Backup Documents 12/15/2009 Item #16F 5
16F5
MEMORANDUM
Date: January 7,2010
To: Diana DeLeon
Purchasing Department
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Resolution 2009-299: Approving a lease-purchase
agreement and all accompanying documents with
Government Capital Corporation for the replacement
of one (1) ambulance for Emergency Medical Services
Attached, please find two original documents and one certified copy of
the Resolution referenced above, (Agenda Item #16F5) adopted by the
Board of County Commissioners on Tuesday, December 15, 2009.
The Minutes and Records Department will hold one of the original
agreements in the official records of the Board.
If you should have any questions, please contact me at 252-8406.
Thank you.
Attachment
ORIGINAL DOCUMENTS CHECKLIST & ROUTING sLi 6 F 5
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 # 1 through #4 as appropriate for additional signatures, dates, andlor information needed. If the document is already complete with the
exce tion of the Chairman's si ature, draw a line throughroutin lines #1 throuO' #4, com lete the checklist, and fOlWard to Executive Mana er on (line #5).
Route to Addressee(s) Office Initials Date
(List in routin order)
1.
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PRIMARY CONTACT INFORMATION (clf'1 *~RE.:Solu.f1o'V\
(The primary contact is the holder of the original document pending Bee approval. Normally the primary contact is the pers'06 who created/prepared the executive
summary. Primary contact information is needed in the event one of the addressees above need to contact staff for additional or missing information. AU original
documents needin the Bee Chairman's si ature are to be delivered to the BCe office onl after the Bee has acted to a rove the item.)
Name of Primary Staff -:'\ . f... Phone Number ,,;' Q .., 7. \_
Contact ' 1.> La. "-"- D~ ,', ^ d.) ->
Agenda Date Item was I d-. Agenda Item Number - r-"
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Type of Document
Attached
2.
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5. Executive Manager
Board of County Commissioners
6. Minutes and Records
Clerk of Court's Office ..:)I:-
LeJ.t.sIL
A ,-i- Number of Original
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INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/ A'" in the Not Applicable column, whichever is
a ro nate.
Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office ofthe 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 Clerk to the Board and ossibly State Officials.)
All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
The Chairman's signature line date has been entered as the date ofBCC approval of the
document or the final ne otiated contract date whichever is a licable.
"Sign here'" tabs are placed on the appropriate pages indicating where the Chairman's
si nature and initials are re uired.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to the Executive Mgr. 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!
The document was approved by the BCC on / ~j'S'tO<J (enter date) and all changes
made during the meeting have heen incorporate in he attached document. The
Count Attorne 's Office has reviewed the chan es, if a licable.
2.
3.
4.
5.
6.
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Yes
(Initial)
N/A (Not
A licable)
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ESCROW SIGNING INSTRUCTIONS
These documents have been prepared and are being provided with the intent of a smooth and
timely funding; however, providing these documents does not represent an irrevocable offer to
provide funding for this transaction until such time as adequate financial information is provided
and loan committee approval is granted.
IF YOU HAVE ANY QUESTIONS, PLEASE CALL THE DOCUMENTATION DEPARTMENT AT 800-883-1199
Enclosed find our Municipal Lease-Purchase Agreement for the financing of your current equipment needs. Please sign
in blue ink the following documents and witness as indicated.
. FINANCIAL INFORMATION
Please send the most current two (2) years audited financial statements and a budget for the current fiscal year.
Please send the financial information as soon as possible in order for credit analysis to be completed.
. MUNICIPAL lEASE-PURCHASE AGREEMENT
Please review and verify that the information contained in this document is correct. The Agreement requires the
signature of ar. authorized individual with the signature witnessed.
. EXHIBIT "B"
Review the Payment Schedule and sign as indicated.
. INCUMBENCY CERTIFICATE
An authorized indi\ .dual needs to sign this document, in front of a witness, who is either the "Keeper of the
Records", Secretary of the Board, Clerk of the Board, City Secretary, or other Administrative Official.
. INSURANCE CERTIFICATE OR SELF-INSURED CERTIFICATE
Please provide current Insurance Information, such as, Company name, Address, Policy Number, etc. If you are
Self-Insured, please indicate.
. ATTORNEY'S OPINION
Provided in your Lease Agreement, is an Attorney's Opinion letter. This letter needs to be retyped on firm's
ietterhead paper. Urge your attorney to call us with any questions, comments, or suggestions, he may have.
. CERTIFICATE OF ACCEPTANCE
If equipment has been received please sign and date this Certificate. If equipment has not been received please do
not sign, but complete the bottom portion of the Certificate.
. RESOLUTION
This Resolution authorizes the actual transaction and the Authorized Signer's authority to sign the documents.
Please sign as indicated.
. ESCROW AGREEMENT
Sign all three originals as indicated. An "Aaent" will be determined upon our receipt of the documents.
. EXHIBIT A AND ATTACHMENT 1 /PAYMENT REOUEST / ACCEPTANCE CERTIFICATE (If Aoolicable)
When you are ready to pay for your equipment, please complete and return this form to our Escrow Department
along with the vendor invoice. If equipment has not been received, please keep this form, so we can proceed with
the paperwork. Then send the Payment Request/Acceptance CertIficate Form when equipment is received. Your
vendor payment will be processed in 24 to 48 hours from our receipt of the form.
. DEMOGRAPHIC INFORMATION (If ADolicable)
Complete the enclosed Demographic Information sheet in detail and return it with the signed Lease Agreement. All
of the above information must be obtained prIor to providing funding for this transaction.
. 8038 FORM
An B038G or 8038GC is required by the IRS. Please sign and date the form. We will file on your behalf.
. ADVANCE PAYMENT (If AODlicable)
Include any Advance Payment, "At Signing", or Fee as invoiced, and return your payment along with the signed
documents.
PLEASE RETURN ALL ORIGINAL DOCUMENTS AND ANY PAYMENTS DUE TO:
Documentation Department
GOVERNMENT CAPITAL CORPORATION
345 Miron Drive
Southlake, TX 76092
800-883-1199
16F5
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT
THIS FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No 5377 (hereafter referred to as "Agreement") dated as of
December 15, 2009, by and between Government Capital Corporation, a Texas Corporation (herein referred to as "Lessor"),
and Collier County Board of County Commissioners, a political subdivision or agency of Florida (hereinafter referred to as
"Lessee").
WITNESSETH: In consIderation of the mutual covenants and conditions hereinafter set forth, the parties hereto agree as
follows:
1. Term and Payments. Lessor hereby leases to Lessee and Lessee hereby leases from Lessor the property
described in Exhibit A hereto (hereinafter, with all replacement parts, substitutions, proceeds, increases, additions, accessions,
repairs and accessories incorporated therein or affixed thereto, referred to as the "Property") for the amounts to be paid in the sums
(the "Lease Payments") and on the dates (the "Lease Payment Dates") set forth in Exhibit B hereto. Except as specifically provided
in Section 2 hereof, the obligation of the Lessee to make the Lease Payments called for in Exhibit 8 hereto shall be absolute and
unconditional in all events and shall not be subject to any set-off, defense, counterclaim or recoupment for any reason. The term of
the lease hereunder shall commence upon the dated date of the lease and shall continue until the end of the Lessee's current fiscal
period and thereafter for such additional fiscal periods as are necessary to complete the anticipated total lease term as set forth in
Exhibit 8, unless earlier terminated as provided herein. All payments will be made in accordance with Chapter 218, Florida Statutes,
also known as the "Local Government Prompt Payment Act".
2. Renewal and Non-Appropriation. Lessee agrees that it will take all necessary steps and make timely requests
for the appropriation of funds to make all Lease Payments called for under Exhibit 8, and use its best efforts and take all steps to
cause such appropriations to be made. In the event that (i) funds for the succeeding fiscal period cannot be obtained, (ii)Lessee
has exhausted all legally available means for making payment called for under this Agreement, (iii) Lessee has invoked and
diligently pursued all legal procedures by which payment called for under this agreement may be made, (iv) such failure to obtain
funds has not resulted from any act or failure to act of Lessee, (v) Lessee has not acquired, and has no intent to acquire during the
subsequent fiscal period, items of property having functions similar to those the Property or which provide similar benefits to Lessee,
and (vi) no funds have been appropriated for the acquisition of such property, Lessee may terminate this Agreement at the end of
any fiscal period during the payment schedule set forth in Exhibit B by giving notice to Lessor or its successors at least sixty (60)
days prior to the first day of such fiscal period for which appropriations cannot be made. Such failure to obtain proper appropriation
and approval of the full amount of funds necessary to make required payments hereunder during any fiscal period subsequent to the
current fiscal period shall terminate all Lessee's right, title and interest in and obligations under this Agreement and to all the
Property, effective on the last day of the last fiscal period for which appropriation or approval was properly obtained.
3. Taxes. In addition to the Lease Payments to be made pursuant to Section 1 hereof, Lessee agrees to indemnify
and hold Lessor harmless from and against and to pay Lessor, as additional rent, on demand, an amount equal to all licenses,
assessments, sales, use, real or personal property, gross receipts or other taxes, levies, imposts, duties or charges, if any, together
with any penalties, fines, or interest thereon imposed against or on Lessor, Lessee or the Property by any governmental authority
upon or with respect to the Property or the purchase, ownership, rental, possession, operation, return or sale of, or receipt of
payments for, the Property, except any Federal or state income taxes, if any, payable by Lessor. Lessee may contest any such taxes
prior to payment provided such contest does not involve any risk of sale, forfeiture or loss of the Property or any interest therein.
