Executive Elevator Svs Agmt
CfI/v)u3 C2.J)
AGREEMENT
THIS AGREEMENT made this 10th day of September 2003, A.D. between the CITY OF
MIAMI BEACH, a Florida municipal corporation, hereinafter called the City, which
term shall include its successors and assigns, party of the one part, and
EXECUTIVE ELEVATOR SERVICE. INC
8107 N.W. 33RD STREET
MIAMI. FLORIDA 33122
hereinafter called the Contractor, which term shall include its heirs, successors and assigns, party
of the other part.
WITNESSETH that the said Contractor for the consideration and compensation herein agreed to
be paid and the said City in consideration of the construction of improvements to be done by said
Contractor and designated "ELEVATOR RENOVATION AT CITY HALL ANNEX
BUILDING, 777 17TH STREET" by said City, do hereby mutually agree as follows:
1. This Agreement shall extend to and be obligatory upon said City, its successors and
assigns, and upon said Contractor and its heirs, successors and assigns. Neither this
Agreement nor any part thereof nor any part of the Work herein contemplated, shall be
assigned or sublet, nor shall any sums of money provided to be paid to said Contractor be
assigned by said Contractor to anyone without the consent of the City Commission of
said City evidenced by its resolution.
2. The foregoing pages of this booklet, including the Notice to Contractors, the Proposal,
and the Contract Documents and such alterations as may be made in said Plans and
Specifications as therein provided for, are hereby referred to and made a part of this
Agreement and the terms and conditions set forth therein, except when in direct conflict
with this written Contract, are as much a part hereof as if copied herein. If conflicts exist
between them and this written instrument, only that part of the matter in direct conflict
herewith shall not be construed to be a part hereof.
3. The Contractor shall commence work within seven (7) days of the Notice to Proceed and
shall construct and complete in a good and workmanlike manner the materials herein
referred to, strictly in accord herewith the following:
3.1 The Contractor shall be Substantially Completed with the Work within one-
hundred and twenty (120) calendar days after the date ofthe Notice to Proceed,
and completed and ready for final payment within one hundred and fifty (150)
calendar days after the date of the Notice to Proceed.
ITB 30-02/03
Agreement Page 1 of 3
3.2 Damages - City and Contractor recognize that the City will suffer direct financial
loss if Work is not completed within the Contract times specified in paragraph 3.1
above plus any extensions thereof allowed. They also recognize the delays,
expense and difficulties involved in proving in a legal or arbitration proceeding
the actual loss suffered by Owner if the Work is not completed on time, and
therefore time is of the essence. Accordingly, instead of requiring any such proof
Contractor agrees to forfeit and pay Owner as liquidated damages for delay (but
not as a penalty) the amount of Fifty Dollars ($50.00) for each calendar day
that expires after the Contract Time specified in paragraph 3.1 for
Substantial Completion until the Work is substantially complete. After
Substantial Completion if Contractor shall neglect, refuse, or fail to complete the
remaining Work within the Contract Time, Contractor shall pay Owner Fifty
Dollars ($50.00) for each calendar day that expires after the time specified in
Paragraph 3.1 for completion and readiness for final payment. These
amounts represent a reasonable estimate of Owner's expenses for extended delays
and for inspection, engineering services and administrative costs associated with
such delay.
4. In such construction said Contractor shall furnish all implements, machinery, equipment,
transportation, tools, materials, supplies labor, and other things necessary to the execution
and completion of the Work, nothing being required of the City except that it may, at its
expense, supervise such construction and enter upon and inspect the same at all
reasonable times.
5. If any dispute arises between the City and said Contractor with reference to the meaning
or requirements of any part of this Contract and they cannot agree, the more stringent
requirements shall govern as determined by the City.
6. If the Contractor shall complete the construction herein contemplated in a good and
workmanlike manner within the time herein specified and in accord herewith, the said
City shall pay to the Contractor the contract sum in accordance with the Conditions ofthe
Contract. The City, by allowing Contractor to continue with said construction after the
time for its completion hereinbefore stated shall not deprive City of the right to exercise
any option in this Agreement contained nor shall it operate to alter any other term of this
Agreement.
