Loading...
HomeMy WebLinkAbout23326AGREEMENT INFORMATION AGREEMENT NUMBER 23326 NAME/TYPE OF AGREEMENT MIAMI LIFE CENTER, INC. DESCRIPTION BUSINESS GRANT AGREEMENT / MATTER ID 20-2302 EFFECTIVE DATE November 2, 2020 ATTESTED BY TODD B. HANNON ATTESTED DATE 12/2/2020 DATE RECEIVED FROM ISSUING DEPT. 12/21/2020 NOTE BUSINESS GRANT AGREEMENT BY AND BETWEEN THE OMNI REDEVELOPMENT DISTRICT COMMUNITY REDEVELOPMENT AGENCY AND MIAMI LIFE CENTER INC. h THIS BUSINESS GRANT AGREEMENT is entered into as of the). day of N OV . , 2020 by and between the OMNI REDEVELOPMENT DISTRICT COMMUNITY REDEVELOPMENT AGENCY, a public agency and body corporate created pursuant to Section 163.356, Florida Statutes, with a principal address at 1401 N. Miami Avenue, Miami, Florida 33136 ("CRA"), and Miami Life Center Inc., a for -profit Florida corporation with a principal address at 736-6th St. Miami Beach, FL 33139 ("PROPERTY OWNER" or" GRANTEE") owners of property located within the CRA boundaries at 1940 NW Miami Court, Miami Florida, 33136. RECITALS WHEREAS, GRANTEE submitted a grant application and proposals directly to the CRA requesting One Hundred Thousand Dollars ($100,000.00) to underwrite the cost associated with the renovation of property for commercial business use within the boundaries of the CRA; and WHEREAS, the CRA through CRA-R-18-0023, adopted April 18, 2018 by the Board of Commissioners of the CRA, attached and incorporated as Exhibit "A" ("Authorizing Resolution"), has authorized a Business Grant Program ("Program") for the purposes of business development in the OMNI Redevelopment Area ("Area"); and WHEREAS, pursuant to the Authorizing Resolution, the Program authorizes the Executive Director of the CRA ("Executive Director") to disburse funds from the Program ("Grants"), at his discretion, on a reimbursement basis or directly to vendors upon presentation of invoices and satisfactory documentation to qualifying businesses; and WHEREAS, GRANTEE and the CRA wish to enter into this Agreement to set forth the terms and conditions relating to the use by GRANTEE of a grant in the not to exceed amount of One Hundred Thousand Dollars ($100,000.00) ("Grant") for the Project as defined below; Page 1.of 18 NOW, THEREFORE, in consideration of the promises and the mutual covenants contained herein, the parties agree to as follows: THE GRANT RECITALS. The recitals and all statements contained therein are true and correct and are hereby incorporated into this Agreement. GRANT. Subject to the terms and conditions set forth herein and GRANTEE's compliance with all of its obligations hereunder, the CRA hereby agrees to make available to the GRANTEE the Grant to be used for the purpose and Project (as defined below), and as disbursed in the manner hereinafter provided. USE OF GRANT. The Grant shall be used by GRANTEE as follows: to underwrite some of the costs to rehabilitate a portion of the property for business use within the CRA's boundaries ("Project"), as described in Composite Exhibit "B", attached and incorporated herein by this reference, which includes GRANTEE's CRA Business Incentive and Assistance Application. COMPLIANCE WITH POLICIES AND PROCEDURES. GRANTEE understands that the use of the Grant is subject to specific reporting, record keeping, administrative and contracting guidelines, audit, and other requirements affecting the activities funded by the Grant for the Project. GRANTEE covenants and agrees to comply with such requirements, and represents and warrants to the CRA that the Grant shall be used in accordance with all of the requirements, terms and conditions contained therein, as the same may be amended during the term hereof. Without limiting the foregoing, GRANTEE represents and warrants that it will comply with, and the Grant will be used in accordance with, all applicable federal, state, and local codes, laws, rules and regulations. RECORDS, INSPECTIONS, REPORTS/AUDITS AND EVALUATION. To the extent required by law, the Inspection and Audit provisions set forth in Sections 18-101 and 18-102 of the Code of the City of Miami, as amended ("City Code"), are deemed as being incorporated by reference herein and additionally, apply to this Agreement. GRANTEE understands, acknowledges, and agrees that: (a) the CRA must meet certain record keeping and reporting requirements with regard to the Grant and that in order to enable the CRA to comply with its record keeping and reporting requirements, GRANTEE shall maintain all records as required by the CRA; and (b) at the CRA's request, and no later than thirty (30) calendar days thereafter, GRANTEE shall deliver to the CRA such reports and written statements relating to the use of the Grant as the CRA may require from time to time; and (c) all costs and expenses of the Project shall be at actual cost with no markups; and (d) the CRA shall have the right to conduct audits of GRANTEE's records pertaining to the Grant and to visit and to inspect the Project, in order to conduct its monitoring and evaluation activities, and that GRANTEE shall cooperate with the CRA in the performance of these activities; and (e) GRANTEE's failure to comply with these requirements or the receipt or discovery (by monitoring, evaluation, or audit) by the CRA of any inconsistent, incomplete, or inadequate information shall be grounds for the immediate termination of this Agreement by the CRA. REVERSION OF ASSETS. Upon the expiration, termination, or cancellation of the term of this Agreement, any unspent Grant funds shall immediately revert to the possession and ownership of the CRA and GRANTEE shall transfer to the CRA all unused Grant funds at the time of such expiration, termination, or cancellation. INSURANCE REQUIREMENTS: Insurance Requirements for the Project are attached and incorporated herein as Exhibit "C". DISBURSEMENT OF GRANT. Subject to the terms and conditions contained in this Agreement, .and at the time of execution of this Agreement, the CRA shall make available to GRANTEE, on a reimbursement basis, an amount not to exceed One Hundred Thousand Dollars ($100,000.00) in Grant funds. Payments will be made only after GRANTEE has submitted to the CRA and the CRA has received and approved in writing such Project specific invoices, (a) which shall be accompanied by sufficient supporting documentation and contain sufficient details, to constitute a "Proper Invoice" as defined by Florida Statutes Section 218.73 and 218.74, and (b) which are subject to verification by the CRA of acceptable work product for the Project. In no Page 3 of 18 event shall payments to GRANTEE under this Grant Agreement exceed One Hundred Thousand Dollars ($1 00,000.00), nor shall Grant funds be used in any form inconsistent with the terms, conditions, obligations, and requirements contained herein. . TERM. The term of this Agreement shall commence on the date first above written and shall terminate upon full disbursement of either (a) One Hundred Thousand Dollars ($100,000.00) or (b) such lesser amount should the final completion of the Project not require the entire not to exceed amount of One Hundred Thousand Dollars ($100,000.00) from the Grant; provided, however, that all rights of the CRA to audit or inspect, to require reversion of assets, to enforce representations, warranties and certifications, to default remedies, to limitation of liability and indemnification, and to recovery of fees, expenses, and costs shall survive the expiration or earlier termination of this Agreement. REMEDIES FOR NON-COMPLIANCE. If GRANTEE fails to perform any of its obligations or covenants hereunder, or materially breaches any of the terms, conditions, obligations, or requirements contained herein, then the CRA shall have the right to take one or more of the following actions, irrespective of any remedies available to it in law and/or equity: (a) Withhold cash payments, pending correction of the deficiency by GRANTEE; (b) Recover payments made to GRANTEE; (c) Disallow (that is, deny the use of the Grant for) all or any part of the cost for the activity or action for the Project not in compliance; (d) Withhold further awards for the Project; and (e) Take such other actions and/or remedies that may be legally permitted. NON-DISCRIMINATION. GRANTEE, for itself and on behalf of its contractors and sub- contractors, agrees that it shall not discriminate as to race, sex, color, religion, national origin, age, marital status, sexual orientation, or disability in connection with its performance under this Agreement. Furthermore, GRANTEE represents that no otherwise qualified individual shall, solely, by reason of his/her race, sex, color, religion, national origin, age, marital status, sexual Page 4 of 18 orientation, or disability be excluded from the participation in, be denied benefits of, or be subjected to discrimination under any program or activity receiving financial assistance pursuant to this Agreement. CONFLICT OF INTEREST. GRANTEE has received copies of, or is familiar with, the following provisions regarding conflict of interest in the performance of this Agreement by GRANTEE. GRANTEE covenants, represents and warrants that it will comply with all applicable conflict of interest provisions including, but not limited to, the: (a) Code of the City of Miami, Florida, Chapter 2, Article V; and (b) Miami -Dade County Code, Section 2-11.1. CONTINGENCY CLAUSE. Funding for this Agreement is contingent on the availability of funds and continued authorization for Project activities, and is subject to amendment or termination due to lack of funds or authorization, reduction of funds, and/or change