8. 02/01/2006 to 01/31/2007 Agreement DANNYL. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: January 9, 2006
TO: Thomas Willi
County Administrator
ATTN:: Connie Cyr
Administrative Assistant
FROM: Pamela G. Han- a�r
Deputy Clerk
At the November 16, 2005, Board of County Commissioners meeting the Board granted
approval and authorized execution of a Consulting Agreement between Monroe County and
Langton Associates, Inc. for assistance with obtaining governmental grants.
Enclosed is a duplicate original of the above-mentioned for your handling. Should you
have any questions please do not hesitate to contact this office.
cc: County Attorney
Finance
File✓
CONSULTING AGREEMENT
J.-S-
This consulting agreement made on this".tlllday of November, by and between Langton
Associates, Inc., hereinafter referred to as "Langton", and the Monroe County Board of
County Commissioners, hereinafter referred to as "Client" or "County" under the
following terms and conditions:
RECITALS
1. Langton agrees to provide professional grant consulting services to Client for the term
of 12 months, commencing December 1, 2005, and ending November 30, 2006. Langton
agrees to exercise its best efforts to obtain governmental grants and benefits for client. It
is understood, however, that Langton cannot guarantee results that any certain amount of
funds will be obtained for Client.
2. Pursuant to this agreement Langton agrees to provide specific services as follows:
a. IN-DEPTH NEEDS ASSESSMENT. Langton shall determine Client
needs through on-site interviews with officials and staff, review of
materials concerning the Client government services and structure (such as
the Comprehensive Plan, Capital Improvement Plan, Budget, etc.)
Langton shall match a list of Client needs with resources available through
various programs. Langton shall develop a Strategic Grants Plan to fund
Client priority projects through various grant and loan programs.
b. DETERMINATION OF RELEVANT FUNDING SOURCES.
Langton shall make extensive use of internal and external resources to
determine appropriate sources of funding to accomplish client goals, and
make recommendations for applications on an on-going basis.
c. PREPARATION AND SUBMISSION OF GRANT APPLICATIONS.
Langton will develop and prepare the grant applications and submit them
to the funding agencies. The typical annual client pursues an average of
eight to ten grants in a contract year. Langton shall also provides technical
assistance to Client staff who are already soliciting grants.
d. TECHNICAL ASSISTANCE ON GRANT ADMINISTRATION.
Langton shall provide client staff and contractors administering grants
with expert advice that will keep them on track.
e. PERSONALIZED GRANT RESEARCH AND CONSULTATION.
Langton shall read extensively in government resources such as Florida
Administrative Weekly and the Federal Register to keep up to date with
changes through the U.S. Congress and the Florida Legislature in order to
Monroe/Langton 11/05
1
follow new programs as they are created and enable County to apply for as
many grants as are available to serve the County's needs.
f. INTERGOVERNMENTAL RELATIONS WITH FEDERAL AND
STATE GOVERNMENTS. Langton shall acts as a liaison to the
funding agency before, during, and after any application is made, and
make use of its extensive network of contacts in Washington, D.C. and
Tallahassee, Florida, to provide our clients with the most accurate, up-to-
date grantsmanship information and resources available.
g. WEEKLY E-MAIL GRANT ALERT. Langton shall send a weekly e-
mail grant alert to all County staff with potential grant projects and will
detail federal, state, and foundation grant opportunities announced the
previous week.
3. In exchange for Langton performing these services as established herein and devoting
agency time, Client agrees to pay Langton the sum of $69,000 to be paid in twelve (12)
equal installments of $5,750.00 per month. Payment will be made by County pursuant to
the Florida Prompt Payment Act upon receipt of a proper invoice submitted with
documentation to show the services provided. This fee is inclusive of travel to and from
Monroe County and grant application production costs. Payment under this agreement is
subject to annual appropriation by County.
4. Langton agrees to devote the necessary time and performance of duties for Client, and
shall report to the County or its designee on all matters concerning this agreement and the
discharge of its scope of services.
A. As to Langton Associates:
Michael Langton
President
118 West Adams Street, Suite 700
Jacksonville, Florida 32202
B. As to Monroe County Board of County Commissioners:
Thomas J. Willi
County Administrator
1100 Simonton Street, Suite 2-205
Key West, Florida 33040
6. Extension of Agreement. This Agreement may be extended on an optional basis at the
end of the term for two (2) one (1)- year periods upon mutual agreement of the parties.
