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SURVEY POTENTIAL GAS SERVICE CUSTOMERS -~.~ " I I EMPLOYMENT CONTRACT This contract is entered this r\' lJ. day of ~ ....<1' ~ , 198_, between the City of Clearwater, Florida (City) and William A. Vierheller. In consideration of the below state promises and conditions, the parties agree as follows: Survey 1. Mr. Vierheller shall conduct a thorough survey, beginning ~ 7,"7 .p. , 19B~, of prospective residential, co_reial and industrial customers for City natural gas service and appliances, as designated by the General Superintendent, Gas Division, City of Clearwater. 2. The survey shall be conducted within the following area: Beginning at Curlew Road running north on Alternate 19 only to include all of Tarpon Springs city limits to Keystone Road; then run east on Keystone Road to U.S. 19 and south on U.S. 19 only to Countryside Boulevard; then north on McMullen- Booth Road from the new Mease Hospital Clinic to Curlew Road, and east on Curlew Road to U.S. 19. Time permitting under this contract, side roads (laterals) shall then be assigned by priority by the General Superintendent, City of Clearwater Gas Division. The survey shall include all of the unincorporated areas in the above-described location. Customer List 3. Mr. Vierheller shall prepare a list of all such prospective 'customers listing: (a) Their names, addresses and phone numbers; (b) The estimated annual consumption of City natural gas; and (c) The type and quantity of appliances expected to be used. 4. The prospective customer list shall be for the sole use of the City. Time 5. The list shall be delivered to the City, in care of Edward W. Maynard, General Superintendent, City's Gas Division (400 N. Myrtle Ave., Clearwater, "' r . '. ,. F}..orida) , '" "',( "'^. I~....,., . 1- .' "'~,-,"-Q r",? ~ ' vh. .,r . / Q.1,~-f. ,v .2 c'I ~ " ( "".' within four months from the date of this contract, or as accumulated \ oj -{X(b -CO-/2: -~ I . I and requested by the General Superintendent. Time is of the essence. Use of City Vehicle 6. The City shall furnish Mr. Vierheller a City vehicle (car) for transportation to conduct the survey. The City vehicle (car) will be used only for survey purposes. The City shall provide all gasoline and maintenance for the vehicle (car). Insurance 7. Mr. Vierheller shall provide the City with proof of liability auto insurance for the City vehicle (car). The proof of insurance must be provided prior to the operation of the City vehicle (car). Hold Harmless 8. Mr. Vierheller shall hold the City harmless from any personal injury or property damage claims to Mr. Vierheller arising out of his operation of the City vehicle (car) to be provided to him per terms described below. Mr. Vierheller further agrees to allow no other person to use said vehicle (car) while in his control. Payment 9. Mr. Vierheller shall submit bills to the City, in care of Mr. Maynard, for service performed during the prior 2-week period with completed attached weekly call report (twice a month--on the first and third Mondays of each month) . 