in regulations. CERTIFICATIONS RELATING TO THE GRANT. GRANTEE certifies that: (a) All expenditures of the Grant shall be made only for the Project and in accordance with the provisions of this Agreement. (b) Reasonable accounting records for the Project shall be maintained by GRANTEE. (c) The expenditures of the Grant shall be properly documented and such documentation shall be maintained on file at the Project site. (d) Periodic progress reports shall be provided to the CRA as requested from time to time. (e) No expenditure of Grant funds shall be used for political activities. (f) GRANTEE shall be liable to the CRA for any amount of the Grant expended in a manner inconsistent with this Agreement. MARKETING. (a) GRANTEE shall consult with the CRA's Executive Director regarding all uses and displays of Page 5 of 18 the recognition of the CRA. (b) GRANTEE shall prominently display signage acknowledging the CRA's Grant contribution to the Project at GRANTEE's primary place of business, and for a period of (2) years after expiration of this Agreement. (c) GRANTEE shall produce, publish, advertise, disclose, or exhibit the CRA's name and/or logo, in acknowledgement of the CRA's contribution to the Project, in all forms of media and communications created by GRANTEE in relation to this Agreement and/or the Project, for the purpose of publication, promotion, illustration, advertising, trade or any other lawful purposes, including but not limited to stationary, newspapers, periodicals, billboards, posters, email, direct mail, flyers, telephone, public events, and television, radio, or internet advertisements or postings, or interviews. (d) The CRA shall have the right to approve the form and placement of all acknowledgements, which approval shall not be unreasonably withheld. (e) GRANTEE further agrees that the CRA's name and logo may not be otherwise used, copied, reproduced, altered in any manner, or sold to others for purposes other than those specified in this Agreement. Nothing in this Agreement, or in GRANTEE's use of the CRA's name and logo, confers or may be construed as conferring GRANTEE any right, title, or interest whatsoever in the CRA's name, identifying information, and logo beyond the limited right granted in this Agreement. DEFAULT. If GRANTEE fails to comply with any term or condition of this Agreement, or fails to perform any of its obligations hereunder, then GRANTEE shall be in default. Upon the occurrence of a default hereunder the CRA, in addition to all remedies available to it by law, may immediately, upon written notice to GRANTEE, terminate this Agreement whereupon all payments, advances, or other compensation paid by the CRA to GRANTEE while GRANTEE was in default shall be immediately returned to the CRA. GRANTEE understands and agrees that termination of this Agreement under this section shall not release GRANTEE from any obligations accruing prior to the effective date of termination. NO LIABILITY OF THE CRA OR THE CITY. None of the respective officers, employees, agents, representatives, or principals, whether disclosed or undisclosed, of the CRA Page 6 of 18 and of the City of Miami ("City") shall have any personal liability with respect to any of the provisions of this Agreement. Any liability of the CRA and of the City under this Agreement shall be subject to the limitations imposed by Section 768.28, Florida Statutes. SPECIFIC PERFORMANCE. In the event of breach of the Grant Agreement by the CRA, the GRANTEE may only seek specific performance of the Grant Agreement and any recovery shall be limited to the actual amount of the Project costs not to exceed the amount of Grant funding authorized for the Project. In no event shall the CRA be liable to GRANTEE for any additional compensation, other than that provided herein, or for any consequential or incidental damages. INDEMNIFICATION OF THE CRA AND THE CITY. GRANTEE hereby agrees to indemnify, protect, defend, save, release, and hold harmless the CRA, the City, and their respective officers, employees, agents, representatives, and principals from and against any and all claims, actions, damages, liability and expense (including fees, costs, and expenses of attorneys, investigators and experts) in connection with Toss of life, personal injury, or damage to property arising out of the performance or non-performance of this Agreement and the Project, except to the extent such loss, injury or damage was caused by the gross negligence of the CRA, the City, or their respective officers, employees, agents, representatives, and principals. DISPUTES. In the event of a dispute between the Executive Director of the CRA and GRANTEE as to the terms and conditions of this Agreement, the Executive Director of the CRA and GRANTEE shall notify each in writing of the dispute and proceed in good faith to resolve the dispute within thirty (30) calendar days of such written notice. If the dispute is not resolved within such thirty (30) calendar days, the dispute shall be submitted to the CRA's Board of Commissioners ("Board") for resolution within ninety (90) calendar days thereof, or such longer period as may be agreed to by the parties to this Agreement. The Board's decision shall be deemed final and binding on the parties. CAPTIONS. The captions in this Agreement are for convenience only and are not a part of this Agreement and do not in any way define, limit, describe, or amplify the terms and provisions of this Agreement or the scope or intent thereof. Page 7 of 18 ENTIRE AGREEMENT. This instrument constitutes the sole and only agreement of the parties hereto relating to the Grant, and correctly set forth the rights, duties, and obligations of the parties. There are no collateral or oral agreements or understandings between the CRA and GRANTEE relating to this Agreement or the Grant and/or Project. Any promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. This Agreement shall not be modified in any manner except by an instrument in writing executed by the authorized representatives of the parties. The CRA's authorized representative is the Executive Director. GRANTEE's authorized representative is Kino Macgregor in accordance with GRANTEE's corporate authorization, attached and incorporated as Composite Exhibit "D", which includes GRANTEE's Corporate Status Update. CONSTRUCTION. Should the provisions of this Agreement require judicial or arbitral interpretation, it is agreed that the judicial or arbitraI body interpreting or construing the same shall not apply the assumption that the terms hereof shall be more strictly construed against one party by reason of the rule of construction that an instrument is to be construed more strictly against the party which itself or through its agents prepared same, it being agreed that the agents of both parties have equally participated in the preparation of this Agreement. COVENANTS. Each covenant, agreement, obligation, term, condition or other provision herein contained shall be deemed and construed as a separate and independent covenant of the party bound by, undertaking or making the same, not dependent on any other provision of this Agreement unless otherwise expressly provided. All of the terms and conditions set forth in this Agreement shall apply throughout the term of this Agreement unless otherwise expressly set forth herein. CONFLICTING TERMS. In the event of conflict between the terms of this Agreement and any terms or conditions contained in any attached documents, the terms of this Agreement shall govern. WAIVER. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing by the non -breaching party. Page 8 of 18 SEVERABILITY. Should any provision contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal, or otherwise unenforceable under the laws of the State of Florida, then such provision shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable to conform with such laws, that same shall be deemed severable, and in either event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect. NO THIRD -PARTY BENEFICIARY RIGHTS. No provision of this Agreement shall, in any way, inure to the benefit of any third parties so as to constitute any such third party a beneficiary of this Agreement, or of anyone or more of the terms hereof, or otherwise give rise to any cause of action in any party not a party hereto. AMENDMENTS. No amendment to this Agreement shall be binding on either party, unless in writing and signed by the authorized representatives of both parties. OWNERSHIP OF DOCUMENTS. Upon request by the CRA, all documents developed by GRANTEE shall be delivered to the CRA upon completion of this Agreement, and may be used by the CRA, without restriction or limitation. GRANTEE agrees that all documents maintained and generated pursuant to this Agreement shall be subject to all provisions of the Public Records Law, Chapter 119, Florida Statutes. It is further understood by and between the parties that any document which is given by the CRA to GRANTEE pursuant to this Agreement shall at all times remain the property of the CRA, and shall not be used by GRANTEE for any other purposes whatsoever, without the written consent of the CRA. AWARD OF AGREEMENT. GRANTEE warrants that it has not employed or retained any person employed by the CRA to solicit or secure this Agreement, and that it has not offered to pay, paid, or agreed to pay any person employed by the CRA any fee, commission percentage, brokerage fee, or gift of any kind contingent upon or resulting from the award of the Grant. NON-DELEGABILITY. The obligations of GRANTEE under this Agreement shall not be