ENGINEERING PROFESSIONAL SERVICES AGREEMENT (9)
AGREEMENT
FOR
PROFESSIONAL SERVICES
~h'
This AGREEMENT is made and entered into on this cJ L./ ~day of
between the City of Clearwater, Florida (CITY) and Owen A res
(ENGINEER)
, 20 c.{;" by and
Inc.
WITNESSETH:
WHEREAS the CITY desires to engage the ENGINEER to perform certain professional services pertinent to
such work in accordance with this Agreement; and
WHEREAS the ENGINEER desires to provide such professional services in accordance with this Agreement,
and
WHEREAS the CITY selected the ENGINEER in accordance with the competitive selection process described
in Section 287.055 of the Florida Statutes, and based on information and representations given by the
ENGINEER in a proposal dated March 31, 2003
NOW, THEREFORE, in consideration of the premises and the mutual benefits which will accrue to the parties
hereto in carrying out the terms of this Agreement, it is mutually understood and agreed as follows:
1. GENERAL SCOPE OF TillS AGREEMENT
The relationship of the ENGINEER to the CITY will be that of a professional consultant, and the ENGINEER
will provide the professional and technical services required under this Agreement in accordance with
acceptable engineering practices and ethical standards.
2. PROFESSIONAL TECHNICAL SERVICES
2A. It shall be the responsibility of the ENGINEER to work with and for the CITY toward solutions to
engineering problems and the approach or technique to be used toward accomplishment of the CITY's
objective for each project or assignment. The ENGINEER's services shall include developing and
presenting advisory opinions regarding the usefulness and continued profitability of Water, Sewer and
Stormwater Utility System facilities, the sufficiency of the rates and charges for the System services, the
proper maintenance of the elements of the System and the design of capital improvements thereto; roads,
6/25/2003
drainage, structural analysis, transportation, traffic, environmental and gas systems. Representative
assignment areas are expected to include, but not be limited to, planning, studies or design services as
listed below:
1. Preparation of construction drawings, specifications and bid documents for public works projects,
including but not limited to:
. structural engineering elements
. streets and roadways, including intersection improvements
. parking facilities
. utility infrastructure, including water, wastewater, natural gas, storm water and reused water
2. land surveying activities, including title search, aerial target placement, topographic surveys, right-of-
way surveys, preparation of right-of-way control surveys, preparation of right-of-way mapping/parcel
descriptions/parcel sketches
3. architectural services
4. transportation improvement planning and studies, including Project Development & Environment
(PD&E) studies
5. appraisals of land under consideration for acquisition by the CITY
6. traffic operations activities, including traffic signal warrant analysis, safety studies, preparation of
traffic signal construction documents, preparation of pavement marking and signing plans, assistance
as needed with the implementation of timing plans for and the operation of the City's Urban Traffic
Signal Computer System
7. hazardous materials investigations, mitigation/remediation plans and associated tasks
8. management of construction contracts
9. review and assessment of the applicability of design/CITY improvements
10. development/preparation of grant applications for CITY projects
11. preparation of permit application packages, including water, wastewater, surface water
management, National Pollution Discharge Elimination System (NPDES), and wetland
impacts: assistance in meeting regulatory and grant requirements, permitting and
preparation of permit documents and representation of the CITY before appropriate
regulatory bodies
12. environmental audits, including evaluation of hazardous materials potential, archeological or
historical resources, impacts to threatened or endangered species
13. hydraulic/hydrologic modeling of streams, watersheds, etc.
14. development of wetland mitigation plans, including compliance monitoring
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15. water quality monitoring, including report preparation
16. preparation and implementation of public involvement programs, including graphics (presentation
boards, slides, handouts, etc.)
17. studies related to stormwater management, master planning, design and financing, including
stormwater utility feasibility and implementation
18. studies related to rates, user charges and impact upon various agreements between the CITY and its
customers, suppliers and consultants
19. studies of recreational facility improvements, including expansIon or improvements to existing
facilities as well as development of new facilities: includes possible preparation of construction
documents (including permits) and construction management
20. aviation services, including master planning and design of planned improvements
21. other work as may be reasonably required under the general scope of professional and technical
engineering services in connection with the CITY's public works/engineering system.
