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HomeMy WebLinkAboutAgreement_General_06/14/2018_Fl Division of Emergency Management Statewde Mutual Aid STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT RICK SCOTT ' Governor WESLEY MAUL Diredor �TATEWIDF T Ai AiD A .RFF1l�F�"^ This Agreement is between the FLORIDA DNISION OF EMERGENCY MANAGEMENT ("Division") and the local government signing this Agreement (the "Participating Parties"). This agreement is based on the existence of the following conditions: A. The State of Florida is vulnerable to a wide range of disasters that are likely to cause the disruption of essential services and the destruction of the infrastructure needed to deliver those services. B. Such disasters are likely to exceed the capability of any one local government to cope with the emergency with existing resources. C. Such disasters may also give rise to unusual technical needs that the local govemment may be unable to meet with existing resources,but that o[her local governments may be able to offer. D. The Emergency Management Act, Chapter 252, provides each local government of the state the authority to develop and enter into mutual aid agreements within the state for reciprocal emergency aid and assistance in case of emergencies too extensive to be dealt with unassisted,and through such agreements to ensure the timely reimbursement of costs incurred by the local govemments which render such assistance. E. Pursuant to Chapter 252, the Division has the authority to coordinate assistance between local governments during emergencies and to concentrate available resources where needed. Based on the existence of the foregoing conditions,the parties agree to the following; ARTICLE I. j2C�pIL1p11S. As used in this Agreement,the following expressions shall have the following meanings: 1 A. The "Agreement" is this Agreement, which shall be referred to as the Statewide Mutual Aid Agreement("SMAA"). B, The"Division"is the Division of Emergency Management C. The "Participating Parties" to this Agreement are the Division and any and all special districts,educational districts,and other local and regional govemments signing this Agreement. D. The"Requesting Parties"to this Agreement are Participating Parties who request assistance during an emergency. E. The"Assisting Parties"to this Agreement are Participating Parties who render assistance in an emergency to a Requesting Party. F. The "State Emergency Operations Center"is the facility designated by the State Coordinating Officer to manage and coordinate assistance to local governments during an emergency. G. The "Comprehensive Emergency Management Plan" is the biennial Plan issued by the Division in accordance with§252.35(2)(a),Florida Statutes. H.The "State Coordinating Officer" is the official whom the Governor designates, by Executive Order, to act for the Governor in responding to a disaster, and to exercise the powers of the Governor in accordance with the Executive Order, Chapter 252, Florida Statutes, and the State Comprehensive Emergency Management Plan. I. The "Period of Assistance" is the time during which any Assisting Party renders assistance to any Requesting Party in an emergency, and shall include both the time necessary for the resources and personnel of the Assisting Party to travel to the place specified by the Requesting Party and the time necessary to return them to their place of origin or to the headquarters of the Assisting Party. J. A "specia) district" is any local or regional governmental entity which is an independent special district within the meaning of section 189.012(3),Florida Statutes,regardless of whether established by local,special,or general act,or by rule,ordinance,resolution,or interlocal agreement. 2 K. An "educational districY' is any school district within the meaning of section 1001.30, Florida Statutes and any community school and state university within the meaning of section 1000.21, Florida Statutes. L. An "interlocal agreement" is any agreement between local governments within the meaning of section 163.01(3)(a),Florida Statutes. M. A "local governmenY' is any educational district or any entity that is a "local governmental entity"within the meaning of section 11.45(1)(e),Florida Statutes. N. Any expressions not assigned definitions elsewhere in this Agreement shall have the definitions assigned them by the Emergency Management Act. ARTICLE II. An�licabilitv of the Agr m n . A Participating Party may request assistance under this Agreement for a "major" or "catastrophic disaster" as defined in section 252.34, Florida Statutes. If the Participating Party has no other mutual aid agreement that covers a"minor" disaster or other emergencies too extensive to be deatt with unassisted, it may also invoke assistance under this Agreement for a"minor disaster"or other such emergencies. ARTICLE III. Invocarion of the Agree_�ent,In t}ie event of an emergency or threatened emergency,a Participating Party may invoke assistance under this Agreement by requesting it from any other Participating Party, or from the Division if, in the judgment of the Requesting Party, its own resources are inadequate to meet the emergency. A. Any reyuest for assistance under this Agreement may be oral, but within five (5) calendar days must be confirmed in writing by the County Emergency Management Agency of the Requesting Party, unless the State Emergency Operations Center has been activated in response to the emergency for which assistance is requested. 3 B. All requests for assistance under this Agreement shall be transmitted by County Emergency Management Agency of the ReGuesting Party to either the Division, or to another Participating Party. If the Requesting Party transmits its request for Assistance directly to a Participating Party other than the Division,the Requesting Party and Assisting Party shall keep the Division advised of their activities. C. The Division shall relay any requests for assistance under this Agreement to such other Participating Parties as it may deem appropriate, and shall coordinate the activities of the Assisting Parties so as to ensure timely assistance to the Requesting Party. All such activities shall be carried out in accordance with the State's Comprehensive Emergency Management Plan. D. Nothing in this Agreement shall be construed to allocate liability for the costs of personnel, equipment, supplies, services and other resources that are staged by the Division, or by other agencies of the State of Florida, for use in responding to an emergency pending the assignment of such personnel, equipment, supplies, services and other resources to an emergency support function/mission. The documentation,payment,repayment, and reimbursement of all such costs shall be rendered in accordance with the Comprehensive Emergency Management Plan, and general accounting best practices procedures and protocols. ARTICLE IV. �nonaihilitiea of R ���c_„ti��, To the extent practicable, all Requesting Parties seeking assistance under this Agreement shall provide the following information to the Division and the other Participating Parties. In providing such information, the Requesting Party may use Form B attached to this Agreement, and the completion of Form B by the Requesting Party shall be deemed sufficient to meet the requirements of this Article: A. A description of the damage sustained or threatened; B. An identification of the specific Emergency Support Function or Functions for which such assistance is needed; 4 C. A description of the specific type of assistance needed within each Emergency Support Function; D. A description of the types of personnel, equipment, services, and supplies needed for each specific type of assistance,with an estimate of the time each will be needed; E. A description of any public infrastructure for which assistance will be needed; F. A description of any sites or structures outside the territorial jurisdiction of the Requesting Party needed as centers to stage incoming personnel,equipment,supplies,services,or other resources; G. The place, date and time for personnel of the Requesting Party to meet and receive the personnel and equipment of the Assisting Patty;and H. A technical description