delegated or assigned to any other party without the CRA's prior written consent which may be withheld by the CRA, in its sole discretion. Page 9 of 18 CONSTRUCTION OF AGREEMENT, GOVERNING LAW, AND VENUE. This Agreement shall be construed and enforced in accordance with Florida law without regard to its conflicts of law provisions. In the event of litigation, controversies, or legal problems arising out of or as a result of this Agreement and/or the Project, shall be submitted to the jurisdiction of the State of Florida courts in the Eleventh Judicial Circuit in and for Miami -Dade County, Florida. The venue shall be Miami -Dade County, Florida. Each party shall be responsible for its own attorney's fees, costs, and expenses. Moreover, GRANTEE acknowledges that it shall adhere to any and all state, local, and federal laws, rules and regulations in undertaking the Project and in complying with this Agreement, to include the Code of the City of Miami, Florida, as amended. WAIVER OF JURY TRIAL. GRANTEE and the CRA hereby knowingly, irrevocably, voluntarily, and intentionally waive any right either may have to a trial by jury in respect to any action, proceeding, claim, or counterclaim based on this Agreement and/or the Project, or arising out of, under, or in connection with this Agreement, the Project, any renewal(s) hereof, any amendment, extension, or modification of this Agreement, or any other agreement executed between the parties in connection with this Agreement, the Project, or any other course of conduct, course of dealing, statements (whether verbal or written), or any other actions of any party hereto. This waiver is a material inducement for the CRA and the GRANTEE to enter into this Agreement. TERMINATION OF CONTRACT FOR CONVENIENCE. The CRA retains the right to terminate this Agreement at any time for convenience, without penalty to the CRA. In that event, the CRA shall give five (5) days written notice of termination to GRANTEE. NOTICE. All notices or other communications which shall or may be given pursuant to this Agreement shall be in writing and shall be delivered by personal service, or by registered mail, addressed to the party at the address indicated herein or as the same may be changed from time to time. Such notice shall be deemed given on the day on which personally served, or, if by mail, on the fifth (5th) day after being posted, or the date of actual receipt, whichever is earlier. To CRA: Omni Redevelopment District Community Redevelopment Agency 1401 North Miami Avenue Miami, FL 33136 Page 10 of 18 Attn: Executive Director With a copy to: Office of the City Attorney 444 S.W. 2nd Avenue, 9th Floor Miami, FL 33130 Attn: Victoria Mendez, General Counsel To GRANTEE: Attn: Kino Macgregor Miami Life Center Inc. 736-66 St. Miami Beach FL 33139 INDEPENDENT CONTRACTOR. GRANTEE, its contractors, subcontractors, employees, and agents shall be deemed to be independent contractors, and not agents or employees of the CRA, and shall not attain any rights or benefits under the civil service or pension programs of the CRA, or any rights generally afforded its employees; further, they shall not be deemed entitled to Florida Workers' Compensation benefits as employees of the CRA. SUCCESSORS AND ASSIGNS. This Agreement shall be binding upon the parties hereto, and their respective heirs, executors, legal representatives, successors, and assigns. AUTHORITY. Both the CRA and GRANTEE certify that each possesses the legal authority to enter into this Agreement. A resolution, motion or similar action has been duly adopted as an official act of each party as a governing body, authorizing the execution of this Agreement, and identifying the official representative of each to act in connection herewith and to provide such additional information as may be required by the terms of this Agreement. Page 11 of 18 PUBLIC RECORDS. GRANTEE understands that the public shall have access, at all reasonable times, to all documents and information pertaining to the CRA, subject to the provisions of Chapter 119, Florida Statutes, and any specific exemptions there from, and GRANTEE agrees to allow access by the CRA and the public to all documents subject to disclosure under applicable law unless there is a specific exemption from such access. GRANTEE's failure or refusal to comply with the provisions of this section shall result in immediate termination of the Agreement by the CRA. Pursuant to the provisions of Section 119.0701, Florida Statutes, GRANTEE must comply with the Florida Public Records Laws, specifically the GRANTEE must: A. Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the service. B. Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. C. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. D. Meet all requirements for retaining public records and transfer, at no cost, to the public agency all public records in possession of the GRANTEE upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. E. All records stored electronically must be provided to the CRA in a format compatible with the information technology systems of the public agency. Page 12 of 18 GRANTEE agrees that any of the obligations in this section will survive the term, termination and cancellation hereof. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT 305-679-6870, IJONES@MIAMIGOV.COM, AND 1401 NORTH MIAMI AVENUE, MIAMI, FLORIDA 33136. SURVIVAL. All obligations (including but not limited to indemnity and obligations to defend, release, and hold harmless) and rights of any party arising during or attributable to the period prior to expiration or earlier termination of this Agreement shall survive such expiration or earlier termination. COUNTERPARTS; ELECTRONIC SIGNATURES. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same instrument. Facsimile, .pdf and other electronic signatures to this Agreement shall have the same effect as original signatures. [SIGNATURES APPEAR ON THE FOLLOWING PAGE] {Remainder of Page Intentionally Left Blank} Page 13 of 18 IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by their respective officials thereunto duly authorized as of the day and year above written. ATTEST: By: Name: T M F i l ^gar ATTEST: By: Todd B. Hann Date: ► a I a of the Board APPROVED AS TO INSURANCE REQUIREMENTS: By: Ann -Marie Sharpe, Director, Risk Management Department Miami Life Center Inc. OMNI REDEVELOPMENT DISTRICT COMMUNITY REDEVELOPMENT AGENCY of the City of Miami, a public agency and body corporate created pursuant to Section 163.356, Florida Statutes ("CRA") By: Jason W - er, Executive Director APPROVED AS TO FORM AND CORRECTNESS: By: gG-.sta-el L 7'iiiL 9/6/9 Victoria Mendez, General Counsel Page 14 of 18 EXHIBIT A OMNI CRA-R 18-0023, adopted April 18, 2018 Page 15 of 18 Miami FL OMNI CRA Resolution CRA-R-18-0023 Aar 8D �PD 8 S: oo PM A RESOLUTION OF THE BOARD OF COMMISSIONERS OF THE OMNI REDEVELOPMENT DISTRICT COMMUNITY REDEVELOPMENT AGENCY ("CRA") CREATING A BUSINESS GRANT PROGRAM ("PROGRAM") FOR THE PURPOSES OF BUSINESS DEVELOPMENT IN THE OMNI REDEVELOPMENT AREA; ALLOCATING $500,000.00 FROM ACCOUNT NO. 10040.920501.883000 FOR THE PROGRAM; AUTHORIZING THE EXECUTIVE DIRECTOR TO DISBURSE FUNDS, AT HIS DISCRETION, ON A REIMBURSEMENT BASIS OR DIRECTLY TO VENDORS UPON PRESENTATION OF INVOICES AND SATISFACTORY DOCUMENTATION TO QUALIFYING BUSINESSES; EXEMPTING THE EXECUTIVE DIRECTOR FROM THE REQUIREMENT TO COMPLY WITH RESOLUTION NO. CRA-R-16-0042 AS ADOPTED BY THE BOARD OF COMMISSIONERS OF THE CRA ON SEPTEMBER 13, 2016 IN ORDER TO DISBURSE FUNDS AS STATED HEREIN. Information Department: Category: Attachments OMNI Community Redevelopment Agency Grant Agenda Summary and Legislation 3987-Submittal-OMN1 CRA-Program Guidelines Sponsors: Body/Legislation WHEREAS, the Omni Redevelopment District Community Redevelopment Agency ("CRA") is responsible for carrying out community redevelopment activities and projects within the Omni Redevelopment Area ("Area") in accordance with the 2009 Omni CRA Redevelopment Plan ("Plan"); and WHEREAS, Section 4.4, C., D-1, at page 41 of the Plan; Section 4.4, D., A02, at page 42 of the Plan; and Section 4.4, E., D-7, at page 42 of the Plan all list maximizing conditions for residents to live in the area, the elimination of conditions which contribute to blight, and minimizing condemnation and relocation as stated redevelopment objectives; and WHEREAS, the Board of Commissioners of the CRA has previously allocated funds to programs that rehabilitate facades and improve the quality of life within the Area; and WHEREAS, these programs have been successful and have accomplished the goals and objectives of the Plan; and WHEREAS, the Board of Commissioners wishes to create a Business Grant Program for the purposes of business development in the Area ("Program"); and WHEREAS, the Board of Commissioners wishes to allocate $500,000.00 to the Program; and and WHEREAS, funds are available from Account No. 10040.920501.883000 for the Program; WHEREAS, the Executive Director is requesting authority to disburse funds from the Program to eligible participants on a reimbursement basis or directly to vendors upon presentation of invoices andsatisfactory documentation without the need for further approval from the Board of Commissioners; NOW, THEREFORE, BE. IT RESOLVED BY THE BOARD OF COMMISSIONERS OF THE OMNI REDEVELOPMENT DISTRICT COMMUNITY REDEVELOPMENT AGENCY OF THE CITY OF MIAMI, FLORIDA: Section 1. The recitals and findings contained in the. Preamble of this Resolution are adopted by reference hereto and incorporated herein as if fully set forth in this Section. Section 