HomeMy WebLinkAboutSpecifications
Property & Casualty Comprehensive
Insurance
PROPOSAL SPECIFICATIONS
Request for Proposal No. 11-08-01
OF SU~
Publish Date:
07/29/2011
Pre-Proposal Conference:
Intentionally Omitted
Proposal Due and Proposal Opening Date:
08/18/2011 at 10:00 AM
Sunny Isles Beach Government Center
18070 Collins Avenue
Sunny Isles Beach, Florida 33160
SECTION 1
TABLE OF CONTENTS
Table of Contents
Legal Advertisement/Notice to Proposer
Instructions to Proposer / General Terms
Special Terms & Conditions
Scope of Work / Technical Specifications
Evaluation Process
proposal Format
Bid Form
Affidavits
Non-Collusive Affidavit
Public Entity Crimes
Equal Opportunity / Affirmative Action Statement
Conflict of Interest Statement
Dispute Disclosure Form
Anti-Kickback Affidavit
Attachments
Summary of Insurance
Declaration Pages
Claim History
Storage Tank Liability
Hull Insurance
Accident Medical Insurance
PAGE 2 OF 24
BID No. 11-08-01
Section 1
Section 2
Section 3
Section 4
Section 5
Section 6
Page 2
Page 3
Page 4
Page 12
Page 14
Page 16
Page 18
Page 20
Page 1 of 7
Page 2 of 7
Page 4 of 7
Page 5 of 7
Page 6 of 7
Page 7 of 7
A
B
C
D
E
F
LEGAL ADVERTISEMENT
NOTICE TO PROPOSER
NOTICE IS HEREBY GIVEN that the City of Sunny Isles Beach is seeking sealed Bids for the following
work as specified.
Property &. Casualty Comprehensive Insurance
Request for proposal No. 11-08-01
The Bid Specifications for this Invitation to Bid are available from DemandStar by calling (800) 711-
1712 or by accessing their website at www.demandstar.com. The Bid Specifications may also be
examined at the City of Sunny Isles Beach - Office of the City Clerk. proposers who obtain the Bid
Specifications from sources other than DemandStar or the City of Sunny Isles Beach are cautioned
that their Bid response package may be incomplete. Addenda will be posted and disseminated by
DemandStar at least five days prior to the submittal date to all proposers who are listed on the official
list. The City may not accept incomplete Bids.
Bids shall be on a unit price basis; segregated Bids will not be accepted. Sealed Bids will be received
by the City Clerk no later than 10:00 AM, on Thursday, 08/18/2011 at the Sunny Isles Beach
Government Center located at 18070 Collins Avenue, 4th floor, Sunny Isles Beach, Florida, 33160. Bids
received after this time will not be considered. The City is under no obligation to return Bids. Timely
submitted Bids will be opened publicly and read aloud at this time.
The envelope containing the sealed Bid must be clearly marked:
"IMPORTANT, BID ENCLOSED"
Proposal No. 11-08-01
Property &. Casualty Comprehensive Insurance
OPENING DATE AND TIME: Thursday, 08/18/2011 at 10:00 AM
The Owner reserves the right to reject any or all Bids, with or without cause, to waive technical errors
and informalities, and to accept the Bid, which best serves the interest of, and represents the best
value to, the Owner in conformity with the criteria set forth in Section 62-8 of the Code of Ordinances
of the City of Sunny Isles Beach.
All questions regarding Request for proposal No. 11-08-01 shall be directed in writinq to Jane A. Hines,
CMC, City Clerk, at least five (5) business days prior to the date of the Bid opening. Questions may be
submitted via email to: JHines@lsibfl.net or via facsimile (305) 792-1563 or via regular mail at: Jane
A. Hines, CMC, City Clerk, City of Sunny Isles Beach, 18070 Collins Avenue, Sunny Isles Beach, FL
33160.
Jane Hines, CMC, City Clerk
City of Sunny Isles Beach
PAGE 3 OF 24
BID No. 11-08-01
SECTION 1
INSTRUCTIONS TO PROPOSER I GENERAL TERMS AND CONDITIONS
TO INSURE ACCEPTANCE OF YOUR BID, PLEASE FOLLOW THESE INSTRUCTIONS:
1.1 CLARIFICATION/EXPLANATION/OUESTlONS
Any questions concerning the Bid Specifications or any required
need for clarification must be made to Jane A. Hines, CMC, City
Clerk via email to: JHines(Qlsibfl.net or via facsimile (30S) 792-
1563 or via regular mail at: Jane A. Hines, CMC, City Clerk, City
of Sunny Isles Beach, 18070 Collins Avenue, Sunny Isles Beach,
FL 33160. Such requests for clarification/explanation or questions
must be made in writing to Jane A. Hines, CMC, City Cieri<, at
least five (5) business days prior to the date of the Bid opening.
Interpretations or clarifications considered necessary by the City
will be issued by addenda and posted/disseminated by
OemandStar (www.demandstar.com) to all parties listed on the
official plan holders' list as having received the Bid documents.
Only questions answered by written addenda shall be binding.
Oral interpretations or clarifications shall be without legal effect.
No plea of ignorance or delay or required need of additional
information shall exempt a Proposers from submitting their Bid on
the required date and time as publicly noted.
1.2 PLAN HOLDER'S LIST
As a convenience to vendors, the City of Sunny Isles Beach has
made available via internet lists of all plan holders for each
invitation to Bid, Invitation to Bid, and request for qualifications.
The information is available on-line at www.demandstar.com or
by calling the Office of the City Clerk at (305) 792-1703.
1.3 ADDENDA TO SPECIFICATIONS
If any addenda are issued after the initial specifications are
released, the City will post and disseminate the addenda through
DemandStar. For those projects with separate plans, blue prints,
or other materials that cannot be accessed through the internet,
the Office of the City Clerk will make good faith effort to ensure
that all registered proposers (those who have been registered as
receiving a Bid package) receive the documents. It is the
responsibility of the vendor prior to the submission of any Bid to
check the above website or contact the Office of the City Clerk at
(305) 792-1703 to verify any addenda issued. The receipt of all
addenda must be acknowledged on the Bid Response Sheet.
1.4 SPECIAL ACCOMMODATIONS
Any person requiring a special accommodation at a Pre-Bid
Conference or Bid/RFP/RFQ opening because of a disability should
call the Office of the City Clerk at (305) 792-1703 at lease five (5)
days prior to the Pre-Bid Conference or Bid/RFP/RFQ opening. If
you are hearing or speech impaired, please contact the Office of
the City Clerk by calling the City of Sunny Isles Beach using the
Florida Relay Service which can be reached at 1(800) 955-8771
(TOO).
1.5 PUBLIC ENTITY CRIMES STATEMENT
Pursuant to the provisions of paragraph (2) (a) of section
287.133, Florida statutes -"a person or affiliate who has been
placed on the convicted vendor list following a conviction for a
public entity crime ~ submit a Bid on a contract to provide
any goods or services to a public entity, may not submit a Bid on
a contract with a public entity for the construction or repair of a
public building or public work, may not submit Bids on leases of
real property to a public entity, may not be awarded to perform
work as a Contractor, supplier, sub-Contractor, or consultant
under a contract with any public entity, and may not transact
business with any public entity in excess of the threshold amount
provided in section 2B7.107, for category two for a period of 36
months from the date of being placed on the convicted vendor
list".
1.6 BID DEADLINE
Bids must be submitted no later than the time and date shown
within this document.
PAGE 4 OF 24
BID No. 11-08-01
1.7 SEALED BID
The entire Bid Response Package shall be placed in an opaque
envelope (with all items listed on the Bid checklist form and all
other items required within this Invitation to Bid must be
executed) and submitted in a sealed envelope.
Proposers shall use the Bid Forms furnished in this Invitation to
Bid. Failure to do so may cause the Bid to be rejected. Proposers
shall deliver to the City, as Bid submission:
1.7.1 Bid Response Sheet and Forms: One (1) original and
four (4) copies of all Bid Forms and other requested
information on the proper forms and in the manner
herein prescribed.
1.7.2 (If applicable) Bid Security/Bonding Requirements:
Bid Security in the form of a cashier's check or
approved Bid Bond in the amount of five percent
(5%) of the total amount of the base Bid must be
attached to the front inside cover of the Bid
Specifications. A company or personal check shall
not be deemed a valid Bid Security.
1.7.3 Certificates of Competencies/Licenses/Local Business
Tax Receipt: Copies of all Certificates of
Competencies, Licenses, and Local Business Tax
Receipt.
1.7.4 Certificate(s) Of Insurance(s): Copies of all
Certificates of Insurance naming the City as an
additional insured in the amounts specified in the
Contract.
1.B. BID EXECUTION. SIGNATURES. ERASURE/CORRECTION
All Bids shall be signed in blue ink. All price quotes shall be
typewritten or printed with ink. All corrections made by the
proposers prior to the opening must be initialed and dated by the
proposers. No changes or corrections will be allowed after Bids
are opened. Bids must contain an original, manual signature of
an authorized representative of the company.
1.8 WITHDRAWAL OF BIDS
Proposers may withdraw Bids only by written request and shall
forward the withdrawal request via "Certified U.s. Mail - Return
Receipt Requested" prior to the Bid opening time. Negligence on
the part of the Proposers in preparing the Bid confers no right for
the withdrawal of the Bid after it has been opened.
1.9 BID OPENING
Bids will be opened publicly at the time and place stated in the
Notice to Proposer. It is the responsibility of the proposers to
insure that the Bid reaches the Office of the City Clerk on or
before the closing hour and date stated on the invitation to Bid.
After the Bid opening, the contents of the Bid Form will be made
public for the information of vendors and other interested parties
who may be present either in person or by representative. Bids
that are received after the Bid opening time will not be considered
and will not be returned.
1.10 EVALUATION OF BIDS
The City, at its sole discretion, reserves the right to inspect any/all
Proposers facilities to determine their capability of meeting the
requirements for the Contract. Also, price, responsibility, and
responsiveness of the Proposers, the financial position,
experience, staffing, equipment, materials, references, and past
history of service to the City and/or with other units of state,
and/or local governments in Florida, or comparable private
entities, will be taken into consideration in the Award of the
Contract.
1.11.1
Hold Harmless: All Proposer's shall hold the City, it's
officials and employees harmless and covenant not to
1.11.2
sue the City, it's officials and employees in reference
to their decisions to reject, award, or not award a
Bid, as applicable.
Cancellation: Failure on the part of the Proposers to
comply with the conditions, specifications,
requirements, and terms as determined by the City,
shall be just cause for cancellation of the Award.
Disputes: If any dispute concerning a question of
fact arises under the Contract, other than termination
for default or convenience, the Contractor and the
City department responsible for the administration of
the Contract shall make a good faith effort to resolve
the dispute. If the dispute cannot be resolved by
agreement, then the department with the advice of
the City Attorney shall resolve the dispute and send a
written copy of its decision to the Contractor, which
shall be binding on both parties.
1.11.3
1.11 AGREEMENT
After the Bid award, the City will, at its option, prepare an
Agreement specifying the terms and conditions resulting from the
award of this Bid. The vendor will have ten (10) calendar days
after notification of the award by the City to execute the
Agreement and provide the required Performance and Payment
Bond.
The Proposers who has the Contract awarded to them and who
fails to execute the Agreement and furnish the Performance and
Payment Bond and Insurance Certificates within the specified time
shall forfeit the Bid Security that accompanied their Bid, and the
Bid Security shall be retained as liquidated damages by the City,
and it is agreed that this sum is a fair estimate of the amount of
damages the City will sustain in case the Proposers fails to enter
into the Contract and furnish the Bonds as herein before provided.
Bid Security deposited in the form of a cashier's check drawn on a
local bank in good standing shall be subject to the same
requirements as a Bid Bond.
The performance of the City of Sunny Isles Beach of any of its
obligations under the agreement shall be subject to and
contingent upon the availability of funds lawfully expendable for
the purposes of the agreement for the current and any future
periods provided for within the Bid specifications.
1.13
INDEPENDENT CONTRACTOR STATUS
The contractor shall at all times, relevant to this contract, be an
independent contractor and in no event shall the Contractor nor
any employees or sub-contractors under it be considered to be
employees of the City of Sunny Isles Beach.
1.14
PAYMENTS
Payment will be made after commodities/services have been
received, accepted, and properly invoiced as indicated in the
contract and/or purchase order. Invoices must bear the purchase
order number.
1.15
LOCAL BUSINESS TAX (OCCUPATIONAL LICENSE
REGISTRATION)
The contractor shall be responsible for obtaining and maintaining
throughout the contract period his or her city and county local
business tax receipts. Each vendor submitting a Bid on this
Invitation to Bid shall include a copy of the company's local
business tax/occupational Iicense(s) with the Bid resoonse. For
information specific to City of Sunny Isles Beach local business
tax/occupational licenses, please call Code Enforcement &
Licensing at (305) 792-1705. If the contractor is operating under
a fictitious name as defined in Section 865.059, Florida Statutes,
proof of current registration with the Florida Secretary of State
shall be submitted with the Bid. A business formed by an
attorney actively licensed to practice law in this state, by a person
actively licensed by the Department of Business and Professional
Regulations or the Department of Health for the purpose of
practicing his or her licensed profession, or by any corporation,
partnership, or other commercial entity that is actively organized
or registered with the Department of 5tate shall submit a copy of
the current licensing from the appropriate agency and/or proof of
current active status with the ~ivision of Corporations of the State
of Florida.
1.16 LIABILITY. INSURANCE. PERMITS AND LICENSES
PAGE 5 OF 24
BID No. 11-08-01
Proposers shall assume the full duty, obligation, and expense of
obtaining all necessary licenses, permits, inspections, and
insurance required. The proposers shall be liable for any
damages or loss to the City occasioned by negligence of the
Proposers (or their agent) or any person the Proposers has
designated in the completion of their contract as a result of the
Bid. Contractor shall be required to furnish a copy of all licenses,
certificates of competency or other licensor requirements
necessary to practice their profession as required by Florida State
Statute, current building code, Miami-Dade County, and City of
Sunny Isles Beach Code. Contractors shall include current Miami-
Dade County Certificates of Competency. These documents shall
be furnished to the City along with the Bid resoonse. Failure to
furnish these documents or to have required licensor will be
grounds for rejecting the Bid and forfeiture of the Bid Bond.
1.17 CERTIFICATE(Sl OF INSURANCE
Proposers shall furnish to the Office of the City Clerk, City of
Sunny Isles Beach, 18070 Collins Avenue, Sunny Isles Beach,
Florida 33160, certificate(s) of insurance which indicate that
insurance coverage has been obtained from an insurance
company authorized to do business in the State of Florida or
otherwise secured in a manner satisfactory to the City, for those
coverage types and amounts listed in this document, in an
amount equal to 100% of the requirements and shall be
presented to the City prior to issuance of any Contract(s) or
Award(s) Oocument(s). The City of Sunny Isles Beach shall be
named as "additional insured" with respect to this coverage. The
required certificates of insurance shall not only name the types of
policies provided, but shall also refer specifically to this Bid and
section. At the time of Bid submission the Proposers must submit
certificates of insurance as outlined in the General Conditions
section. All required insurances shall name the City of Sunny Isles
Beach as additional insured and such insurance shall be issued by
companies authorized to issue insurance in the State of Florida. It
shall be the responsibility of the Proposers and insurer to notify
the City Manager of the City of Sunny Isles Beach of cancellation,
lapse, or material modification of any insurance policies insuring
the proposers, which relate to the activities of such vendor and
the City of Sunny Isles Beach. Such notification shall be in
writing, and shall be submitted to the City finance support service
director thirty (30) days prior to cancellation of such policies. This
requirement shall be reflected on the certificate of insurance.
Failure to fully and satisfactorily comply with the city's insurance
and bonding requirements set forth herein will authorize the City
Manager to implement a rescission of the Bid award without
further City Commission action. The Proposers hereby holds the
City harmless and agrees to indemnify City and covenants not to
sue the City by virtue of such rescission.
1.18
ASSIGNMENT
The Contractor shall not transfer or assign the performance
required by this Bid without prior written consent of the City
Manager. Any award issued pursuant to the Invitation to Bid and
monies which may be due hereunder are not assignable except
with prior written approval of the City Manager. Further, in the
event that the majority ownership or control of the Contractor
changes hands subsequent to the award of this contract,
Contractor shall promptly notify City in writing (via United States
Postal Service - Certified Mail, Return Receipt Requested) of such
change in ownership or control at least thirty (30) days prior to
such change and City shall have the right to terminate the
contract upon Sixty (60) days written notice, at City's sole
discretion.
1.19
HOLD HARMLESSIINDEMNIFICATION
The Contractor shall indemnify, save harmless, and defend the
City of Sunny Isles Beach, it's officers, agents and employees from
and against any claims, demands or causes of action of
whatsoever kind or nature arising out of error, omission, negligent
act, conduct, or misconduct of the Contractor, their agents,
servants or employees in the provision of goods or the
performance of services pursuant to this Bid and / or from any
procurement decision of the City including without limitation,
awarding the Contract to the Contractor.
1.20 NON-CONFORMANCE TO CONTRACT
---- ----
The City of Sunny Isles Beach may withhold acceptance of, or
reject items which are found upon examination, not to meet the
specification requirements. Upon written notification of rejection,
items shall be removed within (5) calendar days by the vendor at
their own expense and redelivered at their expense. Rejected
goods left longer than thirty (30) calendar days will be regarded
as abandoned and the City shall have the right to dispose of them
as its own property. Rejection for non-conformance or failure to
meet delivery schedules may result in the Contractor being found
in default.
City:
Contract Documents:
1.21
DEFAULT PROVISION
In case of default by the Proposers or Contractor, the City of
Sunny Isles Beach may procure the articles or services from other
sources and hold the Proposers or Contractor responsible for any
excess costs occasioned or incurred thereby.
1.22
SECONDARY /OTHER VENDORS
The City reserves the right in the event the primary vendor cannot
provide an item(s) or service(s) in a timely manner as requested,
to seek other sources without violating the intent of the Contract.
1.23
DEFINmONS
Contract Price:
Wherever used in these General Conditions or in the other
Contract Documents, the following terms shall have the meaning
indicated which shall be applicable to both the singular and plural
thereof:
Contract Time:
Acceptance:
Acceptance by the City of
the Work as being fully
complete in accordance with
the Contract Documents
subject to waiver of claims.
Contracting Officer:
Agreement:
The written Agreement
between the City and the
Contractor covering the
Work to be performed,
which includes the Contract
Documents.
Contractor:
Addenda:
Written or graphic
instruments issued prior to
the Bid Opening which
modify or interpret the
Contract Documents,
Drawings and Specifications,
by addition, deletions,
clarifications or corrections.
Day:
Field Order:
Approved:
Means approved by the City.
Bid:
The offer or Bid of the
Proposers submitted on the
prescribed form setting forth
the prices for the Work to be
performed.
Modification:
Proposers:
Any person, firm or
corporation submitting a Bid
for Work.
Bonds:
Bid, performance bond and
other instruments of
security, furnished by the
Contractor and their surety
in accordance with the
Contract Documents and in
accordance with the law of
the State of Florida.
Notice of Award:
Change Order:
A written order to the
Contractor signed by the
City authorizing an addition,
deletion or revision in the
Work, or an adjustment in
the Contract Price or the
Contract Time issued after
execution of the Agreement.
Notice to Proceed:
PAGE 6 OF 24
BID No. 11-08-01
City of Sunny Isles Beach,
18070 Collins Avenue, Sunny
Isles Beach, Florida 33160.
Contract Documents shall
include, Instructions to
Proposers, Contractor's Bid,
the Bonds, the Notice of
Award, the Agreement
between the City and
Contractor as well as any
addenda thereto, these
General Conditions, Special
Conditions, the Technical
Specifications, Drawings and
Modifications, Notice to
Proceed, Invitation to Bid,
Insurance Certificates,
Change Orders and
Acknowledgment of
Conformance with the City
of Sunny Isles Beach.
The total monies payable to
the Contractor under the
Contract Documents.
The number of calendar
days stated in the
Agreement for the
completion of the Work.
The individual who is
authorized to sign the
contract documents on
behalf of the City's
governing body.
The person, firm or
corporation with whom the
City has executed this
Agreement.
A calendar day of twenty-
four hours measured from
midnight to the next
midnight.
A written order issued by
the City which clarifies or
interprets the Contract
Documents or orders minor
changes in the Work.
Modification means anyone
of the following: (a) a
written amendment of the
Contract Documents signed
by both parties, (b) a
Change Order, (c) a written
clarification or interpretation
If issued by the City, or (d) a
written order for minor
change or alteration in the
Work issued by the City. A
modification may only be
issued after execution of the
Agreement.
The written notice by City to
the apparent successful
Proposers stating that upon
compliance with the
conditions precedent to be
fulfilled by him within the
time specified, City will
execute and deliver the
Agreement to him.
A written notice given by
City to Contractor fixing the
Project:
Samples:
Shop Drawings:
Specifications:
Statement of Services:
Sub-Contractor:
Substantial Completion:
Supplier:
Surety:
PAGE 7 OF 24
BID No. 11-08-01
date on which the Contract
Time will commence to run
and on which Contractor
shall start to perform their
obligations under the
Contract Documents.
