R18-091 1 RESOLUTION NO. R18-91
2
3 A RESOLUTION OF THE CITY OF BOYNTON BEACH,
4 FLORIDA, APPROVING AN AWARD OF BID AND
5 AUTHORIZING THE CITY MANAGER TO SIGN A
6 CONTRACT WITH INSITUFORM TECHNOLOGIES,
7 LLC., AS DETERMINED BY REVIEW OF BIDS
8 SUBMITTED IN RESPONSE TO ITB 02-CIPP-18/TP FOR
9 "CURED-IN-PLACE PIPE LINING" IN THE AMOUNT OF
10 $794,652.50; AND PROVIDING AN EFFECTIVE DATE.
11
12 WHEREAS, on January 17, 2017, the City Commission approved a list of three
13 (3) pre-qualified contractors to perform Cured-In-Place Pip (CIPP) Lining as a result of
14 RFQ #057-2821-16/TP so that when Utilities has a CIPP project a bid will be sent to the 3
15 pre-qualified contractors and ask them to submit bids from which one will be
16 recommended to be awarded the contract; and
17 WHEREAS, a Request for Bids was issued to our pre-qualified Contracting firms to
18 submit line item pricing to perform Cured-in-Place Pipe Lining of sewer mains in Leisureville
19 WHEREAS, staff reviewed the bid proposals and it was determined that Insituform
20 Technologies, LLC was the lowest,pre-qualified bidder; and
21 WHEREAS, the City Commission of the City of Boynton Beach upon
22 recommendation of staff, deems it to be in the best interest of the citizens of the City of
23 Boynton Beach to award ITB 02-CIPP-18/TP for Cured-In-Place Pipe Lining in the amount
24 of $794,652.50 and authorize the City Manager to sign a Contract with Insituform
25 Technologies, LLC.
26 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION
27 OF THE CITY OF BOYNTON BEACH,FLORIDA, THAT:
28 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed
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29 as being true and correct and are hereby made a specific part of this Resolution upon
30 adoption.
31 Section 2. The City Commission of the City of Boynton Beach, Florida, hereby
32 approves the award ITB 02-CIPP-18/TP for Cured-In-Place Pipe Lining in the amount of
33 $794,652.50 and authorize the City Manager to sign a Contract with Insituform Technologies,
34 LLC., a copy of which is attached hereto as Exhibit"A".
35 Section 3. That this Resolution shall become effective immediately.
36 PASSED AND ADOPTED this 3rd day of July, 2018.
37 CITY OF BOYNTON BEACH, FLORIDA
38
39 YES NO
40
41 Mayor—Steven B. Grant
42
43 Vice Mayor—Christina L. Romelus
44
45 Commissioner—Mack McCray !✓
46
47 Commissioner—Justin Katz /4) u
48
49 Commissioner—Joe Casello
50
51 VOTE
52 ATTEST:
53
54 �p .111?16--
55 "—
56 Judith . Pyle, CMC
57 City C erk
58 1419a r
59
60 (Corporate Seal)
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PALM BEACH LEISUREVILLE CURED-IN-PLACE PIPE LINING
(CIPP) Phase 5.2
RFQ No..: 057-2821-16/TP
ITB 02-CIPP-18/TP
CONSTRUCTION CONTRACT - DRAFT
THIS AGREEMENT is entered into between the CITY OF BOYNTON BEACH, a municipal
corporation, hereinafter referred to as "CITY", and Insituform Technologies, LLC, a corporation
authorized to do business in the State of Florida, hereinafter referred to as the "CONTRACTOR".
WHEREAS, the CITY has awarded to the CONTRACTOR the work of performing certain
construction services.
WHEREAS, at its meeting of July 3, 2018, by Resolution No.: , the CITY Commission
authorized the proper CITY officials to execute this Contract hereinafter referred to as Contract No.: ITB
02-CIPP-18/TP, and;
NOW, THEREFORE, CITY and CONTRACTOR, in consideration of the mutual covenants
hereinafter set forth, agree as follows:
Article 1. SCOPE OF WORK.
