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Home My WebLink AboutJVA Engineering Contractor, Inc. SECTION 00300 Adm'" 5 BID FORM Bid of JVA ~Y\3\Y)-(o1nj tor1~127c. Address q71t{; SlA) --z4 stl tFZ~ M~arn/, FL 331b5 Phone 305. 55 ~ . 5 } 1-f To furnish all materials, equipment and labor and to perform all work in accordance with the Contract Documents for construction of: sanitary sewer collection system with gravity sewer lines, manholes, WASD Lift Station and Force main; Paving, Grading, and Drainage improvements; Under grounding of certain utilities, such as FPL Power, CATV, and Telephone will require coordination with others. The installation of a new water main with services is also proposed by the City of North Miami Beach to be constructed contemporaneously, but not as a part of this contract located in the CITY OF SUNNY ISLES BEACH. To: CITY OF SUNNY ISLES BEACH 18070 Collins Avenue, Suite 250 Sunny Isles Beach, Florida 33160 The undersigned Bidder has carefully examined the Bidding Documents and the site of the proposed work and is familiar with the nature and extent of the work and any local conditions that may in any manner affect the work to be done. The undersigned Bidder agrees to do all the work and furnish all materials called for by the Bidding Documents, in the manner prescribed therein and to the standards of quality and performance established by the Engineer for the unit price amounts stated in the spaces herein provided, for each of the items or combination of items stipulated. Unit price line items shall include cost of implementing all applicable safety requirements. Bidder acknowledges that estimated quantities scheduled are approximated for the sole purpose of obtaining comparative bids for determination of the lowest responsible and responsive bidder whose bid best serves the interest of, and represents the best value to, the Owner pursuant to the criteria set forth in Section 62-8 of the City Code, and that actual quantities required may increase or decrease. Bidder further agrees that payments will be made on the basis of actual quantities placed and accepted in the construction. Bidder acknowledges that price is only a factor in determining the lowest responsible and responsive bidder. RECEiVED r" \~ J U L 0 7 2008 \; City of sunny lalee BG9Ch Office ollhe CI Clerk 05/08 00300- ] 05-4893 Atlantic Isles Roadway and Utility Improvements Bid Item Description I. General 1 Mobilization and Demobilization (< 5 %) 2 MOT, per FDOT including temporary striping and signage, barricades, barriers, arrow panels, etc. as required. Subtotal-General II. Civil A Demolition / Site Preparation 3 Asphalt pavement demolition/hauling and disposal 4 Driveway demolition/Hauling and disposal 5 Drainage structures to be removed or abandoned in place and filled with flowable fill 6 Relocate or adjust existing street signs 7 Remove power /light poles 8 Relocate existing mailboxes B Earthwork 9 Green areas in R/W, including fine grade swales and sod (between back of curb & R/W) 10 Roadway earthwork C Paving 11 Asphalt type, FC 12.7, 2.0 inches 12 8" limerock base 13 12" Stabilize sub-base material 14 Select fill 15 Driveway restoration (per detail on sheet C19) 16 Type F curb and gutter 17 Valley gutter 18 Transition curb 19 Concrete flume 20 Flare end curb 21 Pavement seam joint at bridge location D Drainage Structures and Piles 22 Curb drop inlets 23 Manhole Cover & Frame 24 Catch basin Type E 25 Catch basin Type D 26 Catch basin Type C 27 Control structures 28 Pollution retardant baffles 29 Furnish & Install 1 5" RCP drainage pipe complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and specifications) 05/08-Addendum NO.5 Estimated Quantity Unit 8.400 10,000 11,000 3,350 2,150 3,170 2,175 500 5 4 1 00300-2 Unit Price LS $ '1-f cx:o . ..:: ., LS .!- 40, DCO. - LS ~'.ODO."':' LS $ ID/sro.,:.o LS $(0 I OOO.~ LS $ 3, OQ() . -" LS $ ftJ. ooo..!-' LS $ ~, 000. ,;.' LS $ ~ I, ODD. ';:" LS $ )8, onD. :;.l SY $ 13. EQ SY $ 14.~ SY $ 4. $l CY $ ,q.':: SY $ ')3.':: LF $, \tl . ~ LF $ '5.,.:!I LF $ J 4. ~ EA $ 250. :: EA $ 400.;' LS $ IQ,OOD." 22 2 3 8 14 1 26 EA $ 3,580. ~ EA $ Q81J. ~.! EA $ 5 100.':'" EA $ 4- I S(). ; EA $ .3: , 30 . :.! LS $) 4- 000. ~ EA $ zis. ~ 770 LF $ 4 ~. ~ Estimated Total .fl) . . $ 11)/. OC() . - ~ 40 . D(1) . .;; ~Z~; 000. ~. --- J, ~3./0DO.~ $ If), 500.; . $ w, 000.; $ 3 bo.:::>.';' I. / JJ $ 'P,OOO. $ 3, 000. - $ (p1,DOD.~ $ /8, ODD. ~ $ 11:2400. - $ I 4&, SoD. $ 4t1. SCO. .:.,' $ 0~. 