Backup Documents 11/13/2018 Item #16A18 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 A 1 8
TO ACCOMPANY ALL ORIGINAL DOCUMENT, loll:, ri
THE BOARD OF COUNTY COMMISSIONERS OFFICE .__ V LEL-11 ��" D
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received [IJ q. irney Office no later
than Monday preceding the Board meeting. jj
**NEW** ROUTING SLIP
Complete routing lines 41 through#2 as appropriate for additional signatures,dates,and/or information needed. If the dcRigicimildhaiiii.,maplete with the
exception of the Chairman's signature,draw a line through routing fines#1 through#2,complete the checklist,and forward to the Cou tTi y A$omey Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Rsiz T)\1/4512, 4044/
2.
3. County Attorney Office County Attorney Office 0y) 'I, ,/, ,p
4. BCC Office Board of County I�
Commissioners � ,/
5. Minutes and Records Clerk of Court's Office
I/Zia I, 0:f°p*,
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event
one of the addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff , Gal Hambright/Coastal Zoning Phone Number 2966
Contact/ Department
Agenda Date Item was 11/13/18 Agenda Item Number 16A18
Approved by the BCC
Type of Document Agreement between Collier County and the City Number of Original 1
Attached of Naples for FY 18 City of Naples Beach Documents Attached
Maintenance Project in the amount of$185,000,
authorize the Chairman to execute Agreement
and make a finding that this item promotes
tourism.
PO number or account
number if document is to
be recorded
INSTRUCTIONS&CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not
(Initial) Applicable)
1. Does the document require the chairman's original signature? N/A
2. Does the document need to be sent to another agency for additional signatures? If yes,provide the N/A
Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by GH
the Chairriian,with the exception of most letters,must be reviewed and signed by the Office of the
County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and N/A
all other parties except the BCC Chairman and the Clerk to the Board _
5. The Chairman's signature line date has been entered as the date of BCC approval of the document or GH
the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and
initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip should GH
be provided to the County Attorney Office at the time the item is input into SIRE. Some documents
are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's
actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 11/13/18 and all changes made during the meeting
have been incorporated in the attached document. The County Attorney's Office has reviewed I • ,!
the changes,if applicable.
oir
9. Initials of attorney verifying that the attached document is the version approved by the BCC,all �
changes directed by the BCC have been made,and the document is ready for the Chairman's
signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised . .! • • • 11/30/12
1 6 A 1 8
MEMORANDUM
Date: November 20, 2018
To: Gail Hambright, Accountant
Coastal Zone Management
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: 2018-2019 Tourism Agreement w/the City of Naples
for FY18 City of Naples Beach Maintenance Projects
Attached for your records is one (1) copy of the original of the document referenced
above, (Item #16A18) approved by the Board of County Commissioners Tuesday,
November 13, 2018.
The original document has been kept by the Board's Minutes & Records
Department as part of the Board's Official Records.
If you have any questions, please call me at 252-8411.
Thank you.
Attachment
2018-2019 TOURISM AGREEMENT BETWEEN 1 6 A 18
COLLIER COUNTY AND THE CITY OF NAPLES
FOR FY 18 CITY OF NAPLES BEACH MAINTENANCE
PROJECTS
THIS AGREEMENT is made and entered into this 1`34i'f° day of N Qf Q b'2$1
2018, by and between the City of Naples ("GRANTEE"), and Collier County, a political
subdivision of the State of Florida("COUNTY").
RECITALS:
WHEREAS, CITY has submitted an application for Tourist Development Tax Funds in the
aggregate amount of One Hundred Eighty-Five Thousand and No/100{$185,000.00)for the City of
Naples Beach Maintenance Projects for Fiscal Year 2018-2019 as described in Exhibit A and
attachments to this Agreement(the "Project"); and
WHEREAS, the Tourist Development Council has reviewed and provided a
recommendation to the Board of County Commissioners that this expenditure promotes tourism;
and
WHEREAS,the Board of County Commissioners has reviewed and made a fmding that this
expenditure promotes tourism.