7. The Contractor shall file with the Procurement Director of said City of Miami Beach a
Performance and Labor and Material Payment Bond, each in the amount of 100 percent
of Contract Amount, in the form as set forth herein or as otherwise approved by the City
of Miami Beach City Attorney and shall be executed by said Contractor and Surety Agent
authorized to do business in the State of Florida.
8. The Contractor shall file Insurance Certificates, as required, and they must be signed by a
Registered Insurance Agent licensed in the State of Florida and approved by the City of
Miami Beach Risk Manager.
ITB 30-02/03
Agreement Page 20f 3
9. All documents shall be executed satisfactorily to said City and until Bonds and Insurance
Certificates have been filed and approved, this Contract Agreement shall not be effective.
10. Owner shall pay Contractor for performance of the Work in accordance with the Contract
Documents in current funds at the lump sum or unit prices presented in the Bid Proposal,
attached to this Agreement. The parties expressly agree that the Contract Price is a
stipulated sum except with regard to the items in the Bid which are subject to unit prices.
Contract Price:
$151.875
11. The Contract Documents which comprise the entire Agreement between City and
Contractor are attached to this Agreement and made a part hereof.
The Contract Documents may only be amended, modified or supplemented as provided
in the General Conditions.
IN WITNESS WHEREOF the said City has caused this Agreement to be signed by the Mayor
of the City of Miami Beach, Florida and its corporate seal to be affixed, attested by the City
Clerk of the City of Miami Beach and the said Contractor has caused this Agreement to be
signed it its name.
(Authorized Corporate Officer)
Fi:a"k T. Wi.l.liars
~1l-i'\e m~ ~CP Trc(SEAL)
Contractor
Bl~
P.t:e:ri.d:J'I:
Title
ATTEST:
~~~
City Clerk
APPROVED AS TO
FORM & LANGUAGE
& FOR EXECUTION
~
,0-<:, - D;
Date
ITB 30-02/03
Agreement Page 30f 3
BOND # S-901-8003 PERFORMANCE BOND
(This bond meets and ex.ceeds the requirements of Florida Statutes Section 255.05)
STATE OF FLOIUDA )
ss
COUNTY OF )MIAMI DADE
KNOW ALL MEN BY THESE PRESENTS that we, EXECUTIVE ELEVATOR SERVICE. INC.
as Principal, hereinafter called Contractor, and
WASHINGTON INTERNATIONAL INSURANCE COMPANY as Surety, are firmly bound unto the City of Miami
'd ObI' h' ft II d h C' . th I f ONE HUNDRED FIFTY ONE THOUSAND EIGIIT
Beach. Flon a, as I gee, erema er ea e t e Ity, In e Pena sum 0 HlJNDRED SEVENTYFIVE AND NO/IOO
Dollars ($151,875.00 ), for the payment of which sum well and truly to be made, we bind
ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally,
firmly by these presents.
WHEREAS, Contractor, on the 10TH day of S~PTEMBER , 20~. entered into a
certain contract with the City, hereto attached, for BID# 30-02103, Entitled, "ELEV A TOR
RENOVATION AT CITY HALL ANNKX BUILDING, 77717TJl STREET" which Contract
is made a part hereof by reference thereto.
NOW, THEREFORE, THE CONDITION OF TillS OBLIGATION IS SUCH, that,
if the Contractor shall well and truly perform and fuum all the undertakings, covenants, terms,
conditions and agreements of said Contract, and all duly authorized modifications of said
Contract that may hereafter be made, notice of which modifications to the Surety being hereby
waived, then this obligation shalI be void; otherwise to remain in fulI force and effect.
WHENEVER the Principal shall be and is declared by the City to be in default under the
Contract, or whenever the Contract has been terminated by default of the Contractor, the City
having performed the City's obligations thereunder, the Surety shall:
I. Complete the Contract in accordance with its terms and conditions, or at the City's
sole option.
