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HomeMy WebLinkAboutWaterhouse, Matt "The Gator Guy" - Independent Contractor Agreement - 2012 04 20 PARKS& RECREATION INSTRUCTOR INDEPENDENT CONTRACTOR AGREEMENT THIS AGREEMENT is made this day of A-Pa-f-r- , 2012 ("Effective Date"), by and between the CITY OF WINTER SPRINGS,FLORIDA,a Florida municipal corporation,whose address is 1126 East State Road 434, Winter Springs, Florida("City"), and Matt Waterhouse,an individual,whose principal address is 5152 Boggy Creek Road, Saint Cloud,Florida 34771 ("Contractor"). RECITALS: WHEREAS,the City has certain recreational facilities available for use by the public;and WHEREAS,the Contractor desires to offer"The Gator Guy"Nature Education Program("Services")for the benefit of the public using the recreational facilities available to the City; and WHEREAS,the City desires to allow the Contractor to offer such Services to the public under the terms and conditions set forth in this Agreement. IN CONSIDERATION of the mutual covenants and provisions hereof,and other good,diverse,and valuable considerations,the receipt and sufficiency all or which is hereby acknowledged,the parties desiring to be legally bound do hereby agree as follows: ARTICLE 1 GENERAL PROVISIONS 1.1 Engagement. The City hereby engages the Contractor and the Contractor agrees to perform the Services outlined in EXHIBIT"A"for the stated fee arrangement. No prior or present agreements or representations shall be binding upon any of the parties hereto unless incorporated in this Agreement. 1.2 Due Diligence. The Contractor acknowledges that he/she has investigated prior to execution of this Agreement and satisfied himself/herself as to the conditions affecting the Services,the availability of materials and labor, the cost thereof,the requirements to obtain necessary insurance as set forth herein,and the steps necessary to complete the Services herein. The Contractor warrants unto the City that he/she has the competence and abilities to carefully and faithfully complete the Services set forth herein. The Contractor will perform the Services with due and reasonable diligence consistent with sound professional practices. 1.3 CCNA Services. The Contractor warrants unto the City that the Services being performed pursuant to this Agreement do not constitute professional services as defined by Section 287.055(2)(a), Florida Statutes. ARTICLE 2 REGISTRATION FEES,COMPENSATION,&PAYMENT TERMS 2.1 Registration Fees. Registration fees for Services rendered shall be determined by City at its sole discretion. 2.2 Compensation. Contractor and City agree to divide the registration fees derived from the Services provided hereunder as follows: (a) Contractor shall receive 80%of the registration fees derived from the Services. (b) The City shall receive 20%of the registration fees derived from the Services. Parks&Recreation Instructor Independent Contractor Agreement City of Winter Springs 1 of 7 Form 1.0 07/2009 (c) No other compensation shall be due Contractor for the Services provided under this Agreement, unless specifically agreed to by City in advance and in writing. 2.3 Payment Terms. All registration fees shall be collected by Contractor and shall be forwarded to the City's Parks and Recreation Program Coordinator within two (2)business days of collection. Contractor agrees to account for any and all fees collected,including the registrant's name and payment method. Registration fees paid by check shall be made payable to the City of Winter Springs. City shall pay to Contractor 80%of the registration fees at the conclusion of the Services, or on a monthly basis, whichever occurs first. Contractor agrees that if the required minimum number of participants for Services is not met, Contractor is not entitled to any compensation and any registration fees paid for such Services shall be refunded. ARTICLE 3 GENERAL CONDITIONS OF SERVICES 3.1 Provision of Services is a Private Undertaking. With regard to any and all Services performed hereunder,it is specifically understood and agreed to by and between the parties hereto that the contractual relationship between the City and the Contractor is such that the Contractor is an independent contractor and not an agent of the City. Nothing in this Agreement shall be interpreted to establish any relationship other than that of an independent contractor, between the City,on one hand,and the Contractor,during or after the performance of the Services under this Agreement. 