of any communications or telecommunications equipment needed to ensure timely communications between the Requesting Party and any Assisting Parties. ARTICLE V. Resnonaibilitie� of Ae4iANno pa�i Q. Each Participating Party shal] render assistance under this Agreement to any Requesting Party to the extent practicable that its personnel, equipment, resources and capabilities can render assistance. If a Participating Party which has received a request for assistance under this Agreement determines that it has the capacity to render some or all of such assistance, it shall provide the following inforrr►ation to the Requesting Party and shall transmit it without delay to the Requesting Party and the Division. In providing such information, the Assisting Party may use Form B attached to this Agreement, and the completion of Form B by the Assisting Party shall be deemed sufficient to meet the requirements of this Article: A. A description of the personnel,equipment,supplies and services it has available,together with a description of the qualifications of any skilled personnel; B. An estimate of the time such personnel, equipment, supplies, and services will continue to be available; 5 C. An estimate of the time it will take to deliver such personnel, equipment, supplies, and services at the date,time and place specified by the Requesting Party; D. A technical description of any communications and telecommunications equipment available for timely communications with the Requesting Party and other Assisting Parties;and E. The names of all personnel whom the Assisting Party designates as Supervisors. F. The estimated costs of the provision of assistance(use FEMA's Schedule of Equipment Rates spreadsheet attached to Form B.) ARTICLE VI. Bendition nf AAsistan p, After the Assisting Party has delivered its personnel, equipment, supplies, services, or other resources to the place specified by the Requesting Party,the Requesting Party shall give specific assignments to the Supervisor(s) of the Assisting Party,who shall be responsible.for directing the pert'ormance of these assignments. The Assisting Party shall have authority to direct the manner in which the assignments are performed. In the event of an emergency that affects the Assisting Party, all personnel, equipment, supplies, services and other resources of the Assisting Party shall be subject to recal] by the Assisting Party upon not less than five (5) calendar days' notice or, if such notice is impracticable,as much notice as is practicable under the circumstances. A. For operations at the scene of catastrophic and major disasters,the Assisting party shall to the fullest extent practicable give its personnel and other resources sufficient equipment and supplies to make them self-sufficient for food,shelter,and operations unless the Requesting Party has specified the contrary. For minor disasters and other emergencies, the Requesting Party shall be responsible to provide food and shelter for the personnel of the Assisting Party unless the Requesting Party has specified the contrary. In its request for assistance the Requesting Party may specify that Assisting Parties send only self-su�cient personnel or self-sufficient resources. B. Unless the Requesting Party has specified the contrary, it shall to the fullest extent practicable, 6 coordinate ail communications between its personnel and those of any Assisting Parties, and shall determine all frequencies and other technical specifications for all communications and telecommunications equipment to be used. C. Personnel of the Assisting Party who render assistance under this Agreement shall receive their usual wages, salaries and other compensation, and shall have all the duties, responsibilities, immunities,rights,interests,and privileges incident to their usual employment. If personnel of the Assisting Party hold local licenses or certifications limited to the county or municipality of issue,then the Requesting Party shall recognize and honor those licenses or certifications for the duration of the support, ARTICLE VII. ProcedLres for Aeimh�rRe•••o�t, Unless the Division or the Assisting Party, as the case may be, state the contrary in writing, the ultimate responsibility for the reimbursement of costs incurred under this Agreement shall rest with the Requesting Party,subject to the following conditions and exceptions: A. [n accordance with this Agreement, the Division shall pay the costs incurred by an Assisting Party in responding to a request that the Division initiates on its own, and not for another Requesting Party. B. An Assisting Party shall bill the Division or other Requesting Party as soon as practicable, but not later than thiriy(30)calendar days after the Period of Assistance has closed. Upon the request of any of the concemed Participating Parties,the State Coordinating Officer may extend this deadline for cause. C. If the Division or the Requesting Party protests any bill or item on a bill from an Assisting Party,it shall do so in writing as soon as practicable, but in no event later than thirty(30) calendar days after the bill is received. Failure to protest any bill or billed item in writing within thirty (30) calendar days shall constitute agreement to the bill and the items on the biq and waive the right to contest the bill. D. If the Division protests any bill or item on a bill from an Assisting Party, the Assisting Party shall have thirty (30) calendar days from the date of protest to present the bill or item to the original 7 Requesting Party for payment,subject to any protest by the Requesting Party. E. If the Assisting Party cannot reach a mutual agreement with the Division or the Reyuesting Party to the settlement of any protested bill or billed item, the Division, the Assisting Party, or the Requesting Party may elect binding arbitration to determine its liability for the protested bill or billed item in accordance with Section F of this Article. F. If the Division or a Participating Party elects binding arbitration, it may select as an arbitrator any elected official of another Participating Party, or any other official of another Participating Party whose normal duties include emergency management, and the other Participating Party sball also select such an official as an arbitrator, and the arbitrators thus chosen shall select another such o�cial as a third arbitrator. G. The three(3)arbitrators shall convene by teleconference or videoconference within thirty(30) calendar days to consider any documents and any statements or arguments by the Department, the Reyuesting Party, or the Assisting Party concerning the protest, and shall render a decision in writing not later than ten (10) business days after the close of the hearing. The decision of a majority of the arbitrators shall bind the parties,and shall be final. H. If the Requesting Party has not forwarded a request through the Division, or if an Assisting Party has rendered assistance without being requested to do so by the Division, the Division shall not be liable for the costs of any such assistance. All requests to the Federal Emergency Management Agency (FEMA) for the reimbursement of costs incurred by any Participating Pariy shall be made by and through the Division. I. If FEMA denies any request for reimbursement of costs which the Division has already advanced to an Assisting Party, the Assisting Party shall repay such costs to the Division, but the Division may waive such repayment for cause. ARTICLE VIII. 8 (_'osta .ligibl�f�r Reimhurea...o.,:, The costs incurred by the Assistin Pa S rty under this Agreement shall be reimbursed as needed to make the Assisting Party whole to the fullest extent practicable. A. Employees of the Assisting Party who render assistance under this Agreement shall be entitled to receive from the Assisting Party all their usual wages, salaries, and any and all other compensation for mobilization, hours worked, and demobilization. Such compensation shall include any and all contributions for insurance and retirement, and such employees shall continue to accumulate seniority at the usual rate. As between the employees and the Assisting Party, the employees shall have all the duties, responsibilities, immunities, rights, interests