2. The Program is hereby establishedwith funds in the amount of $500,000.00 allocated from Account No. 10040.920501.883000. Section 3. The Executive Director is authorized to disburse funds, at his discretion, on a reimbursement basis or directly to vendors upon presentation of invoices and satisfactory documentation to qualifying businesses. Section 4. The Executive Director is exempted from complying with the requirements of Resolution No. CRA-R-16-0042 as adopted by the Board of Commissioners of the CRA on September 13, 2016 in order to disburse funds as stated herein. Section 5. The Executive Director is authorized to execute any and all documents necessary to effectuate the Program, in a form acceptable to the General Counsel Section 6. This Resolution shall become effective immediately. Meeting History OMNI Apr 18, 2018 5:00 PM Community . Redevelopment Regular Meeting Agency Note for the Record: Direction by Commissioner Gort to .the Executive Director to provide a report of the funds previously awarded to businesses within the OMNI Community Redevelopment Area. . Vice Chair Russell: Item Number 4, please. Jason Walker (Executive Director, Omni Community Redevelopment Agency): A resolution of the Board of Commissioners of the Omni Redevelopment District Community. Redevelopment Agency, creating a Business Grant Program for the purposes of business development In the Omni Redevelopment Area; •allocating 500,000 from the account number that's listed for the program; authorizing the Executive Director to disburse funds, at his discretion, on a reimbursement basis or directly to vendors upon presentation of invoices and satisfactory documentation to qualifying businesses; exempting the Executive Director from the requirement to comply with Resolution Number CRA-R 16-0042, as adopted by the Board of C ommissioners of the CRA (Community Redevelopment Agency) on September 13, 2016, in order to disburse funds, as stated. herein. Chair Russell: Is there a motion on Item Number 4? Vice Chair Hardemon: I' have a question for you. Mr. Walker: Yes, sir. Vice Chair Hardemon: The exemption -- Mr. Walker: Yes, sir. Vice Chair Hardemon: -- that's stated in 4, can youexplain it? Mr. Walker: Last year the board adopteda program through La Hito (phonetic) Management Services to provide services for -- they were basically our contractor to expedite the process of dealing with the contractors and the businesses, and they received a 15 percent fee for every contract. And the way the resolution was written, any business had to go through that management company So this resolution is authorizing more funds to that program, but also allows us the flexibility to bring that in-house so that we wouldn't have to pay that 15 percent management fee if we didn't need to. Vice Chair Hardemon: That's great. So moved. Chair Russell: Its been moved. Board Member Gort: The -- Mr. Walker: Yes, sir. And, Commissioner -- Yes. Board Member Gort: You have the cri -- you're going to give me a copy of the crlterias [sic]? Mr. Walker: Yes.. Well, actually -= And we apologize that the program was not in the attachments. The program is basically $100,000. grant.-- up to $100,000 grant. There's a 25 percent requirement for the business owner to contribute. In the past, all of the grants that we'd given out last year, the percentage that the business owners contributed was in excess of 25 percent; 99 percent of them were at least $200,000 ofInvestnient by the property owner or the business, and it's there. Board Member Gort: It's a lot better. You have a higher percenta9e of the owners contributing. Now, my understanding, you've done quite a few of them. Mr. Walker: Yes, sir. Board Member Gort: We want to get the report on all those that have been done. Mr. Walker: Yes. And as I told you.in our briefing this morning, the Chairman has been on us to toot our_ horn a little more, so we are developing a plan to show the public the businesses that:we've, funded. We've probably funded eight businesses, new businesses, in the Omni CRA with this grant: restaurants -- three restaurants, a children's, -- indoor children's facility, playground in Wynw,00d, a childcare center; this building here, the paint on this building at Chapman. So we've done a lot. And we're working on a program to better do == do a better job of tooting our horn with this program and others. Board Member Gort; Great. We need to keep the people inforrned to know what's being accomplished with the- work that you guys do. Mr. Walker: Yes, sir, Chair Russell: If a tree falls in the woods, Mr. Executive Director. Mr. Walker: Yes, sir. Vice Chair Hardemon: As an example. Chair Russell: It's been moved; seconded by the Chair. Any further discussion on this item regarding the grants? All in favor, say „aye;, The Board (Collectively): Aye: Chair Russell: Any opposed? Motion passes. Thank you. RESULT:- ADOPTED [UNANIMOUS] MOVER: • Keon Hardemon, Vice Chair SECONDER: Ken Russell, Chair AYES: Ken Russell, Keon Hardemon, Wifredo (Willy) Gort ABSENT: ]oe Carollo; Manolb Reyes Select Language v Powered byGoogie Translate COMPOSITE EXHIBIT B- PROJECT DESCRIPTION Page 16 of 18 CRA Business Incentive & Assistance Application Applicant Contact lnformallon Business Name Contact Name Mailing Address Telephone Fax '(no iatAlreicr- lit n, 53(3b Email Property Ownership and Corporation Information Corporation Name Mailing Address Corporation Officers & Titles Date & State of Incorporation Tax ID# I It., i OV4 C.exfr.r k,, bli 01.. Aiarn.1 53136 2.0as" aD L#0al Pet nC 1 Project Location & Scope Project Address Folio# Total Retail (Sq. Ft.) i ?D ; mrr t Year Built Oileto cZ) Leased Retail (Sq. Ft.) Description of the business Scope of Work for entire project. Estimated Costs for entire project Yc-cr Se a,-I16r4 15a, Estimated Start Date I 1�/�Zo Estimated I / ` / ( Completion Date 1 I1 gZOZz Omni CRA Business Incentive & Assistance Program 2019 — 2021, Scope of CRA-Funding Request Description of Item 1. sue' QCA,EA Cofv+ -1C 2. 5r).1 3. 4. 5. 6. 7. 8. 9. 10. Estimated Cost 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. TOTAL Acknowledgements As a current business owner in this community or a business seeking to improve business in this community, I wish to participate in the OMNI CRA BUSINESS ASSISTANCE MICROGRANT. I acknowledge that I have received a copy of the Microgrant Grant Program Procedures and will comply with all requirements should I be awarded a grant. Sign / Print Nast; Business Owner // ff /noMu4 Date 3/2CEIS I acknowledge that Tenant, is seeking assistance using the OMNI CRA BUSINESS ASSISTANCE & INCENTIVE GRANT PROGRAM and that the general terms of their lease conform to the terms above. Should the applicant win a grant award, I understand that funds will be used to make improvements to my property. Sign / Print Nome of Property Owner Omni CRA Business Incentive & Assistance Program 2019 — 2020 Date SCHEDULE 40TALGR0&tSf: OF VALUES - BUDGET OVERAGES SN4 ATTI MIAUI 1140 NW PA AM! COURT MIAMI, FL 33136 PT R 3 Lr CONSTRUCTION Sbmielm Doe. 10 33/3020 MWA ii137 P: 335.5336727I F:3[6538.6757 UNSiON COMv_•.-.: CT UOM f?A;E ?WL5 - .. DN2 FASTING COMMONS S 651300 Selective Drivers, Demolition Include. Drirewy Stela 1 L5 $3,64Q33 $ 3640.00 Selective Building Sow:tura Demolition Includes Existing Cohen., BTwbeen. 1 LS 32.675.00 S 2e7600 DN3 CONCRETE S le,65033 Driveway Sleb Includes Cii, Of Miami Added Scope 1 LS 53,500A0 S 3,5003 Wheelchair Lift Additional Concrete Includes City Of Miami Added Scope 1 L5 S7,50000 S 7.500[0 Impest Window Structural Includes Structural Enginner Added Scope 1 LS S5,41600 S 6416.00 Gera. Door Includes Structural &ginner Added Scope 1 I LS S2235.00 S 2735.00 DNA MASONRY -NIA 3 14725.03 Exterior & Interior Walla 'Includes Change Order - Water Inoue ien 1 LS S10,72500 S 1 i 10,725A) ON METALS S 1.3941013 :,d M.. sta ,. Includes Architecture Added Stop 1 EA $6,44550 S 444500 Ship Ladder Includes Enclosed Option - lock 1 LS S650300 S 6503.03 'UV 7 'TKAMAI L M015TA1E PROTECTILA S JfleM000 Roo, Insulation Inc mite s Gil ;:• Miami Adder Scope 1 L5 118,700D0 S 1$70000 Rod 1ncludee Un'oreseen Canni,ion 1 Ls $23150.00 241RL07 d+J3 C4N11661 $ 47.03500 Impel Winoo. & Doors Overage Incur.3ochitecture n:.k., Stripe 1 ,. Sec,475 S 44,675.07 New Garage Door �ncu.-e lx+reeeen Condition 4 EA 11.100i]D S 4.400A0+ 2siv i4¢r;t1LPNE AVG LOUIN4VT S 3 SOT R7 iWnee eKir Litt Ilncuses Ci:, -- Miami Aimed Scope , 1 ALW S2e,500A0 IS 2sr500A0 on., )1 '3rprin 'RESLPFRL55UN S 13 125 D; -Time er S. stem Innuees Existing System1 �mcL..r%5I/r-. LS ; 21.125.00 S 21,125A0 A. arm Add., E Scov< - - 1 3 j•: �.� 1 1471: .1 J/ 77 fPLLRA61Ni j ( S ZOOM) ,,,xr„9 _,. 