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Agenda 12/11/2012 Item #16A3212/11/2012 Item 16.A.32. EXECUTIVE SUMMARY Recommendation to approve a permit to conduct the annual St. Agnes Catholic Church Parish Carnival on January 18th, 19th and 20th, 2013 located at 7775 Vanderbilt Beach Road, in Golden Gate Estates, and to recommend waiver of the Surety Bond in the amount of $2,500 for the St. Agnes Catholic Church Carnival. OBJECTIVE: Recommendation that the Board of County Commissioners approve a permit to conduct the annual St. Agnes Catholic Church Carnival on January 181h, 19th and 20th, 2013 and waive the Surety Bond in the amount of $2,500. CONSIDERATIONS: Very Reverend Robert J. Kantor St. Agnes Catholic Church has made application to the Board of County Commissioners for a permit to conduct their annual carnival and has presented sufficient evidence that all criteria has been met for the issuance of a carnival permit. The required insurance amount of $1,000,000 has been purchased. St. Agnes Catholic Church is a non - for - profit entity. All other Church Carnivals were granted waivers to the Surety Bond. FISCAL IMPACT: Approval of this request would have no fiscal impact on the County. GROWTH MANAGEMENT IMPACT: There is no Growth Management Plan Impact. LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney's Office, is legally sufficient, and requires majority support for approval. Staff has historically brought requests by not - for -profit organizations for waivers of the surety to the Board of County Commissioners for approval. -HFAC RECOMMENDATION: Staff recommends that the Board of County Commissioners approve the permit to conduct the annual St. Agnes Catholic Church Parish Carnival and waive the surety bond in the amount of $2,500. Prepared by: Claudine Auclair, Business Center Manager, Growth Management Division, Operations & Regulatory Management Attachments: 1) Application; 2) Site Plan; 3) Letter from St. Agnes Church; 4) Letter from Sheriff's department; 5) Letter from Golden Gate Fire; 6) Waste Management Back up; 7) Taylor Rental quote; and 8) Insurance Certificates and Certificate of Exemption Packet Page -2631- COLLIER COUNTY Board of County Commissioners Item Number: 16.A.32. 12/11/2012 Item 16.A.32. Item Summary: Recommendation to approve a permit to conduct the annual St. Agnes Catholic Church Parish Carnival on January 18th, 19th and 20th, 2013 located at 7775 Vanderbilt Beach Road, in Golden Gate Estates, and to recommend waiver of the Surety Bond in the amount of $2,500 for the St. Agnes Catholic Church Carnival. Meeting Date: 12/11/2012 Prepared By Name: AuclairClaudine Title: Planner, Principal,Transportation Planning 1 1/1 5/2012 5:22:10 PM Approved By Name: PuigJudy Title: Operations Analyst, GMD P &R Date: 11/16/2012 2:12:25 PM Name: BellowsRay Title: Manager - Planning, Comprehensive Planning Date: 1 1/1 6/2012 4:50:16 PM Name: BosiMichael Title: Manager - Planning,Comprehensive Planning Date: 11/19/2012 8:15:11 AM Name: FrenchJames Title: Manager - CDES Operations,Operations & Regulatory Management Date: 11/26/2012 9:16:23 AM Name: LynchDiane Title: Administrative Assistant Date: 11/26/2012 11:45:57 AM Name: AshtonHeidi Title: Section Chief/Land Use- Transportation,County Attor Packet Page -2632- Date: 11/27/2012 8:33:59 AM Name: KlatzkowJeff Title: County Attorney Date: 11/27/2012 11:46:50 AM Name: FinnEd Title: Senior Budget Analyst, OMB Date: 11/27/2012 1:56:38 PM 12/11/2012 Item 16.A.32. Name: IsacksonMark Title: Director -Corp Financial and Mgmt Svs,CMO Date: 11/27/2012 4:17:19 PM Packet Page -2633- COLLIER COUNTY GOVERNMENT GROWTH MANAGEMENT DIVISION/ PLANNING AND REGULATION 12/11/2012 Item 16.A.32. Cdti' er county 2800 NORTH HORSESHOE DRIVE NAPLES, FLORIDA 34104 (239) 252-2400 FAX (239) 252-6358 www.colliergov.net CARNIVAL OPERATION PETITION PL 2-012- (9002-&4+ PROJECT NUMBER PROJECT NAME To be completed by staff DATE PROCESSED APPLICANVOWNER INFORMATION PETITIONER'S NAME: —S7- X11/65 C,--f`77Avi4C PETITIONER'S ADDRESS: 777--S- TELEPHONE: FAX: —'-13� -3 -V, PETITIONER"S E-MAIL: /,;vP0 Cc--j s jY,:,--s PROPERTY OWNER'S NAME: —ffA,-N'fjc J7 11-' PROPERTY OWNER'S ADDRESS: TELEPHONE: 9W1 FAX: OWNERS'S E-MAIL ADDRESS: A14 PROPERTY INFORMATION LEGAL DESCRIPTION OF SUBJECT PROPERTY: eMztZcj-j GENERAL LOCATION: ZZ-7-S- J� Cj; CURRENT ZONING: F& 4 NATURE OF PETITION: tv; V 4- L r,51�7-1 t4L T-1 14-LO October 13, 2010 Packet Page -2634- COLLIER COUNTY GOVERNMENT GROWTH MANAGEMENT DIVISION/ PLANNING AND REGULATION 12/11/2012 Item 16.A.32. C'018-CY County �` <.. 2800 NORTH HORSESHOE DRIVE NAPLES, FLORIDA 34104 (239) 252 -2400 FAX (239) 252 -6358 www.colliergov.net EVENT INFORMATION HAS THIS EVENT BEEN HELD IN COLLIER COUNTY IN THE PAST? ❑ Yes [R' No IF YES, WHEN? WHERE? WAS THIS EVENT PREVIOUSLY HELD IN THIS SAME LOCATION? ❑ Yes 2 No THE FOLLOWING INFORMATION IS INCLUDED IN THIS PETITION. (FOR EXPLANATION, SEE NEXT PAGE.) [ 3.a. 3.c. 0 3.e.1) N 3.e.3) ® 3.e.5) 0'3.e.7) (K 3.e.9) 3.b. 3.d. 3.e.2) 7 3.e.4) N 3.e.6) 3.e.8) Comments: Signature of Approved: ❑ Not Approved: ❑ Date: Conditions of Approval, if any: SIGNATURE OF COUNTY MANAGER DESIGNEE October 13, 2010 Packet Page -2635- COLLIER COUNTY GOVERNMENT GROWTH MANAGEMENT DIVISION/ PLANNING AND REGULATION 12/11/2012 Item 16.A.32. GdMY C014-nty 2800 NORTH HORSESHOE DRIVE NAPLES, FLORIDA 34104 (239) 252 -2400 FAX (239) 252 -6358 www.colliergov.net INDIVIDUAL BOOTH NOTIFICATION FORM FOR TEMPORARY EVENTS Name of Event: Si 1-U A 4 f'r�x /51t su s i f v' L Name of Booth: / ~1 Tcfi Person in Charge of Booth: cA)A L7 ,? r, cL Types of Food or Beverage to be Served: -k7r au— � xt�v;�°ccz Srs��, .S�z�:foZ- �tS�lf�r +CPC lir'�P.lcus rif'.ssf. •�iS � Florida Administrative Code, Chapter 1OD -13 requires all food to come from an approved source. All food storage, preparation and utensil cleaning for this event shall not be done in private homes. Location of advanced food preparation:�i"�.; How will food be transported to event location? Method of keeping food hot and /or cold at event site: iivl ? o /z,, Q iv Method of cooking food at the location: Food must be protected from dust, insects, flies, coughs, sneezes. How will you provide this protection? Describe type of structure: YSvi� ez. "% tf- Adequate facilities and supplies shall be provided for employee handwashing. How will you provide this? 5/A; iLg , ;,/ t + r--f, z,-,/ For Information and Assistance contact: Environmental Health & Engineering Department - (239) 252 -2499 Failure to comply with applicable food service requirements in accordance with Chapter 1013-13, Florida Administrative Code, may result in enforcement action. Do you understand this completely? YES Q NO ❑ I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. I understand