
INSTRUCTIONS TO BIDDERS
INSURANCE/INDEMNIFICATION/HOLD HARMLESS
A.
The CONTRACTOR shall defend, indemnify and hold harmless
the County as outlined on the attached form identified
as IND1.
B.
The CONTRACTOR will be responsible for all necessary
insurance coverage as indicated by an "X" on the at-
tached forms identified as INSCKLST 1-4, as further
detailed on forms ED1, GL1, VL1, WC1, GIRl, &
GIR2.
Certificates of Insurance must be provided to Monroe
County within fifteen days after award of bid. If the
proper insurance forms are not received within the fif-
teen days, bid will be awarded to the next selected
bidder.
DISQUALIFICATION OF BIDDERS
One Bid: Only one bid from an individual, firm, partner-
ship or corporation under the same or under different
names will be considered. If it is discovered that a
bidder is interested in more than one bid for the work
involved, all bids in which such a bidder is interested
will be rejected.
B.
NON-COLLUSION AFFIDAVIT: Any person submitting a bid
or proposal in response to this invitation must execute
the enclosed NON-COLLUSION AFFIDAVIT. If it is discov-
ered 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 bids for the same work.
C.
PUBLIC ENTITY CRIME AFFIDAVIT: 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 PUB-
LIC ENTITY CRIMES, including proper check(s), in the
space(s) provided, and enclose it with his bid or propos-
al. If you are submitting a bid or proposal on behalf
of dealers or suppliers who will ship commodities and
receive payment from the resulting contract, it is your
responsibility to see that copies of the form are execut-
ed by them and are included with your bid or proposal.
Corrections to the form will not be allowed after the
bid or proposal opening time and date. Failure to com-
plete this form in every detail and submit it with your
bid or proposal will result in immediate disqualifica-
tion of your bid or proposal.
1-1
1. 03
1. 04
1. 05
A.
A.
B.
D.
ETHICS CLAUSE: Any person submitting a bid or proposal
in response to this invitation must execute the enclosed
ETHICS CLAUSE and submit it with his bid or proposal.
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.
E.
Failure to attend the mandatory walk through as stipulat-
ed in Article 1.03A will result in the immediate dis-
qualification of your bid or proposal.
EXAMINATION OF SITE CONDITIONS
There will be a mandatory walk through of the facili-
ties on February 17, 1994 at 2:00 p.m. Failure to
attend the walk throuqh will result in the immediate
disqualification of your bid or proposal.
B.
Each bidder, by and through the submission of his bid,
agrees that he shall be held responsible for having
examined the sites, the location of all proposed work,
and knowledge and experience or professional advice as
to the character and location of the sites and any other
conditions surrounding and affecting the work, any ob-
structions, the nature of any existing construction, and
all other physical characteristics of the job, in order
that he may include in the prices which he bids all
costs pertaining to the work and thereby provide for the
satisfactory completion thereof.
EXAMINATION OF CONTRACT DOCUMENTS
Each bidder shall carefully examine the specifications
and other contract documents, and inform himself thor-
oughly regarding any and all conditions and requirements
that may in any manner affect cost, progress, or perfor-
mance of the work to be performed under the contract.
Ignorance on the part of the CONTRACTOR will in no way
relieve him of the obligations and responsibilities
assumed under the contract.
Should a bidder find discrepancies or ambiguities in, or
omissions from, the specifications, or should he be in
doubt as to their meaning, he shall at once notify the
OWNER.
INTERPRETATIONS, CLARIFICATIONS, AND ADDENDA
No oral interpretations will be made to any bidder as to
the meaning of the contract documents. Any inquiry or
request for interpretation received seven (7) or more
days prior to the date fixed for opening of bids will be
1-2
1. 06
1.07
1. 08
given consideration. All such changes or interpreta-
tions will be made in writing in the form of an addendum
and, if issued, will be mailed or sent by available
means to all known prospective bidders prior to the
established bid opening date. Each bidder shall acknowl-
edge receipt of such addenda in the space provided there-
fore in the bid form. In case any bidder fails to ac-
knowledge receipt of such addenda or addendum, his bid
will nevertheless be construed as though it had been
received and acknowledged and the submission of his bid
will constitute acknowledgement of the receipt of same.
All addenda are a part of the contract documents and
each bidder will be bound by such addenda, whether or
not received by him. It is the responsibility of each
bidder to verify that he has received all addenda issued
before bids are opened.
GOVERNING LAWS AND REGULATIONS
A.
The bidder is required to be familiar with and shall be
responsible for complying with all federal, state and
local laws, ordinances, rules, and regulations that in
any manner affect the work.
B.
The bidder shall include in his bid prices all sales,
consumer, use, and other taxes required to be paid in
accordance with the law of the State of Florida and the
County of Monroe.
PREPARATION OF BIDS
A.
Signature of the bidder: The bidder must sign the Bid
forms in the space provided for the signature. If the
bidder is an individual, the words "doing business as
", or "Sole Owner" must appear be-
neath such signature. In the case of a partnership, the
signature of at least one of the partners must follow
the firm name and the words "Member of the Firm" should
be written beneath such signature. If the bidder is a
corporation, the title of the officer signing the bid in
behalf of the corporation must be stated and evidence of
his authority to sign the bid must be submitted. The
bidder shall state in the bid the name and address of
each person interested therein.
B.
Basis for Bidding: The price bid for each item shall be
on a unit price basis according to the form of the bid.
The bid prices shall remain unchanged for the duration
of the contract and no claims for cost escalation during
the progress of the work will be considered.
SUBMISSION OF BIDS
Two (2) signed originals and one (1) copy of each bid
1-3
shall be submitted in a sealed envelope which shall be
marked so as to clearly indicate its contents and the
name 0 f the bidder. Iff orwarded by mai I, the above
mentioned envelope shall be enclosed in another envelope
addressed to the entity and address stated in the Notice
of Calling For Bids, and preferably by special delivery,
registered mail; if forwarded otherwise than by mail, it
shall be delivered to the same address. Bids will be
received until the date and hour stated in the Notice of
Calling For Bids.
1.09 WITHDRAWAL OF BID
1.10
1.11
Any bid may be withdrawn prior to the time scheduled in
the Notice of Calling For Bids for the opening thereof.
A bid may also be withdrawn thirty (30) days after the
date of the opening of the bids, provided that the bid-
der has not been notified that his bid has been accepted.
MODIFICATION OF BIDS
A.
