Backup Documents 02/12/2013 Item #16G 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO it G 1
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNAT
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2. .
3. County Attorney Office County Attorney Office JAK 2>,-\
4. BCC Office Board of County
Commissioners
5. Minutes and Records Clerk of Court's Office -t'1► , 2-115/(3
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Debra Brue eman,Admin. Airport Phone Number 642-7878 Ext. 34
Contact/ Department Authority
Agenda Date Item was 2/12/13 Agenda Item Number 16-G-1
Approved by the BCC
Type of Document Amendment to Agreement with History Number of Original 6rte-
Attached Flight Documents Attached LO O
PO number or account N/A
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? JAK
2. Does the document need to be sent to another agency for additional signatures? If yes, JAK
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAK
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's JAK
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the JAK
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAK
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding t Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware your deadlines!
8. The document was approved by the BCC on 2/12/13 and all changes made during the JAK
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved b he K
BCC,all changes directed by the BCC have been made,and the document is read for the ham.
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2. •.i evised 11/30/12
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MEMORANDUM
Date: February 19, 2013
To: Debbie Brueggeman, Operations Coordinator
Collier County Airport Authority
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: An Amendment to the License Agreement with History Flight Inc.,
for limited commercial aviation operations at Marco Island Airport
Attached for your records is an original copy of the agreement amendment
referenced above, (Item #16G1) approved by the Board of County Commissioners
on Tuesday, February 12, 2013.
If you have any questions, please feel free to call me at 252-8406.
Thank you.
Attachment
16G1
AMENDMENT TO COMMERCIAL AVIATION OPERATIONS LICENSE
AGREEMENT BETWEEN HISTORY FLIGHT,INC.AND
THE COLLIER COUNTY AIRPORT AUTHORITY
THIS AMENDMENT TO COMMERCIAL AVIATION OPERATIONS LICENSE
AGREEMENT (hereinafter referred to as "Amendment") is entered into this hg 4-0 day of
Febrcar , 2013, by and between History Flight, Inc. (hereinafter the "Licensee") and the
Collier Coutity Airport Authority(hereinafter the"Licensor").
WITNESSETH
WHEREAS, on January 8, 2013, the Licensor and Licensee entered into a Commercial
Aviation Operations License Agreement, a copy of which is attached as Exhibit A; and
WHEREAS, this License Agreement allows for specific commercial aviation operations
between the dates of January 19, 2013 and January 20,2013; and
WHEREAS, the Licensee has requested to delay the dates of commercial aviation
operations to March 9, 2013 and March 10, 2013.
NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein, the parties hereto agree to amend the original Commercial Aviation Operations License
Agreement as follows:
1. The term of this bare license, as set forth in paragraph 1 of the License Agreement, is
hereby amended to begin on March 9, 2013 and continue to March 10, 2013.
2. Except as modified by this Amendment, the Commercial Aviation Operations
License Agreement shall remain in full force and effect. If there is a conflict between the terms
of this Amendment and the License Agreement,the terms of this Amendment shall prevail.
IN WITNESS WHEREOF, the parties have executed this Amendment to Commercial
Aviation Operations License Agreement on the date set forth above.
ATTEST: BOA' I OF OUNT COMMISSIONERS
DWIGHT E.BROCK, Clerk COLL I C U UN ,FLORIDA
T
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4`"' GEqI 11.• V . ILLER, ESQ.
CHAIRWOMAN
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Collier County Airport Authority Commercial Aviation Operations License Agreement
COMMERCIAL AVIATION OPERATIONS LICENSE AGREEMENT
,10.-4 COLLIER COUNTY AIRPORT AUTHORITY
2005 MAINSAIL DRIVE, SUITE 1
} NAPLES,FLORIDA 34114
(239)642-7878
LICENSEE: History Flight, Inc. LICENSEE'S PHONE NUMBER: (888)743-3311
LICENSEE'S ADDRESS: 5490 Overseas Hwy 4101,Marathon,FL 33050
1. Licensee/Commercial Aviation Operator: The Collier County Airport Authority (licensor) hereby
licenses History Flight, Inc. (licensee)to conduct specific and limited commercial aviation operations at
the Marco Island Executive Airport. This bare license with no interest attached, begins on
January 19,2013 and continues to January 20.2013.