Lessee is sales tax exempt pursuant to Chapter 212, Florida Statutes.
4. Lessee's Covenants and Representations. Lessee covenants and represents as follows:
(a) Lessee represents, and will provide an opinion of its counsel to the effect that, it has full power and authority
to enter into this Agreement which has been duly authorized, executed, and delivered by Lessee and is a valid and binding obligation
of Lessee enforceable in accordance with its terms, and all requirements for execution, delivery and performance of this Agreement
have been, or will be, complied with in a timely manner;
(b) All Payments hereunder have been, and will be, duly authorized and paid when due out of funds then on hand
and legally available for such purposes; Lessee will, to the extent permitted by State law and other terms and conditions of this
Agreement, include in its budget for each successive fiscal period during the term of this Agreement a sufficient amount to permit
Lessee to discharge all of its obligations hereunder, and Lessee has budgeted and available for the current fiscal period sufficient
funds to comply with its obligations hereunder;
(e) There are no pending or threatened lawsuits or administrative or other proceedings contesting the authority
for, authorization of performance of, or expenditure of funds pursuant to, this Agreement;
(d) Information supplied and statements made by Lessee in any financial statement or current budget prior to or
contemporaneously with the Agreement are true and correct;
(e) Lessee has an immediate need for, and expects to make immediate use of, substantially all the Property,
which need is not temporary or expected to diminish in the foreseeable future; specifically Lessee will not give priority or parity in
the appropriation of funds for the acquisition or use of any additional property for purposes or functions similar to those of the
Property.
(1) There are no circumstances presently affecting the Lessee that could reasonably be expected to alter its
foreseeable need for the Property or adversely affect its ability or willingness to budget funds for the payment of sums due
hereunder; and
(g) Lessee's right to terminate this Agreement as specified in Section 2 hereof was not an independently
bargained for consideration, but was included solely for the purpose of complying with the requirements of the laws of the State in
which Lessee is located.
(h) No lease, rental agreement, lease-purchase agreement, payment agreement or contract for purchase to which
Lessee has been a party at any time during the past ten (10) years has been terminated by Lessee as a result of insufficient funds
being appropriated in any Fiscal Year. No event has occurred which would constitute an event of default under any debt, revenue
bond or obligation which Lessee has issued during the past ten (10) years.
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 1
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5. Use and Licenses. Lessee shall pay and discharge all operating expenses and shall cause the Property to be
operated by competent persons only. Lessee shall use the Property only for its proper purposes and will not install, use, operate or
maintain the Property improperly, carelessly, or in violation of any applicable law, ordinance, rule or regulation of any governmental
authority, or in a manner contrary to the nature of the Property or the use contemplated by its manufacturer. Lessee shall keep the
property at the location stated on the Certificate of Acceptance executed by Lessee upon delivery of the Property until Lessor, in
writing, permits its removal, and the Property shall be used solely in the conduct of the Lessee's operations. Lessee shall obtain, at
its expense, all registrations, permits and licenses, if any, required by law for the installation and operation of the Property. Any
license plates used on the Property shall be issued in the name of the Lessee. If a certificate of title is issuable with respect to the
Property, it shall be delivered to the Lessor showing the interest of the Lessor.
6. Maintenance. Lessor shall not be obligated to make any repairs or replacements. At its own expense, Lessee
shall service, repair and maintain the Property in as good condition, repair, appearance and working order as when delivered to
Lessee hereunder, ordinary wear and tear from proper use alone excepted, and shall replace any and all parts thereof which may
from time to time become worn out, lost, stolen, destroyed, or damaged beyond repair or rendered unfit for intended use, for any
reason whatsoever, all of which replacements shall be free and clear of all liens, encumbrances and claims of others and shall
become part of the Property and subject to this Agreement. Lessor may, at its option, discharge such costs, expenses and insurance
premiums necessary for the repair, maintenance and preservation of the Property, and all sums so expended shall be due from
Lessee in addition to rental payments hereunder.
7. Alterations.
(a) Lessee may, at its own expense, install or place in or on, or attach or affix to, the Property such equipment or
accessories as may be necessary or convenient to use the Property for its intended purposes provided that such equipment or
accessories do not impair the value or utility of the Property. All such equipment and accessories shall be removed by Lessee upon
termination of this Agreement, provided that any resulting damage shall be repaired at Lessee's expense. Any such equipment or
accessories not removed shall become the property of Lessor.
(b) Without the written consent of Lessor, Lessee shall not make any other alterations, modifications or
improvements to the Property except as required or permitted hereunder. Any other alterations, modifications or improvements to
the Property shall immediately become part of the Property, subject to the provisions hereof. Without the prior written consent of
Lessor, Lessee shall not affix or attach any of the Property to any real property. The Property shall remain personal property
regardless of whether it becomes affixed or attached to real property or permanently rests upon any real property or any
improvement thereon.
8. Liens. Lessee shall not directly or indirectly create, incur, assume or suffer to exist any mortgage, security
interest, pledge, lien, charge, encumbrance or claim on or with respect to the Property, title thereto or any interest therein, except
the respective rights of Lessor and Lessee hereunder.
9. Damage to or Destruction of Property. Lessee shall bear the entire risk of loss, damage, theft or destruction of
the Property from any and every cause whatsoever, and no loss, damage, destruction or other event shall release Lessee from the
obligation to pay the full amount of the rental payments or from any other obligation under this Agreement. In the event of damage
to any item of the Property, Lessee will immediately place the same in good repair, with the proceeds of any insurance recovery
applied to the cost of such repair. If Lessor determines that any item of Property is lost, stolen, destroyed or damaged beyond
repair, Lessee, at the option of Lessee, will either (a) replace the same with like property in good repair or (b) on the next Lease
Payment Date, pay Lessor (i) all amounts then owed by Lessee to Lessor under this Agreement, including the Lease Payment due on
such date, and (ii) an amount equal to the applicable Option to Purchase Value set forth in Exhibit B.
10. Insurance. Lessee shall either be self-insured with regard to the Property or shall purchase and maintain
insurance with regard to the Property. Lessee shall indicate on each Certificate of Acceptance executed in relation to this Agreement
its election to be self-insured or company insured with regard to the Property listed on that Certificate of Acceptance. Whether
Lessee is self-insured or company insured, Lessee shall, for the term of this Agreement, at its own expense, provide comprehensive
liability insurance with respect to the Property, insuring against such risks, and such amounts as are customary for lessees of
property of a character similar to the Property. In addition, Lessee shall, for the term of this Agreement, at its own expense, provide
casualty insurance with respect to the Property, insuring against customary risks, coverage at all times not less than the amount of
the unpaid principal portion of the Lease Payments required to be made pursuant to Section 1 as of the last preceding Payment Date
specified in Exhibit B on which a Lease Payment was made. If insurance policies are provided with respect to the Property, all
insurance policies shall be with insurers authorized to do business in the State where the Property is located and shall name both
Lessor and Lessee as insureds as their respective interest may appear. Insurance proceeds from casualty losses shall be payable
solely to the Lessor, subject to the provisions of Section 9. Lessee shall, upon request, deliver to Lessor evidence of the required
coverages together with premium receipts, and each insurer shall agree to give Lessor written notice of non-payment of any
premium due and ten (10) days notice prior to cancellation or alteration of any such policy. Lessee shall also carry and require any
other person or entity working on, in or about the Property to carry workmen's compensation insurance covering employees on, in or
about the Property. In the event Lessee fails, for any reason, to comply with the requirements of this Section, Lessee shall
indemnify, save harmless and, at Lessee's sole expense, defend Lessor and its agents, employees, officers and directors and the
Property against all risk of loss not covered by insurance, subject to the limitations of Section 768.28, Florida Statutes
11. Indemnification. Lessee shall indemnify, to the extent permitted by law, and save harmless Lessor and its
agents, employees, officers and directors from and, at Lessee's expense, defend Lessor and its agents, employees, officers and
directors against all liability, obligations, losses, damages, penalties, claims, actions, costs and expenses (including but not limited to
reasonable attorneys' fees) of whatsoever kind or nature which in any way relate to or arise out of this Agreement or the ownership,
rental, possession, operation, condition, sale or return of the Property. All amounts which become due from Lessee under this
Section 11 shall be credited with any amounts received by the Lessor from insurance provided by the Lessee and shall be payable by
Lessee within thirty (30) days following demand therefore by Lessor and shall survive the termination or expiration of this
Agreement. The foregoing is subject to the limitations of Section 768.28, Florida Statutes.
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 2
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12. No Warranty. EXCEPT FOR REPRESENTATIONS, WARRANTIES, ANO SERVICE AGREEMENTS RELATING TO THE
PROPERTY MAOE OR ENTEREO INTO BY THE MANUFACfURERS OR SUPPLIERS OF THE PROPERTY, ALL OF WHICH ARE HEREBY
ASSIGNED TO LESSEE, LESSOR HAS MADE AND MAKES NO REPRESENTATION OR WARRANTY, EXPRESS OR IMPLIED, AND
ASSUMES NO OBLIGATION WITH RESPECf TO THE TITLE. MERCHANTABILITY, CONDITION, QUALITY OR FITNESS OF THE PROPERTY
DESCRIBEO IN EXHIBIT A FOR ANY PARTICULAR PURPOSE OR THE CONFORMITY OF THE PROPERTY TO SPECIFICATION OR
PURCHASE ORDER, ITS DESIGN, DELIVERY, INSTALLATION OR OPERATION. All such risks shall be borne by Lessee without in any
way excusing Lessee from its obligations under this Agreement, and Lessor shall not be liable to Lessee for any damages on account
of such risks. All claims or actions on any warranty so assigned shall be made or prosecuted by Lessee, at its sole expense, upon
prior written notice to Lessor. Lessor may, but shall have no obligation whatsoever to, participate in such claim or action on such
warranty, at Lessor's expense. Any recovery under such a warranty shall be made payable jointly to Lessee and Lessor.
