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HomeMy WebLinkAboutFreedom Waste Services ApplicationMemo Community + Economic Development TO: Todd Morley, City Manager Mia Goforth, City Clerk FROM: David Dickey, Director Community & Economic Eievelopment DATE: February 28, 2023 RE: Application for Non -Exclusive Collection Services - Freedom Waste Services Pursuant to Section 62-7 of City Code, any person wishing to obtain a Non -Exclusive Franchise for hauling Construction & Demolition Debris (CDD), must first submit an application to the City. This includes small -haulers, which are defined as roll -off containers under twenty (20) cubic yards. Attached is an small -hauler application (Attachment 1) for a Non -Exclusive Franchise for hauling CDD from Fusionsite Florida, LLC, dba Freedom Waste Services, located in Jensen Beach, FL. Staff has conducted a preliminary sufficiency review of the application: 1. Applicant Information - Complete 2. Applicant's Authorized Representative - Complete 3. Type of Business Entity - Complete (LLC) 4. Applicant's Principals - Complete 5. Applicants Managers - Complete 6. Proof of Good Standing - Complete 7. Authorization to do Business in Florida - Complete 8. Fictitious Name - Complete (Freedom Waste Services) 9. Applicant's Experience - Complete 10. Prior Enforcement Issues - Complete (none) 11. Potential Customers and Service Details; Estimated Gross Revenue - Complete - Revenue unknown 12. Vehicles and Equipment - Complete 13. Insurance Requirements - tbd 14. Bond Requirements - Complete (to be paid at time of franchise award) 15. Other Information - Complete 16. Application Fee - Paid ($1,000) Attachment: Application City of Cape Canaveral Community Development Department APPLICATION FOR NON-EXCLUSIVE CONSTRUCTION & DEMOLITION DEBRIS COLLECTION SERVICES (SMALL -HAULER — UNDER 20 CU YARD ROLL -OFF CONTAINERS) Pursuant to Section 62-7 of the Cape Canaveral Code, this application form must be completed by each person or company ("Applicant") that wishes to obtain a Non -Exclusive Franchise from the City of Cape Canaveral for Construction & Demolition Debris Collection Services. The City Code defines "Construction and Demolition Debris" as follows: Construction and demolition debris shall have the same meaning proscribed in 62-701.200(24), Florida Administrative Code, which at the effective date of this Agreement means: Discarded materials generally considered to be not water soluble and non -hazardous in nature, including but not limited to steel, glass, brick, concrete, asphalt material, pipe, gypsum wallboard, and lumber, from the construction or destruction of a structure as part of a construction or demolition project or from the renovation of a structure, including such debris from construction of structures at a site remote from the construction or demolition project site. The term includes rocks, soils, tree remains, trees, and other vegetative matter that normally results from land clearing or land development operations for a construction project; clean cardboard, paper, plastic, wood, and metal scraps from a construction project; except as provided in Section 403.707(9)(j), Florida Statutes, yard trash and unpainted, non -treated wood scraps from sources other than construction or demolition projects; scrap from manufacturing facilities that is the type of material generally used in construction projects and that would meet the definition of construction and demolition debris if it were generated as part of a construction or demolition project, including debris from the construction of manufactured homes and scrap shingles, wallboard, siding concrete, and similar materials from industrial or commercial facilities and de minimus amounts of other non -hazardous wastes that are generated at construction or demolition projects, provided such amounts are consistent with best management practices of the construction and demolition industries. Mixing of construction and demolition debris with other types of solid waste will cause it to be classified as other than construction and demolition debris. Mailing Address: P.O. Box 326 Physical Address: 100 Polk Avenue Cape Canaveral, FL 32920-0326 Telephone (321) 868-1222 — Fax (321) 868-1247 www.cit ofca Lec,Anaveral.p e-mail: int r cj:ty o 'cane Inaveiai.orf� An Applicant must provide the City with ali of the information and documents requested below, including the application fee and the affidavit that are described below. An Applicant may attach additional sheets of paper to this application form, if necessary. 1. • ; !'cant Information. Please provide the name, address and telephone number of the Applicant. Name of Applicant:VT/la& Mailing Address: r E -Mail Address: Telephone No.: w �, 2. Applicant's Authorized Representative. Please provide the name, address and telephone number of the person that is the Applicant's designated representative with regard to this Application. Name of Representative: , " yma Mailing Address: lqa E -Mail Address: Telephone No.: a: 3. Type of Business Entity. Please state whether the Applicant is an individual, a corporation, a partnership, or other type of business entity. 4. Applicant's Principals. If the Applicant is a corporation, partnership or other business entity, please provide the name, address, and title of the Applicant's majority shareholder and each person that is a principal officer (e.g., Chief Executive Officer; President; Vice -President; Chief Operating Officer; etc.). 'co, 2 5. Applicant's Managers. Please provide the name, address, and telephone number of each person that will serve as the Applicant's local manager (i.e., the person that will be responsible for performing or supervising the Construction & Demolition Debris Collection Services for the Applicant). I KA J4 e (A) n 134'(0_ 3 m-7 ��ccrr�c� 9 -fa N 6. Proof of Good Standing, If the Applicant is a corporation, please provide proof that the corporation is in good standing in the state of Florida. 7. Authorization to do Business in Florida. If the Applicant is not a Florida corporation, please provide proof that the Applicant is authorized to do business in Florida. 8. Fictitious Name. If the Applicant is operating under a fictitious name, please provide information demonstrating that the fictitious name is properly registered by the Applicant. 9. A_„pplicant's Exerience. (a) Please provide a copy of the company's corporate biography. (b) Please provide a summary of the Applicant's experience with regard to the collection of Construction & Demolition Debris collection services. (c) Provide a complete list of all of the communities in Florida and other states (but not more than a total of five (5) communities) where the Applicant has provided construction & demolition debris collection services in the last five (5) years. 3 (d) For each community listed in Section 9(b), aboveplease providetho name, address, and telephone number of a reference (i.e., a person employed by the local government in that community who can provide information concerning the quality of service provided by the Applicant). 10. Prior Enforcement Issues, (a) Please provide a complete tist of alt communities (if any) where the Applicant's permit, approval, franchise, or license to provide any kind of solid waste collection services was suspended or revoked. (b) Provide acomplete list of alt f&ony convictions, and alt misdemeanor convictions within the last five (5) years, involving the Applicant's collection, receiving, storing, separating, transportation, or disposal of solid waste. If the Applicant is not an individual, also provide a list of such convictions for the Applicant's majority shareholder, any person having a controlling interest in the Applicant, and each person that is an officer or partner of the Applicant. (c) Provide a complete list of all civil penalties and liquidated damages in excess of five thousand dollars ($5,000.00) that were assessed against the Applicant by local, state, and federal governmental entities within the last five (5) years involving the collection, transportation, or disposal of sotid waste. (d) With regard to Sections 1O(a) through lO(c), above, provide any information concerning the convictions, penalties, liquidated damages, etc., that the Applicant believes will help the City understand the facts concerning those matters. 11. Potential Customers and Service Details: Estimated Gross Revenue from Services. Please provide a description of the types of customers that the Applicant will offer construction & demolition debris services to within the City of Cape Canaveral if this Application is approved including any proposed pricing for such services and estimated annual gross revenues anticipated for providing services to customers within the City of Cape Canaveral. Please provide this information on a separate sheet of paper with a heading titled; "City of Cape Canaveral Franchise Application Response; Potential Customers, Paragraph 11; Potential Customers". 4 12. V. Igikles and E Please provide a list of the vehicles, equipment, and containers that will be used by the Applicant to provide construction & demolition debris collection services in the City. The list must identify the make, model, identification number, and year of each vehicle and piece of collection equipment. The list also must identify the size and type of each container that wiri be used by the Appllcant and a photograph of any corporate container markings such as logos. Please provide this information on a separate sheet of paper with a heading titled; "Vehicles and Equipment, Paragraph 12; Other Collection Equipment". AIso include the street address of the equipment yard(s) where the Applicant's vehicles, equipn1ent, and containers are stored when they are not in use. 13. InsuranceBequirements. Please provide a properly executed Acord 25 Certificate of Insurance form demonstrating that the Applicant has the following types and amounts of insurance coverages issued by an insurance company that is licensed to do business in the State of Florida, with an A.M. Best Rating of B + or better, Class VII (or higher), or otherwise acceptable to the City, if the company is not rated by A.M. Best. (a) Comprehensive General Liability Insurance with a limit of a one million dollar ($1per occurrence and a two million dollar general aggregate. This policy must include the following coverages: premises and operations |iability, independent contractors, products and completed operations, personal injury, contractual liability, and fire damage; (b) Automotive Liability Insurance coverage providing a combined single limit of not less than one million dollars (t1/0000UO) per occurrence. This policy must inctude the following coverages: bodily i'uryandppmpertVdarnagainc|ud|ng premises and operations; (c) Workers Compensation Insurance shall be provided for all of Franchisee's employees as required under Florida law; and (d) Employers Liability Insurance providing a single limit of not less than one million dollars ($1,00]/000), bodily injury by each aojdent and providing a single limit of not less than one million dollars ($1,00[l000)' bodily injury disease per each employee, and providing a single limit of not less than one million dollars ($1,000,000) bodily injury by disease policy limit. The certificate of insurance must demonstrate that the insurance coverage will be in effect for the term of the proposed Franchise Agreernent. The certificate of insurance must name the City as an additional insured (except with regard to workers 5 compensation and employers liability insurances). 