Written bid modification will be accepted from bidders
if addressed to the entity and address indicated in the
Notice of Calling For Bids and received prior to bid due
date and time.
B.
A bidder may modify his bid by telegraphic communication
at any time prior to the scheduled closing time for
receipt of bids, provided such telegraphic communication
is received prior to the closing time, and provided
further, the OWNER is satisfied that a written confirma-
tion of the telegraphic modification over the signature
of the bidder was mailed prior to the closing time. The
telegraphic communication should not reveal the bid
price, but should provide the addition or subtraction or
other modification so that the final prices or terms
will not be known until the sealed bid is opened. If
written confirmation is not received within two days
from the closing time, no consideration will be given to
the telegraphic modification.
RECEIPT AND OPENING OF BIDS
Bids will be received until the designated time and will
be publicly opened and read aloud at the appointed time
and place stated in the Notice of Calling For Bids. The
person whose duty it is to open them will decide when
the specified time has arrived and no bids received
thereafter will be considered. No responsibility will
be attached to anyone for the premature opening of a bid
not properly addressed and identified. Bidders or their
authorized agents are invited to be present.
1-4
1.12 DETERMINATION OF SUCCESSFUL BIDDER
1.13
1.14
Until the final award of the contract, the OWNER does
not bind to accept the minimum bid, but reserves the
right to reject any and all bids and to waive technical
errors and irregularities as may be deemed best for the
interests of the OWNER. Bids which contain modifica-
tions, are incomplete, unbalanced, conditional, obscure,
or which contain additions not requested or irregulari-
ties of any kind, or which do not comply in every re-
spect with the Instructions to Bidders, and the contract
documents, may be rejected at the option of the OWNER.
AWARD OF CONTRACT
A.
The OWNER reserves the right to reject any or all bids,
or any part of any bid, to waive any informality in any
bid, or to re-advertise for all or part of the work
contemplated. If bids are found to be acceptable by the
OWNER, written notice will be given to the selected
bidder of the acceptance of his bid and of the award of
the contract to him.
B.
If the award of the contract is annulled, the OWNER may
award the contract to another bidder or the work may be
re-advertised or may be performed by day labor as the
OWNER decides.
C.
The contract will be awarded to the qualified bidder
complying with the applicable conditions of the contract
documents.
D.
The OWNER also reserves the right to reject the bid of a
bidder who has previously failed to perform properly or
to complete contracts of a similar nature on time.
EXECUTION OF CONTRACT
The bidder to whom a contract is awarded will be re-
quired to return to the OWNER four (4) executed counter-
parts of the prescribed contract together with the re-
quired certificate of insurance within fifteen (15) days
from the date of notice of acceptance of the bidder's
bid.
1.15 BID FORM
Any person submitting a bid or proposal in response to
this invitation shall utilize the attached Bid Form.
1-5
SECTION TWO
CONTRACT SPECIFICATIONS
2.01
DESCRIPTION
The CONTRACTOR shall furnish janitorial services, including all
necessary supplies and equipment required in the performance of
same, for three offices located at 600 Whitehead Street, Key
West, Monroe County, Florida.
2.02
WORK HOURS
The CONTRACTOR shall clean all required offices two (2) nights
per week, Tuesday and Friday, each week. Work shall be performed
between the hours of 5:00 p.m. and 7:00 a.m. The CONTRACTOR
shall insure all exterior doors are locked while they are servic-
ing the building and upon their departure. The CONTRACTOR shall
insure individual interior doors are locked at all times except
the interior door to the office they are servicing at that time.
2.03
GENERAL CLEANING
General cleaning shall be completed each scheduled cleaning
night as stipulated in Article 2.02, and shall include the
following:
A. All furniture and furnishings dusted and spot cleaned.
B. Low ledges, sills, rails, and baseboards dusted and/or
spot cleaned.
C. All trash receptacles emptied, trash can liners changed.
D. All glass windows to be washed and polished.
E. Vacuum all upholstered furniture.
F. Vacuum carpets.
G. All carpeting will be regularly inspected and spot
cleaned. Carpets will be cleaned/shampooed in accor-
dance with article 2.05 E.
2.04
FLOOR TREATMENT
A.
All flooring shall be cleaned as described in Sections
2.03 and 2.05 of this specification.
2.05
PERIODIC SERVICES
The services below shall be included and shall be performed
at the frequency indicated as follows:
A. All door vents cleaned weekly.
B. All high dusting (i.e. pictures, door frames, air vents,
etc.), shall be cleaned monthly.
C. All walls dusted monthly
D. All interior windows washed bimonthly.
E. Clean/Shampoo all carpeted areas a minimum of once every
three (3) months.
F. All a/c vents cleaned monthly.
2-1
2.06
2.07
A.
B.
2.08
A.
B.
C.
COORDINATION OF THE WORK
A.
CONTRACTOR shall provide maximum amount of Janitorial
Services with the minimum amount of interference to
building tenants.
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.
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.
The CONTRACTOR shall be responsible for the cost of
changing locks, etc., for all keyed secured areas for
which the CONTRACTOR does not return the keys.
The CONTRACTOR shall report any problems regarding open
doors and/or vandalism to the Facilities Maintenance
Area Representative immediately via digital beeper (305)
862-4435.
B.
C.
D.
E.
PAPER PRODUCTS AND SUPPLIES
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,
trash can liners, shall be supplied by the CONTRACTOR.
The CONTRACTOR shall maintain stock in each facility in
a minimum amount sufficient to last through the next
cleaning day.
INSPECTION OF THE WORK
The tenants of each facility shall be deemed the Coun-
ty's representative on a daily basis, and shall deter-
mine if deficiencies exist.
Random inspections shall be performed by County Represen-
tatives from the Public Works Division administering the
contracts.
Deficiencies shall be corrected within a
(24) hour period of notification to the
Failure of the CONTRACTOR to correct such
shall result in prorated deduction from
invoice.
twenty-four
CONTRACTOR.
deficiencies
the monthly
2-2
, .
BID FORM
JANITORIAL SERVICE
600 WHITEHEAD STREET
Date_~_
~ ~W ~~_L4A-Ir.~Mand 00
($ Amount in writing)~~~
....It- I 0 C-, 00__
:3lJ 0.....;. -- PER MONTH
($ Amount in numbers)
/100
Acknowledgement is hereby made of the following Addenda received
since issuance of the Specifications:
Addendum No.
Dated:
Addendum No.
