Backup Documents 06/09/2009 Item #16B 6
16B 6
MEMORANDUM
Date:
July 7, 2009
To:
Rhonda Cummings, Purchasing
Contract Specialist
From:
Martha Vergara, Deputy Clerk
Minutes & Records Department
Re:
Contract #09-5241: "Lely Area Stormwater
Improvement Project (LASIP) Mitigation Park
Restoration Project"
Contractor: EarthBalance Corp.
Enclosed is one original contract, referenced above (Agenda Item
#16B6), approved by the Board of County Commissioners on Tuesday,
June 9, 2009.
The second contract will be kept in the Minutes and Records
Department as part of the Board's permanent records.
If you should have any questions, please contact me at 252-7240.
Thank you.
Enclosure (1)
ITEM NO.:
~U~ \\,-\o~
DATE RECEIVED:
FILE NO.:
1'8. 6
ROUTEDTO:e?,PR~_C7{ ~5 f
DO NOT WRITE ABOVE THIS LINE
'f'::"\ ,~
~ \...~-
-,:'--- -,-
'~ -'I
-:~'t-
./... rf
Date:
REQUEST FOR LEGAL" SER~IC
June 30, 2009 ____ ~
County Attorney's Office ,/ ' 1 .i~ 1:{
Attention: Jeff KlatzkOW/ l \1 J [ v
Rhonda Cummings, FCCN, CPPB, Contract Specialist "I V
Purchasing Department, Extension 8941
\
r....)
To:
--<1
oj:.
'-?
J::"
..J
::-~.c-.
-< -,
-<~-,
,-) -..<<
~,-.,-,
.,"-::,;~'
:.:::: t \
'~
", ,;'.(
From:
Re: Contract: #09-5241 "Lely Area Stormwater Improvement Project
(LASIP) Mitigation Park Restoration Project
Contractor: EarthBalance Corp.
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 9, 2009; Agenda
Item 16.B.6
This item has not been previously submitted.
Contract review and approval.
V
,. lo. oc)
OY\E5
f 1<:: . c[Vs-Z..,
ACTION REQUESTED:
OTHER COMMENTS:
This is a standard contract with no changes. Please forward to BCC
for signature after approval. If there are any questions concerning the
document, please contact me. Purchasing would appreciate notification when
the documents exit your office. Thank you.
C: Margaret Bishop, Stormwater
RLS# {}'l-f1lfC- OP~~ B 6
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: E A-t2 7/.1 tSALMYE.. OsrcP'c;(l...A TIt"..}
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &lor Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ t '{\o\l \.....
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ I Mll
Workers Compensation
Each accident Required $ S()(). CD P
Disease Aggregate Required $ ,
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $ If) 'N\ l L
Aggregate Provided $ \. ,
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $ \ Pt
Per Aggregate Required $ r-s \
Other Insurance
Each Occur Type:
Entity name correct on contract?
Entity registered with FL Sec. of State?
Required $
County required to be named as additional insured?
County named as additional insured?
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
Performance Bond
Bond requirement referenced in contract?
If attached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
~Yes
~Yes
No
No
v' Yes
~Yes
Yes
~Yes
No
No
~No
No
Provided $ -;2: M.t '-
Provided $ 1\
Provided $ , M..\ L
Provided $ H
Provided $ (:5"',) "00
Exp. Date ~
Exp. Date l.
Exp. Date \ ,
Exp. Date ~ t
Exp. Date , .
Provided $
I N\. 'I..L.- Exp Date $ J L7, }ttt
I
/ l'V\,\ L Exp Date 1.1/( I II>
\.\ Exp Date I
, I
\.' Exp Date I'
Provided $
Provided $
Provided $
Exp Date ~'t.31D'i
Exp Date l r
--L Yes
No
Provided $ f MtL
Provided $ I .
Exp. Date 2 (f91 ttJ
Exp. Date I'
Provided $ Exp Date_
--L Yes No
~Yes No
-.LYes - No
Yes ~No
-- Yes No
Yes - No
Yes No
~Yes - No
~Yes - No
~Yes - No
~Yes No
~Yes - No
~Yes No
~Yes No
~~es No ~
ReViewer Imtlals:
Date:
04-COA-O I 03 7222
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
Attachments
Are all required attachments included?
~~
168 ~'~6
MEMORANDUM
TO:
Ray Carter
Risk Management Department
FROM:
f7 J(~ C
Rhonda Cummings, FCCN, CPPB, Contract Specialist -';;;C' ~
Purchasing Department J / -'(l
June 30, 2009
DATE:
RE:
Review of Insurance for Contract: #09-5241 "Lely Area
Stormwater Improvement Project (LASIP) Mitigation Park
Restoration Project
Contractor: EarthBalance Corp.
This Contract was approved by the BCC on June 9, 2009; Agenda Item
16.B.6
Please review the Insurance Certificates for the above referenced contract. If
you have any questions, please contact me at extension 8941.