CONTRACTOR shall furnish all plant, labor, materials, and equipment and perform all the necessary
WORK in the manner and form provided in the Contract Documents entitled: PALM BEACH
LEISUREVILLE CURED-IN-PLACE PIPE LINING (CIPP) PHASE 5.2 RFQ No 057-2821-16/TP, ITB 02-
CIPP-18/TP.
Article 2. CONTRACT TIME; LIQUIDATED DAMAGES.
2.1 The WORK will be substantially completed within 120 calendar days from the date when
the Contract Time commences to run as provided in paragraph 2.3 of the General
Conditions, and completed and ready for final payment in accordance with paragraph
14.9 of the General Conditions within 30 calendar days from the date of Substantial
Completion.
2.2 Liquidated Damages. The CITY and CONTRACTOR recognize and acknowledge that
time is of the essence of this Contract and that the CITY will suffer financial loss if the
WORK is not completed within the times specified in paragraph 3.1 above, plus any
extensions thereof allowed in accordance with Article 12 of the General Conditions. Each
of the parties acknowledges that it has attempted to quantify the damages which would
be suffered by the CITY in the event of the failure of CONTRACTOR to perform in a
timely manner, but neither one has been capable of ascertaining such damages with a
certainty. CITY and CONTRACTOR also recognize and acknowledge the delays,
expense and difficulties involved in proving in a legal preceding the actual loss suffered
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by the CITY if the WORK is not completed on time. Accordingly, instead of requiring any
such proof, the CITY and
2.3 CONTRACTOR agree that as liquidated damages for delay (but not as a penalty)
CONTRACTOR shall pay the CITY, ONE THOUSAND Dollars ($1000.00) for each day
that expires after the time specified in paragraphs 3.1 for substantial completion until the
WORK is substantially complete. After Substantial Completion, if CONTRACTOR shall
neglect, refuse or fail to complete the remaining WORK within the Contract Time or any
proper extension thereof granted by the CITY, CONTRACTOR shall pay CITY, TWO
HUNDRED FIFTY Dollars ($250.00) for each day that expires after the time specified in
paragraph 3.1 for completion and readiness for final payment.
Article 3. CONTRACT PRICE.
CITY shall pay CONTRACTOR, for faithful performance of the Contract, in lawful money of the United States
of America, and subject to the additions and deductions as provided in the Contract Documents, a total sum
as follows:
Based on the Contract prices shown in the Bid Form submitted to the CITY as subsequently
revised and as stated herein,a copy of such Bid Form being a part of the Contract Documents,
the aggregate amount of this Contract (obtained from either the lump sum price, the
application of unit prices to the quantities shown in the Bid Form or the combination
of both) not to exceed:
Seven Hundred Ninety-Four Thousand Six Hundred Fifty-Two Dollars and Fifty Cents
(Written)
$ 794,652.50
(Numerical)
Article 4. PAYMENT PROCEDURES.
CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the General
Conditions. CITY will process Applications for Payment as provided in the General Conditions.Progress
Payments. CONTRACT may submit an Application for Payment as recommended by CONSULTANT, for
WORK completed during the Project at intervals of not more than once a month. All progress payments
will be on the basis of the progress of WORK measured by the schedule of values established in Paragraph
2.9.1 of the General Conditions and in the case of Unit Price Work based on the number of units completed
or, in the event there is no schedule of values, as provided in the General Requirements.Prior to Substantial
Completion progress payments will be made in an amount equal to 90% of WORK completed, but, in each
case, less the aggregate of payments previously made and less such amounts as CONSULTANT shall
determine, or CITY may withhold, in accordance with paragraph 14.5 of the General Conditions.
CONTRACTOR shall submit with each Application for Payment, and updated progress schedule
acceptable to the CITY and a Warranty of Title/release of liens relative to the Work that is the subject of the
Application. Each Application for Payment shall be submitted to the CITY for approval. The CITY shall
make payment to the CONTRACTOR within thirty(30)days after approval by the CITY of CONTRACTOR'S
Application for Payment and submission of an acceptable updated progress schedule.
