Resolution 2020-31304 2020-31304
RESOLUTION NO.
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF
MIAMI BEACH, FLORIDA, APPROVING AND AUTHORIZING THE MAYOR
AND CITY CLERK TO EXECUTE AN INTERAGENCY AGREEMENT WITH
THE STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION, DIVISION OF HOTELS AND
RESTAURANTS, DELEGATING TO THE CITY THE AUTHORITY UNDER
CHAPTER 399, FLORIDA STATUTES, TO (1) ISSUE ELEVATOR
CONSTRUCTION PERMITS, TEMPORARY OPERATION PERMITS, AND
CERTIFICATES OF OPERATION; (2) PROVIDE INSPECTION OF
ELEVATORS; AND (3) ENFORCE THE ELEVATOR SAFETY CODE WITHIN
THE CITY OF MIAMI BEACH FOR ALL ELEVATORS, EXCEPT FOR
ELEVATORS OWNED BY MIAMI-DADE COUNTY; SAID AGREEMENT
HAVING AN INITIAL TERM OF TEN (10)YEARS, COMMENCING ON JULY 1,
2020, WITH ONE (1) TEN-YEAR RENEWAL TERM, TO BE EXERCISED BY
MUTUAL AGREEMENT OF THE PARTIES.
WHEREAS, Since 1990, the City of Miami Beach has been enforcing elevator inspection
laws locally, instead of Miami-Dade County, pursuant to a DBPR Interagency Agreement with
the Department of Business and Professional Regulation, Division of Hotels and Restaurants
(the"Department"); and
WHEREAS, the City issues elevator construction permits, temporary operation permits
and certificates of operation, in addition to providing elevator inspections and enforcing the
Elevator Safety Code for all elevators, except for elevators owned by Miami-Dade County,
within the City's boundaries; and
WHEREAS, the City and the Department executed the first DBPR Interagency
Agreement, effective on October 1, 1990, for an initial term of ten (10) years,.which agreement
was extended for one(1)additional renewal term of ten (10)years; and
WHEREAS, on January 19, 2011, the Mayor and City Commission adopted Resolution
No. 2011-27570, approving the current DBPR Interagency Agreement, which took effect on
November 1, 2010 and expires on June 30, 2020; and
WHEREAS, the Department has agreed to enter into a new DBPR Interagency
Agreement ("Agreement"), incorporating the same provisions contained in the current
agreement, granting the City the right to enforce the provisions of Chapter 399, Florida Statutes,
within the City of Miami Beach, except with respect to elevators owned by Miami-Dade County,
for an initial term of ten (10) years, with one (1) ten-year renewal term, to be exercised by
mutual agreement of the parties, and terminable by either party, upon providing the other party
with 180 days prior written notice; and
WHEREAS, the City Manager recommends executing the Agreement between the
Department and the City, incorporated herein by reference and attached hereto as Exhibit "1",
as it would be in the best interest of the City to continue enforcing elevator inspection laws on a
local level by the City of Miami Beach Building Department, instead of by Miami-Dade County.
NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY
COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City
Commission hereby approve and authorize the Mayor and City Clerk to execute an Interagency
Agreement with the State of Florida, Department of Business and Professional Regulation,
Division of Hotels and Restaurants, delegating to the City the authority under Chapter 399,
Florida Statutes, to (1) issue elevator construction permits, temporary operation permits, and
certificates of operation; (2) provide inspection of elevators; and (3) enforce the elevator safety
code within the City of Miami Beach for all elevators, except for elevators owned by Miami-Dade
County; said Agreement having an initial term of ten (10) years, commencing on July 1, 2020,
with one (1)ten-year renewal term, to be exercised by mutual agreement of the parties.
PASSED and ADOPTED this '� F day of .J��"E , 2020.
•
: CORP RATED
Dan Gelber, Mayor
ATTEST: ;^�'�cH 22 `",^"�=
c_____3 ,„
Rafa" E. Granado, City Clerk
APPROVED AS TO
FORM & LANGUAGE
&F R E ELUTION
City Attorney -� p�Dote
Resolutions -
MIAMI BEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and Members of the City Commission
FROM: Jimmy L. Morales, City Manager
DATE: June 24,2020
SUBJECT:A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY
OF MIAMI BEACH, FLORIDA, APPROVING AND AUTHORIZING THE
MAYOR AND CITY CLERK TO EXECUTE AN INTERAGENCYAGREEMENT
WITH THE STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION, DIVISION OF HOTELS AND
RESTAURANTS, DELEGATING TO THE CITY THE AUTHORITY UNDER
CHAPTER 399, FLORIDA STATUTES, TO (1) ISSUE ELEVATOR
CONSTRUCTION PERMITS, TEMPORARY OPERATION PERMITS, AND
CERTIFICATES OF OPERATION; (2) PROVIDE INSPECTION OF
ELEVATORS;AND (3) ENFORCE THE ELEVATOR SAFETY CODE WITHIN
THE CITY OF MIAMI BEACH FOR ALL ELEVATORS, EXCEPT FOR
ELEVATORS OWNED BY MIAMI-DADE COUNTY; SAID AGREEMENT
HAVING AN INITIAL TERM OF TEN (10) YEARS, COMMENCING ON JULY
1, 2020, WITH ONE (1) TEN-YEAR RENEWAL TERM, TO BE EXERCISED
BY MUTUAL AGREEMENT OF THE PARTIES.
BACKGROUND/HISTORY
Since 1990,the City of Miami Beach has been enforcing elevator inspection laws locally instead
of Miami-Dade County. The City issues elevator construction permits, temporary operation
permits and certificates of operation, in addition to providing elevator inspections and enforcing
the Elevator Safety Code for all elevators, except for elevators owned by Miami-Dade County
within the City's boundaries.
The City and the Department of Business and Professional Regulation, Division of Hotels and
Restaurants (the "Department") executed the first DBPR Interagency Agreement, effective on
October 1, 1990,for an initial term of ten(10)years, which agreement was extended for one (1)
additional renewal term of ten(10)years.
On January 19, 2011, the Mayor and City Commission adopted Resolution No. 2011-27570,
approving the current DBPR Interagency Agreement. The current DBPR Interagency
Agreement took effect on November 1, 2010 and expires on June 30, 2020.
ANALYSIS
The Department has agreed to enter into a new DBPR Interagency Agreement ("Agreement")
Page 1736 of 2046
incorporating the same provisions included in the current agreement, granting the City the right
to enforce the provisions of Chapter 399, Florida Statutes, within the City of Miami Beach,
except with respect to elevators owned by Miami-Dade County, for an initial term of ten (10)
years, with one (1) ten-year renewal term, to be exercised by mutual agreement of the parties,
and terminable by either party, upon providing the other party with 180 days prior written notice.
The new Agreement will not alter in any significant manner the existing process and organization
achieved as a result of improvements during the last 30 years and will not add costs to the
existing budget. A copy of the agreement is attached as Exhibit "1" to the Resolution, attached
hereto.
Results from the 2019 Resident Survey show that 74% of residents rated the overall quality of
City services as very satisfied/satisfied. In order to continue maintaining excellent standards in
this area, the City intents to execute an agreement for elevator permits/inspections & safety
enforcement.
CONCLUSION
The City Manager recommends that the Mayor and City Commission adopt the attached
Resolution, approving and authorizing the Mayor and City Clerk to execute the Agreement
between the Department and the City, as being in the best interest of the City to continue
enforcing elevator inspection laws on a local level by the City of Miami Beach Building
Department, instead of by Miami-Dade County.
Applicable Area
Citywide
Is this a"Residents Right Does this item utilize G.O.
to Know" item. pursuant to Bond Funds?
City Code Section 2-14?