2B. The ENGINEER's services under this Agreement will be provided under Work Orders. Generally, each
Work Order will include the services for a single project or assignment, and it will contain a mutually
agreed-upon detailed scope of work, fee, invoicing method, and schedule of performance in accordance
with applicable fiscal and budgetary constraints. Total compensation for all services shall not exceed
$100.000 per work Order unless specifically authorized by the City Commission.
2C. The ENGINEER shall maintain an adequate and competent staff of professionally qualified personnel
available to the CITY for the purpose of rendering the required engineering services hereunder, and shall
diligently execute the work to meet the completion time established.
2D. The CITY reserves the right to enter into contracts with other engineering firms for similar services.
Owen Ayres & Associ ate swill, when directed to do so by the CITY, coordinate and work with other
engineering firms retained by the CITY.
3. PERIOD OF SERVICE
3A. The ENGINEER shall begin work promptly after receipt of a fully executed copy of each Work Order, in
accordance with Paragraph 2B above. Receipt of a fully executed Work Order shall constitute written
notice to proceed.
3B. If the ENGINEER's services called for under any Work Order are delayed for reasons beyond the
ENGINEER's control, the time of performance shall be adjusted as appropriate.
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3C. It is the intent of the parties hereto that this Agreement continue in force until three (3) years from the
date of execution, subject to the provisions for termination contained herein. Assignments that are in
progress at the Contract termination date will be completed by the ENGINEER unless specifically
terminated by the CITY.
4. INSURANCE REQUIREMENTS
4A. Workers Compensation and Employers Liability. The ENGINEER shall procure and maintain, for the
life of this Agreement, Workers Compensation Insurance covering all employees with limits meeting all
applicable state and federal laws. This coverage shall include Employers Liability with limits meeting all
applicable state and federal laws.
4B. General Liability. The ENGINEER shall procure and maintain, for the life of this Agreement, General
Liability Insurance. This coverage shall be on an "Occurrence" basis. Coverage shall include Premises
and Operations; Independent Contractors; Products and completed Operations and Contractual Liability.
Coverage shall be no more restrictive than the latest edition of the Commercial General Liability polices
of the Insurance Services Office (ISO).
This policy shall provide coverage for death, bodily injury, personal injury or property damage that could
arise directly or indirectly from the performance of this Agreement.
The minimum limits of coverage shall be $500,000 per Occurrence Combined Single Limit for Bodily
Injury Liability and Property Damage Liability.
The CITY shall be included and identified as an Additional Insured under the policy/certificate of
msurance.
4C. Business Automobile Liability. The ENGINEER shall procure and maintain, for the life of the
Agreement, Business Automobile Liability Insurance.
The minimum limits of coverage shall be $500,000 per Occurrence Combined Single Limit for Bodily
Injury Liability and Property Damage Liability. This coverage shall be an "Any Auto" type policy.
Coverage shall be no more restrictive than the latest edition of the Business Automobile Practices of the
Insurance Services Office (ISO).
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The CITY shall be included and identified as an Additional Insured under the policy/certificate of
msurance.
4D. Professional Liability Insurance. The ENGINEER shall procure and maintain for the life of this
Agreement, Professional Liability Insurance. This insurance shall provide coverage against negligent
acts, errors or omissions by the ENGINEER in the performance of this contract. The minimum limits of
coverage shall be $1,000,000.
4E. Indemnify. In consideration of the sum of One Hundred Dollars ($100.00), the receipt and sufficiency of
which is acknowledged, payable as part of the first payment for services, the ENGINEER agrees to save
and hold the CITY, its agents, assigns and employees, harmless from all claims or causes of action,
including costs and attorney's fees, and all judgments whatsoever, involving personal injury, bodily
injury, death, or property damage, arising out of any negligent act or omission, or the violation of any
federal, state or local law or regulations by the ENGINEER, its subcontractors, agents, assigns, invitees
or employees in connection with this Agreement. The ENGINEER agrees to indemnify and hold
harmless the City from losses, damages or lawsuits resulting from the ENGINEER's intentional
misconduct or intentional torts com mitted during the performance of this contract.
