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Backup Documents 05/28/2019 Item #16C6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 16 C 6 Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Risk Risk Management N/4- N/4 2. County Attorney Office County Attorney Office S5k7 �c `T 4. BCC Office Board of County V..)\-\-- - t Commissioners \f (/5( SIzQ\ k 4. Minutes and Records Clerk of Court's Offices I� 2�'"l e6 f d 5. Procurement Services Procurement Services PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,ma need to contact staff for additional or missing information. Name of Primary Staff Ana Reynoso/PURCHA G Contact Information 239-252-8950 Contact/ Department Agenda Date Item was MAY 28, 2019 Agenda Item Number 16.C. Approved by the BCC Type of Document AMENDMENT Number of Original 2 Attached Documents Attached PO number or account N/A 12-5839 Angie Brewer& number if document is Angie Brewer& Associates, LLC to be recorded Associates, LLC INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signatur- STAMP OK N/A 2. Does the document need to be sent to another agency for a.ditional signatures? I es, N/A provide the Contact Information(Name;Agency;Address; ' :le on an attac•-i sheet. 3. Original document has been signed/initialed for legal sufficiency. (A •ocuments to be AR I signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the AR document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's AR signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! _ 8. The document was approved by the BCC on 05/28/2019 and all changes made during N/ the meeting have been incorporated in the attached document. The C V `�O J an Attorney's Office has reviewed the changes,if applicable. v this li . 9. Initials of attorney verifying that the attached documen e s' `•roved by the 1%A is no BCC,all changes directed by the BCC have been made, • docume t i dy for the 0� an option i Chairman's signature. 0 this line. �TBOJ_me t lUsk`nall 16 Co MEMORANDUM Date: May 30, 2019 To: Ana Reynoso, Purchasing Tech Procurement Services From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Contract #12-5839 Extension Contractor: Angie Brewer & Associates, LLC Attached, is an original copy of the contract referenced above, (Item #16C6) approved by the Board of County Commissioners on Tuesday, May 28, 2019. The second original contract has been held in the Minutes and Records Department for the Board's Official Record. If you have any questions, please contact me at 252-8406. Thank you. Attachment 1606 EXTENSION AGREEMENT #12-5839 FOR LOAN GRANT ACQUISITION AND COMPLIANCE SERVICES THIS EXTENSION AGREEMENT is made and entered into on this,2hday of \ 2019, by and between Angie Bre,,, . & R.ociates, L.C..� auth nze n to,o business in the State o orida, whose business address is •'l•4- y,' Drive EasB'radenttn, 'rida 34202 (the "Consultant") and Collier County, a political subdivision of the State of Florida(the "County"). WHEREAS, on June 12, 2012, Item 16.C.3, the County entered into an Agreement with Consultant to procure loan/grant acquisition and compliance services in an efficient and cost effective manner to the benefit of rate payers; and WHEREAS, the Agreement is set to expire June 21, 2019, and there are no further renewal or extension periods available; and WHEREAS,the parties desire to extend the Agreement for an additional year. NOW,THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the parties that the Agreement is hereby extended through June 21,2020. Except as stated herein, all other terms and conditions of Agreement#12-5839 shall remain in full force and effect. Remainder of Page Left Blank Signature Page to Follow Pagc 1 of 2 FIRST AMENDMENT TO AGREEMENT #I2-5839 16C6 IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or agent, have executed this Extension Agreement on the date and year first written above. ATTEST: BOARD OF COUNTY COMMISSIONERS Crystal K. Krnzel,.Coinptroller and Clerk COLLIER COUNTY, FLORIDA of Courts`' , . _ (."ej.Aalbf. Ak Aik ' cS $1 �`t S W`- iam L. Mc•aniels, Jr., C''airman Dated: e , 1i. 1 . 01 (SEAL) Consultant's Witnesses: CONSULTANT: Angie Brewer& Associates, L.C. ±/ A, fia404,iiiti.4.......