2006 Documents Not Signed By BCC
AGREEMENT 06-3937R
for
"Process Server Services for Collier County"
THIS AGREEMENT, made and entered into on this 24th day of April 2006, by and between
SAS Subpoena and Record Retrieval, Inc., authorized to do business in the State of Florida,
whose business address is: PO Box 56, Ft. Myers FL 33902 hereinafter called the "Contractor"
(or "Consultant") and Collier County, a political subdivision of the State of Florida, Collier
County, Naples, hereinafter called the "County":
WITNESSETH:
1. COMMENCEMENT: The contract shall be for a one (1) year period, commencing on
April 24, 2006, and terminating on April 23, 2007. The County may, at its discretion and
with the consent of the Contractor, extend the Agreement under all of the terms and
conditions contained in this Agreement for three (3) additional one (1) year periods. The
County shall give the Contractor written notice of the County's intention to extend the
Agreement term not less than ten (10) days prior to the end of the Agreement term then
in effect.
2. STATEMENT OF WORK: The Contractor shall provide process server services in
accordance with the terms and conditions of RFP #06-3937R and the Contractor's
proposal hereto attached and made an integral part of this agreement.
3. COMPENSATION: The County shall pay the Contractor for the performance of this
Agreement the aggregate of the units actually ordered and furnished at the unit price,
together with the cost of any other charges/ fees submitted in the proposal.
Any county agency may purchase products and services under this contract, provided
sufficient funds are included in their budget(s).
4. NOTICES: All notices from the County to the Contractor shall be deemed duly served
if mailed or faxed to the Contractor at the following Address:
SAS Subpoena and Record Retrieval, Ine.
Attn: Dorn J. Becklow
PO Box 56
Ft. Myers FL 33902
239/671-9676
FAX: 239/543-4386
All Notices from the Contractor to the County shall be deemed duly served if mailed or
faxed to the County to:
Collier County Government Center
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attn: Steve Carnell
The Contractor and the County may change the above mailing address at any time
upon giving the other party written notification. All notices under this Service
Agreement must be in writing.
5. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating
a partnership between the County and the Contractor or to constitute the Contractor as
an agent of the County.
6. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Contractor. Payment
for all such permits issued by the County shall be processed internally by the County.
All non-County permits necessary for the prosecution of the Work shall be procured
and paid for by the Contractor. The Contractor shall also be solely responsible for
payment of any and all taxes levied on the Contractor. In addition, the Contractor shall
comply with all rules, regulations and laws of Collier County, the State of Florida, or the
U. S. Government now in force or hereafter adopted. The Contractor agrees to comply
with all laws governing the responsibility of an employer with respect to persons
employed by the Contractor.
7. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to
use in any manner whatsoever, county facilities for any improper, immoral or offensive
purpose, or for any purpose in violation of any federal, state, county or municipal
ordinance, rule, order or regulation, or of any governmental rule or regulation now in
effect or hereafter enacted or adopted. In the event of such violation by the Contractor
or if the County or its authorized representative shall deem any conduct on the part of
the Contractor to be objectionable or improper, the County shall have the right to
suspend the contract of the Contractor. Should the Contractor fail to correct any such
violation, conduct, or practice to the satisfaction of the County within twenty-four (24)
hours after receiving notice of such violation, conduct, or practice, such suspension to
continue until the violation is cured. The Contractor further agrees not to commence
operation during the suspension period until the violation has been corrected to the
satisfaction of the County.
8. TERMINATION. Should the Contractor be found to have failed to perform his
services in a manner satisfactory to the County as per this Agreement, the County may
terminate said agreement immediately for cause; further the County may terminate this
Agreement for convenience with a thirty (30) day written notice. The County shall be
sole judge of non-performance.
9. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as
to race, sex, color, creed or national origin.
10. INSURANCE. The Contractor shall provide insurance as follows:
A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000
Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Contractors; Products and Completed Operations and Contractual Liability.
B. Business Auto Liability: Coverage shall have minimum limits of $500,000 Per
Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned
Vehicles and Employee Non-Ownership.
C. Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County shall be listed as the Certificate Holder and
included as an Additional Insured on the Comprehensive General Liability
Policy.
Current, valid insurance policies meeting the requirement herein identified shall
be maintained by Contractor during the duration of this Agreement. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Contractor shall insure that all subcontractors comply with the same insurance
requirements that he is required to meet. The same Contractor shall provide
County with certificates of insurance meeting the required insurance provisions.