Thank you.
dod/R C
B€C'E\\1E.D
" 'l\)\)S
~\}~: '"
t,^ j\\,\F\G.EME.N1
R\S\\ \'41
C: Margaret Bishop, Stormwater
mausen_9
168"6
From:
Sent:
To:
Cc:
Subject:
Raym ondCarter
Thursday, July 02, 2009 3:20 PM
CummingsRhonda; DeLeonDiana
BishopMargaret; mausen_g
Contract 09-5241 Lely Area Storm water Improvement Project (LASIP) Mitigbation Park
Restoration Project
All, I have approved the certificate of insurance provided by EarthBalance Corp. for contract 09-5241. The contract will
now be forwarded to the county attorney's office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
wv-w.sunbiz.org - Department of State
Page 1 of3
16B
Home
Contact Us
E-Filing Services
Document Searches
Forms
Help
Previous on List Next on List ~~turILTQJ...jst
I Entity Name Search
Submit I
Events l'i~meJ:lL~19.1Y
Detail by Entity Name
Florida Profit Corporation
EARTH BALANCE CORPORATION
Filing Information
Document Number H84315
FEI/EIN Number 592612208
Date Filed 11/04/1985
State FL
Status ACTIVE
Effective Date 11/01/1985
Last Event AMENDMENT
Event Date Filed 02/14/2007
Event Effective Date NONE
Principal Address
c/o JACK O. HACKETT II
99 NESBIT ST
PUNTA GORDA FL 33950 US
Changed 04/16/2007
Mailing Address
c/o JACK O. HACKETT II
99 NESBIT STREET
PUNTA GORDA FL 33950 US
Changed 04/16/2007
Registered Agent Name & Address
HACKETT, JACK 0 II
99 NESBIT STREET
PUNTA GORDA FL 33950 US
Name Changed: 04/16/2007
Address Changed: 04/09/2002
Officer/Director Detail
Name & Address
TitleVS
KOCUR,CHARLESLJR
27320 EGRET PL.
PUNTA GORDA FL 33983 US
Title P
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&in~ doc _ number=H84315&in... 6/29/2009
~;w.sunbiz.org - Department of State
ROSS, DONALD H
2579 N. TOLEDO BLADE BOULEVARD
NORTH PORT FL 34289 US
TitleVT
CLANCEY, FRANCIS J
4314 LONGCHAMP DR
SARASOTA FL 33946 US
Title VP
BURNETT, KAREN F
2579 N. TOLEDO BLADE BOULEVARD
NORTH PORT FL 34289
TitleVP
LAROQUE, SARAH J
2579 N. TOLEDO BLADE BOULEVARD
NORTH PORT FL 34289
Annual Reports
Report Year Filed Date
2008 04/21/2008
2008 05/12/2008
2009 04/15/2009
Document Images
04/J5f2009~::ANNUAL REPORT
05/12/2008 = ANNUAL REPORT
04/211200a=ANNWAL REPORT
04/16/2007 -- ANNUAL REPORT
02/14/2001 =-Am~n<:lm~Dt
04/24/2009= ANNl.JALRE;PORT
m@9/20Q5:::.ANNUAl,.R~PQRJ
05/10/2004 -- off/Dir Resigmillm
04[:2]/2004. -- Nq,r:!leCh<:!oge
Q~QL2Q{t4.-=ANNl.)ALR,E;,P,QRI
Q4/~QL200~-=ANNl.)Al,.RI;;_PQR.I
01LOlli2003 -- SharELE;xghg!1ge
01/03/2003 -- Amendment
04/09/2002 -- ANNU.AJ,,~RI;;PORI
04/28/2001 -- ANNUAL REPQRT
04/2(312000 -- ANNUAL REPORT
0411(3/J!1!1!1=ANNWAL REPORT
05/07/1998 = ANNUAL REPORT
02/14/1997 -- ANNUAL R!;.PQR..I
03/13/1996:::.ANNUAL REPORT
Page 2 of3
16B
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
Note: This is not official record. See documents if question or conflict.
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&in~ doc _ number=H84315&in... 6/29/2009
. www.sunbiz.org - Department of State
Page 3 of3
16B~6
Previous on List
Next.Q!LList RetJ.lrn To List
Events
Name History
IEntity Name Search
Submit I
I Home I Contact us I Document Searches I E-Fillng Services I Forms I Help I
Copyright and Privacy Policies
Copyright @ 2007 State of Florida, Department of State.
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inCL doc _ number=H84315&in... 6/29/2009
A G R E E MEN T 09-5241
'168 '6
for
Lelv Area Stormwater Improvement Proiect (LASIP) Mitiaation Park Restoration Proiect
THIS AGREEMENT is made and entered into this 9th day of June, 2009, by and between the Board
of County Commissioners for Collier County, Florida, a political subdivision of the State of Florida
(hereinafter referred to as the "County" or "Owner") and EarthBalance Corporation, authorized to do
business in the State of Florida, whose business address is 2579 North Toledo Blade Blvd., North
Port, Florida 34289 (hereinafter referred to as the "Contractor").
WIT N E SSE T H:
1. COMMENCEMENT: The contract shall commence upon issuance of the Notice to Proceed. The
supplemental plantings will be substantially complete on or before ninety (90) days. The first
exotic and nuisance species treatment maintenance event of the entire 1 09.3~ acre property will
be substantially complete on or before October 31, 2009 and the second maintenance treatment
event will be substantially complete on or before April 30, 2010, respectively.
2. STATEMENT OF WORK: The Board of County Commissioners deemed one (1) firm to be pre-
qualified and awarded a Contract to EarthBalance. EarthBalance will provide complete services
for the delivery and installation of the native plants in approximately 36.4 acres of wetlands on the
site and two exotic/nuisance vegetative species maintenance events for the entire 1 09.3~ acre
property as described in the Request for Bid as being located perpendicular to C.R. 951, one (1)
mile north of Rattlesnake Hammock Road in Section 15, Township 50S, Range 26E, Collier
County Florida in an area known as the Lely Area Stormwater Improvement Project, in
accordance with the terms and conditions of Bid #09-5241 and the Contractor's bid, which is
incorporated by reference and made an integral part of this Agreement. .
3. THE CONTRACT SUM: The Owner shall pay the Contractor for the performance of the Work
pursuant to the quoted price offered by the Contractor in his response to the specific Invitation to
Bid.