NOW, THEREFORE, BASED UPON THE MUTUAL COVENANTS AND PREMISES
PROVIDED HEREIN AND OTHER VALUABLE CONSIDERATION, IT IS MUTUALLY
AGREED AS FOLLOWS:
1. SCOPE OF WORK. GRAN TEE prepared detailed applications and proposals outlining the
Project to be accomplished, along with a project budget, as part of the grant application process,
hereinafter referred to as "Proposal," attached as Exhibit "A." GRANTEE shall provide the project
activities outlined in the Proposal within the budgeted amounts provided in the Proposal.
GRANTEE shall not be reimbursed for any expenditures not included in the Proposal nor be
0
1 6 A 1 8
reimbursed for amounts in excess of those provided in the Proposal unless an amendment to this
Agreement is entered into by GRANTEE and COUNTY.
2. PAYMENT AND REIMBURSEMENT. The aggregate maximum reimbursement under
this Agreement shall be One Hundred Eighty-Five Thousand and No/100 ($185,000.00).
GRANTEE shall be paid in accordance with the fiscal procedures of COUNTY upon submittal of
an invoice and upon verification that the services described in the invoice are completed or that
goods have been received.
2.1 GRANTEE shall determine that the goods and services have been properly provided
and shall submit invoices to the County Manager or his designee. The County Manager, or his
designee, shall determine that the invoice payments are authorized and the goods or services
covered by such invoice have been provided or performed in accordance with such authorization.
The budget for each project, attached as Exhibit "B," shall constitute authorization of the
expenditure described in the invoices provided that such expenditure is made in accordance with
this Agreement.
2.2 Each invoice submitted by GRANTEE shall be itemized in sufficient detail for audit
thereof and shall be supported by copies of corresponding vendor invoices and proof of receipt of
goods or performance of the services invoiced. GRANTEE shall certify in writing that all
subcontractors and vendors have been paid for work and materials from previous payments received
prior to receipt of any further payments. COUNTY shall not pay GRANTEE until the Clerk of the
Board of County Commissioners pre-audits payment invoices in accordance with the law.
2.3 GRANTEE shall be paid for its actual cost not to exceed the maximum amount
budgeted pursuant to the attached Exhibit"B."
3. ELIGIBLE EXPENDITURES. Only eligible expenditures described in Proposals will be
paid by COUNTY. Any expenditures paid by COUNTY which are later deemed to be ineligible
expenditures shall be repaid to COUNTY within thirty (30) days of COUNTY'S written request to
[04-CMG-00002/1430693111 2
1 6 A 1 8
repay said funds. COUNTY may request repayment of funds for a period of up to one(1)year after
termination of this Agreement or any extension or renewal thereof.
4. PAYMENT REQUESTS, Payment requests for interim draws and final payment must be
submitted to the County in the form of the Request for Funds form attached to this Agreement as
Exhibit "C." All payments are on a reimbursement basis only after proof of paid invoices are
presented to the County. County may withhold any interim draw for failure to provide the interim
status report,and County shall withhold final payment until receipt of the final status report or other
final report acceptable to County. All invoices and requests for payment including the final
payment must be received within ninety (90)days of termination of this Agreement. Any invoices
and requests for payment not received in this time frame shall be returned to the Grantee and
rejected for payment.
5. INSURANCE. GRANTEE is required to submit a Certificate of Insurance naming Collier
County, and its Board of County Commissioners and the Tourist Development Council as
additional insured. The insurance coverages identified in the Certificate of Insurance shall be
maintained without interruption from the date of commencement of the Projects until the date of
completion of all Projects required hereunder or as specified in this Agreement, whichever is
longer. The Certificate of Insurance shall be issued by a company licensed in the State of Florida,
with a current A.M. Best Financial rating of"Class VI" or higher, and provide General Liability
Insurance for no less than the following amount:
Bodily Injury Liability- $300,000 each claim per person
Property Damage Liability-$300,000 each claim per person
Personal Injury Liability-$300,000 each claim per person
Worker's Compensation and Employer's Liability—Statutory
The Certificate of Insurance must be delivered to the County Manager, or his designee, within ten
(10)days of execution of this Agreement by COUNTY. GRANTEE shall not commence activities
[04-CMG-00002/1430693/11 3
16A18
which are to be funded pursuant to this Agreement until COUNTY has received the Certificate of
Insurance.