11. INDEMNIFICATION. The Contractor/Vendor, in consideration of One Hundred
Dollars ($100.00), the receipt and sufficiency of which is accepted through the signing of
this document, shall hold harmless and defend Collier County and its agents and
employees from all suits and actions, including attorneys' fees and all costs of litigation
and judgments of any name and description arising out of or incidental to the
performance of this contract or work performed thereunder. This provision shall also
pertain to any claims brought against the County by any employee of the named
Contractor/Vendor, any Subcontractor, or anyone directly or indirectly employed by
any of them. The Contractor/Vendor's obligation under this provision shall not be
limited in any way by the agreed upon contract price as shown in this Contract or the
Contractor/Vendor's limit of, or lack of, sufficient insurance protection. The first One
Hundred dollars ($100.00) of money received on the contract price is considered as
payment of this obligation by the County.
This section does not pertain to any incident arising from the sole negligence of Collier
County.
12. CONTRACT ADMINISTRATION: This Agreement shall be administered on behalf of
the County by the County Attorney's Office.
13. CONFLICT OF INTEREST: Contractor represents that it presently has no interest and
shall acquire no interest, either direct or indirect, which would conflict in any manner
with the performance of services required hereunder. Contractor further represents
that no persons having any such interest shall be employed to perform those services.
14. COMPONENT PARTS OF THIS CONTRACT: This Contract consists of the attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Contractor's Proposal, Insurance Certificate, and RFP #06-3937R Scope of
Services.
15. SUBJECT TO APPROPRIATION: It is further understood and agreed by and between
the parties herein that this agreement is subject to appropriation by the Board of County
Commissioners.
IN WITNESS WHEREOF, the Contractor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: s~t:~.I~a~ell, ~:/l /
General Services/Purchasing
~
~12 .lJ()h., l~j
First Witness
SAS Subpoena and Record Retrieval, Inc.
ByconZL ~ ~
Signature
t'Y'e.1i~~q War{
tType/print witness namet
\~;:;., Q~~
Second Witness
~~CA Arn<1m~
tType/ print witness nam
'Pthn4. L. ~t\i,) I Clw\'l&.('
Typed signature and title
CORPORATE SEAL
(corporations only)
Approved as to form and
legal sufficiency:
C~m~
Robert Zachary /
Assistant County Attorney
Ma~ 10 DB 01:58p
Island Coast-FEAH~Mann
(239)275-7829
p.1
13-
HOJr<rce'NIa.1lll
Educated Financial Solutions
The Horace Mann Companies
6281 Metro Plantation Road
Fort Myers, FL 33912
Bus. 239.275-4667
Fax 239-275-7829
magoond l@notes.horacemann,com
www.horacemann.cum
David W. Magoon, LUTe
Senior Account Executive
Horace Mann
Teachers Insurance Company
Fax Cover Sheet
To
r
rom David w. Magoon LUTCF
An:1:o
Home
Number ofpages
Subject
2-
Life
~ t90
/JJ."~
/DU) H'
, ~.:
c.
.1lt'd.ifl ....
Annuity
,
Horace Mann Investors; Inc. Distributor of Securities Products Member NASD
1 Horace Mann Plaza Springfield,1L 62715-0001 217-789-2500 www.horacemann.com
Ma~ 10 OB 01:58p
Island Coast-FEAH.Mann
(239)275-7829
p.2
Teachers Insurance Company
Automobile - Change Policy ReqUest
-- Signature is Required --
Policy #: 09 - 69220180
Effective: 05/10/2006
Agent: 3711 David W. Magoon, LUTCF
Policy Holder(s): ARMSTRONG, ANNE L
t 1J<ocljOl<J)
Vehicle: 2004 SUZU
Created: 05{10/2006 1:36:33 pm
Printed: 05/1O{2006
** Change **
$
Home Office Use Only
IOerl< uaL~
COVERAGE INFORMATION
. Change: Bodily Injury Code: 28 Limits: $250,000.00/$500,000.00
. Change: Property Damage Code: 08 Limit: $100,000.00
DRrVERINFORMATION
(1) IlWe have read this entire application; (2) , The statements that lIWa
made are correct, including ttJose made on any ather application fer
automobile insurance to this company dated this dete which are
incorporated b~ reference and made part of this application; (3) INVe are
the $Ole owner(s) afthe vehicle(s) de5cribed unless othetwise stated; and
(4) The coverages and fimts were selected by meIus. I/Vlle understand
that any ch endered with this appllcatton Is accepted sUbject to
callectia (y.
uw
""'"
coo..-
D.te
5
Horace N1ann
ApplkantSi9~~ .