Dated:
Addendum No.
Dated:
Addendum No.
Dated:
;rll~ BOBlclL ~c.e. 8~ f1lA7't.Jj-,
(NAME OF BIDDER - EASE PRINT)
Address:
(SIG
IcloD ~CNh~
~uJ€:8T State:
City:
FLit-
The full names and residences of persons and firms interested in
the foregoing bid, as principals, are as follows:
Name of the executive who will give personal attention to the
work:
-..
" )0 ~
f6DfO/~f-
ouJ~
)
~~~
I't~% mt1I~
2-3
OK~~rY ~o~~~,,~E
<3:05)2"'=4-4&41
?~blic hcrks Divisic~
Public Facilities ~aint.
5100 College Read
Key West, Fl. 33040
BOARD OF COUNTY COMMISSIONERS
II.AYOR, Jack London, District 2
Mzyor Pro Tern, A Ear1 Cheal, District 4
Wilhelmina Harvey, District 1
Shir1ey Freeman, District 3
Mary Kay Reich, District 5
JA~ITOR!AL CONT?~CT DEFICIENCY RE?O~T
Locatio~
Date
The following deficiency ln Janitorial contractual requirements are
reported as fol1o~s:
CONT~;'C? ITEH #
COMMENTS:
NOTED DEFICIENCY
(Signature of Monitor)
Contractor Action
Date
Foregoing' deficiency has been corrected
(Signat~re - Contractor Rep.)
, .
cc: Facilities Maintenance Department (after contractor has
corrected deficiency or had sufficie~t time to do so and has
not taken action)
'''pril 22. 1')').1
, ]~ I'rinl;"ll
:\10NROE COUNTY, FLORIVA
1:';SURAi'\CE GVIO C
TO
CO~TR:\CT AD.\lL~ISTRA TI0~
fndcmni{jC31ion and Hold Hnrmrcss
for
Suppliers of Goods and Scrdces
The Vendor covenants and agrees 10 ir.de:r.r:ify and hold harmless ~1onroe County Board of
Cour.ty Commissioners from any F..:i:J ;:11 clair.1s fc,r bodily injury (including death), personal injury,
and property damage (including p:-opcrty owned by ,~1onroe County) and any other losses,
C2.11iages, and expenses (ii1cludii1g a:torney's fees) which arise out of, in connection with, or by
reason of services provided by the Vendor or any of it!; Subcontractor(s) in any tier, occasioned
by t!'le negligence, en'ors, or other ""iOr:gful 2ct or omission of The Vender or its Subcontractors
in any tier, their employees, or age:its.
, In the event the completjo:l oftne project (to ji1clude the work of others) is delayed or suspended
as a result of the Vendor's failure to purchc;se or mninlain the required insurance, the Vendor shall
indemnity the County from any and all increased expenses resulting from such delay.
The extei1t of liability is in no way Ijr:1i~ed 10, reduced, or lessened by tile iJ1SUrance rcquiremer:1s
contained elsewhere within this agreement.
I~ml
^dminil"'.1zlivc lll~.11.lC'ii(>n
1:047CJ9.J
IG
'\l'ril ~2. 1')9.1
J,;I J'rinlin;:
:\'10NROE COUNTY, FLORIDA
J:\SUR.\:\CE CHECKUST
fOR
VE:\DORS Sl'B.\llTTJ:\G PROPOSALS
FOR WORK
To assist in the developme:1t ofyo::r proposal, the insurance coverages marked with an "X" \,,'ill
be required in the event an a\\'ard :s made fo your firm. Please review this form with your
insllrance agent and have him/her sign it in the place provided. It is also required thnt the bidder
sign the form and submit it with each proposal.
WORKERS' CO\1PE;-..JSA TION
A1\D
E\1PLOYERS' UABJLJTY
\VCI
WC2
\\'C3
WCUSLH
WCJA
x
X
, Workers' Compensation
Employers Liability
Employers Liability
Employers Liability
US LOD!:!.shoremen &
Harbor ~lorkers Act
Federal Jones Act
Statutory Limits
$100,000/$500,000/$100,000
$500,000/$500,000/$500,000
$ J ,000, OOOi$ J ,000, OOOi$1 ,000,000
Same as Employers'
Liability
Same as Employers'
Liability ,
Admini"'-r&li..c ]n~"u.:'lioll
/r47C19.0 I
lNSCKLST ~
6
I\pli122. 1')93
I~ J'rinlins
GE1\ER.:\L LIABILITY
A.s a minimum, the required general liabiEty coverages will include:
· Premises OperatIons
· Blar.ket COljlractual
· Expanded Definition
of Property Damage
.
Products ~nd Completed Operiltio:1s
. Personal Injury .
.
Required Limits:
GLi
x
5 I 00,000 per Person; $300,000 per Occurrence
550,000 Property Damage
or
$300,000 Combined Single Umit
GL2
5250,000 per Person; 5500,000 per Occurrence
550,000 Property Damage
or
5500,000 Combined Single Limit
GL3
5500,000 per Person; SI,OOO,OOO per OccuITence
S100,000 Property Damage
or
51,000,000 Combined Single Limit
Required Endorsement:
GLXCU
GLLIQ
Underground, Explosio:1 and Collap~e (XCU)
Liquor Liability
AJl endorsements are required to have the same limits as tne basic policy.
^clmini~~r&:h.c In.<NC'lion
/:'-1709,01
J~SCKLST ~
7
'\l':-if 22. 1<)').1
l~ f'rinlins
VEl-DCLE LJABIL1T'"(
As a mini;num, coverege should ex1end to liability for:
· Owned; !\'onow~ed; a:1d Hired Veljicles
Required Limits:
VLl
x
S50,COO per Person: S I 00,000 per OCcu~cJ1c.e
$25,000 Property Damege
or
S100,000 COi:1bined Single Limit
S100,000 per Person; $300,000 per Occurrence
$50,000 Propeny Darnag~
or
S300,000 Combined Single Limit
S500,000 per Person; SJ,OOO,OOO per Occurrenc.e
5 I 00,000 Proper1y Oemage
or
51,000,000 Combined Single Limit
VL2
VL3
M1SCELLA."EOUS COVERAGES
BRl Builders' Limits equal to 1 he
Risk completed project.
.:\1 V C !\1otcr Truck Limits equal to tlje maximum
Cargo value of anyone shipment.
PROI Professional S 250,000 per OccurrenceiS 500,000 Agg.