2. Obtain a Bid or Bids for submission to the City for completing the Contract in
accordance with its terms and conditions, and upon determination by the City and
the Surety of the lowest responsible Bidder, arrange for a Contract between such
Bidder and the City, and make available as Work progresses (even though there
should be a default or a succession of defaults under the Contract or Contracts of
completion arranged under this paragraph) sufficient funds to pay the cost of
completion less the balance of the Contract price; but nol exceeding, including
other costs and damages for which the Surety may be liable hereunder, the
amount set forth in the first paragraph hereof. The term "balance of the Contract
price" as used in this paragraph, shall mean the total amount payable by the City
to the Contractor under the Contract and any amendments thereto, less the amount
properly paid by the City to the Contractor.
ITB 30-02/03
PERFORMANCE BOND (coutd.)
No right of action shall accrue on this Bond to or for the use of any person or corporation
other than the City named herein or the successors or assignees thereof.
The Surety shall and does hereby agree to indemnify the City and hold it harmless of,
from and against any and all liability, loss, cost, damage or expense, including reasonable
attorneys fees, engineering and architectural fees or other professional services which the City
may incur or which may accrue or be imposed upon it by reason of any negligence, default, act
and/or omission on the part of the Contractor, any Subcontractor and Contractor's or
Subcontractors agents, servants and/or employees, in, about or on account of the Construction of
the work and performance of said Contract by the Contractor.
This Bond shall remain in full force and effect for such period or periods of time after the
date of acceptance of the project by the City as are provided for in the Contract Documents, and
the Contractor hereby guarantees to repair or replace for the said periods all work perfonned and
materials and equipment furnished, which were not performed or furnished according to the
terms of the Contract Documents. If no specific periods of warranty are stated in the Contract
Documents for any particular item of work, material or equipment, the Contractor hereby
guarantees the same for a minimum period of one (1) year from the date of final acceptance by
the City of the entire project.
Any suit on this bond must be instituted within such period or periods as may be provided
bylaw.
IN WITNESS WHEREOF, the above bounded parties have caused this Bond to be
executed by their appropriate officials of the 25TH day of
SEPTEMBER ,2003
lTB 30-02/03
PERFORMANCE BOND (Contd.)
WITNESS:
COUNTF.RSIGNED BY
RESID T FLORIDA
AGEN F SURETY:
(Copy of gent's current
License as Issued by State
or Florida Insurance
Commissiouer
JOHN W. CHARLTON
PRINCIPAL:
(If sole Proprietor or partnership)
(Firm Name)
BY
Title: (Sole Proprietor or Partner)
PRINCIPAL (If Corporation)
EXECUTIVE ELEVATOR SERVICE, INC.
:(~'*~ ' -
(Prcsident)FRANK T. WILLIAMS
Attest: ~~tJl-&A~
(Secre ar ARY WILLIAMS
(CORPORATE SEAL)
SURETY:
EXECUTIVE
By:
Attoroey- -factJOHN W. CHARLTON
(Power or Attorney must be attached)
ITB 30-02/03
CERTIFICATES AS TO CORPORATE PRINCIPAL
I, MARY WILLIAMS , certify that I am the Secretary ofthe Corporation named as
Principal in the foregoing bond; that FRANK T. WILLIAMS who signed the said bond on
behalf of the Principal, was then PRESIDENT of said Corporation; that I know
his signature, and his signature hereto is genuine; and that said bond was duly signed, sealed, and
attested for and in behalf of said Corporation by authority of its governing body.
Corporate
AR Y WILLIAMS Seal
STATE OF FLORIDA)
S5
COUNTY OF
)MIAMI-DADE
Before me, a Notary Public, duly commissioned, qualified and acting, personally
appeared JOHN W. CHARLTON to me well known, who being by me first duly sworn
upon oath, says that he is the Attorney-in-Fact, for the WASHINGTON INTERNATIONAL INSURANCE COMPANY and
that he has been authorized by ITS PRESIDENT to execute the foregoing
bond on behalf of the Contractor named therein in favor of the City of Miami Beach, Florida.
Subscribed and sworn before me this 25TH day of SEPTEMB~, 2~ A.D.
(Attach Power of Attorney)
CHAUNTEL GOMEZ-MONT
Chaunte' Gomez.Montes
. . _ MY COMMISSION I 00195242 EXPIRES
~. . . . March 2D, 2007
~~m;I:' 8ONDEDTHRUT1lOYFAlNtelRAIQ Ie.