;/:Z--
Agent Si~r~
.....- irJ/..
Date
1::,J,,,,..,,=.)J [,;",1".;;,,1 ~...I...i'J1''''
f"y,rol
Date
s-cooe INSP AT Al UM.SW eo em-< TERR KINO ClASS SYM 5POA INEX RCP AP VP OEF PIR FIBG MOIED
01
------- - - -
CAR 246
From: Tammy Leigh At: Oswald, Trippe and Company Inc. FaxlD: 239-433-4148 To: Ms Tibbett
Date: 5/1012006 09:26 AM Page: 1 of 1
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 1~ DATE (MMIDDIYYYY)
SEARC-1 05/10/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Oswald Trippe and Company, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
I? O. Box 60139 ALTER THE COVERAGE AFFOROED BY THE POLICIES BELOW.
Ft. Myers FL 33906-6139
I?hone:239-433-4535 Fax:239-433-4148 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Philadelphiil :rn..ul:ilnce company 09566
INSURER B
Search and Serve Subpoena & INSURER C
Anne Beddow
POBox 56 INSURER 0
Fort Myers FL 33902
INSURER E
COVERAGES
mE POLICIES OF INSURJl,NCE LISTED BELOW HAVE BEEN ISSUED TO mE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWlmSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OmER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, mE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOYVN MAY HAVE BEEN REDUCED BY PAID CLAIMS
'~~~ NSR TYPE OF INSURANCE POLICY NUMBER DATE CMMIDDNYJ<=; DATE (MMfDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE .
- PREMISES (E~c;~~'c~~ence)
COMMERCIAL GENERAL LIABILITY .
I CLAIMS MflJJE D OCCUR MED EXP (.Ally one person) .
PERSONAL 8.: ADV INJURY .
GENERAL AGGREGATE .
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG .
~'-POLICY n -:;~& n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ea8ccident) ,
- ANY AUTO
- ALL OWNED AUTOS 80DIL Y INJURY
,
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
I--- ,
NON-OWNED AUTOS (peraccidsnt)
I---
1-- PROPERTY DAMAGE ,
(Peraccidsnt)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ,
R ANY AUTO OTl-1ER THAN EAACC ,
AUTO ONLY AGG ,
~ESSJUMBRELLA LIABILITY EACH OCCURRENCE ,
OCCUR 0 CLAIMS MADE AGGREGATE ,
,
R ,DEDUCTIBLE ,
RETENTION . ,
WORKERS COMPENSATION AND I TORY LIMITS I IV ER
EMPLOYERS' LIABILITY ,
ANY PROPRIETORiPARTNERfEXECUTIVE EL EACH ACCIDENT
OFFICERlMEMBER EXCLUDED? E.L. DISEASE- EA EMPLOYEE ,
Hyes.describeunder EL DISEASE- POLICY LIMIT .
SPECIAL PROVISIONS below
OTHER
A prOfessional. Liab I?HSD189775 05/04/06 05/04/07 1000000
DESCRIPTlON OF OPERATIONS I LOCATIONS I VEHICLES f EXCLUSIONS ADDEO BY ENDORSEMENT J SPECIAL PROVISIONS
CERTIFICATE HOLOER
COL2800
CANCELLATION
SHOULD ANY OF THE ABOYE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Col.lier County Community Dev
fax# 239-403-2469
Purchasing Department
2800 N Horseshoe Drive
Naples FL 34104
@ACORDCORPORATION1988
ACORD 25 (2001108)
JRN-14-2002 10:33P FROM:Lexmark X125 13H0090
TD:12395305598
P:2/5
--
~~(Cre;~WIElDJ
JUN 08 2006
BUREAU OF COMPLIANCE
FT. MYERS
DEPARTMENT OF FINANelAL SERVICES
TOM GALLAGHER
CHIEP FINANCIAL OmcER.
EXEMPTION APPLICATION RECEIPT
This receipt ONLY confirms that the applicant listed below has submitted an application
for exemption from the provisions of the workers' compensation law to the Division of
Workers' Compensation. THIS RECEIPT DOES NOT CONSTITUTE PROOF THAT
AN EXEMPTION HAS BEEN ISSUED TO THE APPLICANT. AN EXEMPTION
SHALL BECOME EFFECTIve WHEN ISSUED BY THE DEPARTMENT. .
