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Contract-Boromei Construction
r I I I CITY OF OKEECHOBEE INVITATION TO BID OKEECHOBEE CITY HALL DOOR REPLACEMENT No. PW 02 -00 -05 -18 -RB OPENING DATE AND TIME: July 18, 2018 at 3:00 P.M. Prepared by: David Allen, Public Works Director Dated: June 27, 2018 CITY OF OKEECHOBEE CITY COUNCIL Bid No. PW 02 -00 -05 -18 -RB DOWLING R. WATFORD, JR., MAYOR NOEL CHANDLER MONICA CLARK GARY RITTER MARCOS MONTES DE OCA, CITY ADMINISTRATOR TABLE OF CONTENTS PW 02 -00 -05 -18 -RB Invitation to Bid Advertisement Form Section I Section II Section III Section IV Section V Section VI Section VII Section VIII Section IX Section X Section XI General Information Scope of Work Submission Requirements Checklist Bid Documentation Bidder's Qualification Questionnaire Bonding and Insurance Requirements Contractual Agreement Performance Bond Rejection of Proposals Notice to Proceed Notice of Award Section XII Miscellaneous Attachments: A No Lobbying Affidavit B Anti -Collusion Statement and No Gift Statement C Proposer's Certification D Sworn Statement Pursuant to Section 287.133(2)(a), FL § on Public Entity Crimes E Conflict of Interest Disclosure Form F Immigration Law Certification G Drug -Free Workplace Certification H Product Specifications 1 2 4 5-6 7-9 10-14 15-23 24-27 28 29 30 31 - 32 33 34 35 36 - 37 38 39 40 41 INVITATION TO BID NO. PW 02 -00 -05 -18 -RB OKEECHOBEE CITY HALL DOOR REPLACEMENT Mandatory Pre -Bid: July 10, 2018, 3:00 PM Opening Date and Time: July 18, 2018, 3:00 PM The City of Okeechobee, Florida is currently soliciting bids to provide construction services needed to replace five (5) existing exterior doors and one (1) double exterior door with side lights and transom at City Hall located at 55 SE 3rd Avenue Okeechobee FL 34974. Sealed bids must be received within the General Services Department at City Hall, 55 SE 3rd Avenue, Rm 101, Okeechobee, FL 34974, no later than 3:00 PM EST on or before Wednesday, June 18, 2018. All responses received by the deadline will be opened and recorded in the presence of one or more witnesses within the Council Chambers, Rm 200, at the address listed above. Any bids received after the above noted 111 date and time will not be opened or considered. Facsimile or emailed bids will not be accepted. A MANDATORY Pre -Bid Meeting will be held on Tuesday, July 10, 2018, at 3:00 PM EST in the Council Chambers, Rm 200, at the address listed above. Bidders MUST attend this meeting in order to submit for this bid. Product specifications are available in the Bid Packets that may be obtained from the General Services Department at City Hall during normal office hours, Mon -Fri, 8 AM -4:30 PM, except holidays, or by contacting Patty Burnette, 863-763-3372 x 9820, or via email at pburnette@cityofokeechobee.com. A $25.00 non- refundable deposit per set of documents is required, made payable to the City of Okeechobee (checks & cash ' only accepted). Questions concerning the scope of work are to be directed to Public Works Director David Allen, 863-763-9790, or dallen@cityofokeechobee.com. NOTE: Bonding Requirements Apply to this Bid Opportunity. Submittals must be within a sealed envelope and contain two (2) clearly identified originals and one (1) copy of the bid, with the outside of the envelope clearly labeled "BID NO. PW 02 -00 -05 -18 -RB OKEECHOBEE CITY HALL DOOR REPLACEMENT, 7-18-18, 3:00 PM" with the submitting Company Name, and Return Address. Bids may be mailed, hand delivered and/or express mailed to the address listed above. Firms properly registered in the State of Florida are encouraged to submit their bid for consideration. i i It is the sole responsibility of the Bidder to deliver personally or by mail, their bid to the General Services Department on or before the closing hour and date for the receipt of bids as noted above. This solicitation does not commit the City of Okeechobee to award any contracts, to pay any costs incurred in the preparation of a response to this bid, or to contract for any services. The City Council reserves the right to reject any or all bids, to waive informalities and to accept or reject all or part of any bid, as they may deem to be in the best interests of the City of Okeechobee. Responses to this bid, upon receipt by the General Services Department, will become public records subject to provisions of Florida Statute Chapter 119 Florida Public Records Law. EEOIADAIGINANP/DFWP By: Mayor Dowling R. Watford, Jr. on June 29, 2018 City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 1 SECTION I PW 02 -00 -05 -18 -RB GENERAL INFORMATION All responses which comply with the requirements of this Bid will be considered. Submittals must be made in the official name of the Firm or Individual under which business is conducted (snowing official business address) and must be signed in ink by a person duly authorized to legally bind the person, Partnership, Company, or Corporation submitting the response to this Bid. Two clearly identified originals and one copy of your proposal submittal are required. Proposal submittals will be received by the General Services Department until 3:00 p.m. on July 18, 2018. Proposal submittals are to be mailed, hand -delivered, and/or Express Mail to: City of Okeechobee General Services Department 55 S.E. 3rd Avenue, Room 101 Okeechobee, FL 34974 The submitting offeror is required to have printed on the sealed envelope or wrapping containing their submission their Company name and return address, the Bid Number, Title, Opening Date and Time. Proposals received after the date and time specified above shall be returned to the sender unopened. Facsimile or emailed bids will not be accepted. All proposals shall remain in effect for a period of ninety (90) days after the last day on which proposals must be submitted. IF APPLICABLE: It is expected that the project for which this bid is being submitted may be partially funded by State Appropriated Funds of fifty percent (50%) or more. In this instance, the provisions of Florida Statute 255.0991 may apply, which states that project funding in this manner prevents the City from relying on a local ordinance which grants preference in awarding bids based upon whether the bidder has a business office within the City; whethqr the bidder intends to hire local employees or agents; and whether the bidder pays local taxes. The Statute does however permit a preference to Contractors, Suppliers, etc. located within the State of Florida. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 2 SECTION II PW 02 -00 -05 -18 -RB SCOPE OF WORK SCOPE OF WORK -1 he scope of work is to provide construction services needed to replace five (5) existing exterior doors and one (1) double exterior door with side lights and transom at the Okeechobee City Hall located at 55 SE 3rd Avenue, Okeechobee FL 34974. Product specifications are attached as Attachment H of this document. Questions about the product specification should be to David Allen, Public Works Director by email to dallen@cityofokeechobee.com. The selected Contractors will be responsible for the entire scope of work, hiring licensed Subcontractors, and paying for all plans and permits from the City of Okeechobee and/or other agencies. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 3 SECTION III PW 02 -00 -05 -18 -RB SUBMISSION REQUIREMENTS A. The proposer shall submit: 1. Proposal on your Company's letterhead including two (2) clearly identified originals and one copy of your proposal. ' 2. Bid Form including qualifications in detail, which shall include information regarding licensing, experience, special qualifications, etc. ' 3. In addition to the Bid Form listed in Section IV, please complete the following forms that must be returned with your proposal: Attachment A — No Lobbying Affidavit Attachment B — Anti Collusion Statement and No Gifts Statement Attachment C — Proposer's Certification Attachment D — Sworn Statement Pursuant to Section 287.133(2)(a), FL Statutes on Public Entity Crimes Attachment E — Conflict of Interest Disclosure Attachment F — Immigration Law Certification Attachment G — Drug Free Workplace Certification Attachment H — Product Specifications City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 4 SECTION IV PW 02 -00 -05 -18 -RB BID FORM City Council City of Okeechobee 55 S.E. 3rd Avenue Okeechobee, FL 34974 ORIGINAL Boromei Construction, Inc. (BIDDER'S COMPANY NAME) I have received the documents titled Okeechobee City Hall Door Replacement, Project No. PW 02 -00 -05 -18 -RB. I have also received addendum number through and have included these provisions in my Bid. I have examined both the Bid documents and the construction site and submit the following Bid in which I agree: 1. To hold my Bid open until an agreement has been executed between the City of Okeechobee and accepted Bidder, including receipt of the Public Construction and Maintenance Bonds, or until ninety (90) days after Bids are opened, whichever is longer. 2. Regarding the Disposition of Bid Security: to accept the provisions of the Instructions to the Bidders. 3. To enter into and execute a Contract on the basis of this Bid and to furnish a 100 percent (100%) Payment and Performance Bond in accordance with the Instructions to Bidders to guarantee my workmanship and materials to be free from construction defects for a period of not less than one (1) year, if this Bid is accepted. 4. To accomplish the work included in, and in accordance with the Contract Documents, if this Bid is accepted. 5. To start work within sixty (60) calendar days from the date of the Notice to Proceed and thereafter to complete the work within ninety (90) calendar days, unless the time is modified by provisions of the contract, if this Bid is accepted. 6. Regarding Compensation for the proposed work: if this Bid is accepted, I will construct this project on a unit price basis as reflected in the Bid Unit Price Schedule on page 6 of this Bid. 7. Regarding the Award of the Contract: if I am awarded a contract for this project, I understand that the award may be for all or any portion thereof of the items listed under the Bid Unit Price Schedule. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 5 BID UNIT PRICE SCHEDULE PW 02 -00 -05 -18 -RB OKEECHOBEE CITY HALL DOOR REPLACEMENT ITEM NO. DESCRIPTION UNIT MEASURE EST. QTY. UNIT PRICE AMOUNT 1 Replace five (5) existing exterior doors with new impact rated doors, Oldcastle FG -5000 series including necessary hardware, including new locks. Four (4) doors will be keyed alike, one (1) will be keyed separate. Bronze frame finish, reflective tinting equivalent to that on existing doors. EACH 5 5 t 000 O t 000 2 Replace one (1) double exterior door with sidelights and transom with new impact rated, Oldcastle FG -5000 series flush glazed aluminum wall system including necessary hardware, including new lock, keyed to match the 4 locks in Item 1. Bronze frame finish, glass in transom and side lights to be same impact rated glass as doors with reflective tinting equivalent to that on existing doors. EA 1 IO,%(o`J ) 0 ,%(.1i3 TOTAL BID AMOUNT (Based on Bid Unit Prices & Estimated Quantities) c� a� t 1��c3 Bidders Company Name Boromei Construction, Inc. NOTE: This Bid is on a unit price basis. The total estimated amount is for Bid comparison purposes only. The Contractor should field verify the actual site conditions prior to time of bidding and before submitting the Bid proposal. The Contractor should read the special conditions and the requirements for insurance before submitting a Bid proposal. The Contractor should verify the quantities to be included in the construction contract. The Contractor shall furnish the City of Okeechobee with a Payment and Performance Bond in 100 percent (100%) of the total estimated amount of the contract. The Payment and Performance Bond shall continue in effect for one (1) year after completion and acceptance of the work as guarantee against construction defects. The Contractor in his Bid shall include the cost of said bond. Density testing shall be at the expense of the City of Okeechobee, except for failing tests, which shall be charged to the Contractor. I have attached the required 5 percent (5%) Bid Security to this Bid. Bidder: Boromei Construction, Inc. Date: By (Company Name) (Signature) Danny Boromei Title: President 7.18.2018 Email: boromeiconstructioninc@gmail.com (Printed Name) Mailing Address: 420B NW 3rd St., Okeechobee, FL 34972 Office Number: 863.623.4314 Fax Number: 863.763.6337 City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 6 SECTION V PW 02 -00 -05 -18 -RB BIDDER'S QUALIFICATION QUESTIONNAIRE THE UNDERSIGNED GUARANTEES THE TRUTH AND ACCURACY OF ALL STATEMENTS AND ANSWERS HEREIN CONTAINED: 1. How many years has your organization been in business as a General Contractor? 14 2. What is the last project of this nature that you have completed? OUA Office Renovation completed for Okeechobee Utility Authority in May 2015. Project included entry door and storefront replacement. 3. Have you ever failed to complete work awarded to you? If so, where and why? No 4. The following are named as three (3) Corporations or Individuals for which you have performed work and to which you refer. Okeechobee Architects Collaborative - Mark McCree 863.467.2690; mccreearch@msn.com (OUA Office) Okeechobee County - Donnie Oden 863.763.0805; doden@co.okeechobee.fl.us (Hwy 98 Annex) DSI Architects - Eddie Muse 407.790.7826; e.muse@dsi-architects.com (Centerstate Bank) 5. Have you personally inspected the proposed work and have you a complete plan or schedule for its performance? Provide schedule to describe the amount of work per month that is to be completed. Yes 6. Will you sublet part of this work? If so, give details. Yes we will subcontract the door replacements to Heartland Insulation out of Sebring, FL. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 7 BIDDER'S QUALIFICATION QUESTIONNAIRE (cont'd) 7. What equipment do you own that is available for the work? None 8. What equipment will you purchase for the proposed work? None 9. What equipment will you rent for the proposed work? None 10. The following is given as a summary of the financial statement of the undersigned: (List assets and liabilities and insert sheets if necessary) See attached Financial Statement 11. Please provide proof of State Certification and/or State Registration by attaching copies of State Certifications. State Registrations shall also be accompanied by proof of Okeechobee County Certificate(s) of Competency by attaching copies of County Certificate(s). Possession of either a State Certification or County Competency card must be attained prior to Bid submittal. See attached General Contractors License 12. State the true, exact, correct, and complete name of the Partnership, Corporation, or trade name under which you do business. (If Corporation, state the name of the President and Secretary. If a Partnership, state the name of all Partners. If a trade name, state the name of the Individuals who do business under the trade name). Boromei Construction, Inc. (CORRECT NAME OF BIDDER) (a.) The business is a Corporation City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 8 (b.) The address of the principal place of business is: 420B NW 3rd St., Okeechobee, FL 34972 (c.) The names of the Corporate Officers, Partners, or Individuals doing business under a trade name are as follows: Danny Boromei, President; Chris Close, Vice President; Sheryl Wells, Treasurer; Melissa Stone, Secretary City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 9 1 SECTION VI ' PW 02 -00 -05 -18 -RB BONDING AND INSURANCE REQUIREMENTS BID BOND A certified check, cashier's check or bank officer's check, for the sum set forth in the advertisement, but not less than 5 percent (5%) of the total Bid, made payable to the City of Okeechobee, UKeechobee, Florida, or Bid bond in such amount, shall accompany each Bid of $25,000.00 or more as evidence of the good faith and responsibility of the Bidder. The check or bond shall be retained by the City as liquidated damages should the Bidder refuse to, or fail to, enter into a contract for the execution of the work embraced in this Bid, in the event the Bid of the Bidder is accepted. Retention of such amount shall not be construed as a penalty or forfeiture. As soon as a satisfactory contract has been executed and bonds furnished and accepted, the check or bond accompanying the Bid of the successful Bidder will be returned. The City will return the certified or other checks or Bid bonds of the unsuccessful Bidders to them only upon acceptance of the Bid of the successful Bidder and formal award of the contract by the City of Okeechobee City Council. PAYMENT AND PERFORMANCE BOND The successful Bidder shall furnish a bond written by a Corporate Surety Company, holding a Certificate of Authority from the Secretary of the Treasury of the United States as acceptable sureties on federal bonds, in an amount equal to the total amount payable by the terms of the contract, executed and issued by a Resident Agent licensed by and having an office in the State of Florida, representing such Corporate Surety, conditioned for the due and faithful performance of the work, and providing in addition to all other conditions, that if the Contractor, or its Subcontractors, fail to duly pay for any labor, materials, or other supplies used or consumed by such Contractor, or its Subcontractors, in performance of the work contracted to be done, the Surety will pay the same in the amount not exceeding the sum provided in such bonds, and that they shall indemnify and save harmless the City to the extent of any and all payments in connection with carrying out of the contract, which the City may be required to make under law. This bond shall be provided to the City within ten (10) days of notification of Bid award. The Contractor is required at all times to have a valid payment and performance bond in force covering the work being performed. A failure to have such bond in force at any time shall constitute a default on the part of the Contractor. A bond written by a Surety, which becomes disqualified to do business in the State of Florida, shall automatically constitute a failure on the part of the Contractor to meet the above requirements. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 10 Such bond shall continue in effect for one (1) year after completion and acceptance of the work with liability equal to 25 percent (25%) of contract price, or an additional bond shall be conditioned that the Contractor will correct any defective or faulty work or material which appear within one (1) year after completion of the contract, upon notification by the City. INDEMNITY [CONTRACTOR] shall defend, indemnify and hold harmless the City of Okeechobee and all of the City of Okeechobee's officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys' fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of [VENDOR], its officers, agents or employees in performance or non-performance of its obligations under the Agreement. [CONTRACTOR] recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City of Okeechobee when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City of Okeechobee in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve [CONTRACTOR] of its liability and obligation to defend, hold harmless and indemnify the City of Okeechobee as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Okeechobee's liability beyond that provided in section 768.28, Florida Statutes. INSURANCE [CONTRACTOR] shall, at its sole cost and expense, procure and maintain throughout the term of this contract, Comprehensive General Liability, Worker's Compensation, and Commercial Automobile Liability insurance, including Employer Liability insurance, with minimum policy limits specified below Combined Single Limits, or to the extent and in such amounts as required and authorized by Florida law, and will provide endorsed certificates of insurance generated and executed by a licensed insurance broker, brokerage or similar licensed insurance professional evidencing such coverage, and naming the City of Okeechobee as a named additional insured, as well as furnishing the City of Okeechobee with a certified copy, or copies, of said insurance policies. Certificates of insurance and certified copies of these insurance policies must accompany this signed contract. Said insurance coverages procured by [CONTRACTOR] as required herein shall be considered, and [CONTRACTOR] agrees that said insurance coverages it City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 11 procures as required herein shall be considered, as primary insurance over and above any other insurance, or self-insurance, available to the City of Okeechobee, and that any other insurance, or self-insurance available to the City of Okeechobee shall be considered secondary to, or in excess of, the insurance coverage(s) procured by [CONTRACTOR] as required herein. Worker's' Compensation - Coverage is to apply for all employees for statutory limits in compliance with the applicable state and federal laws. The policy must include Employers' uaaiiity with a limit of $500,000.00 each accident, $500,000.00 each employee, $500,000.00 policy limit for disease. Commercial General Liability (Occurrence Form Required) - (ContractorNendor) shall maintain commercial general liability (CGL) insurance with a limit of not less than $500,000.00 each occurrence. If such CGL insurance contains a general aggregate limit, it shall apply separately to this location/project in the amount of $1,000,000.00. Products and completed operations aggregate shall be $1,000,000.00. CGL insurance shall be written on an occurrence form and shall include bodily injury and property damage liability for premises, operations, independent Contractors, products and completed operations, contractual liability; broad form property damage and property damage resulting from explosion, collapse or underground (x, c, u) exposures, personal injury and advertising injury. Damage to rented premises shall be included at $100,000.00. Commercial Automobile Liability Insurance - (Contractor/Vendor) shall maintain automobile liability insurance with a limit of not less than $1,000,000.00 each accident for bodily injury and property damage liability. Such insurance shall cover liability arising out of any auto (including owned, hired and non -owned autos). The policy shall be endorsed to provide contractual liability coverage. Nothing herein shall be construed to extend the City of Okeechobee's liability beyond that provided in F.S. 768.28, Florida Statutes. Will need to be completed. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 12 0 . ;, BID BOND 0 0 0 Boromei Construction, LEN THESE PRESENTS, that we Inc. as Principal, 0 • 0 0 X ire Insurance Company are firmly bound unto the City Council, City of Okeechobee, Florida, - 5 8 6 5 • 0 0 x filled the Owner in the sum of Five Percent of Amount Bid 5•00 i of Amount Bid � 793.25 ,. ) being 5 percent (5%) of the attached maximum Bid amount otoc_Vroo5o,c\CI ►lec• 'Aun&td SW\11..kLk dollars ($1 "�g3. 3�j ) �rNncuL abtko.Ws >1wem, Fwe_ C-Qc�.k5 the payment of which sum well and truly to be made, the said Principal and the said surety, bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS the Principal has submitted a Bid for Okeechobee City Hall Door Replacement Bid No. PW 02 -00 -05 -18 -RB based on the contract documents prepared by the City of Okeechobee Public Works Department. NOW, THEREFORE, if the Owner shall accept the Bid of the Principal and the Principal shall enter into a contract with the owner in accordance with the terms of such Bid, and give such 100 percent (100%) Bond as specified in the Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and materials furnished in the prosecution thereof, or in the event the Principal fails to enter such contract and give such bond or bonds, if the Principal shall pay to the Owner the difference not exceeding the penalty hereof between the amount specified in said Bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said Bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 20thday of July , 2018. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 13 FOR CORPORATE BIDDERS: WITNESS: (11eii--1 ) By Boromei Construction, Inc. By Tit! Surety United States Fire Insurance Company 17/((Seoi' Typed Name Charles J. Nielson, Attorney In Fact Address FOR NON -CORPORATE BIDDERS: WITNESS: 305 Madison Avenue Morristown, NJ 07960 (Principal) (Seal) By Title Surety By ;„nn Typed Name Address City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 14 POWER OF ATTORNEY UNITED STATES FIRE INSURANCE COMPANY PRINCIPAL OFFICE - MORRISTOWN, NEW JERSEY 00927402018 KNOW ALL MEN BY THESE PRESENTS: That United States Fire Insurance Company, a corporation duly organized and existing under the laws of the state of Delaware, has made, constituted and appointed, and does hereby make, constitute and appoint: Ian A. Nipper, David Russell Hoover, Joseph Penkitet Nielson, Charles David Nielson, Charles Jackson Nielson, Shawn Alan Burton each, its true and lawful Attomey(s)-In-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver: Any and all bonds and undertakings of surety and other documents that the ordinary course of surety business may require, and to bind United States Fire Insurance Company thereby as fully and to the same extent as if such bonds or undertakings had been duly executed and acknowledged by the regularly elected officers of United States Fire Insurance Company at its principal office, in amounts or penalties not exceeding: Seven Million, Five Hundred Thousand Dollars ($7,500,000). This Power of Attorney limits the act of those named therein to the bonds and undertakings specifically named therein, and they have no authority to bind United States Fire Insurance Company except in the manner and to the extent therein stated. This Power of Attorney revokes all previous Powers of Attorney issued on behalf of the Attorneys -In -Fact named above and expires on January 31, 2019. This Power of Attorney is granted pursuant to Article IV of the By -Laws of United States Fire Insurance Company as now in full force and effect, and consistent with Article III thereof, which Articles provide, in pertinent part: Article IV, Execution of Instruments - Except as the Board of Directors may authorize by resolution, the Chairman of the Board, President. any Vice -President, any Assistant Vice President, the Secretary, or any Assistant Secretary shall have power on behalf of the Corporation: (a) to execute, affix the corporate seal manually or by facsimile to, acknowledge, verify and deliver any contracts, obligations, instruments and documents whatsoever in connection with its business including, without limiting the foregoing, any bonds, guarantees, undertakings, recognizances, powers of attorney or revocations of any powers of attorney, stipulations, policies of insurance, deeds, leases, mortgages, releases, satisfactions and agency agreements; (b) to appoint, in writing, one or more persons for any or all of the purposes mentioned in the preceding paragraph (a), including affixing the seal of the Corporation. Article III, Officers, Section 3.11, Facsimile Signatures. The signature of any officer authorized by the Corporation to sign any bonds, guarantees, undertakings, recognizances, stipulations, powers of attorney or revocations of any powers of attorney and policies of insurance issued by the Corporation may be printed, facsimile, lithographed or otherwise produced. In addition, if and as authorized by the Board of Directors, dividend warrants or checks, or other numerous instruments similar to one another in form, may he signed by the facsimile signature or signatures, lithographed or otherwise produced, of such officer or officers of the Corporation as from time to time may be authorized to sign such instruments on behalf of the Corporation. The Corporation may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Corporation, notwithstanding the fact that he may have ceased to be such at the time when such instruments shall be issued. IN WITNESS WHEREOF, United States Fire Insurance Company has caused these presents to be signed and attested by its appropriate officer and its corporate seal hereunto affixed this 10th day of March, 2016. UNITED STATES FIRE iNSITR /INCE COMPANY !1I Anthony R. Slimowicz, Senior Vice President State of New Jersey} County of Morris } On this 10th day of March 2016, before me, a Notary public of the State of New Jersey, came the above named officer of United States Fire Insurance Company, to me personally known to be the individual and officer described herein, and acknowledged that he executed the foregoing instrument and affixed the seal of United States Fire Insurance Company thereto by the authority of his office. SONIA SCALA NOTARY PUBLIC OF NEW JERSEY Sonia Scala (Notary Public) MY COMMISSION EXPIRES 3/25/2019 I, the undersigned officer of United States Fire Insurance Company, a Delaware corporation, do hereby certify that the original Power of Attorney of which the foregoing is a full, true and correct copy is still in force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal of United States Fire Insurance Company on the20 ity ofJUly UNITED STATES FIRE INSURANCE COMPANY 1 Al Wright, Senior Vice President 20 18 SECTION VII PW 02 -00 -05 -18 -RB AGREEMENT This AGREEMENT is dated as of the 7th day of August in the year 2018, between the City of Okeechobee (CITY) and Boromei Construction, LLC (CONTRACTOR). CITY and CONTRACTOR, in consideration of the mutual covenants hereinafter set forth, agree as follows: ARTICLE 1. WORK 1.1 The Work is described as follows: Provide construction services needed to replace five (5) existing exterior doors and one (1) double exterior door with side lights and transom at the City of Okeechobee City Hall located at 55 SE 3rd Avenue, Okeechobee FL 34974. ARTICLE 2. PUBLIC WORKS DIRECTOR 2.1. PUBLIC WORKS DIRECTOR as named in the Contract Documents shall mean: City of Okeechobee Public Works Director 55 S.E. 3rd Avenue Okeechobee, FL 34974 ARTICLE 3. CONTRACT TIME 3.1 The Work shall be completed within the ninety (90) calendar days specified on the Notice to Proceed for each project assigned. 3.2 CITY and CONTRACTOR recognize that Projects may have important environmental and economic significance and, as required for compliance with Federal and State Regulations, that time is of the essence of this Agreement, and that the CITY will suffer direct financial loss if Projects are not completed as described in paragraph 3.1 Accordingly, CONTRACTOR agrees to pay CITY as liquidated damages the amount established in the following schedule per day for each day that Projects are not completed in accordance with this Article 3, Paragraph 3.1. Original Contract Amount Daily Charge per Calendar Day $500,000.00 and under $ 500.00 Over $500,000.00 but less than $1,000000.00 $ 750.00 Over $1,000,000.00 but less than $2,500,000.00 $ 1,000.00 Over $2,500,000.00 but less than $5,000,000.00 $ 1,250.00 3.3 In addition to the provision for payment to the CITY by CONTRACTOR of liquidated damages due to the failure of the CONTRACTOR to complete each project within the time stipulated in each project's notice to proceed, or City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 15 within such additional time as may have been granted by the Public Works Director, the CITY may also recover from CONTRACTOR amounts paid by the CITY for damages suffered by third parties as a result of CONTRACTOR'S failure to complete each project within the time stipulated, or within such additional time as may have been granted by the Public Works Director, unless the failure to timely complete the project was caused by the CITY's acts or omissions. 3.4 Liquidated damages are cumulative and additive and represent a reasonable estimate of CITY's expenses for extended delays and administrative costs associated with such delay. In addition to the liquidated damage amounts, there will be additional amounts charged to the CONTRACTOR for all delay damacies incurred by the CITY as a result of unavoidable delays by the CONTRACTOR. These actual delay damages will include, but not be limited to, inspection, engineering services, delay damage settlements or awards, penalties, and professional fees incurred in connection with such settlements, awards or penalties and fines imposed by regulatory agencies, contract damages and loss of use. ARTICLE 4. CONTRACT PRICE 4.1 CITY shall pay CONTRACTOR for performance of the work in accordance with the unit prices listed in the contract documents CONTRACTOR'S Bid form on a project by project basis. 4.2 CITY shall pay the CONTRACTOR, or receive as credit, for changes or adjustments in the work made in accordance with the General Conditions, on the basis of the unit prices indicated on the Bid form. ARTICLE 5. MEASUREMENT AND PAYMENT 5.1 Payment for the work, as further specified herein, shall include compensation to be received by the CONTRACTOR for furnishing tools, equipment, supplies, and manufactured articles, and for labor, operations, and incidentals appurtenant to the items of work being described, as necessary to complete the various items of the work in accordance with the requirements of the contract documents, including appurtenances thereto, and including all costs of compliance with the regulations of public agencies having jurisdiction, including Safety and Health Requirements of the Occupational Safety and Health Administration of the U.S. Department of Labor (OSHA). No separate payment will be made for any item that is not specifically set forth in the Bid Schedule, and all costs therefore shall be included in the prices named in the Bid Schedule for the various appurtenant items of work. 5.2 The total Unit Bid Price for each project shall cover all work required by the Contract Documents. All costs in connection with the proper and successful completion of the work, including furnishings all materials, equipment, City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 16 supplies, and appurtenances; providing all construction equipment, and tools; and performing all necessary labor and supervision to fully complete the Work, shall be included in the Unit Bid prices. All related and necessary work not specifically set forth as a pay item in the Bid shall be considered a subsidiary obligation of CONTRACTOR and all costs in connection therewith shall be included. 5.3 Payment for all work done in compliance with the Contract Documents, inclusive of furnishings all manpower, equipment, materials, and performance of all operations relative to construction of this project, will be made under the Unit Bid Price. 5.4 The CITY reserves the right to alter the Drawings, modify incidental work if necessary, and increase or decrease quantities of work to be performed in accordance with such changes, including deduction or cancellation of any one or more of the chapters or items. Changes in the work shall not be considered as a waiver of any conditions of the Contract nor invalidate any provisions thereof. When changes result in changes in the quantities of work to be performed, and proposed change will cause substantial inequity to the CITY or CONTRACTOR the applicable unit prices shall be equitably adjusted by change order. 5.5 Quantities necessary to complete the work as shown on the Drawings or as specified herein shall govern over those shown in the Proposal or Bid Documents. The CONTRACTOR shall take no advantage of any apparent error or omission in the Drawings or Specifications, and the Public Works Director shall be permitted to make corrections and interpretations as may be deemed necessary for fulfillment of the intent of the Contract Documents. 5.6 The quantities for payment, other than Final Payment, under this Contract shall be determined for actual measurement of the completed items, in place, ready for service and accepted by the CITY, in accordance with the applicable method of measurement therefore contained herein. A representative of the CONTRACTOR shall witness all field measurements. 5.7 All estimated quantities stipulated in the Bid Form or other Contract Documents are approximate and supplied for the sole purpose of providing Bidder with a basis which will be used to determine the Base Bid and to obtain unit prices for approvals of progress payments for the Work done. Actual quantities which will be ordered by CITY may vary from those on the Bid Form(s). The CONTRACTOR'S attention is directed to the items of work for which no unit price is set. All work shown on the drawings as outlined in the specifications is to be completed in all respects, and the cost of all miscellaneous and associated work to any specific items shall be included in the Unit Prices. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 17 5.8 All quantities, for the submittal of payments, shall be measured and tabulated by both the Public Works Director, or representative, and CONTRACTOR. Requests for payment and supporting data shall be prepared by the CONTRACTOR and given to the Public Works Director sufficiently in advance of payment date to permit thorough checking of all quantities. 5.9 The CONTRACTOR shall furnish the Public Works Director whatever assistance is required, laborers, clerks and records that will enable the Public Works Director to expeditiously check all estimates and especially the final quantities of the project. 5.10 CONTRACTOR shall submit Applications for Payment in accordance with Article 9 of the General Conditions. Applications for Payment will be processed by Public Works Director as provided in the General Conditions. CITY shall make progress payments on the basis of CONTRACTOR'S Applications for Payment as recommended by the Public Works Director, in accordance with Article 9 of the General Conditions. Prior to Final Completion of the Work of each Individual chapter progress payments will be in an amount equal to ninety percent (90%) of the Work completed. Upon Final Completion and Acceptance of the Work of each Individual Chapter, in accordance with Article 9 of the General Conditions, CITY shall pay the remainder of the Contract Price, as provided in Article 9. ARTICLE 6. RETAINAGE IN ANTICIPATION OF LIQUIDATED DAMAGES 6.1 CITY may withhold additional retainage if CONTRACTOR is behind schedule and it is anticipated by CITY that each portion of the Work will not be completed within the Contract Time, as specified in the Notice to Proceed. 6.2 CITY may consider CONTRACTOR'S progress schedules as amended, and compliance or non-compliance therewith and other factors, including CONTRACTOR'S failure to provide a schedule and/or to update the same. ARTICLE 7. CONTRACTOR'S REPRESENTATIONS In order to induce CITY to enter into this Agreement, CONTRACTOR makes the following representations: 7.1 CONTRACTOR has familiarized himself with the nature and extent of the Contract Documents. Work locality, weather, and with all local conditions and federal, state, and local laws ordinances, rules, policies, and regulations that in any manner affect cost, progress, or performance of the work. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 18 7.2 CONTRACTOR has studied carefully all reports of investigations and tests of subsurface and latent physical conditions of the site or otherwise affecting cost, progress, or performance of the work which were relied upon by the Public Works Director in the preparation of the Drawings and Specifications. 7.3 CONTRACTOR has made or caused to be made examinations, investigations, and tests, and studies of such reports and related data, in addition to those referred to in Paragraph 7.2 above as he deems necessary for the performance of the work at the contract price, within the contract time, and in accordance with the other terms and conditions of the contract documents, and no additional examinations, investigations, tests, reports or similar data are or will be required by the CONTRACTOR for such purposes. 7.4 CONTRACTOR has correlated results of such observations, examinations, investigations, tests, reports, and data with the terms and conditions of the contract documents. 7.5 CONTRACTOR has given Public Works Director written notice of all conflicts, errors, or discrepancies that he has discovered in the contract documents, and the written resolution thereof by Public Works Director is acceptable to the contract. 7.6 Public Records Act Florida Statute Chapter 119 Compliance. CONTRACTOR understands and agrees that records and documents prepared by CONTRACTOR or the CITY for the performance of services may be subject to the Public Records Act, Florida Statute, Chapter 119 and may be required to be produced as provided in said statute. The records subject to Chapter 119 may include, in addition to prepared documents, such communication as e-mails, text messages, inter -office memorandums, social media, and photographs or images; a person or entity may request public records via e-mail, or by oral or written request, and a response to such a request must be prompt; it is the responsibility of the CONTRACTOR to establish an in-house policy in reference to such records, and to identify and retain such communications in the normal course of business in the event a request is made to produce these records. ARTICLE 8. PUNCHLIST PROCEDURES Further to Florida Statutes §218.735(7)(a)(i), Punchlist procedures to render the Work complete, satisfactory and acceptable are established as follows: 8.1 Within five (5) days of Substantial Completion of the construction services purchased as defined in the Contract, CONTRACTOR shall schedule a walkthrough with CITY ("Initial Walkthrough" a/k/a "IW"). The purpose of the City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 19 IW is to develop a preliminary checklist ("Checklist") of items to be performed by the CONTRACTOR, based upon observations made jointly between the CONTRACTOR and CITY during the IW. The IW is to occur within ten (10) days of Substantial Completion of the Work as defined by the Contract, again predicated upon the CONTRACTOR'S timely initiation fortheIW. At its option, CITY mayconduct the 1W with its Field of a request Inspector. 8.2 CONTRACTOR shall endeavor to address and complete as many items as possible noted on the Checklist either during the IW itself, or thereafter for a period of fifteen (15) days from the date of the IW. 8.3 No later than fifteen (15) days following the scheduled IW, CONTRACTOR shall again initiate and request a second walkthrough of the Project with the CITY. The purpose of this second walkthrough is to identify which items remain to be performed from the IW Checklist and to supplement that list as necessary (based, for example, upon work which may have been damaged as a result of the CONTRACTOR'S performance of completion of items contained on the IW Checklist) and for the purpose of developing a joint Final Punchlist. 8.4 The intent of this section is for the CITY and the CONTRACTOR to cooperate to develop a Final Punchlist to be completed no later than five (5) days from the date of reaching Substantial Completion of the construction services purchase as defined in the Contract. 8.5 In no event may the CONTRACTOR request payment of final retainage under Florida Statutes §218.735(7)(d) until the CONTRACTOR considers the Final Punch list to be one hundred percent (100%) complete. 8.6 CONTRACTOR agrees to complete the Final Punchlist items within fifteen (15) days of the date of its issuance by the CITY. 8.7 CONTRACTOR acknowledges and agrees that no item contained on the Final Punchlist shall be considered a warranty item until such time as (a) the Final Punch list is one hundred percent (100%) complete, and (b) the CITY has been able to operate or utilize the affected Punchlist item for an additional period of fifteen (15) days. 8.8 CONTRACTOR acknowledges and agrees that the CITY may, at its option, during performance of the Work and prior to Substantial Completion, issue lists of identified non -conforming or corrective work for the CONTRACTOR to address. The intent of any such the CITY generated lists prior to Substantial Completion is to attempt to streamline the Punchlist process upon achieving Substantial Completion, and to allow for the CONTRACTOR to address needed areas of corrective work as they may be City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 20 observed by the CITY during performance of the Work. CONTRACTOR acknowledges and agrees that in calculating one hundred fifty percent (150%) of the amount which may be withheld by the CITY as to any Final Punchlist item for which a good faith basis exists as to it being complete, as provided for by Florida Statutes §218.735(7)(d), the CITY may include within such percentage calculation its total costs for completing such item of work, including its administrative costs as well as costs to address other services needed or areas of work which may be affected in order to achieve full completion of the Final Punchlist item. Such percentage shall in no event relate to the schedule of value associated with such Work activity, but rather total costs are based upon the value (i.e. cost) of completing such Work activity based upon market conditions at the time of Final Punchlist completion. ARTICLE 9. CONTRACT DOCUMENTS The contract documents which comprise the entire agreement between the CITY and the CONTRACTOR are made a part hereof and consist of the following: • This Agreement • Certificates of Insurance • Payment Bond and Performance Bond • Notice of Award • Notices to Proceed • General Conditions • Product Specifications, as applicable, listed in the Table of Contents thereof. • Drawings, for each project, consisting of a cover sheet and consisting of the sheets as listed in the index thereof. • Addenda numbers to , inclusive. • CONTRACTOR'S Bid Forms (including documentation accompanying the Bid and documentation prior to Notice of Award). • Documentation submitted by CONTRACTOR prior to Notice of Award. • Any modification, including Change Orders and Field Orders, duly delivered after execution of Agreement. • Call for Bids, Instructions to Bidders, Proposal, Bid Forms, Payment and Performance Bonds, and Application for Payment. There are no contract documents other than those listed above in this Article 9. The contract documents may only be altered, amended, or replaced by a modification (as defined in Section 1 of the general conditions). City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 21 ARTICLE 10. MISCELLANEOUS 10.1 Terms used in this agreement which are defined in Article 1 of the general conditions shall have the meanings indicated in the general conditions. 10.2 No assignments by a party hereto of any rights under or interests in the contract documents will be binding on another party hereto without the written consent of the party sought to be bound, and any such assignment shall be void and of no effect; and specifically but without limitation, monies that may become due and monies that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law and unless specifically stated to the contrary in any written consent to an assignment, no assignment will release or discharge the assignor from any duty or responsibility under the contract documents. 10.3 CITY and CONTRACTOR each binds himself, his partners, successors, assigns, and legal representatives to the other party hereto, his partners, successors, assigns, and legal representatives, in respect to all covenants, agreements, and obligations contained in the contract documents. ARTICLE 11. INDEMNIFICATION To the fullest extent permitted by law the Recipient's CONTRACTOR shall indemnify and hold harmless the Recipient, the State of Florida Department of Transportation (FDOT), and its officers and employees, from liabilities, damages, losses and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, or intentional wrongful misconduct of CONTRACTOR and persons employed or utilized by CONTRACTOR in the performance of this Contract. This indemnification shall survive the termination of this Agreement. Nothing contained in this paragraph is intended to nor shall it constitute a waiver of the State of Florida and the Recipient's sovereign immunity. To the fullest extent permitted by law, the Recipient's consultant shall indemnify and hold harmless the Recipient, the FDOT, and its officers and employees, from liabilities, damages, losses and costs, including, but not limited to, reasonable attorney's fees, to the extent caused, in whole or in part, by professional negligence, error or omission, recklessness, or intentional wrongful conduct of the consultant or persons employed or utilized by the consultant in the performance of the Agreement. This indemnification shall survive the termination of this Agreement. Nothing contained in this paragraph is intended to nor shall it constitute a waiver of the State of Florida and the Recipient's sovereign immunity. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 22 ARTICLE 12. E -VERIFICATION Vendors/CONTRACTORS shall utilize the U.S. Department of Homeland Security's E -Verify system to verify the employment eligibility of all new employees hired by the Vendor/CONTRACTOR during the term of the contract. Vendors/CONTRACTORS shall expressly require any Subcontractors performing work or providing services pursuant to the state contract to likewise utilize the U.S. Department of Homeland Security's E -Verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the contract term. IN WITNESS WHEREOF, the parties hereto have signed two (2) copies of this agreement. At least one counterpart each has been delivered to the CITY and CONTRACTOR. All portions of the contract documents have been signed or identified by CITY and CONTRACTOR or by Public Works Director on their behalf. i his Agreement will be effective on 61--.1t) CITY CITY By: ,,e%//�rcY 7jt/ 'Dowling R. Watford,J • Attest:, Lane Gamiotea, MC, CITY Clerk ayor %ZC.e? Title: RtCQ..\ Addresses for giving notices: CITY City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 Approved as to form and legality for the Okeechobee only. )3-2j'\ John R. Cook, City Attorney Attest: Title: 5ecce\-C fLk Corporate Seal CONTRACTOR bocOmik CONS *nX* ()C\ i Y.t_vc_V Uo ce., SIACICA Q ANC.--1ClSoWagq Florida State Contractors License No use and reliance of the City of City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 23 SECTION VIII PW 02 -00 -05 -18 -RB PERFORMANCE BOND Project Name: Okeechobee City Hall Door Replacement Bid No: PW 02 -00 -05 -18 -RB Bond No: 6091001073 Know all men by these presents that: Boromei Construction, Inc. (Name of Contractor) 420B N.W. 3rd Street, Okeechobee, FL 34972 (Address of Contractor) a Corporation (Corporation, Partnership, or Individual) hereinafter called Principal, and United States Fire Insurance Company 305 Madison Avenue, Morristown, NJ 07960 hereinafter called Surety, are held and firmly bound unto: The City of Okeechobee (Name of Owner) 55 S.E. Third Avenue, Okeechobee, FL 34974 (Address of Owner) hereinafter called Owner, in the penal sum of Thirty Five Thousand Eight Hundred Sixty Five And No/100 dollars, ($ 35,865.00 ), in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our successors, and assigns, jointly and severally, firmly by these.presents. The condition of this obligation is such that whereas, the principal entered into a certain contract with the owner, dated the 7th day of August , 2018, a copy of which is hereto attached and made a part hereof, Okeechobee City Hall Door Replacement date(s) to be filled in by owner. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department ?n This bond is being entered into to satisfy the requirements of Section 255.05, Florida Statutes, as the same may be amended. The surety shall be bound by any and all arbitration awards to the same extent as Contractor is bound. Now, therefore, the condition of this obligation is such that if principal: 1. Promptly and taithtuily performs it's duties, all the covenants, terms, conditions, and agreements of said contract and remedies without cost to City any defects which may develop during a period of one (1) year from the date of the issuance of the final certificate of completion and acceptance of the work performed under said agreement, and 2. Pays owner all losses, damages (liquidated or actual), expenses, costs and attorney's fees including costs and attorney's fees on appeal that owner sustains resulting directly or indirectly from any breach or default by principal under the contract, and 3. Satisfies all claims and demands incurred under the contract, and fully indemnifies and holds harmless the owner from all costs and damages which it may suffer by reason of failure to do so, then this bond is void; otherwise it shall remain in full force and effect. In the event that the principal shall fail to perform any of the terms, covenants, and conditions of the contract during the period in which this performance bond is in effect, the surety shall remain liable to the owner for all such loss or damage (including reasonable attorney's fees and costs and attorney's fees on appeal) resulting from any failure to perform up to the amount of the penal sum. In the event that the surety fails to fulfill its obligations under this performance bond, then the surety shall also indemnify and hold the owner harmless from any and all loss, damage, cost and expense, including reasonable attorney's fees and costs for all trial and appellate proceedings, resulting directly or indirectly from the surety's failure to fulfill its obligations hereunder. This paragraph shall survive the termination or cancellation of this performance bond. The surety, for value received, hereby stipulates and agrees that its obligations hereunder shall be direct and immediate and not conditional or contingent upon owner's Pursuit of its remedies against principal, and shall remain in full force and effect notwithstanding (i) amendments or modification to the contract entered into by owner and principal without the surety's knowledge or consent, (ii) waivers of compliance with or any default under the contract granted by owner to principal without the surety's knowledge or consent, or (iii) the discharge of principal from its obligations under the contract as a result of any proceeding initiated under the Bankruptcy Code of 1978, as City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department the same may be amended, or any similar state or federal law, or any limitation of the liability of principal or its estate as a result of any such proceeding. Any changes in or under the contract documents (which include the plans, drawings, and specifications), and compliance or noncompliance with any formalities connected with the contract or the changes therein shall not affect surety's obligations under this bond, and surety hereby waives notice of any such changes. Further, principal and surety acknowledge that the penal sum of this bond shall increase or decrease in accordance with approved changes or other modifications to the contract documents. IN WITNESS WHEREOF, this instrument executed in 2 (Number) counterparts, each of which shall be deemed an original, this 17thday of August 2018. ATTEST: Boromei Construction, Inc. Principal Secretary MQ�,SSO� 5-V011e— Name (Corporate Seal) itness as to principal Witness as to principal Nam(RD0 Title `?c c,s\ dt.C\- ' 420B N.W. 3rd Street Address Okeechobee, FL 34972 City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department ATTEST: United States Fire Insurance Company Surety As per Attached Power of Attorney Surety Secretary Name (Corporate Seal) Witness as to S ety By Attorney -in -Fact Charles J. Nielson z� Name 305 Madison Avenue Address Morristown, NJ 07960 Note: Date of bond must not be prior to date of contract. If Contractor is a Partnership, all partners should execute bond. Important: Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the project is located, unless otherwise specifically approved in writing by the City. Attach: A certified copy of Power of Attorney appointing Individual Attorney -in -Fact for execution of performance bond of behalf of surety. (The performance bond and the payment bond and the covered amounts of each are separate and distinct from each other.) City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 17 POWER OF ATTORNEY UNITED STATES FIRE INSURANCE COMPANY PRINCIPAL OFFICE - MORRISTOWN, NEW JERSEY 00927402018 KNOW ALL MEN BY THESE PRESENTS: That United States Fire Insurance Company, a corporation duly organized and existing under the laws of the state of Delaware, has made. constituted and appointed, and does hereby make, constitute and appoint: Ian A. Nipper, David Russell Hoover, Joseph Penichet Nielson, Charles David Nielson, Charles Jackson Nielson, Shawn Alan Burton each, its true and lawful Attorney(s)-In-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver: Any and all bonds and undertakings of surety and other documents that the ordinary course of surety business may require, and to hind United States Fire Insurance Company thereby as fully and to the same extent as if such bonds or undertakings had been duly executed and acknowledged by the regularly elected officers of United States Fire Insurance Company at its principal office, in amounts or penalties not exceeding: Seven Million, Five Hundred Thousand Dollars ($7,500,000). This Power of Attorney limits the act of those named therein to the bonds and undertakings specifically named therein, and they have no authority to hind United States Fire Insurance Company except in the manner and to the extent therein stated. This Power of Attorney revokes all previous Powers of Attorney issued on behalf of the Attorneys -In -Fact named above and expires on January 31, 2019. This Power of Attorney is granted pursuant to Article IV of the By -Laws of United States Fire Insurance Company as now in full force and effect, and consistent with Article III thereof, which Articles provide, in pertinent part: Article IV, Execution of Instruments - Except as the Board of Directors may authorize by resolution, the Chairman of the Board, President, any Vice -President, any Assistant Vice President, the Secretary, or any Assistant Secretary shall have power on behalf of the Corporation: (a) to execute, affix the corporate seal manually or by facsimile to, acknowledge, verify and deliver any contracts, obligations, instruments and documents whatsoever in connection with its business including, without limiting the foregoing, any bonds, guarantees, undertakings. recognizances, powers of attorney or revocations of any powers of attorney, stipulations, policies of insurance, deeds, leases, mortgages, releases, satisfactions and agency agreements; (b) to appoint, in writing, one or more persons for any or all of the purposes mentioned in the preceding paragraph (a), including affixing the seal of the Corporation. Article III, Officers, Section 3.11, Facsimile Signatures. The signature of any officer authorized by the Corporation to sign any bonds, guarantees, undertakings, recognizances, stipulations, powers of attorney or revocations of any powers of attorney and policies of insurance issued by the Corporation may be printed, facsimile, lithographed or otherwise produced. In addition, if and as authorized by the Board of Directors, dividend warrants or checks, or other numerous instruments similar to one another in form, may he signed by the facsimile signature or signatures, lithographed or otherwise produced, of such officer or officers of the Corporation as from time to time may be authorized to sign such instnnnents on behalf of the Corporation. The Corporation may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Corporation, notwithstanding the fact that he may have ceased to be such at the time when such instruments shall he issued. IN WITNESS WHEREOF, United States Fire Insurance Company has caused these presents to be signed and attested by its appropriate officer and its corporate seal hereunto affixed this 10th day of March, 2016. UNITED STATES F1RF INSTTR ANCE COMPANY • Anthony R. Slimowicz, Senior Vice President State of New Jersey} County of Morris } On this 10th day of March 2016. before me, a Notary public of the State of New Jersey, carne the above named officer of United States Fire Insurance Company, to me personally known to be the individual and officer described herein, and acknowledged that he executed the foregoing instrument and affixed the seal of United States Fire Insurance Company thereto by the authority of his office. SOMA SCALA -•1 -11i� 'a /4-42"."� NOTARY PUBLIC OF NEW JERSEY Sonia Scala (Notary Public) MY COMMISSION EXPIRES 3/25/2019 I, the undersigned officer of United States Fire Insurance Company, a Delaware corporation, do hereby certify that the original Power of Attorney of which the foregoing is a full, true and correct copy is still in force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal of United States Fire Insurance Company on they 7th y of Augu ltl 1 UNITED STATES FIRE INSURANCE COMPANY •;' Al Wright, Senior Vice President SECTION IX PW 02 -00 -05 -18 -RB REJECTION OF PROPOSALS 1 The City may reject a Bid if: a. The Proposer conceals any material fact in the proposal. b. The proposal does not strictly conform to the law or requirements of the proposal. c. The City may, however, reject any or all Bids, whenever it is deemed in the best interest of the City to do so and may reject any part of a Proposal. The City may also waive any minor informalities or irregularities in any Proposal. 2. Proposal Protest Procedure: a. Any Proposer that has submitted a formal proposal to City of Okeechobee, and who is adversely affected by the decision with respect to the award of the formal proposal, may file with the City Administrator's Office, City of Okeechobee, 55 S.E. 3rd Avenue, Okeechobee, FL 34974, a written Protest no later than forty-eight (48) hours (excluding Saturdays, Sundays and Legal Holidays) of the decision of the City of Okeechobee City Council to award the proposal. b. The "Notice of Intent to File a Protest" document shall be in the form of a letter stating all grounds claimed for the Protest. Failure to do so shall constitute a waiver of all rights to seek any further remedies provided for under this Protest Procedure. c. The City Administrator shall submit the protest statement and affidavits along with his or her own statement and affidavits in support of the award of the formal proposal to the City Council for a final determination of the protest. City of Okeechobee Project No. VW u2-uu-u5-125-KB Public works Deparirneni 28 Ho/ Dec_4 -1 0 NOTICE TO PROCEED PW 02 -00 -05 -18 -RB Date: September 5, 2018 To: Boromei Constrution, LLC Contractor. SUBJECT PROJECT: PW 02 -00 -05 -18 -RB Okeechobee City Hall Door Replacement You are hereby notified to proceed with the Work on the subject Project on or after September 5, 2018 and to complete the same within 90 calendar days. The completion date for the Work shall be: December 4, 2018. OWNER: CITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 CONTRACTOR: Mai6os Montes De Oca / ity Administrator CONTRACTOR'S ACKNOWLEDGMENT OF RECEIPT OF NOTICE Name: (6o(ocv- Cnc\S oc- otl Date: Address: k ---\O - Signature O c` Novi -et, 3kAa-t a Title: (cA,c4 (A -k- I O LO (\,c NOTICE OF AWARD PW 02 -00 -05 -18 -RB, OKEECHOBEE C TY HALL DOOR REPLACEMENT August 16, 2018 Boromei Construction, LLC. Attn: Mr. Danny Boromei 420B NW 3rd Street Okeechobee, FL 34972 Dear Mr. Boromei, The City Council awarded the PW 02 -00 -05 -18 -RB, OKEECHOBEE CITY HALL DOOR REPLACEMENT bid to your company, Boromei Construction, LLC at the August 7, 2018 City Council Meeting in the amount of $35,865.00. In order to proceed with the project, you will need to provide the City of Okeechobee with the following by Tuesday, August 28, 2018: QCA toSLtfO eeft:- recd. V V. I. I. I• A certified copy of the insurance policies with the declaration pages for the General Liability and Commercial Auto Insurance. The insurance agent can use a stamp and state that it is a true and original copy and then sign and date it or they can write something to the fact on their letterhead listing the policy numbers, signing and dating iEThe City of Okeechobee also needs to be listed as additional insured with the limits specified per Section VI of the bid packet, pages 11 and 12. Workers Compensation Insurance certificate with the limits specified per Section VI of the bid packet, pages 11 and 12. W-9. Copy of County of Okeechobee Business Tax Receipt. Performance Bond per Section VIII of the bid packet, Pages 24 - 27. Two original executed sets of the attached Agreement. One set will be returned to you after executed by the City. We look forward to working with you on this project. Should you have any questions please feel free to contact Patty Burnette, 863- 763-9820, or by email at pburnettecityofokeechobee.com. David Allen Public Works Director City of Okeechobee 55 SE Third Avenue Okeechobee, FL 34974 Tele: 863-763-9790 Fax: 863-763-1686 dallen@cityofokeechobee.com SECTION XII PW 02 -00 -05 -18 -RB MISCELLANEOUS A. No Lobbying: All respondents are hereby placed on notice that any communication, whether written or oral, with City of Okeechobee elected officials or any City staff or outside Individuals working with the City in respect to this request (with the exception of the Genera! Services personnel designated to receive requests for interpretation or corrections or technical questions), is prohibited. These persons shall not be lobbied, either individually or collectively, regarding any request for Bid, proposals, qualifications and/or any other solicitations released by the City. To do so is grounds for immediate disqualification from the selection process. All respondents must submit the attached No Lobbying Affidavit with their submittal stating that they and their Subcontractor, sub -consultants and agents agree to abide by the no lobbying restrictions in order to be considered for this request. Any respondent that does not submit the required No Lobbying Affidavit will be automatically disqualified from further consideration. NOTE: For respondents' convenience, this certification form is attached and made a part of the procurement package. See Attachment A B. Collusion, Gratuities and Kickbacks: It shall be unethical for any respondent to collude with any other respondent or offer, give or agree to give any City Council member, City employee or City representative (including selection committee members) a gift, gratuity or an offer of employment in connection with any decision, approval, disapproval, recommendation or preparation of any part of the procurement process. NOTE: For respondents' convenience, this certification form is attached and made a part of the procurement package. See Attachment B C. Modifications: The City reserves the right to modify, alter or change the scope or other aspects of this solicitation. D. Level Playing Field: The contents of this solicitation are intended to provide a level playing field on which Firms or Individuals may base their responses. E. Public Entity Crime Affidavit: As requested by Florida Statute 287.133(2)(a), a person or affiliate who has been placed on the convicted vendor list following a conviction for a Public Entity Crime may not submit a Bid on a contract with a Public Entity for the construction or repair of a public building or a public work, may not submit Bids on leases of real property to a Public Entity, may not be awarded or perform work as a Contractor, supplier, Subcontractor, or consultant under a contract with any Public Entity, and may not transact business with any Public Entity in excess of the threshold amount provided in F.S. 287.017 for City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 31 Category Two for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. Any person must notify the City within thirty (30) days after a conviction of a Public Entity crime applicable to that person or to an affiliate of that person. NOTE: For respondents' convenience, this certification form is attached and made a part of the procurement package. See Attachment B Conflict of Interest: The award hereunder is subject to the provisions of Chapter 112, Florida Statutes. All respondents must disclose with their submission the name of any officer, director, employee or agent who is also a public officer, employee or an agent of the City of Okeechobee City Council, or any of its agencies. Furthermore, all respondents must disclose the name of any City officer, employee or agent who owns, directly or indirectly, an interest of five percent (5 %) or more in the Firm or any of its parent companies or subsidiaries. NOTE: For respondents' convenience, this certification form is attached and made a part of the procurement package. See Attachment E G. Immigration Laws: Respondents must comply with all applicable immigration laws in their employment practices. NOTE: For respondents' convenience, this certification form is attached and made a part of the procurement package. See Attachment F H. Tie Proposals: Preference shall be given to businesses with drug-free workplace programs. Whenever two or more proposals which are equal with respect to quality and service are received by the City for the procurement of commodities or contractual services, a proposal received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie proposals will be followed if none of the tied vendors has a drug-free workplace program. NOTE: For respondents' convenience, this certification form is attached and made a part of the procurement package. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 32 ATTACHMENT A PW 02 -00 -05 -18 -RB NO LOBBYING AFFIDAVIT STATE OF FLORIDA COUNTY OF Okeechobee This 18th day of July , 2018, Danny Boromei being first duly sworn, deposes and says that he/she is the authorized representative of Boromei Construction, Inc. (Name of Contractor, Firm or Individual) respondent to the attached request for Bid, proposal or qualifications and/or any other solicitation released by City of Okeechobee, and that the Bidder and any of its agents agrees to abide by the City of Okeechobee no lobbying restrictions in regard to this solicitation. Affiant Darifiy Boromei The foregoing instrument was acknowledged and subscribed before me this 18 day of July , 2018 , by Danny Boromei , who is personally known x OR produced as identification. Sig t. reo Not. Public 0 e4*, Notary Public State of Florida Melissa Ann Stone My Commission GG 159396 4,044"Expires 02/24/2022 Nar4t Commission No. mped City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department qg ATTACHMENT B PW 02 -00 -05 -18 -RB ANTI -COLLUSION STATEMENT AND NO GIFTS STATEMENT Date: 7.18.2018 Anti -collusion statement: The below -signed Bidder has not divulged to, discussed, or compared his/her Bid with other Bidders and has not colluded with any other Bidder or parties to a Bid whatsoever. No gifts statement: Firm Name: No premiums, rebai:es, gifts or gratuities are permitted with, prior to, or after submission of the Bid. Any such violation will result in rejection of the Bid and removal from the Bid list(s). Boromei Construction, Inc. By (printed/typed): Danny Boromei By (signature): 1� Title: President Mailing Address: 420B NW 3rd St. City, State, Zip: Okeechobee, FL 34972 Telephone No.: 863.623.4314 City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department c ATTACHMENT C PW 02 -00 -05 -18 -RB PROPOSER'S CERTIFICATION I have carefully examined this Request for Bids (BID)/Request for Proposals (RFP)/ Request for Qualifications (RFQ), which includes scope, requirements for submission, general information and the evaluation and award process. acknowledge receipt of the following addenda. Addendum # Addendum # Addendum # Date: Addendum # Date: Date: Addendum # Date: Date: Addendum # Date: I hereby propose to provide the services requested in the City's BID/RFP/RFQ and, if awarded, to enter into the attached draft contract. I agree that the terms and conditions of the City's BID/RFP/RFQ shall take precedence over any conflicting terms and conditions submitted with my proposal and agree to abide by all conditions of the BID/RFP/RFQ, unless a properly completed Exceptions to BID/RFP/RFQ form is submitted. I acknowledge that the City may not accept the proposal due to any exceptions. I certify that all information contained in my proposal is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to submit this proposal on behalf of the Company as its agent and that the Company is ready, willing and able to perform if awarded a contract. I further certify, under oath, that this proposal is made without prior understanding, agreement, connection, discussion or collusion with any other person, Company or Corporation submitting a proposal for the same product or service; no gratuities, gifts or kick -backs were offered or given by the Bidder or anyone on its behalf to gain favorable treatment concerning this procurement; no City Council member, employee or agent of City of Okeechobee or of any other Company is interested in said Bid; and that the undersigned executed this Proposer's Certification with full knowledge and understanding of the matters therein contained and was duly authorized to do so. Boromei Construction, Inc. 420B NW 3rd Street Name of Business Danny Boromei, President Name & Title, Typed STATE OF FLORIDA COUNTY OF Okeechobee Mailing Address Okeechobee, FL 34972 City, State & Zip Code 863.623.4314/863.763.6337 Telephone Number/Fax Number boromeiconstructioninc@gmail.com Email Address The foregoing instrument was acknowledged and subscribed before me this 18 day of July 2018 , by Danny Boromei , who is personally known X OR produced as identification. City of Okeechobee Public Works Department Signature of Notary Public Name of Notary Typed, Printed, or S e." a itc,Notary Public State o ' Melissa ASoreat+ n No. y c` My Commission GG 15939 Expires 02/24/2022 Project No. PW 02 -00 -05 -18 -RB ATTACHMENT D PW 02 -00 -05 -18 -RB SWORN STATEMENT PURSUANT TO SECTION 287.133 (2)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. -i. This sworn statement is submitted to CITY OF OKEECHOBEE, FLORIDA by: Danny Boromei, President (print Individual's name and title) for: Boromei Construction, Inc. (print name of entity submitting sworn statement) whose business address is: 4206 NW 3rd St., Okeechobee, FL 34972 and (if applicable) its Federal Employer Identification Number (FEIN) is: 45-2708809 (If the entity has no FEIN, include the Social Security Number of the Individual signing this sworn statement: .) 2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States, including but not limited to, any Bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentations. 3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non jury trial, or entry of a plea of guilty or nolo contendere. 4. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means: a. A predecessor or successor of a person convicted of a public entity crime; or b. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 36 United States with the legal power to enter into a binding contract and which Bids or applies to Bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 6. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Indicate which statement applies). Neither the entity submitting this sworn statement, nor any of its officers; directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. ❑ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. ❑ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list (attach a copy of the final order). I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. STATE OF FLORIDA COUNTY OF Okeechobee The foregoing instrument was acknowledged and subscribed before me this 18 day of July 20 18 , by Danny Boromei , who is personally known X OR produced as identification. Signature of Notary Public ( L Q . 0 yea�"."tWV"7%s 0<7•a:iYu-4"v'-trrZ. Name of Notary Typed, Printed, or Stamped..„,,;.:" P' t Notary Public State of Florida .4' ' Melissa Ann Stone tv ' My 1flti§6imp oct. Expires 02/24/2022 i .."