4F. Hazardous Substances. It is understood and agreed that in seeking the professional services of the
ENGINEER under this Agreement, the CITY does not request the ENGINEER to undertake uninsurable
or potentially uninsurable obligations for the CITY's benefit involving or related in any manner to
hazardous substances. Therefore, the ENGINEER undertakes no such obligation hereunder, and the
CITY agrees to hold harmless and indemnify the ENGINEER from and against any and all claims, losses,
damages, liability, and costs arising out of or in any way connected with the presence, discharge, release,
or escape of contaminants or hazardous substances of any kind, or environmental liability of any nature,
in any manner related to services performed by the ENGINEER under this Agreement.
4G. Supplemental Provisions. The insurance coverages and conditions afforded by the above- mentioned
policies shall not be suspended, voided, canceled or coverage reduced except after thirty (30) days prior
written notice by certified mail return receipt requested has been given to both the City Engineer and the
Risk Management Offices of the CITY.
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Certificates of Insurance meeting the specific required insurance provIsIons specified within this
Contract! Agreement shall be forwarded to both the City Engineer and Risk Management offices of the
CITY and approved prior to the start of any work. After review, the Certificate will be filed with the City
Clerk as a part of the official contract file.
Receipt and acceptance of the ENGINEER Certificate of Insurance, or other similar document does not
constitute acceptance or approval of amounts or types of coverages which may be less than required by
this Agreement.
The City may, at its option, require a copy of the ENGINEER's Insurance Policy(s).
All insurance policies required within this contract shall provide full coverage from the first dollar of
exposure unless otherwise stipulated. No deductible will be accepted without prior approval from the
CITY.
4H. Safety and Health Requirements. It is the ENGINEER'S sole duty to provide safe and healthful working
conditions to its employees on and about the site of Agreement performance. The CITY assumes no duty
for supervision of the ENGINEER. The ENGINEER will provide a "Drug Free" workplace in
accordance with Section 287-987, Florida Statutes.
The CITY may, without any liability to ENGINEER, order that the work stop at the site of Agreement
Performance if a condition of immediate danger to CITY employees, CITY equipment, citizens, or if
property damage exists. This provision shall not shift responsibility for any risk of loss for injuries or
damage sustained from the ENGINEER to the CITY, and the ENGINEER shall remain solely responsible
for compliance with all safety requirements and for the safety of all persons and property at the site of
Agreement Performance until the beginning of construction, which arise out of the ENGINEER's
negligence.
The ENGINEER shall comply with the standards and regulations set forth by the Occupational Safety and
Health Administration (OSHA), the Florida Department of Labor and Employment Security, and all other
appropriate federal, state and local regulations or City safety and health standards.
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5. GENERAL CONSIDERATIONS
5A. All documents including field books, drawings, specifications, calculations, etc. supplied by the
ENGINEER shall become the property of the CITY. The CITY acknowledges that such documents are
not intended or represented to be suitable for use by the CITY or others for purposes other than those for
which the documents are prepared. Any reuse of these documents without written verification or
adaptation by the ENGINEER for the specific purpose intended will be at the CITY's sole risk without
liability or legal exposure to the ENGINEER.
5B. When authorized, the ENGINEER shall prepare a fmal estimate of probable construction costs, following
CITY approval of the bid documents and other prebid activities. The CITY hereby acknowledges that
estimates of probable construction costs cannot be guaranteed, and such estimates are not to be construed
as a promise that designed facilities will not exceed a cost limitation. Should the lowest, responsive and
acceptable bid price received by the CITY within three (3) months from the date of the CITY's approval
of the bid documents exceed the ENGINEER's fmal cost estimate by more than ten percent (10%), the
ENGINEER shall perform a detailed evaluation of the low bid. The evaluation will review the bid prices
on a line item bases, identifying areas of disagreement and providing a rationale for the difference.