4. NOTICES: All notices required or made pursuant to this Agreement to be given by the County to
the Contractor shall be made in writing and shall be delivered by hand, by fax, e-mail, or by the
United States Postal Service Department, first class mail service, postage prepaid, addressed to
the following Contractor's address of record:
EarthBalance Corporation
2579 Toledo Blade Blvd., North Port, FL 34286
Telephone Number: (941) 426-7878
Fax Number: (941) 426-8778
Francis J. Clancey, V.P., Chief Operating Officer
All notices required or made pursuant to this Agreement to be given by the Contractor to the
County shall be in writing and shall be delivered by hand, by fax, e-mail, or by United States
Postal Service Department, first class mail service, postage prepaid, addressed to the following
County's address of record:
Page -1-
160.4>.6
Collier County Government Complex
Purchasing Department
3301 East Tamiami Trail
Purchasing Building G
Naples, Florida 34112
Attention: Stephen Y. Carnell
Purchasing/General Services Director
Phone: 239-252-8371
Fax: 239-252-6584
The Contractor and the County may change the above mailing address at any time upon giving
the other party written notification. All notices under this Service Agreement must be in writing.
5. NO PARTNERSHIP: Nothing herein contained shall create or be construed as creating a
partnership between the County and the Contractor or to constitute the Contractor as an agent of
the County.
6. PERMITS: LICENSES: TAXES: In compliance with Section 218.80, Florida Statutes, all permits
necessary for the prosecution of the Work shall be obtained by the Contractor. Payment for all
such permits issued by the County shall be processed internally by the County. Contractor is not
responsible for paying for permits issued by Collier County, but is responsible for acquiring all
permits. Owner may require the Contractor to deliver internal budget transfer documents to
applicable Collier county agencies when the Contractor is acquiring permits.
All permits, fees and licenses necessary for the prosecution of the Work which are not issued by
Collier County shall be acquired and paid for by the Contractor. Contractor shall pay all sales,
consumer, use and other similar taxes associated with the Work or portions thereof, which are
applicable during the performance of the Work.
7. NO IMPROPER USE: The Contractor will not use, nor suffer or permit any person to use in any
manner whatsoever, county facilities for any improper, immoral or offensive purpose, or for any
purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation,
or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the
event of such violation by the Contractor or if the County or its authorized representative shall
deem any conduct on the part of the Contractor to be objectionable or improper, the County shall
have the right to suspend the Contract of the Contractor. Should the Contractor fail to correct any
such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours
after receiving notice of such violation, conduct, or practice, such suspension to continue until the
violation is cured. The Contractor further agrees not to commence operation during the
suspension period until the violation has been corrected to the satisfaction of the County.
8. TERMINATION: Should the Contractor be found to have failed to perform his services in a
manner satisfactory to the County and requirements of this Agreement, the County may terminate
said Agreement for cause; further the County may terminate this Agreement for convenience with
a thirty (30) day written notice. The County shall be sole judge of non-performance.
9. NO DISCRIMINATION: The Contractor agrees that there shall be no discrimination as to race,
sex, color, creed or national origin.
Page -2-
168 6
10. INSURANCE: The Contractor shall provide insurance as follows:
/ Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per
Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability.
This shall include Premises and Operations; Independent contractors; Products and
Completed Operations and Contractual Liability.
~ Business Auto Liability: Coverage shall have minimum limits of $1,000,000 Per
Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability.
This shall include Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-
Ownership.
~.
Workers' Compensation: Insurance covering all employees meeting Statutory Limits in
compliance with the applicable state and federal laws. The coverage must include Employers'
Liability with a minimum limit of $5~00 for each accident.
Special Requirements: Collier County Board of County Commissioners shall be listed as the
Certificate Holder and included as an AdditionaYlnsured on the Comprehensive General
Liability. /
Current, valid insurance policies meeting the requirement herein identified shall be maintained
by Contractor during the duration of this Agreement. Renewal certificates shall be sent to the
County thirty (30) days prior to any expiration date. There shall be a thirty (30) day
notification to the County in the event of cancellation or modification of any stipulated
insurance coverage.
Contractor shall insure that all subcontractors comply with the same insurance requirements
that he is required to meet. The same Contractor shall provide County with certificates of
insurance meeting the required insurance provisions.
11. INDEMNIFICATION: To the maximum extent permitted by Florida law, the Contractor shall
indemnify and hold harmless Collier County, its officers and employees from any and all
liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees
and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally
wrongful conduct of the Contractor or anyone employed or utilized by the Contractor in the
performance of this Agreement. This indemnification obligation shall not be construed to
negate, abridge or reduce any other rights or remedies which otherwise may be available to an
indemnified party or person described in this paragraph.
This section does not pertain to any incident arising from the sole negligence of Collier County.
12. PAYMENTS. Generally, the Contractor will be paid upon completion; however since work will
be in excess of thirty (30) days, the Contractor may receive Progress Payments. Subsequent
to the first payment, Contractor must provide Owner with a fully executed Release and Affidavit
in the form attached hereto as Exhibit "A" as a condition precedent to release of each progress
payment. All applications for payment, whether for full payment or a progress payment shall
be in writing, and in substantially the form attached hereto as Exhibit "B".
13. PAYMENTS WITHHELD. Owner may decline to approve any Application for Payment, or
portions thereof, because of defective or incomplete work, outstanding punchlist items,
subsequently discovered evidence or subsequent inspections. The Owner may nullify the
Page -3-
16B 6
whole or any part of any approval for payment previously issued and Owner may withhold any
payments otherwise due Contractor under this Agreement or any other agreement between
Owner and Contractor, to such extent as may be necessary in the Owner's opinion to protect it
from loss because of: (a) defective Work not remedied; (b) third party claims failed or
reasonable evidence indicating probable fling of such claims; (c) failure of Contractor to make
payment properly to subcontractors or for labor, materials or equipment; (d) reasonable doubt
that the Work can be completed for the unpaid balance of the Contract Amount; (e) reasonable
indication that the Work will not be completed within the Contract Time; (f) unsatisfactory
prosecution of the Work by the Contractor; or (g) any other material breach of the Contract
Documents.