The entire Scope of Services
to be performed as provided
in the Contract Documents.
Physical examples which
illustrate materials,
equipment or worl<manship
and establish standards by
which the Work will be
judged .
All drawings, diagrams,
illustrations, brochures,
schedules and other data
which are prepared by the
Contractor, a Sub-
Contractor, manufacturer,
supplier, or distributor, and
which illustrate the
equipment, material or some
portion of the work and as
required by the Contract
Documents.
Those portions of the
Contract Documents
consisting of written
technical descriptions of
materials, equipment,
construction systems,
standards and workmanship
as applied to the Work.
The form furnished by the
City which is to be used by
the Contractor in requesting
progress payments.
An individual, firm or
corporation having a direct
contract with Contractor or
with any other Sub-
Contractor for the
performance of a part of the
Work at the site.
The date as certified by the
City when the construction
of the Project or a certified
part thereof is sufficiently
completed, in accordance
with the Contract
Documents, so that the
Project or specified part can
be utilized for the purposes
for which it was intended; or
if there be no such
certification, the date when
final payment is due.
Any person or organization
who supplies materials or
equipment for the Work,
including that fabricated to a
special design, but who does
not perform labor at the
site.
The corporate body which is
bound with the Contractor
and which engages to be
responsible for the
Contractor and their
acceptable performance of
the Work.
Wort<:
Any and all obligations,
duties and responsibilities
necessary to the successful
completion of the Project
assigned to or undertaken
by Contractor under the
Contract Documents,
including all labor, materials,
equipment and other
incidentals, and the
furnishing thereof.
Written Notice:
The term "Notice" as used
herein shall mean and
include all written notices,
demands, instructions,
claims, approvals and
disapproval's required to
obtain compliance with
Contract requirements.
Written notice shall be
deemed to have been duly
served if delivered in person
to the individual or to a
member of the firm or to an
officer of the corporation for
whom it is intended, or to an
authorized representative or
such individual, firm, or
corporation, or if delivered
at or sent by registered mail
to the last business address
known to them who gives
the notice. Unless otherwise
stated in writing, any notice
to or demand upon the City
under this Contract shall be
delivered to the City.
1.24
BID AWARD
The City reserves the right to reject any and all Bids at its sole
discretion. Bids shall be awarded by the City after the City
performs all necessary searches, inquiries, exploration, and
analysis of the Bids. The Bid shall be awarded to the lowest
responsible and responsive proposer whose Bid best serves the
interests of and represents the best value to the City in conformity
with the criteria set forth in Section 62-8 of the City Code. No
Notice of Award will be given until the City has concluded any
investigation(s) as they deem necessary to establish the
Proposer's capability to perform the public works and Waste
Management Services as described in this invitation to bid, as
substantiated by the required professional experience, client
references, technical knowledge and qualifications; and sufficient
labor and equipment to comply with the City's established
standards, as well as the financial capability of the Proposer to
perform the Work in accordance with the Contract Documents to
the satisfaction of the City within the time prescribed. The City
reserves the right to reject the Bid of any Proposers on the basis
of these queries and investigations and who does not meet the
City's satisfaction, even though the firm may be the lowest dollars
and cents Bid. In analyzing Bids, the City will also take into
consideration client references, past work experience and work
product, proven ability to satisfactorily perform If the Contract is
awarded, the City will issue the Notice of Award and give the
successful Proposers a Contract for execution within ninety (90)
days after opening of Bids. The City specifically reserves the right
to award the contract to a proposer who is not necessarily the
lowest dollars and cents proposers on the basis of the results of
these queries and investigation(s).
1.2S
FORFEITURE OF BID SECURnY. PERFORMANCE BOND (IF
APPLICABLE)
Within ten (10) calendar days of being notified of the award,
Contractor shall furnish an executed agreement and attach a
Performance Bond (containing all the provisions of the
Performance Bond herein). The Performance Bond shall be in the
amount of one hundred percent (100%) of the Contract Price
guaranteeing to City the completion and performance of the Work
covered in such Contract as well as full payment of all suppliers,
----
1.26
material man, laborers, or Sub-Contractors employed pursuant to
this Project. Each Bond shall be with a Surety company meeting
the qualifications of this document. Each Bond shall continue in
effect for one and one half years after final completion and
acceptance of the Work with the liability equal to one hundred
percent (100%) of the Contract Sum. The Performance Bond
shall be conditioned that Contractor will, upon notification by City,
correct any defective or faulty Work or materials which appear
within one and one half years after final completion of the
Contract. Pursuant to the requirements of Section 255.05( 1),
Florida Statutes, Contractor shall ensure that the Bond(s)
referenced above shall be recorded in the public records of Miami-
Dade County and provide City with evidence of such recording.
1.25.1
Each Bond must be executed by a surety company
authorized to do business in the State of Florida as a
surety, having a resident agent in the State of Florida
and having been in business with a record of
successful continuous operation for at least five (5)
years.
1.2S.2
The surety company shall hold a current certificate of
authority as acceptable surety on federal bonds in
accordance with the United States Department of
Treasury Circular 570, current Revisions.
1.25.3
The City will accept a surety bond from a company
with a rating B+ or better.
1.25.4
Failure of the successful Proposers to execute and
deliver the Agreement and deliver the required bonds
and Insurance Certificates shall be cause for the City
to annul the Notice of Award and declare the Bid and
any security therefore forfeited.
CONTRACTOR'S PRE-START REPRESENTATION
Contractor represents that they have familiarized themselves with,
and assumes full responsibility for having familiarized themselves
with the nature and extent of the Contract Documents, Work,
locality, and with all local conditions and federal, State and local
laws, ordinances, rules and regulations that may in any manner
affect performance of the Work, and represents that they have
correlated their study and observations with the requirements of
the Contract Documents. Contractor also represents that they
have studied all surveys and investigations reports of subsurface
and latent physical conditions referred to in the specifications and
made such additional surveys and investigations as they deem
necessary for the performance of the Work in the Contract
Documents and that they have correlated the results of all such
data with the requirements of the Contract Documents.
1.27 COMMENCEMENT OF CONTRACT TIME
The Contract Time will commence to run on the date stated in the
Notice to Proceed.
1.2B
STARTING THE PROJECT
Contractor shall start to perform their obligations under the
Contract Documents on the date when the Contract Time
commences to run. No Work shall be done at the site prior to the
date on which the Contract Time commences to run, except with
the written consent of the City.
1.29
BEFORE STARTING CONTRACT
Before undertaking each part of the Work, Contractor shall
carefully study and compare the Contract Documents and check
and verify pertinent figures shown thereon and all applicable field
measurements. They shall at once report in writing to City any
confiict, error, or discrepancy which they may discover; however,
they shall not be liable to City for their failure to discover any
conflict, error, or discrepancy in the Specifications.
1.30
PRE-START MEmNG
Within five (5) days after delivery of the executed Agreement by
City to Contractor, but before starting the Work at the site, a Pre-
Start conference will be held to review the above schedules, and
for processing Statement of Services, and to establish a working
understanding between the parties as to the Project. Present at
PAGE 8 OF 24
BID No. 11-08-01
1.31
the conference will be the City representative and the Contractor.
CORRELATION. INTERPRETATION. AND INTENT OF
CONTRACT DOCUMENTS
It is the intent of the Specifications to describe a complete Project
to be delivered in accordance with the Contract Documents. The
Contract Documents comprise the entire Agreement between the
City and the Contractor. They may be altered only by a
Modification. The Contract Documents are complementary; what
is called for by one is as binding as if called for by all. If
Contractor finds a conflict, error or discrepancy in the Contract
Documents, they shall call it to the City's attention in writing at
once and before proceeding with the Work affected thereby. The
various Contract Documents shall be given precedence in case of
conflict, error or discrepancy, as follows: Change Orders,
Supplemental General Conditions, Agreement Modifications,
Addenda, Special Conditions, Instructions to proposers, General
Conditions, and Specifications. If the requirements of other
Contract Documents are more stringent than those of the
Supplemental General Conditions, the more stringent
requirements shall apply. The words "furnish" and "furnish and
install", "install", and "provide" or words with similar meaning
shall be interpreted, unless otherwise specifically stated, to mean
"furnish and install complete in place and ready for service".
Miscellaneous items and accessories which are not specifically
mentioned, but which are essential to produce a complete and
properly operating installation, or usable structure or plant,
providing the indicated function, shall be furnished and installed
without change in the Contract Price. Such miscellaneous items
and accessories shall be of the same quality standards, including
material, style, finish, strength, class, weight and other applicable
characteristics, as specified for the major component of which the
miscellaneous item or accessory is an essential part, and shall be
approved by the City before installation. The above requirement
is not intended to include major components not covered by or
inferable from the Specifications. The Work of all trades under
this Contract shall be coordinated by the Contractor in such
manner as to obtain the best workmanship possible for the entire
Project, and all components of the Work shall be installed or
erected in accordance with the best practices of the particular
trade.
1.32
CONTRACTOR'S LIABILITY INSURANCE
Contractor shall provide and maintain in force until all the Work to
be performed under this Contract has been completed and
accepted by City (or for such duration as is otherwise specified
hereinafter), the insurance coverage set forth in section 2.0
paragraph 2.8
1.33 CONTRACTOR'S RESPONSIBILITY
The Contractor shall have the following responsibilities:
1.33.1
The Contractor will not employ any Sub-Contractor,
against whom the City may have reasonable
objection, nor will the Contractor be required to
employ any Sub-Contractor who has been accepted
by the City, unless the City determines that there is
good cause for doing so.
1.33.2
The Contractor shall be fully responsible for all acts
and omissions of their Sub-Contractors and of
persons and organizations directly or indirectly
employed by them and of persons and organizations
for whose acts any of them may be liable to the same
extent that they are responsible for the acts and
omissions of persons directly employed by them.
Nothing in the Contract Documents shall create any
contractual relationship between City or Contractor
and any Sub-Contractor or other person or
organization having a direct contract with Contractor,
nor shall it create any obligation on the part of City to
payor to see to payment of any persons due any
Sub-Contractor or other person or organization,
except as may otherwise be required by law. City
may furnish to any Sub-Contractor or other person or
organization, to the extent practicable, evidence of
amounts paid to the Contractor on account of
specified Work done in accordance with the schedule
values.
1.34
1.3S
1.36
1.33.3
The divisions and sections of the Specifications shall
not control the Contractor in dividing the Work
among Sub-Contractors or delineating the Work
performed by any specific trade.
1.33.4
The Contractor agrees to bind specifically every Sub-
Contractor to the applicable terms and conditions of
the Contract Documents for the benefit of the City.
1.33.5
All Work performed for the Contractor by a Sub-
Contractor shall be pursuant to an appropriate
agreement between the Contractor and the Sub-
Contractor.
1.33.6
The Contractor shall be responsible for the
coordination of the trades, Sub-Contractors and
material and men engaged upon their Work:
1.33.6.1 The Contractor shall cause appropriate
provisions to be inserted in all
subcontracts relative to the Work to bind
Sub-Contractors to the Contractor by the
terms of these General Conditions and
other Contract Documents insofar as
applicable to the Work of Sub-
Contractors, and give the Contractor the
same power as regards to terminating
any subcontract that the City may
exercise over the Contractor under any
provisions of the Contract Documents.
1.33.6.2 The City will not undertake to settle any
differences between the Contractor and
their Sub-Contractors or between Sub-
Contractors.
1.33.6.3 If in the opinion of the City, any Sub-
Contractor on the Project proves to be
incompetent or otherwise unsatisfactory;
they shall be promptly replaced by the
Contractor if and when directed by the
City in writing.
LAWS AND REGULATIONS
The Contractor will give all notices and comply with all laws,
ordinances, rules and regulations appiicable to the Work. If the
Contractor observes that the Specifications are at variance
therewith, they will give the City prompt written notice thereof,
and any necessary changes shall be adjusted by an appropriate
modification. If the Contractor performs any Work knowing it to
be contrary to such laws, ordinances, rules and regulations, and
without such notice to the City, they will bear all costs arising
wherefrom.
TAXES
The City of Sunny Isles Beach is exempt from sales tax imposed
by the State and/or Federal Government. Florida Sales Tax
Exemption No. 23-00-477131-S4C appears on each purchase
order. Exemption certificates are available upon request.
DUTY TO DEFEND. INDEMNIFY AND SAVE HARMLESS
In consideration of the separate sum of twenty-five dollars
($25.00) and other valuable consideration, the Contractor shall
defend, indemnify and save harmless the City, its officers, agents
and employees, from or on account of any injuries or damages,
received or sustained by any person or persons during or on
account of any operations connected with the Work described in
the Contract Documents, or by or in consequence of any
negligence in connection with the same; or by use of any
improper materials or by or on account of any act or omission of
the said Contractor or his Sub-Contractor, agents, servants or
employees. The Contractor will defend, indemnify and hold
harmless the City and their agents or employees from and against
all claims, damages, losses and expenses including attorneys' fees
arising out of or resulting from the performance of the Work,
provided that any such claim damage, loss or expense (a) is
attributable to bodily injury, sickness, disease or death, or to
injury to or destruction of tangible property (other than Work
PAGE 9 OF 24
BID No. 11-08-01
itself) including the loss of use resulting wherefrom and (b) is
caused in whole or in part by any negligent act or omission of the
Contractor, Sub-Contractor, anyone directly or indirectly employed
by any of them or anyone for whose acts any of them may be
liable, regardless of whether or not it is caused by a party
indemnified hereunder. In the event that a court of competent
jurisdiction determines that Sec. 725.06 (2), F.5. is applicable to
this Work, then in lieu of the above provisions of this section the
parties agree that Contractor shall indemnify, defend and hold
harmless the City, their officers and employees, to the fullest
extent authorized by Sec. 725.06 (2) F.S., which statutory
provisions shall be deemed to be incorporated herein by reference
as if fully set forth herein. In the event that any action or
proceeding is brought against City by reason of any such claim or
demand, Contractor, upon written notice from City shall defend
such action or proceeding by counsel satisfactory to City. The
indemnification provided above shall obligate Contractor to defend
at its own expense or to provide for such defense, at City's option,
any and all claims of liability and all suits and actions of every
name and description that may be brought against City, excluding
only those which allege that the injuries arose out of the sole
negligence of City, which may result from the operations and
activities under this Contract whether the Work be performed by
Contractor, its Sub-Contractors, or by anyone directly or indirectly
employed by either.
1.37
CITY'S RESPONSIBILITY
The City will issue all communications to the Contractor; the City
will furnish the data required of them under the Contract
Documents promptly; and the City's duties in respect to providing
lands and easements are set forth in this section.
1.38
DECISIONS ON DISAGREEMENTS
The City will be the initial interpreter of the Technical
Specifications.
1.39
CHANGES IN WORK
Without invalidating the Agreement, the City may, at any time or
from time to time, order additions, deletions or revisions in the
Work; these shall be authorized by Change Orders. Upon receipt
of a Change Order, the Contractor will proceed with the Work
involved. All such Work shall be executed under the applicable
conditions of the Contract Documents. If any Change Order
causes an increase or decrease in the Contract Price or an
extension or shortening of the Contract Time, an equitable
adjustment will be made as provided in this document. A Change
Order signed by the Contractor indicates their agreement
therewith.
1.39.1
The City may authorize minor changes or alterations
in the Work not involving extra cost and not
inconsistent with the overall intent of the Contract
Documents. These may be accomplished by a Field
Order. If the Contractor believes that any minor
change or alteration authorized by the City entitles
them to an increase in the Contract Price or extension
of Contract Time, they may make a claim therefore as
provided in this document.
1.39.2
Additional Work performed by the Contractor without
authorization of a Change Order will not entitle them
to an increase in the Contract Price or an extension of
the Contract Time, except in the case of an
emergency as provided in this document.
1.39.3
The City will execute appropriate Change Orders
covering changes in the Work, to be performed and
Work performed in an emergency as provided in this
section and any other claim of the Contractor for a
change in the Contract Time or the Contract Price
which is approved by the City.
1.39.4
It is the Contractor's responsibility to notify his Surety
of any changes affecting the general scope of the
Work or change in the Contract Price or Contract
Time and the amount of the applicable bonds shall be
adjusted accordingly. The Contractor will furnish
proof of such an adjustment to the City.
1.40
SUSPENSION OF WORK AND TERMINATION
The City may, at any time and without cause, suspend the Work
or any portion thereof for a period of not more than ninety (90)
days by notice in writing to the Contractor which shall fix the date
on which Work shall be resumed. For suspensions longer than
ninety (90) days, the Contractor may be allowed an increase in
the Contract Price or an extension of the Contract Time, or both.
1.41
CITY MAY TERMINATE
If the Contractor is adjudged bankrupt or insolvent, or if they
make a general assignment for the benefit of their creditors, or if
a trustee or receiver is appointed for the Contractor or for any of
their property, or if they file a petition to take advantage of any
debtor's act, or to reorganize under bankruptcy or similar laws, or
if they repeatedly fails to supply sufficient skilled workmen or
suitable materials or equipment, or if they repeatedly fail to make
prompt payments to Sub-Contractors or for labor, materials or
equipment or they disregard laws, ordinances, rules, regulations
or orders of any public body having jurisdiction, or if they
disregard the authority of the City, of if they otherwise violate any
provision of, the Contract Documents, then the City may, without
prejudice to any other right or remedy and after giving the
Contractor and the surety ten (10) days written notice, terminate
the services of the Contractor and take possession of the Project
and of all materials, equipment, tools, construction equipment and
machinery thereon owned by the Contractor, and finish the Work
by whatever method they may deem expedient. In such case the
Contractor shall not be entitled to receive any further payment
until the Work is finished. If the unpaid balance of the Contract
Price exceeds the direct and indirect costs of completing the
Project, including compensation for additional professional
services, such excess shall be paid to the Contractor. If such
costs exceed such unpaid balance, the Contractor will pay the
difference to the City. Such costs incurred by the City will be
determined by the City and incorporated in a Change Order. If
after termination of the Contractor under this Section, it is
determined by a court of competent jurisdiction for any reason
that the Contractor was not in default, the rights and obligations
of the City and the Contractor shall be the same as if the
termination had been issued pursuant to this document.
1.41.1
Where the Contractor's services have been so
terminated by the City said termination shall not
affect any rights of the City against the Contractor
then existing or which may thereafter accrue. Any
retention or payment of moneys by the City due the
Contractor will not release the Contractor from
liability.
1.41.2
Upon ten (10) days written notice to the Contractor,
the City may, without cause and without prejudice to
any other right or remedy, elect to terminate the
Agreement. In such case, the Contractor shall be
paid for all Work executed and accepted by the City
as of the date of the termination. No payment shall
be made for profit for Work which has not been
performed.
1.42
MISCELLANEOUS
Proposers acknowledge the following miscellaneous conditions:
1.42.1
Whenever any provision of the Contract Documents
requires the giving of written notice it shall be
deemed to have been validly given if delivered in
person to the individual or to a member of the firm or
to an officer of the corporation for whom it is
intended, or if delivered at or sent by registered or
certified mail, postage prepaid, to the last business
address known to them who gives the notice.
1.42.2
The Contract Documents shall remain the property of
the City. The Contractor shall have the right to keep
one record set of the Contract Documents upon
completion of the Project.
1.42.3
The duties and obligations imposed by these General
Conditions, Special Conditions and Supplemental
Conditions and the rights and remedies available
hereunder, and, in particular but without limitation,
PAGE 10 OF 24
BID No. 11-08-01
1.43
the warranties, guarantees and obligations imposed
upon Contractor and those in the Special Conditions
and the rights and remedies available to the City,
shall be in addition to, and shall not be construed in
any way as a limitation of, any rights and
remedies available by law, by special guarantee or by
other provisions of the Contract Documents.
1.42.4
Should the City or the Contractor suffer injury or
damage to its person or property because of any
error, omission, or act of the other or of any of their
employees or agents or others for whose acts they
are legally liable, claim shall be made in writing to the
other party within a reasonable time of the first
observance of such injury or damage.
WAIVER OF JURY TRIAL
City and Contractor knowingly, irrevocably voluntarily and
intentionally waive any right either may have to a trial by jury in
State or Federal Court proceedings in respect to any action,
proceeding, lawsuit or counterclaim based upon the Contract
Documents or the performance of the Work there under.
1.43.1
GOVERNING LAW
The Contract shall be construed in accordance with
and governed by the law of the State of
Florida.
1.43.2
VENUE
Venue of any action to enforce the Contract
Documents shall be in Miami-Dade County, Florida.
1.43.3
ARBITRATION
It is the intention of the parties that whenever
possible, if a dispute or controversy arises hereunder
then such dispute or controversy sha II be settled by
arbitration in accordance with the procedures, rules
and regulations of the American Arbitration
Association. The decision rendered by the Arbitrator
shall be final and binding upon the parties and
judgment upon the award rendered by the arbitrator
may be entered in any court having jurisdiction.
Arbitration shall be held in Miami-Dade County,
Florida. All costs of arbitration and attorneys' fees
incurred by the parties shall be paid by the non-
prevailing party or, if neither party prevails on the
whole, each party shall be responsible for a portion of
the costs of arbitration and their respective attorneys'
fees as may be determined by the court on
confirmation.
