HomeMy WebLinkAboutResolution 93-06
RESOLUTION NO. 93-06
.
A RESOLUTION OF THE CITY OF OCOEE, FLORIDA APPROVING A
SUPPLEKENTAL AKENDKENT TO AN EQUIPMENT LEASE/PURCHASE
AGREEKENT WITH FORD KOTOR CREDIT COKPANY AND DESIGNATING
IT AS A QUALIFIED TAX-EXEMPT OBLIGATION
WHEREAS, the city has heretofore entered into a certain
Florida Equipment Lease-Purchase Agreement (Lease No. 36895) dated
as of March 10, 1993 ("the Equipment Lease") with Ford Motor Credit
Company ("Lessor"); and
WHEREAS, the City desires to lease additional equipment
from Lessor pursuant to and subject to the terms and conditions of
the Equipment Lease.
NOW THEREFORE, the city commission of the city of Ocoee,
Florida hereby adopts the following resolutions:
RESOLVED, that this City enter into a certain
supplemental amendment to the Equipment Lease with Lessor in
substantially the form attached hereto and by this reference made
a part hereof ("the Supplemental Amendment") and that this City
lease equipment from Lessor pursuant to the terms of such Equipment
Lease and Supplemental Amendment; and that the Mayor and the City
Clerk of this city be and hereby are authorized and directed in the
name and on behalf of this ci ty to execute the Supplemental
Amendment with Lessor in substantially the form presented at this
meeting, with such changes therein and additions thereto as shall
be approved by such officers who execute the same, and such
execution shall be conclusive evidence that each such document so
executed has been authorized and approved by this vote.
FURTHER RESOLVED, that the city commission of the city of
Ocoee, Florida finds that a true and very real need exists for the
acquisition of the Equipment described in the Supplemental
Amendment and that such acquisition is in the best interests of the
City of Ocoee.
FURTHER RESOLVED, that the City commission of the city of
Ocoee, Florida finds that the City of Ocoee has taken the necessary
steps, including compliance with any applicable legal bidding
requirements, under applicable law to arrange for the acquisition
of such equipment.
.
FURTHER RESOLVED, that the obligations of the City under
the Supplemental Amendment be hereby designated, pursuant to
section 265(b) (3) (D) of the Internal Revenue Code of 1986, as
amended (hereinafter called the "Code"), as comprising a portion of
the $10,000,000.00 in aggregate issues which may be designated as
"Qualified Tax-Exempt Obligations" eligible for the exception to
the general rule of the Code which provides for a total
disallowance of a deduction for interest expense allocable to the
carrying of tax-exempt obligations.
.
FURTHER RESOLVED, that the Mayor and the City Clerk of
this City be and hereby are authorized to execute and deliver such
other instruments and take such other actions as they shall deem
necessary and desirable for the purpose of carrying out these
resolutions and consummating the transactions contemplated by the
Supplemental Amendment.
FURTHER RESOLVED, that the foregoing resolutions shall
remain in full force and effect until written notice of their
amendment or rescission shall have been received by Lessor and that
receipt of such notice shall not affect any action taken by Lessor
prior thereto.
FURTHER RESOLVED, that the Clerk of this City be and
hereby is authorized and directed to certify to the Lessor the
foregoing resolutions and that the provisions thereof are in
conformity with the charter of this City.
ADOPTED this /" ~
day of JUL~
, 1993.
ATTEST:
APPROVED:
CITY OF OCOE~ORIDA
(SEAL)
FOR USE AND
THE CITY OF
APPROVE? AS
this ~, 11
RELIANCE ONLY BY
OCOEE, FLORIDA.
TO FORK AND LEGALITY
day of ~~ul7 ' 1993
FOLEY , LARDNER
By: ~(~~
City Attorney
APPROVED BY THE OCOEE CITY
COKKISSION AT A MEETING
HELD ON THE DATE INDICATED
ABOVE UNDER AGENDA ITEK
NO. JI.LA.2.
.
C;\WPSl 1DOCS\OCOE\FORDRESO.IlOC I 6130193 I ODEITEI PER;cx\
Page 1
SCHEDULE A-I - EQUIPMENT LEASE-PURCHASE AGREEMENT
Lease No.