4.1 Ten percent (10) of all monies earned by the CONTRACTOR shall be retained by CITY until
completion of the construction services.
4.2 The CITY may withhold, in whole or in part, payment to such extent as may be necessary to
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protect itself from loss on account of:
4.2.1 Defective Work not remedied.
4.2.2 Claims filed or reasonable evidence indicating probable filing of claims by other
parties against CONTRACTOR.
4.2.3 Failure of CONTRACTOR to make payments properly to SUBCONTRACTORS or
for material or labor.
4.2.4 Damage to another CONTRACTOR not remedied.
4.2.5 Liquidated damages and costs incurred by the CITY for extended construction
administration.
When the above grounds are removed or resolved or CONTRACTOR provides a surety
bond or consent of Surety, satisfactory to the CITY, which will protect the CITY in the
amount withheld, payment may be made in whole or in part.
4.3 Final Payment. Upon final completion and acceptance of the WORK in accordance with
paragraph 14.10 of the General Conditions, CITY shall pay the remainder of the Contract Price
as recommended by CONSULTANT as provided in paragraph 14.10.
Article 5. CONTRACTOR GUARANTEE.
CONTRACTOR warrants all work, materials and equipment shall be free from damages and/or defects
owing to faulty materials or workmanship for a period of one(1)year after completion of the WORK covered
by this Contract. The CONTRACTOR,free of all costs to the CITY, shall replace any part of the equipment,
materials, or work included in this Contract, which proves to be defective by reason of faulty materials,
damages, and/or workmanship within twelve (12) month period.
Article 6. CONTRACT DOCUMENTS.
The Documents hereinafter listed shall form the Contract and they are as fully a part of the Contract as if
attached hereto:
6.1 Invitation to Bid
6.2 Instructions to Bidders
6.3 Bid Forms (including the Bid, Bid Schedule(s), Information Required of Bidder, Approved Bid
Bond, and all required certificates, affidavits and other documentation)
6.3 Contract
6.4 Contractor's Performance and Payment Bond
6.5 General Conditions
6.6 Special Conditions
6.7 Technical Specifications
6.8 Drawings entitled: Appendix "A" Phase 5.2 GIS Maps, Pipe Segments, Plans View Report,
Standard Cleanout Installation
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ARTICLE 7. NOTICE: All notices required in this Contract shall be sent by certified mail, return receipt
requested and if sent to the CITY shall be mailed to:
City of Boynton Beach Copy to: Procurement Services Division
Attn: Joseph Paterniti, Interim Utilities Director Attn: Director of Finance
124 E. Woolbright Road City of Boynton Beach
Boynton Beach, FL 33435 100 E. Boynton Beach Boulevard
Tel (561) 742 -6423 Boynton Beach FL 33425
Tel (561) 742-6311
Fax(561) 742-6322
And if sent to the CONTRACTOR shall be mailed to:
CONTRACTOR; Insituform Technologies, LLC
ADDRESS: 17988 Edison Avenue
CITY/STATE/ZIP: Chesterfield, MO 63005
Attn: Diane Partridge, Contracting and Attesting Officer
Tel: (636) 530-8000
Fax: (636) 530-8701
Article 8. INDEMNITY.
In consideration of Twenty-Five Dollars($25.00)in hand paid and other valuable consideration, receipt of which
is hereby acknowledged, CONTRACTOR agrees to defend, indemnify and hold harmless the CITY, its agents
and employees, in accordance with paragraph 6.17 of the General Conditions which is incorporated herein and
made a part hereof as if fully set forth herein. It is the specific intent of the parties hereto that the foregoing
indemnification complies with Florida Statutes 725.06. It is further the specific intent and agreement of said
parties that all of the Contract Documents on this Project are hereby amended to include the foregoing
indemnification and the Specific Consideration.
Article 9. REIMBURSEMENT OF CONSULTANT EXPENSES.
