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#12-5874 Amendment #2 SECOND AMENDMENT TO AGREEMENT#12-5874 BETWEEN COLLIER COUNTY AND ADVANCED DATA PROCESSING,INC,DIB/A INTERMEDIX FOR EMS BILLING THIS AGREEMENT, made and entered into on this day of Stvkmbe,`c 2017, by and between Advanced Data Processing, Inc, d/b/a Intermedin, a corporation, authorized to do business in the State of Florida, whose business address is 6451 North Federal Highway, Suite 1000. Fort Lauderdale, Florida 33308 (the "Contractor")and Collier County,a political subdivision of the State of Florida, (the "County"): WHEREAS, on November 13, 2012, Item 16.E.6, the County entered an Agreement with Contractor to provide billing services for Collier County Emergency Medical Services; WHEREAS, on November 15, 2016, Item 16.E.6, the County approved an Amendment to the Agreement to include consulting services to County to enroll in the Florida EMS PEMT (Public Emergency Medical Transports)Medicaid program,and to provide ongoing consulting/costing services for both the Florida CPE(Certified Public Expenditures)PEMT which includes Medicaid managed care transports revenue programs. WHEREAS,the parties desire to amend the Amendment No. 2 to correct a Scrivener's error to now say Amendment No. 1 as no prior amendment was executed prior to this second amendment; WHEREAS,the parties desire to further amend the Agreement to add one additional one year period extension to allow the Contractor time to invoice for accounts filed through September 30, 2017 along with any payment due for processing Certified Public Expenditure data through Public Consulting Group; NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the parties as follows: Words Struck-Through are deleted; Words Underlined are added Page 1 of 3 * * * * * 1. COMMENCEMENT.The contract shall be for a two(2)year period,commencing on Board approval date, and terminating two years from that date. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all the terms and conditions contained in this Agreement for three (3) additional one (1) year periods. The County shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten(10)days prior to the end of the Agreement term then in effect. The Parties agree to renew the Agreement for a period of one-year from November 13, 2017 through November 13,2018,for the limited purpose of processing accounts received prior to October 1, 2017. 2. STATEMENT OF WORK. The Contractor shall provide billing services in accordance with the terms and conditions of RFP #12-5874 and the Contractor'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 Contractor and the County Project or Contract Manager or his designee, in compliance with the County Purchasing Policy and Administrative Procedures in effect at the time such services are authorized. The Contractor shall not accept from the County any additional accounts for processing after October 1, 2017. * * * * * SIGNATURE PAGE TO FOLLOW **Remainder of this page left blank intentionally** Page 2 of 3 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. ATTEST: Dwight E.Brock, Clerk of Courts BOARD OF COUNTY COMMISSIONERS COLLI.i9 TY, FLORIDA By: n-C - By: ///, an.,/,.,/, _, _ 'envy aye,. • . ti Dated: (SEAL} �Attest'az Chairman's signature only. t O( 1 C ice, Advanced Data Processing, Inc, d/b/a Fi' t Witness Intermedix Linda Smith Contractor TType/print witness nameT I By: Signature Z_ Melissa Leigh, SVP and General Counsel ,AZ-- Se ; d Witness TType/print signature and titleT Adam Holman TType/print witness nameT A ro edg to F d ality: Depu County Attorney 4 1 0 L 4L Print Name Page 3 of 3 Detail by Entity Name Page 1 of 3 Florida Department of State DIVISION OF CORPORATIONS .org Department of State / Division of Corporations / Search Records / Detail By Document Number/ Detail by Entity Name Foreign Profit Corporation ADVANCED DATA PROCESSING, INC. Filing Information Document Number F02000005151 FEI/EIN Number 22-3875190 Date Filed 10/11/2002 State DE Status ACTIVE Principal Address 6451 N. FEDERAL HIGHWAY SUITE 1000 FORT LAUDERDALE, FL 33308 Changed: 01/14/2011 Mailing Address 6451 N. FEDERAL HIGHWAY SUITE 1000 FORT LAUDERDALE, FL 33308 Changed: 01/14/2011 Registered Agent Name&Address REGISTERED AGENT SOLUTIONS, INC. 155 OFFICE PLAZA DR STE.A TALLAHASSEE, FL 32301 Name Changed: 09/26/2011 Address Changed: 09/26/2011 Officer/Director Detail Name&Address Title Director SHAMON, DOUG 6451 N. FEDERAL HIGHWAY, SUITE 1000 FORT LAUDERDALE, FL 33308 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 8/18/2017 Detail by Entity Name Page 2 of 3 Title President, Director COOKE, KEN 6451 N. FEDERAL HIGHWAY SUITE 1000 FORT LAUDERDALE, FL 33308 Title VP WILLIAMS, BRAD 6451 N. FEDERAL HIGHWAY,SUITE 1000 FORT LAUDERDALE, FL 33308 Title D ABBRECHT,TODD 100 FEDERAL STREET 35TH FLOOR BOSTON, MA 02110 Title D nelson,Josh 100 FEDERAL STREET 35TH FLOOR BOSTON, MA 02110 Title D PRENIER, MEGAN 100 FEDERAL STREET 35TH FLOOR BOSTON, MA 02110 Title D BOROM, MICHAEL 100 FEDERAL STREET 35TH FLOOR BOSTON, MA 02110 Title CEO portice,Joel 6451 N. FEDERAL HIGHWAY SUITE 1000 FORT LAUDERDALE, FL 33308 Title Secretary Leigh, Melissa 6451 N. FEDERAL HIGHWAY SUITE 1000 FORT LAUDERDALE, FL 33308 Annual Reports http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 8/1 8/20 1 7 Detail by Entity Name Page 3 of 3 Report Year Filed Date 2015 05/01/2015 2016 04/14/2016 2017 05/18/2017 Document Images 05/18/2017--ANNUAL REPORT View image in PDF format 04/14/2016--ANNUAL REPORT View image in PDF format 05/01/2015--ANNUAL REPORT View image in PDF format 04/27/2014--ANNUAL REPORT View image in PDF format 04/18/2013--ANNUAL REPORT View image in PDF format 03/27/2012--ANNUAL REPORT View image in PDF format 09/26/2011--Req.Agent Change View image in PDF format 01/14/2011--ANNUAL REPORT View image in PDF format 01/28/2010--ANNUAL REPORT View image in PDF format 01/21/2009--ANNUAL REPORT View image in PDF format 04/28/2008--ANNUAL REPORT View image in PDF format 04/23/2007--ANNUAL REPORT View image in PDF format 03/03/2006--ANNUAL REPORT View image in PDF format 04/18/2005--ANNUAL REPORT View image in PDF format 03/19/2004--ANNUAL REPORT View image in PDF format 04/04/2003--ANNUAL REPORT View image in PDF format 10/11/2002--Foreign Profit View image in PDF format Florida Department of State,Division of Corporations http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 8/1 8/20 1 7