1.44
PROJECT RECORDS
City shall have right to inspect and copy during regular business
hours at City's expense, the books and records and accounts of
Contractor which relate in any way to the Project, and to any
claim for additional compensation made by Contractor, and to
conduct an audit of the financial and accounting records of
Contractor which relate to the Project. Contractor shall retain and
make available to City all such books and records and accounts,
financial or otherwise, which relate to the Project and to any claim
for a period of three years following final completion of the
Project. During the Project and the three year period following
final completion of the Project, Contractor shall provide City
access to its books and records upon five days written notice.
145
SEVERABILITY
If any provision of the Contract or the application thereof to any
person or situation shall to any extent, be held invalid or
unenforceable, the remainder of the Contract, and the application
of such provisions to persons or situations other than those as to
which it shall have been held invalid or unenforceable shall not be
affected thereby, and shall continue in full force and effect, and
be enforced to the fullest extent permitted by law.
1.46
INDEPENDENT CONTRACTOR
The Contractor is an independent Contractor under the Contract.
Services provided by the Contractor shall be by employees of the
Contractor and subject to supervision by the Contractor, and not
as officers, employees, or agents of the City. Personnel policies,
tax responsibilities, social security and health insurance, employee
END OF SECTION
PAGE 11 OF 24
BID No. 11-08-01
benefits, purchasing policies and other similar administrative
procedures, applicable to services rendered under the Contract
shall be those of the Contractor.
Section 2
Special Terms and Conditions
2.1 PURPOSE OF BID:
The City of Sunny Isles Beach (the "City") intends to secure the services of a qualified Property &
Casualty Comprehensive Insurance and other required insurances. It is the intent of this proposal
document that all work shall result in compliance with the specifications documents and all
regulatory requirements applicable to such service.
2.2 PRE-BID CONFERENCE (NON-MANDATORY):
Intentionally Omitted
2.3 TERM
This contract will commence on the first calendar day of the month succeeding approval of the
contract by the City Commission, or designee, unless otherwise stipulated in the Notice of Award
letter, which is distributed by the City's Purchasing Agent; and contingent upon the completion
and submittal of all required proposal documents. This contract shall remain in effect for one (1)
year; provided that the services rendered by the Proposer during the contract period are
satisfactory .
2.4 OPTIONS TO RENEW
Prior to, or upon completion, of that initial term, the City shall have the option at its sole
discretion to renew this contract for an additional four (4) one year renewals.
2.5 METHOD OF AWARD
See section 4
2.6 PRICE
Prices shall remain fixed and firm through the term of the contract
2.7 PERFORMANCE BOND
Intentionally Omitted
2.8 DELIVERY
Intentionally Omitted
2.9 INSURANCE
Intentionally Omitted
2.10 MONTHLY INVOICES PAYMENTS
Cut-off date is the close of the last business day of the month. Proposer shall submit by the 10th
PAGE 12 OF 24
BID No. 11-08-01
day of the following month proposer's completed Statement of Services/Invoice. Should the 10th
fall on a weekend or holiday, Proposer shall submit his application on the next workday.
proposer is advised that processing of invoices must follow this schedule, as the City has funding
requirements and other payment obligations which may prevent payment of late Statement of
Services for that month's billing cycle. A late Statement of Services with a recommendation for
payment will be paid in the next month's billing cycle.
2.11 FEDERAL AND STATE REGULATIONS
The successful proposer shall comply with all federal, state and local rules and regulations
regarding food handling, operation of a concession business, and any other laws that would
apply to operating a similar type of business. Special attention must be paid to the regulations
outlined by the State of Florida, Department of professional and Business Regulation, Division of
Hotels and Restaurants.
END OF SECTION
PAGE 13 OF 24
BID No. 11-08-01
Section 3
Scope of Services 1 Technical Specifications
3.1 SCOPE OF SERVICES
The City of Sunny Isles Beach is seeking a comprehensive property and casualty program as
deemed necessary or beneficial by the City. Attached is a copy of the current policy. The City is
looking for coverage that is equal or better than its current policy. Any deviation from the
current policy should be very c1earlv stated. Coverage's shall include, but are not limited to:
. Commercial Property Coverage
o Including Boiler, Machinery and Breakdown
. Commercial General Liability
o Law Enforcement liability
o Employment Practices liability
. Business Auto Coverage
. Commercial Umbrella Coverage
. Contractors Equipment Floater
. Marine Package
. Workers Compensation
. Public Officials Errors & Omissions
. Commercial Crime
. Plate Glass Coverage
. Storage Tank
. Student Accident
3.2 INSURANCE TERM
The City prefers and will give strong consideration to proposals offering a multi year term,
however if not available proposals quoting a one year term will be accepted.
3.3 TIMING OF SOLICITATIONS
The City's insurance program begins Oct 1st
3.4 NAMED INSURED
The City of Sunny Isles Beach;
1) any Employee of the Named Insured while acting within the scope of his duties for or on
behalf of the Named Insured;
2) any Elected Official, Employee, Officer, Trustee or Volunteer, past or present, acting for
and on behalf of the Named Insured and under its direction and control or appointed by
the Named Insured while acting within the scope of their duties as such, and any person,
organization, trustee or estate to whom the Named Insured is obligated by virtue of
written contract or agreement to provide coverage such as is offered by this Agreement
but only in respect of operations by or on behalf of the Named Insured;
3.5 ONLINE CLAIM MANAGEMENT
The City prefers and will give strong consideration to proposals offering an online account /
claims management system. The system shall include the following but not limited to;
PAGE 14 OF 24
BID No. 11-08-01
. Online Reporting
. Online Claims Management
. Claim History
. Claim Status
3.6 DEDICATED ACCOUNT REPRESENTATIVE
The City prefers and will give strong consideration to proposals offering a dedicated account
representative and a secondary account representative as a back-up who shall be the signal point
of contact for any account issue including claims management, billing and etc.
END OF SECTON
PAGE 15 OF 24
BID No. 11-08-01
Section 4
Evaluation Process
4.1 Review of Proposals For Responsiveness
Each proposal will be reviewed to determine if the proposal is responsive to the
submission requirements outlined in the solicitation. A responsive proposal is one which
follows the requirements of this solicitation that includes all documentation, is submitted
in the format outlined in this solicitation, is of timely submission, and has the appropriate
signatures as required on each document. Failure to comply with these requirements
may result in the proposal being deemed non- responsive. The contract will be awarded
to the lowest responsible and responsive proposer whose proposal best serves the
interest of and represents the best values to the City in conformity with section 62-8 of
the City code.
4.2 Oualifications
Proposals will be evaluated on the criteria listed below.
Technical Oualifications
1. proposer's relevant experience, qualifications and past performance as a company
2. Relevant experience and qualifications of key personnel, including point person that
will be assigned to the Citv.
3. proposers approach methodology to providing the services requested in this
solicitation
4. proposed solution functionality , implementation and other objectives and
reauirements as stated
Price
5. proposer's proposed price
4.2.1 MINIMUM REQUIREMENTS
In order to be considered responsive, proposers shall, at a minimum,
demonstrate compliance with the following Pre-Qualification Criteria in their
proposal. All requested documentation and/or information shall be provided in
the proposal to confirm that the proposer has satisfied the Prequalification
Criteria in order to be properly evaluated as listed herein. proposers failing to
meet these requirements shall be deemed non responsive. The proposer shall, at
the time of Proposal submittal, time of award, and throughout the duration of
the Contract, continue to meet the following Pre-qualification Criteria
requirements as stated in the Solicitation Documents.
. proposalS will be accepted only from or on behalf of insurance
companies authorized to do business in the State of Florida, having a
Best's Rating of "Class A" or better, and a financial size of "Class VII" or
better in the latest edition of Best's Insurance Reports or as otherwise
approved by the City.
4.3 Price Evaluation
The price proposal will be evaluated subjectively in combination with the technical
PAGE 16 OF 24
BID No. 11-08-01
proposal, including an evaluation of how well it matches Proposers understanding of the
City's needs described in this solicitation, the prospers assumptions, and the value of the
proposed services. The pricing evaluation is used as part of the evaluation process. The
City reserves the right to negotiate the final terms, conditions and pricing of the contract
as may be in the best interest of the City.
The City prefers and will give strong consideration to proposers who are submitted
proposals for all the Cities required insurances. If a proposer is unable to submit an offer
on any portion of the Cities insurance needs they shall clearly indicate within their
proposal the items they were unable to quote.
4.4 Neaotiations
The City may award a contract on the basis of initial offers received, without discussions.
Therefore, each initial offer should contain the Proposer's best terms from a monetary
and technical standpoint.
Notwithstanding the foregoing, if the City and said proposer(s) cannot reach agreement
on a contract, the City reserves the right to terminate negotiations and may, at the City
Manager's or designee's discretion, begin negotiations with the next lowest responsible
and responsive proposer. This process may continue until a contact acceptable to the
City has been executed or all proposals are rejected. No Proposer shall have any rights
against the City arising from such negotiations or termination thereof.
Any Proposer recommended for negotiations may be required to provide to the City:
a) Its most recent certified business financial statements as of a date not earlier than
the end of the proposer's preceding official tax accounting period, together with a
statement in writing, signed by a duly authorized representative, stating that the
present financial condition is materially the same as that shown on the balance sheet
and income statement submitted, or with an explanation for material change in the
financial condition. A copy of the most recent business income tax return will be
accepted if certified financial statements are unavailable.
b) Information concerning any prior or pending litigation, either civil or criminal,
involving a governmental agency or which may affect the performance of services to
be rendered herein, in which the Proposer, any of its employees or subProposers is
or has been involved within the last three years.
END OF SECTON
PAGE 17 OF 24
BID No. 11-08-01
Section 5
Proposal Format
5.0 FORMAT
Proposers must submit (1) original and four (4) copies of the Proposal. The original proposal
must contain an original signature. Be sure that the individual signing the proposal is authorized
to commit the Proposer's organization to the Proposal as submitted. Each page of the Proposal
should state the name of the Proposer, the RFP number, and the page number. The City reserves
the right to request additional data or material to support Proposals. All material submitted in
response to the RFP will become the property of the City.
LABEL EACH SECTION AS NUMBERED
The proposal must be in the following format.
1. Company Information
. In response to this Proposal, all Proposers must provide the following:
Name of Agency/Company (including any "Doing Business As" names)
. Company Locations
. Internet Web Site Address (if any)
. Details of Entity Business Structure (Corporation, Partnership, LLC)
· Date Founded
. Home office address and telephone number, and local address and phone
number
. List of any outstanding litigation that would threaten the viability of the firm or
the performance of this contract
· Proof of insurance
Indication of how long it would take to implement service after authorized to
begin
2. Qualifications
proposer's relevant experience, qualifications and past performance
. An explanation of why the proposer is the best qualified to perform the contract
and demonstrate its qualifications including an item-by-item disclosure outlining
how the firm meets or exceeds the requirements of this RFP.
. A schedule of proposed services. The schedule should include the Proposer's
understanding of the issues and tasks of the project at hand.
3. Staffing
Relevant experience and qualifications of key personnel, including key personnel of sub-
Proposers, that will be assigned to this project and experience and qualifications of sub-
Proposers. The size and experience of the company staff pool from which staff assigned
to the management contract can be drawn.
. The composition of the staff team should include.
. The names of the employees in the area responsible for this contract
. Their function in the company.
. The name of the person who will be responsible for the coordination of work.
4. Approach / Methodology
proposers approach methodology to providing the services requested in this solicitation
PAGE 18 OF 24
BID No. 11-08-01
. Suitability of the methodologies and approaches used in achieving tasks
. Overall organization to completing the project
. Ability to meet desired timelines and deadlines
. Description and/or examples of how the broker would develop financial
evaluations of insurance plans
. Description of how the broker would propose to market the program, including a
list of companies that would be approached, and the A.M. Best Company's rating
of each
. A specific explanation of how the broker in-house specialists can be utilized to
control worker's compensation costs.
5. Cost of Services
Each firm shall submit in their price proposal and any pricing conditions or contingencies
must be clearly stated.
6. References
Each proposer must submit a list of three (3) Municipal references of Current and Past
Customers of witch they have provided services similar in scope and size of those
described herein.
. Each Reference must be supplied on Clients Letterhead
. Each Reference letter must me signed with contact person and phone number.
The City retains the right to request any additional information pertaining to the
Proposer's ability, qualifications, and procedures used to accomplish all work under the
contract as it deems necessary to ensure safe and satisfactory work.
7. Online Account Management Demo
Provide a temporary login and password to demo the insurance providers online account
management system.
8. Contract Forms
All completed contract forms
END OF SECTION
PAGE 19 OF 24
BID No. 11-08-01
DELIVER TO:
City of Sunny Isles Beach
City Clerk
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Request for Proposal
SECTION 6
BID SUBMITTAL FORMS
OPENING: 10:00 A.M.
08/18/2011
PLEASE QUOTE PRICES F.O.B. DESTINATION, LESS TAXES, DELIVERED IN
CITY OF SUNNY ISLES BEACH, FLORIDA
NOTE: City of Sunny Isles Beach is exempt from all taxes (Federal, State, and Local). Bid price should be
less all taxes. Tax Exemption Certificate furnished upon request.
Issued by:
Purchasing Agent
Date Issued:
07/29/2011
This Bid Submittal Consists of
Pages 23 through 27
Sealed bids are subject to the Terms and Conditions of this Invitation to Bid and the accompanying Bid
Submittal. Such other contract provisions, specifications, drawings or other data as are attached or
incorporated by reference in the Bid Submittal, will be received at the office of the City Clerk at the
address shown above until the above stated time and date, and at that time, publicly opened for
furnishing the supplies or services described in the accompanying Bid Submittal Requirement.
IFB 11-08-01
Property &. Casualty Comprehensive Insurance
A Bid Deposit in the amount of 0% of the total amount of the bid shall accompany all bids
A Performance Bond in the amount of 00/0 of the total amount of the bid will be required upon execution
of the contract by the successful Proposer and City of Sunny Isles Beach
Procurement AQent:
Marcanthony Tulloch
Firm Name:
Commodity Code(s):
RETURN ONE ORIGINAL AND TWO COPIES OF BID SUBMITTAL PAGES AND AFFIDAVITS
FAILURE TO SIGN PAGE 27 OF SECTION 4 BID SUBMITTAL WILL RENDER YOUR BID NON-
RESPONSIVE
PAGE 20 OF 24
BID No. 11-08-01
SECTION 4
BID SUBMITTAL FOR:
ACKNOWLEDGEMENT OF ADDENDA
INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES
PART I:
LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN
CONNECTION WITH THIS BID
Addendum #1, Dated
Addendum #2, Dated
Addendum #3, Dated
Addendum #4, Dated
Addendum #5, Dated
Addendum #6, Dated
Addendum #7, Dated
Addendum #8, Dated
PART II:
o NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID
FIRM NAME:
AUTHORIZED SIGNATURE:
DATE:
TITLE OF OFFICER:
PAGE 21 OF 24
BID No. 11-08-01
BID SUBMITTAL FORM
Bid Title: Property & Casualty Comprehensive Insurance
The undersigned Proposers proposes and agrees, if this Bid is accepted, to enter into an agreement with The City of
Sunny Isles Beach in the form included in the Contract Documents to perform and furnish all Work as specified or
indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid and in
accordance with the other terms and conditions of the Contract Documents.
The Proposers accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to
Proposers, including without limitation those dealing with the disposition of Bid Security. This Bid will remain subject
to acceptance for 90 days after the day of Bid opening. The Proposers agrees to sign and submit the Agreement with
the Bonds and other documents required by the Bidding Requirements within ten days after the date of the City's
Notice of Award.
In submitting this Bid, the proposer represents, as more fully set forth in the Agreement, that:
. The Proposer has familiarized himself/herself with the nature and extent of the
Contract Documents, Work, site, locality, and all local conditions and Law and
Regulations that in any manner may affect cost, progress, performance, or
furnishing of the Work.
. The Proposer has studied carefully all reports and drawings of subsurface
conditions and drawings of physical conditions.
. The proposer has given the City written notice of all conflicts, errors,
discrepancies that it has discovered in the Contract Documents and the written
resolution thereof by City is acceptable to the proposer.
This Bid is genuine and not made in the interest of or on behalf of any
undisclosed person, firm or corporation and is not submitted in conformity with
any agreement or rules of any group, association, organization, or corporation;
the proposer has not directly or indirectly induced or solicited any other
Proposers to submit a false or sham Bid; the Proposer has not solicited or
induced any person, firm or corporation to refrain from Bidding; and Proposer
has not sought by collusion to obtain for itself any advantage over any other
proposers or over the City.
The City and the successful Proposer will establish completion times for each individual Work Item and
the successful Proposer agrees that the work will be completed within the time frames agreed upon and
stipulated in the individual Purchase Orders and/or Notice to Proceed.
PAGE 22 OF 24
BID No. 11-08-01
FIRM NAME:
Street Address:
Mailing Address (if different):
Telephone No.
Fax No.
Email Address:
FEIN No. -1_--1-1-1-1-1-1-
* "BY SIGNING THIS DOCUMENT THE PROPOSER AGREES TO ALL TERMS
SIGNATURE:
(SIGNATURE OF AUTHORIZED AGENT)
PRINT NAME:
TITLE:
THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF PROPOSER TO BE BOUND
BY THE TERMS OF ITS PROPOSAL. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE
BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE PROPOSAL NON-RESPONSIVE. THE CITY
MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY PROPOSAL THAT INCLUDES AN EXECUTED
DOCUMENT WHICH UNEQUIVOCALLY BINDS THE PROPOSER TO THE TERMS OF ITS OFFER.
PAGE 23 OF 24
BID No. 11-08-01
PAGE 24 OF 24
BID NO. 11-08-01
l.l, ~ L
OF SU~
NON-COLLUSION AFFIDAVIT
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach. FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
STATE OF FLORIDA
COUNTY OF
The undersigned being first duly sworn as provided by law, deposes, and says:
This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be
relied upon by said County, in any consideration which may give to and any action it may take with respect to this Bid.
The undersigned is authorized to make this Affidavit on behalf of,
(Name of Corporation, Partnership, Individual, etc.)
a,
, formed under the laws of
(Type of Business)
(State)
of which he is
(Sole Owner, Partner, President, etc.)
Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10.2, nor anyone else to the knowledge of the
undersigned, have themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any
department or employee therein, or any officer of the City of Sunny Isles Beach, Florida is directly interested therein. '
This Bid is genuine and not collusive or a sham; the person, firm or corporation named above in Paragraph 10.2 has not colluded, conspired,
connived or agreed directly or indirectly with any proposers or person, firm or corporation, to put in a sham Bid, or that such person, firm or
corporation, shall refrain from Bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication
or conference with any person, firm or corporation, to fix the prices of said Bid or Bids of any other proposers; and all statements contained in
the Bid or Bids described above true; and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph
10.2, has directly or indirectly submitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or
to any member or agent thereof.
AFFIANT'S TITLE
AFFIANT'S NAME
TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this _ day of
,200_.
Personally Known
or Produced Identification
Type of identification
(Affix seal here)
NOTARY PUBLIC (name printed or typed)
DECEMBER 28. 2010
1 of 7
PUBLIC ENTITY CRIMES
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
PUBLIC ENTITY CRIMES
Pursuant to the provisions of paragraph (2) (a) of Section 287.133, Florida State Statutes - "A person or affiliate
who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a
Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a
public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of
real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Sub-Contractor, or
Consultant under a Contract with any public entity, and may not transact business with any public entity in excess
of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on
the convicted vendor list".
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
11.1. This sworn statement is submitted to City of Sunny Isles Beach
by
[pnntlndlv'dual s name and title]
for
[pnnt name of entity submitting sworn statement]
whose business address is:
and (if applicable) its Federal Employer Identification number (FEIN) is
(If the entity had no FEIN, include the Social Security Number of the individual signing this sworn
statement: .)
11.2. 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 with 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 of the United States and involving
antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.
11.3. I understand that "convicted" or "conviction" as defined in Para. 287 .133( 1 )(b), Florida Statutes, means a
finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any
federal or state trail court of record relating to charges brought by indictment or information after July 1,
1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere.
11.4. I understand that an "affiliate" as defined in Para. 287.133(1 )(a), Florida Statutes, means:
a.)
predecessor or successor of a person convicted of a public entity crime; or
b.)
Any 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, executors, 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
2 of 7
DECEMBER 28. 2010
market value under an arm's length agreement, shall be a prime 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.
11.5. I understand that a "person" as defined in Para. 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 "persons" includes those officers, directors, executives, partners, shareholders,
employees, members, and agents who are active in management of any entity.
11.6. Based on information and belief, the statement which I have marked below is true in relation to the entity
submitting this sworn statement. (Indicate which statement applies.)
Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor any
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of
Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the
State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer
determined that it was not in the public interest to place the entity submitting this sworn statement on the
convicted vendor list. (Attach a copy of the final order.)
