R06-013
II
1 RESOLUTION R06- 01,3
2
3 A RESOLUTION OF THE CITY COMMISSION OF THE CITY
4 OF BOYNTON BEACH, PALM BEACH COUNTY, FLORIDA,
5 AUTHORIZING EXECUTION OF AN ANIMAL SERVICE
6 AGREEMENT BETWEEN THE CITY OF BOYNTON BEACH
7 AND PALM BEACH COUNTY ANIMAL CARE AND
8 CONTROL DIVISION, FOR THE REIMBURSEMENT OF
9 CERTAIN COSTS ASSOCIATED WITH ANIMAL CARE AND
10 CONTROL SERVICES; AND PROVIDING AN EFFECTIVE
11 DATE.
12
13 WHEREAS, the City of Boynton Beach Animal Care and Control Division received
14 a grant from Palm Beach County for reimbursement of certain costs associated with Animal
15 Control services in an amount not to exceed $10,000.00; and
16 WHEREAS, the City Commission of the City of Boynton Beach upon
17 recommendation of staff, deems it to be in the best interest of the citizens of the City of
18 Boynton Beach to authorize execution of this Animal Services Agreement.
19 NOW, THEREFORE BE IT RESOLVED BY THE CITY COMMISSION OF
20 THE CITY OF BOYNTON BEACH OF PALM BEACH COUNTY, FLORIDA,
21 THAT:
22 I
Section 1:
The foregoing "Whereas" clauses are hereby ratified and confirmed as
23 being true and correct and are hereby made a specific part of this Resolution upon adoption
24 hereof.
25
Section 2:
The City Commission of the City of Boynton Beach, Florida hereby
26 authorizes execution of the Animal Service Agreement with Palm Beach County Animal
27 Care and Control Division, a copy of said Agreement attached hereto.
28
29
Section 3:
This Resolution shall take effect immediately upon adoption.
S:\CA\RESO\GrantslAnimal Control Services 121505.doc
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PASSED AND ADOPTED THIS ~ day of January, 2006.
CITY OF BOYNTON BEACH, FLORIDA
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ANIMAL SERVICES CONTRACT
FOR
PALM BEACH COUNTY ANIMAL CARE AND CONTROL DIVISION
WEST PALM BEACH, FLORIDA -,-
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This Contract is made as of the day of MAR I 4 ~ ' by ana betw~en
The City of Boynton Beach (hereinafter referred to as AGENCY whose "tederilOax
identification number is S<') . (,;<<." ._' " .~. ), a Florida Municipal Corporation
and Palm Beach County, a political subdivision of the State of Florida, by and through its
Division of Animal Care and Control on behalf of the Board of County Commissioners,
hereinafter referred to as the COUNTY, for the provision of animal services.
WHERE~ " the COUNTY provides various animal services; and
WHEREAS, the AGENCY is able to provide said services for compensation.
NOW, THEREFORE, in consideration of the mutual promises contained herein, the
COUNTY and the AGENCY agree as follows:
ARTICLE 1- ANIMAL SERVICES
The AGENCY'S responsibility under this agreement is to provide animal services, as more
specifically set forth in the Application and Scope of Work detailed in Exhibit "A". The
Agency shall provide animal services during the period October L 2005 through September 30,
2006.
ARTICLE 2 _ REIMBURSEMENT RATES FOR SERVICES
The COUNTY may reimburse the AGENCY for services the AGENCY provided hereunder
within the geographical boundaries of Palm Beach County at the following rates:
A. FIELD OFFICER RESPONSE:
1. The rate for providine AGENCY response to calls from the public to pick-
UP stray or confined animals within Palm Beach County and take the
animal to the AGENCY's Palm Beach County shelter: Rate per Response:
$25.00
B. ADOPTION MEDICAL and CLINIC SERVICES:
I. The rate for providine spavine or neuterine. micro-chippine. rabies
inoculation and COUNTY rabies tae of an animal beine prepared for
adoption to a Palm Beach County resident adopter: Rate per Complete
Procedure: $110.00 (Note: Spav or neutering performed bv the Palm Beach
Countv Spav Shuttle are not eligible for reimbursement.)
2. The rate for the AGENCY'S routine adoption medical exam of an animal to
be adopted by a Palm Beach County resident: $~
C. KENNEL/SHEL TERING:
1.
Invoices documenting the AGENCY's reimbursement request may be submitted to
Animal Care and Control monthly. The AGENCY shall receive no additional
compensation for performance under this Contract except as provided for herein and
under no circumstances shall the total value of all combined services exceed
$ 10.000 Ten thousand dollars.