and privileges incident to their usual employment. The Requesting Party shall reimburse the Assisting Party for these costs of employment. B. The costs of equipment supplied by the Assisting Party shall be reimbursed at the rental rate established in FEMA's Schedule of Equipment Rates (attached to Form B), or at any other rental rate agreed to by the Requesting Party. In order to be eligible for reimbursement,equipment must be in actual operation performing eligible work.The labor costs of the operator are not included in the rates and should be approved separately from equipment costs. The Assisting Party shall pay for fuels, other consumable supplies,and repairs to its equipment as needed to keep the equipment in a state of operational readiness. Rent for the equipment shall be deemed to include the cost of fuel and other consumable supplies, maintenance, service, repairs, and ordinary wear and tear. With the consent of the Assisting Party, the Requesting Party may provide fuels, consumable supplies, maintenance, and repair services for such equipment at the site.In that event,the Requesting Party rnay deduct the actual costs of such fuels, consumable supplies, maintenance, and services from the total costs otherwise payable to the Assisting Party. If the equipment is damaged while in use under this Agreement and the Assisting Party receives payment for such damage under any contract of insurance,the Requesting Party may deduct such payment from any item or items billed by the Assisting Party for any of the costs for such damage that may otherwise be payable. 9 C. The Requesting Party shall pay the total costs for the use and consumption of any and all consumable supplies delivered by the Assisting Party for the Requesting Party under this Agreement. In the case of perishable supplies, consumption shall be deemed to include normal deterioration, spoilage and damage notwithstanding the exercise of reasonable care in its storage and use. Supplies remaining unused shall be retumed to the Assisting Party in usable condition upon the close of the Period of Assistance, and the Requesting Pariy may deduct the cost of such returned supplies from the total costs billed by the Assisting Party for such supplies. If the Assisting Party agrees, the Requesting Party may also replace any and all used consumable supplies with like supplies in usable condition and of like grade, quality and quantity within the dme allowed for reimbursement under this Agreement. D. The Assisting Party shall keep records to document all assistance rendered under this Agreement. Such records shall present information sufficient to meet the audit requirements specified in the regulations of FEMA and any applicable circulars issued by the State of Florida Office of Management and Budget. Upon reasonable notice, the Assisting Party shall make its records available to the Division and the Requesting Party for inspection or duplication between 5:00 a.m. and 5:00 p.m. on all weekdays,except for official holidays. ARTICLE IX. �5�. Each Participating Party shall deternvne for itself what insurance to procure, if any. With the exceptions in this Article,nothing in this Agreement shall be construed to require any Participating Party to procure insurance. A. Each Participating Party shall procure employers' insurance meeting the requirements of the Workers' Compensation Act, as amended, affording coverage for any of its employees who may be injured while performing any activities under the authority of this Agreement, and shall file with the Division a certificate issued by the insurer attesting to such coverage. B. Any Participating Party that elects additional insurance affording liability coverage for any 10 activities that may be performed under the authority of this Agreement shall file with the Division a certificate issued by the insurer attesting to such coverage. C. Any Participating Party that is self-insured with respect to any line or lines of insurance shall file with the Division copies of all resolutions in current effect reflecting its determination to act as a self- insurer. D. Subject to the limits of such liability insurance as any Participating Party may elect to procure, nothing in this Agreement shall be construed to waive, in whole or in part, any immunity any Participating Party may have in any judicial or quasi judicial proceeding. E. Each Participating Party which renders assistance under this Ageement shall be deemed to stand in the relation of an independent contractor to all other Participating Parties, and shall not be deemed to be the agent of any other Participating Party, F. Nothing in this Agreement shall be construed to relieve any Participating Party of liability for its own conduct and that of its employees. G. Nothing in this Agreement shall be construed to obligate any Participating Party to indemnify any other Participating Party from liability to tlurd parties. ARTICLE X. �neral R .o�ir �++�.+ra Notwithstanding anything to the contrary elsewhere in this Agreement, all Participating Parties shall be subject to the following requirements in the performance of this Agreement: A. To the extent that assistance under this Agreement is funded by State funds, the obligation of any statewide instrumentality of the State of Florida to reimburse any Assisting Party under this Agreement is contingent upon an annual appropriation by the Legislature. B. All bills for reimbursement under this Agreement from State funds shall be submitted in detail sufficient for auditing purposes. To the extent that such bills represent costs incurred for travel, such bills shall be submitted in accordance with section 112.061, Florida Statutes, and any applicable Il requirements for the reimbursement of state employees for travel costs. C. All Participating Parties shall allow public access to all documents, papers, letters or other materials subject to the requirements of the Public Records Act,as amended,and rnade or received by any Participating Party in conjunction with this Ageement. D. No Participating Party may hire employees in violation of the employment restrictions in the Immigration and Nationality Act,as amended. E. No costs reimbursed under this Agreement may be used directly or indirectly to influence legislation or any other official action by the Legislature of the State of Florida or any of its agencies. F. Any communication to the Division under this Agreement shall be sent to the Director, Division of Emergency Management, 2555 Shumard Oak Boulevard, Tallahassee, Florida 32399-2100. Any communication to any other Participating Party shall be sent to the official or officials specified by that Participating Party on Form C attached to this Agreement. For the purpose of this Section, any such communication may be sent by the U.S.Mail,e-mail,or by facsimile. ARTICLE XI. Effec�AS�e mPnt. Upon its execution by a Participating Party, this Agreement shall have the following effect with respect to that Participating Party: A. The execution of this Agreement by any Participating Party which is a signatory to the Statewide Mutual Aid Agreement of 1994 shall terminate the rights, interests, duties, and responsibilities and obligations of that Participating Party under that agreement, but such termination shall not affect the liability of the Participating Party for the reimbursement of any costs due under that agreement,regardless of whether billed or unbilled. B. The execution of this Agreement by any Participating Party which is a signatory to the Public Works Mutual Aid Agreement shall terminate the rights, interests, duties, responsibilities and obligations of that Participating Party under that agreement, but such termination shall not affect the liability of the 12 Participating Party for the reimbursement of any costs due under that agreement, regardless of whether billed or unbilled. C. Upon the activation of this Agreement by the Requesting Party, this Agreement shall supersede any other existing agreement between it and any Assisting Pariy to the extent that the former may be inconsistent with the latter. D. Unless superseded by the execution of this Agreement in accordance with Section A of this Article, the Statewide