050. ~ $ ) /3,QSO.':'" $ 52) 60S. ~ $ bl. t:J 2.5. .:.! $ 1. '000. .:J $ ",250..;! $ I, &;00.':;" $ /01000. ' $ =t8. 7140 . .;.0 $ J I qvO . v $ IS, 300. ::z $ 33 lIJo. l.' $ 43 ~W..:- J $ 14,000.;- $ 5.8$0, " $ ~4, ~~O...:: 05-4893 Atlantic Isles Roadway and Utility Improvements Bid Estimated Item Description Quantity Unit Unit Price Estimated Total 30 Furnish & Install 18" RCP drainage pipe complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans &2.:': $ 1.0, , r;Q. !.-' and specifications) 325 LF $ 31 Furnish & Install 24" RCP drainage pipe complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and specifications) 1,650 LF ~l. ~ $ 15/, 8tO . ':,) 32 Furnish & Install 30" RCP drainage pipe complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans 130. ,;: $ Q3,lPOO. :.? and specifications) 720 LF $ 33 Ultralite Tideflex Check Valve 1 EA $ Il,OOO.> $ IZ,OOO.~ 34 Vortech-Model 5000 1 LS $ 40, coD.' $ 40, 000 . ". E Sanitary Sewer System and Force Main per WASD Standards/SDec 35 F&I 8" PVC sanitary sewer complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and Q3. ;. .... specifications) 2,340 LF $ $ Zit, " W. 36 F&I 8" DIP sanitary sewer complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and specifications) 120 LF ~ $ ", 180 . :::. 37 F&I 10" PVC sanitary sewer complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and .. 1. =1- FIO. :: IO!> . , specifications) 270 LF $ $ , 38 F&I 12" PVC sanitary sewer complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and 108. ~ specifications) 45 LF $ $ 4 . KlPO. = 39 Sanitary drop manholes 48" dia. 1 EA $ ~~SD.;> $ e,qSD. ~ 40 Core drill existing manhole #24 1 EA $ 4 1-SO. )0 $ 4 150. ". $ C;,' et:;O. ~ I 41 Sanitary manholes 48" dia. 22 EA $ lU. ~D. =' . 42 F&I 6" DIP force main complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and $ 0g.;..!- specifications) 1,150 LF $ ::J.~. ZOO. :: . 43 F&I 8" DIP force main complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and $ 1"S :: ::' specifications) 50 LF $ 3,150. 44 Miscellaneous sanitary PVC fittings $ 4. SUO . .. $ 4-. SOO. ..!:S 1 LS 45 Miscellaneous DIP valves and fittings 1 LS $ 1- SOO. ::' $ 1-.5OO.:? I 46 F&I 6" sanitary services laterals complete (including but not limited to excavation, bedding, backfill, compaction & restoration as per plans and specifications) 1,05D. .. $ {'S. IOD. :- 62 EA $ 47 F&I 6" Force main bridge crossing as per detail on 300. ;: ;J addendum (Bridge No. A) 63 LF $ $ 18'.QOO. 48 F&I 6" Force main bridge crossing as per detail on I~. 3ot>.':" addendum (Bridge No. B) 51 LF $ 300. '; $ 05/08-Addendum NO.5 00300-3 05-4893 Atlantic Isles Roadway and Utility Improvements Bid Item Description F Lift Station 49 Complete as per plans to include but not limited to labor, equipment, materials, electric, mechanical, earthwork, etc G Pavement Marking, Striping and Signage 50 18" yellow solid line 51 18" white solid line 52 24" stop bar 53 6" double yellow 54 8" white 10'-30' skip 55 8" white solid line 56 RPM amberlamber 57 RPM bluelblue 58 R5-1 (Do Not Enter) 59 R6-1 L (One Way) 60 R6-1 R (One Way) 61 R3-1 (No Right Turn) 62 R1-2 (Yield) Subtotal-Civil III. Electrical - Street Lighting 63 Furnish and install decorative light pole cost 64 Furnish and install decorative light fixture cost 65 Wiring of light fixtures 66 Copper wiring (As per Plans) 67 Furnish and install 2" schedule 40 PVC conduit to include trenching (6" x 12" deep). backfill and restoration 68 Handholes 69 Copper clad ground rods (5/8" dia x 10'L) 70 Panel & Meter Enclosure, including connection to service point Subtotal-Electrical IV. North Miami Beach Water Main Installation 71 Mobilization, General Conditions (Only for items in IV Installation of Water Main System) 72 Abandonment I Removal of Existing Water System 73 Install 8" PVC Pipe C-900 74 Install 6" PVC Pipe C-900 75 Install 4" Polyethylene Casing Pipe 76 Install 2" Polyethylene Casing Pipe 77 SS straps 78 Install Fire Hydrants 05/08-Addendum NO.5 Estimated Quantity Unit 76 290 18 122 0.50 351 85 6 3 1 3 1 1 33 33 33 16,000 4,000 33 33 1 2,560 420 85 770 10 6 00300-4 Unit Price LS $ I E6 000. :: LF $ 3. .39 LF $ 3. 19 LF $ 4. 49 LF $ 1. ~ GM $ 10.031.... LF $ I.~ EA $ v,.:'" EA $ ~. :' EA $ '2,QS.:1 EA $ ZC}S. · EA $ 2~S.:l EA $ l.~S.'" EA $ 1.'1$." EA $ 4 J SO, ':' EA $ 4. I so.;" EA $ I, 1-50.-- LF $ 3. ~ LF $ I 'Z. 49 EA $ 440.:J EA $ I 6 S. :..' LS $ \\ I ODD. ::> LS $ ]PI ODD. ;. LS LF LF LF LF EA EA , $ IS.OOO. $ ~4,::' $ Sq. :: $ 54. ;; $ l.Df. :;. $ ~,SOO.;" $ 1, 'i SO. r: Estimated Total ~ $ 19)5, COO. $ 250. ~ $ t; S':f. :: $ ?