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Final Invoice: In order for both parties herein to close their books and records, the
AGENCY will clearly state "final invoice" on the AGENCY'S final/last billing to the
COUNTY. The final invoice must be received by Animal Care and Control no later
than 5:00pm on September 30. 2006. the final dav of the al!:reement period. This
certifies that all services have been properly performed and all charges and costs have
been invoiced to Palm Beach County, Since this account will thereupon be closed, any
and other further charges, if not properly included on this final invoice, are waived by
the AGENCY.
The COUNTY'S representative will review invoices received from the AGENCY
pursuant to the agreement If the invoice has been determined to be in conformity with
the agreement, it will be approved by the COUNTY'S representative and then sent to
the Finance Department for payment Invoices will normally be paid within thirty (30)
days following the COUNTY representatives' approval.
The COUNTY shall not be obligated to provide the AGENCY with any fringe benefits,
The COUNTY shall not be obligated to withhold US. income tax, withholding or social
security tax, unemployment, or worker's compensation payments, and any similar
withholdings, It is expressly understood that the AGENCY is not entitled to participate
in the State Retirement Program.
ARTICLE 3 - MINIMUM REQUIRED DOCUMENT A TION
The services described below are only applicable for the reimbursement request submitted by
the AGENCY in Article 2 above that oecur or are generated from within Palm Beaeh County,
The AGENCY shall use reimbursement forms provided by the COUNTY see attached or
AGENCY forms approved by the COUNTY. By submitting a request for reimbursement, the
AGENCY agrees to be governed by the laws of the State of Florida and the COUNTY which
pertain to the treatment, care, and sheltering of animals,
A. FIELD OFFICER RESPONSE
The AGENCY shall respond to all requests for the pick up of stray or confined animals
within the geographical boundaries of the AGENCY's normal working areas within
Palm Beach County, For each Field Officer Response that will be reimbursed. as a
minimum reQuirement. the AGENCY shall submit documents that record: the
date and time the reQuest for response was received bv the AGENCY: the name,
phone number. and address of the person makinl!: the reQuest: the location of the
pick UP of the animal: a description of the animal. includinl!: its species. markinl!:s,
sex. anv identifvinl!: markinl!:s. tattoos, ID tal!:s. collars. and any other AGENCY
specific numberinl!: or IOl!:l!:inl!: of the animal: and verification that the animal was
checked al!:ainst the COUNTY's "lostJfound" database.
B. ADOPTION MEDICAL AND CLINICAL SERVICES
Animals being adopted from the AGENCY shall be spayed or neutered before the
animal is released to the adopter. A State of Florida licensed veterinarian shall perform
the spaying or neutering procedure, For each spay or neuter that will be reimbursed.
as a minimum. the AGENCY shall submit documents that record: the name of the
veterinarian and hislher State of Florida veterinarv license number: the procedure
performed: the specific AGENCY l!:enerated identification name or number l!:iven
to the animal beinl!: spaved or neutered: the batch or control number and name of
the manufacturer of the rabies vaccine l!:iven to the animal: the manufacturers
name and specific unit number of the implanted micro-chip in the animal: the
name and Palm Beach County address of the adopter: and the Palm Beach County
rabies tal!: number issued for the animal.
Animals available for adoption shall receive a medical evaluation. For each initial
medical examination that will be reimbursed. as a minimum. the AGENCY shall
submit documents that record: the specific AGENCY l!:enerated identification
2
name or number I!iven to the animal beinl! evaluated: the name of the person
performinl! the evaluation: a Iistinl! of the procedures performed and their
findinl!s, if any: and a schedule of medications or treatments as a response to the
dial!nostic findinl!s.
C. KENNEL/SHELTERING
The AGENCY shall kennel or shelter animals generated from within Palm Beach
County according to the minimum criteria established by the COUNTY, For each
animal that the AGENCY will be reimbursed, the AGENCY, at a minimum, shall
submit documents that record: the specific AGENCY I!enerated identification
name or number I!iven to the animal beinl! provided shelter: the date the animal
entered the shelter; and the date the animal left the shelter or is still at the shelter
after a five (5) day holdinl! period.
ARTICLE 4 - PERSONNEL
The AGENCY represents that it has, or will secure at its own expense, all necessary personnel
required to perform the services under this agreement. The AGENCY shall submit the names
of such personnel who are employees of, or have any contractual relationship with, the
COUNTY prior to the execution of this agreement. The COUNTY shall determine the extent
of any conflict of interest with the personnel prior to the execution of this agreement.
