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#12-5856S (Almost Family PC of SWFL, LLC) AGREEMENT12-5856S for Services For Seniors THIS AGREEMENT, made and entered into on this day ofcel,lo. o- 2015, by and between Almost Family PC of SW Florida, LLC, authorized to do business in the State of Florida, whose business address is 851 5th Avenue N, Suite 101, Naples Florida 34102, the "Vendor" and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. COMMENCEMENT. The contract shall be commence on 1)e c g , 20 t Sand terminate no later than June 30, 2018. The County may, at its discretion and with the consent of the Vendor, renew the Agreement under all of the terms and conditions contained in this Agreement for one (1) additional two (2) year periods and monthly thereafter and terminating on June 30, 2018. The County shall give the Vendor written notice of the County's intention to renew the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum possible duration for any Vendor under this Request for Proposal (RFP #12-5856S) for Community Care for the Elderly and Alzheimer's Disease Initiative Program funding will be through June 30, 2018. As outlined in the regulations pertaining to this funding source, the County requires the Vendor to contribute a cash or in-kind match of no less than ten percent (10%) for the Community Care for the Elderly (CCE) and Older American Act (OAIIIB) Programs and no match is required for the Home Care for the Elderly (HCE) and Alzheimer's Disease Initiative Program (ADI). 2. STATEMENT OF WORK. The Vendor shall provide Services for Seniors in accordance with the terms and conditions of RFP #12-5856S, the terms, conditions and requirements of the grant, and the Vendor's proposal referred to herein and made an integral part of this agreement. This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Vendor and the County Contract Manager or his designee, in compliance with the County Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 3. COMPENSATION. The County shall pay the Vendor for the performance of this Agreement the aggregate of the units actually ordered and furnished at the unit price, together with the cost of any other charges/fees submitted in the proposal as set forth in Attachment A, Contract Rates, attached hereto and made an integral part hereof. � .. " Page 1 of 12 U Payment will be made upon receipt of a proper invoice as per Attachment B, Invoice and Logs, attached herein and incorporated by reference and upon approval by the Contract Manager or his designee, and in compliance with Section 218.70, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". 3.1 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of contract. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this agreement. 4. SALES TAX. Vendor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531C-2. 5. NOTICES. All notices from the County to the Vendor shall be deemed duly served if mailed or faxed to the Vendor at the following Address: Almost Family PC of SW Florida, LLC 851 5th Avenue North, Suite 101 Naples, Florida 34102 Attention: Todd Lyles, Sr. Vice President Telephone: (239) 643-3033; Facsimile: (239) 643-3082 E-mail: toddlyles @almostfamily.com All Notices from the Vendor to the County shall be deemed duly served if mailed or faxed to the County to: Collier County Government Center Procurement Services Division 3327 Tamiami Trail, East Naples, Florida 34112 Attention: Joanne Markiewicz, Director, Procurement Services Division Telephone: 239-252-8407; Facsimile: 239-252-6480 ToanneMarkiewicz @colliergov.net The Vendor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 6. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Vendor or to constitute the Vendor as an agent of the County. Page 2 of 12 7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Vendor. The County will not be obligated to pay for any permits obtained by Subcontractors. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Vendor. The Vendor shall also be solely responsible for payment of any and all taxes levied on the Vendor. In addition, the Vendor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Vendor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Vendor. 8. NO IMPROPER USE. The Vendor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Vendor or if the County or its authorized representative shall deem any conduct on the part of the Vendor to be objectionable or improper, the County shall have the right to suspend the contract of the Vendor. Should the Vendor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Vendor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 9. TERMINATION. Should the Vendor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non-performance. In the event that the County terminates this Agreement, Vendor's recovery against the County shall be limited to that portion of the Contract Amount earned through the date of termination. The Vendor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 10. NO DISCRIMINATION. The Vendor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 11. INSURANCE. The Vendor shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. Page 3 of 12 V� B. Business Auto Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-Ownership. C. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $500,000 for each accident. Special Requirements: Collier County Government shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Vendor during the duration of this Agreement. The Vendor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County ten (10) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: ten (10) days prior written notice, or in accordance with policy provisions. Vendor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Consultant from its insurer, and nothing contained herein shall relieve Vendor of this requirement to provide notice. Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. 12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Vendor shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, whether resulting from any claimed breach of this Agreement by Vendor, any statutory or regulatory violations, or from personal injury, property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Vendor or anyone employed or utilized by the Vendor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 12.1 The duty to defend under this Article 12 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Page 4 of 12 Vendor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Vendor. Vendor's obligation to indemnify and defend under this Article 12 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Community and Human Services Department. 14. CONFLICT OF INTEREST: Vendor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Vendor further represents that no persons having any such interest shall be employed to perform those services. 15. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the following component parts, all of which are as fully a part of the contract as if herein set out verbatim: Vendor's Proposal, Insurance Certificate(s), and RFP #12-5856S Scope of Work and any Addendum, Attachment A Contract Rates, and Attachment B Invoice and Logs. 16. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this agreement is subject to appropriation by the Board of County Commissioners. 17. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the individual and/or firm for cause. 