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HomeMy WebLinkAboutSeminole State College Facilities Use Agreement FY21 AGREEMENT FOR LAW ENFORCEMENT AGENCY USE OF SEMINOLE STATE COLLEGE PUBLIC SAFETY TRAINING COMPLEX GENEVA, FLORIDA, FISCAL YEAR 2020-2021 Law Enforcement Agency: Winter Springs Police Department Contracting Agency: City of Winter Springs ContractingAgency Address: 1126 E. State g y Road 434 City, State, Zip: Winter Springs, FL 32708 Contact Person's Name: Marette Sims Contact Person's Telephone Number: 407-327-6559 Contact Person's email address: msims@winterspringsfl.org In consideration of the mutual promises and agreements described herein, The District Board of Trustees of Seminole State College ("College") hereby agrees to the use of its Public Safety Training Complex located at 2450 Gun Range Road, Geneva, Florida, 32732, by the Law Enforcement Agency named above ("User") upon the following terms and conditions: 1. College shall: a. Make available to User the Public Safety Training Complex facilities indicated below and furnish light, heat, and water by means of the appliances installed for ordinary purposes, but for no other purposes. Interruptions, delays, or failure in furnishing any of the same caused by anything beyond the commercially reasonable control of the College will not be chargeable to the College. b. Be fully responsible for its own acts of negligence and the acts of negligence of its respective officers, agents, and employees acting within the scope of their agency or employment and agrees to be responsible for any damages resulting from said negligence, subject to the limitations and defenses provided by Section 768.28, Florida Statutes. Nothing herein is intended to serve as a waiver of sovereign immunity or the limitations and defenses of Section 768.28, Florida Statutes by the College. Nothing herein shall be construed as consent by the College to be sued by third parties in a manner arising out of this Agreement. c. Make reasonable efforts to schedule the use of the Public Safety Training Complex at the request of the User. Activities of College shall have first priority in use of the Public Safety Training Complex. Furthermore, College shall have the right, in the exercise of its discretion, to rescind and cancel this Agreement or the use of the Public Safety Training Complex at any time when, in its opinion, the purpose or purposes for which the premises are being used or intended to be used, is in a manner that is unsafe, obnoxious or inimical to the best interests of the College as determined by the College in its sole discretion, any other provision of this Agreement notwithstanding. d. Designate the Dean Center for Public Safeej as the contact person for the College, who shall be responsible for scheduling use of the Public Safety Training Complex. 2. The User shall indicate its use(s) of the Public Safety Training Complex below. 2020-2021 UPDATFD City of Winter Springs Facilities Agreement-GEN Law Enforcrnt docx 1 AGREEMENT FOR LAW ENFORCEMENT AGENCY USE OF SEMINOLE STATE COLLEGE PUBLIC SAFETY TRAINING COMPLEX GENEVA, FLORIDA, FISCAL YEAR 2020-2021 Check all that apply: a. Gun Range 1. V/ Law Enforcement Officers - User shall submit a roster of the officers and other employees that will use the Gun Range by �rrar 2tg, at which time the annual payment will be due for the period October 1A 2102,110 t.I°trou t Sq2tgm r 3�. Users providing the full roster of their officers and other employees that will use the Gun Range are also authorized to use the Gun Range as follows: a. Law Enforcement Officers' Safety Act (LEOSA) H.R. 218 — Qualified Retired Law Enforcement Officers, as determined by User, under the provisions of this law, will be supervised by User in use of the Gun Range. User is fully responsible for the actions of the participants while using College facilities. User is allowed use of Gun Range for a maximum of six/(6) dates annually. b._ V Citizen Law Enforcement/Police Academy — The Academy introduces residents and