Yes No
Legislative Tracking
Public Works
ATTACHMENTS:
Description
o Elevator Division Contract State of Fl
▪ RESO
Page 1737 of 2046
aOao - 3130 y
DBPR INTERAGENCY AGREEMENT
BETWEEN THE DEPARTMENT OF BUSINESS AND PROFESSIONAL
REGULATION,DIVISION OF HOTELS AND RESTAURANTS AND CITY OF MIAMI
BEACH FOR DELEGATION OF STATUTORY AUTHORITY TO REGULATE
AND ENFORCE ELEVATOR SAFETY
This Agreement is made and entered into this 1st day ofJu ly ,2020,by and between
the Department of Business and Professional Regulation,Division of Hotels and Restaurants,
hereinafter referred to as the DEPARTMENT,and City of Miami Beach,by and through the City
of Miami Beach Public Works,Elevator Safety Division,hereinafter referred to as the
CONTRACTOR.Pursuant to this Agreement,the CONTRACTOR shall issue elevator
construction permits,repair and alteration permits,temporary elevator open a puts and.---
certificates of operation;shall provide and conduct elevator inspections;and,shag enforce the
applicable provisions of the Florida Building Code,as required by Chapter 399,Florida Statutes,
("Elevator Safety Act");and Rule Chapter 61C-5,Florida Administrative Code,("Florida
Elevator Safety Code")on elevator equipment located in and throughout City of Miami Beach
not already subject to a contracted delegation of authority pursuant to the requirements of
Chapter 399,and Rule Chapter 6IC-S,Florida Administrative Code.In recognition of a
jurisdictional Agreement between the Department and City of Miami Beach,the City of Miami
Beach Public Works,Elevator Safety Division,will retain contracted jurisdictional authority of
equipment located in its own properties owned and/or operated by City of Miami Beach,
irrespective of location within City of Miami Beach.Contractual services shall begin,
July 1, 2020 ,or upon full execution of this Agreement,whichever is the earlier date
and services shall end on June 30,2030.
This Agreement is subject to the following provisions:
SPECIAL PROVISIONS
1) INDEPENDENT CONTRACTOR:The CONTRACTOR shall perform and render the
agreed upon services herein as an independent contractor and not as an agent,representative,
or employee of the DEPARTMENT,in a proper and satisfactory manner as determined by
the DEPARTMENT in its sole discretion.
2) INCORPORATION:This Agreement incorporates in full,as if fully set forth herein,the
provisions of the Elevator Safety Act,Florida Elevator Safety Code and Chapters 30 and 35
of the Florida Building Code,as these provisions exist and as they may be amended in the
future.
3) COMMUNICATIONS:The DEPARTMENT agrees to have open and direct lines of
communication with the CONTRACTOR,by providing DBPR staff telephone numbers to
CONTRACTOR designated personnel,and by agreeing to provide advance copies of
Industry Bulletins and Technical Advisories to the CONTRACTOR before they are
published and released to vendors,elevator contractors,license holders and other industry
stakeholders.
ilPage
b. The CONTRACTOR shall enforce the applicable provisions of the Florida
Building Code,as required by the Elevator Safety Act,Florida Elevator Safety
Code,and all other applicable and authorized elevator laws,rules and•local
ordinances,against any elevator owner or other person in violation thereof,except
as otherwise provided in this section."All enforcement activity shall be conducted
in accordance with the provisions of Chapters 120,162 and 399,Florida Statutes,
and Chapter 14-City of Miami Beach City Code and applicable Florida
Administrative Code."
The DEPARTMENT,however,shall retain all authority with respect to
professional credentials issued pursuant to Chapter 399,Florida Statutes.The
CONTRACTOR shall not issue professional credentials nor shall it enforce the
credentialing provisions of Chapter 399,Florida Statutes.The CONTRACTOR
may issue local jurisdiction summons and collect administrative fines from
credentialed persons or credentialed companies for violating the provisions of the
Elevator Safety Act and the Florida Elevator Safety Code.However,the
CONTRACTOR shall report to the DEPARTMENT all known or suspected
violations of Chapter 399,Florida Statutes,or the Florida Elevator Safety Code,
committed by holders of a DEPARTMENT issued professional credential within
thirty(30)days of discovery.
c. The CONTRACTOR shall provide the DEPARTMENT with a Monthly Activity
Report,using either of the approved forms,which are attached hereto and
incorporated by reference as Attachments"113"and"I1B".The Monthly Activity
Report shall include the number of elevator permit applications received and
issued,the number of elevator inspections and callbacks conducted,complaints
and accidents received,inspected and resolved,and the number of actions
initiated to enforce the provisions of the Elevator Safety Act and Florida Elevator
Safety Code.Such report is due to the DEPARTMENT within thirty(30)days of
the end of the month in which activity is reported.
d. The Elevator Safety Act requires that an elevator owner or representative report
any accident occurring on or in an elevator within five(5)working days of the
accident to the DEPARTMENT using an Elevator Owner Accident Report,using
either of the approved forms,which are attached hereto and incorporated by
reference as Attachments"ID"and"IID".However,if the accident occurs within
the City of Miami Beach,a copy of any accident report shall be forwarded to the
DEPARTMENT within thirty(30)days.
e. The CONTRACTOR shall maintain accurate records and documentation,
including copies of all elevator permit applications received and issued,all
elevator inspection reports issued and all elevator certificate of operation
applications received and issued,pursuant to the requirements of Section 399.13,
Florida Statutes.
3IPage
unobstructed access to the DEPARTMENTS staff or any external resource engaged
in the conversion work to merge the CONTRACTOR'S data with the
DEPARTMENT'S'Versa:Regulation'licensing data software,or any successor and
then-current licensing data management software.CONTRACTOR shall abide by the
requirements of Department Information Technology Resources and Data Access
Security,which is attached hereto and incorporated by reference as Attachment"IV".
c. The following specific electronic data is required for conversion at a minimum,for
each item specified in section 399.13,Florida Statutes,to include:elevator permit
applications,permits issued,and certificates of operation issued,and the following:
I. License information,continually maintained:City of Miami Beach
Elevator Certificate Number,prior State Serial Number,Licensee
Name,Classification Code(equivalent to state codes current at time of
migration),Mailing Street Address,Mailing Address Line 2,Mailing
Address Line 3,Location City,Location State Code,Location Zip
Code,Location County Code,Location Phone Number,License Status
Code(equivalent to state codes current at time of migration),License
Secondary Status Code(equivalent to state codes current at time of
migration),Original Date of Issue,Expiration Date,Number of
Landings,Capacity(in pounds),Travel distance(in feet),Speed Up
(feet per minute),Speed Down(feet per minute),and installing
Company and date installed.In addition:Service Contract Number and
Status:Current;Maintenance Company Name,Address,and License
Number;Beginning and Ending Date(of service contract).
2. Inspection information,maintained for the preceding five years:City
of Miami Beach Elevator Certificate Number,prior State Serial
Number,Inspection Date,Inspection Type Code(equivalent to state
codes current at time of migration),Violation Codes,Number of
Violations,Certified Elevator Inspector Number.
8) CONTRACTOR may grant variances and waivers to the Florida Elevator Safety Code,as
authorized in rule and consistent with the provisions of Chapter 120,Florida Statutes.
GENERAL PROVISIONS
1) APPROPRIATION:This is a no-cost Agreement for the DEPARTMENT.The
CONTRACTOR is responsible for all costs associated with the performance of this
Agreement.
2) CANCELLATION:This Agreement may be terminated by either party by giving one
hundred and eighty(180)days written notice of cancellation to the other party;said notice
shall be sufficient if it is delivered to the party personally or mailed by certified mail to the
mailing address as specified herein.In case of cancellation,only the costs actually accrued
Wage
6) PUBLIC DOCUMENTS:The CONTRACTOR shall allow the public and DEPARTMENT
access to all documentation relating to any action required pursuant to the provisions of this
Agreement.Failure to permit such access may result in an action to enforce disclosure
pursuant to Chapter 119,Florida Statutes,and the DEPARTMENT canceling this Agreement
by giving CONTRACTOR immediate written notice of cancellation.
7) ATLORNEY'S FEES:Except as otherwise provided by law,the parties agree to be
responsible for their own attorneys fees incurred in connection with disputes arising under
the terms of this Agreement.
•
8) DISPUTES:This Agreement shell be governed by and construed in accordance with the laws
of Florida.The CONTRACTOR agrees that venue to enforce any provision of this
Agreement shall be in Leon County,Florida.
9) NOTICE TO CONTRACTOR:The DEPARTMENT shall consider the employment by any
contractor of unauthorized aliens a violation of section 274A(e)of the Immigration and
Nationalization Act.If CONTRACTOR violates this section,the DEPARTMENT may
cancel this Agreement by giving CONTRACTOR immediate written notice of cancellation.