1i Zeal. Wrier rtwig -mg. e 1 i I ,5 J ;:.rs ' 1 r 011i OO#T 4CT5ON lw TOTAL Ted redid $ 10t,p25A0 Pwd Godlier. Lk No Omni CRA Business Improvement Grant Award Criteria The Omni CRA's mission to prevent conditions giving rise to slum and blight, to reduce crime, and to improve the quality of life for residents and visitors to the Redevelopment Area, makes the Business Improvement Grant Program an important tool in improving the district. Grants are generally awarded on a rolling basis as funding permits and the program is renewed each fiscal year. Omni CRA's Business Grant Applications are reviewed by CRA staff and recommended to the Executive Director for award based on a set of criteria, including but not limited to neighborhood of the business, specific commercial corridor of business, ownership of the property, historical track record of the business owners, employment projections and/or track record of the business, ability for business to attract visitors to the neighborhood, long term vision and connection to the neighborhood, ability of business to serve unmet needs of residents and stakeholders in the neighborhood, activation of underutilized spaces throughout the neighborhood, previous grants awarded to and projected aesthetic or street level improvements. Each project application is judged by the Executive Director on its individual merits, and how it fits into the CRA's dynamic vision for improvement of the neighborhood. Name of Business: Miami Life Center, INC. Date of Application: 10/13/2020 Executive Director's Notes: $100,000 to underwrite the cost associated with the renovation of the property of Miami life Center, INC. a business that will be in the Omni CRA district. I do hereby approve this business as a grant awardee. Jason ally — Date Execu ve Director, Omni CRA Omni Community Redevelopment Agency • ken Russell, Chairman • Jason Walker, Executive Director 1401 N. Miami Ave. Miami, FL33136 www.omnicra.com • 305.679.6868 EXHIBIT C- INSURANCE REQUIREMENTS Page 17 of 18 EXHIBIT INSURANCE REQUIREMENTS-MIAMI LIFE CENTER, INC. GRANTEE I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $ 2,000,000 Personal and Adv. Injury $ 1,000,000 Products/Completed Operations $ 1,000,000 B. Endorsements Required City of Miami listed as additional insured OMNI CRA listed as an additional insured Contingent & Contractual Liability Premises and Operations Liability Primary Insurance Clause Endorsement II. Business Automobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami listed as an additional insured OMNI CRA listed as an additional insured III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation Employer's Liability A. Limits. of Liability $100,000 for bodily injury caused by an accident, each accident $100,000 for bodily injury caused by disease, each employee $500,000 for bodily injury caused by disease, policy limit The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer in accordance to policy provisions. Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A-" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. RIJ ,r'CERTIFICATE OF LIABILITY INSURANCE I PATS[MMIDDNYYYI 1 D'270020 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 REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the cerUfleate holder Is an ADDITIONAL INSURED, the policy-0es) must have ADDITIONAL INSURED provisions or be endorsed. tf SUBROGATION IS WAIVED, aubbect to the terms and conditions of the poky, certain policies may require en endorsement. A statement on this certificate does not confer rights to the certificate hoiden In (Fete of such er dorsement(s). PRODOCER CONTACT Kno MacGregor NAME: At American Insurance PHONE k FA (jam Na Eedl (305) 233.0H5S {A NO: 9036 SW 152nd St. -i AL . ADDRESS. gllvt+0s@iliooireslnanca,com Miami FL 33157 _ IkSURERIS) AFFORDING COVERAGE I NAIC ■ Phone (305) 233 0 55 Fax (305) 23 -8505 INSURER A Nautilus Insurance Company 17370 A+ INSURED Miami Beach FL 33139- INSURER F INSURER 6 : Miami Life Center Inc INSURER 736- 6 Street INSURER D INSURER E. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: (3D5y 2as-e6os 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 WHCh THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED 8Y THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAM. ICY EFF POLICY EXP L7R - TYPE OF INSURANCE IHSR 1NVO POLICY NUMBER _IM OLSUBR IMIDtifYYYTYIMM/DIVM/DD1YY1'_ LINiTS ® GGYaD1=RGA• .^,FN=RAT +IAb.rv• •LAC*,OCCURRENCE s 2,000,000.00 0 c, AitaSs+ep: 0 o ;L jy DAMAGE. TO RFC:'ED PRPLIS Fa nrri r:, i S 100.000 00 ® AdditionNlinsured ME+SExP(ARycrapa�cr. t 5.00000 A Y N NN1151364 07;18Q024 07i1&2021 PERSONAL RA:nrIN,r+,KY $ 2.000,00000 GE,., AGGREGATE _our hW . 51'ER GENERA AD I_C.AIL $ 2.000.000.0D D go,;;, ❑ 1 ❑ LOC PRODUCTS -COVD.OPADO I I 2.000.000.00 . D Ci -+Eft - i AUTOM{XteLMtiVILtTY - -. eekla• ir` n)SING.F.+ I 1 ElAhYALJ;•� FA'N)IIYML::.9YIPrrpr+sr-. 3 ❑ ow,.FD D s tit Er A!+I75 7DILY Pr_TDS B V(L' AR:'.+ 1 fP r aic.3er+G S ntRD ❑ ALFro NON -Venal r PR•OP`RTYDSV+GE ALTOSONLY ALTO DM Y 'r`I B:rJdP'+rJ S D ❑ 0 UMBRELLA LIAB 0 CX;CUR EACH OCCU RRLNCE 1 Q %.A]MS.MAi7s- fw Ei EZCESS LIRE A t —.-- _ a _.._ CRECAIt s n DEC n RETENTi..IN 5 watKER5 COoPENSATION F13R e'RI AND EMPLOYERS' LABILITY Y r N A ANY PRGPReZ FVF.ARTJFR+FX=C1. n.vt?—-�-T._L4.f-.___J..d E.R. CrFlCER IF+NFRFXCIITI Yt NIA EL ! AOArC(1_0 I I S (Mandatory in tell It yes. downer, uncle, fhiS 'R?•r ON' 4- COr;(,AtiThS a ton DESCRIPTION OF OPEAATIONS 1 LOCATIONS 1 VEHICLES (Muth mono tut Addttenar Remarks Schedule. K more space Is requires) City 01 Kam. is Included as an ADDITIONAL INSURED and LOSS PAYEE General Liability, Contingent and Contractual- Premises and Operational Liabthty is primary and non-contributory Waiver of Subrogation i5 in favor of City of Miami E L DISCASE EA LV 1CYC i _. 01S=As.=•Pais Yi +/-r 1 • Please note that due to the nature of this business and current employment practices, Business Auto Liability and Workers Compensation Pofic(es are not required CERTIFICATE HOLDER City of Miami ATTN Risk Management 444 SW 2nd Avenue. 9th Floor Miami FL 33130 ACORD 25 i2O16/03) QF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED R>p,7ESENTATIVE. c 1$88-2015 /CORD CgRPORATION. All rights resefw The ACORD n And 90 are registered marks of ACOI t- .. ._ - ACCORD CERTIFICATE OF LIABILITY INSURANCE DATB(RikliDDrYYYY) �„-- 1_ 10,17/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- THIS -- CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POL.ICiES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING iNSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. _ I— VAPORTAHTir ine certificate holder is an ADDiTlONAL INSURED, the polieyties) must haveAD0JTlONAL INSURED provisions or be endorsed -- Pi SUBROGATION 18 WAIVED, subject to the terms and Conditions cif the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to Me certificate holder in lieu of such endorsemerafsj. _ _ _ _ — PRODUCER _� — _ .` C HE T Kilototi6Grp$Or — —. — A)l American Insurance _ a pi) (�) 233-0855 — — {nrc,.,Ko1 (3055) 9036 SW 152nd St. Ram- quotes@kinoinsurarxmcom _ — _ AQLtRESS Miami. FL 33157 `_ _ _ INSUAERIS)AFFORaNC3 COVERAGE_ MUG Phone (305) 233-0855 _ Fax (305) 235-8606 _ _ INsuRER A Nautitt s Insurance CotLTpsriy 17370 A+ INSURED Mram; Life Center Inc. 236- 6 Street Miami Beach FL 33139- INS ?DER F _ _ — COVERAGES — CERTIFICATE NUMBER: _ _ _ MS REVISION NUMBER: S IS TO CERTIFY THAT THE POLICIES Or INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERMOR 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 OATS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS _ _ _ 'INr„R� 11BR ' POLICY EFF POLICY EXP I LIMITS LTR _TYPEOFINSURANCE _ I WVD, POLICY NUMBER — jrlatioDM_YYYIiIMIANWYYY: _. — , ® CQMMERVAI GEliL-RA: s1A&LIr a EACH nGCURREHCE _ S 2 .000y00 I ®CLa,M i-Y c_ —DAMAGE 1O REN Cti to - FIRASEs tr"0 accyRr-1 1 S 100,000 00 ER] Additional Insured _ _ MED EXP me persons 5,OD0.00 I D 07 A la _ Ti _ _ Y N NN1151354 I47j18242rI812021 i LAW rE35UtiaLRADVYt•r`RY S 2.000.000 00 SENL►GORE5,ETF.LMTAPPLIES L'_-4 I 3C4ERALl.C-GRF3A-E 5 2,000,00000 ❑ PCLD( 0 F2CT 0 LOC r'gocuc's-Goiri'rC•P AG+: f 2.000.000 00 AUTOMODILE LIADILITY — — ..— — _ _ — . CCMR'r'Eb S W3 L• LIM'T 3 rm..A UrC I gook Y cotof y per pArsac) 3 I.-} OWNED0 SO.1EDUL Fr: L,.i AL.ROS ONLY AaTOS EtiDILYINJURY i4,ffi-- tAerTi 5 N;ccD Q rUOh^PgopERTCAVAPF ' s❑•UTOS CVO' aU'^S C.- YI , !Pe' e5G4rr:_ _ _ 0.— —E• — — - - . _ S IDn UMBRELLA ;ABIDOCCUR 7 eAC=• CGGuRRENeE I s 1.�� ExcEss LIAR — D G?'Nr'.1k7L7t 1 ' aC�RtGA`•F — `_ELL.. 0 RETE't„✓JN S _ VaORNERS tQt11p4 i1$AT)ON AND EMPLOYERS' LIABILITY Y r it ANY PROYRIETDRIPARTNERIEXFCL1'. P. OFF!CERJMFMBER ExcLUDt:ri i N 1 A DESCRIPr,mNM) — — — — — — — — — Ir Ks describe un:er Dt£GRIPTfJN 0= OIL 10.Tr345 py1FN U15GJRER BB INSIJ'RER C . INSURER D I E _ N1SURER DESCRIPTOR OF OPER►I ONS 1 LOCATIONS i VEHICLES 'Much ACORD l ot, Arniition 1 Remarks 5cheeule. tr Dare spice iS raquireeN OMNI CRA is included as an ADDITIONAL INSURED and LOSS PAYEE General Llabikty. Contingent and Contractual. Premises and Operational Lrabildy is primary and non-contributory Waiver of Subrogation is in favor of OMNI CRA --- $Ln�_ ❑ E. 1 — F FL EAC-i TCC'UE!:T S — "-LII JSEA F • E0 EMPLOYETS C L.:7P.EASt • Pa1CY L V'' 5 Please rate that due to the nature of this business and current employment practices . Business Auto LLaDkIIty and Workers Compensation Policies are not requl CERTIFICATE HOLDER CAAICELLATION OMNI CRA Mlanli Community Redevelopment Agency 1401 N Miami Avenue Miami FL 33136 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFS THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDAidCE WITH THE POLICY PROVISIONS AUSHORQED RE SENTATive 7 1888-2615 ORD RPORATION. A11 rights res ACORD 26 (2016/03) OF The ACORD natoe ar logo are registered marks of e MIAMI LIFE CENTER To Whom it May Concern: Miami Life Center, the yoga center currently applying for a grant from the CRA, does not currently own any cars, auto or other vehicles. Therefore no auto will be used to complete the project at 1940 N.W. Miami Court. Additionally, Miami Life Center does not currently have employees therefore we will do not currently have any requirement or need to have worker's comp coverage. My husband and I are co-founders and co -owners of the business. Feel welcome to reach out to us directly with any further questions. Thank you and best regards, Kino MacGregor kino@miamilifecenter.com 786-218-2220 INSURANCE REQUIREMENTS FOR A CERTIFICATE OF INSURANCE -CONSTRUCTION REQUIREMENTS MIAMI