Monroe/Langton 11/05
2
7. Early Termination. County may terminate this agreement with or without cause prior
to its natural expiration date by giving Langton written notice at least fourteen (14) days
in advance of the proposed termination date. Any work conducted after the noticed
termination date will not be compensated.
8. Insurance. Langton shall secure and maintain throughout the duration of this
Agreement insurance of such type and in such amounts as required by the County
Administrator. The underwriter of such insurance shall be qualified to do business in the
State of Florida and have agents upon whom service of process may be made in the State
of Florida. If requested by the County Administrator, the insurance coverage shall be
primary insurance with respect to the County, its officials, employees, agents and
volunteers. The insurance coverage shall include a minimum of:
a) Worker's Compensation and Employer's Liability Insurance. If
applicable, coverage to apply for all employees at minimum statutory limits as required
by Florida Law.
b) Comprehensive Automobile and Vehicle Liability Insurance. Motor
vehicle liability insurance, including applicable no-fault coverage, with limits of liability
of not less that $1,000,000.00 per occurrence, combined single limit for Bodily Injury
Liability and Property Damage Liability. Coverage shall include all owned vehicles, all
non-owned vehicles, and all hired vehicles.
c) Commercial General Liability. If applicable, commercial general liability
coverage with limits of liability of not less than $1,000,000.00 per occurrence combined
single limit for Bodily Injury Liability and Property Damage Liability.
d) Certificates of Insurance shall be provided to the County at the time of
execution of this Agreement and certified copies provided if requested. Each policy
certificate shall be endorsed with a provision that not less than thirty (30) calendar days'
written notice shall be provided to the County before any policy or coverage is cancelled
or restricted.
9. General Conditions:
a) Langton shall maintain all books, records, and documents directly
pertinent to performance under this Agreement in accordance with generally accepted
accounting principles consistently applied. Each party to this Agreement or their
authorized representatives shall have reasonable and timely access to such records of
each other party to this Agreement for public records purposes during the term of the
Agreement and for four years following the termination of this Agreement. If an auditor
employed by the County or Clerk determines that monies paid to Langton pursuant to this
Agreement were spent for purposes not authorized by this Agreement, the Langton shall
repay the monies together with interest calculated pursuant to Sec. 55.03, FS, running
from the date the monies were paid to Langton.
Monroe/Langton 11/05
3
b) Governing Law, Venue, Interpretation, Costs, and Fees: This Agreement
shall be governed by and construed in accordance with the laws of the State of Florida
applicable to contracts made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is
instituted for the enforcement or interpretation of this Agreement, the County and
Langton agree that venue will lie in the appropriate court or before the appropriate
administrative body in Monroe County, Florida.
The County and Langton agree that, in the event of conflicting
interpretations of the terms or a term of this Agreement by or between any of them the
issue shall be submitted to mediation prior to the institution of any other administrative or
legal proceeding.
c) Severability. If any term, covenant, condition or proVISIOn of this
Agreement (or the application thereof to any circumstance or person) shall be declared
invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining
terms, covenants, conditions and provisions of this Agreement, shall not be affected
thereby; and each remaining term, covenant, condition and provision of this Agreement
shall be valid and shall be enforceable to the fullest extent permitted by law unless the
enforcement of the remaining terms, covenants, conditions and provisions of this
Agreement would prevent the accomplishment of the original intent of this Agreement.
The County and Langton agree to reform the Agreement to replace any stricken provision
with a valid provision that comes as close as possible to the intent of the stricken
provision.
d) Attorney's Fees and Costs. The County and Langton agree that in the
event any cause of action or administrative proceeding is initiated or defended by any
party relative to the enforcement or interpretation of this Agreement, the prevailing party
shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-
pocket expenses, as an award against the non-prevailing party, and shall include
attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate
proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement
shall be in accordance with the Florida Rules of Civil Procedure and usual and customary
procedures required by the circuit court of Monroe County.
e) Binding Effect. The terms, covenants, conditions, and provisions of this
Agreement shall bind and inure to the benefit of the County and Langton and their
respective legal representatives, successors, and assigns.
t) Authority. Each party represents and warrants to the other that the
execution, delivery and performance of this Agreement have been duly authorized by all
necessary County and corporate action, as required by law.
g) Claims for Federal or State Aid. Langton and County agree that each shall
be, and is, empowered to apply for, seek, and obtain federal and state funds to further the
purpose of this Agreement; provided that all applications, requests, grant proposals, and
funding solicitations shall be approved by each party prior to submission.