5C. The ENGINEER will provide expert witnesses, if required, to testify in connection with any suit at law.
A supplemental agreement will be negotiated between the CITY and the ENGINEER describing the
services desired and providing a basis for compensation to the ENGINEER.
5D. Upon the ENGINEER's written request, the CITY will furnish or cause to be furnished such reports,
studies, instruments, documents, and other information as the ENGINEER and CITY mutually deem
necessary .
5E. The CITY and the ENGINEER each bind themselves and their successors, legal representatives and
assigns to the other party to this Agreement and to the partners, successors, legal representatives and
assigns of each other party, in respect to all covenants of this Agreement; and, neither the CITY nor the
ENGINEER will assign or transfer its interest in this A greement without consent of the other.
5F. The ENGINEER hereby agrees to indemnify, save and hold harmless the CITY from all claims, demands,
liabilities and suits caused by any negligent act, error or omission of the ENGINEER, the ENGINEER's
subcontractors, agents or employees in rendering the professional services called for herein. It is
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specifically understood and agreed, however, that this indemnification agreement does not cover or
indemnify the CITY for its own negligence. The ENGINEER hereby further agrees to indemnify, save
and hold harmless the CITY from any and all fmes, costs, and expenses caused by, directly or indirectly,
with the ENGINEER's failure to comply with any applicable laws, statutes, ordinances, or government
regulations.
5G. The ENGINEER agrees not to engage the services of any person or persons in the employ of the CITY to
an allied capacity, on either a full or part-time basis, on the date of the signing of this Agreement, or
during its term.
5H. Key personnel assigned to City projects by the ENGINEER shall not be removed from the projects until
alternate personnel acceptable to the CITY are approved in writing by the CITY. Key personnel are
identified as:
. Nizar Jetha, P.E.
. Hamid Bojd, Ph. D . , P .E. .
. Britton Hardy, P.E.
. Dan Kelly, P.E.
. Jorge Perez, P.E.
51. The ENGINEER shall execute the appropriate State of Florida sworn statement under Section
287. 133(3)(a), Florida Statutes, Public Entity Crimes prior to the execution of this Agreement.
5J. The ENGINEER shall attach a brief status report on the proj ect(s) with each request for payment.
5K. The ENGINEER shall provide a Certificate regarding a "Drug Free Workplace" per the requirements of
State of Florida directive: City Memorandum No. 23 (90-91) dated December 17,1990, from George C.
Banks, CPPO, Director, Division of Purchasing.
6. COMPENSATION
6A. The ENGINEER shall be compensated for all services rendered under this Agreement in accordance with
the provisions of each Work Order, upon presentation of ENGINEER's invoice. An hourly rate schedule
and typical methods of compensation are attached hereto as Exhibit A.
8
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6B. Except as may be addressed in the initiating Work Order, the compensation for services shall be invoiced
by the ENGINEER and paid by the CITY once each month. Such invoices shall be due and payable upon
receipt.
Invoices are to be pre-numbered by the ENGINEER and issued per Work Order. Each invoice will
include a summary by CITY charge code as identified in the Work Order or addendums. Copies of
invoices for sub-consultants or other expenses of $50.00 or more per item will be attached to the
ENGINEER'S invoice.
Invoices are to be mailed to the City Invoices are to be mailed to the City of Clearwater,
PW AlEngineering, Administrative Analyst, P.O. Box 4748, Clearwater, FL 33758-4748 or 100 S. Myrtle
Avenue, #220, Clearwater, FL 33756-5520.
6C. The ENGINEER agrees to allow full and open inspection of payroll records and expenditures m
connection with hourly rate and cost plus fixed fee work assignments upon request of the CITY.
