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Contract/Turf mowing services CITY OF MIAMI BEACH PROCUREMENT DIVISION Interoffice Memorandum C(T~ (!iu ~ 6r1 --:- ~ '" -\ From: Robert Parcher City Clerk !J-- Gus Lopez, CPPO Procurement Director Date: January 17, 2003 To: Subject: CONTRACT FOR BID. 63-01102, TO PROVIDE TURF MOWING SERVICES MIAMI BEACH Five (5) copies of the above referenced Contract are attached for the Mayor's signature and execution. The insurance certificate has been approved by Risk Management and the City Attorney has approved the form and language for contract execution. Thank you for your prompt attention to this matter. //;' 9' /- /' -/ (~ ('-::~--- Gus Lopez, CPPO Procurement Director 1J ~+~ .. . PERFORMAi"iCE BOND Bond No. 100054 (This bond meets and exceeds the requirements of Florida Stalutes Section 255.05) ST ATE OF FLORIDA) ss COUNTY OF ) KNOW ALL MEN BY THESE PRESENTS that we,Sou thern Landsea Din gEn ter_l(rises Ine. as Principal, hereinafter called Contractor,\\ and' N a v ~A t n.r c; Tn c; 11 rA n r p \.nmpalLy_.a5 Surety, are firmly bound unto the City of Miami Beac , Flonda. as Obligee, hereinafter called the City, in the Penal sum orTwen t~Ei ve Tho usand ,:. Dollars ($ 25--, 000 . 00 J, for the payment of which sum well and truly to be ma ,we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, Contractor, on the 28 t h day of 0 eta b e r , 2@entered into a certain contract with the City, hereto attached, for BID NO. 63-01102, Entitled: TO PROVIDE TURF MOWING SERVICES~ which Contract is made a part hereofby reference thereto. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that, if the Contractor shall well and truly perform and fulfill all the undertakings, covenants, tenus, 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 shall be void; otherwise to remain in full 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 tenninated by default ofthe Contractor, the City having perfonned the City's obligations thereunder, the Surety shall: 1. 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 not 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 Conrract price" as used in this paragraph, shall mean the total amount payable by the City to the ContraCtor under the Contract and any amendments the:eto, less the amount properly paid by the City to the contractor. ....&~. nA/11tn1 CITY OF MIAMI BEACH l'2 BID NO: 63~1/02 J .' 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 shalt and does hereby agree to indemnify the City and hold it harmless o( 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 performed 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 (l) 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 by law. Bm NO: 63-01101 DATE: 09113101 CITY OF MIAMI BEACH 33 (. IN WITNESS WHEREOF, the above bounded parties have caused this Bond to be executed by their appropriate officials of the R j- h day of .T '" n 11 " r y , 20 -D 3 . WIT~"ESS: PRINCIPAL: (If sole Proprietor or partnership) (Finn Name) BY Title: (Sole Proprietor or Partner) PRINCIPAL (If Corporation) '~outhern Landscaping_Enterp~ises Inc. (Corporate Name) ,- BY ~ 1.114- (president) Attest: ~~ ~ c:;::: =-=~ Secretary) (CORPORATE SEAL) SURETY: (Copy of A 5 current Liceas issued by State of Florida Insurance By: Commissioner (Power of Attorney mllst be attached) BID NO: 63-01101 DATE: 09/1310Z CITY OF MIAMI BEACH 34 CERTIFICATES AS TO CORPORATE PRINCIPAL I, r;, (O(l.,'f3, tk"NC U I certify that I am the Secretary of the Corporation named as Principal in the foregoing bond; that J 1" ! v~,., rff-.. /1./ . who signed the said bond on behalf of the Principal, was then r:p ~.s~b~u~' 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. ~~~ ~orporate Seal STATE OF FLORIDA) II COU~ OF ) \ bMlwl'l-f'l) . . /" . Before me, a Notary Public, duly commissioned, qualified and acting. personally appeared &?/O~I.4 AdlAH'o to me well known, who t::.g by me first duly sworn upon oath, says that he is the Attorney-in-Fact, fo~ the jO~"'H4"" 41f1l!