6. CHOICE OF VENDORS AND FAIR DEALING. GRANTEE may select vendors or
subcontractors to provide services as described in Proposal, COUNTY shall not be responsible for
paying vendors and shall not be involved in the selection of subcontractors or vendors. GRANTEE
agrees to disclose any relationship between GRANTEE and subcontractors and/or vendors,
including, but not limited to, similar or related employees, agents, officers, directors and/or
shareholders. COUNTY may, in its discretion, object to the reasonableness of the expenditures and
require repayment if invoices have been paid under this Agreement for unreasonable expenditures.
The reasonableness of the expenditures shall be based on industry standards.
7, INDEMNIFICATION. To the extent permitted by law, GRANTEE shall hold harmless and
defend COUNTY, and its agents and employees, from any and all suits and actions including
attorney's fees and all costs of litigation and judgments of any name and description arising out of or
incidental to the performance of this Agreement or work performed thereunder. This provision
shall also pertain to any claims brought against the COUNTY by any employee of the named
GRANTEE, any subcontractor, or anyone directly or indirectly employed or authorized to perform
work by any of them. GRANTEE'S obligation under this provision shall not be limited in any way
by the agreed upon Agreement price as shown in this Agreement or GRANTEE'S limit of, or lack
of, sufficient insurance protection. Nothing contained herein shall operate to waive the sovereign
immunity or limits of liability of either party.
8. NOTICES. All notices from COUNTY to GRANTEE shall be in writing and deemed duly
served if mailed by registered or certified mail to GRANTEE at the following address:
A. William Moss,City Manager
City of Naples
280 Riverside Circle
Naples,Florida 34102
[04-C1v1G-00002/1430693/1] 4
t,9
4
16A18
All notices from GRANTEE to COUNTY shall be in writing and deemed duly served if mailed by
registered or certified mail to COUNTY at the following address:
Gary McAlpin,Manager
Coastal Zone Management
Collier County Government
2685 S.Horseshoe Drive
Naples,Florida 34104
GRANTEE and COUNTY may change their above mailing address at any time upon giving the
other party written notification pursuant to this section.
9. NO PARTNERSHIP, Nothing herein contained shall be construed as creating a partnership
between COUNTY and GRANTEE, or its vendor or subcontractor, or to constitute GRANTEE, or
its vendor or subcontractor,as an agent or employee of COUNTY.
10. TERMINATION. COUNTY or GRANTEE may cancel this Agreement with or without
cause by giving thirty (30) days advance written notice of such termination pursuant to Section 8
and specifying the effective date of termination. If COUNTY terminates this Agreement,
COUNTY will pay GRANTEE for all expenditures incurred, or contractual obligations incurred
with subcontractors and vendors, by GRANTEE up to the effective date of the termination so long
as such expenses are eligible.
11. GENERAL ACCOUNTING. GRANTEE is required to maintain complete and accurate
accounting records and keep tourism tourist development tax funds in a separate checking account.
All revenue related to the Agreement should be recorded, and all expenditures must be incurred
within the terms of this Agreement.
12, AVAILABILITY OF RECORDS. GRANTEE shall maintain records, books, documents,
papers and financial information pertaining to work performed under this Agreement. GRANTEE
agrees that COUNTY, or any of its duly authorized representatives, shall, until the expiration of
three (3) years after final payment under this Agreement, have access to, and the right to examine
[04-CMG-00002/1430693/I] 5
1 6 A 1 8
and photocopy any pertinent books, documents, papers, and records of GRANTEE involving
transactions related to this Agreement.
13. AVAILABILITY OF FUNDS: This agreement is subject to the availability of Tourist
Development Tax revenues. If for any reason tourist tax funds are not available to fund all or part
of this Agreement, the COUNTY may upon written notice, at any time during the terms of this
Agreement, and at its sole discretion,reduce or eliminate funding under this Agreement.
14. PROHIBITION OF ASSIGNMENT. GRAN FEE shall not assign, convey, or transfer in
whole or in part its interest in this Agreement without the prior written consent of COUNTY.
15. TERM. This Agreement shall become effective on October 1, 2018, and shall remain
effective until sixty (60) days after completion of the Project described in Exhibit "A," but no later
than November 29,2019.