Monroe/Langton 11/05
4
h) Adjudication of Disputes or Disagreements. County and Langton agree
that all disputes and disagreements shall be attempted to be resolved by meet and confer
sessions between representatives of each of the parties. If no resolution can be agreed
upon within 30 days after the first meet and confer session, the issue or issues shall be
discussed at a public meeting of the Board of County Commissioners. If the issue or
issues are still not resolved to the satisfaction of the parties, then any party shall have the
right to seek such relief or remedy as may be provided by this Agreement or by Florida
law.
i) Cooperation. In the event any administrative or legal proceeding is
instituted against either party relating to the formation, execution, performance, or breach
of this Agreement, County and Langton agree to participate, to the extent required by the
other party, in all proceedings, hearings, processes, meetings, and other activities related
to the substance of this Agreement or provision of the services under this Agreement.
County and Langton specifically agree that no party to this Agreement shall be required
to enter into any arbitration proceedings related to this Agreement.
j) Nondiscrimination. County and Langton agree that there will be no
discrimination against any person, and it is expressly understood that upon a
determination by a court of competent jurisdiction that discrimination has occurred, this
Agreement automatically terminates without any further action on the part of any party,
effective the date of the court order. County or Langton agree to comply with all Federal
and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination.
These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88-
352) which prohibits discrimination on the basis of race, color or national origin; 2) Title
IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-
1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the
Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits discrimination
on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC
ss.6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug
Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as
amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7)
The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-
3), as amended, relating to confidentiality of alcohol and drug abuse patent records; 8)
Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; 9) The Americans with
Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to time,
relating to nondiscrimination on the basis of disability; 10) Monroe County Code Ch.
13, Art. VI, prohibiting discrimination on the bases of race, color, sex, religion, disability,
national origin, ancestry, sexual orientation, gender identity or expression, familial status
or age; and 11) any other nondiscrimination provisions in any Federal or state statutes
which may apply to the parties to, or the subject matter of, this Agreement.
Monroe/Langton 11/05
5
k) Covenant of No Interest. County and Langton covenant that neither
presently has any interest, and shall not acquire any interest, which would conflict in any
manner or degree with its performance under this Agreement, and that only interest of
each is to perform and receive benefits as recited in this Agreement.
1) Code of Ethics. County agrees that officers and employees of the County
recognize and will be required to comply with the standards of conduct for public officers
and employees as delineated in Section 112.313, Florida Statutes, regarding, but not
limited to, solicitation or acceptance of gifts; doing business with one's agency;
unauthorized compensation; misuse of public position, conflicting employment or
contractual relationship; and disclosure or use of certain information.
m) No SolicitationlPayment. The County and Langton warrant that, in
respect to itself, it has neither employed nor retained any company or person, other than a
bona fide employee working solely for it, to solicit or secure this Agreement and that it
has not paid or agreed to pay any person, company, corporation, individual, or firm, other
than a bona fide employee working solely for it, any fee, commission, percentage, gift, or
other consideration contingent upon or resulting from the award or making of this
Agreement. For the breach or violation of the provision, the Langton agrees that the
County shall have the right to terminate this Agreement without liability and, at its
discretion, to offset from monies owed, or otherwise recover, the full amount of such fee,
commission, percentage, gift, or consideration.
n) Public Access. The County and Langton shall allow and permit
reasonable access to, and inspection of, all documents, papers, letters or other materials in
its possession or under its control subject to the provisions of Chapter 119, Florida
Statutes, and made or received by the County and Langton in conjunction with this
Agreement; and the County shall have the right to unilaterally cancel this Agreement
upon violation of this provision by Langton.
0) Non-Waiver of Immunity. Notwithstanding he provisions of Sec. 768.28,
Florida Statutes, the participation of the County and the Langton in this Agreement and
the acquisition of any commercial liability insurance coverage, self-insurance coverage,
or local government liability insurance pool coverage shall not be deemed a waiver of
immunity to the extent of liability coverage, nor shall any contract entered into by the
County be required to contain any provision for waiver.
p) Privileges and Immunities. All of the privileges and immunities from
liability, exemptions from laws, ordinances, and rules and pensions and relief, disability,
workers' compensation, and other benefits which apply to the activity of officers, agents,
or employees of any public agents or employees of the County, when performing their
respective functions under this Agreement within the territorial limits of the County shall
apply to the same degree and extent to the performance of such functions and duties of
such officers, agents, volunteers, or employees outside the territorial limits of the County.