Mutual Aid Agreement of 1994 shall terminate and cease to have legal existence after June 30,2001. E. Upon its execution by any Participating Party, this Agreement will continue in effect for one (l) year from its date of execution by that Participating Party, and it shall automatically renew each year after its execution, unless within sixty (60) calendar days before that date the Participating Party notifies the Division,in writing,of its intent to withdraw from the Agreement. F. The Division shall transmit any amendment to this Agreement by sending the amendment to al] Participating Parties not later than five (5) business days after its execution by the Division. Such amendment shall take effect not later than sixty (60) calendar days after the date of its execution by the Division, and shall then be binding on all Participating Parties. Notwithstanding the preceding sentence, any Participating Party v►,ho objects to the amendment may withdraw from the Agreement by notifying the Division in writing of its intent to do so within that time in accordance with Section E of this Articie. ARTICLE XII. Interoretation 8nd A�nlico�inn ..r s��, ,,,p,,. The interpretation and application of this Agreement shall be governed by the following conditions: A. The obligations and conditions resting upon the Participating Parties under this Agreement aze not independent,but dependent. B. Time shall be of the essence of this Agreement, and of the performance of all conditions, 13 obligations,duties,responsibilities,and promises under it. C. This Agreement states all the conditions, obligations, duties, responsibilities, and promises of the Participating Parties with respect to the subject of this Agreement, and there are no conditions, obligations,duties,responsibilities,or promises other than those expressed in this Agreement. D. If any sentence, clause, phrase, or other portion of this Agreement is ruled unenforceable or invalid, every other sentence, clause,phrase, or other portion of the Agreement shall remain in full force and effect, it being the intent of the Division and the other Participating Parties that every portion of the Agreement shall be severable from every other portion to the fullest extent practicable. The Division reserves the right, at its sole and absolute discretion, to change, modify, add, or remove portions of any sentence, clause, phrase, or other portion of this Agreement that conflicts with state law, regulation, or policy. If the change is minor, the Division wi11 notify the Participating Party of the change and such changes will become effective immediately; therefore,please check these terms periodically for changes. If the change is substantive, the Participating Party may be required to execute the Agreement with the adopted changes. Your continued or subsequent use of this Agreement following the posting of minor changes to this Agreement will mean you accept those changes. E. The waiver of any obligation or condition in this Agreement by a Participating Party shall not be construed as a waiver of any other obligation or condition in this Agreement. NOTE:On February Z6,2018,this Agreement was modified by the Division ofEinergency Management. This document replaces the August 20,2007 edition of the Statewide Mutual Aid Agreement; however, any and al!Agreements previously executed shal[remnin in full force and e.J)''ec�Any local government, special district, or educat�ona[ institution which hqs yet to execute this Agreement should use the February 26,2018 edition for the purposes of becoming a signatory. IN WITNESS WHEREOF, the Participating Parties have duly executed this Agreement on the date specified below; 14 FOR ADOPTION BY A COUNTY STATE OF FLORIDA DNISION OF EMERGENCY MANAGEMENT BY� Date: Director ATTEST: BOARD OF COUNTY COMMISSIONERS CLERK OF THE CIRCUIT COURT OF COUNTY, . STATE OF FLORIDA By: By; Deputy Clerk Chairman Date: Approved as to Form: By: County Attorney 15 FOR ADOPTION BY A CITY STATE OF FLORIDA DIVISION OF EMERG Y M GEMENT BY: Date: 1� b Director ATTEST: CITY CLERK "� By:la � � M 1 t'djutz&, Title: CITY OF STATE OF FLORIDA By: Title: Date: vll fe V FOR ADOPTION BY A CITY STATE OF FLORIDA DNISION OF EMERGENCY MANAGEMENT By� Date: Director ATTEST: CITY OF CITY CLERK STATE OF FC,ORIDA By: gY: / Title: Title: `"' t �"""'"' �� Date: Approved as to Form: By: City Attorney 16 FOR ADOPTION BY AN EDUCATIONAL DISTRICT STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT BY� Date: Director SCHOOL DISTRICT, STATE OF FLORIDA By: gy. Title: Title: Date: Approved as to Form: By: Attomey for District 17 FOR ADOPTION BY A COMMUNITY COLLEGE OR STATE UNIVERSITY STATE OF FLORIDA DNISION OF EMERGENCY MANAGEMENT BY� Date: Director ATTEST: BOARD OF TRUSTEES OF COMMUNITY COLLEGE, STATE OF FLORIDA BOARD OF TRUSTEES OF UNNERSITY, STATE OF FLORIDA By: By: Clerk Chairman Date: Approved as to Form: By: Attorney for Board 18 FOR ADOPTION BY A SPECIAL DISTRICT STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT BY� Date: Director SPECIAL DISTRICT, STATE OF FLORIDA By: gy. Title: Title: Dete: Approved as to Form: By: Attorney for District 19 FOR ADOPTION BY AN AUTHORITY STATE OF FLORiDA DIVISION OF EMERGENCY MANAGEMENT By� Date: Director ATTEST: BOARD OF TRUSTEES OF AUTHORITY, STATE OF FLORIDA By: By. Clerk Chairman Date: Approved as to Form: By: Attorney for Board 20 FOR ADOPTION BY A NATIVE AMERICAN TRIBE STATE OF FLORTDA DIVISION OF EMERGENCY MANAGEMENT By� Date: Director ATTEST: TRIBAL COUNCiL OF THE TRIBE OF FLORIDA By: By, Council Clerk Chairman Date: Approved as to Form: Dy: Attorney for Council 21 FOR ADOPTION BY A COMMUNITY DEVELOPMENT DISTRICT STATE OF FLORIDA DiVIS10N OF EMERGENCY MANAGEMENT By� Date: Director COMMLTNITY DEVELOPMENT DISTRICT, STATE OF FLORIDA By: By: Title: Title: Date: Approved as to Form: By: Attorney for District Date: 22 FORM C CONTACT INFORMATION FOR AUTHORIZED REpRESENTATIVES Name of Government: Mailing Address: Authorized Representative Contact Information Primary Authorized Representative Name: Title: Address: Day Phone: Night Phone: Facsimile: Email: 18f Alternate Authorized Re resentative Name: Title: Address: Day Phone: Night Phone: Facsimile: Email: Z"a Alternate Authorized Re resentative Name: Title: Address: Day Phone: Night Phone: Facsimile: Email: ***PLEASE UPDATE AS ELECTIONS OR APPOINTMENTS OCCUR*** 23 Attachment 1 STATEWIDE MUTUAL AID AGREEMENT rypa or print all information except sipnatures Fomt B PART I TO BE COMPLETED BY THE REQUESTING PARTY te: me: Mission No: HRS E-mail Polnt of Contact: Tel hone No: address: Assisting Party: uestl Pa Incident R uirin Assistance: T e of Assistance Resources Needed use Part IV for additional s ce Date&Time Resources Location Needed: (address): Approximated Date/lime Resources Released: Authorized OPfldal's Name: Signature: Title: Agency: PART II TO BE COMPLETED BY THE ASSISTING PARTY E-mall Contact Person: Telephone No: address: Type of Assistance Available: Date&Tlme Resources Avaflable To: Location(address): Approximate Total cost for missbn: # Equipment& Travet: � Personnel: $ Materlals: $ Contract Rental: � Logistics Required from Requesting Party Yes (Provide informatlon on attached Part IV) No Authorized Offldal's Name: Title; Date: Signature: Local Missfon No: PART III TO BE COMPLETED BY THE RE UESTING PARTY Authorized Offidal's Name: Title: Signature: Agency: Revised:March 2018 Page 1 PART IV STATEWIDE MUTUAL AID AGREEMENT iypa or print a���Mormation except stgnatures Form 8(contlnued) MISCELLANEOUS ITEMS/OTHER MISSION INFORMATION Revised:March 2018 Page 2 FEMA's SCHEDULE OF EQUIPMENT RATES DEPARTMENT OF HOMELAND 8ECURITY FEDERAL EMEROENCY MANAOEMENT AGENCY RECOVERY DIRECTORATE PUBLIC A9813TANCE DIVISION WASHINGTON,DC 20472 The rates on Ihis 3diedule W EqWpmeM Ratee are far eDpl�cent owned equlpmeM in goad mechanlcal condlGon, cortqlete with all reQulred atlaclxnenta.Each rate covera all coats eliglble under the Robert T.Staflord Disester Reliaf and Emerpency Aseietence Act,�2 U.S.C.