Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
#17-7112 (John Eastern Company, Inc.)
FIXED FEE/PRICE PROFESSIONAL SERVICE AGREEMENT #17-7112 for PROPERTY CASUALTY AND WORKERS' COMPENSATION THIRD PARTY ADMINISTRATION SERVICES THIS AGREEMENT, made and entered into on this 12141 day of btu.m er 2017, by and between Johns Eastern Company Inc., authorized to do business in the State of Florida, whose business address is 6015 Resource Lane, Lakewood Ranch, Florida 34202, (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. AGREEMENT TERM. The Agreement shall be for a three (3) year period, commencing on January 1, 2018, and terminating three (3) years from that date or until all outstanding Purchase Order(s) issued prior to the expiration of the Agreement period have been completed or terminated. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for one (1) additional two (2) year periods. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. COMMENCEMENT OF SERVICES. The Contractor shall commence the work upon issuance of a Purchase Order. 3. STATEMENT OF WORK. The Contractor shall provide Property Casualty and Workers' Compensation Third Party Administration Services in accordance with the terms and conditions of Request for Proposal (RFP)#17-7112, including all Attachments and Addenda and the Contractor's proposal referred to herein and made an integral part of this Agreement and Exhibit A — Scope of Services attached hereto. 3.1 This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. Page 1 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services 4. THE AGREEMENT SUM. The County shall pay the Contractor for the performance of this Agreement based on Exhibit B- Fee Schedule, attached hereto and the price methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the Contract Administrative Agent/Risk Management Director or designee, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". 4.1 Price Methodology: Time and Materials: The County agrees to pay the contractor for the amount of labor time spent by the contractor's employees and subcontractors to perform the work (number of hours times hourly rate), and for materials and equipment used in the project (cost of materials plus the contractor's markup). This methodology is generally used in projects in which it is not possible to accurately estimate the size of the project, or when it is expected that the project requirements would most likely change. As a general business practice, these contracts include back-up documentation of costs; invoices would include number of hours worked and billing rate by position (and not company (or subcontractor) timekeeping or payroll records), material or equipment invoices, and other reimbursable documentation for the project. Unit Price: The County agrees to pay a firm total fixed price (inclusive of all costs, including labor, materials, equipment, overhead, etc.) for a repetitive product or service delivered (i.e. installation price per ton, delivery price per package or carton, etc.). The invoice must identify the unit price and the number of units received (no contractor inventory or cost verification. 4.2 Any County agency may obtain services under this Agreement, provided sufficient funds are included in their budget(s). 4.3 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 the Agreement. 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. 4.4 Travel and Reimbursable Expenses: Travel and Reimbursable Expenses must be approved in advance in writing by the County. Travel expenses shall be reimbursed as per Section 112.061 Fla. Stats. Reimbursements shall be at the following rates: Mileage $0.44.5 per mile Breakfast $6.00 Lunch $11.00 Dinner $19.00 Page 2 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services Airfare Actual ticket cost limited to tourist or coach class fare Rental car Actual rental cost limited to compact or standard-size vehicles Lodging Actual cost of lodging at single occupancy rate with a cap of no more than $150.00 per night Parking Actual cost of parking Taxi or Airport Limousine Actual cost of either taxi or airport limousine Reimbursable items other than travel expenses shall be limited to the following: telephone long-distance charges, fax charges, photocopying charges and postage. Reimbursable items will be paid only after Contractor has provided all receipts. Contractor shall be responsible for all other costs and expenses associated with activities and solicitations undertaken pursuant to this Agreement. 5. SALES TAX. Contractor 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. No mark-up shall be applied to these taxes or fees. 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. 6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or faxed to the Contractor at the following Address: Johns Eastern Company, Inc. 6015 Resource Lane Lakewood Ranch, Florida 34202 Attention: Beverly Adkins, AIC, AIM, Executive Vice President Telephone: (941) 907-3100 Fax: (813) 402-7914 Email: bakinsAjohnseastern.com All Notices from the Contractor to the County shall be deemed duly served if mailed or faxed to the County to: Board of County Commissioners for Collier County, Florida Risk Management Division 3311 Tamiami Trail East, Building D Naples, Florida 34112 Telephone: 239-252-8906 Fax: 239-252-8048 Attention: Jeffrey Walker, Risk Management Division Director Email: ieffwalker(c colliergov.net ?p Page 3 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services -,,."` The Contractor 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. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 8. 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 Contractor. 