business owners of the community to law enforcement by providing an overview of the functions of the User organization. The Academy is intended to provide the participants with a better understanding of police services. Academy participants will be supervised by User in use of the Gun Range. User is fully responsible for the actions of the Academy participants while using College facilities. User is allowed use of Gun Range for a maximum of four (4) dates annually. c. V Job Applicant Testing — As part of the hiring process, applicants for jobs with the User, will be supervised by User in use of the Gun Range. User is fully responsible for the actions of the job applicants while using College facilities. User is allowed use of Gun Range for a maximum of twenty-four (24) dates annually_ d. � Explorer Training — The Explorers is governed by the Boy Scouts of America and is for males and females, ages 14 to 20, that are interested in law enforcement and serving their community. Explorer participants will be supervised by User in use of the Gun Range. User is fully responsible for the actions of the Explorer participants while using College facilities. User is allowed use of Gun Range for a maximum of thirty-six (36) dates annually. e. V Training Demonstrations for Family Members of User or Others — Family members of employees of User or Others will be supervised by User in use of the Gun Range. User is fully responsible for the actions of the family members while using College facilities. User is allowed use of Gun Range for a maximum of three (3) dates annually. 2020-2021 UPDATED City of tNinWr Springs Facilities Agrpeiywnt-GEN Laver Er1f0rcrr1t.d(.Xx 2 AGREEMENT FOR LAW ENFORCEMENT AGENCY USE OF SEMINOLE STATE COLLEGE PUBLIC SAFETY TRAINING COMPLEX GENEVA, FLORIDA, FISCAL YEAR 2020-2021 f. Supplier Product Evaluation or Demonstration — When certain types of law enforcement related equipment such as firearms, ammunition, or chemical control agents, are being considered for purchase by a User, the User may invite a supplier to demonstrate the product(s)for evaluation. User is fully responsible for the actions of the Supplier using college facilities and shall ensure that Supplier has in force and effect one or more policies of commercial general liability insurance with limits of not less than $1,000,000/$2,000,000 naming the District Board of Trustees of Seminole State College as additional insured. User shall require Supplier to provide proof of such coverage to College upon request. User shall also require Supplier to enter into a hold harmless and indemnification agreement with the College upon request. b. Driving Track: 1.-J Law Enforcement Officers - User shall submit a roster of the officers and other employees that will use the Driving Track by 5 .eaQprter;0 2020, at � _..,. which time the annual payment will be due for the period October 1, through September 30, 2021. Users providing the full roster of their officers and other employees that will use the Driving Track are also authorized to use the Driving Track as follows: a. V Citizen Law Enforcement/Police Academy — The Academy introduces residents and business owners of the community to law enforcement by providing an overview of the functions of the User organization. The Academy is intended to provide the participants with a better understanding of police services. Academy participants will be supervised by User in use of the Driving Track. User is fully responsible for the actions of the Academy participants while using College facilities. User is allowed use of Driving Track for a maximum of four (4) dates annually. b. Teen Driving Challenge — The Teen Driver Challenge provides young drivers with the knowledge and hands on experience to reduce their chances of being involved in a crash. The Teen Driver Challenge class consists of 8 hours of classroom instruction and driving exercises. Participants will be supervised by User in use of the Driving Track. User is fully responsible for the actions of the Challenge