7. PROillBITION AGAINST CONTINGENT FEES
The ENGINEER warrants that it has not employed or retained any company or person, other than a bona
fide employee working solely for the ENGINEER, to solicit or secure this Agreement and that it has not
paid or agreed to pay any persons, company, corporation individual or firm, other than a bona fide
employee working for the ENGINEER any fee, commission, percentage, gift, or any other consideration,
contingent upon or resulting from the award or making of this Agreement.
8. TERMINATION
This Agreement may be terminated by either party with seven (7) days prior written notice, in the event of
substantial failure to perform in accordance with the terms hereof by the other party through no fault of
the terminating party. If this Agreement is terminated, the ENGINEER shall be paid in accordance with
the provisions of outstanding Work Orders for all work performed up to the date of termination.
9. SUSPENSION, CANCELLATION OR ABANDONMENT
If the project described in any Work Order is suspended, canceled or abandoned by the CITY, without
affecting any other Work Order or this Agreement, the ENGINEER shall be given vie (5) days prior
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written notice of such action and shall be compensated for professional services provided up to the date
of suspension, cancellation or abandonment.
This Agreement shall be administered and interpreted under the laws of the State of Florida.
10. TERMINATION OF CONVENIENCE
Either the CITY or the ENGINEER may terminate the Agreement at any time by giving written notice to
the other of such termination and specifying the effective date of such termination at least thirty (30) days
before said termination date. If the Agreement is terminated by the CITY as provided herein, the
ENGINEER will be paid for services rendered through the date or termination.
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IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement on the date and
year above written.
CITY OF CLEARWATER
IN PINELLAS COUNTY, FLORIDA
B~:'."~'"3Z
1lliam B. Home, II
City Manager
Countersigned:
By:
(Engineer must indicate whether
Corporation, Partnership, Company
or Individual.)
(The person signing shall, in his
own handwriting, sign the Principal's
name, his own name, and his title;
where the person is signing for a
Corporation, he must, by Affidavit,
show his authority to bind the
Corporation).
11
(Seal)
Attest:
;J'. -
t'. ~
-Ltf-1~'~nr~
~ynthia 1:. Goudeau, . Ity Clerk
Approved as to form:
~.JJe;
.Ruf
Assistant City Attorney
~. _.11~~
~-Ja!~, VP - FL Ops
Owen Ayres & Associates, Inc.
(Engineer)
By:
(SEAL)
6/25/2003
EXIDBIT A
PROVISION OF PAYMENT
BASIS FOR PAYMENT
The OWNER shall pay ENGINEER and ENGINEER agrees to accept as full compensation for
its services (as established by Work Order) compensation as computed by one of the following
methods.
METHOD A - COSTS TIMES MULTIPLIER BASIS
Compensation in the form of actual costs times a multiplier as determined by the following
formula:
Actual Raw Salary Cost x Multiplier + Subconsultant Cost + Other Direct Costs
Multiplier 3.10 includes fringe benefit rate, overhead, operating margin and profit and is
subject to annual review.
Subconsultant Costs are actual costs incurred times a factor of 1.00. Actual costs shall be
based on billing rates for required labor classifications.
Other Direct Costs are actual costs incurred for travel outside of Tampa Bay area, printing,
copying, long distance telephone calls, etc., times a factor of 1.00.
METHOD B - LUMP SUM
Compensation in the form of "lump sum" shall be determined by mutual agreement between the
ENGINEER and the CITY. The lump sum amount shall be negotiated based upon a scope of
services developed by the ENGINEER and approved by the CITY.