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,
THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I
ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO
A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
STATUTES, FOR CATEGORY TWO OF ANY, CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
By:
(Signature)
(Printed Name)
(Title)
Sworn to and subscribed before me this
day of
,20_, by
(AFFIX NOTARY STAMP HERE)
Signature: Notary Public - State of Florida
Print or Type Commissioned Name
Personally Known
OR Produced Identification
Type of Identification Produced
10/1998
3 of 7
EQUAL OPPORTUNITY /
AFFIRMATIVE ACTION
City of Sunny Isles Beach
1B070 Collins Avenue
Sunny Isles Beach. FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
EQUAL OPPORTUNITY I AFFIRMATIVE ACTION STATEMENT
The contractors and all subcontractors hereby agree to a commitment to the principles and
practices of equal opportunity in employment and to comply with the letter and spirit of
federal, state, and local laws and regulations prohibiting discrimination based on race,
color, religion, national region, sex, age, handicap, marital status, and political affiliation or
belief.
Signed:
Title:
Firm:
Address:
DECEMBER 28. 2010
4 of?
CONFLICT OF INTEREST
City of Sunny Isles Beach
1 B070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
CONFLICT OF INTEREST STATEMENT
The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must
disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the
City of Sunny Isles Beach or its agencies.
STATE OF FLORIDA
COUNTY OF
BEFORE ME, the undersigned authority, personally appeared
deposes, and states:
, who was duly sworn,
of
and principal office in
18.1.
am
the
with a local office in
18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. described
as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this
Affidavit based upon his own knowledge.
18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has
no financial interest in other entities submitting Bids for the same project.
18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in
any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for
the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and
execution of the Contract for this project.
18.5 Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from
participation in contract letting by any local, State, or Federal Agency.
18.6 Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any
other clients, contracts, or property interests for this project.
18.71 certify that no member of the entity's ownership or management is presently applying for any employee position or
actively seeking an elected position with the City of Sunny Isles Beach.
18.8 I certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City
of Sunny Isles Beach.
18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will
immediately notify the City of Sunny Isles Beach.
Dated this
day of
,2010.
Print or Type Name and Title
AFFIANT
Sworn to and subscribed before me this _ day of
D Personally Known OR
D Produced Identification ; Type of Identification
,2010.
NOTARY PUBLIC STATE OF FLORIDA
DECEMBER 28. 2010
5of7
DISPUTE DISCLOSURE
City of Sunny Isles Beach
1B070 Collins Avenue
Sunny Isles Beach. FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
DISPUTE DISCLOSURE FORM
Answer the following questions by placing a "X" after "Yes" or "No". If you answer "Yes", please
explain in the space provided, or on a separate sheet attached to this form.
19.1. Has your firm or any of its officers, received a reprimand of any nature or been suspended by the
Department of Professional Regulations or any other regulatory agency or professional associations within the last
five (5) years?
YES
NO
19.2. Has your firm, or any member of your firm, been declared in default, terminated or removed from a
contract or job related to the services your firm provides in the regular course of business within the last five (5)
years?
YES
NO
19.3. Has your firm had against it or filed any requests for equitable adjustment, contract claims, Bid protests,
or litigation in the past five (5) years that is related to the services your firm provides in the regular course of
business?
YES NO If yes, state the nature of the request for equitable adjustment, contract
claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the
monetary amounts of extended contract time involved.
I hereby certify that all statements made are true and agree and understand that any misstatement or
misrepresentation of falsification of facts shall be cause for forfeiture of rights for further consideration of this Bid
for the City of Sunny Isles Beach.
Firm
Date
Print or Type Name and Title
Authorized Signature
DECEMBER 28. 2010
6 of 7
-
ANTI-KICKBACK
City of Sunny Isles Beach
1 B070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
ANTI-KICKBACK AFFIDAVIT
STATE OF FLORIDA )
)
COUNTY OF )
I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid
will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a
commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or
by an officer of the corporation.
By:
Title:
The foregoing instrument was acknowledged before me this day of
, 20_, by [name
of person], as [type of authority], for
[name of party on behalf of whom instrument was
executed].
AFFIX NOTARY STAMP HERE:
Notary Public - State of Florida
Print or Type Commissioned Name
Personally Known OR Produced Identification
Type of Identification Produced
DECEMBER 28. 2010
7 of 7
-;.~~i~~~gJ~!~'~;lri:..-,m ..
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Commercial Application *Preferred PKFL101320261008 10/01110 10/01/11 461,445.
Gvrnmntllns
Trust*
I Premises
Premise 001 Building 001
19160 N Bay Road
Sunny Isles Beach, FL
33160
Nature of Business
Storm Water Pump Station
Premise 002 Building 001
18070 Collins Ave.
Sunny Isles Beach, FL
33160
Nature of Business
City Hall & Parking Garage
Premise 003 Building 001
18070 Collins Ave.
Sunny Isles Beach, FL
33160
Nature of Business
3000 Gallon Diesel Fuel Storage Tank
Premise 004 Building 001
301 Sunny Isles Blvd.
Sunny Isles Beach, FL
33160
Nature of Business
Storage Units - #B430, #B343, #112
Premise 005 Building 001
17425 Collins Ave.
Sunny Isles Beach, FL
33160
Nature of Business
Samson Park Restroom
Premise 006 Building 001
19141 Collins Ave.
Sunny Isles Beach, FL
~!'~qmm;~~Rif!;1f!rig;s~iJtW~l1,;:r~i
....;'~f~~g~~~~~,;fk~li~~~~~~!M{~i~ti{:{
For:
City of Sunny Isles Beach
AUn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
I 33160
I
I
Nature of Business
Northside Ocean 2 Restroom
Premise 008 Building 001
16501 Collins Ave
Sunny Isles Beach, FL
33160
I Nature of Business
I Pier Park Restroom
Premise 009 Building 001
18115 North Bay Road
Sunny Isles Beach, FL
33160
Nature of Business
Community Center/Pelican Community Pk
Premise 010 Building 001
18115 North Bay Road
Sunny Isles Beach, FL
33160
I Nature of Business
I Gymnasium
Premise 012 Building 001
Throughout District
Sunny Isles Beach, FL
33160
Nature of Business
48 Bus Shelters ($8,000 each)
Premise 013 Building 1
17620 Atlantic Blvd
Sunny Isles Beach, FL
33160
I Nature of Business
I Parking Lot - GL Only
Premise 014 Building 1
151 Sunny Isles Blvd
Sunny Isles Beach, FL
33160
For:
City of Sunny Isles Beach
Altn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Nature of Business
Strip Shopping Center GL only
Premise 015 Building 1
16100 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Strip Shopping Center GL Only
Premise 016 Building 1
16200 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Strip Shopping Center GL Only
Premise 017 Building 1
19200 Collins Avenue
Sunny Isles Beach, FL
33160
I Nature of Business
I Garage Building
Premise 018 Building
17200 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Skate Park in the Town Center Park
Premise 018 Building
17200 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Skate Park in the Town Center Park
Premise 018 Building
17200 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Skate Park in the Town Center Park
.(;t~ym'm<<~~i9~;:!q~Yr~l{~~irt~i;gf~~;,~~':[:~!~~%J~~ii;;;~i'i~;~;J:ft)cw
:' :., ~,~~': ~:" ~ ::~;.~: i .:. :.~.:.;-.
'~'g':
. -, ;.\,:;~,::,:';";~:':':.
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Premise 018 Building
17200 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Skate Park in the Town Center Park
Premise 019 Building
19200 Collins Avenue
Sunny Isles Beach, FL
33160
I Nature of Business
I Heritage Park
Premise 020 Building 1
191 Terrace & Atlantic Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Golden Shores Community Park
Premise 021 Building 1
17815 N Bay Road
Sunny Isles Beach, FL
33160
Nature of Business
Senator Gwen Margolis Park
Premise 022 Building 1
17425 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
Samson Oceanfront Park
Premise 023 Building 1
500 Sunny Isles Blvd
Sunny Isles Beach, FL
33160
Nature of Business
Bella Vista Bay Park
Premise 024 Building 1
Various Locations
~~,~Y'm'mlfiY:l~q~~lnl!iif;g:~';;:0;%Y
For:
City of Sunny Isles Beach
AUn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
I Sunny Isles Beach, FL
33160
I Nature of Business
I 5 Lifeguard Towers
Premise 025 Building
Various Locations
Sunny Isles Beach, FL
33160
I Nature of Business
I 6 Parking Meters
Premise 026 Building
Under Lehman Causeway
wlaccess
Sunny Isles Beach, FL
33160
Nature of Business
Public Works Compound
Premise 027 Building
Atlantic Isles
Sunny Isles Beach, FL
33160
Nature of Business
Single Family Area (33 Street Lights)
General Liability *Preferred PKFL101320261008 10101110 10101111 Included
Gvrnmntllns
Trust*
Occurrence Basis
General Aggregate 5,000,000
Products/Completed Oper. Aggr. Included
Personal & Advertising Injury Included
Each Occurrence 5,000,000
Damage to Rented Premises 50,000
Medical Expense (Any One 2,500
Person)
Employee Benefits 5,000,000
Per Occurrence
Property Damage Deductible 2,500
Bodily Injury Deductible 2,500
:),;~y'm:m@~t~f~;~,qr!!~I,'
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
5000000 10000 OCC
LAW ENFORCEMENT L1AB
5000000 2500
EMPL PRACTICES
5000000 2500
PUBLIC OFFICIALS L1A
5000000 2500
EMPL BENEFITS
1000 2500
NO FAULT SEWER BACKU
I 1000000
HERBICIDE/PESTICIDE
GL lncl Prod/CO and Pers/Adv Inj; Blkt Additional
Insured - Limited by FL Statute 768.28 EBL is on an
Occurence Basis (no retro date)
Location Building
GL Premium Basis - Payroll (Excluding
Police)
Premium Basis: 6,000,000
(P) Payroll - Per $1,OOO/Pay
Location Building
Law Enforcement Liability Premium Basis:
48 FT Officers
Location Building
EPLI Premium Basis: 155 FT Employees,
5 PT Employees, 0 Volunteers
Location Building
POL Premium Basis
Premium Basis: 6,000,000
(P) Payroll - Per $1,OOO/Pay
Crime "Preferred PKFL101320261008 10/01/10 10/01/11
Gvrnmntllns
Trust"
',it'~p:mm~~~~~filJ!!t~!!n~~[i%j ..........
.... .;i~~~ii~~~.?f:~&~~~~g~~a&%.
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beacht FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Employee Dishonesty 1,000,000
Deductible 5,000
Blanket
Forgery or Alteration 250,000
Deductible 5,000
Theft, Disappearance &
Destruction
Inside Premises 250,000
Deductible 1,000
Outside Premises 250,000
Deductible 1,000
Blanket
Computer Fraud
Deductible
250,000
1,000
Coverage Amemdments (Endorsements)
Funds Transfer Fraud $250,000 / $5,000 Oed.
Business Auto .Preferred PKFL101320261008 10/01/10 10/01/11
Gvrnmntllns
Trust.
I ~~~Hty
Any Auto
All Owned Autos Which Require
No-Fault Coverage
Medical Payments Ea Per 2,500
All Owned Autos
Uninsured Motorists
CSL 100,000
All Owned Autos
Underinsured Motorists
CSL 100,000
All Owned Autos
;!tSimmi;&;:g~
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
I Towing and Labor
11,000
Comprehensive
All Owned Autos
Hired Autos
j
I Collision
All Owned Autos
Hired Autos
Comprehensive Deductible
Collision Deductible
2,500
2,500
Endorsements, Forms,
Conditions.
$50,000 Hired Car Physical
Damage limit.
Property "Preferred PKFL101320261008 10101/10 10/01/11 Included
Gvrnmntllns
Trust.
I Policy Level Information
I Premise 1 Building 1
BUILDING - 600,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED.
Additional Coverages, Options, Restrictions, Endorsements, and Rating Information
"5% TIV Per Occurrence/Per Location for "Named Storm" wind subject to
minimum of $20,000 Per Occurrence
I Premise 2 Building 1
I BUILDING-
Valuation RC
18,501 ,050 I
;~~;g;,m'm'~~j:9f1lg~~'Ml~~.g~t,.<
^~"~~R~[~~~';~~,~~~~f',
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
CONTENTS - 1,000,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # WIND DED
FUEL TANK- 20,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I Premise 4 Building 1
STORAGE UNITS - 15,000
Valuation RC
Cause of Loss SPECIAL
I Premise 5 Building 1
BUILDING - 50,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I Premise 6 Building 1
BUILDING - 50,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I Premise 8 Building 1
BUILDING - 50,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
~t~Hm'm:;li~i~_Q~!lll~y~~ln~~i#I~r;
For:
City of Sunny Isles Beach
Alto: PriscilIa Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869305-364-7800
I Forms # 5% NAMED
I Premise 9 Building 1
BUILDING - 3,000,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
CONTENTS - 200,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # WIND OED
SHADE STRUCTU - 45.000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
I Premise 10 Building 1
BUILDING - 2,000,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
CONTENTS - 50,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # WIND OED
I Premise 12 Building 1
BUILDING - 384,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I (BUS SHELTERS -
~~1~Y:m.mi~;i9fjii!!~Yr!;;,s~~K'
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
I Forms # WIND DED
I
I
'-
I
I Premise 17 Building 1
I
I
GARAGE BLDG - 7.500,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I Premise 18 Building 1
BUILDING. 80,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
BATHROOM - 65,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # WIND
SHADE STRUCTU . 60,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
FENCE - 40,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
SKATE PARK - 95,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
I SHELTER-
I Premise 18 Building 2
I BLEACHERS/-
6,100 I
i:t~Ym'm'@;r~gI0.19~!!~!qS~;'
-;:~~~~,ri!~!ji~~l-~g.~'~'
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I PICNIC TABLES-
Forms # WIND
I Premise 18 Building 3
SHADE STRUCTU - 100,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I Premise 19 Building 1
PLAYGROUND EQ- 267,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
PAVILLlON - 75,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # WIND
WATER FEATURE - 175,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
I Premise 20 Building 1
PLAYGROUND EQ- 67,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
~
I ALUM FENCE -
5,300 I
t'f~l!mml,,';.""j~:~!in~Y:~;!l~~gf;~
"'~E~~~Ii~i4~~l~lg~~!l~'-(""
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Valuation RC
I Cause of Loss SPECIAL
Forms # WIND
I Premise 21 Building 1
BATHROOM BLOG - 100,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
SHADE STRUCTU - 65,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # WIND
PLAYGROUND EO- 75,000
Valuation RC I
Cause of Loss SPECIAL
Deductible 5000
I Premise 22 Building 1
SHADE STRUCTU - 35,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
PLAYGROUND EO- 55,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # WIND
I Premise 23 Building 1
DOCK- 115,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
I Premise 24 Building
5 LIFEGUARD - 150,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I TOWERS-
Forms # WIND
I Premise 25 Building
6 PARKING - 60,000
Valuation RC
Cause of Loss SPECIAL
Deductible 5000
Forms # 5% NAMED
I METERS-
Forms # WIND
Prof. Errors & Omissions *Preferred PKFL101320261008 10/01/10 10/01/11 0.00
Gvrnmntllns
Trust*
I TYPE OF POLICY
I Public Official
Boiler and Machinery *Preferred I PKFL 101320261008 10/01/10 10/01/11
Gvrnmntllns
Trust*
Small Business Policy Coverage:
Spoilage
Covered Equipment
Comprehensive
Incl Production Machines PO
Coverages
Property Damage 26,820,600
Deductible 5.000
l[,~9Jnm'~,i;Y~~~i!;~y:~;~~~:'?
'~~f.~~f:~~:'~~~1~4~~g~::":X
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
I Business Interuption
~
I
I Valued Form
Additional Information
$50,000 Water Damage; $100,000 Ammonia Contamination; $100,000 Hazardous I
Substance; $100,000 Ordinance or Law; Expediting Expenses and Spoilage
Damage included; Utility Interruption combined with BI & EE
I Commercial Notepad
Notepad # 001
Breakdown of Property Limits totaling $29,312,248.
City Hall Bldg = $18,501,050
City Hall Contents - $ 1,000,000
Pump Station Bldg = $ 600,000
Diesel Fuel Tank =$ 20,000
Storage Rooms @ $5000 =$ 15,000
Park Restrooms (3) =$ 150,000
Nature Center Bldg = $ 405,790
Nature Center Contents =$ 75,000
Community Center Bldg = $ 3,000,000
Community Center Cnts = $ 200,000
Gymnasium Bldg = $ 2,000,000
Gymnasium Cnts =$ 50,000
Strip Shopping Center Bldg = $ 419,760
48 Bus Shelters @$8,000 =$ 384,000
Strip Shopping Center Bldg = $ 1,301,643
Strip Shopping Center Bldg = $ 632,640
Strip Shopping Center Bldg = $ 557,365
Notepad # 002
Inland Marine Schedule totaling $3,184,556
Contractors/Mobile Equip = $ 174,019
EDP Equipment - $ 600,000
Fine Arts - $ 417,137*
Other Inland Marine = $ 892,000"
':;.~Ym:m;'~J,~f{I;~:;i!!!n~~!;~i~;~l~,t.,'
For:
City of Sunny [Sles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Leased Equipment =$ 50,000
Valuable Papers = $1,000,000
Watercraft = $ 219,400
."Rising Horizons" Sculpture at Town Center - $160,000, "Family" Sculpture
at Samson Park - $190,000, China Dinnerware Set $10.137. "Pelican"
Sculpture at Pelican Community Center - $3.500, "Fisherman" Sculpture at
Pier Park - $3,500, "Butterfly" Sculpture at Margolis Park - $20.000,
Dolphin with Lions, City Hall- $15,000., Ring Around the Rosie @ Town
Center $5,000., Baseball Player @ Pelican Comm Park $4,000., Baseball
Pitcher, Pelican Comm Park $4,000.. Floral Metal Sculpture/Green Light,
Pelican Comm Ctr - $1,000., Fish Metal Sculpture/Blue Light @ Pelican Comm
Ctr $1,000.
Notepad # 003
Extensions of Coverage w/$5000 Ded Applicable unless otherwise shown:
Accounts Receivable = $250,000
Animals = $1,000 anyone animal/ $5.000 Annual Aggregate
Debris Removal Expense = $250,000
Demolition. Ordinance & ICC = $250,000
Errors & Omissions = $15,000
Fire Department Charges = $25,000
Fungus Cleanup Expense = $2,500/$10,000
Lawns, Plants, Trees & Shrubs = $25.000
New Locations - $1,000,000 (60 days)
Personal Property of Employees - $25,000 anyone empl; $50,000 occurrence
Pollution Cleanup Expense - $50,000 occ I $50,000 agg
Recertification = $10,000
Service Interruption Coverage = $100,000
Transit = $250,000
Notepad # 004
"10 entry signs @$15.000 = $150,000,100 street signs @$1,OOO = $100,000,
20 light poles @$6,000 = $120,000, Decorative median fence - $300,000, 42
Beach access signs @$2,000 = $84,000, 33 Streetlights $2,000.=$66.000. @
Atlantic Isles. Trailers * @ $4,550=$36,000 & Tools & Equipment 6 @ $4.500
= $36,000. @ Public Works Compound
\!(~~mm;;R;q~)ip'~~'f~!'~
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Storage Tank Liability
*lllnois Union
Insurance Co.
G21828518007
1,711.97
Claims Made
Storage Tank Liab
General Aggregate 5,000,000
Each Occurrence 5,000,000
Per Claim
Other Deductible Deductible 5,000
5000000 5000
Agg Legal Defense Ex
TANK SCHEDULE:
Install 10/01/04 - 2,000 Diesel
Install 01101/95 - 4,000 Unleaded
Location Building
Third Party Liability & Clean-Up
I Premises
Premise 001 Building 001
18070 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
2000 Gallon Diesel Above-ground Storage Tank
Premise 002 Building 001
18080 Collins Avenue
Sunny Isles Beach, FL
33160
Nature of Business
4000 Gallon Unleaded Above-ground Storage Tank
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305.947.0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
Workers Compensation .Preferred VVCFL101320261 001 10/01/10 10/01/11 99,908.00
GvmmnUlns
Trust.
; Named States: FL
Employer's Liability
Each Accident 1,000.000
Disease Policy Limit 1,000.000
Disease Each Employee 1,000.000
Additional coverages/Endorsements
Schedule Adj. -$76,818
All States
Total Est. Annual Premo 99,908
Minimum Premium
Deposit Premium
I · See Attached Rating Information
Flood - Commercial Lines
.Hartford Ins Co 87047053592010
of Midwest
1 ,279.00
PROPERTY ADDRESS
18070 Collins Avenue Sunny Isles Beach, FL 33160
I BUILDING AMOUNT
I CONTENTS AMOUNT
I BUILDING DEDUCTIBLE
I CONTENTS DEDUCTIBLE
I 500,000
I 500,000
11.000
11.000
Flood - Commercial Lines
.Hartford Ins Co 87047053562010
of Midwest
2,366.00
PROPERTY ADDRESS
18115 N Bay Rd (NORTH BLDG) Sunny Isles Beach. FL 33160
I BUILDING AMOUNT
I CONTENTS AMOUNT
I 500,000
I 210.000
For:
City of Sunny Isles Beach
AUn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
,'c.(,Y~rage,'(:.\2J:THF;
:;.::..::i::.:\.,::.'........-.