10) RENEWAL:This Agreement may be renewed for one additional ten-year term provided the
DEPARTMENT is satisfied with the CONTRACTOR'S performance and provided that the
CONTRACTOR notifies the DEPARTMENT in writing at least 180 days prior to expiration
of its intent to renew.
IN WITNESS WHEREOF,the parties hereto have made and executed this Agreement between
the Department of Business and Professional Regulation,Division of Hotels and Restaurants and
City of Miami Beach on the respective dates under each signature:City of Miami Beach through
its Board of City Commissioners,signing by and through its Chair or Vice Chair,or designee,
authorized to execute same by commission action,and the STATE OF FLORIDA,signing by
and through its Director,Department of Business and Professional Regulation,Division of
Hotels and Restaurants,and Secretary of the Department of Business and
Professional Regulation authorized to execute same.
•
7IPage
STATE OF FLORIDA •
STEVEN VON BODUNGEN,DIRECTOR
Department of Business and Professional Regulation
Division of Hotels and Restaurants
2601 Blair Stone Road
Tallahassee,Florida 32399-1011
Date:
Approved: -
HALSEY BESI{EARS,SECRETARY
Department of Business and Professional Regulation •
2601 Blair Stone Road
Tallahassee,Florida 32399-0750
Date:
Approved:
Approved as to Form and substance
Attorney Name,General Counsel
8 ' Page
Page 1745 of 2046
CONTRACTOR NAME CITY OF MIAMI BEACH,FLORIDA
By:
Dan Gelber, ayor
ATT
6 aj -144.12idayof ,2020
Rafae E.Granado,City Clerk
`••IKCORP RATED`
',')... A' ...;,
i,
''76-i.116x)--
APPROED AS TO
9IPage
FORM&LAN U GE
&FOR EXCUTWON
��/1 _ ¢ z4- Za
city Attorney Ar Demote
ATTACHMENTS
I. DBPR Forms
"A"—DBPR Elevator Inspection Report(Form HR 5023-003)
"B"—DBPR Monthly Activity Report
"C"—DBPR Construction Supervisor Affidavit signatory form for Certificate of
Operation
(see Supervisor of Construction attestation on Attachment A)
"D"—DBPR Elevator Owner Accident Report(Form HR 7016)
II.City of Miami Beach APPROVED DBPR EQUIVALENT Forms
(provided by the CONTRACTOR)•
"A"—City of Miami Beach Elevator Inspection Report
"B"—City of Miami Beach Monthly Activity Report
"C"—City of Miami Beach Construction Supervisor Affidavit
(similar to attestation on DBPR Attachment A)
"D"—City of Miami Beach Elevator Owner Accident Report
HI. reserved
IV. Department Information Technology Resources and Data Access Security
10IPage
Page 1747 of 2046
•
Stale of Florida Page of
INSPECTION DATE CERTIFIED ELEVAKUN TYPE OF INSPECTION TIME iN SERIAL NUMBER r
INSPECTOR ICE:Ja ELEVATOR INSPECTION REPORT .1.-
Routine
rQv Alloratlon Acceptance TIME OUT Inspection Company Name REC# 0 0 0 0 0 0
et,..
0 0 0 0 14 0 0 0 0 Callback 1 • 1 1 1 1 I t
1 1 1 1 15 i i 'i 1 Construction •
2 Z 2 2 1 2 2.
c2 •2 2 .16 2 '2' • 2' 2 • Initial Acceptance alluding Nave 3•'i•3 ' -3 3`•• 3 ;
•
•
•
PERIODIC INSPECTION OF HYDRAULIC ELEVATORS
I
I. TYPE OF INSPECTION I INSPECTION ACTION^i —!� • CITY OF MIAMI BEACH
Periodic Inspection I AP •PassPUBLIC WORKS
I Compliance Inspection JPA Partial Pass , M lA M I B EAC H ELEVATOR SAFETY DIVISION
Complaint— — Sealed + REPORT OF ELEVATOR VIOLATIONS i 1700 CONVENTION CENTER DRIVE.15T ILOOR
Other MIAMI REACH FE 334.19
E , I Accident 11 Tel 30s378aUs
Owner/Agent: / Tel.No. ! Serial NO.
•Received By: Print:
I EBL No.
Building Name: I
• Case No.
Property Address: Miami Beach,Florida j ---
Elevator Coma Inspection Company: INSPECTION DATE:
Company:
Inspector Name: CEI:No: _ _ - -
VIOLATIONS:See Reverse Side for Description - ��—"
I,Time spent in this unit
I B U•3.I.i Prisms theCar ; Start Time:
8.11.3.1 1 Marhine Room
End Time:I
8.11.1.1.3 Too-OF•Car - �-�-_---..- �j
- - I�O7�,E TQELEVATOR OWNER
8 11.3.1.4 Outside the?footway ,.
8 11•3,1.5 PR ANY VIOLATIONS NOTED MUST PI CORAECIED
Wf3)IIN 90 DAYS FROM INE DATE OF IMAS
B 11.3 L6 Firefighters'Service -�— INSPECTION FAILURE BY OWNER TO COMPLY IS j
SUBJECT TO AN ADMINISTRATIVE FINS, VI+
8113.1.7 WOrkirSPlsirarml I ADDITION TO ANT O114ER PCAALTI MOVIDED
86.5.14 Pertodl[Test Cat l I BY LAW .F TIaS ELEVATOR IS OPERAre r :
UNDER A FULL SERVICE CONTU.CT, NOtIFv I
136.5 15 Periodic Test Cat 3 i YOUR ELEVATOR COMPANY IMMEDIATELY I
- - 1
j a.6.S.lti Peri0dc7estCat S A air. cls CR aPERAI:ON Wit.NOT BE
:
wet AMY
I
SSUED MATIONS NOTED LIME
5.6.1 General Requirements REEK CORRECTED.A CLEAR INSPECTION REPORT l
1.6.4 Meintensnte 14A5 RCrn etCEIVET AND THE CERTIIICATC FEES I
_. _-......---�._..._..- ...._..... ..__. .....-^ PND.
, Additional Vlolotiont/Comments
I hereby certify that the above violations have been corrected. - INIr WON!MUST BE RECEIVED Br ENE DT,OT
miAMI BEAN WORN S BUSINESS DAYS DI 1 WI I
Elevator Contractor; Title: Date: IRENE TION DAR
Owner/Developer' Title: Date:
Al 7.tb-'.013 ttiKK IpwamIbcachtl.8ov I 12018 I
•
Attachment-IIA
•
Page 1749 of 2046
1...
WITNESSING OF HYDRAULIC ELEVATORS CATEGORY 1 PERIODIC TESTS
TYPE OF INSPECTION I INSPECTION ACTION y__ ^�— CITY OF MIAMI BEACH
— Periodic Test ___ _ _AP_Pass _ PUBLIC WORKS
Partial Pass
Compliance Inspection PA ELEVATOR SAFETY DIVISION
Complaint ,Sealed REPORT OF WITNESSING OF TESTS t700 caws/mom LINTER DANE.1ST 110CM
MIAMI BEACH Ft 11539
Accident
--- Tel 105.471 T7r5
Owner/Agent: Tel.No. -
Serial No.
Received By: Print:
EBL No.
Building Name:
Property Address: Case No.