16. AMENDMENTS. This Agreement may only be amended in writing by mutual agreement of
the parties and after recommendation by the Tourist Development Council.
17. REQUEST FOR EXTENSION. Any request for additional time to complete the project
described herein or any request for additional tourist development tax funds must be made in
writing and received by the County Manager or designee at least thirty (30) days prior to the end
date of this Agreement as provided in Section 15,TERM.
18. RECORDATION. This Agreement shall be recorded in the public records of Collier
County,Florida.
IN WITNESS WHEREOF, GRANTEE and COUNTY have each respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
[04-CMG-00002/143069311] 6
S
1 6 A 1 8
DATED: t /2015E. BOARD OF COUNTY COMMISSIONERS
ATTEST: COIA.IFR COUNTY, FLORIDA
CRYSTAL KINZEL, Clerk
t/.
.
01/111
BY:
At14:t as tO'ditireAlfgerk ney Solis, Chairman
only.
Approved as to form and
legality
Colleen M. Greene
Assistant County Attorney
Rem# 641€
Agenda
Date 11-1
, n
RD ecate,d
16. .
Deputy Clerk
[04-CMG-00002/1430693/11 7
1 6A18
ATTEST: 1.
/�. '�M/ ,,,.- It r* •"s~.
162,.--
�// 0>
t ,
' 1"r .....'
PATRICIA rijAi, f$!K i
ro•'
Approved asticl rm-ate; ,•c,��'
legal sufficiency:isr#r::/;0ase`st
A(NW 117
ROBRT D. PRITT, Ci orney
/
(corporate seal)
CITY OF NAPLES
CITY OF NAPLES
f
By: . ,0r l:j` ' ' 1
1 B L :ARNETT, Mayor
WITNESSES:
(1)
si I,ature
Printed! •ed Name
(2)
signature
Printed/Typed Name '
[04-CMG-00002/1430693!1) S
e40
. EXHIBIT A
COLLIER CoiTNPy TOURIST DEV1 All NT COUNCIL
CATEGORY*A"GRANT APPLICATION 1 6 A 18
2019 Beath lisnenriakmant and has Miintmu tree
Navin1V1'ainpagace
(Prefect'tido)
1. Name and Adm of Project j.a Sponsor Orgrodeathin
city of Naples
735 Eighth Street South
Nom,Florida 34102
2. Perm,Tide and Phone Number:
Name:Dana A.fico,Corammity Saviors Director
Address:280 Riverside Circle
Naples Stator FL ZIP: 34102
239/213-7120 FAX 239/213-7130 broth dsonereamojesetmc
3. Organisation's Chief mato Offid dnod Thlet.
Hoa Bin Damen,Mayor
4. Details of Prefect- La float:
Daserlptim This is an annual 'MC flsnded projectessential for support of maintenance on local
beaches. The City is responsible fry the whoop and grooming of TDC
City limit,.Under this t 'b1e bo~clws within the
P��, the Cly imovea litter, tion of algae and rock:along public
access beach portions of the Gulf within the Ws jurisdictional limits,and cuetodial ustvic of
the Naples Pier end Lowder=nilk Pink The Naples Pier receives over 1.0 nkat visitations
annually resulting in a high level of maintenance needs. Funding is a benefit to both residents and
tourist populations, and to the preservation of the beach, timeline sad overall appearance and
lave lment in beachfrout facilities. Thus yews request includes: 1) partial went far
Maintweance equipment operator, landscape WA's,lind esrsice worked salaries and baso 2)
beach cam, and 3) fuel and. . Requested equesled emcivat of 3183,000 is an iacrmsa
from last yea's amount'of 3180,000 to cover the annual salary &creme kr beech nesiateaance
staff
Lasatba: Signification coordlni ion of effort contitmpr between the'City and Collier City
concerning beach Via. The project boundary location is faom•aouthernaost Stete-
penralted beach cleaning area within the City's jurisdictional boundary northward to Clam Psis to
Collier Cody.
3. Estimated proj.et start date: October 1„2018
6. Fadepded-projeei:dmwtioa: 12 Months
I 7. Total'1'@C Tax Panda Requested: S111549
S. lithe ilk amount requestad cornet dee awarded,;out the prow•aah/pxo jest
be restructured to accommodate a smaller award?