2. PREMISES: Marco Island Executive Airport located at 2005 Mainsail Drive Naples, Florida. The
premises consist of the airport air operations areas, common use areas and other public use areas on
airport specifically designated for aviation use or as approved by the Immokalee Airport Manager.
3. OPERATIONS: this license agreement allows for the specific commercial aviation operations as listed:
AIRCRAFT STATIC DISPLAY & FLIGHT TOUR OPERATIONS OF WWII VINTAGE AIRCRAFT. SALE OF
RELATED MERCHANDISE, SOUVENIRES & MEMEROBILIA BY LICENSEE ONLY.
Any related activity or sale of merchandise by others in conjunction with licensee but not provided for
under the not for profit status of the licensee shall be prohibited except as authorized by separate license
agreement by licensor in consideration of then applicable rates and fees for said commercial activity.
4. FEE: Licensee shall pay a nominal license fee of$50.00 in consideration of licensee status as 501(c) 3
not-for-profit corporation. Documented proof of 501(c) 3 incorporation shall be provided by licensee
and become a part hereof
5. MINIMUM STANDARD REOUIREMENTS: The Collier County Airport Authority (CCAA)
Minimum Standards for Commercial Specialized Aviation Service Operations requires that for the
licensed activities listed in paragraph 3 (above), a minimum of 300 square feet of office space, restroom
facilities and aircraft tie down or hanger space to accommodate each type of activity. For the terms of
this license,the CCAA is allowing on a temporary basis,the minimum standards he met through use of
the common area and restroom facilities in the airport terminal building. The aircraft tie down
requirements must continue to meet the written requirements independently. The use of the terminal's
common areas and restroom facilities are available to the licensee in the same manner as the general
public and under the same terms and conditions as allowed to the general public and only during normal
operating hours of the terminal building.
6. LIABILITIES: Licensee hereby waives all future claims against Licensor, its employees, agents and or
representatives for any and all liability for damage to aircraft and any other property on the premises
except for physical damage caused by movement of aircraft solely by Licensor's employees, agents or
representatives without any participation in such movement (or instructions to move same) from
Page 1 of 3
16G1
Collier County Airport Authority Commercial Aviation Operations License Agreement 1 6 G 1
Licensee or Licensee's agents, employees or any other person with apparent authority on behalf of
Licensee. Any act or use of the premises by Licensee not expressly authorized by this license or which
is deemed unsafe by the airport manager or against the CC.AA rules and regulations, policies and
procedures or other regulation is unauthorized.
7. INDEMNIFICATION AND INSURANCE:
a. Licensee agrees to indemnify fully and save and hold harmless Collier County, Authority. and
their officers, agents, and employees from and against all losses, damages, claims, liabilities, and
causes of action of every kind or character and nature as well as costs and fees, including
reasonable attorney's fees connected therewith including any and all appeals. and the expense of
the investigation thereof, based upon or arising out of damages or injuries to any and all third
persons or their property. Authority shall give Licensee prompt and reasonable notice of any
such claim or action. Licensee shall have the right to investigate, compromise. and defend the
same to the extent of its own interest.
b. During the entire term of this agreement, Licensee shall provide. pay for, and maintain the types
of insurance required by the Collier County Risk Management Department as listed in exhibit B
attached and made a part hereof for the commercial aeronautical activities to be conducted as
listed in item 3 of this agreement. All insurance shall be from responsible companies duly
authorized to conduct the respective insurance in the State of Florida and/or responsible risk
retention group insurance companies registered with the State of Florida. All liability policies
shall provide that the Authority and the County of Collier as additional insured as to the uses of
the licensed premises under this agreement and shall also provide the Separation of Insured's
Provision. Prior to the execution of this agreement by licensee,the specified insurance coverage
and limits required must be evidenced by properly executed Certificates of Insurance on the
forms which are deemed acceptable by Authority.