If any conditions described above are not remedied or removed, Owner may, after three (3)
days written notice, rectify the same at Contractor's expense. Owner also may offset against
any sums due Contractor the amount of any liquidated or unliquidated obligations of Contractor
to Owner, whether relating to or arising out of this Agreement or any other agreement between
Contractor and Owner.
14. SUBMITTALS AND SUBSTITUTIONS. Any substitution of products/materials from
specifications shall be approved in writing by Owner in advance.
15. CONTRACT TIME AND TIME EXTENSIONS.
A. Time is of the essence in the performance of any Work under this Agreement and Contractor
shall diligently pursue the completion of the Work and coordinate the Work being done on the
Project by its subcontractors and materialmen, as well as coordinating its Work with all work of
others at the Project Site, so that its Work or the work of others shall not be delayed or
impaired by any act or omission by Contractor. Contractor shall be solely responsible for all
construction means, methods, techniques, sequences, and procedures as well as coordination
of all portions of the Work under the Contract Documents, and the coordination of Owner's
supplies and contractors.
B. Should Contractor be obstructed or delayed in the prosecution of or completion of the Work as
a result of unforeseeable causes beyond the control of Contractor, and not due to its fault or
neglect, including but not restricted to acts of Nature or of the public enemy, acts of
Government, fires, floods, epidemics, quarantine regulation, strikes or lockouts, Contractor
shall notify the Owner in writing within forty-eight (48) hours after the commencement of such
delay, stating the cause or causes thereof, or be deemed to have waived any right which
Contractor may have had to request a time extension.
C. No interruption, interference, inefficiency, suspension or delay in the commencement or
progress of the Work from any cause whatever, including those for which Owner may be
responsible, in whole or in part, shall relieve Contractor of his duty to perform or give rise to
any right to damages or additional compensation from Owner. Contractor expressly
acknowledges and agrees that it shall receive no damages for delay. Contractor's sole
remedy, if any, against Owner will be the right to seek an extension to the Contract Time;
provided, however, the granting of any such time extension shall not be a condition precedent
to the aforementioned "No Damage for Delay" provision. This paragraph shall expressly apply
to claims for early completion, as well as to claims based on late completion.
16. CHANGES IN THE WORK. Owner shall have the right at any time during the progress of the
Work to increase or decrease the Work. Promptly after being notified of a change, Contractor
shall submit an itemized estimate of any cost or time increases or savings it foresees as a
result of the change. Except in an emergency endangering life or property, or as expressly set
Page -4-
, ".""_"'_"'~"'_''''_'''_"_~'''''''<'''~;'._''_''''''',o''e. ,_. "","""~,_,.',_~___,___
168 6
forth herein, no addition or changes to the Work shall be made except upon written order of
Owner, and Owner shall not be liable to the Contractor for any increased compensation
without such written order. No officer, employee or agent of Owner is authorized to direct any
extra or changed work orally. Any modifications to this Contract shall be in compliance with the
County Purchasing Policy and Administrative Procedures in effect at the time such
modifications are authorized.
A Change Order in the form attached as Exhibit "D" to this Agreement, shall be issued and
executed promptly after an agreement is reached between Contractor and Owner concerning
the requested changes. Contractor shall promptly perform changes authorized by duly
executed Change Orders. The Contract Amount and Contract Time shall be adjusted in the
Change order in the manner as Owner and Contractor shall mutually agree.
17.COMPLlANCE WITH LAWS. Contractor agrees to comply, at its own expense, with all
federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements
applicable to the Project, including but not limited to those dealing with taxation, workers'
compensation, equal employment and safety (including, but not limited to, the Trench Safety
Act, Chapter 553, Florida Statutes). If Contractor observes that the Contract Documents are at
variance therewith, it shall promptly notify Owner in writing.
18. CLEAN UP. Contractor agrees to keep the Project site clean at all times of debris, rubbish
and waste materials arising out of the Work. At the completion of the Work, Contractor shall
remove all debris, rubbish and waste materials from and about the Project site, as well as all
tools, appliances, construction equipment and machinery and surplus materials, and shall
leave the Project site clean and ready for occupancy by Owner.
19. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the
prior consent in writing of Owner. If Contractor does, with approval, assign this Agreement or
any part thereof, it shall require that its assignee be bound to it and to assume toward
Contractor all of the obligations and responsibilities that Contractor has assumed toward
Owner.
20. WARRANTY. Contractor shall obtain and assign to Owner all express warranties given to
Contractor or any subcontractors by any materialmen supplying materials, equipment or
fixtures to be incorporated into the Project. Contractor warrants to Owner that any materials
and equipment furnished under the Contract Documents shall be new unless otherwise
specified, and that all Work shall be of good quality, free from all defects and in conformance
with the Contract Documents.
Contractor further warrants to Owner that all materials and equipment furnished under the
Contract Documents shall be applied, installed, connected, erected, used, cleaned and
conditioned in accordance with the instructions of the applicable manufacturers, fabricators,
suppliers or processors except as otherwise provided for in the Contract Documents.
If, within one (1) year after final completion, any Work is found to be defective or not in
conformance with the Contract Documents, Contractor shall correct it promptly after receipt of
written notice from Owner. Contractor shall also be responsible for and pay for replacement or
repair of adjacent materials or Work which may be damaged as a result of such replacement
or repair. These warranties are in addition to those implied warranties to which Owner is
entitled as a matter of law.