participants while using College facilities. User is allowed use of the Driving Track for a maximum of eight (8) dates annually. C. Supplier Product Evaluation or Demonstration — When certain types of law enforcement related equipment such as specially equipped vehicles are being considered for purchase by a User, the User may invite 2020-2021 UPDATED City of Winter Springs Facilities Agreement-GEN Law Enforcmt.docx 3 AGREEMENT FOR LAW ENFORCEMENT AGENCY USE OF SEMINOLE STATE COLLEGE PUBLIC SAFETY TRAINING COMPLEX GENEVA, FLORIDA, FISCAL YEAR 2020-2021 a supplier to demonstrate the product(s) for evaluation. User is fully responsible for the actions of the Supplier using college facilities and shall ensure that Supplier has in force and effect one or more policies of commercial general liability insurance with limits of not less than $1,000,000/$2,000,000 naming the District Board of Trustees of Seminole State College as additional insured. User shall require Supplier to provide proof of such coverage to College upon request. User shall also require Supplier to enter into a hold harmless and indemnification agreement with the College upon request. 3. The User shall: a. Obtain at the User's own cost and expense any and all licenses or permits required by law or ordinance. Any statement of rules or regulation accompanying each license or permit shall be a part of this agreement. b. Provide a Certificate of Insurance or a qualified letter of self-insurance showing coverage for general liability and property & casualty insurance in amounts not less than those set forth in Section 768.28, Florida Statutes, and worker'q compensation in the amounts required by statute (the "Proof of Insurance"). The Proof of Insurance must show adequate coverage for the acts of all persons utilizing the Public Safety Training Complex pursuant to this Agreement. c. Not remove any College property from the Gun Range or Driving Track. In the event any College property is found missing, the User is responsible for its replacement cost. d. Make no alteration or changes to the premises without the prior written consent of the Vice President of Business Operations/Chief Financial Officer or designee. All changes must be done under the supervision of College personnel. e. Not reassign this Agreement or sublet the premises or any part thereof, or use said premises or any party thereof, for any purpose other than that herein specified, without the advance written consent of the Vice President of Business Operations/Chief Financial Officer or designee, which may be given or withheld in such person's sole discretion. f. Not bring on the premises, possess, or use of any alcoholic beverages, drugs, or gambling devices of any kind. Any person under the influence of intoxicating beverages or drugs shall be denied the opportunity to participate in any activities on College premises. g. Not use, store, or permit to be used or stored, in or on any part of the College's premises, any substance or thing prohibited by law or ordinance, or by standard policies or fire insurance companies operating in the State of Florida, h. Be responsible for adherence to all federal, state, county and municipal laws, rules, regulations, orders, and ordinances, including workers' compensation laws. Additionally, User shall be responsible for compliance with all federal, state, county and municipal laws, rules, regulations, orders, and ordinances by all applicable public health agencies regarding any pandemic or other infectious disease outbreak (e.g. COVID-19). Such compliance includes, but is not limited to, social distancing and the wearing of appropriate face coverings or other protective clothing. User shall require and be responsible for ensuring that User's guests, licensees, invitees, 2020-2021 UPDATED City of Winter Springs Facilities Agreement-GEN Law Enforcrnt.docx 4 AGREEMENT FOR LAW ENFORCEMENT AGENCY USE OF SEMINOLE STATE COLLEGE PUBLIC SAFETY TRAINING COMPLEX GENEVA, FLORIDA, FISCAL YEAR 2020-2021 visitors, and other persons attending