(;''';~of,,JJdtit~~ he has been authorized b~~ r~~... lA..IILc.irP'#I" f", of.f,..(/ ",Jil :[,40 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 .a day of JI1/o1f,l""t . 201)3 A.D. (Attach Power of Attorney) ublic State of Florida-at-Large BID NO: 63-01102 DATE: 09113102 CITY OF MIAMI BEACH 35 .. '- LABOR AND MATERIAL PAYMENT BOND (SECTION 255.05, FLA. STAT.) I Bond No. 100054 BY THIS BOND. We, Sou t he rn Land sca pin g. E_n t er pr i ses.... Igscrrincipal, and NavigatorS Insurance Company _ .<:a.s corporation, as Surety, are bound to the City of Miami Beach, Flonda, as obligee, herein called City, in the sum of $ 25,000.00 __ for the payment of which we bind ourselves, our heirs, personal representatives, successors and assigns, jointly and severally. THE 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 attorneys fees, including appellate proceedings, that the City sustains in enforcement of this 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 formalities connected with the contract or the changes does not affect Surety's obligation under this bond. The provisions of Section 255.05, Fla. Stat.. are specifically adopted by reference and made a part hereof for the purposes specified therein. October 28 2002 The contract dated . _ '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. _.-. "'1'''_ "'., l\1/n., CITY OF MIAMI BEACH NAVIGATORS INSURANCE COMPANY " LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the NA VIGA TORS INSURANCE COMPANY, a corporation organized and existing by virtue of the laws of the Stale of New Yark ("Company" or "Corporation"), does hereby nominate, constitute and appoint, John Sachanda its true and lawful Attomey(s)-in-fact to make, execute, attest, seal and deliver for and on its behalf. as surety, and as its act and deed, where required, any and all bonds. undertakings, recognizances and written obligations in the nature thereof, the penal sum of no one of which is in any event to exceed $ 500~OOO.OO. Such bonds and undertakings, when duly executed by the aforesaid Attorney(s).in-fact shall be binding upon the said Company as fully and to the same extent as if such bonds and undertakings were signed by the President and Secretary of the Company and sealed with its corporate seal. This power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company on the 7th day of June, 2002: RESOLVED, that the President, or any Vice President of the Company or any person designated by anyone of them is hereby authorized to execute Powers 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 suretyship, and that any Secretary or any Assistant Secretary of the Company be, and that each or any of them hereby is authorized to attest the execution of any such Power of Attorney, and to attach thereto the Seal of the Company, and it was FURTHER RESOLVED, that the signature of such officers and the Seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney OT certificate bearing such facsimile signatures or facsimile seal shall be thereafter valid and binding upon the Company with respect to any bond, undertaking or contract of suretyship to which it is attached. Bonds executed under this Power of Attorney may be executed under facsimile signature and seal pursuant to the following Resolution adopted by the Board of Directors of the Company on June 7, 2002. RESOLVED, that the signature of the President of this Company, and the seal of this Company may be affixed or printed on any and all bonds, undertakings. recognizances. or other written obligations thereof, on any revocation of any Power of Attorney, or on any certificate relating thereto, by facsimile, and any Power of Attorney, any revocation of any Power of Attorney, bonds, undertakings, recognizances, certificate or other written obligation, bearing such facsimile signature or facsimile seal shall be valid and binding upon the Corporation. IN WITNESS WHEREOF, the