Monroe/Langton 11/05
6
q) Legal Obligations and Responsibilities: Non-Delegation of Constitutional
or Statutory Duties. This Agreement is not intended to, nor shall it be construed as,
relieving any participating entity from any obligation or responsibility imposed upon the
entity by law except to the extent of actual and timely performance thereof by any
participating entity, in which case the performance may be offered in satisfaction of the
obligation or responsibility. Further, this Agreement is not intended to, nor shall it be
construed as, authorizing the delegation of the constitutional or statutory duties of the
County, except to the extent permitted by the Florida constitution, state statute, and case
law.
r) Non-Reliance by Non-Parties. No person or entity shall be entitled to rely
upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any
third-party claim or entitlement to or benefit of any service or program contemplated
hereunder, and the County and the Langton agree that neither the County nor the Langton
or any agent, officer, or employee of either shall have the authority to inform, counsel, or
otherwise indicate that any particular individual or group of individuals, entity or entities,
have entitlements or benefits under this Agreement separate and apart, inferior to, or
superior to the community in general or for the purposes contemplated in this Agreement.
s) Attestations. Langton agrees to execute such documents as the County
may reasonably require, to include a Public Entity Crime Statement, an Ethics Statement,
and a Drug-Free Workplace Statement.
t) No Personal Liability. No covenant or agreement contained herein shall
be deemed to be a covenant or agreement of any member, officer, agent or employee of
Monroe County in his or her individual capacity, and no member, officer, agent or
employee of Monroe County shall be liable personally on this Agreement or be subject to
any personal liability or accountability by reason of the execution of this Agreement.
u) Execution in Counterparts. This Agreement may be executed in any
number of counterparts, each of which shall be regarded as an original, all of which taken
together shall constitute one and the same instrument and any of the parties hereto may
execute this Agreement by singing any such counterpart.
v) Section Headings. Section headings have been inserted in this Agreement
as a matter of convenience of reference only, and it is agreed that such section headings
are not a part of this Agreement and will not be used in the interpretation of any provision
of this Agreement.
w) Assignment. This Agreement shall not be assignable by Langton unless
such assignment is first approved by the County Administrator. The County is relying
upon the apparent qualifications and personal expertise of Langton, and such firm's
familiarity with the County's area, circumstances and desires. The terms, covenants,
conditions, and provisions of this Agreement shall bind and inure to the benefit of the
County and Contractor and their respective legal representatives, successors, and assigns.
Monroe/Langton 11/05
7
x) Independent Contractor. Langton and its employees, volunteers and
agents shall be and remain independent contractor and not agents or employees of the
County with respect to all of the acts and services performed by and under the terms of
this Agreement. This Agreement shall not in any way be construed to create a
partnership, association or any other kind of joint undertaking, enterprise or venture
between the parties.
y) Compliance with Laws. Langton shall comply with all applicable laws,
ordinances, rules, regulations, and lawful orders of public authorities relating to the
Project.
z) Waiver. The failure of either party to this Agreement to object to or to
take affirmative action with respect to any conduct of the other which is in violation of
the terms of this Agreement shall not be construed as a waiver of the violation or breach,
or of any future violation, breach or wrongful conduct.
WHERETO, the parties have set their hands and seal effective this ,'d... day of November,
2005.
AITEST:
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LANGTON ASSOCIATES, INe.
AITEST:
Monroe County Board of County
Commissio rs
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Monroe/Langton 11/05
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LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
Langton Associates. Inc. warrants that helit 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.
Date:
~~
/1 /%.~.$
STATE OF ":f-~~
COUNTY OF ~.1
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
IJ& ~k.p J ~+ who, after first being sworn by me, affixed hislber
signature (name of individual SIgning) in the space provided above on this ~a ~ day of
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My commission expires: ~. Q I j QDD'j
CHRISTINA M. KING
NOlary PUblic, State ot Florida
My comm. expo Jan. 21, 2009
Comm. No. DD 386592
OMB - MCP FORM #4
Public Entitv Crime Statement
"A person of affiliate who has been placed on the convicted vendor list following a
convection for public entity crime may not submit a bid on a contract to provide any
goods or services to a public entity, may not submit a bid on a contract with a public
entity for the construction or repair of a public building or a public work, may not submit
bids on leases of real property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any public entity,
and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017 for CATEGORY TWO for a period of36 months from the
date of being placed on the convicted vendor list."