-Ct. ~ $Zfli'.~ $ t;. Oltp...:' $ C;.~~.19 $ 51O.::J. $ .3lP. p $ ggs. :J $ zt:)~:J $ ees. :> $ Z4'JS.~ $ z."'7s. ~ $ L,on 014. ?B. I $ 1,3(,.,. CfSO. ~ $ ,~/~,.::s $ S "+ ~5o. ~ $ 52:000. :: $ 4Q. (PO/). - $ '4~SlO.~ $ ~, IDS..::" $ " , 000. ;. ~ $ 20, oou. :: b $ IS. 000. $ I f.I,~. S'4V. ~ $ 24.1W. :; $ 4, se,D. ~ $ 7. z., 330 . .::- $ 2S~ 000. a $ Ilj toO.';" 05-4893 Atlantic Isles Roadway and Utility Improvements Bid Item Estimated Quantity Unit Description Unit Price 79 Install 6" Transitional Sleeve 80 Install 8" Gate Valves 81 Install 6" Gate Valves 82 Install 8" x 8" Tee 83 Install 8" x 900 Bend 84 Install 8" x 450 Bend 85 Install 8" x 22.50 Bend 86 Install 8" x 11.250 Bend 87 Install 8" x 6" Tee 88 Install 8" x 6" Reducer 89 Install 6" x 450 Bend 90 Install 6" x 22.50 Bend 91 Install 6" x 6"Tee 92 Install 6" Cap 93 Install 6" x 2" Tapped Cap 94 Install Corporation Stop Tap to 8" DIP w/Tapping Saddle 95 Install 2" RSGV 96 Install Service Connection 1" w/PVC Casing 97 Install Service Connection 1" Double w/PVC Casing 98 Install Service Connection 2" w/PVC Casing 99 Install Service Connection 2" Double w/PVC Casing 1 EA $ 1-1 DbO. ~ 6 EA $ \, SOD. ..: 1 0 EA $ r I '00.:-' 2 EA $ C,OO.':: 4 EA $ 4 ~o. ,:l 1 4 EA $ 4 SO . .. 2 EA $ 4-9). ~ 3 EA $ 4S0.:" 9 EA $ SOO. ~ 3 EA $ 415. .' 1 EA $ 400. .:: 1 EA $ 400..:' 2 EA $ 400. ~- 1 EA $ .~.sO . J' 2 EA $150.:" 2 EA $/,500.': 2 EA $ I,SOD. ~ 34 EA $ ~SO. J' 1 EA $ l. lm. ;1 6 EA $ 1.. I<;D.':' 10 EA $ '2..150. :." Subtotal - North Miami Beach Water Main Installation V. Miscellaneous 100 Contingency LS $250,000.00 VI. FPL Undergrounding 101 Allowance Account LS $500,000.00 TOTAL BASE BID (Item I Thru VI) !II ~ Thru Mil\iOYl NIY\C Hw1eh-zJ n,i1~ - h>U( 1}.,O\4St4"d 1l1yu lMnel"Uf Sl""l-N~"" DbllMS a6\d 1\1iil-f ~ I\JAb1jinnn~ ('()flh-zuJty. lnf., Written (Contractor) 05/08-Addendum No.5 00300-5 Estimated Total $ 21000.::: $ tf. 0t::D. ~ $ /1.000...... $ /, ODD.=" $ I, S'bO. ~ $ lth 300. ~ $ qoo. ~ $ / 1 ~5 o. ".. $ ~:SOD. III $ ',425.:3- $ 400.:: $ 4-00.:" $ 800. ;' $ 350. :: $ I,C;OO.;" $ ~,OCO. :- $ 3. Doo . '.! $ l8,qaJ, ~ $ I. taJ. =' $ 11,100. .) $ 21, SoD. ~ ~( $250,000.00 $500,000.00 l.t3,(H4. 3~q.lSl ~h>. 1- t ,01 (Date) 05-4893 BID SECURITY Accompanying this Bid is a certified or cashier's check or a bid bond in the amount of $ 5% of the bid made payable to the Owner which may be forfeited as liquidated damages if, in the event this proposal is accepted, the undersigned fails to execute the Agreement and furnish and pay for the required performance and payment bonds for the Owner within 10 days after acceptance of the Bid; otherwise said certified or cashier's check or bid bond will be returned to the undersigned. The undersigned Bidder agrees to commence work within 10 days after the date of written Notice to Proceed, and further agrees to substantially complete the work within 160 consecutive calendar days after the date of written Notice to Proceed, subject to such extensions of time allowed by the Conditions of the Contract. The undersigned Bidder also agrees to complete the entire work within 170 days after the Contract time commences to run. The undersigned Bidder agrees that this Bid shall be good and may not be withdrawn for a period of 60 days after the scheduled closing time for receiving bids. The undersigned further agrees to forfeit to the Owner, as liquidated damages for each calendar day elapsing between the date established as the date of final completion and the actual date of final completion of the contract work, the amount of $2,000.00 per calendar day. The Owner agrees, as a bonus for each calendar day of early completion before the date established as the date of final completion and the actual date of final completion of the contract work, the amount of $2,000.00 per calendar day. The bonus is limited to a maximum of $60,000.00. 05/08 00300-6 05-4893 ." : . . ADDENDA Bidder acknowledges the receipt of Addendum No.'s 1._,2.~,3. ~h~o1,4. c,ltD)05,5.~ Dated this ~ day of ~ UJJs. ~ (year) JVA t;~Jn-(cY10:) UJI1MJuy, ;[Y7C. 011t;(P X\AJ 24> Sf- . #l3 I M ,'am/, Pc, '33/05 I Contractor: Address: * SEAL * Attachments: Subcontractor List Bid Security Trench Safety Act documentation 05/08 END OF DOCUMENT 00300-7 05-4893 , ,. DOCUMENT 00401 BID BOND BIDDER (Name and Address): . .. . JVA Engineering Contractor, Inc::.... 