Miami Beach,Florida — —
Elevator Company: Inspection Company: INSPECTION DATE:
Inspector Name: CEI:No:
A17.1b•2013 8.6.5.14 Periodic Test Requirements—Category I _,__ r — Time spent in this unit
8.6.5.14.1 Relief Valve Setting and System Pressure Test Passed Failed N/A Start Time:
8.6.5.14.2 Cylinders and Pressure Piping _Passed Farted N/A End Time:
8.6.5.14.3(a) Normal and Final Terminal Stopping Devices Passed Failed N/A
8.6.5.14.3(b) Governors Passed Failed N/A
8.6.5.14.3(c) Safeties Passed Failed N/A •
NOTICE TO ELEVATOR Emma
8.6.5.14.3(d) Oil Buffers Passed rafted N/A
8.6.5.14.3(e) Firefighters Emergency Operation Passed Failed N/A PER CHAPTER 61C•5 FLORIDA ELEVATOR
8.6,5.14.3(1) Standby or Emergency Power Operation Passed Failed N/A SAFETY CODE, SERVICE MAINTENANCE
8.6.5.14.3(g) Power Operations of Door System Passed Failed_ N/A CONTRACT.RULE 61C-5.01312):
8.6.5.14.3(h) Emergency Terminal SpeedUmltlng Device Passed Failed N/A A SERVICE MAINTENANCE CONTRACT AS
8.6.5.14.3(h) Emergency Terminal Stopping Device Passed Failed N/A DEFINE UY SECTION379.01110).F.S. MUST
8.6.5.24.341) Low Oil Protection Operation _ Passed Failed N/A INCLUDE ROUTINE EXAMINATIONS AND
PERIODIC SAFETY TESTS AND MEET THE
8.6,5.14.4 flexible Hose and Fitting Assemblies Passed Failed N/A FOLLOWING MINIMUM REQUIREMENTS:
8.6.5.14.5 Pressure Switch Passed Failed N/A — (tl ROUTINE EXAMINATIONS SHALL BE
No Load(PSI): Full Load(PSI):Rellef(PSI): !_Y PERFORMED AT LEAST ANNUALLY.
Additional Comments: CATERORY I PERIODIC SAFETY IESTS,AS
Tests performed by: !.- •- -, DEFINED IN ASMI A17.1,AS ADOPTED BY
REFERENCE IN RULE 61C-5.001.,SHALL BE
Elevator Technician: CC:_ Date: PERFORMED ANNUALLY.
AI7.Ih-2013w v.vi.misrnihea.htl.};ct1I220182
Attachment-HA
Page 1750 of 2046
•
r-
•
PERIODIC INSPECTION OF ELECTRIC TRACTION ELEVATORS
•
TYPE OF INSPECTION _ INSPECTION ACTION E CITY OF MIAMI BEACH
Periodic Inspection AP Pass i PUBLIC WORKS
Compliance Inspection PA Partial Pass ELEVATOR SAFETY DIVISION
_ Co• mplaint Sealed •. 1700CONVENTION CENTER DRME.1ST FLOOR
• '- REPORT OF ELEVATOR VIOLATIONS warm BEACH FI 35139
Other Accident Tel,30S-67172B
T22s
Owner/Agent: Tel.No.
Serial No,
Received By: Print: EBL No.
_._.�
Building Name:
Case No,
I Property Address: Miami Beach,Florida —._..._....___- -
Elevator Company:
Inspection Company: INSPECTION DATE:
Inspector Name: CEI:No:
VIOLATIONS:See Reverse Side for Description = I Time spent in this unit
8.11.2 1 1 inside the Car _--___._._-_
Start Time:
8 11.2.3 2 MiChine ROOM
R.11.2.1 3 Too-al-Car — —'—" ' — 1 End Time.
NOTICE TO ELEVATOR OWNER
811 2 1.4 Oatde the Hoistwav
611 2 1.5 Pit ANY manes NOTED MUST BE CORRECTED
.•----_. WITIHIN PO DAYS FROM THE DATE OF THIS
8.11.2.1.6 Firatighters'Service _ — -- INSPECTION.FAILURE 8Y OWNER TO COMPLY is
suertcr TO AN AOminiSTRATIVE FINE. IN
8.11.1.1.7 working Platforms ADDITION TO ANY OTHER PENALTY PRONOEO
9V LAW. If TNA ELEVAWR IS OPERATING
8.6 4.19 Periodic Test Cat t
---- UNDER A FULL SERVICE CONTRACT. NOTIFY
YouR ELEVATOR COMPANY IMMEDIATELY
1.6.4.20 Periodic ittT Cat S A CERTIFICATE Or OPERATION WILL NOT at
ISSUED UNTIL ANY VIOLATIONS NO1E6 NAVE
6.6.1 General Requirements
ow+CORRCCTEO.A[TEAR INSPECTION REPORT
6.6.4 MAinlenanCe HAS BEEN AMMO MO THE CERTIFICATE FEES
itional Violations/Comments PAS
Add
llereb certify J--- - •---�� —_-. THLS REPORT MUST BE RECEIVED 8Y THE CrtY OF
1
y rtify that ilia have been corrected_ MIAMI BEACH w rwN S!HARNESS DAYS OF THE
Elevator Contractor: Tide: Date: INSPECTION DATE
Owner/Developer: —,_ Title: Date:
A 17.lb•2013 w•a_w.inhmib t:hR g I 12018
•
Attachment-HA
•
Page 1751 of 2046
WITNESSING OF ELECTRIC TRACTION ELEVATORS CATEGORY 1 PERIODIC TESTS
TYPE OF INSPECTION INSPECTION ACTION•SI I CITY OF MIAMI BEACH
Periodic Inspection AP I Pass f ` PUBUC WORKS
Compliance In •ection — PA I Partial Pass_ I i;'tii;\AflI B EACH ELEVATOR SAFETY DIVISION
Periodic Tests Sealed 170D CONvENTION CEN:FK DRIVE.1St FLOOR
Other: REPORT OF WITNESSING OF TESTS .RREAOAFt35110
Other: MWTH.3OS47a,72:6
Owner/Agent: Tel.No. —.Y.. . Serial No. _
Received By: Print: E
Building Name: EBL No.
Case No.
Property Address: Miami Beach,Florida -
Elevator Company: Inspection Company: INSPECTION DATE:
Inspector Name: CEI:No:
A17.1b-2013 8.8.4.19 Periodic Test Requirements—Category 1 Time spent in this unit
6.6.4.19.1 Oil Buffers
Passed Failed N/A Start Time:I i
8.6.4.19.2 Safeties — Passed Failed N/A End Time: I T
8.6.4.19.3 Governors Passed Failed N A
8_6.4.19.4 Slack-Rope Devices on Winding Drum Machines Passed _—Failed N/A
8.6.4.19.5 Normal and Final Terminal Stopping Devices Passed Failed N/A L TO ELEVaTORWINFR
8.6.4.19.6 firefighters'Emergency Operation
Passed Failed N/A
8.6.4.19.7 Standby or Emergency Power Operation Passed Palled N/A PER CHAPTER 61C-S FLORIDA ELEVATOR;
.8.6.4.19.8 Power Operation of Door System Passed Failed N/A SAFETY CODE. SERVICE MAINTENANCE
8.6.4.19.9 Broken Rope,Tape,or Cfwin Switch Passed Failed N/A CONTRACT,RULE SIC-S.013(21:
8.6.4.19.10 Written checkout procedure and E/E/PES test Passed Failed N/A A SERVICE MAINTENANCE CONTRACT AS I
8.6.4.19.11 Ascending Car Overspeed Protection and Passed Failed N/A ;DEFINE BY SECTION 399.D1(to),F.S.,MUST L,
Unintended Car Maim Devices I INCLUDE ROUTINE EIUMINATIONS AND
Unintended Car Movement Stopping Distance{in): - -' — —_. PERIODIC SAFETY TESTS AND MEET THE
FOLLOWING MINIMUM REQUIREMENTS: I
Additional Comments; (b) ROUnNE ExAMINATIQN5 SHALL BC
PERFORMED AT LEAST ANNUALLY.
CATERORY I PERIODIC SAFETY TESTS, AS
..._. ... ---.--======-.7::::: -. ..--.---- DEFINED IN ASME A17.1,AS ADOPTED DY i
Tests performed be: REFERENCE IN RULE. SIC-S 001.,SHALL Bt G
Elevator Technician; CC; Date: PERFORMED ANNUALLY. i
A I7.ib-2013 www.mirTnlheaclifl.r n 03/2018 Page 2
Attachment-IIA
)
Page 1752 of 2046
.,-...
(--
•
WITNESSING OF ELECTRIC TRACTION ELEVATORS CATEGORY 5 PERIODIC TESTS
. ........ _...
—- • - ---
!.. .TYPE OF INSPECTION INSPECTION ACTION CITY OF MIAMI BEACH i
_ •PerrodirInspection . ! AP Pass PUBLIC WORKS
, •
• ;Compliance Inspection ...,PA Partial Pass • . .. . ELEVATOR SAFETY DIVISION
. .