14. Bond Requirements.. A performance bond in the amount of fifty thousand dollars ($50,000) to secure compliance with the City Code and any non-exclusive franchise awarded by the City will be required as a condition of approval of the non-exclusive franchise. The bond must be in the form approved by the City Attorney. The bond must be issued by a surety licensed to do business in the state of Florida. By the Applicant's submittal of this Application, Applicant agrees to provide the required performance bond if a non- exclusive franchise is approved by the City. 15. Other Information. Please provide any other information the Applicant believes will demonstrate that: (a) The Applicant has the experience, personnel, equipment, and other resources necessary to provide construction & demolition debris collection services in compliance with the requirements in the City Code and any non-exclusive franchise awarded by the City; (b) The Applicant has the capacity and willingness to comply with all applicable local, state, and federal laws; and (c) The award of a Franchise to the Applicant will be in the public interest. 16. Franchise Agreement. Upon preliminary approval of the Application by the City Manager. The City Manager will present a Non -Exclusive Construction & Demolition Debris Franchise Ordinance (Small Hauler — under 20 cu yards) to the City Council for consideration and approval. Said Ordinance shall set forth the terms and conditions under which the Applicant will be authorized to provide construction & demolition debris collection services within the jurisdictional limits of the City. Upon approval of the Ordinance by the City Council, the Applicant shall be responsible for properly executing the Non -Exclusive Franchise Ordinance adopted by the City Council as a condition of providing construction & demolition collection services within the jurisdictional limits of the city of Cape Canaveral. 17. Application Fee. Please provide an application fee with this Application. The amount of the application fee is $1,000.00 (One Thousand Dollars) to defray a portion of the City's administrative expenses incurred in processing the Application. Payments shall be made payable to the City of Cape Canaveral. 6 18. Effective Date of Franchise Agreement, Please identify the date when the Applicant wants its Franchise to take effect [Applicants are u advised that a franchise requires City Council approval by Ordinance at two separate meetings. Processing of an Application will likely take at least 90 days or more to complete.] 19. Atta hment t All of the information and documents requested in paragraphs 1-19, above, must be attached to this Application and submitted to the City. The undersigned hereby represents to the City of Cape Canaveral that the information contained in this Application is true and correct to the undersigned's knowledge and that the undersigned is duly authorized to execute and file this Application on behalf of the Applicant. APPLICANT Vit,^ Print Company Name By: ..,u.,._. Print name/title: (Seal) Cgrporate Secretary — Signature Witness - Signature Witness — Type or Print 7 OFFICIAL USE ONLY: Application deemed complete and Preliminary Approval subject to City Council adoption of franchise ordinance. Preliminary approval only constitutes an acknowledgement that the Application is ready for the City Council's consideration and does not constitute approval of the franchise. The franchise requires City Council approval to be binding: CITY OF CAPE CANAVERAL By: Todd Morley, City Manager ATTEST: Mia Goforth, CMC City Clerk Date: 8 t 2'i4 0 State of Florida Department of State I certify from the records of this office that FUSIONSITE FLORIDA LLC is a Delaware limited liability company authorized to transact business in the State of Florida, qualified on April 21, 2021. The document number of this limited liability company is M21000004790. I further certify that said limited liability company has paid all fees due this office through December 31, 2022, that its most recent annual report was filed on April 13, 2022, and that its status is active. I further certify that said limited liability company has not filed a Certificate of Withdrawal. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Third day of February, 2023 Secretory of tote i Tracking Number: 0922330813CU To authenticate this certificate,visit the following site,enter this number, and then follow the instructions displayed. h ttp s: Nservices.su nbiz.org/FilingslCertific ateOfStatusiCertiticateAuthent ication f>r3 1:71k4A.;`,4„....; Department or state / pivision et Corporations / Serth Records. / Search Eatty Name Detail by Entity Name Foreign Limited Liability Company FUSIONSITE FLORIDA LLC filing information Document Number M21000004790 FEI/EIN Number 86-3344531 Date Filed 04/21/2021 State DE Status ACTIVE Principal Address 5611 OHIO AVENUE NASHVILLE; TN 37209 mailing Address 5611 OHIO AVENUE NASHVILLE, TN 37209 aegistered Agent Name & Address C T CORPORATION SYSTEM 1200 S PINE ISLAND RD #250 PLANTATION, FL 33324 Authorized Person(s) Detail Name & Address Title AP PATE, NEWT 327 54TH AVE N NASHVILLE, TN 37209 Annual Reports Report Year Filed Date 2022 04/13/2022 Document Imam ¢4/13,2Q22 — ANN OAL REPORT. Vie e it-riago in PDF format Cia/21 /2021 — Forelqn Limited View Image Ir. PDF format DIVISION OF\C:613P.Co.YATIO4S ro: 18506176383 Pboe: 2 of 5 4/2012021 2021-04-20 15:44:10 CST ivision of Corporations r �. 19542080845 From: Renee McGraw CV c 90 Note: Please print this page and use it as a cover sheet. Type the fax audit number (Shown below) on the top and bottom of all pages of the document. (((H210001 X8602 3))) 1111111111111111111111111111111111111 j1,1111111I91111111111111111111111111111111111111 Note: DO NOT hit the REFRESH/RELOAD button on your browser from this page. Doing so will generate another cover sheet. To: From: Division of Corporations Fax Number : (85e)617-6383 Account Name : C T CORPORATION SYSTEM Account Number : FCA088000023 Phone : (614)280-3338 Fax Number : (954)208-0845 "'Enter the email address for this business entity to be used for future annual report mailings. Enter only one email address please.** Email Address: Foreign Limited Liability Company FusionSite Florida 1.1.0 Cenificatc of Status 0 ✓ •C.enilied Copy j i '}'age Count 04 Estimated Charge S155.011 1 Electronic Filing orf tans Corp rtltc Filing Mcnit Help 111 To: 18506176383 Page: 3 of 5 eef 2021-04-20 15:44:10 CST 1954208 .; • 5 From: Ranae McGrew APPLICATION BY FORF.R1N LIMITED LIARILITY COMPA7CY FOR AUTHORIZATION TO TRANSAC.T 'BUSINESS IN FLORIDA IN(..(21117141�Y-W ItrIN .91.7110N 4151.902. 111.0114 573.111;11:N7111.:1•011.01i77r i S .VS81077:2)70 1.N1171711.1.4811.111" CO\ IPANY77.)TiNIZACINNYK\N .S7.477-:01.7•701211.1.1: FusionSite Florida LLC n °reign OnirrArrrt 'Mist Mat! .flfl)t j, OtTleptlIty, (0.r4111v ssatioLlr1;, cot; Alk.;;;..ls smolt ...4.1.1pb...1 lid the ;sr utst cot Itus,..sAutts !,s..;s1s. I-1;nsig SG shamus same ftu IM1 Litnnut 1.4nInyt!osi('on,." 4. Delaware flunsIsstes; tridcs the IA, of s•Isth Crtriss; losto.:0 IJItVC.:wsrany sr;t2nried) April 23, 2021 3. 86-3344531 ;FIJ rtuinFcr.,r app1osahle.1 5611 Ohio Avenue 5. ti AJJ;rec nt Principal ntlics1 Nashville, TN 37209 tIk60.11 tlf am,Actal twe-" en FIANIso. roe:It tet eat sentszatene ) st:tecos 603 C9S4 FOS S. F s &ace' pertsliN lis1ait5; 6. 7, Name and street address of Florida registered arra: (P.O. Box NOT acctplablc I Nlme: Office Address: CT Corporation System 1200 S Pine Island Rd. #250 Plantation 33324 Florida ihr Registered ugent's Having been named us registered agent and to rierept service of process for the above stated limited liability compa,i. at the plate designated in this application, 1 hereby accept the appointment as regivered agent and agree to act ht this capacity. !further agree frfirnp/y witi the provisions of sustain relativc to the proper and complete perforntanee of my duties, and 1 am familiar vrith crnd accept the obligations 41fm' position as registered agent. o 18506176353 Pane: 4 ot 5 fic uk" 2021-04-20 15:44:10 CST 19542050845 From: Rema McGrew 8. For initial indexing purposes, list names, title or capacity and addresses of the primary niernbersImanagers or persons authorized to manage (up to six (6) tritel): Title or Capacity: Name and Address: Title or Capacfry: 0:Manager Manager Name: t re. 0 Member Address: NashviN, TN 37209 0 M ember @Authorized Person 00ther Newt Pate Address: °Authorized Person OOthcr 001w DManager Name: °Manager Otvlembcr Address: 0Member °Authorized 0 Au thori zed Person Person DOther °Other 00thcr Name and Address: DOther Name: Address: Olvlanagvq- Name: OManager ONIernber Address: OMember D Authorized 0Authorind Person Pe;son DOther 00ther 00ther DOiher Name: Address: 00(1r Important Notice: Use 3n attachment to report more than six (6). The attachment will he imaged for reporting purposes only. Non- indexed individuals may be added to the index when filing your Florida Departrrcid of State Annual Report form. 9. Attached is a certificate of existence, no more than 90 days old. duly authenticated by the official having custody of records in the jurisdiction under the law of which it is organized. (If the cer.ificate is in a foreign language, a translation of the certificate under oath of tlx translator tout be submitted) 10. This document i executed in accordance with section 003.0203 (1) (b), Florida Statutes, I am aware thar any false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.S17. 