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 Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor 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 Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 9. NO IMPROPER USE. The Contractor 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 Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor 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 Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 10. TERMINATION. Should the Contractor 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, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or Page 4 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 12. INSURANCE. The Contractor 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. B. 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 $100,000 for each accident. C. Professional Liability: Shall be maintained by the Contractor to ensure its legal liability for claims arising out of the performance of professional services under this Agreement. Contractor waives its right of recovery against County as to any claims under this insurance. Such insurance shall have limits of not less than $1,000,00 each claim and $2,000,000 aggregate. E. Cyber Liability: Coverage shall have minimum limits of $1,000,000 per claim. Special Requirements: Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR, Collier County Government shall be listed as the Certificate Holder and included as an "Additional Insured" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Contractor's policy shall be endorsed accordingly. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County thirty (30) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: thirty (30) days prior written notice, or in accordance with policy provisions. Contractor 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 Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Page 5 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services Contractor shall ensure that all subcontractors comply with the same insurance requirements that the Contractor is required to meet. 13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall defend, 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 Contractor, 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 Contractor or anyone employed or utilized by the Contractor 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. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, 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 Contractor. Contractor's obligation to indemnify and defend under this Article 13 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. 14. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Risk Management Division. 15. CONFLICT OF INTEREST. Contractor 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. Contractor further represents that no persons having any such interest shall be employed to perform those services. 16. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: Contractor's Proposal, Insurance Certificate(s), Exhibit A Scope of Services, Exhibit B Fee Schedule, RFP #17-7112-Property Casualty and Workers' Compensation Third Party Administration Services, including Attachments and Addenda/Addendum. Page 6 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services 17. 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. 18. 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 Agreement held by the individual and/or firm for cause. 19. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor 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 Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(b) as stated as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone: (239) 252-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records Page 7 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor 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. 20. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful Contractor extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful Contractor. 21. 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. 22. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 23. 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 Contractor 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 Page 8 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor 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. 24. 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. 25. KEY PERSONNEL. The Contractor's personnel and management to be utilized for this project 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 Agreement. The Contractor shall assign as many people as necessary to complete the services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet the required service dates. The Contractor shall not change Key Personnel unless the following conditions are met: (1) Proposed replacements have substantially the same or better qualifications and/or experience. (2)that the County is notified in writing as far in advance as possible. The Contractor shall make commercially reasonable efforts to notify Collier County within seven (7) days of the change. The County retains final approval of proposed replacement personnel. 26. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the RFP, the Contractor's Proposal, and/or the County's Board approved Executive Summary, the Contract Documents shall take precedence. 27. ASSIGNMENT. Contractor 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 Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. 28. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related Page 9 of 28 .� #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services -1 records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four (4) years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPS ac colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of$500 per incident. * * * * * (SIGNATURE PAGE TO FOLLOW) ***************Remainder of page left blank intentionally*************** Page 10 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services 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: COLLIE' CP • STY, FLORIDA Dwig E, Brock, rk of Courts rat \A-VgSC__, By: /&7 4....-//4_,...- • _ - 1Penny Tay , Chairma Dated: '943151---i--- ((„At) Rest to Chairman's. signature only. Contractor's Witnesses: Johns Eastern Company, Inc. Contractor A61-9 :6413-777,1A-n By: /174A,, First Witness , gnature 0 Dcoei 11 At..