User's event(s) comply with the requirements of this section. i. Assume full responsibility for the character, acts, and conduct of all persons admitted to the Public Safety Training Complex with the consent of the User or User's agents. User indemnifies the College for User negligence subject only to the limitations (including monetary limitations) and defenses provided by section 768.28, Florida Statutes. j. The College owns and controls its name(s), marks, logos, insignias, seals, colors, designs and symbols, and they are strictly for College use only. 1. The User may use the College's name ("Seminole State College of Florida") in materials to indicate the location of the event. However, it must be in a basic font (so as not confused with the College's logo/branding). 2. The User may not set up URLs that are similar to the College's name (SSC, Seminole State, etc.), as this could lead to confusion. 3. The User must add on all promotional materials (poster, flyer, website, etc.): "This event is not affiliated with Seminole State College of Florida." k. Hereby be notified that the College is a tobacco-free college. Tobacco of any kind, in any form, is prohibited on College property. This includes but is not limited to tobacco used in cigarettes, cigars, pipes, and electronic cigarettes. Snuff, chewing tobacco, and other tobacco products are also prohibited. Furthermore, User and all of User's guests, invitees, and licensees shall comply with College Policy 6.021. 1. Use frangible, lead free ammunition only. Exceptions may be granted for expending duty ammunition carried by officers at the end of its useful cycle. Other exceptions may be granted in writing by the Range Manager or Dean, Center for Public Safety, m. Provide to the Range Manager daily, the amount and type of ammunition expended and the number of officers participating. n. Use handguns and rifles only on Range A. Shotgun use will be permitted on all other ranges, except Range A. o. Comply with all College policies and procedures, including but not limited to the College's Protection of Vulnerable Persons Policy 1.115 and the College's Children on Campus procedure 8.0110. By signing this Agreement, User acknowledges that the policies and procedures are available on the College's website and they reviewed same before signing. 4. Payment of Charges: a. Payment is to be made annually in advance of the commencement date for the Agreement and shall be made by check, payable to: Seminole State College. For public law enforcement agencies, the College will accept either the payment or a purchase order prior to the commencement date of the agreement. 2020-2021 UPDATED City of Winter Springs Facilities Agreement-GEN law Enforcrnt docx 5 AGREEMENT FOR LAW ENFORCEMENT AGENCY USE OF SE8UINOLE STATE COLLEGE PUBLIC SAFETY TRAINING COMPLEX GENEVA, FLORIDA, FISCAL YEAR 2020-2021 -' All Pavirnents, or for qg����,,@geqLies urchase Q(dprs, are due at !he t�jrne fti_agreement is signed by_Q��qL. Notwithstanding. the fory in, Aqreement shall not be binding UDon the College until acce11ted,_gpg[pved,,,_pq0 executed by the Vice President of Business Opg[gy20§i&hief Financial Officer or designee, Cgl[@qq's SUbmissioQ_of tki§�Agreement for examination and si nature by User does not const1tutg_an offer to lease or a reservation or option for lease, 1 understands and agLgLes its recovery shall be strictly JMited to tLe re c. The fees and epacU5o details as needed for the use of College facilities are outlined in the attached Facilities Reservation hurD, and said form is hereby incorporated into this Agreement bythis reference. 