155. F.S. Sit.ner of an miohorirpei parson Newt Pate Typed of rinsed mem ortiocc - t\iaty-,1_,,e. DiViSiON OF CORPORATIONS Previous on List Next on List , Retum to List No Filing History Fictitious Name Search Submit Fictitious Name Detail Fictitious Name FREEDOM WASTE SERVICES Filing Information Registration Number G21000058245 Status ACTIVE Filed Date 04128/2021 Expiration Date 12/31/2026 Current Owners 1 County MULTIPLE Total Pages 1 Events Filed NONE FEWEIN Number NONE Maiflng Address 5611 OHIO AVE UNITB NASHVILLE, TN 37209 Owner Information FUSIONSITE FLORIDA LLC 5611 OHIO AVE, UNIT B NASHVILLE, TN 37209 FEI/EIN Number: 36-3344531 Document Number: M21000004790 Document Imaes f • -, 04/2g/2021 — Fictitious Name Filing View •e in PDF format Previous on List Next on List Return to List No Filing History 1>ciltrtmant Strte: Otvrt e 1Fictitious Name Search SuMmit Previous on List Next on List Return to List No Filing History DIVISION OF CORPORATIONS ( P.-17 Uf Fictitious Name Search Submit Fictitious Name Detail Fictitious Name FREEDOM WASTE OF BREVARD Filing Information Registration Number G21000059357 tus ACTIVE 04/29/2021 12/31/2026 1 MULTIPLE 1 NONE NONE Filed Date Expiration Date Current ers County Total Pages Events Filed FEI/EIN Number Mailing Address 5611 OHIO AVE UNIT B NASHVILLE, TN 37209 Owner Information FUSIONSITE FLORIDA LLC 5611 OHIO AVENUE, UNIT B NASVHILLE, TN 37209 FEllEIN Number: 86-3344531 Document Number: M21000004790 Document Images Q4/29/2021 -- Fictitious Name Filing View irn - 'In PDF format Previous on List Next on List Return to List No Filing History f-kvitie f)4n; Fictitious Name Search Submit A U DEE:Pis g WASTE RESMOVA1,. POPTASLE ESTPCOM SOLUrIoNs CONTAC1 GET QUO E Vel 7, Nat 74z...a, GET A PPE7E c:4.10 -re. Who We Are v. 7c, 4:241, q, For over 20 years, Freedom Waste Services has been the proud provider of dumpster rental.and porta john rental services on the Treasure Coast including Indian River, St. Lucie and Martin counties. With our extensive inventory of debris containers, including roll off dumpsters, recycling containers, construction hoppers and job shutes, we ensure your job site stays clean and safe. In addition, we believe everyone should have access to dean facilities which is why we take pride in our porta johns. We go the extra mile to ensure our porta johns are the cleanest anywhere! But, the thing that truly sets us apart is our people. Our team is knowledgeable and dependable, and we believe great customer service goes a long way! *ricbte,fi, r v.., -6.,49 f . r ) s Q r 7. r. A,80;1 FB[. S %s WASTE T EMO &L. POP ABLE 1:4 ES i i•23OM S03.UTIONS CON TACT Dependable &Timely Our team has been thoroughly trained on how to efficiently service a porta john so they can create the same great result time after time. We have developed our cleaning and inspection process to ensure that quality is delivered quickly and consistently! We take pride in the fact that we offer essential service and the quality of our job can directly impact the quality of yours. In addition, Freedom Waste is licensed and insured and DOT compliant keeping our operation, and yours running smoothly. What Makes Us Different Vast Inventory at Competitive Prices We aim to give great service, at a great price. You'll truly; see the value when your porta johns are serviced on time, every time, and your debris is quickly hauled off the site. We understand no two jobs are exactly the same and our inventory of waste containers and porta johns are sure to fit your needs. Whether you are cleaning out your garage, or building a high rise, Freedom Waste has the inventory to complete your project while staying within your budget. GET r UO E 4iCt (Experienced and Courteous With 20 years of experience under our belts, you can rest assured we know how to get the job done! In addition to industry know-how, our team members are the most knowledgeable and friendliest in town. We understand the pressures of projects both large and small, and our team aims to make the waste removal process as easy as possible. If you are unsure of where to start, our experienced staff can assist you in finding the right waste container for your needs. Give us a call today to find out why we receive consistently great reviews from our customers. A8OU DEBTS & WAST E EMQVAL Pt:YR-1%42LE RESIPCKAil SOLLMONS coNTAcr QUC L S SHOW YOU jOW r: , A 1) I F.' C.77, REI !CE IN V/ G F 1\1 E NT, Service Area - We are proud to serve Brevard County, Indian Rtver County and Martin County In the great state of Florida. Not sure if we service your area? Give us a call and speak to one of our friendly customer service representatives. High quality, fast and friendly service, Contact. Freed° Waste Services for ail your waste. ternovat and porta potty n eeds, GET A FREE QUOTE Proud Partner of the FuslonSite Group Cli.i.T;P er to'Avoid Common Dumpster Rental Mistakes U.SCT&T'TODAY 4 540 NE Dbde 34957 Jensen Beach, FL ." Martin 772334.9700 .,„/ Indian Riiver 772.552.8611 ABOUT DEEEPIS S WASTE ;:2EMOVAL. POPT;-BLE. PESi7200?-.5 SOLUTIONS CONTACT O QUOTE E > Your Guide to Roll Off Dumpster Sizes > 5 Advantages of Luxury Restroom Trailer Rental for Your Next Event COPYRIGHT 2019 P. S1ON S{TE I ALL !MGI TS RESERVED I Jensen Beady Web Design 0 Mon - Fri 7:OOam - 4:OOpm in 0 3t E Community List, Paragraph 9c and References 9d City of Port St Lucie Mike Villanti 121 SW Port St Lucie Blvd Port St Lucie, FL 34984 772-344-4234 City of Ft Pierce Rick Stauffer 100 N US 1 Ft Pierce, FL 34950 772-359-0511 City of Melbourne Nick Coster 900 E Strawbridge Ave Melbourne, FL 32901 321-536-3690 City of Stuart Milton Leggett 121 SW Flagler Avenue Stuart, FL 34994 772-260-1271 Town of Sewall's Point Tina Ciechanowski 1 S Sewalis Point Rd Sewall's Point, FL 34996 772-781-3378 Paragraph 10 Prior Enforcement Issues A None B None C None D None City of Cape Canaveral Franchise Application Response: Potential Customers, Paragraph 11; Potential Customers lOyd dumpster would be provided to contractors for construction & demolition debris The estimated annual gross revenues that we anticipate is unknown at this time Vehicles and Equipment, Paragraph 12: Other Collection Equipment 2019 Hino 338 5PVNV8JJ9L5S50597 2021 Hino 338 5PVNV8AV7M5T50038 l0yd Dumpster FREEDOM 334-9700 FAi'iivDON I ti� k -fit 14) / f ••• (. r*4 IY CERTIFICATE OF L ABILITY -INSURANCE DATE5/202YYY) ��2s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSU ` ' CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In iieu of such endorsement(s). sRODUCER (OR) Heffernan Insurance Brokers 5100 S Macadam, Suite 440 Portland OR 97239 INSURED FusionSite Florida LLC _ License#:0564249 CONTACT NAME: iA/C No, Fx0' 503-226-1320 -MAIL ADOR€SS' INSURER(S) AFFORDING CDVERAGE INSURER A: Depositors Insurance Company A/c, Nor 503-226-1478 __ NAIC* dba: Freedom Waste Services, dba: Freedom Portables, dba: Freedom Waste of Brevard 940 NE Dixie Highway Jensen Beach FL 34957 FUSISER-01 INSURERS : ALLIED Property and Casualty Insurance Company INSURER c : AMCO Insurance Company 42587 42579 19100 INSURER D : Berkshire Hathaway Homestate Insurance Company 20044 INSURER E INSURER F : v"•=^'+=s GEIIFIC U :1471657389 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL T1iE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLISUBR .... LTR TYPE OF INSURANCE INSD I Yr" POLICY NUMBER (WPOLICY EFF.POLICY EXP M1OD(YYYY1 ((M1DO/YYYY) {{ A X COMMERCIAL GENERAL LIABILITY Y ACP3039167903 5/1/2022 5/1/2023 EACH OCCURRENCE 15 1,000,000 CLAIMS -MADE 7 OCCUR WATTS B GEN'L AGGREGATE LIMIT APPLIES PER X POLICY ! JECT LOC OTHER: DAMAGE TO RENTED PREMISES (Ea occurrence) 61,000,000 MED EXP (Any one person) $10,000 PERSONAL 8. ADV INJURY $1,000,000 GENERAL AGGREGATE 5 2,000,000 PRODUCTS - COMP/OP AGO $ 2,000,000 AUTOMOBILE LtA131UTY X ANY AUTO OWNED AUTOS ONLY X HIRED AUTOS ONLY X PIP X SCHEDULED NUTOS O OWNED AUTOS ONLY ACP3C39167903 5/1/2022 5/1/2023 COMBINED SINGLE LIMIT (E./accident) $ $ 1,000,000 BODILY INJURY (Per person) C X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE DED x D RETENTION $ n ACP3039167903 1 5/1/2022 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECU TI VE OFFICER/MEMBEREXCUJOEO? (Mandatory In NH) If yes, descxibe under DESCRIPTION OF OPERATIONS below YIN NIA 5/1/2023 BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) PIP $ $ 10,000 EACH OCCURRENCE 1 $ 5,000,000 AGGREGATE 5 5,000,000 FUWC318455 5/1/2022 A GL Pollution Liability CG7079 o I Auto Potlutton Uabtlty CAS948 ACP3039167903 ACP3039167903 5/1/2023PER X_sTATS E.L. EACH ACCIDENT ETRH- $1,000,000 E.L. DISEASE - EA EMPLOYEE 5 1,000,000 EL DISEASE- POLICY LIMIT 61,000,000 5/1/2022 511/2022 5/1/2023 5/1/2023 Limit UTTO 31,000,000 Included h CSL DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Ls required) Re: As Per Contract or Agreement on File with Insured. City of Cape Canaveral is included as an additional insured on General Liability policy per the attached endorsement, if required. CERTIFICATE HOLDER City of Cape Canaveral 100 Polk Ave. Cape Canaveral, FL 32920 ACORD 25 (2016/03) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. ' AUTHORREDREPRESEHTATIVE t71988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i L —J3llb/:JV3 COMMERCIAL GENERAL LIABILITY CG73231216 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCEMENT PLUS ENDORSEMENT INCLUDING MEDICAL PAYMENTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Lost Key Coverage D. 1. Under Section I — Coverages, Coverage A Bodily injury And Property Damage Liability, coverage is extended to include the following: If a customer's master or grand key, excluding electronic key card, is lost, damaged or stolen while in your care, custody or control we will pay the cost of replacing the keys, including the master lock and all keys used in the same lock, the cost of adjusting locks to accept the new keys, or the cost to replace the locks, whichever is less. 2. Limit of Insurance — For the purpose of this coverage the most we will pay is $ 10,000 per "occurrence". B. Voluntary Property Damage 1. Section 1 — Coverages, Coverage A Bodily Injury And Property Damage Liability, coverage is extended to include the following: At your request, we will pay for "property damage" to property of others caused by you and while in your possession, arising out of your business operations and occurring during the policy period. 