DATE RECEIVED: J \JH Q 81006
APPLICANT'S NAME: ~ L. &.ddow
BUSINESS NAME: Sfi.s 5CLb roe h D..- <f /2a.-h-Ie-vcJ ]'.he..,
.L~
Receipt comple~ed by:
Exemption applications are processed in the order it was received. The Division of
Workers' Compensation has 30 days to process the application after it has been
received.
The exemption application was received, at the following Division of Workers'
Carripensation office:
Bureau of Compliance
4415 METRO PKWY
Suite # 300
Ft. Myers, FL. 33916
Telephone (239) 938.1840
DrvIS~ON OF WORKERS' COMPENSATION ~ BUREAU OF COMPUANCE
Affirmll;i~ Al;tion f EqUIII Oppommity Emplc}'er
JAN-1-2002 01: 3BP FRUI1: Le,mark X125 UH0090
IU: 1<'.0" ((4clIYRl
1-':3/..5
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AGREEMENT 06-3937R
for
"Process Server Services for Collier County"
THIS AGREEMENT, made and entered into on this 24th day of April 2006, by and between
Ortino Enterprises, Inc., authorized to do business in the State of Florida, whose business
address is: PO Box 10398, Naples FL 34101 hereinafter called the "Contractor" (or
"Consultant") and Collier County, a political subdivision of the State of Florida, Collier
County, Naples, hereinafter called the "County":
WITNESSETH:
1. COMMENCEMENT: The contract shall be for a one (1) year period, commencing on
April 24, 2006, and terminating on April 23, 2007. The County may, at its discretion and
with the consent of the Contractor, extend the Agreement under all of the terms and
conditions contained in this Agreement for three (3) additional one (1) year periods. The
County shall give the Contractor written notice of the County's intention to extend the
Agreement term not less than ten (10) days prior to the end of the Agreement term then
in effect.
2. STATEMENT OF WORK: The Contractor shall provide process server services in
accordance with the terms and conditions of RFP #06-3937R and the Contractor's
proposal hereto attached and made an integral part of this agreement.
3. COMPENSATION: The County shall pay the Contractor for the performance of this
Agreement the aggregate of the units actually ordered and furnished at the unit price,
together with the cost of any other charges/ fees submitted in the proposal.
Any county agency may purchase products and services under this contract, provided
sufficient funds are included in their budget(s).
4. NOTICES: All notices from the County to the Contractor shall be deemed duly served
if mailed or faxed to the Contractor at the following Address:
Ortino Enterprises, Inc.
Attn: Mr. Victor Ortino
PO Box 10398
Naples FL 34101
239/353-4224
FAX: 239/353-1907
All Notices from the Contractor to the County shall be deemed duly served if mailed or
faxed to the County to:
Collier County Government Center
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attn: Steve Carnell
The Contractor and the County may change the above mailing address at any time
upon giving the other party written notification. All notices under this Service
Agreement must be in writing.
5. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating
a partnership between the County and the Contractor or to constitute the Contractor as
an agent of the County.
6. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits
necessary for the prosecution of the Work shall be obtained by the Contractor. Payment
for all such permits issued by the County shall be processed internally by the County.
All non-County permits necessary for the prosecution of the Work shall be procured
and paid for by the Contractor. The Contractor shall also be solely responsible for
payment of any and all taxes levied on the Contractor. In addition, the Contractor shall
comply with all rules, regulations and laws of Collier County, the State of Florida, or the
U. S. Government now in force or hereafter adopted. The Contractor agrees to comply
with all laws governing the responsibility of an employer with respect to persons
employed by the Contractor.
7. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to
use in any manner whatsoever, county facilities for any improper, immoral or offensive
purpose, or for any purpose in violation of any federal, state, county or municipal
ordinance, rule, order or regulation, or of any governmental rule or regulation now in
effect or hereafter enacted or adopted. In the event of such violation by the Contractor
or if the County or its authorized representative shall deem any conduct on the part of
the Contractor to be objectionable or improper, the County shall have the right to
suspend the contract of the Contractor. Should the Contractor fail to correct any such
violation, conduct, or practice to the satisfaction of the County within twenty-four (24)
hours after receiving notice of such violation, conduct, or practice, such suspension to
continue until the violation is cured. The Contractor further agrees not to commence
operation during the suspension period until the violation has been corrected to the
satisfaction of the County.
8. TERMINATION. Should the Contractor be found to have failed to perform his
services in a manner satisfactory to the County as per this Agreement, the County may
terminate said agreement immediately for cause; further the County may terminate this
Agreement for convenience with a thirty (30) day written notice. The County shall be
sole judge of non-performance.
9. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as
to race, sex, color, creed or national origin.
10. INSURANCE. The Contractor shall provide insurance as follows:
A. Commercial General Liabilitv: Coverage shall have minimum limits of $1,000,000
Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Contractors; Products and Completed Operations and Contractual Liability.
B. Business Auto Liability: Coverage shall have minimum limits of $500,000 Per
Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned
Vehicles and Employee Non-Ownership.
C. Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County shall be listed as the Certificate Holder and
included as an Additional Insured on the Comprehensive General Liability
Policy.
Current, valid insurance policies meeting the requirement herein identified shall
be maintained by Contractor during the duration of this Agreement. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Contractor shall insure that all subcontractors comply with the same insurance
requirements that he is required to meet. The same Contractor shall provide
County with certificates of insurance meeting the required insurance provisions.
11. INDEMNIFICATION. The Contractor/Vendor, in consideration of One Hundred
Dollars ($100.00), the receipt and sufficiency of which is accepted through the signing of
this document, shall hold harmless and defend Collier County and its agents and
employees from all suits and actions, including attorneys' fees and all costs of litigation
and judgments of any name and description arising out of or incidental to the
performance of this contract or work performed thereunder. This provision shall also
pertain to any claims brought against the County by any employee of the named
Contractor/Vendor, any Subcontractor, or anyone directly or indirectly employed by
any of them. The Contractor/Vendor's obligation under this provision shall not be
limited in any way by the agreed upon contract price as shown in this Contract or the
Contractor/Vendor's limit of, or lack of, sufficient insurance protection. The first One
Hundred dollars ($100.00) of money received on the contract price is considered as
payment of this obligation by the County.
This section does not pertain to any incident arising from the sole negligence of Collier
County.
12. CONTRACT ADMINISTRATION: This Agreement shall be administered on behalf of
the County by the County Attorney's Office.
13. CONFLICT OF INTEREST: Contractor represents that it presently has no interest and
shall acquire no interest, either direct or indirect, which would conflict in any manner
with the performance of services required hereunder. Contractor further represents
that no persons having any such interest shall be employed to perform those services.
14. COMPONENT PARTS OF THIS CONTRACT: This Contract consists of the attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Contractor's Proposal, Insurance Certificate, and RFP #06-3937R Scope of
Services.
15. SUBJECT TO APPROPRIATION: It is further understood and agreed by and between
the parties herein that this agreement is subject to appropriation by the Board of County
Commissioners.
IN WITNESS WHEREOF, the Contractor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
BOARD OF COUN1Y COMMISSIONERS
COLLIER COUN1Y, FLORIDA
(I.A . . ..
By: ,ct\~V\ ~' lJ;?L //171
Stephen Y. Car ell, DIrector
General Services/Purchasing
~~.,~
First itness
,xI'lN bl S~.LLo
tTy e/print witness namet
Ortino Enterprises. Inc.
B:OO""dO~J4-v
Signature
Second Witness
tl,c...fo~ P. ()R,r/A/O/ !>/I'.ff/JIP/7!-
Typed signature and title
!JiJto(.... ':D~Sa.("o
tType/print witness namet
CORPORATE SEAL
(corporations only)
Approved as to form and
legal sufficiency: ~
~/
Robert Zac y
Assistant County Attorney
~ Allstate.
You''''ing<KMlhsool''-
BUSINESS AUTO DECLARATIONS
POLICY NU MSER: 649866509 SAP
ALLSTATE INSURANCE COMPANY
2775 Sanders Road
Northbrook, IL 60062-6127
AGENT:
CHUCK EAGLESTON
12330 TMIMI TR E101
NAPLES, FL 34113
ITEM ONE
NAMED INSURED:
MAILING ADDRESS:
ORTINO ENTERPRISES INC
1890 40TH TERR SW
NAPLES, FL 34116-6030
FROM JANUARY 09, 2006 TO JANUARY 09, 2007
At 12:01 AM. Standard Time at your mailing address shown above.
POLICY PERIOD:
PREVIOUS POLICY NUMBER:
FORM OF BUSINESS:
ITI CORPORATION
D PARTNERSHIP
D LIMITED LIABILITY COMPANY
D OTHER
D INDIVIDUAL
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH
YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
PREMIUM FOR ENDORSEMENTS
'ESTIMATED TOTAL PREMIUM
-"This policy may be subject to final audit.