9766 S.W. 24th Street, Suite 2:3 M i am i, F L 3 3 1 6 5 SURETY (Name and Address of Principal Place of Business): Travelers Casualty and Surety Company of America .One Tower Square, Hartford, CT 06183 OWNER (Name and Addressl: CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach. Florida 33160 IDQ BID DUE DATE: J un e 1 6 t h , 20 0 8. PROJECT (Brief Description including Location):-.. . Atlantic Isles Roadway. and Utility Improvements- C i t Y 0 f Sun n y I s 1 e s Be a c,h Bid No.. 0 8 - 0 6 - 0 1 BOND NUMBER: N / A DATE: (Not later than Bid Due Date): 0 6 / 1 6 -/'2 0 a8 . PENAL SUM: F i ve Per c e n t 0 f Bid (5 % 0 f Bid) C GAP r 0 j e c t No. 05--4893 IN WITNESS WHEREOF, Surety and Bidder, intending to be legally bound hereby, subject to the terms printed on the reverse si hereof, do ea.ch cause this Bid Bond to be duly executed on its behalf by its authorized officer, en , or representative. . BIDDER SURETY (rl Travelers Casualty and Surety COfl1P~ 9-'~ Ame rica... (Seal) Surety's Nape anlt COrPorate'Seal BY:' . -I ~7 4~ . Signature and Title Qlarles J. NielS2n c; .. (Attacl) Power of Attorneyyttorrey-in-Fa::t Please see enclosed Attest: Power of Attorney ," Signature and Title By: Note: Above addresses are to be used for giving required notice. Any singular reference to' I Biqder, Surely, Owner or other party shall be considered plural where applipabte; . 05/08 Final Version . ,:ri04'dj:'~f 05-4893 I. Bidder and Surety, jointly and severally, 'bind themselves, their heirs, executors. administrators, successors and assigns to pay to Owner upon default of 'Bidder any difference between the total amoullt of Bidder's bid and the total. amount of the bid of the next lowest, respOl1sible and responsive bidder as determined by Owner for the Work required by the Contract Documents, provided that: . 1.1. If there is no such next lowest, responsible and responsi\lEl bidder, and OWner does not abandon the Project. then Bidder and Surety shalt pay to Owner the penal sum set forth on the face of this Bond, and 1,2. In no event shall Bidder's and Surety's obligation llereunder exceed the penal sum sat forth on lhe face oflhis Bond. .2. Default of Bidder shall occur upon the failure of Bidder to deliver w;thin the time required by the Bidding Documents Jor any.extension thereof agreed to In writing by Owner) the ececuted Agreement required by the Bidding Documents 'fldany.'performance and payment bonds required by the aJdcling Documents and Contract Documents. . . '" .'. . . 3. ';';T~is obli9Oltion shall be null and void if: '. ::''3.C OWner accepts Bidder's bid and Bidder delivers:': within the- time required by the Bidding Documents (or any exten5iOfl thereof agreed to In writing by Owner) the executed Agreement r,equired by the Bidding Documents and' any perfQrmance and payment bonds required by the . Bidding Documents and Contract Documents. or ,5.2. All bids are rejected by Owner, or 5.3. Owner fails to issue a notice of award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by BIdder and, If applicable, consented to by Surety when required by paragrapn 5 hereof). 4. Payment under this Bond will be due and payable upon default by Bidder and within 30 calendar days after recoipt by Bidder and within 30 calendar days after receipt by Bidder and Surety of written notics of default from Owner, wIlich notice will be given. with reasonable promptnes5, identifying this Bond andtne Project and including a statement of the amount dUe. 5. Surely waives notice of and any and r.1I defenses basEld on or arising out of any time extension to issue notice _., of B'lfclrd' agreed tQin wrIting by Owner and Bidder, provided that tile total time for issuing notice of award including e~en&lons shall flot in the aggregate exceed 120 days from .' Bid Que Date without Surety's wrttten consent. 6.". . No suit or action shall be Commenced under this Bond prior ter30 calendar days after the notice of default, as required in Paragraph 4 above, Is received by Bidder and Surely and in no case laler than one year after Bid Due Date. 7. Any suit or action under this Bond shall be commenced only In a court of competent jurisdiction located in the state In which the Project is located. 8.' Notices required hereunder shall be in wrning and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery. commercial courier or by United States Registered or. .Certified Mail, return receipt requested, postage pre-paid, and shall be deemed to be effective upon re~~t ~~ttJ~ paryy concerned,,- 9. Surety shall cause to be attached to., this Bond a ,.