"....\.,.i....:f\m(,l.lIlt ...'.::.p.}C.OtnPwlY.........,:..........., './NI!cyl';io'
'~:..-.'.;,;., .
x..''"\\..<..f:fi",,......,..
, Exp '':C:PremiuIIi}.......
I BUILDING DEDUCTIBLE
I CONTENTS DEDUCTIBLE
11.000
11.000
1--1
I I
Flood - Commercial Lines
*Hartford Ins Co 87047053602010
of Midwest
1.845.00
PROPERTY ADDRESS
18115 N Bay Rd (South Bldg) Sunny Isles Beach, FL 33160
I BUILDING DEDUCTIBLE
I 500,000
I 52,500
11,000
11,000
I BUILDING AMOUNT
I CONTENTS AMOUNT
I CONTENTS DEDUCTIBLE
Crime *Fidelity & CCP005689908 10101/10 10/01/11 714.07
Deposit Co of
MD
Employee Dishonesty 1,000,000
Deductible 5,000
Schedule
Coverage Amendments (Endorsements)
Position Schedule Bond: City Manager
Faithful Performance of Duty Coverage
Student Accident Policy I*Mutualof .\ 090874320112 \ 01/01111 10/01/11 11,163.75
Omaha Ins Co*
ACCIDENTAL DEATH 10.000
DISMEMBERMENT 1 MEMBER 5,000
DISMEMBERMENT - 2 OR 10,000
MORE
ACCIDENTAL DENTAL PER U&C
TOOTH
ACCIDENTAL DENTAL 1.000
MAXIMUM
AGGREGATE LIMIT 25,000
10S~mm,~~lg!A\!g~:~r~~,~.~~~~"}X
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869305-364-7800
HULL COMMERCIAL *RLllnsurance HUL02000452 03/16/11 10/01/11 1.866.39
Company
"GREY PEARL" $160,000
$2,500. Deductible
Glass
"USPlate Glass 63283
Insurance Cow
8.947.00
I * See Attached Glass Schedule
I Premises
Premise 001 Building 001
18070 Collins Avenue
Sunny Isles Beach, FL
33160
I Nature of Business
I City Hall
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869305-364-7800
Glass Coverage
Policy No. 63283
rPreinis4;Y)13.tijl~irigO: }l;tteiU}(#:.'i>late.sA.PPLcngth.. .:'Widtli':;?Af~~:i:Yl)esti[ii>li~il.:? ........ .........\, 1JseaiidP~sjiion:.P'.. .r.:.imit\:",'De~PJ ......}Pr~.:.('...;
1 1 1 2 62 58 Fronts All Impact Plates
1 1 2 2 67 58 Fronts
1 1 3 2 36 58 Fronts Click Next for
1 1 4 7 62 54 Fronts Add'l Apps
1 1 5 7 67 54 Fronts
1 1 6 7 36 54 Fronts
1 1 7 6 62 55 Fronts
1 1 8 6 67 55 Fronts
1 1 9 6 36 55 Fronts
1 1 10 3 62 53 Fronts
For:
City of Sunny Isles Beach
Attn: Priscilla Walker
18070 Collins Avenue
Sunny Isles Beach, FL
33160 305-947-0606
Workers Compensation - Rating
Information
Policy No. WCI'Ll01320261001
BROWN & BROWN OF FLORIDA INC
14900 NW 79th Court Suite#200
Miami Lakes, FL
33016-5869 305-364-7800
'A.<i4!~s~}('~'<.D'7?(' ,..... .,.,..,.......,........>:,.Class.Co:de( ",.............ClaSsific~tioris.\;,.\:]f"t:Ei#pls'.. ..P.JI~mpls>, ...; Remuneration..,' Rate.::" <iPremilinl'"
18070 Collins Avenue 7382 Bus Co-Empl & 224400
Sunny Isles Beach FL Driver
18070 Collins Avenue 7720 Police Officers & 3724754
Sunny Isles Beach FL Dr
18070 Collins Avenue 8810 Clerical 3003556
Sunny Isles Beach FL
18070 Collins Avenue 8820 Attorney-Empl 282596
Sunny Isles Beach FL &Cleri
18070 Collins Avenue 9015 Bldgs-Owner or 827978
Sunny Isles Beach FL Lesse
18070 Collins Avenue 9102 Park NOC 1383645
Sunny Isles Beach FL
18070 Collins Avenue 9402 Street Cleaning 50391
Sunny Isles Beach FL & Dr
18070 Collins Avenue 9410 Municipality 632304
Sunny Isles Beach FL NOC
',,-
ACCIDENT MEDICAL INSURANCE
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO
THE POLICY DOCUMENT
ACCIDRNT AL DBA TH & SPECIFIC LOSS (*)
Loss of Life Principal Sum $10,000
Single Dismemberment Principal Sum $ 5,000
Double Dismemberment Principal Sum $10,000
Loss Period: Loss within 180 Days of Injury
Group Travel Only
Coverage: Full Excess
ACCIDENT MEDICAL EXPENSE (*)
Maximum Benefit
Accident Medical Deductible (Corridor)
Loss Period:
Benefit Period:
Group Travel Only
Coverage: Full Excess
$25,000
$ 100
Initial treatment received within 30 days of injury
Benefits payable for 52 weeks from accident date
. Cove/'age Limits /nllsl bd IIltima/ery chosen by the Insured. We as Agen/s ca/lIIol ,'scommelld the adeql/Qte 1/ml/
ofp,'olecffon. Higher "mi/s nl/U' be available. Please leI liS /01011' if a quote Is dell/'ed.
ELIGIBILITY
All registered youth (ages 18 and under), adult participants and staff members of the Day Camp
activities sponsored and supervised by the Policyholder.
COVERED ACTIVITIES
Coverage is provided while participating in the follOWing activities, sponsored and supervised by
the Policyholder; while traveling during such activities as a member of a group in transportation
furnished or arranged by the Policyholder.
# of PIR
Activitv AJ!,e8 RCJ!,istronts Rates
Le1l2ues Soccer (Season Rates) , r' ~ ....:.. : 3-12 150 $8.25
BasebaWSoftball ,. .~. . " .5-12 75 $6.25
V ollevball . ' 5-12 50 $6.25
-
Basketball 3-14 150 $6.25
.
ChcerlcBdinR 5-12 40 $8.25
Karate $-12 20 $8.25
Fief!. Football 5-12 $0.00
Soccer Lea~e Adult 210 $25.00
Basketball League Adult 60 $12.25
Volleyball League
Adult 30 $12.25
Summer Camp - Sports I Week (Weekly Rate)
Sport Basketball, Baseball, Cheerleading, Volloyball, Soccer, Softball
Camps & Camo Olvmpics 3-15 350 $1.50
Brown & Brow'? of Florida, hlc.
Non Sp0l1
earn 5 5-]2 $0.75
6-16 100 $4,50
Adults SO $4.50
5-15 20 $3.00
Adult 20 $5.00
Youth 220 $3.25
Youth 80 $3.25
Youth $0.00
Adult 30 $2.75
Adult 40 $4.50
Brown & BraW1~ of Florida, Inc.
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8 ~ C1I ..... f .~ (IJ ::l
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a: a. # a c:U: s. Iii&'S/O~
tl. tl. D. .g. o.
i i '0 '0 ~~ifl) J~ fQ. C)~
i ~ ~ ~ ~
fit ~ lit ~~o~ j!I 01-
X X X X X >< I ... '< ~tns. ~
tf ~ 13 f (1'1 '" boolii'
co 0) ......i- o~ :!l
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01 Ul i'JOltIl -,,(Oi
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frehX!~d.
~ IN,UIlANCE "lUST
AboulUs
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"'brkers' Componsatioo
Welcome Yael
Report WC Claim I Report PKG Claim I List New WC Claims' List New PKG Claims I
Claim Lookup I Loss Runs' Charts I Reports I Loss Control I Hurricane Claims I Hurricane Walch I Log Out
Sunny Isles Beach . -- Last 5 Years --
. [Filter I
Fund Year
2006
2007
2007
2008
2009
2010
Policy Number
PK FL1 013202606-04
PK FL1 013202607-05
PKMFL 1 0132026 08-06
PKMFL1 013202608-06
PK FL1 013202609-07
PK FL1 0132026 10-08
Loss History Summary
Annual Premium Paid Reserve Incurred Claims Average Cost Loss Ratio Freq Ratio
$586,285 $148,999 $12,951 $161,950 18 $8,997 28% 3%
$436,108 $1,218 $0 $1,218 3 $406 0% 1%
$118,981 $3,466 $0 $3,466 8 $433 3% 7%
$494,987 $117,628 $133,902 $251,530 24 $10,480 51% 5%
$495,743 $37,639 $114,847 $152,486 18 $8,471 31% 4%
$463,009 $50,332 $247,978 $298,310 9 $33,146 64% 2%
Mod
2006
2007
2010
we FL 1 0132026 06-07
we FL1 013202607-08
we FL1 013202610-01
$349,696 $25,680 $0 $25,680
$299,026 $48,358 $0 $48,358
$99,908 $52,B78 $50,711 $103,589
11
24
17
$2,335
$2,015
$6,093
7%
16%
104 %
3% 0.900
8%0.830
17%0.860
Frequency Ratio by Coverage
II AL l!J APD Ii] GL 0 we
50%
40%
30%
20%
10%
0%
2006
2007
2008
2009
2010
Cause Group by Coverage History
Fund Year Coverage Cause Group Paid Reserve Incurred Claims Avg Cost Loss Ratio Freq Ratio
2006 AL Intersection Accident $20,060 $0 $20,060 2 $10,030 13% 1%
2006 AL Rea $467 $0 $467 1 $467 0% 1%
2006 AL Vehicle Accident on Streets/Roadway $0 $0 $0 2 $0 0% 1%
2006 AL Vehicle Backing Accident $809 $0 $809 1 $809 1% 1%
2007 AL Rea $2,145 $0 $2,145 2 $1,072 12% 11%
2007 AL Vehicle $0 $0 $0 1 $0 0% 1%
2007 AL Vehicle Accident due to Police Pursuit $0 $0 $0 1 $0 0% 6%
2007 AL Vehicle Accident on Streets/Roadway $1,205 $0 $1,205 1 $1,205 7% 6%
2007 AL Vehicle Backing Accident $1,116 $0 $1,116 1 $1,116 1% 1%
2008 AL Intersection Accident $17,911 $117,818 $135,729 4 $33,932 190% 6%
2008 AL Vehicle Backing Accident $774 $0 $774 1 $774 1% 1%
2009 AL Vehicle $2,604 $0 $2,604 1 $2,604 3% 1%
2009 AL Vehicle Accident on Streets/Roadway $1,839 $27,914 $29,753 6 $4,959 40% 8%
2010 AL Rea $6,251 $10,949 $17,200 2 $8,600 22% 3%
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Page 2 of3
2010 AL Vehicle Backing Accident $1,623 $15,487 $17,110 2 $B,555 22% 3%
AL TOTALS $56,804 $172,168 $229,972 29 $9,179 57% 7%
2006 APD Intersection Accident $6,659 $0 $6,659 1 $6,659 43% 6%
2006 APD Rea $6,775 $0 $6,775 3 $2,258 44% 19%
2006 APD Vehicle Accident on Streets/Roadway $2,985 $0 $2,985 2 $1,492 19% 13%
2006 APD Vehicle Fire $95,995 $12,951 $108,946 1 $108,946 703% 6%
2007 APD Vehicle Accident on Streets/Roadway $218 $0 $218 2 $109 1% 12%
2008 APD Intersection Accident $7,236 $16,084 $23,319 3 $7,773 121% 16%
2008 APD Vehicle Backing Accident $0 $0 $0 1 $0 0% 5%
2009 APD Vehicle Accident on Streets/Roadway $7,121 $0 $7,121 1 $7,121 51% 7%
2009 APD Vehicle Water Damage $4,323 $0 $4,323 1 $ 4, 323 31% 7%
APD TOTALS $131,312 $29,035 $160,346 15 $10,690 244% 23%
2006 GL False Arrest $0 $0 $0 1 $0 0% 3%
2006 GL Slip and Fall $15,250 $0 $15,250 4 $3,812 49% 13%
2007 GL Slip and Fall $0 $0 $0 3 $0 0% 20%
2008 GL Premises Liability $0 $0 $0 2 $0 0% 3%
2008 GL Slip and Fall $91,708 $0 $91,708 12 $7,642 119% 16%
2008 GL Water Services $0 $0 $0 1 $0 0% 1%
2009 GL Code/Ordinance Violations $2,670 $0 $2,670 1 $2,670 3% 1%
2009 GL Improper Maintenance $0 $0 $0 2 $0 0% 2%
2009 GL Slip and Fall $19,081 $86,933 $106,015 5 $21,203 122% 6%
2010 GL Slip and Fall $0 $9,000 $9,000 2 $4,500 13% 3%
GL TOTALS $128,709 $95,933 $224,643 33 $6,807 81% 12%
2006 WC Caught In or Between $3,296 $0 $3,296 3 $1,099 1% 1%
2006 WC Exposure $1,043 $0 $1,043 1 $1,043 0% 0%
2006 WC Fall or Slip $11,478 $0 $11,478 1 $11,478 3% 0%
2006 WC Miscellaneous Causes $6,094 $0 $6,094 3 $2, 031 2% 1%
2006 WC Motor Vehicle $411 $0 $411 1 $411 0% 0%
2006 WC Strain or Injury By $3,027 $0 $3,027 1 $3,027 1% 0%
2006 WC Struck or Injured By $331 $0 $331 I $331 0% 0%
2007 WC Animal/Insect $344 $0 $344 1 $344 0% 0%
2007 WC Cut,Puncture,Scrape $520 $0 $520 1 $520 0% 0%
2007 WC Exposure $412 $0 $412 1 $412 0% 0%
2007 WC Fall or Slip $5,735 $0 $5,735 4 $1,434 2% 1%
2007 WC Miscellaneous Causes $2,919 $0 $2,919 6 $487 1% 2%
2007 WC Motor Vehicle $99 $0 $99 1 $99 0% 0%
2007 WC Strain or Injury By $10,341 $0 $10,341 4 $2,585 3% 1%
2007 WC Struck or Injured By $27,988 $0 $27,988 6 $4,665 9% 2%
2010 WC Caught In or Between $4,149 $5,321 $9,470 1 $9,470 9% 1%
2010 WC Cut,Puncture,Scrape $534 $0 $534 1 $534 1% 1%
2010 WC Exposure $0 $1,100 $1,100 2 $550 1% 2%
2010 WC Fall or Slip $0 $550 $550 1 $550 1% 1%
2010 WC Miscellaneous Causes $440 $110 $550 1 $550 1% 1%
2010 WC Motor Vehicle $20,571 $26,859 $47,430 2 $23,715 47% 2%
2010 WC Strain or Injury By $11,266 $7,865 $19,132 5 $3,826 19% 5%
2010 WC Struck or Injured By $15,919 $8,905 $24,824 $6,206 25% 4%
WC TOTALS $126,917 $50,710 $177,628 52 $3,416 24% 7%
WC by Employee Class & Year
Show By: Employee Class I Employee Class, Year, Cause I Cause
Fund Year Coverage WC Class Code Paid Reserve Incurred Claims Avg Cost Loss Ratio Freq Ratio
2010 WC 7382 Auto Bus Taxi $19,992 $25,788 $45,780 1 $45,780 46% 1%
2010 WC 7720 Police Officers and Drivers $1,380 $6,620 $8,000 4 $2,000 8% 4%
2010 WC 8810 Clerical $792 $842 $1,634 2 $817 2% 2%
2010 WC 8868 College: Professional and Cler. $13,597 $2,126 $15,724 2 $7,862 16% 2%
2010 WC 9015 Bldg Oper-Owners (Maintenance) $3,819 $3,514 $7,332 1 $7,332 7% 1%
2010 WC 9102 Park Noc- All Employees $6,999 $11,821 $18,820 6 $3,137 19% 6%
2010 WC 9410 Municipal Employee $6,299 $0 $6,299 1 $6,299 6% 1%
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Page 3 of3
2007 WC 7382 Auto Bus Taxi $6,533 $0 $6,533 1 $6,533 2% 0%
2007 WC 7720 Police Officers and Drivers $9,404 $0 $9,404 6 $1,567 3% 2%
2007 WC 8810 Clerical $3,053 $0 $3,053 1 $3,053 1% 0%
2007 WC 9015 Bldg Oper-Owners (Maintenance) $9,540 $0 $9,540 6 $1,590 3% 2%
2007 WC 9102 Park Noc- All Employees $19,076 $0 $19,076 8 $2,385 6% 3%
2007 WC 9410 Municipal Employee $752 $0 $752 2 $376 0% 1%
2006 we 7720 Police Officers and Drivers $7,707 $0 $7,707 5 $1,541 2% 1%
2006 WC 8810 Clerical $698 $0 $698 1 $698 0% 0%
2006 WC 9102 Park Noc- All Employees $13,907 $0 $13,907 2 $6,953 4% 1%
2006 WC 9410 Municipal Employee $3,368 $0 $3,368 3 $1,123 1% 1%
we TOTALS $126,916 $50,711 $177,627 52 $3,416 24% 7%
Combined Vehicle Frequency Ratio by Cause Detail
IIIlntersectfon Accident (]!I Rear -End damage Vehicle Accident
iii Vehicle - Illegal Turn o Vehicle - collision while elCltlng parking lot
III Vehicle Accident due to POIICB Pursuit . Vehicle Accident on streetsJRoadway - not at Inter
o Vehicle Backing Accident o Vehicle Fire
o Vehicle Water Damage
12%
10%
8%
6%
2%
1
4%
0%
2006
2007
2008
2009
2010
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Preferred
r:J~VERNMfJ/TAL
_ INSURANCE TRUST
PUBLIC ENTITY
COMMON AGREEMENT DECLARATIONS
Administered By;
Public Risk Underwriters of Florida @
P.O. Box 958455
Lake Mary, FL 32795-8455
TRUST:
Preferred Govemmentallnsurance Trust
P.O. Box 958455
Lake Mary, FL 32795-8455
Agreement Number: PK FL 1 0132026 10-08
NAMED COVERED PARTY AND MAILING ADDRESS:
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
AGENT NAME AND ADDRESS:
Brown & Brown, Inc.
8000 Governors Square Blvd. Suite 400
Miami Lakes, FL 33016
AGREEMENT PERIOD: From: 10/0112010 To: 10/01/2011
At 12:01 a.m. Eastern Standard Time at your mailing address shown above.
In return for the payment of the premium. and subject to all the terms of this agreement, we agree with you to
provide the coverage as stated in this agreement.
This agreement consists of the following coverage parts for which a premium is indicated. This premium may be
subject to adjustment.
COVERAGE PART
Property and Inland Marine Coverage
General Liability Coverage
Law Enforcement Coverage
School Leaders' Liability Coverage
Automobile Coverage
Garage Keepers I Garage Coverage
Public Officials Liability Coverage
Employment Practices liability Coverage
Crime Coverage
Excess Workers' Compensation Coverage
ANNUAL PREMIUM
Included
Included
Included
Not Included
Included
Not Included
Included
Included
Included
Not Included
TOTAL ANNUAL PREMIUM
FORMS APPLICABLE TO ALL COVERAGE PARTS:
See PGIT 002
$417,656
THESE DECLARATIONS TOGETHER WITH THE COMMON AGREEMENT CONDITIONS, COVERAGE PARTS
SUPPLEMENTAL DECLARATIONS, COVERAGE PARTS, FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO
FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED AGREEMENT.
..
COUNTERSIGNED
PGIT 001 (07 09)
10/07/2010
DATE
by
U~ e~~--
AUTHORIZED REPRESENTATIVE
Preferred
~ ~VERNMENTAl
lIB] INSURANCETRUST
PUBLIC ENTITY
PROPERTY AND INLAND MARINE
COVERAGE PART DECLARA liONS
COVERED PARTY:
City of Sunny Isles Beach
AGREEMENT NO.: PK FL1 013202610-08
SCHEDULE OF COVERAGES AND LIMITS OF COVERAGE
DeductJbles
5% TIV Per Occurrence/Per location for "Named Storm" subject to
minimum of $20,000 Per Occurrence
$5,000 Per Occurrence - All other Perils - Buildings & Contents and
Extensions of Coverage
Per Attached Schedule Inland Marine
Covered Property
Total Insured Values - Blanket Building and Contents - Per Schedule on file totaling
loss of Business Income $500,000
Additional Expense $500,000
$26,339,810
Inland Marine
Communication Equlpmenl
Contractor's / Mobile Equipment
Electronic Data Processing Equipment
Emergency Services Portable Equipment
Fine Arts
Other Inland Marine
Rented, Borrowed, leased Equipment
Valuable Papers
Watercraft
$0
$174,019
$600,000
$0
$370,637
$754,000
$50,000
$1,000,000
$219,400
If marked with an "X. we will cover the following EXTENSIONS OF COVERAGE on form PGIT 104 (07 09).
These limits of liability do not Increase any other applicable limit of liability.