that these regulations include food intended for service to the public regardless of whether there is a charge for the food. I agree to assume responsibility for this establishment and I certify that said business will be conducted in complian,a ith t4e;Flopida Administrative Code, Chapter 10D -13. Signatdire of Appi Packet Page -2636- Date October 13, 2010 12/11/2012 Item 16.A.32. C.1006T County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION/ NAPLES, FLORIDA 34104 PLANNING AND REGULATION (239) 252 -2400 FAX (239) 252 -6358 www.coliiergov.net SPONSOR NOTIFICATION FORM FOR TEMPORARY EVENTS Name of Event: "i % /�<<5 �f�Tlv`�L Address of Event: 727SVt4j 16IL7 6�H ifc( 744e Date(s) of Event: 14A/ i y:, 20 -- 2oi� Hours of Operation:`�'f 4 -4-4 f Sponsor of Event: .S i r A-6'VE J /17" r Address of Sponsor: 7.775 4 z)td RiLT Person in Charge of Food Service: W61,Ma- f(vwtu Phone: x-39 �f3 6 C 7 1 Number of Food and Beverage Booths: �7- Estimated number of attendees expected at the event at one time? �oz✓ Number of toilets to be provided: Portable: Male . s Female' Permanent: Male Female Method of toilet waste disposal: ' /i-1c r r-'a-r -1E 5 AAW Describe method of liquid kitchen waste disposal: ca , ,l wr—,i+? 4 5E,E:,z w %e,&-1tsF '1KA'4 Describe containers and method of solid waste disposal (garbage):r.,wo Number of solid waste disposal containers provided: o"i 3c, yr+r,,) i) ti wtps nr'c Describe facilities and method of hand - washing: A f e' -Ari ;z i Describe facilities and method of utensil washing, rinsing and sanitizing: h915tt c6N-(1k 1C ITCHCAY Source of potable water: For Information and Assistance, contact: Environmental Health & Engineering Department — (239) 252 -2499 As the sponsor of this event you are responsible to notify all food vendors of the temporary food service requirements. Failure to comply may subject the booths to be closed for public health reasons. Do you understand this completely? YES NO ❑ I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. I understand that these regulations include food intended for service to the public regardless of whether there is a charge for the food. I agree to assume responsibility for this establishment and I certify that said business will be conducted in compnpe witWthe Florida Administrative Code, Chapter 1 OD -13. Sinnafure of Packet Page -2637- Date October 13, 2010 12/11/2012 Item 16.A.32. C41ie-r County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION/ NAPLES, FLORIDA 34104 PLANNING AND REGULATION (239) 252 -2400 FAX (239) 252 -5724 WWW.COLLIERGOV.NET ADDRESSING CHECKLIST Please complete the following and fax to the Operations Department at 239 - 252 -5724 or submit in person to the Addressing Department at the above address. Form must be signed by Addressing personnel prior to pre - application meeting, please allow 3 days for processing. Not all items will apply to every project. Items in bold type are required. FOLIO NUMBERS MUST BE PROVIDED. Forms older than 6 months will require additional review and approval by the Addressing Department. PETITION TYPE (Indicate type below, complete a separate Addressing Checklist for each Petition type) ❑ BL (Blasting Permit) ❑ SDP (Site Development Plan) ❑ BD (Boat Dock Extension) ❑ SDPA (SDP Amendment) ❑E Carnival /Circus Permit ❑ SDPI (Insubstantial Change to SDP) ❑ CU (Conditional Use) ❑ SIP (Site Improvement Plan) ❑ EXP (Excavation Permit) ❑ SIPI (Insubstantial Change to SIP) ❑ FP (Final Plat ❑ SNR (Street Name Change) ❑ LLA (Lot Line Adjustment) ❑ SNC (Street Name Change — Unplatted) ❑ PNC (Project Name Change) ❑ TDR (Transfer of Development Rights) ❑ PPL (Plans & Plat Review) ❑ VA (Variance) ❑ PSP (Preliminary Subdivision Plat) ❑ VRP (Vegetation Removal Permit) ❑ PUD Rezone ❑ VRSFP (Vegetation Removal & Site Fill Permit) ❑ RZ (Standard Rezone) ❑ OTHER LEGAL DESCRIPTION of subject property or properties (copy of lengthy description may be attached) FOLIO (Property ID) NUMBER(s) of above (attach to, or associate with, legal description if more than one) STREET ADDRESS or ADDRESSES (as applicable, if already assigned) 7775 VANDERBILT BEACH ROAD • LOCATION MAP must be attached showing exact location of project/site in relation to nearest public road right- of -way • SURVEY (copy - needed only for unplatted properties) PROPOSED PROJECT NAME (if applicable) ST. AGNES CATHOLIC CHURCH CARNIVAL PROPOSED STREET NAMES (ff applicable) VANDERBILT BEACH ROAD SITE DEVELOPMENT PLAN NUMBER (forexisting projects/sites only) SDP - or AR or PL # Packet Page -2638- CDANer County COLLIER COUNTY GOVERNMENT GROWTH MANAGEMENT DIVISION/ PLANNING AND REGULATION 12/11/2012 Item 16.A.32. 2800 NORTH HORSESHOE DRIVE NAPLES, FLORIDA 34104 (239) 252 -2400 FAX (239) 252 -5724 WWW.COLLIERGOV.NET Project or development names proposed for, or already appearing in, condominium documents (if application; indicate whether proposed or e)isting) Please Check One: ❑ Checklist is to be Faxed back ❑ Personally Picked Up APPLICANT NAME: DIOCESE OF VENICE PHONE 941- 484 -9543 FAX Signature on Addressing Checklist does not constitute Project and /or Street Name approval and is subject to further review by the Operations Department. FOR STAFF-USE ONLY FLN Number (Primary) Folio Number Folio Number Folio Number Approved by:. n nr t�f. ° �", Date: Updated by: Date: E OLDER, THAN 6 MONTHS, FORM MUS .£ BE UPDATED NEVVi-FOORM SUBMITTED Packet Page -2639- 12/11/2012 Item 16.A.32. Collier County Payment Slip (PL) Date: November 08, 2012 Contact: DEWANE, BISHOP FRANK J DIOCESE OF VENICE 1000 PINEBROOK RD VENICE , FL 34285 - Project Name: St. Agnes Catholic Church Carnival Permit Project Number: PL20120002644 Web Access Code: 1627 FEES: Fee Description Reference Number I Amount Carnival Circus Permit PL20120002644 275.00 Fire Code Review - CARNY I PL20120002644 100.00 Packet Page -2640- Packet Page -2641- j 0 n T r S Q c� T— �1 R� 12/11/2012 Item 16.A.32. 71,J i Packet Page -2642- G 4 Q � V � y ,3 yyS\ L R rti �y y c� y4- V Ll tom. �W Packet Page -2642- G 4 Q � V � y ,3 yyS\ L R rti �y y 12/11/2012 Item 16.A.32. SzKA f y i. �-y . 9"es CLVC6 tC L.. 1U1-C6 7775 VANDERBILT BEACH ROAD NAPLES,: FL 34420 (239) 592 -1949 FAX (23 9) 325 -9150 WWW.5TA6N ESNAPLE5.OR6 November 6, 2012 Paula J. Brethauer, Business center Project Coordinator Collier County Government Growth Management Division/Planning and Regulation 2800 North Horseshoe Drive Naples, FL 34104 RE: St Agnes Parish, Carnival January 2413 Ordinance No. 2006 -016 — 3 (a) Dear Ms. Brethauer: Per previous discussions, St. Agnes Parish is seeking a waiver for the above mentioned event and ordinance regarding the surety bond. We are in the process of completing the carnival application. Thanking you in advance for your help and attention to this important matter. Yours 'n Christ, Wry Rev. obert J. Kantor Pastor .