Backup Documents 11/13/2012 Item #16B 11681 1
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
(Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The
completed routing slip and original documents are to be forwarded to the Board Office only after the Board has taken action on
the item.)
ROUTING SLIP
Complete routing lines 41 through #4 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 41 through #4, complete the
checklist, and forward to Ian Mitchell (line #5).
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
l.Jeffrey Klatzkow
County Attorney's Office
A_ genda Item Number
16. B.1.
2.
-.
Yes
3.
�-.
Number of Original
1
4. Kristi Bartlett
Board of County Commissioners,y'
Documents Attached
5. Trish Morgan
Clerk's Minutes and Recordsn
;F �kwlwar\
(`► 1
`� �CZ
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. 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, including Ian Mitchell, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Contact
Bradley Muckel
Phone Number
239.867.4121
Agenda Date Item was
Nov , 13, 2012
A_ genda Item Number
16. B.1.
Approved by the BCC
-.
Yes
Type of Documen
�-.
Number of Original
1
Attached
the Office of the County Attorney. This includes signature pages from ordinances,
Documents Attached
INSTRUCTIONS & CHECKLIST
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip �, <; G i?✓ ,
WWS Original 9.03.04
itf?J
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
Original document has been signed /initialed for legal sufficiency. (All documents to be
Yes
signed by the Chairman, with the exception of most letters, must be reviewed and signed by
the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from contracts,
agreements, etc. that have been fully executed by all parties except the BCC Chairman and
l'
Clerk to the Board and possibly State Officials.)
2.
All handwritten strike - through and revisions have been initialed by the County Attorney's
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
-
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
6.
Return I fully executed copy to &(I 077, c 4t,-j 1 ,, <
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip �, <; G i?✓ ,
WWS Original 9.03.04
itf?J
SITE ACCESS AGREEMENT
DATE: November 13, 2012
16B1 '^
THIS AGREEMENT made and entered into between Stevens and Layton, Inc, a Florida Corporation, residing at
11260 Palm Beach Boulevard, Fort Myers, Florida 33905 (herein called the Contractor) and
PROPERTY OWNER: Collier County Community Redevelopment Agency (CRA) - Immokalee
ENGINEER: Q. Grady Minor
PROJECT: Boston Avenue Sidewalk Improvements
LOCATION: Immokalee, Collier County
For and in consideration of the mutual covenants and agreements contained herein and other good and
valuable consideration, the receipt whereof is hereby acknowledged, the property Owner and the Contractor have
jointly negotiated, drafted and agreed as follows:
Agreement:
(a) Collier County CRA, Immokalee, will allow Stevens & Layton to store project related materials, house
equipment and temporarily park vehicles for the above mentioned project on their property located on the
SW corner of Main Street (SR 29) and South W" Street in Immokalee (see highlighted area of aerial
photograph below).
(b) This Agreement will remain in place until final completion of the project, which could occur on or before
March, 2013.
(c) Contractor agrees to restore the property to its original state, which may include, but not be limited to,
grading any tire "ruts" left be equipment/vehicles, sodding/fertilizing /watering -in of any grass areas killed
by vehicles, clean up of any vehicular fluids, etc.
(d) Contractor and its partners will not damage any of the exiting trees or other vegetation located on the site
without prior written approval by the CRA Executive Director.
(e) Contractor will NOT change equipment/vehicular fluids or perform equipment maintenance of any kind
on the subject CRA property.
(f) All stored materials will remain the responsibility of the Contractor until such time as the
materials are installed and become part of the finished County sidewalk improvement product.
Also, no materials will be paid for by the Owner until such time as the materials have been
installed into the finished sidewalk system and invoiced at 100% of their contracted value.
Invoices for stored materials will be rejected by Owner.