-tk...ns tXi ? *f St)-to T")\<-0 ,L),n TType/print signature and titleT TT /print witness nameT i.i , f/r , Second Witness 1 /4 TType/print witness nameT A proVed as to F arJ Legality: AssistantountyAttoAney Print Name 1 i page.ven ft17.711 2 Property Casuaity and WritersCompensation Third Party Administration Services Exhibit A Scope of Services GENERAL REQUIREMEMTS COMPLIANCE. It shall be the responsibility of the Contractor to comply with all rules and regulations promulgated by the various state agencies prescribing the practices and procedures of self-insurer service companies. Contractor will be responsible for all required EDI DWC reporting. OWNERSHIP OF RECORDS AND DATA. The County shall have all right, title, interest, and ownership to all loss statistics and claim files created as a result of the services to be provided by the Contractor. Further, at the sole option of the County and upon ten (10) days written notice, the Contractor shall return such files to the County. At the termination of the contract, at the sole expense of the Contractor, the Contractor shall provide the County with computer media containing all of the claim data. Such data shall be made available in a format generally importable into a commonly recognized database for claims administration services. AUDIT. At the sole option of Collier County, the Contractor shall agree, at no additional cost to cooperate with any audits conducted by Collier County or Collier County's designee (hereinafter, "Auditor") of Contractor's claim files and procedures as they relate to the services under this Agreement. Collier County shall have the right to audit during the contract period and for five years following the termination of the Agreement. RECORDS DEFINED. The term "Records," shall mean all documentary and electronic records of the Contractor and Contractor's subcontractors that are related to the services performed under this Agreement including, but not be limited to: • Financial records (including accounting records, payroll records, timesheets, audited and unaudited financial statements) • Contracts (including contracts with subcontractors and contracts between subcontractors and others) • Contractor performance data • Network and provider agreements • Cost data PROPRIETARY DOUMENTS. To the extent Contractor or Contractor's subcontractor designates any "Records" requested for audit as "Proprietary Records" (i.e., containing confidential information, trade secrets, or private information), the Contractor shall be allowed to limit the access of Auditor such that Auditor will only be permitted to review such Proprietary Records in controlled conditions at Contractor's chosen location. With respect to such Proprietary Records,Auditor's rights will be limited to on-premises review of such Records and Auditor will not be permitted to retain copies or make reproductions of such Records. Such designation of Records as proprietary by Contractor or Contractor's subcontractor shall only be made to the extent reasonable grounds exist for Page 12 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services Contractor or Contractor's subcontractor to protect the information contained in such Records. INTERNAL AUDIT. The firm must demonstrate that they maintain an ongoing internal audit practice that is commensurate with generally accepted accounting principles. They must also show that they maintain an ongoing internal claims audit practice to assure that claims are processed in accordance with generally accepted claims practices. Page 13 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services WORKERS COMPENSATION PROGRAM The program is focused on achieving the best medical outcomes for injured workers at the most reasonable cost. To accomplish this, efforts have been initiated and are on- going to partner with the best medical providers in the local community. The program partners with Community Health Partners (CHP) for case management services. CHP works with the Contactor to assure that injured employees receive timely, appropriate care and to assure compliance with the County's Return to Work Practice. Collier County has established a local network of medicals providers to deliver care according to the appropriate need. Collier County also operates an occupational health program which is tasked with providing first injury care to injured employees who meet the appropriate criteria. In instances where care cannot be provided in-house, the occupational health nurse also provides first evaluation services and directs injured workers to the appropriate primary or specialty provider to avoid unnecessary or duplicate services. WORKERS' COMPENSATION SCOPE OF SERVICES Contractor must agree to provide all the following Scope of Services: • administrative services, • claims services, • first notice of injury services, • loss statistic services, • network access and development services, • medical bill review and audit services, • pharmaceutical benefit management services, and • communicable disease management program services. The County requires full and total transparency in its vendor relationships. Therefore, any commission, service fee or other form of remuneration paid to any agent, broker, lobbyist or third party must be identified in the proposal and throughout the term of the contract. ADMINISTRATIVE SERVICES Contractor are requested to provide the following administrative services: 1. In accordance with state mandated time frames, prepare (with the County's assistance) and file with the appropriate state agencies all applications, bonds, documentation, and data required (if any) for implementation and continuance of the program. 