Should the completion of this Contract be delayed beyond the specified or adjusted time limit, CONTRACTOR
shall reimburse the CITY for all expenses of consulting and inspection incurred by the CITY during the period
between said specified or adjusted time and the actual date of final completion. All such expenses for
consulting and inspection incurred by the CITY will be charged to CONTRACTOR and be deducted from
payments due CONTRACTOR as provided by this Contract. Said expenses shall be further defined as
CONSULTANT charges associated with the construction contract administration, including resident project
representative costs.
Article 10. FLORIDA'S PUBLIC RECORDS LAW.
The City is a public agency subject to Chapter 119, Florida Statutes. The Contractor shall comply with Florida's
Public Records Law. Specifically,the Contractor shall:
10.1 Keep and maintain public records required by the CITY to perform the service;
10.2 Upon request from the CITY's custodian of public records, provide the CITY with a
copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in Chapter 119,
Florida Statue or as otherwise provided by law;
10.3 Ensure that public records that are exempt or that are confidential and exempt from public
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record disclosure requirements are not disclosed except as authorized by law for the
duration of the contact term and, following completion of the contract, Contractor shall
destroy all copies of such confidential and exempt records remaining in its possession once
the Contractor transfers the records in its possession to the City; and,
10.4 Upon completion of the contract, Contractor shall transfer to the CITY, at no cost to the
CITY, all public records in Contractor's possession. All records stored electronically by
Contractor must be provided to the CITY, upon request from the CITY's custodian of public
records, in a format that is compatible with the information technology systems of the CITY.
10.5 IF THE CONTRACTOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO
THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC
RECORDS RELATING TO THIS CONTRACT, CONTACT THE
CUSTODIAN OF PUBLIC RECORDS:
JUDY PYLE, CITY CLERK
100 E. BOYNTON BEACH BOULEVARD.
BOYNTON BEACH, FLORIDA, 33435.
561-742-6061.
PYLEJ@BBFL.US
Article 11. MISCELLANEOUS.
11.1 No assignment by a party hereto of any rights under or interests in the Contract
Documents will be binding on another party hereto without the written consent of the
party sought to be bound; and specifically but without limitation, moneys that may
become due and moneys that are due may not be assigned without such consent (except
to the extent that the effect of this restriction may be limited by law), and unless
specifically stated to the contrary in any written consent to an assignment no assignment
will release or discharge the assignor from any duty or responsibility under the Contract
Documents.
11.2 CITY and CONTRACTOR each binds itself, their partners, successors, assigns and legal
representatives to the other party hereto, their partners, successors, assigns and legal
representatives in respect of all covenants, agreements and obligations contained in the
Contract Documents.
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LIN WITNESS WHEREOF,the parties have hereunto set their hands and seals on the day
and year set forth below their respective signatures.
IN WITNESS WHEREOF, the parties hereto have executed this Contract in multiple copies, each
of which shall be considered an original on the following dates:
DATED this .,2Y4 day of ir , 2018.
CITY OF BOYNTON BEACH CONTRACTOR
Insituform Techno ogi , LLC
7 -04.44)9.4....-...fg.t. 6-lit-RA- ea(' 01L----
Lon LaVerriere, City Manager Name
Diane Partridge
Contracting and Attesting Officer
Attest/Authenticated:
Title
(Corporate Seal)
LJudy P rk
Approv=, as t• •rm: 'ttgst/Authenticated: ;
1 ?
1i.. .Lrl/ i di ...A la
Jame T• . Cherof r Attorney ►.P:l.'s Christlanda Ai s
Contracting and Attesting Officer
L
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Iwo,.
1.,0„v"
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS: that
(Insert name of Contractor)
as Principal,
(Address or legal title of Contractor)
hereinafter called Contractor, and
(Name and address of Surety)
as Surety, hereinafter called Surety, are held and firmly bound unto CITY OF BOYNTON BEACH,
P.O. BOX 310, BOYNTON BEACH, FLORIDA 33425-0310 as Obligee, hereinafter called Owner,
in the amount of Dollars
($ ), for payment whereof Contractor and Surety bind themselves, their
heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these
presents.