• Packet Page -2643- r+ � R . 0 12/'11 /2012 Item 16.A.32. November 1, 2012 Saint Agnes Chapel 7775 Vanderbilt Beach Road Naples. Florida 34119 Attention: Allan Stencil. Business Manager RE: Security for upcoming events To Whom It Mav Concern* This is to advise you that the Collier County Sherifrs Office is prepared to provide security for the Parish Festival at Saint Agnes Chapel as listed below: Saint Agnes Chapel 7775 Vanderbilt Beach Road - Naples. Florida 34119 Parish Festival January 18- 20.2013 January 18. 2013/Fridav: 6tim — 12pm t hours): 2 deputies for security. January 19.2013/Saturday: 4pm — 1212m (8 hours): 2 deputies for security. January 20. 2013 /Sundae: 2nm -''l Opm (8 hours): 2 deputies for security. If you have an. questions, please contact me at (23 )9) 2-52 -0017 Sincerely. Lieutenant Mike Jones Collier County Sheriffs Office Patrol I Special Services Packet Page -2644- M LJ/eeb 12/� 1/2012 Item 16.A.32. GOLDEN GATE FIRE CONTROL AND RESCUE DISTRICT 14575 Collier Boulevard • Naples. FL 34119 • (239) 348-7540 - (239) 346-7546 FAX fir November 2. 2012 Allan Stencil Business Manager St Agnes Parish 7775 Vanderbilt Beach Rd, Naples, FL 34119 Subject- Festival Dear: Mr. Stencil-, Thank you for your letter informing the Golden Gate Fire District of your plans to hold a special event. The event is schedule from January 18, thru the 2C'�` 2013. Please note any vendors that conduct deep fat frying must have a UL 300 compliant hood system if they are cooking in a concession -stand. If during an inspection or later the fire district finds a vendor in violation. they will be required to stop all deep frying operations. Also. please be aware all tents or tarps shall be required to have the California State Fire Marshal Seal on them. The only exceptions are sun shades or small pop up tents with no sides that are occupied by only two or three persons. These sun shades or pop tents are still required to be flame resistant. Under no circumstances is cooking allowed under any tents. LP gas cylinders mus', stay at least 10 feet from any teni, A site plan showing the location of attractions, rides, booths and emergency vehicle access shall be required This plan should be sent to the Fire department as soon as possible. but no later than 24 hours prior to any inspection, Faiiure to comply with the Code or the inspection requirements may res t. it in the event being canceled or vendor may not be able to open. Prior to their opening the Fire District shall require inspections of this event. An inspection request form can be obtained at ggfire.com, fire prevention drop down tab. The inspection needs to be made at least 12 hours before the event in order to correct any problems that may be found. All vendors. rides and displays must be in place open fol- inspection. I Packet Page -2645- 12/11/2012 Item 16.A.32. Please let this letter serve as conformation that you have contacted the Fire District. A copy of this letter should be attached when applying for your permits from the County. Please let this letter serve as conformation that the Golden Gate Fire District has been notified of your intent to have this special event. If you have any questions, please feel free contact me at (239) 348-7540, Sincerely, William T. Silvester Fire Marshal Packet Page -2646- 12/11/2012 Item 16.A.32. DocuSign Envelope 10: 9E5FOOSC-ED2F-4FE2-9183-WEE10A9EO9 'r> WM.fC.h-fN-*_ WADI Agreement t S0002914006 4A.V F­h."t %�- Customer Aw V Xwk+ FL Service Agreement ACCL Name St Agne% Church AW WMAM" %4^10"Mamam Non-Hazardous waste slc X"Il Salesperson Robert Burns Bil lino Infomiation ProductilElIttiproLM Name St Agnes ChuMh c(mlart A"Anstencill Effective Date V I M 13 A.ddrcx, 7T75 VANDERBILT Telephone ;1 (2391592-1949 Last AM Date BEACH RD ('try Stale Zip NAPLYS, FL 34120 Fax 0 County.Tarish COLLIER Email m11an6i, tagunnap1mort 0\1 DEMAND (see details for amounts & charges) Rep ProductilElIttiproLM "WoftType — I frequency 1-1 30Y-dOpenTOP MsWco mcrctal I On Call TOTAL INITIAL FEES s 0.00 A fuel surcharge and environmental cost recovery charge calculated as a percentage of the Charge(s). will be included on your invoice. Information about the Fuel! Environmental Charge can be found on our luclasite at State and Local taxc.% it applicabic. will aLw be added to the Charges. A monthly administrative fee of$ 4.00 per invoice will be au;samd, this fee can be mialoved by crurailing in paperless statements and automated payments. 11'applicable to your account. a Recycle Material Offset (KMO) will appear on your invoice and may vary from month to month based on the recyclable material commodtiv, market conditions. Vv`a, sic Matcoals not to exceed an average weight of( lbsivard 1. 'nit: individual signing this agreement on behalf of customer acknowledges that heshe has read and accepts the terms and condition.,; of this a-urccol-ent which accompany this service summary sheet and that hcJshc has the authority to sign on behalfof the customer. Allan Stencil 11/2/2012 7A?%fftVftqM;;,%ure Printed Name Date Company Signature Printed Name Packet Page -2647- Date P a S-), e 1 of; 12/11/2012 Item 16.A.32. DocuSign Envelope ID: 9E5FOOBC-ED2F-4FE2-9183-WEEI0A9EO9 WIM, Service Agreement WMA- cmcnt: SM291441116 *w^ww*ft*AJw^Jft**W~ Non-Hazardous Waste Service Location: 7775 VANDERBILT BEACH RD, NAPLES, FL. 34120 Name St Agnes Church Contact Name Altan Stencil Email allantistagncsmsples.org t "Unry"Pan'sh COLLIER Telephotm s (239) 592-1949 Mobile 9 CuslotorrCommcnis Del (I I 30yd NISW Fax Total Initial Fen For This Location $0.00 'Total Recurring Charges for This Location $0.00 ROLL OFF SERVICES I I Quantity I Eqaiwnmt I waste, TvM IFmauenev lReaucated Pie Wday Altnibuics Ran] Pwl:: t?is sal Rate 11-1 1 1 130 Yard (mcnTor 1XISWCowuncrcial I On Call I MISC WM Owns 1. Dcliverv: 1. S 193,60 1 S 52-51 To., I PaL,e 2 of , Packet Page -2648- 12/11/2012 Item 16.A.32. DocuSign Envelope ID: 9E5FOOBC- ED2F -4FE2- 9183- B48EE10A9EO9 THE FOLLOWING •TERINIS AND, CONDMONS APPLYTO SOLID 'WAM AND NON - REBATE RECYCLING SERVICES.