13. Option to Purchase. Provided Lessee has complied with the terms and conditions of this Agreement, Lessee shall
have the option to purchase not less than all of the Property which is then subject to this Agreement, "as is" at the payment date, for
the Option to Purchase Values set forth in Exhibit B by giving written notice to Lessor not less than sixty (60) days prior to the date
specified in Exhibit B for the exercise of such option; provided that upon Lessee's timely payment of all Lease Payments specified in
Exhibit B, Lessee shall be deemed to have properly exercised its option to purchase the Property and shall be deemed to have
acquired all of Lessor's right, title and interest in and to the Property, free of any lien, encumbrance or security interest except such
liens, encumbrances or security interest as may be created, or permitted and not discharged, by Lessee but without other
warranties. Payment of the applicable Option to Purchase Value shall occur on the applicable Lease Payment Date specified in
Exhibit B hereto, at which time Lessor shall, unless not required hereunder, deliver to Lessee a bill of sale transferring Lessor's
interest in the Property to Lessee free from any lien, encumbrance or security interest except such as may be created, or permitted
and not discharged, by Lessee but without other warranties. Upon Lessee's actual or constructive payment of the Option to Purchase
Value and Lessor's actual or constructive delivery of a bill of sale covering the Property, this Agreement shall terminate except as to
obligations or liabilities accruing hereunder prior to such termination.
14. Default and Lessor's Remedies.
(a) The occurrence of one or more of the following events shall constitute an Event of Default, whether occurring
voluntarily or involuntarily, by operation of law or pursuant to any order of any court or governmental agency:
(1) Lessee fails to make any payment hereunder when due or within ten (10) days thereafter, in
accordance with Chapter 218, Florida Statutes, also known as the "Local Government Prompt Payment Act"
(2) Lessee fails to comply with any other covenant, condition or agreement of Lessee hereunder for a
period of the ten (10) days after notice thereof;
(3) Any representation or warranty made by Lessee hereunder shall be untrue in any material respect as
of the date made;
(4) Lessee makes, permits or suffers any unauthorized assignment, transfer or other disposition of this
Agreement or any interest herein, or any part of the Property or any interest therein; or
(5) Lessee becomes insolvent; or admits in writing its inability to pay its debts as they mature; or applies
for, consents to or acquiesces in the appointment of a trustee, receiver or custodian for the Lessee or a substantial part of its
property; or, in the absence of such application, consent or acquiescence, a trustee, receiver or custodian is appointed for Lessee or
a substantial part of its property and is not discharged within sixty (60) days; or any bankruptcy, reorganization, debt arrangement,
moratorium, or any proceeding under any bankruptcy or insolvency law, or any dissolution or liquidation proceeding is instituted by
or against Lessee and, if instituted against Lessee, is consented to or acquiesced in by Lessee or is not dismissed within sixty (60)
days.
(b) Upon the occurrence of any Event of Default specified herein, Lessor may, at its sole discretion, exercise
any or all of the following remedies:
(1) Enforce this Agreement by appropriate action to collect amounts due or to become due hereunder, by
acceleration of otherwise, or to cause Lessee to perform its other obligations hereunder in which event Lessee shall be liable for all
costs and expenses incurred by Lessor;
(2) Take possession of the Property, without demand or notice and without court order or any process of
law, and remove and relet the same for Lessee's account, in which event Lessee waives any and all damages resulting therefrom and
shall be liable for all costs and expenses incurred by Lessor in connection therewith and the difference, if any, between the amounts
to be paid pursuant to Section 1 hereof and the amounts received and to be received by Lessor in connection with any such reletting;
(3) Terminate this Agreement and repossess the Property, in which event Lessee shall be liable for any
amounts payable hereunder through the date of such termination and all costs and expenses incurred by Lessor in connection
therewith;
(4) Sell the Property or any portion thereof for Lessor's account at public or private sale, for cash or
credit, without demand on notice to Lessee of Lessor's intention to do so, or relet the Property for a term and a rental which may be
equal to, greater than or less than the rental and term provided herein. If the proceeds from any such sale or rental payments
received under a new agreement made for the periods prior to the expiration of this Agreement are less than the sum of (i) the
costs of such repossession, sale, relocation, storage, reconditioning, reletting and reinstallation (including but not limited to
reasonable attorneys' fees), (ii) the unpaid principal balance derived from Exhibit 5 as of the last preceding Lease Payment Date
specified in Exhibit 5, and (Ui) any past due amounts hereunder (plus interest on such unpaid principal balance in accordance with
Chapter 218, Florida Statutes, also known as the "Local Government Prompt Payment Act" prorated to the date of such sale), all of
which shall be paid to Lessor, Lessor shall retain all such proceeds and Lessee shall remain liable for any deficiency; or
(5) Pursue and exercise any other remedy available at law or in equity, in which event Lessee shall be
liable for any and all costs and expenses incurred by Lessor in connection therewith. "Costs and expenses," as that term is used in
this Section 14, shall mean, to the extent allowed by law: (i) reasonable attorneys' fees if this Agreement is referred for collection
to an attorney not a salaried employee of Lessor or the holder of this Agreement; (ii) court costs and disbursements including such
costs in the event of any action necessary to secure possession of the Property; and (Ui) actual and reasonable out-of-pocket
expenses incurred in connection with any repossession or foreclosure, including costs of storing, reconditioning and reselling the
Property, subject to the standards of good faith and commercial reasonableness set by the applicable Uniform Commercial Code,
Lessee waives all rights under all exemption laws, except Section 768,28, Florida Statutes
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 3
16F5
(6) Under no circumstances shall Lessee be liable under this subsection 14 (b) for any amount in excess
of the sum appropriated pursuant to Section 1 hereof for the previous and current fiscal years, less all amounts previously due and
paid during such previous and current fiscal years from amounts 50 appropriated.
15. Termination. Unless Lessee has properly exercised its option to purchase pursuant to Section 13 hereof, lessee
shall, upon the expiration of the term of this Agreement or any earlier termination hereof pursuant to the terms of this Agreement,
deliver the Property to Lessor unencumbered and in at least as good condition and repair as when delivered to Lessee, ordinary wear
and tear resulting from proper use alone excepted, by loading the Property, at Lessee's sole expense, on such carrier, or delivering
the Property to such location, as Lessor shall provide or designate at or within a reasonable distance from the general location of the
Property. If Lessee fails to deliver the Property to Lessor, as provided in this Section 15, on or before the date of termination of this
Agreement, Lessee shall pay to Lessor upon demand, for the hold-over period, a portion of the total payment for the applicable
period as set forth in Exhibit B prorated from the date of termination of this Agreement to the date Lessee either redelivers the
Property to Lessor or Lessor repossesses the Property. Lessee hereby waives any right which it now has or which might be acquired
or conferred upon it by any law or order of any court or other governmental authority to terminate this Agreement or its obligations
hereunder, except in accordance with the express provisions hereof.
16. Assignment. Without Lessor's prior written consent, Lessee will not either (i) assign, transfer, pledge,
hypothecate, grant any security interest in or otherwise dispose of this Agreement or the Property or any interest in this Agreement
or the Property; or (if) sublet or lend the Property or permit it to be used by anyone other than Lessee or Lessee's employees.
Lessor may assign its rights, title and interest in and to this Agreement, the Property and any other documents executed with
respect to this Agreement and/or grant or assign a security interest in this Agreement and the Property, in whole or in part. Any
such assignees shall have all of the rights of Lessor under this Agreement. Subject to the foregoing, this Agreement inures to the
benefit of and is binding upon the heirs, executors, administrators, successors and assigns of the parties hereto. No assignment or
reassignment of any of Lessor's rights, title or interest in this Agreement or the Property shall be effective with regard to Lessee
unless and until Lessee shall have received a copy of the document by which the assignment or reassignment is made, disclosing the
name and address of such assignee. No further action will be required by Lessor or by Lessee to evidence the assignment, but
Lessee will acknowledge receipt of such assignments in writing if so required. During the term of this Agreement, Lessee shall keep
a complete and accurate record of all such assignments in form necessary to comply with the United States Internal Revenue Code of
1986, Section 149 (a), and the regulations, proposed or existing, from time to time promulgated thereunder. Prior to any assignment
by Lessor it shall first be approved by Lessee with haste and the knowledge that time is of the essence. Such approval shall be in
accordance with Lessee's Procurement Administrative Procedure, Section IV.C.9 and Lessee's execution of the Lessor provided
Notification of Assignment Letter shall be deemed as approval by the Lessee and that it is the Lessee's responsibility to be in
accordance with said Section before such execution.
17. Personal Property. The Property is and shall at all times be and remain personal property.
18. Title. Lessor shall have title to the Property during the term of this Agreement. Upon payment of all sums due
hereunder to Lessor, Lessor shall convey title to the Property to Lessee.
19. Lessor's Right to Perform for Lessee. If Lessee fails to make any payment or perform or comply with any of its
covenants or obligations hereunder, Lessor may, but shall not be required to, make such payment or perform or comply with such
covenants and obligations on behalf of Lessee, and the amount of any such payment and the expenses (including but not limited to
reasonable attorneys' fees) incurred by Lessor in performing or complying with such covenants and obligations, as the case may be,
together with interest thereon, in accordance with Chapter 218, Florida Statutes, also known as the "Local Government Prompt
Payment Act" shall be payable by Lessee upon demand.