§5121,et saq.,for ownerahip end aperellon ot equpmeM,Induding deprecletlon,overhead,all meinterrence,fleld repairs,fual,lubricenta,droe,OSHA equlpment end olher costs fnddaMal to operedon.Standby equlpmeM coats aro not eligible. Equipment must be In eclual operatlon performing ellglble work in order tor rdmbureemant ta be eliglde.LABOR COSTS OF OPERATOR ARE NOT INCLUDED In the reles end should be approved separalely from equipmenl coste. IMamatlan regerding the we of the Schedule Ie conlalned in 44 CFR§208.228 Allowable Costs.Ratas for equlpmeM not Ileled wip be fumished by FEMA upon request.My eppeals shall be In accadence with 44 CFR§208,208 Appeals. THESE RATES ARE APPLICABLE TO MAJOR DISASTERS AND EMERGENCIES DECIARED BY THE PRESIDENT ON OR AFTER SEPTMBER 1,2017. O� . :,,•r. - - 6 r:::.: '�.,+�F:�, Code 8 ecificatfons '��! "'>� HP NOtrs Unit 8010 Alr Com reeaor Air Deli 41 CFM to 10 Haeee Included, hour 51.51 8011 Air Com Alr Delivs 103 CFM to 30 Hoeae InGuded. hoW �,gq �1z ��O1^ °� ����� 130 CFM �Sp Hosea Induded. hour i11.14 8013 Alr C esa Nr Dali 175 CFM to 80 Hoaee Induded. Fpur 518.39 8014 Alr Com asa Air Dellva 400 CFM l0145 Hosas included. hour =30.47 8015 Ak Com asor Alr Dellve 575 CFM to 230 Hosea 7ncluded. hour 548.77 8018 Alr Co ssw Nr Dellve 1100 CFM to 366 Hoses Induded. hour 582.88 8017 Alr Can reasor Air Dellve 1800 CFM ta 500 Fbsea Included, har 598.88 � ��a� to 150 hour 528.00 8041 Ambu�ence to 210 hour s40.50 8050 Board Arrow to 8 Treiler Mounted. hour y1.43 8051 Boaid Messa a l0 5 7raAer Mounted. hour 511.81 8060 a,Portable Hole Dlameler 16 In to 6 hour 52.74 8081 r,Portable Hole Dlemeler 18 In to 13 hour s4.30 InU�ea digger,boom and 8082 r,Tractor MMd Max. er Dlameter 381n to 13 mounting heMware. how 53.16 mouMing herdwere. Add this 8083 r,Truck Mntd Mex, er Siza 241n to 100 rale to Vector rete for lolel hour s34,2B 8084 H reulic Post Odver hour 535.70 Horizontsl DlreUlonal Boring 8065 A er Mechine 250 X 100 300 DD-1408 YR-2003 hour E169.40 Horimntel DI onal oring BOB6 er Machine 50 X 100 hour 531.85 Auper,Dlredlonal8aing 8087 Mechlne er,Directlanel Borin Machine hour f36.97 8070 Automobile to 130 Transportinp people. mile fO.SJ$ 6071 Automob(le to 130 Trengporting car9o• hour E12.32 8072 Aulomoblle,Pdlce to 250 Patrolling. mile t0.53a Sfetlonery wlth enpine 8073 /4Aomobile,Pdlce to 250 running. hour 515.89 8075 Motor s,Pollce mile j0.b05 8076 Automlhile-Che Treilblazar 6 or 8 d 285 to 300 hour sZZ.00 l077 Automoblle-Ford E Ition Fire Command CaMer Iwur 518.00 8080 IJI Terraln Vehide ATV E ne 110cc,4-Wheel;20' re 6.6-7.5 hour 58.20 8081 All Tertein Vehide AN En ine 125a,4Wheel;21' e 7.8-8.6 �� �.� BOB2 All Terrafn Vehlde AN En ine 150cc,4Wheel;22' e 9.0-10.0 hour 58.51 8083 All Teneln Vehide AN E ne 200cc,4-Wheel;24" e 12-14.0 hour S8.D0 9084 All Tertain Vehlcle AN En ine 250cc,MWheel;pq• 15-17 hour s9.40 8085 AU Terteln Vehide AN En 'ne 300cc,4Wheel;24" e 18-20 hour 510.20 BOBB All TaRaln Vehide AN E Ino 400cc.4-Wheel;25' re 28-28 hour 511.84 BOB7 All Terreln Vehide AN E 'ne�50cc,4-Whael;25' ra 26-28 hour 512.40 8088 NI Terreln VeNcle AN En ine 850cc,4Whee1;25' re 38�0 hour 573.20 80BB All Terraln Vehlde AN En Ine 750cc,4Wheel;25' e 44-46 hour 514.00 8110 Ba e,Dedc Slze 50'x355c7.25' hour y18.10 8111 Ba ,Deck Slze 50'x3Sx9' hour t5B.70 8112 Ba ,Dedc Siza 120'x45k10' hour 5109.50 9113 Be e,Deck 51ze 7B0'x45k11" hour 5133.75 8120 Boet,Tow Size 55'x20'x5' to B70 Sleal, hour 5317.54 8121 Boat,Tow Size 60'x21k5' to 1060 Sleel. hour 5358.85 8122 Boet,Tow Size 70'x30'x7.5' to 1350 Steel. hour 5589.00 8123 Boet,Tow Slze 120'x34k8' fo 2000 3teel. hour f1,084.24 8124 Airboat B15AGIS Alrboat w/ ra uNt 15'x8' 400 har 531.00 8125 Aiiboat 915A013 Airboet w ra unit 75k8' 425 haur 531.85 8126 Swa C ueet 360 har 538.25 Compador-2-Ton Pevement B129 Rdler 2 tan hour 528.25 8130 Boat,Row Heavy du�y. hour =1.44 8131 Boat,Runaboul Size 13k5' to 50 Outboard. hour 512.00 r e 8132 Boat,Tender Slze 14'xT l0 700 drive. hour s16.50 8133 Boet,Push Slze 45k21'x8' l0 435 Flal hull. haur 5217.20 8134 Boat,Puah Size 54'�1'x8' to 525 Flet hull. hour E267.35 8135 Boel,Push Size 5B'�f24'x7.5' l0 705 Flet hult. hour E325.35 8138 Boat,Puah Slze 64'�Q5'xB' l0 870 Flet hull. hour f35B.50 8140 Boet Tu L th 16 Ft to 100 hour 542.80 8141 Boet,Tu Len 1B Ft to 175 hour 562.55 E142 Boet,Tu Len th 28 Ft to 250 hour E78.B5 8143 Boal,Tu Len th 40 Ft to 380 hour 5798.50 81M Boa4 Tu L th 51 Ft to 700 how 5271.85 9147 Boat,InAateWe Reecue ReR Zodiac �W =��p 8148 Boet,Runebout 1544 Ibs 71 aesen er ce d 196-250 hour 562.55 000 Johneon Oulboerd Motw w 8149 Boet,romovable e Ine 15"ahaft 15 hour 51.50 8150 Broom,pevement Broom Le th 72 In ta 35 hour 524.50 8151 Broom,PevemeM Broom L ih 96 In to 100 hour 527.80 me over coet or 8153 Broom,PevemeM,MMd Broom La th 72 In to 18 lolal rale har 58.20 Add P�Ime Mover cost for 8154 8room,Pavement,Pull Broom Le th 84 In to 2D total rate hour 520.77 8167 Swee w,Pavement to 110 hour 578,70 8158 Swee ei,Pevement to 230 hour S96.B0 8180 Bue to 150 hour 520.8b B1B/ Bue to 210 hour E25.45 B�� � to 300 hour j38.35 8183 Blower Oaeoline red Toro Pro Forca 27 hour =15.37 1184 Back-PeckBlower to4.4 hour j1,50 etes Welk•BeMnd Blower 73 hour 56.50 87l7 Cl�eineaw 20"Bar,3.0 cu In hour 51.40 t1E� Cheinsaw 20"Bar b.0 cu In Iwur E2.45 61l9 Chelnsew 20"Ber6.0 culn hour iz.85 8190 Chein Sew Bar La th 18 In hour 51.70 8191 Chain Saw Ber Len lh 25 In how t3.45 8182 Cheln Saw,Pde Ber Size 1B In how E�.25 8183 Skidder model 748 E to 173 hour E52.70 8191 SWdder mode1648 011 to 177 hour 5104.30 8196 CuKer,Brueh Cutler Size 8 ft to 150 hour E115.35 8198 Cutter,Bruah Cutler 31ze 8 ft to 180 hour 5129.35 8197 Cuttar,Brueh Cutter Slze t01t to 245 Fqur 5136.30 Cutter,Bnmh-247 hp,1997 Model 8198 &uncher Cutter 511 FeAer to 247 hour E187.75 8199 L Trellar 40 fi hour 59.90 8200 Chi r,Bruah Chl I Ca d 8 In to 35 Treller Mounted. hour :g,gp 8201 Chl r,Brush CN Ce eG B in to 65 Traller Mounted. hour 518.88 9202 Chi r,Brueh Chi In Ca acl 12 In to 100 Traller MouMed, hour =24.31 8�03 Chi er,Brush Ch In Ca ad 15 In to 125 Traller Mounlad. hour 535.00 8204 CM r,&ueh Chl i Ca d 18 In to 200 Treller Mounted. haur oe r- redor- 550.10 8208 Knucklaboom model Berko 595 ML to 173 hour E161.89 model 210 w/Buck Saw 50 Indi 8209 Loader-Wheel 8ar to 240 hour 597.00 8210 Clemshell 8 Dre Ilna,Crawler 149,999 Iba to 235 Budcal not indudad In rale, hour �727.�0 8211 Gemshell 8 D Ine,Gewler 250,OW Ibe to 520 Budtet not Included in rete. hour 5186.20 8212 Clemahell 8 D Ilne,Truck to 240 Buckel not Included in rete. hour 5115.00 8220 Co ector to 10 hour 575.10 P or� ow , aWry 8221 Drum to 45 har 531.70 8222 Com ctor,Vibrel ,Drum W 75 hour SZZ.30 8223 C dor, neumetic,whael to 100 hour 528.00 8225 Com dor,Sanifatlon to 300 hour 582.75 8228 Com r.Sanitatlm to 400 hour 5152.30 8227 Cam edor,SaMtetlon 635 hour 5249.75 Compacior,towed, 8228 Pneumatic,Wheal 10000 Iba Include pNme mover rete hour E17.00 8228 Compadar,towed,Dnxn 3tatic 200001bs Include pAme mover rale ►rour 515.80 8240 Feeder,Orlal l0 35 hoir E22.20 8241 Feeder,Grlyd to 55 hour =32.45 B242 Feeder,Oriv1 to 75 hour 584.25 8250 Dozer,Crawler l0 75 hour 551.30 8251 Doze�,Crewlar to 105 hour E38.30 8252 Dozer,Crawler to 160 hour E93.71 8253 Dozer,CreyNar ta 250 haur f149.75 82W Oozer,Crewler l0 380 hour 5201.10 8255 Dozer,Crawler to 585 hour 5311.80 8268 Dozer,Cravrler to 850 hour 5284.10 8280 Dozer,Wheel to 300 hour E67.00 8281 Dozer,Wheel to400 hour E84.10 8282 Dozer,Wheel b 500 hour 5778.85 8283 Dozer,Whael to825 hour :238.80 3 hlich attach far lrector;2007 8288 Box Scre er Befco hour j3.50 8270 Bucket,Clemahell Ce acl Indudas teeth.Doea not 1.0 CY Indude Clamehell 8 DragBne hoa yt.62 8271 Bucket,Clamahell Ce aG Indudea teelh.Dces rrot 2.5 CY induda Clamal�ell 8 Dragline hour E6.73 Includea teeth.Daea rot 8272 Bucket,Clemehall Ce acit 5.0 CY indude Clemehdl 8 Draglina hour f 13.10 Includea teeth.Doee rrot 8273 Bucket,ClamaheN Ce d 7.5 CY include Clemehell 6 DreB��� hour 522.40 8275 Budcet,Dr �trre �8 � Doea nat indude Clemehell 8 2A CY Dregllne Iroir 53.86 Does not Include Clamahell 6 8T78 Bucket,Ora Ilne Ce ci 5.0 CV Oragline hour j9.90 8277 Bucket,Dra Ilne Ca ad Does not Indude Clemehell 8 10 CY prepline hour 514.10 Doea rwt Indude Clemshe118 8278 Bucket,Dre line CepaG 14 CY Drapl7ne hour 518.65 Crawlx,Truck 8 Wheel. 8280 Excavator,H reullc Bucket Ca G 0.5 CY to 45 Includes buaket hour j�g,pp Gawler,Truck d Wheel. 