(INCLLIDLNG PERMANENT. TEMPORARY. _ COMMERCIAL AND RESIDENTIAL) AS MAV RE PROVIDED BY AFFILIATES AND SUBSIDIARIES OF WASTE MANAGE.4(ENT, INC. ('CO%1PAN %—) THIS IS A LEGALLY BINDING AGREE.NfEN"L 1. SERVICES RFNDFRF.D; WASTE MATERIALS. Custonxrgrant$ to Company the eulu"i c right, and Company shall famish equipment and services, to collect and dispose of and,or recycle alt of Customer.. ' W as'le Matmals. Customer represents and warrants that the materials m be collected under dus Agrcemag shall.be.00ly "Waster Mnw-rialr' as defined harm. For purposes of this Agreement. "Waal~ Maf rildl' means all noa-hazatdous said waste and. Recyclabic Materials (as defined to Section 11 below) gertarated by Customer oral Custnmet's Service Address. Waste Materials includes Special Waster, such as industrial proem waders, asbrstos,contaming material, Pdrolcum Conamiated soils, trcatecLdc- cltararxerized wastes, and demolition debris, but Customer shall complete a Wage Profile for such Special Waste which has been approved by Company in writing, lair Materials spKlflcsHv exchildim and Customer agrees not m deposit or permit the deposit for tolimftost of atry -date tire-- ndoacnve, volatile, trrrrusivs, flammable.. explosiyc, biomedical, infeennac hioharardous, regulated medical or hszudtws waste. toxic substance or material, as defined by, characterized or ltstced under applicable federal, state, or local laws or regulations, or Special Waste not approved in writing by Company. (collectively. '"eluded Materials`). Title to and liability for Excluded Material shalt remain with Cu tuna at all times. Title to Waste Materials Provided by Customer to Company is transferred to Company upon Company's receipt or colle¢ non unless otherwise provided in this Agreement or applicable tau. :. TERN. The term ("Temf "l of this Agreement is set firth an the scryice summary sheet of this Agreement The -initial Tenn" shall lx the initial period afla rite Effec+iye Iiarc set shish rm the scrvice summary sheet of this Agreement f"tnitisl Term *). LrnIca Whcrwisc spechficd on the servicc amnmary duet the Term shall automatically renew for the period set forth on the .crviec summary shect of thin Agreement ( 'Rencual Term') unless tither party gives io the other party written notice (See Section Illicit of tern+inmh in at )east ninety (go) days. but no mom than one hundred eighty 1180) days, prior to the famanauon of the thcrrextsung term.. t. SERVICES GUARANTY; CUSTOMER TERMINATION. If the Company fails to perfmn the smicct dcwnbcd within fivv business days of its nreipi of a wrinen demand from Cusromer tree Section )Ole)), Customer may temminatc this Agreement writs the payment of alt monies due through the unnimmon dater. If Company increases the Charges payable by Cc snr r hcrcunda- for reasons other than" set forth m -Sect ion 4 Iselow,. Customer shall have lbe right to imninate thin Agreerrent by w•nuen notice to the Company no later than thirty (301 days after Company witiffes Customer of such increase in ChatEcs in writing, If Customers so notifies Company of its urnrmalion of this Agreement, such termination shall be of m force and effect if Cmnparhy withdraws o removes such increase within fifteen f t.5) days allim Cuslov= pruvidcs timciv notification of termination. Absent such lanninauaon, the mcmiu ed Charges shall be binding and enforceable against Customer under this Agimmumf for drc remaining Term 4. CIIARC, ES; PAYMENTS: ADJUSTMENTS. Ups r im, pt of an invoke. Customer shill pay for the services is"or egmpmem (including repair and mainux a we) furnished by Company in accordance with the Charge on tine first page, as it tray be adeuAcd rivet the term of this Agreement as noted herein (lire `Charges "). Company reserves the right to meacasc the Charges payable by Customer during the Term: (a) for any ch rages or modifications to, m ditfercnt:ts betwom the actual equipment and services provided by Company to Customer and the agreed upon Equipments Service specifications on the frrm.page, (b) any change in the composition of the Waste Matemafs or if the avemga weight per yard of Customers W suer Materials ctcaatis din atneinM spccificd on the first page; (c) fors ny increase in or other modification to its fuel or environmental cost recovery tharom (d) to cover any increases in disposal ando third partyuttspartation costs; (e) to cover triaeased costs due to unarntrollahle circmnstr KIM including, witbout liinirotian, thangts intocal, sale Of It'AMl laws w' regulations. imposition of taxes, fees or sumbarges or acts of Cwd etch as floods: fuex. burrirames and natural disasters:: and ( ft no more often than armually from the Eflic five Dale for if speci fiat on the first page ;.Cusaumer's Lase API DaJel for nwrti-us in the Consumer Prue hider= plus four percent of the then cutnnu Charges .'Any increase in Charges entuneruted in clsusca f ai tbmurit Jet above may include an amount for Company's operating or gross profmtmatgin. Company also resents the right to change Customer additional fees if the following additional services are provided to Cus'lomar. Administrative Fee. Eack sure Cbarge- Saviccsr on. Iligh: Demand Days. PuI W'ush Out Scrvicm Conarner Relocation Fee, or Seasonal Restart Fee. In the event Company adjusts the Charges as provided in this Seexian A; Custonscr and Company agree that this Agreement as so adjusted will continue in full force and effect for the remaining Term. Any Cusumna invoice balance am paid wiihun thirty (M) days of the date of invoice is subjrxi to ,a late fee, and any Customer check returned tut insufficiesifthulds; is subject to a -NSF far, both to the maximum extent allowed . by applicable law. In the cvsnt that parmeat is sotmade when due Company Mari the right to sngratd aerviee until the pest due balance is paid in fide in the event that service is suspended in eac+en of fifl«n 115) days, Company mayletamnaic this Agmminew for such defauh and mcov many cqupinent. 5. CHANGES. Changes in the frequency of. collection servtcc, eelmdule, number, capacity and or type of equipment. may be agreed to orally, in writing,. by payment of the invoice or by We actions and practices ordsepar irs. if Customer changes its Service Address during the Term. this Agreement stall remain valid and enforceable with respect to services rendered at Cu>toinces new service location ifsuch location is within Corrpmy's smite arm. n. EOUI PMENT- ACCESS. All equiptnent furnished by Company shall remain the proptny of Company; however, Customer shall have care, custody and control of the equipment and shall ia-ar responsibility and liability for all loss or damage m the equipment and her eta con1cros while d CustomtK s location. Cusmmer sloth not ovcrload, move or alto the equipment and shall user the equipment Only for its intended purpose. At the termination of this Agreement: Customer %hull return the equipment. to Company in the condition in which it was provided, normal uVarand tsar cxcepual Customer shall provide umrhaur lac d access w the equipment on the scheduled collection day- Cus4rrner shall pay, if.churged by Company. an addiurmat (err for any seryier modifications caused by Or resulrmg fiham cusuanes failure to provide access. Customa warmnts that Cuslamet's propct+y is su.frictent to hear the weight of Compmy's equ.ipimot and vehicles and that Company shall not be tesponsibte fur any damage to the Cus omer's property resulting From the Provision of sci vices. 