5. Term and Termination: a. This agreement shall commence on ' and shall be in effect until . orbe cancelled by either party upon written notice tO the other pmdv not less than 30 days prior to the termination date. 6. Acknowledgement: a. This agreement will not be binding upon the College until a000p1ad, approved, and executed by the Vice President of Business Operations/Chief Financial Officer or designee. Aocmrdin0|y, the undersigned acknowledges and agrees that the formation of this Agreement constitutes the making of contract within the State of Florida and agrees to submit to the jurisdiction of the courts in the State of Florida with respect to claims arising out of this Agreement. Venue for any action arising hereunder shall be exclusively in Seminole County. Florida. b. It is understood that "Seminole State College" or "College" as used herein oho|| include the employees, |imenaaea, invitees' agentm, and the District Board of Trustees of Seminole State [:n||age. IN WITNESS WHEREOF: The parties hereto have caused this Agreement for use of Seminole State Co||ege'a Public Safety Training Complex by the named Lovv Enforcement Agency to be executed as of the date indicated below. For Seminole State College: Nov l9,ZOZO F. Joseph Mazur III Date ----' V.P. Business Operations 8` CFO For User Organization ~ Contmmcting Agency: City of WintgLSp(ings P | tR h Position Title Signature Date 2020-2021 UPDATED City of�V4 1v Springs Facilities Agreement-GEN Law EnforcHit.docx 6 nrMANI' Nif . . (vWNNJln „g. .I YYXAfiwlrtVM1I'IItIVPu„N.frM"SIIAdpawlwrrf'i ,. .... ggfUNM1FO)Nv91/!la!"l ff✓/�,!9.Nm)Ide/ANNIJ i. ) II 1 :21 2 20 21 C iii ty of s pii° iii r,, �, �ku�;R � al � vl � �3l i �'� °�, �" �I �B '�°�II� ° �u � � ��d1� °��f, � Ili u" 4 � m �„ �. �� ��.�ni i t i Y���n � rA��� v �i� ���mN,�r »���u ���� ii� � ��� ��,��nruru a Bf Q u���������w i1 Final Audit Report 2020-11-19 J �Z. Created: 2020-11-19 a By: Suzanne Dausman(dausmans@seminolestate.edu) J J Status: Signed J Transaction ID: CBJCHBCAABAAX76YEdLXlz5sSsAC6Z_Rh_MxvtQC2TD3 F! i Ya "2020-2021 UPDATED City of Winter Springs Facilities Agreeme y t nt -signed- GEN Law Enforcmt" History > Document created by Suzanne Dausman (dausmans@seminolestate.edu) 2020-11-19-6:03:58 PM GMT-IP address:216,120,209.101 fr Document emailed to F. Joseph Mazur(mazurj@seminolestate.edu)for signature 2020-11-19-6:04:43 PM GMT I Email viewed by F. Joseph Mazur(mazurj@seminolestate.edu) 2020-11-19-6:51:41 PM GMT-IP address:97,100,167.71 i Document e-signed by F. Joseph Mazur(mazurj@seminolestate.edu) j Signature Date:2020-11-19-6:55:44 PM GMT-Time Source:server-IP address:97,100,167.71 1; Agreement completed. 1. 2020-11-19-6:55:44 PM GMT : U i x (I I r ,i j l 1, i' Adobe Sign nl,(A lU'1 r Y N//N.JiJIt�nY rY drJdyf}lr. ryJ�.,4F I!llGNmld'%Y.W!'w(WMI a dNdYWXr b11.lkri)UI1fFAl;l,N9AVWW W�fi/Jb,�,WGJ�Mn�liltilYflVA4,rvWA,/a/amna h'Yrt Ilu WM1/n/Yfdl/Adul�l YINbIGJldAdRldlON2 Aifiw lba�M2lllJilE10/W�,tl.UPd�9V9NYi49Mt'rU!fiWld'NiAd/Ar�lAr9PWrUmN�ln'rV0/l'WmvninYilltl G.tNIdIMM1WaO/ni✓xwV;�NitulfY�N,uv4WilII�9UfUluIXn4rIWUM/!P!nYn,141Y1IG9eWNiR,Vfih '//@Y;Id�WddMli9W9MPIFW�,MId%F'rUfAMGdrw:t%Ive AGREEMENT FOR LAW ENFORCEMENT AGENCY USE OF SEMINOLE STATE COLLEGE PUBLIC SAFETY TRAINING COMPLEX GENEVA, FLORIDA, FISCAL YEAR 2020-2021 CONTRACTING AGENCY: City of Winter Springs Facilities Reservation Seminole State College RA:I`I+ �1� I�Ircparq rcnj izains, Re0eweLt Facility Description of Activity Rate Amount o— 1-1111111-1 1-11---11— ---­-­­nnn­ -—----------- �Ig"!i ns Annual Fees:$15 per Gun Range Law Enforcement and Correctional Officers— officer and others on The roster of officers and others indicates a count roster. $870.00 of58. Annual Fees:$34 per Driving Track Law Enforcement Officers—The roster of officer and others on officers and others indicates a of of 5 1. roster. $1,734.00 Site Supervision $40 per hour $N/A ............ ...... Subtotal Sales Tax E6.�5 701X. . ................. ..exert_._._..... Grand Total $21,604.00 2020-2021 UPDATED City of Winter Springs Facilities Agreement-GEN Law Enforcrnt.docx Winter Springs Police Department Training Roster-Gun Range 1. Aldridge, Oisa 2. Angeloff, Michelle 3. Ballew,Thomas m4.ITIT Briggle,John �............ 5, Camacho, Louis �6. Castro,Jonathan �.�....7.�........Chavez, Cesar ,..._M....._.�..._�. ._. ____ ... 8. Chin-Toyloy, Roger 9. Colangelo, Adam 10. Cook,Joshua 11. Deisler, Christopher 12. Donovan, Gerard (Pat) 13. Fugate,Tracy _. �._.a_......