36895
This Equipment Schedule dated as of 07/07/93, is being executed by Ford Motor
Credit Company ("Lessor"), and City of Ocoee ("Lessee"), as a supplement to, and is
.rebY attached to and made a part of that certain Equipment Lease~Purchase Agreement
ted as of 03/10/93 ("Lease"), between Lessor and Lessee.
Lessor hereby leases to Lessee under and pursuant to the Lease, and Lessee hereby
accepts and leases from Lessor under and pursuant to the Lease, subject to and upon the
terms and conditions set forth in the Lease and upon the terms set forth below, the
following items of Equipment:
I I I I
I QUANTITY I DESCRIPTION (MANUFACTURER, MODEL AND SERIAL NO.) I SUPPLIER I
I I I I
I I I I
I 1 I 1993 Ford Crown Victoria Police Interceptor I Don Reid Ford, Inc. I
I I Serial No.: 2FACP71Y4PX175079 I I
I I I I
I I I I
I I I I
I I I I
I I I I
I I I I
I I I I
I I I I
I I I I
IEQUIPMENT LOCATION: City of Ocoee I
I 150 North Lakeshore Drive I
I Ocoee, FL 34761 I
I I
Initial Term:
36 Months
Commencement Date: 07/07/93
Periodic Rent: ' 5 Consecutive Semi-Annual Payments of $2,300.38 each (including
interest), followed by one final payment of $2,300.36 plus any and all
other payments due under this Lease-Purchase Agreement. The Periodic
Rent Payments also include any applicable sales/use taX due and payable
on the Lease Payment Dates, set forth in Schedule A-I, Page 2.
EXECUTED as of the date first herein set forth.
LESSEE: CITY OF OCOEE
LESSOR: FORD MOTOR CREDIT COMPANY
.
BY:
S. Scott Vandergrift
Mayor
K. A. Carlson
Manager, Marketing & Sales
Schedule A-I Page 2
Payment Schedule Lease Humber: 36895
Lease Lease
Payment Payment Lease Interest Principal Concluding
Humber Date Payment Portion Portion Payment
1 7 / 7 /1993 $2,300.38 $0.00 $2,300.38 $10,482.62
2 1 / 7 /1994 2,300.38 332.82 1,967.56 8,515.06
. 3 7 / 7 /1994 2,300.38 270.35 2,030.03 6,485.03
4 1 / 7 /1995 2,300.38 205.90 2,094.48 4,390.55
5 7 / 7 /1995 2,300.38 139.40 2,160.98 2,229.57
6 1 / 7 /1996 2,300.36 70.79 2,229.57 1.00
TOTALS 13,802.26 1,019.26 12,783.00
.
LESSOR: FORD MOTOR CREDIT COMPANY
P. O. Box 1739
Dearborn, MI 48121
DELIVERY AND ACCEPTANCE CERTIFICATE
~e undersigned Lessee hereby acknowledges receipt of the Equipment described below
..,Equipment") as fully installed and in good working condition; and Lessee hereby
accepts the Equipment after full inspection thereof as satisfactory for all purposes of
the Equipment Lease-Purchase Agreement ("Lease") executed by Lessee and Lessor.
LEASE
DATE
LEASE
NUMBER
SCHEDULE A-I
DATE
DELIVERY
NUMBER
PURCHASE PURCHASE
DATE ORDER NO.
03/10/93
36895
07/07/93
1
EQUIPMENT INFORMATION
QUANTITY DESCRIPTION (MANUFACTURER, MODEL AND SERIAL NO.)
SUPPLIER
1 1993 Ford Crown Victoria Police Interceptor
Serial No.: 2FACP71Y4PX175079
Don Reid Ford, Inc.
LESSEE: City of Ocoee
150 North Lakeshore Drive
Ocoee, FL 34761
BY:
.