I,i:ii toms Niles CIN7fa tow:. ISA
0tier: r i Snaled i REPORT OF WITNESSING OF TESTS 1 •
..,tv.vi I.F.Lt.ri.11 i P':
'
le v.7./•ie:, •
Owner/Agent:_ ________ _ _ _ Tel.No. _ Serial No
Received By: Print.
• Eat No
,Building Name: i
. —
. Case No. .
Property Address Miami Beach.Floc Ida ••
.
Elevator Company:_ .__ ._ inspection Company: INSPECTION DATE:
1 •
•
Inspector Name. CEI:No: _ '
•- • , ._ .
•'
Al 7 16.2013 8.6.4.20 Periodic Test Requirements-Category 5 :: Time spent in this unit
. .. ..._ ...._ ... ....
8.6A.2011 Car and Counterweight Safeties Passed Failed N/A 1' Start Tirn
me:
.. .. _ . _
8.6
-4.2O 2 Governors Passed Faiied 14/A End Time •
_ ... .._ ... _........ ._. _...... .._ _ . ....
8.6.4 20.3 Oil Buffers Passed Failed N/A
........ . !"- " _ ....... .. . ......_..... ..........
' I
8 6A.20.4 Br ekinm g SystePassed Faded H/A. NOTICE TO ELEVATOR OWNER
. . . . .. ._.._ ... ._ _
8.6.4.20.5 Emergency and Standby Power Operation Passed Failed N/A .PER CHAPTER 611.S FLORIDA ELEVATOR
8.6.4.20.6 Emergency Terminal Stopping and Speed-Limiting Devices_ Passed _Failed .N/A SAFETY CODE. SERVICE MAINTENANCE i
Passed ialied NiA ' i CONTRACT,Ruff 61C.5.01311):
8.6:4.-20:-F;ovier-Cipeniniol Doo-r-s - •
.._.. ._ . . . ... _
86,44043 Leveliadne and Leveling Speed Passed Failed N/A A SERVICE MAIN EENANCE CONTRACT AS i
. _ ...._ ___. __._ .. _ ......
DEFINED BY SECTION 395 0410). F.S, .
Inner Landing 29ps .__ . Passed Failed N/A
. . _.....,_...... r____.
al/A miiST iNCLUM ROUUNF ExAmiNATIONS .
8,6.4.20.1o_ Emergency Stsipping Distance Passed Failed
i AND PERIODIC SAFETY TB! AND MEET I
..1.5.1.20:11 __IFmr_g_ency si.Ice.._ _Passed
_ F3iled N/A . THE FOLLOWING MINIMUM
Governor Overspeed SwitiVSpeed(ft/risks): Goverrtor Tripping Speed Ift/min). REOuIREMENYS
-
Governor Rope Pull Mu ForctlIbs) Pull Out Fru ce Ilha '
_ .. . .... ibl ROUTINE EXAMINATIONS SHALL ILL
Saf-ut ..
y Stopping Distance tin): Unintended Car Movement Stoopmg_Clistence(M) ____ PERFORMED AT LEAST ANNUALLY
..._.. .
Additional Comments: . Contract Speed(fi/min .
): CATEGORY I PERIODIC SA/En'TESE.Ai.
:DEFINED IN ASME All I.AS ADOPTED BY
7.. .......
1 REEERENCE IN RULE 61E.S.00I. FA E.
1 Tests performed by:
,SNAll BE PERFORMED EVERY EWE YEAR!.
,Elevator Technician. CC. Uate•
.. _ _. __. _ ...... ._ . . • . . . .. . • •-- • . .
A i 7.ib.20 I:I v...n.11.11.#1111,q4ct II to_ (I2(1115
. •
•
Attachment-11A
Page 1753 of 2046
ESCALATORS/MOVING WALKS INSPECTION
TYPE OF INSPECTION IN_SPECTION ACTION CITY OF MIAMI BEACH w–'
Periodic Inspection _AP Pass ~_ PUBLIC WORKS
_�
Compliance Inspection _ PA Partial Pass _ •
ELEVATOR SAFETY DIVISION
Other: Sall Sealed REPORT OF ESCALATORS/MOVING WALKS i76ticOrsVEMINnDN BEAcENrLCH FRL wSI1SrvEA.1ST FLOOR
III AMJ
Mill Other: ._ _ __. VIOLATIONS _ tel SDS.671.MS
Owner/Agent: Tel.No. ..__---
Serial No. _
Received By: Print:
Building Name: EBL No.
Property Address: Case No.
Miami Beach,Florida •--_ ..._.__ .. _.__ . .
Elevator Company: —Inspection Company: i INSPECTION DATE:
.Inspector Name: CEI:No:
i----- �..�___ _ __._._ .....___.._._.._.-..._.._....__�
VIOLATIONS:See Reverse Side for Description r-- ""---,
____.._"..�.. .._�._ ._^� e
Timspent
L_ in this unit
periodic Inspection and Test _..__.�
8.11.4.1 RIgvtrementsEsplatas and Moving Walks: Start Time:t il!
.-
8.6.8.15 PerfodicInspection atldTest
.----1I End Time.I_____
RegvirememsCategotyE: — '
�_.._ _.._ _. --.�_______........__......— NOTICE JO ESCALATOROWNEI{
8.6 MainfelianCe ANY VIOLATIONS NOTED MUST DE CORRECTED
- �.. WITHIN 10 OATS FROM THE DATE Or TIOS
I 8.6.8 Maintenance of Escalator
INSPECTION FAMINE BY OWNE6 t0 COMPLY IS
i SUbIECt TO AN AOMINISTIENIAnFINE. IN
- ADDITION TO Any omen PENALTY
PROVIDED
I 8.6.9 Maintenance of Moving Walks sr Law IF THIS ESCAIATOR/Mo%ING wMts li
"- "----'-.-' , OPERATING UNDER A FULL SERVICE CONTRACT.I
A.173 Part V Escalators NOWT YOUR ELEVATTiII COMPANY i
•
A17.3 part lismoving Walks T-- A CERTIFICATE Or OPERATION WILL NOT BE I
.�_.___._..-- •--....—__�__. ISSUED UNTIL ANY tnOtATIDNS NOTED HAVE 11
Comments BEEN=RCM,A CLEAR INSatC nom REPORT 1
f — _- — -- NAS SEEN RECEIVED AND THE CERTIFICATE FEE'it
,I hereby certify that the above violations have been corrected. THIS AEPTM T MUST BE RECENED Br THE OTTO'
I
Elevator Contractor Title:— _Dale: I MIAMI BEACH WITHIN S BUSINESS DAYS OF THE 1
i Owner/Di
elopor: Title: INSPECnoNDATE
_._..— �_....__.._.__ .... ._
A17.1b-2013 www.miamibeaciifl.pov 112018 PAGE 1 OF 2
Attachment-IIA
Page 1754 of 2046
_
ESCALATOR/MOVING WALKS TESTING REPORT
DO'S or rrisPrnoni - TYPE OF UNIT INSPECTION ACIICN :._ITEM5 TO TEST LOWER UPPER
la,
'7411111
, _ .:'71%.,. _—__— .