Yes O No(X)
S
monism
EXHIBIT A
Collier Counos Taoist Development Coma 1 6 A 18
0}+«A°6r Apr -VSs 2
O )
PROGRAIVI ELEMENT Asomirr
'roc Funds Rapeseed $
CitylTering NOM Share S.
State oids Share $
Federal Share
TOTAL $1
PROMCr. ► :
Enema Mobilination,Contractor,Meldtort'age#c)
Beadialliaintsampre Stead! $10.009
Beach Catt- al Maanidjhal Litt $ 14109
Esexinnust Fuel $_
1 TOTAL $18 .tom
I hove read the Tort Development Category +'A 'Dumb Ponding Policy covering beech
renemithmani.end pass made and sem that my organization will comply with all
gahhifnes and criteria.
k' : ;1 iti'
)_ Moss,eft Meow Date
1 6A18
' , EXHIBIT A
ADDiTIONNAL IN IORMATION
ELIGIBILITY: Batch Maintenance activities will tithe place on best area that are least 80%
classified as eligibl under the. TDC guidelines. The project dant' loo Zion is Boni
south"fit Statopennitted beach cleaning area within the City's jurisdicdonid boundary to Clam
Pass in Collier County.
ORGANTZATIONAL CAPACITY: The Cray of tiles will be the primary recipkm and lead
atienoY oordrol1411sad activities praposed in this grant application.
The aly will remain the lead agency fir the duration of ibmihig and will be the sole point of
cwt far all manes axed to this.inoposal. The City has las managerial l end mal capability
to tmsurepsoperphinning,mom,,and ation of the project described in thisapp,
ABT A$8gIRAN8: Dual Compensation: If a City project stiff mamba or consulting is
involved siaeatkeneously.in two or more projects, the staff will not be compensated for more than
100%of their time fix any such dual involvement
PR JEC T LOC ►1 I MAP:
i-
►. r
*,� � �°
1 6 A 1 8
EXHIBIT B
BUDGET—CITY OF NAPLES
Beach Maintenance Staff Salaries&Benefits S164,000.00
Beach Cart--Gas w/Manual Bed Lift $ 14,000.00
Equipment Fuel and Maintenance S 7.000.00
AGGREGATE TOTAL $185,000.00
16Ai8
EXHIBIT C
REQUEST FOR FUNDS
COLLIER COUNTY TOURIST DEVELOPMENT COUNCIL
EVENT NAME
ORGANIZATION
ADDRESS
CONTACT PERSON TELEPHONE( )
REQUEST PERIOD FROM TO
REQUEST#
( )INTERIM REPORT ( )FINAL REPORT
TOTAL CONTRACT AMOUNT$
EXPENSE BUDGET REIMBURSEMENT REQUESTED
TOTALS
NOTE: Reimbursement of funds must stay within the confines of the Project Expenses outlined in your
application. Copies of paid invoices,cancelled checks,tear sheets,printed samples or other backup information
to substantiate payment must accompany request for funds. The following will not be accepted for payments:
statements in place of invoices; checks or invoices not dated; tear sheets without date,company or organizations
name. A tear sheet is required for each ad for each day or month of publication. A proof of an ad will not be
accepted.
Each additional request for payment subsequent to the first request,Grantee is required to submit verification In
writing that all subcontractors and vendors have been paid for work and materials previously performed or
received prior to receipt of any further payments.
If project budget has specific categories with set dollar limits,the Grantee is required to include a spreadsheet to
show which category each invoice Is being paid from and total of category before payment can be made to
Grantee. Organizations receiving funding should take into consideration that It will take a maximum of 45 days
for the County to process a check.
Furnishing false information may constitute a violation of applicable State and Federal laws.
CERTIFICATION OF FINANCIAL OFFICER: I certify that the above information is correct based on our
official accounting system and records, consistently applied and maintained and that the cost shown have been
made for the purpose of and in accordance with, the terms of the contract. The funds requested are for
reimbursement of actual cost made during this time period.