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~ Clearwater
u
EXHIBIT B
City of Clearwater Engineer Of Record - RFQ 21-03
2003 Direct Hourly Salary Rates
CATEGORY MINIMUM PROBABLE MAXIMUM
Sr. Vice President $62.00 $71.00 $94.00
Vice PresidentlOfficer-in-Charge $52.00 $56.00 $65.00
Project Manager/Assoc. Principal $42.00 $47.00 $54.00
Construction Manager $32.00 $38.00 $48.00
Construction Engineer $24.00 $28.00 $36.00
Senior Engineer/Scientist $37.00 $41.00 $49.00
Engineer/Scientist (III-IV) $30.00 $33.00 $38.00
Engineer/Scientist (1-11) $22.00 $26.00 $33.00
Planner $27.00 $34.00 $42.00
Landscape Architect $28.00 $32.00 $41.00
Field Technician $17.00 $20.00 $25.00
Senior Designer $24.00 $28.00 $34.00
Drafter/CADD Operator $16.00 $20.00 $24.00
Operations Specialist $22.00 $30.00 $39.00
Fiscal/Accounting $22.00 $26.00 $35.00
Administrative/Clerical $14.00 $17.00 $23.00
REQUESTED MULTIPLIER
3.10
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
OP 10 co
OWENA-1 06/27/03
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
DATE IMMlDDIYYI
PRODUCER
Johnson Insurance - Madison
525 Junction Road
Madison WI 53717
Phone: 608-245-6580
Fax: 262-619-2805
INSURERS AFFORDING COVERAGE
INSURED
NSURER A
CNA Insurance
Owen Ayres & Associates, Inc
DBA AYFes Associates
3433 Oakwood Hills Pkwy
Eau Claire WI 54702
INSURER B:
INSURER C
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POUCY EFFECTIVE POUCY EXPIRATION
LTR TYPE OF INSURANCE POUCY NUMBER DATE MMlDDffY' DATE 'MMlDDlYY' UMITS
GENERAL UASIUT'l' EACH OCCURRENCE $
-
COMMERCIAL GENERAL LIABILITY FIRE OAMAG::: (Anyone fire) $
- 8--Cl:AlMS w..or---.c_-B-- OC-CUR-
- - .-~---- _.-- - - -.- ---- ---- .~- -MED EX? (Art{One person) -'- $- -----" .-- '-
-
- -- ~------ .-- _.-
- .
GENERAL AGGREGATE $
-
GENLAGGREGATE UMIT APPUES PER. PRODUCTS - COMPtQP AGG $
"I n PRO- nLOC
POUCY JECT
AUTOMOBILE UABIUT'l' COMBINED S NGLE UMIT
- $
ANY AUTO (Ea accident)
~
AU OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident,
-
- PROPERTY DAMAGE $
(Per accldenti
GARAGE LIABIUT'l' AUTO ONLY. EA ACCIDENT $
=1 ANY AUTO OTHER THA' EAACC $
AUTO ONLY: AGG $
EXCESS LIABIUTY EACH OCCURRENCE $
=:J OCCUR D ClAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I ~~ 0~~s I 10TH-
ER
EMPLOYERS' LIABILITY
EL EACH ACCIDENT $
EL DISEASE- EAEMPLOYEE $ .
EL DISEASE - POLICY LIMIT $
OTHER
A Prof Liabiltiy AEA254025050 06/30/03 06/30/04 Ea Claim 5000000
Aqqreqate 5000000
DESCRIPTION OF OPERATlONBlLOCATlONSNEHICLESlEXCWSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Claims Made - Environmental Coverage Included. Regarding: City of Clearwater
2003 Engineer of Record Contract.
CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITCLEA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUINClINSURI!R WILL ENDEAVOR TO MAIL ..3L DAYS WRmEN
City NanCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
of Clearwater
P 0 Box 4748 IMPOSE NO OBUGATlON OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Clear Water FL 33758-4748 REPRESENTATIVES.
AUTlIORIZED REPRESENTATIVE
I Patrick Kellv
ACORD 25-8 (7/97)
@ACORDCORPORATION 1988
SWORN STATEMENT PURSUANT TO SECTION 287.113
FLORIDA STATUTES ON PUBLIC ENTITY CRIMES
This sworn statement is submitted to the City of Clearwater by Nizar K. Jetha, P.E., Vice President - Florida
Operations for Owen Ayres & Associates, /nc., 8875 Hidden River Parkway, Suite 200, Tampa, Florida 33637
and its Federal Employer Identification Number (FEIN) is 39-096-5082
287.133 Public entity crime; denial or revocation of the right to transact business with public
entities
(2)(a) 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 or perform work as a contractor, supplier, subcontractor, 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 287.017 for CATEGORY TWO for a period of 36 months from the date of
being placed on the convicted vendor list.