2. Limit of Insurance — For the purpose of this coverage the most we will pay is $1,500 per "occurrence". C. Non -Owned Watercraft Under Section 1 — Coverages, Coverage A Bodily Injury And Property Damage Liability, 2. Exclusions, Exclusion g. Aircraft, Auto Or Watercraft Paragraph (2) (a) is replaced with: (a) Less than 51 feet long; and CG 73 23 12 16 Expanded Property Damage Coverage 1. For the purposes of this endorsement only: Section I — Coverages, Coverage A Bodily Injury And Property Damage Liability, 2. Exclusions, Exclusion j. Damage To Property is amended as follows: a. Paragraphs (3), (5), and (6) are deleted in their entirety. b. Paragraph (4) is deleted in its entirety and replaced with: (4) Personal property in the care, custody, or control of the insured: (a) for storage or sale at premises you own, rent or occupy, or (b) while being transported by any aircraft, "auto" or watercraft owned or operated by or rented to or loaned to any insured. c. The coverage provided by this endorsement does not apply to "property damage": (1) Arising out of the disappearance or loss of use of personal property; or (2) Included in the "products -completed operations hazard". 2. Limit of Insurance - The most we will pay for Toss arising out of any one "occurrence" is $5,000. 3. Deductible - Our obligation to pay for a covered loss applies only to the amount of Toss in excess of $250. We will pay the deductible amount to effect settlement of any claim or "suit" and, upon notification of this action having been taken, you shall promptly reimburse us for the deductible as has been paid by us. Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 5 with its permission. CG73231216 This insurance is primary to any expanded property damage coverage provided by a separate endorsement attached to this policy, and it will supplant any deductible in saki endorsement E. Damage To Premises Rented To You 1. Under Section I — Coverages, Coverage A Bodily Injury And Property Damage Liability, the last paragraph of 2. Exclusions is replaced with: if Damage To Premises Rented To You is not otherwise excluded, Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. 2. Under Section III — Limits Of Insurance, Paragraph 6 is replaced with: 6. Subject to 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke or sprinkler leakage, while rented to you or temporarily occupied by you with permission of the owner. The limit is increased to $1,000,000. 3. Under Section IV — Commercial General Liability Conditions, 4. Other Insurance, b. Excess Insurance (1) (a) (11) is replaced with: (ii) That is Fire, Lightning, Explosion, Smoke or Sprinkler leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner. F. Supplementary Payments Under Section I -- Coverages, Supplementary Payments — Coverages A and B Paragraphs 1.b and 1.d. are replaced with: b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Page 2 of 5 d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. Newly Formed And Acquired Organizations Under SECTION II — WHO IS AN INSURED Paragraph 3.a. is replaced with: • a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; H. Additional Insured — Automatic Status When Required In An Agreement Or Contract With You Section II — Who Is An Insured is amended to include: 1. Any person(s) or organization(s) described in Paragraph a. — d. below with whom you have agreed in writing in a contract or written agreement that such person or organization be added as an additional insured on your policy during the policy period shown In the Declarations. 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. The person or organization added as an insured by this endorsement is an insured only for liability due to: a. Lessors of Leased Equipment — with respect to their liability for "bodily injury', "property damage", or "personal and advertising injury", caused in whole or in part by your maintenance, operation, or use of equipment leased to you by such person(s) or organization(s). This insurance does not apply to any "occurrence" which takes place after the equipment lease expires. However, their status as additional insured under this policy ends when their lease, contract, or agreement with you for such leased equipment expires. b. Managers or Lessors of Premises — with respect to liability arising out of the ownership, maintenance, or use of that •part of the premises you own, rent, lease, or occupy. Includes copyrighted material of Insurance Services Office, Inc., CG 73 23 12 16 with its permission. This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new con- struction, or demolition operations performed by or on behalf of the person or organization. However, their status as .additional insured under this policy ends when you cease to be a tenant of such premises. c. State or Political Subdivision — Permits Relating to Premises — with respect to the following hazards for which the state or political subdivision has issued a permit or authorization in connection with premises you own, rent, or control and to which this insurance applies. (1) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away ;openings, sidewalk vaults, street banners, or decorations and similar exposures; or (2) The construction, erection, or removal of elevators; or The ownership maintenance or use of any elevators covered by this insurance. This insurance does not apply to: (1) "Bodily injury" or "property damage" or "personal or advertising injury" arising out of operations performed for the state or municipality; or (2) "Bodily injury" or "property damage" included within the "products - completed operations hazard". However, such state or political subdivision's status as additional insured under this policy ends when the permit ends. d. Owners, Lessees, or Contractors — with respect to liability for "bodily injury", "property damage", or "personal and advertising injury" caused in whole or in part, by: (3) CG 73 23 12 16 CG 73 23 12 16 (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed for that additional insured, whether the work is performed by you or on your behaff. The insurance does not apply to: (1) "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of or the failure to render any professional architectural, engineering, or survey services, including: (a) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, survey, field orders, change orders, or drawings and specifications; or (b) Supervisory, inspection, archi- tectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or failure to render, any professional, architectural, engineering, or surveying services. (2) "Bodily injury" or "property damage" occurring after: (a) All work, including materials, parts, or equipment furnished in connection with such work, on the project (other than service, maintenance, or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 5 with its permission. CG 73 23 12 16 (b) That portion of "your wore out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same p'eot. However, a person person or organizatior's status as additional insured under this policy ends when your operations for that additional insured are completed. With respect to the insurance afforded to such additional insureds a.~d.described above, the following is added to Section 111 — Limits Of Insurance: If coverage provided to the additional insured Is required by a contract or agreement, the moat we wiIl pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the api of tnsurance shown in the Declarations: whichever is Iess. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Howevar, the insurance afforded to such additional insureds a. — d. descibed above: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement tnprovide for such additional insured. 3. Primary and Noncontributory — Other Insurance Conditions The following is added to the Other Insurance Condition and supersedes any provisions to the contrary: Primary and Noncontributory nsurance This insurance is primary to and will not seek contribution from any other insurance avaUable to an additiona( insured under your policy provided that a. The additional insured is a Named Insured under such other insurance; and Page 4 of 5 b. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek conbibution from any other insurance available to the additional insured. I. Employee Bodily Injury To Another Empoyee Under Section 11 —Whm is An insured The following is added to Paragraph 2.a.(1): Paragraphs 2.a.(f)(a),(b) -and (c)do. not apply to 'bodily injury" to a co -"employee" in the course of the co -"employee's" employment by you, or to 'bodily injury" to a no-nvo|untmer worker" while performing duties related to the conduct of your business. J. Broad Form Named Insured Under Section II — Who Is An Insured The foflowing is added to Paragraph 2,: e. Any business entity incorporated or organized under the laws of the Unted State of America (including any State thereof), its territories or possessions, or Canada (inoludng any Province thereof) h -t which the Named Insured shown in the Declarations owns, during the policy period, an lnterest of more than fifty percent. If other valid collectible insurance is available to any business entity covered by this solely by reason of ownership by the Named Insured shown in the Declarations in excess of fifty pencent, this insurance is excess over the other inaunmnce, whether primary, excess, contingent, or on any other basis. K. Aggregm±mUnmlt Per Location Under Section Dl— Limits Of Insurance the following is added to Paragraph 2: The General Aggregate Llmit under Section 111 Limits Of lnsurance applies separately to each of your Iocatioris owned by or rented to you or temporarily occupied by you with the permission of the owner. For the purposes of this provision, location means premises involving the sarne or connecting |ots, or premises whose connection is interrupted only by a public otnaot, roadway, waterway or raUroad right-of-way. L Aggregate Limit Per Project Under Section III — Limits Of Insurance The following paragraph is added to Paragraph 2: The General Aggregate Limit under Section 0 Limits Of Insurance applies separatey to each of your construction projects away from premises owned