(X) Code Extensions of Coverage Limit of Llablllty
X A Accounts Receivable $250,000 in anyone occurrence
X B Animals $1,000 anyone Animal
$5,000 Annual Aggregate in anyone agreement period
X C Buildings Under Construction If shown on Property Schedule
X D Debris Removal Expense $250,000 in anyone occurrence
Demolition Cost, Operation of
X E Building laws and Increased $500,000 in anyone occurrence
Construction Cost
X F Duty to Defend Included
X G Errors and Omissions $250,000 in anyone occurrence
X H Expediting Expenses $5,000 in anyone occurrence
X I Fire Department Charges $25,000 in anyone occurrence
X J Fungus Cleanup Expense $10,000 in anyone occurrence
$20,000 Annual Aggregate in anyone agreement period
X K lawns, Plants, Trees and Shrubs $25,000 in anyone occurrence
L leasehold Interest $0 in anyone occurrence
PGIT 010 (07 10)
Includes copyrighted material of Insurance Services Office, Inc. with its permission
Page 1
.
X New Locations $2,000,000 in anyone occurrence for up to 60 days from
N the date such new location(s) is first purchased, rented or
occupied, whichever is earlier
X 0 Personal Property of Employees $25,000 for anyone employee
$50.000 in anyone occurrence
X P Pollution Cleanup Expense $25,000 In anyone occurrence
$50,000 Annual Aggregate in anyone agreement period
X Q Professional Fees $10,000 in anyone occurrence
X R Recertification $10,000 in anyone occurrence
X S Service Interruption Coverage $100,000 In anyone occurrence
X T Transit $250,000 in anyone occurrence
U Vehicle Property Coverage $0 in anyone occurrence
X V Preservation of Property Coverage $250,000 in anyone occurrence
Coveraae
Earth Movement
Flood
TRIA
Special Property Coverages
Deductlbles
$5,000 except for Zones A & V
Limit
Not Included
$5,000,000
Not Included
Equipment Breakdown (Boller & Machinery)
Covera~e
Limit
Property Damage I Loss of Business Income I Additional Expense per accident
Water Damage
Ammonia Contamination
Hazardous Substance Coverage
Ut~ily Interruption
Spoilage Damage
Ordinance or Law
Expediting Expenses
$26.339,810
$50,000
$100,000
$100,000
Combined with Business Income and Additional Expense
Included
$100,000
Included
Deductible
Amount
$5,00
Equipment Breakdown
FORMS AND ENDORSEMENTS
Forms and endorsements applying to this Coverage Part and made part of the coverage agreement at this time of issue:
See PGIT 002
Premium: $ INCLUDED
THIS SUPPLEMENTAL DECLARATIONS AND THE COMMON AGREEMENT DECLARATIONS, TOGETHER
WITH THE COMMON AGREEMENT CONDITIONS, COVERAGE PART(S), FORMS AND ENDORSEMENTS, IF
ANY, COMPLETE THE ABOVE NUMBERED AGREEMENT.
PGIl 010 (0710)
Includes copyrighted material of Insurance Services Office. Inc. with its permission
Page 2
Prpferretl Property Schedule
iiinii ':I~PJiMOOAl City of Sunny Isles Beach
~ IHlUlW<<:ETRUSr
Agreement No.: PK FL1 013202610-08
Apncy: Brown & Brown, Inc.
Agreement Period: 10/01/2010 through 10/0112011
Unit' Descrfptfon Year Built Eft. Date Butldlnl Value I Total Insured Value
Address - Term Date - Contents Value
Roof Shape I Roof Pitch Const Type Roof Cowring I Cowrlnl Replac.d I Roof Vr BIt
I water Pumps 1989 10/01/2010 $600,OOC
001 19160 N Bay Road -zsr:- $600,00<
Sumy Isles Beach, Fl 33160 Pump/Lift 10/0112011 $0
I Station I I
I Lity Hall and ParKIng Garage 2004 10/01/2010 $18,501,050
002 18070 Collins Avenue 131 - FR . ---.--- $19,501,05e
Sunny Isles Beach, Fl33160 10/01/2011 $1,000,000
Rat I Low (< 10) Butlt up roof with gravel I 2004 I 2004
JOOO Gallon [)Iesel fuel rank 2004 10/01/2010 $20,000
003 18070 Collins Avenue $20,000
Sunny Isles Beach, FL 33160 213 . on 10/0112011 $0
Ground
Flat I Liquid I I
Stora!!e
:.torage LOCkers. Contents only (3 units, ~:l,000 each) 2005 10/0112010 $0
004 301 Sunny Isles Blvd 1)1 - MFR -....-.-- $15,OOC
Sunny Isles Beach, FL 33160 10/01/2011 $15,000
Flat I Low (< 10) Built up roof with gravel I 2005 I 2005
~rnson Park Restrooms 2000 10/01/2010 $50,000
005 17..25 Collins Ave 131 - fR 00- 1----_00'-- $5O,()()(
Sunny Isles Beach, Fl33160 10/01/2011 $0
Rat I Low (< 10) Built up roof with gravel I 2000 I 2000
NorthSlde OCean 2 Restrooms 2005 10/0112010 $50,000
006 19141 Collins Ave 119 - JM -------.. $50,00<
Sunny Isles Beach, Fl33160 10/0112011 $0
Flat I low (< 10) Built up roof with gravel I 2005 I 2005
I Pier Pari< Restrooms 2006 10/01/2010 $50,000
008 16501 Collins Ave '1!r:-fR $5O,OOC
Sunny Isles Beach, FL 33160 10/01/2011 $0
Flat I Low (< 10) Built up roof with gravel I I 2006
I commootty Center 2007 10/0112010 $3.000.000
009 18115 N.Bay Road 131 . ~R $3,200,000
Sunny Isles Beach, Fl33160 10/01/2011 $200,000
Hip I High (> 30) Steel - Standing Seam I I 2007
Gynaslum 2007 1010112010 $2.000.000
010 18115 N.BayRoad --------..-----.--- $2,05O,OOC
Sunny Isles Beach, FL 33160 Ul' ~K 10/0112011 $50.000
Gable end with bracing I Medium (10 to 30) Steel - Standing Seam I I 2007
048 X Bus Shelters (S8,OOO each) 10/01/2010 $384,000
011 Various locations within the Cfty of Sunny Isles 111 - NoNC -- $lIl4,OOC
Sunny Is(es Beach, FL 33160 10/0112011 $0
Flat I I I
I Retail Building 10/0112010 $419.760
012 287 SUMY Isles Blvd l11-MNC - ."- $419,76C
Sunny Isles Beach, FL 33160 10/01/2011 $0
I I I I
Total: I $25,074,810 $1,265,000 , $26.339,810
Preferred Governmental Insurance Trust
Coverage Agreement Endorsement
Endorsement No.: 7
Member: City of Sunny Isles Beach
Effective Date: 05/13/2011
Agreement No.: PK FL 1 0132026 10-08
Coverage Period: 10/01/2010 to 10/01/2011
In consideration of an additional premium of $10,715.00, the Coverage Agreement is amended as follows:
ProDertv
Added
Location 017: Heritage Park - Playground - 19200 Collins Avenue, Sunny Isles Beach, FL. 33160 (Miami-
Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type JM, Protection Class 4.
Building Value: $267,000
Contents Value: $0.00
Location 018: Heritage Park - Pavilion - 19200 Collins Avenue, Sunny Isles Beach, FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type MNC, Protection Class 4.
Building Value: $75,000
Contents Value: $0.00
Location 019: Heritage Park - Interactive Water Feature - 19200 Collins Avenue, Sunny Isles Beach, FL.
33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type Pump/Lift Station, Protection Class 4.
Building Value: $175,000
Contents Value: $0.00
Location 020: Golden Shore Community Park - Playground Equipment - 191 Terrace & Atlantic Avenue,
Sunny Isles Beach, FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type JM, Protection Class 4.
Building Value: $67,000
Contents Value: $0.00
Location 021: Golden Shore Community Park - Aluminum Fence - 191 Terrace & Atlantic Avenue, Sunny
Isles Beach, FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type JM, Protection Class 4.
Building Value: $5,300
Contents Value: $0.00
Location 022: Senator Gwen Margolis Park - Bathroom Building - 17815 N. Bay Road, Sunny Isles Beach,
FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type MNC, Protection Class 4.
Building Value: $100,000
Contents Value: $0.00
Location 023: Senator Gwen Margolis Park - Shade Structure - 17815 N. Bay Road, Sunny Isles Beach, FL.
33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type NC, Protection Class 4.
Building Value: $65,000
Contents Value: $0.00
Location 024: Senator Gwen Margolis Park - Playground Equipment - 17815 N. Bay Road, Sunny Isles
Beach, FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type JM, Protection Class 4.
Building Value: $75,000
Contents Value: $0.00
Preferred Governmental Insurance Trust
Coverage Agreement Endorsement
Endorsement No.: 7
Member: City of Sunny Isles Beach
Effective Date: 05/13/2011
Agreement No.: PK FL 1 0132026 10-08
Location 025: Samson Oceanfront Park - Shade Structure - 17425 Collins Avenue, Sunny Isles Beach, FL.
33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type JM, Protection Class 4.
Building Value: $35,000
Contents Value: $0.00
Location 026: Samson Oceanfront Park - Playground Equipment - 17425 Collins Avenue, Sunny Isles
Beach, FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type JM, Protection Class 4.
Building Value: $55,000
Contents Value: $0.00
Location 027: Town Center Park - Bathroom Building - 17200 Collins Avenue, Sunny Isles Beach, FL. 33160
(Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type MNC, Protection Class 4.
Building Value: $65,000
Contents Value: $0.00
Location 028: Town Center Park - Shade Structure - 17200 Collins Avenue, Sunny Isles Beach, FL. 33160
(Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type NC, Protection Class 4.
Building Value: $60,000
Contents Value: $0.00
Location 029: Town Center Park - Fence - 17200 Collins Avenue, Sunny Isles Beach, FL. 33160 (Miami-
Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type NC, Protection Class 4.
Building Value: $40,000
Contents Value: $0.00
Location 030: Town Center Park - Skate Park - 17200 Collins Avenue, Sunny Isles Beach, FL. 33160 (Miami
-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type JM, Protection Class 4.
Building Value: $95,000
Contents Value: $0.00
Location 031: Bella Vista Bay Park - Dock - 500 Sunny Isles Blvd., Sunny Isles Beach, FL. 33160 (Miami-
Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type Waterfront Structures, Protection Class 4.
Building Value: $115,000
Contents Value: $0.00
Location 032: Pelican Community Park - Shade Structure - 18115 N. Bay Road, Sunny Isles Beach, FL.
33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type NC, Protection Class 4.
Building Value: $45,000
Contents Value: $0.00
Preferred Governmental Insurance Trust
Coverage Agreement Endorsement
Endorsement No.: 7
Member: City of Sunny Isles Beach
Effective Date: 05/13/2011
Agreement No.: PK FL 1 0132026 10-08
Location 033: Lifeguard Towers/Sunny Isles Beach - 5 @$30,OOO - 17200 Collins Avenue, Sunny Isles
Beach, FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type NC, Protection Class 4.
Building Value: $150,000
Contents Value: $0.00
Location 034: Parking Meters - Various locations - 6 @$10,OOO , Sunny Isles Beach, FL. 33160 (Miami-
Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type NC, Protection Class 4.
Building Value: $60,000
Contents Value: $0.00
Location 035: Public Works Compound - 8 Trailers @$4,500 each, Tools & Equipment @$4,500 each-
Lehman Causeway with access off of Collins Avenue, Sunny Isles Beach, FL. 33160 (Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type MNC, Protection Class 4.
Building Value: $36,000
Contents Value: $36,000
Location 036: 33 Decorative Light Poles at Atlantic Isles - Atlantic Isles, Sunny Isles Beach, FL. 33160
(Miami-Dade)
Yr Built: N/A; N/A Sq. Ft.; Construction Type MNC, Protection Class 4.
Building Value: $66,000
Contents Value: $0.00
Revised TIV
Buildings: $ 33,992,450
Contents: $ 1.301.000
Total: $ 35,293,450
Subject otherwise to the tenns, conditions and exclusions of the coverage agreement.
..
Issued: 05/31/2011
Authorized by:
l,j~ &~b-
Preferred Governmental Insurance Trust
Coverage Agreement Endorsement
Endorsement No.: 5
Member: City of Sunny Isles Beach
Effective Date: See Below
Agreement No.: PK FL1 013202610-08
Coverage Period: 10/0112010 to 10/01/2011
In consideration of a total additional premium of $33,290.00, the Coverage Agreement is amended as
follows:
Effective 10/01/10
Prooertv- Inland Marine
Fine Arts
Chanced
#016: Butterfly Sculpture - Limit is increased from $3,500 to $20,000
Revised Inland Marine TIV
Total:
$3,184,556
Effective 01/26/11
ProDertv
Changed
Location 013: Parking Garage, 19200 Collins Ave., Sunny Isles Beach, FL. 33160 (Miami-Dade)
Building Value is increased from: $750,000 to $7,500,000
Contents Value remains unchanged ($0.00)
Revised T1V
Buildings: $ 32,341,150
Contents: $ 1.265,000
Total: $33,606,150
Subject otherwise to the tenns, conditions and exclusions of the coverage agreement.
..
Issued: 04/21/2011
Authorized by:
~~ e~-
Preferred Governmental Insurance Trust
Coverage Agreement Endorsement
Endorsement No.: 6
Member: City of Sunny Isles Beach
Effective Date: 04/01/2011
Agreement No.: PK FL 1 0132026 10-08
Coverage Period: 10/01/2010 to 10/01/2011
In consideration of an additional premium of $76.00, the Coverage Agreement is amended as follows:
Prooertv- Inland Marine
Communication Equipment
Added
#026: 2011 Yamaha Jetski, Model FY1800K, Serial#YAMA3673B111, Value $12,000
#027: 2011 Yamaha Jetski, Model FY1800K, Serial#YAMA3679B111, Value $12,000
Revised Inland Marine T1V
Total:
$3,208,556
Subject otherwise to the tenns, conditions and exclusions of the coverage agreement.
..
Issued: 04/28/2011
Authorized by:
LJ~ &,v. --
~~W!! PUBLIC ENTITY
GENERAL LIABILITY COVERAGE PART
DECLARATIONS
COVERED PARTY: City of Sunny Isles Beach
AGREEMENT NO.: PK FL1 013202610.08
SCHEDULE OF COVERAGES AND LIMITS OF COVERAGE
DeductlbJes
Bodily Injury, Property Damage $2,500
Employee Benefits Liability $2,500
Law Enforcement Liability $2,500
Coverage is only provided for the coverages Indicated by an X.
Coveraae
0 Bodily Injury and Property Damage $5,000,000 Per Occurrence
Personal Injury and Advertising Injury Included Per Person or Organization
Products I Completed Operation Aggregate Limit Included
$5,000,000 General Aggregate Limit
Medical Payments $2,500
0 Employee Benefits Liability $5,000,000 Per Occurrence
$5,000,000 Aggregate Limit
0 Fire Damage Limit $50,000 Any One Premise
0 No Fault Sewer Backup $1,000 Per Claimant
$5,000 Aggregate Limit
0 Pesticide I Herbicide limit $1,000,000 Aggregate Limit
0 Law Enforcement $5,000,000 Per Person
$5,000,000 Per Occurrence
$5,000,000 Aggregate Limit
FORMS AND ENDORSEMENTS
Forms and endorsements applying to this Coverage Part and made part of the coverage agreement at this time of Issue:
See PGIT 002
Premium: $ INCLUDED
THIS SUPPLEMENTAL DECLARATIONS AND THE COMMON AGREEMENT DECLARATIONS, TOGETHER
WITH THE COMMON AGREEMENT CONDITIONS, COVERAGE PART(S), FORMS AND ENDORSEMENTS, IF
ANY, COMPLETE THE ABOVE NUMBERED AGREEMENT.
I PGIT 020 (07 10) Page 1
~~~
PUBLIC ENTITY
AUTOMOBILE
COVERAGE PART DECLARATIONS
ITEM ONE
COVERED PAR1Y:
AGREEMENT NO.:
City of Sunny Isles Beach
PK FL 1 0132026 10-08
ITEM TWO
SCHEDULE OF COVERAGES AND LIMITS OF COVERAGE
This agreement provides only those coverages where s charge Is shown In the premium column below. Each of these coverages will apply only to those
"autos" shown as covered "autos." "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the
Covered Autos Section of the Public Entity Automobile Coveraas Fonn next to the name of the coveraQs.
COVERED AUTOS
(Entry of one or more of the LIMIT
COVERAGES symbols from the Covered THE MOST WE WILL PAY FOR ANY ONE PREMIUM
Auto Secfion of the Public
Entity Automobile Coverage ACCIDENT OR LOSS
Form shows which autos are
co...,ed aulca)
UABIUTY 1 Total Any One Accident $5,000,000 Included
$2,500 Deductible Subject to PGIT 306
PERSONAL INJURY PROTECnON 5 STATUTORY Included
(or equivalent No-faun Coverage)
AUTO MEDICAL PAYMENTS 2 $2.500 Included
UNINSURED MOTORISTS 2 $100,000 Included
UNDERlNSURED MOTORISTS 2 $100,000 Includsd
('MIen not included In Uninsu<ed Motorists
Coverage)
PHYSICAL DAMAGE 2,8 ACTUAL CASH VALUE OR COST OF REPAIR, WHICHEVER IS Included
COMPREHENSIVE COVERAGE LESS, MINUS OED. AS SCHEDULED FOR EACH COVERED
AUTO PER ATIACHED SCHEDULE, BUT NO DEDUCTIBLE
APPLIES TO LOSS CAUSED BY FIRE OR LIGHTNING. See ITEM
FOUR For Hired Or Borrowed "Autos."
PHYSICAL DAMAGE SPECIFIED N/A ACTUAL CASH VALUE OR COST OF REPAIR, WHICHEVER IS Not Included
CAUSES OF LOSS COVERAGE LESS, MINUS $_ OED. FOR EACH COVERED AUTO FOR
LOSS CAUSED BY MISCHIEF OR VANDALISM. See ITEM FOUR
For Hired Or Borrowed 'Autos"
PHYSICAL DAMAGE 2,8 ACTUAL CASH VALUE OR COST OF REPAIR, WHICHEVER IS Included
COLUSION COVERAGE LESS, MINUS OED. AS SCHEDULED FOR EACH COVERED
AUTO PER A TIACHED SCHEDULE. See ITEM FOUR For Hired
Or Borrowed "Autos."
PHYSICAL DAMAGE TOWING AND 2 $1,000 For Each Disablement of A Private Passenger "Auto" Induded
LABOR (Not available In Califomia)
PREMIUM INCLUCEC
PGIT 030 (07 10)
Includes copyrighted material of Insurance Services Office, Inc. with its permission
Page 1
ITEM THREE
SCHEDULE OF COVERED AUTOS YOU OWN
SEe ATTACHED SCHEDULE
ITEM FOUR
SCHEDULE FOR HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS
LIABILITY COVERAGE
STATE
EST1MAlED COST OF HIRE FOR EACH STATE
RATE
FACTOR (If Llablllty Cov.
Is Primary)
PREMIUM
FL
s
IF ANY
FLAT CHARGE
Included
PHYSICAL DAMAGE COVERAGE
COVERAGES LIMIT OF COVERAGE ESTIMATED ANNUAL RATE PER EACH $100 PREMIUM
THE MOST WE .....,LL PAY DEDUCTIBLE COST OF HIRE ANNUAL COST OF HIRE
COMPREHENSIVE ACTUAL CASH VALUE OR COST OF REPAIRS OR $IF ANY $ Induded
$50,000. WHICHEVER IS LESS. MINUS $2,500 OED.
FOR EACH COVERED AUTO.
SPECIFIED CAUSES ACTUAL CASH VALUE OR COST OF REPAIR. $ $ $
OF LOSS WHICHEVER IS LESS, MINUS $ OED. FOR EACH
COVERED AUTO FOR LOSS CAUSED BY MISCHIEF
OR VANDALISM
COLLISION ACTUAL CASH VALUE OR COST OF REPAIRS OR $IF ANY $ Induded
$50,000. WHICHEVER IS LESS, MINUS $2,500 OED.
FOR EACH COVERED AUTO
PREMIUM Included
ITEM FIVE
SCHEDULE FOR NON.OWNERSHIP LIABILITY
NAMED COVERED PARTY'S BUSINESS
RATING BASIS
PREMIUM
Induded
Muricipality
IFANY
FORMS AND ENDORSEMENTS
Forms and endorsements applying to this Coverage Part and made part of the coverage agreement at this time of issue:
See PGIT 002
Premium: $ INCLUDED
THIS SUPPLEMENTAL DECLARATIONS AND THE COMMON AGREEMENT DECLARATIONS, TOGETHER
WITH THE COMMON AGREEMENT CONDITIONS, COVERAGE PART(S), FORMS AND ENDORSEMENTS, IF
ANY, COMPLETE THE ABOVE NUMBERED AGREEMENT.
PGll 030 (07 10)
Includes copyrighted material of Insurance Services Office, Inc. with its permission
Page 2
.