2. In accordance with state mandated time frames, prepare, maintain, and file all records and reports as may be required by legal authorities (state, local, and federal). The vendor shall be responsible for any penalties that result from their failure to provide reports to authorities on a timely basis. Page 14 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services 3. Prepare, maintain, and file statistical or other records and reports as required by the County's excess insurers. Report claims to the County's excess insurer(s) in accordance with the requirements of the excess insurer(s). Provide a copy of the reports to the County. Follow specific written investigation procedures for any case for which the Excess Workers' Compensation Insurer requires specific notification or investigation. 4. In accordance with state mandated time frames, prepare, maintain, and file statistical information required by Workers' Compensation Rating Bureaus or appropriate state agencies, including EDI and data necessary for the promulgation of experience modifications. 5. Comply fully with all rules, regulations, guidelines or procedures established by the County and the State of Florida, including EDI. Prepare and submit all state required reports on behalf of the County in a timely manner. 6. Recognize that the County will be continuing a Workers' Compensation program which focuses on respecting the injured worker and the medical providers providing care. Contractors must be committed to work collaboratively with the County to effect program changes and enhancements as requested by the County. 7. Annually, provide the County with a SAS-70 or similar audit, by whatever name called as required by the County's financial auditors. The report with a bridge letter, if necessary, must be submitted to the Risk Management Division during the month of October of each year for the period October 1st through September 30tH 8. Prepare and follow provisions for ensuring that in the event of an emergency, e.g.; hurricane preparedness, including how Contractor's services will continue, how the County's employees will be paid indemnity in advance, and how they will be instructed on obtaining medical care. 9. Coordinate and cooperate with any audits associated with the Workers' Compensation program. 10.Assist the County with its Return to Work program, including identifying return to work opportunities and appropriate use of outside vendors. 11.Attend on-site quarterly claims file review meetings with County staff at no additional cost to the County. 12.Be approved by the County's excess carrier(s) as an approved TPA. 13.Coordinate data reporting requirements to the County's actuarial firm to prepare annual actuarial evaluations. ci Page 15 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services CLAIMS SERVICES Contractor is requested to provide the following claims services: 1. Establish reporting procedures which are compatible with the needs and organizational structure of the County. 2. Provide necessary forms and instructions for use, as needed. Such forms are to include appropriate First Reports of Injury with mailing address of primary recipients preprinted thereon. 3. Provide toll free customer service telephone lines. 4. Develop specific service instructions with the County for the handling of the County's claims. Develop specific service instructions with the County for the handling of the County's catastrophic claims. 5. Conduct such investigation into the specifics of each individual report of employee injury as in the exercise of professional judgment would seem necessary. Enhanced efforts shall be taken to identify possible fraudulent claims including recorded statements from claimants and discussions with the claimant's supervisors. 6. Recommend settlements or denials subject to the exercise of professional judgment and in accordance with County Resolution 2004-15 as may be amended from time to and in accordance with the applicable Workers' Compensation Law or law of damages. The Contractor shall work in cooperation with the County's appointed attorney in the development of recommendations, the preparation and actuation of all necessary stipulations, compromise, and release agreements. 7. The Contractor will recommend outside professionals such as surveillance personnel, expert witnesses, accident reconstruction experts and others to assist in the investigation, adjustment, and defense of claims. The approval of experts is subject to the provisions of Resolution 2004-15. The County shall select all outside counsel. (a) The Contractor must be able to review all bills for such services for reasonableness and conformity to any pre-established rates or fees and have the ability to adhere to any set pricing schedules. (b) Other firms with whom the County contracts must agree to work collaboratively with these outside professionals, including data sharing, portals and other methods for sharing information. 8. Review all medical bills and bills for other services for which a claim is being made for reasonableness and conformity to rules, regulations, and legally imposed medical and surgical fee schedules. Page 16 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services 9. Prepare and maintain files necessary for legal defense of claims and/or other litigation (such as actions for subrogation, contribution, or indemnity) or other proceedings. 10.Where appropriate, attend hearings, depositions, mediations, and other proceedings. The adjuster handling the claim file will provide an updated written file note within 48 hours after the hearing, deposition, mediation or other proceeding. 11.At the request of the County, provide a complete copy of all files involving litigation, potential or actual subrogation, or potential or actual recovery from special or second injury funds to the Director, Risk Management or designee. 12.Aggressively pursue all possibilities of subrogation, excess insurance reimbursement, third party liens, contribution or indemnity and/or recovery from special or second injury funds on behalf of the County. 