10. The City shall pay Mr. Vierheller a total of $4,000, to be paid in bimonthly installments of $500.00, to be paid the second and fourth Friday of each month. Review by City 11. The City reserves the right to review the prospective customer list at the end of each pay period, and terminate the contract, if in the City's opinion, the survey and list is being prepared in an undesirable manner. The City will pay for all services properly rendered by Mr. Vierheller up to termination. -2- .~ -, I, . .1 Breach 12. In the event of a breach by either party, the non-breaching party has the right to immediately terminate this contract. In the event of a breach, the prevailing party in a breach of contract action shall be awarded reasonable attorneys' fees and court costs. Employment Conditions 13. Mr. Vierheller shall be employed by the City, on a temporary basis, as an independent contractor, not as an unclassified City employee. Mr. Vierheller agrees to waive any employee rights and benefits he may have under the City of Clearwater Civil Service Rules and Regulations. Addresses 14. All documents sent to Mr. Vierheller shall be sent to the following address: Wi lIiam A. Vierheller, 2/0 Melody Lane, Largo, Florida 33541. All correspondence to the City shall be sent to: Edward W. Maynard, Gas Oivision, 400 North Myrtle Avenue, Clearwater, Florida 33515. By Attest: cfZ,~ l~~ City Clerk -3- APPLICATION FOR AUTOMOBILE INSURANCIi. co, USE I SOCIAL SECURITY __ IY'I A lit STATE I NUMBER f / If} .. i~' NAME. '1! 1,/ /' ;.4,44./7 1/ J,!:J?/rll.-lA' J- MAILlNGAu"","~~ .' ~ "/ I?'J /'/1'}:.io ,0 j1 UV. . / A:J ' ~ 0. /-lj7, ... E XA CT LOCA..-ION 01;. II ESi DENCE.HE-OI.Hl'iRI,HAN MA\I./NQc: AClQ'flE;S$I<;;-;,;;""i....,,,i3,'x:. it",. 4''''''''''''''' ,Ak.-,c",t4;:,...:::;\"i';; ~ I co. ex: Ir'\:":; '~)';:!':'l.-.'.I~ANPR.O. p.:"~.'.'..~T. ~'.i:~.,..i.N. b.....:.."...............,....'..:....'.i...r- I ~ tNSURANCllCOMPANy,,;1 ....')01' "j J ~I COMPANY USE II - "r I ~ VI ONLY SUFFIX · "~~;!ii .' ,ZII'COOe-. .' ,.;'".. . I : 3~s-4/ ;..' /;;l\;Lb. "0.;;;"; ,UQ'THAN DYES' o NO APP1:!fANJ'SEMp!;!OYER'\/" ",~i':;i.i;i,:;:}.~::,;;d..;;.;...i;,;FSS:;':s;.?iS:y;;/,>< f:. ,rrV O~ . ~ze, '1 'JP i 2, IND.'. CATEf. R:EAS()I\I..I;OR.ALIE.RNATI;GARAql;:.IN.l'RI;MARKS..,;J'O~EACH. VEHI%~"LISTEq'.8E!;OW; /NClICATESIREl:T;CIIY. STATe; ANDZIP'.CODE<OiCS);\,'; ;(;;i;;iL'Ji2;:;'if.:.1a6~""" A;~ ~6~':" ' !~!fCQQ~';IN~~:: I I /. hI~../ / / THERE lOR NAME RELATIONSHIP ~IRTH DATEI~EX NAME ".' ',;;RELATlONSHI!":;' BIRTHDATE SEX RESIDENTS . PLI CANT'S HO , INCLUDINGCHILDR ? o NO 0 YES'cOMPLETE; tPR;tf:'!;!;;;';)0~:;;:C/'; :Y'JjACTJIIAMErS&kJdikdd;:;',,;.:x;;,.-, CUUSECOCODE, ,..",EVIO"" POLICY NUMBER.:: ^ " .~. I". AT..;...~"!il!'!1"'-!"!Tl!~.I!.m!F;9; ~ · ~";;; ~,~~_,;:~g.b~~~:Q~~ THe:,P ~~y ~~lu~~gsJ~e~~!.1EM~E~e~ ~~Jv~&'eUDLf'cfR ~rg~;~iTED' ~~~~~~cru~~I~?~FR%?JI~:~~~I~.