(TITLE)
DATE ACCEPTED:
geReenll.te. Information Return for Small Tax-Exempt
Governmental Bond Issues, Leases and Installment Sales
. . . Under Section 149(.) . For calendar yar endtlll 19....._
(Use Form 8038.G If the issue price of theluuel. $100.000 or mon.)
thority Check box if Amended R.turn ~
F<<'" 8038.GC
(RI'I. Octallel- 1989)
.
re :J)ti 16
Issue price of the snaIl tax-exefl1jt governmental obliqation
5 TIt.' illVI !lFlI. If illlAillll _1l1..mlll .I.!. ...l1InalIIiliS.lll..1 i.".~ jMri,. 1ha ii.l'lIaqear.
6 ~k the box that most nearly approximates the weighted average maturity of the obligations:
a.3l Less than 5 years
b 0 From 5 to 10 years
c 0 More than 10 years
7 Check the box that most nearly approximates the weighted average interest rate on the obligations:
a~ Less than 5%
b From 596 to 10%
c More than 10CJ6
8 Total issue price of the obligations reported on line 5 that are:
a Obligations issued in the form of a lease or installment sale .
b Obligations designated by the issuer under section 265(b)(3)(B)(i)(III)
c Obligations issued to refund prior issues . . . . . .
d Loans made from the proceeds of another tax.exempt obli tion
OM8 No. 1545.0720
UOI'ft 05/31/92
Z Is_, s employer 1Cl-mlfiallOn numllef
$'-'0/9 '111
8b
Ie
()-
o
Under Denalties 01 perjury. I declare tllat I have eumlMd thIS return ... accamPMYinl sc/leduIes and statements. Jlld to tile tIest 01 my knowledC. and be".f.
they at. true. correct. and complet..
, 8d
Please
Sign
Here
I ~ Sicnatur. 01 officer
.
General Instructions
(Section references are to the 'ntem.'
Revenue Code unless otherwise noted.)
Paperwork Reduction Act N'otlce
We ask for this information to carry out the
Internal Revenue laws of the United States.
We need it to ensure that you are complying
with these laws. You are required to &ive US
this information.
The time needed to complete and file this
form varies depending on individual
circumstances. The estimated average time
is:
Recordkeepinc. .
learnlne about the
law or the form. .
Preparine the form.
Copyinc. assembllnc. and
sendlne the form to IRS .
3 hrs.. 21 min.
.1 hr.. 34 min.
2 hrs.. 37 min.
. . .16 min.
11/2/92
Date
~ Type or 1IfWll- Jnd tJtIe .
If you have comments conceminl the
accuracy of this time estimate or
suggestions for making this form more
simple. we would be happy to hear from
you. You can write to either the Internal
Revenue Service. Washington, DC 20224,
Attention: IRS Reports Clearance Officer,
T:Fp;. or the Office of Manacement and
Budcet. Paperwork Reduction Project
(1545-0720), Washington, DC 20503.
Item You Should Note
A governmental unit is required to file this
form for all small tax-exempt governmental
obligations on which it pays interest. These
obligations include bonds, leases and
installment sales.
Purpose of Form
Form 8038.GC is to be used by issuers of
tax.exempt governmental obligations to
provide IRS with the information required by
section 149(e) and to monitor the
requirements of sections 141 through 150.
Who Must File
Each issuer must file Form a038.GC for all
tax-exempt governmental bonds. leases and
installment sales issued during the catender
year. with an issue price of less than
$100.000. Form 8038-G is filed to report
each issue of governmental obligations with
issue prices of $100.000 or more.
When To File
File Form 8038-GC on or before February
15th after the close of the calendar year in
which the issue is issued. Form a038.GC
must be completed based on the facts as of
the close of the calendar year.
Lat. ftlinc.-A Form 8038.GC filed after
the due date may be granted an extension
of time to file under section 3 of Rev. Proc.
88-10.1988-1 C.S. 635. if it is determined
that the failure to file in a timely manner is
not due to willful negtect. A late Form
Form 8038-GC (Rev 10.89)
Published by Tax Management Inc., a Subsidiary of The BurMU of NatIonal Affairs, Inc.
53
8038-GC.l
F'o,m 80J8-GC (ReY. 10.89)
a038-GC should be sent to: Internal
Revenue Service, Philadelphia Service
Center, Statistics of Income Unit. P:OA:
Umt F.SOI, Philadelphia, PA 19255, Stop
=335. Type or print at the top of the form,
-This Statement Is Submitted in
Accordance wIth Rev. Proc. as.l0.. Attach
to the Form S038.GC a Jetter brrefly setting
I]he reasons why Form 803a-GC was
bmittedto the IRS on time. and also
in Icating whether the obligation ,n
Question IS under examination by the IRS.