20. Interest on Default. If Lessee fails to pay any Lease Payment specified in Section 1 hereof within ten (10) days
after the due date thereof, Lessee shall pay to Lessor interest on such delinquent payment from the due date until paid accordance
with Chapter 218, Florida Statutes, also know as the "Local Government Prompt Payment Act".
21. Notices. Any notices to be given or to be served upon any party hereto in connection with this Agreement must
be in writing and may be given by certified or registered mail, and shall be deemed to have been given and received forty-eight (48)
hours after a registered or certified letter containing such notice, postage prepaid, is deposited in the United States mail, and if given
otherwise shall be deemed to have been given when delivered to and received by the party to whom it is addressed. Such notice
shall be given to the parties at their respective addresses designated on the signature page of this Agreement or at such other
address as either party may hereafter designate.
22. No Security Interest. In order to comply with the law of the State, Lessee is not granted a security interest in
the Property. However, Lessee agrees to cooperate in filing this Agreement, if requested, as notice of its existence and the retention
of title by Lessor in the Property.
23. Tax Exemption. Lessee certifies that it does reasonably anticipate that not more than $30,000,000 of "qualified
tax-exempt obligations," as that term is defined in Section 265 (b) 3 (D) of the Internal Revenue Code of 1986 ("the Code"), will be
issued by it and any subordinate entities during this current calendar year, 2009. Further, Lessee designates this issue as
comprising a portion of the $30 million in aggregate issues to be designated as "qualified tax exempt obligations" eligible for the
exception contained in Section 265 (b) 3 (D) of the Code allowing for an exception to the general rule of the Code which provides for
a total disallowance of a deduction for interest expense allocable to the carrying of tax exempt obligations.
24. Continuing Disclosure. Specifically and without limitation, Lessee agrees to provide audited financial statements,
prepared by a certified public accountant not later than six (6) months after and as of the end of each fiscal year. Periodic financial
statements shall include a combined balance sheet as of the end of each such period, and a combined statement of revenues,
expenditures and changes in fund balances, from the beginning of the then fiscal year to the end of such period. These reports must
be certified as correct by one of Lessee's authorized agents. If Lessee has subsidiaries, the financial statements required will be
provided on a consolidated and consolidation basis. Lessee's confidentiality of financial statements is subject to Chapter 119, Florida
Statutes, also known as the "Public Records Law".
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 4
16F5
25. Miscellaneous.
(a) Lessee shall, whenever requested, advise Lessor of the exact location and condition of the Property and shall
give the Lessor immediate notice of any attachment or other judicial process affecting the Property, and indemnify and save Lessor
harmless from any loss or damage caused thereby, subject to the limitations of Section 768.28, Florida Statutes. Lessor may, for the
purpose of inspection, following a written ten (10) day notice to the Lessee, enter upon any job, building or place where the Property
and the books and records of the Lessee with respect thereto are located.
(b) Lessee agrees to equitably adjust the payments payable under this Agreement if there is a determination for
any reason that the interest payable pursuant to this Agreement (as incorporated within the schedule of payments) is not excludable
from income in accordance with the Internal Revenue Code of 1986, as amended, such as to make Lessor and its assigns whole.
(e) Time is of the essence. No covenant or obligations hereunder to be performed by Lessee may be waived
except by the written consent of Lessor, and a waiver of any such covenant or obligation or a forbearance to invoke any remedy on
any occasion shall not constitute or be treated as a waiver of such covenant or obligation as to any other occasion and shall not
preclude Lessor from invoking such remedy at any later time prior to Lessee's cure of the condition giving rise to such remedy.
Lessor's rights hereunder ate cumulative and not alternative.
(d) This Agreement shall be construed in accordance with, and governed by, the laws of the State of Florida.
(e) This Agreement constitutes the entire agreement between the parties and shall not be modified, waived,
discharged, terminated, amended, altered or changed in any respect except by a written document signed by both Lessor and
Lessee.
(f) Any term or provision of this Agreement found to be prohibited by law or unenforceable shall be ineffective to
the extent of such prohibition or unenforceability without, to the extent reasonably possible, invalidating the remainder of this
Agreement.
(g) The Lessor hereunder shall have the right at any time or times, by notice to Lessee, to designate or appoint
any person or entity to act as agent or trustee for Lessor for any purposes hereunder.
(h) All transportation charges shall be borne by Lessee. Lessee will immediately notify Lessor of any change
occurring in or to the Property, of a change in Lessee's address, or in any fact or circumstance warranted or represented by Lessee
to Lessor, or if any Event of Default occurs.
(i) Use of the neuter gender herein is for purposes of convenience only and shall be deemed to mean and include
the masculine or feminine gender whenever and wherever appropriate.
(j) The captions set forth herein are for convenience of reference only and shall not define or limit any of the
terms or provisions hereof.
(k) Except as otherwise provided herein, this Agreement shall be binding upon and inure to the benefit of the
Parties hereto and their respective heirs, executors, administrators, legal representatives, successors and assigns, where permitted
by this Agreement.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the
year 2009.
1'5""
day of
}).,~e.......be.~ in the
Lessor: Government Capital Corporation
Witness Signature
Authorized Signature
345 Miron Dr.
Southlake, TX 76092
Print Name
Print Title
Lessee: Board of County Commissioners
Collier County, Fylfida
IA~
Donna Fiala, C airman
3301 Tamaimi Trail East
Naples, Fiorida 34112
Attest: Dwight E. Brock,.Clerk
,.F /
~.L&:..f~
fhw~&.
D~le~.,
........ 0Il~ ~ 'Vi
.~
APProv~ ;o?i]~CienCY:
Scott R. Teach
Deputy County Attorney
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 5
16F5
EXHIBIT A
DESCRIPTION OF PROPERTY
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No 5377(THE "AGREEMENT")
BY AND BETWEEN
LESSOR, Government Capital Corporation
and LESSEE, Collier County Board of County Commissioners
Dated as of December 15, 2009
QTY DESCRIPTION
CUSTOM RESCUE TRANSPORT AND CHASSIS
One (1)
2010 Horton Model F623 Custom/Rescue/Transport Vehicle on a Ford F550 Chassis
PROPERTY LOCATION:
8075 Lely Cultural Parkway
Naples, Florida 34113
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 6
16F5
EXHIBIT B
>> SCHEDULE OF PAYMENTS & OPTION TO PURCHASE PRICE <<
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No. 5377, (THE "AGREEMENT")
BY AND BETWEEN
LESSOR: Government Capital Corporation
and LESSEE: Collier County Board of County Commissioners
Dated as of December 15, 2009
(Revised 11-17-09)
PMT PMT DATE TOTAL INTEREST PRINCIPAL OPTION TO PURCHASE
NO. MO DAY YR PAYMENT PAID PAID after pmt on this line
1 09/15/10 $41,575.74 $6,751.61 $34,824.13 N/A
2 09/15/11 $41,57574 $7,180.37 $34,395.37 N/A
3 09/15/12 $41,575.74 $5,510.82 $36,064.92 N/A
4 09/15/13 $41,575.74 $3,760.23 $37,815.51 $39,976.67
5 09/15/14 $41,575.74 $1,924.67 $39,651.07 $1.00
****This Schedule is subject to current Market Indexing if Funding occurs 14 days after Proposal Date****
Lessee~'. rd of County com.miSSion. ers
COllie~ ty, Florida I ~
{l,+-~ otl4.~
Donna Fiala, Chairman
Attest: Dwight E. Brock, CI~rk ..,,(W,. vc.
fuAA . >~;>::~:....::..,: -
~.' "'. ,?
, '" OC' -
~k tI~...;-
.. '. - ,'. ." .'
,t__ 01' ~ . ,.. '. . ,.,
........ .,..,. ...., t....l,.:.;t....:..,..,... _,~~,~
" L- 1'1,,\,"e:1.'V
""" l.!\. .~~ll'
Sco R. Teach
Deputy County Attorney
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 7
16F5
INCUMBENCY, INSURANCE, AND ESSENTIAL USE CERTIFICATES
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No. 5377 (THE "AGREEMENT")
BY AND BETWEEN
LESSOR, Government Capital Corporation
and LESSEE, Collier County Board of County Commissioners
Dated as of December 15, 2009
I, Dwight E. Brock (NAME), do hereby certify that I am the duly elected or appointed and acting Deputy Clerk (Keeper of the
Records), of Collier County, a political subdivision or agency duly organized and existing under the laws of the State of Florida, that I have
custody of the records of such entity, and that, as of the date hereof, the individual(s) named below are the duly elected or appointed
officer(s) of such entity holding the office(s) set forth opposite their respective name(s). I further certify that (i) the signature(s) set opposite
their respective name(s) and title(s) are their true and authentic signature(s), and (ii) such officers have the authority on behalf of such
entity to enter into that certain Municipal Lease~Purchase Agreement dated as of December is, 2009, between such entity and Government
Capital Corporation,
()
~qMN~L.,
I~.lrNE.?~_'/IIJiE~E9I', I have duly executed this certificate and affixed the seal of suctf':entlty' hereto" thIS !.15-1+1
. ..1..!C( ~ , 2009.
Name
Title
".5
..f-" /
,-"/.. tl //
~..r<,.' _~t'~(:...