- aWy°.!V vt City of Okeechobee Public Works Department Project No. PW 02 -00 -05 -18 -RB ATTACHMENT E PW 02 -00 -05 -18 -RB CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all Bidders must disclose if any City of Okeechobee employee(s), elected official(s), or any of its agents is also an owner, corporate officer, director, agent, employee, etc., of their business. Indicate either "yes" (a City employee, elected official or agent is associated with your business), or "no". If yes, give person(s) name(s) and position(s) with your business. YES NO X Name(s) Position(s) Firm Name: Boromei Construction, Inc. By (Printed): Danny Boromei By (Signature):c�------ Title: President Address: 420B NW 3rd St., Okeechobee, FL 34972 Phone Number: 863.623.4314 City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 3R ATTACHMENT F PW 02 -00 -05 -18 -RB IMMIGRATION LAW CERTIFICATION City of Okeechobee will not intentionally award City contracts to any Contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324 a(e) (Section 274a(e) of the immigration and nationality act ("INA")). City of Okeechobee may consider the employment by any Contractor of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation by the recipient of the employment provisions contained in Section 274A(e) of the INA shall be grounds for unilateral cancellation of the contract by City of Okeechobee. Respondent attests that it is fully compliant with all applicable immigration laws, specifically relating to the 1986 immigration act and subsequent amendments. Boromei Construction, Inc. Company Name Signature President Title 7.18.2018 Date STATE OF FLORIDA COUNTY OF Okeechobee The foregoing instrument was acknowledged and subscribed before me this 18 day of July 2018 , by Danny Boromei , who is personally known X OR produced as identification. City of Okeechobee Public Works Department Signature of Notary Public Name of Notary Typed, Printed, or Stamped gy p ^7f$'ioct Site of Florida • e• My Commission GG 159396 .,,,;09 Expires 02/24/2022 Project No. PW 02 -00 -05 -18 -RB ATTACHMENT G PW 02 -00 -05 -18 -RB DRUG-FREE WORKPLACE CERTIFICATION THE BELOW SIGNED Bidder/proposer CERTIFIES that it has implemented a drug-free workplace program. In order to have a drug-free workplace program, a business shall: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the work place and specifying the actions that will be taken against employees for violation of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under quote a copy of the statement specified in subsection 1. 4. In the statement specified in subsection 1, notify the employees that, as a condition of working on the commodities or contractual services that are under quote, the employee will abide by the terms of the statement and will notify the employer of any conviction or plea of guilty or nolo contendere to any violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in, drug abuse assistance or rehabilitation program if such is available in the employee's community, by an employee who is convicted. 6. Make a good faith effort to continue to maintain a . drug-free workplace through implementation of this section. As the person authorized to sign this statement, I certify that this Firm complies fully with the above requirements. Signature: Date: 7.18.2018 Company: Boromei Construction, Inc. Name: Danny Boromei Address: 4206 NW 3rd St., Okeechobee, FL 34972 Title: President Phone Number: 863.623.4314 City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department an PRODUCT APPROVAL FOR SERIES FG -5000 FLUSH GLAZED ALUMINUM WINDOW WALL SYSTEM FOR USE IN HURRICANE ZONES REQUIRING LARGE & SMALL MISSILE IMPACT PROTECTION. (WET & DRY GLAZED) GENERAL NOTES: 1. SERIFS F0-5000 FLUSH GLAZED ALUMINUM WINDOW WAU. SYSTEM LARGE k SMALL MISSILE IMPACT LAMINATED GLASSACCORDANCE WITH THE 201461sumo; ON THIS ((00. EDITION) OF THE FT EVALUATION LORIDA 65110INNGG COOOL BM VERIFIED FOR COMPLIANCE IN HURRICANE LEESFC ZONES (USH AHED ALUMINUM M (AIN OW W� �� MAY BE INSTALLED WITHIN HIGH VELOCITY DESIGN WIND LOADS SHALL BE DETERMINED AS PER SECTION 1620 (RITZ) & 1609 (NHJHZ) OF THE ADORE MENTIONED CODE, FOR A BASIC WIND SPEED AS REQUIRED BY THE JURISDICTION WHERE THIS PRODUCT TO BE INSTALLED FOR A DIRECTIONALITY FACTOR Ed -0.85, USING ASCE 7-10 & SHALL NOT EXCEED THE MAXIMUM (ASA.) DESIGN PRESSURE RATING INDICATED ON NOTE 2. IN ORDER TO VERIFY THE ABOVE CONDITION, ULTIMATE DESIGN WIND LOADS DETERMINES PER ASCE 7-10 SHALL BE FIRST REDUCED TO A.S.O. DESIGN WAD LOADS BY MULTIPLYING THEM BY 0,8 IN ORDER TO COMPARE THESE W/ MAX. (AS.S) DESIGN PRESSURE RATINGS INDICATED ON NOTE 2. IN ORDER TO VERIFY THAT ANCHORS ON THIS P.0.0., AS 110110, WERE NOT OVERSTRESSED, A 33% INCREASE IN ALLOWABLE STRESS FOR WIND LOADS WAS 5100 USED IN THEIR ANALYSIS. FASTENERS SPACING TO WOOD HAS BEEN DETERMINED IN ACCORDANCE WITH 9.0,5. 2012. • THIS PRODUCT'S ADEQUACY FOR IMPACT AND CYCLIC RESISTANCE NAS BEEN VERIFIED IN ACCORDANCE WITH SECTION 1628 & 1609.1.2 OF THE ABOVE MENTIONED CDOE AS PER PROTOCOLS TAS -201, TAS -202, TAS -203, PER ARCHITECTURAL TESTING, INC. LABORATORY REPORTS 174785,02-401-18, 89818,01-401-18, 88107.01-401-1B, 86111.01-401-18, A1052.01-801-18 ANO AS PER SUBMITTED STRUCTURAL CALCULATIONS, PERFORMED AS PER SECTION 1816 & 1604 OF 111E FLORIDA BUILDING CDDE. IC ' L. INT` .• W 2. SHEETS 6. 7. 8 RA. TI 19 AND 70, 3. THIS PRODUCT WII1 NOT REQUIRE A HURRICANE PROTECTION ISE, 4. THIS PRODUCT IS APPROVED FOR AR/WATR• IN A a 5. SERIES FC -5000 FLUSH GLAZED ALUMINUM WINDOW WALL SYSTEM LARGE & SMALL MISSILE IMPACT LAMINATED CLASS SIULL COMPLY WITH SECTIONS 2405.1, 2411.4.1 AND 2411.4.2 OF THE FLORIDA DULDING CODE. 6. PROVIDE 1 3/8' MAX LOAD BEARING SHIM (TEP.), WHEN ALLOWED BY THIS DRAWING. 7. WOOD BUCKS BY OTHERS, MUST BE ANCHORED PROPERLY TO TRANSFER LOADS TO THE BUILDING STRUCTURE WOOD DUCKS MUST BE SOURIERN PINE, 0 - 0.55. ,..1,- . • 1 I,. B. R0.WNING COMPONENTS FOR THIS WINDOW WAIL SYSTEM SHALL DE AS INDICATED ON BILL OF MATERIALS, SHEET 3 OF THIS DRAWING. 9. ALL ALUMINUM EXTRUSIONS IN CONTACT WITH STEEL, CONCRETE, GROUT FILLED CONCRETE BLOCK AID WOOD SHALL COMPLY WITH SECTIONS 2003.8.4.2, 2003.8.4.4, 2003.8.45 AND 2003.8.4.6 OF THE FLORIDA BUILDING CODE, RESPECTIVELY. 10. SHOP DRAWINGS PREPARED BASED ON THIS APPROVAL AND TAXING INTO ACCOUNT THE SPECIFIC JOB CONDITIONS, SHAD. BE SUBMITTED TO THE BUILDING OFFICIAL AS PMT OF 1110 PERMIT 00CUMENTS. 11. STRUCTURAL SUBSTRATES NOTED ON THS DRAWING AS EOSINS STEEL BY OTHERS, POURED CONCRETE. GROUT • FILLED CONCRETE BLOCK AND WOOD MUST wITHSTAID THE LOADS IMPOSED BY THIS PRODUCT'. 12. (a) THIS P,EG, PREPARED BY THIS ENGINEER IS'GENERIC MD DOES NOT PROVIDE INFORMATION FOR A SITE SPECIFIC PROJECT; I.c. WHERE THE ORE CONDITIONS DEVIATE FROM THE P.E.D. '(b) CONTRACTOR TO BE RESPONSIBLE FOR THE SELECTION, PURCHASE MD INSTALLATION INCLUDING LIFE SAFETY OF THIS PRODUCT. BASED ON THIS P.ED„ PROVIDED HE/SHE DOES NOT DEVIATE FROM 1HE CONDITIONS DETAILED ON THIS DOCUMENT, CONSTRUCTION SAFETY AT SITE IS THE CONTRACTOR'S RESPONSIBILITY. (o) THIS P.ED. WILL BE CONSIDERED INVALID IF ALTERED BY ANY BEANS. (0) SITE SPECIFIC PROJECTS SHALL BE PREPARED BY A FLORIDA REGISTERED ENGINEER OR ARCHITECT WHOM VA L BECOME THE ENGINEER OF RECORD (EO.0.) FOR THE PROJECT MD WHO WILL BE RESPONSIBLE FOR THE PROPER USE OF THE P.ED. ENGINEER OF RECORD. ACRID AS DELEGATED ENGINEER TO THE P.ED. ENGINEER, SILALL SUBMIT TO THIS LATTER PIE SITE SPECIFIC DRAWINGS FOR REVIEW. (a) ORIGINAL P.E0. SHALL BEAR THE DATE AND ORIGINAL SEAL AND SIGNATURE OF THE PROFESSIONAL ENGINEER OF RECORD THAT PREPARED IT. 15. PRCOUCT MANUFACTURER'S LABEL SHALL BE LOCATED EN A READILY VISIBLE LOCATION AT PRODUCT IN ACCCRWNCE 111TH SECTION 17105 OF THE FLORIDA BUILDING CODE ONE LABEL SNAIL BE PLACER FOR EViR:f OPENING. SHEET 1: GENERAL NOTES, INDEX MD INSTRUCTIONS. SHEET 2: COMPONENTS. SHEET 3: BILL OF MATERIALS. SHEET 4: ISOMETRIC ELEVATION FOR FG -5000 FLUSH GLAZED ALUMINUM WINDOW WALL SYSTEM. SHEET 5: TYPICAL GLAZING DETAILS & GLASS SCHEDULE. SHEET RI MAXI/AUL! A.S.D. DESIGN PRESSURE RATING SCHEDULE FOR A OVEN CLASS TYPE AND GLASS PANEL DIMENSIONS. SHEET 7: MAXIMUM ALS.D. DESIGN PRESSURE RATING FOR STANDARD AND CORNER MULLIONS, SHEET 8: MAXIMUM A.S.D. DESIGN PRESSURE RATING FOR MUWON CONNECTIONS W/ 4' IAN. E.D. EXCEPT AS NOTED. SHEET 6A MAXIMUM AS.p. DESIGN PRESSURE RATING FOR MULLION CONNECTIONS W/ 2 3/4' MIN. ED.. EXCEPT AS NOTED. SHEET 9: SILL AND HEAD CONNECTIONS DETAILS FOR STANDARD MULUDNS AND JAMBS (PLAN MEWS). SHEET 10: SILL AND HEAD CONNECTION DETAILS FOR CORNER MULLIONS (PLAN VIEWS). SHEET I1: HEAD CONNECTION DETAILS (SIDE IEW). SHEET 12: HEAD CONNECTION DETAILS (SIDE VIEW) (CONTINUED). SHEET 13: HORIZONTAL CONNECTION DETAIL (SIDE IEW), WINDOW WALL ELEVATION W/ HORIZONTAL, MAXIMUM ALSO. DESIGN PRESSURE RATING FOR HORIZONTAL AND MAXIMUM ASO. DESIGN PRESSURE RATING FOR JAMBS 11/0 ANCHORAGE. SHEET 14: SILL CONNECTION DETAILS (SIDE VIEWS). SHEET 15: SILL CONNECTION DETAILS SIDE VIEWS) (CONTINUED). SHEET 16: SILL CONNECTION DETAILS (SIDE VIEWS) (CONTINUED). SHEET 17: HORIZONTAL SECTIONS AT STANDARD AND CORNER MULLION. SHEET 18: HORIZONTAL SECTIONS AT JAMBS. SHEET 19: MAXIMUM A.S.D DESIGN PRESSURE RATING FOR JAMBS FASTENED W/ 3/8'A FASTENERS. SHEET 20: MAXIMUM ASLO. DESIGN PRESSURE RATING FOR JAMBS FASTENED W/ 1/2'0 FASTENERS. SHEET 21: CORNER DETAIL AT JAMB. INSTRUCTIONS: SIFP 1• DERRMINE A5.5, DESIGN WIND LOAD REQUIREMENTS BASED ON WIND VELOCITY, BUILDING HEIGHT, WIND ZONE, USING APPUCABLE ASCE 7 STANDARDS. EEEE_T: GO TO SCHEDULE DESIRED GLASS SIZE ONBASED ON GLASSHEET 6 SS PAANEL DIMENI SIONS.UM SD. DESIGN PRESSURE RATING (pef) OF SIFP 3: DETERMINE MAXIMUM MULLION SPAN 1'(FT) FOR A GIVEN MULLION EFFECTIVE SPACING 'b', ON SCHEDULE ON SHEET 7, AND SELECT ANCHOR OPTION W/ A.S.D. DESIGN PRESSURE RATING EQUAL. OR GREATER THAN DESIGN LOAD SPECIFIED IN STEP I USING SCHEDULES ON SHEETS 8 AND BA STEP 4: USE SCHEDULES ON SHEETS 19 AND 20, TO SELECT JA10 MCIIOR OPTION W/ ANCHORAGE OR SHEET 13 FOR W/0 ANCHORAGE WITH A.S.D. DESIGN PRESSURE RATING EQUAL OR GREATER THAN AS0. DESIGN LOAD SPECIFIED IN STEP 1. STEP 5; USE SCHEDULE ON SHEET 13, TO VERIFY MAXIMUM A.S.D. DESIGN PRESSURE RATING OF HORIZONTALS (IF USED), TO BE EQUAL OR GREATER THAN DESIGN LOAD SPECIRED IN STEP 1. SIEE _E: THE LOWEST VALUE OF 9.5.0. DE ON PRESSURE RATING RESULTING FROM STEPS 2, 3, 4 AND 5 SHALL APPLY TO THE ENTIRE SYSTEM. THIS DRAWING SHALL ONLY BE USED TO OBTAIN PERMITS IN THE STATE OF FLORIDA RORIDA BUILDING CODE (High & Non Ifgh Velocity Runcorn Zone) n. a a w0 A ITEM No. PART NUMBER DESCRIPTION DIMENSIONS MATERIAL MANUFACTURER NOTES 1. FS -54 PHIWPS FLAT HEAD MACHINE SCREW UC #10-24 x 3/8" STEEL VARIES ZINC COATED, PER ASTM B-633. 2. FG -5199 SETTING BLOCK .800" x .688" x 4.00" EPDM EPG 3. FG -5185 SPACER GASKET .250" x .250" EPDM EPG • 4. FG -1133 EXTERIOR GASKET .500" x .548" EPDM EPG WET & DRY GLAZED GASKET 7. FS -8 SPLINE ASSEMBLY SCREW #14 x 1" HHSTS FS -322 STEEL VARIES STALGARD COATED, BY ELCO 8. ANCHOR SILL ANCHOR SCREW #14 x 3/4' HHVTEK ITW/BUILDEX ZINC COATED, PER ASTM B-633, 9. ANCHOR HEAD ANCHOR SCREW #14 x 1 1/2" HHVTEK ITW/BUILDEX ZINC COATED, PER ASTM B-633. 11. FASTENER PPH SELF TAPPING SCREW #10 x 2 1/2" STEEL VARIES ZINC COATED, 'PER ASN B-633. 12. FASTENER PPH STEEL ATTACHMENT SCREW #10 x 1" STEEL VARIES ZINC COATED, PER ASTM 6-633. 13. SM -5601 ISOCRYL TAPE .125" x .500' VARIES POLYISOBUTYLENE SCHNEE-MOOREHEAD 14. FG5000-FP-5 WATER DIVERTER .876' x .54147' x .040' x 1.500' RIGID PVC OBE 15. FG -5000 -FP -1C SILL END DAM 3.500' x .562' x 0.062" x 5.000' 6063-T6 ALUMINUM OBE 16. FG-5000-PP8 STEEL REINFORCEMENT 1.250" x 4.563" x .250' ZINC PAINTED STEEL VARIES ASTM A-36 17. FG -5113 CHANNEL FILLER W HEAD & SILL 1.697" x .500" x .062' 6063-T5 OBE 18. FG -5204 HEAD / SILL 4.980" x 2.500" x .080" 6063-T6 OBE 19. FG -5190 GLASS STOP 2.010" x 1.392" x .078" 6063-T5 OBE 20. FG -5196 POCKET FILLER 4.660". x 1.392" x .080" 6063-T5 OBE 21. FG -5205 HIGH PERFORMANCE SILL PAN 5.276" x 2.750' x .100' 6063-T6 OBE 22. FG -5180 SILL PAN 5.402' x 2.625" x ,080" 6063-T6 OBE 23. FG -5206 SILL / HEAD 4.980' x 2.500" x .080" 6063-T6 OBE 24. FG -5201 JAMB 5.000" x 2.500" x .094" 6063-T6 OBE 25. NOT .USED 26. FG -5193 MULLION 5.000" x 2.500" x .094' 6063-T6 OBE 27. FG -5200 90 DEGREE CORNER MULLION 5.500" x 5.500" x .125" 6063-T6 OBE 28. FG -5202 HORIZONTAL 4.980" x 2.500" x .080" 6063-T6 OBE 29. 995 STRUCTURAL SEALANT - SILICONE DOW CORNING # 995 30. 795 PERIMETER SEALANT - SILICONE DOW CORNING # 795 31. FG -5192 SETTING CHAIR .844" x 1.062' x .094" 6063-T5 OBE 32. FG -2122 ALUMINUM JAMB FILLER 4.000" x .365" x .078" 6063-T6 OBE 34. ANCHOR PFH TEK SCREW #10 x 2.000" ZINC COATED STEEL VARIES ZINC COATED, PER ASTM B-633. 35. FG -5948 INTERIOR GASKET .381" x .718" EPDM EPG DRY GLAZED GASKET. BILL OF MATERIALS S hg S TYPICAL GLAZING DETAILS GLASS TYPE Cl. G2. G31. G33 WET GLAZED GLASS SCHEDULE WET GLAZED CLASS LABEL GLASS COMPOSRION MANUFACTURER NAME MAXIMUM D.L.O. 1 0, I. OVERALL Dimas tmaraTED GLASS CONSISTING OF TW0 R' HS PASS, ANO A 0.090. 00000E FOB RRERUYER DUPONT • SEE SCHEDULE ON SHEET 6 0W G2 WO OVERALL THCIEEESS UNMATED GLOSS 0 9T910 OF Two r.• HS CLASS, µDA00 0.090• SENROLUS PLUS IxD10A 00 DUPONT SEE SCHEDULE ON SHEET 6 ®W01UTm N. OVER/11. TIRODESS GLASSMMISTM HS GLASS, AOATMOY- 0.090• SURE( PVB RUMMER EASTMAN CHEMICAL COMPANY SEE SCHEDULE ON SHEET 6 ® Na' ovum. TH00009 LAMMED CLASS conmxc of TRo X' HS 01Ass. Ax0 A 0.079• SWISS CP -SORER No wt. H' 0000001E OATS @MAYER w/ PET COVE EASTMAN CHEMICAL COMPANY SEE SCHEDULE ON SHEET 6 GLASS TYPE G2 DRY GLAZED GLASS SCHEDULE DRY GLAZED CLASS LABEL CLASS COMPOSITION MANUFACTURER NAME MAXIMUM 0.LO. 0LLLORAhD TI. OVERALL mI0009S CUSS CONSISTING AIMA O A' HS GLASS.Qom.9EN0RYCLOS PLUS MERGYER DUPONT SEE SCHEDULE ON SHEET 6 MAXIMUM DESIGN PRESSURE RATING FOR STANDARD & CORNER MULLIONS' z a co a g 3 �'���I-31 ''� C/SE;1 Ix= 5.580 TM MAXIMUM MUWONSPAN'L'(FT)SCHEDULEFORAGIVENDESIGNPRESSURERATING z P A STANDARD MUWON®+® Sr -2227 in3 ANDA GIVENMUWONEFFECTIVESPACING'b i _ NR/WA11R INRLIRAIION IS 15.0 psi , NT88B 0 MBAMAx01wCASE 1 CASE 2 CASE 3 ,'•' "a OFSECN EFFEC/nE s1AYMRD 6TANMND OUTSWWaDC> 3� d��NETGlA7®6{IONNF�6uPE BEESHEETSFDRDRi8Am1pMLUI(INA Ws9 SPACING 'b-(lin) �A01FaRtE[ R' Ot+O �WFORG£0 MUWNB t' ow CORNBtZ,j NU110NCc L' cRin)o ���>G$�FGIiVE00ETAL Zvi �aJ Err x tlNII ULWN�-3'-6' 4'•0' 9'- 0' 8'•10' 10'- 0' 10'- 0 •- 10•- 0' 10 •- 0•_ �+I@y £`4 s -0 5'-6' 7'- 4 6'- 8' 10- o• 10'- 0' to•- D 70'• 0's9�5INSIDE'' S� m' i, �+ 660 e'-0' 6'-6' 8'- 1' 8' 10'- D' 9'-10' 1 0' 10'- 0• w � le 9_ CORNERmth-uoN CORNER- ISOMETRIC SDE VIEW 7 •- 6' 5'- 3• t'- n • 9'- 8' e •- o • 8'- 8' s •- o' u : W Yg MULLION 8•-6' 8•-2' 4'- 7• 4'• 5• 0'- 5' 8•- 3' 8•- 0• 8'• 3• n�� D �9 L = MUWON SPAN EFFECTIVE SPACING b - SI + Sz (SEE SCHEDULE.) 3'-b' 4'-0' 46' '- 9• 8• 7• 0' 6• 6• • 111, 0' 10'- 0• t0 •- 0• 10'- 0' 10'- 0' 10'- O. SI 43g Nati 888 (IOR STNdW01081101) 2 CASF:7 Ix= 18.160 i14 65.0 56a 6 •- 0 • ' 5 • 2' 8 • 10o7a•-• '. • 9 •-10 • - 0• 10'- 0 • ig3 EFFECTIVE SPACING b = Si + Ss (SEE SCHED6LE) STANDARD W/ MULLION STEEL CHANNEL ®+® n S5I Sx= 7.266 iO3 6 •- 6 • 7'-0' '-6• 5 . 4' 2 • 15• 9'- 6' 8•-11' 9'- 7. 8•-1i• 8'- 4' o -s II, (FOR CORM YBI1M� �— AR/WIRER INEB.R)AIION IS 15.0 (of wins 7 8 •- 0 • 4• 4' 6• 3 • 8'- 4• 7'- 9' 7 •- 9 • ,,/- to ' 8•.27j, 8•-B• 4• 1 • 10'- 0' 10•- 0 � z u�ycE CASE DEFINITIONS —� ��� �i� WEY6U7iDSHONU SEESHEETSFORORY GIAZEODETAL #Y 76.0 4'-0' 4'-6' 5•-0' 5'.6' 8'-0' 7'•0• 10'- 0' 10'- 0' 10•- 0• 9'.11' 9'- 8' a••1t3• 10'- 0' 10'• 0' 10 .. 0' 10'- 0' 9•- 8' 88'.13 • - . 0 0 i5 3 cG 3 •B 3 111 - 8 =NOM 84v� • • A W - 4 +1 pT.g(r63 --'•-• �� — - _ 7'•6' e'•0' 7•• 9' 7•- 3' 7 9• 7'- 3'4. p� CASE 1 : UNRDNFORCED STANDARD MUWON A (SEE DET. 5/17) /' ,g8 CASE 2 : REINFORCED STANDARD MUWON B FULL HEIGHT. 4E BET. 17 CASE 3 : CORNER MULLION C FULL HEIGHT. (SEE DEE. 6/17 & 6A/17) lr - 3 •-6 • 5'-0' 5'-8' 10'• 0 • 10'- 0• 9'- 7' 10'- 0' 10 '• 0• 9'-10• �F0 I"u R•' li (EITHER INSIDE OR OUTSIDE) 75.0 0•-0• 9'- 0' 9•• 0' • UU1NtN 0,04. 7'- 9' 7'- 2' 7•- 9' 7'- 2 • 1`x" -....... N` DESIGN PRESSURE RATING FOR STANDARD & CORNER MUWON CASE.3 Ix= 17.141 in4 8-0' e•-2• - - 8'- 9• g 7' 6•- 9'• 8'- 7' \G�i,'C .. MAXIMUM WELL AUTOMATICALLY OUAIJFY DESIGN PRESSURE RATINGS FOR JAMBS W/ (� L' SIDEN I MUWON2 (HER +� 9r-4.33661, s '•6 ' 4'-D• 4•-6• 10 .- 0- 10•- o• 10'- 0' 10'• 0' fo'- 6• 10•- 0'• ` _ "7' r ,� : V ANCHORAGE FOR ANY GIVEN MUWON SPACING. FOR MAX. JAMB SPAN �>� INFILIPA710N G 15.0 psf N 1886 W AUL 5 •- 6 • 10'- 0 • 10.. o W/O ANCHORAGE SEE SCHEDULE ON SHEET 13. JAMB ANCHORAGE (WHEN USED) SHALT. BE PERFORMED AT MID HEIGHT 76.0 5'-6' 6 .. 0 • 9•- O. 8 •. It' 8 •- 2 • 9'• 8• B.-11 • 6'- 2' ?- OF JAMBS. • NETGIAD7151xMN SEE SDDETIAORORY 8'•D' 7'- 1• 8 .. 8• 8'- 6• 7 .. 1' 6'- 8' 6 .. 8• _•-� •�i• r I's'�1'� ** UA GlA7E00ETA8. ff 3 •• b' 10'• 0' 10 - 0 • ���� 10o..nxrs0"- MAXIMUM DESIGN PRESSURE RATING FOR DRY GLAZED 1I �- I • 4 -- o • ;_ 6 • 10'. a. 10, 0 • 10, 6 • W •• o MULLION INSTALLATIONS IS +60. -70 sf. P a 8' s' - B• 9•- s• 9•- 2• m•- o - 9•- 2' BDA 8'-0' 7'-0' 7•-8• 8'- 5' 7•- 3• 6'• 9• 8'- 5' 7'- 3' IP - 9• 8'-0' 6'- 4' 6•• 4' e'-2' 8'- 2' •- 8'- 2' � 85.0 3•-e' •-0• 10 6• to•- 6• • 960 j:: 5'-0' MAXIMUM DESIGN PRESSURE RATING FOR MUWON CONNECTIONS CONTINUED ® STANDARD I g 11 si w€ g 4'` h S S YAARLY ,£0187 M9AWN DESIGN PRESSURE RUM (P.,) STANDARD MUWON MULLION S h _ a R0U108 CMO POURED CONCRETE Maa ssuaEptoY ■ 8 c ■ •■ SPS•■� i��I E'-'4� WA.. •■ p 9 ■��4•�1 I�•i•� 1 j3 O. WAI 69619 R9o9185RNTE 7R swam .„,..1Tryte 3149 5.17E � L I 2 11 O t ' v.) '6•+ffNi ISA •90.0 790:On a' 1.ae09:0 TTT ('� jI tea• &0 i c,q a511 6•-2• 7 ,-8 a s ••• • '-0• e •-s • '.0• °7 •-z• .0 aaa 72.9 9.a m.9 u] 900 w.o w.0 IS aa0 Tnea >is 90.0 6.0 9wA OA 6.0 I°0:0 SS. sa - or: (. ].0 e].a s@ei 51.] 90.0 90.0 aero WA v.0 72:0 090.0 o FASTENERS FASTENERS (4 REO'D) (B REQ'0) EXTERIOR EXTERIOR FLORIDA BUILDING CODE (High 8 SERIES VO -3000 FLUSH GLAZE WINDOW WALL SYSTEM LARGE IMPACT LAMINATED GLASS 3 COGi @ eg 3 Q• a i •:I • 990:9° �s 90 a9¢a 9 iro o SCHEMATIC CONCRETE 812 GAGE STEEL SCHEMATIC GROUT -RUED CONCRETE BLOCK -oma 960:0 o:°a 69:0 .a 'as.' 9s°D:0 CONNECTIONDETAIL * CONNECTION DETAIL * iTc - e•e• •-e• •-o- •-e- •:o• ::e W.o eao W.o ez3 w.o w.o 41.7 ea.e 990.0 w-0 .9 9.8 s. ]ss m1 6]9 55.9 X8.8 90.0 Ino a9 60.0 00:0 (AT�STANDARD MUWON) (A7 STANDARD MULLION) 0 o •-0• ma 9.0 MA w.0 RS w.0 9A IOSB- o.o FASTENERS A , 7'•O' '.a- •-D• •-e• '-a• '•0' •.n• o 6¢e W.A 72.0 81.6 765 W.a w.0 72.0 38.2 B89 ate 0.o 1,0.0 9.0 9.0 899'10 9.d ]e] ]e MT ]0a' 61.3 5BSI9i 61A �] Ie.e 0.0 ao.o I0.0 a°o 10.0 9na 23-1- (2 REQ'D) , " Illl FASTENERS / n (3 REOb) \ a c -. 4" spcg.e .. n FASTENERS4\ °i (3 REQ'D) /<a it = Asa aR _-�• •.s• dos.o s6.o omo.9 e>a in Ip:a .e 9.9 80'0 mrz's .... BOO Eno OUTSIDE INSIDE ���.'_ ��_ :: . I,II '4" zRA 38�' 6 ,i- 7•-e• ::°a• e:I 9ilz m.6 ea'A° ss:a s+.I RS goo CORNER-- MUWON i OUTSIDE/INSIDE ,INSIDE&A- to 7'•8• >e.2 e9•e 9I.3 sea .d 729 id m.0 45.0 4 60 60 , FASTENERS EXTERIOR CORNER- L-W � a1� J d{ � j§ -2 $ •'a• •-0• 6ae ene bb.a 9o.a a3.I a.d $98 .0 MUWON (2 REVD) G t 7 •-e• s ••o• W.o 6.o 6ao we so.a 9.o so.4 sa.o ]s.e e].s me 990 SCHEMATIC CONCRETE 812 GAGE STEEL Gpcg.a :Tog.: EXTERIOR tt_ e'D• s ••n• s••D• W.o 96.3 tlz] ]s.d WA 9.a 61.d s 90.90 CONNECTION DETAIL * t: e ••s• > •-a• 621 >as es.e el.e 9I1 ]a., da:z9 000 OUTSIDE INSIDE CORNER (AT/ MULUON) SCHEMATIC GROUT=FILLED CONCRETE BLOCK \y0 e ::0o• 977 sme:e ea+ <qq'i':i 9A00.0 CONNECTION DETAIL 1` • ,a WA SAL 990 90:0 •NIN.SPACING (9PcR,IREQUIRED FOR (AT OUTSIDE/INSIDE CORNER MULLION) 7 •: t '.e• : so.°a 9.0 w.0 WA 9.0 I )Ob ' DIFFERENT SUBSTRATES Ij IiN]fff] 8'•G• 9 '•a• s •.e• 6'•0• m:°o 81.0 852 n.I 11.0 WA WA m.9 sTA 990.9 as°o MO - /lF� -POURED CONCRETE I12•MN O.C. I1F SEE CONNECTION DETAILS ON SHEETS 9,10622. �> ,• IT✓(� j1 :-a• >).8 tb.6 782 73.0 90.0 Eno`-iE 010141N. O.C. � "•- -5)0, 7 7'-6• e'•0• %.." ]20 72.2 eAe 90:8 61.z A ABA sA B» ;5.9 .{ 39.] Z 6.0 989 _R6 - STEEL: STEEL• sill MN. O.C.• . V ••...\�6 Q • V 1 •-o• •.6• ••0 • 66.0 9. aao w.0 17.1 Ill WA eei 00.7 m.T m.o 90 72.0 w.9 ik ` ; \O ,FASTENERS TYPES AND SUBSTRATES REQUIREMENTS WI INDICATED 'e: • � Y 11 4 9••0• ••o• ]9.< 6].o IA .0 MIN. E.D., BEYOND ANY FINISH MATERIAL -e• 52.1 Sao . w1gg...q!q��A ata JlA 969.0 r...0 y O+t•,� q•., PLQ , F-816'0 HILT WOK BOLT TLANCHOR WSMv�. EM8E0MENTINT06'Mn.TWCK POURED CONCREIE(A1n. � ��•T,!J �_� 9'-6' yby•-n• 8. 6 1: S '•e• a ••0• a ••6• )'-0• T' -e• '-n • •-2 • 90.2, 72.0 820 Tit mA 84t 60., 587 55.0 W9.a ]6.2 aA 1.6 S3.e SIA 50.6 1].8 d8 9900A 9A 81A e.6 709 mA 5tA 5].6 pa and ,1.1 ]A U.1 MA 3r9 151 9900.9 •00.0 910 eau 9.0 •90.0 10.0 0_ PC 93*OWE 8H'MIN.EO. �2lf'f,FES' iGiV\„' G-2 0 POWER FASTENERS TAPPER ANCHOR W/1 LP M0. EMBEDMENT INTO POURED CONCRETE (1.09. Tao 161.7722 or U. EO. H-380 HILT HUSH SCREWANCTIOR WT M8 EMBEDMENT INTO POURED CONCRETE (Mtn. To 43660 W2YrMIN. EO. 10•-0• ! ••6• 4'-0• 5'•0• '-0• S 'A• e'-0• 7 '•D• ] '•6' 9 b '-2' I 959 6.0 9.0 71.9 TIA 659 81.2 1 .6546 922 w. 9.0 w.1 ]21 66.6 IS 55.] 51.7 d8A 4411 17.t 999.0 ]5 TBA 729 OTA els 59.7 53.3 5].! 72.5 6.0 51D 00.3 BA N.S 96.9 33.0 OTA 929 '0 BOo .w.0 69 MO .) 70.0 Sill 150 YA1 G' -1e.0 POKER FASTENERS TAPPER ANCHOR W 134- Min. E.EDMENT INTO GROUT ,OLEO CONCRETE BLOCK W PMH ED. I-LSOTYPEF BOLT OR LSD-18SAE GRADE S CvLLWNDED STEEL HMO DOW BOLTW NUT bLOCK WASIIER82•MIN. EDGE DISTANCETOI2 GAGE (0.100- MIN THK)Fp83WI STEEL IL10 In MIS w MANp BTi��Jr{ 3313 %A MOW oxr KVITI amaae�nronUVIX4 olrcziTrenwcmc laawva3 edoienu3BuIppng easesPf0 n 55310 outworn 10Vd01' 3110010 11V0S A 301131 0310AS 1100 14000K 00010013 030310 00013 0000-04 531435 LOIS) I '00 009103 3'd 'i 11300 1111.701 91[0000-93-63 'Ic00.,1N 4MA,-* 'm`-mo�lx°0'e INVArove`;irSin:w0M Cif) A300100 ONI933NI033 i 00115311TLL �'ON10331111 ON '033141 33003 (3±00 I000wn4 4000100 4014 ±00 A 40114) 3003 04(01100 3018014 SILL AND HEAD CONNECTION DETAILS FOR CORNER MULLIONS (PLAN EXISTING POURED CONCRETE OR GROUT FILLED CONCRETE BLOCK STRUCTURE (8Y OTHERS) SEE SHEETS B & 8A HEAD CONNECTION DETAILS (Continued) tet EIX see onus oti SEEa & Ca FASTENERS (SEE SCHEDULE ON SHEETS 8 & BA) WET GLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED READ SEE SCHEDULE ON SHEET 5 EXISTING STEEL STRUCTURE SEE SHEETS 8 AND 8A FASTENERS (SEE SCHEDULE w ON SHEETS 8 & 8A) WET GLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED SEE SCHEDULE ON SHEET 5 EXISTING (2) 2"x PT WOOD BUCK STRUCTURE (BY OTHERS) FASTENERS (SEE SCHEDULE ON SHEET 8) WET GLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED DETAIL X SEE SCHEDULE ON SHEET 5 A e. S a `v' -'z N'S 0 CE CO dd a SILL CONNECTION DETAILS SEE SCHEDULE ON SHEET 5 9@158& SCHZDULE SHEETS 8 & 84 CSILL 3 I„, smounk oN J� o �1110 : A� __ *71W 7 p.. MIMI' • ® 3 iiimia0..] P MN ED. MIN. ED. SCHEDULE • SEE SCHEDULE SHEETS 8 & 8A SHEETS 8 & 84 WET GLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED EXISTING POURED CONCRETE OR GROUT FILLED CONCRETE BLOCK STRUCTURE (BY OTHERS) SEE SHEETS 8 & 8A FASTENERS (SEE SCHEDULE ON SHEETS 8 AND 8A) WET GLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED EXISTING STEEL STRUCTURE SEE SHEETS 8 AND 8A FASTENERS (SEE SCHEDULE ON SHEETS 8 AND 8A) EXTERIOR SEE SCHEDULE ON SHEET 5 30 FASTENERS (SEE SCHEDULE ON SHEET 8) MIN. ED. H@!. ED. SEE SCHEDULE ON SHEET 8 SEE SCHEDULE ON SHEET 8 CSILL DETAIL X WETGLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED a N$ i E Y EXISTING (2) 2"x WOOD g BUCK STRUCTURE R dN gw N OSEE SCHEDULE ON SHEET 5 m "PA © irori rIdr EXT ERIOR l� L�<!II , it Ili . ) 0 a) NEar" ' T•II�I�I is wow r ION. EE SEE SCHREEFS N CE ON REEFS 8&84 C3H SILL SEE SCHEDULE SILL CONNECTION DETAILS (Continued) WET GLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED FASTENERS (SEE SCHEDULE ON SHEETS 8 & 8A) EXISTING POURED CONCRETE OR GROUT FILLED CONCRETE BLOCK STRUCTURE (BY OTHERS) SEE SHEETS 8 & 8A ION. EO. SEE SDIEDIJE C%I SES a&R L OSEE SCHEDULE C) ON SHEET 5 EXTERIOR * THIS SILL TYPE SHALL ONLY BE USED FOR MAX. DESIGN LOADS UP TO 65 psf & FOR MULLION HEIGHTS UP TO 108". EXTERIOR a 7/Te' UN. ED. SEE SCHEDULE ON SHEETS 8 & 8A 3J SILL WET GLAZED SHOWN SEE DETAIL(X) FOR DRY GLAZED EXISTING STEEL STRUCTURE SEE SHEETS 8 AND 8A FASTENERS (SEE SCHEDULE ON SHEETS 8 & BA) NIH. ED. SEE SOESIAE ON RESTS 8 & 8A DETAIL X NE. NA SEE SCHEDULE ON SHEET O C SLL IL WET GLAZED SHOWN SEE DETAIL (X) FOR DRY GLAZED FASTENERS (SEE SCHEDULE ON SHEET 8) EXISTING (2) 2 x WOOD BUCK STRUCTURE OWE EO. SEEMMOUIE CH IEEE 8 F 2 MIN. E.D. SEE SCHEDULE MIN. E.D. SEE SCHEDULE ON SHEETS 19 & 20 ON SHEETS 19 & 20 MIN. E.D. SEE SCHEDULE MIN. E.D. SEE SCHEDULE ON SHEETS 19 & 20 ON SHEETS 19 & 20 8 2 at v3 2r1 ti7►— �NNO UM 1141 g CJ ON SHEETS eMle TLTECO, INC 19 & 20 IL ECOtt,�.F� �'r TESTIN0 r ENOINEENINO COMPANY am.rt os,rta+m 4-mo TI 001,cam RB-DO5071I w€€LT01 50 Up. f 101 N10P7E' MIN. E.D. 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Mbaa NNNMnnmv.-IyNNNMMmn NNNnnnna .NNNNMOMne V44NNNmMMM4 .NNNNnnnm 1 F. W 6 A 6 O 3/19/2018 DBPR - BOROMEI, DANNY LOWRY; Doing Business As: BOROMEI CONSTRUCTION INC, Certified General Contractor 1:00:08 PM 3/19/2018 Licensee Details Licensee Information Name: Main Address: County: License Mailing: LicenseLocation: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business Alternate Names BOROMEI, DANNY LOWRY (Primary Name) BOROMEI CONSTRUCTION INC (DBA Name) 881 SW 128TH AVE OKEECHOBEE Florida 34974 OKEECHOBEE Certified General Contractor Cert General CGC1508299 Cu rrentrActive 01/06/2005 08/31/2018 Qualification Effective 01/06/2005 View Related License Information View License Complaint 2601 Blair Stone Road, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Copyright 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public -records request, do not send electronic mail to this entity. instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. ',Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. httpsaiwww.myfloridalicense.com/LicenseDetail.asp?SID=Bid=5670BB4B8DDB5A63BE4A84E2106BBCB3 111 BOROM-1 OP ID: ME A`_ ORD k,..----. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDEVYYYY) 06/12/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. 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). PRODUCER Pritchards and Associates -SLC 10791 SW Tradition Square Port St. Lucie, FL 34987 Krishna M. Morgan CONTACT NAME: Kristina M. Morgan PHONE FAX No Ext : 772-345-7700 (Arc, No): 772-345-7703 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC INSURER : Southern Owners 10190 INSURED Boromei Construction, Inc. Danny Boromei 420 B Nw 3rd Street Okeechobee, FL 34972 INSURERB: INSURER C: INSURERD: $ 1,000,000 INSURER E : INSURER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADUL INSD SUER WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMfDDYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR 72744569 04/01/2018 04/01/2019 DAMAGETO RENTED PREMM(Ea occurrence) 300 000ISES $ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ 1,000,000 POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT SEa accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS _ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB _ CLAIMS -MADE AGGREGATE $ DOD RETENTION $ $ WORKERS COMPENSATION PER STATUTE OTH- ER AND EMPLOYERS' LIABILITY Y ANY PROPRIETORIPARTNERIEXECUTIVENIA f N E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) FORIN-1 **FOR INFORMATION ONLY** Certificate can be issued to specific holder upon receipt of holder name and address. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �J� /f %� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Boromei Construction, Inc. Financial Statements For the Period March 31, 2018. Boromei Construction, Inc. Period ended March 31, 2018 CONTENTS Accountants' Review Report 1 Financial Statements: Balance Sheet 2 Statement of Income and Retained Earnings 3 Notes to Financial Statements 4-5 ;11k Sirns.Munson Nog Fr CERTIFIED PUBLIC ACCOUNTANT Accountants' Review Report To the Board of Directors Boromei Construction, Inc. 420 NW 3rd Street Okeechobee, FL 34972 We have reviewed the accompanying balance sheets of Boromei Construction, Inc. as of March 31, 2018, and the related statement income and expenses for the three months then ended, in accordance with Statements on Standards for Accounting and Review Services issued by the American Institute of Certified Public Accountants. All information included in these financial statements is the representation of the management of Boromei Construction, Inc. A review consists principally of inquiries of company personnel and analytical procedures applied to financial data. It is substantially less in scope than an examination in accordance with generally accepted auditing standards, the objective of which is the expression of an opinion regarding the financial statements taken as a whole. Accordingly, we do not express such an opinion. Our review was made for the purpose of expressing limited assurances and based on our review, we are not aware of any material modifications that should be made to the accompanying financial statements in order for them to be in conformity with generally accepted accounting standards. 44412714A40.1,..h"..--. Sims Munson Certified Public Accountants, PLLC April 15, 2018 Laura K. Sims, CPA 319 N. Parrott Avenue, Okeechobee, Florida 34972 Phone: 863/467-3000 Fax: 863/467-3002 Laura@simsmunsoncpa.com Boromei Construction, Inc. Balance Sheet March 31, 2018 ASSETS Cash and cash equivalents $ 132,532 Total Assets $ 132,532 LIABILITIES AND SHAREHOLDER'S EQUITY Liabilities $ Contributed Capital 132,532 Total Liabilities and Shareholder's Equity $ 132,532 See Notes to Financial Statements -2- Boromei Construction, Inc. Statement of Income & Expenses For the 3 months ended March 31, 2018 The Company has no revenue or expenses as of the date of these financial statements. The Company has secured contracts on projects. Please read the notes to the financial statements for more detail. See Notes to Financial Statements -3- Boromei Construction, Inc. For the Three Months Ending March 31, 2018 NOTES TO FINANCIAL STATEMENTS NOTE 1 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Company's Activities and Operating Cycle The Company is engaged in business as a licensed general contractor. It intends to construct commercial and institutional buildings and single-family homes. The work is performed under cost-plus fee contracts, fixed-price contracts, fixed-price contracts modified by incentive and penalty provisions and on time and material basis. The company, as a condition for entering into certain construction contracts, will obtain surety bonds. Revenue and Cost Recognition Revenues from fixed-price and modified fixed-price construction contracts are recognized on the percentage -of - completion method, measured by the cost -to -cost method. Specifically, revenues to date for individual contracts uncompleted at the end of the period are based on the percentage of costs to date to total costs estimated to perform the contract, applied to total revenue estimated to be realized from the contract. Contract costs include all direct material and labor costs and those indirect costs related to contract performance. Selling, general, and administrative costs are charged to expense as incurred. Provisions for estimated losses on uncompleted contracts are made in the period in which such losses are determined. Changes in job performance, job conditions, and estimated profitability, including those arising from contract penalty provisions and final contract settlements, may result in revisions to costs and revenues and are recognized in the period in which the revisions are determined. Profit incentives are included in revenues when realization is probable and the amount can be reliably estimated. Contract costs arising from elements outside the original scope of the contract that will be recovered through a change in a contract amount are deferred until the amount of change in the contract can be reliably estimated. Business and Credit Concentration Risk Financial instruments which potentially subject the Company to concentrations of credit risk will consist principally of temporary cash investments and trade receivables. Additionally, the Company concentrates its activities in- the construction field and is subject to the risks inherent with the industry. Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles (GAAP) requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. -4- See 'nand, S'taternents Boromei Construction, Inc. For the Three Months Ending March 31, 2018 NOTES TO FINANCIAL STATEMENTS Cash For purposes of reporting cash flows, the Company's cash includes cash on hand and demand deposits. NOTE 2 SURETY BONDS The Company, as a condition for entering into certain construction contracts, has to furnish payment and performance bonds to contract owners. The bonds are collateralized by the related contract receivables and an indemnification agreement signed by the Company's stockholder. As of March 31, 2018, the Company had no outstanding surety bonds. NOTE 3 INCOME TAXES The Company, with the consent of the stockholder, has elected under the Internal Revenue Code to be taxed as an S Corporation. In lieu of corporate income taxes, the stockholder of an S Corporation is taxed on his proportionate share of the Company's taxable income. Therefore, no provision or liability for federal income taxes has been included in the financial statements. The company recognizes income from long-term contracts on the percentage -of -completion basis for tax reporting purposes. Due to various temporary differences, income is recognized in different periods for tax reporting purposes than for financial statement purposes. The Company currently has no prior income tax obligations. NOTE 4 Current Projects The Company currently has the following contracts scheduled to begin with respective estimated revenue and profit: Job Gross Revenue Cost of Revenue Projected Profit % Torry Island Security Gate $ 5,000 $ 4,500 $ 500 10% Lafayette Park Canopy 750 675 75 10% LabCorp Remodel 4,100 3,690 410 10% Sarasota Storage Shed 3,500 3,150 350 10% STOF Bollards & Windows 1,000 900 100 10% Bognar Garage & Addition 5,000 4,500 500 10% Hardee County Landfill 14,000 2,600 1,400 10% -5- See Financial Statements PROFESSIONAL LICENSES AND REGISTRATIONS Certified General Contractor, State of Florida, CGC 1508299 State of Florida Department of Environmental Protection Qualified Stormwater Management Inspector Number: 20834 EDUCATION High School Diploma Year Earned: 1985 Naval Aviation Academy Year Earned: 1993 Continuing Education Courses in Construction Industry Safety and Management CERTIFICATIONS 30 -Hour OSHA Hazard Recognition Training for the Construction Industry — 2015 10 -Hour OSHA Construction Safety & Health TECHNICAL COURSES Florida Stormwater Regulations for Contractors Project Management Workshops YEARS EXPERIENCE 25+ Boromei Construction DANNY BOROMEI, President/ Project Manager TECHNICAL EXPERTISE Mr. Boromei has over 25 years of professional experience in construction, project management and quality control. Throughout his career he has demonstrated his skills in various roles including: Construction and Project Management, including Cost Control and Quality Assurance. Mr. Boromei's contributions have lead to the successful, safe and timely completion of our client projects. EXPERIENCE HIGHLIGHTS — (Completed as Project Manager of Close Construction, LLC) • Douglas Brown Community Center Lift Station Improvements — Project Manager. Repalce the existing sanitary sewer septic system that serves the Douglas Brown Community Center with a proposed pump station that meets current construction standards. Completed February 2018. • St. Lucie County Administration Building Drainage Connections — Project Manager. Drainage improvements including remove and dispose of existing outlets and concrete, installation of 3 new FDOT inlets, 18" RCP, pavement and restoration. Completed September 2017. • Hollywood WTP Electrical Reliability Improvements — Project Manager. Construction of a vertical annex building to house redundant electrical equipment. Completed January 2017. • Gumbo Limbo Nature Center Phase I Boardwalk and Observation Tower — Project Manager. Demolition of existing boardwalk and observation tower. Installation of a new boardwalk and landscaping. • PC South Algal Nutrient Removal Facility, Indian River County, Florida — Project Manager. Construction of an algal nutrient removal facility, storm water pumping stations, force mains, and associated peripheral systems. Completion: January 2015. • Lake Holden Alum Treatment System Upgrades, Orlando, Florida — Project Manager. Upgrades to an Alum Treatment System including replacement of existing flow meters, control panels and pumps and included telemetry devices to convey flow rates wirelessly. Completed: March 2014 Phone 863.467.0831 Fax 863.763.6337 www.closeconstruction.us 301 NW 4th Avenue Okeechobee, FL 34972 • West Dearborn Low Impact Development Storm Water Pilot Project, Sarasota, Florida — Project Manager. Construction of bio-detention/bio-retention systems, storm water piping and structures, irrigation and landscape, and miscellaneous streetscape items. Project included construction of pervious parking, sidewalks, permeable pavers, clearing and grubbing, pavement and sidewalk removal, excavation, grading and compaction, curbing, erosion and pollution control, pavement striping, and signage. Completed: February, 2014. • Town of Hillsboro Beach Water Treatment Plant Improvements — Project Manager. Improvements to an existing Water Treatment Plant including construction of a chemical building and an electrical building. Completed in August 2013. • Storm water System Improvements WM003 — St. Lucie West Services District, St. Lucie, Florida - Project Manager. Upgrades to existing storm water system, including, but not limited to, stilling wells, water level sensors, concrete structures, pipes, headwalls, slide gates, electric, control panels, RTU's, actuator motors, excavation, site work, and restoration. Completed: February, 2013. • Lakes Park Water Quality Restoration Project, Lee County, Florida - Project Manager. Construction of rock/soil peninsulas within the East and West Lakes at Lakes Regional Park, creating a serpentine flow way with extensive associated littoral zones and upland areas planted with appropriate vegetation to enhance nutrient removal from the water and provide wildlife habitat. Included clearing and grubbing, temporary access road with water crossing and turbidity monitoring throughout the project. Completed: December, 2012. Powell Creek Preserve Filter Marsh and Hydrologic Restoration, Lee County, Florida — Project Manager. Construction of 19 -acre wetland filter marsh on existing undeveloped site. Work included clearing and grubbing, excavation and removal offsite of 143,049 CY of excess fill, grading, construction of trails/maintenance berms, installation of control structures, wet well, pumps, controls, fencing, storm water inlets, rip rap, manholes, and stabilized low flow crossing of Powell Creek. Extensive dewatering, erosion/sediment control was required in an environmentally sensitive location. Completed: September, 2012. Centerstate Bank, Okeechobee Branch - Project Manager. Construction of a 6200 SF bank including offices, teller line, work areas, self serve walk in vault of safety deposit boxes and a grand lobby area with a fully functional fireplace. Completed March 2012. • Indian River Estates Alum Facility, St. Lucie County, Florida — Project Manager. Construction and installation of a 5,025 gallon aluminum sulfate storage, two chemical metering pump skids each with two pumps on them, an eyewash shower and all piping, concrete labor and appurtenances. Completed: September 2009. • Area 11A Reclaim Booster Pump Station, City of Delray Beach, Florida Project Manager. Installation of (2) horizontal split case pumps, RTU, instrumentation, electrical upgrades, and tie-in all new components to existing reclaimed water piping. Completed: August, 2009. www.closeconstruction.us Page 2 of 3 • Indian River Estates Storm water Improvements and Pump Station, St. Lucie County, Florida — Project Manager. The project entailed several storm water improvements in the Indian River Estates area and the Savannahs Preserve State Park in Port St. Lucie, Florida. It involved the construction of a pump station including (4) four Axial flow pumps. The pump station was housed within a CBS structure. It also included the construction of a 16 -acre primary retention pond, 6,000 linear feet of levee, access road, outfall structure and overflow control structure. Completed: January, 2009. • Platt's Creek Stormwater Treatment Alum Facility, St. Lucie County, Florida — Project Manager. Installation of six alum injection pumps, tank and prefab building, and associated site work. Competed: August 2008. • Ridgway Acres Subdivision, Okeechobee County, Florida — Project Manager. Developed a 60 -acre residential subdivision. Work included clearing, earthwork, installation of underground utilities, roadway, and drainage system consisting of two retention lakes and drainage outfall structures. Completed February, 2007. www.closeconstruction.us Page 3 of 3 7/19/2018 Detail by Entity Name DIVISION OF CORPORATIONS DiYo.n!t of PpDp AT rci L' off coil .Jto.0 of Florida webjii' Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Profit Corporation BOROMEI CONSTRUCTION INC. Filing Information Document Number P04000099841 FEI/EIN Number 20-1321621 Date Filed 07/02/2004 State FL Status ACTIVE Last Event AMENDMENT Event Date Filed 07/07/2014 Event Effective Date NONE Principal Address 420B NW 3rd Street OKEECHOBEE, FL 34972 Changed: 01/16/2018 Mailing Address 420B NW 3rd Street Okeechobee, FL 34972 Changed: 01/16/2018 Registered Agent Name & Address BOROMEI, DANNY LJR 881 SW 128TH AVENUE OKEECHOBEE, FL 34974 Officer/Director Detail Name & Address Title P BOROMEI, DANNY LJR 881 SW 128TH AVENUE OKEECHOBEE, FL 34974 Title VP Close, Thomas C http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=BOROMEI .. 1/2 BOROM-1 OP ID: ME ACORD CERTIFICATE OF LIABILITY INSURANCE �� DATE(M 08/16//201201YYY) 8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the 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). PRODUCER Pritchards and Associates -SLCPHONE 10791 SW Tradition Square Port St. Lucie, FL 34987 Kristina M. Morgan CONTNAME: Kristina Kristina M. Morgan FAX PAic No Ext: 772-345-7700 (NC, No): 772-345-7703 n ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC f INSURER A: Southern Owners 10190 INSURED Boromei Construction, Inc. Danny Boromei 420 B Nw 3rd Street Okeechobee, FL 34972 INSURERS: 72744569 INSURER C: 04/01/2019 INSURERD: $ 1,000;000 INSURER E : $ 300,000 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE I3EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSD 1/LAID POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 0 72744569 04/01/2018 04/01/2019 EACH OCCURRENCE $ 1,000;000 DAMAGE ro RENTED PREMISES (Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES JE� PER'. LOC -- PRODUCTS - COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUOS HIRTED AUTOS X SCHEDULED AUTOS AUT OWNED 72744569 04/01/2018 04/01/2019 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ DAMAGE PROPERTY accident) $ Hired non owned 8 1,000,000 UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE. $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe Under DESCRIPTION OF OPERATIONS below f N -N A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Holder is listed as additional insured with regards to General Liability. PW02-00-05-18-RB, Okeechobee City Hall Door Replacement CANCELLATION OKEEC-4 Cityof Okeechobee 55 SE 3rd Ave. Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVEENi� �( ,1 V iii ACORD 25 (2014101) © 1988-2014 ACORD CORPORATION. AID rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE Date 6/15/2018 Producer: Plymouth Insurance Agency 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938-5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # - Insured: South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B. Insurer C: Insurer D: Insurer E: Coverages The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM/DD/YY) Policy Expiration Date (MM/DD/YY) Limits GENERAL LIABILITY Commercial General Liability Each Occurrence $ Damage to rented premises (EA occurrence) $ Claims Made ❑ Occur i. General D Med Exp $ Personal Adv Injury $ aggregate limit applies per: Policy ❑ Project ❑ LOC General Aggregate $ Products - Comp/Op Agg $ AUTOMOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non-Owned Autos Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ EXCESS/UMBRELLA LIABILITY IOccur ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor/partner/executive officer/member excluded? NO If Yes, describe under special provisions below. WC 71949 01/01/2018 01/01/2019 x I WC Statu- I tory Limits I OTH- ER E.L. Each Accident $1,000,000 E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/LocationsNehicles!Exclusions added by Endorsement/Special Provisions: Client ID: 98-65-373 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Boromei Construction Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938-5562. Project Name: ISSUE 06-15-18 (BP) Begin Date:5/2/2015 CERTIFICATE HOLDER CANCELLATION Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. OKEECHOBEE COUNTY 1 f Business Tax Receipt STATE OF FLORIDA IN CONSIDERATION of the TOTAL SUM OF MONEY shown hereon, the receipt of which is hereby acknowledged. Company ID #: 8448 No. 765 2018-2019 8/21/2018 Contractor (001 5A) (01-10 Employees)$ 00 Delq_ Fee (201 5-201 8) TOTAL BOROMEI CONSTRUCTION INC is hereby licensed to. engage in the business, profession or occupation of Contractor (0015A).(6140 Employees) Certified General Lic# CGC1508299 at 881 SW 128TH AVE r ire Okeechobee, Florida, for the period beginning the 1st day of October 2018 , an • epcling on the 34t day of September, 2019 tj Celeste Watford, C. F. C - Tax Collector 3OROMEI, DANNY }00-0000 \ddress: 420B NW 3RD STREET OKEECHOBEE, FL 34974 4ctivity: 201 CONTRACTOR Issued to: CITY OF OKEECHOBEE BUSINESS TAX RECEIPT 55 SE 3rd Avenue, Okeechobee, FL 34974 OCTOBER 1, 2018 - SEPTEMBER 30, 2019 BOROMEI CONSTRUCTION, INC. BOROMEI, DANNY 420B NW 3RD STREET OKEECHOBEE, FL 34974 B FOR A NEW BUSINESS BTR IS VALID FROM DATE OF ISSUE BUSINESS TAX RECEIPT OFFICIAL No: 2563 Date: 8/10/18 RECEIPT 98.44 PENALTY APP/TRAN BLDG INSP FIRE INSP Total Paid 98.44 9/5/2018 DBPR - BOROMEI, DANNY LOWRY; Doing Business As: BOROMEI CONSTRUCTION INC, Certified General Contractor 11:16:39 AM 9/5/2018 Licensee Details Licensee Information Name: Main Address: County: License Mailing: License Location: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business Alternate Names BOROMEI, DANNY LOWRY (Primary Name) BOROMEI CONSTRUCTION INC (DBA Name) 881 SW 128TH AVE OKEECHOBEE Florida 34974 OKEECHOBEE Certified General Contractor Cert General CGC1508299 Current,Active 01/06/2005 08/31/2020 Qualification Effective 01/06/2005 View Related License Information View License Complaint 2601 Blair Stone Road, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Copyright 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public -records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=567DBB4B8DDB5A63BE4A84E2106BBCB3 1/1 2018 FLORIDA PROFIT CORPORATION ANNUAL REPORT DOCUMENT# P04000099841 Entity Name: BOROMEI CONSTRUCTION INC. Current Principal Place of Business: 4206 NW 3RD STREET OKEECHOBEE, FL 34972 Current Mailing Address: 420B NW 3RD STREET OKEECHOBEE, FL 34972 US FEI Number: 20-1321621 Name and Address of Current Registered Agent: BOROMEI, DANNY LJR 881 SW 128TH AVENUE OKEECHOBEE, FL 34974 US FILED Jan 16, 2018 Secretary of State CCI002720801 Certificate of Status Desired: No The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Officer/Director Detail : Title Name Address City -State -Zip: Title Name Address City -State -Zip: P BOROMEI, DANNY LJR 881 SW 128TH AVENUE OKEECHOBEE FL 34974 SECRETARY STONE, MELISSA 301 NW 4TH AVENUE OKEECHOBEE FL 34972 Title Name Address City -State -Zip: Title Name Address City -State -Zip: VP CLOSE, THOMAS C 301 NW 4TH AVENUE OKEECHOBEE FL 34972 TREASURER WELLS, SHERYL L 301 NW 4TH AVENUE OKEECHOBEE FL 34972 Date I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that i am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: SHERYL L WELLS TREASURER 01/16/2018 Electronic Signature of Signing Officer/Director Detail Date Patty Burnette From: Melissa Stone <melissa@boromeiconstruction.com> Sent: Wednesday, August 29, 2018 1:16 PM To: Patty Burnette Subject: City Hall Door Replacement Insurance Comments Good Afternoon Patty: OK Boromei Construction carries a Non Owned Hired Only policy due to the fact that Boromei Construction currently does not E -- any vehicles. Please let us know if you have any questions or need anything additional regarding the auto policy insurance comments. Thank you, Melissa Stone Boromei Construction, Inc: 420: NW 3rd St. Okeechobee, FL 34972 (P) 863.623.4314 www.boromeiconstruction. com i Patty Burnette From: Patty Burnette Sent: Monday, August 27, 2018 12:53 PM To: 'boromeiconstructioninc@gmail.com' Subject: PW -02 -00 -05 -18 -RB Attachments: Insurance requirements.pdf Importance: High Good Afternoon Melissa. Please see the attached information that is needed in regards to the Commercial Auto Insurance. Beside this information and the certified copies of the insurance policies with the declaration pages, the rest of the information submitted is in order. I will be working on getting the contracts signed on our end. Please forward the corrected certificate as soon as possible and let me know if you have any questions. Thank you, Patty PaMfy M. 131.4-ineif e, Genera/Services Coordinator City of Okeechobee 55 Southeast 3rd Avenue Okeechobee, EL 34974 'fel: 863-763-3372 Direct: 863-763-982o Tax: 863-763-1686 e -mai[ yburnette@cityofokeechobee.com -website: -www.cityofokeecholee.com NOTICE: Florida has a very broad public records law. As a result, any written communication created or received by the City of Okeechobee officials and employees will be available to the public and media, upon request, unless otherwise exempt. Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this office. Instead, contact our office by phone or in writing. 1 BOROM-1 OP ID: ME , 6.---- CERTIFICATE OF LIABILITY INSURANCE `•.—�� DATE(MMIDDIYYI'Y) 08116/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. 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). PRODUCER Pritchards and Associates -SLC 10791 SW Tradition Square Port St. Lucie, FL 34987 Kristina M. Morgan NAAMMEACT Kristina M. Morgan PHONE FAX ((AJC No, Ext): 772-345-7700 (Arc, No): 772-345-7703 A -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Southern Owners 10190 INSURED Boromei Construction, Inc. Danny Boromei 420 B Nw 3rd Street Okeechobee, FL 34972 INSURERS: INSURER C: INSURERD: $ 1,000,000 INSURER E : INSURER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AUUL INSD SUI3k WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDYY) DIW LIMITS ' A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR l"" 7274456904!01!2018 04/01/2019 DAMAGE TO RENTED PREMISES (Ea occurrence) 300 000 $ , MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 3,000,000 OTHER: _- $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ A ANY AUTO 72744569 04/01/2018 04/01/2019 BODILY INJURY (Per person) $ ALL OWNED AUTOS ' SCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X AO OOWNED DAMAGE (fReracctlent) $ Hired non owned $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE. $ EXCESS LIAB _ CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER STATUTE H ER AND EMPLOYERS' LIABILITY Y ANY PROPRIETORIPARTNERIEXECUT1VEN / N , E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) / A E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Holder is listed as additional insured with regards to General Liability. PW02-00-05-18-RB, Okeechobee City Hall Door Replacement CERTIFICATE HOLDER CANCELLATION OKEEC-4 City of Okeechobee 55 SE 3rd Ave. Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2014/01) Such bond shall continue in effect for one (1) year after completion and acceptance of the work with liability equal to 25 percent (25%) of contract price, or an additional bond shall be conditioned that the Contractor will correct any defective or faulty work or material which appear within one (1) year after completion of the contract, upon notification by the City. INDEMNITY [CONTRACTOR] shall defend, indemnify and hold harmless the City of Okeechobee and all of the City of Okeechobee's officers, agents, and employees from and against all claims, liability, loss and expense, including reasonable costs, collection expenses, attorneys' fees, and court costs which may arise because of the negligence (whether active or passive), misconduct, or other fault, in whole or in part (whether joint, concurrent, or contributing), of [VENDOR], its officers, agents or employees in performance or non-performance of its obligations under the Agreement. [CONTRACTOR] recognizes the broad nature of this indemnification and hold harmless clause, as well as the provision of a legal defense to the City of Okeechobee when necessary, and voluntarily makes this covenant and expressly acknowledges the receipt of such good and valuable consideration provided by the City of Okeechobee in support of these indemnification, legal defense and hold harmless contractual obligations in accordance with the laws of the State of Florida. This clause shall survive the termination of this Agreement. Compliance with any insurance requirements required elsewhere within this Agreement shall not relieve [CONTRACTOR] of its liability and obligation to defend, hold harmless and indemnify the City of Okeechobee as set forth in this article of the Agreement. Nothing herein shall be construed to extend the City of Okeechobee's liability beyond that provided in section 768.28, Florida Statutes. INSURANCE [CONTRACTOR] shall, at its sole cost and expense, procure and maintain throughout the term of this contract, Comprehensive General Liability, Worker's Compensation, and Commercial Automobile Liability insurance, including Employer Liability insurance, with minimum policy limits specified below Combined Single Limits, or to the extent and in such amounts as required and authorized by Florida law, and will provide endorsed certificates of insurance generated and executed by a licensed insurance broker, brokerage or similar licensed insurance professional evidencing such coverage, and naming the City of Okeechobee as a named additional insured, as well as furnishing the City of Okeechobee with a certified copy, or copies, of said insurance policies. Certificates of insurance and certified copies of these insurance policies must accompany this signed contract. Said insurance coverages procured by [CONTRACTOR] as required herein shall be considered, and [CONTRACTOR] agrees that said insurance coverages it City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 11 procures as required herein shall be considered, as primary insurance over and above any other insurance, or self-insurance, available to the City of Okeechobee, and that any other insurance, or self-insurance available to the City of Okeechobee shall be considered secondary to, or in excess of, the insurance coverage(s) procured by [CONTRACTOR] as required herein. Worker's' Compensation - Coverage is to apply for all employees for statutory limits in compliance with the applicable state and federal laws. The policy must include Employers' Liability with a limit of $500,000.00 each accident, $500,000.00 each employee, $500,000.00 policy limit for disease. Commercial General Liability (Occurrence Form Required) - (ContractorNendor) shall maintain commercial general liability (CGL) insurance with a limit of not less than $500,000.00 each occurrence. If such CGL insurance contains a general aggregate limit, it shall apply separately to this location/project in the amount of $1,000,000.00. Products and completed operations aggregate shall be $1,000,000.00. CGL insurance shall be written on an occurrence form and shall include bodily injury and property damage liability for premises, operations, independent Contractors, products and completed operations, contractual liability, broad form property damage and property damage resulting from explosion, collapse or underground (x, c, u) exposures, personal injury and advertising injury. Damage to rented premises shall be included at $100,000.00. Commercial Automobile Liability Insurance - (ContractorNendor) shall maintain automobile liability insurance with a limit of not less than $1,000,000.00 each accident for bodily injury and property damage liability. Such insurance shall cover liability arising out of any auto (including owned, hired and non -owned autos). The policy shall be endorsed to provide contractual liability coverage. Nothing herein shall be construed to extend the City of Okeechobee's liability beyond that provided in F.S. 768.28, Florida Statutes. Will need to be completed. City of Okeechobee Project No. PW 02 -00 -05 -18 -RB Public Works Department 12 September 5, 2018 City of Okeechobee 55 SE 3rd Ave. Okeechobee FL 34974 Pritchards AND ASSOCIATES To whom this may concern, Enclosed Declaration pages, certificate and endorsements for Boromei Construction Inc. Project; PW02-00-05-18-RB, Okeechobee City Hall Door Replacement General Liability policy# 72744569 If you have any questions or need any other information please contact our office at 863- 763-7711. Thanking you, Lowell H Pritchard 1802 South Parrott Avenue Okeechobee, FL 34974 Phone: (863) 763-7711 Fax: (863) 763-5629 www. pritchardsinc.corn Agency Code 12-0626-00 Policy Number 182382-72744569 COMMERCIAL GENERAL LIABILITY 55205 (12-04) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization (Additional Insured): CITY OF OKEECHOBEE (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Under SECTION II - WHO IS AN INSURED, the following is added: The person or organization shown in the above Schedule is an Additional Insured, but only with re- spect to liability arising out of "your work" for that insured by or for you. B. Under SECTION III - LIMITS OF INSURANCE, the following is added: The limits of liability for the Additional Insured are those specified in the written contract or agreement between the insured and the owner, lessee or con- tractor, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. C. Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, the following is added: This insurance is primary for the person or organi- zation shown in the Schedule, but only with respect to liability arising out of "your work" for that person or organization by or for you. Other insurance available to the person or organization shown in the Schedule will apply as excess insurance and not contribute as primary insurance to the insurance provided by this endorsement. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 55205 (12-04) Copyright, Insurance Services office, Inc., 1984, 2003. Page 1 of 1 V 12-0626-00 PRITCHARDS AND ASSOCIATES INC 1802 S PARROTT AVE OKEECHOBEE FL 34974-6179 08-31-2018 BOROMEI CONSTRUCTION INC 420B NW 3RD ST OKEECHOBEE FL 34972-4129 RE: Policy 182382-72744569-18 59511 (7-15) 4ito- Owners INSURANCE LIFE • HOME • CAR • BUSINESS P.O. BOX 30660 • LANSING, MICHIGAN 48909-8160 Southern -Owners Insurance Company Remember, you can view your policy, pay your bill or change your paperless options any time online, at www.auto-owners.com. If you have not already enrolled your policy, you may do so using policy number 182382-72744569-18 and Personal ID Code (PID) 8N3 A9R 67T. Your agency's phone number is 877-763-6625. Thank you for selecting Auto -Owners Insurance Group to serve your insurance needs! Feel free to contact your independent Auto -Owners agent with questions you may have. Auto -Owners and its affiliate companies offer a variety of programs, each of which has its own eligibility requirements, coverages and rates. In addition, Auto -Owners also offers many billing options. Please take this opportunity to review your insurance needs with your Auto -Owners agent, and discuss which company, program, and billing option may be most appropriate for you. Auto -Owners Insurance Company was formed in 1916. The Auto -Owners Insurance Group is comprised of five property and casualty companies and a life insurance company. Our A++ (Superior) rating by A.M. Best Company signifies that we have the financial strength to provide the insurance protection you need. Serving Our Policyholders and Agents Since 1916 J"outhern-Owners INSURANCE COMPANY 6101 ANACAPRI BLVD., LANSING, MI 48917-3999 AGENCY PRITCHARDS AND ASSOCIATES INC 12-0626-00 MKT TERR 114 INSURED BOROMEI CONSTRUCTION INC ADDRESS 420B NW 3RD ST OKEECHOBEE FL 34972-4129 Page 1 877-763-6625 Issued 08-31-2018 TAILORED PROTECTION POLICY DECLARATIONS Change Endorsement Effective 08-16-2018 POLICY NUMBER 182382-72744569-18 Company Use 72 -23 -FL -1804 Company Bill Policy Term 12:01 a.m. 12:01 a.m. to 04-01-2018 04-01-2019 Description of Change ADDING: 55205 SCHEDULED ADDITIONAL INSURED - O/L/C INCLUDING PRODUCTS / COMPLETED OPERATIONS NAME OF ORGANIZATION: CITY OF OKEECHOBEE Transaction Number: 003 Endorsement Premium: (THIS IS NOTA BILL) $56.00 ADDITIONAL Agency Code 12-0626-00 Policy Number 182382-72744569 COMMERCIAL GENERAL LIABILITY 55205 (12-04) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization (Additional Insured): CITY OF OKEECHOBEE (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Under SECTION II - WHO IS AN INSURED, the following is added: The person or organization shown in the above Schedule is an Additional Insured, but only with re- spect to liability arising out of "your work" for that insured by or for you. B. Under SECTION III - LIMITS OF INSURANCE, the following is added: The limits of liability for the Additional Insured are those specified in the written contract or agreement between the insured and the owner, lessee or con- tractor, not to exceed the limits provided in this 55205 (12-04) policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. C. Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, the following is added: This insurance is primary for the person or organi- zation shown in the Schedule, but only with respect to liability arising out of "your work" for that person or organization by or for you. Other insurance available to the person or organization shown in the Schedule will apply as excess insurance and not contribute as primary insurance to the insurance provided by this endorsement. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services office, Inc., 1984, 2003. Page 1 of 1 12-0626-00 PRITCHARDS AND ASSOCIATES INC 1802 S PARROTT AVE OKEECHOBEE FL 34974-6179 08-13-2018 BOROMEI CONSTRUCTION INC 420B NW 3RD ST OKEECHOBEE FL 34972-4129 RE: Policy 182382-72744569-18 59511 (7-15) auto -Owners INSURANCE LIFE • HOME • CAR • BUSINESS P.O. BOX 30660 • LANSING, MICHIGAN 48909-8160 Southern -Owners Insurance Company Remember, you can view your policy, pay your bill or change your paperless options any time online, at www.auto-owners.com. If you have not already enrolled your policy, you may do so using policy number 182382-72744569-18 and Personal ID Code (PID) 8N3 A9R 67T. Your agency's phone number is 877-763-6625. Thank you for selecting Auto -Owners Insurance Group to serve your insurance needs! Feel free to contact your independent Auto -Owners agent with questions you may have. Auto -Owners and its affiliate companies offer a variety of programs, each of which has its own eligibility requirements, coverages and rates. In addition, Auto -Owners also offers many billing options. Please take this opportunity to review your insurance needs with your Auto -Owners agent, and discuss which company, program, and billing option may be most appropriate for you. Auto -Owners Insurance Company was formed in 1916. The Auto -Owners Insurance Group is comprised of five property and casualty companies and a life insurance company. Our A++ (Superior) rating by A.M. Best Company signifies that we have the financial strength to provide the insurance protection you need. Serving Our Policyholders and Agents Since 1916 Jouthern-Owners INSURANCE COMPANY 6101 ANACAPRI BLVD., LANSING, MI 48917-3999 AGENCY Page 1 Issued 08-13-2018 TAILORED PROTECTION POLICY DECLARATIONS PRITCHARDS AND ASSOCIATES INC Change Endorsement Effective 08-06-2018 12-0626-00 MKT TERR 114 INSURED BOROMEI CONSTRUCTION INC ADDRESS 4203 NW 3RD ST OKEECHOBEE FL 34972-4129 877-763-6625 POLICY NUMBER Company Use Company Bill 182382-72744569-18 72 -23 -FL -1804 Policy Term 12:01 a.m. 12:01 a.m. to 04-01-2018 04-01-2019 Description of Change AMEND LIABILITY LIMITS AS FOLLOWS: **SINGLE LIMITS** GENERAL AGGREGATE $ 3,000,000 PRODUCTS/COMP OP AGGREGATE $ 3,000,000 Transaction Number: 002 Endorsement Premium: (THIS IS NOTA BILL) $53.00 ADDITIONAL 12-0626-00 PRITCHARDS AND ASSOCIATES INC 1802 S PARROTT AVE OKEECHOBEE FL 34974-6179 05-10-2018 BOROMEI CONSTRUCTION INC 420B NW 3RD ST OKEECHOBEE FL 34972-4129 RE: Policy 182382-72744569-18 59511 (7-15) auto -Owners INSURANCE LIFE • HOME • CAR • BUSINESS P.O. BOX 30660 • LANSING, MICHIGAN 48909-8160 Southern -Owners Insurance Company Remember, you can view your policy, pay your bill or change your paperless options any time online, at www.auto-owners.com. If you have not already enrolled your policy, you may do so using policy number 182382-72744569-18 and Personal ID Code (PID) 8N3 A9R 67T. Your agency's phone number is 877-763-6625. Thank you for selecting Auto -Owners Insurance Group to serve your insurance needs! Feel free to contact your independent Auto -Owners agent with questions you may have. Auto -Owners and its affiliate companies offer a variety of programs, each of which has its own eligibility requirements, coverages and rates. In addition, Auto -Owners also offers many billing options. Please take this opportunity to review your insurance needs with your Auto -Owners agent, and discuss which company, program, and billing option may be most appropriate for you. Auto -Owners Insurance Company was formed in 1916. The Auto -Owners Insurance Group is comprised of five property and casualty companies and a life insurance company. Our A++ (Superior) rating by A.M. Best Company signifies that we have the financial strength to provide the insurance protection you need. Serving Our Policyholders and Agents Since 1916 Agency Code 12-0626-00 Policy Number 182382-72744569 HOW CAN YOU SAVE MONEY? There are several ways you can save on premium dollars depending on the type of business and coverages you have. Not all of the following may apply to your particular business. • PAYROLL DIVISION - A single employee's payroll can be divided, except when the employee works in a clerical, sales, drafting or driving position. Proper records must be kept in dollar amounts that reflect work actually performed before a breakdown can be applied. Without adequate records, the entire payroll for the employee must be placed in the highest rated classification. • EMPLOYEE TIPS - Tips declared by employees may be excluded from their gross payroll only if separately identified. Amounts added to customer's bills, such as service charges, which are collected by you and disbursed to your employees are not excludable. • CERTIFICATES OF INSURANCE - Have certificates available for the audit at your premises (or your accountant's) to ensure that charges are not made unnecessarily. It is best to obtain a certificate of insurance prior to a subcontractor performing work for you. Certificates must cover the period when the subcontractor worked for you. This may require certificates covering two different policy terms for the subcontractor. • DRIVERS - (For general liability coverage), employees with the sole responsibility of driving may often be excluded from chargeable payroll, if their wages are shown separately. However, employees who perform other duties besides driving must be placed in the highest rated class describing their duties. • COST OF HIRE is commonly used on commercial automobile policies as a premium basis for hired auto coverage. This includes automobiles and trailers used under contract on behalf of or loaned to the named insured, which may include rental units as well as subcontracted hauling for the insured. Your business is unique. If you have questions about how your specific circumstances will affect savings, please contact your insurance agent. BASIC DEFINITIONS • REMUNERATION is commonly called payroll, but can include items not normally part of payroll, or exclude items which are part of payroll. It includes wages, the value of meals and lodging, and other substitutes for money. (Substitutes for money include draws, dividends, traveling expenses and travel time payments, gift certificates or merchandise credits, annuities, and contributions to individual retirement accounts. This list is not all inclusive but represents common substitutes for money.) Your premium auditor will discuss this with you at the time of your audit. • OVERTIME is the hours worked for which there is an increase in the rate of pay. It includes: 1. Work in excess of 8 hours per day, or 40 hours per week. 2. Work on Saturdays, Sundays or holidays. 3. Work in any day or week, in excess of a guaranteed wage agreement. 4. Ordinarily, overtime pay is equal to 1 1/2 times the regular hourly rate. For example, a regular pay rate of $10 per hour at time and a half generates a $15 per hour overtime rate. If the extra $5 of pay is shown separately, it is excluded in total. If total overtime wage is shown in in a combined amount of $15 (regular pay plus increase) and included in gross payroll, one third ($5) will be deducted from gross pay. If the overtime wage is calculated at double time, one half will be deducted from gross pay. 5. Extra pay for shift differential is not considered overtime. • GROSS SALES is the gross amount charged by you or others trading under your name for all goods or products sold or distributed, operations performed and rentals. Some deductions from gross sales include sales or excise tax, returns and allowances and finance charges for items sold on installment. SUBCONTRACTOR is often used interchangeably with "independent contractor". We ordinarily apply the definition to subcontractors performing construction, erection or structural alteration for a general contractor. Most workers compensation laws hold you responsible for employees of an uninsured subcontractor. In some states, they may extend to an uninsured subcontractor without employees, if an employee -employer relationship 14019 (10-16) Page 2 of 3 Agency Code 12-0626-00 Policy Number 182382-72744569 NOTICE OF CHANGE IN POLICY TERMS YOUR SUBCONTRACTED WORK Dear Policyholder, 55531 (6-11) Your policy has a subcontracted work classification. The subcontracted work classification requires that your sub- contractors are "adequately insured contractors". We define an "adequately insured subcontractor" to be a subcontractor who carries commercial general liability insurance. If your subcontractors are not "adequately insured subcontractors", they will be classified and rated as your employees and charged a premium which best describes their work. This classification procedure will result in a substantial additional premium charge to you at final audit. We suggest that you take immediate steps to qualify your subcontractors as "adequately insured subcontractors" to avoid any additional premium charges at final audit. If you have any questions, please contact your Auto -Owners Insurance agency. 55531 (6-11) Page 1 of 1 59243 (6-00) Florida POLICYHOLDER INFORMATION AND ASSISTANCE We are here to serve you and as our policyholder your satisfaction is very important to us. Should you have any questions or a complaint regarding your policy that cannot be resolved by your agent, you may contact our Lakeland Regional Office for information and assistance by calling 863-687-4505. Auto -Owners Insurance Company Owners Insurance Company Southern -Owners Insurance Company 59243 (6-00) Page 1 of 1 In witness whereof, we, the Southern -Owners Insurance Company, have caused this policy to be issued and to be duly signed by our President and Secretary. bae,:--7141Xek Secretary 55156 (7-12) President Page 2 Southern -Owners Ins. Co. Issued 05-10-2018 AGENCY PRITCHARDS AND ASSOCIATES INC Company POLICY NUMBER 182382-72744569-18 12-0626-00 MKT TERR 114 Bill 72 -23 -FL -1804 INSURED BOROMEI CONSTRUCTION INC Term 04-01-2018 to 04-01-2019 55040 (11-87) COMMERCIAL GENERAL LIABILITY COVERAGE COVERAGE LIMITS OF INSURANCE General Aggregate (Other Than Products -Completed Operations) Products -Completed Operations Aggregate Personal Injury and Advertising Injury Each Occurrence COMMERCIAL GENERAL LIABILITY PLUS ENDORSEMENT Damage to Premises Rented to You (Fire, Lightning, Explosion, Smoke or Water Damage) Medical Payments Hired Auto & Non -Owned Auto Expanded Coverage Details See Form: Extended Watercraft Personal Injury Extension Broadened Supplementary Payments Broadened Knowledge Of Occurrence Additional Products -Completed Operations Aggregate Blanket Additional Insured - Lessor of Leased Equipment Blanket Additional Insured - Managers or Lessors of Premises Newly Formed or Acquired Organizations Extension Blanket Waiver of Subrogation $1,000,000 $1,000,000 $1,000,000 $1,000,000 $300,000 Any One Premises $10,000 Any One Person $1,000,000 Each Occurrence Twice the "General Aggregate Limit", shown above, is provided at no additional charge for each 12 month period in accordance with form 55300. AUDIT TYPE: Annual Audit Forms that apply to this coverage: 59350 (01-15) CG2149 (09-99) 55592 (02-14) 55091 (10-08) 55296 (09-09) 55637 (09-14) 55513 (11-11) 55719 (11-15) 55146 55371 55300 55718 (06-04) (01-07) (07-05) (11-15) 55189 (09-04) 55531 (06-11) CG0220 (03-12) 55238 (06-04) IL0021 (07-02) IL0017 (11-85) Agency Code 12-0626-00 Policy Number 182382-72744569 55371 (1-07) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - PROJECTS AND OPERATIONS COVERED BY A CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. The following exclusion is added to paragraph SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: This insurance does not apply to: Projects And Operations Covered By a Consolidated (Wrap-up) Insurance Program "Bodily injury" or "property damage" arising out of your ongoing operations or completed operations including those within the "products -completed operations hazard" for which a consolidated (wrap-up) insurance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated (wrap-up) insurance program: (1) Provides coverage identical to that provided by this Coverage Part; (2) Has limits adequate to cover all claims; or (3) Remains in effect. This exclusion shall not apply at the location described in the Schedule of this endorsement. All other policy terms and conditions apply. SCHEDULE Description and Location of Projects and Operation(s): (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) 55371 (1-07) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002 Page 1 of 1 Agency Code 12-0626-00 Policy Number 182382-72744569 COMMERCIAL GENERAL LIABILITY 55238 (6-04) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. A. Under SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, the following exclusions are added: 1. Bodily injury" or "property damage" arising out of, in whole or in part, the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or presence of, any "fungi" or bacteria, whether air -borne or not, on or within a building or structure, including its contents. This exclusion applies whether any other cause, event, material or product contributed concurrently or in any sequence to such injury or damage. 2. Any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating or disposing of, or in any way responding to, or assessing the effects of, "fungi" or bacteria, by any insured or by any other person, entity or governmental authority. These exclusions do not apply to any "fungi" or bacteria that are on, or are contained in, a good or product intended for human consumption. B. Under SECTION I - COVERAGES, COVERAGE B. PERSONAL INJURY AND ADVERTISING INJURY LIABILITY, 2. Exclusions, the following exclusions are added: 55238 (6-04) 1. Arising out of, in whole or in part, the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or presence of, any "fungi" or bacteria, whether airborne or not, on or within a building or structure, including its contents. This exclusion applies whether any other cause, event, material or product contributed concurrently or in any sequence to such injury. 2. For any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating or disposing of, or in any way responding to, or assessing the effects of, "fungi" or bacteria, by any insured or by any other person, entity or governmental authority. C. The following definition is added to SECTION V - DEFINITIONS: "Fungi" means any type or form of fungus, including but not limited to, any mold, mildew, mycotoxins, spores, scents or byproducts produced or released by any type or form of fungus. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright Insurance Services Office, Inc., 1982, 1988, 2001, 2002. Page 1 of 1 Agency Code 12-0626-00 Policy Number 182382-72744569 55592 (2-14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY - WITH LIMITED BODILY INJURY EXCEPTION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to Paragraph 2. Exclusion Section I - Coverage A Bodily Injury And Property Damage Liability: This insurance does not apply to: Access Or Disclosure Of Confidential Or Personal Information And Data -related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal in- formation, including patents, trade secrets, processing methods, customer lists, finan- cial information, credit card information, health information or any other type of non- public information; or (2) The loss of, loss of use of, damage to, cor- ruption of, inability to access, or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense in- curred by you or others arising out of that which is described in Paragraph (1) or (2) above. However, unless Paragraph (1) above applies, this exclusion does not apply to damages be- cause of "bodily injury". As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, 55592 (2-14) CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section I - Coverage B - Personal Injury And Advertising Injury Liability: 2. Exclusions This insurance does not apply to: Access Or Disclosure Of Confidential Or Personal Information "Personal injury" and "advertising injury" arising out of any access to or disclosure of any per- son's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health infor- mation or any other type of nonpublic informa- tion. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of any ac- cess to or disclosure of any person's or organi- zation's confidential or personal information. All other policy terms and conditions apply. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Agency Code 12-0626-00 Policy Number 182382-72744569 55719 (11-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA AMENDATORY ENDORSEMENT SUPPLEMENTARY PAYMENTS - COVERAGES A AND B This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Under SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B, 5. is deleted and replaced by the following. 5. All costs taxed against the insured in the "suit" we defend. However, such costs shall not include attorneys' fees or attorneys' expenses taxed against 55719 (11-15) the insured unless the attorneys' fees or attorneys' expenses were taxed against the insured as a result of our rejection of an offer of judgment at or below the applicable limit of insurance while providing a defense for that insured. All other policy terms and conditions apply. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Agency Code 12-0626-00 Policy Number 182382-72744569 3) Being disposed of, stored, treated or processed into or upon the "auto"; (b) Before such "pollutants" or property con- taining "pollutants" are moved from the place they are accepted by you or anyone acting on your behalf for placement into or onto the "auto"; or (c) After such "pollutants" or property containing "pollutants" are removed from the "auto" to where they are delivered, disposed of or abandoned by you or anyone acting in your behalf. c. (1) (a) above does not apply to "pollu- tants" that are needed or result from the normal mechanical, electrical or hydraulic functioning of the "auto" or its parts, if the discharge, release, escape, seepage, migration or dispersal of such "pollutants" is directly from a part of the "auto" designed to hold, store, receive or dispose of such "pollutants" by the "auto" manufacturer. c. (1) (b) and c. (1) (c) above do not apply, if as a direct result of maintenance or use of the "auto", "pollutants" or property contain- ing "pollutants" which are not in or upon the "auto", are upset, overturned or damaged at any premises not owned by or leased to you. The discharge, release, escape, seepage, migration or dispersal of the "pollutants" must be directly caused by such upset, overturn or damage. (2) Any loss, cost or expense arising out of any: (a) Request, demand or order that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or (b) Claim or "suit" by or on behalf of a gov- ernmental authority for damages be- cause of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of "pollutants". d. "Bodily injury" or "property damage" however caused, arising directly or indirectly, out of: 55091 (10-08) (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any govern- ment, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. e. "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subse- quent to the execution of the contract or agreement. However, if the insurance under this policy does not apply to the liability of the insured, it also does not apply to such liability assumed by the insured under an "insured contract". (2) That the insured would have in the absence of the contract or agreement. f. "Property damage" to: g. (1) Property owned or being transported by, or rented or loaned to any insured; or (2) Property in the care, custody or control of any insured other than "property damage" to a residence or a private garage by a private passenger "auto" covered by this coverage. "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of employment by the insured; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies: Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright Insurance Services Office, Inc., 1982, 1988, 2002, 2004 Page 2 of 7 Agency Code 12-0626-00 Policy Number 182382-72744569 (3) Persons or organizations making claims or bringing "suits". b. We will pay damages for "bodily injury" or "property damage" up to the limits of liability stated in the Declarations for this coverage. Such damages shall be paid as follows: (1) When Hired Auto and Non -Owned Auto Each Occurrence Limit is shown in the Declarations, such limit is the total amount of coverage and the most we will pay for all damages because of or arising out of all "bodily injury" and "property damage" in any one "occurrence". (2) When Bodily Injury Hired Auto and Non - Owned Auto Each Occurrence Limit and Property Damage Hired Auto and Non - Owned Auto Each Occurrence Limit are shown in the Declarations: (a) The limit shown for Bodily Injury Hired Auto and Non -Owned Auto Each Occur- rence is the total amount of coverage and the most we will pay for all dam- ages because of or arising out of all "bodily injury" in any one "occurrence". (b) The limit shown for Property Damage Hired Auto and Non -Owned Auto Each Occurrence is the total amount of cover- age and the most we will pay for all damages because of or arising out of all "property damage" in any one "occur - re nce". 3. BROADENED SUPPLEMENTARY PAYMENTS Under SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, COVERAGE B. PERSONAL INJURY AND ADVERTISING INJURY LIABILITY and SUPPLEMENTARY PAYMENTS - COVERAGES A AND B: Paragraph 4., the amount we will pay for the actual loss of earnings is increased from $250 per day to $400 per day. 4. ADDITIONAL PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT If the endorsement, EXCLUSION - PRODUCTS COMPLETED OPERATIONS HAZARD, CG 21 04, 55091 (10-08) is not attached to this policy, then the following is added to SECTION III - LIMITS OF INSURANCE: Commencing with the effective date of this policy, we will provide one additional Products -Completed Operations Aggregate Limit, for each annual period, equal to the amount of the Products -Completed Operations Aggregate Limit shown in the Declara- tions. The maximum Products -Completed Opera- tions Aggregate Limit for any annual period will be no more than two times the original Products - Completed Operations Aggregate Limit. 5. PERSONAL INJURY EXTENSION a. If the endorsement EXCLUSION - PERSONAL INJURY AND ADVERTISING INJURY, 55350, is attached to this policy, then this provision, 5. PERSONAL INJURY EXTENSION, does not apply. b. If the endorsement EXCLUSION - PERSONAL INJURY AND ADVERTISING INJURY, 55350, is not attached to this policy, then under SEC- TION V - DEFINITIONS, 15. "Personal injury" is deleted and replaced by the following: 15. "Personal injury" means, other than "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies by or on behalf of its owner, landlord or lessor; d. Oral or written publication of material that slanders or libels a person or or- ganization or disparages a person's or organization's goods, products or services; e. Oral or written publication of material that violates a person's right of privacy; or f. Discrimination, humiliation, sexual harassment and any violation of civil rights caused by such discrimination, humiliation or sexual harassment. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright Insurance Services Office, Inc., 1982, 1988, 2002, 2004 Page 4 of 7 Agency Code 12-0626-00 Policy Number 182382-72744569 a. (f) Water under the ground surface pressing on, or seeping or flowing through: 1) Walls, foundations, floors or paved surfaces; 2) Basements, whether paved or not; or 3) Doors, windows or other openings. (4) "Property damage" for which the insured is obligated to pay as damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of this contract or agreement. Limits of Insurance With respect to this coverage only, under SECTION III - LIMITS OF INSURANCE, paragraph 6. is deleted and replaced by the following: 6. The most we will pay under Coverage A for damages because of "property damage" to premises rented to you or temporarily occupied by you with permission of the owner arising out of or caused by fire, lightning, explosion, smoke and water damage is the amount shown in the Declarations under Damage to Premises Rented to You. b. Under SECTION IV - COMMERCIAL GEN- ERAL LIABILITY CONDITIONS, 4. Other Insurance, paragraph b., the word fire is amended to include fire, lightning, explosion, smoke or water damage. 8. BLANKET ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT a. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization with whom you have agreed: (1) In a written contract or agreement, executed prior to loss, to name as an additional insured; or (2) In an oral contract or agreement, executed prior to loss, to name as an additional 55091 (10-08) insured only if a Certificate of Insurance was issued prior to loss indicating that the person or organization was an additional insured but only with respect to liability for: (1) "Bodily injury"; (2) "Property damage"; (3) "Personal injury"; or (4) "Advertising injury" caused in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. b. With respect to the insurance afforded to an additional insured, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. c. The following is added to SECTION III - LIMITS OF INSURANCE: The Limits of Insurance for the additional in- sured are those specified in the written contract or agreement between the insured and the lessor, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. 9. BLANKET ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES a. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization with whom you have agreed: (1) In a written contract or agreement, executed prior to loss, to name as an additional insured; or (2) In an oral contract or agreement, executed prior to loss, to name as an additional insured only if a Certificate of Insurance was issued prior to loss indicating that the person or organization was an additional insured but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright Insurance Services Office, Inc., 1982, 1988, 2002, 2004 Page 6 of 7 Agency Code 12-0626-00 Policy Number 182382-72744569 COMMERCIAL GENERAL LIABILITY 55146 (6-04) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UPSET AND OVERSPRAY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is agreed the coverage for "property damage" liability with respect to your operations is extended as follows: 1. COVERAGE We will pay those sums which you become legally obligated to pay for "property damage" caused directly by immediate, abrupt and accidental: a. Upset, overturn or collision of your "mobile equipment" while transporting; or b. "Overspray" during your application or dispersal of "pollutants" which are intended for and normally used in your operations. The operations must be in compliance with local, state, and federal ordinances and laws. This is not an additional amount of insurance and does not increase the Limits of Insurance stated in the Decla- rations. 2. EXCLUSIONS a. With regard only to the coverage provided by this endorsement, Exclusion f. of Section I - Coverage A - Bodily Injury And Property Damage Liability is deleted and replaced by the following: f. Pollution Any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or (2) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of "pollutants". However, this paragraph does not apply to liability for damages because of covered "property damage" that the insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a governmental authority. 55146 (6-04) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 2000 Page 1 of 2 Agency Code 12-0626-00 Policy Number 182382-72744569 55300 (7-05) COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and "our" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under Section II - Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V - Definitions. SECTION I - COVERAGES COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured be- comes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. We may at our discretion investigate any claim or "occur- rence" and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III - Limits of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverage A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments - Coverages A and B. b. This insurance applies to "bodily injury" and "property damage" only if: 55300 (7-05) (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; (2) The "bodily injury" or "property damage" occurs during the policy period; and (3) Prior to the policy period, no insured listed under Paragraph 1. of Section II - Who Is An Insured and no "employee" authorized by you to give or receive notice of an "occurrence" or claim, knew that the "bodily injury" or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. c. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section II - Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 1 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 55300 (7-05) (i) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat water for personal use by the building's occupants or their guests; (ii) "Bodily injury" or "property damage" for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured, other than that additional insured; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the han- dling, storage, disposal, processing or treatment of waste; (c) Which are or were at any time trans- ported, handled, stored, treated, dis- posed of, or processed as waste by or for: (i) Any insured; or (ii) Any person or organization for whom you may be legally respon- sible; (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the "pollutants" are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor. However, this subparagraph does not apply to: (i) "Bodily injury" or "property damage" arising out of the escape of fuels, lubricants or other operating fluids which are needed to perform the normal electrical, hydraulic or mech- anical functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them. This exception does not apply if the "bodily injury" or "property damage" arises out of the intentional discharge, dispersal or release of the fuels, lubricants or other operating fluids, or if such fuels, lubricants or other operating fluids are brought on or to the premises, site or location with the intent that they be discharged, dispersed or released as part of the operations being performed by such insured, contractor or subcontractor; (ii) "Bodily injury" or "property damage" sustained within a building and caused by the release of gases, fumes or vapors from materials brought into that building in connec- tion with operations being performed by you or on your behalfbya contractor or subcontractor; or (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; or (e) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants". (2) Any loss, cost or expense arising out of any: (a). Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 3 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 (2) Property that any of your: (a) "Employees"; (b) "Volunteer workers"; (c) Partners or members (if you are a partnership or joint venture); or (d) Members (if you are a limited liability company) own, rent, occupy or use. However, this exclusion j.(2), shall not apply to your liability for damage to such property; (3) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (4) Property loaned to you; (5) Personal property in the care, custody or control of, or over which physical control is being exercised for any purpose by any insured; (6) That particular part of real property on which any insured or any contractors or subcon- tractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (7) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (2). (4) and (5) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. Paragraph (3) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (4), (5), (6) and (7) of this exclusion do not apply to liability assumed under a side- track agreement. 55300 (7-05) Paragraph (7) of this exclusion does not apply to "property damage" included in the "products - completed operations hazard". k. Damage To Your Product "Property damage" to "your product" arising out of it or any part of it. I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". m. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or danger- ous condition in "your product" or "your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. n. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replace- ment, adjustment, removal or disposal of: (1) "Your product "; (2) "Your work"; or (3) "Impaired property" if such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 5 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 (1) The "personal injury" or "advertising injury" is caused by an offense arising out of your business; and (2) The offense causing the "personal injury" or "advertising injury" was committed in the "coverage territory" during the policy period. 2. Exclusions This insurance does not apply to "personal injury" or "advertising injury": a. Knowing Violation Of Rights Of Another Or Expected Or Intended Injury (1) Caused by or at the direction of any insured with the knowledge that the act would vio- late the rights of another and would inflict "personal injury" or "advertising injury"; or (2) Expected or intended by any insured. This exclusion a.(2), does not apply to "personal injury". b. Material Published With Knowledge Of Falsity Arising out of oral or written publication of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior To Policy Period Arising out of oral or written publication of material whose first publication took place before the beginning of the policy period. d. Criminal Acts Arising out of a criminal act or violation of a penal statute or ordinance committed by or at the direction of the insured. e. Contractual Liability For which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. f. Breach of Contract 55300 (7-05) g. Arising out of a breach of contract, except an implied contract to use another's advertising idea in your "advertisement". Quality Or Performance Of Goods - Failure To Conform To Statements Or Representa- tions Arising out of the failure of goods, products or services to conform with any statement or repre- sentation of quality or performance made in your "advertisement". h. Wrong Description Of Prices Arising out of the wrong description of the price of goods, products or services. i. Infringement Of Copyright, Patent, Trademark Or Trade Secret J• Arising out of the infringement of copyright, patent, "trademark", trade secret or other intellectual property rights. However, this exclusion does not apply to in- fringement, in your "advertisement" of copy- right, "trade dress" or slogan. Insureds In Media And Internet Type Businesses Committed by an insured whose business is: (1) Advertising, broadcasting, publishing or telecasting; (2) Designing or determining content of websites for others; or (3) An Internet search, access, content or service provider. However, this exclusion does not apply to Paragraphs 15. a., b. and c. of "personal injury" under Section V - Definitions. For the purposes of j.(1) of this exclusion, the placing of frames, borders, links, or advertising, for you or others anywhere on the Internet, is not by itself, considered the business of adver- tising, broadcasting, publishing or telecasting. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 7 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. r. Silica Or Silica -Related Dust Any claim, "suit", action or proceeding against any insured arising out of the discharge, disper- sal, release, escape or inhalation of any "silica" or "silica -related dust". COVERAGE C. MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (1) The accident takes place in the "coverage territory" and during the policy period; (2) The expenses are incurred and reported to us within one year of the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the ap- plicable limit of insurance. We will pay reason- able expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hospital, profes- sional nursing and funeral services. 55300 (7-05) 2. Exclusions We will not pay expenses for "bodily injury": a. Any Insured To any insured, except "volunteer workers". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers Compensation And Similar Laws To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a workers compensation or disability benefit law or a similar law. e. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports or athletics contests. f. Products -Completed Operations Hazard g. Included within the "products -completed opera- tions hazard". Coverage A Exclusions Excluded under Coverage A. h. Asbestos For any claim, "suit", action or proceeding against any insured arising out of the discharge, dispersal, release, escape or inhalation of any asbestos related particle, dust, irritant, contami- nant, pollutant, toxic element or material. i. Communicable Disease Arising out of or resulting from the transmission of any communicable disease by any insured. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 9 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equip- ment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co -"employee" of the person driving the equipment; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 4. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal injury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. 55300 (7-05) No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III - LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay re- gardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products completed operations hazard"; and c. Damages under Coverage B. 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". 4. Subject to 2. above, the Personal Injury and Adver- tising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal injury" and all "advertising injury" sustained by any one person or organization. 5. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence". 6. The Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 11 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 an insured obtained after an actual trial; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed set- tlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverage A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obliga- tions are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (b) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I - Coverage A - Bodily Injury And Property Damage Liability. (2) Any other primary insurance available to an insured, other than an additional insured, covering liability for damages arising out of the premises or operations, or the products 55300 (7-05) and completed operations, for which you have been added as an additional insured by attachment of an endorsement. When this insurance is excess, we will have no duty under Coverage A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insur- ance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insur- ance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applcable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 13 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 5. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in a. above; or c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in a. above: (2) The activities of a person whose home is in the territory described in a. above, but is away for a short time on your business; or (3) "Personal injury" or "advertising injury" of- fenses that take place through the Internet or similar electronic means of comunication provided the insured's responsibility to pay damages is determined in a "suit" on the merits, in the territory described in a. above or in a settlement we agree to. 6. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker". 7. "Executive officer" means a person holding any of the officer positions created by your charter, con- stitution, by-laws or any other similar governing document. 8. "Hostile fire" means one which becomes uncontrol- lable or breaks out from where it was intended to be. 9. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by: 55300 (7-05) a. The repair, replacement, adjustment or removal of "your product" or "your work"; or b. Your fulfilling the terms of the contract or agree- ment. 10. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of pre- mises that indemnifies any person or organiza- tion for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to in- demnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; or f. That part of any other contract or agreement pertaining to your business (including an indem- nification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contractor agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of con- struction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road- beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to pre- pare or approve, maps, shop drawings, Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 15 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 15. "Personal injury" means other than "bodily injury" arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person's or organi- zation's goods, products or services; or e. Oral or written publication, in any manner, of material that violates a person's right of privacy. 16. "Pollutants" mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. 