- l:urrent' alld effective Power of Attorney evidencing the authority of the officer, agent or representative who executed this Bond on behalf of Surety to execute, seal and deliver such Bond and bind tQ_~ Surety thereby. . , .. ".10. ." Thl5 Bon~ is intended to conform to all appUcable s~utory requirements. Any, applicable requirement of any applicable statute thai has been omitted from this Bond shan .. be d~ined to be included herein as If set forth at length. If any..provision of this Bond conflicts with any applicable provision of this Bond conflicts with any applicable provision of any applicable statute, then the provision 0'1 said statutetshall govern and the remainder of this Bond that is not in conflict therewith shall continue in full force and effect. 11. The term "bid" as used herein includes a bid, offer or proposal as applicable. 05/08 Final Version 00401~2 05-4893 ~ TRAVELERSJ POWER OF ATTORNEY WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. Seahoard Surety Company SI. Paul Fire and Marine Insurance Company Attorney-In Fact No. 2]9740 St. Paul Guardian Insurance Company SI. Paul Mercury Insurance Compan~' Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company Certilicate No. 0 0 2 2 5 7 4 41 KNOW ALL MEN BY THESE PRESENTS: That Seahoard Surety Company is a corporation duly organized under the laws of the State of New Vork. that SI. Paul Fire and Marine Insuranee Company. SI. Paul Guardian Insurance Company and SI. Paul Mercury Insurance Company are corporations duly organized under the laws of the State of Minnesota. that Farmington Casualty Company. Travelers Casualty and Surety Company. and Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut. that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc. is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"). and that the Companies do herehy make. constitute and appoint Charles D. Nielson, Charles J. Nielson, Mary C. Aceves, Warren M. Alter, David R. Hoover, Gicelle Pajon, Olga Iglesias, and Gloria McClure of the City of Miami Lakes . State of F]orida . their true and lawful Attorney(s)-in-Fact. each in their separate capacity if more than one is named ahove. to sign. execute. seal and acknowledge any and all honds. recognizances. conditional undertakings and other writings ohligatory in the nature thereof on hehalf of the Companies in their business of guaranteeing the fidelity of persons. guaranteeing the performance of contracts and executing or guaranteeing honds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITN~~S WHEREOF. the CompaniJ<s have caused this instrument to be signed and their corporate seals to be hereto affixed. this lVIarch 2u08 day of ,. 11th Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Ine. Sea hoard Surety Company SI. Paul Fire and Marine Insurance Company (;,~~~ ~v., '," ,.tORPO~",,;"~ fgf _ l'"~~, \':~\ Sf: IiL /'>1 ~.~...........~"tt:>; .;~.:.,;~- State of Connecticut City of Hartford ss. SI. Paul Guardian Insurance Cml1pan~' SI. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualt~. and Surety Company of America United States Fidelit~. and Guar:lI1ty Compan~' ~/~~~~~~~~~...~ ! $:'"c.ot\poR.qri".,I"' \ \~~~:.~iA~.]) " .........0(>."/ s . ""~ "--~ By: On this the 11 th day of March 200~hcrore me personally appeared George W. Thompson. who acknowledged himself to he the Senior Vice President of Farmington Casualty Company. Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters. Inc.. Seahoard Surety Company. SI. Paul Fire and Marine Insurance Company. SI. Paul Guardian Insurance Company. SI. Paul Mercury Insurance Company. Travelers Casualty and Surety Company. Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company. and that he. as such. being authorized so to do. executed the foregoing instrument for the purposes therein contained hy signing on hehalf of the corporations hy himself as a duly authorized officer. In Witness Whereof, I hereunto set my hand and official seal. My Commission expires the 30th day of June. 20 II. 58440-5-07 Printed in U.S.A. "f{\w c. j~ '- Marie C. Tetreault. Notary Puhlie WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER I I I II SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES 1. This sworn statement is submitted to whose business address is C1~(~ Sw 14 Sf. 1hZ2> M ) (i m; PL 3~/flS I and (if applicable) its Federal Employer Identification Number (FEIN) is 46"- /Z+1&AS (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: .) 2. I understand that a "public entity crime" as defined in Paragraph 287.133(1 )(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or of the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1 )(b), Florida Statues, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere. I understand that an "affiliate" as defined in Paragraph 287.133(1 )(a), Florida Statutes, means: 4. 