3.2 Warranty of Services. The Contractor hereby warrants unto the City that he/she has sufficient experience to properly complete the Services specified herein or as may be performed pursuant to this Agreement. The Contractor shall comply with all laws, ordinances, rules, and regulations in the performance of the Services. The Contractor shall pay all taxes, fees, license fees required by law, including but not limited to occupational fees and withholding taxes and assume all costs incident to the Services, except as provided herein. 3.3 City's Responsibilities. The City shall cooperate with the Contractor by: (a) Storing equipment and materials, after approval of Parks and Recreation Program Coordinator. The City shall not be responsible for any loss or damage of equipment and materials stored by the City. (b) Locking up the Recreation Center or alternative location after each class/camp. (c) Arranging for access to facilities as necessary to the Contractor for provision of the Services. (d) Keeping the facilities provided in good repair,and providing custodial services to the facilities. ARTICLE 4 SUBCONTRACTS; ASSIGNMENT 4.1 Assignment and Subcontracting. Unless otherwise specifically required by this Agreement, the Contractor shall not assign, sublet, or transfer any rights or Services under or interest in (including, but without limitations,moneys that may become due)this Agreement without the written consent of the City,except to the extent that any assignment, sublet, or transfer is mandated by law or the effect of this limitation may be restricted by law. Unless specifically stated to the contrary in any written consent to any assignment, no assignment will release or discharge the assignor from any duty or responsibility under this Agreement. Further, the Contractor shall not subcontract any portion or all of the Services without the written consent of the City. Nothing under this Agreement shall be construed to give any rights or benefits in this Agreement to anyone other than the City and the Contractor,and all duties and responsibilities undertaken pursuant to this Agreement will be for the sole and exclusive benefit of the City and the Contractor and not for the benefit of any other party. Parks&Recreation Instructor Independent Contractor Agreement City of Winter Springs 2 of 7 Form 1.0 07/2009 ARTICLE 5 MISCELLANEOUS PROVISIONS 5.1 Governing Law;Venue. This Contract shall be governed by the law of the State of Florida. Venue of all disputes shall be properly placed in Seminole County,Florida. The parties agree that the Agreement was consummated in Seminole County,and the site of the Services is Seminole County. If any dispute concerning this Contract arises under Federal law,the venue will be Orlando, Florida. 5.2 Notices. All projects hereunder,all notices,demands,requests,instructions,approvals,and claims shall be in writing. All notices of any type hereunder shall be given by U.S.mail or by hand delivery to an individual authorized to receive mail for the below listed individuals,all to the following individuals at the following locations: TO THE CITY: Kevin L. Smith City Manager City of Winter Springs 1126 East State Road 434 Winter Springs,FL 32708-2799 407-327-1800(Phone) 407-327-4753 (Fax) TO THE CONTRACTOR: Matt Waterhouse 5152 Boggy Creek Road,#F10 Saint Cloud,FL 34771 Te lephone:407-5 05-9540 Notice shall be deemed to have been given and received on the date the notice is physically received if given by hand delivery,or if notice is given by first class U.S.mail,postage prepaid,then notice shall be deemed to have been given upon the date said notice was deposited in the U.S.Mail addressed in the manner set forth above. Any party hereto by giving notice in the manner set forth herein may unilaterally change the name of the person to whom notice is to be given or the address at which notice is to be received. 