$82.00
$3,546.00
Premium shown Is payable: $3,546.00
AUDIT PERIOD (IF APPLICABLE): D ANNUALLY
at inception.
D SEMI-ANNUALLY D QUARTERLY
. D MONTHLY
ENDORSEMENTS ATTACHED TO THIS POLICY:
IL 00 17 - Common Policy Conditions (IL 01 46 in Washington)
IL 00 21 - Broad Form Nuclear Exclusion (Not Applicable in New York)
FORMS AND ENDORSEMENTS CONTAINED IN THIS POLICY AT ITS INCEPTION:
BU1330A-3 BU1401-21001 CA0001 1001
CA0128 0203 CA2172 0401 CA2210 0704
CA0051 1204 CA0045 0303 CA9903 0797
CA9923 1293 CA9944 1293 I L0021 0702
IL0017 1198 CA0267 1094 CA2001 1001
BU1127 0297 BU1129C10702 CA2356 1102
BU181 1092 BU1109 0590 BU1110 0590
BU1455-11001
COUNTERSIGNED
.~.
,,!-li-.:.-
(Date)
, ))1
I, / 11~"'t14:_-
BY 7;17q(
/ Authorized Representative)
BU10426-3 (Ed. 10-03)
PAGE 1 OF 3
tc=.'..
~j~
DECLARATIONS - BUSINESS AUTO POLICY - (Continued)
ALLSTATE INSURANCE COMPANY
POLICY NUMBER: 649866509 SAP
ITEM TWO - SCHEDULE OF COVERAGES AND COVERED AUTOS
This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages
will apply only to those "autos" shown as covered "autos." "Autos" are shown as covered "autos" for a particular coverage
by the entry of one or more of the symbols from the Covered Auto Section of the Business Auto Coverage Form next to the
name of the coverage.
COVERAGES COVERED AUTOS LIMIT PREMIUM
(Entry of one or more
of the symbols from
the Covered Autos
Section of the Business
-- - --- ---- - - -Auto-Coverage Form--- - ----- -- ----...---- ----,-- .--------- ,--oo---- --- - -----------"-- - -
shows which autos
are covered autos.)
LlABI L1TY 07,09 $300,000 $1,758.00
PERSONAL INJURY 05 SEPARATELY STATED IN EACH P.IP. $210.00
PROTECTION (or equivalent ENDORSEMENT MINUS $ SEE SCHEDULE
No-fault coverage) DED.
ADDED PERSONAL INJURY SEPARA TEL Y STATED IN EACH ADDED
PROTECTION (or equivalent PIP. ENDORSEMENT
added No-fault coverage)
PROPERTY PROTECTION SEPARATELY STATED IN THE P.P.I
INSURANCE (Michigan only) ENDORSEMENT
AUTO MEDICAL PAYMENTS 07 SEE SCHEDULE $30.00
UNINSURED MOTORISTS 07 $100,000 $402.00
UNDERINSURED MOTORISTS
(When not included in Un-
insured Motorists Coverage)
PHYSICAL DAMAGE 07 ACTUAL CASH VALUE OR COST OF REPAIR. $293.00
COMPREHENSIVE WHICHEVER IS LESS, MINUS $ (See Schedule)
COVERAGE DED. FOR EACH COVERED AUTO, BUT NO
DEDUCTIBLE APPLIES TO LOSS CAUSED
BY FIRE OR LIGHTNING. See ITEM
FOUR For Hired Or Borrowed "Autos".
PHYSICAL DAMAGE ACTUAL CASH VALUE OR COST OF REPAIR,
SPECIFIED CAUSES OF LOSS WHICHEVER IS LESS, MINUS $25 DED. FOR
COVERAGE EACH COVERED AUTO FOR LOSS CAUSED BY
MISCHIEF OR VANDALISM. See ITEM FOUR For
Hired Or Borrowed" Autos".
PHYSICAL DAMAGE 07 ACTUAL CASH VALUE OR COST OF REPAIR, $745.00
COLLISION COVERAGE WHICHEVER IS LESS, MINUS $ (See Schedule)
DED. FOR EACH COVERED AUTO. See ITEM
FOUR For Hired Or Borrowed "Autos".
PHYSICAL DAMAGE TOWING 07 $ (See Schedule) For Each Disablement Of A $26.00
AND LABOR Private Passenger" Auto".
PREMIUM FOR ENDORSEMENTS I $82.00
'ESTIMATED TOTAL PREMIUM I $3,546.00
'This policy may be subject to final audit.