8281 Excevetor,H raWlc Bucket acl 1.0 CY to 80 Includes buckel. hour 534.2p Gawler,Trudc 8 Wheel. 8282 Excavator,H reulic Bucket acl 1.5 CY to 160 Includes bucket. hour 552.70 C�ewler,Trudc 3 Wheel. 8283 Excavator,H dre�ic Bucket Ca ea 2.5 CY to 285 Indudea bucket. hp� s��� Crawler,Truck 8 Wheel. 8284 Ezcavalor,H dreWic Budcet Ca cl 4.5 CY to 420 Indudea bucket. pp�� szgq,gp Crewler,Truck 8 Whed. 8285 Excevatw,H rauHc Budcet Ca I 7,5 CY to 660 Includea huckeL hour 5223.70 Crawler,Truck&Wheal. 8288 Excavator,H reullc Bucket Ca ed 12 CY to 1000 Includea hucket. hour y{b5.00 8287 Excevetor 2007 model Gredell XL3100 III 1B4 hour f105.48 8298 Excavator 2003 model Gradell XL4100 III 238 har 5113.20 8288 Excavator 2008 model C3rede1l XL5100 230 hour SBB.BO 8290 Trowel,Concrete Dlemeter 48 In to 12 hour s4.80 8300 Fork LHI C cl 8000 Lbe to 60 hour E13.00 8301 Fork LIR Ca 12000 Lba to BO hour 518.50 8302 Fork Uft Ce ed 18000 Lbs to 140 hour E24.0p 8303 Fork LIR Ca ad 50000 Lba l0 215 hour 551.40 8308 Fork LIft Materiel hendler Dlesel,CAT TH380B 8800-11500 gvwr Ibs 99.8 hour =27.90 8307 Fqk LIft Material harMler Dleael,CAT TH�608 98.8 hour 530.15 8308 Fork LiR Malerlal handlx Dleael,CAT TH560B 99.9 hour 535.80 8309 Fork Lift Acceseo 2003 ACS Paddle Fork hour :3,46 8310 Oenerator Prima O 5.5 KW to 10 hour t3.35 8311 Oeneretor Prime O 18 KW to 25 hour :7.45 8312 Oenarola Pnme O 43 KW to 65 hour 515.00 8313 Generalor Prlme Out 100 KW l0125 hour E34.95 8314 Generalor P�ime O 150 KW to 240 haur 550.00 831b Generata Prime Out 210 KW ta 300 hour i82.46 8316 Qeneralor Prime 280 KW to 400 hour 580.40 8317 Generata Prime O 35D KW to 500 hour 580.50 8318 Gsnerator Prlma 0ut 530 KW to 7b0 hour 5153.30 8319 Generator Prime O 710 KW to 7000 hour S2T2.00 8320 Oeneretor Prime Out ul 1100 KW to 1500 Open har 5349.00 8321 Generelor Prfma Out uf 2500 KW to 3000 hour =533.75 8322 Oeneretor Prime O t 1,000 KW la 1645 Enclosed hour y103.30 8323 (�enereta Prime Out t 1,600 KW to 2500 Endoeed hour 5511.22 8324 Generalor Prime 1100KW 2500 Encloaed hour E485.80 8326 Generala Prlme Out ut 40KW 80 hour 51�.90 8328 Oeneralor Prima ut 20KW 40 hour 513.32 Ineludea Popld and Artiadate 8330 Oredara Moldboard 3ize 10 Ft to 110 equipment. hour 543.30 kid�ae Rlgld and ArUculela 8331 Orsders Mddboerd Slu 12 Ft l0150 equipment. hour yt6.50 Indudes Rigid and ArUculats 8332 Gredern Moldboard Slze 14 Ft to 225 equipment, hour s87.50 Par 26 foot lenpih.Induden 8360 Hose,Dlechar Diemeter 3 In couplln8g• hour $0.15 Per 25 foot length.Includes 8351 Hose,Diachar Diameler 4 In couplings, hour y0.24 Per 26 fool lengtti.Includea 8362 Hoss,qecha e Dlameler 6 In cauplinge. hour f0.80 Per 25 foot lengm.Indudea 8353 Hoae,Dlscha e Diemeler B In couplings, hour =0.60 Par 25 faot length.Indudes 8354 Hoae,Discha e Dlemeter 121n couplinga. Faur :0.8p Per 25/oot length.Indudea 8355 Hoee,Disch e Diameter 18 In couplln8s• hour 51.70 Per 25/aot lenpth,Indudes 8358 Hoee,Sudlon Dlameter 31n ooupllnps• hour 50.30 Per 25(oot lergth.Includes B357 Hoee,SucUan Diameter 41n cauplln s, hotr 50.35 Pe�25 foot lenpth.Includea 8358 Hoae,Suctlon Dlemeter B ln couplinga, hour 51.15 Per 25footlength.lncludee 8358 Hoae,Sudfon Dlameler 8 In couplinps. hour 51.10 Pa 25 foot lanpth.Indudes 8380 Hoee,Sucdon Diemeler 121n couplinge. hour =1.70 Per 25/oot langth.Indudea 8381 Hoee,Suctlon Diameter 161n cauqirpa, hour 53.15 8380 Loeder,Crawler Bucket Ca a ' 0.5 CY to 32 Includea bucket. hour 514.86 8381 Loeder,Crewler Budcet Ca acl 1 CY to 60 Indudes buckaL Fwur 534.30 8382 Loedar,Crewlar Budcet Ce d 2 CY to 118 I�ludes bucket. hour 568.10 B3B3 Loeder,Crewler Budcet d 3 CY to 178 Includes buckeL hour 5101.30 8384 Loeder,Crewler Budcat Ce 4 CY to 238 Indudes buckel hour 5120.00 8380 Loader,Wheel Bucket Ce G 0.5 CY to 38 har Sz0.10 8381 Loader,Wheel Buckel C acl 1 CY to 80 hour 536.90 9392 Loader,Wheel Bucket Ca aci 2 CV to 105 CAT-928 har =35.50 8393 Load�,W heel Budcet Ca eG 3 CY to 152 har y43.85 8394 Loader,Wheel Buckel Ce aci 4 CV to 200 twtr s59.30 8395 Loeder,W heel Bucket Ca eci 5 CY l0 250 hour jg4,pp 8398 Loedx,Wheel Budcet Ce ci 8 CY to 305 hour E104.00 8387 Loeder,Wheel Bucket Ca d 7 CY to 360 hour 5124.50 8398 Loader,Wheel Budcet Ca 8 CY to 530 hour 5171.40 8401 Loader,Trecta,Wheel Budcet Ce d 0.87 CY l0 80 Case 580 Super L hour 533.73 8�10 Mlxer,Conaete Portade BetW Ca acl 10 Cft hour 53.06 8411 Mlxer,Conaeta PortaWe Balchln adt 12 Cfl 11 hour s4.00 8412 Mixer,Concrete,Treller MMd Batchi cl 11 CR to 10 hour 512.70 8413 Mlxer,Conaete,Trailer Mntd Batdd Ce ci 18 Cft to 25 hour j79.80 8419 Brsakx,Pavamerd Hend•Hald Wei 25-90 Lbs hour 51.10 8420 Broaker,Pavament to 70 hour E57.45 8423 S eder,Chi S read H Width 12.5 Ft to 152 hour SB5.85 8424 S reader,Chl 3 reed Ho er Wldth 16.5 Ft ta 215 hour 5116.60 8425 S eader,Chi ,MnW Ho er Slze 8 Ft lo B Trailar 3 trudc mounted. hour =4.80 Does not include Pnme 8430 Paver,Ae halt,Towad Mover. hour 512.40 Includea wtreel and crewler �� Pa��� �� to 50 equlpment. hour E73.78 Includes wheel end crewlar 8432 Pever,Aa helt ta 125 equlpmont, hour 595.10 Includee wheel and crewler 8433 Paver,As helt ���5 equipment. hour 5126.80 Includes wheel and crawler 8434 Pever,Ae hall 35,OOOLbs 8 Over to 250 equiprt�ent. hotr f209.85 8138 Pldc- ,As ell to 110 Frour 596.85 &137 Plck- , helt to 150 hour 5135.00 8438 Pick-u ,Ae halt to 200 hour =83.50 8438 Pidc-u ,Aephelt to 275 hour 5204.00 8440 Stri Paint Ce 40 Gel to 22 hour 518.2t1 8441 SU1 Peint Ce 90 Oal to 60 hour E22.90 8442 Siri r PaiM C aci 120 Gel to 122 hour =42.80 8H6 6VI x,Truck Mntd Pelnl Ce e 120 Gal l0 460 hour f78.80 8/48 Strl ,Walk-behind Pelnt Ce e 12 Gal ��� =q,pp ever ecceseory-Be t 2002 e oy Canveyor Belt 8447 6Aenalon Exlenabn crewler twur =32.50 8450 Plow,Snow,Oradx Mntd Width to 10 Ft Indude Grader fw totel cost hour S2B.00 8461 Plow,Srrow,dreder Mntd Widih to 14 Ft Indude Oreder for lotal cost haur E32 90 &152 Plow,Truck Mntd Widlh to 15 Ft Include truck for totel coet hour 524.35 Wlth Ieveling wing. ude 8�53 Plow,Tnxk Mntd Wldth to 15 FI Wck for tolal coet hour 510.80 8155 eder,Sand Mountl Tell ete,Chesele hour 57.35 8458 S edar,Send Mounlin Du Bod har 510.45 8457 S reader,Sa� Mountln Truck 10 d hour 513.15 8458 eder,Chemical Ce d 5 CY to 4 Traller&Vuck mouMed. hour s8.00 6488 Pump-Trash Pump 10 MTC 2"Pum l0 7 10,000 ph hour 57.25 8470 Pum Cerdrifu ,8M um 2'-10,000 el/hr, l0 4.5 Hoeea not Induded, hour =(i.10 8471 Pum Dla hr m pu 2"-3,000 al/hr. to 8 Hosea not Induded. hour j6.75 8472 P Cwidi sl,18M m 3'-18,000 el/hr. m to 10 Hoaee not induded. hour S7.B9 8473 Pum W 15 Hosea nd induded. hour 5�0.30 �74 P� ro 25 Hosea notircluded. hour 513.80 ��5 P� to 40 Hoses not Induded. hour 518.85 8476 Pum 4"-40,000 el/hr. 4"-40,000 al/hr. to 80 Hoses nW induded. haur 527.10 9477 Pum to 95 Hosee not indudad. hour s32.00 8478 Pum to 140 Hoses notinduded. hour y11.50 8479 Pum ta 200 Hoses nolinduded. hour 549.90 �� P� l0 276 Ooee not Indude Hosea. hour 588.85 8481 Pump to 350 Dosa not Include Moses. hour 582.00 8482 Pump ta 425 Does not include Hoses. hour SB6.80 �3 P� to 500 Does notlnGude Hoeas. hour E114,00 �� �� to b75 Doea not Include Hoses. how E133.30 8A95 Pump W 850 Doea nol Include Hoses. hour 5154.70 Add tMs rate to truck rete fa 8�88 Aerlal Lifl,Tnick MMd Max.Platlorm Hel ht 40 Fl total IIR end huck rate ►b�� s��,3g Add thle rate to truck rate for 8487 Aeriat Lift,Tnx;k MMd Max.Platlortn Hei hl 81 ft total Iift end lruck rate hour 520.54 Add this ra�e to huck rate far 6488 Aeri�LiR,Tnnic Mntd Mex.Platlortn Hei ht 80 Ft totel lift and I�uck rete hour 539.00 Add this rete to Uuck rate fw B48B Aeriel Litt,Truck Mntd Max.Platform Load-60ULbs 81 Ft-100 Ft.Ht, tWel IIft end tnrdc rate hour f38.50 Articuleted,Telescoping, 8490 Aerial Lift,SeIFPro Iled Mex.Platform Hei ht 37 Ft.Ht. W 15 Sclaeor. hour E8.85 ANculated,Telescoping, 8491 Aoriel Lift,Self-Pro elled Mez.Pletfarm Hei ht 60 Ft.Ht. to 30 Sciseor. hour 516.10 ArUculeted,Teleecoqnp, 8492 Aeriel LiR,Solt-Pro Isd Mex.Plalfarm Hel M 70 Ft.Ht. to 50 Sdssar. hour j29,28 8483 Aerlal LIft,Sd1-P bd Maz.PlaHorm Hsl ht 125 Ft.Ht. to 85 Mlculated and Telascaping. how E55.85 8484 Aeri�Lill,Sdf- led Max.Platfortn Hei M 160 Ft.Ht. to 130 Articulated and Telescopirg, hour 570.15 949b I.C.Aenal Lifl,Se1FPro