Page -5-
-'.""-,"'"......~,-,.,._.,..,..,~._'.,,~.," "-"''''"^''"'~.'-'';-'''''''''-'''-_'"'___ 'W'
168 .6
21.STANDARDS OF CONDUCT: PROJECT MANAGER. SUPERVISOR. EMPLOYEES. The
Contractor shall employ people to work on County projects who are neat, clean, well-groomed
and courteous. Subject to the American with Disabilities Act, Contractor shall supply
competent employees who are physically capable of performing their employment duties. The
County may require the Contractor to remove an employee it deems careless, incompetent,
insubordinate or otherwise objectionable and whose continued employment on Collier County
projects is not in the best interest of the County.
22. TESTS AND INSPECTIONS. If the Contract Documents or any codes, laws, ordinances, rules
or regulations of any public authority having jurisdiction over the Project requires any portion of
the Work to be specifically inspected, tested or approved, Contractor shall assume full
responsibility therefore, pay all costs in connection therewith and furnish to the Owner the
required certificates of inspection, testing or approval. All inspections, tests or approvals shall
be performed in a manner and by organizations acceptable to the Owner.
23. PROTECTION OF WORK.
A. Contractor shall fully protect the Work from loss or damage and shall bear the cost of any such
loss or damage until final payment has been made. If Contractor or anyone for whom
Contractor is legally liable is responsible for any loss or damage to the Work, or other work or
materials of Owner or Owner's separate contractors, Contractor shall be charged with the
same, and any monies necessary to replace such loss or damage shall be deducted from any
amounts due Contractor.
B. Contractor shall not load nor permit any part of any structure to be loaded in any manner that
will endanger the structure, nor shall Contractor subject any part of the Work or adjacent
property to stresses or pressures that will endanger it.
C. Contractor shall not disturb any benchmark established by the Owner with respect to the
Project. If Contractor, or its subcontractors, agents or anyone, for whom Contractor is legally
liable, disturbs the Owner's benchmarks, Contractor shall immediately notify Owner. The
Owner shall re-establish the benchmarks and Contractor shall be liable for all costs incurred by
Owner associated therewith.
24. EMERGENCIES. In the event of any emergency affecting the safety or protection of persons
or the Work or property at the Project site or adjacent thereto, Contractor, without special
instruction or authorization from Owner is obligated to act to prevent threatened damage, injury
or loss. Contractor shall give the Owner written notice within forty-eight (48) hours after the
occurrence of the emergency, if Contractor believes that any significant changes in the Work
or variations from the Contract Documents have been caused thereby.
If the Owner determines that a change in the Contract Documents is required because of the
action taken in response to an emergency, a Change Order shall be issued to document the
consequences of the changes or variations.
If Contractor fails to provide the forty-eight (48) hour written notice noted above, the Contractor
shall be deemed to have waived any right it otherwise may have had to seek an adjustment to
the Contract Amount or an extension to the Contract Time.
25. COMPLETION. When the entire Work (or any portion thereof designated in writing by Owner)
is ready for its intended use, Contractor shall notify Owner in writing that the entire Work (or
such designated portion) is substantially complete and request that Owner issue a Certificate
of Substantial Completion. Within a reasonable time thereafter, Owner and Contractor shall
Page -6-
16B 6
make an inspection of the Work (or designated portion thereof) to determine the status of
completion. If Owner does not consider the Work (or designated portion) substantially
complete, the Owner shall notify Contractor in writing giving the reasons therefor.
If Owner considers the Work (or designated portion) substantially complete, Owner shall
prepare and deliver to Contractor a Certificate of Substantial Completion, Exhibit D, which shall
fix the date of Substantial Completion for the entire Work (or designated portion thereof) and
include a tentative punchlist of items to be completed or corrected by Contractor before final
payment.
Owner shall have the right to exclude Contractor from the Work and Project site (or designated
portions thereof) after the date of Substantial Completion, but Owner shall allow Contractor
reasonable access to complete or correct items on the tentative punch list.
Upon receipt of written certification by Contractor that the Work is completed in accordance
with the Contract Documents and is ready for final inspection and acceptance, Owner will
make such inspection and, if Owner finds the Work acceptable and fully performed under the
Contract Documents, he shall promptly issue a Certificate of Final Completion, Exhibit E,
recommending that on the basis of his observations and inspections, and the Contractor's
certification that the Work has been completed in accordance with the terms and conditions of
the Contract Documents, that the entire balance found to be due Contractor is due and
payable. Final payment shall not become due and payable until Contractor submits:
(1) The Release and Affidavit in the form attached as Exhibit "A".
(2) Consent of Surety (if applicable) to final payment.
(3) If required by Owner, other data establishing payment or satisfaction of all obligations,
such as receipt, releases and waivers of liens, arising out of the Contract Documents, to the
extent and in such form as may be designated by Owner.
Owner reserves the right to inspect the Work and make an independent determination as to
the acceptability of the Work. Unless and until the Owner is completely satisfied, the final
payment shall not become due and payable.
26. LIQUIDATED DAMAGES. The "Commencement Date" shall be established in the Notice to
Proceed to be issued by the Owner. Contractor shall commence the work within five (5)
calendar days from the Commencement Date. No Work shall be performed at the Project site
prior to the Commencement Date. Any Work performed by Contractor prior to the
Commencement Date shall be at the sole risk of Contractor.
The Work shall be substantially completed within the time specified in the Request for
Quotation. The date of substantial completion of the Work (or designated portions thereof) is
the date certified by the Owner when construction is sufficiently complete, in accordance with
the Contract Documents, so Owner can occupy or utilize the Work (or designated portions
thereof) for the use for which it is intended. The Work shall reach final completion and be
ready for final acceptance by Owner within the time specified in the Request for Quotation.