13.Periodically as appropriate, but at least every quarter, review all open cases and complete a strategic action plan in order to assist in the settlement of the cases. Such written reviews shall include a review and verification of outstanding reserves. Participate in quarterly reviews of field case management progress and legal progress. A written summary of the review shall be documented in the open case file. 14.Provide rehabilitative services for injured employees including consultation for retraining or reassignment of employees with limited physical performance arising from covered injuries. 15.Aid in communications/coordination with the County's safety and accident prevention program staff as necessary including providing claims data needed to target safety and prevention initiatives. 16.Conduct adequate, timely and complete 24 hour contact investigation of claims regardless of exposure (24 hours from first notice to WC management organization, not 24 hours from when adjuster received). 17.Pay vendor bills (attorneys, surveillance, etc.), within 20 days. 18.Develop and follow appropriate written policies when (i) the injured employee requests a second opinion, (ii) medical evaluation is questioned, or (iii) grievance report is filed. 19.Assist, as appropriate, in the scheduling of independent medical examinations 20.Follow all provisions of Florida Statutes in regard to medical benefit entitlement and administration. Page 17 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services ACCESS TO CLAIMS SYSTEM The Contractor shall provide the County access to comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost. If requested, the Contractor shall provide the County with monthly reports, as agreed upon by the parties, in such a format as is acceptable to the County. The Contractor agrees that the County shall have real-time access to all claim files, including all adjuster notes, supervisory notes, field case management notes, diary items, payment records, medical bills and expense bills in an electronic manner with internet based access available to the County. The system must also permit the County to add notes to the file as needed. The County utilizes the CS STARS Risk Management Information System for its internal use. The Contractor hall be able to provide and upload financial data to the system at a minimum, a monthly basis. NETWORK ACCESS & DEVELOPMENT SERVICES Contractor is requested to provide the following network access and development services: 1. Provide the County access to a provider network that contains appropriate providers outside Collier County. The County is interested in working with the Contractor to assure that high quality providers, particularly in key specialties, are encouraged to participate in the network and who contractually agree to preferred appointment setting criteria, reporting and standards to best address the medical and rehabilitative needs of the County injured employees. Key specialties include internists, orthopedics, neurology, neurosurgery, occupational medicine specialties, pulmonology, infectious disease specialists, ear/nose/throat specialists, allergists, psychiatry and psychology. 2. Assist the County in the development of a client specific network of key providers, as needed, particularly in key specialties. Provide contracting and credentialing services required to develop this client specific network. Provide a local provider relations staff member. Develop and maintain combined directory of customized and traditional providers. 3. Provide peer review and utilization review services, as appropriate. 4. Provide reporting regarding network access, provider costs and outcomes. Page 18 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services MEDICAL BILL REVIEW AND AUDIT SERVICES Contractor is requested to provide the following medical bill review and audit services: 1. For Medical Bill Review: (a) Promptly review medical/surgical bills (in and out of network) for accuracy including, but not limited to, as they relate to the following: (i) Duplicate billings (ii) Unbundling of charges (iii) Up coding of charges (iv) Approval and appropriate precertification. (b) Review all medical bills that: (i) Are not subject to fee schedule coding (ii) Are for services not specifically addressed in the fee schedule (iii) Need an in-depth medical interpretation of the rules and regulations (iv) In the exercise of professional judgment, specifically warrant review. (c) Process, pay and mail bills within 20 days of receipt. 2. Reimburse the County for any overpayments made in the bill review process, within 30 days of identification of overpayment. Reimburse the County for any penalties and/or interest associated with inaccurate payments. 3. For Medical Auditing Services: (a) Audit in-network and out-network hospital/provider bills (i) Exceeding $5,000 (ii) Where a departmental charge exceeds 10% of the total bill, excluding room and County charges (iii) Others at the Contractor's discretion or specific request by the County for accuracy and appropriateness (b) Develop and follow written policies on how late charges, no show charges and special payment arrangements are to be handled. 4. Develop and provide communication materials to explain the policies and procedures of the Medical Bill Review and Audit Services to: (a) The County (b) Medical providers 5. Develop and follow written grievance procedures for provider concerns. Page 19 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services PHARMACEUTICAL MANAGEMENT SERVICES The Contractor shall recommend a prescription benefit management (PBM) vendor. It is anticipated that the successful Contractor will sub-contract these services. Details regarding the PBM's services should be provided, including access, utilization review services, coordination of claims data and reporting. Fees for pharmaceuticals or pharmaceutical services shall be reimbursable at the applicable fee schedule amount (F.S. 440.13(12)(c)), except where the employer/carrier has contracted for a lower amount. Where the employer/carrier has contracted for such services and the employee elects to obtain them through a provider not a party to the contract, the reimbursement shall be at the schedule, negotiated, or contract price, whichever