_-- —' � —`--
' ..... ,—_--_'-�' . = .1.'._ »' —_-- _
•
•
Attachment-11A
Page 1755 of 2046
1 �" STATE OF FLORIDA
; "� `� DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
<a _ 4' MONTHLY CONTRACTED ACTIVITY REPORT
TO: Bureau of Elevator Safety-Compliance Section
FROM: Reedy Creek Improvement District
City of Miami
X City of Miami Beach
Miami-Dade
Broward County
SUBJECT: ELEVATOR INSPECTION FOR THE MONTH OF to
1 ROUTINE/PERIODIC INSPECTIONS PERFORMED
2 PERIODIC TESTS PERFORMED Cat.1,3,5
3 INITIAL INSPECTIONS PERFORMED (FINAL)
4 CALLBACK INSPECTIONS PERFORMED
5 ALTERATION INSPECTIONS PERFORMED(FINAL)
6 CONSTRUCTION INSPECTIONS PERFORMED
7 COMPLAINT INSPECTIONS PERFORMED
8 ACCIDENT INSPECTIONS PERFORMED
9 ELEVATORS SEALED FROM PUBLIC USE
10 NEW ELEVATOR/ESCALATOR PERMITS ISSUED
11 ALTERATION PERMITS ISSUED
12 TEMPORARY OPERATION PERMITS ISSUED
13 NUMBER OF ACCIDENTS REPORTED
14 NUMBER OF COMPLAINTS REPORTED
15 NUMBER OF ELEVATORS/ESCALATORS
TOTAL INSPECTIONS( 1 THROUGH 8)
.CEI#
REPRESENTATIVE OF CONTRACTED AGENCY DATE
Attachment-IS
Page 1756 of 2046
Start G3;1.' 1?/:/2/20:9Date. .
r
'LST+-E C:F -:ORiUA
., F DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONS
rtMONTHLY CONTRACTED ACTIVITY REPORT
TO: Bureau of Elevator Safety-Compliance Section
FROM: Reedy Creek improvement District
City of Miami
X City of Miami Beach
Miami Dade
Broward County
SUBJECT: ELEVATOR INSPECTION FOR THE MONTH OF December 12/02/2019 to 12/31/2019
ITEMS INSPECTION TYPE COUNT
1 ROUTINE/PERIODIC INSPECTIONS PERFORMED 31
2 PERIODIC TESTS PERFORMED cat 1,5 26
3 INITIAL INSPECTIONS PERFORMED(FINAL) 13
4 CALLBACK INSPECTIONS PERFORMED 31
5 ALTERATION INSPECTIONS PERFORMED FINAL 2
6 CONSTRUCTION INSPECTIONS PERFORMED 13
7 COMPLAINTS INSPECTIONS PERFORMED 1
10 NEW ELEVATOR/ESCALATOR PERMITS ISSUED
11 ALTERATION PERMITS ISSUED 4
12 TEMPORARY OPERATION PERMITS ISSUED 5
15 NUMBER OF ELEVATORS/SCAI_ATORS 2402
Printed 113/2020 2:30:06 PM Page 1 of T
•
Attachment-IIB
Page 1757 of 2046
INSPECTION DATE CERTIFIEDELIrVA101r TYPE OF INSPECTION TIME IN Stale of Florida Page of SERIAL NUMBER
INSPECTOR ICED• ELEVATOR INSPECTION REPORT1.
Routine
E:. Alteration Acceptance !0; 0•: 0 : 0. 0 0. x
> TIME OUT Inspection Company Name REC#
0 :0 :1.0 0 i1'4 ,6 0 .6 0 :Callback .i i 1 1,1 1 : 1 r
11 11 11" 1 : ;15 ;i 1,.1 I I !Construction r :2 : 2 ' 2 ' 2 .2 '2
•
0 2' 12. 2 '.!16 L 1,2 2' ,2 Initial Acceptance Building Name 3 ' ' r i
m9 3:'t,3 3' 17 3 ;13 3 , 3 ' 'Temporary Operating Attachment-IC ,I .:•'i ! a a '4.
• i.: , f� ry P 9 r
w Inspection Building Address 5 5 ,o ti'I'S I:5 v
� 'q'.. 4.:118 !ri :i4' ',1. � 4 P v -
"I 5:' ;5 '19 ,.,4: 15:' '1'I ', a:.vi��� til 1 41!tfi iY7iT.ilii i r I l-.
e •6 6 20 (i lila 6 :6' Accident city
li
� �!�I° 'i 7 I"21, 7 ,7.•;7: 17 Complaint 1 1 i � 1J::, ? ? I18
IDEFINITIONS !B;18 .;8 8i18 ',8
o. 8 ,8 :�22i 6' :8;:;8!;;8 i Compliance Monitoring i CO•FL Certified Elevator Inspector I SUPERVISOR O i- CONSTRUCTION
`I I'.11: ib'! *- 9 119
a 6; :•91 t13 :9 19. :,91;19 I • ,Industry Oversight/Audit CET•FL Corned Elevator Technician I I caddy That nor sin olavntnr rnmpany throe*I thrucouiarRaud the tanetn/r:llon or Intonation of This olovnlor
I NEC•FL Registered Llovatar Compnny 01 sue nttnchod olovutor Installation aNlduvii.
VIOLATIONS s"'""mfe CFI cera
FOR VIOLATION CODES,PLEASE GO To:www.mylorlda8conso.comldbprfbrlolovatore.htm1 Pant Raine Phone Rundlur
•
VIOLATION1 VIOLATION i VIOLATION] VIOLATION I VIOLA710NS VIOLATION• VIOLATION! Yoh ORM A ' VIOIAIIONO
•
E '0' 0' 0 E 0 U: 0 E I61 '0. 0' ;E 10 ,0 .0 ''E• 0' ;0 0 E: '0 .0' 10 1E 10 0 '0' .E. 0 0 0 F.; 0 0 0 }
H 1 1 I H 1 - 1 1 41 '1 .1 1 'H. 1 1 '1. Al '1' 1 '1 H '1 :1 1 •H 1 1 ,i H' I 1 1 H 1 1 1. O
$ 2 2 2 S2 2 2 •S 2 ,2• 2: S 2' 2 2• !S 2 '2 2 5• ••2 2- 2. S 2 2'• .2 S. 2 2 2 ' S' 2 2 ,2 U
M 3 3 3 M 3 ! 3 M 3 3 3 M 3 3 .3 ;M: 3 3 .3 M. .3 3• '3 :M; 3 3 3 M 3 :3 3 M 3 3 3
O 4 4 4 O 1 l O 4 .4 Il .O 4' ;4; 4 ;O; '•1 4 :4 :_0 4 4 4 O 4 I 4 t7 4 A p .1 4 4
LL
5 5 5" 5 5 5 5 5 •5 5 5 5 �5 L5. _5 .5 :5 5 5 5 5 5 ,5 5 5 5 5 G
-J
6 6 -•6 •6 6 6 6 6 6- •6' .6 6' :_6 -6 6 6 6 6 6 6 6 6 6 6 6 6 6
cl
7 7 / 7 7 7 7 7 7 7 7 7 •7 7. `7 7 7 7 7 7 7 7 7 7 7 7 7 z
8 8 8 fi 8 B 8 9 8 t3 8 e :6 8. 'B 8 8 8 8 8 8 8 8 8 8 8 B y
9 9 9 9 9 9 9 9 •9 9 9 9 ;9 9. 9. 9. �9 9 9 9 9 9 9 9 9 9 9
COMMENTS AND DRIEP DESCRIPTION WITH CODE CITATION CERTIFIED ELEVATOR INSPCC1OR•
I certify that i have personally performed or witnessed:
Routine inspection
Periodic tests as prescribed by ASME A17 I This device
Acceptance Inspection al now or
• altered installation as recommended _ Complies With
by the ASME A17.2 Inspectors Manual Does Not Comply With •
Violations ellen on the previous inspection Is Exempt From
report have been corrected. Section 399 15.Florida Statutes.
Installation Meets or exceeds minimum standards • Regional emergency elevator
• of Chapter 399.Florida Statutes.and Chapter 30 of the accoss'firo key requirements. .
Florida Budding Code adopted by Rule 98.3 017.
' Florida Adntlnlsirattvc Code Attachment-IA
i PERSON: RECEIVING THIS REPORT ' Signature Chic
If violations are cited.This report constitutes an Order to erred as oull ned In s.399.061(4),Florida Pass
Statutes. Violations rust be corrected within 90 days in accordance with s.399.105(4).Florida Statutes.
..• Fail Pnnt Nano: /hone Rumble
Signature lotto
• Cupluted inspuculomat lepuit at u1
Pont Name Mena Number
NOTICE TO CERTIFIED nl
submitted to the Bureau of Elevator Safety
ELEVATOR INSPECTOR within live(5)working days of inspection
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 E egJ 148 If 21441 1 1 1 11 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 11
PUBLIC WORKS--Elevator Safety Division
it.1.1k.or.v.snLion 1st FL
Midmi(3pach.;Alric!..133139
Main Line:.105-6734225
SUPERVISOR AFFIDAVIT FOR NEW CONSTRUCTION OR ALTERATION
• , _(supervisor's name), do hereby attest Ihoi
•
_(property name) constructed or loccied Cr
(property ocklress1 under Permit Number
• EVC/EVR#. . . . . .