NAVIGATORS INSURANCE COMPANY has caused its corporate seal to be hereunto affixed, and these presents to be signed by its duly authorized officers this 26'" day of June, 2002. (fi~7ij;~" \{~;~i,~:-)~} ',.,,~~ BY: J1:iEN~ ~. ~& tJ~ SECRETARY Attest: STATE OF NEW YORK On this 26'" day of June, 2002, before me personally came Stanley A. GaIanski, to me known, who, being duly sworn, did depose and say: that he is President of the Company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to the aforesaid instrument is such corporate seal and was affixed thereto by order and authority of the Board of Directors of said Company; and that he executed the said instrument by like order and authority: ANGELA CONENNA Notary Public, State of New York No. 01C06029961 Qualified in Kings County Commission Expires August 30, 200'> ~~ NOTARY PUBLIC STATE OF NEW YORK COUNTY OF NEW YORK ss. I, Bradley D. Wiley, Secretary of the NAVIGATORS INSURANCE COMPANY, a corporation of the State of New York, do hereby certify that the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and that I have compared same with the original and that it is a correct transcript therefrom and oflhe whole of the original and that the said Power of Attorney is still in full force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company, at the City of New York, this 8th day of January, 2003. {~o:ft\ "'''~''~'r':;:::;;~'/ ~& CJ~ SECRETARY ,- ", .. , ", '. " . ~.. ''...'J " .' .. '. 'C' ,. '. . . " ", ~. /' ~. ,. . ...,.'" ..::.:-.. - ....-/ f' A. '1' ., " ". " ''-./' ~ ...- .. ," , . AGREEMENT THIS AGREEMENT made this 28th day of October 2001 . A.D. between the CITY OF MIAMI BEACH, a F]orida municipal corporation, hereinafter called the City, which term shall include its successors and assigns, party ofthe one part, and Southern LandscaoiDlz 10350 N. W. 55th Street Sunrise.F]orida 33]5] 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 ofthe construction of improvements to be done by said Contractor and designated "TO PROVIDE TURF MOWING SERVICES" by said City, do hereby mutually agree as follows: ]. 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 in accordance with the Mowing Schedule 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 provide Turf Mowing in accordance with Section 5.0 "Grounds, Maintenance Functions and Task" and Section 6.0, "Performance Control and Inspection", of the Contract Documents. 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. They also recognize the delays, expense and difficulties involved in proving in a 1ega] or arbitration proceeding the actual loss suffered by Owner if BID NO. 63-01/02 PAGE 1 of 4 DATE: 10/28/02 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 Two Hundred Dollars (5200.00) for eacb calendar day tbat expires after tbe Contract Time specified in Section 6.4.0 "Deficiency Notices and Liquidated Damages" until the Work is substantially complete. 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 of the 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 $25,000, 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. 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. BID NO. 63-01/02 DATE: 10/28/02 PAGE2of4 ~ 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: $96.840 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. BID NO. 63-01/02 DATE: 10/28/02 PAGE 3 of4 ~ IN WITNESS WHEREOF, the parties have set their hands and seals the day and year first above written. ATTEST: _~8 ~~~ City Clerk CONTRACTOR MUST EXECUTE THIS CONTRACT AS INDICATED BELOW. USE CORPORATION OR NONCORPORA TION FORMAT, AS APPLICABLE. [If incorporated sign below.] ATTEST: CONTRACTOR c:--"-~u-\le,<,,,lo.Jc,c~~\~fh\ .T-..c. . (Name of Corporat on By: ~~_) ~~ (Signature) -:=;-\e......c. '" \... ?C2o...r L ~ ces.'