00 not submit copies of any bond
documents. leases. or installment sale
documents.
Where To File
File Form a03S.GC with the Internal
Revenue Service Center, Philadelphia, PA
19255.
Definitions
same issuer, on the same date, and
pursuant to a single transaction (or series at
refated transactIons). With respect to
draw-down loans. all amounts reasonably
expected to be advanced within 3 years of
the date of the first draw may be treated as
part of the same issue If the draws are .
equally and ratably secured by the same
loan agreement and are pursuant to a
common financing arrangement. An
obligations that are Issued pursuant to a
single finance lease or installment
purchase agreement may be treated as
part of the same issue if all at the property
covered by that agreement is reasonably
expected to be delivered within 3 years of
the date of issue of the first obligation.
Specific Instructions
Part I.-Reporting Authority
Amended Return.-If you are filing an
amended Form 8038-GC, check the
amended return box and complete Part I
and only those parts of Form 8038-GC you
are amending by entering the correct
informatIon. 00 not file an amended Form
8038-GC to amend estimated amounts you
previously reported once the actual
amounts are determined. (See the Part II
instruction, below.)
line 1.- The issuer's name is the name of
the entity issuing the obligations, not the
name of the entity receiving the benefit of
the financing. In the case of a lease or
installment sale, the issuer is the lessee or
purchaser.
line 2-lssuer's employer identification
number (EIN).-If the issuer does not have
an employer identification number. enter
.none. and attach a completed Form SS-4,
Application for Employer Identification
Number, to Form a038-GC. If, however, the
issuer has previously applied for such a
number, attach a statement giving the date
of the application and the office where It
was submitted.
. A tax.exempt obll,atlon is not limited to
the formal issuance of bonds. It also
includes installment purchase agreements
and financial leases.
. A tax.exempt ,overnmental obll,atlon
is a tax.exempt obligation that is not a
private activity bond.
. A private activity bond is generally an
obligation issued as part of an issue of
which: (1) More than 10% of the proceeds
are to be used for any private business use;
and (2) More than 10% of the payment of
prinCIpal or interest of the issue is either
secured by an interest in property to be
used for a private business use (or
payments In respect of such property), or is
to be derived from payments in respect of
property (or borrowed money) used for a
prrvate business use. An obligation is also
considered a private activity bond if the
amount of the proceeds to be used to make
or finance Joans (other than loans described
in section 141(cX2)) to certain persons
exceeds the lesser of 5% of the proceeds. or
$5,000.000. Private activity bonds should
be reported on Form 8038, Information
Return for Tax-Exempt Private Activity Bond
Issues.
. Issue -Generally. separate obligations
should not be treated as part of the same
issue if the obligations are not issued by the
AdcIIIIoMt IIV- I ~ I ... . ,_ -.-<<. Connl........
In'onneloft R.... far ...... Ta-b...... GovemlMl'lt 10M
,...... Lee....... Ir1 ninlll........ ...... 0c:eI0er.1M"
AnncMInoeI Inll2-147
Part II.-Description of Obligations
Th/s p~rt m~y ". comp/.tH based on
/nfo'm~t'on '..d//y ..,.lIabl. to the'ssu.,
~t the clOM of the a/enda, y.a"
Punaut to T.D. 1425, laIormadall RepordII, for TIS-
Eump' Sood I--. 1112-31 UUI. 7, IsIaen of IOverDo
meatal baDd __ wt baft .. __ price of 1_ lJwI
$100.000 IDd lIIat are DOt prlyac.e ac:Uyity boadI. bave aD
.. oi IIMICiIIC &.be iDlorma&Ioa rwpartiD, reqairemeats
by fWD, a FGrIII .GSI-GC .,.,...., for _eta smaU iIslIe.
AJI ..... ... file a Fona I8JI.-GC oa . eoaoUdaced buia
tor aU IIDaJ1 p..--ui baad.... iaaed duriD, tbe
same caIeDdar rear for wIUdl iIIIorma&ioa was not reported
oa . II1IARte ret1InI.