My Commission Expires: MARCH 20, 2007
ITB 30-02/03
BOND # S-901-8003 LABOR AND MATERIAL PAYMENT BOND
(SECTION 255.05, FLA. STAT.)
BY THIS BOND, We,
EXECUTIVE ELEVATOR SERVICE, INC.
, as Principal, and
WASHINGTON !NTERNATIONALINSlJRANCE COMPANY as corporation, as Surety, are bound to the City of Miami
Beach, Florida, as obligee, herein called City, in the sum of $151,875.00------------------:--------
for the payment of which we bind ourselves, our heirs, personal representatives, successors and
assigns, jointly and severally.
TIlE CONDITION OF THIS BOND is that if Principal:
Promptly makes payments to all claimants, as defined in Section 255.05 (1), Fla. Stat.,
supplying Principal with labor, materials, or supplies, used directly or indirectly by
Principal in the prosecution of the work provided for in the contract; and
Pays City all losses, damages, expenses, costs, and attorney's fees, including appellate
proceedings, that Lbe City sustains in enforcement ofthis bond.
Perfonns the guarantee of all labor and materials furnished under the contract for the time
specified in the contract, then this bond is void, otherwise it remains in full force.
Any changes in or under the contract documents and compliance or noncompliance with
any fonnalitics connected with the contract or the changes does not affect Surety's
obligation under this bond.
The provisions of Section 255.05, Fla. Stal., are specifically adopted by reference and
made a part hereof for the purposes specified therein.
The contract dated SEPTEMBER 10, 2003 between the City and Principal is made a part of
this Bond by reference.
Claimants are advised that Section 255.05, Fla. Stat., contains notice and time limitation
provisions which must be strictly complied with.
ITS 30-02/03
LABOR AND MATERIAL PAYMENT BOND (contd.)
IN WITNESS WHEREOF, the above bounded parties have caused this Bond to be
executed by their appropriate officials of the 25TH day of
SEPTEMBER , 2003
WITNESS:
(Cop f Agent's current
License as issued by State
of Florida Insurance By:
Commissioner
JOHNW. CHARLTON
PRINCIPAL:
(If sole Proprietor or partnership)
(Firm Name)
BY
Title: (Sole Proprietor or Partner)
PRINCIPAL (If Corporation)
EXECUTIVE ELEVATOR SERVICE, INC.
(Corporate Name
(CORPORATE SEAL)
SURETY:
W ASHINGTO
(Power of Attorney must be att-ached)
ITIl 30-02f03
CERTIFICATES AS TO CORPORATE PRINCIPAL
I,
MARY WILLIAMS
, certify that I am the Secretary of the Corporation
named as Principal in the foregoing bond; that FRANK T. WILLIAMS who signed the said
bond on behalf of the Principal, was then PRESIDENT
of said Corporation;
that I know his signature, and his signature hereto is genuine; and that said bond was duly
signed, sealed, and attested for and in behalf of said Corporation by authority of its
governing body.
STATE OF FLORIDA)
55
COUNTY OF
) MIAMI-DADE
Before me, a Notary Public, duly commissioned, qualified and acting, personally
appeared JOHN W. CHARLTON
to me well known, who being by me first duly
sworn upon oath, says that he IS the Attorney 111 Fact, for
the WASHINGTON JNTFRNATIONAL INURANCE COMPANY
and that he has been authorized by
ITS PRESIDENT
to execute the foregoing bond on behalf of the
Contractor named therein in favor of the City of Miami Beach, Florida.
Subscribed and sworn before me this 25TH day of SFPTFMRFR , 20~
A.D.