CERTIFICATE OF INSURJ8,.1 "CE
RANCE AS RESPECTS niE INTEREST OF THE CERTIFICATE Ir IOWI=R NAMED BELOW WILL NOT BE
OR OTHERWISE TEFI~IIf~ATED WITHOUT GIVING 10 DAY:;, PROR WRITTEN NonCE TO THE
CERTIFICATE HOlOER, BUT IN NO EVENT SHAll THIS CERTIfiCATE Hi; V,I.UD MORE THAN 30 DAYS FROM
THE DATE WRITTEN. THIS CERTIf'!i(;ATE OF INSURANCE DOES NOT CtlPd'iGlE THE COVERAGE PROVIDED BY
ANY POLICY DESCRIBED BELOW.
This certifies that 18I STATE FARM MUTUAL AUTOMOBilE INSURANCE C:OMPJ,NY of Bloomington, Illinois
o STATE FARM FIRE AND CASUALTY COMPANY of f:I o)mirl!)lon, Illinois
o STATE FARM COUNTY MUTUAL INSURANCE COMf'!=INY OF TEXAS of Dallas, Texas, or
o STATE FARM INDEMNITY COMPANY of Bloomington, Illinois
has coverage in force "or the followir~~ Named Insured as shown below:
NAMED '!'I~URED: l,angton As~oc!: tes Inc
POLICY NUMBER
EFFECTIVE DATE
OF POLICY
ADDRESS OF NAMEOINSURED; 118 \0' Adams St Ste 700 Jacksonville, 1'1. 32:i02-3B16
-.----.-..--------1 -.-r--.-.--.-.....-
492 9633
DESCRIPTION OF
VEHICLE (Including VIN)
I'_~I~~IUTY COVERAGE
LIMITS OF LIABILITY
I Cl. Bodily Injury
Each Person
----
Each Accident
b. Property Damage
Each Accident
c. Bodily Injury &
Property Damage
Single Limit
Each Accident
PHYSICAL DAMAGE
COVERAGES
a. Comp!,"ehensive
Additional Insured
I ==--l
-1'---
1,000,00G
--............. .......--
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J088895
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]NO DYES DNO 0'
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JNO DVES ONO 0'
ledUCllble $ DedUCtible $
JNO DVES ONO 0'
)eductible $ OedllCtible $
-
JNO DYES DNO 0'
JNO DYES DNO 0'
---
JNO DYES DNO LIt
DNO
DNO
b. Collision
..................--_m~__._...
EMPlOYERSNON~NED
CAR LIABILITY COVERAGE
HIRED CAR LIABILITY
COVERAGE
flEET. COV AGE FOR
ALL~~ Ie EUsCENSED J.Q ,!,ES ._ r (:::3 0 NO _ ...1 DYES
'7z~= ~':k1;2. ..-"~;ice R~.. __. ."-."023
Sign orized Repr~ - Tille AGc.nt.s Code Number
I Name and Address of Certificate HOlder__ Name and Address_'~~!~~L_
06/l0/200!,
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I2l YES
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$0
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$ 100
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DYES
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DNO
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DNO
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DNO
DNO
DNO
12/08/05
Date
Neil Nelson
5650 Tirnuquana L:!
Jacksonville, 1'1. :-12.::.:>
Monroe County
Board of county Commissioners
I ;100 S~monton St Ste 2-205
~EY West, Fl 33040
INTERNAL STATE FARM U-Se-ONL Y: 0 Rer~Jest penna~nl CeJtJficate of Insurance tor Uablflty c r:...era,i,;
122429.2 Rav.06-10-2004 0 Ret,LIes! CertificaCe Holder 10 be Ildckd as an Adcilicrull fraun.( .
This certifies tI;at 0 STATE FARM FIHE AND GASUAUY COMP.l\NY, 8loornington. Illinois
o STATE F/:,RM GENERAL INSURANCE COMPANY. Bloomington, Illinois
LJ STf.\TE FARM FIR.E ANf.J C;'tSU/\L TV COPv1PANY, Scarborough. Ontar'io
[ZJ STATE F.t.\RM FLORIDA INSURANCE COMPANY, Winter Haven. Florida
[J ;31ATE Fi\Rf1f1 LLOYD!':; Dallas, Texas
insure::; the follc)',Ning poilcynolder lor '.he coverages Indicated bE'low:
CERTIFICATE OF INSURANCE
p,)lleyhalde!