The AGENCY shall assure that all of the serviees performed and required herein shall be
performed by the AGENCY or by personnel under its supervision, All personnel engaged in
performing the services shall be fully qualified and, if required, authorized or permitted under
state and local law to perform such services,
The AGENCY warrants that all of the services provided by, or on its behalf, pursuant to the
Agreement will be performed with reasonable care, skill and diligence in accordance with
generally and currently accepted professional principles and practices for similar services,
ARTICLE 5. A V AILABILlTY OF FUNDS
The COUNTY's performance and obligation to pay under this agreement is contingent upon an
annual appropriation for its purpose by the Board of County Commissioners,
ARTICLE 6 - INSURANCE
A. AGENCY shall, at its sole expense, agree to maintain in full force and effect at all times
during the life of this Contract, insurance coverage and limits (including endorsements),
as described herein, The requirements contained herein, as well as COUNTY'S review
or acceptance of insurance maintained by AGENCY are not intended to and shall not in
any manner limit or qualify the liabilities and obligations assumed by AGENCY under
the contract. The COUNTY may approve different coverage and limits if requested by
the AGENCY prior to execution of the contract.
B. Commercial General Liability The COUNTY requests the AGENCY maintain
Commercial General Liability at a limit of liability not less than $500,000 Each
Occurrence. Coverage shall not contain any endorsement excluding Contractual
Liability or Cross Liability unless granted in writing by County's Risk Management
Department. AGENCY shall provide this coverage on a primary basis, The COUNTY
may approve different coverage and limits if requested by the AGENCY prior to
execution of the contract.
C. Business Automobile Liabilitv The COUNTY requests the AGENCY maintain
Business Automobile Liability at a limit of liability not less than $500,000 Each
Oecurrence for all owned, non.owned and hired automobiles, In the event AGENCY
doesn't own any automobiles, the Business Auto Liability requirement shall be
amended allowing AGENCY to agree to maintain only Hired & Non.Owned Auto
3
Liability. This amended requirement may be satisfied by way of endorsement to the
Commercial General Liability, or separate Business Auto coverage form, AGENCY
shall provide this coverage on a primary basis, The COUNTY may approve different
coverage and limits if requested by the AGENCY prior to execution of the contract.
D, Worker's Compensation Insurance & Emplovers Liability AGENCY shall maintain
Worker's Compensation & Employers Liability in accordance with Florida Statute
Chapter 440. AGENCY shall provide this coverage on a primary basis,
E. Additional Insured AGENCY shall endorse the COUNTY as an Additional Insured
with a CG 2026 Additional Insured - Designated Person or Organization endorsement,
or its equivalent, to the Commercial General Liability, The Additional Insured
endorsement shall read "Palm Beach County Board of County Commissioners, a
Political Subdivision of the State of Florida. its Officers. Emplovees and Agents,"
AGENCY shall provide the Additional Insured endorsements coverage on a primary
basis,
F. Waiver of Subrol!ation AGENCY hereby waives any and all rights of Subrogation
against the County, its officers, employees and agents for each required policy, When
required by the insurer, or should a policy condition not permit an insured to enter into a
pre.loss agreement to waive subrogation without an endorsement, then AGENCY shall
agree to notify the insurer and request the policy be endorsed with a Waiver of Transfer
of rights of Recovery Against Others, or its equivalent. This Waiver of Subrogation
requirement shall not apply to any policy, which a condition to the poliey specifically
prohibits such an endorsement, or voids coverage should AGENCY enter into such an
agreement on a pre. loss basis,
G, Certificate(s) of Insurance Prior to execution of this Contract, AGENCY shall
deliver to the COUNTY a Certificate(s) of Insurance evidencing that all types and
amounts of insurance coverage required by this Contract have been obtained and are in
full force and effect. Such Certificate(s) of Insurance shall include a minimum thirty
(30) day endeavor to notify due to cancellation or non-renewal of coverage,
H. Umbrella or Excess Liabilitv If neeessary, AGENCY may satisfy the mInImum
limits required above for either Commercial General Liability, Business Auto Liability,
and Employer's Liability coverage under Umbrella or Excess Liability, The Umbrella
or Excess Liability shall have an Aggregate limit not less than the highest "Each
Occurrence" limit for either Commercial General Liability, Business Auto Liability. or
Employer's Liability, The COUNTY shall be specifically endorsed as an "Additional
Insured" on the Umbrella or Excess Liability, unless the Certificate of Insurance notes
the Umbrella or Excess Liability provides coverage on a "Follow.Form" basis.
j, Ril!ht to Review COUNTY, by and through its Risk Management Department, 10
cooperation with the contracting/monitoring department, reserves the right to review,
modify, reject or accept any required policies of insurance, including limits, coverage,
or endorsements, herein from time to time throughout the term of this Contract.
COUNTY reserves the right, but not the obligation, to review and reject any insurer
providing coverage because of its poor financial condition or failure to operate legally.