(g) Contractor agrees to carry, and provide written proof of prior to construction commencement, the
following minimum insurance coverage throughout the duration of this Agreement:
a. Auto: $1,000,000
b. General Liability: $1,000,000
c. Workers Compensation Statutory with Employer Liability of $1,000,000
ATTEST:
DWIGHT E. BROCK, Clerk
i
Deputy Clerk
form and legal sufficiency:
Jeffre latzkow, County Attorney
ATTESt-
D VIGHT E. BROC ; CLgRK
UoputY Clark'
4 " - ,U,
1*
PROPERTY OWNER
Collier County CRA
Commissioner Donna Fiala, CRA Chair
Name (print or type) (\ Title
77'--�� l l k I -At Z
Signature Date
i \ F
ilE
1661
q� p•
CERTIFICATE. OF LIABILITY INSURANCE _
DATB(MWDDIYYYY)
I 3/26/2012
THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES,
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(3), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terns 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 endorsemen s .
PRODUCER
Valenti Trobec &Woody, Inc.
4110 Center Point Drive
Suits 215
Fort Myers, FL 33916
LOWNP CT Wendy Hingson
PNONE 239- 275 -8226 FAx 239- 273 -9037
EA=L.s.whingson@vtwins.com
INSURER AFFORDING COVERAGE
NAICS
INSURERA'Travelers IndemnitY ComPanY
LIMITS
BISURED I
Stevens & Layton, Inc.
11260 Palm Beach Blvd
Fort Myers, Florida 33905
R1suRERs :Travelers ProPerty Casualty Co.
25674
INSURER C:
INSURER 0!
INSURER
S 1,000,000
INSURER
s 300 000
COVERAGES CERTIFICATF N1IMELFR.-2012 -2013 REVISION NUMBER:
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IM
LTR OR
TYPE OF INSURANCE
Collier County Board of County Commission
CYNUMBER
POLICY EFF
POLJCY EXP
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S 1,000,000
s 300 000
X COMMERCIAL GENERAL LIABILITY
!
A
CLAIMS -MADE ❑X OCCUR
X
C� &III8'1y'2A L
/26/2012
/26/2013
MED EXP (Any one Person) .
S 5,000
PERSONAL S AOV INJURY
$ 1,000,000
GENERAL AGGREGATE
S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
S 2,000,000
S
X POLICY F7 PRO- LOC
AUTOMOBILE LABILITY
COMBINED SINGLE000
BODILY INJURY IP« parson)
S
A
X ANY AUTO
AUTOS OWNED SCHEDULED
HIRED AUTOS NON4"EO
ALTOS
TB10- 73118822
/26/2012
/26/2013
SOOILY INJURY (Psrscddwa)
S
PROPERTY
S
Medical
S 2
.
-
X
UMBRELLA LAB
X
OCCUR
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
S 4,000,000
A
EXCESS LIAB
CLAIMS-MADE
-
X I RETENTION s 10,00
$
-SM- CUP-73118022
/26/2012
/26/2013
WORKERS COMPENSATION
WC STATU I I 0TH -
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERMEM13ER EXCLUDED?
(Mandatory In NH)
NIA
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYE
S
E.L. DISEASE - POLICY LIMIT
S
h describe undo
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addleonal Rarrwka Sbhe", N more space is ro*dmd)
"For any and all work performed on behalf of Collier County" Collier County Board of County
Commissioners, Naples, Florida are added as Additional Insureds with respects to General Liability.
Waiver of Subrogation is included for General Liability. Umbrella coverage noted above overrides all
other insurance limits shown on this certificate. Thirty (30) day notice of cancellation shall apply.
e-COTrCIPATC LJnI nCO rAU1%C1 1 A.TIf1ar
ACORD 25 (2010105) ®1833 -2010 ACUKU GUKt'VKA I wFl. All ngnm reserves.
IN3025 (2Dtoos).ot The ACORD name and logo are registered marks of ACORD d Y--/ 0
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Collier County Board of County Commission
3301 Tamiami Trail East
AUTHORIZED REPRESENTATIVE
7
Naples, FL 34112
ACORD 25 (2010105) ®1833 -2010 ACUKU GUKt'VKA I wFl. All ngnm reserves.
IN3025 (2Dtoos).ot The ACORD name and logo are registered marks of ACORD d Y--/ 0
Legal Description:
above.
IN WITNESS
1681 "
?SS R/W, S122FT OF
d year first written
CONTRACTOR
S�teeve s and Layton, Inc.
/
n RIB
Signed and delivered in our presence as witnesses:
Name (print or type) Title
fitness A o ontr c or
Signa re Dat
W e s ntractor
I
i
I