18. COMPLIANCE WITH LAWS. By executing and entering into this agreement, the Vendor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety (including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes), and the Florida Page 5 of 12 CO' Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(d) and (3) stated as follows: (2) In addition to other contract requirements provided by law, each public agency contract for services must include a provision that requires the contractor to comply with public records laws, specifically to: (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 contractor upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. (3) If a contractor does not comply with a public records request, the public agency shall enforce the contract provisions in accordance with the contract. If Vendor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Vendor to comply with the laws referenced herein shall constitute a breach of this agreement and the County shall have the discretion to unilaterally terminate this agreement immediately. 19. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful proposer extending the pricing, terms and conditions of this solicitation or resultant contract to other governmental entities at the discretion of the successful proposer. 20. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 21. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this contract in compliance with the Procurement Ordinance, as amended, and Procurement Procedures and Grantor Agency Requirements. 9 Page 6 of 12 22. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Vendor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Vendor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 23. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 24. CONTRACT STAFFING. The Vendor's personnel and management to be utilized for this contract shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the contract. The Vendor's shall assign as many people as necessary to complete the required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet the required service delivery dates. 25. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents and/or the County's Board approved Executive Summary, the terms of the Agreement shall take precedence over the terms of all other Contract Documents: except the terms of any Supplemental Conditions shall take precedence over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the more strict or costly obligation under the Contract Documents upon the Vendor at Owner's discretion. 26. ASSIGNMENT. Vendor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Vendor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Vendor all of the obligations and responsibilities that Vendor has assumed toward the County. * * * * * Page 7 of 12 (7) IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or agent, have executed this Agreement on the date and year first written above. BOARD OF COUNTY COMMISSIONERS ATTEST: COLLIER COUNTY, FLORIDA Dwight E. Brock, Clerk of Courts By: - • . By: vorso Tim Nance, Chairman Dated: 1 ( AS to Chairman's signature only. Almost Family PC of SW Florida, LLC Vendor 111Y\ ETV tness Signature 64.* TType/print witness nameT TType/print signature and tit1eT f14-4 SUui2A n�� With ss 001Nh TType/print witness nameT Approved as to Form and Legality: Assistant County Att y Print Name ktii‘k\tc002 Page 8 of 12 2, U Agreement #12-5856S "Services for Seniors" Attachment A Contract Rates Total Cost Reimbursement Item Services Grant Service Unit Per Service Rate Per Unit To Unit Supplier 4. Companion CCE Per Hour 19.60 17.64 5. Homemaking CCE Per Hour 18.56 16.70 6. Shopping Assistance CCE See Item#5 7. Personal Care CCE Per Hour 21.46 19.31 8a. Respite (In-Home) CCE Per Hour 20.00 18.00 8b. Respite (In-Home) ADI Per Hour 20.00 20.00 9. Facility Respite ADI Per Hour 11.00 11.00 10. Escort CCE See Item#7 11. Skilled Nursing CCE Per Hour 35.26 31.73 Page 9of12 (4 p 9 Agreement#12-5856S "Services for Seniors" Attachment B Invoice and Logs (Minimum Standard Invoice Information) Vendor Name Invoice Number Vendor Address From Date and To Date County Purchasing Order Number Reimbursement TOTAL Total Rate Per Unit AMOUNT Service Cost In Kind to Supplier (Multiply the Description Referenced Per Match (Subtract In Unit Reimbursement (identified Grant Amount Kind Match Quantity Rate Per Unit by line) Service Amount from to Supplier x Unit Total Cost Per the Unit Service Unit) Quantity) I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustments Reasons: Lead Agency Authorization: Attachments: Weekly Service Log and Weekly Client Service Time Sheet Page 10 of 12 m u a ) u au _ .r '' E = c E 0 V L y Q t C y O a) Q I) et 6 a- E E an mi .4 ■ cA z (4 z v L E W W w C 0 C 0 ISI ad)A./ g cT. Cdr fs0 Ch 0 E I. o �x � o z 0 O L O L h 0 vi Ct . G. C. rct o � , c_ C'o, at c C �-1 vi o= o d v I. 1- Ct to CZ E E 'C = c —4 o g O a Q • r. E E c U U � o�r O CI = .0 R .0 a A 4 O W W= V = V H Z 0 0 e:/ .= U el v V c O ca "0 y O ..V. = b i CI 'O 6, z Cy o a °o '- o �; � � 0 � �� 0 Q v v 0 was ‘.1.4 U z c z N ;' v) 0 N a) OJ bA ct 5 4 GJ 4 ✓ v) 0 5 bA b O G m ry y A v 0 CU c4 w 0 m a ✓ at Cr a) till A a) +.4 O Z r. " ; . L t "0 o V) '0 y a) O c) a a v . 3 v 5 fl O y 0 ✓ t cr v 0 CI 3) i. V E ° o do C v 'p U C.) D rt „O N _t 1. a) 0 w E Q v Z Z CI +. �, o q b ~ V V v ... 0 c,\ ALMOFAM-01 JWILLIAMS AC-OR/7' CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/YYYY) 12/29/2015 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 WAIVER,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Jenny Williams Louisville/Assured Neace Lukens Insurance Agency,Inc. PHONE 5502 894-2100 FAX 502 894-8602 2305 River Road IA/C,No,Ext):( ) (A/c,No):( ) Louisville,KY 40206 A ADD DREDRE SS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Homeland Insurance Co of NY 34452 INSURED INSURER B:Charter Oak Fire Insurance Co 25615 Almost Family,Inc. See Attached ADDITIONAL REMARKS INSURER C:Travelers Indemnity Company 25658 for all Named Insureds&FL Locations INSURER D:Travelers Property Casualty Co of America 25674 9510 Ormsby Station Road#300 INSURER E Louisville,KY 40223 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 WTH 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. I S POLICY R TYPE OF INSURANCE _INSD WVD POLICY NUMBER (MM D LTR D /YYYY) (MM/DD//YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X CLAIMS-MADE OCCUR X MFL-004029-0615 06/01/2015 06/01/2016 DAMAGE TO RENTED 1,000,000 PREMISES(Ea occurrence) $ X Prof Liab$1 M Ea Cla MED EXP(Any one person)_ $ Included X Prof Liab$3M Aggr - PERSONAL&ADV INJURY $ Included GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY JEO LOC PRODUCTS-COMP/OPAGG $ Included OTHER: EBL AGGREGATE $ 3,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS — HIRED AUTOS NONOSWNED PROPERTY accidentDAMAGE $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 9,000,000 A EXCESS LIAB , X CLAIMS-MADE MFX-002004-0615 06/01/2015 06/01/2016 AGGREGATE $ DED X RETENTION$ 5,000 PolicyAggregate $ 9,000,000 WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y B ANY PROPRIETOR/PARTNER/EXECUTIVE N N N TC2O-UB-134D7073-15 06/01/2015 06/01/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Workers Compensation TRK-UB-134D7085-15 06/01/2015 06/01/2016 SEE BELOW D Excess Workers Comp TWXJ-UB-134D7061-15 06/01/2015 06/01/2016 See BELOW DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) WC Retro(MA ONLY)-Carrier:Travelers Indemnity Company Employers Liability Limit: $1,000,000-Each Accident $1,000,000-Disease-Policy Limit $1,000,000-Disease-Each Employee SEE ATTACHED ACORD 104 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y y ACCORDANCE WITH THE POLICY PROVISIONS. (or Collier County Government) 3327 Tamiami Trail East Naples,FL 34112 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:ALMOFAM-01 JWILLIAMS LOC#: 1 ACCORD ADDITIONAL REMARKS SCHEDULE Page 1 of 4 AGENCY NAMED INSURED Louisville/Assured Neace Lukens Insurance Agency, Inc. Almost Family,Inc. See Attached ADDITIONAL REMARKS POLICY NUMBER for all Named Insureds&FL Locations SEE PAGE 1 9510 Ormsby Station Road#300 CARRIER NAIC CODE Louisville,KY 40223 SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: OH Excess WC(OH