ARTICLE 7 - INDEMNIFICATION
The AGENCY agrees to be responsible, as set forth in Section 768,28, Florida Statutes, for its
own negligent acts or omissions or tortuous acts which result in claims or suits against the
COUNTY and agrees to be liable to the limits set forth in Seetion 768,28, Florida Statutes, for
any damages proximately caused by said acts or omissions, Nothing herein is intended to serve
as a waiver of sovereign immunity by the CITY to which sovereign immunity applies. Nothing
herein shall be construed as consent by CITY to be sued by third parties in any matter arising
out of any contract.
4
The COUNTY, as a political subdivision of the State of Florida, agrees to be fully responsible
for its own negligent acts or omissions or tortuous acts which result in claims or suits against
the CITY, and shall be liable to the limits set forth in Section 768.28, Florida Statutes, for any
damages proximately caused said acts or omissions, Nothing herein is intended to serve as a
waiver of sovereign immunity by the COUNTY to which sovereign immunity applies. Nothing
herein shall be construed as consent to be sued by third parties in any matter arising out of any
contract.
ARTICLE 8 - SUCCESSORS AND ASSIGNS
The COUNTY and the AGENCY each binds itself and its partners, successors, executors,
administrators and assigns to the other party of this Contract and to the partners, successors,
executors, administrators and assigns of such other party, in respect to all covenants of this
Contract. Except as above, neither the COUNTY nor the AGENCY shall assign, sublet,
conveyor transfer its interest in this Contract without the written consent of the other, except
that the AGENCY may assign his/her right to receive payment. Nothing herein shall be
construed as creating any personal liability on the part of any officer or agent of the COUNTY
which may be a party hereto, nor shall it be construed as giving any rights or benefits hereunder
to anyone other than the COUNTY and the AGENCY.
ARTICLE 9 - REMEDIES
This Contract shall be governed by the laws of the State of Florida. Any and all legal action
neeessary to enforce the Contract will be held in Palm Beach County. No remedy herein
conferred upon any party is intended to be exclusive of any other remedy, and each and every
such remedy shall be cumulative and shall be in addition to every other remedy given
hereunder or now or hereafter existing at law or in equity or by statute or otherwise, No single
or partial exercise by any party of any right, power, or remedy hereunder shall preclude any
other or further exercise thereof.
ARTICLE 10 - CONFLICT OF INTEREST
The AGENCY represents that he/she presently has no interest and shall aequire no interest,
either direet or indirect, which would conflict in any manner with the performance or services
required hereunder, or as provided for in Florida Statute 112.31 L The AGENCY further
represents that no person having any interest shall be employed for said performance,
The AGENCY shall promptly notify the COUNTY'S representative, in writing by certified
mail, of all potential conflicts of interest for any prospective business association, interest or
other circumstance which may influence or appear to influence the AGENCY'S judgment or
quality of services being provided hereunder. Such written notification shall identify the
prospective business assoeiation, interest or circumstance, the nature of work that the
AGENCY may undertake and request an opinion of the COUNTY, as to whether the
assoeiation, interest or circumstance would, in the opinion of the COUNTY constitute a
conflict of interest if entered into by the AGENCY. The COUNTY agrees to notify the
AGENCY of his/her opinion by certified mail within thirty (30) days of receipt of notification
by the AGENCY. If, in the opinion of the COUNTY, the prospective business association,
interest or circumstance would not constitute a conflict of interest by the AGENCY, the
COUNTY shall so state in the notification and the AGENCY shall, at his/her option, enter into
said association, interest or circumstance and he/she shall be deemed not in conflict of interest
with respect to services provided to the COUNTY by the AGENCY under the terms of this
Contract.
ARTICLE 11 - DISCLOSURE AND OWNERSHIP OF DOCUMENTS
The AGENCY shall deliver to the COUNTY'S representative for approval and acceptance, and
before being eligible for final payment of any amounts due, all documents and materials
prepared by and for the COUNTY under this Contract.
5
All written and oral information not in the public domain or not previously known, and all
information and data obtained, developed, or supplied by the COUNTY or at its expense will
be kept confidential by the AGENCY and will not be disclosed to any other party, directly or
indirectly, without the COUNTY'S prior written consent unless required by a lawful order. All
drawings, maps, sketches, programs, data base, reports and other data developed, or purchased,
under this Contract for or at the COUNTY'S expense shall be and remain the COUNTY'S
property and may be reproduced and reused at the discretion of the COUNTY,
The COUNTY and the AGENCY shall comply with the provisions of Chapter 119, Florida
Statute (Public Records Law).