/\~, ~:; PC i a t: (2:''':;
(-\ddress of policyholder
eil
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Location of cpeiJlions
=".'e~~.(~(iDt.:un of ()pGt',:ll;:)nS
Tile poliCies listed below i13V,,, been 'ssued to the pol:cylwlder br he pOlK}" per'ods Sh(Wili. '((.enSU8nce desco!)E'J In tneS? poliCies's
subj8'ct tD ail the teirns, eXdusjons, and conditions of those po!;('~.jes_ The Lrnrts of snovvn rnElY i'lave t)een reduced by any paid dairns
_.__m I ---- - -1-- POLICY PER!Oml) -.. '--I '-- - , LIMITS OF lU\BIUTY-
POLICY NUMBER mmml ~'~E ~~~~l!~ANCE I E~ectlve Date U~Xpi~n 01-- La.,! beginning of policy period)
-'3i):::j.~, F 1 '~.orll'ipl,t!'18h'e . /. .~:C _ / :/, t BODILY IN~lIRY I,I\JO
. .. I P :: ':0',-<- .1. _ __: _ ___ PROP:::R-;-Y r\4(\fA,-:;;::
This Insurance includes [J PIG:!Uc!- - COmpieli"d Ope' oVans
Contractua~ Liability 1 t"::.acn C:c(:Ur1't::nce S 1
Personal
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InJl.lry
General Aggregate
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Products - COfnoletecl .";
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mmm.'i .' EXCESS LlABI~;~-;T:::~ti:O~~~ey.:p~:~l~~on-~::-1 ~~~rti;~~~;~~~~)PROPE~;~~ DA~'AC;E-'-
--- +0 ~:;'~,.'" -- +---=-POl;:;~ERIOO=)~~i?~~::::::::on"e":t'o' _ St""",
i I Effective Date : Expiration Date i
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V\/i..)r'~'({jrs Part
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[ PO Lie Yfffi'OD I
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THE CERTIfiCATE Of lNSUR/U\\CE is NOT A CONTR<'\CT OF INSURANCE AND NEITHER AFfiRMATIVELY NOR NEGATIVELY
AMEl'mS. EXTENDS OHA.LTERS THE COVERAGE APPROVED BY A.NY POLICY DESCRIBED HEFIE1N
Each ,i\ccid(;.nt
$
Disease - Each Emplovee $
. .... qise?~f.i:p.?jicy. Lirlll: S
UI\'llTS OF LIABILITY
.mmJatt:.~gjflnjng ()!.p'?I.i.:::Y~~i?~___..
"'acne and AddreSS of CertincdtE' Holder
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q. ..,
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If any o-f the descr10ed pOUC.l-es dre C(HiCf)}fyj before
their expiratie,p date, State- Farro \:vdi try to (nail a
\'\, dt0'{' ""otlre >.... tile :-;-.rt ~':::clt2 ~lo:,Jer ~ ~ d8YS c~fcre
> t..d;1Lc'Hat1\)n\l~ hD\t'h.."/dt. v"e Zdll ~Oi:' I. ,:u,.:;{, notIce,
(.' n,j ODlV,J<3tIOn or I;abll,ty Will 'be" imp se(,l on State
IF",: m or It:, a,q6nts Of repreS"fltatl, e~/
\ i /(.:' , 'l{.r,.. I /, J !
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Si[lnatl.uf2,X";-:-4\ lJthcn::ed Repi\~';e{1tat I\\;~
;.\..
~ ~
Title
Uat0
.fr-..
'..
"
AQ0n-t Nalne
Telephone Nurnber
Agenrs Code Sl3inp
Agent Code € ()
AfO Code ;;) ;!
:;30-~-Ff.'-! n.;-;. ,,(-yo 1-D8--2D04 {::'rlrlft-::f In \..' ;3'.J\.
Neil Nelson
AFO Jacksonvflfe
A 190679
59.6023
F349