PR02 Liability S 500,000 per Occurrence/SI ,000,000 Agg.
PR03 SI ,000,000 per OccuTTencel52,000,OOO Agg.
POLl Pollution $ 500,000 per Occurrence/SJ ,000,000 Agg.
POL2 Liability $J,OOO,OOO per OccuTTence/S2,000,000 Agg.
POL3 S5,000,000 per OccurrencelS 1 0,000,000 Agg.
EDI X - Employee S 10,000
ED2 Dishonesty SIOO,OOO
GKl Gara~e S 300,000 ($ 25,000 per Veil)
GK2 Kecpef,s $ 500,000 (S100,000 per Yell)
GK3 SJ,OOO,OOO ($250,000 per Veh)
:-'1EDI Medical S 500,000/$ 1,000,000 Agg.
!\fED2 Professional Sl,OOO,OOO/$ 3,000,000 Agg.
.\fED3 55,000,000/51O,OOO,000/\gg.
/,c:nini~n:h'c 1l",~_""~i(\1I
t.'.709.C J
J~SCKLST :;
8
IF
VLPI
VLP2
VLP3
BLL
HKLI
HKL2
HKL3
AL~I
A1R2
AlRJ
AEOI
AE02
AE03
^l'lil :2. 1'.1:.1.'
J~ 1'ri111inS
L1s(2.l1ation
Floater
~iaximurn value of Equipment
J nst2.JJed
Hazardous
Cargo
Tran5por.er
S 300,000 (Requires 1\'1C5-90)
S 500,000 (Requires 1\'1C5-90)
SI,OOO,OOO (Requires ~1CS-90)
Bailee Lia:,.
~\1aximUl:l Value of Property
Har.garkeepers
Liability
S 300,000
S 500,000
S 1,000,000
Aircraft
Liability
$25,000,000
S ) ,000,000
S ],000,000
Architects Errors
& Omissions
S 250,000 per OccurrencelS 500,000 Agg.
S 500,000 per OccurrencelS I ,000,000 Agg.
$ ] ,000,000 per Occurrence/S3,000,OOO Agg.
I~SURA:.rCE AGENT'S STATE~1ENT
I have reviewed the above reguiren:ents with the bidcer named below. The fol1owL1g dcductib!es
apply to the corresponding policy. .
POLICY
DEDCCTIBLES
Liability policies are _ Occurrence
Claims Made
Insurance Agency
Signature
BIDDERS STATEMENT
r ~ndersfand the insurance that wiU~e mandatory ifawarded the contract and will comply in full
Vt1th all the requirements. <
^:!m,niS".,:i\'c ln~r....-:i(tll
t:<709.01
Bid c er
Signllture
INSCKLST L{
y
.'\pril22. 1'.1:1.1
l~ l'rilllill~
E:\lPLOYEE DISIIOi'ESTY
INSllRANCE REQUlREM E.\TS
fOR
CO:\TRACT
BETWEEN
.\10NROE COUNTY, FLOIHOA
A:\D
The Contractor shall purchase and mainlain, throughout the Icnll oflhe conlrncl, Employee
Dishonesty lnsurance which will pay for lusses to County property or money caused by the
fraudulent or dishonest acts of the Contractor's <::mployees or its agents, whether acting alone or
in coUusion of others.
The minimum limits shall be:
$ I 0,000 per Occurrence
^<lminiNlili\'t' 1n.<tn'(1i,,"
t.~709.1
EDI
4')
I.rlil 22. I')~.l
1~ "riutin:;
GEi\ERJ\L LJAnILlTY
INSUIV\;\CE REQUIREt\1C~TS
, FOR
CO:\T~\CT
I3ETWEE~
~10NROE COUNTY, FLORIDA
A:\D
Prior ~o the COlT.LT.ile:1ce:r:er:t ofwcrk governed by this contrnct, the Contrnctor s/iall obtain
Gcneral Liability Insurance. Cover<lge shaH be maintaind throughculthe life of the cont filet and
include, (is a minimur:1:
· Prerruses Operations
· Products and Completed Opera1ions
· Blanket Contractual LiEbility
· Personal Injury Liability
· Expanded Definition of Proper1y Damage
The minimum limits acce?table sha:! be:
5300,000 Combi:1ed Sbgle Limit (CSL)
If split limits are provided, the miliil7lum limits acceptable shall be:
SIOO,OOO per Person
5300,000 per Occurrence
5 50,000 Property Damage
/\n Occurrence Form policy is preferred. Ifcoverage is provided on a Claims Made policy, its
provisions should include coverage for clAims filcd on or aller the em~ctive date of this contract.
In addition, the period for which claims may be reponed should extend for a minimum oftwclve
(J 2) months follov,ing the acceptance of work by the County.
The Monroe County Board of County COl1'1missioners shall be named as Additional Insured 011 all
policies issued to satisfY the above requirements.
^dnlinj~..n:i\."e Jrb'1r.Jc:io"
GLl
t.<4iO!J.1
54
^l'ril 22. 1'1').1
1~1 "ril1~in1:
VEH1CLE LL\DJLITY
INSl1RAI\CE REQUIRE1\1E~TS
FOR
CONTR.ACT
f3 E'nVEE:'\
:\10NROE COUNTI', FLORIDA
A..'\D
Recognizing that the work govemed by this contract requires the u!:e ofvellicles, tile Contrnclor,
prior to the commcnccmC:1t cfwork, shnll cbain Vehicle Liability Insurance. Coverage shail be
maintained throughout tile life of the contract and include, as a minimum., liability coverage for:
· Owned, Non-Owned, and 1 IiredVchicles
The miniJnum limits acceptable shall be:
SIOO,OOO Combined Single Li;r:it (CSL)
Ifsplit limits are provided, tne mir:imum limits acceptable shall be:
$ 50,000 per Person
S I 00.000 per Occu rre:1 ce
S 25,000 Properi)' Damage
The Monroe County 130ard of Count)' Commissioners shall be named as Additional Insured Oil all
policies issued to satisfY the above requirements.