LIFE CENTER, INC. I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $ 2,000,000 Products/Completed Operations $ 1,000,000 Personal and Advertising Injury $1,000,000 B. Endorsements Required City of Miami and OMNI CRA listed as an additional insured Contingent and Contractual Liability Premises and Operations Liability Explosion, Collapse and Underground Hazard Primary Insurance Clause Endorsement II. Business Automobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Any Auto Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami and OMNI CRA listed as an additional insured III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of subrogation Employer's Liability A. Limits of Liability $1,000,000 for bodily injury caused by an accident, each accident. $1,000,000 for bodily injury caused by disease, each employee $1,000,000 for bodily injury caused by disease, policy limit IV. Umbrella Policy (Excess Follow Form) A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $ 1,000,000 Aggregate $ 1,000,000 City of Miami & OMNI CRA listed as an additional insured. Coverage is excess follow form over the general liability and auto policies. V. Payment and Performance Bond $400,000 City & OMNI CRA listed as obligees VI. Builders' Risk Causes of Loss: All Risk -Specific Coverage Project Location Valuation: Replacement Cost Deductible: $10,000 All other Perils 5% maximum on Wind/Hail and Flood City of Miami & OMNI CRA listed as loss payees The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer not less than (30) days prior to any such cancellation or material change, or in accordance to policy provisions. Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A-" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. ,�►coR®® CERTIFICATE OF LIABILITY INSURANCE �...'"-.. DATE(MMIDDITYYY) 11/16/2020 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 pollcy(les) must 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 cerUflcate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Wilson, Washbum & Forster Insurance 16505 NW 13th Ave Miami FL 33169 CONTACT PHONE . ,.. Fax _IBIC.t1o, gxU. 305-666-6636 J (A/c, Not: 305-662-7778 ADDRESS: certificates@wwfins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Insurance Company of the West INSURED PETER-7 Aster Pe r Diazuction, Inc. Attn: Peter Diaz� 37 NE 28th Street Miami FL 33137 INSURER e : Travelers Cas Surety Co of Am 31194 INSURERC: Gemini Insurance Company y 10833 INSURER D: Nautilus Insurance Company 17370 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 692604237 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 INSRL TYPE OF INSURANCE NSD I wv0 POUCY NUMBER (MMMIDDDY�I IMM POUCY OMITS C X COMMERCIAL GENERAL CLAIMS MADE X UABIUTY OCCUR Y Y VGGP005298 911/2020 9/12021 EACH OCCURRENCE -6grAGE TORENTE PREMISES (Ea occurrence) $1,000,000 5100,000 MED EXP (My one person) 5 5,000 GEM_ _I 1I PERSONAL & ADV INJURY 51,000,000 AGGREGATE LIMIT APPLIES PER: POLICY X JJEET. LOC OTHER: GENERAL AGGREGATE $ 2,003,000 PRODUCTS - COMP/OP AGG $2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED AUTOS 1 Y Y BA4N11487A 9/1/2020 9/1/2021 COMBINED O BIKED) SINGLE LIMIT $ 1 000090 BODILY INJURY (Per person) 5 BODILY INJURY (Per ( ) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA UAB EXCESS LIAR OCCUR CLAIMS -MADE Y Y AN092481 9/12020 9112021 EACH OCCURRENCE $1,000,00D AGGREGATE $ 1,030,000 DED I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS Y / N NIA Y WFL 5037662 03 9/12020 9/12021 X I STATUTE 1 I ERH- EL. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 below E.L DISEASE - POLICY LIMIT $ 1.000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace le required) City of Miami is listed as additional insured on a primary non-contributory basis with waiver of subrogation per the attached endorsements. Coverage is afforded for contingent (see contractors warranty) and contractual (lability and x.c.u. (explosion collapse, and underground) hazards subject to policy terms and conditions. Umbrella follows form. CERTIFICATE HOLDER CANCELLATION City Of Miami 444 SW 2nd Ave Miami FL 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTA • ACORD 25 (2014/01) Co 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modes insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS E. TRAILERS — INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A. 1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". B. EMPLOYEE HIRED AUTOS 1. The following is added to Paragraph A. 1., Who Is An Insured of SECTION II — LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating a covered "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. CA FO 79 08 17 H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT — INCREASED LIMIT 1. WAIVER OF DEDUCTIBLE — GLASS J. PERSONAL PROPERTY K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSINESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee under a contract in that an "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". C. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. m 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission COMMERCIAL AUTO D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. E. TRAILERS — INCREASED LOAD CAPACITY The following replaces Paragraph C. 1. , of SECTION I — COVERED AUTOS: 1. "Trailers" with a load capacity of 3,000 pounds or less designed primarily for travel on public roads. F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph A. 4., Coverage Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage Extension If hired "autos" are covered "autos" for Liability Coverage and this policy also provides Physical Damage Coverage for an owned "auto", then the Physical Damage Coverage is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" in any one "accident" to a hired, rented or borrowed "auto° is the lesser of: (a) $50,000; (b) The actual cash value of the damaged,or stolen property as of the time of the "loss"; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". Page 2 of 3 (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or borrowed with a driver; or (b) Any "auto" that is hired, rented or borrowed from your "employee". G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Paragraph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT — INCREASED LIMIT Paragraph C.1.b. of SECTION III — PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D. Deductible, of SECTION III — PHYSCIAL DAMAGE COVERAGE: No deductible applies under Specified Causes of Loss or Comprehensive coverage for "loss" to glass used in the windshield. J. PERSONAL PROPERTY The following Is added to Paragraph A. 4. Coverage Extensions, of SECTION III PHYSCIAL DAMAGE COVERAGE: Personal Property Coverage We will pay up to $400 for "loss" to wearing apparel and other personal effects which are: (1) owned by an "insured"; and (2) in or on your covered "auto"; in the event of a total theft "loss" of your covered "auto". No deductibles apply to Personal Effects Coverage. 0 2016 The Travelers Indemnity Company. All rights reserved. CA FO 79 08 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission K. AIRBAGS The following is added to Paragraph B.3., Exclusions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that inflate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Comprehensive Coverage under this policy; b. The airbags are not covered under any warranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph A. 4. Coverage Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Coverage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto"; and COMMERCIAL AUTO (2) Any: (a) Overdue lease/loan payments at the time of the "loss' (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the lessor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A. 5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDITIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. CA FO 79 08 17 © 2016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 3 of 3 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: CG 2010 07 04 Effective Date: 09/01/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations City Of Miami 444 SW 2nd Ave 8th Floor Miami FL 33130 ;Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — WhoIsAn Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. CG20100704 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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 2. 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. @ ISO Properties, Inc., 2004 Page 1 of 1 Policy Number: Insured Name: Peterbilt Construction, Inc. Number: CG 2010 07 04 Effective Date: 09/01 /2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations City of Miami Beach , 1700 Convention Center Drive Miami Beach FL 33139 Project Name: Owade Residence Project Description: Driveway Approach Installation Project. Address: 1410 S. Biscayne Point Road Project Description: Sidewalk Replacement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily : injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. CG 2010 07 04 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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 2. 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. © ISO Properties, Inc., 2004 Page 1 of 1 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 33 CG 20 10 12 19 Effective Date:09/01/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any person or organization when you have agreed in a written and executed contract, prior to an "occurrence, that such person or organization be added as an additional insured on your policy. All locations for which you have agreed in a written and executed contract prior to an 'occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 2010 1219 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" ' or "property damage" occurring after: 1. 