7. LIQUIDATED DAMAGES. In the mean Customer xnmaustes this Agreement lr oor to the expiration of the Tcsm for any reason otherrhan d slat forth in Section 3, or, in the even Caivpany terminates this Agreement for Cmionaces dcinult, Customer shall pay the following liquidated damages in addition to die Company`s legal tees: in) if the remaining Initial Tam under this Agreement is six or more months, Cusuomershall pay its most recent manfldy Charges multiplied by six: Owl if the remaining Initial Tam under ibis Agreement is Icss Ilan six months. Cusirrimt shall pay its most recerhi monthly Charges rtutltiplitd by the m abcr of anobths remaining to the Term; jet if the remaining.Remewal Term under this Agreement is three or more months. Customer sball pay its moo recent monthly Chuges multiplied by three, or (tit if the rcm Luting Renewal Tent under this Agreement is less than dace months. Cusmmer shall pay its most recent monddy Charges multiplied by the number of months remaining in the Renewal Tema. Customer acknowlatge: that fire actual damage to Company in the event of termination is di fiicuIt to fix in pmvc, and tic foregoing Inquidaacd damages un oant is rcdsonabit and cammcrttinntc with the anticipated lens to Company resulting from such terminatfmr and is an Agreed upon fee and is ma imposed as a penalty. Customer shall pay liquidated damages of$I00.for every Customer waste tin filar is found at the disposal factlity. s. INGEMATry. Tic Company agrees to inflemnify, &fend and save C'ustoter harmks: from and against any and all liability which Customer may be rcspgnsiblc tilt err pay out a& a result of bodily injuries tinclufing death), prupeny damage, or aqv vfolai(in err allege] violation of law, to the extent caused b1' any negligent act negligent omission or —fit.) misconduct . of the Company or its emnployees, which occurs (a) during the collection or ttarisporfanon of Customer's Waue Materials. or (Ti) as -a result of tide disposal of Cussomers Waste Materials in a facilty owned by the Company lug subsadaary of Wasu, 4tanaueraem. Inc., provided that the Company s ihh&tnndicatieM obligstions will not apply to rxcumenees involving Excluded Mwcnals_ Cumorria agrees ms indermmfv, defend and save the Company harmless from and agaimst my and all liability which the Company may be responsible for or pay out as a. result of bodily tniurics (including death), property damage, its any yiolatics o or alleged violation of lain to the extent caused by Customes breach of Chit Agreemam or by any rxgliecm act negligent omission w willful misconduct . of disc Customer or ru cmplo_veca, agents or conu chin. in the pcnnniwcee of this Agroemcnr or Customer's user, opmlj— or possession of any equipment furmished by the Company. vicirher party stall be liable to the oiler fo consequentiaL incidenul o Pura!, e damages arising oul of the perfurmasuc of this Agrccmrnt 9_ R.IGIff OF FIRST REFUSAL. Custtuna grants to Company a right of first refusal to match any off" relating to s —cm similar to thaw provided hereunder which Cusrunr ore— for intends to mnakci upon termination of nhhs Agrcenem for any r°asrmn and C uaomncr half give Company prompt written notice of am, such offer and i rcasrrable opportunity tL respond to it. 10, MISCELLANEOUS. tat Except for the obligation to make payments heminider, nmthcr pang shall be in dcfault for its frtilum to perform err delay in performance caused by events or sigmfcant threats of evavi beyond its masonabie comnil, whether or not (0—Clablc, including. but not limited ter, strikes. Cstxr trouble, riots, imposition of laws or governmental orders. Fires, acts of war or tcrressism, acts of God and the mablity its olraus equrtmmiti. and.the- alfcded party shall le excused from perfilmumm during the occurrence of suds events, (bl Th" Agreement shag be binding on and shall inure to the barest otTle, parties hercw and their respecove successors and assigns. (C I This Agreement rethresents the entire ammernrrat betty ecu the panics and supersedes . any and all ader agreements, wheffsa wro wn o oral, that may exist betaken the pang id) This Agreemem shall be com arued in at'cordance with the law of the ware in winch the sinkers are pmvidcd. it) All wrivan notification to Company required by this Agrecment shall be by Ccnifsed Mail, Return Receipt Requested. (ft Any blanks in unfilled or unmarked boxes or spaces on this first page slallbe demand to oc anappwvblc anti no alf crt. the validity of this A;7cancnL tgl If any provision of this Agreement is itcdarcd invalid m urrs:nf treeable. dhet such provision shall be severed from and shah rut a.Brcr the rememdm of this AgMeMrnC how'avr, the pasties "I amend this Agreement to give efTcct ht the nmaxinium extent sllowrd, to the intent and meaning of the several provisi< +n ill) In the event the Company successfully crrlom" its rights against Customer hereunder, the Cu.+raner shalt be required to pay the Compamy's atmrncy ' fcca and court cost . I L SPECIFICATIONS FOR RECYCLABLE SLATERIALS -. Single scram, commingled r Clabfes win consist ol` recvclsbte glass Aluminum. cans„ Plastics and papas. are as follow% . aluminum loud and beverage conminirs: glass food and bcwtin , containers, ;embus t iron) cans; plastrca with symbols -1 through v ?; am, paper a catdkhoaud wafiuwt was Isms, .Any materials not set forth above arc uihxccprshle (" Unacceptable Materials°? Ail glass c,liatu tin. tin cart+. bi -metal cans. aluminum cans, aerosol cans, and plastic containers must be empny: All fiber must be dry and free rif food debris and other contaminating mat, sal. and Tissues.. paper towels or ofiici paper that has been in contact with food is not acceptable, All sarparated paper shad meet the standard; set forth m the most orient ISRI s+.