5.3 Public Record. It is hereby specifically agreed that any record,document,computerized information and program, audio or video tape, photograph, or other writing of the Contractor related, directly or indirectly, to this Agreement, may be deemed to be a Public Record whether in the possession or control of the City or the Contractor. Said record,document,computerized information and program,audio or video tape,photograph,or other writing of the Contractor is subject to the provisions of Chapter 119, Florida Statutes,and may not be destroyed without the specific written approval of the City. Upon request by the City, the Contractor shall promptly supply copies of said public records to the City. All books,cards,registers,receipts,documents,and other papers in connection with this Agreement shall at any and all reasonable times during the normal working hours of the Contractor be open and freely exhibited to the City for the purpose of examination and/or audit. 5.4 Amendment of Agreement. Modifications or changes in this Agreement must be in writing and executed by the parties bound to this Agreement. 5.5 Severability. If a word, sentence, or paragraph herein shall be declared illegal, unenforceable, or unconstitutional,the said word,sentence,or paragraph shall be severed from this Contract,and this Contract shall be read as if said illegal,unenforceable,or unconstitutional word, sentence, or paragraph did not exist. 5.6 Attorney's Fees. Should any litigation arise concerning this Agreement between the parties hereto,the parties agree to bear their own costs and attorney's fees. Parks&Recreation Instructor Independent Contractor Agreement City of Winter Springs 3 of 7 Form 1.0 07/2009 5.7 Entire Agreement. This Agreement represents the entire and integrated Agreement between the parties and supersedes all prior negotiations,representations,or Agreements,either oral or written,and all such matters shall be deemed merged into this Agreement. 5.8 Sovereign Immunity. Notwithstanding any other provision set forth in this Agreement,nothing contained in this Agreement shall be construed as a waiver of the City's right to sovereign immunity under Section 768.28,Florida Statutes, or other limitations imposed on the City's potential liability under state or federal law. As such, Contractor agrees that the City shall not be liable under this Agreement for punitive damages or interest for the period before judgment. Further,the City shall not be liable for any claim or judgment,or portion thereof,to any one person for more than one hundred thousand dollars($100,000.00),or any claim or judgment,or portion thereof,which,when totaled with all other claims or judgments paid by the State or its agencies and subdivisions arising out of the same incident or occurrence,exceeds the sum of two hundred thousand dollars($200,000.00). ARTICLE 6 PROTECTION OF PERSONS AND PROPERTY; INSURANCE 6.1 Worker's Compensation. Upon the effective date of this Agreement,Contractor shall provide proof of worker's compensation insurance in the minimum amount required by law(if required). 6.2 Professional Liability/Malpractice and General Liability. Upon the effective date of this Agreement, Contractor shall submit proof of professional liability/malpractice and general liability insurance to cover claims for professional liability/malpractice(if applicable)and general liability because of bodily injury or death of any person or property damage arising out of this Agreement or any Services provided hereunder. The insurance shall have minimum limits of coverage of$1,000,000.00 per occurrence. 6.3 This paragraph shall be applicable to Sections 6.1 and 6.2 The insurance required by this Article shall include the liability and coverage provided herein,or as required by law,whichever requirements afford greater coverage. All of the policies of insurance so required to be purchased and maintained for the certificates(or other evidence thereof) shall contain a provision or endorsement that the coverage afforded will not be canceled,materially changed or renewal refused until at least thirty(30)days'prior written notice has been given to the City and the Contractor by certified mail, return receipt requested. All such insurance shall remain in effect until final payment.Unless agreed to by the City to the contrary, the City shall be named on the foregoing insurance policies as "additional insured," except for professional liability/malpractice coverage. The Contractor shall cause its insurance carriers to furnish insurance certificates specifying the types and amounts of coverage in effect pursuant hereto, the expiration dates of such policies, and a statement that no insurance under such policies will be canceled without thirty(30)days'prior written notice to the City in compliance with other provisions of this Agreement. For all Services performed pursuant to this Agreement, the Contractor shall continuously maintain such insurance in the amounts,type,and quality as required by Sections 6.1,6.2, and 6.3. In the event Contractor fails to maintain said insurance,City,at its option,may elect to terminate this Agreement by written notice to Contractor. 