City of Sunny Isles Beach
Fleet List
as of 7/12/2011
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
,
,~ '.
YEAR MAKE MODEL VIN
1992 MERCURY GRAND MARQUIS 2MELM75W5NX735359
1998 CHEV 5-10 P/U 1 GCCS19X7W8238354
1998 FORD CROWN VIC 2FAFP71W2W123428
1998 FORD CROWN VIC 2FAFP71WOVVX123430
1998 FORD CROWN VIC 2FAFP71W7VVX123425
1998 KUSTOM SMART TRAILER 1K9B50813WK118886
1999 FORD RANGER 1FTVR10V5XUB21491
1999 FORD TAURUS 1FAFP52U5XA212681
1999 TRAILER UL TV TRAILER 1E9AL10131L25274
2000 BUICK REGAL LS 2G4WB55K9Y1339105
2000 FORD CROWN VIC 2FAFP71WOYX140957
2000 FORD F-350 P/U 4X4 1FTSW31S9YEC57228
2000 FORD FOCUS 1FAFP33P3YVV304289
2000 FORD TAURUS 1 F AFP5220YG136865
2000 FORD TAURUS 1FAFP5222YG136866
2000 FORD TAURUS 2FAFP5826YA236852
2000 POLARIS GENESIS PLE03160K900
2001 ARROW TRAILER 146UB1217YM040808
2001 ARROW TRAILER 146UB1211 M041457
2001 FORD CROWN VIC 2FAFP71W81X121868
2001 FORD CROWN VIC 2FAFP71VVX1X121869
2001 FORD CROWN VIC 2FAFP71W31X124015
2001 FORD CROWN VIC 2FAFP71W51X124016
2001 FORD CROWN VIC 2FAFP71W71X124017
2001 FORD CROWN VIC 2FAFP71W91X124018
2001 FORD CROWN VIC 2FAFP71W21X124023
2001 FORD CROWN VIC 2FAFP71W41X124024
2001 FORD CROWN VIC 2FAFP71W61X124025
2001 FORD EXPLORER 1 FMZU72E31 ZA54351
2001 FORD F 150 P/U 1 FTZF172XWNB49773
2001 FORD F-250 P/U 1FTNF21L21EB57977
2001 FORD EXPLORER 1 FMZU72E11ZA54350
2001 TRAILER JET SKI TRAILER 146DA 1413YM040808
2003 TOYOTA CAMRY 4T1BF32K834056591
2004 CONT ATV TRAILER 1ZJUT14X4M025518
2004 ELDORADO C5500 AEROLITE 1 GBE5V1254F518956
2004 ELDORADO C5500 AEROLITE 1 GBE5V1284F518823
2004 FORD E-550 1FDAE55F93HBOO115
2004 FORD EXPLORER 1 FMZU72K44UA82245
2004 FORD EXPLORER 1 FMZU72K44UA82246
2004 FORD EXPLORER 1 FMZU72K84UA82167
City of Sunny Isles Beach
Fleet List
as of7/12/2011
43
44
45
46
47
48
49
50
51
52
53
54
55
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
j
~ '.
!
\
" "
YEAR MAKE MODEL ~, VIN
2004 FORD EXPLORER 1 FMZU72KX4UA82168
2004 FORD EXPLORER 1FMZU72K14UA82169
2004 FORD EXPLORER 1 FMZU72K64UA82247
2004 FORD F-250 4X4 1FTNF21L93ED58701
2004 FORD F-350 4X4 1FTSF31SX4EB72117
2004 YAMAHA KODIAC ATV 5Y4AJ07Y24A021825
2005 ANDERSON TRAILER 4YNBN18245C026637
2005 BOBCAT LOADER 525018616
2005 CECO WASHERlTRAIL NOVIN0200444887
2005 CHEV IMPLALA 2G1WH52K259248321
2005 CONT ATV TRAILER 1ZJUT18175M030168
2005 CONT JETSKI TRAILER 1ZJBE20115M030167
2005 CONT SKI TRAILER 1ZJBE141X5M030169
2005 CONT SKI TRAILER 1ZJBE146X5M030170
2005 CONT TRAILER 1ZJUT18175M030162
2005 CONT TRAILER 1ZJUT18175M030155
2005 FORD EXPLORER 1 FMZU72KX5UB05725
2005 FORD CROWN VIC 2FAFP71W05X141814
2005 FORD CROWN VIC 2FAFP71W05X141815
2005 FORD CROWN VIC 2FAFP71VV95X141813
2005 FORD EXPEDITION 1FMPU165X5LA66505
2005 FORD EXPEDITION 1FMFU18255LA65079
2005 FORD EXPLORER 1 FMZU72K05UB05720
2005 FORD EXPLORER 1 FMZU72K25UB05721
2005 FORD EXPLORER 1 FMZU72K45UB05722
2005 FORD EXPLORER 1 FMZU72K65UB05723
2005 FORD EXPLORER 1 FMZU72K85UB05724
2005 FORD EXPLORER 1 FMZU64K15UB58899
2005 FORD F-150 4X4 1 FTVX14555NA84968
2005 FORD F-650 DUMP 3FRWF65E36V167079
2005 FORD RANGER 4X4 1FTYR11E65PA58377
2005 FORD SPORT - TRAC 1 FMZU77K45UB98914
2005 YAMAHA ATV 5Y4AJ15Y15A004564
2005 YAMAHA ATV 5Y4AJ15Y15A001883
2005 YAMAHA FX140 JETSKI YAMA27281405
2005 YAMAHA JET SKI YAMA28921405
2005 YAMAHA JET SKI Y AMA27301405
2005 YAMAHA KODIAK 400 ATV 5Y4AJ15Y45A001182
2005 YAMAHA KODIAK 400 ATV 5Y4AJ15Y05A004029
2005 KUSTOM SMART TRAILER 2S9US11135S132322
2006 BIG 0 CHOPPER 5J11YBJ196WOO0570
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
lUti
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
City of Sunny Isles Beach
Fleet List
as of 7/12/2011
.
,
YEAR MAKE t', MODEL VIN
2006 CHEV IMPALA 2G1VVU581469220371
2006 ELDORADO AEROTECH 240 1 FDXE45P06HB23977
2006 FORD CROVVN VIC 2FAFP71VV86X124986
2006 FORD CROVVN VIC 2FAFP71VV96X124978
2006 FORD CROVVN VIC 2FAFP71VV76X124980
2006 FORD CROVVN VIC 2FAFP71VV96X124981
2006 FORD CROVVN VIC 2FAFP71VV26X124983
2006 FORD CROVVN VIC 2FAFP71VV46X124984
2006 FORD CROVVN VIC 2FAFP71VV66X124985
2006 FORD CROVVN VIC 2FAFP71VV86X124979
2006 FORD CROVVN VIC 2FAFP71VV06X124982
2006 FORD EXPLORER 1 FMEU72E2GUA93029
2006 FORD F-150 4X4 1FTRF14616NA63718
2006 FORD RANGER 4X4 1FTYR11E36PA49220
2006 FORD RANGER 4X4 1FTYR11E56PA49221
2006 HAUM UTL Y TRAILER 16HCB12126G083098
2006 SEAARK BOAT SAMA17811606
2006 TRAILER UTL Y TRAILER 1A9BB302X7F714512
2006 YAMAHA ATV JY 4AM03Y56C083960
2006 FORD F-150 4X4 1FTRF145X6NA63717
2007 FORD CROVVN VIC 2FAFP71VV57X155100
~UUf rUKU VI\,; .... ..... . . ~I VV f f ^ ..h' I U I
2007 FORD CROVVN VIC 2FAFP71VV97X155102
2007 FORD CROVVN VIC 2FAFP71VV07X155103
2007 FORD CROVVN VIC 2FAFP71VV27X155104
2007 FORD CROVVN VIC 2FAFP71VV67X155106
2007 FORD CROVVN VIC 2FAFP71VV87X155107
2007 FORD CROVVN VIC 2FAFP71VV47X155105
2007 STERLING ELGIN 49HAADBV17DX57959
2007 YAMAHA YFM66FGVVR JY4AM03Y27C103048
2008 FORD AEROTECH 240 1FDXE45P87DA95189
2008 FORD EXPEDITION 1FMFK195X7LA74796
2008 FORD F.550 1FDAF56R38EC75765
2008 GEM eL 5ASAK27 448F047 426
2008 GEM eL 5ASAK27 4X8F047 429
2008 MIDVVEST JETSKI TRAILER 1MDKNKK118A411928
2008 VERA VT/ MIXER 2S9U821108S132160
2008 YAMAHA RHINO 5Y 4AM 16Y08A009631
2008 YAMAHA RHINO 5Y4AM16Y88A002734
2008 YAMAHA RHINO 5Y 4AM23Y89A003863
2009 FORD CROVVN VIC 2FAHP71V79X129519
2009 FORD CROVVN VIC 2FAHP71V39X129520
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
City of Sunny Isles Beach
Fleet List
as of 7/12/2011
.. ,
-~ ,-
YEAR M~KE MODEL VIN
2009 FORD CROWN VIC 2FAHP71V79X129522
2009 FORD CROWN VIC 2FAHP71V59X129521
2009 FORD CROWN VIC 2FAHP71V99X129523
2009 FORD EXPLORER 1FMEU73E69UA21432
2009 FORD EXPLORER 1FMEU73E49UA21431
2009 FORD F-150 4X4 1 FTRF14879KC35833
2009 POLARIS ATV 4XAMN76A59A542186
2009 POLARIS ATV 4XAMN76A39A543675
2009 POLARIS RANGER 4XAMN76A39A543675
2010 CHEVY C5500 AEROLITE 1GBG5U1928F414849
2010 CHEVY TAHOE 1 GNUKAEOXAR1 09533
2010 CHEVY TAHOE 1GNUKAE04AR110760
2010 CHEVY TAHOE 1GNUKAE05AR108676
2010 CHRYSLER 300 2C3CA4CD4AH140313
2010 CHRYSLER 300 2C3CA4CD2AH140312
2010 DODGE CHARGER 2B3AA4CTOAH143981
2010 FORD CROWN VIC 2FABP7BVXAX112562
2010 FORD EXPLORER 1 FMEU7DE3AUA30138
2010 FORD EXPLORER 1 FMEU7DE4AUA30133
2010 FORD EXPLORER 1 FMEU7DE8AUA30135
2010 FORD EXPLORER 1 FMEU7DEXAUA30136
2010 FORD EXPLORER 1 FMEU7DE1 AUA30137
2010 FORD EXPLORER 1 FMEU7DE6AUA30134
2010 FORD EXPLORER 1 FMEU6FE9AUA34332
2010 FORD F-150 4X4 1 FTEW1 E82AFC 17296
2010 HARLEY-D ROAD KING 1 HD1 FHM19AB673703
2010 HARLEY-D ROAD KING 1HD1FHM13AB673809
2010 HARLEY-D ROAD KING 1HD1FHM18AB674101
2010 HARLEY-D ROAD KING 1HD1FHM1XAB674276
2010 POLARIS RANGER 4XATH76A9A2885214
2010 POLARIS RANGER 4XATH76A2A2885202
2010 VOLVO YV1382MS8A2490264
2011 ASPT TRAILER FL T10002AD
2011 CHEVY IMPALA 2G1WG5EK4B1248040
2011 DODGE CHARGER 2B3CL1CT7BH554295
2011 FORD CROWN VIC 2FABP7BV1BX121815
2011 FORD CROWN VIC 2FABP7BV5BX121820
2011 FORD CROWN VIC 2F ABP7BVOBX121823
2011 FORD CROWN VIC 2FABP7BV2BX121824
2011 FORD CROWN VIC 2FABP7BV4BX121825
2011 FORD CROWN VIC 2FABP7BVXBX121831
City of Sunny Isles Beach
Fleet List
as of 7/12/2011
172
173
174
175
176
177
178
~F ..
YEAR MAKE MODEL VIN
2011 FORD CROWN VIC 2FABP7BV5BX121834
2011 FORD CROWN VIC 2FABP7BV7BX121835
2011 FORD F-150 1 FTMF1 CMXBKD65765
2011 FORD F-150 4X4 1 FTMF1 EM2BKD62484
2011 HARLEY-D ROAD KING 1 HD1 FHM1 OBB649789
2011 YAMAHA FY1800K Y AMA3673B 111
2011 YAMAHA FY1800K Y AMA3679B111
Preferred Governmental Insurance Trust
Coverage Agreement Endorsement
Endorsement No.: 1
Member: City of Sunny Isles Beach
Effective Date: 10/0112010
Agreement No.: PK Fl1 0132026 10-08
Coverage Period: 10101/2010 to 10/01/2011
In consideration of an additional premium of $2.114. the Coverage Agreement is amended as follows:
Professional Liability
Public Officials & Employment Practices Liability Coverage Part Declarations, PGIT 025 (07 100) is
amended to read:
Deductible
Employment Practices Liability $2,500
Public Officials liabiJIy $2,500
Limit
Employment Practices liability $5,000,000 Per Claim
$5,000,000 Aggregate Limit
Public Officials liability
$5,000,000 Per Claim
$5,000,000 Aggregate limit
Coverage Agreement Forms List - PGfT 002 (07 10) is amended as follows:
Delete;
Public Entity Self Insured Retention Schedule and Endorsement PGIT 903 (07 09)
Subject otherwise to the terms, conditions and exclusions of the coverage agreement.
.
Issued: 10/0712010
Authorized by: ~ ~ e Nf...~-""-'
Preferred
r:J ~VERNMENTAl
11III INSURANCE TRUST
PUBLIC ENTITY
CRIME COVERAGE PART DECLARATIONS
COVERED PARTY: City of Sunny Isles Beach
AGREEMENT NO.: PK FL 1 013202610-08
SCHEDULE OF COVERAGES AND LIMITS OF COVERAGE
Coverage is only provided for the coverages indicated by an X.
Coverage
o Employee Dishonesty Per Loss Coverage
o Forgery or Alteration Coverage
o Theft, Disappearance and Destruction Coverage - Inside
Outside
o Computer Fraud Coverage (Including Funds Transfer)
Limit of Coverage Deductible
$1,000,000 $5,000
$250,000 $5,000
$250.000 $1.000
$250,000 $1,000
$250,000 $1.000
FORMS AND ENDORSEMENTS
Forms and endorsements applying to this Coverage Part and made part of the coverage agreement at this lime of Issue:
See PGIT 002
Premium: $ INCLUDED
THIS SUPPLEMENTAL DECLARATIONS AND THE COMMON AGREEMENT DECLARATIONS, TOGETHER
WITH THE COMMON AGREEMENT CONDITIONS, COVERAGE PART(S), FORMS AND ENDORSEMENTS, IF
ANY, COMPLETE THE ABOVE NUMBERED AGREEMENT.
I PGIT 080 (07 10)
Page 1
Workers Compensation Renewal Worksheet
Class Description 09/10 Audited Payroll 10/11 Renewal Payroll
Code
7382 BUS CO - EMPLOYEES & DRIVERS 224,400 225,449
7720 POLICE OFFICERS & DRIVERS 3,724,754 3,646,860
8810 CLERICAL 3,003,556 2,547,828
8820 ATTORNEY - ALL EMPL & CLERICAL 282,596 281,063
9015 BULDINGS - OWNER OR LESSEE 827,978 930,782
9102 PARK NOC -EMPLOYEES & DRIVERS 1,383,645 842,871
9402 STREET CLEANING & DRIVERS 50,391 119,480
9410 MUNICIPAL NOC 632,304 644,791
Number of Employees:
. Full-time: 155
. Intermittent (On-Call): 13
. Part-Time: 72
. Temporary: 8
Total # of employees: 243
.....
. .
...:
. NCCI.INC
901 PENINSUlA CORPORATE CIRCLE
, OOCARATOfl, rL 33487.1362
OOI1VOOOI4~/onOl("1 1 007. CX14F.
SUNNY ISLES BEACH CITY OF
18070 COLLINS AVE
SUNNY ISLES BEACH FL 33160-2723
1111111I/111I1"'" ..1111I111.1/ 11.1'11.1111/.111I11I111111..1
.'1$1001\.1'
Covncj(lil
. CCllf>pCnla))n
InS'Jh1nc9.lr,c
Important InformatKln MoUl YourWlIkers O:rnpensalion Insurance
Dear Policyrolder:
The Nalional Council on Compensation Insurance, fnc, (NCCI), headquartered in Boca Ralon, Fbrida, is the
nation's largest informal ion rompany selVlng the wOlkers rxmpensalion malkelplace We provide inforrnalion
selvices to state funds, seIHnst/reds, indepenclenl bureaus, insurance agents, regulatory aUlhorities, insurance
oompanies, and employers like you
A copy of }Qur current experience raling worksheet is enclosed NXI calculates your rating annuaUy on behalf
of the insurance industry. The experience rating modifIer, detailed on this wOfl<sheel, is one of the factors used
to calculate your oorkers compensafion insurance premium. A copy of ~ur oorl~heel will be senl to you each
year as part of NeD's conlinuing effo/1s to Increase employer awareness of safely in Ihe workplace and its im-
pact not onty on your employees, bul on your bollcm line, Please remember, SAFElY in Ihe workplace is one
of the besl wa:p to reduce WJrkers compensation insurance rosts,
Your experience raling factor can be found in Ihe botlcm righf corner of the sumnary. A factor higher Ihan 1.00
means }Qur premium will be higher than lhat of the average company in your category For excmple, a facta of
1. 10 means your base premium WIll be surcharged 10 percent A faclor of .90 means you have earned a 10
percent credit on }Qur base premilln
Many items ~llpact your final experience factor, including your payroll classification(s), your payroll, the fre-
quency of injuries to your employees, and the dollar value of those injuries (Ihe amount of medical and lost
wage benefits paid 10 your injured employees as well as lhe amount of money held in reserve to pay oonlinuing
benef/ls) This information is reported to NCCI annually by your insurer.
If you have any questions regarding your experience rating, YOll should rontact }QUf insurance agent or insur-
ance rompany for assistance, II is also reeonmended that you retain this wOI~.sheet for ~ur tiles and for rom-
parison to future annual calculations.
WORKERS COMPENSATION EXPERIENCE RATING
CS1 Risk Name: CITY OF SUNNY ISLES BEACH Risk 10: 091103249
Rilling Effective Date: 10/01/2011 Production Date: 06/15/2011 State: FLORIDA
State Wt SRP Exp Excess Expected Exp Prim Act Exc Losses Ballast Act Inc Losses Acl Prim
Losses Losses Losses Losses
rl .24 0 222,562 278,284 55,722 353,145 46,800 406,860 53,715
(Alf(S)1 (e) Exp Excess (0) Expected (E) Exp Prim I (F) Act Exc I (G) Ballast I (H) Act Inc I (I) Act Prim
Wt Losses (0 - E) Losses losses Losses (H -I' Losses Losses
~[~ 222.56. 278,284 55.7221 353.145j 46,8001 406,8601 53.7151
Primary Losses Stabilizing Vlllue Ratable Excess Tolals
(I) C . (1 - A) + G (A)' (F) (J)
Actual 53,715 215,947 84,755 354.417
(E) C ' (1 - A) + G (A) '(C) (K)
Expected 55.722 215,947 53,415 325,084
~...-
ARAP FLARAP SARAP MAARAP Exp Mod
(J) / (1<)
Factors 1,11 1.09
_._'~.
RATING REFLECTS A DECREASE OF 70% MEDICAL ONLY PRIMARY AND EXCESS LOSS
DOLLARS WHERE ERA IS APPLIED.
~~
~
Copyrigh[ 1993-2011, All rights re$erved. Thrs eJ:.f1ct'~nce IT'lOdtr4eation faclor IS comprised of compilat ons and inlorm,tion which are the pforxietcllrY and ex<;lu5IVt' proper1yof lh&NalIONI
Council on Compen$Oilion Insurance, Inc. (NCCI) No further u~e, dis$~minatJor'll, !tale, trans'!r, 8sstgnmenl or diiposHion 01 this experi.nce rab~ moditlccation betor Of' any p~ lhereot
may be used w;th()(Jt 1he writtenc:onsent of NCe!. Neel ma~es n~ represent4lbon Of wa,,;nry, expresHd Of Implied, as to In)' matteJwh41lsoe..e( includll"lg blA nollimlte-d to tho 3,ccuraCYQr
any Intormat,on, prod~t or servjee furntshed hereunder '00, as to NeCl, recipient of thIS e)Cpi'nence rating modiflnhon fackn sum-cribes to and utilizes. tn.lntOlmat,on servICe "a~ i,~.
Page 1 of3
000145/000J65 CX1435 T
_ Risk Name: CITY OF SUNNY ISLES BEACH
WORKERS COMPENSATION EXPERIENCE RATING
Rating Effective Date: 10/01/2011
Productfon Date: 06/1512011
09-FLORIDA
Firm ID:
State: FLORIDA
Risk ID: 091103249
Firm Name: CITY OF SUNNY ISLES BEACH
Carrier: 38849
Policy No. WCFL 101320280708
! Code ELR -/ R~tio j----P;yro"l E~::~~~d
5509 .2,nT .15 01 0
7380 2,201. .21 5,460! 120
7382 2,16~1 214,359. 4,630
~_~~_ ~46,915L 46,533
6810 .10 ,22 2,890.496L 2,890
8820 ,07 .20 364.648l 255 .