It. FonD 103I-CC Wed IepUat.el, mlllt be fiJeii DO later
tJau tile 15tJ1 da1 of &.be ..... ea1eadar moatll after tile
e.. of tJM caleadar qua.rtIr ID ftidl tile iSIae Ia isInaed. It.
Form 103I-GC fUed 011 a COIIIOildated basis must be Wed DO
.
8038-CC.2
Pap 2
supplemented by e.tlmat.s made In 600d
faith. Allentrl.. m.y b. based on 600d
faith 6pp,oximat/ons.
LIne 5.-Enter the total issue price of all
small tax.exempt governmental obligations
iSSUed during the calendar year. Small
governmental obligations means those with
an issue price of less than SI00,OOO. If the
obligations are reaffered to the public by an
intermediary. the issue price is the
reoffering price (excluding accrued
interest).
The issue price of an obligation means
the principal amount due on the obligation
and does not include interest paid or to be
paid. Therefore line 5 should include onty
the principal amount due on obligations
sold during the calendar year. For example,
only the purchase price of an asset acquired
pursuant to a lease should be included on
Line 5 and only in the year such lease is
entered into. A lease or installment sale is
treated as issued on the date interest starts
to accrue.
LIne 6.- The weighted average maturity is
the average maturity on the obligations.
With respect to bonds, each bond should be
weighted to its par value. For a lease or
installment sale, enter the total number of
years the lease or installment sale will be
outstanding.
Line 7.- The weighted average interest
rate is the average interest rate on the
obligations. Each bond should be weighted
in proportion to its par value and its length
of maturity.
Line 8.-Enter the total issue price of the
obligations reported on line 5 that are
described on lines 8a, 8b. ae, and 8d. More
than one line may apply to a particular
obligation. For example. obligations issued
to refund prior issues which were
designated by the issuer under section
265(b)(3X8Xi)(lII) should be reported on
line 8b and line 8c.
Signature
Form 8038.GC must be signed by an
authorized representative of the issuer. Also
print the name and title of the person
signing the Form 8038.GC.
later tIlaa F.,.." 15Ua of tile ca........ Jar folJowiDC tile
caleadar year ia wtlida tile __ Ia ....
U tJM ... oi wIIkII tile .... Ia a pan .. iIIaed dariaC
tile fint ar IICOIId caJ.dar qaarten oIltt2. 1Iow..,., tile
de.adJ1ae far fWD, a Form I03I-GC .,....t.eIJ Is ateaded
ualil NO'ftIIdMr 1" 1112. Far rDI8c a FormlOSl-GC.,..
ratel, far boadI .... dariq tile tIl1rII quaner of 1112. &.be
filiD, ducIliM nmaiaI NowembIr I', IIn.
Boad IsIaen tbt c-.. to file a .,.rate ret1Inl ma,
adapc aad fIJe tile 1'" rmsiGI of Foml 103I-GC UDtil a
oew ~ Ia 1'11eaMd. To adapt tile 1'" N'riIioa of Fonn
ao3I-GC for.,.rate fWD&, tile __1DOaId (I) strib tile
word "Coaolldaled" iD &.be title. aDd (2) atrib 11M 5 01 tile
form aDd 1ITia "1sIae pric:. of tJM IIIIall tu-aempt IOftrD-
meatal oblipUaD" ID Ita plae&
lSSII8'S tJIat dean to file . a ~datld ..... Deed not
alter tbe I'" rniIioa of Form M3I-GC ID 01 wa,.
U the __ is a coastnclioa ... aDd a irre'roc:able
electioa lO pa1 a pealt1 ia U. oi artIIItrap "te UI !Mea
made 011 or before tbe elate tile boadI ... ...... eoad1rae
to foUcnr tbe &WdeJu.. coataiDed ID RaY. Proc. 12-22.
1912-12 LR.B. 33. for ameadlDc r.m I03I-GC.
Published by Tax Management Inc.. a Subsidiary of The Bureau of National Affairs, Inc.
11/2/92
"....z-:--,."'::........... ......
.
.