6.4 Indemnification and Hold Harmless. For all Services performed pursuant to this Agreement, the Contractor agrees to the fullest extent permitted by law, to indemnify and hold harmless the City and its employees, officers,and attorneys from and against all claims,losses,damages,personal injuries(including but not limited to death), or liability(including reasonable attorney's fees),directly or indirectly arising from the negligent acts,errors,omissions, intentional or otherwise,arising out of or resulting from Contractor's performance of any Services provided pursuant to this Agreement. The indemnification provided above shall obligate the Contractor to defend at his own expense or to provide for such defense, at the option of the City,as the case may be,of any and all claims of liability and all suits and actions of every name and description that may be brought against the City or its employees, officers, and attorneys which may result from the Services under this Agreement whether the Services be performed by the Contractor or anyone directly or indirectly employed by them. In all events the City shall be permitted to choose legal counsel of its sole choice,the fees Parks&Recreation Instructor Independent Contractor Agreement City of Winter Springs 4 of 7 Form 1.0 07/2009 r ' for which shall be reasonable and subject to and included with this indemnification provided herein. This paragraph 6.4 shall survive termination of this Agreement. 6.5 Standard of Care. In performing its Services hereunder,the Contractor will use that degree of care and skill ordinarily exercised,under similar circumstances by reputable members of its profession practicing in the same or similar locality. ARTICLE 7 TERMINATION OF THE CONTRACT 7.1 Termination by City. The City may terminate this Agreement without penalty with five(5)days written notice to Contractor. Such termination shall be at City's sole discretion. 7.2 Termination by Contractor. With at least five (5) days written notice to the City, Contractor may terminate this Agreement if the City fails to comply with the terms and conditions of this Agreement. 7.3 Termination by Consent. This agreement may be terminated by the mutual written consent of both parties at any time, and without penalty. 7.4 Upon Termination. Upon termination of this Agreement,the City shall pay the Contractor,as full payment for all Services performed and all expenses incurred,sums due and owing to the Contractor for payment of all Services completed to the City's satisfaction through the termination date. Upon notice of termination,the Contractor shall cease all Services being provided hereunder. 7.5 Waiver. Failure of the City to insist upon performance within any time period or upon a proper level or quality of performance shall not act as a waiver of the City's right to later claim a failure to perform on the part of the Contractor. ARTICLE 8 TERM OF AGREEMENT 8.1 Term. The term of this Agreement shall commence on the Effective Date of this Agreement and terminate after one(1)year unless extended by mutual written agreement of the parties. ARTICLE 9 CONFLICTS 9.1 Conflicts. In the event that a conflict arises as to the contents of Exhibit"A"and the Agreement,the Agreement shall govern. (Signature Page Follows) Parks&Recreation Instructor Independent Contractor Agreement City of Winter Springs 5 of 7 Form 1.0 07/2009 IN WITNESS WHEREOF,the parties hereto caused this Agreement to be executed as of the date first written above. CONTRACTOR: CITY: MATT WATERHOUSE CITY OF WINTER SPRINGS, FLORIDA By: . . , By: V ., I M�7atttt�Wat rhouse evin L. .mith,City Manager Dated: v `7 a v/7 Dated: Z/I v STATE OF FLORIDA COUNTY OF SEMINOLE The foregoing instrument was acknowledged before me this day of ,2012 by Matt Waterhouse,who executed the foregoing instrument and acknowledged before me that