is lower. Contractors are requested to address the issue of physician dispensing and the high cost of repackaged drugs. Contractors should describe how their other Florida based clients have handled this issue. CONTAGIOUS DISEASE MANAGEMENT SERVICES The Contractor must assist the County in the investigation of and management of the contagious disease management program. When an employee contracts a contagious disease for which there is a likelihood that the disease exposure occurred on the job, the County policy is to treat the illness as a workers' compensation claim. The administrator will be expected to assist in the investigation of these situations, provide quarterly (or more often, at the request of the County) reporting regarding these situations, as appropriate provide disease management services and manage these claims as workers' compensation claims. STAFFING REQUIREMENTS Contractor must agree to an average open case load, per adjuster, of no more than 170 cases per licensed adjuster. Page 20 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services PROPERTY AND CAUALTY PROGRAM SCOPE OF SERVICES Contractor must agree to provide all of the following services: • administrative services, • claims services, and • access to claims system The County requires full and total transparency in its vendor relationships. Therefore, any commission, service fee or other form of remuneration paid to any agent, broker, lobbyist or third party must be identified in the-proposal and throughout the term of the contract. Contractors must identify all sub-contractors who will be used to provide the services outlined in the RFP. The flat fee paid by the County must be the only remuneration to the Contractor for services provided to the County and Contractor must receive no revenue for these services from sub-contractors. ADMINISTRATIVE SERVICES Contractor is requested to provide the following administrative services: 1. Prepare (with the County's assistance) and file with the appropriate state agencies all applications, bonds, documentation, and data required (if any) for implementation and continuance of the program. 2. Prepare, maintain, and file all records and reports as may be required by legal authorities (state, local, and federal) including Form 1099 and all reporting required for Medicare set aside provisions. 3. Prepare, maintain, and file statistical or other records and reports as required by the County's excess insurers. 4. Prepare, maintain, and file statistical information required by Rating Bureaus or appropriate state agencies. 5. Comply fully with all rules, regulations, guidelines or procedures established by the County and the State of Florida. Page 21 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services CLAIMS SERVICES Contractor is requested to provide the following claims services: 1. Establish reporting procedures which are compatible with the needs and organizational structure of the County. 2. Provide necessary forms and instructions for use, as needed. Such forms are to include appropriate accident reports with mailing address of primary recipients preprinted thereon. 3. Be available on a 24 hour basis, and provide immediate response to claims investigation requests through use of email or cellular telephones. 4. Provide toll free customer service telephone lines. 5. Prepare a work plan that has been approved by Risk Management in the handling of the County's claims to include catastrophe claims. 6. Receive and examine on behalf of the County all reports of third party claims including claims by an employee of one Insured against another Insured. 7. Report claims to the County's excess insurer(s) in accordance with the requirements of the excess insurer(s); request coverage opinions as needed; and secure settlement authority as needed. Follow specific written investigation procedures for any case for which the excess insurer requires specific notification. 8. Within 24 hours after notification of a serious (one requiring more than first aid) third party bodily injury claim, contact the claimant by telephone or in person. Within two working days after notification of any other third party claim, contact the claimant by telephone or in person. 9. Recommend settlements or denials subject to the exercise of professional judgment and in accordance with County Resolution 2004-15 as may be amended from time to and in accordance with the applicable Law or law of damages. The Contractor shall work in cooperation with the County Attorney or the County's appointed attorney in the development of recommendations, the preparation and actuation of all necessary stipulations, compromise, and release agreements. 10.Conduct such investigation as in the exercise of professional judgment would seem necessary. Follow specific written investigation procedures for any case for which the excess insurer requires specific notification. 11.The Contractor will recommend outside professionals such as surveillance personnel, expert witnesses, accident reconstruction experts and others to assist in the investigation, adjustment, and defense of claims. The approval of experts is Page 22 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services subject to the provisions of Resolution 2004-15. The County shall select all outside counsel. (a) The Contractor must be able to review all bills for such services for reasonableness and conformity to any pre-established rates or fees and have the ability to adhere to any set pricing schedules. (b) Other firms with whom the County contracts must agree to work collaboratively with these outside professionals, including data sharing, portals and other methods for sharing information. 12.Prepare and maintain files necessary for legal defense of claims and/or other litigation (such as actions for subrogation, contribution, or indemnity) or other proceedings. 13.Where appropriate, attend hearings, depositions, mediations, and other proceedings. The adjuster handling the claim file will provide an updated written file note within 48 hours after the hearing, deposition, mediation or other proceeding. 