by or rented to you. Includes copyrighted material ofInsurance Services Office, Inn. CG 73 23 12 16 with its permission. M. Medical Payments Under Section III — Limits Of Insurance, Paragraph 7. is replaced with: 7. Subject to 5. above, the higher of: a. $10,000; or b. The amount shown in the Declarations for Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by one person. This coverage does not apply if Coverage C — Medical Payments is excluded either by the provisions of any coverage forms attached to the policy or by endorsement. N. Knowledge Of An Occurrence Under Section IV — Commercial General Liability Conditions, the following is added to 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit: e. Knowledge of an occurrence, offense, claim or suit by an agent or employee of any insured shall not in itself constitute knowledge of the insured unless you, a partner, if you are a partnership; or an executive officer or insurance manager, if you are a corporation receives such notice of an occurrence, offense, claim or suit from the agent or employee. f. The requirements in Paragraph b. will not be considered breached unless there is knowledge of occurrence as outlined in Paragraph e. above. O. Unintentional Failure To Disclose Hazard Under Section IV — Commercial General Liability Conditions, Condition 6. Representations the following paragraph is added: d. Your failure to disclose all hazards or prior "occurrences" or offenses existing as of the CG73231216 CG 73 23 12 16 inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" or offenses is not intentional. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non- renewal. P. Waiver Of Subrogation Under Section IV — Commercial General Liability Conditions, 8. Transfer Of Rights Of Recovery Against Others To Us thefollowing paragraph is added: If required by a written contract executed prior to Toss, we waive any right of subrogation we may have against the contracting person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". Q. Liberalization Under Section IV — Commercial • General Liability Conditions, the following paragraph is added: 10. Liberalization If we revise this coverage form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. R. Broadened Bodily Injury Definition (Mental Anguish) Under Section V — Definitions Definition 3. "Bodily Injury" is replaced with: 3. "Bodily injury" means physical injury, sickness, or disease to a person and if arising out of the foregoing, mental anguish, mental injury, shock, or humiliation, including death at any time resulting therefrom. All terms and conditions of this policy apply unless modified by this endorsement. Includes copyrighted materiai of Insurance Services Office, inc., Page 5 of 5 with its permission. ACRD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDITYYY) 2/14/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER (OR) Heffernan Insurance Brokers 5100 S Macadam, Suite 440 Portland OR 97239 License#: 0564249 CONTACT NAME: PHONE (A/C No Ext503-226-1320 ): E-MAIL ADDRESS: FAX No): 503-226-1478 INSURER(S) AFFORDING COVERAGE NAIC S INSURER A: Depositors Insurance Company 42587 INSURED FusionSite Florida LLC dba: Freedom Waste Services, dba: Freedom Portables, dba: Freedom Waste of Brevard 940 NE Dixie Highway Jensen Beach FL 34957 COVERAGES FUSISER-01 CERTIFICATE NUMBER: 446077095 INSURER B: ALLIED Property and Casualty Insurance Company 42579 INSURER C : AMCO Insurance Company 19100 INSURER D : INSURER E : INSURER F : REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iNSR LTR TYPE OF INSURANCE INSD SUBR POLICY NUMBER EFF (MM/DDY/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y ACP3039167903 5/1/2022 5/1/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GE X 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X X X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY PIP X SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y ACP3039167903 5/1/2022 5/1/2023 (Ea COMaccidBINEDent)SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $ 10,000 C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ACP3039167903 5/1/2022 5/1/2023 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED X RETENTION $ n WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N/A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A B GL Pollution Liability CG7079 Auto Pollution Liability CA9948 ACP3039167903 ACP3039167903 5/1/2022 511/2022 5/1/2023 5/1/2023 Limit Limit $1,000,000 Included in CSL DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES Re: As Per Contract or Agreement on File General Liability policy and additional ins all previously issued certificates. with red.ori.Automcbile '�' (ACORD 101, Additional Remarks Schedule, may be Insured. City of Cape Canaveral is included I lability PQI1GJpeLthe attached i i== .;::_= ; 7 �1 j!• !-,17.7.7.1 ; -'\ attached N more space is required) as an additional insured (includes product/completed operations) on endorsement, if required. This Certificate replaces and supersedes I 11 F:". q° d 102",. , ;; 1 CERTIFICATE HOLDERy��@-------7------7------------- F„G[dELLATION A”.s eWt1R n i..:' gHoULD i ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cape Canaveral 100 Polk Ave. Cape Canaveral, FL 32920 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACP3039167903 COMMERCIAL GENERAL LIABILITY CG72461115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured: Ongoing Operations 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured for ongoing operations ends when your operations for the person or organization described in Paragraph 1. above are completed. With respect to insurance afforded to these additional insureds for ongoing operations, this insurance does not apply to "bodily injury" or "property damage" occurring after: CG 72 46 11 15 a. All work, including material, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed: or b. that operation of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. B. Section 11 — Who Is An Insured is amended to include as an additional insured: Products --Completed Operations Any person or organization with whom you have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed for such person or organization and included in the "products -completed operations hazard". However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. C. With respect to the insurance afforded to these additional insureds, this insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2 with its permission. CG 72 46 11 15 of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. D. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1. or Paragraph B.; or Page 2 of 2 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. E. With respect to the insurance afforded to these additional insureds, the following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All terms and conditions of this policy apply unless modified by this endorsement. Includes copyrighted material of Insurance Services Office, Inc. CG 72 46 11 15 with its permission. ACP3039167903 COMMERCIAL GENERAL LIABILITY CG 73 23 12 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCEMENT PLUS ENDORSEMENT INCLUDING MEDICAL PAYMENTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Lost Key Coverage D. 1. Under Section I — Coverages, Coverage A Bodily Injury And Property Damage Liability, coverage is extended to include the following: If a customer's master or grand key, excluding electronic key card, is lost, damaged or stolen while in your care, custody or control we will pay the cost of replacing the keys, including the master lock and all keys used in the same lock, the cost of adjusting locks to accept the new keys, or the cost to replace the locks, whichever is less. 2. Limit of Insurance — For the purpose of this coverage the most we will pay is $ 10,000 per "occurrence". B. Voluntary Property Damage 1. Section I — Coverages, Coverage A Bodily Injury And Property Damage Liability, coverage is extended to include the following: At your request, we will pay for "property damage" to property of others caused by you and while in your possession, arising out of your business operations and occurring during the policy period. 2. Limit of Insurance — For the purpose of this coverage the most we will pay is $1,500 per "occurrence". C. Non -Owned Watercraft Under Section I — Coverages, Coverage A Bodily Injury And Property Damage Liability, 2. Exclusions, Exclusion g. Aircraft, Auto Or Watercraft Paragraph (2) (a) is replaced with: (a) Less than 51 feet long; and CG 73 23 12 16 Expanded Property Damage Coverage 1. For the purposes of this endorsement only: Section I — Coverages, Coverage A Bodily Injury And Property Damage Liability, 2. Exclusions, Exclusion j. Damage To Property is amended as follows: a. Paragraphs (3), (5), and (6) are deleted in their entirety. b. Paragraph (4) is deleted in its entirety and replaced with: (4) Personal property in the care, custody, or control of the insured: (a) for storage or sale at premises you own, rent or occupy; or (b) while being transported by any aircraft, "auto" or watercraft owned or operated by or rented to or loaned to any insured. c. The coverage provided by this endorsement does not apply to "property damage": (1) Arising out of the disappearance or loss of use of personal property; or (2) Included in the "products -completed operations hazard". 2. Limit of Insurance - The most we will pay for Toss arising out of any one "occurrence" is $5,000. 3. Deductible - Our obligation to pay for a covered loss applies only to the amount of loss in excess of $250. We will pay the deductible amount to effect settlement of any claim or "suit" and, upon notification of this action having been taken, you shall promptly reimburse us for the deductible as has been paid by us. Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 5 with its permission. CG73231216 This insurance is primary to any expanded property damage coverage provided by a separate endorsement attached to this policy, and it will supplant any deductible in said endorsement E. Damage To Premises Rented To You 1. Under Section I — Coverages, Coverage A Bodily Injury And Property Damage Liability, the last paragraph of 2. Exclusions is replaced with: If Damage To Premises Rented To You is not otherwise excluded, Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. 