I.dminirtnth.c Jnlltn,c:inn
t.~i09.1
VLl
is
l\j11il22. 1')9.1
!sll'rilllillS
WORKERS' COJ\1PE:\SA TlON
I;\SURA1"CE REQUIRE1\fE:'\TS
FOR
CO~TR.\CT
.GETWEE~
:\lC:\ROE COUNTY, FLORIDA
A:\D
Prior to the commencemer:t of worK goveT:ied by this contract, the Contractor shall obtain
\Vorkers' Compensation Insura.nce wit:' limits suiiicier:t to respond to Florida Statute 440.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
S100,000 Bodily IrJu!)' by Ac.dder:t
$500,000 Bodily Injury by Di::ease, policy limits
S I 00,000 Bodily Ir:ju!)' by Oi sease, each employee
Coverage shall be maintabed tlJrou~hout the entire term of the contn:ct.
~ -
Coverage shall be provided by a CO:1:pa:1Y or companies authorized to transact business in tlie
state of Florida and the compar.y or ccmp:lrjes mU5t n1ilir.tain a minimum rating of A- VI, as
assigned by the AJ\1. Best Compar:y.
If the Contractor has been approved cy the Florida's Department of Labor, as an authorized self-
insurer, the Cour.ty shall recognize r.r.d honor the Contractor's status. Tljc Contractor may be
required to submit a Letter of Authorization issued by the Department of Labor and a Certificate
of Insurance, providing details on the Contractor's Excess Insurance Program.
If the Contractor panicipates in a self-insurance fund, a Certjficate of In5ur?l1Ce Vt'il/ be required.
In addition, the Contractor may be re<;uired to submit updated financial statements from tbe fund
upon request ITom the County.
^clminis:n:i\'c W".n>c:inn
1i47C1'.1
WCI
~I
!lp"' n. 19''''
J:<II'';lIlill~
:"\10NROE COUNTY, FLORIDA
INS UR-,\~'CE GlJI 0 E
TO
CONTR.!..CT AD~lINISTRA TION
Gcnend Jnsimlnce Requirements
for
Suppliers of Goods or Services
As a pre-requisite of the v,'ork goyemed, or the goocs supplied under this contract (including the
pre-slagir.g ofpersonncJ and mater:al), the Vendor sl:al/ obtain, at hi~her own expense, insurt'.:1ce
as specified in any attached schedules, which are mace part of this contract. The Vendor will
ensure that the insurance obtained wiH extend protection to all Subcontractors e:lgaged by the
Vendor. As an aiternatiye, the Ver.ccr may require ail Subcontractors to obtain insurance
consistent \vith the al1ached schedules.
The Vendor will not be permitted to commence work governed by this contract (including pre-
staging of personnel and material) until satisfactory evidence ofine required insurance has been
, furruslJed to the Cour.ty as specUied below. Delays in the commencement of work. resulting from
the failure oftne Vendor to provide sntisfactory c\idence oftne required insurClnce, shaH not
extend deadlines specified in this contract and any penalties and failure to perform assessments
shc.l1 be imposed as if the work co:nme:lced 0:1 the specified date and time, except for the
Vendor's failure to pro\ide satisfactorj evidence.
The Vendor shall maintain the required insun::lce throughout tile entire tenn ofth:s contract and
any extensions specified L1the attached schedules. Failure to comply with this provision may
result in the immediate suspension of all -,,,.,ork until the required insurance has been reinstated or
replaced. Delays in the completion of work resulting from tile failure oftne Vendor to maintain
the required insurance shaH not extend deadlines specified in this contract and any penalties and
failure to perform assessments shall be Ll1posed as if the work had not been suspended. except for
t~e Vendor's failure to maintain the required insurance.
The Vendor shall provide, to the County, as satisfactory evidence of the required insurance,
either:
· Certificate of Insurance
or
· A Certified copy of the actual insurance policy.
The County, at its sole option, has tlJe right to request a certified copy of any or all insurance
policies required by this contract. ,
All insurance policies must specifY that they are not subject to cancellation. non-renewal, material
change, or reduction in coverage unless a minimum of thirty (30) days prior notification is give;,
to the County by the L1surer.
The acceptance and/or approval of-the Vendor's insurance shall not be construed as relieving the
Vendor from any liabi!it)' or obligation assumed under lhis contract or imposed by law.
GIRl
I\dlTli.oirtnlh'c In.....r\l.:1ion
/:~709,1
17
/Iflril 22. l'nJ
1"11'ril\lill~
The ?\{or,roe County Beard ofCou:1ty CO:1:missioner::, its employees and officials will be included
as "Additional Insured" en all policies, exc,c?t fer WOikers' Corr:pensntio;1.
Any deviations from these General I:1surnr;ce Requiremcr.ts must be requested in writing 0:1 the
Ceur.ty prepared form entitled "Requcst for W:linr of Insurance Requiremcnts" aJld approved
by ~femee County Risk Managcmerlt. .
"":'
^llmini""J~li"t' J~n',,1i"n
li~i09.1
GIR2
J8
NON-COLLUSION AFFIDAVIT
JU ~ \60 lOltCk-
city of ~ l)JE:S,
under penalty of pe jury, depose and say that;
1) I am JV~ ~~ * A-C.6 B t~ -MAi"~, the bidder mak-
ing the Proposal for the project described as follows:
I,
of the
according to law on my oath, and
,31\N \'-t- O~\ ~ L
H~
bOO
~'l~ S~
2) The prices in this bid have been arrived at independently without collusion,
consultation, communication or agreementforthe 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 corp,oration 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 ofthe statements contained in this
affidavit in awarding contracts for said project.
STATE OF
COUNTY OF
ffi{)N~~
5. d- ql\
DA E '
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
Tu..d.~ bob Ie K. who, after first being sworn by me, (name of ."
individual s gning) affixed his/her signature in the space provided above on this
;)ND
day of
rn o,rch
, 19 Cf4
Sh~ ~ 1J~
c' ( I NOTARY PUBl.IC
~ h I4teo.v I.e. ,0 /h/ IS
My commission eXPires:~/l.R !J7,
fClf?
SHARON K. DAVIS
MY COMMISSION' CC 297555
:Jl EXPmES: June '0. 1997
.' ',x BClIId8d Thru NolIIy Public UndIIWlIln
..
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETIDCS CLAUSE
~~ &i>l~
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. 10-1990 or any County officer or employee in violation 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 employee.
~s~
Date: (3 -~-9'Lj
STATE OF
rLO/G.i o/f
COUNTY OF m tJ/V etJc:-
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
~JUclLf ~objCIC
who, after first being sworn by me, affixed hislher
signature (name of individual signing) in the space provided above on this
mUf~C h
(}I.J/J day of
, 19 9'1.