-m. p 4p,- cificatirms Cirular, av ulais)c upon mqucst Recyclablcs may canam up ur 5% Unacceptable Maerals, pnviJcd Ihownr. Recyrlabks may nut lal certain Fxcihhdcd M:urrials. tby canWin ciremil o otter propmies xitich arc- deietcriaus tx capable of causing . material damage to any paid of Company's pro)rcnv, its posormel or the public: and tc) %halve not marerally impair the strcn-gill ram the durahilm of the CompanVu smncliam err equmpment,. Company rr,Ctves the ngto xi its sole diureiian upon notice to Customer to drscunrimrc acrep4uacc of any category rat' Recv'efable M utcrudi set. forth above "a result of tnaticr rnnihtiovs related lo s--ii RY?chible'staterrats arad bakes ito represenmurms as ur the rnzcb40,1: of the rrianmai. see forth a'aove. f.nade t rn rtnlF the St— ifhcahnuo., for Recychab)c Matercai, may M< r tett:d in -thole err in pan by C.mp.nN PaPc 3 of 5 Packet Page -2649- 12)11/2012 Item 16.A.32. DocuSign Envelope Mi 9E5FOOBC-ED2F-4FE2-9183-B48EElOA9EO9 IN ADDITION TO THE A IIEUVE. THE FULLOWING TERMS AND CONDITIONS APPLY TO 1. Aerosol. Sanest, flattery, Dental Slincrial. Electronics. Fluorescent Lamps—Slindical Waste, and Merton RecycilaWDispelild Semites. and M*U-Back Ink Cantridge, Toner, Battle. C.E., and Paper Recycling Services SPECIALTY SERVICES. Capitalized terms used hercut, shitl have the imuctrig aacribed above, unit" otherwise, undEcato& 'Specialty Scryiets", as used lixtem, include lite following Company producivia-mm: aerosol, ballaso, battery, dental Emitcrud, ciccituram f1tuarwCat lamps, medical wasic, and mercury recycling and-or disposal Stnicc.. and mail back recycling Services and the consumer applicable to each of The Specialty Scm�jcct ( the !Ccumaima"). Subject to i1nse Terms, and the larritaimins, Iscrem. Company will (EE) treat. process. mcycicarad.'ar dispinc or the CusaminceN AcceptabIc Waaic in accoidance, with federal, state and local laws and regulations; and fbi Intelsat and procns legally required paperwork The Corltaursar may only be used for those materials as tradictifiall an the Container (lite 'Acticiftble Waste "). Far any questions Erg � arit or corrapki-ing with these icirraii. or a detailed her or Acceptable Wasac eligible far shipping in each Comaimm please visit www-wni-corn or call Z. RETURNS. If C.usitorncr does not acticluttlEctic Terms. Cusiorna may not use thcCorstauncir or dicScryiec6, I lowcvcr,Cu�torraer my Ecturn a Conriuncrwalim I= (I I) I days the 'Return Period ") tharin the day C.u-qtmff received the Container by doing am of the fullowingdaring the Return Pcnoiijai return the 6ortiouncir to the place of purchase, cir (b) contact Compaim• at the phone number noted above and contrilctt all mum instructions 3. LIMIT ON' AVAILABILITY. Specish) Services are only iivalllrbft as Ant; and certain of the Spochkity Services are not svidlable for one in certain States as follows ("Prohibited sultes"i: This Up iblited For use in Patrin Rice, and in the States of Alaska and Hawaii, and such Service Is further tarcilliblieder restricted far use in the RecychugUspostal followiagsddlflonirl States (collectively, "Prohibited Sixtet"I: -stirs-Ice: ist. oil Islam Cornatners Hampshire. Nc.York.PeaauvI— Rhode . Vermont and Virginia It is. "Icurionor law- to ship the Container lo. from o,through any of thc ProbibitcdSturs. Carriparty mrsents the right to modify the listol'ProbilloW States al any time. 4. TITLE 10, AND RISK OF LOSS FOP. CONTAINFRAND CONTENTS. Linless and until Company receives and accepts the Contlinct-(a) little to and risk of loss of the Container and its Contents gull remain with Cum. mer and (b) Customer is solely responsible for the contents at The Ccxrntaimcr. 5. EXPIRATION 0FCONTALNER,IJItf.SEDCONTALSERS Each Ctintaincriousi bereceived by Company hy the expiration date punted an the Continuer t-Expiration Dale") if an Expiration Date is inificatcAL Company has ten obligation aftcribliExpiration Date evcti where the ca tricridenfificit an a Prepaid Label fails, or refuses to d4 the Container. Company xlWl not be obligated to provide Cusalarracr a refund forcimuned, unused Conanuters, 6. PACFL.%ClN'G. Customer 9W] pack and acid the Continuer in accolislaote with rise tustrutums, included with the Constauser and Eurs, Additional smanuctitnui that Company may send to the Customer or pits; on the Company Web Site prior to -shipmad of the Comorstar by Cusuntiff (the " instructions" Customer shall pack in the Comuner only Acceptable W.I.. and shall citclude any and all Nort-Con liamming Waste, as defined below. 7. SHIPPING. Cwswmr shall comply with all humuciacm related to shrppin -- Custurtmer wil I have mcci ved a prepaid trium, slapping lak I (the "Prepaid Label"ji wish the Container. The Container may not be shipped tram any, Prohibited Stare.. Both the Imaturmants and Prepaid Lbehitt, may be obtained at wyw.%-mxwn tie by calling 1-900-664-14-14, Company shall not have any responsibility or liability with respect to any mater retailed to colter a carrier collecting or shipping the CmistarEM 8. ADDITIONAL Slit IPPING CHARGES. tat Customer shall Ectintim responsible for all Claorges of shipping the Contaoticir to Company. including. without limitation. increases imposed by the shipper %her Customer has purthalsed a Prepaid Label. If the shipper udcmrifi*d on the Prepaid Label will not ship she Camurer, Company mile obligation will he w refund to Cumorracr the actual shipping charge received by Comptia, This obhp V. tion mounditurruid upon receipt of wraten request for such refund prior to six (h) months from the date Cuitorracr purchased or mccwtJ the Contatincr. (b) Customer rentaurna mrstruiibit fm all Chinges relating it) exceeding the weight limits applicable it) the Container. If Customer selects a monthly Charge, additional Charges will be applied should weights or frequency of shipments tatted the repansted monthly scrynt it) Cusiorricr agrees I. all.. Company I. charge, Critswiner's credit card for, additional shipping Chwjcs as Exudicamd above. whether or not Customer selects monthly Smices or a one -time purchase of a Container. 9 ACCEPTABLE WA-STFiNON-CONFORMING WASTUADD11 IONAL CHARGES. Cti.foroors must check wwww-mcorn for update- U) this list p6of to initiating it shipancrint of. Contanner in order u, crimm, that only Acceptable Waste is shipped in the Cantam", Mratcrix6 other than the Acceptable Waste Indicated " eligible for shipping in each Contatner, and maminal Itsnig constituents, chmactcristi , componcints W properties not included within. the hints) eirAcceplurble Waste for each Ccuttanner.luill be "Nun-Carifortning Waste ,' I.) Special Terms Applicable to Medical Waste Services: OnlyRegulared Medical Waste (as defused firrefir) quallfies as Acceptable Waste for the purp"Its orsdedWasir Tracker .l.crOtts ' Regulated Medical Wa!U'tn.ituL-s bin ii tact limiWiosbari s.gaumbuAvm.c4)ntuiswm.tahirrg„biuW,bkxAlxodwts.tmccchemadhempy%,"c.tinw,5,p"imcns generaW in the cuunic of disanims and medical treatment ca medical waste as defirund by Cusaimices State medical waste mutilations or the OSHA Blocuibintic pathogen Standard ( 24 CFR 19 10. 