(AU"hPowocofAUOffiOY) (l~l!~atb:J
CHAUNTEL GOMEZ-MONTES Notary P he
State of Florida-at-Large
..... 'w::,., Chauntel Gomez-Monlel
. ,''f:6\ MY COMMISS1ON I 00195242 EXPlllES
March 20. 2007
IlONI)iO lHRU TROY fAIN INSURNlCE.INC
My corrunission Expires MARCH 20, 2007
ITB 30-02/03
NAS SURETY GROUP
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a cOJ:poration duly organized and exis'ing under
laws ofthe State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International
Insurance Company, a corporation organized and existing under the laws of the State of Arizona and having its principal office in the City ofltasca,
Illinois, each does hereby make, constitute and appoint:
JOHN W. CHARLTON and D. W. MA TSON,III
jointly or severally
Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature ofa bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of:
TEN MILLION (10,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 24tl1 of March, 2000:
"RESOLVED, that any two ofthe President, any Executive Vice President, any Vice President, any Assistant Vice President, the Secretary or any
Assistant Secretary be, and each or any of them hereby is authorized tu execute a Power of Attorney qualifying the attorney named in the given Power
of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any ofthem hereby is authorized to
attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Company maybe affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached."
~,~UIIIII",,1.
t~~J.{;~~\\
~"TY' ~" 'l
i SEAL \'~
,,\\, 1m Ilfl/e a
".f.I'~"~
"-<1IO'ii'.'~'"
All"",,,'
By
Ste'ft. P. AlMlenoa, Euclltlve Vlee PmWeJlt orw...I......I.lera.ti.n.1 In.unna! c..pu)' It
VIce Pretlde.t ofNortll American SpeclaUy Inwrucc Compall}'
ac
~~~
fiJJ
* ..'[I'
...,""",
By ~J~
Paul D. AmMtz, Pratclea.t" Chid IEHUltln Omen orWa.llInp. lateraatloulluaruu:e CoIn".Y &.
Vice Pmlde.. et NOI'tIl Amnica. Spec:'-Iry luu,oec Company
IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their
official seals to be hereunto affixed, and these presents to be signed by their authorized officers this ~day of September ,20~.
North American SpecIalty Insurance Company
WashIngton Intemationallnsuranee Company
State of Illinois
County of Du Page
On this --12... day of September, 20~, before me, a Notary Public personally appeared Paul D. Amstutz , President and CEO of
Washington International Insurance Company and Vice Presiden' of North American Specialty Insurance Company and Steven P Anderson
Executive Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company,
personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrnment to be the voluntary act and deed of their respective companies.
ss:
~a.zY'~
Yasmin A. Patel, Notary Public
I, James A. Camenter ,the duly elected Assistant Secretary of North American Specialty Insurance Company and .washingt~n
International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy ofa Power of Attorney given by saId North
American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect.
IN WITNESS WHEREOF, I have set my hand and affixed the seals ofthe Companies this25th day of SEPTEMBER. 20M-.
?~~y6~
James 1\.. Catpcn1.er, V\ce PttsideN. It ^,niSbU\t Secmuy o(Wubmston 1ntcmation&IlnIurance Company It
AmI1.IUrt Secretary ofNorIh AmerlCIfl SpeciaJly Jnaurance Company
POLICYHOLDER DISCLOSURE
NOTICE OF TERRORISM INSURANCE COVERAGE
ENDORSEMENT
Coverage for acts of terrorism as defined in 9 102(1) of the Terrorism Risk Insurance
Act of 2002 ("the Act") is already included in this surety bond. You should know that,
effective November 26, 2002, under your existing coverage, any losses caused by
certified acts of terrorism would be partially reimbursed by the United States under a
formula established by federal law. Under this formula, the United States pays 90%
of covered terrorism losses exceeding the statutorily established deductible paid by
the insurance company providing the coverage. The portion of your annual premium
that is attributable to coverage for acts of terrorism is M:.
As your insurance/surety company we are sending you this notice to comply with the Terrorism Risk
Insurance Act of 2002.
For questions regarding this notice please visit our website www.nassuretv.com or you may call our
office at 630- 227.4825.
REV: 2/03 agent notice
------- -~.~--..,
I
\
\:-
A CORD,. CERTIFICA TE OF LIABILITY INSURANCE I DATE IMMfDDIYYI
9/25/03
,~ODUCER 305.443-4886 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Acordia ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Miami Division HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
3225 Aviation Ave., Ste #400
Coconut Grove, FL 33133 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Great American Insurance Co
Executive Elevator Service Inc
8107 N. W. 33rd Street INSURER 8: Bridgefield Employers Ins.Co.
Miami FL 33122 INSURER c:
INSURER 0:
I 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 DR CONDITION OF ANY CONTRACT DR OTHER DOCUMENT WITH RESPECT TO WHiCH THIS CERTIFICATE MAY BE ISSUED DR
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.