~~ K:' ~tWh
NOT ARY PUBLIC <<;;' 1/ A-/2-0~ K. O/l-I/I-.S
My commission eXPires~ ;;}7. 1'19 ')
SHARON K. DAVIS I
MY COMMISSION' CC 297~ii5
.~~ EXPIRES: June 27. 1997
".r..~:~ Bonded Thru Notary Public Undfllv;liieffi
MCP#4
.'
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES. ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL TH RIZED TO ADMINISTER OATHS. This sworn statement is submitted
to (Y\O Q.
[print name of th! p'ublic entityJ o.Il.f)
by ~~l~~8t~ O~
(priW~&d~al's name ~nd titleJ
for ~ &tlA1'~ ~ 0'\ FlIV..1QI1.NCL
[print name of entity s bmitting sworn statement]
~ S b>-L
31_
and (if applicable) its Federal Employer Identification Number (FEIN) is
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement:
.)
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 ofthe 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 misrepresen-
tation.
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.
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 control of any natural person who is active in the management of the entity and who has been convicted
of a public entity crime. Tbe 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 pooling of equipment or income among persons when not forfair 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.
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 "person" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in management of an entity.1.2.3.4.5.
..
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.]
V 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 with and convicted of a public entity crime subsequent to July
1,1989. '
_ 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 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 Hearings 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]
6. I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER
FOR THE PUBLIC ENTITY IDENTIFIED ON PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC
ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER31 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 EXCESS OF THE THRESHOLD
AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGORY lWO OF ANY
CHANGE IN THE INFORMATION ,CONTAINED IN THIS FORM.
C\~ fl~. ()Q~~
[si~ture] , ~
Sworn to and subscribed before me this cJNO day of maR... c-l-l ,19 qLj, .
Penonallyknown V,,~ j-~ l3n.lwf SIJ~ K /)~
Notary Public - State of I=' Lo /<...-1 .0 /~
My Commission expires ~ 0/.7, 1997.
5HMoAJ K. O;4U/s
(printed typed or stamped
commissioned name of notary public) ,
OR Produced identification
(Type of identification)
Form PUR 7068 (Rev. 06/11/92)
SHARON K. DAVIS
MY COMMISSION' CC 297555
EXPIRES: June %1. 1997
IloncIIlI Thru NolIry PuIllIc IMHIIrwrltn
..
Ae.~7cE~~I~tTE~:;~S~~~~q~ ~ rrzaJ
ISSUE DATE (MM/DD/YY)
Regan Insurance Agency,
90144 Overseas Highway
Tavernier, FI 33070
Inc.
3/30/94
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
PQbIQtl;~_E!!:LOW. ______'___________,__,..__..'..
PRODUCER
COMPANIES AFFORDING COVERAGE
f~T~~~NY A
Ohio Casualty
APPROVED B~ISK MANAGEMENT
BY ~/~1'
. VL{ I Cl f
DATE ~
INSURED
f~T~~~NY B
Judy Bobick
dba Ace Building Maintenance
1200 20th Terr
Key West, FL 33042
f~T~~~NY C
COMPANY D
LETTER
WAIVER:
Ohio Casualty
N/A
YES
COMPANY E
LETTER
COVERAGES
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,
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMIDDIYY) DATE (MMIDD/YY)
LIMITS
CLAIMS MADE
OCCUR,
GENERAL AGGREGA TE-iI, 000 ~55(L-'-
PRODUCTS-COMP/OP AGG, $1 ,000,000.
PERSONAL & ADV, INJURY $1 ,000,000.
EACH OCCURRENCE $1 ,000,000.
FIRE DAMAGE (Anyone fire) $ 50,000.
_"._,___________________,,____,____,_~~~~~ (An~~~~;o'i $?,gQO.
A GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
BHO 50 71 44 28
2/25/94
2/25/95
OWNER'S & CONTRACTOR'S PROT,
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
COMBINED SINGLE $
LIMIT
BODILY INJURY $
(Per person)
BODIL Y INJURY $
(Per accident)
PROPERTY DAMAGE $
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
AND
Received
His\<: Mgmt. & Loss Control
;)"'-8 __ = 11-7-11
.':"',',' " '1(A
~"\'..j ....-....--..-.---
EACH OCCURRENCE
AGGREGATE
$
$
WORKER'S COMPENSATION
STATUTORY LIMiTS
01'.,. ~H ACCIDENT $
v>/ ~~ISEASE-POLlCY LIMIT $
DISEASE-EACH EMPLOYEE $
EMPLOYERS' LIABILITY
"'".~..._,.~...._.'""~........--~"..~_."-,-,,.._------,_..'-....._,~"...,,_..,.__.-_._~---..__...
OTHER
E
bond
3-043-696
3/3/94
3/3/95
$5,000.00
DESCRIPTION OF OPERA TIONS/LOCA T10NS/VEHICLES/SPECIAL ITEMS
Janitorial Maintenance
JOB:
600 Whitehead, Key West. Fl 33040
CANCELLATION
CERTIFICATE HOLDER
Monroe County Board of County Commissioners
Additional Insured
5100 College Rd
Stock Island
Key West, Fl 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPO HE COMPANY, ITS AGENTS OR REPRESENTATIVES,
ACORD 25-5 (?/90)
.t">/ @ACORD CORPORATION 1990
.,I;i7-.----'---'-----..... -... ., ,..--
04/07/94 10:33
30S ;;;.9 ~ - '106.5
REGAtl I t6URAHCE .. 3052924083
NO. 170
~01
April 7, 1991t
Judy Babich Db::!
Ace 8idS Maint
1200 20 TerT'
Key West Fl 33042
ReI Policyt OH-30~3696 (BONO JANITORIAL)
Effective March~, 1994 to Marc~ 3, 1995
Dear JUDY:
In response to your recent request, we ~re making the following
chanses on the ~bove captioned policyt
INCREASED SOND TO $10,000
PLEASE REMIT $36 MAD€ OUT TO REGAN INSURANCE AGENCY, INC.
Please notify us immediately if the above does not correspond
with your instructions.
Th~nk you for this opportunity to be of service.
Very truly yours,
qz.a ~
BRENDA MONROE/ere
B/pe
(~~
.~
A.~.tlllt~ CERTIRCATE OF INSURANCE
ISSUE DATE (MMIDDIYY)
03/30/94
PRODUCER
ISLAND INSURANCE AGENCY,INC.
