#09-5089 (Commercial Land Maintenance)
A G R E E MEN T 09-5089
for
Lely Golf Estates MSTU Roadway Grounds Maintenance
THIS AGREEMENT is made and entered into this 14th day of April 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 Florida Land Maintenance, Inc., d/b/a
Commercial Land Maintenance authorized to do business in the State of Florida, whose business
address is 3980 Exchange Avenue, FL 34104 (hereinafter referred to as the "Contractor").
WIT N E SSE T H:
1. COMMENCEMENT: The contract shall be for a one year (1) year period from the date of Notice
to Proceed, with three (3) one (1) year renewal options. The County Manager, or his designee,
may, at his discretion, extend the Agreement under all of the terms and conditions contained in
this Agreement for up to one hundred eighty (180) days. The County Manager, or his designee,
shall give the Contractor written notice of the County's intention to extend the Agreement term not
less than ten (10) days prior to the end of the Agreement term then in effect.
2. STATEMENT OF WORK: The Board of County Commissioners deemed one (1) firm to be pre-
qualified and awarded a Contract to one (1) firm. The awardee will enter into an Agreement to
provide complete services for Lely Golf Estates MSTU Roadway Grounds Maintenance on an
as-needed basis as may be required by the Owner in accordance with the terms and conditions of
Bid #09-5089 and the Contractor's proposal, which is incorporated by reference and made an
integral part of this Agreement. The execution of this Agreement shall not be a commitment to the
Contractor that any work will be awarded to the Contractor. Rather, this Agreement governs the
rights and obligation of the Quotation procedure outlined in the next paragraphs and all Work
undertaken by Contractor for Owner pursuant to this Agreement and that procedure during the
term and any extension of the term of this Agreement.
Prior to the issuance of a Purchase Order, the Owner shall provide a summary of Work to be
performed to the Contractor who will have the opportunity to submit a formal quotation for the
Work. The Contractor shall respond with the information sought within seven (7) working days.
In each Request for Quotation, the Owner reserves the right to specify the period of completion
and the collection of liquidated damages in the event of late completion.
3. COMPENSATION: The Owner shall pay the Contractor for the performance of the Agreement
pursuant to the unit price schedule offered by the Contractor in his bid, together with the cost of
any other charges/fees submitted in the proposal. In such instances, the Contractor shall submit a
copy of the appropriate pages from said price list with the invoice for the non-bid items. Payment
will be made upon receipt of a proper invoice and upon approval by the Project Manager or his
designee, and in compliance with Section 218.70, Fla. Stats., otherwise known as the "Local
Government Prompt Payment Act". Any County agency may utilize the services offered under this
contract, provided sufficient funds are included in its budget(s). Requests for consideration of a
price adjustment must be made on contract anniversary date, in writing, to the Purchasing Director
and, if approved by using Department (could be contingent on funding), must be based upon
South Urban Consumer Price Index (CPI) based on the previous twelve (12) months. Any upward
price adjustment approved by the County shall impose upon the Contractor the requirement to
advise and extend credit to the County when costs' similarly decrease. Surcharges, if applicable,
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will not be accepted in conjunction with this contract, and such charges should be incorporated
into the pricing structures.
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:
Florida Land Maintenance, Inc.
d/b/a Commercial Land Maintenance
3980 Exchange Avenue, Naples, FL 34104
239-643-6205 Telephone
239-643-5012 Fax
Robert Kindelan, President
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:
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
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'5e in violation of any federal, state, county or municipal ordinance, rule, order or regulation,
~ny governmental rule or regulation now in effect or hereafter enacted or adopted. In the
..:\lent 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 immediately 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.
10. INSURANCE: The Contractor shall provide insurance as follows:
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A. Commercial General Liability: Coverage shall have minimum limits of $2,000,000 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 9fI9 Cont~~ctual Liability.
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B. Business Auto Liability: Coverage shall have minimum limits of $2,000,000 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.
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C. 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 $1 'OJD'OOO for each accident.