__....____ 14. Harrop, Kyle 15. Harvey, Michael 16. Hataway, Michael _..._..........______. ..___17. Heath, Bradlea _�.� ..,,,,...�....._......_.. 18. Hernandez, Cristina 19. Herwick, Kristin 20. Hilerio,Jesus 21. Hill, Brittany _._ 22. Holcomb,Jacob..._.._._..�,�...,.,W.�..... ...... 23.Jameson, Dylan��� ������������������� 24.Jones,Andrew 25. Lail, Dakota 26. Maxwell,Jr., William 27. Mayhugh, Bill 28. Neisler, ..�.,Terence 29. Philbrook, Shaun 30. Presley, Kevin 31. . Quick.Charles ...._.nww m .TM.....�.................... .._...� .._ _ 32. Raney, David 33. Roland, Christopher 34. Roman,Jean 35. Romano, Nicholas 36. Saccente, Lynn 37. Scovel, Matthew 38. Schmidt,Samatha 39.Seely, Douglass 40. Sims, Hecmarette 41.Smith,Allison 42.Stephens, Robert 43. Thrush, Dale 44.Tracht, Matthew 45. Valentin, Leidy 46. Vonbargen, Ryan 47. Vose, Ben 48.Watson, Isaiah 49. Whitmore, Keith 50. Wilkins,Aaron 51. Woodard, D A'llesandro 52. Knorst,Andrew 53. Pierce,Tyler 54. Freeman, Kennedi 55. Hale, Kaley 56. Welch, Elias 57. Lenning, Conner 58. Ramirez, Daniel Winter Springs Police Department Training Roster-Driving Track 1. Aldridge,Oisa 2. Angeloff, Michelle 3. Ballew,Thomas 4. Briggle,John 5. Camacho, Louis 6. Castro,Jonathan 7. Chavez, Cesar 8, Chin-Toyloy, Roger 9. Colangelo,Adam 10. Cook,Joshua 11. Deisler,Ch ristopher 12. Donovan,Gerard (Pat) ............ 13. Fugate,Tracy 14. Harrop, Kyle 15. Harvey,Michael 16. Hataway, Michael 17. Heath, Bradlea ................ 18. Hernandez, Cristina 19. Herwick, Kristin 20. Hilerio,Jesus 21. Hill, Brittany 22. Holcomb,Jacob 23.Jameson, Dylan, 24.Jones,Andrew 25. Lail, Dakota 26. Maxwell,Jr., WilliammmITmmWWH� 27. Mayhugh, Bill 28 Neisler,Terence 29. Philbrook,Shaun 30. Presley, Kevin 31. Quick, Charles 32. Raney, David 33. Roland, Christopher 34. Roman,Jean 35. Romano, Nicholas 36. Saccente, Lynn 37.Scovel, Matthew 38.Schmidt, Samatha 39. Seely, Douglass 40. Sims, Hecmarette � 41. Smith, Allison 42. Stephens, Robert 43. Thrush, Dale 44. Tracht, Matthew 45. Valentin, Leidy 46.Vonbargen, Ryan 47. Vose, Ben 48. Watson, Isaiah 49. Whitmore,Keith 50. Wilkins,Aaron 51. Woodard, D A'llesandro LA °,� c: .. t SEMINOLE Invoice No: AUX0000223 kP"-7 STATE INVOICE Invoice Date: 11/05/2020 COLLEGE OF FLORIDA Page: 1 of 1 Remit To: Customer ID: 0000000053 Seminole State College Payment Terms: 1stNxtMnth Student Accounting& Cashier Services Due Date: 12/01/2020 100 Weldon Blvd Sanford FL 32773-6199 Bill To: AMOUNT DUE: 2,604.00 USD Winter Springs Police Department 1126 E State Road 434 Winter Springs FL 32708-2715 iN" OICE NUMBERMUST"BE: INCIII....UDE:D WITH PAYMENT For billing questions, please call 4071708-2551. Pay invoice online hp,,/ r -_�91IC : rrlpprirE. Original inal Line Descri tionlProect Chianti UOM! Unit Amt Not Amount 1 Geneva Campus Annual Training 1.00 EA 2,604.0000 2,604.00 October 1,2020 through September 30,2021 Subtotal: 2,604.00 AMOUNT DUE: $2,604.00 Fees pursuant to Facility Use Agreement with Seminole State College. THANK. ° OkP CERTIFICATE OF COVERAGE Certificate Holder Administrator Issue Date 11/05/2020 Administrator SEMINOLE STATE COLLEGE rFlorida League of Cities,Inc. 100 WELDON BLVD Department of Insurance and Financial Services P.O. o. P.OBox 53OC65 - 5 SANFORD FL 32773 6199 Orlando, "Florida -0065 Orlando, lri 32853 COVERAGES THIS IS TO CFRFIFYTHATTHE AGREEMENT BELOW HAS BEEN ISSUED TO THE DESIGNATED MEMBER FOR THE COVERAGE PERIOD INDICATED NO[WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE COVERAGE AFFORDED By THE_ AGREEMENT DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH AGREEMENT. COVERAGE PROVIDED BY: FLORIDA MUNICIPAL INSURANCE TRUST AGREEMENT NUMBER: FMIT0 6487COVERAGE PERIOD:FROM 10/01/20 COVERAGE PERIOD:TO 10/1/21 12:01 AM STANDARD TIME TYPE OF COVERAGE-LIABILITY TYPE OF COVERAGE-PROPERTY General Liability D Buildings El Miscellaneous Comprehensive General Liability,Bodily Injury,Property Damage and E] Basic Form 0 Inland Marine Personal Injury 0 Special Form F1 Electronic Data Processing