Owner and Contractor recognize that since time is of the essence for any work under this
Agreement, Owner will suffer financial loss if the Work is not substantially completed within the
time specified in the Request for Quotation. Should Contractor fail to substantially complete
the Work within the specified time period, Owner shall be entitled to assess as liquidated
Page -7-
16 Q ~6
damages, but not as a penalty, the amount specified in the Request for Quotation for each
calendar day thereafter until substantial completion is achieved.
The Project shall be deemed to be substantially completed on the date the Owner issues a
Certificate of Substantial Completion pursuant to the terms hereof. Contractor hereby
expressly waives and relinquishes any right which it may have to seek characterize the above
noted liquidated damages as a penalty, which the parties agree represents a fair and
reasonable estimate of the Owner's actual damages at the time of contracting if Contractor
fails to substantially complete the Work in a timely manner.
When any period of time is referenced by days herein, it shall be computed to exclude the first
day and include the last day of such period. If the last day of any such period falls on a
Saturday or Sunday or on a day made a legal holiday by the law of the applicable jurisdiction,
such day shall be omitted from the computation, and the last day shall become the next
succeeding day which is not a Saturday, Sunday or legal holiday.
27.CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the
County by the Stormwater Department.
28. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the attached or
referenced component parts, all of which are as fully a part of the Agreement as if herein set
out verbatim, including: Contractor's Bid, Insurance Certificate, RFB No. 09-5241, and any
addenda made or issued pursuant to this Agreement, and any related plans or specifications.
29.PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall
offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value
to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County
Ethics Ordinance No. 2004-05, and County Administrative Procedure 5311. Violation of this
provision may result in one or more of the following consequences: a. Prohibition by the
individual, firm, and/or any employee of the firm from contact with County staff for a specified
period of time; b. Prohibition by the individual and/or firm from doing business with the County
for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes;
and, c. immediate termination of any contract held by the individual and/or firm for cause.
30.SUBJECT TO APPROPRIATION. It is further understood and agreed, by and between the
parties herein that this Agreement is subject to appropriation by the Board of County
Commissioners.
31.SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated
with the Work or portions thereof, which are applicable during the performance of the Work. No
markup shall be applied to sales tax.
32.IMMIGRATION LAW COMPLIANCE: By executing and entering into this agreement, the
Contractor is formally acknowledging without exception or stipulation that it is fully responsible
for complying with the provisions of the Immigration Reform and Control Act of 1986 as located
at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended. Failure
by the Contractor to comply with the laws referenced herein shall constitute a breach of this
agreement and the County shall have the discretion to unilaterally terminate this agreement
immediately.
Page -8-
168 6
33. VENUE: Any suit or action brought by either party to this Agreement against the other party
relating to or arising out of this Agreement must be brought in the appropriate federal or state
courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such
matters.
34.AGREEMENT TERMS: If any portion of this Agreement is held to be void, invalid, or
otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall
remain in effect.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
.:.
Page -9-
168 6
IN WITNESS WHEREOF, the Contractor and the County, have each, respectively, by
an authorized person or agent, hereunder set their hands and seals on the date and
year first above written.
ATTEST: _
D . ht E;Brbck,Clerk of Courts
BOARD OF COUNTY COMMISSIONERS
::LLlER ?f::::Od~
Donna Fiala, Chairman
~.,J( v: JlfldiJ
First Witness
~rmra k. V;VJne~
Type/Print Witness Name
JA.k/.; tJd.!." \ -
Second Witness ~
jNOlol~ Wet (flW\l(.eV'
Type/Print Witness Name
EarthBalance CorDoration
Contractor
BY:~~ r: ~
~ Signature{
c:Kae.t:=1J ~ ~e.tJl!!S1I
'\ Typed Signature
0C!.E. lAcs / h ~ 'lrr
Title
Approved as to form and
legal sufficiency:
CfJ1h1JA d1~
Assistant County Attorney
COlleb1 CsreenL
Print Name
Page -10-
EXHIBIT A
RELEASE AND AFFIDAVIT FORM
168
6
COUNTY OF COLLIER )
STATE OF FLORIDA )
Before me, the undersigned authority, personally appeared
who after being duly sworn, deposes and says:
(1) In accordance with the Contract Documents and in consideration of $
paid, ("Contractor") releases and waives for itself and it's
subcontractors, material-men, successors and assigns, all claims demands, damages, costs and expenses,
whether in contract or in tort, against the Board of County Commissioners of Collier County, Florida, relating in
any way to the performance of the Agreement between Contractor and Owner, dated
200_ for the period from to
(2) Contractor certifies for itself and its subcontractors, material-men, successors and assigns, that all charges
for labor, materials, supplies, lands, licenses and other expenses for which Owner might be sued or for which a
lien or a demand against any payment bond might be filed, have been fully satisfied and paid.
(3) Contractor agrees to indemnify, defend and save harmless Owner from all demands or suits, actions,
claims of liens or other charges filed or asserted against the Owner arising out of the performance by
Contractor of the Work covered by this Release and Affidavit.
(4) This Release and Affidavit is given in connection with Contractor's [monthly/final] Application for Payment
No.
CONTRACTOR
BY:
ITS:
President
DATE:
Witnesses
[Corporate Seal]
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me this day of
200_, by , as of
I a corporation, on behalf of the corporation. He/she is
personally known to me or has produced as
identification and did (did not) take an oath.
My Commission Expires:
(Signature of Notary)
NAME:
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
Notary Public, State of
Commissioner No.:
Page -11-
168 6
EXHIBIT B
FORM OF CONTRACT APPLICATION FOR PAYMENT
(County Project Manager)
(County Department)
Collier County Board of County Commissioners (the OWNER) or
Collier County Water-Sewer District (the OWNER)
FROM:
(Contractor's Representative)
(Contractor's Name)
(Contractor's Address)
RE:
Name)
Bid No. 09-5241
Project No.