All covenants, agreements, representations and warranties made herein, or otherwise made in
writing by any party pursuant hereto, including but not limited to any representations made
herein relating to disclosure or ownership of documents, shall survive the execution and
delivery of this Contract and the consummation of the transactions contemplated hereby,
ARTICLE 12. INDEPENDENT CONTRACTOR RELA TIONSHIP
The AGENCY is, and shall be, in the performance of all work services and activities under this
Contract, an Independent Contractor, and not an employee, agent, or servant of the COUNTY.
All persons engaged in any of the work or services performed pursuant to this Contract shall at
all times, and in all places, be subject to the AGENCY'S sole direction, supervision, and
controL The AGENCY shall exercise control over the means and manner in which he/she and
his/her employees perform the work, and in all respects the AGENCY'S relationship and the
relationship of his/her employees to the COUNTY shall be that of an Independent Contractor
and not as employees or agents of the COUNTY,
The AGENCY does not have the power or authority to bind the COUNTY in any promise,
agreement or representation other than specifically provided for in this Contract.
ARTICLE 13. ACCESS AND AUDITS
The AGENCY shall maintain adequate records related to all charges, expenses, and costs
incurred in estimating and performing the work for at least three (3) years after completion of
this Contract. The COUNTY shall have aceess to such books, records, and documents as
required in this section for the purpose of inspection or audit during normal business hours, at
the AGENCY'S place of business,
ARTICLE 14. NONDISCRIMINATION
The AGENCY warrants and represents that all of its employees are treated equally during
employment without regard to race, color, religion, disability, sex, age, national origin,
ancestry, marital status, or sexual orientation,
ARTICLE 15. ENFORCEMENT COSTS
If any legal action or other proceeding is brought for the enforcement of this Contract, or
because of an alleged dispute, breach, default or misrepresentation in connection with any
provisions of this Contract, the successful or prevailing party or parties shall be entitled to
recover reasonable attorney's fees, court costs and all expenses (including taxes) even if not
taxable as court costs (including, without limitation, all such fees, costs and expenses incident
to appeals), incurred in that action or proceeding, in addition to any other relief to which such
party or parties may be entitled,
ARTICLE 16 - AUTHORITY TO PRACTICE
The AGENCY hereby represents and warrants that he/she has and will continue to maintain all
licenses, designations, certifications and approvals required to conduct his/her business, and
that he/she will at all times conduct its business acti vities in a reputable manner. Proof of such
licenses and approvals shall be submitted to the COUNTY'S representative upon request.
6
ARTICLE 17. SEVERABILITY
If any term or provision of this Contract, or the application thereof to any person or
circumstances shall, to any extent, be held invalid or unenforceable, the remainder of this
Contract, or the application of such tenns or provisions, to persons or circumstances other than
those as to which it is held invalid or unenforceable, shall not be affected, and every other term
and provision of this Contract shall be deemed valid and enforceable to the extent permitted by
law,
ARTICLE 18 . PUBLIC ENTITY CRIMES
As provided in ES. 287.132-133, by entering into this Contract or perfonning any work in
furtherance hereof, the AGENCY certifies that he/she, his/her affiliates, suppliers,
subcontractors and AGENCY'S who will perfonn hereunder, have not been placed on the
convicted vendor list maintained by the State of Florida Department of Management Services
within the thirty.six (36) months immediately preceding the date hereof. This notice is
required by Florida Statutes, Section 287, 133(3)(a),
ARTICLE 19 - NOTICE
All notices required in the Contraet shall be sent by certified mail, return receipt requested, and
if sent to the COUNTY'S representative shall be mailed to:
County Administrator
P,O. Box 1989
West Palm Beach, Florida 33402
and
Animal Care and Control
7100 Belvedere Road
West Palm Beach, Florida 33411
with a copy to:
County Attorney's Office
P,O, Box 1989
West Palm Beach, Florida 33402
and if sent to the AGENCY shall be mailed to:
Boynton Beach Animal Control
100 E. Boynton Beach Blvd,
Boynton Beach, Florida 33435
ARTICLE 20. CONTRACT TERMINATION
This Contract may be canceled by the AGENCY upon thirty (30) days prior written notice to
the COUNTY'S representative, It may also be tenninated by the COUNTY, with or without
cause, immediately upon written notice to the AGENCY. Unless the AGENCY is in breach of
this Contract, the AGENCY shall be paid for services rendered to the COUNTY'S satisfaction
through the date of tennination.