17. "Products -completed operations hazard": a. Includes all "bodily injury" and "property dam- age" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: 55300 (7-05) (a) When all of the work called for in your contract has been completed. (b) When all of the work to be done at the job site has been completed if your con- tract calls for work at more than one job site. (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include "bodily injury" or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equip- ment or abandoned or unused materials; or (3) Products or operations for which the clas- sification, shown in the Declarations, states that products -completed operations are included. 18. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physi- cally injured. All such loss shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, electronic data is not tangible property. As used in this definition, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and appli- cations software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 19. "Silica" means silicon dioxide (occurring in crystal- line, amorphous and impure forms), silica particles, silica dust or silica compounds. 20. "Silica -related dust" means a mixture or combination of silica and other dust or particles. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1982, 1988, 1997, 2000, 2002, 2003. Page 17 of 18 Agency Code 12-0626-00 Policy Number 182382-72744569 COMMERCIAL GENERAL LIABILITY 55513 (11-11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYER'S LIABILITY EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. SECTION I - COVERAGES is amended as follows. Under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. EXCLU- SIONS, exclusion e. Employer's Liability is deleted and replaced by the following exclusion. e. Employer's Liability "Bodily injury" to: (1) An "employee" of any insured arising out of and in the course of employment by any in- sured; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies: (1) Whether any insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay dam- ages because of the injury. This exclusion does not apply to liability as- sumed by any insured under an "insured con- tract". 2. SECTION II - WHO IS AN INSURED is amended as follows. Paragraph 1. is deleted and replaced by the follow- ing. 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the con- duct of a business of which you are the sole owner. b. A partnership or joint venture, you are an in- sured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your busi- ness. c. A limited liability company, you are an in- sured. Your members are also insureds, but only with respect to the conduct of your business. 55513 (11-11) d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with re- spect to their duties as your officers or direc- tors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. However, with respect to paragraphs 1.a. through 1.e. above, no person is an insured for "bodily injury", "personal injury" or "advertising injury": a. To: (1) You and your spouse if the Named In- sured is an individual; (2) Your members, your partners and their spouses if the Named Insured is a part- nership or joint venture; Your members if the Named Insured is a Limited Liability Company; (4) Your "executive officers" and directors if the Named Insured is other than a part- nership, joint venture or limited liability company; or (5) Your trustees if the Named Insured is a trust. b. To an "employee" of any insured while in the course of his or her employment or perform- ing duties related to the conduct of any in- sured's business. c. To any insured's "volunteer workers" while performing duties related to the conduct of any insured's business; d. To the spouse, child, parent, brother or sis- ter of any "employee" or "volunteer worker"" as a consequence of Paragraphs b. or c. immediately above. (3) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 Agency Code 12-0626-00 Policy Number 182382-72744569 55718 (11-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - UNMANNED AIRCRAFT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.g. Aircraft, Auto Or Watercraft under SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIA- BILITY is deleted and replaced by the following. 2. Exclusions This insurance does not apply to: Aircraft, Auto Or Watercraft (1) Unmanned Aircraft "Bodily injury" or "property damage" arising out of the ownership, mainte- nance, use or entrustment to others of any aircraft that is an "unmanned air- craft". Use includes operation and "loading or unloading". This Paragraph g.(1) applies even if the claims against any insured allege negli- gence or other wrongdoing in the super- vision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any air- craft that is an "unmanned aircraft". (2) Aircraft (Other Than Unmanned Aircraft), Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, mainte- nance, use or entrustment to others of any aircraft (other than "unmanned air- craft"), "auto" or watercraft owned or op- erated by or rented or loaned to any in- sured. Use includes operation and "loading or unloading". This Paragraph g.(2) applies even if the claims against any insured allege negli- gence or other wrongdoing in the super- vision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, g. 55718 (11-15) use or entrustment to others of any air- craft (other than "unmanned aircraft"), "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.(2) does not apply to: (a) A watercraft while ashore on premises you own or rent; (b) A watercraft you do not own that is: (i) Less than 26 feet long; and (ii) Not being used to carry persons or property for a charge; (c) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (d) Liability assumed under any "in- sured contract" for the ownership, maintenance or use of aircraft or watercraft; or (e) "Bodily injury" or "property damage" arising out of the operation of any of the equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". B. The following exclusion is added to Paragraph 2. Exclusions of COVERAGE B. PERSONAL IN- JURY AND ADVERTISING INJURY LIABILITY. 2. Exclusions This insurance does not apply to: Unmanned Aircraft "Personal injury" or "advertising injury" arising out of the ownership, maintenance, use or en- trustment to others of any aircraft that is an "un- manned aircraft". Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrong- doing in the supervision, hiring, employment, training or monitoring of others by that insured, if the offense which caused the "personal injury" Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 Agency Code 12-0626-00 Policy Number 182382-72744569 COMMERCIAL GENERAL LIABILITY CG 02 20 03 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART A. Paragraph 2. of the Cancellation Common Policy Condition is replaced by the following: 2. Cancellation Of Policies In Effect: a. For 90 Days Or Less If this policy has been in effect for 90 days or less, we may cancel this policy by mailing or delivering to the first Named Insured writ- ten notice of cancellation, accompanied by the reasons for cancellation, at least: (1) 10 days before the effective date of can- cellation if we cancel for non-payment of premium; or (2) 20 days before the effective date of can- cellation if we cancel for any other rea- son, except we may cancel immediately if there has been: (a) A material misstatement or misrep- resentation; or (b) A failure to comply with the under- writing requirements established by the insurer. b. For More Than 90 Days If this policy has been in effect for more than 90 days, we may cancel this policy only for one or more of the following reasons: (1) Nonpayment of premium; (2) The policy was obtained by a material misstatement; (3) Failure to comply with underwriting re- quirements established by the insurer within 90 days of the effective date of coverage; (4) A substantial change in the risk covered by the policy; or CG 02 20 03 12 (5) The cancellation is for all insureds under such policies for a given class of in- sureds. If we cancel this policy for any of these rea- sons, we will mail or deliver to the first Named Insured written notice of cancella- tion, accompanied by the reasons for can- cellation, at least: (a) 10 days before the effective date of can- cellation if we cancel for non-payment of premium; (b) 45 days before the effective date of can- cellation if we cancel for any of the other reasons stated in paragraph 2.b. B. Paragraph 3. of the Cancellation Common Policy Condition is replaced by the following: 3. We will mail or deliver our notice to the first Named Insured at the last mailing address known to us. C. Paragraph 5. of the Cancellation Common Policy Condition is replaced by the following: 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. If the return premium is not re- funded with the notice of cancellation or when this policy is returned to us, we will mail the re- fund within 15 working days after the date can- cellation takes effect, unless this is an audit policy. If this is an audit policy, then, subject to your full cooperation with us or our agent in securing the necessary data for audit, we will return any pre - Copyright, Insurance Services Office, Inc., 1992 Page 1 of 2 Agency Code 12-0626-00 Policy Number 182382-72744569 COMMERCIAL GENERAL LIABILITY CG 21 49 09 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. Exclusion f. under Paragraph 2. , Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: This insurance does not apply to: f. Pollution (1) "Bodily injury" or "property damage" which would not have occurred in whole or part but for the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants" at any time. (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". CG 21 49 09 99 © Insurance Services Office, Inc., 1998 Page 1 of 1 Agency Code 12-0626-00 Policy Number 182382-72744569 IMPORTANT INFORMATION REGARDING TERRORISM RISK INSURANCE COVERAGE The Terrorism Risk Insurance Act of 2002 was signed into law on November 26, 2002. The Act (including ensuing Con- gressional actions pursuant to the Act) defines an act of terrorism, to mean any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security and the Attorney General of the United States to be (i) an act of terrorism; (ii) to be a violent act or an act that is dangerous to human life, property or infrastructure; (iii) to have resulted in damage within the United States or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and (iv) to have been committed by an individual or individuals as part of an ef- fort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States government by coercion. Subject to the policy terms and conditions, this policy provides insurance coverage for acts of terrorism as defined in the Act. Any coverage for certain commercial lines of property and casualty insurance provided by your policy for losses caused by certified acts of terrorism are partially paid by the federal government under a formula established by federal law. Un- der this formula, the government will reimburse us for 85% of such covered losses that exceed the statutory deductible paid by us. However, beginning January 1, 2016 the share will decrease 1% per calendar year until it equals 80%. You should also know that in the event aggregate insured losses exceed $100 billion during any year the Act is in ef- fect, then the federal government and participating United States insurers that have met their insurer deductible shall not be liable for the payment of any portion of that amount of the loss that exceeds $100 billion. In the event that aggregate insured losses exceed $100 billion annually, no additional claims will be paid by the federal gov- ernment or insurers. This formula is currently effective through December 31, 2020 unless extended. The premium charge, if any, for this coverage is shown separately on the attached Declarations page. In the event of a certified act of terrorism, future policies also may include a government assessed terrorism loss risk -spreading premium in accordance with the provisions of the Act. Please contact us if you would like to reject coverage for certified acts of terrorism. 59350 (1-15) Page 2 of 2 Agency Code 12-0626-00 F. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS POLICY Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. IL 00 17 11 85 Policy Number 182382-72744569 If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa- tive. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Copyright, Insurance Services Office, 1982, 1983 Page 2 of 2 Agency Code 12-0626-00 Policy Number 182382-72744569 within the United States of America, its territories or possessions or Canada, this exclusion (3) applies only to "property damage" to such "nuclear facility" and any property thereat. 2. As used in this endorsement: "Hazardous properties" include radioactive, toxic or explosive properties. "Nuclear material" means "source material", "Special nuclear material" or "by-product material". "Source material", "special nuclear material", and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. "Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a "nuclear reactor". "Waste" means any waste material (a) containing "by-product material" other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its "source material" content, and (b) resulting from the operation by any person or or- ganization of any "nuclear facility" included under the first two paragraphs of the definition of "nuclear facility". "Nuclear facility" means: IL 00 21 07 02 (a) Any "nuclear reactor"; (b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing "spent fuel", or (3) handling, processing or packaging "waste"; (c) Any equipment or device used for the process- ing, fabricating or alloying of "special nuclear material" if at any time the total amount of such material in the custody of the "insured" at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any com- bination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin, excavation, premises or place prepared or used for the storage or disposal of "waste"; and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fis- sionable material. "Property damage" includes all forms of radioactive contamination of property. Copyright, Insurance Services Office, Inc., 1983, 1984 Page 2 of 2 Form (Rev. Depai Intern CO rn m 0. 0 N 0. 0 �•U 02 C N C ft 0 d 0. rn co to W-9 lovember 2017) ment of the Treasury ii Revenue Service Request for Taxpayer Identification Number and Certification ► Go to www.irs.gov/FormW9 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Boromei Construction, Inc. 2 Business name/disregarded entity name. if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. 4 Exemptions certain entities, instructions Exempt payee Exemption code (if any) (App°es m accounts (codes apply only to not Individuals; see on page 3): code (if any) • IndividuaVsole proprietor or IS C Corporation In S Corporation I Partnership III Trust/estate single -member • Limited liability Note: Check the LLC if the LLC another LLC that is disregarded LLC company. Enter the tax classification (C=C corporation. S=S corporation, P=Partnership) appropriate box in the line above for the tax classification of the single -member owner. is classified as a single -member LLC that Is disregarded from the owner unless the is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single from the owner should check the appropriate box for the tax classification of its owner. ► I. from FATCA reporting Do not check owner of the LLC Is -member LLC that maintained oufsclo The U.S.) • Other (see instructions) 5 Address (number, street, and apt. or suite no.) See instructions. 420-B NW 3rd Street Requester's name and address (optional) 6 City, state, and ZIP code Okeechobee, FL 34972 isr account number(s) nere (options Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, seethe instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Social security number or Employer identification number 2 0 3 2 1 6 2 1 Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (If any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later. Sign Here Signature of `'//%J /t U.S. person ► V'eel. ,G / J L_AV--Lc.G'?yiz_, Date ► lO i t,�t) l SI General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 11-2017) AUGUST 7, 2018 - REGULAR MEETING - PAGE 6 OF 11 AGENDA COUNCIL ACTION - DISCUSSION - VOTE VII. NEW BUSINESS CONTINUED D. Motion to amend a Bid award in the amount of $19,580.00 for Project No. PW 03-00-06-18 for pressure washing and painting City Hall, Fire Department, and Records Retention Building - Public Works Director (Exhibit 3). E. Motion to grant a request for a 21 -day extension for Project No. PW 01-00-04-18, Police Department Roof Replacement - City Administrator and Public Works Director (Exhibit 4). F. Motion to award a Bid in the amount of $35,865.00 to Boromei Construction for Project No. PW 02 -00 -05 -18 -RB, City Hall Door Replacement - Public Works Director (Exhibit 5). Motion and second by Council Members Ritter and Clark to amend the Contract awarded to Painting and Pressure Cleaning by Big Lake, LLC, for Bid No. PW 03-00-06-18 Pressure Washing and Painting City Hall, Fire Department, and Records Retention Building as follows: waive the performance bond requirement; amend and clarify the workers compensation requirement to read that Big Lake Painting and Pressure Cleaning, LLC may operate under the Florida workers compensation exemption law, or outside workers must be hired through an agency with workers compensation insurance. VOTE: WATFORD - YEA CHANDLER - YEA CLARK -YEA RITTER - YEA MOTION CARRIED. Motion and second by Council Members Chandler and Clark to grant an extension of the Police Department Roof Replacement Contract for Bid No. PW 01-00-04-18. The Contract began June 28, 2018, with a completion date of August 27, 2018. However, after the forensic investigation of the roof was concluded, it was discovered that the underlying roofing material is metal as opposed to the assumed plywood. The specifications have to be modified; the price remains the same. The Contractor requested extending the Contract completion by 21 -days in order to obtain approval by the manufacturer to assure the 15 year warranty would be valid with the minor specification change. Additionally, there could be weather delays and staff requested authorization to extend the project 60 -days if needed. Mayor Watford asked if there was any additional discussion on the request for a 60 -day extension; there was none. VOTE: WATFORD - YEA CHANDLER - YEA CLARK- YEA RITTER - YEA MOTION CARRIED. Council Member Chandler moved to award Bid No. PW 02 -00 -05 -18 -RB City Hall Door Replacement, in the amount of $35,865.00 to Boromei Construction of Okeechobee; seconded by Council Member Clark. The Re -Bid was let on June 29, 2018, with a mandatory Pre -Bid meeting held on July 10, 2018. The opening was July 18, 2018. In addition to Boromei Construction, Meticulous Construction of West Palm Beach submitted a bid for $79,000.00. Council Member Ritter expressed concern with the almost 50 percent price difference from the opposing Bidder. Administrator MontesDeOca assured him research has been done on the discrepancies of prices. VOTE: WATFORD - YEA CHANDLER - YEA CLARK - YEA RITTER-YEA MOTION CARRIED. Boromei Construction July 18, 2018 City of Okeechobee 55 SE 3rd Ave. Rm 101 Okeechobee, FL 34974 Re: ITB PW 02 -00 -05 -18 -RB Okeechobee City Hall Door Replacement To Whom It May Concern: ORIGINAL Please find enclosed our proposal for ITB PW 02 -00 -05 -18 -RB Okeechobee City Hall Door Replacement Project. Boromei Construction was founded in 2004 by Danny Boromei. Mr. Boromei has over 25 years in construction experience. I have enclosed his Resume for your reference. If you have any questions or need anything additional please do not hesitate to contact our office. Sincerely; 1 Danny Boromei, President/Owner Phone 863.623.4314 420B NW 3rd Street Fax 863.763.6337 Okeechobee, FL 34972 Boromei Construction August 24, 2018 City of Okeechobee Attn: David Allen 55 SE 3rd Ave. Okeechobee, FL 34974 Re: PW 02 -05 -18 -RB, Okeechobee City Hall Door Replacement Dear Mr. Allen: Please find enclosed the requested contract documents per the Notice of Award dated August 16, 2018 for the above referenced project. The only item I am still waiting on is the certified copy of the insurance policies with the declaration pages for the GL and Auto Insurance. I have requested this from our insurance agent and was told it would be 10 — 20 days before we receive. As soon as we receive the requested insurance documents I will forward them to you. We look forward to working with you on this project. If you have any questions or need anything additional please do not hesitate to contact our office. Sincerely; Melissa Stone, Secretary Phone 863.623.4314 420B NW 3rd Street Fax 863.763.6337 Okeechobee, FL 34972 CERTIFICATE OF' LIABILI I Y INSUKAIVLC . 112/11/2018 Producer: Plymouth Insurance Agency 2739 U.S. Highway 19 N. This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Holiday, FL 34691 (727) 938-5562 Insurers Affording Coverage NAIC # Insurer A: Lion Insurance Company 11075 Insured: South East Personnel Leasing, Inc.& Subsidiaries Insurer B: 2739 U.S. Highway 19 N. Insurer C: Holiday. FL 34691 Coverages The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDLPolicy INSRD Type of Insurance Policy Number Effective Date (MM/DD/YY) Policy Expiration Date (MM/DD/YY) Limits $ GENERAL LIABILITY Each Occurrence Commercial General Liability Damage to rented premises (EA Claims Made Occur occurrence) $ Med Exp $ Personal Adv Injury $ „„.—. General aggregate limit applies per: General Aggregate $ Policy Project ❑ LOC Products -Comp/Op Agg $ Single Limit AUTOMOBILE LIABILITY Combined (EA Accident) $ Any Auto All Owned Autos Bodily Injury (Per Person) $ Scheduled Autos Hired Autos Bodily Injury (Per Accident) $ Non -Owned Autos Property Damage Accident) (Per $ LIABILITY Each Occurrence EXCESS/UMBRELLA Claims Made Aggregate IOccur ❑ Deductible A Workers Compensation and WC 71949 01/01/2019 01/01/2020 x I WC Statu- tory Limits I I OTH- ER Employers' Liability E.L. Each Accident 1,000,000 ,Any proprietor/partner/executive officer/member E.L. Disease - Ea Employee 1,000,00o excluded? Np If Yes, describe under special provisions below. E.L. Disease - Policy Limits 1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/LocationsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 98-65-373 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Boromei Construction Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or email certificates@lioninsurancecomPany.com Project Name: ISSUE 11-12-18 (TD) Begin Date 5/2/2018 CANCELLATION date thereof, the CERTIFICATE HOLDER CITY OF OKEECHOBEE Should any of the above described policies be cancelled before the expiration issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. 55 SE 3RD AVENUE OKEECHOBEE, fl 34974--- .-;'(,-())PNA/ ��, / CJ 1U-2b-LU1ti tS:U1 HM rax Lity or UKeechobee L7 1 ACORN` CERTIFICATE OF LIABILITY INSURANCE kb.------ DATE(MMIDD/YYYY( 10/26/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Heacock Insurance Group, LLC 32313 Broadway St., Suite 101 Sebring FL 33870 CONTNAME: 1.. Courtney Stuart PHONE FAX lC. No Extl: 863-385-5171 (AIC, No): 863-385-4130 E ADDRESS: cstuarta@heacock.com INSURERS) AFFORDING COVERAGE NAIL a INSURER A: Southern -Owners Insurance Company 10190 INSURED MJCVENT-01 MJC Ventures Inc. DBA Heartland Insulation & Acoustics 225 Commercial Ct. Sebring FL 33876 INSURER B: Autc-Owners Insurance Company 18988 INSIJRERC: Fall 10/20/2010 INSURER D: $ 1.000.000 INSURER E: $ 350,050 INSIJRER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: 1573000866 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AUU1 INSD SUBR WVD(MMIDDIYYYY) POLICY NUMBER POLICY EFF PGLICY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 72101027 10120/2010 10/20/2010 EACH OCCURRENCE $ 1.000.000 DAMAGE TO TED PREMISES (Ea occurrence)l $ 350,050 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10.005 PERSONAL &ADV INJURY $ 1,000.000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS x SCHEDULED AUTOS AUTO-0WNED 1901301550 1/200230 1/20001) COMBINED SINGLE LIMIT {Ea acddent) $ 1 000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ DAMAGE Per acadent) $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 19911015:1 -10/23/2018 10/23/2319 EACH OCCURRENCE $ 1,000.000 AGGREGATE $ 1,000,000 $ DED RETENTION $ c WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N IA 15358897 5/3/2013 5/3/2013 X PER STATUTE X 0TH - ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1.000.000 E.L. DISEASE - POLICY LIMIT $ 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requi ed) CERTIFICATE HOLDER CANCELLATION City of Okeechobee 55 SE Third Avenue Okeechobee FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 10/30/2018 DBPR - RITTER, JAMES P; Doing Business As: HEARTLAND INSULATION & ACOUSTICS, Certified Building Contractor Licensee Details Licensee Information Name: Main Address: County: License Mailing: License Location : County: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business Alternate Names 10:03:42 AM 10/30/2018 RITTER, JAMES P (Primary Name) HEARTLAND INSULATION & ACOUSTICS (DBA Name) 3212 PAR ROAD SEBRING Florida 33872 HIGHLANDS 225 COMMERCIAL CT SEBRING FL 33876 HIGHLANDS Certified Building Contractor Cert Building CBC1260205 Current,Active 01/07/2015 08/31/2020 Qualification Effective 01/07/2015 View Related License Information View License Complaint 2601 Blair Stone Road, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Copyright 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public -records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. https://www.myfloridalicense.com/LicenseDetail.asp?SI D=&id=8E9A11 F07A6EE2712A81 AC608A62A0A0 1/1