8. USE OF PREMISES: The premises shall be used only for those commercial operations listed in this
agreement for aircraft owned by or leased to Licensee with a valid proof of insurance on file with the
CCAA.
9. 1tRMINATION FOR CAUSE: Licensor may terminate this license immediately for cause. Any
breach of this agreement by Licensee is cause for such termination.
10. SECURITY AND SAFETY: Licensee agrees to always cooperate with Licensor in every respect to
insure the security and safety on the premises.
11. EMERGENCY SITUATIONS: In the event of an emergency,(e.g. hurricane) access may he denied to
the premises at the discretion of the Executive Director, Airport manager or designee, provided such
denial of access is to protect the public or airport from potential exposure to loss, damage or safety
because of the emergency.
Page 2 of 3
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1661
Collier County Airport Authority Commercial Aviation Operations License Agreement
12. AUTHORIZED AIRCRAFT:
Aircraft L D.: lQ tarp e . Aircraft Color: ea wit,
Aircraft Make:isLo?4 p r}CA.r,. Aircraft Model: AT-6 Te,xa N
Aircraft I. D.: tJ 54()67 . Aircraft Color:
Aircraft Make: bait" . Aircraft Model: Sdt.�y�tcs` 13 t -?)A,► ' s
Aircraft I. D.: �1 Aircraft Color:
Aircraft Make: . Aircraft Model: .
Aircraft I.D.: . Aircraft Color:
Aircraft Make: . Aircraft Model: .
A TOT LICENSEE:
I HISTo `Y FLIG , • C.
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Witness(si ature)
AV I I .. r r ♦ _, 4._4'4..
(Print Name and Title)
(print name)
0
Witness(signature)
(print name)
AS TO THE LICENSOR:
Attest: BOARD OF COUNTY COMMISSIONERS
DWIGHT F.-BROCK..Clerk OF COLLIER COUNT FLORIDA,serving as the
COLL COUNTY •TRPORT AUTHORITY
toit. ''; - -t.' 1 k\mod`k�
^"� By: ,
ct 'n t4 "; t 15110eik G I•• 'IT'A. HILLER.ESQ.
31 "'t i ;."7 C •WOMAN
Appiq *e,, ,i. to form
and 1.t,t , -j- iclenc : `
Item#
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Jeffre ' 1,tzkow Date --A—
County! orney
Date , 11.k k�}
Rec
Page 3 of 3
Deputy erk
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INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P Gl. PDX 25OR
CINCINNATI, OH 45201
Employer Identification Number:
Date: 76-0806901
JUL 2 6 2012 DLx:
17053046347022
HISTORY FLIGHT INC Contact Person:
C/O MARK NOAH THOMAS E GERITY ID# 31664
5409 OVERSEAS HWY 101 Contact Telephone Number:
MARATHON, FL 33050 (877) 829-5500
Accounting Period Ending:
December 31
Public Charity Status:
509(a) (2)
Form 990 Required:
Yes
Effective Date of Exemption:
February 10, 2012
Contribution Deductibility:
Yes
Addendum Applies:
Yes
Dear Applicant:
We are pleased to inform you that upon review of your application for tax
exempt status we have determined that you are exempt from Federal income tax
under section 501(c) (3) of the Internal Revenue Code. Contributions to you are
deductible under section 170 of the Code. You are also qualified to receive
tax deductible bequests, devises, transfers or gifts under section 2055, 2106
or 2522 of the Code. Because this letter could help resolve any questions
regarding your exempt status, you should keep it in your permanent records.
Organizations exempt under section 501(c) (3) of the Code are further classified
as either public charities or private foundations. We determined that you are
a public charity under the Code section(s) listed in the heading of this
letter.
Please see enclosed Publication 4221-PC, Compliance Guide for 501(c) (3) Public
Charities, for some helpful information about your responsibilities as an
exempt organization.
ioabos^ 947 (no/CC)
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_2-
HISTORY PLIGHT INC
Sincerely,
Holly 0 Paz
Director, Exempt Organizations
Rulings and Agreements
Enclosure: Publication 4221-PC
Latter 947 (DO/cG)