1. A predecessor or successor of a person convicted of a public entity crime; or 2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. I understand that a "person" as defined in Paragraph 287.133(1 )(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 05/08 Final Version 00402-1 05-4893 6. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. [Indicate which statement applies] ~ither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. ~ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. [attach a copy of the final order] I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE ON ACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOV IS F R THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 1 OF HE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQU RED 0 INF;ORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS F T E THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CA EGO ':( TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. Sworn to and subscribed before me this JWW , 20af' Personally known OR Produced identification ..,/ (Type of identification) My c~ ission expires A. 2D . ZOJ L \ J( flnmti J / () (Printed type or stamped commissioned name of notary public) ,'''''II, Jenny Fiallo ....'\.'t..'t PI.J;", 6 !i~"~"'~COMMISSION #DD76729 ~~:.~.:~hXPIRES: APR. 20, 2012 ~,:'i ~'f...l)~~ ufWW AARONNOTAR~.com ""JUl\" 11" ,.. 05/08 Final Version 00402-2 05-4893 DOCUMENT 00403 TRENCH SAFETY ACT (90-96, Laws of Florida) Bidder acknowledges that included in the appropriate bid items of the proposal and in the Total Bid Price are costs for complying with the Florida Trench Safety Act (90-96, Laws of Florida) effective October 1, 1990. The bidder further identifies the costs of such compliance to be summarized below: Trench Safety Measure (Description) A. lrtJ1J1 eu B. C. D. Unit of Measure (LFSF) LF Unit (Quantity) Unit Cost Extended Cost It/[f). - 10 Iil[).~ Total $ IO() {J.t J fi . I If applicable, the Contractor certifies that all trench excavation done within his control in excess of five feet in depth shall be in accordance with the Florida Department of Transportation's Special Provisions Article 125-1 and Subarticle 125-4.1 (TRE E VA TION SAFETY SYSTEM AND SHORING, SPECIAL - TRENCH EXCAVATION) Failure to complete the above may result in the bid being deda d no~ respon ive. Contractor agrees that the above safety compliances and cos are i c uded n his bid package. END OF DOCUMENT 05/08 Final Version 00403-1 05-4893 DOCUMENT 00420 INFORMATION REQUIRED FROM BIDDERS GENERAL INFORMATION The Bidder shall furnish the following information. Failure to comply with this requirement may cause its rejection. Additional sheets shall be attached as required. 1. Contractor's Name/Address: ( me. I 2. Contractor's Telephone Number: ,?l:JS. SS 3> . 5 J lr::J 3. Contractor's License: E 2'LI?JOD Primary Classification: f~!j'Y1ra1~ {:()r')~~" 4. Number of years as a Co ractor in construction work of the type involved in this Contract: S. 5. List the names and titles of all officers of Contractor's firm: J D5G M. AI va Y Cb-,. fJ n51(ilJ1f (lIDJds aJ/(;)'f(Jvvz.Jc P05;Ho~~ ID14\ SlJJ 3D s-\-. M"lam'l fL ??JIbS 6. Name of person who inspected site or proposed work for your firm: Name: S;[l\~Ctdo( G~W1aV7. Date of Inspection: ~ Dc\CY\ 7. What is the last project of this nature you have completed? 8. Have you ever failed to complete work awarded to you; if so, where and why? N tW 05/08 Final Version 00420-1 05-4893 9. I I I I I I I I I I I I I Th D C1 ~ ~5')1 d-h M I am j - JDSe () / i vv - (30$ (~~ B -133+ t.P> ~i~Jlhs - .Don Mttl't~ - (z,oS) 381 - wtr30 10. List the following information concerning all contracts on hand as of the date of submission of this proposal. (In case of co-venture, list the information for all co-ventures). NAME TOTAL CONTRACTED % OF CONTRACT DATE OF COMPLETION PROJECT CITY VALUE COMPLETION TO DATE " Jc:J,} '1 () w~ ~1;tWiovt tJ1, cun; ~~~JDCO . JAne- lCV8 W~!) - Z4 "wulY' Mt&in Mi am. ~~'j~~ N~v.. wot> 15~o I (Continue list on inset sheet, if necessary) 11. What equipment do you own thpt is available for the workfo? W~ OWY\ a\1 etftUpmutt 1\.Q.C.e$ti~ (,OMtJ!Jk StdPt- of-~o(1c.- ~Vy41Y\"tt\ Wu\-fi Ifnu l' I ~, ~\:) l?(.-bt, t\Sp~l t ~~vzr. ~phlH- iulW; . D \ ruhtx \ E illlV ~>{ .. . 