Application Date
Payment Application No.
for Work accomplished through the Date:
(Project
Original Contract Time:
Revised Contract Time:
Retainage @ 10% thru[insert date] $
Retainage @ _% after [insert date] $
Percent Work completed to Date:
Percent Contract Time completed to Date
%
%
Liquidated Damages to be Accrued $
Original Contract Amount: $
Total Change Orders to Date $
Revised Contract Amount $
Total value of Work Completed
and stored to Date $
Less previous payment (s) $
AMOUNT DUE THIS
APPLICATION: $
ATTACH SCHEDULE OF VALUES AND ACCOMPANYING DOCUMENTATION TO THIS APPLICATION
CONTRACTOR'S CERTIFICATION: The undersigned CONTRACTOR certifies that: (1) all previous progress payments
received from OWNER on account of Work done under the Contract referred to above have been applied to discharge in
full all obligations of CONTRACTOR incurred in connection with Work covered by prior Applications for Payment
numbered 1 through _ inclusive; (2) title to all materials and equipment incorporated in said Work or otherwise listed
in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all liens, claims,
security interests and encumbrances (except such as covered by Bond acceptable to OWNER); (3) all amounts have
been paid for work which previous payments were issued and received from the OWNER and that current payment is now
due; (4) and CONTRACTOR agrees that all overruns as shown on the monthly estimate summary shall, in fact, be added
to the revised contract and shall be incorporated into a future Change Order:
By CONTRACTOR:
DATE:
(Contractor's Name)
(Signature)
(Type Name & Title)
(shall be signed by a duly authorized representative of CONTRACTOR)
Payment to the CONTRACTOR for the above AMOUNT DUE THIS APPLICATION is recommended:
(DP's Name)
(Signature) DATE:
(Type Name & Title)
Payment to the CONTRACTOR for the above AMOUNT DUE THIS APPLICATION is approved:
By Design Professional:
By OWNER'S Project Manager:
Page -12-
(Signature) DATE:
(Type Name and Title)
EXHIBIT C
CHANGE ORDER
16R
6
CHANGE ORDER NO.
CONTRACT NO. 09-5241
TO:
DATE:
PROJECT NAME:
PROJECT NO.:
Under our AGREEMENT dated
,200_.
You hereby are authorized and directed to make the following change(s) in accordance with terms and conditions
of the Agreement:
FOR THE (Additive) (Deductive)
Sum of: $
($
Original Agreement Amount $
Sum of Previous Changes $
This Change Order (Add) (Deduct) $
Present Agreement Amount $
The time for completion shall be (increased/decreased) by calendar days due to this Change Order. Accordingly,
the Contract Time is now (-> calendar days. The substantial completion date is and the
final completion date is . Your acceptance of this Change Order shall constitute a modification to our
Agreement and will be performed subject to all the same terms and conditions as contained in our Agreement indicated above,
as fully as if the same were repeated in this acceptance. The adjustment, if any, to the Agreement shall constitute a full and
final settlement of any and all claims of the Contractor arising out of or related to the change set forth herein, including claims
for impact and delay costs.
Accepted:
,200_
CONTRACTOR:
OWNER:
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
By:
By:
DESIGN PROFESSIONAL:
By:
Page -13-
168 6
EXHIBIT D
CERTIFICATE OF SUBSTANTIAL COMPLETION
OWNER'S Project No.
ENGINEER'S Project No.
PROJECT:
CONTRACTOR
Contract For
Contract Date
This Certificate of Substantial completion applies to all Work under the Contract documents or to the
following specified parts thereof:
To
OWNER
And
To
The Work to which this Certificate applies has been inspected by authorized representatives of
OWNER, CONTRACTOR AND DESIGN PROFESSIONAL, and that Work is hereby declared to be
substantially complete in accordance with the contract documents on:
DATE OF SUBSTANTIAL COMPLETION
A tentative list of items to be completed or corrected is attached hereto. This list may not be all-
inclusive, and the failure to include an item in it does not alter the responsibility of CONTRACTOR to
complete all the Work in accordance with the Contract Documents. The items in the tentative list
shall be completed or corrected by CONTRACTOR within days of the above date of
Substantial Completion.
Page -14-
168 '6
The responsibilities between OWNER and CONTRACTOR for security, operation, safety,
maintenance, heat, utilities, insurance and warranties shall be as follows:
RESPONSIBILITIES:
OWNER:
CONTRACTOR:
The following documents are attached to and made a part of this Certificate:
This certificate does not constitute an acceptance of Work not in accordance with the Contract
Documents nor is it a release of CONTRACTOR'S obligation to complete the Work in accordance
with the Contract Documents.
Executed by Design Professional on
,2004
Design Professional
By:
Type Name and Title
CONTRACTOR accepts this Certificate of Substantial Completion on
,2009
CONTRACTOR
By:
Type Name and Title
OWNER accepts this Certificate of Substantial Completion on
,2009
OWNER
By:
Type Name and Title
Page -15-
168 6
EXHIBIT E
CERTIFICATE OF FINAL COMPLETION
OWNER'S Project No.
PROJECT:
ENGINEER'S Project No.
CONTRACTOR
Contract For
Contract Date
This Certificate of Final completion applies to all Work under the Contract documents.
To
OWNER
And
To
The Work to which this Certificate applies has been inspected by authorized representatives of
OWNER, CONTRACTOR AND DESIGN PROFESSIONAL, and that Work is hereby declared to be
finally complete in accordance with the contract documents on:
DATE OF FINAL COMPLETION
Page -16-
168 6
The following warranty is attached to and made a part of this Certificate:
Executed by Design Professional on
,2009
Design Professional
By:
Type Name and Title
CONTRACTOR accepts this Certificate of Final Completion on
2004
CONTRACTOR
By:
Type Name and Title
OWNER accepts this Certificate of Final Completion on
2004
OWNER
By:
Type Name and Title
Page -17-
'~"'"""''''"''.'''iH'~ '""'<t' .. .......,.__..___""_",_"~......_"_,..,..,,,.,.,._~.O".T'.'.__".v,,,,.."'....-.-.".v........_....___.