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 2. 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. © Insurance Services Office, Inc., 2018 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, 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; whichever is Tess. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG 20101219 © Insurance Services Office, Inc., 2018 Page 2 of 2 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 34 CG20121219 Effective Date:0910112020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule State Or Governmental Agency Or Subdivision Or Political Subdivision: Any qualifying entity when you have agreed in a written and executed contract, prior to an "occurrence", that such qualifying entity be added as an additional insured on your policy Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG20121219 B. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". With respect to the insurance afforded to these additional insureds, 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. © Insurance Services Office, Inc., 2018 Page 1 of 2 All other terms and conditions of this Policy remain unchanged. CG20121219 © Insurance Services Office, Inc., 2018 Page 2 of 2 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 38 CG 20 37 12 19 Effective Date: 09/01/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS: This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule , Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization when you have agreed in a written and executed contract, prior to an "occurrence", that such person or organization be added as an additional insured on your policy. :All locations and completed operations for which you have agreed in a written and executed contract prior to an "occurrence." Information required to complete this Schedule, if not shown above, will be shown in the Declarations. ___ A. Section II — Who Is An Insured is amended to B. include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, 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; whichever is Tess. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG20371219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 41 CG24041219 Effective Date: 09/01/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 'WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule_ Name Of Persons) Or Organization(s): Any person or organization you have agreed in a written and executed contract, prior to an "occurrence", that you would provide such person or organization a waiver of transfer of rights of recovery against others to us on your policy. Information required to cornplete.this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. All other terms and conditions of this Policy remain unchanged. CG24041219 © Insurance Services Office, Inc., 2018 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER. RE: ALL FLORIDA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 09-01-19 Policy No. WFL 5037662 02 Insured PETERBILT CONSTRUCTION INC Insurance Company INSURANCE COMPANY OF THE WEST WC000313 (Ed. 4-84) 1983 National Council on Compensation Insurance. Countersigned By Endorsement No. Premium $ INCL. INSURED ACc.RD® CERTIFICATE OF LIABILITY INSURANCE ems' DATE(MMIDD/YYYY) 11/16/2020 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on thls certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Wilson, Washbum & Forster Insurance 16505 NW 13th Ave Miami FL 33169 CONTACT NAME: PHONE FAX Ago No Elm. 305-666-6636 I (wo, Nol: 305-662-7778 L AADDRESS: certficates(wwtins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Insurance Company of the West INSURED PETER-7 Peterbilt Construction, Inc. Attn: Peter Diaz 37 NE 28th Street Miami FL 33137 INSURER B : Travelers Cas Surety Co of Am 31194 INSURER C: Gemini Insurance Company 10833 INSURER D: Nautilus Insurance Company 17370 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 1389417181 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. NOTWrrHSTANDING 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 7TDDL INSD SUBR 'wVD POLICY NUMBER POLICY EFF IMMIDD/YYYYI POLICY EXP 1MMIDDIYYYY) LIMITS C X COMMERCIAL GENERAL LIABILITY Y VGGPOOS299 9112020 9f12021 EACH OCCURRENCE $1,000,000 ICLAIMS -MADE X OCCUR R PREMISES Ea oc0URencel 3 100,000DAMAGETO MED EXP (My one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER X LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ a AUTOMOBILE X IJABILI Y - SCHEDULED Y Y BA4N11487A 9/12020 9f12021 COMBINED SINGLE LIMIT {Ee accident) $ 1 000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acddenf $ $ D X UMBRELLA LIAB I EXCESS LIAB r O OCCUR CLAIMS -MADE Y Y AN092451 9112020 9r12021 EACH OCCURRENCE AGGREGATE AGGREGATE $1,000 000 DED I RETENTION S $ A WORKERS COMPENSATION AND EMPLOYERS' UABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) H yes, describe under DESCRIPTION OF OPERATIONS below N / A Y WFL 5037662 03 9/12020 9/12021 X I STATUTE I I OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 51,000,000 E.L. DISEASE- POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more apace la required) OMNI CRA Is listed as additional insured on a primary non-contributory basis with waiver of subrogation per the attached endorsements. Coverage is afforded for contingent (see contractors wan-anty) and contractual liabiilty and x.c.u. (explosion, collapse, and underground) hazards subject to policy terms and conditions. Umbrella follows form. CERTIFICATE HOLDER CANCELLATION OMNI CRA 1401 N. Miami Ave Miami FL 33136 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIV Q.: • . ACORD 26 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a -general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS E. TRAILERS — INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. 'PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A. 1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". B. EMPLOYEE HIRED AUTOS 1. The following is added to Paragraph A. 1., Who Is An Insured of SECTION II — LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating a covered "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT — INCREASED LIMIT 1. WAIVER OF DEDUCTIBLE — GLASS J. PERSONAL PROPERTY K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSINESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee under a contract in that an "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". C. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. CA FO 79 08 17 ® 2016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with Its permission Page 1 of 3 COMMERCIAL AUTO D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual Toss of earnings up to $500 a day because of time off from work. E. TRAILERS — INCREASED LOAD CAPACITY The following replaces Paragraph C. 1. , of SECTION 1— COVERED AUTOS: 1. "Trailers" with a Toad capacity of 3,000 pounds or less designed primarily for travel on public roads. F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph A. 4., Coverage Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage Extension If hired "autos" are covered "autos" for Liability Coverage and this policy also provides Physical Damage Coverage for an owned "auto", then the Physical Damage Coverage is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" in any one "accident" to a hired, rented or borrowed "auto" is the lesser of: (a) $50,000; (b) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". Page 2 of 3 (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or borrowed with a driver; or (b) Any "auto" that is hired, rented or borrowed from your "employee". G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Paragraph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT — INCREASED LIMIT Paragraph C.1.b. of SECTION III — PHYSICAL DAMAGE COVERAGE is deleted. 1. WAIVER OF DEDUCTIBLE — GLASS The following isadded to Paragraph D. Deductible, of SECTION III — PHYSCIAL DAMAGE COVERAGE: No deductible applies under Specified Causes of Loss or Comprehensive coverage for "loss" to glass used in the windshield. J. PERSONAL PROPERTY The following is added to Paragraph A. 4. Coverage Extensions, of SECTION III — PHYSCIAL DAMAGE COVERAGE: Personal Property Coverage We will pay up to $400 for "loss" to wearing apparel and other personal effects which are: (1) owned by an "insured"; and (2) in or on your covered "auto"; in the event of a total theft "loss" of your covered "auto". No deductibles apply to Personal Effects Coverage. © 2016 The Travelers Indemnity Company. All rights reserved. CA FO 79 08 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission K. AIRBAGS The following is added to Paragraph B.3., Exclusions, of SECTION 11I — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that inflate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Comprehensive Coverage under this policy; b. The airbags are not covered under any warranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph A. 4. Coverage Extensions, of SECTION 1I1 — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles • In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Coverage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto"; and CA FO 79 08 17 COMMERCIAL AUTO (2) Any: (a) Overdue lease/loan payments at the time of the "loss"; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the lessor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A. 5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDITIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. © 2016 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Once, Inc. with its permission Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 33 CG 20 10 12 19 Effective Date:0910112020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Additional Insured Person(s) Or Organization(s), Location(s) Of Covered Operations Any person or organization when you have agreed in a written and executed contract, prior to an "occurrence", that such person or organization be added as an additional insured on your policy. All locations for which you have agreed in a written and executed contract prior to an "occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section I1— Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 201012 19 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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 2. 