Based on information and belief, the statement which I have marked below is true in relation to the entity submitting
this sworn statement.
X Neither the entity submitting this sworn statement, not any of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in 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.
State of Florida
County of Hillsborough
By:
June 30. 2003
Date
Title: Vice President-Florida Operations
Subscribed before me by
Nizar K. Jetha, who is
personally known by me.
Attest NQU. ffD -2?ck'""",
(SEAL)
If individual, furnish two (2) witnesses:
....,..~\ CHERYL O. ZIHMER
i. . s Notary Public - Stat8 of Florida
:I _
MrCl....,Mlal. EllRsAug 22, 2IXl5
.. Comml8.lon , 00052145
Witness (1)
Witness (2)
Client#: 14106
OWENAYRES
"ACQRDTM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
06127/03
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
WAUSAU INSURANCE COMPANIES
3430 OAKWOOD MALL DRIVE
SUITE 300
EAU CLAIRE, WI 54701
OWEN AYRES AND ASSOCIATES INC
ATTN TOM STUMM
PO BOX 1590
EAU CLAIRE, WI 54702-1590
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: WAUSAU UNDERWRITERS INSURANCE O.
INSURER B: EMPLOYERS INSURANCE OF WAUSAU
INSURED
INSURER C:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSuED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSRI TYPE OF INSURANCE POLICY NUMBER PJ'A~~,j~f~8>>~\E Pg~flt~~~J~N LIMITS
A GENERAL LIABILITY YY JY91503188063 01/01/03 01101/04 EACH OCCURRENCE $1.000.000
I-- ~~~~~lJo E~E~~b~r~enc~\
~ COMMERCIAL GENERAL LIABILITY $300 000
~. CLAIMS MADE [~12CCUR .CC..r ---- ~ MED EXP (Anyone person) $5.000 --
f-- PERSONAL & ADV INJURY $1 000,000
GENERAL AGGREGATE $1 000.000
I--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1 000,000
n nPRO- n
POLICY JECT LOC
A ~TOMOBILE LIABILITY ASJY91503188023 01/01/03 01/01/04 COMBINED SINGLE LIMIT
r-!- ANY AUTO (Ea accident) $1,000,000
ALL OWNED AUTOS BODILY INJURY
I-- $
SCHEDULED AUTOS (Per person)
f---'-
X HIRED AUTOS BODILY INJURY
- $
~ NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
B EXCESS/UMBRELLA LIABILITY THCY91503188033 01/01/03 01/01/04 EACH OCCURRENCE $5 000 000
~ OCCUR D CLAIMS MADE AGGREGATE $5 000 000
$
~ DEDUCTIBLE $
X RETENTION $ 1 0000 $
A WORKERS COMPENSATION AND WCJY91503188043 01/01/03 01/01/04 X I T'f..~J(~~~<: I 10J~~
EMPLOYERS' LIABILITY $100,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $100,000
If yes, describe under $500,000
SPECIALPROVISIONS below E.L. DISEASE. POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
PROJECT: CITY OF CLEARWATER, 2003 ENGINEER OF RECORD CONTACT
CITY OF CLEARWATER IS INCLUDED AS ADDITIONAL INSURED UNDER THE
GENERAL LIABILITY POLICY PER GL0492 AND AS LIMITED INSURED-VICARIOUS
LIABILITY UNDER THE AUTO POLICY PER WA8421.
CERTIFICATE HOLDER
CANCELLATION
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER, FL 33758-4748
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ----3D..- DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
UTHORIZED REPRESENTATIVE
- C
ACORD 25 (2001/08) 1 of 2
#288329
AR1
@ ACORD CORPORATION 1988
.'"
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
-.-.
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (2001/08)
2 of2
#288329