7
After receipt of a Termination Notice and except as otherwise directed by the COUNTY, the
AGENCY shall:
A. Stop work on the date and to the extent specified,
B, Terminate and settle all orders and subcontracts relating to the performance of the
terminated work,
C. Transfer all work in process, completed work, and other materials related to the
terminated work to the COUNTY,
D. Continue and eomplete all parts of the work that have not been terminated,
ARTICLE 21 - ENTIRETY OF CONTRACTUAL AGREEMENT
The COUNTY and the AGENCY agree that this Contract sets forth the entire agreement
between the parties, and that there are no promises or understandings other than those stated
herein, None of the provisions, terms and conditions contained in this Contract may be added
to, modified, superseded or otherwise altered, except by written instrument executed by the
parties hereto,
ARTICLE 22 - CRIMINAL HISTORY RECORDS CHECK
The CONSULTANT shall comply with the provisions of Ordinance 2003.030, the Criminal
History Records Check Ordinance ("ordinance"), if CONSULTANT'S employees or
subcontractors are required under this contract to enter a "critical facility" as identified in
Resolution R.2003-1274, The CONSULTANT acknowledges and agrees that all employees
and subcontractors who are to enter a "critical facility" will be subject to a fingerprint based
criminal history records checks, Although The CONSULTANT shall be solely responsible for
the finaneial, schedule, and staffing implications associated in complying with Ordinance 2003-
030.
IN WITNESS WHEREOF, the Board of County Commissioners of Palm Beach
County, Florida has made and executed this Contract on behalf of the COUNTY and the
AGENCY has hereunto set its hand the day ana year ilQPVl;: written,
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Sharon Bock, Clerk and Comptroller PALM BEACH COUNTY, FLORIDA
BOAR!) OF COUNTY COMMISSIONERS
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Deputy Clerk
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Vincent J:Bo~ven~~.
Assistant County Administrator
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APPROVED AS TO FORM
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APPROVED AS TO THE TERMS AND
CONDITIONS
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Paul W, Milelli, Director
Public Safety Department
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Palm Beach County PubUe Safety Department
A nlmal Care and Control Division.
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Palm Beach County Board of County Commissioners
Department of Public Safety
PALM BEACH COUNTY
ANIMAL CARE AND CONTROL DIVISION
2005/06
APPLICATION FOR FINANCIAL ASSISTANCE
Application Deadline: JULY 29, 2005
Palm Beach County Board of County Commissioners
Tony MasUotti"Chairman
Addie L. Greene, Vice Chair
Karen Marcus
Jeft'Koons
Warren H. Newell
Mary McCarty
JJurt Aaronson
County Administrator
Robert WeiAmAn
Funding Amount Requested $
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8. Is your organization or agency a 50le3 charity as detennined by the IRS? 9 Yes ~ a()",*N~tI/J;
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If yes, please attach a copy of your Detennination Letter.
9. Please provide the name, address, and telephone number(s) of your attorney and attach a letter from counsel
verifying that your IRS Detennination as a charity has not been revoked If the organization does not have an
attorney, the president/director should provide this information on a notarized statement.
:'\ ,I I llL' .\ddtl'...,"l':--, I ck'pl)()11C Tckpl1nlll'
10.
11.
What is your projected operating budget for the current year? $
What types of animals are accepted at your shelter or facility?
/~~ 4;51)'->/ 1..1()()s'-~{P)
I. sf.,-RI'J
5. JIM
2. .6r'~1'J c?.&l~
W.Q,.!.d ?<}/-'-~.,(/~"./
~Mb ~.4'.6.:';V"'A ,7$
:;( 7"tJA&
A/!tJ,6..J /MI't1rJNAM~A/d{ A-eJlf A
,/(fi"'6W! tiP' f'l~.1 Ah?V/7?~~
"'. 'I .......1 ), . J.
12.
How many animals are brought to your organization each year?
13. D~s your organization use a computerized animal-tracking program such as Chameleon? 9 Yes !5'9
If not Chameleon, identify computer software: //II;d!~A)I'f"; /J/'1~ /lJlfd
14. Does your organization have a 'lost and found' service? r9 No
IS. Does your agency have a Field Operations Service to respond for pick up of stray/confined/injured animals?
?9 No If yes, please describe: t7oM'l"'d& ;:7~.d ~A"V/(".;("'~ / OIt'A/#'A'K'e'...of" AM::!
~';"~tJ1Jf' //IIFt'A"e'A"A1,A"'d / ..dtl.M'...f'~1?t"- AJ/.Al>~/r,K - A'Xt77'/~
Number of animals picked up in Palm Beach County from October 1, 2004, through September 30, 2005:
i( ,?{I-/I, .;ftl~,f - AMy'o8'l,.:in5"' (vf~) jt' /1Vt?,I.(JAI!~ Mt?..<"'A'6'A AN/MIfA~ A"A"'h1"~<1
- r/f'''M .li'M~W'9"Q
(please provide documentation of these statistics)
16. Do you provide a spay/neuter service to the public? 9 Yes ~
If yes, please attach a list of services and fees for each type of service provided.