3229 FLAGLER AVENUE UNIT #112
KEY WEST FL 33040
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
COMPANIES AFFORDING COVERAGE
f~T~~~NY A
BANKERS~AND~SHIPPERS INS.CO.
BY A~~~NT
DATEVt.{l((q J(
N/A A YES
WAIVER:
-.
CODE
SUB-CODE
INSURED
f~T~~~NY B
JUDY T. BOBICK
ACE BUILDING MAINTENANCE
1200 20TH TERRACE
KEY WEST FL 33040
f~T~~NY C
f~T~~~NY D
f~T~~~NY E
COVERAGeS
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,
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MMIDD/YY)
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
GENERAL AGGREGATE
$
CLAIMS MADE
OCCUR,
PRODUCTS-COMP/OPS AGGREGATE $
PERSONAL & ADVERTISING INJURY $
OWNER'S & CONTRACTOR'S PROT,
EACH OCCURRENCE
$
A AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
X SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
CFL019925401
2/24/94
2/24/95
FIRE DAMAGE (Anyone fire) $
MEDICAL EXPENSE (Anyone person) $
COMBINED
SINGLE $ 500,000
LIMIT
BODILY
INJURY
(Per person)
BODILY
INJURY
(Per accident)
6~~~~~TY $
EXCESS LIABILITY
EACH AGGREGATE
OCCURRENCE
$ $
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
STATUTORY
$
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT) i
(DISEASE-EACH EMPLOYEEl
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS
JANITORIAL OPERATIONS
1987 NISSAN PICKUP TRUCK #JNIHN05S1HX071568
cemFtcA"F~.'''()''DER
BANKERS & SHIPPERS INS.CO.,
WILL--NOT LIST ANY GOVERNMENT ENTITY
AS AN CERTIFICATE HOLDER OR AS AN
ADDITIONAL INSURED..
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 10 DAYS WRITTE E CERTIFICATE HOLDER NAMED TO fHE
LEFT, BUT F I SHALL IMPOSE NO OBLIGATION OR
LI Y, S AGENTS OR REPRESENTATIVES,
L
AUTHO
ACORD 25.93/88
ACORD CORPORATION 1988!
...
o
Cl.
. A_~
.~~~..
:~~~
. ~ ~~=''f"
'~~Y5_:-
.::'
."" .~
- "I.~' '. '"'
.......:p.
:~/:
...
,
....... .
:~.:
~~~~~
it.~
';~.
....~~.. .
~;~
::~:
;$:
1],.
"-:0.,-.
~?r
.,'~
.~ ~
~j
..y,
'~,,:.
.~..:.
:i. .~
:)~f-'
.....~~
.;.;,{
.P:
.{,t;~
:':{~
:~~
~;.
.: .
~;.~ ~;
. ~~i.
~.:.
..!t~~
..~.:
-'t""
,,i" .
cr', '.--." .~...
~ ~f{
CI ~;
.:::. ,-
w .:
..:& ".,
...- .
0: ~;,
1]', : .
I ' -
.~
o ,-
to~1 ~. ,
I '.
".
e::: ".
<I ..~
E" ~'"
"
, ~-
0,
J
~---_.--
..
,r".
. "
.
-..
;; ~
....
.
~
It of pages
~
I
0000000000 0000002200 0000471400020566 1001 9
-- ------ -- -- - --:-- - ~ - - - --- - '-
BUSINESS
ADDRESS MOBILE UNIT
01 - C I T Y OF KEY WEST
N~ME Act~8urLDING MAINTENANce
MAILING
ADDRESS EADY'JUDY OWNER
P 0 'BOX 2763
I<EY WEST FL 33040
JANITORIAL SERVICE
TMISBECOMESATA.X HARRY f' KNIGHT CFC TAX COLLECTOR
F'.ECEIPT~\'I-;ENVAliDArEDP 0 BOX 1129" KEY WfST FL 33041-1129
~-tO~ _=
Q_.~~ D~
-'-~~W.,~~
Q~~~o ~
gg:
~~~.
.,~~
I~ ~J.~~
~~ OO~=
.~O"OO~
1~~~~O~~
~~-w~ =
4MOUNT
PENALTY
COU.ECTION COST
TOTAl
22.00
22.00
SUPPlEMEIoITA1.
RENEW4l
NEW UCENSE
T~~NSFEFl .
OAIGINAL TAX
TYPE OF
BUSINESS
47
40
JAt-'
I
TORrAl
SERVICE
MUST BE DISPlAYED IN CONSPrcuous PlACE
EMPlOYEES 0 - 5
x
AOOMS
"..:-:"'
~;.
~..~-~
, . .
.=-=:""'" ~..,~" ", '='=="""=~""~"~=-,.,,,,,,:, '---="",=~........",,-....._- . - -== = "'"
[J 993-1994 ACCO"'T 471
FACILmES
OR
MACHfNES
SEArS
MONROE
OCCUPATIONAL
STATE OF FlOAIQA
UCENSE
EXPIRES S E P T
40-0020566
30" 1994
I-
oJ:-
W
:3
>-
W
::L
l.J..
Co
)-
l-
I--<
U
~
.
,
0:)
r,-
('~
CO:)
I
C-J
VO
('~
I
Lr)
C:-
r~~'
Q
I--<
.J
,~
"
: \,
\\../
CL
\
SJ}.2~ ! 90.00 93.15
NO I I I DECBlIlER J.UlJAR"f
TOT"L UNtTS 1
tIll ~(;li~?<;~ tFt ~ W ~
l j. ~ ~f ~::~t '2~ U( Oi It
iRt~~ ijt ~~'!J.I~~ l~~)~
;.u:m~1-~n~~t2 +
~{E ~~lL~I~G r.A!~lt~~t
~~ng;a f~lT.:~:..~il
! ~., ~(( t I ~
~..~ ~~..;~
~,..
~
~;l
'-~~.
<::T
0'1
C'
to')
c.:::
a:
~
......
o
0...
r,-
o
o
o
:z:
Vo
('-I
(',I
......
..
~.
.,.....
:.--::...:-:..:.:.~-
1/93
'~.:~_-.::-'~~:...o-:.;..a..:-~";:':':~' - ...:-- .;.
OCCUPATIONAL LICENSE
City of Key West, Florida
ntAOUGH
09/30/QIo
-'
No.