he/she executed the same for the uses and purposes therein expressed and who is personally known to me or who has produced as identification and who did not take an oath. (NOTARY SEAL) Notary Public Signature Typed or Printed Notary Name STATE OF FLORIDA COUNTY OF SEMINOLE The foregoing instrument was acknowledged before me this day of ,2012,by KEVIN L. SMITH,City Manager of Winter Springs, Florida,who is personally known to me. (NOTARY SEAL) Notary Public Signature Typed or Printed Notary Name Parks&Recreation Instructor Independent Contractor Agreement City of Winter Springs 6 of 7 Form 1.0 07/2009 • EXHIBIT"A" DESCRIPTION OF SERVICES TO BE PERFORMED Scope of Services. The Contractor agrees to provide the following Services to the City: (a) Contractor agrees to offer"The Gator Guy"Nature Education Program to the public on an ongoing basis. The dates,times and location of such class/camp shall be specified by the City in coordination with the Contractor. (b) Contractor shall be responsible for registration of participants. A copy of each registration form shall be provided to the Program Supervisor. Each class/camp must contain a minimum of one(1)participant. (c) Contractor shall provide the Program Supervisor with a schedule at least fourteen(14)days prior to the start of the Services. Any changes to the program must be submitted with seven (7) days advance notice. The Program Supervisor must approve the submitted schedule prior to the start of the Services. (d) Contractor shall provide all equipment and materials needed to provide Services. Contractor shall be responsible for preparing/setting up prior to each class/camp. (e) Contractor shall insure that all participants sign a release form,the specifications of which must be approved by City prior to commencement of Services. A copy of all release forms signed by participants shall be forwarded to Program Director. (f) Contractor shall keep an accurate record of the date, time and location of each class, the number of participants and their names. Such information shall be provided to the Program Supervisor promptly upon request. (g) Contractor shall be responsible for hiring additional instructors,if necessary,in order to insure a reasonable and proper instructor/participant ratio. (h) Contractor shall be responsible for any sponsorship obtained. Contractor shall forward information as to proposed sponsors to the City for approval prior to agreeing to sponsorship. (i) Contractor agrees to coordinate with the Program Supervisor to ensure program does not interfere with other City events. Contractor agrees that such events might impact the provision of Services. Parks&Recreation Instructor Independent Contractor Agreement City of Winter Springs 7 of 7 Form 1.0 07/2009 1 A� COMMERCIAL INSURANCE APPLICATION DATE(MMroo/YYYY) 1,.....--' APPLICANT INFORMATION SECTION 11/2412011 AGENCY CARRIER I NA/C CODE: UNDERWRITER I UNDERWRITER OFF. AXA INSURANCE AGENCY 1810 SR 436 SUITE 100 POLICIES OR PROGRAM REQUESTED POLICY NUMBER WINTER PARK,FL 32792 General Liability INDICATE SECTIONS ATTACHED EQUIPMENT FLOATER GARAGE AND DEALERS PHONE 407-478-8808 PROPERTY INSTAUATION/BUILDERS RISK VEHICLE SCHEDULE FAX NeL 321-280-8888 .s GLASS AND SIGN ELECTRONIC DATA PROC BOILER&MACHINERY EMAIL -..""" ACCOUNTS RECEIVABLE/ COMMERCIAL ADDRESS: VALUABLE PAPERS L GENERAL LIABILITY WORKERS COMPENSATION CODE: SUB CODE: _• CRIMEIMISCELUNEOUS CRIME ` BUSINESS AUTO UMBRELLA AGENCY CUSTOMER ID: 7 TRANSPORTATIONI _TRUCKERS/MOTOR CARRIER MOTOR TRUCK CARGO STATUS OF TRANSACTION PACKAGE POLICY INFORMATION QUOTE 0 ISSUE POLICY ®RENEW ENTER THIS INFORMATION WHEN COMMON DATES AND TERMS APPLY TO SEVERAL LINES.OR FOR MONOLINE POLICIES. BOUND(Give Dale and/or Attach Copy): PROPOSED EFF DATE PROPOSED EXP DATE BILUNG PLAN PAYMENT PLAN AUDIT CHANGE DATE I TIME -AM DIRECT BILL CANCEL PM `•"( Annual I Annual ✓ AGENCY BILL APPLICANT INFORMATION NAME(First Named Insured&Other Named Insureds) MAILING ADDRESS NCL ZIP+4(of First Named Insured) H2O House Enterprises,LLC 782 Andover Circle Winter Springs,FL 32708 FEIN OR SOC SEC* PHONE 407-505-9540 for First Named Insured): INC.No.Extk E-MAIL DDDRESS(ES): zoologist1923@gmail.com �OREss(Es): INDIVIDUAL CORPORATION SUBCHAPTER p pLFLC �E V ID NUMBER DATE PARTNERSHIP N JOINT VENTURE �, PROFITT FOR AN6 MANAvss 2011 INSPECTION CONTACT: Matthew Waterhouse ACCOUNTING RECORDS CONTACT: PHONE I EMAIL PHONE I EMAIL INC.No.Extl: ADDRESS: INC.No.Eau: ADDRESS: PREMISES INFORMATION LOC B : BLD S STREET,CITY,COUNTY,STATE,ZIP+4 CITY LIMITS INTEREST YR i It ANNUAL Y,OCCUPIED BUILT EMPLOYEES REVENUES 1 11 3485 N CR 426 Geneva,FL 32732 ..