SIGNATURE TITLE
1 6 A 1 8
CERTIFICATE OF COVERAGE ISSUED ON: 5/14/2018
COVERAGE PROVIDED BY:PREFERRED GOVERNMENTAL INSURANCE TRUST
PACKAGE AGREEMENT NUMBER:PX2FL1 0112002 17-15 COVERAGE PERIOD:10/1/2017 TO 10/1/2019 12:01 AM
COVERAGES:This is to certify that the agreement below has been issued to the designated member for the coverage 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 coverage afforded by the
agreement described herein subject to all the terms,exclusions and conditions of such agreement.
Mail to:Certificate Holder Designated Member
Collier County Board of County Commissioners City of Naples
3299 Tamiami Trl.E;Ste.700 735 Eighth Street South
Naples,FL 34112 •
Naples,FL 34102
LIABILITY COVERAGE WORKERS'COMPENSATION COVERAGE
X Comprehensive General Liability,Bodily Injury,Property Damage
and Personal Injury
Limit$2,000,000 $200,000 SIR X Self Insured Workers'Compensation
X Public Officials Liability $350,000 Self Insured Retention
Limit$1,000,000 $200,000 SIR X Statutory Workers'Compensation
X Employment Practices Liability
Limit$1,000,000 $200,000 SIR X Employers Liability
X Employee Benefits Liability $1,000,000 Each Accident
Limit$2,000,000 $200,000 SIR $1,000,000 By Disease
$1,000,000 Aggregate Disease
X Law Enforcement Liability
Limit$2,000,000 $200,000 SIR
PROPERTY COVERAGE AUTOMOBILE COVERAGE
X Buildings&Personal Property Automobile Liability
Per schedule on file with $25,000 Deductible Limit$2,000,000 $200,000 SIR
TrustLimit X All Owned
Note:See coverage agreement for details on wind,flood,and other Specifically Described Autos
deductibles. X Hired Autos
X Rented,Borrowed and Leased Equipment
„ Limit$50,000 TIV See Schedule for Deductible X Non-Owned Autos
Automobile Physical Damage
X Total All other Inland Marine X Comprehensive See Schedule for Deductible
Limit$3,213,022 TIV See Schedule for Deductible X Collision See Schedule for Deductible
X Hired Auto with limit of$35,000
CRIME COVERAGE
X Employee Dishonesty
Limit$500,000 $1,000 Deductible
X Forgery or Alteration Garage Keepers
Limit$500,000 $1,000 Deductible Liability Limit
X Theft Disappearance&Destruction Liability Deductible
Limit$500,000 $1,000 Deductible Comprehensive Deductible
X Computer Fraud 9 Collision Deductible
Limit$500,000 $1,000 Deductible
NOTEAdditional Covered Party status is excluded for non-governmental entities.The most we will pay is further limited by the limitations set forth in Section 768.28(5),
Florida Statutes(2010)or the equivalent limitations of successor law which are applicable at the time of loss.
Description of Operations/Locations/Vehicles/Special items:
Certificate of Insurance issued as proof of coverage including Collier County and its Board of County Commissioners and the Tourist Development Council as
Additional Insured.
This section completed by member's agent,who hears complete responsibility and liability for its accuracy.
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 agreement above.
Administrator CANCELLATIONS
Public Risk Underwriters® SHOULD ANY PART OF THE ABOVE DESCRIBED AGREEMENT BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
P.O.Box 958455 PREFERRED GOVERNMENTAL INSURANCE TRUST WILL ENDEAVOR TO MAIL 60 DAYS WRITTEN NOTICE.OR IS DAYS
WRITTEN NOTICE FOR NON-PAYMENT OF PREMIUM,TO THE CERTIFICATE HOLDER NAMED ABOVE.BUT FAILURE TO MAIL
Lake Mary,FL 32795-8455 SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE PROGRAM,ITS AGENTS OR
REPRESENTATIVES.
Producer
Public Risk Insurance Agency 'e
P.O.Box 2416
Daytona Beach,FL 32115 —°—
AUTHORIZED REPRESENTATIVE
��� „ -
PGIT-CERT(11/09)PRINT FORM 5/14/20181
1 6 A 1 8
Preferred PUBLIC ENTITY
VERNMENT.AL
INSURANCE TRUST AUTOMATIC ADDITIONAL COVERED PARTIES
THIS ENDORSEMENT CHANGES THE AGREEMENT. PLEASE READ IT CAREFULLY.