Donna Fiala
Chairman
day of
BY:
Dwight tctltltSlDdt
Lessee certifies that property and liability insurance, if apPlicabll_~s ~#In accor~~~c.e w)~h t~e Agreeme~t and such coverage
will be maintained in full force for the term of the Agreement. "Lessor or its Assigns" should '!Be '~signatect as 10$ payee until Lessee is
notified, in writing, to substitute a new loss payee, T".' foHowlneln'Drmatlon I. provided abo~n)i'Urilnce-'- '
J"..i~CJ . f~'
INSURANCE COMPANY/AGENT'S NAME:
INSURANCE COMPANY ADDRESS:
PHONE NUMBER:
POLICY NUMBER:
I, Donna Fiala, Chairman, of Collier County Board of County Commissioners ("Lessee"), hereby certify that the equipment, to be
leased to the undersigned under the certain Lease Agreement, dated as of December 15, 2009, between such entity and
Government Capit~l Corpo~ation ("Lessor"), will be used by the undersigned Lessee for the following purpose-- ~.&.EASEFJ"'t. OUT
IlNMARV USE IIElOW)
PRIMARY USE:
Emerqeney TranspOrtation Service
The undersigned hereby represents the use of the Equipment is essential to its proper, efficient and economic operation.
IN WITNESS WHEREOF, I have set my hand this
'S4~ day of
Del'-U"f'\ne y; 2009.
Attest: Dwight E. Brock, Clerk
/
~~~
ea..
"'"
~', ""
',('., '.
r;. " .
,:/(,,) -:.,':'
. I'.f"j,\~,~\i >
,
Donna Fiala, Chairman
Scott R. each
Deputy County Attorney
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 8
16F5
CERTIFICATE OF ACCEPTANCE
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No. 5377 (THE "AGREEMENT")
BY AND BETWEEN
Lessor, Government Capital Corporation and Lessee Collier County Board of County Commissioners
Dated as of December 15, 2009
1. ACCEPTANCE: In accordance with the Agreement, Lessee hereby certifies that all of the Property described herein (i) has been
received by Lessee, (Ii) has been thoroughly examined and inspected to the complete satisfaction of Lessee, (iii) had been found by
Lessee to be in good operating order, repair and condition, (iv) has been found to be of the size, design, quality, type and
manufacture specified by Lessee, (v) has been found to be and is wholly suitable for Lessee's purposes, and (vi) is hereby
unconditionally accepted by Lessee, in the condition received, for all purposes of this Agreement.
ACCEPTED on this the
day of
,2009 (*).
Lessee: Board of County Commissioners
Collier County, Florida
Attest: Dwight E. Brock, Cierk
Donna Fiala, Chairman
Deputy Clerk
Approved as to form and legal sufficiency:
Scott R. Teach
Deputy County Attorney
("'l' ":~ANCE MUST BE SIGNED !J/!IJ.:t.IF f!iQ ESCROW AGREEMENT IS INCLUPED
2. PROPERTY: 2010 Horton Model F623 Custom/RescuefTransport Vehicle on a Ford F550 Chassis, SEE ATTACHED EXHIBIT A.
(I USE: The primary use of the Property is as followsn (PLEASE FILL OUT PRIMARY USE BEl.OW)
PRIMARY USE: . Emergency Transportation Service
4. PROPERTY LOCATION:
8075 Lely Cultural Parkway
Naples, Florida 34113
5. INVOICING: Invoices shall be sent to the following address, including to whose attention invoices should be directed:
Collier County Board of County Commissioners
Attention: Artie Bay
3301 Tamaimi Trail East
Naples, Florida 34112
artiebay@colliergov.net
# INSURANCE: Lessee certifies that property and liability insurance have been secured in accordance with the Agreement and such
coverage will be maintained in force for the term of the Agreement. Lessor will be designated as loss payee until Lessee is notified,
in writing, to substitute a new loss payee.
----X-Company Insured
Election to self-insure (in accordance with Section 10 of the Agreement).
(!.;. MAINTENANCE: In accordance with Section 6 of the Agreement, Lessee agrees to, at its own expense, service, repair and
maintain the Property for the term of the Agreement as follows:
Maintenance Contract
-----X....- Election to self-maintain
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 9
Office of the County Attorney
Jeffrey A. Klatzkow
16F5
.....-.~~~..,,...----~--------''''''''''"''''''''''--
Deputy County Attorney' Scott R. Teach
Section Chiefs. Heidi F. Ashton-Cicko. Jacqueline W. Hubbardll '"Board Certified City, County and Local Govemment Law
Assistant County Attorneys' Colleen M. Greene Jennifer B. White Steven T. Williams Jeff E. Wright Robert N. Zachary
December 15, 2009
Government Capital Corporation
Attention Documentation Department
345 Miron Drive
Southlake, TX 76092
RE: Florida Municipal Lease-Purchase Agreement No 5377
Dear Lessor:
I have acted as Counsel to Collier County with respect to that certain Florida Municipal Lease-Purchase
Agreement No 5377, by and between Government Capital Corporation as Lessor and Collier County
Board of County Commissioners as Lessee. I have reviewed the Agreement and such other documents,
records and certificates of Lessee and appropriate public officials as I have deemed relevant and am of the
opinion that:
1. The Lessee is a political subdivision or agency of the State of Florida with the requisite power
and authority to incur obligations, the interest on which is exempt from taxation by virtue of
Section 1 03( a) of the Internal Revenue Code of 1986;
2. The execution, delivery and performance by the Lessee of the Agreement have been duly
authorized by all necessary action on the part of the Lessee; and
3. The Agreement constitutes a legal, valid and binding obligation of the Lessee enforceable in
accordance with its terms.
4. The above opinions may be relied upon by the Lessee, Lessor, or its Assigns.
Sincerely,
~iJ- (?(~L
Scott R. Teach
Deputy County Attorney
3301 East Tamiami Trail' Naples Florida 34112-4902' (239) 252-8400' FAX: (239) 252-6300
16F5
RESOLUTION # 299
A RESOLUTION REGARDING A LEASE PURCHASE AGREEMENT FOR
THE PURPOSE OF PROCURING A "CUSTOM RESCUE TRANSPORT AND CHASSIS".
WHEREAS, Collier County Board of County Commissioners desires to enter into that certain lease-
Purchase Agreement No 5377, by and between Government Capital Corporation and Collier County Board
of County Commissioners, for the purpose of procuring a "Custom Rescue Transport and Chassis". The
Collier County Board of County Commissioners desires to designate this Agreement as a "quaiified tax
exempt obiigation" of the Collier County Board of County Commissioners for the purposes of Section 265
(b) (3) of the Internal Revenue Code of 1986, as amended. The Collier County Board of County
Commissioners desires to designate Donna Fiala, Chairman, as an authorized signer of the Agreement.
NOW THEREFORE, BE IT RESOLVED BY THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS:
Section 1. That the Collier County Board of County Commissioners enter into a lease Purchase
Agreement with Government Capitai Corporation for the purpose of procuring a "Custom Rescue Transport
and Chassis",
Section 2. That the lease Purchase Agreement No 5377 , by and between the Government
Capitai Corporation and Collier County Board of County Commissioners is designated by the as a
"qualified tax exempt obligation" for the purposes of Section 265 (b) (3) of the Internal Revenue Code of
1986, as amended.
Section 3. That the Collier County Board of County Commissioners designates Donna Fiala,
Chairman, as an authorized signer of the lease Purchase Agreement dated as of December 15, 2009 by
and between the Collier County Board of County Commissioners and Government Capital Corporation.
PASSED AND APPROVED by the Collier County Board of County Commissioners in a meeting held on the
IS*' day of. ill (J() mbt...-; 2009.
Lessee: Board of County Commissioners
Collier CountYj f1rida ,
f II / -
/, j! -f; ..4
'. .It-~ <::><,Ltt .
Donna Fiala, <thairman
Attest: Dwight E. Brock, Clerk...
"
Approved as to form a21egal sufficiency:
Scott ~~y R ~L
Deputy County Attorney
~IIOd{."'"
Depu " '"F_:'.'<:::'._
.c-..-.:. ~l_: . ,,~.'
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;<i
Item# ~
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 11
~~:da 12-15711
~:d I-<rUH[
~~
16F5
ESCROW AGREEMENT
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No. 5377 (THE "AGREEMENT")
BY AND BETWEEN
LESSOR, Government Capital Corporation and LESSEE, Collier County Board of County Commissioners
Federal Tax 10 # 59-6000558 Dated as of December 15, 2009
among
THIS ESCROW
Government
AGREEMENT (the "Agreement") is made and
Capital Corporation ("Lessor"), Collier
("Agent").
entered into as of December 15, 2009 ("Agreement Date") by and
County Board of County Commissioners ("Lessee") and
WIT N E SSE T H:
WHEREAS, Lessor and Lessee have entered into a certain Florida Municipal Lease-Purchase Agreement dated as of December 15,
2009 (the "Lease") pursuant to which the property more particularly described therein (the "Equipment") will be leased to the Lessee under
the terms stated in the lease;
WHEREAS, Lessor and Lessee desire to make funding arrangements for the acquisition of the Equipment, and Agent agrees to
serve as escrow agent for such funding and acquisition;
NOW THEREFORE, in consideration of the mutual agreements and covenant herein contained and for other valuable consideration,
the parties hereby agree as follows:
1. Agent shall undertake the duties and obligations of escrow agent as set forth in this Agreement. Agent shall not be deemed to be a party
to the Lease.
2. Lessor has delivered to Agent the sum of $182,751.00 for deposit by Agent in the Collier County Escrow Account (the "Fund"). The Fund
will be administered by Agent pursuant to the terms of this Agreement.