Iled Mex.Plalfortn Loed-500 L6s 75'x155',40F1 HI. to 80 2000 Lbe Capedty hour S2B.95 &t86 Crane,Truck MMd Max.Lift Ca aci 24000 Lbe Indude huck rate fw total cosl hour 514.90 8487 Crane,Truck Mntd Max.Llfl Ca ac 36000 Lbe Indude truck rete(or tdel cost hour 522.40 8488 Crene,Ttuck MnW Max,LIR Ca e 60000 Lbe Include lruck rela tor totel coat hour 536.50 8488 Pump-TrasF►Pump CPB Ralln -10MTC 10000 alMr 7 Self-Priming Tresh Pump hour 57.55 8500 Gane Mex.Lift Ca acl B MT to BO hour 538.70 8501 Gane Max.LIR Ce ad 15 MT ta 150 hour jgg.gp 8502 Crene Max.Lift d 50 MT to 200 hov 590.00 8503 Crene Mex.LIR C cl 70 MT to 300 hour 5178.60 8504 Crane Mex Lift C cl 110 MT to 350 hour t24320 8510 3aw,Concrete Blade Dlametar 14 In to 14 hour 57.20 8611 Sew,Conaete 81ede Dlemeter 26 In to 35 hour y12.00 8512 Saw,Comxele Blede Dlameter 48 In to 85 hour 525.10 8513 Saw,Rodc ta 100 hour 533.50 8514 Sew,Rock to 200 hour s83.00 8617 Jeckhammer Wel ht Class 26-45 Lbs hour S1.8g 8518 Jadchemmer el Wal ht Cless 30-55 Lbs ��� _�� 8521 Scre r Scre r d 16 CY to 250 hour 5107.15 �� Scra Ca d 23 CY l0 385 how s155.50 8523 Scra Spa Ga d 34 CY to 475 hour 5270.00 8524 Scre Sas er Ca ed 44 CY to 600 hour E285.70 8540 Loeder,Skid-Steer O eratin Ce ecl 1000 Lbs to 35 hou� j14.15 8541 Loader,SkldSteer tl Ce 2000 Lbe to 65 hour 537.00 8542 Loeder,Skld-Steer reti 3000 Lbe to B5 Mwur 538.05 8550 Snow Bbwer,Tiuck Mntd Ca ei 600 T l0 75 Doea not inciude Wck hour 534.80 B557 Snow Blower,Tnck MMd Ce 1400 T h to 200 Doas not Indude truck hour s9�,Op 8562 Snow Blowar,Truck Mntd Ce 2000 T to 340 Doss not Indude Wck hour 5142.50 8553 3now Bbwer,Tnick Mntd Ce a zsoo r W 400 Does nol Indude truck hour =154.80 8558 3now Throwor,Welk Behind Cutting Width 25 In to 5 hour 52.80 8659 Sraw TTrowar,Walk Behind Cutting Width 601n to 15 haur 514.10 8580 Sraw&ower Ca aci 2,000 T h to 400 hour E234.00 8581 Snow Blower Ce eG 2,500 7 h to 500 hour 5265.00 8582 Snow&awer Ce eG 3,500 Tph lo B00 hour 5284.00 8588 Dimt ControlDedce Unfl 1300-2000 el 173'Lx98"Wz51•H 5.5 Hydro Pump w/100'1YY hose hour =3.45 Loeda�end Backhos Budcets 8570 Loeder-Backhoe,Wheel Loedx Bucket Ca ad 0.5 CY to 40 included. hour 522.75 Loaderand Beckhoe Bucketa 8671 Loeder-BerJchoe,Wheel Loeder Buckel Ca adt 1 CY to 70 induded, hour 529.50 Loederend Beckhoe 8udcets 8572 Loeder-Badchoe,Wheel Loeder Bucket Ce eci 1.5 CY to 95 induded. hour 538.60 Laeder and BackFioe Buckets 9673 Loadx-Beckhoe,Wheel Loeder Bucket Ca aci 1.75 CY to 115 induded. hour 547.77 burtbre,Insulated tank,and 8680 Dietributor, ft Tenk Ca 500 Gel dreulatlng apray bar, hoW f��,7g bumeB,ineuleted tank,and 85B1 Dletributor, halt Tenk Ca aci 7000 Oel ckculaUnp eprey bei. Include hour 521.30 bumera,IneWeted tenk,end 8582 DlelribuWr, halt Tank Ca 4000 Gal cfrculating eprey bar. Include haur 530.15 8583 Diatributor ETNYRE OII Dietributor Modal-PB349 300 hour 5�1.80 8584 DlstilbWa ETNYRE Quad Chi S reader 280 hau s83.20 Does not Include Prime 8680 Treller,Dum Ca aci 20 CY Mover, hour 511.38 Doee not include Prime 8581 Traller,Dum Ca aG 30 CY Mover. hour 513.10 8800 Traller,E ui ment Ca ad 30 Tons hour s14.15 6801 Treiler,E ui meM Ca ecl 40 Tone hour 515.50 880T TraHer,E ul rA Ce c( 80Tana hour 518.85 8803 Trailer,E ui meM Ce ad 120 Tonn hour j2B.35 wlth aump and a rear 8810 Treller,Wetar Tenk Ca ecit 4000 Gal epre hour 513.50 wlfh aump and e rear 8811 Treller,Water Tank Ca ci 8000 Gal sprayber. haur 516.55 wlth sunp and a rear 8812 Trallm,Water Tank Ce 1000D C,al sprayber. haur E19.20 with eump and a rear 8813 Trallar,Water Tank Ceped 14000 Gal sprayber. hour Sz3.77 8814 Truck-Water Tenker 1000 al.tank 175 hour i33.35 8820 Tub Orinder to MO haur 595.35 8821 Tub Grindar to 830 hour 5113.85 8822 Tub Grinder la 780 hour =183.80 8823 Tub Grinder to 1000 hour E322.00 BB27 Horizonlal prinder Model HO8000 630 hour 557.38 8828 SWm Orinder 1988 Vertnaer SG112 102 hour ¢17.00 8629 5tu Grinder 24' ndin wheel 110 hour 545.00 Doae not Include Prime 8630 5 ,Seed Worki Ce ac 750 Gel to 30 Mover. hour 514.00 Traller R truck mounted. B831 S ,Seed Worki Ca ad 1250 Gal to 50 Doea not Indude Wime hour 518.80 Doea not Include Prime 8832 S re x,Seed Workl C eG 3500 Gel to 115 Mover. hour s29,25 BB33 Mulcher,Traller MrKd Wakln Ca 7 TPH to 35 hour 514.10 9831 MWcher,Trailer Mntd Workl acl 10 TPH to 55 hour 520.80 8635 Mulcher,Traller MMd Wrnkin d 20 TPH to 120 how 529.45 8838 Scra r Shc R er WR 2400 w 317 el fuel lank 563 har j238.B5 8837 Traller CAT Double Belly Bottortrdump Trailer 26 CY of edl In one dump 330 13 CY of sdl each berty hour 592.33 Berber Beach Sand Reke 800HDr, 8838 Rake towad haur 516.40 WHdcat 828 Couper Trommd 8839 Chi r Screen chlpper w belt 125 hour 534.30 8840 Trailer,OHice Treiler Size B'x 24' Cargo Size 18R hour 51.95 8841 Traller,Oflice Treiler Sim B'x 32' Cergo Size 24tt hour 52.30 8842 TreNer,O(fice Treiler Slze 10'x 32' Cargo Slza 20ft hour sY.85 8843 Traller Hez•Met E ul ment Vailer 8'x18' hour E37.75 8844 Tretkr,Cove►ed UUII Traller 7'X 18' hour 55.65 8845 Traller,Dod a Rarn B'x 24'showar treller-12 ehowers 101 hour 529.46 8846 Treller,Dod e 32'fletbed water hour 527.90 Wheel Mounted.Chain end 8650 7rencher to 40 Wheel. hour E18.30 Wheel Mounted.Chain end 8851 Trencher to 85 Wheel. har 524.70 8854 Trencher acceseoriee 2008 Griewo�d Tronchbox hour 51.80 8880 Plow,CaWe Plow th 24 in to 30 hour s12.00 8887 Plow,Ceble Plow pe Ih 36 in to 65 hour 537.45 8882 Plow,Ceble Plow De th 4B in to 110 hour E41.25 alignment attechment. 8870 Dertick,H draulic DI er Max.Boom L Ih 60 Ft Indude Vuck rate hour 534.16 alipivnent attachmeM. 8871 Denick,H W�DI er Mex.Boom L th 90 f� Include hudc rate hour E54.6g BB80 Truck,Canaele Mixer Mixer d 73 CY to 300 hour s82.35 8884 Tnuk,Fire 100 Ft ledder hour =100.00 8890 Tnidc,Fire Pu Ce eci 1000 GPM hour E88.00 8891 Tnxk,Flre Pu Ca ecl 1250 GPM hour 572.25 B�2 Trucic,Fire Pwn Ca ecl 1500 GPM hour 578.90 8883 Tnidc,Fire Pum ad 2000 GPM hour 581.40 8884 Truck,Fire Ladder Ladder I th 75 FT hour 5117.10 8985 Truck,Flre Ladde� Ladder I th 150 FT hour 5142.75 8898 Truck,Flre No Ladder 330 Rascure Equipment hour 593.47 8700 Tniclt,Relbad Mexlmum Gvw 15000 Lbe to 200 hour 520.80 8701 TruGc,Fletbed Meximum Gvw 25000 Lbe to 275 hour f35.00 8702 Truck,Flalbed Medmum Ovw 30000 Lbs to 300 har 527.10 8703 Truck,Fletbed Ma�dmum Gvw 45000 Lba to 3B0 hour 544.70 4Bfl to 53fl,Ilet-bed,freight,iwo e�oe Traller,aeml exle 5p,000+ vwr hour 58.45 8708 Treiler,eemi endosed 4B R W 53 fl,two axles 50,000+ vwr hour :9.50 8710 Treller,eeml 28fl,ai le ade,frel hl 25,000 r hour :9,70 8711 Flet bed WII treilar B ton ho� E3.10 8712 Cbaner,9ewerlCelch Baeln Ho er C p 5 CY Truck Mounted. hour 524.80 8713 Cbener,Sewer/Cetch Basin Ho er Ca aci 14 CY Truck MouMed. hour 531.30 8714 Vactor B00 Gal S le/400 Oal Weter 500/B00 al 49 hour SB2.75 8715 Truck,H Mo Vac model LPb55DT hour S1B.00 8718 Leaf Vec Tow b Tnrdc 22,000 dm caped B6 Loaf Vac+Truck Code 8811 hour t51,25 8717 TruGc,Veaum 60,000 GVW 400 hour 574.20 8719 Lltter Pldcer model 21107 Berber towed by UeUor hour 59.80 8720 Truck,Oum SWck C d 8 CY to 220 fwur y4B.80 8721 Truck,Dum Slruck Ca a 10 CY l0 320 hour s80.77 8722 Tnick.Dum Stnx;k C acl 12 CY [a 400 hwr :87.70 8723 Trucic,Du SWdc acl 18 CY ta 400 hov 575.50 8724 Truck,Dum ,OIf Hi hwa Sfnr.k Ce ci 28 CY to 450 haur =121.20 8726 Truck,Dum SUudc Ce d 14 CY to 400 hour S77.B0 8730 Truck,Ga e Ca ed 25 CY l0 255 hour S4B.60 8731 Tnrck,Oarb e Ca d 32 CY l0 325 hour 555.80 Emironmental Bata Attenuatlon Alr 8733 E-BAM SeMces Monitor Powered by Soler System hour 53.00 8734 AUenuator,safe that cart st a vehlde at 60 m h hour =5.50 8735 Truck,Attenuelor 2004 Trudc Moumed fo�60 m h hour 53.85 8738 Tnrdc,tow 1987 Che Kodlak 70 175 hour f27.70 8744 Van,Cuatom S edel Sarvica Centaen Truck 350 hour 518.00 8745 Van,Me model MT10FD 300 hour 521.25 8748 Van-u to 15 r II ht du ,desa 1 225300 how 520.00 8747 Ve la 15 II ht du ,daea 2 225-300 hour 520.15 8748 Van-car o li ht d ,Gaes 1 226-300 hour 522.26 8749 Ven-ce o I ht du ,dass 2 225300 haur 522.25 8760 Vehlcle,Small to 30 hour f8.10 8753 Vehlde,Reaeatiaial to 10 hour 52.80 8755 Gdf Cart Ce acl 2 person hour 53.75 8781 VlMator,Cancrate to 4 hour E1.60 Indudas ground cable and 8770 Welder,PorteWe to 16 lead cable. hour 