- _____ First fitness By: WCGA-6---46-1"-- Firs), "t Ty e/print witness name I/VI f fZK A., e2Cut.) TI2 ( 1 j i TType/print signature and titleT e 41110. fir.40...i Secon: fr ess 513/zoi 5 -Z W S� Date TType/print witness nameT I I Approv:i a .r + and legality: Mil ' Jeffrey A latz +w, County Attorney Item# •SIC C le Agenda Q_7�j.�-' Date cJ V Date 6-zei ill Rec'd Page 2 01'2 Deputy Cier di • -- • 1'' TO AGREEMENT #12-5839 DocuSign Envelope ID:7A6A448F-F0D6-46C8-92A7-9707F138E251 1 6 C 6 A CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/08/2019 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 The Small Business Team NAME: Stratum Insurance Agency LLC (A/ON,Eat)Eat): 949-270-0609 (AA,Nol: 949-270-0608 10620 Southern Highlands Pkwy#110-276 n-MRESS: helpdesk@stratuminsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Las Vegas NV 89141 - INSURERA: RL Insurance Company 13058 INSURED INSURER B: Angie Brewer&Associates,LLC INSURER C: 9080 58th Drive East,Suite 200 INSURER D: INSURER E: Bradenton FL 34202 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. ADDL SUBR POLICY EFF POLICY EXP INSR TYPE OF INSURANCE LIMITS LTR INSR WVD POLICY NUMBER (MMIDD/YYYY) {MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR _MED EXP(Any one person) $ 10,000 A PMB0001254 12/20/2018 12/20/2019 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 " POLICY P c LOC COMBINED SINGLE LIMIT $ 2,000,000 AUTOMOBILE LIABILITY (Ea accident) $ BODILY INJURY(Per person) $ ANY AUTO A ALL OWNED SCHEDULED PMB0001254 12/20/2018 12/20/2019 BODILY INJURY(Per accident) $ AUTOS AUTOS NON OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability Per Claim :$1,000,000 A RTP0011523 02/17/2018 02/17/2020 Per Aggregate :$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Blanket Additional Insured for business owner liability applies per form PPB3046 04 13 and RTP 335(09/11). • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Collier County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Agreement#12-5839 Loan/Grant Acquisition&Compliance 3301 E Tamiami Tri AUTHORIZED REPRESENTATIVE Naples FL 34112 Stratum Insurance Agency LLC I ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD T3-83S 16 ■_ Q A ® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/27/2018 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT p NAME: g Risk Management Department Commercial Lines-(305)443-4886 PHONE 866 443 8489 FAX 800 889-0021 (AIc.No,Ext): ( ) (AIC,Nor. ( ) USI Insurance Services National, Inc. E-MAIL ADDRESS: Work.Comp@Trinet.com 2601 South Bayshore Drive,Suite 1600 INSURER(S)AFFORDING COVERAGE NAIC S Coconut Grove,FL 33133 INSURER A: Indemnity Insurance Company of North America 43575 INSURED INSURER B: TriNet HR III,Inc. INSURER C: RE:Angie Brewer And Associates LC INSURER D: 9000 Town Center Parkway INSURER E: Bradenton,FL 34202 INSURER F COVERAGES CERTIFICATE NUMBER: 13227035 REVISION NUMBER: See below 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. NSR ADDL SUBR POLICY EFF POLICY EXP ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DOIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED $ CLAIMS-MADE OCCUR PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ PRO- POLICY OTHER: AUTOMOBILE LIABILITY (EaMcINEcidentSINGLELIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED 1 NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY 1 AUTOS ONLY (Per accident) _ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ _ $ WORKERS COMPENSATION WLR C65440738 7/1/2018 7/1/2019 X STATUTE ERPLR H A AND EMPLOYERS'LIABILITY Y/N — 2,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? Di, N/A 2,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If Yes,describe under E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Re:06-3901 (Loan/Grant Acquistion and Compliance Services)//Workers Compensation is limited to worksite employees of Angie Brewer And Associates LC through a co-employment contract with TriNet HR III, Inc. 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 Collier County Purchasing Dept ACCORDANCE WITH THE POLICY PROVISIONS. 3299 Tamiami Trail East Ste 303 Naples FL 34112 AUTHORIZED REPRESENTATIVE 9€44101. I The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103)