Special Requirements: Collier County Board of Co nty Commissioners shall be listed as the
Certificate Holder and included as an Addition Insured 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
ContractorNendor/Consultant shall indemnify and hold harmless Collier County, its officers and
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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 Contractoror 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, for Work in
excess of thirty (30) days, the Contractor may indicate on his response to the Request for
Quotation his wish to 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 "B" 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 "C".
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
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. Subcontractors will not be allowed in this
contract. 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
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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
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 "C" 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. COMPLIANCE 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
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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.
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, 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
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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
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 E, which shall
fix the date of Substantial Completion for the entire Work (or designated portion thereof) and
include a tentative punch list 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 F,
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 "B".
(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)
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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
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 Alternative Transportation Modes 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 Proposal, Insurance Certificate, Bid No. 09-5089, any
addenda, any Quotation/Work Order made or issued pursuant to this Agreement, and any
related plans or specifications for any such Quotations or Work Orders.
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.
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.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.
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.
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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.
By: L .
BOARD OF COUNTY COMMISSIONERS
COLLIER COU ifY, FLORIDA
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ATTEST:
Dwight E. Brock, Clerk of Courts
By:
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Dated; .!"'~
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Donna Fiala, Chairman
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First ness
Florida Land Maintenance, Inc.
d/b/a Commercial Land Maintenance
Contracto.... r.... '. ...../ '/ /
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Signature
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Type/Print Witness Name
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Second Witness
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Type/Print Witness Name
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Typed Signature
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Title
County Attorney
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EXHIBIT A
RELEASE AND AFFIDAVIT FORM
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
, 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.:
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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. 09-5089
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 $
ATTACH SCHEDULE OF VALUES AND ACCOMPANYING DOCUMENTATION TO THIS APPLICATION
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: $
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:
By Design Professional:
(DP's Name)
(Signature) DATE:
(Type Name & Title)
Payment to the CONTRACTOR for the above AMOUNT DUE THIS APPLICATION is approved:
By OWNER'S Project Manager:
Page -12-
(Signature) DATE:
(Type Name and Title)
EXHIBIT C
CHANGE ORDER
CHANGE ORDER NO.
CONTRACT NO, 09-5089
TO:
DATE:
PROJECT NAME:
PROJECT NO.:
,200_,
Under our AGREEMENT dated
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 L-> 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-
EXHIBIT D
WARRANTY
In 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 -14-
/~
ACORV@
~
CERTIFICATE OF LIABILITY INSURANCE
DA TE (MMIDDIYYYY)
PRODUCER Phone: 239-262-5143 Fax: 239-261-8265
Brown & Brown of Florida, Inc.
999 Vanderbilt Beach Road, #507
Naples FL 34108-3507
8 6 2009
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.
INSURED
Commercial Land Maintenance
Florida Land Maintenance, Inc. dba
3980 Exchange Avenue
Naples FL 34104
INSURERS AFFORDING COVERAGE
INSURERAFCCI Commercial Insurance Com
INSURERB:National Trust Insur n C m
INsliRERCNo:t;:t:h River Ins. CO.
INSURER D'
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~;: I':"~~} TVDC '"'. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA TlON LIMITS t..{,-~-'-
A X ~NERAL LIABILITY GLOO074082 7/1/2009 7/1/2010 EACH OCCURRENCE 51 000 000 '"
DAMAGE
x... OMMERCIAL GENERAL LIABILITY PREMISES Ea oo::urrence\ 5300 000
- CLAIMS MADE Ii:] OCCUR MED EXP (Any ona oernon) 510.00Q____
-. PERSONAL & ADV INJURY IS 1 000 000
~ GENERAL AGGREGATE $2 000 000
~'L AGG~Er;-T1E LIMIT APFx'I~t PER PRODUCTS - COMP/OP AGG $2 000 000
POLICY X ~fl~.,: X LOC I . ,Iff
B 0l!.TOMOBILE LIABILITY CAOO11222 7/1/2009 7/1/2010 'f /'
COMBINED SINGLE LIMIT $1,000,000........