50016139012
,
,
_....~
04/07/1994 14:25 '1~~tJ.i~bwTH
. {;'I' ~\s" lV'
r>.\'\'RO'Jt\l, ::J
,I ,,\
'~, -'Cll- II
MGT . DIll. Mi=lRIHHON
TO 45'~0
v: CONSTRUCllOH INDUSTRY
'l'r.sCiftnAt:ATE Of ELECllOH to 8E EXEMPT mOM
~/l\ -- THE FLOR1DA WORKERS. COMPENSAllON LAW
MAl\. TO: ~......... LIMI" I.....r-".....,.,
........ .,c:..~
,.... 0.. ........ · I '8 0 0
T....._.... "u,~not
T........ ~ Ct041 ....tiat
PUAM "" 0" I'lIlIn':
'U REWA'E I IDE OF THII FOIW FOR ELIOI8H.rrYR&QVIR~n AND RENEWAL IHFORM"TI0f4.
~ CE: B' " It \ AI ,1-'-' \, ,JJQ~ ~V(
(L."~NwM.'ClI'~, ..~(O/B(A.~"
I ~ 0 (] d Cf-Vh -rE P-PA CY.- i
(Udirog ,f.cIcnu) (s.... Ad~ I '*"II'W'C)
k/,w \~)E5)' PL l~OLlO (;S-OJ.~& Y'57
-, ($I<) (tipl(F'fdnl Emp(0)'t' "*~ticn~"
'JH-N )TI'K i ~L
)
J
(~
He..... 01 ~IIT\... or Tft".:
F'. (11
.:
... aNI" ~ ...... ~.... ......
,~lIf__"-"''' _ ~1Dt.
.. CIIl/'pO<'...- -.. Nt_
B DfJ I~
3 of.~1 L( t:d-()~
(TlhlphCl'ltl #)
Pllrwant to Ruk W".OOt(a), .. of 1l:01 8JL ao cSar-loIIowlntlllM lSd, of 1M _1Un; of thl, tOl'lft. J'CXl .,.. ~y notHkd 'flat ;1\. tonowl"" IoIe ~,
Pu1n<H or CocpcKIII Oiftoer ollhl .bo", nalMd bu.... If-. Mwet _1M ,hntpt from h pI'Orl.!ont 04 1M ~ W<<Mn' ~~ 1,.1.. I .
Ilnd....und !ha'''' ~ ptoptl.~, Ind'pe~nt conlrec.." pann.r, or om- .1. MfPO'ltIon who .t.cl. u,"'ptlon ~ 1111, 011.,,-, lrt lIHntI'
-nl1l..,. .1 ~tIoft unci., .. 440.01 IDa)' I'IO'_"" ~ata <<_m~'''oll uM.r li\l. dlap.... 1 furtheot ,VMt>t.-n4 flal tt.,. I. . 1I111'1.'Il\~ pe""*-
or .UN ~II ''''M''' I C'Wtf)' flat .t\y IfI\ploYM .llhI buttne.,. I'WtmM .bo....l. oo~ by -"M.' OOM~.tIOI\ !nll<a,,"-
FlEQUIFI T: L1aT CI:Ilt\f'l~ <it REClattRED uca;.Hau HELD p'URaUNiT TO CHAPTER..I F.lJ, Oft L<>C.'l OOCWATIOHAlllCCH&EL
,~ LI C.Q~~ ..)0\11J, 13 ~ 0 I ot:t.. t.L.
(1)Typ.: 0 Ltc HImlb..: '7JliO ~~05~~ Nutnb.-:
'M"ORTAHT: II H .RUUHOA8\.1i ~TT FIW OC>U..A.R' (h5.00) lnd~ ~...ptIOft tUllt1tM lonoqu4rM punuaft1 tD CMp.... +4O.{)$.I'.'
...... ~u'- ~oot(a)..t04 I. P"Yilblil~" by ~iItIlilt". ~l Of ~ ot4et _ W.e. UMlnlatra__ Trv. FvnC. Fal!IYrt.. ~lo.. ....,...-nr.tr
.,.. "~lIy _plo..lhI, ~..ur ,...ull In ,..lIUtIof fie ~"'.. end __. c!oIay 111..,....101\.
Al'FID" vrr OF INDrPEHDEHT COHlMC'TOA . T It TW:
I, .3"'1 A.~ r.:;~ It k- . ~ urHSw odI, do thopow "' toIlofl:
1. l-m.ln. ..,...... kilt'll.. Mil illY own..t tItolltIy, trvok, ~ulpfMn" _1iINl., or IImnar ~
1. 'hoW _twiN appIkd lor . w.r.I-Po)'ll' w.nllkadoft t\1mlbw;
:so I r' rlonlI or .,'" to pI410mI ~ ..mC4I<< __ toI' Ipftlf\c ._nte of _, and eon", tM ~n. of ~lng ~ ..,... Of -';
4. '!now 1M prindpel.ltplnMI rMtM to 111. I<<VIoe Of ~ lhat I ,.norlll or ..,.. to ,.Mot",.
t. (_ '"f>OtIII," ,., h ..tI~ MftIpMlClft 01 WOtk Of MfYloot,1Mt (~ DI' -er.. t\) pMfOm\ eMf" Of -'4 "- btlcllII~ lor. teIurt tit eom,...
... w.ft ., -no.;
.. I,""," oom,.,...1otI ,., WOft Ol' ..m.., ~ lor. _mlMloft Of Oft a pIf )011 or _pelU_bId Mill. aM nol on en)' 0'* ktltl;
1. ''''I''''~' ~oat IIf tIUftw . 10M 1ft OOl\MCtIoft wl1h pMtonnJ"I WNt << ..mo.a;
.. I MW tOfIlrWfnI Of rMVrMt k....II.tIIl1t1. or obI\tdoft-: .".
.. TM.~.. or te"lIB of "', ""e1_ ",.Me Oft 1M rt'-llOMhIp tf """_l9nl~ta .. .~tutl..
~''''''' ~v J..Li !!xiJi. ct
. ...d.- ~&d~
(Only en. S' Mw P.- Form)
.Fl.0AD0\.
QJ}1.1M Df) 6
PubtlC. 8la18 ell f'0MI&
~t>m:~:;~sL
--
$~'~~r.
CORPOAATE OFFlCl:P/T1ll.E
Po.itiClt\:
!3ql\
CAY OF
P.-.cMIly ~ To M.
PrcQJcld u lcJM'\liti(.a~CI"
typ. ClICIIIlO,,"1I1ln
~: """'" y.
,:)- 0 3-1l! -J-S-qf "
~