INSURANCE FACT SHEET
We require a Certificate of Insurance or Declaration Page shown in the name of the Municipal-
ity listed below. If Self-Insured for any coverage, a letter on Municipality letterhead is
required. If more than one insurance company is used, indicate each & for what type
coverage. Per the Agreement, we require Liability & Physical Damage on all vehicles, Liability
& Property Damage on all other equipment & FORD MOTOR CREDIT COMPANY named as
Loss Payee or Additional Insured. RETURN TO: Ford Motor Credit Company, P.O. Box 1739,
Dearborn, MI 48121-1739
TRANS NO:
3689501
L1P AGREEMENT NO: 36895
MUNI:
City of Ocoee
ADDRESS:
150 North Lakeshore Drive
CITY:
Ocoee, FL 34761
CONTACT:
Karen Murphy
PHONE: (407)656-2322
EQUIP DESC: One 1993 Ford Crown Victoria Police Interceptor, 2FACP71 W4PX175079
INSURANCE CONTACT:
Florida Leaque of Cities. Inc.
ADDRESS:
P.o. Box 530065
CITY:
STATE: FT.
ZIP: .17H"l1-00f;"l
Orlando
PHONE: (407) 425-g142 CONTACT PERSON: Dawn Smith
POLICY NO: EMIT 428 EXPIRATION DATE: g/.10/g.1
(SEE ATI'ACHED CERTIFICATE OF COVERAGE)
LIABILITY AMT: PROPERTY DAMAGE AMT:
PHYSICAL DAMAGE AMT: COMPREHENSIVE DEDUCTIBLE:
COLLISION DEDUCTIBLE:
INSURANCE CONTACT:
ADDRESS:
CITY:
STATE:
ZIP:
PHONE:
POLICY NO:
CONTACT PERSON:
EXPIRATION DATE:
LIABILITY AMT: PROPERTY DAMAGE AMT:
PHYSICAL DAMAGE AMT: COMPREHENSIVE DEDUCTIBLE:
COLLISION DEDUCTIBLE:
SELF-INSURED FOR: LIABILITY: PROPERTY: PHYSICAL:
CONTINUOUS COVERAGE: FROM TO
.
.
JUL- 1-93 THU 13:49
FLA LEAGUE OF CIT1ES
FAX NO. 407 425 9378
P.01
CERllFlCATE OF COVERAGE
CertJIlcate HoId6r & l.OM Payee Itdminltlnltor 188U8 Date 7/1;113 OMS
FORD MOTOR CREDIT 00 Florid. LNg... of ClUe., Ine.
POST OfAce BOX 173G Public Rllk ServicH
DeARBORN Ml 48121-1739 P.o. Box lS3OOlS5
Otiando, Florida 32853-0085
~~
m. ,.lUCl'ImF't1HAT1l4EAGAIlI'_Il8.OW HI.S BEl'P119Wen m-rntoe;IGItIITl'iJ Mt!!_R FOR nt: """"'lWlEl'mlOO IHDIet.TEO. NO'TWffilSTI\NOII'lC .0"'''1
....--. ~RM ClIlCQNO'!1ON OF .lNVIlOHTIlACTt;ll1 m>fl!A OOClJMEHTWlTll Pl!6I'ECl 1OWfI1(;" ntSCEIlTlFlCATIl MAY Be19SUlDCR MA" A:RT_.1ltI!C~(;ll\
AFfOI't1eg.,. """ _MEIIT IlEllCAI8lP Hl'.IW!lN 19I11JIlJECT1O ALl-TltE TEllIolS, ER::UJ5ICllo1S ANtll:tlt4OlllOll5 O~ IIlJCtt AlII&MEHT.
~ 1"OCNDD8Y: FLORIDA MUMICIPAL tNSURAHCE TRUST
~_.EJfI' JUoIBDt NT 4. '0CJlIBWlE f'liHOO; moM IO/1!9a -I 00YmI\BE l'9IOO: TO Ufaq/ft 12:00 Mtdlol;/11 Sl..wm Time
ll'fE OF 00\0t':h01l0E-1.JMIUrf T'tI'E OF CXlIIEfWJE - PR:'lPI:JlTY
....~ DIWd~
OCcmpnllleMw Gann Uilbl/lly. Bodily lnjl./Ty. f'Mp~ DBlulo form
OItmaQtl Md ~lIIlnllMY D$peo:lll' "arm
OErrura..,d OIIWlI..lo"1 UalliII\1r O.......na1 Propedy
OEmp1oyet lItMll. Program Admlnllllmlon Ulbftity DBulo Form
O~ -'"'(ld....../Modlclll ~. Ma~CUC. Uablllly DSpeellol Form
DBfnd FtJII'n I'mpenv 0Im0Ig. O"ORedAmounl
Olaw ,,",IorOOl/l"llnlllablllty OOeduclibl. .L-
DlJnItItgtlll.ll'ld, Explollon .. C'AllIIph HImud OO'i.....t...... -!l..
0 OBlJlllclt
(.mfto d ......... O!lt>-.:l1Ie
.'00.000 E'aeIl PWaon 01 · ~mblnld S1I1gl. Urnlt OAl!'pI_8n1 Coot
$2l:)O.ooo E'lldI Oocurnnc:e D!\t:Iua' Cillsh v......
~ -'-- 0...........,..,...
#uhlnd,I. ~ OmlMd Marine
~ Nt CWflfld IoJlQw (prw. P_.) o !:'krct","io Data PrOcetlSlng
080f1~
(!) AI own-' Aulot (OttrIt..... PIll'. Pau.) 0
l!J H11t1d ~lM
~ Hon.o..n.cs ......011 Umb of U~ fin AlIo .... AdmW........
l)rAr vJ \JobIlIIt
'100,oao EIloII ~t<oOn or · Combfned Single Umlt
$ZOO.OOO Each Oiccuf_
Deduelibla ..L.-
~'Equ~-~
1!9 PhyIlIlIII own.g. ",ClOO Oompoehe_. hll., .1,(100 Co",,,,,,,. Aulo . UaelUsne..... Equ!prMrtt
ClIher
~ limit cillIIlbIIity '- '100.000 Bocllly Inluty aM/or Pr<1I*iY 0._ P'" ~....... or $2OO.oJO 80clllllitlfY Illd/or Properly rwn. ".,. ctlOOr_.
-n.... apt- limits oI1lablfll)l .... ~ to $2,(IQO,llOO (oomblned ,;nQ~ Bmlt\ per ooelJIfllnott, eo1ol1y k>r t!nf IIbllll)' reeuldllll from .....lry of . ~lIIms
bII ,...,.,.,. till 8edIon ""a .. Fblda StaMn. or RebOily lmp...d p,,",uant \l) FlIdmII \.Ilw or ac:ticlo1. lWitIcM .,. 8IBlI af FIarIda.
DnarfpIIMof ~JVlIhioMIsr-w.....
p., 1l1ll3 N1rd Crown VIctarIIt, ID# 1a1tI, Colt N_ $17.ooo..en. ~dl~e 7f8/~.
'IIiIlI_lE IS In'JID IIlI A *l1BIllf'_llONQN\.... 1l1<<) CQWI!fIII NO "lJK11l uroN11lE CII/I;tII"IIOt IlOI.ID. THlSCI!!ImACA-';Old NOr.ue>C>. t!XfBNl0ll
-....,.1IlE~1II'RlRJB)1IY'PEAGl&M9lT ,..,..,..
lleilGfWID_ CldlCIalATIllllI
SliOutONiY PAm' OF1liEA~ llElla1I!IED~ e!CANCalSlBEFQfl!
AnN OEBOAAH BERTUNG THE m'lAA1101t O~11! THERE\lI'. niE ISS~GCllhII""lYVi\U.am5\VOR 10 Wll-1lO
DAY~ W!1IfT9/ P<<1llCE TQ TIlE Cl:Rl1F1CAl1! HOl.CEI'l NAMEII ASove, IIIJT FAlWflE TO
CITY OF OCOEE ",,,"- S\lC~ HlmCE $~AU.IMI'O~ l\1008lJG1\'llOIi OR LrAIlfU'l'I'Of N/Y KJIIIO UFCN
1SO NORTH LAKESt-lOfW: DRIVE THI; I'RlGAAlol rrs AOEIIITS OR R9'fI!!Sl!IfT"1\~.
OOOEE FL 34761
~ L~IJ~~
Alffi<oot2ED <ENTI\Tl1Ir'
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