~ ANY AUTO (Ea accidert)
I--- ALL OWNED AUTOS BODILY INJURY
(Per person) 5
I-- SCHEDULED AUTOS
I--- HIRED AUTOS BODILY INJURY
5
NON.QWNED AUTOS (Per accident)
I--
f-- PROPERTY DAMAGE $
(Per eccident)
RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
1 AUTO ONLY: AGG 5
C OESS I UMBRELLA LIABILITY 5530925385 7/1/2009 7/1/2010 EACH OCCURRENCE $,5000000 ./'
OCCUR D CLAIMS MADE AGGREGATE $10000000
5
8 DEDUCTIBLE 5 ..-
X RETENTION 50 5
WORKERS COMPENSA TlON 1 T~.7m~~ I 1OJ~-
AND EMPLOYERS' LIABILITY Y/N I
ANY PROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCOENT $
OFFICERJMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE
(Mandatory In NH) S
~~~t,~tS~:~';:~16~s below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERA TIDNS I LOCA TlONS 1 VEHICLES I EXCLUSIONS ADDED ZORSEMENT I SPECIAL PROVISIONS
andscaping Contractor.
*10 Days Notice Given for Non-Payment of Premium.
ertificate Holder is included as additional insu ed per form ~ CGL021 (04-03) - Additional Insured - Owners,
.Jessees, or Contractors _ Scheduled Person or Organization when required under a written contract or agreement. \llaiver
of Subrogation applies when required under written contract per form ~ CGL004 (02-0B)Genera1 Liability Advantage
'ndorsement.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
WILL ENDEAVOR TO MAIL *45 DAYS WRITTEN NOTICE TO THE
Collier County Board of County CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
Commissioners SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON
3301 East Tamiami Trail THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Naples FL 34112
AUTHORIZED REPRESENTA TIVE ,"OJ,,, ~ ,{'.//'.. J" "5
I
ACORD 25 (2009/01)
@ 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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
This Certificate of Insurance 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 (2009/01)
COMMERCIAL GENERAL LIABILITY
CGL 021 (0403)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Any person or organization whom you are required to add as an additional insured on this policy under a written
contract or written agreement in effect during this policy period and signed and executed by you prior to the
loss for which coverage is sought.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
Who is an Insured (Section II) is amended to include as an insured the person or organization shown in the
Schedule. but only with respect to your negligent actions which cause liability 10 be imposed on such person or
organization without fault on the part of said person or organization, as a result of "your work" performed for that
insured.
CGL 021 (04 03)
Includes copynghted material of ISO Properties, Inc., with Its permission.
Page 1 of 1
.... .of
ACORqM CERTIFICATE OF LIABILITY INSURANCE I 08/04/2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Risk Concepts Corporation ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
410 43rd Street West Suite N ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Bradenton Fl, 34209
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Southern Eaole Insurance Company
Administrative Concepts Corporation INSURER B: L10yds of London M-1122000
406 43rd Street West INSURER C: Asoen Reinsurance M-1120337
Bradenton Fl, 34209 INSURER D: Max Re Bermuda AA-3190829
INSURER E: Odvssey Re 23680
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L POLICY EFFECllVE Pgk~:(~:~~N
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE IMMIDDIYY\ LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
~
COMMERC~L GENERAL LIABILITY PREMISES lEa ocwrrencel $
~ =:J CLAIMS MADE DOCCUR
MED EXP (Any ""e per"'n) $
I--
PERSONAL & mv INJURY $
I--
GENERAL AGGREGATE $
I--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUClS-CaMP/OP AGG $
hi n,PRO- nL
POLICY JECT LOC
AUTOMOBilE LIABILITY COMBINED SINGLE LIMIT
I-- (Ee eccident) S
ANY AUTO
I--
ALL OVVNED AUTOS BODILY INJURY
I-- (Per pe""nl S
SCHEDULED AUTOS
I--
HIRED AUTOS BODILY INJURY
- (Per acddenl) S
NON-OVVNED AUTOS
-
- PROPERTY DAMAGE $
(Per acddent)
GARAGE liABILITY AUTO ONLY -EA ACCIOENT S
=1 ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCESs/UMBRELLA LIABILITY EACH OCURRENCE S
=:J OCCUR D CLAIMS MADE AGGREGATE S
$
=1 DEDUCTIBLE / S
RETENTION S ", $
A WJRKERS COMPENSATION AND X I we ~IAru- T 100tR
EMPLOYERS' L1ABILlTTY WC0272682-00 01/01/2009 12/31/2009 TORY LIMITS
ANY PROPRIETORIPARTNER/EXECUnVE E.L EACH ACCIDENT S 1,000,000.00
OFFICER/MEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE S 1,000,00000
If yes, descnbe under EL. DISEASE.POLICY LIMIT S 1.000,00000
SPECIAL PROVISIONS below
IUIM~" Please note that Southern Eagle Insurance Company has reinsured it's liabilities in excess of $250,000 under the policies of
BC Workers Compensation insurance listed above with the underwr~ers listed A- or beller at the time of placement of such reinsurance, Such reinsurance
DE Excess Coverage are subjeclto their own terms, conditions and limits. This is for informational purposes and nothing shall create any right
under such relnsurances.