�.INSIDE OWNER 197 ' 1 7,000 100 I OUTSIDE ✓ TENANT 7 J E INSIDE OWNER i OUTSIDE C TENANT NATURE OF BUSINESS/DESCRIPTION OF OPERATIONS BY PREMISE(S) Teaches schools kids that come to the Nature Center about nature. GENERAL INFORMATION EXPLAIN ALL"YES`RESPONSES YES NO EXPLAIN ALL"YES"RESPONSES YES NO 1a.IS THE APPUCANT A SUBSIDIARY OF ANOTHER ENTITY 7 Ulm 8. DURING THE LAST FIVE YEARS(TEN IN RI),HAS ANY APPLICANT BEEN I INDICTED FOR OR CONVICTED OF ANY DEGREE OF THE CRIME OF FRAUD, lb.DOES THE APPLICANT HAVE ANY SUBSIDIARIES? ■ BRIBERY,ARSON OR ANY OTHER ARSON•RELATED CRIME IN CONNECTION 2. IS R FORMAL SAFETY PROGRAM IN OPERATION? WITH THIS OR ANY OTHER PROPERTY?(In RI,this question must be answered by any applicant tor property insurance. Failure is 3. ANY EXPOSURE TO FLAMMABLES,EXPLOSIVES,CHEMICALS? . 10 disclose the existence of an arson conviction Is a misdemeanor punishable by a sentence of 0•to one . • im, • 4. ANY CATASTROPHE EXPOSURE? .ri 8. ANY UNCORRECTED FIRE CODE VIOLATIONS? ✓ 5, ANY OTHER INSURANCE WITH THIS COMPANY OR BEING SUBMITTED? in.0 10. ANY BANKRUPTCIES,TAX OR CREDIT UENS AGAINST THE APPLICANT 6, ANY POLICY OR COVERAGE DECLINED.CANCELLED OR NON-RENEWED DURING 11. HAS BUSINESS BEEN PLA ED IN A TRUST? THE PRIOR 3 YEARS?(Not applicable In MO) A IF NY YES NAME OF TRUST: '.� 12. ANY FOREIGN OPERATIONS,FOREIGN PRODUCTS DISTRIBUTED IN USA.OR US 7. ANY PAST LOSSES OR CLAIMS RELATING TO SEXUAL ABUSE OR MOLESTATION :■0 PRODUCTS SOLD/DISTRIBUTED IN FOREIGN COUNTRIES?(if-YES",attach ALLEGATIONS.DISCRIMINATION OR NEGLIGENT HIRING? ACORD 815 Tor LlabiBN Exposure and/Or ACORD 816 for Property Exposure) REMARKS/PROCESSING INSTRUCTIONS(Attach additional sheets K more space is required) ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT,WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND(NY:SUBSTANTIAL)CIVIL PENALTIES.(Not applicable in CO,HI,NE,OH,OK,OR.or VT;in DC,IA, ME,TN and VA insurance benefits may also be denied) THE UNDERSIGNED IS AN AUTHORIZED REPRESENTATIVE OF THE APPUCANT AND CERTIFIES THAT REASONABLE ENQUIRY HAS BEEN MADE TO OBTAIN THE ANSWERS TO QUESTIONS ON THIS APPLICATION.HE/SHE CERTIFIES THAT THE ANSWERS ARE TRUE,CORRECT AND COMPLETE TO THE BEST OF HIS/HER KNOWLEDGE. Miti•LK:ANT'S SIGNA RE DATE I P,•r UCER'S SIGNATUR- I N OVAL P-•^UCFR NU.i" 1 • 'CORD 125(2005/06) PLEASE COMPLE E REVERSE SIDE ©ACORD CORP*- TION 1993-2005 APPALACHIAN UNDERWRITERS, INC. t A aIathi�n 800 Oak Ridge Turnpike,Suite A-1000 PP Oak Ridge,TN 37830 I 'Underwriters, Inc. (888)376-9633 ext 1036 Fax: (866)409-3367 MGL011 N70L2 Please bind effective: 0.- .e)1 Quote is valid until 1/20/2012 Re: H2O House Enterprises, LLC x optional coverages: o not indude any optional coverages. ❑Include the following optional coverages from Section V (Taxes&Fees may apply to optional premium if purchased) To: AXA Insurance Agency ❑ Option 1-(add:'5100.00)-Terrorism Coverage *See Terrorism Section for Exact Pricing and Terms Attn: Karla Carreno X0 & .3c4-0 Y Commission: 10 % Signature: /�/j'/ From: Rick Schiliro rickschiliro(appund.com/ (888)376-9633 ext. 1036 I. PREMIUM AND UNDERWRITING NOTES/REQUIREMENTS COMMERCIAL LIABILITY POLICY INFORMATION Carrier: Mount Vernon Fire Insurance Company Status: Non-admitted A.M. Best Rating: A++(Superior)-IX Term Quoted: Annual COVERAGE PART PREMIUM Commercial General Liability $610.00 TOTAL PREMIUM DUE TO CARRIER $610.00 ADDITIONAL COSTS Wholesaler Broker Fee $35.00 Florida Surplus Lines Tax(5.000%) $32.25 Florida Service Fee(.100%) $.85 Florida FL CAT Fund Assess(1.300%) $8.39 TOTAL AMOUNT DUE $68829 The premium quoted was calculated based on information provided by you in your application for insurance. The premium quoted may be adjusted based on an audit of your books and records during and/or at the conclusion of the policy period to determine actual receipts, payroll and other factors used to calculate earned premium. Please note that we will not be able to bind coverage until we satisfy all Prior to Binding requirements. Prior to binding,this account is subject to the following: • Functioning and operational