12. What equipm~t\t will you purchase for the proposed work? NOhQ., NOTE: Attach additional sheets if required. If requested by the City, the Bidder shall furnish a notarized financial statement, references and other information, sufficiently comprehensive to permit an appraisal of his current financial condition. I I I 05/08 Final Version 00420-2 05-4893 LIST OF SUBCONTRACTORS The Bidder SHALL list below the name and address of each Subcontractor who will perform work under this Contract in excess of one-half percent of the total bid price, and shall also list the portion of the work which will be done by such Subcontractor. After the opening of Proposals, changes or substitutions will be allowed with written approval of the City of Sunny Isles Beach. Subcontractors must be properly licensed. Work to be Performed Subcontractor's Name/Address 1. E1~fvi(Cd W/J{k... --.IA Vl; I-ul Po Wet L L L . 150 ~+r.'t:>nll'e:, Ave. u saq. Cot'Z.1 bG< bU c;. Fz. 3 ~ I ~+ 2. 3. 4. 5. 6. 7. 8. 9. 10. NOTE: Attach additional sheets if required. 05/08 Final Version 00420-3 05-4893 f' MIAM..!- GZtllli CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPffiNCY Is certified under the, provisions of Chapter 10 of Miami-Dade County E221300 Exp. Date: 09/30/2009 ALVAREZ JOSE M JVA ENGINEERING CONTRAcrOR INC D.B.A.: . . 0003 0007 0009 0010 --... -9.l,JALlFYING TRADE(ID-~_______ PIPE LINE ENG PAVING ENGINEERING EXCAU & GRADING ENG LAND CLEAR &. GRUBY Herminio 1', GOhza'ez P:E. !I.. -. r 111. . ~. ~0cn:'11'lry of the Board ~ ~'() F""a""da~.gDVibuildjngCDd~ '. .' VAUD FOR CONTRACTING : , Miami-Dade County Building Code Compliance Office ' retains all property rights 10 this card, if found please maillhis card 10: BCCO 140 W Flagler SI. Suite 1603. Miami. FL 33130...' I . I ' " of MIAlIill..OADE COUi;::-; n~x COLLECTor; 140 w. FLAGLEr'! ;', .. 14th FLOOR l\!lIAM1, FL 33130 2007 LOCAL BUSINESS TAX RECEIPT 2008 MIAMI-DADE COUNTY - STATE OF FLORIDA . EXPIRES SEPT. 30, 2008 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 THIS IS NOT A BILL-DO NOT PAY FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PEAIVlIT NO. 231 492516-1 13U:j~<Jt3;E'W'ffI N'Ei{WI'~~ 9766 CORAL WAY 33165 UNIN DADE , CONTRACTOR INC COUNTY, RENEWAL CC tfICE~~~~~OO 5U1185-8 23 O\N~Vh ENGINEERING CONTRACTOR INC WORKER/S 1 , 'Sec1'Wge 'S'p~e'iAL TY ENGINEERiNG CONTRACT tll!~~ !~"" ON!.'! h l._llCI\L HW,II':E~:,~~ T^ x I1ECEIPT. IT [;n':;.~j HlJll~EHJV\IT lHE HI'II,LiEH hi VIOLt\TE ^NY r:}:I~;lINC, 011 Ill-;CUI..~\TOnY ';.'fi ll.HlINCi LAW~ Of" rtlE C(,tIN"j"V on Gl'I'Ir::~::. Non Di",rS IT Lf~EI\ilPT THE IiI!l.Of..:!1 FI.l(JM J~l\I'i lHHE8 1'1.':r;~.liIT OH L1CFi"ISf.. iil~OUlrjr:D BY LAlli. TillS IS ;'hYi A CE.FlTH'ICJ\TlON OF Ilii~: HGLOLH'S CHIAUFlC.l\- Tl()i\1 . DO NOT FORWARD JVA:ENGINEERING CONTRACTOR INC JOSE M ALVAREZ PRES 9766 SW 24 ST #23 MIAMI FL 33165 PA',' l\I:i::,NT HECc:I'/UJ r~IIJ\MHjt-\f)E COIJj\,~TY fA}: ,'",-" GTO" '1. 0/02/2007 02270019001 000082.50 . I' .i I] I' . I' . j' J; . . : i lj 81-4 I II Ii,,, III I I' /1111,111, ,illlldllll illll 1111"1,,,,1/ 1'1 j i ,{ SEE OTHER SlI ii' I II MUNICIPAL CONTRACTOR'S TAX RECEIPT MIAMI-DADE COUNTY - STATE OF FLORIDA PURSUANT TO DADE COUNTY CODE SEC. 10-24 I EXPIRES SEPT. 30, 2008 LICENSE NO. 30-5141858 CC! NO: E221300 I IS HEREBY LICENSED TO DO BUSINESS NAME / LOCATION 'THIS IS NOT A BILL-DO NOT PAY BUSINESS AS A CONTRACTOR JVA ENGINEERING CONTRACTbR INC AS SPECIFIED HEREON. 9766 CORAL WAY : OWNER :JVA ENGINEERING CONTRACTOR INC MIAMI-DADE COUNTY TAX COLLECTOR 140 W. FL.I\GLER ST. 14th FLOOR MIAMI, FL 33130 2007 2008 FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 ~-EE BACK OFu RECEIPT FOR : A LIST OF NON-PARTICIPAT~,. NG MUNICIPALITIES : I SPECIALTY ENGINEERING CONTRACT DO NOT FORWARD Receipt holder must regisler in the city where work is to be done. I JVA ENGINEERING CONTRACTOR INC JOSE M ALVAREZ PRES 9766 SW 24 ST #23 MIAMI FL 33165 PAYMENT RECEIVED MIAMI-DADE CNTY TAX COLLfj,C09f10 2/2 0 0 7 02270019002 000250.00 I . I' .'. .... ... .., .. . . .. .. 7: 0:, liilijiil.iliiiillill:ilti,liiiil!iliijiiliii;!:lirJ1J!!!iifilj ; ACORD,.. CERTIFICATE OF LIABILITY INSURANCE r DATE (MMIDDIYYYV) 06/26/2008 PRODUCER 305-222-9001 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MORGAN INSURANCE GROUP INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 13155 SW 42ND ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. #107 MIAMI, FL 33175 INSURERS AFFORDING COVERAGE NAIC# ._..__..__...._. __.....n__n_.nn____.n__n______ 1-- .- INSURED INSURERA SCOTTSDALE INS COMPANY ___.._.__...___.______n_ JVA ENGINEERING CONTRACTOR INC INSURERB PROGRESSIVE INS COMPANY _. . 