17. Are all adopted animals spayed and/or neutered? 9 Yes 9 No ,i)1//
18.
Are all adopted animals micro-chipped? 9 Yes 9 No
NIl'!
19. Does your organization provide a rabies vaccination and County license tag for all adopted dogs and cats?
9 Yes 9 No II/I'!
20. Please provide the number of animals adopted from your agency that were spayed, neutered, micro-chipped
AND given a rabies vaccination and County license tag for the fiscal year of October I, 2004, through
September 30, 2005.
Please attach documentation for these statistics. Reimbursements for this catel!:orv will reouire that all
adooted animals be sterilized. micro-ehiooed. and bave a current rabies vaccination and County Ucense
tal!:. (Not mandatory !!' your organization received funding in the 20M/OS fiscaI year.)
21. Does your organization provide routine medical exams for all animals? 9 Yes ~
22. Does your organization provide shelter (food and housing) on-site for domestic animals? 9& No
23. How many animals were sheltered at your facility from October I, 2004, through September 30, 2005?
1K If) 111/ 1''''1- ~~31 Id~ (.t3'7 'J- (H this is the first time you have appUed to this program, please
attach documentation for these statistics.)
24. Please furnish copies of the following:
A. Organization's most recent 990 IRS filing form B. Organization's Current Certificate of Insurance
Organization! Agency Name:
~1"y II" ~"Y~H' /ik:1t1# - -4/'//.#",,-< 61V'?1ft7";
, .
The agency may request funding for any or all of the services identified below.
Anticipated Number of Field Services to be Provided
5~ x $ 25.00 = $ /~, ~-b,r;/
Anticipated Number of SpaylNeuter Services Provided*
&l x $ 110.00 = $
AJ/..-f
* This servree MUST include spay/neuter, mrero-chip, rabies vaccination and issuance of
County lU:ense tag. AUfour servrees must be performed on each animal to qualify.
Anticipated Number of Medical Exams to be Provided
t:? x $ 50.00 = $ j)/tf
Anticipated Number of Dogs and Cats to be Sheltered ~ <1f?,
7~ x $ 5.00/day = $ /~~:;)~ r
# /5#~t; ON AV~~IfM N' (3) M/.5 ,sMR}J M''o/'...-fN/A1'1'f1)
, f-J,
= $ .J~O't't'n/
7h.r"
IDa
otal Amount of Funding Requested
e of Agency Representative
Mail or deliver application packages to: Attn: Dianne M. Sauve, Director
Palm Beach County Animal Care and Control
7100 Belvedere Road
West Palm Beach, FL 33411
Please call 561-233-1252 for additional infonnation.
C. Organization's HunicanelDisaster Plan
25. Please complete the foUowing Agency Funding Proposal. Review the application checklist and include
all requested documentation.
AGENCY FUNDING REQUEST PROPOSAL
OcrOBER 1, 2005 . S~Pl'EMBER 30, 2006
J\IIU1~11!.
~-
STATE NATIONAL INSURANCE CO.
CERTIFICATE OF INSURANCE
fJATE ISSUED: 12/7/04
I PRODUCER This certificate is Issued as a matter of Information onl,y and confers no rights upon
Arthur J, Gallagher & Co the certificate holder. This certificate DOES NOT amend" extend or alter Ihe coverage
2255 Glades Road afforded by th~pollcles below.
Sulle 400 E. COMPANIES AFFORDING COVEf?AGE
Boca Raton, FL 33431
COMPANY (A) STATE NATIONAL INSURANCE C~)MPANY
INSURED COMPANY (8)
City of Boynton Beach, FL
100 E. Boynlon Beach Blvd, COMPANY (C)
Boynton Beach, FL 33435 ,
COMPANY (D)
:~:'~<k':i&1 'i'e' M ,'" I'. '.'~i'1(' '1'1,;' t(;: ',.';;-"<Hf; "I',~t' "'~-1':>;~lf "'Yi~~~,'. ",)i"'" '-:''','1','
COVERAGES ,
This Is to certify that the policies of Insurance listed below have been Issued to the Insured named above for the polley period Indicated,
notwithstanding any requirement, term or condlUon of any contract or other document with raspect to whtch thiS Cjlrtlflcate may be Issued or may
pertain, the Insurance afforded by the policies described herein Is subjeclto all the terms,. exclusions and condlUon~ of such policies. LImits shown
may have been reduced by peld claims. ,
" '." i~t .. ,Or .,' i', .~;;' ':i"'>'i;>.'1jw. ,'<"t'" . . J' . . ~:r,'f "i'.-t~J"~ ';':liri'J::;;d'~,:,i\!i-k'~M 'I' ~ . ,';~i~!~:):l;k:
co TYPE OF IN8URAN~E POLICY NUMBER POlICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE lMMIDDlYYI OATE lMMIODlYYI
GENERAL LIABIUTY ,
A III COMMERCIAL GENERAl LIABILITY MDB 02214 94 1011104 10/1105 GENERA,L AGGREGATE HAIIlw.t
[J CLAIMS MADe aoOCCUR. PRODUGTSCOMProPAGG
a OWNER'S & CONTRACTOR'S PROr EACH ~URRENCE
FIRE 0 oe (anyone lire)
MED. EX;PENSE <any one person)
AUTOMOBILE lIABILITY ,
A a ANY AUTO NotAppllceble Not Applicable ""'_bIo COMBINrO SINGLE LIMIT ~
C All OWNED AUTOS BODllY~URY(jNr_1
a SCHEDULED AUTOS BOOIL Y JURY (po......)