3. Deposits in the Fund shall be used to pay for the acquisition of the Equipment. The Equipment may be acquired as individual items or as
groups of items. Agent shall make disbursements from the Fund in payment for the acquisition of each item or group of items of the
Equipment promptly upon receipt of a properly executed Payment Request Form, in the form attached hereto as Exhibit "A", for that portion
of the acquisition of the Equipment for which payment is requested. Upon full acquisition of an item or group of items of the Equipment, any
remaining cost of such item or group of items shall be disbursed promptly by the Agent upon receipt of a properly executed Acceptance
Certificate and a corresponding Payment Request Form in the form attached hereto as Exhibit "A", for that portion of the Equipment for which
payment is requested. Payment by Agent shall be to the payee shown on the Payment Request Form.
4. Agent will invest the Fund, as specified by Lessor, in general obligations of the United States or in obligations fully insured by the United
States or in certificates of deposit of a bank which is either fuliy insured by an agency of the federal government or fully collateralized by such
federal or federally guaranteed obligations, or in no~load money market mutual funds registered with and regulated by the Securities and
Exchange Commission that includes in their investment objectives the maintenance of a stable net asset value of $1 for each share, or Money
Market Mutual Funds registered under the Investment Act of 1940. Agent will retain in the Fund all earnings from investment of the Fund until
termination of the Fund pursuant to Section 5 hereof.
5. Upon execution of one or more Certificates of Acceptance by Lessee and payment of acquisition costs by Agent for ali the Equipment, this
Agreement and the Funds shall terminate, and Agent shall transfer to Lessor all remaining sums in the Fund. If not terminated earlier, this
Agreement and the Fund shall terminate on June 15, 2010 ("Termination Date"). In this latter event, interest accrued pursuant to investment
of the Fund under the terms of Section 4 hereof and all remaining principal in the Fund shall be transferred by Agent to Lessor; Exhibit "An
attached to the Lease shall thereupon be revised to delete any non-acquired portions of the Equipment and to substitute an amended
amortization payment schedule to reflect the reduced acquisition costs.
6. Lessor and Lessee may by written agreement between themselves remove the Agent, at any time and for any reason, and appoint a
successor escrow agent. Such removal shall not be effective until thirty (30) days after written notice thereof if provided to Agent.
7. Agent may at any time and for any reason resign as escrow agent by giving written notice to Lessor and Lessee of its intention to resign
and of the proposed date of resignation, which date shall be not iess than thirty (30) days after giving Lessee and Lessor written notice of
intent to resign, nor less than thirty (30) days after being appointed by Lessor and Lessee.
8. Agent shall have no obligation under the terms of this Agreement to make any disbursement except from the Fund. Agent makes no
warranties or representations as to the Equipment or as to performance of the obligations of Lessor or Lessee under this Agreement or the
Lease.
9. Agent shall be entitled to rely in good faith upon any documents signed by a party hereto and shall have no duty to investigate the
veracity of such documents. Agent (i) may assume that any person giving notice pursuant to the terms hereof is authorized to do so and (ii)
shall not be liable for good faith reliance thereon.
10. To the limited extent required to perfect the security interest granted by Lessee to Lessor in the cash and negotiable instrument from time
to time comprising the Fund, lessor hereby appoints the Agent as its security agent, and the Agent hereby accepts the appointment as
security agent, and agrees to hold physical possession of such cash negotiable instruments on behalf of Lessor.
11. This Agreement may be amended by written agreement executed by all the parties.
12. This Agreement may be executed in several counterparts, each of which shall be an original.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first written above.
LESSOR: Government Capital Corporation
LESSEE:
BY:
Authorized Signr
Collier corf ~ard of County commis~oners..: Attest: DWight:: ~,,"I"QCI<.~'Clerk
d;J,) . r..f_/;
BY' ,~_. <y'L.-dJ~BY'
Donna Fial ,Chairman Deputy Clet"k; :
'7:':ff=
Teac , Deputy County Attorney
BY:
Scott R.
AGENT:
~'.'" t..-.
"tQll4~ .~.
BY:
Agent Rep, Agent Rep Title
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 12
16F5
ESCROW AGREEMENT
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No. S377 (THE "AGREEMENT")
BY AND BETWEEN
LESSOR, Government Capital Corporation and LESSEE, Collier County Board of County Commissioners
Federal Tax 10 # 59-6000558 Dated as of December 15, 2009
among
THIS ESCROW AGREEMENT (the "Agreement") is made and
Government Capital Corporation ("lessor"), Collier
("Agent").
entered into as of December 15, 2009 ("Agreement Date") by and
County Board of County Commissioners ("Lessee") and
WIT N E SSE T H:
WHEREAS, lessor and Lessee have entered into a certain Florida Municipal Lease-Purchase Agreement dated as of December 15,
2009 (the "Lease") pursuant to which the property more particularly described therein (the "Equipment") will be leased to the Lessee under
the terms stated in the lease;
WHEREAS, Lessor and lessee desire to make funding arrangements for the acquisition of the Equipment, and Agent agrees to
serve as escrow agent for such funding and acquisition;
NOW THEREFORE, in consideration of the mutual agreements and covenant herein contained and for other valuable consideration,
the parties hereby agree as follows:
1. Agent shall undertake the duties and obligations of escrow agent as set forth in this Agreement. Agent shall not be deemed to be a party
to the lease.
2. lessor has delivered to Agent the sum of $182,751.00 for deposit by Agent in the Collier County Escrow Account (the "Fund"). The Fund
will be administered by Agent pursuant to the terms of this Agreement.
3. Deposits in the Fund shall be used to pay for the acquisition of the Equipment. The Equipment may be acquired as individual items or as
groups of items. Agent shall make disbursements from the Fund in payment for the acquisition of each item or group of Items of the
Equipment promptly upon receipt of a properly executed Payment Request Form, in the form attached hereto as Exhibit "A", for that portion
of the acquisition of the Equipment for which payment is requested. Upon full acquisition of an item or group of items of the Equipment, any
remaining cost of such item or group of items shall be disbursed promptly by the Agent upon receipt of a properly executed Acceptance
Certificate and a corresponding Payment Request Form in the form attached hereto as Exhibit "A", for that portion of the Equipment for which
payment is requested. Payment by Agent shall be to the payee shown on the Payment Request Form.
4. Agent will invest the Fund, as specified by lessor, in general obligations of the United States or in obligations fully insured by the United
States or in certificates of deposit of a bank which is either fully insured by an agency of the federal government or fully collateralized by such
federal or federally guaranteed obligations, or in no-load money market mutual funds registered with and regulated by the Securities and
Exchange Commission that includes in their investment objectives the maintenance of a stable net asset value of $1 for each share, or Money
Market Mutual Funds registered under the Investment Act of 1940. Agent will retain in the Fund all earnings from investment of the Fund until
termination of the Fund pursuant to Section 5 hereof.
5. Upon execution of one or more Certificates of Acceptance by lessee and payment of acquisition costs by Agent for all the Equipment, this
Agreement and the Funds shall terminate, and Agent shall transfer to lessor all remaining sums in the Fund. If not terminated earlier, this
Agreement and the Fund shall terminate on June 15, 2010 ("Termination Date"). In this latter event, interest accrued pursuant to investment
of the Fund under the terms of Section 4 hereof and all remaining principal in the Fund shall be transferred by Agent to lessor; Exhibit "A"
attached to the lease shall thereupon be revised to delete any non-acquired portions of the Equipment and to substitute an amended
amortization payment schedule to reflect the reduced acquisition costs.
6. Lessor and Lessee may by written agreement between themselves remove the Agent, at any time and for any reason, and appoint a
successor escrow agent. Such removal shall not be effective until thirty (30) days after written notice thereof if provided to Agent.
7. Agent may at any time and for any reason resign as escrow agent by giving written notice to Lessor and lessee of its intention to resign
and of the proposed date of resignation, which date shall be not less than thirty (30) days after giving Lessee and lessor written notice of
intent to resign, nor less than thirty (30) days after being appointed by Lessor and Lessee.
8. Agent shall have no obligation under the terms of this Agreement to make any disbursement except from the Fund. Agent makes no
warranties or representations as to the Equipment or as to performance of the obligations of lessor or Lessee under this Agreement or the
Lease.
9. Agent shall be entitled to rely in good faith upon any documents signed by a party hereto and shall have no duty to investigate the
veracity of such documents. Agent (i) may assume that any person giving notice pursuant to the terms hereof is authorized to do so and (ii)
shall not be liable for good faith reliance thereon.
10. To the limited extent required to perfect the security interest granted by lessee to Lessor in the cash and negotiable instrument from time
to time comprising the Fund, lessor hereby appoints the Agent as its security agent, and the Agent hereby accepts the appointment as
security agent, and agrees to hold physical possession of such cash negotiable instruments on behalf of Lessor.
11. This Agreement may be amended by written agreement executed by all the parties.
12. This Agreement may be executed In several counterparts, each of which shall be an original.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first written above.