This endorsement modifies coverage provided under the AUTOMOBILE COVERAGE FORM, PGIT MN-300, the
GENERAL LIABILITY COVERAGE FORM, PGIT MN-200 and the PROPERTY AND INLAND MARINE
COVERAGE FORM, PGIT MN-104
Where indicated by(X) below, coverage applies to the subdivision or an agency of the state of Florida as their
interest may appear. The provisions in this endorsement do not supersede Florida Statute 768.28, Article 10 and
13 of the Florida Constitution, or any other Statute or law limiting whom a Public Entity can indemnify.
X ADDITIONAL COVERED PARTY - BY CONTRACT,AGREEMENT OR PERMIT
SECTION I -WHO IS A COVERED PARTY is amended to include any subdivision or agency of the state
of Florida (hereinafter called Additional Covered Party)with whom the Covered Party agrees in a written
"insured contract"to name as an Additional Covered Party, but only with respect to liability arising solely
out of the Covered Party's operation, "your work" or facilities owned or used by the Covered Party.
The coverage afforded to the Additional Covered Party does not apply:
(1) Unless the written "insured contract", agreement or permit was executed prior to the"bodily injury,"
"property damage," "personal injury" or"advertising injury;"
(2) To any person(s) or organization(s) included as a Covered Party under this coverage agreement or
by an endorsement made part of this coverage agreement.
X ADDITIONAL COVERED PARTY-OWNERS OF LEASED EQUIPMENT
SECTION II -WHO IS A COVERED PARTY is amended to include any subdivision or an agency of the
state of Florida (hereinafter called Additional Covered Party)with whom the Covered Party agrees in a
written "insured contract", for the lease or rental of equipment, to name as an Additional Covered Party,
but only with respect to liability arising out of the sole negligence of the Covered Party, and only while
such equipment is in the care, custody or control of the Covered Party, or any employee or agent of the
Covered Party.
The coverage afforded to the Additional Covered Party does not apply to:
(1) "Bodily injury" or"property damage" occurring after you cease to lease or rent the equipment;
(2) "Bodily injury" or"property damage" arising out of any negligence of the Additional Covered Party;
(3) Structural alterations, new construction or demolition operations performed by or on behalf of the
Additional Covered Party;
(4) Liability assumed by the Additional Covered Party under any contract or agreement;
(5) "Property damage"to:
(a) Property owned, used, occupied by, or rented to the Additional Covered Party;
(b) Property in the care, custody or control of the Additional Covered Party or its employees or
agents, or of which the Additional Covered Party, its employees or agents are for any purpose
exercising physical control.
PGIT MN-902(10 16) Page 1
1 6 A 1 8
X ADDITIONAL COVERED PARTY -MANAGERS OR LESSORS OF PREMISES
SECTION II -WHO IS A COVERED PARTY is amended to include any subdivision or an agency of the
state of Florida (hereinafter called Additional Covered Party)with whom the Covered Party agrees in a
written "insured contract"to name as an Additional Covered Party, but only with respect to liability arising
solely out of the"premises" leased to the Covered Party by such subdivision or agency of the state of
Florida.
The coverage afforded to the Additional Covered Party does not apply to:
(1) "Bodily injury" or"property damage" occurring after the Covered Party cease to be a tenant in that
"premises";
(2) "Bodily injury" or"property damage" arising out of any negligence of the Additional Covered Party;
(3) Structural alterations, new construction or demolition operations performed by or on behalf of the
Additional Covered Party;
(4) Liability assumed by the Additional Covered Party under any contract or agreement;
(5) "Property damage"to:
(a) Property owned, used, occupied by, or rented to the Additional Covered Party;
(b) Property in the care, custody or control of the Additional Covered Party or its employees or
agents, or of which the Additional Covered Party, its employees or agents are for any purpose
exercising physical control.
Notwithstanding any other provision of this agreement, this endorsement extends
coverage to an Additional Covered Party, only in the event that said entity is a
subdivision or agency of the state of Florida, within the contemplation of Section
768.28, Florida Statutes, and entitled to the privileges, immunities and protections
afforded by said statute.
PGIT MN-902(10 16) Page 2