~~9P~I'~~fMSl<1;~~:,Bi~ ." . R. E. G.'.STR. A TlON. SUS. PE.N.D. E....O... '....... IN.SU. R..E.D.... L. .0...5.......S... OR ~..C...C....I.D...E. .N......T..1 . SA... I...L.I F. OR TRAFFIC VIOLATIONS7 A. DURING THE PAST 5 YEARSL HAS ANY OPERATOR HAD AJlJ~ ~ 1::::~::iCl~::0~"5 IFYES'~X:riI:~:::~' 'bM':F'Y~~~E~P~N 1~~CTION 5 :~Th~~ff[~~ll~~i~1?~rJ~~:~!~*'::~~ a: '.. '. . ~ ~OESTt-lEAPPLICANr,ANYH()USEHOLD MEMBER. OR ANY REGULAR DRIVER, HAVE ANY PHYSICAL OR MENTAL IMPAIRMENT? 5.~~: IJl~c ego';;E' ""'A-T~ .... ........ DETAILS OF V~,~~~g;':G~Jg~~.s~J~R.k5:~J..~~i~~~~m.~~~ATION~ cri:. ~;" ',; I /... .", .r ,;j;;" '.' ..' ~ -' '. '- 1""''' #1''-' ~- . "" :.~; ..:;;.. ~ i 'I""" ~f '~:;l~;5S4~'~~1!1~f~--' ..~.. ... 0"'" ,:.:J.,~~!~:ll'1~~~~~7~_,-.,;";"",,,,~ ... . .. .... .."'.... .~:~1r..VEAR . MANUFA~IJREFl . ~;,., , ,"eqDVl:Yl'f!.;." vE~fl:~STEyPE.. ."EHICLEloeNnFICj\TIONNUM8ER,,!iy;tg," ;;J1 d7 17,.J\L'~ /).,...."Jl/ '?"', .A :';"'2 - . lilt 'ti !;~~ :c ~.el-l. III :> D?JlJ:~ . ~ - 17_ __ .liT ---1 ,. DYES . ~ y.....;: ..... '.' .. '. ...~......,. --,-'DENT-WAS THERE %"!. ,},:" t-Ot DEAT DAMAGE TO':A.NY PRoPERTy? FAVlT YES NO DYES $ oYES$ DYES $ DYES $ 01'1.0 DNO oNO ONO , ~lJFl!:"AsE;!)A're ::Ck::~:.jti~I~~~~~~~~U~fW~tilyi\;~="r.~'y==,~ YES ,);;.'.',...i".',yoiOH....tllfilf' 'l!!!:!'lfJ!!>,y.Dfl!!!'!l: .'" 'dHFORMA TlOH1);#'L ...;.I)l!VICl;".". ~P'1?l!:,~G6t ~. '" '0 '" '" CAR POOL;"'" CO USE P AND E ,4 SYM I RATE CLASS o NUMBER DAYStMON H MilE. P 0 p.J .., -A - 1-1 MI 2 3 CO.USE CODE =~=~ YES NO . J. N~' TERR. ANNUAL MILEAGE USE ..... Z J' .., , - . lIT " 1. PLEASURE (TO WORK '''' c~ 1 ""'" 4, -,., LESS THAN J MILESI ~ Ili~ 2 2. ~::':J:l.~K3_, c c 3. BUSINESS ~a: 3 :: ~~~N VEHICLE 8. PER ONAL INJURY PROTECTION I REPARATIONS BENEFITS ...... ~ 0 ADDITIONAL ... ... .. ~!:: ~ TOTALIENEFITS DEDUCTIBLE MEDICAL INCOME LOSS OTHER c! ~ S s 15-' s >0 I 8~ C 9. ~~ ILi WOR AP~~ED C T~ E~~ %9 %U S % E LOSS TO OVEREO AUTOM BIL UMPO LIMIT ACTUAL C~.t!'y'ALU ,!:~~ SVEH. CO -',,,uN' IUIHERTHANCOLLlSION 1 S S - 2 S S 3 S S h VII o I"JOIVIO. OFAMILY lABILITY PACKAGE DI/POLlMI MED. EXP. ~:~~~=~fJ:PJ~~~T~~. -. LIMIT, INSURED MOTOFUSTSI_ . S $ :J5J _ '2J(A1 ~ ~ ~~~ER ~ /J2J ~~~ - oOTHER TOTAL ESTIMATED PREMIUM 1SUBJECT TO ROUTINE COMPANY VERIFICATlONI TOTAL PREMIUM PER VEHICLE 1 S 2 S 3 S · t / ',::/"",-, 'i",,- I J /) Ve /V- $ 06 MONTH F .. .,;SILLMODE ... o I-INSURED 03-OTl1ER" 04.PAYROLL DEDUCTION PAY PLAN E" FINANce COMPANYf,;(it~0j~~i.v~+:>t'(t}~I'1l~5 ~'./' ."t.t;;^Z1pcOolil'.. . 1.. '01: z! !!!... -'0 % ..;. , ~~:~i!iJ~~l, lII\IMIIEII~l)!IY"""" ~:: UHOMEOWNEAS ~[JHEALTH 1~:E!IIfT-=-IG/if;..:::r ~Z!!DlS;': ~RTMENT ~CONOOMIN'UM .1Z'IHERE 'IF dT~~~~tl f:. ~T'1~~~l..~==~Jr~tii're&~'~~J.fioJ!~Eo=I:r:~~*Je~~ PLIEDFO Cf'r!:RMSANOC (). OTHERWISE STATED. .. . ............,'..".,..,.;.''';r-',...:''..../i;.''...,....... '. ,;..... ....'.'