LESSOR: Government Capital Corporation
LESSEE:
BY:
Authorized~i ,
COllie't y ; ooed of Cocoty co~mti,"e':..i
BY':~">A.-. -.;J/ <1-ik
Donna Fiafa, Chairman
\'
Attest: DW,ight'E.. Brock, Clerk
. ~i.((tr:
to foem a?l~"L
each, Deputy County Attorney
AGENT:
At~t .$ to
'~..J'
,
BY:
Agent Rep, Agent Rep Title
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 13
16F5
ESCROW AGREEMENT
FLORIOA MUNICIPAL LEASE-PURCHASE AGREEMENT No, 5377 (THE "AGREEMENT")
BY AND BETWEEN
LESSOR, Government Capital Corporation and LESSEE, Collier County Board of County Commissioners
Federal Tax ID # 59-6000558 Dated as of December 15, 2009
among
THIS ESCROW AGREEMENT (the "Agreement") is made and
Government Capital Corporation ("Lessor"), Collier
("Agent").
entered into as of December 15, 2009 ("Agreement Date") by and
County Board of County Commissioners ("Lessee") and
WIT N E SSE T H:
WHEREAS, Lessor and lessee have entered into a certain Florida Municipal Lease-Purchase Agreement dated as of December 15,
2009 (the "Lease") pursuant to which the property more particularly described therein (the "Equipment") will be leased to the Lessee under
the terms stated in the Lease;
WHEREAS, Lessor and Lessee desire to make funding arrangements for the acquisition of the Equipment, and Agent agrees to
serve as escrow agent for such funding and acquisition;
NOW THEREFORE, in consideration of the mutual agreements and covenant herein contained and for other valuable consideration,
the parties hereby agree as follows:
1. Agent shall undertake the duties and obligations of escrow agent as set forth in this Agreement. Agent shall not be deemed to be a party
to the Lease.
2. Lessor has delivered to Agent the sum of $182,751.00 for deposit by Agent in the Collier County Escrow Account (the "Fund"). The Fund
will be administered by Agent pursuant to the terms of this Agreement.
3. Deposits in the Fund shall be used to pay for the acquisition of the Equipment. The Equipment may be acquired as individual items or as
groups of items. Agent shall make disbursements from the Fund in payment for the acquisition of each item or group of items of the
Equipment promptly upon receipt of a properly executed Payment Request Form, in the form attached hereto as Exhibit "A", for that portion
of the acquisition of the Equipment for which payment is requested. Upon full acquisition of an item or group of items of the Equipment, any
remaining cost of such item or group of items shall be disbursed promptly by the Agent upon receipt of a properiy executed Acceptance
Certificate and a corresponding Payment Request Form in the form attached hereto as Exhibit "A", for that portion of the Equipment for which
payment is requested. Payment by Agent shall be to the payee shown on the Payment Request Form.
4. Agent will invest the Fund, as specified by Lessor, in general obligations of the United States or in obligations fully insured by the United
States or in certificates of deposit of a bank which is either fully insured by an agency of the federai government or fully coliateralized by such
federal or federally guaranteed obligations, or in no-load money market mutual funds registered with and regulated by the Securities and
Exchange Commission that includes in their investment objectives the maintenance of a stable net asset value of $1 for each share, or Money
Market Mutual Funds registered under the Investment Act of 1940. Agent will retain in the Fund all earnings from investment of the Fund until
termination of the Fund pursuant to Section 5 hereof.
5. Upon execution of one or more Certificates of Acceptance by Lessee and payment of acquisition costs by Agent for ail the Equipment, this
Agreement and the Funds shali terminate, and Agent shall transfer to Lessor all remaining sums in the Fund. If not terminated earlier, this
Agreement and the Fund shall terminate on June 15, 2010 ("Termination Date"). In this latter event, interest accrued pursuant to investment
of the Fund under the terms of Section 4 hereof and all remaining principal in the Fund shall be transferred by Agent to Lessor; Exhibit "A"
attached to the Lease shall thereupon be revised to delete any non-acquired portions of the Equipment and to substitute an amended
amortization payment schedule to refiect the reduced acquisition costs.
6. Lessor and Lessee may by written agreement between themselves remove the Agent, at any time and for any reason, and appoint a
successor escrow agent. Such removal shall not be effective untii thirty (30) days after written notice thereof if provided to Agent.
7. Agent may at any time and for any reason resign as escrow agent by giving written notice to Lessor and Lessee of its intention to resign
and of the proposed date of resignation, which date shall be not less than thirty (30) days after giving Lessee and Lessor written notice of
intent to resign, nor less than thirty (30) days after being appointed by Lessor and Lessee.
8. Agent shall have no obligation under the terms of this Agreement to make any disbursement except from the Fund. Agent makes no
warranties or representations as to the Equipment or as to performance of the obligations of Lessor or Lessee under this Agreement or the
Lease.
9. Agent shall be entitled to rely in good faith upon any documents signed by a party hereto and shall have no duty to investigate the
veracity of such documents. Agent (i) may assume that any person giving notice pursuant to the terms hereof is authorized to do so and (ii)
shall not be liable for good faith reliance thereon.
10. To the limited extent required to perfect the security interest granted by Lessee to Lessor in the cash and negotiable instrument from time
to time comprising the Fund, Lessor hereby appoints the Agent as its security agent, and the Agent hereby accepts the appointment as
security agent, and agrees to hold physical possession of such cash negotiable instruments on behalf of Lessor.
11. This Agreement may be amended by written agreement executed by all the parties.
12. This Agreement may be executed in several counterparts, each of which shall be an original.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first written above.
LESSOR: Government Capital Corporation
LESSEE:
BY:
Authorized Sig ~
Colli" cot~"d of Co",ty co:;ionm ",,/ Attest' Dwight 0, ~;OCk,p~'k ,
BY ':~. - .-< 4,J"-BY l)J J"~ . ~. '.P-e OJ:.f;Y
Donna Fiala, Chairman Deputy ClerR' ~ ,J:J,' ,~Scot
__:., . G1t61,..,
.i9lllt.... Ofti ~ .
I sufficiency:
fL-
. Teach, Deputy County Attorney
AGENT:
BY:
Agent Rep, Agent Rep Title
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 14
16F5
TO AUTHORIZE PAYMENT TO YOUR VENDOR
WHEN YOU ARE READY TO PAY FOR YOUR EQUIPMENT,
PLEASE COMPLETE AND RETURN THIS FORM TO OUR
"ESCROW DEPARTMENT," WITH THE VENDOR'S INVOICE.
1. This form may be copied for multiple disbursements, however each
form sent for payment must have an original signature on the
PAYMENT REQUEST FORM and on the ACCEPTANCE CERTIFICATE
and be dated.
2. Send PAYMENT REQUEST FORM (attached) with INVOICE to:
GOVERNMENT CAPITAL CORPORATION
345 Miron Drive
Southlake, TX 76092
Attention: Marti Harger
Toll Free:
Phone:
Fax:
800-883-1199
817-421-5400
817-251-3208
16F5
EXHIBIT A AND ATTACHMENT 1
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT No. 5377 (THE "AGREEMENT")
BY AND BETWEEN
LESSOR, Government Capital Corporation and LESSEE, Collier County Board of County Commissioners
Dated as of December 15, 2009
PAYMENT REQUEST FORM
I acting as escrow agent (the "Agent") under the Escrow Agreement dated as of
December 15, 2009 (Escrow Date) by and among the Agent, Government Capital Corporation as Lessor and Collier County Board of
County Commissioners as Lessee, is hereby requested to pay to the person or corporation designated below as Payee the sum set
forth below in payment of the acquisition and installation costs of the equipment described below. The amount shown below is due
and payable under the invoice of Payee with respect to the described equipment and has not formed the basis any prior request for
payment.
PAYEE:
AMOUNT:
DESCRIPTION OF EQUIPMENT:
DATED:
Indicate Method for Payment Disbursement:
_ Overnight Check _ Regular Mail Check
Wire Funds
Mailing Address:
Wire Instructions:
Lessee: Collier County Board of County Commissioners
By:
Authorized Signer
Lessor: Government Capital Corporation
By:
Name:
Title:
ACCEPTANCE CERTIFICATE
Collier County Board of County Commissioners as Lessee under that certain FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT
dated as of December 15, 2009 ("Agreement Date") (the "Lease"), hereby acknowledges receipt in good condition of all the
equipment described on the attached Exhibit "Au hereby accepts such equipment and hereby certifies that Lessor has fully and
satisfactorily performed all covenants and conditions to be performed by it under the Lease with regard to such equipment, that such
equipment is fully insured in accordance with Section 10 of the Lease and that such equipment constitutes all or a portion of the
Equipment as that term as defined in the Lease.
Date:
,2009.
By Lessee:
Authorized Signer
For Lessee: Collier County
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT - 15
Foem 8038-G
6F5
(Rev. November 2000)
Department of the Treasury
Internal Revenue Service
Information Return for Tax-Exempt Governmental Obligations
.... Under Internal Revenue Code section 149(e)
.... See separate Instructions.
Caution: If the issue price is under $100,000, use Form B038-CC.
If Amended Return, check here.... D
2 Issuer's employer identification number
59 : 6000558
OMB No. 1545-0720
Re ortin Authorit
3
Issuer's name
Collier County Board of County Commissioners
Number and street (or P.O. box if mail is not delivered to street address)
3301 Tamaimi Trail East
Room/suite 4 Report number
3 -01
6 Date of issue
8 CUSIP number
NA
5
City, town. or post office, state, and ZIP code
Naples, FL 34112
7
Name of issue
Agreement No. 5377
Name and title of officer or legal representative whom the IRS may call for more information
Donna Fiala. Board Chairman
T e of Issue (check a
9
10 Telephone number of officer or legal representative
( 239 ) 252 - 3740
rice) See instructions and attach schedule
11
12
13
14
15
16
17
18
licable box(es) and enter the issue
11
12
13
14
15
16
17
18
19
20
o
o
o
o
o
o
o
121 Other. Describe ~
If obligations are TANs or RANs, check box.... D If obligations are BANs, check box .... D
If obli ations are in the form of a lease or installment sale, check box .... III
Oescri tion of Obli ations. Com lete for the entire issue for which this form is bein
Education
Health and hospital
Transportation
Public safety.