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. © Insurance Services Office, Inc., 2018 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG20101219 © Insurance Services Office, Inc., 2018 Page 2 of 2 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 34 CG20121219 Effective Date:09/01/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule State Or Governmental Agency Or Subdivision Or Political Subdivision: Any qualifying entity when you have agreed in a written and executed contract, prior to an "occurrence", that such qualifying entity be added as an additional insured on your policy Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section I1— Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG20121219 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". B. With respect to the insurance afforded to these additional insureds, 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. © Insurance Services Office, Inc., 2018 Page 1 of 2 All other terms and conditions of this Policy remain unchanged. CG20121219 © Insurance Services Office, Inc., 2018 Page 2 of 2 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 38 CG20371219 Effective Date: 09101 /2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization when you have agreed in a written and executed contract, prior to an "occurrence", that such person or organization be added as an additional insured on your policy. All locations and completed operations for which you have agreed in a written and executed contract prior to an "occurrence." Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, 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; whichever is Tess. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG20371219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Policy Number: VGGP005298 Insured Name: Peterbilt Construction, Inc. Number: 41 CG24041219 Effective Date: 09/01 /2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Person(s) Or Organization(s): Any person or organization you have agreed in a written and executed contract, prior to an "occurrence", that you would provide such person or organization a waiver of transfer of rights of recovery against others to us on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. All other terms and conditions of this Policy remain unchanged. CG24041219 © Insurance Services Office, Inc., 2018 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER. RE: ALL FLORIDA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective 09-01-19 Policy No. WFL 5037662 02 Insured PETERBILT CONSTRUCTION INC Insurance Company INSURANCE COMPANY OF THE WEST WC 00 0313 (Ed. 4-84) ®1983 National Council on Compensation Insurance. Countersigned By INSURED Endorsement No. Premium $ INCL. EXHIBIT D GRANTEE'S Certificate of Corporate Authorization And Corporate Status Update Page 18 of 18 CERTIFICATE OF AUTHORITY STATE OF FLORIDA ) COUNTY OF MIAMI-DADE ) SS / EIN: 20-4084665 I HEREBY CERTIFY that a meeting of the members MIAMI LIFE CENTER, INC, a Florida Profit Corporation (the "company"), whose mailing address is 73�16-g St. Miami Beach, FL 33139 organized and existing under the laws of the State of Florida held ona) , of((1\.2020, the following resolution was duly passed and adopted: "RESOLVED, that, Kino MacGregor, President of MIAMI LIFE CENTER, INC, be and is hereby authorized to execute all Grant agreement, each made by the Omni Redevelopment District Community Redevelopment Agency ("CRA") to the MIAMI LIFE CENTER, INC, and dated on or about the date hereof." I further certify that said resolution is now in full force and effect. IN WITNESS WHEREOF, the undersigned has hereunto set its hand as of the day and year fist above written. (Printed typed or stamped commissioned) MIAMI LIFE ENTER, I 'C. a Florida P o t Cor orat4n By: Pr. N ' e: K ' MacGregor Title: Prsideat Sworn to and subscribed before me thisA4tIday of 0' 1/y,44( ,sty ino MacGregor, President of MIAMI LIFE CENTER, INC, on behalf of said entity who is ( f ) personally known by me or has pr vided the following identification itette<� ........... lt� f hq • I *.0,9077 S. One Notary Public — StaltstSf F1ori 442A2,12fMy commission expires W:zc \ t?ito21 11/4 (Printed, typed or stamped commissioned DIVISION OF CORPORATIONS Livlil(,i of CO 00.1011"...1.2■00"'11111.4 Un of rf ftl/ :I'f, DXpatrttnent of State / Division of Corporations / Search Records / Search batly Name / Detail by Entity Name Florida Profit Corporation MIAMI LIFE CENTER INC. Elting Information Document Number P05000162776 FEI/EIN Number 20-4084865 Date Flied 12/142005 State FL Status ACTIVE Last Event AMENDMENT Event Date Filed 11/08/2019 Event Effective Date 11/08/2019 ri ipal Address 736 - 6TH ST. MIAMI BEACH, FL 33139 Changed: 09/20/2006 Mailing Address 736 - 6TH ST. MIAMI BEACH, FL 33139 Changed: 03/24/2009 Registered Agent Name & Address MACGREGOR, KINO MMS 9036 SOUTH WEST 152 STREET MIAMI, FL 33157 Name Changed: 09/20/2006 Address Changed: 09/20/2006 Officer/Director Detail Name & Address Title P MACGREGOR, KINO AMS 4473 PRAIRIE AVENUE MIAMI BEACH, FL 33140 Title Secretary MACGREGOR, KINO MMS. 7441 SW 176 STREET MIAMI, FL 33157 Title CEO FELDMANN, TIM MR 4473 PRAIRIE AVENUE MIAMI BEACH, FL 33140 Annual kotti Report Year 2018 2019 2020 Flied Date 04/26/2018 04/23/2019 06/25/2020 Document linanfi 08/25/2620 -ANNUAL REPORT . View image la PDF fermat 11/08/2019 - Amendment View image in PDF format 0412312019 -.ANNUAL REPORT View image in PDF formal 04126/2018 - 'ANNUAL REPORT 04/27/2017 - ANNUAL REPORT 03/08/2016 - ANNUAL -REPORT 05/18/2015 - ANNUAL REPORT 04/28/2014 - ANNUAL REPO]: 04/09/2013 -ANNUAL REPORT View image in PDF format View image in PDF format 04 /11/2012 -; ANNUAL REPORT 01/p6/2j11 -•-• ANNUAL REPORT 01/07/2010 -ANNUAL REPORT 03/24/2009- ANNUAL REPORT .62/21/2008 - ANNUAL REPORT .. • 92/07/2007 - ANNUAL REPORT .09/20/2008 - REINSTATEMENT 12/14/2005 - Domestic Profit View image in PDF format View image in POF forinat View linage:in PDF format View Image in PDF format View image in PDF format View Image in PDF forrriat View image in PDF format View Image in PDF format View image In PDF format View image in PDF format View image in PDF format View image in PDF format Florida Department of Stale, Division of Carpoieloris . ' — DIVISION OF CORPORATIONS JIYLicp40.011101 % Jf u'l nit Oxus' ,A1 f ',Hiatt 1 tl, 'tr pgpArtrnent of State / Division of Corpretions I Search Records I Search by n y Name Detail by Entity Name Florida Limited Liability Company OMSTARS LLC filing Information Document Number L15000110714 FEI/EIN Number 47-4543367 Date Filed 06/25/2015 State FL Status ACTIVE Last Event LC AMENDMENT Event Date Filed 03/04/2019 Event Effective Date NONE Principal Address 736 6TH STREET MIAMI, FL 33139 Changed: 04/26/2018 Mailing Address 736 6 ST MIAMI, FL 33139 Changed: 04/26/2018 Registered Agent Name & Address MACGREGOR, KINO 736 6TH STREET MIAMI, FL 33139 Address Changed: 04/26/2018 Authorized Person(s) Detail Name & Address Title MGR MACGREGOR, KINO 9036 SW 152 STREET MIAMI, FL 33157 Annual Reps Report Year Filed Date 2018 04/28/2018 2019 04/23/2019 2020 08125/2020 Document Imagga 06/25/2020 —:ANNUAL REPORT View image in PDF format • J 04/23/2010- ANNUAL liffORT . View linage in PDF 'format . 03/04/20197 LC Amendment Viewimage in PDFformat . 04/26/2018 ANNUAL REPORT • View image. in PDF format 10/13/2017 — CORLCOSMEM V1eW ma ge PDF forma t 04/27/2017 ANNUAL REPORT View image in PDF format : 09/03/2016 — ANNUAL REPORT . View. image in PDF krmat 06/25/2 015 •‘- Florida Limited Liability. View Image In PDF format Florida Department of State, Division of Corporations � DIVUr-/ti I2PpaRmentsf$iate / Division of CotpQi trans / Search Records / Search by Entity Name / Detail by Entity Name Florida Limited Liability Company SAMPATTI MIAMI LLC Elting Information Document Number L19000195589 FEI/EIN Number 84-2788976 Date Filed 07/31/2019 Effective Date 08/01 /2019 State FL Status ACTIVE Principal Address 4473 PRAIRIE AVENUE MIAMI BEACH, FL 33140 Mailing Address 4473 PRAIRIE AVENUE MIAMI BEACH, FL 33140 gggistered Agent Name & Address Carmen Terneus, CPA, P.A. 8925 SW 148th Street Suite 210 Palmetto Bay, FL 33176 Name Changed: 05/12/2020 Address Changed: 05/12/2020 Authorized Person(s) Detail Name & Address Title MGR MacGregor, Kino 4473 Prairie Avenue Miami Beach, FL 33140 Title MGR Feldmann, Tim DIVISION OF CORPORATIONS a_ 33Q C2 4473 Prairie Avenue Miami Beach, FL 33140 Annual Ramis Report Year Filed Date 2020 05/12/2020 pocument Imago. 05/12/2020 —ANNUAL REPORT View image in PDF format 07/A1/2019 Florida Limited Liability View image in PDF format Florida Department of State, Division of Corporations