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Effective: 10/10/2004 022514
Coverage is extended to the leased employees of alternate employer (Florida Operations Only): Commercial land Maintenance, Inc DBA Florida Land Maintenance, Ine Conlracl#09.5089 "LelyGoll Estates MSTU Roadway Grounds Maintance"
DISCLAIMER: This Certificate of Insurance does not constitule a contract between the issuing insurer(s). authorized representative or producer. and the certificate
holder nor does it affirmitivelv or neoativelv amend extend or alter the coveraoe afforded bv the Dolicies listed thereon,
/
CERTIFICATE HOLDER
CANCELLA TION
SHOULD toNY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Collier County DATE THEREOF, THE tSSUING INSURER INLl ENDEAVOR TO MAil ~DAYS 'MlITTEN
Board of Commissioners NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL
3301 East Tamiami Trail IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS CR
Naples FL, 34112 REPRESENT A TtVES.
AUTHORIZED REPRESENTATIVE -. ~\2i-.~--
Fax# .~~) O--~- ..J... ~,
ACORD 25 (2001/08)
444 - 20090804
@ ACORD CORPORATION 1988
DO NOT WRITE ABOVE THIS LINE
JJUJ gjlL\ \ 04
Jr7 t /.. <wP L ~A TE RECEIVE~j
~ + r1 ~~A I
/)tfA "~
DI' (",
+ ~ 6t S{l;1
tJ/~b1 ,0
/'
,- .)
ITEM NO.: 01"~"OQ.~l
FILE NO.:
ROUTED TO:
Date:
REQUEST FOR LEGAL SERVICES
~
August 4": 2009
'_< .J
To:
County Attorney's Office
Attention: Jeff Klatzkow - ~ T
From:
Rhonda Cummings, FCCN, CPPB, Contract Specialist
Purchasing Department, Extension 8941
Re:
Contract: #09-5089 "Lely Golf Estates MSTU Roadway Grounds
Maintenance"
Contractor: Florida Land Maintenance, Inc., d/b/a Commercial Land
Maintenance
BACKGROUND OF REQUEST: ~
This Contract was approved by the BCC on April 14, 2009; Agend(J)!.t~
Item 16.8.6 ~/
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Jeff, 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: Darryl Richard, ATM
MEMORANDUM
FROM: Rhonda Cummings, FCCN, CPPB, Contract Specialist
Purchasing Department
~
DATE: Augus~2009
_ flflr
() c?-/
..-r'"' ~..."- ~c
'f.-l,J;~~'
TO: Ray Carter
Risk Management Department
RE: Review of Insurance for Contract: #09-5089 "Lely Golf Estates
MSTU Roadway Grounds Maintenance"
Contractor: Florida Land Maintenance, Inc., d/b/a Commercial
Land Maintenance
This Contract was approved by the BCC on April 14, 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/RC
C: Darryl Richard, ATM
~TE RECEIVEO
AUG 0 1 2009
RlS\<. AANAGEME
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Monday, August 10,20092:00 PM
CummingsRhonda
RichardDarryl; DeLeonDiana; mausen_g
Contract 09-5089 "Lely Golf Estates MSTU Roadway Grounds Maintenance"
I have approved the Certificate of Insurance (COI) provided by Florida Land Maintenance d/b/a Commercial Land
Maintenance for contract 09-5089. The Contract will now be forwarded to the County Attorney's Office for their review.