1 030). Customer shall, prior to shipping- provide to Company accurate and compictie documents, shipping papers or smunificsts as required for the lawful transfer of the Ree.l.t.dMetfical Wasre under all applicable federal. state or ILVAI laws. W"m' for the purposes EEfMcdWxsEc Tracker Serv7ecs mcants (I t am waste or ottic, material WE falling withint the definition of Regulated Medical Wiiau including complete human nerranum and abortion pnxlucu; (2) radioactive waste; 0 1 any chcrinical %—tc and any Uzardau, watm-, 44) cturitairrim that arc Elsortaged. leaking oreculd cause harm m exposure I- employees, the grisenui public or others; (3) waste that Just been incorrectly idcnIjficJ- I.Mcd anal. on' ,cgn:gbux[; (6) any waste or dcvicc ctitaummi; mercury including stuadfAm, vacostat pumps and other medical dcyiccs; and 17) phimivaccuumail waste (except what it accepted under a Company pharmccutical disposal programIr (b) 5jaccialternis Applicable to Aerosol Conitifirwr Semites:. Only certain aerosol cam quality as Acceptable Waste, sad Aerosol Container Semites are only 11121111fle for use by a hainwhold or a Conditionally Eirentit Small Quantity Generator as certified to Company's reasonable -16f.acti— ("CESQG-), 'Non-cortfortionis Nk tc- ton the purl— ofAcir—ol-Irackor Sc—cci uscJudet, but is not Inuited to, thc,&e examples 01"AcrosolTraiker Se- iecs Non-C,aifornurg Waste. contained — Exhibit A Mo.,, (c) Special Terms Applicable to Dental Material Semices: Deartill Matcrial Stn ift are only ryidisible for use b, CESQG. all Acceptable Waste must be disinfeciect, and so more than net I lb of elemental mercury may be placed in the Container. fill Special Terms Applicable to Merton Se"ices: Untm specifically aipprmcd by votrapany,No more than act 11h ofknicinal .aiwry may be placed utithe Cornainner. (,) Terms,10—ges Applicable to Waste: If Company dencrinaries that any Container contains Nvon•Cctnformjng Wamr, Company Entity, at its sole discreLica, and at Cusiatinces sale trio. and cxpcn�.-: (it rtmet Hit C oritumer and return A to Customer, (it) return [tie Non-Confomme Waite to Cuminnier: at I oil arat, pros:csii and to dispusc of lite conitcrium of the Comirinm Customer shull he liable for any and all .", —usnod with Noo-Ccofbjnuaig Waste. Company 4 or any cdxitncesr ofcorripanty) shall WE take title IoNon-Conforinting Waste. and title W Non-Conturriving Waitc shall Alwav, Ionian wide Customer.. 10. CHA FiCES FOR FAILURE TO COMPLYWTTII TERMS .AND INSTRUCTIONS: CHANGED CONDIT IONS.AND ADDITIONAL SERVICES. Company rc.,,crycs the right 10 charge or bill Custorruer additional Entiounits for any of the tollo.'rig: (., my Comancr .—ding iI. specified inumucturn weight: (b) shipping unamr.1s; I. the isrong Crun.uicr. or mixing mater -61c in a Container; let addiijunial shipping Charges beyond me- amounts prepaid for any Prepaid Label: (d) any cous or ciperse* incurred by Company a, a vcuh of (-Eisionner'i fail= to comply with lbcsc 1 —us or the Instructions, other than the inaid and "minnuary costs ofC Wmaoy to the performance of the Tracker SCEVIC" Or 10 any gOsU ,elated tc, chmen to applirabli, law occurring alter live date of purchase of the Corumoti, 11. ;VAR RANT;'. Company warrants, cxccpt where Tracker Scmiccs am used in Proiltdoird states. as follows (:I) the Container has posed. and toccii or mceds the applicable of federal, sole and local and (b) it the Container is packed- scaled 3nd shipped sinctly in accordausce with the Instructions, it is adqdate m natispoil AcccTicalbic Waste to the linicLising facility train ividInKized points under cirdiriart traruncnial shipping conditions, Other than as expressly warranted hemm, the Soactilt.y Sn'lees are provided '.s is." and Company disclaims any and all warranties, express or implicit inclualmr—but not limited to, implied warrant s of merchantability and fitrocss for a partaLidar purrxnc Customer %sirmats that it will not ship any Non - Conforming Mk arm in The Contain" and that Customer will otherwise comply with these Terms and sit Instructions. EXIIIIII I A - Examples of Aerosol Servim lion- Conforming Waster I I I Aero=sols ;lint inc rout in g—1 condition to datrinjitcd, ctntodcJ, punctured. icaking. or crushed): (2) Acyo,,ols with IsIbels that am trusmyr. c-cm4l, fflcgihk-•, or old s umd, I-',) Aerosols with acarsate'ty of gimaxer than I liter 11004) roll (4) Prodwt, [bit arm not true I I-. Wit-refillable cylinders ttmttnning a gas under paes,Eac, used .surely in expel a liquid. Paste, v powder finarri the "hader through a self-clvsinp mlr dc%n:t)-Exarnpis 6ituohibiled non - w*ols Include: ? Pump sprjy3; ? Olivem canister: '.1 Signed hons: N­pre, unrtd sptriyl;? LiquefQ ficimicam gas t"LPG'E cybrallm: 9 Gas lot p.-cony toy pcitet inins; ' Oil," "hinders tuntautung gusts only, (5 ) Aerosols that we qx-oally regulated a not stiffimzttl for receipt, jtkluihng ? CF-containtirrig protilacts (c.- nist; products Insulation foam), ? g_ cermin inhalers and reth2cra I Expanding foam produ PL-Ulont--e pr +htctl (e-g- certain paints- pelllides- or alth"ile- that are greater than 21 war-4 old);' pepper spaays. I Pemicnim1hcriatcuics dot arc not intended fot household use Page 4 of 5 Packet Page -2650- 12/11/2012 Item 16.A.32. DocuSign Envelope ID: 9E5FOOBC- ED2F -4FE2- 9183- B48EE1OA9EO9 or chat have labels which do trW authorire recyclum of used aerosol cans; ?Silicone gas►et -maker pnxitttts; ?tear gas :artrrdgts vu da°tea; ?Zinc based perms primers:cesitings t e.g.. rmc -rich cold galvanizing spraysY:. (6) Industrial or other aerosols that do tot lase pWential. iwassimurr uses; (7) Acruaoli that do to(. have taps., gaps, or lids that are capable of preventing accidental dischargz dewing trangmrt and related handling (t.g., aeroso6 designed with a removable tap if the cap is missing), (g) Acreftols that are discatded by facilities in any of the following industries: (a) peuulcum refining. (b) chemical manufactunng, (c f coke by-product recovery, or (d) trcatmeot, sttnage, of disposal farihties handling benzene wastes from any of these three mtluslnes. Customers should check the Web Site (ra updates to this list poor to initiatine a shiptnent of a Container in order to ensure that tar Non- Conforming Wa:n-t arz 'hipped'" the Container. Page 4, of Packet Page -2651- Nmmr /,tilldm4w St. Agnes Attn: Charlotte 1 12/11/2012 Item 16.A.32. Date Estimate # 111112012 038 P.O. No. I Project Item libmeAription Rate Qty Total Bent: Carnival - January 2013 Dclivery ! flick up 0.00 R 0.00 party Toilet regular price $85icach 45.00 6 270.00 Handicapped Toilet regular price S I Weich 55.00 1 55.00 Free-Standing Sink regular price $851each 5 x.00 Extra Service Saturday AM clearuna sere e: 20. ()0 8 160.00 Extra Servicc Sunday AM cleaning smice 10.00 8 160.