9015 1.63 ,22 836,390 13,633
9102 1.36 ,22 795,305 10.8161
194021 2.35 .1B 45,144 1,0611
~~ 12.402
r ~~~
IPollcy Total: 9,802,812 Premium:
09-FLORIDA
Ef1' Date: 10/0112007
Exi> Prim
Losses .
Claim Dala IJ OF
Exp Date: 1010112008
o 0153194
25 0154650
1,019 0147128
8,376 NO, 18
636 0147836
51 0152876
2,999 0152605
2,36Oj 0155084
191
2,728
441,478
uJ
Total Act Ino
Losses:
5 F
5 F
5 F
6 .
6 F
6 F
6 F
16 F
..I
Firm 10:
Firm Name: CITY OF SUNNY ISLES BEACH
Exp Dale: 10/0112009
Carrier: 31860
Polley No. FMIT0820
Eft Date:
10/01/2008
Act Ine
Losses
4,178J
6,207
6,432
10.233
2,267
2.930
4.049
6.210
42,506
Act Prim '
Losses i
4,1781
5,ooOJ
5,000
10.233
2.267
2,930
4,049
5,0001
.1
Code ELR D. Payroll Expected EXpP~ ~m~ IJ OF Act Ine Act Prim ,
Ratio Losses Losses .....,..... . Losses losses
-
7382 2.16 .22 226,420 4,891 1,076 WC20D911213 5 F 3,789 3.789
7720 1.35 .18 3,457,800 46,680 8.402 WC200911 rB7 5 F 4,570 4,570
2,648,406/ -
8810 .10 .22 2.648 583 WC200911217 5 F 21,862 5,000
8820 .07 .20 353,8161 248 50 WC200811035 5 0 162,281 5,000
-
9015 1.63 .22 914,0561 14.699 3,278
9102 1.36 .22 1.203,5481 16,368 3,601
9402 2.361 .18 I 50.6991 1.191 214
9410 1.03 .22 1.531,053 15,770 3.469
9765 WORKPLACE SAFETY C -2.164 -436
9841 DRUG FREE CREDIT -5,3021 -1,067 --~-W I ,
-.- 1---.---- -
9944 PREMIUM CREDIT FOR _.~L. 0 1 I I I
Subject 304,2451 Total Act Inc
Policy Total: 10,385,798 Premium: Losses: 192.502
Copyright 1993.2011, All rlgNs '.,.N9d. Th" eJlCpenence mOChf,catJo" factor is comprised or COmpilation, and inforrnation which OIIre lhe pfQpfletary and exclysrve propertyot the National
Counctl on CompqnsatfOl1 Insurance,lne {Nea) No rurther use, dissemination. ..r~ .Ira....ster. 35Sign~t or disposilion or this expenence ,,'ing mochhcatlonf.ctct Of any part thereof
may be used WIthout the wr~en conse,,' of Neel Neel make, no repri!senration or w~"an!y. expren.d or impied. ,$ to any m.ah~ whatsoever indudlng but not limited 10 the acwracy 01
an... ",foanat)oll, product or s.er\lll::e ttJtnisl1ed "ereUf1de.r and. as to Neel, lecrpient of Ihis C'llpellence rating fJ'I()diflCahonfaclOf sub~cnbes to and utilizes the- inlcm1ation seJVice ~as lS~_
, T 0101 by Po~cy Year of all e.... $2000 Of I... 0 Di.ease Loss
C Cata&(rophi~ los.s E Employets liability Loss
Page 2 of 3
X Ex~Medical Cov."g.
"limIted los,s
UUSl&HW
GJ Risk Name: CITY OF SUNNY ISLES BEACH
WORKERS COMPENSATION EXPERIENCE RATING
Risk 10: 091103249
Rating Effective Date: 10/0112011
Product/on Date: 06/15/2011
State: FLORIDA
09.FLORIDA
Firm 10:
Firm Name: CITY OF SUNNY ISLES BEACH
Carrier; 31860
Polley No. FMIT0820
EN Date:
10/01/2009
Exp Date: 10/0112010
i Code I ElR D- Payroll I Expected Exp Prim /. Claim Oall I'J OF Actlnc Acip~
Ratio Losses Losses Losses Losses ;
7382 2.16 .22 241'247t 5,211 1,146 WC201011535 5 0 6,500 5.000
7720 1.35 .18 47.890 8,620 WC201011457 5 0 200,000 # 5.000
3.547,432
8810 .10 .22 2.815.793 2,816 620 INO. 3 /6 . 1,504 1.504
8820 .07 .20 312,351 219 44 WC200911372 6 F 2,244 2.244
.-- --
9015 1.63 .22 978,113 15.943 3,507 WC201011497 6 0 2,500 2,500
9102 1.36 .22 1,250.140L 17.002 3,740 WC200911337 6 F 2.884 2,884
- -- r---- . 37,080f
9402 2.35 .18 871 157 WC200911334 6 F 3.650 3.650
9410 ~L-~~_ I ~79,219L_ 8'0/.61 1,7661 I
~
9765 WORKPLACE SAFETY C -2,105 -421
9841 DRUG FREE CREDIT .5,158 -1.032 ~
9944 P~EMIUM CREDIT FOR 0 0
SUbject Total Act Inc
Policy Total: 9,961,375 Premium: 252,005 Losses: 219,282
F'~~
~
Copyright 1993.2011, All rights ,eserved n.~ e)l!~rJence mod'ltlcahon fiKtor ts corr.priSf-d of compllallons and inlofm~fiol"l wntcll are the plopr~ary and t'lldusive pio~rtyof .tle National
Council on COmp'lOsabon Insurilnce.lnc. (NCCQ. No turUle, uso. di$semt~tjon, sate, t/;ln5ter. assignm.nt ordlspo~tio'" of thls elCpen!'nr:;:e raring modiflcahon ractor or any part thereof
may bl! used withovt the written COI'Iaer'lt or Heel Nee! makes no rePfesentation or warunty, e)(ptes~cd or Impled, as to arlY matt.erwttat5Oever Iflcluchng but lIot limited 10 the accuracy 01
any inforrniltlon, producl or service ftrnrs,hed ~reUf1der and, as to Neer, reClp1ent ollfus experience fating modi' ~al,on factor :s.vbsaibe-s tQ and lllil,ZeoS (he fntorm3hon seoMce -IS is",
. ToIal by Policy Year 0' all cas.es. $2OJO or ress 0 Disease Loss
C CatastrophIC lo.s E Employer. lIability Loss
X Ex.Medical COv'''ge
" limited Loss
UUSl&HW
Page 3 of 3
000115/000366 CX1435 T
.RL[
RLllnsurance Company
9025 N. LIndbergh Drive · Peoria, IL 61615. (309) 692-1000
A stock Insurance company, hereIn called the Company.
POLICY DECLARATIONS
Policy Number: HUL0200045
Renewal of: HUL0200045
Broker Reference Number:
"NAMED INSURED" AND ADDRESS:
City Of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
AGENT/BROKER:
59649 Britt Paulk Ins Agency, Inc.
100 Glen Eagles Court
Carrollton. GA 30117
POLICY PERIOD From 03116/2011 To 10/01/2011 at 12:01 AM Standard Time at your mailing address shown
above.
In consideration of the premium as outlined below and subject to all the terms of this Policy. this Company agrees to
provIde the insurance coverage as stated In the attached Policy. This premium may be subject to adjustment.
Coverage Part Premium
Hull $1,645.00
TRIA $200.00
See attached Tax, Fee & surcharge Schedule (OMP 900) if applicable. Taxes/Fees/Surcharges: $21.39
Premium payable at Inception unless Payment Schedule (OMP 113) applies. Total Premium: $1,866.39
Minimum Premium: N/A
ADDITIONAL FORMS AND ENDORSEMENTS - MADE PART OF THIS POLICY AT TIME OF ISSUE
See Attached Schedule of Endorsements (OMP 2150)
'~~rJ(6
Authorized Signature
OM? 100 (07/09)
INSURED
RLllnsurance Company
9025 North Lindbergh Drive. Peoria, IL 61615
SUPPLEMENTAL OECLARA liONS
Policy No: HUL0200045
Named Insured and Mailing Address
City Of Sunny Isles Beach
16070 Collins Avenue
Sunny Isles Beach, FL 33160
portion of premium attributable to coverage for Certified Acts of Terrorism $200.00
Portion of premium attributable to coverage for Certified Acts of Terrorism
(fire only), as required by state law $ 0
RIL 110B (01/08)
INSURED
~ .......
.,- "
'"
...;-.......
~...,
WESTCHESTER. ILLINOIS
~
PLATE GLASS
INSURANCE POLICY
RENEWAL OF 09 -
NUMBER 6 3 2 8 3
:y
.,/,'
rC.f~""
. allY .,'
" .Ie ,Suite 320, Westchester, Il60154. 708-449-6060
NAME AND ADDRESS INSURED
EFFECTIVE 12:01 A.M.
Ar ADDRESS OF
GLASS INSURED
FROM:
10:
January I, 2011
October 1, 2011
CITY OF SUNNY ISLES BEACH
18070 COLLINS AVE.
SUNNY ISLES BEACH, FL 33160
ISSUING OFFICE
MASSPLATE INSURANCE
ONE WESTBROOK CORP CTR STE 320
WESTCHESTER IL . 60154
AGENCY
BROWN & BROWN INC
8000 GOVERNORS SQ - #400
MIAMI LAKES, FL 33016-1588
INSUREO IS AT ABOVE ADDRESS UNLESS STATED HERE
en
~
['U
CX)
(J..)
OCCUPANCY
11"/1 B. 00 +
OFFICE
fORM OF COVERAGE
$100.00
Per Occurrence
Deductible
**********************************************
EXTERIOR:' ONLY GLASS AS ITEMIZED
IN GLASS SCHEDULE DATED.l/1/2010.
NO OTHER GLASS INSURED HEREUNDER
SEE ATTACHED SCHEDULE.
**********************************************
NOTICE: DONIT ORDER BOARDUP OR GLASS REPLACEMENT
WITHOUT OUR AUTHORITY
CALL TOLL-FREE 1-877-SHATTER TO REPORT ALL
E~DORSEMENTSlAOOITIONAL COVERAGES
FL : 1195 (7 - 2 006); 160; 1 71; 0605 i 100
.
'"
FORM. PG 103.lJ.69
Y.~!m~!/
v
Glass Sched-ule
Date: 1/1/2011
Policy If :
Name:
09-63283
at}' of Sunny Isles Beach
18070 Collins Ave, Sunny Isles Beach, FL 33160
.. Number of Width Length Position Type of Glass Description
-' plates
.... ..'..'.
Gmd FL . .. ' ,-: . ":"', ...'...... ....:.:..., " " . " .:. ,i...' .,.: ,... i~.' ..... : ""':';'/.:
2 58 62 Front TulC Impact
2 58 67 Front TUlt Impact
2 58 36 Front TUlt Impact
7 54 62 Front '!'int Impact
7 54 67 Front TUlt Impact
7 54 36 Front Tmt Impact
6 55 62 Pront TUlt Impact
6 55 67 Front Tint Impact
6 55 36 Front Tmt Impact
3 53 62 Front Tmt Impact
3 53 67 Front Tint Impact
3 53 36 Front Tmt Impact
2 56 62 Front Tmt Impact
2 56 67 Front TUlt Impact
2 56 36 Front TUlt Impact
3 58 32 Front YUlt Impact
6 58 67 Front YUlt Impact
7 54 32 Front Y Ult Impact
14 54 67 Front Tmt Impact
2 56 32 Front Tml Impact
4 56 67 Front TInt Impact
7 55 32 Front Tmt Impact
14 55 67 Front Tint Impact
1 53 32 Front Tmt Impact
2 53 67 Finnt TUlt Impact
4 9 67 Sidelire TUlt Impact
2 42 36 'transom Ymt Impact
2 53 35 Front Ymt Impact
1 72 78 Transom Ymt Impact
4 28 79 Door Ymt Impact
2 17 94 Front Tun Impact
2 17 73 Front TUlt Impact
1 17 94 Front TUlt Impact
2nd FL . . .... .:....... ., ,'<.: ': .::::'" :',:
, . ~"- .
20 65 65 Front Tint Imoact
20 65 20 Front Tint Impact
20 20 84 Front Ymt Impact
5 63 29 Front TmtImoact
10 65 29 Front Tmt Impact
1 63 29 Front Tmt Impact Spandrel
2 65 29 Front Tmt Impact Spandrel
8 42 29 Front TUlt Impact
12 59 29 Front Tun Impact
2 42 29 Front Tint Impact Spandrel
Address:
Page 1 of 2
USPl'ATE ."
USPf.r'8IasS'''IUra~.~~llInJ .,.,of
.,'\-"."
Glass Schedu.le
Number of Width Length Position Type of Glass Description
plates
3 59 29 Front Tmt Imoact Spandrel
5 63 29 Front Tint Impact
10 65 29 Front Tint Impact
1 63 29 Front Tmt Impact Spandrel
2 65 29 Front Tmt Impact Spandrel
3rd Fi --,- ,-'...... ..
.. ..
20 65 65 Front lDlt Impact
20 65 20 Front Tmt Impact
20 20 84 Front l~mt Impact
5 63 29 Front Tmt Impact
10 65 29 Front Tmt Impact
1 63 29 Front Tmt Impact Spandrel
2 65 29 Front Tint Impact Spandrel
5 63 29 Front Tmt Impact
10 65 29 Front Tmt Impact
1 63 29 Ftont Tmt Impact Spandrel
2 65 29 Front TIDt Impact Spandrel
8 42 29 Front Tmt Impact
12 59 29 Front Tmt Impact
4 42 29 Front rmt Impact Spandrel
6 59 29 Front rmt Impact Spandrel
3rd FL .. . , .:....:":.':,.,.,':.S ....: l.'.. .......,: ,.
26 65 65 Front Tmt Impact
26 65 20 Front Tmt Impact
26 20 84 Front rmt Impact
4 63 29 Front rmt Impact
8 65 29 Front Tmt Impact
4 63 29 Front Tint Impact
8 65 29 Front lmt Impact
8 42 29 Front Tmt Impact
12 59 29 Front Tmt Impact
4 42 29 Front Tmt Impact Spandrel
6 59 29 Front Tmt Impact Spandrel
Policy # :
Name:
Address:
09-63283 Date: 1/1/2011
Gtyof S1UUlY Isles Beach
18070 Collins Ave, Swmy Isles Beach, FL :n 160
Page 2 of 2
,
.
GLASS COVERAGE
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO
THE POLICY DOCUMENT
LOCATION
18070 Collins Avenue, Sunny [sles Beach, FL 33160
COVERED PROPERTY
Exterior Glass only comprising of 517 Impact Plates (Per Schedule)
COVERAGE
Breakage of glass by any meBOS subject to standard policy exclusions
Excludes scratching and marring
Temporary Board-up limit is $250.00 per Location
$100 Deductible per OccUn'ence
CLAIMS REPORTING
All claims must be submitted to a 24.houl'"hotlinll (1-871-SHATrER).
If a claim is presented that does not go through this service the amount recoverable will be
subject to the carriers "usual and customal}' limits".
SEE COMPANY GLASS SCHEDULE ATTACHED
Brown & B1'oW11 of Florida, Inc.
m
. ...--
Illinois Union Insurance Company
TANK SAFE -
Storage Tank Liability
Insurance Policy
Declarations
This Policy is issued by the stock insurance company listed above (herein called the "Insurer").
COVERAGE A OF THIS POLICY PROVIDES BODILY INJURY AND PROPERTY DAMAGE LIABILITY COVERAGE
FOR CLAIMS FIRST MADE AGAINST THE INSURED AND REPORTED TO THE INSURER, IN WRITING, DURING
THE POLICY PERIOD. COVERAGE B OF THIS POLICY PROVIDES CORRECTIVE ACTION COSTS COVERAGE ON
AN INCIDENT-REPORTED BASIS.
PLEASE READ THIS POLICY CAREFULLY. SOME OF THE PROVISIONS CONTAINED IN THIS POLICY RESTRICT
COVERAGE, SPECIFY WHAT IS AND IS NOT COVERED AND DESIGNATE RIGHTS AND DUTIES. LEGAL
DEFENSE EXPENSES ARE SUBJECT TO AND WILL ERODE A SEPARATE AGGREGATE LIMIT OF LIABILITY.
THE DECLARATIONS, TOGETHER WITH THE COMPLETED AND SIGNED APPLICATION, THIS POLICY AND ANY
ENDORSEMENTS OR SCHEDULES ATTACHED HERETO, CONSTITUTE THE INSURANCE POLICY.
Policy No.: G21828518 007 Renewal of: G21828518 006
Item 1. Named Insured: City of Sunny Isles Beach
Principal Address: 18070 Collins Avenue, #250
Sunny Isles Beaeh,FL,33160
Policy Period:
From 01/0112011 12:01 A.M. To 01/0112012 12:01 A.M.
(Local time at the address shown in lIem 1.)
Item 2.
Item 3.
Item 4.
Item 5.
Item 6.
Item 7.
Retroactive Date:
Limits of Liability:
a. $ N/A
$ 5,000,000
01/01/2005
Per Storage Tank Incident Limit (USTs)
Per Storage Tank Incident Limit (ASTs)
b. $ N/A
$ 5,000,000
$ N/A
Aggregate Limit (USTs)
A t L' 't (ASTs) This insumnec issued pursuant 10 Florida Snrplus Lincs Law
ggrega e Iml Surplus lincs Agenl:
Aggregate Total Limit (UST & ASTs -NtllRl/;ijlil.lfMlfAJe~a1<Defense)
Public Risk Underwriters or Florid1 llle.
A L I 0 ~ E . . PO "ox 958455
ggregate ega elense xpense lI"1'lke MalY, FL 32795
c. $ 5,000,000
Deductible:
$ 5,000
Premium:
$1 690 Q}J PJ.odu<;ing Agent Address ,
, '/ 9"t70 AJ/A) '197JJC!f St""..xtY.1 /J}/c.l/I,i k/<,"", 17
Quarter:_LFSLSO Confl/-Q1!IJ1Jl~$,..!'sLSO Servicc Fec-1f-
J . fi~~ r7
$1.6!XH1Qm:.tt,itl,tltJ lax: t2.-0IherFccs: ;(!.
TOTAL AMOUNT DUE:
Notice to Insurer: This 'nsuranc. is issu.d pUl1ulll1llo florida Surplus Lin.s Law. Pmons insured by Surplus
" . !.incs ('arrlel1 do no! have lhe prol<cllon nflh< Florid~ Insurance Guaranly Acllo Ih. .xlenl
a. Nolree of Claim or Storage Tank InCident: of allY righl ofreool'elY ro.lh. obl/solion of 011 insolvent unlicensed insurer.
Environmental Risk Claims Managef SlIrplu I.~illes enl'. Counlersignalure:
ACE USA Claims ~1I~
P.O. Box 5103 ~ ~~
~~:~~~g~<tWEs INSURERS'
ARE NOT APPROVED BY ANY
ACE TankSafe"'.Dec 4/0'FLORIDA REGUt5f~~ii'Y~'6iE~CY
Page 10f2
First NoUce Fax: (800) 951-411 9
First Notice Email:
Q..asualtvRiskEnvi ronmentaIFirsJNotice@aceQroup_com
b. All Other Notices:
Environmental Risk Underwriting Officer
ACE Environmental Risk
P.O. Box 1000
436 Walnut Street- WA 07A
Philadelphia, PA 19106
Item 8. Schedule of Covered Underground Storage Tank(s):
Not Applicable
Item 9. Schedule of Covered Aboveground Storage Tank(s):
Per Schedule of Covered Storage Tank Endorsement
Item 10. Producer Name and Address: Public Risk Underwriters of Florida
P. 0_ Box 956455
lake Mary,FL,32795
-... ----
Forms and Endorsements Attached at Policy Issuance:
Endorsement Form Number: Form Name:
Number:
001 PF-14104 Schedule of Covered Storage Tanks
002 PF-14624 Regulatory Compliance Exclusion Endorsement
003 LD-5S23g Signature Form
004 PF-23728 Terrorism Risk Insurance Act Endorsement
005 TRIA11b Disclosure Pursuant To Terrorism Risk Insurance Act
ALL-20887 Producer Compensation Practices-Policies Policyholder Notice
ALL-5X45 Questions about your Insurance - FL, MO. TN
SL-24680 Florida Surplus Lines Notification
006 ALL-21101 Trade or Economic Sanctions Endorsement
ILPOD10104 OFAC Advisory Notice to Policyholders
007 XS-3U96f Service of Suit Endorsement
IN WITNESS WHEREOF, the Insurer has caused this Policy to be countersigned by a duly authorizod
representative of the Insurer.
DATE:
12/30/2010
MOIDAYNR.
Dj,cA..~':' f J~'1'('-h,--
---
AUTHORIZED REPRESENTATIVE
ACE TankSafesm.Dec 4/04
ACE USA Copyright, 2004
Page 2 of 2