....) ". .... ITlONS OF CURRENT BY IT IS UNOERSTOOD AND AGREED THAT NO NSURANC& IS EFFECTtV&WEREVf\lOEfl lAI UlfLESS THE M;; "";THE.CO YSFROMS EF-' PUTEO AND StONED ey'ANAUTHOfUZEf)' l!l'RESEJfTATtVEOF 'THe~,~ 181 UNTJLT-Hl!. FECf'VE I) FOR I'Ol.ICV OR BINOER lS3Uf:D BVTHE I'TING'TH1S .......I.ICA:T.QIlL,.......'''i\.;t..i.. ';":...'>"\' ',; iffi 8 ' ;..,,......,.:. .,,,,(~. .."",.'''.,.,-.,,,/, ?i+,;~;.i'..A.';';"'i".-'+,i'> 'i E T 7/:~" ., ~ 0~./Z;~:~;i";~A I / ~J1fl;,1J4;;';4.",'i ,~~ !:;:;tA:Tt:~I\IPJ:t~~/I'2./: ~ 1.1.., - L,.~.v ";I7!l HER18y'1f ,y~o~'~ 'EXPLAIN IN "REMARK'S" "'SU~ECIAL DRIVER QUESTIONNAIRE ON ALL UNMARRIED UNDER AGE 2). MPL 1277.000 COMPANY COPY Printed in USA 1081 I I IMPORTANT NOTICE TO POLICY HOLDER: This Automobile Insurance Schedule supersedes any Previous Schedule you have. Be sure to keep it with your Policy and Declarations. r-'--- '''" .--- ,-, ------ t--METROPOLITA~ ROPERT_Y-AN I 1'01 ICY NUMBER SCHUl EHEC DATE !--2.8.D - '-9~.a I NAMED I INSURED WILLIAM A VIERHELLER , AND 210 MELODY LN roDDRESS LARGO R I I ' . V I c I Po I (S) FL 335~1 AUTOMOBilE INSURANCE SCHEOULE I NCLCOMPANY., ..lssuedJo form~~,f!.~.!..!!leJ>IlClarilllonS. I SALES RlP'S CODElSTATrCODEr-TlRR, I : : I B608323,_L_a9~OE : 13 113-L-.----,~ D1AL.A.SEBVICE SEE SERVICE DIRECTORY lOR WfllTE TO I DIAL-A-CLAIM SERVICE - SEE CLAIM DIRECTORY I . i i METROPOLITAN PROPERTY AND LIABILITY 1 INSURANCE COHPANY OX 25000 TAMPA, FLORIDA 33623] NAME DATE or S rnel RH R ~~li.LJ I I ! I I I I j I I I I I, , I I I I I I I I COVERAGES APPLICABLE AND LIMITS OF LIABILITY PERSONAL INJURY PROTECTION --< I BASIC ADDITIONAL PERSONAL INJURY , 1 TOTAL BENEFITS I MEDICAL I INCOME LOSS I SUBSTITUTE SERVICES I SURVIVOR BENEFIE SEE BELOW ,-- I ---.- ----< I AUTOMOBILE LIABILITY - MEDICAL EXPENSE - UNINSURED MOTORISTS LOSS TO COVERED AUTUMGfk ': ! n'ODILY INJURY AND -- .,- ,,- , AUTOMOBILE UNINSURED ACTUAL CASH VALUE l fSS I I PROPERTY DAMAGE MEDICAL MOTORISTS DEDUCTI BLE AMOU N T ,'.Pf'l j I , LIABILITY EXPENSE CABLE TO LOSS CAU~)! [I F~,{ i ~ACH OCfURRENCE EACH PERSON EACH PERSON EACH AfCIDENT VE COlliSION Q~\1,li,~~rH';Ul $ $ I CD. 1-").I()~"--1 I 35,000 2,500 25,000 25,000 1 $ Is . I 2 $ 100 I~ONE I 3 $ is p v PERSONAL AUTO LIABILITY LOSS TO COVERED CURRENT ANNUAL R E INJURY MEDICAL EXPENSE E H PROTECTION UNINSURED MOTORISTS AUTOMOBILE POLICY PREMIUM M I 1 $ 24 $ 100 $ $ ~12 - U 2 S 32 S 120 $136 M 3 S $ $ i PLUS PREMIUM TOTAL TOTAL OF PREVIOUS PRO.RATA CHANGE IN THE I ENDORSEMENTS ANNUAL PREMIUM ANNUAL ANNUAL PREMIUM FOR THIS TRANSACTION PREMIUM INCREASE DECREASE I $ $ ~12 $ ~12 $ I FORM NUMBERS OF ENDORSEMENTS FORMING A PART OF THIS POLICY OR ATIACHED TO THE POLICY. P708A P907 P817 - VEH YEAR TRADE NAME VEHICLE IDENTIFICATION NUMBER MODEL BODY TYPE CLASS SYM 1 DESCRiPTION 1 64 OF OWNED AUTOMOSILE(S) 2 79 3 :-6ssl'vfiT2 a-A 'l\YUlvllf :PlCIAL INFORMATION: BASIC PERSONAL INJURY PROTECTION AMENDATORY ENDORSEMENT P708A,APPLY CHANGE IN VEHICLE INFORMATION. FORD PONTIAC 4KCf-2T229317 2L35Y91732226 FAIRLNE CATLINA DR TA WAG BENEFITS, AS DESCRIBED IN THE FLORIDA UP TO LIMITS OF 510,000. '", 000 Printed ,in U,S,A 09RI