9766 SW 24 ST #23 INSURERC TECHNOLOGY INS CO __0.__.__--..------------ MIAMI FL 33165 INSURER D. ------- I INSURER E: COVERAGES I THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MA Y PERTAIN, THE INSUPANCr: AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SlIBJECT TO All. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO CLAIMS INSR ~~~L _n ____.n_.__n..___n_n___._. .._ _._......__. ono __ _.. U__ _ _._n_.________ --.-- ----_._-------~~-_.__._- LTR T POLICY NUMBER POLICY EFFEC Qlr POLICY EXPIRA ~~~N LIMITS ~NERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY CLS1373052 6-1-08 G-1-09 PREMISES (Ea occurence\ $ 100,000 I CLAIMS MADE W OCCUR MED EXP (Anyone person) $ 5,000 f-- ~ERSONAL & ADV INJURY $ 2,000,000 f-- GENERAL AGGREGATE $ 2,000,000 n'L AGGREAE LIMIT APPLIES PER: PRODUCTS) COMP/OP AGG $ 2,000,000 POLICY P'[}!?~ n LOC B ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ $1,000,000 ~ ANY AUTO 03600947-1 6/26/08 6/26/09 (Ea accident) --- ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - - HIRED AUTOS BODIL Y INJURY I (Per accident) $ "- NON,OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) ~AGE LIABILITY AUTO ONLY, EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONL Y: AGG $ ~ESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 A X OCCUR D CLAIMS MADE XLS0044031 6-1-08 6-1-09 AGGREGATE $ 5,000,000 $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I WCSTATU, I 10TH, TORY LIMITS ER C EMPLOYERS' LIABILITY TWC3125021 12-13-01 12-13-08 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ I OFFICERIMEMBER EXCLUDED? E.L. DISEASE) EA EMPLOYEE $ 1,000,000 If yes. describe under 1,000,000 SPECIAL PROVISIONS below E.L. DISEASE, POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCA nONS I VEHICLES I EXCLUSIONS ADDEO BY ENOORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS ALSO ADD'L INSURED I , , CERTIFICATE HOLDER CANCELLATION CALVIN, GIORDANO & ASSOCIATES, INC. ENGINEERS, PLANNERS, & SURVEYORS 1800 ELLER DRIVE SUITE 600 FT. LAUDERDALE, FL 33316 I I ACORD 25 (2001/08) SHOULD ANY OF TIlE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA TION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTA TlVES, AUTHORIZED REPRESENTATIVE 'Do:;;&81t~ , ACORD CORPORATION 1988 ACORDT/A CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYVY) 06/26/2008 PRODUCER 305-222-9001 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MORGAN INSURANCE GROUP INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 13155 SW 42ND ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. #107 MIAMI, FL 33175 INSURERS AFFORDING COVERAGE NAIC# -- -- INSURED INSURER A SCOTTSDALE INS COMPANY JVA ENGINEERING CONTRACTOR INC INSURER B: PROGRESSIVE INS COMPANY 9766 SW 24 ST #23 INSURER C: TECHNOLOGY INS CO MIAMI FL 33165 INSURER D. I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AJ~~~ - - -- POllCYEFFECTIV"[-- POLICVEXPlRATION --.-----.--.lIMITS LTR POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A f--- CLS1373052 6-1-08 6-1-09 ~REM;Sh rEa occurencel L ~MERCIAL GENERAL LIABILITY $ 100,000 CLAIMS MADE W OCCUR MED EXP (Anyone person) $ 5,000 - PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 - GEN'L AGGREGA TE LIMIT APPLIES PER: PRODUCTS, COMP/OP AGG $ 2,000,000 I POLICY n P,f;-p{ n LOC B ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ $1,000,000 ~ ANY AUTO 03600947-1 6/26/08 6/26/09 (Ea accidenl) - ALL OWNED AUTOS BODIL Y INJURY (Per person) $ - SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY $ NON,OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accidenl) GARAGE LIABILITY AUTO ONLY, EA ACCIDENT $ =l ANY AUTO OTHER TH,.'\N EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 A ~ OCCUR D CLAIMS MADE XLS0044031 6-1-08 6-1-09 AGGREGATE $ 5,000,000 $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I T~fSTAT% I 10TH, T RY LIMIT ER C EMPLOYERS' LIABILITY TWC3125021 12-13-07 12-13-08 1,000,000 ANY PROPRIETORlPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICERiMEMBER EXCLUDED? , E.L. DISEASE, EA EMPLOYEE $ 1,000,000 ~~~~;iec~~~Jrs~~NS below E.L. DISEASE, POLICY LIMIT $ 1 000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER IS ALSO ADD'L INSURED I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA TION CITY OF SUNNY ISLES DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 18070 COLLINS AVE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTA TlVES. SUNNY ISLES BEACH, FL 33160 AUTHORIZED REPRESENTATIVE 1)Oil?&Z7t "ll1GMJt I ACORD 25 (2001/08) . ACORD CORPORA TION 1988