14.Pay in a timely fashion all claims and expenses pertaining to the County's claims. 15.Assist in the collection of subrogation, excess insurance reimbursement, third party liens, contribution or indemnity on behalf of the County. 16.Periodically as appropriate, but at least every quarter, review all open cases and complete a strategic action plan in order to assist in the settlement of the cases. Such written reviews shall include a review and verification of outstanding reserves. Participate in quarterly reviews of field case management progress and legal progress. A written summary of the review shall be documented in the open case file. 17.The Contractor shall include a per claim fee in their proposal for claims requiring only the issuance of a check (data capture and check issuance claims). Examples include minor automobile and property losses that do not include the full services of an adjuster, but do require the issuance of a check. ACCESS TO CLAIMS SYSTEM The Contractor shall provide the County with the ability to access comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost to the County. If requested, the Contractor shall provide the County with monthly reports, as agreed upon by the parties, in such a format as is acceptable to the County. The Contractor agrees that the County shall have real-time access to all claim files, including all adjuster notes, supervisory notes, field case management notes, diary Page 23 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services items, payment records, medical bills and expense bills in an electronic manner with Internet based access available to the County The County utilizes the CS STARS Risk Management Information System. The Contractor is tasked with providing updated financial data to the system at a minimum, on a monthly basis. STAFFING REQUIREMENTS Contractor must agree to an average open case load, per adjuster, of no more than 170 cases per licensed adjuster. Page 24 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services Exhibit B Fee Schedule COST PROPOSAL FOR: WORKERS' COMPENSTATION Duration/Description Fee January 1, 2018 through $39,500/per year December 31, 2020 *The annual fee includes the takeover of all old claims Field Investigations Fee (for $85/hour plus related *expenses, such as police investigations exceed 10 per year) reports, appraisals reports, etc. *Expenses require pre-approved written approval by the Risk Management Director, or designee. All miles driven at .44.5 cents per mile. Mileage charges will be incurred only for time and travel occurring within Employer's/County's boundaries. There will be no charge for travel time to or from the Employer/County. Medical Review and Bill Audit $5.95 /per bill audited and Services Charge 30% savings over Fee Scheduled Savings* *Retrospective bill review/hospital bill audits and out-of-network negotiated bills will be billed at 35% of savings over and above the Fee Schedule savings. Page 25 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services COST PROPOSAL FOR: PROPERTY CASUALTY (NORMAL CLAIMS SERVICES) Duration/Description Fee January 1, 2018 through $57,120/per year December 31, 2020 *The annual fee includes the takeover of all old claims. The annual fee does not include the Allocated Loss Adjusting Expenses (ALAE) services listed on Page 18 of Contractor's Proposal. Field Investigations Fee (for $85/hour plus *expenses, such as police reports, investigations exceed 10 per year) appraisals reports, etc. *Expenses require pre-approved written approval by the Risk Management Director, or designee. Field Investigations may include recorded statements, and scene inspections needed to determine liability. Those fees are listed under the Property Fee Schedule. All miles driven at .44.5 cents per mile. Mileage charges will be incurred only for time and travel occurring within Employer's/County's boundaries. There will be no charge for travel time to or from the Employer/County. Page 26 of 28 #17-7112 Property Casually and Workers'Compensation Third Party Administration Services COST PROPOSAL FOR: CATASTROPHE FEE SCHEDULE Full Repair Cost Service Fee $ 0.01 — $ 2,500.00 $427.00 2,500.01 — 10,000.00 $603.00 10,000.01 — 20,000.00 $998.00 20,000.01 — 25,000.00 4.5% of Loss — $1,025 minimum 25,000.01 — 35,000.00 4% of Loss — $1,200 minimum 35,000.01 — 50,000.00 3.5% of Loss — $1,400 minimum 50,000.01 — 100,000.00 3% of Loss — $1,750 minimum Over 100,000.00 Billed at Time and Expense *Expenses require pre-approved written approval by the Risk Management Director, or designee. 1. Full Repair Cost — Agreed cost to repair or replace before applying depreciation, deductible, or other clauses limiting coverage. 2. In addition to the schedule, the following charges will be made: a. All miles driven at .44.5 cents per mile. b. Photo - $1.00 each c. Outside fees, reports, telephone, and other direct expense, at cost. d. Administrative/Set up fee — $50.00 e. Drive time charged and mileage (both prorated when possible) when loss is more than 20 miles from Contractor's base of operation. 3. Hourly Rate: Adjuster at $98.00 Expense Executive General Adjuster: $150.00 per hour General Adjuster: $135.00 per hour Managers: $135.00 per hour Page 27 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services PROPERTY FEE SCHEDULE Full Repair Cost Full Adjustment $ 0.01 — $ 2,500.00 $395.00 $ 2,500.01 - 10,000.00 $559.00 $ 10,000.01 - 20,000.00 $929.00 $ 20,000.01 - 30,000.00 4.5% of Loss - $995 minimum $ 30,000.01 - 40,000.00 3.5% of Loss - $1,350 minimum $ 40,000.01 - 55,000.00 3.0% of Loss - $1,400 minimum $ 55,000.01 - 70,000.00 2.5% of Loss - $1,650 minimum $ 70,000.01 - 90,000.00 2.0% of Loss - $1,750 minimum $ 90,000.01 - 100,000.00 2.0% of Loss - $1,800 minimum $ 100,000.01- Billed at Time and Expense* *Expenses require pre-approved written approval by the Risk Management Director, or designee. 1. Above fees include local telephone, file creation, copying, and secretarial support. 