The estimated total premium for this policy is based on the exposures you told us you would have when this policy began.
We will compute your final premium due when we determine your actual exposures. The estimated total premium will be
credited against the final premium due and you will be billed for the balance. if any. If the estimated total premium exceeds
the final premium due, the first Named Insured will get a refund. The portion of the estimated total premium shown above
that is attributable to coverage for "acts of terrorism" covered by the Program established by the "Terrorism Risk Insurance
Act of 2002" is $0.00. SEE DISCLOSURE NOTICE ON PAGE 3 OF 3.
BU10426-3 (Ed. 10-03)
PAGE 2 OF 3
~OLD DOMINION
~INSUR/\NCE COMPANY
4601 Touchton Road East, Ste. 3300
P.o. Box 16100. JacksonVille, FL 32245-6100
Telephone: 1-904-642-3000/ 1-800-226.0875
INSURED
SPECIAL COMMERCIAL PACKAGE POLICY
Named Insured and Mailing Address
ORTINO ENTERPIRSES, INC
1890 40TH TERRACE SW
NAPLES, FL 34116
Agent: EDISON INSURANCE AGENCY INC
AGENT PHONE : 239 693 0400
POLICYHOLDER INFORMATION
Policy Number: B P G 5 8107
Account Number: CACG581 07
Producer Code: 090290003
Named Insureds Business:
Entity:
Policy Term:
Effective:
Expiration:
OFFICE
CORPORATION
12
11/06/05
11/06/06
(12:01 A.M. Standard Time at the address
of the Named Insured stated above)
In return for the payment of the premium and subject to all the terms of this poiicy, we agree with you to provide
the in.surance as stated in this policy. See the attached schedules for Descrrption of Premises, Property Coverage,
Optional Coverages, Forms and Enaorsements applying to this policy and Mortgagee Schedule if applicable.
LIABILITY COVERAGE LIMITS OF INSURANCE
Liability & Medical Expenses - each occurrence $ 1 , 000, 000
Personal and Advenising Injury Limit $ 1 , 000,000
Products-Completed Operations Aggregate Limit $ 2,000,000
General Aggregate Limit $ 2, 000,000
Fire Legal Liability - anyone fire or explosion $ 50,000
Medical Expense Limit - per person $ 5,000
Business liability and Medical Expense: Except for Fire Legal Liability, each paid claim for the above cover-
ages reduces the amount of insurance we provide during the applicable annual period.
For policies subject 10 premium audit: Annual Audit Applies.
Total Annual Premium:
$
960
FL EMPAT FUND:
FL FIRE MARSHALL:
$
$
4.00
.86
TOTAL PREMIUM AND CHARGES
$
964.86
Countersigned:
By:
64-5255 (1/04)
09/22/05 RENEWAL
MW
OLD DOMINION INSURANCE CO.
ORTINO ENTERPIRSES, INC
Policy Number: BPG581 07
Account Number: CACG581 07
Effective Date: 11/06/05
Producer Code: 090290003
Agent EDISON INSURANCE AGENCY INC
SPECIAL CPP DECLARATIONS - COVERAGES APPLYING TO THIS LOCATION
DESCRIPTION OF PREMISES
Prems. Bldg.
No. No.
1 1
- ADDRESSES
Address
1888/1890 40TH TERRACE SW
NAPLES, FL 34116
DESCRIPTION OF PREMISES - OCCUPANCY AND
Prems. Bldg.
No. No. .
1 1
CONSTRUCTION
Construction
NDN-COMBUSTIBLE
Occupancy
OFFICE - OWNER OCCUPIED
COVERAGES PROVIDED
Prems. Bldg.,
No. No. Coverage
1 1 CONT COV - SPCL (90% COINS)
Limit of
Insurance
200,000
OPTIONAL COVERAGES
Prems. Bldg.
No. No.