16B 6
EXHIBIT F
WARRANTY
I n consideration of ten dollars, ($10.00), receipt of which is hereby acknowledged, the undersigned
CONTRACTOR does hereby provide, warrant and guarantee all work done and executed under the
contract either directly performed by the CONTRACTOR or at the express request of the
CONTRACTOR by a SUBCONTRACTOR or CONSULTANT.
Project Name:
Date of Final Completion:
Name and Address of CONTRACTOR:
CONTRACTOR warrants and guarantees the work performed pursuant to the contract shall be free of
all defects of materials and workmanship for a period of one year from the DATE OF FINAL
COMPLETION.
The undersigned party further agrees that it will, at its own expense, replace and/or repair all
defective work and materials and all other work damaged by any defective work upon written demand
by the COUNTY. It is further understood that further consideration for this warranty and guaranty is
the consideration given for the requirement pursuant to the general conditions and specifications
under which the contract was let that such warranty and guaranty would be given.
This warranty and guaranty is in addition to any other warranties or guaranties for the work performed
under the contract and does not constitute a waiver of any rights provided pursuant to Florida
Statutes, Chapter 95, et seq.
DATE:
CONTRACTOR
BY:
Attest:
Page -18-
From: Becky Scarfone At: Lykes Insurance, Inc, FaxlD: 813-249-8607 To: Diana
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
Date: 6129121960BM pa96 of 4
OP 10 B2 I DATE (MM/DDIYYYY)
EARTH-2 06/29/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Lykes Insurance, Inc
400 N. Tampa st., suite 2200
Tampa FL 33602
Phone:813-223-3911 Fax: 813-221-1857
INSURED
INSURERS AFFORDING COVERAGE
INSURER A
INSURER 8
we"tfi.ld Insu:rance COMpany
Bxidg.field Employers Ins Co.
NAlC#
24112 '"
10701 v'
42374 V
Earthbalance corporation DBA
EarthBalance
2579 North Toledo Blade Blvd
Northport FL 34286
_I':JSU~~I<~___}{ous tOl! Cas ~~!ty Ins. CO.
INSURER D
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BE_OW HAVE BEEN ISSUED TO THE INSURED NAMED ABO\/E FOR TH= POLlCv PERIOD INDICATED NOTV\,' THSTANDING
,ANy REQUIRE'AENT, TERM OR CONDITIOr-. OF ANY CONTRACT OR OTHER DOCl,MENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TC ALL THE TERMS, EXCLUSIONS AI~D CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
I'N"" NS'RC POLICY NUMBER 'i:J~'1!~(MM/DDIYYI '6'kWl(MMIDDIYYI LIMITS ./
LTR TYPE OF INSURANCE
GENERAL LIABILITY EACH OCCURRENCE $ 1000000 .r
- 08/23/08 08/23/09 p'REMisEs '( E~c~~~~~ence)
A X ~ COMMERCI.t\L GENERAL LIABILITY CMM4053914 $ 150000
o CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10000
-
~ Contractual Liab PERSONAL & A~V INJURY $ 1000000
GENERAL AGGREGATE $2000000
-
GEN'L AGGREGA-E L'MIT APPLIES PER PRODUCTS - COMP/OP ASS $2000000
"I !Xl PRO- nLOC ----,
POLICY X JECT Emp Ben. 1000000
AUTOMOBILE LIABILITY COMBII,ED SINGLE L'MIT $ 1,000,000 V ..,/
-
A ~ ANY AUTO CMM4053914 08/23/08 08/23/09 (Ea aCCIdent)
AL_ OWNED AUTOS 80DIL Y INJURY
- $
SCHEDULED AUTOS (Per p8~son)
-
~ HIRED AUTOS BODIL Y INJURY
$
~ NOr,-OWNED AUTOS Wer acolden!)
- PROPERTY DAMAGE $
(Per aCCident)
GARAGE LIABILITY AUTO ONe Y - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUlD ONLY AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000
A 8 OCCUR D CLAIMS MADE CMM4053914 08/23/08 08/23/09 AGGREGATE $ 10,000,000
$
8 DEDUCTIBLE $
X RETENTION $ 0 $ /
WORKERS COMPENSATION AND X :T6~\-t:~"TuS I xIJ~~' ./
B EMPLOYERS' LIABILITY 0830-37583 04/01/09 04/01/10 $ 1000000 ""
ANY PROPRIETORfPARTNERfEXECUTIVE E LEACH ACCIDEr-. T
OFFICER/MEMBER EXCLUDED? E L DISEASE - EA EMPLOYEE $ 1000000
If yes, describe under $ 1000000
SPECIAL PROVISIONS oelow E L DISEASE - P:JLlCY LIMIT
OTHER
A Property Section CMM4053914 08/23/08 08/23/09 Varies Varies
C I Professional Liab H70711038 02/18/09 02/18/10 Prof Liab 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Collier County BOCC Purchasing Department is an addi7nal insured with
respect to General Liability.
CERTIFICATE HOLDER
COLL413
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Collier county BOCC
Purchasing Department
Attn: Diana
P.O. Box 413016
Naples FL 34101-3016
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10
DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES,
A Z DR E
ACORD 25 (20011081
@ACORD CORPORATION 1988
From: Becky Scarfone At: Lykes Insurance. Inc, FaxlD: 813-249-8607 To: Diana
Date: 612912001026 pe Page: ~ 4
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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 endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon,
ACORD 25 (2001/08)