2. Under Section 11I — Limits Of Insurance, Paragraph 6 is replaced with: 6. Subject to 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke or sprinkler leakage, while rented to you or temporarily occupied by you with permission of the owner. The limit is increased to $1,000,000. 3. Under Section IV — Commercial General Liability Conditions, 4. Other Insurance, b. Excess Insurance (1) (a) (ii) is replaced with: (ii) That is Fire, Lightning, Explosion, Smoke or Sprinkler leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner. F. Supplementary Payments Under Section I — Coverages, Supplementary Payments — Coverages A and B Paragraphs 1.b and 1.d. are replaced with: b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Page 2 of 5 d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. Newly Formed And Acquired Organizations Under SECTION II — WHO IS AN INSURED Paragraph 3.a. is replaced with: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; H. Additional Insured — Automatic Status When Required In An Agreement Or Contract With You Section II — Who Is An Insured is amended to include: 1. Any person(s) or organization(s) described in Paragraph a. — d. below with whom you have agreed in writing in a contract or written agreement that such person or organization be added as an additional insured on your policy during the policy period shown in the Declarations. 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. The person or organization added as an insured by this endorsement is an insured only for liability due to: a. Lessors of Leased Equipment — with respect to their liability for "bodily injury", "property damage", or "personal and advertising injury", caused in whole or in part by your maintenance, operation, or use of equipment leased to you by such person(s) or organization(s). This insurance does not apply to any "occurrence" which takes place after the equipment lease expires. However, their status as additional insured under this policy ends when their lease, contract, or agreement with you for such leased equipment expires. b. Managers or Lessors of Premises — with respect to liability arising out of the ownership, maintenance, or use of that part of the premises you own, rent, lease, or occupy. Includes copyrighted material of Insurance Services Office, Inc., CG 73 23 12 16 with its permission. This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new con- struction, or demolition operations performed by or on behalf of the person or organization. However, their status as additional insured under this policy ends when you cease to be a tenant of such premises. c. State or Political Subdivision — Permits Relating to Premises — with respect to the following hazards for which the state or political subdivision has issued a permit or authorization in connection with premises you own, rent, or control and to which this insurance applies. (1) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or (2) The construction, erection, or removal of elevators; or The ownership maintenance or use of any elevators covered by this insurance. This insurance does not apply to: (1) "Bodily injury" or "property damage" or "personal or advertising injury" arising out of operations performed for the state or municipality; or (2) "Bodily injury" or "property damage" included within the "products - completed operations hazard". However, such state or political subdivision's status as additional insured under this policy ends when the permit ends. d. Owners, Lessees, or Contractors — with respect to liability for "bodily injury", "property damage", or "personal and advertising injury" caused in whole or in part, by: (3) CG 73 23 12 16 CG 73 23 1216 (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed for that additional insured, whether the work is performed by you or on your behalf. The insurance does not apply to: (1) "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of or the failure to render any professional architectural, engineering, or survey services, including: (a) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, survey, field orders, change orders, or drawings and specifications; or (b) Supervisory, inspection, archi- tectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or failure to render, any professional, architectural, engineering, or surveying services. (2) "Bodily injury" or "property damage" occurring after: (a) All work, including materials, parts, or equipment furnished in connection with such work, on the project (other than service, maintenance, or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 5 with its permission. CG 73 23 12 16 (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. However, a person or organization's status as additional insured under this policy ends when your operations for that additional insured are completed. With respect to the insurance afforded to such additional insureds a. — d. described above, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations: whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. However, the insurance afforded to such additional insureds a. — d. described above: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 3. Primary and Noncontributory — Other Insurance Conditions The following is added to the Other Insurance Condition and supersedes any provisions to the contrary: Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a. The additional insured is a Named Insured under such other insurance; and Page 4 of 5 b. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. I. Employee Bodily Injury To Another Employee Under Section II — Who Is An Insured The following is added to Paragraph 2.a.(1): Paragraphs 2.a.(1) (a), (b) and (c) do not apply to "bodily injury" to a co -"employee" in the course of the co -"employee's" employment by you, or to "bodily injury" to a co -"volunteer worker" while performing duties related to the conduct of your business. J. Broad Form Named Insured Under Section II — Who Is An Insured The following is added to Paragraph 2.: e. Any business entity incorporated or organized under the laws of the United State of America (including any State thereof), its territories or possessions, or Canada (including any Province thereof) in which the Named Insured shown in the Declarations owns, during the policy period, an interest of more than fifty percent. If other valid collectible insurance is available to any business entity covered by this solely by reason of ownership by the Named Insured shown in the Declarations in excess of fifty percent, this insurance is excess over the other insurance, whether primary, excess, contingent, or on any other basis. K. Aggregate Limit Per Location Under Section 11I — Limits Of Insurance the following is added to Paragraph 2: The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your locations owned by or rented to you or temporarily occupied by you with the permission of the owner. For the purposes of this provision, location means premises involving the same or connecting lots, or premises whose connection is interrupted only by a public street, roadway, waterway or railroad right-of-way. L. Aggregate Limit Per Project Under Section III — Limits Of Insurance The following paragraph is added to Paragraph 2: The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your construction projects away from premises owned by or rented to you. Includes copyrighted material of Insurance Services Office, Inc., CG 73 23 12 16 with its permission. M. Medical Payments Under Section III — Limits Of Insurance, Paragraph 7. is replaced with: 7. Subject to 5. above, the higher of: a. $10,000; or b. The amount shown in the Declarations for Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by one person. This coverage does not apply if Coverage C — Medical Payments is excluded either by the provisions of any coverage forms attached to the policy or by endorsement. N. Knowledge Of An Occurrence Under Section IV — Commercial General Liability Conditions, the following is added to 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit: e. Knowledge of an occurrence, offense, claim or suit by an agent or employee of any insured shall not in itself constitute knowledge of the insured unless you, a partner, if you are a partnership; or an executive officer or insurance manager, if you are a corporation receives such notice of an occurrence, offense, claim or suit from the agent or employee. f. The requirements in Paragraph b. will not be considered breached unless there is knowledge of occurrence as outlined in Paragraph e. above. O. Unintentional Failure To Disclose Hazard Under Section IV — Commercial General Liability Conditions, Condition 6. Representations the following paragraph is added: d. Your failure to disclose all hazards or prior "occurrences" or offenses existing as of the CG 73 23 12 16 CG 73 23 12 16 inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior `occurrences" or offenses is not intentional. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non- renewal. P. Waiver Of Subrogation Under Section IV — Commercial General Liability Conditions, 8. Transfer Of Rights Of Recovery Against Others To Us the following paragraph is added: If required by a written contract executed prior to loss, we waive any right of subrogation we may have against the contracting person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". Q. Liberalization Under Section IV — Commercial General Liability Conditions, the following paragraph is added: 10. Liberalization If we revise this coverage form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. R. Broadened Bodily Injury Definition (Mental Anguish) Under Section V — Definitions Definition 3. "Bodily Injury" is replaced with: 3. "Bodily injury" means physical injury, sickness, or disease to a person and if arising out of the foregoing, mental anguish, mental injury, shock, or humiliation, including death at any time resulting therefrom. All terms and conditions of this policy apply unless modified by this endorsement. Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 5 with its permission. ACP3039167903 COMMERCIAL AUTO AC 70 06 03 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO PROTECTION - PLATINUM This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A. Effect of This Endorsement B. Newly Acquired of Formed Entities C. Employees as insureds — Nonowned Autos D. Additional Insured by Contract, Permit or Agreement E. Supplementary Payments — Bail Bonds F. Supplementary Payments — Loss of Earnings G. Personal Effects and Property of Others Extension H. Prejudgment Interest Coverage L Fellow Employees J. Hired Auto Physical Damage K. Temporary Substitute Autos — Physical Damage Coverage L. Expanded Towing Coverage M. Auto Loan or Lease Coverage N. Original Equipment Manufacturer Parts — Leased Private Passenger Types O. Deductible Amendments P. Expanded Transportation Expense Q. Extra Expense — Stolen Autos R. Physical Damage Limit of Insurance S. New Vehicle Replacement Cost T. Physical Damage Coverage Extensions U. Business Income and Extra Expense Coverage V. Transfer of Rights Of Recovery Against Others To Us W. Section IV — Business Auto Conditions — Notice of and Knowledge of Occurrence X. Hired Car Coverage Territory Y. Emergency Lockout Z. Cancellation Condition AC 70 06 03 16 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 7 with its permission COMMERCIAL AUTO AC 70 06 03 16 A. EFFECT OF THIS ENDORSEMENT Coverage provided under this policy is modified by the provisions of this endorsement. If there is any conflict between the provisions of this endorsement and the provision(s) of any state - specific endorsement also attached to this poli- cy, then the provision(s) of the state -specific endorsement shall apply instead of the provi- sions of this endorsement that are in conflict, but only to the extent of the conflict, and only to the extent necessary to bring such provisions into conformance with the state requirement(s) contained in the provision(s) of the state -specific endorsement. B. NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include any organization you newly acquire or form, other than a partnership, joint venture, or limited liability company, and over which you maintain ownership or majority (more than 50%) interest; if there is no other similar in- surance available to that organization. Coverage under this provision is afforded until the 180th day after you acquire or form the organization or the end of the policy period, whichever is later. C. EMPLOYEES AS INSUREDS — NONOWNED AUTOS The following is added to paragraph A.1. Who Is An Insured of SECTION II — COVERED AUTOS LIABILITY COVERAGE; d. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your per- sonal affairs. D. ADDITIONAL INSURED BY CONTRACT, PERMIT OR AGREEMENT The following is added to A.1. Who Is An In- sured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization that you are re- quired to name as an additional insured in a written contract or agreement that is executed or signed by you prior to a "bodily injury" or "property damage" occurrence is an "insured" for Covered Auto Liability coverage. How- ever, with respect to covered "autos", such person or organization is an insured only to the extent that person or organization qualifies as an "insured" under A.1. Who is an Insured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Page 2 of 7 If specifically required by the written contract or agreement referenced in the paragraph above, any coverage provided by this endorsement to an additional insured shall be primary and any other valid and collectible insurance avail- able to the additional insured shall be non- contributory with this insurance. If the written contract does not require this coverage to be primary and the additional insured's coverage to be non-contributory, then this insurance will be excess over any other valid and collectible insur- ance available to the additional insured. E. SUPPLEMENTARY PAYMENTS — BAIL BONDS Supplementary Payments of SECTION II — COVERED AUTOS LIABILITY COVERAGE is revised as follows: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) re- quired because of an "accident" we cover. We do not have to furnish these bonds. F. SUPPLEMENTARY PAYMENTS — LOSS OF EARNINGS Supplementary Payments of SECTION II — COVERED AUTOS LIABILITY COVERAGE is revised as follows: (4) All reasonable expenses incurred by the "in- sured" at our request, including actual loss of earnings up to $1,000 a day because of time off from work. G. PERSONAL EFFECTS AND PROPERTY OF OTHERS EXTENSION 1. The Care, Custody or Control Exclusion of SECTION II — COVERED AUTOS LIABILITY COVERAGE, does not apply to "property dam- age" to property, other than your property, up to an amount not exceeding $500 in any one "acci- dent". Coverage is excess over any other valid and collectible insurance. 2. The following paragraph is added to A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE: c. We will pay up to $1,000 for your prop- erty that is lost or damaged as a result of a covered "loss", without applying a deductible. Coverage is excess over any other valid and collectible insur- ance. Includes copyrighted material of Insurance Services Office, Inc. AC 70 06 03 16 with its permission H. PREJUDGMENT INTEREST COVERAGE The following paragraph is added to SECTION II — COVERED AUTOS LIABILITY COVERAGE, 2. Coverage Extensions, a. Supplementary Payments: (7) Prejudgment interest awarded against the "insured" on that part of the judgment we pay. If we make an offer to pay the appli- cable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. I. FELLOW EMPLOYEE The Fellow Employee Exclusion of SECTION II - COVERED AUTOS LIABILITY COVERAGE, does not apply if the "bodily Injury" results from the use of a covered "auto" you own or hire. The insurance provided under this provision is excess over any other collectible insurance. J. HIRED AUTO PHYSICAL DAMAGE If covered "auto" designation symbols 1 or 8 ap- ply to Liability Coverage and if at least one "au- to" you own is covered by this policy for Com- prehensive, Specified Causes of Loss, or Colli- sion coverages, then the Physical Damage coverages provided are extended to "autos" you lease, hire, rent or borrow without a driver; and provisions in the Business Auto Coverage Form applicable to Hired Auto Physical Damage apply up to a limit of $125,000. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. Any Compre- hensive deductible does not apply to fire or lightning. K. TEMPORARY SUBSTITUTE AUTOS — PHYSICAL DAMAGE COVERAGE The following is added to paragraph C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos of SECTION I — COVERED AUTOS: If Physical Damage Coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Physi- cal Damage Coverage: Any "auto" you do not own while used with the permission of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or AC 70 06 03 16 L. M. COMMERCIAL AUTO AC 70 06 03 16 e. Destruction The coverage that applies is the same as the coverage provided for the vehicle being replaced. EXPANDED TOWING COVERAGE 1. We will pay up to: a. $150 for a covered "auto" you own of the private passenger type, or b. $750 for a covered "auto" you own that is not of the private passenger type, for towing and labor costs incurred each time the covered "auto" is disabled. Howev- er, the labor must be performed at the place of disablement. 2. This coverage applies only for an "auto" covered on this policy for Comprehensive or Specified Causes of Loss Coverage and Collision Coverages. 3. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". AUTO LOAN OR LEASE COVERAGE 1. In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the loan or lease, including up to a max- imum of $500 for early termination fees or penalties, for your covered "auto" less: a. The amount paid under SECTION III — PHYSICAL DAMAGE COVERAGE of this policy; and b. Any: 1) Overdue lease/loan payments at the time of the "loss"; 2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; 3) Security deposits not refunded by a lessor; 4) Costs of extended warranties, Credit Life insurance, Health, Accident, or Disability insurance purchased with the lease; and 5) Carry-over balances from previous leases. 2. This coverage only applies to a "loss" which is also covered under this policy for Com- prehensive, Specified Causes of Loss, or Collision coverage. Includes copyrighted material of Insurance Services Office, Inc. Page 3 of 7 with its permission COMMERCIAL AUTO AC 70 06 03 16 3. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. N. ORIGINAL EQUIPMENT MANUFACTURER PARTS — LEASED PRIVATE PASSENGER TYPES Under Paragraph C. Limit of Insurance of SECTION III — PHYSICAL DAMAGE COVERAGE, Section 4 is added as follows: 4. We will use new original equipment vehicle manufacturer parts for any private passen- ger type covered "auto" where required by the lease agreement which has a term of at least six months. If a new original equip- ment vehicle manufacturer part is not in pro- duction or distribution we may use a like, kind and quality replacement part. O. DEDUCTIBLE AMENDMENTS The following are added to the Deductible provi- sion of SECTION III — PHYSICAL DAMAGE COVERAGE: If another policy or coverage form that is not an automobile policy or coverage form issued by this company applies to the same "accident", the following applies: 1. If the deductible under this coverage is the smaller (or smallest) deductible, it will be waived: 2. If the deductible under this coverage is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. If a Comprehensive or Specified Causes of Loss Coverage "loss" from one "accident" involves two or more covered "autos", only the highest deductible applicable to those coverages will be applied to the "accident," if the cause of the loss is covered for those vehicles. This provision only applies if you carry Comprehensive or Specified Causes of Loss Coverage for those vehicles, and does not extend coverage to any covered "autos" for which you do not carry such coverage. No deductible applies to glass if the glass is re- paired, in a manner acceptable to us, rather than replaced. P. EXPANDED TRANSPORTATION EXPENSE Paragraph A.4.a. of SECTION III — PHYSICAL DAMAGE COVERAGE is replaced by the following: We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense in - Page 4 of 7 curred by you because of the total theft of a covered "auto" of the private passenger type. We will only pay for those covered "autos" for which you carry Comprehensive or Specified Causes of Loss Coverage. We will pay for tem- porary transportation expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". Q. EXTRA EXPENSE — STOLEN AUTOS The following paragraph is added to Section A.4. of SECTION HI — PHYSICAL DAMAGE COVERAGE: c. We will pay for up to $5,000 for the expense of returning a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Spec- ified Causes of Loss Coverage. R. PHYSICAL DAMAGE LIMIT OF INSURANCE Under SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph C., Limit of Insurance is replaced by the following: C. Limit Of Insurance 1. The most we will pay for "loss" in any one "accident" is the lesser of: a. The actual cash value of the damaged or stolen property as of the time of the "loss", or b. The cost of repairing or replacing the damaged or stolen property. 