ALL ALL
ELECTRICAL AND PRESS SYS BRKDWN
AND NON-OWNED AUTO LIABILITY
Limits
INCLUDED
$500,000
Coverage
MECHANICAL
HIRED AUTO
64-5258 9/00
09/22/05 RENEWAL
MW
~..,
~'"
<:)'"
'"
')<1:-
Protectic
2
Ded
1,000
l.;t~i,~~!~~
I~!-~~~~'
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",,~,; , ']..":~?';;;'-C;~~
"''":';;''.;~
FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES
DIVISION OF UCENSING
Post Office Box 6687 . Tallahassee, FL 32314-6687 . (850) 488-5381
Internet Address: http://Iicgwcb.doacs.state.fl.usI
Chapter 493. Florida Statutes
CDAllt..Y.8 n. llROi'lSON
m'\lMISSIONER
CERTIFICATION OF INSURANCE
Pursuant to Section 493.6110, Florida Statutes, a private investigative agency, a private security agency or a recovery
agency must maintain continuous insurance coverage as a prerequisite for doing business in the State of Florida. As a
person lawfully authorized to sell insurance in the State of Florida for an insurance company that is lawfully engaged to
provide insurance coverage in Florida, I hereby certify that the beiow named agency licensed under Chapter 493. Florida
Statutes, is presently insured in an amount of not less than $300,000 which includes comprehensive general liability
coverage for death, bodily injury, property damage, and personal injury coverage including false arrest. detention or
imprisonment, malicious prosecution, libel, slander, defamation of character and violation of the right of privacy. I further
state that this policy insures for the liability for all agency employees required to be licensed by the State of Florida while
engaged in activities pursuant to their employment..
I further acknowledge that the Department of Agriculture and Consumer Services, Division of Licensing, is listed as an
additional insured party to assure that all notices regarding coverage are sent by the insurance provider to the Department.
Failure to maintain insurance coverage as required by law results in the AUTOMATIC suspension of the agency license.
Continuation of activities regulated under Chapter 493, Florida Statutes, without insurance coverage or with a suspended
license may result in administrative action pursuant to Section 493.6118(1)(h), Florida Statues, or criminal penalties
pursuant to Section 493.6120, Florida Statues.
Oct/no Investigations
Name of Insured as it appears on license
Licenses Insured - check all that apply and provide corresponding license numbers:
~Class "A" - Private Investigative Agency License Number: A 8900082
DClass "B" - Security Agency License Number: B
DClass "R" - Recovery Agency License Number: R
1890 40th Terrace Southwest, Naples, FL 33999
Florida Address of Insured's Location Covered by this Certification
Policy Number FMMI007080 Expiration Date 6/6/2006
First Mercury Insurance Company
Name of Insurance Company La-,.;/ully Authorized to Sell Insurance in the State of Florida
29621 Northwestern HWY/Southfield, MI 48034
Mailing Address of In ance-9mpany (Street, PO Box, etc) State
248-358-4010
Telephone Number
Zip Code
Signature of Florida Licensed Insurance Agent
E049378
Florida License Number of Insurance Agent
STATE OF FLORIDA
COUNTY OF
/
The foregoing instrument was sworn to (or affirmed) and subscribed before me t
R. L. Ring, Jr.
Name ofFforida Licensed Insurance Agent
t: M Sc:huIla
e"" ".. ,,-,-~L"_
-L.,<"" .-1~
.'>,.~ ;;~Tca:15,.dSrl
Personally Known X
entification Produced 0
ntification produced)
Ann Schultz
Print. Type, or Stamp Name of Notary
Page I of2
~110Rlr);\
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--.,...-- ........". ...-..--
I Exemption Details I
E:JEJ l:ffective *'fcnnination Ex('mption
Dale Dale 'f;.'pc Employer Name
VICTOR IEJIOol61989 II C"~,,,t I Non QRT1NO
ORTINO Construction eNTERPRISES fNC
. Tcnninatinn may be throllgh the rcvOC<llion orlhe exemption, exriration of the exemption, or invalidation by
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DIVISION OF WORKERS' COMPENSATION (800) 742-2214 or (850) 413-1601
8
Florida Department of Financial Services' Division of Workers' Compensation' 200 East Gaines Street. Tallahassee, Florida 32399~4228 . Pri,'acv
Statement
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I Employe." Information - 999153001 I
Employer IORTINO ENTERPRISES INC I
Name
IAddress 115254 32ND PLACE S W 1
ICity IINAPLES I
IState IIFL IIZip 113394111CountyllCollier 1
Employer ICORPORA TIONj l?dustry 17380 I
Iype (odc
No Coverage History
Exemption Listings
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I Name I
I ELAJNAORTINQ I
I ylCTQKORIlHO I
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No Additional Locations
I Employer Name History I
I':>nployer Name II Name Type II Change Date
I ORTlNO ENTERPRISES INC II Legal II Current I
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DIVISION OF WORKERS' COMPENSATION (800) 742-2214 or (850) 413-1601
&3
Florida Department of Financial Sen'ices' Division of Workers' Compensation' 200 East Gaines Street. Tallahassee, Florida 32399M4228' frjYJl.~
Statement
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