D/MB#: was supervised by me and is in
. .
compliance with the applicable provisions of Florida Statutes, Chapter 399, the American Society of Mechanical Enginee:s
(ASME)Standard Al7 1 and the Florida Administrative Code, Chapter 61 C-S.
I represent . _ .
_. (elevator company name). Gs
..._... .
the supervisor of installation
. Elevator Certificate of Competency No - Nome of CC holder:
—
Supervisor's Signature(x) Date: . _ _
rti:5 ORKilfgAt StrThHi )0CLIAt 'tPLIP.M.D iC. THI: tLEVJVC,q :NSpicitx• •:jr.; : priGf.!
ORDER TO 1551.1E A [KIN FOP Tifi, EL.:V.41'OP1fca:RinD 1E g:ErN N6W CO'VV,R1-1,:;11.)!
n-us DOCUMENT will isc tier.; punuc wocx.5 ILE VA?CV Splf Efl"
STATE OF FLORIDA
COUNT'''.OF
•
The foregoing instrument was acknowledged before me this day of_ . ._. 20_ , by
(name or person acknowledging)
Personally Known or Produced Identification .
Type of Identification Produced .
_ .
Signature of Notary Public, State of Florida
— –
Printed Name of Notary Public, Stole of Fiona°
•
Apnl,2019
Attachment-DC
Page 1759 of 2046
••-•
DBPR HR-7016- Division of Hots. .nd Restaurants, Bureau of Elevator St' /
Elevator Owners Accident Report
Florida law requires certificate of operation holders to submit the following form to the division in the event of an elevator
accident. Failure to file this report within five workings days of the accident could result in a fine of up to$1,000.
•
SECTION 1-EQUIPMENT LOCATION
License i Elevator r Moving Walkway Accident Date (mm/dd/y
Number Escalator I Wheelchair Lift Time of Accident Hour Minute AM PM
Owner Name Business Name
, Building Address City
County r State Zip Code Phone Number
SECTION 2- SERVICE MAINTENANCE
Is the elevator or escalator under a service maintenance contract? 0 Yes ❑ No 0 Unknown
Name of Elevator Maintenance Company
Was the elevator service maintenance company notified? Most recent required test performed? Test Date
(- 7 If yes,indicate date(MM/DD/YYYY) I 6 I 1 i 3 !5
Yes No months year years
years (mm/dd/yyyy)
SECTION 3-ACCIDENT DETAILS
Brief Narrative:(attach additional sheets as necessary)
PLEASE CHECK ALL THAT APPLY
Medical Attention - Fall EBruises Entrapment C Hand =Fingers [Hair Other
Req'd -1 Y I N „Trip Cuts Arm G Leg Knee Foot E Toes ❑Torso
Other Factors: 0 Canyon ttems/Packages 0 Stroller 0 Safety issues 0 Mechanical ❑Other
Clothing/Footwear Involved: 0 Sleeves 0 Purse 0 Shoes 0 Dress/skirt 0 Pants 0 Coat 0 Other
Equipment Involved: 0 Door Open 0 Step-Stair Tread 0 Floor Leveling 0 Esc.Side Wall ❑Esc.Railing
Witnessed Activities: 0 Unsafe Rider Behavior ❑Equipment Malfunction 0 Other
•
Post Event Inspection Req'd -1 Y — N Performed by: Date
i (optimise Unit Cleared for Continued Use: Y _N [-Cleared By: I CEI# Date
SECTION 4-REPORTING SIGNATURE
Report Submitted by Date Title Current Certificate?
(print name) _ VI NL NA
Signature Phone Number Contracted Jurisdiction
•
Disclaimer: This report will assist the division in identifying ways to improve rider safety and will not be used to assign
blame or liability. Florida law requires the elevator's certificate of operation holder to submit the report to the Bureau of
Elevator Safety within 5 days of the accident. You may fill in the online form or Portable Document Format(PDF)version
of this report,save it to your hard drive and e-mail it to:dhr.elevators( mvfioridalicense.com,or you may mail the report
to:
Attachment-ID
Department of Business and Professional Regulation,
Division of Hotels and Restaurants,Bureau of Elevator Safety.
2601 Blair Stone Road
Tallahassee,FL 32399-1013
Phone:850,487.1395
2009 October 14 www.myfloridalicense.com/DBPR/elevator-safety/ , ' Page 1 of 1
Page 1760 of 2046
PUBLIC WORKS-Elevator Safety Division
I79U Cony.%mron Canter Drive,1st FL
alar,8ai i'.Ftar,ria 1;139
&iron t riii 'V.15-;7; :225
ELEVATOR OWNERS ACCIDENT REPORT
Florida low requires certificate of operut;an holders to submit tie follow.-g form to the division the edent of an eevaror occ,denr.
l Failure to fife this reFotr w•irnln:;business clays of me occident could result in a fine OF up l0 31.000 00
L —_ SECTION 1 -EQUIPMENT LOCATION --
i r License NumbercrElevator 0 Mow''Wai v.ay _
'• # ❑ Escalator - _— .0 'Wneelcnoii;,.. •
Ac c,denr D-•-• / 2'J Time of ciaeor How M,mvle ❑AM❑?M '
• Qwne!Nume g.rsiness'dome _. --- -
: Property Addles;
i Ciry. ,Caunr; I Stara —. 1.
4.:,. odc
! Phone Nurraer ti ) f• Email AddressT -- ----
SECTION 2-SERVICE MAINTENANCE
Is the elevator or escalator alder ci te•vrce maintenance:onlrocro-F 0 Yes i'•lc o�jnrr•..p,.r: •
I
None o Elevator;,Aa,ntertonce Company
- . . . ...
Was the elevator service maintenance company notifiedG Most recent required equued lest cerformed2 - lest Dare --
❑Yes ❑No if�es, ,ndicotc dote / /20 (❑ b MrH❑ i ye❑ 3 YF.❑ 5n2
0
SECTION 3-ACCIDENT DETAILS -- -
Brio?'Narr:mive (attach ocdiricro:sneers as necessar ) -- --
I
.
that a
Please check all ( b, _ _—
PP y TMecrcol Anen•icn, uire ec , - -��
t ❑Fall 0 Bruises❑Entrup'nenr 0 Hand 0 Fingers Q Hair 0 Other—,-_
• ❑►rip 0 Cuts ❑Ali:, ❑leg ❑Knee ❑Foot ❑ Toes 0 is so ~- -
Oilier Fxlors __. - --
... . . --
• ❑ Carr/on!terns/Packages ❑Stro:lar Safes issues Mechanical :trier _
, Clothing/Fcorwoot,nvolvc:! . — -
❑ skew,. Q Purse 0 Sloe:, 0 Dress/.:vin ❑Fonts['Coot ❑Other
Equipment Involved
_..__ . I
❑ Door Moen 0 Step-Star'read ❑ Fir„lieu.;rr.3 ❑ Es,.:ctct ,_-,...1,,,.,.: ii
. ❑ Escalator 3oi1in9 .. — -
Witnessed Activities 0 Un':ale Ride Behavior ❑ Equipment Maifrrnrtion ❑ r,lh-+r ..
T
Post Event Inspection Required v_s P rfcr - - _.. -
❑ e mrd By.- Dute. 2-0—
i
❑ No
I ----Unit Cleared:Or Continued.Jsu 0 'fes r `.fearer{By ' ��:h , r.,a�• r r o
SECTION 4-REPORTING SIGNATURE
Curren);•er!,'reere cf ODeration2 ❑ Yes ❑ N0 1:21 N/A I Contracted Jurrsdic4cr - - -_—
Report Suom,aed fay i Title -- Dare. / /20 —
• (Print Name) f
Srgttau,re(X) - -- _ Phone
DISCLAMIER -
I
Intl rer=o-t will av,,,.r!-e di,...*•• n.tien,;•,•ny wa.”•w•••n�•cse-:rr.rr scrkiy or..w,:nji::a triad:o assgn•o erne r,; 'robs.!. fr.::3rt w riles 1;7
ee IJr•r;,erhticQii 21 everOhon holder!J-,tic-.,11:e ir:r:_rr,mu'hg:.•I.,.r m•orr•aaU• t'utl.4 Wt.:14 il.f(Par J•XatV W:.. N•!,i
..ws.••_15
I day:of the occident Kee., a;,
a cavy et this• crr ane rrrrou 1' ,..).q1.!r'c'!r.ter .lIf -
_.il':',.or morr' rhe aadress above .