53.10 8771 W elder,PaAade Includes grourd ceWe end to 34 lead ceble. � sg,gp Includea grouxl ceble and 8772 Welder,Partablo to 50 leed ceble. har 510.00 Indudes ground ceble and 8773 Welder PortaWe to BO lead cable. haur t13.78 Include pump and reer aprey 8780 Truck,Waler Tenk Ca dt 2500 Gal to 175 syatem. hour 526.70 Include pump end rear spray 8781 Trudc,Water Tank C 4000 Gal to 250 eyetam. hour SS0.00 8788 Catalner 6 rdl oR Wck 30 a hour 523.05 8789 Truck,T�ector 1887 Fraf hUlner F120 430 hour s5�4.9p 8790 TNck Trector 4 z 2 25000 Ibs to 210 hour :42.40 8797 Truck,Treqa 4 x 2 35000 Iba to 330 hour =46.00 8782 Truck,Trector 6 z 2 45000 Ibe to 380 hour E52.75 Endosed wAlfl Qete.Medlum duty 8784 Truck,frel M deae 5 vwr 18000-19500 Lbs hour 523.26 8785 Truck,backhoe car�ier Three axle,dass 8,hea over 33000Lbs hour 534.50 Eendosed wAIR gate.Heavy duly, 7,28,001 to 33,000 Ibe 8786 Tnidc,frei ht deea gvwr hour 531.00 Tilt end roll-badc,two axle,dass 7 8798 Truck heevy dury, to 33,000 vwr �� s�pp Tllt and rdl badc,tFxee ede.daee 8798 Tnn;k, 8 heavy duly over 33,001+ y�y� hour S/0.80 8800 Truck,Pidcu When IranspoAlnp people. mlle 50.54 8801 Truck,Plck 1l2don Plcku Tnick 4z2-/Wa 160 hour f12.30 BB02 Tn�ck,Pidcu 1-ton Pldcu Tnick 4x2-Axle 234 hour 517.65 8803 Truck,Picku 1 1/4-ton Pidcu Truck 4u2-Azle 260 hour 578.86 89W Truck,Plcku 1 1l2-ton PI Trudc 4x2-A�de 300 hour =22.25 BB05 Tnick,Plck 13/4-tonPicku T�uck 4X!-!We 300 hour 523.10 8808 Trudc,Plcku 3/4-ton Plck Trudc 4z2-/�de 185 hour 513.40 8807 Truck,Picku 3/4ton Picku Truck 4x4-Axle 285 Crew hour s20.80 BBOB T�uck,Plcku 1-ton Plck Trudc 4x4A�de 340 Crew how E22.B5 �� T^��� ���'Ha�P�� T� 4x4-Axla 360 Crew hour 528.40 8810 Truck,Picku 1 1Y1•ton Pidtu Truck 4z4A�de 382 Crew hour 528.76 8811 Tnuk,Pidcu 1 314-1on Plck Truck 4x4-Axle 362 Crew hax 527.50 8820 Skldder a 2005 JCB G e Clew hour 51.75 8821 Fakllll,ecce 2005 ACS Gra le Budcet har 51.50 Debrle/Log (KnucWeboom 8822 Truck, Loeder LoadeNiruck) 230 hour 552.28 8823 CN r-Wood R er Cat 18 en ine 700 hour 5115.00 8824 Skidder rtadel Cat 5258 up to 180 hour 562.80 9825 Skidder 40K Ibs-model Cat 626C 181 and up hour E11B.77 8840 Truck,aervfce fuel and lube u to 28,000 vwr 275-225 hour 539.85 20081Mematlonel 1,800 pal. 8841 Truck,Nel etaa tenk 200 hour 530.50 8842 MoWle Command Trailer 8'X 2B')with 7.5 KW Generata hour 514.88 8843 Moblle Ree onee Treiler (B'X 31')with 4.6 KW Generator7 hour =13.60 88�4 Moblla Commend CeMe� unifled)(RV)UIIHmaster MP-36 43 FT Lon with Generatw 400 hour j75.00 8845 MobUe Canmend Pott Vehide RV Ir�-MaUon 22-Ft Lon 340 ( Stellrnary)w/9.8 hour 531.00 8846 Modle Commend Post Vehide Generator 22-Ft Lon 340 hour 519.26 e Commend Canter 48'x8' ra er,F y Equlped Mod e 8&17 (TreNer) Command Center 48-Ft Lon hour 529.45 Mobile Command Cente► 48'x9'When being Moved w/Truck BBIB (TrellerJ TreGoi 310 hour =48.90 4 'x. x 13. with se f 30kw BB49 Mobile Commend Cenler Oeneratar hour E52.00 BB50 Mobile Command Center 2007•Fr htliner MT•55, RV 280 hour :45.50 1990-Ford Econoline- 8851 Moblle Commend Van Communlcatlon Van 230 hour E41.00 47.b'X 8.75 Fully Equip'(In 8852 Moblle Commend CeMer motlon)(R� 410 hour 565.30 47.5'X 8.75 FWIy Equip' 8853 Moblle Commend Cenle� (Statlonary) 410 hour f45.00 BB54 Mobile Commend Vehlde 53'X 8.75 Full E ul 480-550 Fqv =96.20 TerexlAmida AL 4000. with(4) BB70 LI ht Tower 500 wett IIgMa w/10kw power unll 13.5 hour 510.88 8871 U ht Tower 2004 Allmend har �6.3p BB72 SandBa er MrdYne ider aulameUc 4.5 hou 548.75 OH•5B KIOWA(Mflltary)ie Ihe 8900 Hell ter aeme as'BeA-208B3 420 hour y174.00 OH-59 KIOWA(Mllltary)is the 8907 Hell er eame ae'Bell-208BR 420 hour 5496.00 Model BeN 208-L3 Jet Rarge 8902 Hell ter Hallcopter 850 Jel Renge III-Helicopter hour E582.00 8903 Hdl er Model Bell 208L1 Lo Ra er 850 Lonp Ranper hour :598.00 ModN Bell 206LT Long Renge 8904 Hellco r Twlnranger 450 7wlrrenger hour E780.00 8905 Hellco ter Model Bell 40T EM&AmbWance 260 haur 5626.00 8908 r-Fixed wl Madel Nave o PM31 310 hour 5458.00 PA-31-3b0,NeveJo ChieM twin 8907 PI -Flxed wl engine 350 hour y187.00 Model UH-80(&eckhawk) , B90B 3ikask Helic ter medium Ifft Medlum Lift 1690 Flre FigMer Seme as S70C hour 52,945.00 Model UH-A(Blackhawk)Medlum 8908 Hellw IIft Medium Lift 1890 Flre Fighter hour 55,504.00 8810 Boein Helico ter Model CH-47(Chlnook)heavy IIR Hea Lift 2850 Flre Fiphter hour 510,750.00 8911 Heli ter-U hl utlll Modal 8ell 407GX-7 sealer 7-Seatera 875 Pesee�per Alrcreft hour 5821.00 8812 Helico ter-I ht uliR Modle Be1208L-7 seater 7-Seaters �20 Passenger Alrcrefl how 5598.00 8913 Hell ter Model Bd1-208L4 726 hour 5576.00 8914 Klnp Alr 200 Turboprop Alrcrefl Bledchewk Kln Alr B200XP81 869 hour 51,318.00 8975 Tixboprops&ackhewk Aircraft Blackhawk Cereven XP42 A 850 hour E887.00 8916 Tu Blackhewk Aircrefl King Air C80 XP135 A 550 hour 51,075.00 8817 Aeroetar Piston AkcraR Aarostar 601P 280 hour t447.00 Overheed/Undarground Wlre 8943 Wi�e Puller Machlne Overhead Wire Pulling Mechine 30 Pulling Machlne hour f18.B5 Overhead W Ire Tenabnirg 8944 Wlre TaneloM Machine 3000 Lbs Machine hour f14.50 8845 Aerial Lift model 2008 Oanie Sdesor Llft hour 58.30 CERTIFICATE OF COVERAGE Cartfflcata Hotder Adminishator Lssue Date 30/11/17 FLORIDA DEPAR7MENT OF NEALTH Fiorida leapue of CfHes,Inc. DIVISION OF EMERGENGY MANAGEMENT oepartment of insurance and Finandal Servlces 4052 BALD CYPRESS WAY,MAIL BIN#G18 P•O,eox 530065 ONaodo,Florida 32853-0065 TALLAHqSSEE,FL 32399 mveHea �s is To�nw narn�,wn�+EKr eenw ws��ssu�ro n�omrru�nene�c wa n�covaencE rouou uaa�o.xmvanisr�nou+c µv x�uunaerr,rew oamnortmx oF un CONiPAR OR OlIIBI DOCU19/T NrtIM Rf�7T0�NaOf 7W S CFAfIP1U7E 1MV!E�59U�00.WU'PeIU1N.T!E d0VBN8!AflORUED 6I THE AliPlFIAEM D6CNBFD/6iE11115 SU67BL770 ALL 771E 7ERM,q, OfCLL61�MS AIID CONOIf10N5 OF StlCll AGp@MpR COVERAGE PROV1DEp BY: FLORIDA MUNICIPAL INSURANCE TRUST A6REEMEM NUMBER; FMTf OS% COVERAGE pERIOD: FROM 10/1/17 COVERAC,E PERIOD: Tp 10/1/1812:01 AM STANDARD TIME TYPE OF COVERAfiE-LIABILITY TYP!OP COVERAG[-PROPERTY G�eral LlsbtOty � Buildinps � Mircellanaou� � ComDrehensMe General uablpry,Body Ir�jwY,Property oamage, � Bask Farm I Persoral InJ�vy ard Adverthing In}ury � nland MaHne ❑ SpecJal frorm � Electrardc D�Praessing � Ertors anG pmissbns IJabYlty � ParwnN Property � �� � �P�M P�actkes Llablity � Basic Form � Ertployee Ben�s Program Administratlon Uab6Ry ❑ SPecW�Form � Medlol AtGendantsyMedkal Direcbors'Malaactice Llability � Btuad Fotm Wopa(y Damage ❑ A9reed Amourd � �aw Enrorcement uaairty � �uaroie ;ioo,000 [� co�ns�ran�e �00% � ���9��d.F�losim A CaYapse Hazard ❑ Blanket Limib of LbblUq � S� 'Combined Sinple L6nR � Replacenent COSt Deductlbk#2,500 ❑ Adual Cbsh Value ,. Aubomobila Llabiilyr L(mits o(LirbiYty on Flk wkh AdminiRratpr � All owned AuOos(PrlvaDe Passenger) TYPE OF COVERpp!.WORKERS'COMiENSATION � All owned Auhoc(Other than Private Passdger) � Hlred AuOos � ��Y worlaers'Compersatlon � �PbYe1s�ality s1,000,000 Ead1 qoddprn � Non-Owned M�6oc f1,000,000 By pkease UmNs of WWqty SS,�0,000 Appreflale By Dlsease ❑ Deduqide N/A •Cort�hk�ed Slrgk Limlt ❑ SiR�eduWbk N/A Dedudlble N/A AuOomobpa/Equipman!-Daductlbte � PhYs�l�ama0e Per SchedWe-Canprahensive-AuOo Per Srhedule•falNsbn•Auto Per Schedule-Mlscdlaneous EqWDrrrnt Ofhar •The Nmft of NabWry k SZp0,000 Bodly L�ury end/a Prope�ty Damape D�Person or 4300,000 BodMy InJury and/or Property DamaGe Per oawra�te.These spxillc Iimfls of NadlRy ere ina�eased L�s2,ppp,pp0(mmbNied sinple IMK)par occurrence,adel�,{a am,I�a�ph,��0�e�,of a claYns btll pursuer�to Secttai 76&28(�flarida SUtutes or I�ability/settlemeM for which no delms bl�has been fllea a IIaWRY�mposed Pursuant bo Federal Lew or adioM outsida the Stahe of Fbrkla, Dmaiptlon W Opaqyons/LpotlomNd�idas/Spec(al Ibami RE:6ngB�r.Y Medkal Servixs nas ca�rm�r�re n mu��se�umx oc n�wuunox anr�xn mx�as xo wu�ns uon n�ceirwGte�aineR nas cem�un ooa xor�4 ocr�o oaurein�aareNr��rro�ar naer.nrs�err�eore. DdpnaEed Mamber Csnoellatlons � Vlilage of TequeSt� �p�.�p,.������K����� , 345 Tequesta DMve c� w�ieNa�m"°""Y"m1°�°°"e°"'°"y��°"y���'fOTME ' oe�nax oa u�eam ar u�r�'iaxo�ueai�i 7�10 M�LL wOl NoncE s�uLL wv0�No i � Tequesta Fl.33469-3062 °�`'""'�'�''L°`rs°R"E'"ee""""�, C�!/c.�-.�� � AU1F10PIIID NE1R�ffATry� RIR�f(10/2011) .