I~;: TYPE OF INSURANCE POLICY NUMBER ~<1'4~TJFFECTlVE P~~!9I:V' EXPIRATION LIMITS
A GENERAL L1ABIUTY GLP6536663 11/14/02 11/14/03 EACH OCCURRENCE $ 1000000
-
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE IAny one fire) $ 100000
I CLAIMS MADE W OCCUR MED EXP (Anyone person) $ 5000
- PERSONAL & ADV INJURY $ 1000000
- GENERAL AGGREGATE $ 3000000
~.~ AGGREn ~IMIT AP~ PER: PRODUCTS. COMP/OP AGG $ Incl.
POLICY ~~~T X LOC
AUTOMOBILE L1ABILlTY COMBINED SINGLE LIMIT
$
~ ANY AUTO lEa accidentl
ALL OWNED AUTOS ~ rrlAPe. BODILY INJURY
$
~ ~~'ffi ~'" (Per person)
HIRED AUTOS
~ 'fJf/oy BODILY INJURY $
NON-OWNED AUTOS (Per accident!
-j PROPERTY DAMAGe $
(Per accident)
~AGE LIABILITY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
pESS LIABILITY EACH OCCURRENCE $
: OCCUR 0 CLAIMS MAOE AGGREGATE $
$
~ DEOUCTIBLE $
i RETENTION $ $
B WORKERS COMPENSATION AND 83028978 4/01/03 4/01/04 X I~PW~<I IOJ,\'-
T RY 1M IT
EMPLOYERS' LIABILITY
E.l. EACH ACCIDENT $ 500 000
I E.l. DISEASe - EA EMPLOYEE $ 500.000
E.L. DISEASE - POLICY LIMIT $ 500 000
I OTHER
I
DESCRIPTION OF OPERATIONSfLOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Miami Beach named as an Additional Insured with regards to: Elevator Renovation at City Hall Annex.Rldg..
777 17th Street, BID' 30-02/03 "The Contractor hereby agrees to Indemnify and Hold Har1ll1ess the City of Miami
Beach. A Municipal Corp.. its officers. ,agents and employees frolll all reasonable claims for BI to the public in
and up to the amount of $1.000,000. for each occurence and for the reasonable damages to the property of others
in and up to $1,000.000. for each occurence per the insurance requirement under_the specifications including
costs of investigations, all expenses of litigation including reasonable attorney fees and the cost of appeals
arising out of any such. da:Lm~ or 8u~ts._B/C _of any .reason!1fl1~ .commission"of:.any:, by. the ..contractor, hiS ~ge~~8;
servents or employees, or through the mere existance of the project under contract."
CERTIFICATE HOLDER 1 -1 ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF MIAMI BEACH DATE THEREOF. THE ISSUING INSURER WIll ENDEAVOR TO MAil ~ DAYS WRITTEN
PROCUREMENT D1V/C1TY HALL NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHAll
1700 CONVENTION CENTER IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
MIAMI BEACH, FL 33139 REP~
AUTHORIZE ESENTATIVE...
,
ACORD 25.S (7197)
60-50
lil ACORD CORPORATION 1988
IMPORT ANT
If the certificate holder is an ADDITIONAL INSURED, the policy{ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement Is) .
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(sl. authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25.S (7/97)
CERTIFICATE OF INSURANCE
NCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERWISE
HATED THOUT GMNG 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT IN NO
=N~L THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE
~ NGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW.