Revised 09/20:8 Attachment-IID
Page 1761 of 2046
ATTACHMENT IV
DEPARTMENT INFORMATION TECHNOLOGY RESOURCES
AND DATA ACCESS SECURITY
The Contractor shall comply with Rule 74-2, Florida Administrative Code(F.A.C.), and comply
with the following data security requirements in the event the Contractor has access to any
Department data systems or software:
a. Data Security Officer.The Contractor shall designate an appropriately skilled individual to
function as its Data Security Officer.The Data Security Officer shall act as the liaison to
the Department's Division of Technology and shall maintain an appropriate level of data
security for the information the Contractor is collecting or using in the performance of this
contract.An appropriate level of security includes submitting required access request
documents for Department approval,and tracking all contractor employees that have
access to any Departmental data system or information.The Data Security Officer shall
ensure that user access to the data system or information is timely removed for all
separated Contractor employees.The Contractor agrees to notify the Department's
assigned contract manager in writing within twenty-four(24)hours of employee
resignations or layoffs, and immediately for involuntary terminations for staff that have
access to the Department's information systems. As applicable,the Contractor shall
execute a network connection agreement that shall ensure compliance with Department
security policies prior to connection to the Departments internal network as required by
Rule 74-2, F.A.C.
b. Security Policies and Attestation:All Contractor employees who have access to
Departmental information technology systems and/or Department data shall be required to
read and comply with all appropriate Department information technology security policies
and shall sign and submit to the Department's assigned contract manager an attestation
that they have read, understood and agree to comply with each policy. Upon execution of
this contract,the Department's assigned contract manager shall provide a copy of all
appropriate Department information technology security policies to the Contractor.
c. Technology Access:The Department reserves the right, at its sole discretion,to grant
permissions for access to Department network,systems, and data. Any staff employed by
an entity under contract to the Department must be granted specific permission by the
Department for access to the Department's network, systems, and data. The Department
reserves the right to unilaterally suspend access for security reasons. Contractor
employees shall be granted access to Department information technology resources
based on the principles of least privilege" and"need to know." The Department's
assigned contract manager, in conjunction with the Department's Division of Technology,
shall conduct quarterly access reviews of the Contractor's employees to ensure that
access for separated employees was timely reported and removed.
d. Employee Background Screening: Background screening is required for all Contractor
employees hired as Information Technology workers with access to information processing
facilities, or who have system,database, developer, network,or other administrative
capabilities for systems, applications,or-servers with risk categorization of moderate or
high. The Contractor agrees to conduct Level 2 background screening for such
employees as described in s. 435.05, F.S.,and Rule 74-2, F.A.C., at the Contractor's
expense. For other Contractor employees who request access to Department data or
Revised 12/15/2016
Page 1762 of 2046
information technology systems but do not fall into the above category, the Contractor
agrees to conduct a Level 1 background screening as described in s. 110.1127 and s.
435.05, F.S., at the Contractor's expense. For each Contractor employee, the Contractor
shall sign and submit to the Department's assigned contract manager an attestation,
provided by the Department,that verifies the appropriate Level 1 or Level 2 background
screening was completed and reviewed by the Contractor, that the screening has not
revealed disqualifying information pursuant to ss.435.03(2) and(3), F.S. (for Level 1) or
ss.435.04 (2)and (3), F.S. (for Level 2), or computer-related crimes pursuant to Chapter
815, F.S.; and that the Contractor assumes responsibility for the employee's use of the
Department's data and information resources.
e. Employee Security Training:The Contractor shall provide information security awareness
training to employees with access to Department information technology resources and
data in accordance with Rule 74-2, F.A.C. Initial training shall be provided within 30 days
of contract execution or employment start date,and annually thereafter. Employees with
access to records that are exempt or confidential and exempt from public records
disclosure requirements shall be given specialized training regarding access and use of
this information. All information security awareness training materials used by the
Contractor shall be submitted to the Department's assigned contract manager upon
request. The Contractor shall maintain records of individuals who have completed initial
and annual security awareness training and shall make these records available to the
Department upon request.
f. Data Protection: Vendors, contractors,and providers employed by the Department or
acting on behalf of the Department shall comply with the Department's information
technology security policies, and employ adequate security measures to protect agency
information, applications,data, resources, and services. These measures include
protecting technology resources through physical controls such as building security and
strategic placement of computer monitors. If Department data will reside on the
Contractor's system,the Department may conduct, or request the Contractor conduct at
the Contractor's expense, an annual network penetration test or security audit of the
Contractor's system on which Department data resides. No Department data or
information shall be stored in, processed in, or shipped to offshore locations or out of the
United States of America, regardless of method, except as required by law or expressly
agreed to by the Department.
g. Data Encryption: The Contractor shall make every effort to protect and avoid unauthorized
release of any sensitive,exempt or confidential information by ensuring both data and
storage devices are encrypted. If encryption of these devices is not possible, then the
Contractor shall assure that unencrypted personal and confidential Departmental data will
not be stored on unencrypted storage devices. Remote data access shall be provided via
a trusted method such as SSL,TLS, SSH,VPN, IPSec or a comparable protocol approved
by the Department.
h. Sensitive, Exempt and Confidential Information: Vendors, contractors, and providers
• employed by the Department or acting on behalf of the Department shall protect sensitive,
exempt and confidential information from unauthorized access and use as required by the
Department's information technology security policies. Such information includes, but is
not limited to, personal information as described in ss. 501.171(g), F.S. Access to
sensitive, exempt and confidential data shall be granted to the Contractor and
subcontractors by the Department on a need to know basis. Except as required by law or
Revised 12!15/2016
Page 1763 of 2046
•
legal process and after notice to the Department,the Contractor shall not divulge to third
parties any sensitive, exempt or confidential information obtained by the Contractor or its
agents, distributors, resellers, subcontractors, officers or employees in the course of
performing contractual services.
Investiaation of Breaches:The Department shall have the right to investigate any error
attributable to the Contractor relating to access or dissemination of exempt or confidential
and exempt records, as well as any instance of lost or missing data. The Department may
take appropriate legal action as a result of such investigation.
j. Security Breach Notification:The Contractor agrees to notify the Department's assigned
contract manager as soon as possible, but no later than 3 business days following the
determination of any breach or potential breach of personal information and/or confidential
departmental data. The Contractor shall provide notice to affected parties of a security
breach in accordance with s. 501.171, F.S.
k. Equipment Sanitization:The Contractor shall enforce a procedure for sanitizing surplus or
transferred equipment to protect any sensitive or confidential Department data that may
reside on that equipment. At a minimum, the Contractor shall ensure that sanitization is
completed according to acceptable methods described in Rule 74-2, F.A.C., and provide
documentation to the Department's Division of Technology, evidencing completion of the
equipment sanitization.
I. Contract Termination: Upon contract termination or expiration, the Contractor will:
i. Copies: Submit to the Department's assigned contract manager copies of all finished
or unfinished documents,data studies, correspondence, reports and other products
prepared by or for the Contractor under this contract;submit copies of all Department
data to the Department in a format to be designated by the Department in
accordance with s. 119.0701, F.S.; shred or erase parts of any retained duplicates
containing personal information (as defined by s. 501.171, F.S.); all copies
containing personal information must be made unreadable;
ii. Originals: Retain its original records such as data required by this contract and
maintain(in confidence to the extent required by law)the Contractor's original
records in un-redacted form, until the records retention schedule expires according to
State of Florida General Records Schedule GS1-SL, and to reasonably protect such
documents and data during any pending legal hold,investigation or audit;
iii. Both copies and originals: Upon expiration of all retention schedules and legal holds,
audits or investigations,with notice to the Department,destroy all Department data
from the Contractor's systems, including but not limited to,electronic data and
documents containing personal information or other data that is confidential and
exempt under Florida public records law.
m. Subcontractors:The Contractor shall require that any entities subcontracting with the
Contractor who are granted access to Department data or information technology systems
comply with the data security requirements stated above.
•
Revised 12/15/2016
Page 1764 of 2046