smoke and/or heat detectors in all units and/or occupancies • No overnight exposures Please contact us with any questions regarding the terminology used or the coverages provided. "Read the quote carefully,it may not match the coverages requested"" Page 1 of 3 MGL011 N70L2 Within 21 days of the inception date of coverage,this account will be subiect to the following: • Our completed&signed application;or • A completed&signed ACORD application as long as all underwriting information needed has been provided to us;or • A completed&signed application from another company as long as all underwriting information needed has been provided to us. II. COVERED LOCATION(S)AND CORRESPONDING CLASSIFICATIONS Location#1-3485 N Cr 426,Geneva,FL 32732 Liability Coverage Desc[iptron d 13�s s4,M fi 4PosUre ProeJComppps,;Rl her.00d/Cota'1pC0 r(p om Schools-Other than Not-For-Profit 67512 Sales 7,000 Ind 4.896 Ind $510 MP Per 1,000 Sales Professional Liability 72990 Flat Flat Ind 0.000 Ind Ind Additional Insured-Managers or 49950 Additional 1 Ind 100.000 Ind $100 Lessors of Premises Insured Per Additional Insured Liability Coverage Premium for Location#1:$610 Ill. LIABILITY LIMITS OF INSURANCE COMMERCIAL GENERAL LIABILITY PROFESSIONAL LIABILITY Each Occurrence $1,000,000 Each Claim Included Personal Injury and Advertising Injury $1,000,000 Aggregate Included Medical Expense(Any One Person) $5,000 Damage to Premises Rented to You $100,000 Products/Completed Ops Aggregate Included General Aggregate $3,000,000 General Liability Deductible $0 Please contact us with any questions regarding the terminology used or the coverages provided. "Read the quote carefully.it may not match the coverages requested" Page 2 of 3 • MGL011 N70L2 IV. REQUIRED FORMS& ENDORSEMENTS General Liability Endorsements 2110 (09110)Service Of Suit L-249 (07/07)Professional Liability Insurance Coverage CG0001 (10/01)Commercial General Liability Coverage L-280s (10/08)Amendment-Limits Of Insurance Form CG0220 (04111)Florida Changes-Cancellation And L-526 (06/06)Absolute War or Terrorism Exclusion Nonrenewal CG2011 (01/96)Additional Insured-Managers or Lessors L-599 (10/07)Absolute Exclusion For Pollution, of Premises Organic Pathogen,Silica,Asbestos And Lead With A Hostile Fire Exception _ CG2139 (10/93)Contractual Liability Limitation L-610 (11/04)Expanded Definition Of Bodily Injury CG2147 (12/07)Employment-Related Practices Exclusion L-729 (08/09)Exclusion-Violation Of Statutes That Govern E Mails,Fax,Phone Calls Or Other Methods Of Sending Material Or lnformat CG2271 (10/01)Colleges or Schools(limited form) LLQ100 (07/06)Amendatory Endorsement IL0017 (11/98)Common Policy Conditions LLQ368 (08/10)Separation Of Insureds Clarification Endorsement IL0021 (09108)Nuclear Energy Liability Exclusion NTE (01/08)Notice Of Terrorism Exclusion Endorsement Jacket (09/10)Commercial Insurance Policy Jacket TRIADN (01/08)Disclosure Notice of Terrorism Insurance Coverage L-224 (10/10)Punitive Or Exemplary Damages Exclusion V.OFFER OF OPTIONAL COVERAGE(S) Based on the information provided,the following additional coverages are available to this applicant but are not currently included in the quotation.The additional premium may be subject to taxes&fees.For a firm final amount please contact us and we will revise the quote. Couerag a. ?f! '..,.., Additi Preriiium Option 1 Terrorism Coverage $100.00 Important Information • If this coverage is purchased,add L-541 Extension of Terrorism Coverage • Terrorism coverage is available per the Terrorism Risk Insurance Program Reauthorization Act of 2007. If not purchased,please provide the signed TRIADN Disclosure Notice or add form NTE-Notice of Terrorism Exclusion. When malting your decision to purchase Terrorism Coverage,please be aware that coverage for "insured losses"as defined by the Act is subject to the coverage terms, conditions,amount,and limits in this policy applicable to losses arising from events other than acts of terrorism. • The Terrorism premium shown above has been calculated as a percentage of the quoted coverages. If any coverages are added or removed at binding,the additional premium shown above is subject to change. • This coverage cannot be added mid-term. Please contact us with any questions regarding the tem'imology used or the coverages provided. 