1:81 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois, or
o STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois
has coverage in force for the following Named Insured as shown below :
Named Insured Executive Elevator Service
Address of Named Insured 8107 NW 33rd St
POLICY NUMBER
EFFECTIVE DATE OF
POLICY
DESCRIPTION OF
VEHICLE
LIABILITY COVERAGE
LIMITS OF LIABILITY
a. Bodily Injury
Each Person
a. Bodily Injury
Each Accident
b. Property Damage
c. Bodily Injury &
Property Damage
Single Limit Each
Accident
PHYSICAL DAMAGE
COVERAGES
a. Com rehensive
b. Collision
Miami, FL 33122-1005
618-5351-59
09-07-03 to 03-07-03
2000 CHEVROLET ASTRO
623-6728-59
07-01-03 to 01-01-04
2000 CHEVROLET ASTRO
I81YES DNO
YES DNO
$1,000,000.00
$1,000,000.00
YES NO
$250.00 Deductible
I8IYES DNO
$250.00 Deductible
I81YES DNO
$250.00 Deductible
YES DNO
$250.00 Deductible
569-0171.59
07.27-03 to 01.27-04
1997 GMC SAFARI
545-6505-59
07.14-03 to 01.14-04
1997 GMC SAFARI
I81YES DNO
I81YES NO
$1,000,000.00
$1,000,000.00
I81YES NO
$0.00 Deductible
I81YES DNO
$250.00 Deductible
I8IYES DNO
$0.00 Deductible
I81YES DNO
$250.00 Deductible
I81YES DNO I81YES DNO I8IYES DNO I8IYES DNO
NO DYES NO NO
Agent 1337 09125/03
Title Agent's Code Number Date
Name and Address of Certificate Holder
I
I
I
City of Miami Beach
L
~
L
Name and Address of Agent
I
James T. Bernhardt
1700 Ponce De Leon Blvd
Coral Gables, FL 33134
~
---------------------------------------------
Check if a permanent Certificate of Insurance for liability coverage is needed: D
Check if the Certificate Holder should be added as an Additional Insured: 181
Remarks: Bid # 30-02103
Elevator Renovation at City Hall Annex Building, 777 17m Street
158-4430.2 Rev. &.904 Printed in U.S.A.
CERTIFICATE OF INSURANCE
SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERWISE
T THOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT IN NO
THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE
NGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW.
~ STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois. or
o STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois
has coverage in force for the following Named Insured as shown below:
Named Insured Executive Elevator Service
Address of Named Insured 8107 NW 33rd St
POLICY NUMBER
EFFECTIVE DATE OF
POllCV
DESCRIPTION OF
VEHICLE
LIABILITY COVERAGE
LIMITS OF lIABILITV
a. Bodily Injury
Each Person
a. BodHy Injury
Each Accident
b. Property Damage
c. Bodily Injury &
Property Damage
Single limit Each
Accident
PHYSICAL DAMAGE
COVERAGES
a. Com rehensive
b. Collision
Miami, FL 33122-1005
011-4052-59
07-28-03 to 01-28-04
2003 DODGE 83500
NO
$1,000,000.00
YES DNO
$250.00 Deductible
YES DNO
$250.00 Deductible
I
City of Miami Beach
Name and Address of Certificate Holder
L
653-0286-59
09-05-03 to 03-05-04
1993 GMC VANDURA
~YES DNO
$1,000,000.00
~VES NO
$250.00 Deductible
YES DNO
$250.00 Deductible
167-7575-59
06-20-03 to 12.20-03
650-0097-59
05-16-03 to 11-16-03
1996 GMC SAFARI
1996 GMC C1500
I:8IVES NO
~VES DNO
$1,000,000.00
$1,000,000.00
I:8IVES DNO
$250.00 Deductible
I:8IVES DNO
$250.00 Deductible
~VES NO
$250.00 Deductible
I:8IVES DNO
$250.00 Deductible
~YES DNO I:8IYES DNO ~YES DNO
DYES NO DYES NO DYES
~ Agent 1337
Title Agent's Code Number
Name and Address of Agent
James T. Bernhardt
1700 Ponce De Leon Blvd
Coral Gables, FL 33134
I
I
I
-.J
Check if a permanent Certificate of Insurance for liability coverage is needed: 0
Check if the Certificate Holder should be added as an Additional Insured: 1:81
Remarks: Bid # 30-02103
Elevator Renovation at City Hall Annex Building, 777 17'" Street
-.J
L
158.4430.2 Rev. 9-94 Printed in U.S.A.