Thank you,
Ray
~ Cah.i:.eh.
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
www.sunbiz.org - Department of State
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Florida Profit Corporation
FLORIDA LAND MAINTENANCE, INC.
Filing Information
Document Number P99000047430
FEI/EIN Number 650923754
Date Filed OS/20/1999
State FL
Status ACTIVE
Last Event CANCEL ADM DISS/REV
Event Date Filed 10/18/2004
Event Effective Date NONE
Principal Address
3980 EXCHANGE AVE
NAPLES FL 34104
Changed 04/10/2006
Mailing Address
3980 EXCHANGE AVE
NAPLES FL 34104
Changed 04/10/2006
Registered Agent Name & Address
KINOELAN, ROBERTO JR.
3980 EXCHANGE AVE
NAPLES FL 34104 US
Address Changed: 04/10/2006
Officer/Director Detail
Name & Address
Title PO
KINOELAN, ROBERT JR.
3980 EXCHANGE AVE
NAPLES FL 34104
Annual Reports
Report Year Filed Date
2007 02/09/2007
2008 01/11/2008
http://www . sunbiz.org/ scripts/ cordet.exe ?action= D E TFI L& inCL doc _ number=P9900004 743... 7/1/2009
www.sunbiz.org - Department of State
2009 01/07/2009
Document Images
9J.L07f2QQ9-- ANNUAL REPORT
01/11/2008 =ANNUAL REPORT
02/09/2007 ~~ANNUAL REPORT
Q4!lQ!2QQ6:=ANNlJAl..BEeQRI
Q 1/24LZQQ5.=AN N UALRE;EQBI
JQ/Ja./2.QQ.4:=BEtN SIAJEM I;NI
QJ!J:3.[2.Q03=--At'-INLJALBI; PQRI
Q2!2QjZQQ2~.::.ANNl.JAl..8EPQRI
04/26/2001 -- ANNUAL REPORT
Q5/22/200Q-=---AN I'il.J ALJiEE'Q8 I
Q9/22j19!t.~L=Am~nqm~D1
Q;ij2Q!1f)!t.f)=--Dom~J?tic::.E'JQf[t
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RLS # fJCI- PRe - O/;J-C(Cf
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: PL~dUt>A~"'p MA'A)7f;/JANCt..} / NC.,. d..lh! fA,. e.OmtrtE.l2-o..tA-<-f,...AIJ1> f.AAINT~NNL'i..
Exp Date ~! I ('2-PIP
Exp Date 1;)./31/0</
Exp Date II
Exp Date · ,
I) I. I ~tI
Exp Date~_
Exp Date ~ I
~Yes
-LYes No
Yes I./'" No
Yes No
Yes No
Yes No
/Yes No
VYes No
~Yes No
~\~ ~Yes No
\ ~Yes No
......-rYes No
~Yes No
LYes No ~
Reviewer lnitlals:
Date: q
04-COA-0 030222
Entity name correct on contract?
Entity registered with FL Sec. of State?
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ 'Z. M, f.,...
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ 2 M, L
Workers Compensation
Each accident Required $ i ~ I L
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $ S ~I L
Aggregate Provided $ 10M I L
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:
Provided $
Provided $
Provided $
Provided $
Provided $
-z. MtL
I I
I Mo\L
II
3 pOj ff)/)
Provided $
I ,,^-'L
Provided $
Provided $
Provided $
I'
, ~lL
l,
Provided $
Provided $
Required $
Provided $
County required to be named as additional insured?
County named as additional insured?
~Yes
-L Yes
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?
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?
V Yes
~Yes
No
No
~Yes
~Yes
~Yes
~Yes
No
No
No
No
Exp. Date
Exp. Date
Exp. Date
Exp. Date
Exp. Date
~ I, ! UIt)
lC
~ .
II
, /
No
Exp. Date
Exp. Date
Exp Date_
No
No
Attachments
Are all required attachments included?