Environment (including sewage bonds)
Housing
Utilities
(d) Weighted
average maturity
(c) Stated redemption
price at maturity
(e) Yield
(b) Issue price
ears
%
NA 5
underwriters' discount)
09 -15 -14 $ 182,751.00 $
Uses of Proceeds of Bond Issue (includin
NA
NA
NA
NA
22
23
24
25
26
27
28
29
30
Proceeds used for accrued interest .
Issue price of entire issue (enter amount from line 21, column (b))
Proceeds used for bond issuance costs (including underwriters' discount)
Proceeds used for credit enhancement .
Proceeds allocated to reasonably required reserve or replacement fund
Proceeds used to currently refund prior issues
Proceeds used to advance refund prior issues
Total (add lines 24 through 28) .
Nonrefundin roceeds of the issue subtract line 29 from line 23 and enter amount here) .
Oescri tion of Refunded Bonds (Com lete this art ani for refundin bonds.)
Enter the remaining weighted average maturity of the bonds to be currently refunded ....
Enter the remaining weighted average maturity of the bonds to be advance refunded ....
Enter the last date on which the refunded bonds will be called ....
Enter the date(s) the refunded bonds were issued ....
Miscellaneous
NA
NA
24
25
26
27
28
NA
NA
NA
NA
NA
NA
NA
NA
NA
years
years
31
32
33
34
35
36a
b
37
b
Enter the amount of the state volume cap allocated to the issue under section 141 (b)(5)
Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (see instructions)
Enter the final maturity date of the guaranteed investment contract.... NA
Pooled financings: a Proceeds of this issue that are to be used to make loans to other governmental units 37a NA
If this issue is a loan made from the proceeds of another tax-exempt issue, check box.... D and enter the name of the
issuer.... and the date of the issue ....
If the issuer has designated the issue under section 265(b)(3)(B)(i)(lIl) (small issuer exception), check box ~ [;zJ
If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box .... 0
If the issuer has identified a hed e, check box .... D
Under penalties of perjur, declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are tr c rrect. and complete.
38
39
40
Sign
Here
Date
~ Donna Fiala, Board Chairman
,.. Type or print name and title
Cat. No. 63773S Form 8038-G (Rev, 11-2000)
For Paperwork Reduction Act Notice, see page 2 of the Instructions.
(i)
16F5
DEMOGRAPHIC INFORMATION
X PLEASE COMPLETE THIS PAGE IN FULLf
Name and Address COLLIER COUNTY
3301 Tam'l,imi Trail East
Naples, Florida 34112
County: Collier Federal ID Number 59-6000558
Total Net Assessed Valuation
Tax Levy Rate ~.S('45
Max Levy Rate Allowable 16 .~d,.
2006
~ c./. "Nt, '22-2-
I '
2007
i 77,o'{2,IQX
, ,
i ?2f ~f<,<(('6q(
2008
1.
Top Ten Area Taxpayers
ftn",J. p".,u~: L..~i..-I-
$
].,5'-t7.,<lL
, t
Assessed Amounts
2.
t-I # iZ "hot" LLC
r '
$
I, G.30, '172.
. r
3.
f..... bc.rk (<''''r
(>t~ .A)/,-(( O'"/.. c( f.-{,,;.-{f
(~,;c/{,".c1 ('",,-f.r )<,~1 I,L,-h<~
NII"t..., I-(MA .1..."
I '
('" diP;'" r-hi.;j -i""
,
$
'19(01 172
i?S-:J. &-I'{
$
I, 351 :0(,7
4.
$
I( C7s. 7<("
(
5.
$
q if 7 <;9....,-
.
6.
$
t"1(J. /7:?
, -
7.
8.
I/--Ii I (t.("r-f .~fz,,, ~ G,,,,! Lf'
$
9.
'-(f..;
IL( c?(' r'M:j~ . -1..,.,<::
,
$
1'79; CIvic
10.
L",..
(~"d~ /"(",,-fvu (r,f)", )At. $
I (
Jete. 2C..()
.
Population 2006
330 I 2Sil
331,13<-{
,
Population 2007
Population 2008
3'-{3, 7<{~
.
FLORIDA MUNICIPAL LEASE-PURCHASE AGREEMENT
16
lhF5
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP IDcu I DATE (MMlDOIYYYY)
COLLI-2 12/21/0.
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance and Risk Management ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
8950 Fontana Del Sol Way #200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Naples FL 34109-4374
Phone: 239-649-1444 Fax: 239-649-7933 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Princeton Excess & Surplus 10786
INSURERS ><i""".t_"<>l"'U~""tycc 23612
Collier County Government INSURERC
Risk Management Department .
3301 Tamiami Trail East, #n INSURER 0
Naples FL 34112
INSURERE
COVERAGES
THE POLICIES OF INSURANCE L1STEOBELOWfolO.VE BEENISSUEDTOTllEINSUREDNA MEOABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANYREOUIREMENT.TERMORCONOITIONOFANYCONTRACTOROT1-IEROOCUMENTlMTHRESPECTTOWHICHTHISCERTlFICATEMAVBEISSUEDOR
MAY PERTAIN,THEINSURANCEAFFORDEDBYTHEPOllCIES DESCRIBED HER EINISSUBJECTTOALLTHETERMS,EXCLUSIONSANDCONDITlONSOFSUCH
POliCIES. AGGREGATE LIMITS SHOV'<N MAY HAVE BEEN REDUCED BY PAID CLAIMS
,,~ '" PQLICYEFFECTlVE POUCYEXPIRATlDN
em ,~ TYPE OF INSURANCE POUCYNIJMBER DATEIMINODIYY) DATE(MMiOO/YY) uon
~~ERAlUABlllTY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
A -"- 5ERCIAL GENERAl LIABILITY 64A3EXOOOOO1506 10/01/09 10/01/10 PREMISES (E. o""","n,,") S Included
-- CLAIMSIAAOE [i] OCCUR MEOEXP(Anyonepol'$Onl $ 1,000
,,"$'oo,OOOOOClJiUWlCl 'PERSONAL&ADVINJURY $ Included
- 'IR $100,000 nIlPDOON GENERAL AGGREGATE $ 1,000,000
~~GGREGATEAP:~:PER: n I PRODUCTS-COMPIQPAGG $ 1,000,000
X POliCY JECT LOC
~OMOBlLElIABLITY COMBINEPSINGLElIMIT $ 1,000,000
A X -"- ANY AUTO 64A3EXOOOOO1506 10/01/09 10/01/10 (E..eQdenl)
- AllolMlEOAUTOS BODILY INJURY
,
SCHEOOLEDAUTOS SIR $200,000 """""""IICI <__n)
-
-"- HIREOAUTos SIR $100,000 nIl_ BODILY INJURY
,
-"- NON-O\l\/NEDAUTOS (Pe,o.eoI<lonl;1
PROPERTYOAMACE ,
(Pe"OCiGOnt)
~~,~::~ :AUTOONLY-EAACCIDENT ,
OTHER THAN EAAce ,
AllTooNlY '00 ,
EXCESSIUMBRElLALIABlUTY EACH OCCURRENCE $ 1,000,000
A ~oCCUR o CLAIMS MADE 64A3FFOOOO01104 10/01/0. 10/01/10 AGGREGATE $ 1,000,000
Excess .
R:mcc,"" General .
RETENTION . Liability ,
WORKERSCOMPENSATlONANO X IT~~~~~. I IOTH-
'"
EMPLOYERS' LIABilITY 64A3EXOOOOO1506 10/01/0.
A ANYPROPRIETORiPARTNERlEXECUTlVE 10/01/10 E.L.EACHACCIDENT $ 600,000
OFFICEMdEMBEREXClUOEO? SIR $500,000 E.LOISEASE EAEMPlOYEE $ 600,000
Ifyos, doocr1bo undo,
SPECIAL PROVISIONS belOW E.lDlSEASE POLICY liMIT $ 600,000
OTHER
B Excess Workers EWC008020 10/01/09 10/01/10 Work Comp Statutory
Compensation SIR $600,000 E.L. 3,000,000
DESCRlPTIONOFOPERAnDNSILOCATlONlllVEHlClESIEXClUSIONSADllEOBYENDORSEIJIENTISPECIAlPROVISIONS
Certificate holder is listed as loss payee with respect to 2010 Horton Model
F623 Custom/Rescue/Transport Vehicle on . Ford F550 Chassis.
Self Insured Retention included within limits of liability. AS allowed by
Florida Statute 768.28.
CERTIFICATE HOLDER
CANCELLATION
GOVERN1 St!OUUlANYOFTHEABOVEDESCRlBEDPOllClESBECANCElLEDSEFORETHEElU'lRATlDN
DATETItEREOF.THEIS$OINGlNSURERWlLLENDEAVORTOMAIl 10 DAYS WRITTEN
-
Government Capital corporation NOTICETOTHECElmFICATEHOlOERNAMEDTOTHElEFT,BUTFAllURETODOSOSHALl
Documentation Department
345 Miron Drive IMPDSE NO DBUGATlDNOR UABllITYOF ANY KIND UPON THE INSURER,ITS AGENTS OR
Southlake TX 76092 REPRESENTATIVES.
? '~~~ /7
,
ACORD 25 (2001/08)
@ACORDCORPORATION 1988
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 Of alter the coverage afforded by the policies listed thereon.
16F5
ACORD 25 (2001/08)