ONLY)-Carrier: Travelers Property Casualty Company of America Employers Liability Limit: $1,000,000-Each Accident $1,000,000-Disease-Policy Limit $1,000,000-Disease-Each Employee Combined General Liability and Professional Liability Policy. General Liability Coverage includes the following coverages under the$1,000,000 Each Claim Limit and also subject to the $3,0000,000 Aggregate for All Claims: Personal and Advertising Injury Products and Completed Operations Hired and Non-Owned Auto Liability Coverages are included on an Occurrence Basis with the following limits-$1,000,000 Each Claim and Aggregate Also, Medical Payments coverage is included with limits of$5,000 Each Accident and$25,000 Aggregate. The Excess/Umbrella Policy Limits are as follows: Form A-Follow Form Excess Liability-$9,000,000 Each Claim and$9,000,000 Aggregate for All Claims Form B-Umbrella Liability-$9,000,000 Each Claim and$9,000,000 Aggregate for All Claims POLICY AGGREGATE -$9,000,000 Collier County Board of County Commissioners is included as additional insured as respects general liability when required by written contract,subject to policy conditions,terms&exclusions. Remarks: "Certificates for FL Regulatory Offices" Almost Family PC of Ft.Lauderdale, LLC 1.5440 NW 33rd Ave., Suite 111, Ft Lauderdale, FL 33309 Almost Family PC of SW Florida,LLC 1.The Collier Commercial Building, 851 Fifth Avenue, North,Suite 101, Naples, FL 34102 2.5741 Bee Ridger Road,Suite 230,Sarasota,FL 34233-5064 Almost Family PC of West Palm,LLC 1.Four Harvard Circle,Suite 900,West Palm Beach, FL 33409 Caretenders Visiting Services of St Augustine, LLC 1.6789 Southpoint Parkway,Suite 200,Jacksonville, FL 32216 2.310 Wilmette Avenue,Suite 4,Ormond Beach, FL 32174 Mederi Caretenders VS of Broward, LLC 1.4901 NW 17th Way,Suite 104 Ft. Lauderdale,FL 33309 2.Four Harvard Circle,Suite 950,West Palm Beach, FL 33409 ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:ALMOFAM-01 JWILLIAMS LOC#: 1 ACOR;DR ADDITIONAL REMARKS SCHEDULE Page 2 of 4 AGENCY - NAMED INSURED Louisville/Assured Neace Lukens Insurance Agency,Inc. Almost Family,Inc. See Attached ADDITIONAL REMARKS POLICY NUMBER for all Named Insureds&FL Locations SEE PAGE 1 9510 Ormsby Station Road#300 CARRIER NAIC CODE Louisville,KY 40223 SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Mederi Caretenders VS of SE FL, LLC 1.1285 36th Street,Suite 202 Vero Beach,FL 32960 2.1800-1801 SE Port St. Lucie Boulevard, Morningside Professional Plaza, Port St. Lucie,FL 34952 3. 824 US Highway One, North Palm Beach, FL 33408 Caretenders Visiting Services of District 7, LLC 1.3800 W.Eau Gallie Blvd.,Suite 103, Melbourne, FL 32935 Caretenders Visiting Services of St.Augustine, LLC 1.Anderson-Gibbs Building, 301 Health Park Blvd.,Suite 110 St.Augustine,FL 32086 Mederi Caretenders VS of SW FL, LLC 1.6150 Diamond Center Court, Bldg 600 Suite A&B Ft.Myers, FL 33912 2.3459 Pine Ridge Road,#801, Naples,FL 34109 3."Sarasota Medical Center",5741 Bee Ridge Road,Suite 230,Sarasota, FL 34240 4.18501 Murdock Circle,Suite 308, Pt.Charlotte, FL 33948 Caretenders Visiting Services of District 6, LLC 1.4201 Whidden Blvd., Unit#00A37, Port Charlotte, FL 33980 2.201 2nd Street East, Bradenton, FL 34208 3.3806 Manatee Ave.W,Suite 100, Bradenton,FL 34205 4.306 S. 10th St.,Suite 340,Haines City, FL 33844-5602 5.18501 Murdock Circle,Suite 308,Pt.Charlotte, FL 33948 6.2155 US 27 South Sebring, FL 7."Sarasota Medical Center",5741 Bee Ridge Road,Suite 230,Sarasota, FL 34240 8. 1802 59th Street West,Bradenton, FL 34209 9.306 S.10th Street,Suite 340, Haines City, FL 33844-5602 Caretenders Visiting Services of Orlando, LLC 1.474 South Northlake Blvd.,Altamonte Springs, FL 32701-5245 2. 