WHEREAS.
Contractor has by written agreement dated , 20 , entered
into a contract with Owner for in
accordance with drawings and specifications prepared by
which contract is by reference made a part of hereof, and is hereinafter referred to as the Contract.
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THIS FORM SHALL BE EXECUTED BY CONTRACTOR AND SUBMITTED
AT AWARD
NOW THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if Contractor shall
promptly and faithfully perform such Contract, then this obligation shall be null and void; otherwise
it shall remain in full force and effect.
The Surety hereby waives notice of any alteration or extension of time made by the Owner.
Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the
Owner having performed Owner's obligations thereunder, the Surety may promptly remedy the
default, or shall promptly:
1. Complete the Contract in accordance with its terms and conditions, or
2. Obtain a bid or bids for completing the Contract in accordance with its terms and conditions,
and upon determination by Surety of the most responsible bidder, or, if the Owner elects, upon
determination by the Owner and the Surety jointly of the most responsible bidder, arrange for
a contract between such bidder and Owner, and make available as work progresses (even
though there should be a default or a succession of defaults under the contract or contracts
of completion arranged under this paragraph) sufficient funds to pay the cost of completion
less the balance of the contract price; but not exceeding, including other costs and damages
for which the Surety may be liable hereunder, the amount set forth in the first paragraph
hereof. The term "balance of the contract price", as used in this paragraph, shall mean the
total amount payable by Owner to Contractor under the contract and any amendments thereto,
less the amount properly paid by Owner to Contractor.
Any suit under this bond must be instituted before the expiration of one (1) year from the date on
which final payment under the Contract falls due.
No right of action shall accrue on this bond to or for the use of any person or corporation other
than the Owner named herein or the heirs, executors, administrators or successors of the Owner.
This bond is issued in compliance with Section 255.05, Florida Statutes as may be amended. A
claimant, except a laborer, who is not in privity with the Contractor and who has not received
payment for its labor, materials, or supplies shall, within 45 days after beginning to furnish labor,
materials, or supplies for the prosecution of the work, furnish the Contractor with a notice that he
intends to look to the bond for protection. A claimant who is not in privity with the Contractor and
who has not received payment for its labor, materials, or supplies shall, within 90 days after
performance of the labor or after complete delivery of the materials or supplies, deliver to the
Contractor and to the Surety written notice of the performance of the labor or delivery of the
materials or supplies and the nonpayment. No action for the labor, materials, or supplies may be
instituted against the Contractor or the Surety unless both notices have been given. No action
shall be instituted against the Contractor or the Surety on the bond after one (1) year from the
performance of the labor or completion of delivery of the materials or supplies.
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THIS FORM SHALL BE EXECUTED BY CONTRACTOR AND SUBMITTED
AT AWARD
Signed and sealed this day of , 2018.
Principal (Seal)
Witness
Title
Surety
Witness
Attorney-in-Fact
END OF PERFORMANCE BOND
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THIS FORM SHALL BE EXECUTED BY CONTRACTOR AND SUBMITTED
AT AWARD
OF
\..
O „P
ryTON
PAYMENT BOND
THIS BOND IS ISSUED SIMULTANEOUSLY WITH PERFORMANCE BOND IN FAVOR OF THE
OWNER CONDITIONED ON THE FULL AND FAITHFUL PERFORMANCE OF THE CONTRACT
KNOW ALL MEN BY THESE PRESENTS: that
(Insert name of Contractor)
as Principal,
(Address or legal title of contractor)
hereinafter called Principal, and
(Name and address of Surety)
as Surety, hereinafter called Surety, are held and firmly bound unto CITY OF BOYNTON BEACH,
P.O. BOX 310, BOYNTON BEACH, FLORIDA 33425-0310 as Obligee, hereinafter called Owner,
for the use and benefit of claimants as here below defined, in the amount of
Dollars ($ ), for payment whereof Principal and Surety bind themselves, their
heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these
presents.
WHEREAS, Principal has by written agreement dated
2018, entered into a contract with Owner for
in
accordance with drawings and specifications prepared by
which contract is by reference made a part of hereof, and is hereinafter referred to as the Contract.
NOW THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if Principal shall
promptly make payment to all claimants as hereinafter defined, for all labor and material used or
reasonably required for use in the performance of the Contract, then this obligation shall be null
and void; otherwise it shall remain in full force and effect, subject, however, to the following
conditions:
1. A claimant is defined as one having a direct contract with the Principal or with a subcontractor
Boynton Beach Utilities—Palm Beach Leisureville(CIPP)Phase 5.2 PYB-1
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THIS FORM SHALL BE EXECUTED BY CONTRACTOR AND SUBMITTED
AT AWARD
of the Principal for labor, material or both, used or reasonably required for use in the
performance of the Contract, labor and material being construed to include that part of water,
gas, power, light, heat, oil, gasoline, telephone service or rental of equipment directly
applicable to the Contract.
2. The above named Principal and Surety hereby jointly and severally agree with the Owner that
every claimant as herein defined, who has not been paid in full before the expiration of a
period of ninety(90) days after the date on which the last of such claimant's work or labor was
done or performed, or materials were furnished by such claimant, may sue on this bond for
the use of such claimant, prosecute the suit to final judgment for such sum or sums as may
be justly due claimant, and have execution thereon. The Owner shall not be liable for the
payment of any costs or expenses of any such suit.
3. No suit or action shall be commenced hereunder by any claimant:
a. Unless claimant, other than one having a direct contract with the Principal, shall have
given written notice to any two of the following: the Principal, the Owner, or the Surety
above named, within ninety (90) days after such claimant did or performed the last of the
work or labor, or furnished the last of the materials for which such claimant is made, stating
with substantial accuracy the amount claimed and the name of the party to whom the
materials were furnished, or for when the work or labor was done or performed. Such
notice shall be served by mailing the same by registered mail or certified mail, postage
prepaid, in an envelope addressed to the Principal, Owner or Surety, at any place where
an office is regularly maintained for the transaction of business, or served in any manner
in which legal process may be served in the State in which the aforesaid project is located,
save that such service need not be made by a public officer.
b. After the expiration of one (1) year following the date on which Principal ceased work on
such Contract, it being understood, however, that if any limitation embodied in this bond
is prohibited by any law controlling the construction hereof such limitation shall be deemed
to be amended so as to be equal to the minimum period of limitation permitted by such
law.
c. Other than in a State Court of competent jurisdiction in and for the County or other political
subdivision of the State in which the Project, or any part thereof, is situated, or in the
United States District Court for the district in which the Project, or any part thereof, is
situated, and not elsewhere.
4. The amount of this bond shall be reduced by and to the extent of a payment or payments
made in good faith hereunder, inclusive of the payment by Surety of mechanics liens which
may be filed of record against such improvements, whether or not claim for the amount of
such lien be presented under and against this bond.
5. This bond is issued in compliance with Section 255.05, Florida Statutes, as may be amended.
A claimant, except a laborer,who is not in privity with the Contractor and who has not received
payment for its labor, materials, or supplies shall, within 45 days after beginning to furnish
labor, materials, or supplies for the prosecution of the work, furnish the Contractor with a
notice that he intends to look to the bond for protection. A claimant who is not in privity with
the Contractor and who has not received payment for its labor, materials, or supplies shall,
within 90 days after performance of the labor or after complete delivery of the materials or
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THIS FORM SHALL BE EXECUTED BY CONTRACTOR AND SUBMITTED
AT AWARD
supplies, deliver to the Contractor and to the Surety written notice of the performance of the
labor or delivery of the materials or supplies and the nonpayment. No action for the labor,
materials, or supplies may be instituted against the Contractor or the Surety unless both
notices have been given. No action shall be instituted against the Contractor or the Surety on
the bond after one (1) year from the performance of the labor or completion of delivery of the
materials or supplies.
Signed and sealed this day of , 2018.