'Tead the quote carefully,it may not match the coverages requested*" Page 3 of 3 i -- L r vt%./w- - 'U ' / PREMIUM FINANCE AGREEMENT DUVAL PREMIUM BUDGET,INC. PHONE(904)355-0888 P.O.BOX 40866 JACKSONVILLE,FLORIDA 32203-0866 THIS AGREEMENT,Made,executed and delivered at Jacksonville,Florida,this 21 day of November , 2011 ,between (Name) H2O House Enterprises,LLC Phone# (407)505-9540 (Address) 782 Andover Circle,Winter Springs FL Zip Code 32708 (NAME OF INSURED EXACTLY AS IT APPEARS IN POLICIES) hereinafter called the insured,and Duval Premium Budget,Inc.a Florida Corporation,hereinafter called DPB for the financing of the balance of the premiums on the following insurance policies: SCHEDULE OF POLICIES EFFECT EXPIRY NAME AND ADDRESS OF INSURING COMPANY TYPE OF POLICY NO. PREMIUM DATE DATE (INCLUDE GENERAL AGENCY AND COMPANY,IF BROKERED) COVERAG 11/22/2011 11/22/2012 MOUNT VERNON FIRE INS.CO. COL Pending 686.29 APPALACHIAN UNDERWRITERS,INC.CLINTON FEDERAL TRUTH-IN-LENDING DISCLOSURE STATEMENT CASH PRICE -CASH DOWN =UNPAID +DOC =AMOUNT +FINANCE =TOTAL OF ANNUAL (Total Premium) PAYMENT BALANCE OF STAMPS(If FINANCED CHARGE .PAYMENTS PERCENTAGE CASH PRICE applicable) The amount of The dollar he amount you RATES credit provided to amount the will have paid The cost of your you or on your credit costs you. after you have credit as a yearly behalf. made all rate payments as scheduled. 686.29 ( 240.p) 446.09 1.75 447.84 64.76 512.60 30.41% Security: You are giving a security interest in any and all unearned return YOUR PAYMENT SCHEDULE WILL BE: premiums which may become payable under the policies. Late Charge:If a payment is late you will be charged a maximum of r' I,`_I ( f r, r P.7 ,F °J F I F '' $10.00 for personal policies or 5%of scheduled payment [-F�GH YP,^FP!r _N P! 1 vT i GUE for commercial policies, 51.26 10 12120/2011 Prepayment: If you pay off early,you will not have to pay a penalty and you may be entitled to a refund of part of the finance charge. Each of the monthly payments is due on the same day of See the following provisions for additional information about nonpayment, each succeeding month until paid in full. default,any required repayment in full before the scheduled date,and prepayment refunds and penalties. "ITEMIZATION"OF THE AMOUNT FINANCED: WARRANTIES OF AGENT 1.A in Block C above will be paid to your insurance The undersigned hereby certifies that: (1) The down payment as 1.Amount rno y(ies)or their agents on your behalf. shown in the contract has been paid by or on behalf of the 2.Amount in Block D above(if applicable)will be paid to insured.(2)All policies listed are or will be in force on the stated effective dates and delivered by him.(3) No audit,reporting form, public officials. or minimum earned premium policy is included in this agreement, NOTICE:(1)Do not sign this agreement before you read it except as indicated in the schedule of policies. (4) The above or if it contains any blank space.(2)You are entitled to a agreement Is a bona fide and binding contract (5)The signatures completely filled-in copy of this agreement (3) Under the are genuine.(6) A copy of this agreement has been delivered to law, you have the right to pay off In advance the full the insured.The undersigned agent further certifies that he is an amount due and under certain conditions to obtain a authorized agent of the insuring companies and acknowledges partial refund of the service charge. that he is not affiliated in any capacity with DPB. ALL INSUREDS NAMED IN POLICIES SIGN HERE.INSURED Agency ACKNOWLEDGES THAT HE/SHE HAS RECEIVED A COPY Name AXA Insurance Agency 70 OF THIS AG j EMENT. ■LaSt 4 (SEAL) Address 1810 N Semoran Blvd,Ste 100,Winter Park FL 32792 (Insured's signature exactly as appears in policies)(BORROWER) (SEAL) Signatures get..6i44/v2 (SEAL) (Insured's signature exactly as appears in policies)(BORROWER) NO f ICL:SEE.REVERSE SIDE FOR IMPORTANT INTORMAT:ON LICENSE TO SELL OR EXHIBIT CLASS I f` ` &/OR CLASS II WILDLIFE (1 TO 25 ANIMALS) 4 , r Florida Fish and Wildlife Conservation Commission G PO Box 6150, Tallahassee, FL 32314-6150 (850) 488-3641 ESA 2822 Cost: $150.00 Issued: 02/03/2012 Applicant ID: 23189 License ID: 401-80800 Location Address: Expires: 02/02/2013 THE GATOR GUY WATERHOUSE,MATTHEW 782 ANDOVER CIRCLE 3485 N. COUNTY ROAD#426 WINTER SPRINGS,FL 32708 GENEVA,FL 32732 LICENSEE AUTHORIZATIONS CLASS 2 CROCODYLIA 129108