Errors and Omissions Liability El Personal Property El Bond Supplemental Employment Practice ❑ Basic Form El Employee Benefits Program Administration Liability Special Form Medical Attendants'/Medical Directors'Malpractice Liability ❑ Agreed Amount Broad Form Property Damage El Deductible$1,000 Law Enforcement Liability ❑ Coinsurance N/A Underground,Explosion&Collapse Hazard ❑ Blanket El Specific Limits of Liability *Combined Single Limit D Replacement Cost E] Actual Cash Value Deductible Stoploss$25,000 Automobile Liability Limits of Liability on File with Administrator All owned Autos(Private Passenger) TYPE OF COVERAGE-WORKERS'COMPENSATION All owned Autos(Other than Private Passenger) Hired Autos El Statutory Workers'Compensation Non-owned Autos El Employers Liability $1,000,000 Each Accident $1,000,000 By Disease Limits of Liability $1,000,000 Aggregate By Disease *Combined Single Limit El Deductible N/A Deductible Stoploss$25,000 ❑ Automobile/Equipment—Deductible Z Physical Damage $1,000-Comprehensive-Auto $1,000-Collision-Auto N/A-Miscellaneous Equipment Other The limit of liability is$200,000 Bodily Injury and/or Property Damage per person or$300,000 Bodily Injury and/or Property Damage per occurrence. These specific limits of liability are increased to$2,000,000(combined single limit)per occurrence,solely for any liability resulting from entry of a claims bill pursuant to Section 768.28(5)Florida Statutes or liability/settlement for which no claims bill has been filed or liability imposed pursuant to Federal Law or actions outside the State of Florida Description of Operations/Locations/Vehicles/Special Items Re:Firearms Training and Emergency Vehicle Operations(Driving) The certificate holder is hereby added as an additional insured,except for Workers'Compensation and Employers Liability,as respects the member's liability for the above described event. 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 AGREEMENT ABOVE. DESIGNATED MEMBER CANCELLATIONS SHOULD ANY PART OF THE ABOVE DESCRIBED AGREEMENT BE CANCELLED BEFORE THE EXPIRATION DA FE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NO TICE TO THE CERTIFICATE HOLDER NAMED ABOVE,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILFTY OF ANY KIND UPON THE PROGRAM, CITY OF WINTER SPRINGS I FS Afl4i N T�,W HOTLSq N1 ATII1 j,' � J 1126 EAST STATE ROAD 434 WINTER SPRINGS FL 32708 . ..................... -------- AUTI.III-DREIRESENIFAIFIVE F.IT-CER1001961 COnSUm DR-1 er's _Certificate of Exemption R.,o/,5 Issued Pursuant to Chapter 212, Florida Statutes FLORIDA ... _ 2529604C 0 04/30/2017 04/30/2022 MUNICIPAL GOVERNMENT cort ilicCaC��'rawCi `_.. . 85 80 �" �P�r�rs#owes I�ts6� 6��c�adA'�ipic�n���ra Lac�r�r�S�a�r�"d�atag�r�ry This certifies that CITY OF WINTER SPRINGS 1126 E STATE ROAD 434 WINTER SPRINGS FL 32708-2715 is exempt from the payment of Florida sales and use tax on real property rented,transient rental property rented, tangible personal property purchased or rented, or services purchased. . ti; Important Information for Exempt Organizations RD0/15 FLORIDA 1, You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases. See Rule 12A-1.038, Florida Administrative Code(F.A.C.). 2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable,even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible personal property, sleeping accommodations,or other real property is taxable. Your organization must register, and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this requirement except when they are the lessor of real property(Rule 12A-1.070, F.A.C.). 5, It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200%of the tax,and may be subject to conviction of a third-degree felony. Any violation will require the revocation of this certificate. 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account Management at 800-352-3671. From the available options, select"Registration of Taxes,"then"Registration Information," and finally"Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480, Tallahassee, FL 32314-6480.