(70 We "k iorward to working nith won! 4329 Enterprise Ave. Naples. Fl. .74104 Phone # Fas # 239/261-574;8 239/Cvl3.3 all 1 E-mail Signature: - Pit"mil Name: Title: Packet Page -2652- Subtotal 5700.00 Sale& Tax 46.0%) $0.00 Total 5700.00 12/11/2012 Item 16.A.32. OW 4472 Corporate Square Status. k. cute °Naples, FL34104 Quote#: g3630 www.taylormntalrwpi".com �' 238- 643 -1334 stone Event Beg: Thu 111712013 7:OOAM IN 239- 643 -7391 fax Event End- Mon 1127/2013 5:30P AOW Operator: Porschen, Maryann Customertr 19953 St Agnes Catholic Church 239 592 -1949 FAX 239 325 -1150 7775 Vanderbilt Beach Rd Contract Info: JANUARY 18-20 EVENT NAPLES, FL 34120 Oiy Key items Rented Each Status Event End Date Price 1 4525-1 Tent 4000 while eV $1,040,00 Quote 121/29113 5,30PM $1,040:00 3 4525 -1 tent 4040, white 5520;00 Ouoted 11212013 5 :30PM 311580:00 above= 40 X 100 7 TYd MOLS Tent Wall 8'g 20' Solid $45.00 Ouoted 112112093 5:30PM $315,00 3 4596-1 tight ring blight 560,00 Quoted 1R112O13 5:30PM $240.00 5 4602.1 Tent Fire Extinguish 525.00 Otxitsd 1121129113 5:30PM S125A0 8 4603.1 Tent no smoking sign 53.00 Q idled 112112013 5:30PM 824.00 1 4365 Tank dunkdeluxe 5200:00 ouo�d 12112013 5;30PM 5200:00 Oty Key hems Sold Par* Status Each Price 9 t34120P -1 P- DEUPlt, 34120 Delivery 58500; $9500 Standard daimery charges are tot detwenes made to the door at ground level and to easy access areas. For all other deliveries, rates will vary depending an the labor, time and !! 1 distance involved.. 4 [t Quoted To: CHARLOTTE LOCKE DEUVER AN© PICKUP Delivery Date: Thu 1 /:17/:13 7 :00 AM Contact: Pickup! Date: Mon 1/21/13 5:30 PM Phone: - Address: 7775 Vanderbilt Beach Rd: NAPLES, FL 34120 SET UP BEGINNING EARLY Quote valid for 30 days. Ely 'si int" below, .1 car* Out i have react and 29M to sit Of this ax "M SIGNATURE: St Agnes Catholic Church Printed on 501911201212:04:11 om OPEN MON -F€ 17:001.0 5 :30, SAT 7:00 TO 3 :00, SUNDAY CLOSED MtdxScabon # $ora."r r%amsd -Bonet yt'a vvvvW;'D Rr_oP- RENTAL Coo Co r'r..sma.ro is r Rental: ` 53,504.00 Damage Waiter. $490:56 Sutras: $0.00 j Delivery Charge: $95.00 >IS+sc Charges: $0.00 ! Subtotal: 54;089,56 EmdDisp �.. 5122.84 Sates Tax: $0.00 I TOTAL: $4.212.20 t RAID: AMt3ilhlT' i7111E: $ Packet Page - 2653 - _- ' 4.272.20 SIGNATURE: St Agnes Catholic Church Printed on 501911201212:04:11 om OPEN MON -F€ 17:001.0 5 :30, SAT 7:00 TO 3 :00, SUNDAY CLOSED MtdxScabon # $ora."r r%amsd -Bonet yt'a vvvvW;'D Rr_oP- RENTAL Coo Co r'r..sma.ro is r Rental: ` 53,504.00 Damage Waiter. $490:56 Sutras: $0.00 j Delivery Charge: $95.00 >IS+sc Charges: $0.00 ! Subtotal: 54;089,56 EmdDisp �.. 5122.84 Sates Tax: $0.00 I TOTAL: $4.212.20 t RAID: AMt3ilhlT' i7111E: $ Packet Page - 2653 - _- / 11/89/2012 12:42 2,395860683 SPEEDY COURIER 1�/11��/�1�� U���� i/� J1 �� 11�8S/�n�c ee/W� 28�9azmse� ap��A�TY INS '-- ' ''-- '— -- '-- ----' ~--_ _ CORDL P.0, box 15901 C2MIFANISILAFFO�!RING-COVNRAGE west Haven. r-T 06516 cow-&w RIVERPORT )N%UR;kNCE COMPANY Cap* 0=4 FL 3300 9 012 A VA AL UVIA.Fly oh F js AWALIM 9V0>4*AjVUF AUTOS ARY AUTO NOW Date of Event JoinuaN 18,20, 2013 ^ Thomas A, Piouffe Packet Page -2654- 11/3/2012 0:42 Remote ID Remote ID 12/11/2012 Item 16.A.32. CERTIFICATE OF LIABILITY IN DATE (11IINIDD) YYYYI 11/08/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICI - BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZI REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsernert s . PRODUCER 1- 305 - 592 -6080 Arthur J. Gallagher Risk Management Services, Inc. CONTACT P QNE :FAX A/C No: 8200 N.W. 41st Street Suite 200 E-MAIL ADDRESS: A OENERALLIABILITY Miami, FL 33166 INSURER(S), AFFORDING COVERAGE NAIOV pSIRER A; UNDERWRITERS AT LLOYDS LONDON 15792 04/01/13 INSURED WSURERB: LX INS CORP 33600 DIOCESE OF VENICE EE j ST. ACRES CATHOLIC CHURCH INSURER C: INSURER O: R PREMISES (Ea oc4m79nc9f 7775 VANDBRSSLT BEACH ROAD NAPLES, FL 34120 INSURER E: _ PERSONAL &_ADV W. U_R_Y — INSURER F: —' COVERAGES CERTIFICATE NUMBER-, 30224291 REVISION tV11MBFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 NKY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMFTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TYPE OF INSURANCE POLICY NUMBER PO DDfYYYYY MM/OD/YYYP Lvwrs A OENERALLIABILITY PK1006811 04J01j1 04/01/13 EACH OCCURRENCE $ 1,000,000 _COMMERCIAL GEWRALLLABIUTY r CLAIMS -MADE LK I OCCUR EE j R R PREMISES (Ea oc4m79nc9f InClndOd MED EXF (Anyone pemn' �$ _ $Nil _ PERSONAL &_ADV W. U_R_Y — $ 1> 04t7V 000 -- —' —'-- ---- -- -- --_ —' --- _ c GENERAL AGGRE_GATE_v $ OEN'L AGGREGATE L:MiT APPLIES PER. PRODUCTS - COMP /OW AGC: $ t X POLICY PRO- I ! LO' JFC jj $ A AUTOMOBILE LUIBILrrY PKID06911 04 MBINED SiN LE LIMIT Fina mdant+ 1r040r000 x BODE Y INJURY (Perperson) ANY AUTO WNED SCHEDULED AUTOS AUTOS 8ODeYIN.I0RY(Paraccidant)I $ 8 PROPERTY UAMAGE Per accioartl I $ K NON -OWNED KRED AUTOS AUTOS I$ — UMBRELLA LWB OCCUR EACH OCCURRENCE — _ EXCESS LIAR CLAIMS-10AM AGGREGATE I $ D y £. PETFNT;O ..... -- $ 8 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIEI'ORlPAR7NER:$XECCIriVE -•'•'•'� OFF- CERmEW18F� F Ct CWOED7 N; a RFd'66514289881 -012 04/p1j3 D4/01/13 X WC SI'ATU- i OTH-) .... Ta`iFiX.L.lbtll,z_:_ —_.. _ t: I{_..—.... E.L Efi.CH AG «IOEtY(' ..__ .................... .......YIN $ 500,000 _ ...... _ ___._..... (ManaiaturyinNH} "' F.I.,01SFA:3F- F.AEMPL.OYF1 $ 500,000 N yos, cieacdtx. u,wer OESCRIPTIONOFOPERATIONSbelow F.L.MSFASF - POLICYLIrATT $ 50 C, 000 DESCRIPTION OF OPERATIONS /LOCATIONS / VENICL!S (Attach ACORD 101, Additional Rernarks Schedule, itmoro space is required) Limits shown for insurer A and B are inclusive of defense and insured retention. The Certificate Holder is named as additional insured for General Liability as respects Permit application for Carnival Operation at St. Agnes on January 18, 19 & 211, 2013 TE H SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Growth MGAT. DIV. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 2800 Horseshoe Dr. AUTHORFZEDREPRESENTATIVE Naples ,, FL 34104 ^jt. US.*a ------- - - - - -- 0 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 {2010105} The ACORD name And Inan arrr renistertld markS of ACORD nitinmia Packet Page -2655- 30224291 12/11/2012 Item 16.A.32. 0000099 05!25/11 • ' Consumer's Certificate of Exemption R. DR-14 1 DEPARTMENT Issued Pursuant to Chapter 212, Florida Statutes OF REVENUE .. Important Information for Exempt Organizations DEPARTMENT OF REVENUE DR -14 R. 04/11 1. You must provide all vendors and suppliers with an exemption certificate before making tax- exempt purchases. See Rule 12A- 1.038, Florida Administrative Code (F.A.C.). 2. Your Consumer's. Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible personal property, sleeping accommodations, or other real property is taxable. Your organization must register, and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this requirement except when they are the lessor of real property (Rule 12A- 1.070, F.A.C.). 5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third - degree felony. Any violation will require the revocation of this certificate. 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account Management at 800 -352 -3671. From the available options, select "Registration of Taxes," then "Registration Information," and finally "Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480, Tallahassee, FL 32314 -6480. Packet Page -2656-