2. Full Repair Cost — Agreed cost to repair or replace before applying depreciation, deductible, or other clauses limiting coverage. 3. In addition to the schedule, the following charges will be made: a. All miles driven at $0.44.5 cents per mile. b. Photos - $1.00 each c. Outside fees, reports, telephone, and other direct expense, at cost. 4. These schedules do not apply to catastrophes. Catastrophes are CAT Codes that are tied to events which would qualify an event to be considered a catastrophe, such as a Hurricane. 5. Hourly Rate: Adjuster at $98.00 Expense Executive General Adjuster: $150.00 per hour General Adjuster: $135.00 per hour Managers: $135.00 per hour DATA CAPTURE AND CHECK ISSUANCE SERVICES Service Fee Fee per Data Capture and Check $60/per issuance Issuance Page 28 of 28 #17-7112 Property Casualty and Workers'Compensation Third Party Administration Services Ami o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 5/1/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Margi Furey NAME: g Al Purmort Insurance (A CONE.Ext): (941)924-3808 (A/C,FAX (941)924-8799 3340 Bee Ridge Road AIL ADDRESS:margi@alpurmort.com INSURER(S)AFFORDING COVERAGE NAIC# Sarasota FL 34239 INsuRERA:Cincinnati Insurance Company 10677 INSURED INSURER B:Zenith Insurance Company 13269 Johns Eastern Company Inc INSURER C:Chubb Group 38989 PO Box 110259 INSURER D: INSURER E: Lakewood Ranch FL 34211-0004 INSURERF: COVERAGES CERTIFICATE NUMBER:17/18 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP WLIMITS LTR INSD VD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500,000 A CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ X CAP5177615 2/1/2017 2/1/2018 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: GA210 Blkt Al endt $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ 500,000 A ALL OWNED SCHEDULED AUTOS AUTOS X CAP5177615 2/1/2017 2/1/2018 BODILY INJURY(Per accident) $ 500,000 NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) $ 100,000 $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000_ A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTION$ 0 CAP5177615 2/1/2017 2/1/2018 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N I A B (Mandatory in NH) M1099006 1/1/2017 1/1/2018 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 C Crime 82117112 5/1/2017 5/1/2018 Limit $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Collier County Board of County Commissioners is additional insured as required by written contract, on a primary and non-contributory basis but only in accordance with policy term, provisions and exclusions. CERTIFICATE HOLDER CANCELLATION purchasing_temp@colliergov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 3295 Tamiami Trail East Naples, FL 34112 AUTHORIZED REPRESENTATIVE Clyde Purmort/KTHAYX �® `—� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) Certificate of Liability Insurance Coverage provided by Claim Professionals Liabililty CLAIM PROFCYBIDNALB LIABILITY INSURANCE COMPANY insurance Company, RRG.This certificate is issued for A MEM.RR ,e.<BRGIUP information purposes only and confers no rights to or upon the Certificate Holder. It does not extend nor alter 17742 Irvine Blvd.,Suite 102 Tustin,CA 92780 the coverage under the policies itemized in this Certificate of insurance. Telephone:714.731.7860 Fax:714.731.4605 Certificate Holder I Additional Insured? Yes Named Insured Collier County Board of County Commissioners Johns Eastern Company,Inc. Purchasing Department PO Box 110259 !� 327 Tamiami Trail East Lakewood Ranch, FL 34211-0004 Naples,FL 34112-4901 dlederer@Joh nsEastern.com This is to certify that the policies of insurance described below have been issued to the insured named above for the policy period indicated below. The insurance afforded by the policies described by this certificate is subject to all the terms,conditions,and exclusions of such policies.Limits shown below may have been reduced by paid claims. Policy Policy Policy Type of Insurance Number Effective Date Expiration Date Limits Errors and Omissions, CP 40116-13 5/15/2017 5/15/2018 Each Occurrence $5,000,000.00 a Claims Made Policy General Aggregate $5,000,000.00 Deductible $25,000.00 General Liability, Each Occurrence Not Covered a Claims Made Policy General Aggregate Not Covered Deductible Description of Insured's Operations I Adjusting, investigation,surveying and damage appraisal of claims or losses for insurance companies,self-insured entities, TPA services, and JECO Excess Agency, Inc. Cancellation Should any of the above policies be cancelled before the expiration date thereof,Claim Professionals Liability Insurance Company will endeavor to mail 30 days written notice to the certificate holder named herein,but failure to mail such notice shall impose no obligation or liability of any kind upon the company or its agents or representatives. 5/4/2017 Authorized Signature: Client#: 1432613 JOHNSEASI ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)11/27/2017 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Insurance Services, LLC PHONE 813 321-7500 FAX 813 321-7525 1715 N.Westshore Blvd.#700 (ECANo,Ext): (A/c,No): IL ADDRESS: Tampa, FL 33607 INSURER(S)AFFORDING COVERAGE NAIC# 813 321-7500 INSURER A Federal Insurance Company 20281 INSURED INSURER B Johns Eastern Company, Inc. INSURER C: P.O. Box 110259 INSURER D: Bradenton, FL 34211 INSURER E: 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 WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRR TYPE OF INSURANCE NW ADDL SUBR SR VD POLICY NUMBER /YPOLICY EFF POLICY EXP L (MM/DD/YYYY) (MMIDDYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE O(Ea RENTED $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Cyber Liability 82249944 01/10/2017 01/10/2018 $3,000,000 Each Claim DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Collier County Board of County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 3295 Tamiami Trail East Naples,FL 34112 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S21966353/M21966121 BXAEW