2. $2000 is the most we will pay for "loss" in any one "accident" to all electronic equip- ment that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is: a. Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the instal- lation of such equipment. b. Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or c. An integral part of such equipment. 3. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". 4. The cost of repairing or replacing may: Includes copyrighted material of Insurance Services Office, Inc AC 70 06 03 16 with its permission. a. Be based on an estimate which includes parts furnished by the original equip- ment manufacturer or other sources in- cluding non -original equipment manu- facturers and b. If a repair or replacement results in bet- ter than like kind or quality, we will not pay for the amount of the net improve- ment. 5. If we offer to pay the actual cash value of the damaged or stolen property, we will value auto advertising wraps, paint customi- zation, and similar business related advertis- ing modifications, in addition to the actual cash value of the property. Auto advertising wraps, paint customization, and similar business related advertising modifications will be valued at the cost to replace them with an adjustment made for depreciation and physical condition. S. NEW VEHICLE REPLACEMENT COST The following is added to the Limit of Insurance provision of SECTION 111 — PHYSICAL DAMAGE COVERAGE: 5. The provisions of paragraphs 1.and 3. do not apply to a covered "auto" of the private passenger type or a vehicle with a gross ve- hicle weight rating of 20,000 pounds or Tess which is a "new vehicle." In the event of a total "loss" to your "new ve- hicle" to which this coverage applies, we will pay at your option: a. The verifiable "new vehicle" purchase price you paid for your damaged vehi- cle, not including any insurance or war- ranties purchased; b. If it is available, the purchase price, as negotiated by us, of a "new vehicle" of the same make, model, and equipment or the most similar model available, not including any furnishings, parts, or equipment not installed by the manufac- turer or manufacturers' dealership; or . c. The market value of your damaged ve- hicle, not including any furnishings, parts, or equipment not installed by the manufacturer or manufacturer's dealer- ship. We will not pay for initiation or set up costs associated with loans or leases As used in this endorsement, a "new vehi- cle" means an "auto" of which you are the original owner that has not been previously COMMERCIAL AUTO AC 70 06 03 16 titled and which you purchased Tess than 365 days before the date of the "loss". T. PHYSICAL DAMAGE COVERAGE EXTENSIONS Under SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Exten- sions, b. Loss of Use Expenses is replaced by the following: b. Loss of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision if the Decla- rations indicate that Comprehen- sive Coverage is provided for any covered "auto"; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Cover- age is provided for any covered "auto"; or Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto." However, the most we will pay for any expenses for loss of use is $50 per day, to a maximum of $1,500. The insurance provided by this provision is excess over any other collectible insurance. U. BUSINESS INCOME AND EXTRA EXPENSE COVERAGE 1. Business Income Coverage We will pay the actual loss of business in- come sustained by you as a result of the necessary suspension of your business dur- ing the period of restoration due to "loss" to a covered "auto" used in your business. The loss must be caused by a cause of loss cov- ered under item Al of Physical Damage Coverage in this Coverage Part. 2. Extra Expense Coverage We will pay the necessary and reasonable extra expenses that you incur during the pe- riod of restoration that you would not have incurred had there been no "loss" to a cov- ered "auto" used in your business. The loss (3) AC 70 06 03 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 5 of 7 COMMERCIAL AUTO AC 70 06 03 16 must be caused by a cause of loss listed under item Al of Physical Damage Cover- age in this Coverage Part. Extra Expenses means those expenses you incur to avoid or minimize the suspension of business and to continue your business operations. 3. Additional Conditions We will not pay for "loss" or expenses caused by suspension, lapse or cancellation of any license, lease or contract. But if the suspension, lapse or cancellation is directly caused by the suspension of your business, we will cover such "loss" that affects your business income. We will riot pay under this coverage if you do not repair or replace the covered "auto". You must resume all or part of your business as quickly as possible. If you have other autos you can use to reduce the amount of loss payable under this cov- erage, you are required to use them. We will pay for expenses you incur to reduce the amount that otherwise would have been payable under this coverage. We will not pay more than the amount by which you ac- tually reduce the business income loss or extra expense incurred. 4. Limit The most we will pay for "loss" arising out of one covered "auto" is $10,000 per loss with an annual aggregate of $20,000. Payment applies in addition to the otherwise applica- ble amount of each coverage you have on a covered "auto". 5. Definitions a. "Business Income" means the: 1.). Net income (Net profit or loss before income taxes) that would have been earned or incurred if no loss would have occurred; and 2.). Continuing normal operating expenses incurred, including payroll. b. "Period of Restoration" means the period of time that: 1.). Begins: (a) 24 hours after the time of loss for Business Income Coverage; or (b) Immediately after the time of loss for Extra Expense Coverage; and 2.) Ends at the earliest of: Page 6 of 7 (a) The time required to resume your normal business opera- tions; or (b) The time that is reasonably necessary to repair or replace the covered auto with a maxi- mum time period of 180 days. Period of Restoration does riot include any increased period required due to the enforcement of any ordinance or law that re- quires any insured or others to test for, monitor, clean up, re- move, contain, treat, detoxify or neutralize or in any way respond to or assess the effects of pollu- tants. The expiration date of this policy will not cut short the peri- od of restoration. V. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: We waive any right of recovery we may have against any person or organization to the extent required of you by a written con- tract executed prior to any "accident" be- cause of payments we make for damages under this coverage form. W. NOTICE OF AND KNOWLEDGE OF OCCURRENCE SECTION IV — BUSINESS AUTO CONDITIONS, Paragraph A is amended as follows: 6. NOTICE OF AND KNOWLEDGE OF OCCURRENCE a. Your obligation in the Duties in the Event of Accident, Claim, Suit or Loss Condi- tion relative to notification require- ments applies only when the "accident" or "loss" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. b. Your obligation in the. Duties in the Event of Accident, Claim, Suit or Loss Condition relative to providing us with documents concerning a claim or "suit" will not be Includes copyrighted material of Insurance Services Office, Inc. AC 70 06 03 16 with its permission considered breached unless the breach occurs after such claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. X. HIRED CAR — COVERAGE TERRITORY Item (5) of the Policy Period, Coverage Territory General Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and Y. EMERGENCY LOCKOUT We will reimburse you up to $100 for reasonable expense incurred for the services of a locksmith to gain entry into your covered "auto" subject to these provisions: 1. Your door key, electronic key or key entry pad has been lost, stolen or locked in your AC 70 06 03 16 COMMERCIAL AUTO AC 70 06 03 16 covered "auto" and you are unable to enter such "auto" , or 2. Your keyless entry device battery dies and you are unable to enter such "auto" as a result, 3. Your key, electronic key or key entry pad has been lost or stolen and you have changed the lock to prevent an unauthorized entry; and 4. Original copies of receipts for services of a locksmith must be provided before reimbursement is payable. Z. CANCELLATION CONDITION Paragraph A.2. of the COMMON POLICY CONDITION — CANCELLATION applies except as follows: If we cancel for any reason other than nonpay- ment of premium, we will mail or deliver to the First Named Insured written notice of cancella- tion at least 60 days before the effective date of cancellation. This provision does not apply in those states that require more than 60 days prior notice of cancellation. Includes copyrighted material of Insurance Services Office, Inc. Page 7 of 7 with its permission Paragraph 14 Bond Requirements When approved, a $50,000 bond will be provided Paragraph #15 Other information (a) I can attest that Freedom Waste has the experience, personnel, equipment and other; resources necessary to provide construction and demolition dumpsters within the City of Cape Canaveral (b) I can attest that Freedom Waste has the capacity and willingness to comply with all applicable local, state, and federal laws (c) I can attest that the award of a Franchise to Freedom Waste will be in the public interest CITY OF CAPE CANAVERAL ZONE FE", CITY OF CAPE CANAVERAL 100 POLK AVE. CAPE CANAVERAL, FL 32920 (321) 868-1220 Received Of: . , VIS WADDELL The sum of: $1,000.00 ES RECEIPT 02/08/2023 10:55 Number: Cashier: r. 85796 P.Roth $1,000.00 $1, .00 Remaining balance: $0.00 TENDERED: CHECK 1310 $1,000.00 FUSIONSITE FLORIDA LLC 940 NE DIXIE HIGHWAY JENSEN BEACH, FL 34957 PAY TO THE ORDER OF 87- 63/640 '44,, DAT DOLLARS MEMO Pinna sta. or -1:06400136371: L 3 LOvi300 LO? L 3 L LEI Lim SSEMEARIERMINEUXIMENIMMAilill V -A\11