Principal (Seal)
Witness
Surety
Witness
Attorney-in-Fact
END OF PAYMENT BOND
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THIS FORM SHALL BE EXECUTED BY CONTRACTOR AND SUBMITTED
AT AWARD
CITY OF BOYNTON BEACH
WARRANTY OF TITLE
STATE OF FLORIDA
COUNTY OF , being first duly sworn, deposes and says
as follows:
He is
of
(Title) (Name of Corporation or Firm)
a Florida Corporation C_____) Check One
a Florida General Partnership (.___)
a Florida Limited Partnership ( )
a Sole Proprietor ( )
which is named in Construction Contract dated the day of ,
20 , between such corporation as the CONTRACTOR and the City of Boynton Beach, Florida
as the OWNER, for the construction of
and Affiant is authorized to make this
Affidavit as, or on behalf of, the Contractor as named above.
Title to all work, materials and equipment covered by the attached Final Application for
Payment dated , passes to the Owner at the time of payment free and
clear of all liens, and all laborers, material men and subcontractors have been paid for performing or
furnishing the work, labor or materials upon such Contract work covered by the aforesaid Final
Application for Payment.
This statement under oath is given in compliance with Section 713.06 Florida Statutes.
Affiant
Sworn to and subscribed before me this
day of , 2018
Notary Public, State of Florida at Large
My Commission expires:
(SEAL)
END OF WARRANTY OF TITLE
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THIS FORM SHALL BE EXECUTED BY CONTRACTOR AND SUBMITTED AT AWARD
City of Boynton Beach
Risk Management Department
INSURANCE ADVISORY FORM
Under the terms and conditions of all contracts, leases,and agreements,the City requires appropriate coverages listing
the City of Boynton Beach as Additional Insured. This is done by providing a Certificate of Insurance listing the City as
"Certificate Holder" and "The City of Boynton Beach is Additional Insured as respect to coverages noted." Insurance
companies providing insurance coverages must have a current rating by A.M. Best Co. of"B+"or higher. (NOTE: An
insurance contract or binder may be accepted as proof of insurance if Certificate is provided upon selection of vendor.)
The following is a list of types of insurance required of contractors, lessees, etc., and the limits required by the City:
(NOTE: This list is not all inclusive,and the City reserves the right to require additional types of insurance,or
to raise or lower the stated limits,based upon identified risk.)
TYPE (Occurrence Based Only) MINIMUM LIMITS REQUIRED
General Liability General Aggregate $ 1,000,000.00
Commercial General Liability Products-Comp/Op Agg. $ 1,000,000.00
Owners&Contractor's Protective(OCP) Personal&Adv. Injury $ 1,000,000.00
Liquor Liability Each Occurrence $ 1,000,000.00
Professional Liability Fire Damage(any one fire) $ 50,000.00
Employees&Officers Med. Expense(any one person) $ 5,000.00
Pollution Liability
Asbestos Abatement
Lead Abatement
Broad Form Vendors
Premises Operations
Underground Explosion&Collapse
Products Completed Operations
Contractual
Independent Contractors
Broad Form Property Damage
Fire Legal Liability
Automobile Liability Combined Single Limit $ 300,000.00
Any Auto Bodily Injury(per person) to be determined
All Owned Autos Bodily Injury(per accident) to be determined
Scheduled Autos Property Damage to be determined
Hired Autos Trailer Interchange $ 50,000.00
Non-Owned Autos
PIP Basic
Intermodal
Garage Liability Auto Only, Each Accident $ 1,000,000.00
Any Auto Other Than Auto Only $ 100,000.00
Garage Keepers Liability Each Accident $ 1,000,000.00
Aggregate $ 1,000,000.00
Excess Liability Each Occurrence to be determined
Umbrella Form Aggregate to be determined
Worker's Compensation Statutory Limits
Employer's Liability Each Accident $ 100,000.00
Disease, Policy Limit $ 500,000.00
Disease Each Employee $ 100,000.00
Property
Homeowners Revocable Permit $ 300,000.00
Builder's Risk Limits based on Project Cost
Other- As Risk Identified to be determined
INSURANCE ADVISORY FORM