\Je---.. -\ . (Print Name and Title) -c b day of No ...J . , 20 0"2. .. ~~r~ (Corporate Seal) [If not incorporated sign below.] CONTRACTOR WITNESSES: By: (Name of Firm) (Signature) (Print Name and Title) _ day of ,20_. CITY REQUIRES FIVE (5) FULLY-EXECUTED CONTRACTS, FOR DISTRIBUTION. ._~"."" APPROVED AS TO FORM & LANGUAGE & FOR EXECUTION BID NO. 63-01102 DATE: 10/28/02 PAGE4of4 AJJ /J,f\1I1l ~ J- 17- () 3 I~ Date . ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE TO' 1/15/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION COVER ALL INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5800 W. ATLANTIC BLVD. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, MARGATE, FL 33063 INSURERS AFFORDING COVERAGE INSURED SOUTHERN LANDSCAPING ENTERPRISES INC INSURER A: BURLINGTON INSURANCE COMPANY 10350 N,W, 55TH STREET INSURER B: HARTFORD ACCIDENT & INDEMNITY COMPANY SUNRISE, FL 33351 INSURER C: INSURER 0: I INSURER E: COVERAGES THEPOLICIESOFINSURANCELlSTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLlCYPERIODINDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MA YPERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSANDCONDITIONSOFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,1,N.$i.\l TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ~NERAL LIABILITY EACH OCCURRENCE 51000000 A X COMMERCIAL GENERAL LIABILITY B0167Q514617 R.1 12/11/02 12111/03 FIRE DAMAGE IAnv one fire' 5100000 I CLAIMS MADE ~ OCCUR MED EXP (Anv on. D.,.on~ 55 000 - PERSONAL & ADV INJURY 51 000000 - GENERAL AGGREGATE 51.000.000 ~'L AGG~nE LIMIT AFlS PER PRODUCTS. COMPIOP AGG 51.000.00 POLICY ~~.9.; LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 - ANY AUTO (Eli accident) - ALL OWNED AUTOS ~ BODILY INJURY 5 - SCHEDULED AUTOS (Per penlon) - HIRED AUTOS iIII/o BODILY INJURY , 5 - NON.()WNED AUTOS (Per accld.nt~ - PROPERTY DAMAGE 5 (Per accident) ~~GE LIABILITY AUTO ONLY. EA ACCIDENT 5 ANY AUTO OTHER THAN EA ACC 5 AUTO ONLY: AGG 5 EXCESS LIABILITY EACH OCCURRENCE 5 ::]"OCCUR D CLAIMS MADE AGGREGATE 5 5 ==1 DEDUCTIBLE 5 RETENTION 5 5 WORKERS COMPENSATION AND X T,.vx~~~J.~~ I 10J~. B EMPLOYERS'lIABILITY 38WBGGA4231 03/09/02 03/09/03 5100000 E.L. EACH ACCIDENT E.L. DISEASE. EA EMPLOYE 5100000 E.L. DISEASE. POLICY LIMIT 5500,000 OTHER DESCRIPTION OF OPERATlONSILOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS LANDSCAPING CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED: CERTIFICATE HOLDER I Y I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION CITY OF MIAMI BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1700 CONVENTION CENTER DRIVE DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .llL. DAYS WRITTEN MIAMI BEACH, FL. 33939 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. AUTHOR' REP~~:~vr. (J ..---- I 7"" ACORD 2S-S 7/97 II c @ACORD CORPORATION 1988 CERTIFICATE OF INSURANCE S~CH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERWISE 'TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT IN NO E , THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE E~ C ANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. T is f!IMII t: 0 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois, or IN'URANC' ~ STATE FARM FIRE AND CASUALTY COMPANY of Bloomington,llIinois has coverage in force for the following Named Insured as shown below: Named Insured Southern Landscaping Enterprises inc Address of Named Insured 10350 NW 55 St Sunrise FI 33351 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 Limft Each Accident PHYSICAL DAMAGE COVERAGES a. Com ehensive b. Collision EMPLOYER'S NON-OWNERSHIP COVERAGE HIRED CAR COVER 132 9755-C07-59-OO1 AUG-14-02 to FEB-14-1l3 1996 TOYOTA T100 $1,000,000.00 DYES YES DNO S5oo.00 Deductible YES DNO SO.OO Deductible DYES DNO Deductible I8lVES DYES DNO DNO DYES DNO DYES DNO NO NO NO AGENT Title 6557 Agenfs Code Number 01/15/03 Date Signature of Authorized Representative I Name and Address of Certificate Holder I Name and Address of Agent I I CITY OF MIAMI BEACH 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FL 33939 L ~ ~ L 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: 0 Remarks: 158-M30.2 Rev. 9-94 Printed in U.S.A.