C HIRED AUTOS P~OPE~ DAMAGE
C NON~NEDAUTOS
C GARAGE LIABILITY
EXCESS LIABILITY
A C UMBRELLA FORM EACH OC;CURRENCE $5,000,000.
III OTHER THAN UMBRELLA FORM MOB 02214 94- 1011104 10101105 AGGRE'jATE $10,000,000.
WORKERS' COMPENSATION MOB 02214 94 1011104 10101106 STATUTORY LIMITS Statutory
ANO
EMPLOYERS'LIABILITY EACH AqclDENT
DtsEAS~.POllce LIMIT
DISEASe-EACH EMPLOYEE
XXXX POLICY SUBJECT TO SIR As per Genaral Endorsement SNS GEN ( 1,
..~...........................................................M............................................................M........._........................................................................................................................ "''''''''''''''''''''''f''''''''''''''''''''''''''''''''''''''''.'''''''''''''''''''''''''''''''''''
DESCRiPTION OF OPERATlONS/LOCATlONSNEHICLES/SPECIAL ITEMS _ Ail operations usual to a City Government including
Palm Beach County Board of County Commissioners, a poilticel subdivision of the State of fiorida, ,'its officers, employees and
agents as additional insured-as their Interests may appear throughout the poilcy periOd for municipal acllvllies in coordination andlor
"'~!.)j!:',!.),<=,ll!>.!:'.~!1".P.!l!~"I3"~~~!1,,c::,".!:',n.!Y.,,!3.".,~,~<>.f.,,9?~_n.!Y..~,!!1.'!1,'~I".!:'!''!!,',,~II,''.,I!1,~.r.,!!'I1!!~~!',c:t,~!:'~IY.''.,!.)~,,''.f.r.''.II~:tr.!'f1!,~1!:',':'!.).!!.~_~,n.Ji.!',c:t:"",,,,
CERTIFICATE HOLDER
Should any of the above described policies be canpelled before the explraUon
Palm Beach County Board of County date thereof, the issuing company will endeavor to mall E days wrItlen noUce to
Commissioners the certificate holder named to the left, but failure to l1)all such noUce shall Impose
Risk Mgt Dept no obllgaUon or liability of any kind upon thel company, Its agents or
160 Australian Ave. representaUves.
VVestPalmBeach, FL 33406 r
Attention: Dick Cohen ,t:L J!2
Authorized signature: h"
,,/ Sandra~. uonag~y <-
-:_.1.';-'
Meadowbrook Insurance Group
.',.Jl....~"',<
The City of Boynton Beach
(SC .... ".~. '.~ ... ..... '\..\)
\ \ I.
\" . l..' ../
'\-'''- '~""" """",,^,,,.../
City Clerk's Office
100 E BOYNTON BEACH BLVD
BOYNTON BEACH FL 33435
(561) 742-6060
FAX: (561) 742-6090
e-mail: prainitoj@ci.boynton-beach.f1.us
www.boynton-beach.org
January 12, 2006
Lisa Raymond
Animal Care and Control
7100 Belvedere Road
West Palm Beach, FL 33411
Dear Ms. Raymond:
Attached are two original partially executed Agreements between Palm Beach County
Animal Care and Control Division and the City of Boynton Beach for reimbursement of
certain costs associated with animal care and control services. These agreements were
approved by Resolution No. R06-013 that the City Commission adopted on January 3rd,
2006.
Once the documents have been fully executed, please return one original agreement to
my office for our Central File.
Very truly yours,
CITY OF BOYNTON BEACH
~ Yn. p~
Unet M. Prainito, CMC
City Clerk
Attachments
S:\CC\WP\AFTER COMMISSION\County Transmittals\R05-151 to County.doc
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