1167 Miranda Lane, Kissimmee, FL 34741 Caretenders Visiting Services of Gainesville LLC 1.3593 NW Devane Street,Lake City,FL 32055 2.4923 NW 43rd Street,Suite A Gainesville, FL 32606 3.210 South Lake Suite 10,11 Leesburg, FL 34748 4.95 NW 253rd Street, Newberry,FL 32669 5.The Village,8109 NW 27th Boulevard,Gainesville, FL 32606 Caretenders Visiting Services of Hernando County LLC 1.3900 Crill Avenue Palatka, FL 32177 2.2400 S. US Hwy 27, Clermont, FL 34711 3.12106 Cortez Blvd., Brooksville, FL 34613-5514 4.2210 and 2212 West Highway 44 West,Inverness, FL 34453 5. 1554 Bella Cruz Drive,The Villages,FL 32159. Caretenders Visiting Services of Ocala,LLC 1.1333 SE 2th Loop,Suite 102,Ocala,FL 34471 2. 8960 SW Hwy.200, Unit 5,Ocala,FL 34481 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:ALMOFAM-01 JWILLIAMS LOC#: 1 ACORO ADDITIONAL REMARKS SCHEDULE Page 3 of 4 AGENCY NAMED INSURED Louisville/Assured Neace Lukens Insurance Agency, Inc. Almost Family,Inc. See Attached ADDITIONAL REMARKS POUCY NUMBER for all Named Insureds&FL Locations SEE PAGE 1 9510 Ormsby Station Road#300 CARRIER NAIC CODE Louisville,KY 40223 SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Caretenders Visiting Services of Pinellas County LLC 1.6445 102nd Ave. North Pinellas Park, FL 33782 2.7615 Little Road, New Port Richey, FL 34654 Mederi Caretenders VS of Tampa, LLC 1. Lakeside Village, 1476 Town Center Drive,Suite N-211 Lakeland, FL 33803 2. University Professional Center,3500 E. Fletcher Ave.,Suite 100,Tampa,FL 33613 Home Health Agency-Hillsborough, LLC 1. 139 South Pebble Blvd.,Suite 201,Sun City Center, FL 33573 Caretenders of Jacksonville, LLC 1.6789 Southpoint Parkway,Suite 200,Jacksonville, FL 32216 2. 6789 Southpoint Parkway,Suite 100,Jacksonville, FL 32216 3. 1425 Hand Avenue,Suite 1,Ormond beach, FL 32174 4. Dunn Avenue West Office Park,3890 Dunn Avenue,Suites 103&104, Jacksonville, FL 32218 5. 155 Blanding Blvd.,Suite 1 Orange Park, FL 32073 6. Harley Office Complex,775 Harley Stickland Blvd.,Suite 108 Orange City 32763 7.2237 Riverside Ave.,Jacksonville,FL 32204 8. Las Palmas,70 Town Court, Palm Coast,FL 32137 OMNI Home Health-District 1, LLC 1.8800 University Parkway,Ste C-3, Pensacola,FL 32514-4928 OMNI Home Health-District 2, LLC 1.1617 Tennessee Ave.,Lynn Haven,FL 32444-3652 OMNI Home Health-District 2, LLC dba SunCrest Omni 1.2343 Hansen Lane,Suite 1,Tallahassee, FL 32301-4888 OMNI Home Health-District 4, LLC 1.2651 Park Street,Jacksonville,FL 32204-4519 OMNI Home Health-Hernando, LLC 1.4359 South Suncoast Boulevard,Homosassa, FL 34446-1181 2. 183 SW Bascom Norris Drive, Lake City, FL 32025 3.4045 NW 43rd Street,Suite B,Gainesville, FL 32606-4608 4.3200 SW 34th Avenue,Suite 301 ,Ocala, FL 34474-7463 5.700 Zeagler Dr.Suite 6, Palatka,FL 32177-3826 Omni Home Health-Jacksonville, LLC 1.9143 Phillips Highway,Suite 170,Jacksonville, FL 32256-1361 Home Health Agency, Pinellas, LLC 1. 2430 Estancia Blvd.,Suite 201,Clearwater, FL 33761-2644 Home Health Agency-Collier, LLC ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:ALMOFAM-01 JWILLIAMS LOC#: 1 ACOREr ADDITIONAL REMARKS SCHEDULE Page 4 of 4 AGENCY NAMED INSURED Louisville/Assured Neace Lukens Insurance Agency, Inc. Almost Family,Inc. See Attached ADDITIONAL REMARKS POLICY NUMBER for all Named Insureds&FL Locations SEE PAGE 1 9510 Ormsby Station Road#300 CARRIER NAIC CODE Louisville,KY 40223 SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance 1.5260 Station Way,Building B,Sarasota, FL 34233-3232 BGR Acquisition, LLC 1.Town Center I Office Building,Suite 100,475 West Town Place, Augustine, FL 32086-3100 Home Health Agency-Brevard,LLC 1.780 S.Apollo Blvd.,Suite 106,Melbourne, FL 32901-1402 2.720 W.Oak St.,Suite 303,Kissimmee,FL 34741-4992 Suncrest Home Health of Central FL, LLC 1.994 Douglas Ave.,Suite 100,Altamonte Springs, FL 32714-2068 Suncrest Home Health of Tampa,LLC 1.200 S. Hoover Blvd.,Suite 160,Tampa,FL 33609-3597 Suncrest Outpatient Rehab Services,LLC 1.1503 oak Street,Jacksonville,FL 32204-3911 Ingenios Health Co.,Inc. 1. 7406 Fullerton Street,Suite 200,Jacksonville, FL 32256 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD