Backup Documents 06/23/2009 Item #16E10
i1' E 1 0
MEMORANDUM
DATE:
July 1, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Arcadia Health Services, Inc.
Enclosed, please find one (1) original, referenced above (Agenda Item
#16E10) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
DO NOT WRITE ABOVE THIS LINE
16E 10 ~
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REQUEST FOR LEGAL SERVICES /' p\
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3)vY
ITEM NO.: CPt' pOc,. 0 \'LL\. ~
FILE NO.:
ROUTED TO:
Date:
June 26, 2009
To:
Office of the County Attorney
Jeff Klatzkow
From: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re: Contract: #09-5227 "Services for Seniors"
Contractor: Arcadia Health Services, Inc. d/b/a Arcadia Health
Care
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Age~~ ~ )
Item 16.E.10 ~
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
RLS# t''1-I.e1'-I.'(;! t' E 1 0
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: A tV! A-Dt Il &4I-TH SElJ...vlCfS IN(!.
c1flJ (t!{. A~A-l>(A ife-Al- 71-1 L'A-,Q €
Entity name correct on contract?
Entity registered with FL Sec. of State?
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ I Me L.
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ I t'\ t (.....
Workers Compensation
Each accident Required $ STA7'. /..11&4/7
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $ 10 MIL
Aggregate Provided $ / ,
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:~IJJ~f6~NA/.. Required $ ___
County required to be named as additional insured?
County named as additional insured?
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
~Yes
~Yes
Yes
~Yes
Provided $ 3 Me L.-
Provided $ t (
Provided $ r MIL
Provided $ 11
Provided $ "0) PO/)
Provided $ l Mll
Provided $ {lI.A, 1
Provided $ It
Provided $ l I
~Yes
~Yes
No
No
No
No
~No
No
Exp. Date
Exp. Date
Exp. Date
Exp. Date
Exp. Date
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Exp Date ~.( I { Dq
Exp Date S-( f) /7-()/t)
Exp Date l.
Exp Date I '
Exp Date q/ I f()9
Exp Date l'
~es
Provided $
Provided $
No
Exp. Date
Exp. Date
Exp Date ~q
No
No
Provided $L{ {lIlI L.
-LYes
~Yes
/" Yes
Yes
Signatllre Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
Attachments
Are all required attachments included?
~\\\
\
~Yes
----..L. Yes
~Yes
~Yes
~Yes
~Yes
~Yes
/Yes
No
~No
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No "-
ReViewer Initials: ~
Date: 6131'/ tJ9
04-COA-O" mCi222
MEMORANDUM
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TO: Ray Carter
Risk Management Department
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
,() D ~ \
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. t~tr
(, (;.tt'-'V .
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DATE: June 26, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Arcadia Health Services, Inc. d/b/a Arcadia Health
Care
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
C: Terri Daniels, Housing & Human Services
16E10
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Monday, June 29,2009 1 :17 PM
LynWood; DeLeonDiana
DanielsTerri; mausen_9
Contract 09-5227 "Services for Seniors"
All, I have reviewed and approved the certificate(s) for the following vendors under contract 09-5227:
L Arcadia Health services. Inc. d/b/a Arcadia Health Care
2. Executive Healthcare Solutions, LLC d/b/a Brightstar Healthcare
3. Eleven Ash, Inc. d/b/a Health Force
The contract s will now be forwarded to the county attorney's office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
www.sunbiz.org - Department of State
Page 1 of2
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Foreign Profit Corporation
ARCADIA HEALTH SERVICES, INC.
Filing Information
Document Number P21141
FEI/EIN Number 382186866
Date Filed 10/03/1988
State M I
Status ACTIVE
Last Event NAME CHANGE AMENDMENT
Event Date Filed 01/21/1994
Event Effective Date NONE
Principal Address
9229 DELEGATES ROW, SUITE 260
INDIANAPOLIS IN 46240 US
Changed 01/14/2009
Mailing Address
9229 DELEGATES ROW, SUITE 260
INDIANAPOLIS IN 46240 US
Changed 01/14/2009
Registered Agent Name & Address
NRAI SERVICES, INC.
2731 EXECUTIVE PARK DRIVE - SUITE 4
WESTON FL 33331 US
Name Changed: 05/07/2008
Address Changed: 05/07/2008
Officer/Director Detail
Name & Address
Title PRES
RICHARDSON, MARVIN R
9229 DELEGATES ROW, STE. 260
INDIANAPOLIS IN 46240 US
Title VP
SPARLING, CATHY
26777 CENTRAL PARK BLVD, STE 200
SOUTHFIELD MI 48076 US
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&in~doc _ number=P21141 &inq... 6/24/2009
www.sunbiz.org - Department of State
Title TRS
MIDDENDORF, MATTHEW R
9229 DELEGATES ROW, STE. 260
INDIANAPOLIS IN 46240 US
Title SEC
MOLIN, MICHEllE M
9229 DELEGATES ROW, STE. 260
INDIANAPOLIS IN 46240 US
Title DIR
RICHARDSON, MARVIN R
9229 DELEGATES ROW, STE. 260
INDIANAPOLIS IN 46240 US
Annual Reports
Report Year Filed Date
2007 12/12/2007
2008 02/11/2008
2009 01/14/2009
Document Images
01J14/2009=.A.NNu.A.LHEPQ RT
05/0712008::-:Heg,Agent Change
02/11l2008=ANNUAl REPORT
12/12/2007 -- ANNUAL REPORT
07/16/2007 =ANNUAl REPORT
01/23/2006 =ANNUALREPORT
04/14/2005=- ANNUAL REPORT
04/12/2004 -- ANNUAL REpQRL
Q2L2tJ,./200::t=.A.NNu61.BI;PQRT
04/02/2002 =ANNlJAL REPORT
05/Q_~200J:::..ANNUAI..BEPQRT
0;3115/2000=: ANNuAl.. REPORT
02/10/1999 -- ANN UAL REPORT
Q2Lt2L19iHL:::..ANN UAL REPORT
02/25/1997 -- ANNUAL REPORT
04/231199('1-- AN.NUAL B.E.P_QRJ
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http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inCL doc _ number=P21141 &inq... 6/24/2009
.16 E 10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Arcadia Health Services, Inc. d/b/a Arcadia Health Care, authorized to do business in the
State of Florida, whose business address is 4350 Fowler Street, Suite 3, Fort Myers, Florida
33901, hereinafter called the "Vendor" and Collier County, a political subdivision of the State
of Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30,2012.
2. ST A TEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page I of7
16EIO
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:
Arcadia Health Services Inc. d/b/ a Arcadia Health Care
26777 Central Park Blvd., Ste. 200
Southfield, MI 48076
Attention: Claudia Skewes, Contracting Supervisor
Telephone: 239-466-8889
Facsimile: 239-466-5152
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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
Page 2 of7
16EIO
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.
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:
~.
Commercial General 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 Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
~.
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.
~.
Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an Additional..lhsured 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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
IGEIO
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Vendor
shall indenmify 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, 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 indenmification 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. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EIO
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 USe. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16EIO
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST:
Dwight E.~rock,':Glerk~f Courts
BOARD OF COUNTY COMMISSIONERS
COLLIER; fiUNTY, FLORIDA
By: fJJ~ d~
Donna Fiala, Chairman
By:
Dated: I
(SEAL)
Attest .s ..t9 a.......;-
S1gnltwe CNli~0 ji.:- I
Arcadia Health Services, Inc.
d/b/a Arcadia Health Care
d~~
First Witness
By:
Kurnia Brown
tTypejprint witness namet
of. '-('Y\_.i..Jr~-:\:) u.. r '{)c..5'l ~
Second ess
Cathy Sparling, Sf. Vice President
Typed signature and title
Lindsay Ducharme
tTypej print witness namet
Approved as to form and
l~f;ep LL
A5S~S~~rrCounty Attorney
Dep \A
S e-.1! R --;e4 ?-i,
Print Name
Page 6 of7
16E10
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEE/UNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
ACORD", CERTIFICATE OF INSURANCE ISSUE DATE
06/24/2009
PRODUCER This certificate is issued as a matter of information only and confers no rights
MCGRIFF, SEIBELS & WILLIAMS, INC. upon the Certificate Holder. This Certificate does not amend, extend or alter the
PO. Box 10265 coverage afforded by the pOlicies below.
Birmingham, AL 35202 COMPANIES AFFORDING COVERAGE
800-476-2211
Company Firemans Fund Insurance Company A1JrtL
A .1.1% ? :3
INSURED Company Hartford Casualty Insurance Company :t- tjif,.lf
Arcadia Resources, Inc. and all of it's subsidiaries B
26777 Central Park Blvd.
Suite 200 Company Hartford Fire Insurance Company .t1 ^ ,'Jlooor.
Southfield, MI48076 C I '1 fI1'7j v
Company
D
Company
E
This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding
any requirement, term or condition of 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, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims.
CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE LIMITS OF LIABILITY
LT EXPIRATION
A GENERAL LIABILITY HYO-1 000030-0 1 05/07/2008 EACH OCCURRENCE $ 1,000,000
IXI Commercial General liability 09/01/2009 FIRE DAMAGE $ 100,000
D Claims Made IXI Occurrence MEDICAL EXPENSE $ 10,000
D Owners' and Contractors' Protection
IXI Medical Professional Liability PERS. AND ADVERTISING INJURY $ 1,000,000
D GENERAL AGGREGATE $ 3,000,000
General Aggregate Limit applies per' PRODUCTS AND COMP OPER. AGG. $ 3,000,000
IXI Policy D Project D Location
B AUTOMOBILE LIABILITY 21UENIT9404 05/07/2008 COMBINED SINGLE LIMIT $ 1,000,000
IXI Any Automobile 09/01/2009 BODILY INJURY (Per oerson) $
D All Owned Automobiles Medical Payments: $5,000 BODILY INJURY (Per accident\ $
D Scheduled Automobiles
D Hired Automobiles PROPERTY DAMAGE (Per accident) $
D Non-owned Automobiles COMPREHENSIVE $1000 deductible
!XI Includes Hired Auto Physical Damage COLLISION $1000 deductible
WORKERS' COMPENSATION WC Statutorv Limit I I Other I I
AND EMPLOYERS' LIABILITY EL EACH ACCIDENT $
EL DISEASE (Each emolovee) $
EL DISEASE (Policv Limit) $
A EXCESS LIABILITY HE01000006-01 05/07/2008 EACH OCCURRENCE $ 10,000,000
IXI Occurrence DClaims Made 09/01/2009 AGGREGATE $ 10,000,000
C BUSINESS PERSONAL 21UUMIT9320 05/07/2008 Personal Property Limit $ 4,386,000
09/01/2009 Deductible $ 1,000
Replacement Cost $
^ Special Form, Including theft, $
/ flood and earthquake $
The Certificate Holder is named as Additional Insured with respect to General Liability as required by written contract subject to policy terms, conditions, and
exclusions.
CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Collier County Authorized Representative
Purchasing Department q.d 13l1.. a-s. J?:
3301 Tamiami Trail East
Naples, FL 34112
paae 1 of 1 Certificate I D # C9M62KJ6
l'EIO
/'
/
ACORDrr.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
517/2010 4/29/2009
PRODUCER Lockton Companies, LLC Denver THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
8110 E. Union Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suite 700 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver 80237
(303) 414-6000 INSURERS AFFORDING COVERAGE NAIC # /
INSURED Arcadia Resources, Inc., ETAL INSURER A: ACE American Insurance Comnanv 22667 /
]305587 26777 Central Park Boulevard INSURER B:
Southfield, MI 48076 INSURER C:
INSURER D:
I INSURER E:
16EIO
COVERAGES
ARCHEOI
EN
TH'S CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRAcr BETWEEN THE ISSUING
INSURER SI. AUTHORIZEO REPRESENTATIVE OR PRODUCER AND THE CERTIF'CATE HOLDER.
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD' POLICY NUMBER P~..k+~~:~~88,w~ Pg~!fJf~~~~N
LTR NSR! TYPE OF INSURANCE LIMITS
~ENERAL LIABILITY EACH OCCURRENCE < XXXXXXX
COMMERCIAL GENERAL LIABILITY NOT APPLICABLE ~~~~~H9E~~~~~nce' $ XXXXXXX
- tJ CLAIMS MADE 0 OCCUR
- ME D EXP (Anyone person) $ XXXXXXX
I.- PERSONAL & ADV INJURY $ XXXXXXX
I.- GENERAL AGGREGATE $ XXXXXXX
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ XXXXXXX
h nPRO- n
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ XXXXXXX
ANY AUTO NOT APPLICABLE (Ea accident)
I.-
- ALL OWNED AUTOS BODILY INJURY
(Per person) $ XXXXXXX
- SCHEDULED AUTOS
- HIRED AUTOS BODILY INJURY
$ XXXXXXX
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $ XXXXXXX
(Per aCCident)
~RAGE LIABILITY AUTO ONLY- EA ACCIDENT $ XXXXXXX
ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX
AUTO ONLY: AGG $ XXXXXXX
OCESSJUMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX
OCCUR D CLAIMS MADE NOT APPLICABLE AGGREGATE $ XXXXXXX
$ XXXXXXX
R 0 UMBRELLA /
DEDUCTIBLE FORM $ XXXXXXX
RETENTION $ V $ XXXXXXX
WORKERS COMPENSATION AND X I T~~~r:lJNs I 10TH-
A WLRC456983 ]2 5/7/2009 5/7/2010 ER
EMPLOYERS' LIABILITY
A ANY PROPRIETOR/PARTNER/EXECUTIVE SCFC45698324 5/7/2009 517/2010 E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000
~~~~I~~~~V~~?ONS below NO
E.L. DISEASE - POLICY LIMIT $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS
$250.000 Deductible. Waiver of Subrogation applies with regard to Worker's Compensation coverage. Alternate Employer Endorsement is provided. RE: Branch
#721.
CERTIFICATE HOLDER
3640465
CANCELLATION
ACORD 25 (2001/08)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTH D PRESENTATIVE
Arcadia Health Care
4350 Fowler Street, #IB
Ft. Myers, FL 33901
16E10
MEMORANDUM
DATE:
July 1, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Summit Home Respiratory Services, Inc.
Enclosed, please find one (1) original, referenced above (Agenda Item
#16E10) approved by the Board of County Commissioners on Tuesday,
June 23,2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
o fI\--r,..-'" 0--'\\'\016 E 10
ITEM NO.: CA - i J!..C-.- 04f':a I I/> <I~ V) ,~( ::R~ElN~D
V 0 ;!; <so I. ,C)! 1],/; Y AI~-,r.'C"I~\I[:-'v
, I \~ I ~I- I
FILE NO.: (& '-
V~ ~?~(Vf ~::o ,';" 13
ROUTED TO:
Re:
Contract: #09-5227 "Services for Seniors"
srY15
'1/ J-.
Ii V'I. J
REQUEST'l!OR LEGAL SERVICES.. c] / ~ () {\ktA,"\I/~
~ If-- \
June 25, 2009 . ~ J~ ........
(;) ~. t'~~ .~
.Ut.- ,; l//' (I/V
r ,.-.. IV"
I~' /'./ 'IV'
(J .\.. . V..
'1 d ~
tV" Ill' ~.
-'r\tJ~ 'JL/1 v
I/" \) ,~'\..,. ~ ' ~. ,
J < t 'v t I ~;A) b 1
t }> ~
Date:
To:
Office of the County Attorney
Jeff Klatzkow
From:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Contractor: Summit Home Respiratory Services, Inc. d/b/a Summit
Home Healthcare Products
BACKGROUND OF REQUEST: .~-
// /
This Contract was approved by the BCC on June 23, 2009, Agenc;fa '-f'Ap.J
Item 16.E.1 0 \
-"-. ~
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
RLS # or - Ae~ - 0/.;1 ~c4--.t 1 0
CHECKLIST FOR REVIEWING CONTRACTS .I. Q E
EntityName: ..5t,/i!' r ~ti kf~~fJrf2IJ-mi2-1 .....rE~ulct<.,/ Ill)(!.. ct/f>/a..
. $UM.!tur tbmi /ft/lt-T/I('Ak~ I~Ct)l.k!::e;
EntIty name correct on contract? ~y es _No
Entity registered with FL Sec. of State? __0'es __No
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ t IV\ I L
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ IN A.. vW Provided $
Workers Compensation
Each accident Required $
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:
Required $
County required to be named as additional insured?
County named as additional insured?
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
---L.. Yes
-./ Yes
v Yes
V Yes
Provided $ "'2- 'Iv\ ll-
Provided $ II
Provided $ I MI L..-
Provided $ II
Provided $ SO,"oo
Provided $St1Q, {I'D
Provided $ l /
Provided $ l '
Exp Date
Exp Date
Yes
Provided $
Provided $
Provided $
/Yes
~Yes
~Yes
Yes
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
Attachments
Are all required attachments included?
~Yes
---L.. Yes
V Yes
~Yes
.00 n, ~1)lUl(/V tW~\ "t.> ...'" \-r
~Yes
~Yes
I,/' Yes
Aes
No
No
_No
No
Exp. Date ~
Exp. Date L I
Exp. Date \ I
Exp. Date { I
Exp. Date ( ,
Exp Date -
Exp Date hlsl (~
Exp Date I I,
Exp Date I I
Yes
Yes
Yes
Exp. Date
Exp. Date
No
Exp Date_
No
No
No
~No
No
No
No
No
No
No
No
No
No
No
-
No
Reviewer InitjaIS~(!
Date: ~ 3/JeJ'?
04-COA- ] 03 /222
16EIO
MEMORANDUM
TO:
Ray Carter
Risk Management Department
FROM:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
j
v
.}~vM
./ ()t^ '1-\
J'~ lI(;
DATE:
June 25, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Summit Home Respiratory Services, Inc. d/b/a
Summit Home Healthcare Products
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
'V~;'
dod/LMW
v J..:-
}.I lA, ~ .... ;'"
V" ,/ t..
1:J d,..J "ll')
i1/~f('. ((/(7j7
MAI'v~
.4p'~lr;:~? G'flvttNl
4~;{
. ._ t;/z ;-k'l
t'(,/~4-tdg '.'
#~ ~_/J ~ 4.~4 ~
. {!~;~ {!~ d/ ~// /
~~~~~
C: Terri Daniels, Housing & Human Services
mausen_9
From:
Sent:
To:
Cc:
Subject:
Raym ondCarter
Friday, June 26, 2009 7:22 AM
DeLeonDiana
LynWood; DanielsTerri; mausen_9
Contract 09-5227 "Services for Seniors"
All, I have approved the following contracts this morning:
1. United Senior Services, LLC d/b/a Visiting Angels of Naples
2 Summit Hom~ R~~pir~tory S~rvic:~.. Inc. d/b/a Summit Home Healthcare Products
3. Care Club of Collier County, Inc.
The Contracts will now be forwarded to the County Attorney's Office for their review.
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
16EIQ
JU::;l 24 09 11:34a
Summit Home Respirator~
9415965017
p. 1
Summit Home Respiratory Services, Ine 16 E 1 0
d.b.a. Summit Home Healthcare Products
1467 RAIL FIEAD BL YD.
NAPLES, FL 34110
PHONE (800) 395-6940 PHONE: (888) 731-0404
FAX: (800) 853-2858
FAX
DATE:
Cover page
6-24-09
PAGES 3
Including
TO: Diana De Leon
COMPANY: _Collier County Purchasing Department
FAX:
239-252-6597
FROM:
_Constance G. De Vozza , Chief Operating Officer
SUBJECT/REF: _Request for Waiver of Proof of Automobile Ins. Contract #09-
5227 "Collier County Services for Seniors"
COMMENTS:
_Thank you for your help. Have a great day!
Confidential Notice
The documcmts accompanying this fac.tmile transmhsion contain ICEally privileEed confidential infomlatioll that beloJlI" to
the sender. Tlte information ill intended only for the use of the individual or entity nllJllf!d above. If you al'e not the intended
recipient, YQU ore hereby notined that lUIy disdosure, copying. distribution, or the taking of any action in reliance or the
contents of this trallsmlssion is strictly prohibited. If you have l'eccl\'ed this facsimile transmission In error, please notily us at
the above telephone number Immediately to arrall&e for the return of the original document to us. Thank you.
Jun .24 09 11: 34a
Summit Home Respirator~
9415965017
p.2
Summit Home Respiratory Services, Inc.
d.b.a. Summit Home HeaIthcare Products
1467 RAIL HEAD BLVD.
NAPLES, FL 34110
l,~( 10
Phone: (800) 395-6940
(888) 731-0404
FAX (800) 853-2858
Lyn M. Wood, Contract Specialist
Collier County Purchasing Department
3301 East Tamiami Trail
Naples, Florida 34110
Re: Contract #09-5227 "Collier County Services for Seniors"
Dear Ms. Wood,
Summit was asked to attach proof of Auto Liability Insurance to this contract. Our company
does not have any company owned vehicles so we are asking for this requirement to be
waived.
I have attached "About Us" to this letter. It will tell you more about our business and how
we work very hard to provide the best products at the very best possible price to Medicaid
Waiver Program recipients throughout the State of Florida. All products are shipped, most
next day throughout Florida.
Thank you in advance for your consideration in this matter. We look fOf\vard to another
great year. Please call me ifI can be of further assistance.
Sincerely,
~<<~aH;7~
Constance G. De V ozza
Chief Operating Officer
,Jun ~4 09 11: 34a
Summit Home Respirator~
9415965017
p.3
SUMMIT
HOME HEAL THCARE PRODUCTS
1467 RAIL HEAD BLVD.
NAPLES, FL 34110
16EI0
PHONE (888) 73) -0404
(800) 395-6940
FAX (800) 853-2858
(888) 697-9868
ABOUT US
... Established medical supply company located in S.W. Florida since 1983.
... Affiliated with Medicaid Waiver Program throughout the state of Florida for over 15
years. Sold DME portion of business in 2005 to concentrate solely on Medicaid
Waiver Program.
... Have signed referral agreements with over one hWldred agencies throughout Florida.
Currently participate with Aged or Disabled Adult Waiver, Alzheimer's Disease
Waiver, Consumer Directed Waiver, Developmental Services Waiver, Family
Supportive Living Waiver, Nursing Home Diversion Waiver, PAC Waiver and
Traumatic Brain and Spinal Cord Injury Waiver.
~ November 2008, company added d.b.a. to company name to better reflect current
operation. Summit Horne Respiratory Services !rico will be d.b.a. Summit Home
Healthcare Products.
~ Currently have a total of twelve knowledgeable staff members dedicated solely to the
Waiver Program. We work closely with case managers and clients to answer
questions or concerns and assure correct and efficient shipping and billing of
products ordered.
~ Computerized UPS and FEDEX shipments to assure accurate and fast delivery of
products. FREE EXPRESS DELIVERY on all orders. Orders received by 4 p.m.
will arrive at client's home the next day. Florida panhandk requires 2nd day delivery.
... Orders are electronically billed with Month End Expenditure Reports sent within two
business days of end of month, or billed via invoice with mailing of such on a weekly
basis.
... Four toll-fiee numbers to speak with our staff or to fax orders/other communications.
... Catalog containing pictures, descriptions and pricing of consumable supplies and
specialized medical equipment. We supply as many catalogs as needed.
... November 2008, published ftrst "Additional Product List" to help agencies cut costs.
Some prices lowered and some great new products offered at the lowest possible
pnces.
... We maintain a large warehouse stocked with most supplies. We also maintain a large
catalog library used by us to assist case managers in locating needed specialty items.
~ Free Sample Program available for most incontinent products.
... We have continued to maintain the same or lower price levels since 1999.
SUMMIT
HOME RESPIRATORY SERVICES, INC.
1467 RAIL HEAD BLVD.
NAPLES, FL 34110
16EIO
PHONE (239) 596-5000
FAX (239) 596-5017
June 1,2009
I, Keith E. Glisch, President/CEO of Summit Home Respiratory Services, Inc. d.b.a.
Summit Home Healthcare Products, in my absence, transfer my administrative power to
Constance G. DeVozza, Summit's Chief Operating Officer.
Ms. DeVozza will be listed on all bank accounts as an additional signer. I also give her
the authority to sign any agreement necessary for the day to day operation of the
company whether I am present or not.
~~~~
Keith E. Glisch /0
President/CEO
State of ~/2i.1J.,<J
County of & II l..e fL,
Th~ing instrument was signc;4 and aCknOWledg~ before me this L day
of~--L- ,2009, by (~AI~A-A~ !1; JJ,.,,( yt)2.2..A personally
known to me.
0~>J-/~p"
Notary Public Signature
E / ,Ih/l/-'! /J1. /V~/J C) ,c/
Printed Name of Not Public
:D .L/7t:J I! I
Notary Commissio
,~~~ '1/
..co ......;.'i. ELAINE M. NELSON
*..bL * MY COMMISSION # DO 470181
"'~'" EXPIRES: September 11,2009
-fr", Of F'-O~ Bonded Thru Budget Notal)' Services
- www.sunbiz.org - Department of State
f6e ffi 0
", ~l""~
FLORIDA DEPARTMENT OF STATE ~ I."/~ i,~ 411I
DIVISION OF C ORPORArIO\~ ,__' _,._ ;j~~b~:_ ..~ _ . ~~!~~~:,
~~~~., Jlj'
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Florida Profit Corporation
SUMMIT HOME RESPIRATORY SERVICES, INC.
Filing Information
Document Number G60163
FEI/EIN Number 592321210
Date Filed 09/20/1983
State FL
Status ACTIVE
Last Event AMENDMENT
Event Date Filed 12/06/1993
Event Effective Date NONE
Principal Address
1467 RAIL HEAD BLVD.
NAPLES FL 34110 US
Changed 03/01/1999
Mailing Address
1467 RAIL HEAD BLVD.
NAPLES FL 34110 US
Changed 03/01/1999
Registered Agent Name & Address
GLlSCH, KEITH
25 LAS BRISAS WAY
NAPLES FL 34108 US
Name Changed: 06/23/1992
Address Changed: 05/08/1997
Officer/Director Detail
Name & Address
Title PRES
GLlSCH, KEITH
25 LAS BRISAS WAY
NAPLES FL 34110
Annual Reports
Report Year Filed Date
2007 04/05/2007
http://www.sunbiz.org/scripts/cordet.exc?action=D ETFIL&inCL... doc number=G60 163&in... 6/23/2009
. W\vw.sunbiz.org - Department of State
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2008 04/25/2008
2009 04/13/2009
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04[01'[2006 -- AI\I_NWALREPORT
~4/1~L20Q_5 -- ANNUA1BEP_ORT
Q4/3012004 -- Al'mVAL_REEQRT
Q4[17/2003::~_ANNW61,B.EP_ORT
05/01 /2002.::~ANN1J6LBJ;PQ81
Q5/0212QQL:_6NNVAbR EPQRT
09L2912QQQ -- AJIll,tVALREEQRI
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05/08/1991:3::.:...ANNVAl REPQRT
05!Oa!1997::~AN N l,JAL REPORT
05LOJ/ 1996.::::.ANNI.1 AL RE PQR L
05/01/1995 ~~ANNUAL REPORT
16EIO
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16E10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009/ by and between
Summit Home Respiratory Services, Inc., d/b/a Summit Home Healthcare Products,
authorized to do business in the State of Florida, whose business address is 1467 Railhead
Boulevard, Naples, Florida 34110/ hereinafter called the "Vendor" and Collier County, a
political subdivision of the State of Florida, Collier County, Naples, hereinafter called the
"County":
WITNESS ETH:
1. COMMENCEMENT. This Agreement shall commence on July 1/ 2009 and shall
terminate on June 30/ 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix 1/ Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page 10f7
16E10
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:
Summit Home Respiratory Services, Inc. dba Summit Home Healthcare Products
1467 Railhead Blvd.
Naples, FL 34110
Attention: Constance G. DeV ozza
Telephone: 239-596-5000
Facsimile: 239-596-5017
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing! GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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
Page 2 of7
16EIO
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.
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, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
/'
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.
//
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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of?
J6El(}
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing and Human Services Deparbnent.
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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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 timej 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EIO
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 USe. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
t6lEIO
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST:
Dwight E. Brock, Clerk of Courts
~~'~ ~
By:/K~. .... I
Date;~ i .; .'
Attest ~.)to Cht~-
14QA.a+uAA: . " .,
........ .;,,, It, . " ;:
I ~ 0. l, ~:. 1. . .....'
BOARD OF COUNTY COMMISSIONERS
COLLIE~ WUNTY, FLORIDA
I}J~_, d~
By:
Donna Fiala, Chairman
Summit Home Respiratory Services, Inc.
d/b/a Summit Home Healthcare Products
Vendor
7J1-1~wu
First Witness
/JJF ,/;~(je?
tType/print witness namet
d)~
~,06~_' ~. . ./' --.
SJcond Witness
Q
). . ()
By: '~N.x!; ,{ :/;ilJr
Signature (
Cfj,>,k/Jrf' (;'.Jxt/ZZIl
Typed signature and title
'w \ Cl V\. ~< l\p , L-.. e.c, ,."\
,
tType/print witness namet
Approved as to form and
l~fCf? )~
Assis~t County Attorney
"tUp&c:
S 411 Q 7Z.c-d-
Print Name
Page 6 of7
1'.___.__.......,"'_.__._-_.._..,,-~._~~-"""~~~~''"----
\16 E 1 0
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEEIUNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
.",.........""___..,.""'.....,__"".""''''__''"_~,____~".,__.,..._,...~.__ ,....,;,...'.c..,.,.<,_,..",_..~,~.,,_..'''"'"'''M'.'_~_-''u~.__~____
JUN-05-2009 11:03
Integrated Insurance
239 549 79
ACORD
TII
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYYI
06/05/2009
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA nON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PROOUCER
Integrated Ins. Services, Inc.
1316 Sf 46th Lane #1
Ca e Coral FL 33904
IHSURED Summit Home Respiratory Services, Inc.
1467 Rail Head Blvd.
: INSURER A
i INSURER 9:
INSURER C
INSURER D
INSURER E
Naples FL 34110
COVERAGES
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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
I~~: ~~~ .,.""""" POL.ICY NUMBER POL.ICY EFFECTIVE POL.ICY EXPIRATION L.IMITS
~NERAL L.IABlUTY EACH OCCURRENCE $ 1,000,000 ./
A ..!. 3MMERClAL GENERAL LIABILITY 28CMCFL.138 09/27/08 09/27(09 DAMAGE TO ~';.~~~" "' $ 50,000
- CLA'MS MADE [!J OCCUR MED EXP IAnv one _sonl $
X Products/Com pI. Ops ~~ONAL. & ADV INJURY $ 1 ,000 000
X Professional Liability GENERAL AGGREGATE :; 2,000,000 ./ /'
4'L AGGREnE ~IMIT APF~t PER. PRODUCTS. COMP/OP AGG :; 2,000,000 ./
POLICY ~~9; X LOC
.MLTOIlllOBlLJi LIABILITY COMBINED SINGLE L.IMIT $
ANY AUTO (Ea accident)
-
f- ALL OWNED AUTOS BODIL Y INJURY
$
SCHEDULED AUTOS Iper person)
f-
~ !
HIRED AUTOS BODILY INJURY ,
NON-OWNED AUTOS (Per acddenl) 1$
i
I PROPERTY DAMAGE
(Per aocidenl) :;
RGE LIABILITY AUTO ONL V . EA ACCIDENT :;
ANY AUTO OTHER THAN EA ACe :;
AUTO ONLY' AGG :;
~ESSlUMBRELLA LIABILITY EACH OCCURRENCE :;
OCCUR D CLAIMS MADE AGGREGATE S
I $ --
=1 DEDUCTIBLE :;
RETENTION $ :;
WORKERS COMPENSAnoN AND X I T'X~JTf.:I.';1:-1 10J~'
B EMPLOYERS' LIASIUTY TWC3200066 06/05/09 06/05/10 :; 500,000
ANY PROPRIETORIPARTNERIEXECUTIVE EL. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E,I.. DISEASE - EA EMPLOYEE :; 500.000
~m ~e~~~~~?~~" ""'~ E L DISEASE. POLICY LIMIT :; 500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEM&.NT I SPECIAL PROVISIONS
Sales of medical supplies.
Certificate Holder is an Additional Insured with respects to the policies noted on this certificate.
Bid: #ITQ #09.5227
Title: Collier County Services for Seniors
Collier County
Board of County Commissioners
CANCELLATION
SHOUL.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOf', THE ISSUING INSURER WIL~ ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOlDER NAMED TO THE LEFT, BUT FAI~URE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS /\GENTS OR
REPRESENTATIVE$.
AUTHORlZff REP~E NTATlVE
,JL 1\. /}f/-:ztlJ-
CERTIFICATE HOLDER
Naples, FL
ACORD 25 (2001/08)
@ ACORD CORPORATION 1988
TOTAL P.007
.~...._-""
~ i,il.bE 10
MEMORANDUM
DATE:
July 1, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Bidwell Home Care Services, LLC
Enclosed, please find one (1) original, referenced above (Agenda Item
#16E10) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
FILE NO.:
'? r ^ r
.:.
\ q:::r"J:' (Ie THr:. 16 E 10.
ern 'iiI1;,;-\TTCIJ,l.il~!E RECEI~ED ~
r ~ tt~~\i~
~ ~~pA
15 ~ l. ); 1>)6'1
V ~ b t;fij
/o~ ;;?
)< /\/1;
S&J
S)
ITEM NO.: 0C1-?aL" D\dLl(P
ROUTED TO:
DO NOT WRITE ABOVE THIS LINE
REQUEST FOR LEGAL SERVICES
Date:
June 25, 2009
To:
Office of the County Attorney
Jeff Klatzkow
From: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re: Contract: #09-5227 "Services for Seniors"
Contractor: Bidwell Home Care Services, LLC d/b/a Home Instead
Senior Care
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agen
Item 16.E.10
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
"'1'1>'"" _'_~W""'1'1l nw
16E10
RLS # tJCj -jJ~c- ~(:)- y&
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: l./l>Vtt.L- ~y c:1M<C. Scf1..vlC<C.. LU!
oLllJ it?\.. ~"- ''''57 EA-'P SEIU( (7fL ~€..
Entity name correct on contract? Yes
Entity registered with FL Sec. of State? ~ Yes
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ I M.I L.-
Products/Compl/Op Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ \ Wl..l L-
Workers Compensation
Each accident Required $
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $ I Y\A.1 L
Aggregate Provided $ I MIl-
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:
Provided $ -Z ~l L-
Provided $ l ,
Provided $ f MIl-
Provided $ I I
Provided $ ?,()o) (JfJO
Provided $ t ~ l L.
Provided $ .s-6'tt:'. ()e?D
Provided $ t ~
Provided $ I .
Exp Date
Exp Date
~Yes
Provided $ I ~ I (....
Provided $ 2- M' L
Required $
Provided $
County required to be named as additional insured?
County named as additional insured?
-L Yes
~Yes
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
~Yes
Yes
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
-L Yes
~Yes
~Yes
~Yes
..\~
\
~Yes
~Yes
~Yes
Attachments
Are all required attachments included?
LYes
No
No
~Yes
~Yes
~Yes
-.1L... Yes
No
No
No
No
Exp. Date till} I ;}.()t l)
Exp. Date ( II
Exp. Date l I
Exp. Date II
Exp. Date I'
Exp Date \/,4. IU(f)
( I
Exp Date I" \l J-z~ It?
Exp Date I d
Exp Date ' ,
\} I '"i {2_(1( ()
f "
No
Exp. Date 'flY (UfO
Exp. Date I '
Exp Date_
No
No
No
~No
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No <:::..
ReViewer InitIals: ~
Date: t, /3p / b9
04-COA-O i o3oli22
16EIO
MEMORANDUM
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
j). Vr'
/ " "f-'~
J ~l'" J?
TO: Ray Carter
Risk Management Department
DATE: June 25, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Bidwell Home Care Services, LLC d/b/a Home
Instead Senior Care
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
RECE\VED
JUN1 5 1009
. t l\\ f\CEMEN
Zi1:~
&/7Yj/O~
C: Terri Daniels, Housing & Human Services
16EIO
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Monday, June 29, 2009 10:32 AM
LynWood; DeLeonDiana
DanielsTerri; mausen_9
Contract 09-5227 "Services for Seniors"
All, I have approved the certificate(s) of insurance as provided by Bidwell Home Care Services, LLC d/b/a Home Instead
Senior Care. The contract will now be forwarded to the county attorney's office for their review.
Thank you,
Ray
~ Ca.1d.eh.
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
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Florida Limited Liability Company
BIDWELL HOME CARE SERVICE LLC
Filing Information
Document Number L07000059780
FEI/EIN Number 260188884
Date Filed 06/06/2007
State FL
Status ACTIVE
Effective Date 06/06/2007
Principal Address
10621 AIRPORT PULLING RD. #8
NAPLES FL 34109
Changed 06/12/2007
Mailing Address
10621 AIRPORT PULLING RD. #8
NAPLES FL 34109
Changed 06/12/2007
Registered Agent Name & Address
BIDWELL, WILLIAM J JR.
1912 EMPRESS COURT
NAPLES FL 34110 US
Manager/Member Detail
Name & Address
Title MS.
BIDWELL, SUSAN C
1912 EMPRESS COURT
NAPLES FL 34110
Title MR.
BIDWELL, WILLIAM J JR.
1912 EMPRESS COURT
NAPLES FL 34110
Annual Reports
Report Year Filed Date
2008 07/11/2008
http://www. sunbiz.org/scri pts/cOl-det.exe?action=D ETFI L&inCL doc ~number= L0700005 97... 6/22/2009
W\\-w.sunbiz.org - Department of State
Page 2 of2
16EIO
2009 04/15/2009
Document Images
Q...4L15/2QQ9 ~-=-At\l N 1.!6LBEPQ RT
07/1J/20Q!3-=ANNUAL REPORT
06/06/2007 ::-:...Florillit1imire<LLiaQility
View image in PDF format
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Note: This is not official record. See documents if question or conflict.
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http://www. sunbiz.org/scriptslcordet.cxe?action= D ETFI L&inCL doc _ number= L070000597... 6/22/2009
JUN/26/2009/FRI 02:04 PM
BIDWELL
FAX No, 2375969532
Ip~o~ 10
Fa
n~MI ~rTr~.'Io~.
w, "mn" Knll<lflIl. .If.. CfrlliraKrIl
G~r~ ~~,..dcf(r, ~C\I ChiliF>>1.,,,
lulJll D. r.I~l1Sjehnou
Ni!5'N~()n
Tl,ulllltll $, PCl<:of'(
Charl.~ It WillI;?,
.Ad~"i~;~((n:1/ ffi S'H'mfl' tltKIf (iJ'f
P.O. Box '88' Ulk~14I\d. rt JJiro2-ij98a. "'II"r~wllmil),qldilllP.rom
TclcplKmc(863) 665.60(;0 or 1"800-:u.'Z-.64S 'PlIX 100:;)066-19:13
lII. U llIIliIII.J III
IJIUI Ill. nil
CERTIFICATe Of' INSURANce
RE: 0520-32582
ISSUED TO: Collier County Housing and Human Services
Building H
Ni!lpll!S, f'L 34112
Attn:3301 Tamlaml Trail East
Producer: Janis Linda Russell
Company: Russell InsurOlnt;:e Agency, Int;:.
AddresS: 1750 Carlis!e Farms Drille
traverse City, MI49686-0000
Phone: (231) 932-7603
This Is to certify that Bidwell Service Care, I LC Home rnstead Senior Care 16520 S Tamlaml Trail Suite 203 Ft. Mvers F, being
subject to the provisions of the Florida Workers' Compensation law, has secured the payment of any workers' compensatIon benefits
dye by insuring their risk with the Florida Retail Federation Self Insurer.;; Fund.
POUCY NUMBER:
0520-32582
we Statutory Llmlt5--State of Florida
Employers Uability
EFFECTIVE DA~:
January 14, 2009
500,000 (Each Accident)
500,000 (Dlsease--Each Employee)
500,000 (Dlsease-.Pollcy l.lmit)
EXPIRATION DATE:
Januarv 14. 2010
This certificate Is not a polley and of Itself does not afford any Insurance. Nothing contained in this certificate shall be construed as
amending, extending, or altering coverage not afforded by the poliCY shown above or affording Insurance to any insured not named
above.
ihe polley of Insurance listed above has been Issued to the named Insured for the polley period Indicated. Notwithstanding any
requirement, term or condition of any contract or other document to which thl5 certificate may pertain. the In5urance made available
by the described policy in this certificate is subject to only the terms, exclusions and conditions of such policy. Paid claims may have
reduced the shown limits.
If the polley described above Is cancelled before the expiration date Indicated, the Issuing company will endeavor to mall 30 days'
written notice to the certificate holder named above, although if cancellation is for nonpayment of premiym, then the issuing company
will endeavor to mi!lll .3J:l days' written notlc1!! to the cl!!rtlflcatl!! holdl!!r. In any I!!Vl!!l1t, thl!! IlI;lI;ulng company, Its agents, and
representatives accept no obligation or liability of any kInd for failure to mall such notice.
Date: June 26, 2009
~}J~
Summit, Administrator
Florldn Retal1 f~det'ntioo Self 111$LJrel'S Fund
16EIO
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Bidwell Home Care Services, LLC, d/b/a Home Instead Senior Care, authorized to do
business in the State of Florida, whose business address is 10621 Airport Pulling Road, Suite
8, Naples, Florida 34109, hereinafter called the "Vendor" and Collier County, a political
subdivision of the State of Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. ST A TEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
4. SALES TAX. Vendor shall pay all sales, consumer, use and other similar taxes
associated with the Work or portions thereot which are applicable during the
performance of the Work.
Page I of7
16EIO
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:
Bidwell Home Care Services, LLC, dba Home Instead Senior Care
10621 Airport Pulling Road, Suite 8
Naples, FL 34109
Attention: Susan Bidwell
Telephone: 239-596-2030
Facsimile: 239-596-9532
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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
Page 2 of7
16E10
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.
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, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
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.
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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of?
16EI0
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EIO
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 USe. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16EIO
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST:
D~
By: .; .. .':: ~
Date& .., , '.:
. 1PE~;) -;,
Attest "'1. to o...~,.,
11.....+"'-".... .' '.
......1. -0 ~. .
\-J/
· . ;....b;b ,..:
BOARD OF COUNTY COMMISSIONERS
COLLIER OUNTY, FLORIDA
~d~
By:
Donna Fiala, Chairman
Bidwell Home Care Services, LLC
d/b/a Home Instead Senior Care
Vendor
,/~. ~~-
First itness
By:
"
~.~A
Signature
U t t>,"'-.<":" b.~~c.",
t~ej print witness nam~t
/~r/4; ~ 6'
Second Witness
'13relld~?eC{ Ve (~
tTypejprint witness namet
~ t>lJWe.\ J
Typed signature and title
Approved as to form and
legal sufficiency:
?;# R Lt
l\ssi..,bul+ County Attorney
t:)~.. 'hI
.5e-oit R. ILA~
Print Name
Page 6 of7
16f10
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEE/UNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
16EIO
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
PRODUCffi
THIS CERTIACA TE IS ISSUED AS A MA TIER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIACA TE
HOLDER. THIS CERTIACA TE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BB..OW.
Lockton Risk Services
P.O. Box 410679
Kansas City, MO 64141-0679
INSURERS AFFORDING COVERAGE
NAIC#
Service Care LLC dba Horne
Senior Care; Bidwell Horne Care
Trail, #203
INSURER A: First Specialty Insurance Company
INSURER B:
INSURER C:
INSURER D:
INSURER E:
Ft ers, FL 33908
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~,w ~f~ TYPE ~~ ,..~, ,~. .~~ POUCY NUMBER POllCY e:FB:TIVE POUCY EXPlRA TION UMITS ./
A ~ERAL UABlUTY '-CP1l4005638903 01/14/2009 01/14/2010 EACH OCCURRENCE $ 1 n n n n n n'
OMMERCIAL GENERAL LIABILITY DAMA~~_ T~i RENTED $ ~nn nnn
L PREMISES Ea occurence)
- CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 1 n nnn
X PERSONAL & ADV INJURY $ 1 nnn nnn
- /'
- GENERAL AGGREGATE $ ? nnn nnn
~'L AGGRnE LIMIT AFlS PER: PRODUCTS. COMP/OP AGG $? nnn nnn
POLICY ~~RT LOC
A ~OMOBILE UABlUTY IFCP114005638903 01/14/2009 01/14/2010 COMBINED SINGLE LIMIT /
(Ea accident) $ 1,000,000
- ANY AUTO
- ALL OWNED AUTOS BODILY INJURY
(Per person) $
- SCHEDULED AUTOS
II-. HIRED AUTOS BODIL Y INJURY
(Per accident) $
II-. NON.OWNED AUTOS
- PROPERTY DAMAGE $
(Per accident)
~RAGE UABlUTY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A EXCESSIUMBRaLA UABlUTY E'UM1l4009342000 01/14/2009 e1/14/2010 EACH OCCURRENCE $ 1 ()()().OOO
~ OCCUR D CLAIMS MADE AGGREGATE $ 1 ()()() 000
$
R DEDUCTIBLE $
" RETENTION $1 n nnn $
WORKERS COMPENSATION AND I T"X~JT~~;" I IOJ~'
EMPLOY8'lS' UABlUTY
ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYE $
~~l~i:~s~~~~I'ffi~~s below E.L. DISEASE. POLICY LIMIT $
A OTHER "'CP1l4005638903 01/14/2009 101/14/2010 "'ach Professional
Professional Incident $1,000,000
Liabili ty Pro Liab Aggregate $2,000,000
DescRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADOs) BY 8llDORSBolEM" I SPB:IAL PROVISIONS
Certificate Bolider is listed as Additional Insured as respects to Work Performed by Named Insured.
Reference #09-5227; Title: Collier County Services for Seniors
Coverage for incidents arising out of Non-Medical Professional Services for Bodily Injury, Property Damage and
Personal & Advertising Injury.
CERTIACA TE HOLDER
CANCB..l.A TION
SHOULD Arff OF THE ABOVE DESCRlBBJ POUCIES BE CANC8.l..8:> BETORE THE EXPlRA TION
Collier County DATE THERroF. THE ISSUING INSURER WILL 8IIDEAVOR TO MAIL.J..O.--- DAYS WRlTT811
Board of County Commissioners NOTICE TO THE CERTIRCA TE HOLDER NAM 8J TO THE LEFT, BUT FAILURE TO DO SO SHALL
3301 E. Tamiami Trail IMPOSE NO OBUGATION OR UABlUTY OF Arff KIND UPON THE INSURER, ITS AGBIITS OR
R8'RE5EM"A TIVES.
Naples, FL 34112 AUTHORIZED R8'RESEM"ATIVE
I o -~ J?II-
ACORD 25 (2001/08)
08#7380299
CACORD CORPORATION 1988
719432
16E10
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
16E10
MEMORANDUM
DATE:
July 1, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: United Senior Services, LLC
Enclosed, please find one (1) original, referenced above (Agenda Item
#16EI0) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
ITEM NO.: CA,. ?Q.c- D(2-\JO
FILE NO.:
'\\\\c{~6E 10
O~F;ge. TJF:l~!ECEIVED:
l/~'r\i lilT I' "/ tn','),',\ '~\i
.11.).' , I ('I ,t j,"/"I.-y
,- , '''; '~ ,.,. ;.
ROUTED TO:
c
i .: I 3
From:
4 ,vr;vt~
'V' ~-t
REQUEST FOR LEGAL SERVICES ~ Clo !,L t) !tt 1; vv1
June 25.2009 'Jr. V ~ ~j OP
Office of the County Attorney / \-C
Jeff Klatzkow
fb S 6) 'Jp)p4
DO NOT WRITE ABOVE THIS LINE
Date:
To:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re:
Contract: #09-5227 "Services for Seniors"
Contractor: United Senior Services, LLC d/b/a Visiting Angels of
Naples
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agend
Item 16.E.10
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
16E10
MEMORANDUM
DATE: June 25, 2009
'"\/
r)~
/j)~<
)v~~
TO: Ray Carter
Risk Management Department
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: United Senior Services, LLC d/b/a Visiting Angels of
Naples
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
C: Terri Daniels, Housing & Human Services
~~
.//, 00
l~ V/fI . D,/.>
/<S..::- ? .1"".. '.-
~, ,../ ..,
~ 011'11.'. . <i~t?9
4/:"
LJ P;'~h
n~.~'..
tJ4s-~~
dod/LMW
mausen_9
From:
Sent:
To:
Cc:
Subject:
Raym ond Carter
Friday, June 26, 20097:22 AM
DeLeon Diana
LynWood; DanielsTerri; mausen_9
Contract 09-5227 "Services for Seniors"
All, I have approved the following contracts this morning:
1. Unit~d S~nior S~rvic~5r LLC d/b/a Visitini Anlzels of NaDles
2. Summit Home Respiratory Services, Inc. d/b/a Summit Home Healthcare Products
3. Care Club of Collier County, Inc.
The Contracts will now be forwarded to the County Attorney's Office for their review.
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
16EIO
www.sunbiz.org - Department of State
Page 1 of2
16EIO
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Florida Limited Liability Company
UNITED SENIOR SERVICES, LLC
Filing Information
Document Number L04000046452
FEIIEIN Number 205579983
Date Filed 06/21/2004
State FL
Status ACTIVE
Last Event NAME CHANGE AMENDMENT
Event Date Filed 07/19/2005
Event Effective Date NONE
Principal Address
2800 DAVIS BLVD.
SUITE 207
NAPLES FL 34104
Changed 02/13/2009
Mailing Address
2800 DAVIS BLVD.
SU ITE 207
NAPLES FL 34104
Changed 02/13/2009
Registered Agent Name & Address
WILLKOMM, CONRAD
1100 FIFTH AVENUE SOUTH
SUITE 409
NAPLES FL 34102 US
Name Changed: 02/13/2009
Address Changed: 02/13/2009
Manager/Member Detail
Name & Address
Title MGRM
MUELLER, ANDREAS J
665 FOUNTAINHEAD WAY
NAPLES FL 34103
Annual Reports
http://www. sun biz. org/ scripts/ cordet. exe ?action = 0 ETFI L&inq_ doc _ num ber= L040000464... 6/25/2009
www.sunbiz.org - Department of State
Page 2 of2
16E10
Report Year Filed Date
2007 01/08/2007
2008 01/04/2008
2009 02/13/2009
Document Images
02/1:3/2009::-...AN N LJAI,RE:PQRT
OJ!04/2008:::ANNLJALREEQRT
01/08/2007 :::ANNUAL REPORT
OJ/06/2006 -=-ANNUAL REPORT
07t19/20Qf> =-NCl rn~LCbClDil~
0.J1L9/20QQ_ -- ANNUALREPQRI
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06/21/2004 :.::FloriganLimlte.ctl,i,:1Qilites
I Note: This is not official record. See documents if question or conflict.-I
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RLS# ()t?-fJeL- Ot~~6 E 10
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: IJllJlrt.D SfIV1P/2 SfRlllCfS. J L..l-~ d/h/a Ji!:.trtNJb<- jk6"c:.~ 0;:- ).JNc..E.S
Entity name correct on contract?
Entity registered with FL Sec. of State?
~es
~Yes
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ \ VY..l L-
Products/Compl/Op Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ \ \\A l L-
Workers Compensation
Each accident Required $
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:f'"r"'~L.M~.
~es
vYes
~Yes
~Yes
Provided $ Z M.\ L-
Provided $ l \
Provided $ i ~ 1\
Provided $ i l
Provided $ 30()} (1) P
Provided $
(M.\ L
Provided $ tOO. (){)()
Provided $ SOO. {)Cf?
Provided $ IDl'Dco
I
Exp Date
Exp Date
Yes
Provided $
Provided $
Provided $ i 0 J 00 l'
Required $
County required to be named as additional insured?
County named as additional insured?
-1LYes
V""'Yes
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
--LYes
Yes
Performance Bond
Bond requirement referenced in contract?
If attached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
v\~
.../Yes
Yes
-l.L- Yes
~Yes
----L.Yes
VYes
vYes
Attachments
Are all required attachments included?
~es
No
No
No
No
No
No
Exp. Date ~
Exp. Date \ \
Exp. Date I \
Exp. Date I I
Exp. Date I I
Exp Date ~
Exp Date ~( I 11t:'1 t
Exp Date. ,
Exp Date ( ,
No
Exp. Date
Exp. Date
Exp Date ~l /)
No
_No
No
~No
Yes
No
Yes
Yes
No
No
No
~No
_No
_No
. -( fl.-A" 1 .
(.,-'~/-i r0~~~l
.... ci.J ~ (J'
. .l't-' 1>\....' G('\~~'
.....~ e-jv
~ a.n.t^-
No
No
No
ReVie~e~ Initial~ ,
Date: b j.;).q / tJ<?
04-COA-of030d2
16EIO
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
United Senior Services, LLC d/b/ a Visiting Angels of Naples, authorized to do business in
the State of Florida, whose business address is 2800 Davis Boulevard, Suite 207, Naples,
Florida 34104, hereinafter called the "Vendor" and Collier County, a political subdivision of
the State of Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30,2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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" .
4. SALES T AX. 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.
Page I of7
116 E 1 0
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:
United Senior Services, LLC d/b/ a Visiting Angels of Naples
2800 Davis Blvd., Suite 207
Naples, FL 34104
Attention: Andreas J. Mueller
Telephone: 239-530-1101
Facsimile: 239-530-1102
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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
Page 2 of7
16EIO
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.
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, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
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.
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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
16EI0
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 40f7
1.6( 10
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 USe. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16[10
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST: ',"
By:..:."..... .
DateeI:. . , .~.
{SEAL?' -, .
Atttst .,. to,,'~""" .
119ft.tare Oft."
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: ~ ~~,
Do a Fiala, Chairman
United Senior Services, LLC d/b/a
Visiting Angels of Naples
L ~.
. - )~)
~(/Z.. ,r=C ~.
Fitst Witness
By:
cZ2. /endor
/
.'-
Signature
7" 'b-
.LJ c. Q t.., r- (fL ( P" q
ejprint witness namet
/)
Second Witness
ft-:;. 'n4':;i.--u;/L
Typed signature and title
;;;,J("I!.C .... -1- "vL- 8 .. r.( c 'f oJ"......
~ ((0/1'7 d A f?fJ q VI" d-
tType/ print witness name t
Approved as to form and
legal sufficiency:
~l!t;{ LL
~is~ County Attorney
pI-(..- y
t\ 4 if- 12 k.a.d...
~
Print Name
Page 6 00
16EI0
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEE/UNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 70f7
.4CQRDTM CERTIFICAl
OF LIABILITY INSURA.,CE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERfIFICA TE
HOLDER THIS CERTIACATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRCOOCER
Lockton Risk Services
P O. Box 410679
.sas City, MO 64141-0679
INSURERS AFFORDING COVERAGE
NAIC#
INSURED Uni ted Senior Services, LLC. dba
Visiting Angels of Naples
2800 Davis Blvd, Suite 207
INSURER A: First Specialty Insurance Company
INSURER B: ITT Hartford
INSURER C:
INSURER D:
INSURER E:
Na es, FL 34104
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I,N;: ~9:~ "l""VPF'm: POLICY NUMBER ~}{.CY EFFECTNE POLICY EXPI~mN L1M ITS
A ~ERAL LIABILITY FCP1l4007454502 01/01/2009 01/01/2010 EACH OCCURRENCE $ , ()()() ()nn
DAMAGE, I ~: RENTED $ ":l,()() ()()()
COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence\
I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ , () ()()()
X PERSONAL & ADV INJURY $, ()()() ()()()
-
- GENERAL AGGREGATE $ ? nnn ()()()
~'l AGGRnE LIMIT AFlS PER: PRODUCTS - COMP/OP AGG $? ()()() ()()()
Iv POLICY ~~9.;. lOC
A ~TOMOBllE LIABILITY FCP1l4007454502 01/01/2009 01/01/2010 COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
I-- ANY AUTO
I----- ALL OWNED AUTOS BODilY INJURY
(Per person) $
I----- SCHEDULED AUTOS
fK-- HIRED AUTOS BODilY INJURY
(Per accident) $
~ NON-OWNED AUTOS
( I-- PROPERTY DAMAGE $
(Per accident)
1==rGE LIABiliTY AUTO ONl Y - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSlUMBRBlA LIABiliTY EACH OCCURRENCE $
~::loCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I T"X~JIjj]Ns I IOlbl-
e..IPLOYERS' LIABIUTY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E,L. DISEASE - EA EMPLOYE $
~~:~i1~s~~g~~%~s below E.L. DISEASE - POLICY LIMIT $
OTHER 37BDDDB9559-04 01/01/2009 01/01/2010 Limit $10,000
B
Employee Dishonesty Deductible $500
DESCRI?TION OF OPERATIONS IlOCA TIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSE3111 ENT I SPECIAL PROVISIONS
Coverage for incidents arising out of Non-Medical Professional Services for Bodily Injury, Property Damage and
Personal & Advertising Injury. Certificate Holder is listed as Additional Insured as respects to Work Performed
by Named Insured. ITQ 09-05227 Title: Collier County Services for Seniors
***10 Day Notice of Cancellation for Non-Pay***
CERfIACA TE HOLDER
CANCELLATION
Collier County
~rd of County Commissioners
_JOl E Tamiami Trail
Naples, FL 34112
SHOULD ANY OF THE ABOVE DESCRIBED POliCIES BE CANCB.lED Be=ORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBliGATION OR LIABILITY 0 A K N INSURER, ITS AGENTS OR
REPRESENTA TNES.
AUTHORIZED
@ACORD CORPORATION 1988
ACORD25 (2001/08)
DS#7377404
827847
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD25 (2001/08)
ACORQM
CERTIFICATF ~F LIABILITY INSURAN(
DATE (MMlDDlYYYY)
6/212009
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ASVA
'RODUCER
\utomat:c Data Processing Insurance Agency, Inc
ADP Boulevard
loseland, NJ 07068
NSURED
United Senior Services, LLC
Suite 201
Naples, FL 34102
INSURERS AFFORDING COVERAGE
INSURER A: Aequicap - Aequicap
INSURER B:
INSURER C:
INSURER D:
INSURER E:
NAIC#
EOUIC
:OVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ISR ~~~~ POLICY NUMBER PRHSY EFFECTIVE POLICY EXPIRATION LIMITS
.TR
GENERAL LIABILITY EACH OCCURRENCE $
-
COMMERCiAl GENERAL LIABILITY PREMISES lEa occurencel $
I CLAIMS MADE D OCCUR MED EXP (Anyone person) $
- PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $
I POLICY n ~~R;: n LOC
~OMOBILE LIABILITY COMBINED SINGLE LIMIT $
M-JY AUTO (Ea accident)
-
AlL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accidenl)
-
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
:=J OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I WCSTATU-: I 10TH.
TORY LIMITS ER
\ EMPLOYERS' LIABILITY WC07074646 1/1/2009 11112010 100,00C
ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 100,OOC
If yes, describe under SOO,OOC
SPECIAL PROVISIONS below E L. DISEASE - POLICY LIMIT $
OTHER
ESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
:ERTIFICATE HOLDER
CANCELLATION
Collier County Services for Seniors
Bid#ITO#09-5227
Collier Couty Florida
Board of County Commisioners
Naples, FL -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~'
@ACORDCORPORATION 1988
,CORD 2S (2001108)
UNITSEN-01
ASVA
16'EI0
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ICORD 25 (2001/08)
MEMORANDUM
DATE:
July 1,2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Accu-Care Nursing Services, Inc.
Enclosed, please find one (1) original, referenced above (Agenda Item
#16E10) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
.... lIII.._.....~_..1lL n "'Of. ...
16E10
OC1 .. \'nr ,.. D\?-~ '1
ITEM NO.: -, \~'-
"\ \\\O~
I,) Q~TEif: ~~~Ell~ E 1 0
r\l~.'li :\ 11'/
\.1 .'.' '" :
FILE NO.:
ROUTED TO:
",l'\
....---
"
"
"" 13
t'r'. .
Date:
~ vi>
REQUEST FOR LEGAL SERVICES~, / 1 rv 07
LA f) $/- 11:- .~A
June 25,2009 '..J- & IV- f
Office of the County Attorney (j) _ L, ~ 1I;o..a-o
Jeff Klatzkow V (,../' ~, f)/tIv
Lyn M. Wood, C.P.M., Contract Specialist ~ / ' , In 1
Purchasing Department, Extension 2667 ~ (..... l-- .j 'I'
7' b)t,()}o1
DO NOT WRITE ABOVE THIS LINE
To:
From:
Re:
Contract: #09-5227 "Services for Seniors"
Contractor: Accu-Care Nursing Service, Inc.
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agenda ,/
Item 16.E.10 @J
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
RLS# tJ7-fJR.t'- ol,~3916E 1 r
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: 4('1'4.'- (?Akl.~ )..)111<..5;1/1)(,;'" Sc.:..€.VIC'L) 11t)(!..,
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ , ~ I I
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ I Vv.. \ L
Workers Compensation
Each accident Required $
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:
Entity name correct on contract?
Entity registered with FL Sec. of State?
Required $
County required to be named as additional insured?
County named as additional insured?
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
-LYes
~Yes
Yes
-.U.Yes
Provided $ 3 "^ I L
Provided $ I ,
Provided $ MIL
Provided $ l '
Provided $ I j
Provided $ ~.~'i5
Provided $
Provided $
Provided $
IMIL
\ I
I I
Exp Date
Exp Date
Yes
Provided $
Provided $
Provided $
V'" Yes
~Yes
V Yes
Yes
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
Attachments
Are all required attachments included?
tJ\\\
I
-L Yes
V Yes
~Yes
.VYes
~Yes
~Yes
~Yes
1Yes
vYes
v-:: Yes
No
No
No
No
\./No
No
Exp. Date (P/OZt}lt>
Exp. Date , ,
Exp. Date I ;
Exp. Date 1 ,
Exp. Date ( r
Exp Date (;/Zr/I()
I
Exp Date 1.\/, !201P
Exp Date f I I
Exp Date l '
No
Exp. Date
Exp. Date
Exp Date_
No
No
No
~No
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No \. .L
Reviewer Inilials: Y/,lRt.
Date: Ittvl~ ~ he;
04-COA-ofo30f 22
16EIO
MEMORANDUM
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
ft. ~
, t~
J c~~t
TO: Ray Carter
Risk Management Department
DATE: June 25,2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Accu-Care Nursing Service, Inc.
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
t?~Ct:
./Vl:'-
J/),A./ ". c:: {)
''1 (. !j
'lIS/( . "2009
111;q1\~
., ,CI:/vt.
~ :tNI'
r~~
€ibl.,~. ,...,,7
~~~-
~~7
C: Terri Daniels, Housing & Human Services
16E10
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Friday, June 26, 20098:17 AM
DeLeonDiana; LynWood
DanielsTerri; mausen_9
Contract 09-5227 "Services for Seniors"
All, I have approved the Certificate(s) of Insurance provided by Accu-Care Nursing Service, Inc with respect to the above
referenced contract. The contract will now be forwarded to the County Attorney's Office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
Www.sunbiz.org - Department of State
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Florida Profit Corporation
ACCU-CARE NURSING SERVICE, INC.
Filing Information
Document Number P95000045987
FEI/EIN Number 650583500
Date Filed 06/13/1995
State FL
Status ACTIVE
Effective Date 06/10/1995
Principal Address
2375 N TAMIAMI TRAIL
SUITE 300
NAPLES FL 34103 US
Changed 04/03/2007
Mailing Address
2375 N TAMIAMI TRAIL
SUITE 300
NAPLES FL 34103 US
Changed 04/03/2007
Registered Agent Name & Address
c T CORPORATION SYSTEM
1200 SOUTH PINE ISLAND ROAD
PLANTATION FL 33324 US
Name Changed: 05/13/1996
Address Changed: 05/13/1996
Officer/Director Detail
Name & Address
Title DP
HUGHES, KATHLEEN K DCEOP
1210 STONE COURT
MARCO ISLAND FL 34145
Annual Reports
Report Year Filed Date
2008 02/29/2008
http://www .sunbiz.org/scripts/cordet.exe?action= D ETFlL&in~ doc _l1umbero= P95 0000459... 6/25/2009
"www.sunbiz.org - Department of State
i~e rfi 0
2008 05/30/2008
2009 03/01/2009
Document Images
03/01120Q9=-.ANNl.Jf\.LREPQRT
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Q.:4LQ3/2Q07 -- ANNUAL REeDEI
04/Ha.QJ2~~- ANNUAl.REPORT
02/21/2005-- ANNUAL REeQBL
01/26/2004 - ANNUAL REPORT_
01/21/20~==AtI.!Nl.)A...L_REF)OBT_
03/28/2002 =-.ANNUAL REPORT
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01/19/2000 =-ANNUAL REPORT
01/28/1999 =-=_ANNl.JAL REPORT
01/2,21199a==ANNl.JAL REPORT
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04/19/1996 =ANNUAL REPORT
06/13/1995 =-.DOCUMENTS PRIOR TO 1997
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Copyright and Pnvacy Policies
Copyright @ 2007 State of Florida, Department of State.
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inq_ doc _ number=P950000459... 6/25/2009
16E10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Accu-Care Nursing Service, Inc., authorized to do business in the State of Florida, whose
business address is 2375 Tamiami Trail North, Suite 300, Naples, Florida 34103, hereinafter
called the "Vendor" and Collier County, a political subdivision of the State of Florida, Collier
County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July I, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
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16EIO
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:
Accu-Care Nursing Service, Inc.
2375 Tamiami Trail North, Suite 300
Naples, FL 34103
Attention: Kathleen K. Hughes
Telephone: 239-263-3011
Facsimile: 239-263-1552
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
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. 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
Page 2 of7
16E10
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.
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, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
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.
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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 on
16E10
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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 IIt Florida
Statutes, Collier County Ethics Ordinance No. 2004-05, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16E10
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U.s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
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16EIO
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST:
D~
By. ..., ., '.'
Dated': l",
(SEA~f.. ._~
~" to Cb, t"..,. ,
s 1 gnature Oft I, ,.. ,,' 'J
./ ,I..
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: ~,d~
Dorm, Ia a, airman
Accu-Care Nursing Service, Inc.
~_ c. .' J i"
Vendor
B~'~'~
Signature
+(d--'~O:I~,-
First Wib1ess
,a.....Le."
tTypej print witness name
e~ 7~
Secon WItness
fP-'!.tl y /./? <.! ff
tTypejprint witness namet
Approved as to form and
legal sufficiency:
c ruff- f2 Lc
j\~~ County Attorney
S ~#- R fLa~L.
Print Name
Page 6 of7
.~"'''.J><i.Iol
16EIO
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEEIUNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
16E10
ACDRQ CERTIFICATE OF LIABILITY INSURANCE I CERllFlCATE NO. J DATE
AC09-15400 103-8064 4 5
6/22/2009 1:17:54PM
PROOUCER THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
Biqhpoint JU..k Service. LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
14160 Dalla. Parkway '500 ~P}~:~JHIS CERTIFICATE DOES NC;>~1:MEND. EXTEN~ ~~
Dalla., TX 75254
(8001 632-5096 (972) 715-0959
"ax: (972) 404-4450 INSURERS AFFORDING COVERAGE
INSURED: Equity Group Leasing I, Inc l/c/f: INSURER A: .~- .-" ,....~...,~ ("'
ACCU-CARE FT. MYERS INSURER S:
3594 BROADWAY STE B INSURER C:
FT. MYERS, FL 33901 INSURER D:
(239) 931-9788 Fax: (239) 931-9791
INSURER E:
THE POLICIES OF INSURANCE Ll8TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD t1D1CATED. NOTWfTHSTANDlNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUIENT WITH RESPECT TO WHICH T" CERTIFICATE MAY BE ISSUED OR
MAY PERT AtI, THE INSUIlAHCE AFFORDED BY THE POLICIES DESCRIBED HERUlIS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND COHOITION8 OF SUCH
POLICIES. AGGREGATE LMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CI.AIIotS. ~
~ TYPE OF INSURANCE POLICY NUMBER poUl Y EF....CTIYE ~ 1.lIoWT8
~NERAL LIABILITY EACH OCCURRENCE .
~ ~RCIAL GENERAL LIABIliTY FIRE DAMAGE (Any One FIre) .
~ ---l CLAIMS MADE D OCCUR MED EXP (Any ON person) .
PERSONAl & ADY INJURY .
GENERAL AGGREGATE .
PRODUCTS. CONIPIOP AGG .
~N'l AGGREGAnTE LIMIT A~S PER:
I I POLICY ~~ I I LOC
AUTOMOBLE LIABILITY
I--
ANY AUTO
I--
I-
-
-
-
-
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NQN.OWNED AUTOS
RETENTION .
WORKERS COMPENSATION AND
EMPLOYERS' UAIILITY
WC77779990901
COMBINED SINGLE LIMIT .
(Ea_l
BOOlLY NJURY .
(Par personl
BOOIl Y INURY .
(Par accldanI)
PROPERTY DAMAGE .
(Per accident)
AUTO ONLY. EA ACCIDENT .
OTHER THAN EAACC .
AUTO ONLY: AGO .
EACH OCCURRENCE .
AGGREGATE .
.
.
.
04/01/2009 04/01/2010 X . I JqI.tl-
E.L. EACHACClDENT . 1000000
E.L. DISEASE - EA EMPLOYEE . 1000000
E.L. DISEASE - POLICY LIMIT . 1000000
~AGE LIABILITY
I ANY AUTO
EXCESS UABlLlTY
= OCCUR o CLAIMS MADE
-
-
DEDUCTIllE
A
RHER
LIMITS
LIMITS
.
.
1. This certificate remains in effect, provided the client's account is in good standing with Equity
Group Leasing I. Inc. Coverage is not provided for any employee for which the client is not report~ng
wages to Equity Group Leasing I, Inc. A~plies to 100% of the employees of Equity Group Leasing I,
Inc leased to ACCU-CARE FT. MYERS, effect~ve 04/01/2009.
CERTIFICATE HOLDER I I ADDmOHAL INSUIlED; IN8URI!R LETTER:
COLLIER COUNTY BOARD OF COONTY COMMISIONERS
3301 E. TAMIAMI TRL.
NAPLES, FL 34112
CANCELLATION
r<ll'
DATE THEREOF, TIE IS8U1HO INSURER -... ENDEAVOR TO MAlI. 30 DAYS WRITTEH
NOTICE TO TIE CERTFlCATE HOLDER ~ TO TIE LEFT, BUT FaURE TO DO 80 SHALL
IW'OlIE NO O8UOATION OR UABIUTY OF _ KIND l.-oN TIE I18URER, ITS AOENT8 OR
REPRESENTATIVES.
~ TQ 01 -"5"~~ '1
ACORD 25-S (7/97)
AUTHORIZED REPRESENTATIVE
.-~- ~ ~
--- .. -- ... .
C ACORD cORPORATION 1988
Sabal Insurance Group, Inc.
805 E Broward Boulevard, Ste 303
Fort Lauderdale, FL 33301
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Y)
ACORD",
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Accu-Care Nursing Service, Inc.
INSURERS AFFORDING COVERAGE
INSURER A American Al ternative Ins Corp
INSURER B'
INSURER C:
INSURER D:
INSURER E:
NAIC#
1 72
2375 Tamiami Trail N, #300
Naples, FL 34103
COVERAGES
THE POLICIES OF INSURANCE L1STEDBELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT V\,HH 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR DD'L b~i-'nM~fD'b~~E P8kM~~~6'b~R9N
IT" INSRD TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE S 1000000
I---
X COMMERCIAL GENERAL LIABILITY I ~~~'~~~s (E~~~u~~nce) $ 1 000 000
xl CLAIMS MADE CI OCCUR MED EXP (Any oneperson) $ I:;n 000
-
A X Professional Liab VHHG3052541-01 06/21/09 06/21/10 PERSONAL & ADV INJURY $ 1 000 000
X Retro Date* *06/21/03 GENERAL AGGREGATE $ 3 000 000
--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $ .~ nnn .nnn
-I r-I PRO. IILoc
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- S Included
ANY AUTO (Ea aCCident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
A :x HIRED AUTOS VHHG3052541-01 06/21/09 06/21/10 BODILY INJURY
$
.x NON.OWNED AUTOS (per accident)
- PROPERTY DAMAGE S
(Per accident)
GARAGE LIABILITY AUTO ONLY. EAACCIDENT S
FIANYAUTO OTHER THAN EAACC $
AUTO ONLY AGG $
~~ --
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
1---1 OCCUR CI CLAIMS MADE AGGREGATE $
1---' 1----
$
FI DEDUCTIBLE S
RETENTION $ $
WORKERS COMPENSATION AND IT'ORYLIMITS I IUiH.
ER
EMPLOYERS' LIABILITY
EL, EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E,L DISEASE. EAEMPLOYEE $
Iryes, describe under
SPECIAL PROVISIONS below EL. DISEASE- POLICY LIMIT S
OTHER -'_L
DESCRIPTION OF OPERATIONS / LOCATIONS {VEHICLES {EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Collier County is named as additional insured in respect to General Liability
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
Collier County NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Board of County Commissioners IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
Naples, Florida REPRESENTATIVES. ~
~---
~^i'8 .~ AUTHORIZED REPRESENTATIVE
I oq-S:LJ- f
ACORD25 (2001/08)
@ACORD CORPORATION 1988
16EIO
>:
MEMORANDUM
DA TE:
July 7, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Care Club of Collier County, Inc.
Enclosed, please find one (1) original, referenced above (Agenda Item
#16EI0) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
. J\6~~
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DO NOT WRITE ABOVE THIS LINE
REQUEST FOR LEGAL SERVICES
Date:
June 25, 2009
To:
Office of the County Attorney
Jeff Klatzkow
From:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re:
Contract: #09-5227 "Services for Seniors"
Contractor: Care Club of Collier County, Inc.
BACKGROUND OF REQUEST:
s-,zAdP"J->
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This Contract was approved by the BCC on June 23, 2009, Agenda
Item 16.E.10
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
16El0
MEMORANDUM
TO: Ray Carter
Risk Management Department
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
}L'.: -
j "
j,.1 ~
DATE: June 25, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Care Club of Collier County, Inc.
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
C: Terri Daniels, Housing & Human Services
16EIQ
mausen_9
From:
Sent:
To:
Cc:
Subject:
Raym ondCarter
Friday, June 26, 2009 7:22 AM
DeLeonDiana
LynWood; DanielsTerri; mausen_9
Contract 09-5227 "Services for Seniors"
All, I have approved the following contracts this morning:
1. United Senior Services, LLC d/b/a Visiting Angels of Naples
2. Summit Home Respiratory Services, Inc. d/b/a Summit Home Healthcare Products
3._ Care Club of Collier Countv. Inc.
The Contracts will now be forwarded to the County Attorney's Office for their review.
~ CaJr.i:.ch.
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
Care Club of Collier County, Inc.
Page 1 of 1
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Cctre
Club
of C~ollicr C~ollnty, Inc.
The Care Club of Collier County
1800 Santa Barbara Blvd. Naples, FL 34116
Phone: (239) 353-1994 Fax: (239) 455-8507
Email: careclub1@aol.com
Home
Tra nsportation
Eligibility & Mission
Transportation of participants to the Care Club can be provided by:
Our Services
. Family members or friends
. Community-based services
Schedule, Rates and
Attendance
We will assist you in accessing these services, if needed.
Transportation
Location
1800 Santa Barbara Blvd.
Naples, FL 34116
Phone: (239) 353-1994
Fax: (239) 455-8507
http://www.colliercareclub.org/transportation.htm
6/25/2009
16E ,10
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.
9. 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 immediately for cause; further the County may terminate this
Agreement for convenience with a seven (7) day written notice. The County shall be
sole judge of non-performance.
10. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as
to race, sex, color, creed or national origin.
11. INSURANCE. The Contractor shall provide insurance as follows:
A. Commercial General 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 Premises and Operations; Independent
Contractors; Products and Completed Operations and Contractual Liability.
B. Business Auto Liability: As directed by the Collier County Risk Manager, on
May 4, 2005 this requirement has been waived
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
$1,000,000 for each accident.
D. Professional Liability Insurance: The Consultant shall maintain Insurance to
insure it's legal liability for claims arising out of the performance of professional
services under this Agreement. Coverage shall have minimum limits of $1,000,000
Per Occurrence.
Special Requirements: Collier County 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 Contractor during the duration of this Agreement. Renewal
certificates shall be sent to the County 30 days prior to any expiration date. There
shall be a 30 day notification to the County in the event of cancellation or
modification of any stipulated insurance coverage.
16EI0
AGREEMENT
THIS AGREEMENT, made and entered into on this 14th day of June 2005, by and between
Care Club of Collier County, Inc. authorized to do business in the State of Florida whose
business address is 1800 Santa Barbara Boulevard, Naples, FL 34116, hereinafter called the
"Contractor" (or "Consultant") and Collier County, a political subdivision of the State of
Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. The contract shall be for a two (2) year period, commencing on
July 1, 2005, and terminating on June 30, 2007.
2. STATEMENT OF WORK. The Contractor shall provide services in accordance with
the terms and conditions of BidfRFP #05-3823, "Collier County Services for Seniors"
and the Contractor's proposal hereto attached and made an integral part of this
agreement.
3. COMPENSATION. The County shall pay the Contractor 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 Appendix I, Contract Rate Caps.
Any county agency may purchase products and services under this contract, provided
sofficient funds are included in their budget(s).
4. 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:
Care Club of Collier County, Inc.
1800 Santa Barbara Boulevard
Naples, FL 34116
Luanne Wahlstrom
Executive Director
Phone: 239/353-1994
Fax: 239/455-8507
16EIQ
DeLeon Diana
From:
Sent:
To:
Subject:
careclub1@aol.com
Monday, June 22, 2009 8:39 AM
DeLeon Diana
signature authorization
Diana, As per our telephone conversation this morning I am out of town until June 29th. I therefore authorize
my assistant at the Care Club, Mindy Johnson, to sign the contract in my absence. The contract is for Collier
County Services for Seniors services. Would you please acknowledge this email so I know that you received
it? I have spoken with Mindy and she will call you for directions to your office. Thank you for your assistance
in this matter.
Luanne Wahlstrom
Executive Director
Care Club of Collier County, Inc.
1800 Santa Barbara Blvd.
Naples, FL 34116
239-353-1994
239-455-8507 (fax)
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To Whom It May Concern:
Pleasc.be advised that the Board of Directors orCme Club ofCullicr
Counly, IlIc. aulhorizes LuAnne Dupree Wahlstrom the Execulive Director,
to apply for grants and to execute contracts with the ArCD. Agency On Aging,
unils of Governmenl, and other agencies that provide funding for facilities.
programs and services to Care Club of Collier Counly.
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Page 1 of2
16EI0
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FLORIDA DEPARTMENT OF STATE ~ j.l"~'~~;' 4
D 11'I5 [():\ OF C ORPOR\ II 0\5 _ _ . :4f?j.i'!.. . ~- \~~:~7.,
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Florida Non Profit Corporation
CARE CLUB OF COLLIER COUNTY, INC.
Filing Information
Document Number N42797
FEI/EIN Number 650253054
Date Filed 04/01/1991
State FL
Status ACTIVE
Principal Address
1800 SANTA BARABARA BLVD
NAPLES FL 34116 US
Changed 02/05/1997
Mailing Address
1800 SANTA BARBARA BLVD
NAPLES FL 34116 US
Changed 02/05/1997
Registered Agent Name & Address
DUPREE-WAHLSTROM, LUANNE
1800 SANTA BARBARA BLVD
NAPLES FL 34116 US
Name Changed: 01/29/2000
Address Changed: 01/29/2000
Officer/Director Detail
Name & Address
Title TREA
DENDOOVEN, EDWARD J
551 BINNACLE DRIVE
NAPLES FL 33940
Title VP
DAVID, ROSATO
103 GLEN EAGLE CIRCLE
NAPLES FL 34104 US
Title D
SILVESTRI, ERROL
226 BELVILLE BLVD
http://www.sunbiz.org/scripts/cordet.exe?action=DETFI L&imL doc _number=N42797 &in... 6/17/2009
~.sunbiz.org - Department of State
NAPLES FL 34104
Title D
POLLARD, CHARLES
660 TAMIAMI TRL, SUITE 21
NAPLES FL 34102
Title SEC
MARSHALL, SARAH
3054 DRIFTWOOD WAY #4504
NAPLES FL 34103
Title P
LYKINS, LAURA
5770 WESTPORT LANE
NAPLES FL 34116
Annual Reports
Report Year Filed Date
2007 01/04/2007
2008 01/07/2008
2009 01/12/2009
Document Images
0...1112/2009 -- ANNUAL REP.0RI
01j07/2008 ::::_.8NNJ..J.6J,BE.P0RI
oU04L2Q01:::8NI'JW8L Rl::pQRI
QJ /09/2096 --...8NNLi6L-....E.EE..OFU
OJ/06/2005. ::8NNU8LRl::pQRT
01113/2004::.AN NUAL REPORT
01/07/2003 :::....ANNUAL REPORT
01It5/2002.:=..6NNUAL REPORT
01/22/2001 -- ANNUAL REPORT
01/29/2000-::.ANNUAL REPORT
02/24/1999 :=_ANNUAL REPORT
03/19/1998 =::..ANNUAL REPORT
02/0...QLt997 -- ANNU6LR...EE'OEU
02/27/1999 -:ANNUAL REPORT
09/15/1995 ::ANNUAL REPORT
16rfo
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16E 10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Care Club of Collier County, Inc., authorized to do business in the State of Florida, whose
business address is 1800 Santa Barbara Boulevard, Naples, Florida 34116, hereinafter called
the "Vendor" and Collier County, a political subdivision of the State of Florida, Collier
County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30,2012.
2. ST A TEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page I of?
'll'W 1l'''_1lII1a
16E1Q
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:
Care Club of Collier County, Inc.
1800 Santa Barbara Boulevard
Naples, Florida 34116
Attention: Luanne WaWstrom, Executive Director
Telephone: 239-353-1994
Facsimile: 239-455-8507
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
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. 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
Page 2 of?
16EIQ
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.
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, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
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.
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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
16EIO
Vendor shall insure that all sub Vendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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.
Page 4 of7
16E 10
18. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U.s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and Vendor.
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.
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.
Page 5 of7
16 E 10
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first
above written.
ATIFST:
Dwi t E. Brock, Oerk of Courts
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: ~ dd
D a Fiala, Chairman
By:
Dated: tJ,
,f!-
'(SEA )
.... . te C!tI ".... ,
.t...... .'.J..,- \,
Care Club of Collier County, Inc.
Vendor
.~~t~
First Witness
ByafL~/Jk)~
Signature
Pat Akers
~~~~.
Second Witness
Luanne Wahlstrom, Executive Director
Typed signature and title
Iris Sesma
Approved as to form and
legal sufficiency:
C~~
Assistant County Attorney
Colleen 6reeYL1L
Print Name
Page 6 of 7
16E 10
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEEIUNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Em Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
16E10
IJCORDm CERTIFICATE OF LIABILITY INSURANCE OP 10 s~ DATE (MMIDDiYYY'f)
CAREC-1 OS/22/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlm
Insurance and Risk Management ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
8950 Fontana Del Sol Way #200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Naples FL 34109-4374
Phone: 239-649-1444 Fax:239-649-7933 INSURERS AFFORDING COVERAGE ~~I~.#, /C'
~-~_. -~----~.- --------------- ---~-~--~--~ ._- -_..-. -"- _. ---.----..--.--.----.- -...-.--. -----.--
INSURED -'-"'-SURER A: Scot tsda:t.':_:X::'~"-"~C:"._~~an.!:____________._ -i6~~~-7'-<
INSURER B: Florida Retail Federation SIF
Care Club of Collier INSURER C:
courtt~, Inc. Boulevard ---~-~~~-_._._.__._---_.._- ----
1800 anta Barbara INSURER D:
Naples FL 34116
INSURER E:
COVERAGES
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 DOCUMENTWITH 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 CONmflONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1N5R lIDIY[ ------.--..--------------- -----.---~-. ----.----- l'ODtYE~TWl=_poUcy EXPfRA-fioN ----. '.- ~--- ~ - ,----.----.---...- -. ~-_.-._- , - ,..
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER DATE(MMIODIY"iI~ DATE"/MMIOONYi' LIMITS
GENERAL LIABILITY EACH OCCURRENCE SlI()C)(}..!OOO
_n_ TJAMAGETO'RENTED" .......
A X X COMMERCIAL GENERAL LIABILITY CPS0938894 09/15/08 09/15/09 _j>.~E_~I~ES_lE" ~c~r~~",,! n slO.!l! (log
-- -~ CLAIMS MADE Ii] OCCUR ,n
-.- MED EXP (Anyone po",on) S Excluded
__~_.__>__V_~.m_..._... ..__ .._u _. .______.__.~.. _no_........_...
PERSONAL & ADV INJURY Sl,()()OJO()()
--- ____~..__.________._u_.____~_.___ ----_.- ---- -..
GENERAL AGGREGATE ~} lQ()()!. () () 0
- ---------- ----.__._--------,-
GEN"L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMProPAGG !.:t-'..9() _Cl ! ()C).O ,.
-nl POLICY II ~~ [Ul LOC '_-B~;~n_-_n--- .-..
Excluded
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
-- $
ANY AUTO (Ea accident)
-- ----.-----.---.-----------.. --~---_.- __.u______.___.
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per porson)
f-- -.- --~. - ------ --.---.-.-- --..-- .-.-.-- ---- ----- ---~-- ... -.. ...-.---....
HIRED AUTOS BODILY INJURY
-- $
NON-OWNED AUTOS (Per accident)
- --_._-~---- ..-'-.-- -------- -- -----------.---.-.---.-....-
~ -- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==i ANY AUTO .-.-----..-- .-----.-.-- - --..._---.~--._...~_... .~-- .- -'- .-.-..-
OTHER THAN EAACC $
AUTO ONLY: ----...- ~"'-"- 1-' '"
AGG $
EXCEss/UMBRELLA LIABILITY EACH OCCURRENCE $
-=] OCCUR [] CLAIMS MADE -'.. - . -.--.------- -~-_. -- ---_. .-..-.- ~.- ..--
AGGREGATE $
---- ----_._---. --._-- ------- . ---
$
-~_~~ DEDUCTIBLE --
S
-.-.------.-.---.-- -----.------...-.. .-..-.----..--- ... ___
RETENTION $ $
WORKERS COMPENSATION AND _~b:Q.ffY~ll~I~J _.l~ER:
EMPLOYERS' LIABILITY 52030001 02/02/09 02/02/10 _~.____... __n..
B ANY PROPRIETORIPARTNERIEXEClJTlVE E.L. EACH ACCIDENT -$-~()~,g(}()
OFFICERlMEMBER EXCLUDED? . ---_.._.._~. ---------- ---'--'-
E.LOISEASE - EA EMPLOYEE !n~.()()-'()()_ 0
Ilf ~es. describe under ._._._---_.~---_._._--------_..--"
S ECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000
i OTHER I
I
DESCRIPTION OF OPERA TIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDfD BY ENDORSEMENT I SPECIAL PROVISIONS
Adult Day Care Center; The Certificate Holder is listed as Additional
Insured with respects to General Liability only, ITQ'09-5227 Collier
County Services for Seniors; *30 day cancellation notice, 10 day for non
payment. Professional Liability, 1,000,000; Sexual/Physical Abuse 100,000 per
occurrence/300,OOO Aggregate.
CERTIFICATE HOLDER
CANCELLATION
COLLC02 SHOULD ANY OF THE ABOVE DESCRIBED POLlClfS BE CANCELLED BEFORE THE EXPIRA TION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil 30 * DAYS WRITTEN
Collier County Board of County NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL
Commissioners
3301 Tamiami Trail East IMPOSE NO OBLIGATION OR LIABILITY OF A/fY KIND UPON THE INSURER,ITS AGENTS OR
Naples FL 34112 REPRESENTATIVES.
A ESENTATlV~
(' ~
- \.
ACORD 25 (2001/08)
@ACORDCORPORATION 1
17
16EIQ
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
11'
16EI0
MEMORANDUM
DA TE:
July 7, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Millenium House of SW Fla., Inc.
Enclosed, please find one (1) original, referenced above (Agenda Item
#16EIO) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
ITEM NO.:()1-Ve.c~O'?5q
'\;)~ \ \~\!'6E 10
, '--"'-",'I""I~J~"
(J1}AiE~'REC; . D:
,-' '')'' , ',I '
i " j, ,',;"',..\
I! . l '
FILE NO.:
\ . r I")
, ,u:....
ROUTED TO:
DO NOT WRITE ABOVE THIS LINE
REQUEST FOR LEGAL SERVICES
1-'\
Date: June 26, 2009
To: Office of the County Attorney C~ L - ~~
Jeff Klatzkow
From: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
,. L, . oct
Cftlb
fIS'~
Re: Contract: #09-5227 "Services for Seniors"
Contractor: Millenium House of SW Fla., Inc.
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Age
Item 16.E.1 0
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
RLS # tJf- leL-
CHECKLIST FOR REVIEWING CONTRACTS
t'/.;!s<;1' E 10
Entity Name:
/111 L.L eNN ~L(Wl iba.c..r.- .s~l':"'td.S"f" k.tJIU7>It~ lAX!..
Entity name correct on contract?
Entity registered with FL Sec. of State?
..........Yes
---;::7Yes
No
No
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ \ ~ l L- Provided $ -z..- V\A\ L
Products/CompVOp Required $ Provided $ IN/U.Ubt~'i
Personal & Advert Required $ Provided $ I wt I L
Each Occurrence Required $ Provided $ / t
Fire/Prop Damage Required $ Provided $ ,r;(), fi)o
Automobile Liability ~
Bodily Inj & Prop Required $ cr6.I'c.-fIo\~ $ Provided $ ~
Workers Compensation \,
Each accident Required $ St#('(. \..\.../6 Provided $ (k-\I L
Disease Aggregate Required $ Provided $ , ,
Disease Each Empl Required $ Provided $ I I
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:
-L Yes
vYes
V Yes
~Yes
_No
No
No
No
Exp. Date 3f""l.-t> !l~
Exp. Date I"
Exp. Date i f
Exp. Date II
Exp. Date ( .
Exp Date N!p
Exp Date \/, 11-1'10
Exp Date f I'
Exp Date "
Exp Date
Exp Date
Yes
No
Provided $
Provided $
Exp. Date
Exp. Date
Required $
Provided $
Exp Date_
County required to be named as additional insured?
County named as additional insured?
-LYes
v'" Yes
No
No
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
-LYes
Yes
No
---t.L- N 0
Performance Bond
Bond requirement referenced in contract?
If attached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Yes
No
Yes
Yes
No
No
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
~Yes
~Yes
V Yes
~Yes
No
No
No
No
V Yes
~Yes
--LL. Y es
No
No
No
Attachments
Are all required attachments included?
~es
No '- .
Reviewer Initials: ){)I!!~
Date: I'J I {p I tll
04-COA-O 1 cJ30//22
16 E 101
MEMORANDUM
TO:
Ray Carter
Risk Management Department
. ~JJr-
( r.-/ OL'if
j.X l-O- \5
FROM:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
June~, 2009
DATE:
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Millenium House of SW Fla., Inc.
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
C: Terri Daniels, Housing & Human Services
OATE RECEIVED
JUN 30 2009
RISK tWfN:iEHENT
liE 10
mausen_g
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Thursday, July 02, 2009 3:28 PM
LynWood; DeLeonDiana
DanielsTerri; mausen_9
Contract 09-5227 Services for Seniors
All, I have approved the certificate of insurance provided by Millenium House of SW Fla., Inc. for contract 09-5227. The
contract will now be forwarded to the county attorney's office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
16EI0
DeLeon Diana
From:
Sent:
To:
Subject:
Cindi Ryerson [cryerson@embarqmail.com]
Friday, June 26, 20098:32 PM
DeLeon Diana
Millennium House
Diana,
Millennium House does not use private vehicles for the transportation of our clients to or from Millennium
House. Millennium House does not own a shuttle bus for this purpose. Therefore, myself or my employees do
not carry business liability insurance on our vehicles. We will assist families in giving them resources for
transportation to our center. All of our families do transport their family member to our center that live in
Naples.
Cindi Ryerson
Millennium House
992-5513
1
www.sunbiz.org - Department of State
Page lof2
16EI0
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Florida Profit Corporation
MillENNIUM HOUSE SOUTHWEST FLORIDA INC.
Filing Information
Document Number P00000077735
FEI/EIN Number 651055880
Date Filed 08/10/2000
State Fl
Status ACTIVE
Principal Address
8951 BONITA BEACH RO STE 297
BONITA SPRINGS Fl 34135
Changed 03/03/2003
Mailing Address
8951 BONITA BEACH RO STE 297
BONITA SPRINGS Fl 34135
Changed 03/03/2003
Registered Agent Name & Address
RYERSON, CINOI K
1466 XAVIER AVE S
FORT MYERS Fl 33919 US
Name Changed: 03/30/2004
Address Changed: 03/03/2003
Officer/Director Detail
Name & Address
Title P
RYERSON, CINOI
1466 XAVIER AVE S
FORT MYERS Fl 33919
Annual Reports
Report Year Filed Date
2007 01/06/2007
2008 01/27/2008
2009 OS/27/2009
http://www.sunbiz.org/scripts/cordet.exe?action= D ETFI L&inq_ doc _ number= P000000777... 6/23/2009
~.sunbiz.org - Department of State
Document Images
OS/27/2009 =-ANNUAL REPORT
01/27/2008 ~~ANNUAbREPORT
01/06/2007 :~ANNUAL REPORT
04/0~/2006 ~_6tit'-!UAL8.J;PQBI
0301 /200ti=-ANNVAb REPQRT
Q~/~Q/2QQ4,=--ANNVAbR,EPDRT
QQ!Q9/2003=-B~6ill'!ntCbqng,~
03/03/2003, ::ANNUAI.REPQBI
0212AL20Q2 -- ANt'LV6LREPQBT
04/02/2001 -- ANNUAL REPORT
12/01312000 -- Reg.6genLCbqog~
08/10/20QQ=.J)~m~!>tic Profit
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16 E 10
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16E10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Millennium House of Southwest Florida, Inc., authorized to do business in the State of
Florida, whose business address is 8951 Bonita Beach Road, Suite 297, Bonita Springs, Florida
34135, hereinafter called the "Vendor" and Collier County, a political subdivision of the State
of Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page I of7
16EIQ
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:
Millennium House of SW Florida, Inc.
8951 Bonita Springs Road, Suite 297
Bonita Springs, FL 34135
Attention: Cindi Ryerson
Telephone: 239-992-5513
Facsimile: 239-992-2238
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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
Page 2 of7
16E1Q
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.
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, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
~.
c/c.
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.
Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
I6E 10
Vendor shall insure that all sub Vendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 on
16EIO
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U.s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16E10
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST:
D~
B ' ~
y: ',', ,,'~,
Date (S~AL. .:. ..~
tttllt .. .....,.
'1........~...". .,'
By:
BOARD OF COUNTY COMMISSIONERS
COLLIER CODifY, FLORIDA
'!~ d~
Donna Fiala, Chairman
c.. _~.
Millennium House of SW Florida, Inc.
Vendor
L'
,{?tttA - ~$ '~
First Witness
By:
UI/1{i{ if f~
Slgnah;l'f
DlalA~ OLL~cl
tTypej print witness namet1
~~~y
Second Witness
~I rvoi K.\..-l<{G~)O(' f\::C fl\1f\l:JtrJcr
Typed signature and title cA.-A....,\\.e(L
7S ye Ylda. ~t:{ ve5..--
tType/print witness namet
Approved as to form and
legal sufficiency:
c~~
Assistant County Attorney
Colleen breerUL-
Print Name
Page 6 of7
'16 t 10
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEE/UNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 on
16E1Q
DATE': (MWDDtf\?
CERTIFICATE OF LIABILITY INSURANCE OO/26f2009
PROOUCSA Serial # 153615 nlls cERllFICATE IS ISSUED AS A MAlTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATe
CONDON MEEK HOLDER. THI-S CERTlf1CATE DOES NOT AMeND. EXTf!ND OR
1211 COURT STREET AI.. lEA THE COVERAGE MFORDED BY THE POLICIES BELOW.
CLEARWATER FL 33756 INSURJ:R.S AFFORDING COVERAGE NAIC#
INSURED INSUFl5Jt A: FRANK WINSTON CRUM INSURANCF= INC. 1I"0f}
INSURER B;
FrankCrum 1-800-277-1620 INSURER c.
100 S MISSOURI AVENUE IN$UAER 0:
CL.EARWATER FL 33756 INBURE'FI e;
THe POLICIES OF INSURANCE USTED BI!LOW HAVE BeEN ISSUI!D TO THE INSURI!D NAMED ABOVE fOft THE POLICY PERIOD INDICA TED. NOTWITHSTANDING
ANY IU:QUIR.EMENT. 'TERM OR CONDITION 01' ANY CONTRACT OF OTHllR DOCUMENT WITH RESPECT TO WHICW THIS CERTIFICATE MAY BE IssueD OR
MAY PERTAIN, THE INSURANce Al'J'ORDED BY THE POLICIES DESCRIeED ""REIN IS SUBJeCT TO ALL THe TeRMS, exCLUSIONS ANI) CONDITIONS OF SUCH
pOLICIES. AGGREGATE UMITS SHOWN MAY HAVE SEal REDUCED BY PAID CLAIMS.
IN'-'f\ ADe," TYPE OF INSUl'IANCE POlICY NUMBEfI PATEIMMJDDIY'Yl I UMIT6
LTR _0 DATI! (MMJDDIYYI
~~LIABIU"'" !ACH OCCI,JRRENCE .$
- DIoI~CW. l3EN~ lIABI~fTY FlRE DAMAGE 'M. ona h) .$
- CLAlMe p,t,I,!;)I; DocCUR MED EXP 'Anv on. "'l'IQ~\ S
PeRSON..... & "00 INJURY .$
l3ENERAl. AQ~Et.J"TE $
~n~~r~rAPPUEn~ PRODUCTS. cOMl'IOP AQQ S
POUCY PRO-ECT LOC
!!!f04\1OUILE UABI.l'TY eDMl3lNEO slNGLE ~IMIT $
~Y AUTO (Ea acclda.1)
-
- ALL OWNOO ~T06 !I0DIL Y INJURY S
(P.rp.....1I)
- SCH~D~O "U1t)S
- HIREO~fO' UOI;lIL Y NAJR'" $
(p.r acakllnQ
- hION.QWNEO AUTOS
PROPI!R]Y CAloW3E .$
(P.r acddeo>Q
aAfI,ABE UAI!I8..I'TY AUTO O......Y. EAACelDENT S
~~ AUTO o'fHERTHNl Ell ACC S
AUTO ONLY'" AG(; $
=:i~a I UMIMJ.lJ\ L./IlBIUTY EACH OCC\JRRf1;NCIl .$
OCCUR Da.Al""B MADE ACll3REGJ\T!! $
,
=l~u~ - ./ $
RETENTlDN $ .$
~IUl;IlRB COIFENaATlON AND I we STAn/-, I I DTHE"
A EWIPLO'fall."lJAIIII-IT"/' we 9 0000 OOCO 0110112009 01/C112010 X TORY uMlTS
ANY PROPRETQR I PARn.IeA II!XEevTl\IE
oFFlcl!Il1 MIlMBER EllCLUDED7 E,L. IlACH ACCloEN1 $ 1 000 000
If liK. d.Kriblllftd.r E.L. OI$l!Mc -1lA Bl.PLOYEE $ 1 000 000
SPECIAl.. pROVISION" bolow
E!.L DISEASE - POUCY UloIIT $ 1 000 000
OTHER
ol!$Q!\P'IlQN OP oPERATlO...' I ~DCAnDN& / V!H1CUiB I El<CLUlIlOtol$ ADOED BY ENOOIISIM~T I SPECIAL I'PlOVI/loIONa
EFFECTive 09/15f2005. COVERAGE IS FOR 100% OF THE EMPLOYEES OF FRANKCRUM LEASED TO MILLENNIUM HOUSE
sou-rHWEST FLORIDA, INC. (CLIENT) FOR WHOM THE CLIENT IS REPORTING HOURS TO FRANKCRUM. COVERAGE IS NOT
EXTENDED TO STATUTORY EMPLOYEES.
./"
CERTlflCA TE HOUleR
CANCELLATION
SHOULD AN'( OF THE AIKlVS DESCRIBED POUClI!S BE CANCELU5D BEf'QRE T141! I!XPIRATION
DATE THEREOF, THI! ISSUINO INSURI!R WILl.. EiNDEAVOR TO MAlt.. 30 DAYS WRITtEN NOTICE
TO "tHE CERTIFICATE HOLDeR NAMED TO THE LliiFT, aUT I'An...UREi TO rlO SHAU. IMPOSE
BOARD OF COUNTY COMMISSIONERS NO OaUOATlON OR UABIUTY OF ANY 10140 UPON TIlE INGURER. ITS AGENTlI Oil
COLLIER COUNTY RSPRE8ENTA TIVl!la.
3301 E TAMIAMI TRAIL AUTHO~ MEl'RSSE.NTATIV&
NAPLES FL. 34112 cr K-1&.t(1'
LOO/LOOIeJ
UJnJ 8
POLOL8LLGL X~~ 09:0L 800G/8G/80
06/25/2009 THU 14:24 FAX 239 261 7574
16 E 100/002
ACORD~ CERTIFICA TE OF LIABILITY INSURANCE OP 10 TD I DATE (MM1DDNYYY)
MILL-13 06/25/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Oswald Trippe and Company, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4089 Tamiami Trail North A203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Nap1es FL 34103
Phone: 239-261-0428 Fax:239-261-7574 INSURERS AFFORDING COVERAGE NAIC#
INSUREO INSURER Ii; Western Wor1d Insurance Co J 2./qftt
INSURER B:
Mi1lennium House SW FL Inc INSURER C:
Cin~ Ryerson
8951 Bonita Beach Rd. #297 INSURER 0:
Bonita Springs FL 34135 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
Af>N REQUIREMENT, TERM OR COlwmON OF Af>N CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, TIlE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
NSRJ: POLICY NUMBER I r;,~l;!~~M~~ I LIMITS
l.TR TYPE OF INSURANCE DATE MM/DDIYYI
GENERAl.l.IABJUlY EACH OCCURRENCE $l,OOO,OOO~/
-
A ~ COMMERCIAL GENERAL LIABILITY NPP1l85844 03/20/09 03/20/10 P~EM;SES lEa occurence) $SO,OOO
- =:J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 1 r 000
PERSONAL & ADV INJURY $ 1/000 r 000
X Prof Liab inc1ude GENERAL AGGREGATE $ 2 r 000,000 ..
GEN'L AGGREGATE l.IMIT APPl.IES PER: PRODUCTS - COMP/OP AGG $ Included
II ,nPRO- n
POLICY JEeT l.OC
AUTOMOBILE L1ABIl.ITY COMBINED SINGl.E LIMIT
'--- $
ANY AUTO (Ee accident)
-
- ALL OWNED AUTOS BODtL Y INJURY
$
. SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODlt Y INJURY
- $
NON-OIMlED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE L1ABIl.ITY AUTO ONLY - EA ACCIDENT $
R ANY AlITO OTHER THAN EA ACC $ ,
AUTO ONLY: AGG $
EXCESS/UMBRELlA LlA61UTY EACH OCCURRENCE $
t:J OCCUR 0 CLAIMS MADE AGGREGATE $
$
R OEDUCTlBLE $
RETENTION $ $
WORKERS COMPENSATION AND ITORYlIl.1lTS I I01H-
ER
EMPLOYERS' UABILlTY
ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~~~I1f~td~~J~s below E. L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
*10 day notice is required for nonpayment of premium.
Renewal of Contract #06-3823 "Provide Adult Day Care and In-Home Care
Services (Col1ier County Services for Senior)"
Certificate holder is named as addi ti7al insured with respect to the
general li.abili. ty .
CERTIFICA TE HOLDER
COL3301
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPtRATlO
DATE THEREOF, TIlE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALl.
Coll.ier County
Board of County Commissioners
3301 East Tamiami Trail
Naples FL 34112
@ ACORD CORPORATION 1988
ACORD 25 (2001f08)
06/25/2009 THU 14:24 FAX 239 261 7574
16 E 1(}002
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED. the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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
horder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
16 E 10
MEMORANDUM
DA TE:
July 7, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Eleven Ash, Inc. d/b/a HealthForce
Enclosed, please find one (I) original, referenced above (Agenda Item
#16EIO) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
-- -, '--",
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16EIQ
DATE RECEIVED:
ROUTED TO:
""H"H':
.:.
,- :-' '"; '~, 3
~ i '\..1
DO NOT WRITE ABOVE THIS LINE
From:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
REQUESTFOR LEGAL SERVICES Y ^:,:: ,S y
c 0J~/ .- 5k'
~ ~~~
~~ ~ y ;: y fP \
V?j'<~
(; ~11 ~O ;~~
I ~, ,1~ if /
/ \--~/{fiOj1,~'V/
~
Date:
June 25, 2009
To:
Office of the County Attorney
Jeff Klatzkow
Re:
Contract: #09-5227 "Services for Seniors"
Contractor: Eleven Ash, Inc. d/b/a Health Force
ACTION REQUESTED:
I
I
\
\
BACKGROUND OF REQUEST: ~
This Contract was approved by the BCC on June 23, 200 , Agend/;" ~)
Item 16.E.10 \ ~
This item has not been previously submitted. \
~o}i? ~
Contract review and approval.
OTHER COMMENTS:
C: Terri Daniels, Housing & Human Services
/
,,~'cA
c,{Y1&-
~IG . clOs/---
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
RLS# 09-/~ - 0101</1=6 E 10
CHECKLIST FOR REVIEWING CONTRACTS
d../ ~ l t:l -Nt AI.- on. FOILC E.
I
Entity Name: EJLv f tJ 4.5 W) IfV~.
Entity name correct on contract?
Entity registered with FL Sec. of State?
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ I Nd L-
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ I 'M.l L
Workers Compensation
Each accident Required $ J.T.#rT. 1-1 u ..1
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:
V Yes
~Yes
Yes
~Yes
Provided $ 5' M., L
Provided $ ~ loA [ L..
Provided $ t I
Provided $ L I
Provided $ ~'''. p, 0
Provided $ ~~l'
Provided $
Provided $
Provided $
M.ll
0\.1
\ I
Exp Date
Exp Date
Yes
Provided $
Provided $
Required $
Provided $
County required to be named as additional insured?
County named as additional insured?
~Yes
~Yes
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
~Yes
Yes
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
/Yes
~Yes
V Yes
~Yes
~ n~R.-"2.A;b LJ~"l: T'~R-
~Yes
V Yes
/Yes
Attachments
Are all required attachments included?
---.L. Yes
VYes
\,./'Yes
No
No
No
No
~No
No
Exp. Date rz/ Z'tll'tt
Exp. Date r
, ,
Exp. Date \ I
Exp. Date I'
Exp. Date , ,
Exp Date I?hfl) f)q
I r
Exp Date ~/.).'i I hq
Exp Date ( ,
Exp Date I '
No
Exp. Date
Exp. Date
Exp Date_
No
No
No
-LNo
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No "- . ^A
Reviewer Initials: ~
Date: '1 ~ t, loq
04-COA-0 I 30/222
16E 10
MEMORANDUM
TO: Ray Carter
Risk Management Department
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
DATE: June 25, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Eleven Ash, Inc. d/b/a Health Force
This Contract was approved by the BCe on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
REC IVEi")
C: Terri Daniels, Housing & Human Services
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Monday, June 29, 2009 1: 17 PM
LynWood; DeLeonDiana
DanielsTerri; mausen_9
Contract 09-5227 "Services for Seniors"
All, I have reviewed and approved the certificate(s) for the following vendors under contract 09-5227:
1. Arcadia Health services, Inc. d/b/a Arcadia Health Care
2. Executive Healthcare Solutions, LLC d/b/a Brightstar Healthcare
3. Eleven Ash. Inc. d/b/a Health Force
The contract s will now be forwarded to the county attorney's office for their review.
Thank you,
Ray
~ CaJd.e1L
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
16E 10
Ju1. 1. 2009 1:13PM
Heal th Force
No. [016 16 E 10
~HEALTH
~[?mJ[R][c!E
THE PROFESSIONAL HOME CARE PEOPLE ,.
5276 Summerlin Commons Way, Suite 702
Fort Myers, Florida 33901
,.
(239) 275-4747
Fax: (239) 275-4210
June 30, 2009
To Whom It May Concern:
Charlene Miller has full authority to sign all contracts, legal documents and any
paperwork pertaining to Eleven Ash Inc. dba Health Force, Any questions or concerns
please contact me at 239-275-4747.
Sincerely
'-1L~ /tIl!Ji~
Nancy Me Oann
President
I) ~/ go IOc;
~(A /vItur,~ -tJa1~
cyz-- .'
~
r- " 'IIITiNA~MAAiE' MALoNE" ......i
':, _~\"""f>> "'~m(n# 000697628 =
.. ~ III "" .
i Ii. E)lp!res7123/2011!
i ';f' FlQlId~ Notary Aun., Ino 5
~. "1."1~~ ~"'1Il II I ,.".'1,...'..1"..... 11II111 .1."
THEALTH
$~ if[Jj][R][b[E
i16f 10
THE PROFESSIONAL HOME CARE PEOPLE '"
5276 Summerlin Commons Way, Suite 702
Fort Myers, Florida 33907
(239) 275-4747
Fax: (239) 275-4210
June 23, 2009
To Whom It May Concern:
Charlene Miller has full authority to sign all contracts, legal documents and any
paperwork pertaining to Eleven Ash Inc. dba Health Force. Any questions or concerns
please contact me at 239-275-4747.
'-
Sincerely
ll~ '1JL c lJ~
Nancy Me Gann
President
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Florida Profit Corporation
ELEVEN ASH, INC.
Filing Information
Document Number P93000034439
FEI/EIN Number 650410505
Date Filed 05/13/1993
State FL
Status ACTIVE
Principal Address
5276 SUMMERLIN COMMONS WAY
#702
FT MYERS FL 33907 US
Changed 03/17/2009
Mailing Address
5276 SUMMERLIN COMMONS WAY
#702
FT MYERS FL 33907 US
Changed 03/17/2009
Registered Agent Name & Address
MCGANN,NANCY
5276 SUMMERLIN COMMONS WAY
702
FORT MYERS FL 33907 US
Name Changed: 09/23/1997
Address Changed: 03/17/2009
Officer/Director Detail
Name & Address
Title PVD
MCGANN, NANCY
5276 SUMMERLIN COMMONS WAY #702
FORT MYERS FL 33907
Title ST
MCGANN, NANCY
5276 SUMMERLIN COMMONS WAY #702
FORT MYERS FL 33907
http://www. sunbiz.org/ scripts/ cordet.exe ?action= D ETFIL&inq_ doc _ n umber= P9 3 0000344... 6/23/2009
Page 2 of2
:16E 10
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Report Year Filed Date
2007 01/08/2007
2008 01/07/2008
2009 03/17/2009
Document Images
03/17/2009=-ANNUAL.REPQRT
o 1/07/2008:-.=-ANNuAL. BEP OR T
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01L13/2009 -- ANNlJ-.AL.J3EPORT
01/04/2005 =-ANNUAL. REPORT
01/16/2004 =-ANNUAL. REPORT
03/03/2003 =-ANNUAL. REPORT
QQ/O 1I2~o~=-ANNI"JAL.J3.EE'QRI
02/QQJZOO~ANNUAL.EEPORT
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021OQ/19J)L:::.:::l\NJ'.tu.AL.-B.EPi)R T
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http://www. sunbiz.org/scripts!cordet.exe?action=D ETFIL&in~ doc _ number= P93 0000344". 6/23/2009
16E10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Eleven Ash, Inc. d/b/ a Health Force, authorized to do business in the State of Florida, whose
business address is 5276 Summerlin Commons Way, Suite 702, Fort Myers, Florida 33907,
hereinafter called the II Vend or" and Collier County, a political subdivision of the State of
Florida, Collier County, Naples, hereinafter called the IICountyll:
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30,2012.
2. ST A TEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page 1 of7
16EIQ
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:
Eleven Ash, Inc. d/b/ a Health Force
5276 Summerlin Commons Way, Suite 702
Ft. Myers, FL 33907
Attention: Charlene Miller
Telephone: 239-275-4747
Facsimile: 239-275-4210
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
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. 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
Page 2 of7
16EI0
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.
10. NO DISCRIMINATION. The Vendor agrees that there shall be no discrimination as to
race, sex, color, creed or national origin.
INSURANCE. The Vendor shall provide insurance as follows:
~.
11.
la
~A,~'
~~~s.
k
Commercial General 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 Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
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.
Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an AdditiotYcll 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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
16EIQ
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EIO
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U.s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor .
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.
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.
Page 5 of7
16E10
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
A TTES!:'
Dwi'ht ]j. Brock, Clerk of Courts
BOARD OF COUNTY COMMISSIONERS
COLLIER C UNTY, FLORIDA
By::
Date4: U "'7,
(S~~.)' ,.-.,'
\....l..., ,';'..'"
.1_1t . te .~ I
......... ..."
By:
Donna Fiala, Chairman
Eleven Ash, Inc. d/b/a Health Force
~1~~
ClA U\)JL~(}L)1A('
tTyp,e/print witness namet
W ftrt ~,.Cr
Second WItness ~
lYJ/brl-li, All IJJ Tl~
tTy~ witness namet
Vendor
~~
By:
Signature
(J};J' Ie ne Ill/.. /1.14. !/dm'hls &.d-r/l...
Typed signature and title
Approved as to form and
legal sufficiency:
~~
J
Assistant County Attorney
Co\\OO) 6ree~
Print Name
Page 6 of7
16E10
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEEIUNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
Jun 26 2009 12'42PM----Insurance Office
16E10
No 4761 P 1/2
- -.
ACOBlt CERTIFICATE OF LIABILITY INSURANCE I DATE! (UIIJDDfYYYY)
06/26/2009
PRODUCER (813)637-8877 FAX (813)637-8484 THIS CERTIFJCATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
4915 W. Cypress Street ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
SuUe 100
TaJq)a, FL H607 INSURERS AFFORDING COVERAGE HAlC# /
INSURED Eleven Ash, Inc. lN$1.IRER A: United National Ins Co 13064 v
DBA:Health Force INSl..lR!:R B: AmCDMP, Inc. .L A..,'" .e;c51 '7
5276 Summerlin Commons Way IN&URER C:
Suite #702 INSURER D;
Fort Myers, FL 33907 INSURER E:
COVERAGES
!
i
i
~
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABO\l!! FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANOINQ
AJolY REQUIREMENT. TERM OR CONDITION OF AN'( CONTRACT OR OTHER DOCUMENT WITH RE!SP~CT 'r0 WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORCED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMfTS SHOWN MAY HAVE 6EEN REDUCED BY PAID CLAIMS.
1~1.N=: 'TYPE OF INSURANCE POUCVNUU8E.R POLICY EFFECTNE POLJC't' EXPIRATION ullITS
GEN~RA1. UAIIILlTl' AHBOS9905S 12/27/2008 12/27/2009 EACH OCCUAAENCE $ 3,000.0
--
X COMME~ClAL GENERAL LIABILITY DAMAGE TO FleN'rEO I 100,0
- n CLAIMS MADE [!] OCCUR Meo EXP (Any gnoJ pot$Qr1) I 10,1
A X ~'Pr'ofessional Liab PERSONAL a NJV INJUR.Y , 3,000.
~ H1red/Non-Dwned GENelW.AGGREGATE , 5 000.,
GEN'L AGGRE GoA TE l..AMT APPLIES PER: PRODUCTS-COMProPAGG I 3 000,1
Xl POLICy n ~8T n Loe
AUTOMOBILE UA8lUTY COMBINED SlNGLE UUIT
- (Ea acr:id9nt) I
AN'fAUTO
-
All OWNED At,fTOS BODIL V INJURY
- $
SCHEDUlED AUTOS (per peroonl
-
HIRED AUTOS BOOn. Y INJURY
- (per accldent) "
NON-OWNED AUTOS
-
PROPEJllY DAMAGE $
(Pet aecilleIllJ
clARAaE UABlUTY AUTO ONLY - EAACCIDeNT $
=1 AN'f AUTO 01'HeR 'rHAN EA ACe s
AUTO ONLY; AGG .
DCESSlUMBltELlA UABIUTY EACJo! OCCURRENCE; .
tJ OCCUR DCLAJMS IMDE AGGREGATE ,
.
R ~EDVCTL8LE I
RETENTlON . .
, WO~COMP~noNAND WCV7070446 12/24/2008 12/24/2009 X I we STATU- I IO~
EMPLOYERS' LIA8IUTY E.L EACH ACCIDENl' , 1.000.00
B ANt Pl'loPRlETORJPARTNERlEXECUTIYE
OFFICERlMEMBER EXCLUOEO? E.L. DISEASE - EA EMPLOVEE I 1,000.00
If ~ d.'IQ1~ IIlldw lS.t. olswe . POLICY LIMIT $ 1,000,00
!If'eClAL pRO\llSIONS belDW
OTIlI;R
'~""'"''''I-'l:ll'''H''''' Y"....."'''......''''''''........-....
Co er County BeC 1S Clitional I ured with respects to General Liability.
I
/1
I
I
I
I
!
Collier County BeC
3301 E. Tamiami Trail
Naples. FL 34112
IATlnt.l
!lHOULD ANY 01' THE A80Vlii DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE TlfEREOF. THE ISSUING LN9URER WILL ENDl!A.VOR TO MAlL.
..J,L DAYS WRlTnN NOTll;E TO THE CI!R'T1F1CAT! HOLDI!R HAAlI!D TO THE Len.
BUT FAJl..URE TO MAIL SUCH NOTICE SH,AllIWPO$E NO OSUGATION OR L1ABIUTV
OF ANf I<IND UI>ON THE INSURER, ITS AGENTS OR REPRESENTAtlVES.
A~RIZED REPRESENTATIVE ./ ~___
Sam Potter/BRlDGR /1- ,,'-
CERTIFIC
ACORD 25 (2001/08) FAX: (239)252-6597
@ACORD CORPORATION 1988
Jun. 26. 2009_12:42P~Insurance Off ice
1h~10
No. 476e...y t'2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject: to the terms and conditions of the policy, certain policies may
require an endoraement. A statement On this certificate does not confer rights to the certificate
holder In lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer{s), authorized representative or producer, and the certificate holder. nor does it
aflfrmatlvely or negatively amend, extend 01' alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
16E1Q
MEMORANDUM
DA TE:
July 7, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: Executive Healthcare Solutions, LLC d/b/a
Brightstar Healthcare
Enclosed, please find one (1) original, referenced above (Agenda Item
#16EI0) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
ROUTED TO:
~-~~_ . 16 E 10
~ \ ~~\';~ ~:~_" 1f;~'~~EIVED:
1 .( 'I ~ \ . "-',"(";~,~ .
I., l \ ',)J'i; 'cj~-\,
"',r . ,i., 0 k~
./ "",.., vJ\
....~ /" -' ,j ,-,;' \..oJ
----/ _ - ~J;<---
-- / ~ ~'(J.. ~
DO NOT WRITE ABOVE THIS LINE /" ~ ~
:; \(>.v~/ 9::, '
~t" j 9':1.
~A:/~~v~
S~,)' A'-<\
)j tl~~)
vJO ct??~ J \
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Vrf (
ITEM NO.:
FILE NO.:
REQUEST FOR LEGAL SERVICES
Date:
June 25, 2009
To:
Office of the County Attorney
Jeff Klatzkow
From:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re:
Contract: #09-5227 "Services for Seniors"
Contractor:
Healthcare
Executive Healthcare Solutions, LLC d/b/a Brightstar
ACTION REQUESTED:
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agen,d~;/?~f/)I"'___
Item 16.E.10 ' 'yV1""'2-
.i
,1
/
J'~'O~
crYlG-
rl~ .clo~
This item has not been previously submitted.
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
16E10
RLS # or -I.ec!.. - /) J:J.. '1'1
CHECKLIST FOR REVIEWING CONTRACTS
I #/tIS (...I-(!
/
/
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ I ""'-I l,....
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ l ~l l.-
Workers Compensation
Each accident Required $ .5T1<\r; ht"IT~
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type: Q i_\ML-
..,/ Yes
-L Yes
Yes
-L Yes
No
No
~No
No
(
ef-f (,A../C.. > ~pt.t/lot-U.
'7rf""Y"
/
Q 1:'011
I
~
_ ./' Yes
~Yes
No
No
.3 MIL Exp. Date
~ ( Exp. Date
MIl.- Exp. Date
II Exp. Date
p Exp. Date
r ""-I L Exp Date
Provided $
Provided $
Provided $
Provided $
Provided $
Provided $
Provided $ 5Oo) ()Ob
Provided $ S'()()} OPt?
Provided $5"0. 6t>/J
,
Exp Date:,\1 ( I, ()
Exp Date I / I
Exp Date , ,
Exp Date
Exp Date
Yes
No
Provided $
Provided $
Exp. Date
Exp. Date
Required $
Provided $ ~ ~o
Exp Date ~q
County required to be named as additional insured?
County named as additional insured?
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Attachments
Are all required attachments included?
16 E 10
MEMORANDUM
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
.y~/
)l~/ 1<
TO: Ray Carter
Risk Management Department
DATE: June 25, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Executive Healthcare Solutions, LLC d/b/a
Brightstar Healthcare
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
RECE\VED
JUN 1 6 2009
RISK MANAG - NT
C: Terri Daniels, Housing & Human Services
mausen_9
16E 10
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Monday, June 29, 2009 1 :17 PM
LynWood; DeLeonDiana
DanielsTerri; mausen_g
Contract 09-5227 "Services for Seniors"
All, I have reviewed and approved the certificate{s) for the following vendors under contract 09-5227:
1. Arcadia Health services, Inc. d/b/a Arcadia Health Care
2. Executive Healthcare Solutions, LLC d/b/a Brightstar !:ie~thca~~_
3. Eleven Ash, Inc. d/b/a Health Force
The contract s will now be forwarded to the county attorney's office for their review.
Thank you,
Ray
~ Ca.h:.t.eJL
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
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Florida Limited Liability Company
EXECUTIVE HEAL THCARE SOLUTIONS, LLC
Filing Information
Document Number L06000013155
FEI/EIN Number 204870885
Date Filed 02/06/2006
State FL
Status ACTIVE
Effective Date 02/06/2006
Principal Address
9001 HIGHLAND WOODS BLVD
SUITE # 5
BONITA SPRINGS FL 34135 US
Changed 04/14/2009
Mailing Address
9001 HIGHLAND WOODS BLVD
SUITE # 5
BONITA SPRINGS FL 34135 US
Changed 04/14/2009
Registered Agent Name & Address
BOTSKO, JOHN JR.
9001 HIGHLAND WOODS BLVD, SUITE 5
BONITA SPRINGS FL 34135 US
Address Changed: 09/03/2008
Manager/Member Detail
Name & Address
Title MGR
BOTSKO, JOHN JR.
9001 HIGHLAND WOODS BLVD, SUITE 5
BONITA SPRINGS FL 34135
Title MGR
BOTSKO, MARLA J
9001 HIGHLAND WOODS BLVD
BONITA SPRINGS FL 34135 US
Annual Reports
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inq_ doc _ number=L060000 131... 6/25/2009
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Report Year Filed Date
2007 OS/22/2007
2008 09/03/2008
2009 04/14/2009
Document Images
04/14/2QQ9=.ANNLJAI.."R I;PQRT
09/03/2Q08-~ANNLJAI..HEPQRT
OS/22/2007 =-ANNUAL REPORT
Q2/0B/2 QQ6 =-Flo rictL Li mit~!:Lb.ja bility
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Copyright @ 2007 State of FlOrida, Department of State.
http://www.sunbiz.org/scripts/cordet.exe?action=D ETFIL&inCL doc _number=L060000 131". 6/25/2009
16EIQ
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Executive Healthcare Solutions, LLC d/b/ a Brightstar Healthcare, authorized to do business
in the State of Florida, whose business address is 9001 Highland Woods Boulevard, Suite 5,
Bonita Springs, Florida, 34135, hereinafter called the "Vendor" and Collier County, a political
subdivision of the State of Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page 1 of7
16EIQ
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:
Executive Healthcare Solutions, LLC djb/ a Brightstar Healthcare
9001 Highland Woods Blvd., Suite 5
Bonita Springs, FL 34135
Attention: John Botsko, Jr.
Telephone: 239-992-4779
Facsimile: 239-992-4764
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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
Page20f7
16EIQ
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.
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:
IA. Commercial General 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 Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
~
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.
~
Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an Additiona~lnsured on the Comprehensive
General Liability Policy. V
Current, valid insurance policies meeting the requirement herein identified shall
be maintained by Vendor during the duration of this Agreement. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
16E 10
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EI0
....
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U.s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 GOVERNMENT AL 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16EIQ
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST:
Dwi htR'.Brd<<k;!Clerk of Courts
~ -',.,.. .....,
"', .. ",.>
BOARD OF COUNTY COMMISSIONERS
COLLIER CO NTY, FLORIDA
By: '.
Date.g:
""(SEAlJ
At't..'. W..... t
tt...... -tlI,.,S:>'
By:
Donna Fiala, Chairman
4ca~...d? J2
First Witness
Executive Healthcare Solutions, LLC
d/b/a Bright Star Healthcare
By UJleifJi ~
Signature /
'}) l C\ ~C, ~L~u! '"
tType/print witness na~et
fIJ/VCIl
~w/-+___ J: Cb {)Q~
Second Witness
Jr\~~\~jn I. Chi 1\:\
tType/print witness namet
Approved as to form and
legal sufficiency:
~fMM-~
t
Assistant County Attorney
Co/leen 6reen-e-.
Print Name
Page 6 of7
16 t, 10
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEE/UNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
16EIQ
Jul 06 2009 1:43PM
Bri~htStar Healthcare
239-992-4764
p.2
ACORD... CERTIFICATE OF LIABILITY INSURANCE
DAT!! CMMIOOo'YYYY)
Sabal. Insurance Group, Inc.
805 E Broward Boulevard, Ste 303
Port Lauderdal.e, FL 33301
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
F'RODl./CI!I\
Exeoutive Hea1thoare Solut:i.ons, LLC
DBA Brigbt8t:ar Heal. tha~/24-'1Br.i.ghatar
9001 Hiqh1and Woods Blvd, Suite #S
Bonita Spr:i.ng., I'L 34135
INSURER A'
INSURER II."
INSURER c:
INSURER D:
INSURER E;
COVERAGES
THE FOUClES OF I~CE USTEDElELOWHAVE ilEEN ISSUED TO THE IHSUFlEO NAMBl AIlOVI! FOR Tl-lE POUCY PERIOD INDICA~. NOTV\IITHSTANOlNG
MlV REQUIREllIIENT, 'TERM OR CONDITION OF AIiY CONTRACT OR OTHER DOCUMENT I'\oITI-l RESP'ECT TO IM-IICH THIS CERTIFICATe W,V Be ISSUED OR
MAY PERTAI". 1l1ElNSURANCE AFFORDEO BY niE POUCIESOBSCRlBED HEREIN IS SUBJECT TO ALL THETE""-4S, EXCLUSIONS AND CONDITIOIiS OF &!CH
POLICII!5. AGGREGATE UIIITS SHO\I\N MAY HAVE BEEN RB:)UCEC BY PAID ClAIMS,
POLICY NUMBER
~
F Tl E
COMMERCIAL GENERAL LIABILITY
ClAlNSMACE D OCCUR
A Profeeej,onal Llab VHBG 3051715-03 07/01/09 07/01/10
Ratro Datil!l* *06/01/06
GEN't. AGGREGATE UMI'T APPueSPER.
PliO. LOC
PO LICV JEeT
AUTONlOlllLE UABlUTY CQIolBINED SNGLE LIMIT
(Ea aceldllnl) S 1,000,000
ANYAUTO
ALLOWNEO AUTOS ElODILY INJUR"
SCHEDl.lLEO AUTOS (Pe,_)
A HIRED "-UTOS VBHG 3051715-03 07/01/09 07/01/10 ElODILY II'tJl.lR"
IotON-oWNED AUTOS (Per ""_)
PROi>ERTY OAMACl e
(Per"",,"*,,)
ao.RAGE UABIUTY AUTO ONLY. EAACCIO!NT
ANYAUTO OTHER THAN EAACC $
AUTO ONLY: AGO .
I!XCESSIUMBIlaLA UAilIUTY EACH OCCLlRRENce
OCCUR CI ClAIMSMAOE AGGREGATE
DEDUCTIBLE
RETeNTION $
VIORKERS OQIotPENl!ATlON AIiD
eMPLOYERS' LIABILITY
ANY ~CJlWARTlERlE)(EctJTIVE
B OFFIC_U EXCLUDI!Il1 CPW002528 01/0/09 01/01/10 EL DISEASE- EAEMPl..OYEE $
Ity... dooortt>....do'
SPECIAL PROVISIONS billow E.l. 0ISEASl!!- POU CY UMIT $
OTHER
C Crime Bond LFMOO02970 07/01/09 07/01/10 $25,000 Limit
OESCIIIPTIQt< OF oPERATIONS ILOCATiO..s (VEHICLES I EXCLUSIONS ADDED BVENDORSEMENT ISPEC,^LPROVISlONS
Certificate Holder is named additional insured in respect to General Liability
CERnFICATE HOLDER
CANCEl-LA TION
Collier County Government
3301 Tamiami Trail, East
Naples, FL 34112
SHOULD ANY OF THE! ABOVE DESCRIBED POLICIES BE CANCEI.1.ED IIEPORE THE EXPIRATION
DATE THEREOF, WE ISSUING INSURER 'MLL ENDEAVOR TO MAIL 30 DAYS 'hRIlTEN
NOTICE TO THE CER11FICATE HOLDEIl NMAEO TO THE LEFT, ElUT FAIlURE TO !Xl so SHALL
IMPOSE NO OBLIGATION OR LlABlLITV OF ANY I(jNO UPON THE INSURER, ITS AGENTS OR
REPRESENTAoTIV6S
AUTHORIZED REPRESeNTATlIIE
~ACOROCORPORAnON1~
ACORD2S (2001108)
16EI0
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
TM. 0$2812009
PRODUCER Phcne: (847) 623-0456 Fax: (847) 623-5600 THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
WESrS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1733 W WASHINGTON STREET ~?;~:R. THIS CERTIFICATE DOES ~,?~~D.;.~~~ ~
WAUKEGAN tL 60085
INSURERS AFFORDING COVERAGE NAlC..
INSURED INSURER A: Insurance Co of the Stale of PA
EXECUTIVE HEAL THCARE SOLUTIONS LLC INSURER B:
DBA BRlGHTSTAR HEAL THCARE INSURER C:
9001 HIGHLAND WOODS BLVD, STE 5 INSURER 0:
BONITA SPRINGS FL 34135
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWITHSTANDiNG
mY REQUIRELlENT. TERM OR CONDITION OF ~Y 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. AGGREGATE ULlITS SHOWl MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 1= TYPE OF INSURANCE POUCY NUMBER ~~.r~ ~.:~ LIMITS
LlR
~ERAL UABIUTY EACH OCCURRENCE $
- :5MERClAL GENERAL UASlLITY ~::~....., $
ClA'MSMADED OCCUR MED. EXP (Any one person) $
-
- PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
-
GEN'L AGGREGATE UMIT APP~rER: PROOUCTS-COMP.op AGG. $
I ,nPRO.
POLICY JECT LOC
~OMOBlLE UABlUTY COMBINED SINGLE UMIT S
mY AUTO (Ea accident)
i---
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
I-- SCHEDULED AUTOS
I-- HIRED AUTOS BODILY INJURY
(Per lICdclent) S
NON-OWNED AUTOS
f---
I-- ff~.:e~~AGE s
GARAGE LlABIUTY AUTO ONLY - EA ACCIDENT S
~ Am AUTO OTHER THAN EAACC $
AUTO ONLY: AGG S
5CESS I UMBRElLA LIABILITY EACH OCCURRENCE S
OCCUR 0 ClAIMS MADE AGGREGATE S
S
R DEDUCTIBlE S
RETENTION S S
WORKERS COMPENSATION AND WC006783007 02/01109 02101/10 I~~I I=-
EMPLOYERS" UABIUTY E.L. EACH ACCIDENT $ 500,000
A AItt PR~OIIIl'AR1'IIERIEJlECUlNE 500,000
OfF_EMIleIt UC:WllEIl? E.L DISEASE-EA EMPlOYEE S
.)'Mi...... under E.L DlSEASE-POUCY LIMIT S 500,000
SPECIAL PRO'MlONllIooIow
OTHER:
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS
CERTIFICATE HOLDER
COVERAGES
~
CoUler County
Board of County CommissIoners
Naples, Florida
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEUED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING INSURER WLL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO
00 so SHALL IMPOSE NO OllUGATION OR UABlUTY OF}.N'( KIND UPON THE INSURER, rrs
AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
8,
AttentIon:
ACORD 25 (2001108)
Certificate #
8903
Brent es
o ACORD CORPORATION 1988
_ r..........IJ...:I:...:I....I.IM:.I...........t:'f!"'(II-...I'.,I:I.'~...:I.:".'~.IJ"'... ...:I_....J~.,I:I"~....
AGENT NUMBER
1~
0026814-00 we 006-78-30C
-------------------------------------
o 13-82-020g-0(
THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA
13889
. I
~hcCUTIVE HEALTHCARE SOLUTIONS, LLC DBA
(SEE WC990013 FOR COMPLETE NAME)
9001 HIGRLAND WOODS BLVD
SUITE 5
BONITA SPRINGS, FL 34135-0000
~~ Member Companies of
,..IL ., American International Group
EXECUTIVE OFFICES:
70 PINE STREET. NEW VORK. N.V. 10270
SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610
1.01
PRODUCERS tJAME ~ND ADDRESS
WORKERS COMPENSATION AND EMPLOYERS
LIABILITY POLICY INFORMATION PAGE
SMITH BELL & THOMPSON INC.
40 MAIN STREET
SUITE 500
INSURED IS PREVIOUS POLICY NUMBER
LIMITED LIABILITY COMPANY NEW
OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF ITEM 1. OF THE INfORMATION PAGE - WC990610
ITEM 2 POLICY PERIOD 12:01 A.M. standard lIme .t the IMured'S
...lJlnlll .deI.....
ITEM 3
FROM 02/01/09 1'0 02/01/10
A. Workers Compensation Insurance: Part One of the polley applies to the Workers Compensation Law of the states llsted
here:
FL
B. Employers Uablllty Insurance: Part Two of the polley applies to the work In each state listed In Item 3.A.
The limits of our llablllty under Part Two are: Bodily Injury by Accldent $ 500.000 each acclclent
Bodily Injury by Disease $ &;00.000 polley limit
Bodily Injury bV Disease $ 1;00.000 each employee
C. Other States Insurance: Part Three of the polley applies to the states. if any. listed here:
AK AL AR AZ CO CT DC DE GA HilA lOlL IN KS KY LA MA MD ME MI MN MO MS MT NC NE NH NJ
NK NV NY OK OR PA RI SC SO TN TX UT VA VT WI WV
D. This policy Includes these
SEe EXTENSION OF ITEM 3.0. OF THE INFORMATION PAGE - WC990612
ITEM 4 The premium tor this polley will be determined by our Manuals of Rules. Classifications, Rates and Rltlng Plans.
All Information required betow Is subject to verification and change by audit.
C1asslfiullons
Cod. Number
3 Year
Rate Per
$100 OF Re-
muneration
Esllmated
Premium
00 Annual
3
SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE - WC7754
EXPENSE CONSTANT (EXCEPT WHERE APPLICABLE BY STATE)
MINIMUM PREMIUM S '.\8'.\ F L
If Indicated below. Interim adjustments of premium ahan be made:
o Semi-Annually .
.200 FL
TOTAL ESTIMATED PREMIUM
SB.O
Issue Oate
39967 (Rlv'd 04/081
, Monthly
DEPOSIT PREMIUM
02/16/09 PARSIPPANY
82
we 00 0<
Issuing Office
INSURED'S COPY
:16E 10
MEMORANDUM
DA TE:
July 8, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: ADT Security Services, Inc.
Enclosed, please find one (1) original, referenced above (Agenda Item
#16EI0) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
ITEM NO.: CA ,1> rI2C - or ~ ~
~ ~ ~ "",,"-oM E 1 0
:'of!\ 1RE' RECEIVED:
FILE NO.:
ROUTED TO:
, ",..,
, L'L
DO NOT WRITE ABOVE THIS LINE
REQUEST FOR LEGAL SERVICES
Date: July 1, 2009
To:
Office of the County Attorney :r ~~ \.2)",-~~
Jeff Klatzkow
'Z...~~
From: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re: Contract: #09-5227 "Services for Seniors"
Contractor: ADT Security Services, Inc.
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agenda
Item 16.E.10
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
tjJ - ~ +- ~'l~ 1)' Y
16EI0
MEMORANDUM
TO: Ray Carter
Risk Management Department
DATE: July 1, 2009
')W~
1 /-ef'''
&L~
""-
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: ADT Security Services, Inc.
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
C: Terri Daniels, Housing & Human Services
RECEIVED
JUL 0 2 2009
16EI0
mausen_g
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Thursday, July 02, 2009 3:08 PM
LynWood; DeLeonDiana
DanielsTerri; mausen_9
Contract 09-5227 Services for Seniors
All, I have approved the insurance provided by ADT Security Services, Inc. for contract 09-5227. The contract will now be
forwarded to the County Attorney's Office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
16 EIO
ADT SECURITY SERVICES~ INC.
SECRETARY'S CERTIFICATE
I, John S.Jenkins, Jr., Secretary of ADT Security Services, Inc., a Delaware
corporation (the "Corporation"), hereby certify that Martin E. Levenson, Director,
Program Development, ADT Home Health Security Services, of ADT Security Services,
Inc. is authorized to sign the Non-Institutional Medicaid Provider Agreement and other
various agreements, on behalf of the Corporati<fP.
IN WITNESS WHEREOF, the undersigned has executed this Certificate on this
d~ day of June; 2009.
[SEAL]
.
ADT Securi~ sele~ E 1 0
One Town Center Road
Boca Raton. FL 33486
Te'e: 561-988-3600
Fax: 561-988-3601
vvwwadt.com
June 30, 2009
John Sharpe
ADT Home Health Security Services
32100 U.S. Hwy 19 North
Palm Harbor, FL 34684
'/(f'
Re: ADT Security Services, Inc. Secretary's Certificate
Dear John:
Per your email request today, enclosed please find the original Secretary's Certificate
giving authorization to Martin E. Levenson to execute Non-Institutional Medicaid Provider
Agreements along with other various agreements that fall under his jurisdiction.
- If you have any questions relating to the enclosed or if you need anything additional,
please feel free to contact me at 561-981-4268 or by em ail atPdonahoe@tycoint.com.
:z2YCJ!J
, ~.DonahO.
Senior Corporate Paralegal
PLD
Enclosure:
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ADT SECURITY SERVICES, INC.
Filing Information
Document Number P22392
FEI/EIN Number 581814102
Date Filed 01/04/1989
State DE
Status ACTIVE
Last Event MERGER
Event Date Filed 12/31/2001
Event Effective Date NONE
Principal Address
c/o TFS LAW DEPARTMENT
ONE TOWN CENTER ROAD
BOCA RATON FL 33486
Changed 03/25/2009
Mailing Address
c/o TFS LAW DEPARTMENT
ONE TOWN CENTER ROAD
BOCA RATON FL 33486
Changed 03/25/2009
Registered Agent Name & Address
C T CORPORATION SYSTEM
1200 SOUTH PINE ISLAND ROAD
PLANTATION FL 33324 US
Name Changed: 04/03/1998
Address Changed: 04/03/1998
Officer/Director Detail
Name & Address
Title PD
KOCH, JOHN B
C/O TFS LAW DEPARTMENT ONE TOWN CENTER RD
BOCA RATON FL 33486
Title SEC
JENKINS, JOHN S JR
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16E1Q
c/o TFS LAW DEPARTMENT ONE TOWN CENTER RD
BOCA RATON FL 33486
Title TRES
MACKAY, KEVIN
C/O TFS LAW DEPARTMENT ONE TOWN CENTER RD
BOCA RATON FL 33486
TitleVP
ED OFF, MARK N
C/O TFS LAW DEPARTMENT ONE TOWN CENTER RD
BOCA RATON FL 33486
Title DAS
BLEISCH, N. DAVID
C/O TFS LAW DEPARTMENT ONE TOWN CENTER RD
BOCA RATON FL 33486
Title DVP
RAMO" BRUCE
C/O TFS LAW DEPARTMENT ONE TOWN CENTER RD
BOCA RATON FL 33486
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2009 03/25/2009
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16EIQ
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
ADT Security Services, Inc., authorized to do business in the State of Florida, whose business
address is 32100 U.s. Highway 19 North, Palm Harbor, Florida 34684, hereinafter called the
"Vendor" and Collier County, a political subdivision of the State of Florida, Collier County,
Naples, hereinafter called the t1Countyll:
WITNESSETH:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page I of7
16E 10
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:
ADT Security Services, Inc.
32100 U.s. Highway 19 North
Palm Harbor, FL 34684
Attention: Martin E. Levenson
Telephone: 877-456-1787
Facsimile: 877-666-4390
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
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. 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
Page 2 of7
16EIO
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.
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, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
~.
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.
/,./
e. Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an AdditionaI.Ji1.sured 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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
16E10
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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 .
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EIQ
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U .s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of?
16EI0
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
A TrEST:
,: "":..
Dwight~,,:'Br()Ck.. 'Cle~~ of Courts
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
Dated~.
~'"
'(~AL ;.~
',{ , ' "
.........', .w.c;,&" ,.,.,'....... .
""...., .."~ ~.~i........
.,..........'.:fi u ."
By:
ADT Security Services, Inc.
Vendor
By:
First Witness
rK~I\JC V.'l6l0
tType/ print witness namet
tkL;~
Second Witness
Martin E. Levenson
ADT HHSS Director. Program Development
Typed signature and title
HuJ J i P<ll unJl:.. I'
tTypejprint witness namet
BY:
Jeff
l1/tlfT/1V E" ?l:-'{./ ;1;t:/")1/ /f-P/J-;(l/ff/l
.8Af/tI,.fL /'1t:'" (1;1/ J7{IlIE 74 ?cJ{J!j,
d4
DA~C:'(MURPHY
Notartl=!~lic, Massachusetts
My CommissIOn Expires September 20,2013
Approved as to form and
legal sufficiency:
right, Assistant County Attorney
Page 6 of7
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEEIUNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24m. $125.00 per 24m.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 70f7
16EIO
16E 10
CERTIFICATE OF INSURANCE CERTIFICATE NUMBER
616443
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICAn: HOLDER OTHER THAN THOSE PROYlDED IN THE POUCY.
THIS CERTIFICAn: DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES DESCRIBED HEREIN.
Marsh, Inc. COMPANIES AFFORDING COVERAGE
1166 Avenue of the Americas
New York, NY 10036 COMPANY A: New Hampshire Ins. Co.
Telephone (212) 345-5000 COMPANY B: Fireman's Fund Insurance Company
COMPANY C: Nat'l Union Fire Ins Co of Pittsburgh, PA
INSURED COMPANY D: Illinois National Insurance Co.
COMPANY E: Commerce & Industry Ins CO
ADT Security Services. Inc. COMPANY F: AI South Insurance Co.
32100 US Hwy 19 N COMPANY G: Insurance Company of the State of PA
Palm Harbor, FL 34684-3727
United States
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
PNY REQUIRMENTS. TERM OR CONDITION OF PNY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE
AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY
PAID CLAIMS.
CO TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY LIMITS
LTR DATE (MMlDDNY) EXPIRATION
A GENERAL LlABlUTY GL 1871924 (Primary GL) 10/1/2008 10/1/2009 GENERAL AGGREGATE $2.000.000.00
-
X COMMERCIAL GENERAL PRODUCTS - COMP/OP AGG $2 000 000.00
== tJ CLAIMS MADE [R] OCCU PERSONAL & ADV INJURY !l;1 000 000.00
OWNER'S & CONTRACTOR'S EACH OCCURRENCE $1.000.000.00
-
FIRE DAMAGE (Anyone fire) $1,000,000.00
MED EXP (Anyone person) $10000.00
C AUTOMOBILE LIABILITY CA 1607774 (MA) 10/1/2008 10/1/2009 COMBINED SINGLE LIMIT $1,000.000.00
-
C ~ PNY AUTO CA 1607775 (VA) 10/1/2008 1 011/2009
C ~ HIRED AUTOS CA 1607776 (ADS) 1 0/1/2008 10/1/2009 /
X NON-OWNED AUTOS
C WORKERS COMPENSATION AND WC 1872471 (CA) 10/112008 10/112009 X I :':.~,f.'TUTORY I I ~T"E
C EMPLOYERS' LIABILITY WC 3754201 (ADS) 10/1/2008 10/112009 El EACH ACCIDENT $2.000,000.00
0 THE PROPRIETOR! we 1872475 (MI) 10/112008 10/112009
E PARTNERSJEXECUTIVE WC 1872472 (FL) 10/112008 10/1/2009 El DISEASE-POLICY LIMIT $2,000.000.00
F OFFICERS ARE: WC 1872478 (CT.GA.PA,SC) 10/1/2008 10/112009 El DISEASE-EACH $2,000.000.00
A we 1872477 (NY. OH. WI) 10/112008 10/1/2009
C we 1872473 (OR) 10/1/2008 10/1/2009
G we 1872476 (AR.MA,VA) 10/112008 10/1/2009
A we 1872474 (TX) 10/1/2008 10/1/2009
EXCESS UABILITY GENERAL AGGREGATE
~ OTHER THAN UMBRELLA FORM PRODUCTS - COMP/oP AGG
::=J UMBRELLA FORM EACH OCCURRENCE
--
OTHER
B Builde(s Rlskllnslallation/Contract Worl<s OC 9112860 5/1/2009 5/112010 USD $1,000,000.00 per jobslle
B Rental Equipment/Contractor's Equipment OC 9112860 5/112009 5/112010 USD $1,000,000,00 per jobsile
B Blanket Trans~ OC 9112860 5/112009 5/112010 USD $1,000,000.00 per conveyance
DESCRIPTION OF OPERATlONSlLOCATIONSNEHICLES/SPECIAL ITEMS
Collier County Board of County or any other third party shall not be afforded status of an additional insured except as expressly agreed to and
subject to the terms and conditions of a written agreement between the Named Insured and Collier County Board of COll
Job Number: 0191 CUstomer Number: 0'191 Town Number: 0791 //
Otber Additional Insureds: Collier County Board of County conunissione:t-s
CERTIFICATE HOLDER CANCELLATION
Collier County Board of County SHOULD ANY OF THE POUCIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE
INSURER AFfORDING COVERAGE WIll ENDEAVOR TO MAIL 30 DAYS WRmEN NOTICE TO THE CERTifiCATE HOLDER
Commissioners NMlED HEREIN. BUT fAILURE TO MAIL SUCH NonCE SHALL IMPOSE NO OBUGAnON OR LIABILIlY OF mY KIND UPON
Purchasing Dept, Building G THE INSURER AFFORDING COVERAGE. ITS AGENTS OR REPRESENTATIVES, OR THE ISSUER OF THIS CERTIFICATE_
3301 E. Tamiami Trail ..:J~ __ 1~ '}/. ~
Naples, FL 34112 MARSH USA INC, BY: Franklin Hallock. Global Marine
United States David Kong, Casualty Program Transit Program
VAUD AS OF: 6/26/2009
/
I
/
/'
Par questions !:egarding this certificate contact: JOHN SHARPE (Email: jfsharpe1,l1a.dt.com PhO:le: 800"S6B-1216-0PT-))
16EIO
MEMORANDUM
DA TE:
July 8, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Martha Vergara, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Seniors"
Contractor: VIP America of SW Florida, LLC
Enclosed, please find one (I) original, referenced above (Agenda Item
#16EIO) approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-7240.
Thank you,
Enclosures
\)U'~ \\.\\<:)~
ITEM NO.:
DATE 1~tr..: 0
FILE NO.:
ROUTED TO: 0 9-P ~C - ~ J~55
DO NOT WRITE ABOVE THIS LINE
REQUEST FOR LEGAL SERVICES
Date: July 1, 2009
t' .)
,
:_)
To:
Office of the County Attorney
Jeff Klatzkow
--l~~ ~,~~ c~~
From:
Lyn M. Wood, C.P.M., Contract Specialist dr' ,
Purchasing Department, Extension 2667
I
r
\
Contract: #09-5227 "Services for Seniors"
('I
1..0
Re:
Contractor: VIP America of SW Florida, LLC.
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agenda
Item 16.E.10
This item has not been previously submitted.
Contract review and approval.
~\-'
,
} (:r
ACTION REQUESTED:
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
w - ~ +Sly-J-,~ .
r/~ ~ Mr, VVhl~4-
__ .~;"2!. M~ ?j. (J
j
"
~"
((lres~~
C: Terri Daniels, Housing & Human Services
16EIQ
MEMORANDUM
TO:
FROM:
Ray Carter
Risk Management Department
Lyn M. Wood, C.P .M., Contract Specialist k"
Purchasing Department / "
,-
July 1, 2009
DATE:
RE:
Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: VIP America of SW Florida, LLC.
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
C: Terri Daniels, Housing & Human Services
16EIQ
mausen_g
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Thursday, July 02, 2009 2:56 PM
LynWood; DeLeon Diana
DanielsTerri; mausen_9
Contract 09-5227 Services for Seniors
All, I have approved the Certificate(s) of Insurance provided by VIP America of SW Florida, LLC for contract 09-5227. The
contract will now be forwarded to the County Attorney's Office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
_www.sunbiz.org - Department of State
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Florida Limited Liability Company
VIP AMERICA OF SOUTHWEST FLORIDA, LLC
Filing Information
Document Number L09000031164
FEI/EIN Number NONE
Date Filed 03/31/2009
State FL
Status ACTIVE
Effective Date 03/31/2009
Principal Address
45 N. ALABAMA ROAD, STE 3
LEHIGH ACRES FL 33936
Mailing Address
45 N. ALABAMA ROAD, STE 3
LEHIGH ACRES FL 33936
Registered Agent Name & Address
BRECHBILL, MARK
215 SOUTH FEDERAL HIGHWAY, STE 100
STUART FL 34994 US
Manager/Member Detail
Name & Address
Title MGR
WHITE, GILBERT
45 N. ALABAMA ROAD, STE 3
LEHIGH ACRES FL 33936
Annual Reports
No Annual Reports Filed
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Q3/31/2QQ~=BQrida Lirnited Li9bility
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Note: This is not official record. See documents if question or conflict.
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16E 10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
VIP America of Southwest Florida, LLC, authorized to do business in the State of Florida,
whose business address is 45 North Alabama Road, Suite 3, Lehigh Acres, Florida 33936,
hereinafter called the "Vendor" and Collier County, a political subdivision of the State of
Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page 1 of7
16E10
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:
VIP America of Southwest Florida, LLC
45 N. Alabama Road, Suite 3
Lehigh Acres, FL 33936
Attention: Gilbert White, President
Telephone: 239-303-2422
Facsimile: 239-303-2922
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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
Page 2 of7
i.16E 10
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.
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:
IA.
Commercial General 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 Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
~.
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.
~.
Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an Additional..htsured 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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
16EIQ
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EI0
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U.s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16EIO
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
By: ,
Dated: l
, (SEAL, i 1
Aft......'.... I
.'f..~. ~...;\.,;'
.'il'" ,,\,,-
~'/l ' "L :\1'"
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: (f~< .k~
Donna Fi la, Chairman
ATTEST:
Dwight E. Brock, Clerk of Courts
VIP America of Southwest Florida, LLC
~i~
First Witness
Vendor
By:A~OU ~
Signature
Gro. te. LllillUr
tType/ print witness namet
~~<
'----"" econd Witness
Bilw+ Whl-ie ,Pres,'detlt-
Typed signature and title
---'inCLtr+- ~dsoo
tType/p . t wi~ess namet
Approved as to form and
legal sufficiency:
BY:
Jeff. right, Assistant County Attorney
Page 6 of7
16 E 10
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEEIUNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page70f7
ACORQM CERTIFICATE OF LIABILITY INSURANC ;'. '1 DATE (MMlDDIYYYV>
06/29/2009
PRODUCER (561)776-0660 FAX (561) 776-0670 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Abacoa Town Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1200 University B1 vd. , Ste 200
Jupiter, FL 33458 INSURERS AFFORDING COVERAGE NAIC#
INSURED VIP Amen ca, LLC & JCOL, LLC Ace American Insurance Company ?-U6-? ~~"."~--"'''''-
INSURER A
2500 s. Kanner Hwy INSURER B:
Suite 1 ~ ' ',..
INSURER C:
Stuart, FL 34994 ~,~ --'--'--
lNSURER D'
- n_____
INSURER E:
il6EIQ
COVERAGES
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 KEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 00'1 POUCY EFFECTIVE POLICY EXPIRAllON ",,-"""---
TYPE OF INSURANCE POUCY NUMBER LIMITS
GENERAL UABlLITY CRLG23591261001 09/11/2008 09/11/2009 EACH OCCURRENCE $ l,OOO,Ooe
f--- DAMAGE T9_RENTED 100,00C
X COMMERCIAL GENERAL LIABILITY $
>_.>,J ClAJMS MADE o OCCUR MED EXP (Anyone person) $ E~~!~
-
A PEHSONAL & MJV INJURY $ 1,000,000
f--- 3""OOQ~
GENERAL AGGREGATE :;
I-- --"""""_.
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 1,000,000
Ii n PRO- nLOC -
POLICY JECT
AUTOMOBlLE UABILITY COMBINED SINGLE LIMIT
f..- (E8 ltCCident) $ 1 ,J}OO, 000
ANY AUTO
I-- ......,,~.""_, .n
ALL OWNED AUTOS CRlG23591261001 09/11/2008 09/11/2009 BODILY INJURY
I-- $
SCHEDULED AUTOS (pI!( person)
A X ,- -
HIRED AUTOS BODilY INJURY
'X- (Per accident) $
NON.OWNED AUTOS
- .~.~
- PROPERTY DAMAGE $
{per il<'Aidtlntl
GARAGE UABILlTY AUTO ONt.. Y - EA ACCIDENT $
=1 ANY AUTO OTHER THAN lOA ACC $
AUTO ONLY AGG $
I EXCESSIUMBREtLA UABlLllY EACH OCCURRENCE $
! l OCCUR D ClAJMS MADE AGGREGATE $
1 .~,,~ ,-- _._>_..~
$ .-
=-~ DEDUCTIBLE $
-. ~m" -~
RETENTION $ $
WORKERS COMPENSATION AND WC STATU. I I OJ:
EMPLOYERS' UABIUTY EL EACH ACCIDENT $
ANY PROPRIETORfPARTNERiEXECUTlVE
OFFICERiMEM8ER EXCLUDED? EI.. DISEASE. lOA EMPLOYEr $
~~~~I;tts~~~V~NS belOw E,L. DISEASE. POLICY LIMIT $
~TliER & Molestation CRLG23591261001 09/11/2008 09/11/2009 Aggregate Limit $ 300,000
A use
DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES ( EXCLUSIONS AD~D BY ENDO.R$i<MSHT I SPEClAL PROVISIONS /
e: ITQ# 09-5227 Collier County Services or Sen10rs
ertificate Holder is Additional Insured with respects to General liabil ity
10 DAYS NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM
/
j,;
Collier County
Board of County Commissioners
Naples, Fl
SHOUI.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLOER NAMED TO TliE LEFT,
BUT FAILURE TO MAIl. SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTliORlZED REPRESENTATIVE r'l . . ~~
Sean Thomas BECKP ~
ACORD 25 (2001108)
eACORD CORPORATION 1988
16EI0
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the pOlicy(ies} must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s}, authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
16E1Q
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured Endorsement Number
VIP America, LLC; JCOL, LLC 3
Policy Symbol I Policy Number I Policy Period Effective Date
CRL G23591261 001 09/11/08 to 09/11/09 09/11/08
Issued By (Name of Insurance Company)
ACE American Insurance Company
NON-OWNED AUTOMOBILE LIABILITY ENDORSEMENT
It is agreed that:
1. The Declarations is amended by adding the following:
a. The Premium is amended to add the following:
Coverage
Non-Owned Automobile Liability
Additional Premium
$1,664.
b. The section providing the General Liability Coverage Part Limits of Insurance is amended to add the
following:
Non-owned Automobile Each Accident Limit: $500,000. each accident
Non-owned Automobile Aggregate Limit:
$500,000.
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
2. Section I, Insuring Agreements, of the General Liability Coverage Part is amended at subsection A 1 by
adding the following immediately after the first sentence:
Bodily Injury and Property Damage Liability includes "bodily injury" or "property damage" arising out of the use
of a "non-owned automobile" by any natural person, other than you, in the course of your business.
3. Solely for purposes of coverage provided by this endorsement only, the Additional Exclusions section of the
General Liability Coverage Part is amended as follows;
a. The Additional Exclusions titled Contractual Liability, Liquor Liability, Aircraft, Automobile Or Watercraft,
Damage To Property, Damage To Your Product, Damage To Your Work, Damage To Impaired Property
Or Property Not Physically Injured, and Recall Of Products, Work Or Impaired Property, are deleted in
their entirety.
b. The following Additional Exclusions are added:
. Contractual Liability
"Bodily injury" or "property damage" for which the "insured" is obligated to pay damages by reason of
the assumption of liability in a contract or agreement. This exclusion does not apply to liability for
damages:
(1) That the "insured" would have in the absence of the contract or agreement; or
(2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or
"property damage" occurs subsequent to the execution of the contract or agreement.
PF-14487c (11/06) AH, LTC & FAC @ACE USA, 2006 Page 1 of 3
Not Approved in Louisiana
Includes copyrighted material of Insurance Services Office, Inc., with its permission
16E10
. Bodily Injury to Your Employees
"Bodily injury" to:
(1) An "employee" of the "insured" arising out of and in the course of:
(a) Employment by the "insured"; or
(b) Performing duties related to the conduct of the "insured's" business; or
(2) The spouse, child, parent, brother or sister of that "employee" as a consequence of
paragraph (1) above.
This exclusion applies:
(1) Whether the "insured" may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay the damages
because of the injury.
This exclusion does not apply to:
(1) Liability assumed by the "insured" under an "insured contract"; or
(2) "Bodily Injury" to domestic "employees" not entitled to workers compensation benefits.
. Damage to Property
"Property damage" to:
(1) Property owned or being transported by, or rented or loaned to the "insured"; or
(2) Property in the care, custody or control of the "insured".
4. Solely for the purposes of coverage provided by this endorsement, Section III, Exclusions, of the General
Liability and Professional Liability General Policy Provisions is amended by deleting in its entirety
subparagraph C, Employers Liability.
5. Solely for the purposes of coverage provided by this endorsement, the Who Is An Insured section of the
General Liability Coverage Part is deleted in its entirety and replaced by the following:
Each of the following is an "insured" under this insurance to the extent set forth below:
1. You.
2. Any partner or "executive officer" of yours, but only while such "non-owned automobile" is being used in
your business.
3. Any other person or organization, but only with respect to their liability because of acts or omissions of an
"insured" under paragraphs 1 or 2 above.
None of the following is an "insured":
1. Any person engaged in the business of his or her employer with respect to "bodily injury" to any co-
"employee" of such person injured in the course of employment;
2. Any partner or "executive officer" with respect to any "automobile" owned by such partner or officer or a
member of his or her household;
3. Any person while employed in or otherwise engaged in performing duties related to the conduct of an
"automobile business", other than an "automobile business" you operate;
4. The owner of a "non-owned automobile" or any agent or "employee" of any such owner or lessee;
5. Any person or organization with respect to the conduct of any current or past partnership or joint venture
that is not shown as a Named Insured in the Declarations.
6. Solely for the purposes of this endorsement, Section I, Definitions, of the General Liability and Professional
Liability General Policy Provisions is amended by adding the following definitions:
PF-14487c (11/06) AH, LTC & FAC @ ACE USA, 2006 Page 2 of 3
Not Approved in Louisiana
Includes copyrighted material of Insurance Services Office, Inc., with its permission
16E 10
1. "Automobile business" means the business or occupation of selling, repairing, servicing, storing or
parking "automobiles".
2. "Non-owned automobile" means any "automobile" you do not own, lease, hire, rent or borrow which is
used in connection with your business. This includes "automobiles. owned by your "employees", your
partners or your "executive officers., or members of their households, but only while used in your
business or your personal affairs.
7. Solely for the purposes of this endorsement, the Limits of Insurance section of the General Liability Policy is
amended by adding the following subsections:
. The Non-owned Automobile Liability Each Accident Limit set forth in the Declarations, is the most we will
pay for the sum of all "bodily injury" and "property damage" resulting from of anyone "automobile"
accident arising from the use, other than by you, of a "non-owned automobile" in the course of your
business.
. The Non-owned Automobile Aggregate Limit set forth in the Declarations, is the most we will pay for the
sum of all "bodily injury" and "property damage resulting from all "automobile" accidents arising out of the
use, other than by you, of a "non-owned automobile" in the course of your business.
All other terms and conditions of the policy remain unchanged.
Authorized Representative
PF-14487c (11/06) AH, LTC & FAC @ACE USA, 2006 Page 3 of 3
Not Approved in Louisiana
Includes copyrighted material of Insurance Services Office, Inc., with its permission
AC.OBDrM
CERTIFICATE OF LIABILITY INSURANCE
05/11/09
PRODUCER
Paychex Agency. Inc.
1-800-472-0072
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
150 Sawgrass Dr
Rochester. NY 14620
INSURERS AFFORDING COVERAGE
INSURED
Paychex Business Solutions. Inc.
VIP AMERICA LLC
INSURER A ILLINOIS NATIONAL INSURANCE COMPANY
INSURER B,
INSURER C
911 Panorama Trail South
Rochester. NY 14625
877-266-6850
COVERAGES
INSURER Dc
INSURER Ec
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, AGGREGATE LIMITS
SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
iNSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIVV) DATE (MMlDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
--,
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone 1irel $
- ~ CLAIMS MADE 0 OCCUR
MED EX? (Anyone person) $
-
PERSONAL & ADV INJURY $
-
GENERAL AGGREGATE $
i--
GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMPIOP AGG $
h nPRO-n
POLICY JECT LOC
~OMOBILE LIABILITY ! COMBINED SINGLE LIMIT I l~
ANY AUTO \ 1 I (Ea accident)
I-- t
ALL OWNED AUTOS BODIL Y INJURY 1$
- (Per person)
SCHEDULED AUTOS
- ~-
HIRED AUTOS ' BODILY INJURY I
- ! (Per accident) 1$
NON-OWNED AUTOS
-
--' I PROPERTY DAMAGE
I i (Po< accKlent) $
~AGE LIABILITY I AUTO ONLY' EA ACCIDENT $
ANY AUTO I EA ACC $
i OTHER THAN AUTO
ONLY AGG $
:5ESS LIABILITY I ! ! EACH OCCURRENCE $
D CLAIMS MADE , IAGGREGA TE
OCCUR I I $
.--"
I i $
I I
q ~EDUCTIBLE I $
RETENTION $ $
A WORKERS COMPENSATION AND EMPLOYERS' 125890435 i 06/01/09 06/01/10 I WC STATU- I I OTH-
LIABILITY X TORY LIMITS ER
EL EACH ACCIDENT $ 1.000,000 V-
EL DISEASE - EA EMPLOYEE $ 1,000.000
E L DISEASE - POLICY LIMIT $ 1.000.000
I OTHER $
i $
! $
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
WORKERS COMPENSATION COVERAGE IS PROVIDED TO ONLY THOSE EMPLOYEES LEASED TO, BUT NOT SUBCONTRACTORS OF THE NAMED INSUR D
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
VIP AMERICA LLC THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION
2500 KANNER WAY SUITE 1 OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES,
STUART, FL 34994 AUTHORIZED REPRESENT A TIVE 71>>'~~,A
USA
ACORD 25-S (7197)
DISGRO
11880315
@ ACORD CORPORATION 1988
16E10
MEMORANDUM
DA TE:
July 17, 2009
TO:
Lyn Wood, Contract Specialist
Purchasing Department
FROM:
Ann Jennejohn, Deputy Clerk
Minutes and Records Department
RE:
Contract #09-5227 "Services for Senior's"
Contractor: Dial-A-Nurse
Enclosed is an original contract, referenced above (Agenda Item #16EI0)
approved by the Board of County Commissioners Tuesday, June 23, 2009.
The second original contract will be held in the Minutes and Records
Department with the Official Records of the Board.
If you should have any questions, you may contact me at 252-8406.
Thank you.
Enclosure
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
~~ I
rf\70~ () d--b ?p.A~~
'It 0 L ~!VbATE RECEIVE~"
~- ~~
r ~] ~6~JO
1/ Sf b 1. <-_
DO NOT WRITE ABOVE THIS LINE /}.J ~ ' '
wlb?l yf
REQUEST FOR LEGAL SERVIC~ "iJ -l ~ S ~
() ;Jr ~~
.J-- ~~ IS e-{,
V~ <tV tn
7)IS)b~
ITEM No.:D1'" ~ \(C,6tl.11 S
FILE NO.:
ROUTED TO:
Date:
'l'
July.8; 2009
To:
Office of the County Attorney
Jeff Klatzkow
From:
CSf2..'
O~ I' \&;3 .oq
Re: Contract: #09-5227 "Services for Seniors"
Contractor: Dial-A-Nurse
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agen
Item 16.E.10
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
RLS # 1)1 -jJl2.e - ~ (CJ. bS
CHECKLIST FOR REVIEWING CONTRACTS 16 E 1 0
JJfAL-IJ- JJU~S2-, !fN~
Entity Name:
Entity name correct on contract?
Entity registered with FL Sec. of State?
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ f M ll--
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $
Workers Compensation
Each accident Required $.s-r~. fW'IJIttJf Provided $ '"0)000
Disease Aggregate Required $ Provided $ S":/ (1()V
Disease Each Empl Required $ Provided $ I ~ \ 00 P
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $ __
Per Aggregate Required $ ~
Other Insurance
Each Occur Type:
~Yes
~Yes
--Y:::. Yes
V Yes
'2.Mt\...
I M.lL-
l.
II
501 ,fJ()
W~\V~ ~~~J~
Provided $
Provided $
Provided $
Provided $
Provided $
Exp Date
Exp Date
Yes
Provided $ I Ml. L
Provided $ '3 M-( L
Required $
Provided $
County required to be named as additional insured?
County named as additional insured?
V Yes
vYes
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
~es
Yes
Performance Bond
Bond requirement referenced in contract?
If attached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
~ ~~. \.... f~;'\1\~
/Yes
~Yes
--\L.... Yes
~Yes
~Yes
-L Yes
v'Yes
Attachments
Are all required attachments included?
JYes
~Yes
~Yes
No
No
No
No
't" ~No
No
pOl CHf- )
~~c.~-(') &Ut'pft'ltft-
Exp. Date
Exp. Date
Exp. Date
Exp. Date
Exp. Date
tr/3 l,P
I L t I
\ ,
\ ,
I'
Exp Date
<---
Exp Date ~ Ito
Exp Date L I
Exp Date L .
No
Exp. Date
Exp. Date
') / f7 //tI
I t!-
Exp Date_
No
No
No
~No
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No ""- , . _
Reviewer Initials: ~
Date:~
04-COA~ .
16EI0
MEMORANDUM
i' "
,
TO: Ray Carter
Risk Management Department
LJ
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
Cf
DATE: July ~ 2009
,
_Ij~
j)P'!. _.
,/ nxA f r
, \ I.- tV"..)() ....-
.-/
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Dial-A-Nurse
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
C: Terri Daniels, Housing & Human Services
DATE RECEIVED
JUL 1 0 2009
RISK MAHAGEMENT
16EI0
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Friday, July 10, 2009 3:22 PM
LynWood; DeLeonDiana
DanielsTerri; mausen_9
Contract 09-5227 Services for Seniors
All, I have approved the Certificate(s) provided by Dial-A-Nurse for contract 09-5227 which will now be forwarded to the
County Attorney's Office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
16E10
DeLeon Diana
From:
Sent:
To:
Cc:
Subject:
Ted Wolfendale [twolfendale@dialanurse,com]
Monday, June 29, 20092:57 PM
DeLeon Diana
Deemae Sell
Dial-a-Nurse
~ l,~''\
0'1/ ~ -'\~
Diana,
Regarding item B, Business Auto Liability Coverage, Dial-a-Nurse, Inc. does not own any company vehicles. All of our
patients sign a driving release in the event they are to be transported.
This is how we have operated for thirty years, and would therefore request that you please waive this requirement.
Sincerely,
Ted Wolfendale, Esq.
Administrator
Dial-a-Nurse
1
Jul 12 09 10:08a
.r~
'., ,"j .
,r~'''''-~. -\
:"~f]'~ "
','-' ~'--,,\
t t ;:: ~ \ I
. :-.:...! ... .I I
,,~, III ,:",_
~ -- '. -.;;. ....!-~. -
, .. , I.
...... " ',."i'
-- -
Professioncl Nursing Core for your loved ones
DiaiaQzrNurse@
Serving Our Community for over 25 Years
16E 1 0
June 24, 2009
Collier County
3301 Tamiami Trail East
Naples, FL 34112
To Whom It May Concern:
Permission is given for Ted Wolfendale to be an authorized signatory for Dial-a-Nurse,
Inc.
Signature~ Y;;:~/.rA-
//
Name: Lynette Grossenbacher
Title: President & CEO
~~ 91L~
lIARClAJ.DlJMV
MY COMMISSION t DO 735486
EXPIRES: Man:h 9,2012
BondodThN NoIDIy PUlIc lImlorlioko..
TIB Bonk Canter. 599 91h Street North, Suite 207 . Naples, florido 34102-5625 . (239) .:134.8000
From:Dial A Nurse
Professional Nursing Care for your loved ones
June 24, 2009
Collier County
3301 Tamiami Trail East
Naples, FL 34112
To Whom It May Concern:
239 434 8796
DlaJ.a.Nanee
08/24/2008 18: 69
1783 P.001/001
16E10
ECEIVED
J" f'c1 ^ ,~
,urv / " "nng
'- '" (vI)
bt,,,,iP'MQINo
Serving Our Community for over 25 Years
Permission is given for Ted Wo1fendale to be an authorized signatory for Dial-a-Nurse,
Inc.
Signab=~
Name: Lyn e Grossenbacher
Title: President & CEO
4
1
I
TlB Bonk CAntf!lr. 599 9th ~trA..t Nnrth ~lIifA ?07 . Nnnl... I=I...ri,./,.. 'lA 1 n?I\A?I\ . 1?~OI A':lA_Annn
www.sunbiz.org - Department of State
Page 1 of2
16E10
~-> ~* ~'>\J>>-~ .
FLORIDA DEPARTMENT OF STATE .'~ it"'" t"~.:,..; .....,
U :ill ,. ' ~ ll!~
DI\'IS[O~ OF CORPOR.\nO\~ .,.' ;~{~~!::. "', ,,:~:',t~.'r~.. ~
"""'\;!.!'1%" ,<;Y
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Florida Profit Corporation
DIAL-A-NURSE, INC.
Filing Information
Document Number P01000053816
FEI/EIN Number 651109460
Date Filed 05/31/2001
State FL
Status ACTIVE
Principal Address
599 9TH STREET NORTH
SUITE 207
NAPLES FL 34102-5625
Changed 01/22/2004
Mailing Address
599 9TH STREET NORTH
SUITE 207
NAPLES FL 34102-5625
Changed 01/22/2004
Registered Agent Name & Address
GROSSENBACHER,ROBERTJ
599 9TH STREET NORTH
SUITE 207
NAPLES FL 34102-5625 US
Address Changed: 05/03/2004
Officer/Director Detail
Name & Address
Title PC EO
GROSSENBACHER,LYNETTE
599 9TH ST N, STE 207
NAPLES FL 34102
Title VPST
GROSSENBACHER,LYNETTE
599 9TH ST N, STE 207
NAPLES FL 34102
Annual Reports
http://www.sunbiz.org/scripts/cordet.exe?action=D ETFIL&inq_ doc _ number= PO 1 000053 8.,. 6/24/2009
www.sunbiz.org - Department of State
Report Year Filed Date
2007 04/19/2007
2008 04/21/2008
2009 01/28/2009
Document Images
01!28/2009=-AN NLJAL.REPQRT
04/21,/2008,~~ANNLJAL.REPQRT
04/19/2007 =-ANNUAL REPORT
04/24/2006 =--ANNUAL REPORT
OQ/03/2005 =_ANNUAL REPORT
05{Q~L2QQ.4_=_6NN!J_AL._RI;PQRI
04/25/2003~~ANNUAL REPORT
0410212002=--6NNWAL. REPORT
OQI~j !20QL::_Oom~::;tjG,Profit
Page 2 of2
16EIO
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Note: This is not official record. See documents if question or conflict.
pre"iQ!,'-~L91LI,JS!
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http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&in~ doc _ number=PO 1 0000538... 6/24/2009
16E10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Dial-A-Nurse, Inc., authorized to do business in the State of Florida, whose business address
is 599 Ninth Street North" Naples, Rorida 34102, hereinafter called the "Vendor" and Collier
County, a political subdivision of the State of Florida, Collier County, Naples, hereinafter
called the "County I':
WITNESSETH:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the tenns and conditions of ITQ 109-5227 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice and upon approval by the
Contract Manager or his designee, and in compliance with Section 218.70, Fla. Slats.,
otherwise known as the "Local Government Prompt Payment Act".
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
perfonnance of the Work.
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:
Page 1 of7
16E10
Dial-A-Nurse, Inc.
599 Ninth Street North
Naples, FL 34102
Attention: Ted Wolfendale
Telephone: 239-434-8000
Facsimile: 239-434-6795
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
A ttention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, P.5., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. 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 pennit 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
Page 2 of7
16E10
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 manneJ'satisfactory to the County as per this Agreement; the County may terminate
said agreement for cause; furtheJ' the County may terminate this Agreement for
convenience with a thirty (30) day written notice. The County shall be sole judge of
non-performance.
10. NO DISCRIMINATION. The Vendor agrees that there shall be no discrimination as to
race, sex, color, creed or national origin.
11. ~ The Vendor shall provide insurance as follows:
/A. ~ial General Uability: 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 Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
e7
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-0wned
/Vehicles and Employee Non-Ownership.
k. Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an Additional Insured on the Comprehensive
General Lia bili ty PoHcy .
Current, valid insurance policies meeting the requirement herein identified shall
be maintained by Vendor during the duration of this Agreement. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
12. INDEMNIFICATION. To the maximum extent pennitted by Florida law, the Vendor
shall indemnify and hold harmless Collier County, its officers and employees from any
Page 30f7
16[10
and all liabilities~ damages, losses and costs, including. but not limited to, reasonable
attorneys' fees and paralegals' fees~ 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 01 reduce any other rights or remedies which otherwise
may be available to an indemnified party or person described in this paragYaph.
This section does not pertain to any incident arising from the sole negligence of Collier
County .
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 CONTRACI'. This Contract consists of the attached
component parts~ all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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 GIFI'S 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 Olapter 112, Part IIl~ Florida
Statutes, Collier County Ethics Ordinance No. 2004-05, and County Administrative
Procedure 5311. Violation of this provision may result in one or more of the following
consequences: a.) Prohibition by the individual, finn, 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 finn for cause.
18. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
responsible for complying with the provisions of the Immigration Refonn and Control
Act of 1986 as located at 8 U.s.e. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 tenninate this agreement immediately.
Page 4 of7
16E10
19. OFFER EXTENDED TO OTHER GOVERNMENT At ENTmES. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page.5 of7
16E10
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
au thorized person or agent, hereunder set their hands and seals on the date and year first above
written.
cO'-.
BOARD OF COUNTY COMMlSSIONERS
::LLJER/f!=R'~
Donna Fiala, Chairman
A ITEST:
Dwight ~,\~(~rk of Courts
"i'o, ',...'!
.,)' "'. '-~ A'
.
~ i --'
Dial-A-Nurse, Inc.
tJ~ ~\nv JdL
First Witness
By:
Vendor
// )t/#;
v Signature ______~
D Ee: rrt~ r S(Ll
fTy ellprint witness na
'/
JEt' lJ)Ol fEt\\UU\Ll: 1!\.DlY\LclJS\~A\Of\
Typed signature and title
econd Witness ,
1l{jc,h?Je :71fY?nflldb
fType/print~tnessruunef
Item# j(P~D
Page 6of7
16EIO
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEFlUNIT OF SERVICE
Total Cost Reimbursemeot
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ l.1} per Day $ 1.00
Hom.emaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursiog $38.89 per Hour $35.00
Specialized Med Equipment t 00% cost 900/0 of cost
Facility Respite (24 Roun) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 70f7
From:l<risten Himmel FaxlD:
Page:2 of3
Date:7112eot3 pip~ of 3
~
~R CERTIFICA TE OF LIABILITY INSURANCE DATE IMMlDDIYYYYI
OP 10 HIKRI
DIALA-1 07/07/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Sabrina C Dulaney Ins Agcy Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1217 Piper Blvd suite 102 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
naples FL 34110
Phone: 239 254-9005 Fax:239 254-9002 INSURERS AFFORDING COVERAGE NAIC# ./
I~JSURED -.. --.,.,---" , ./
INSU~ER A Nationwide Insurance 25453
! II-JSUREt;; B
.~-,
Dial-A-Nurse Inc. INSURER C
599 9th street N #207 II.'SURER D
Naples FL 34102 ,.-,._---~-- ~' -
I 1t.ISURER E
COVERAGES
Tl'iE POLICIES OF INSURilNCE lISTEC- BELOW HAVE BEEN ISSUED TO TIlE IflSURED NAMED AEovE FOR THE FOLIC (FERIOD INDICil.TED IJOTWITI'ISTAlIC'n,G
N'N RE')UIREM,,'.IT TERM OR CO"JDITIOI.j OF NJY COIHRACT OR OTHER DOCUME'.(j' WITH RESPECT TO WHIo:H THIS CEhTlFICATE ~N\Y BE ISSU"D ,)f;
MAY PERTAII,J THE II'ISUR,AIKE AFFORDED 8'1 TI.t:: POLICIES DESCRIBED HEREIN IS SUBJECT TO ,ALL THE TERMS, EXCLUSIONS N'D cmJDITIOllS OF SUCH
POLICE,S AGGREGATE LIMITS SHOWN MAY H'\VE 8EEIIREDUCED 8'1 PAID CLAIM"
LTR flSR[ TYPE OF INSURANCE POLICY HUMBER DATE (I4MJDDIYYYYI DATE IMMIDDIYYYY) LIMITS
GEIJERAL LIABILITY EA.CH 0CCUR~EIKE $1,000,000
- 07/03/09 07/03/10 L.!,,~t~..,c I v KC" IE'"'
A X X COMI.1ERCIAL GEnERAL UilBILlTY 77B07189053001 P"EJAIS"S lEa o"crence) $ 50 ,000
- b (LA.lMS M"DE 0 OCCUR ,,-~
I-- tilED E),:F :Any one pe-r!'ion) $ 5,000
PERSCNA,L & ADV INJURY f1,000,OOO
- ---~',~,
(.EIJE!;AL A':;GPEl~ATE $2,000,000
I--
GEfI'L AGGRE':ATE LIMIT APPUE:;; PER r"ODUCTS' COMP/OP AGG $ 1,000,000
II n PRO- nLC":
POLIO JECT
AUTOMOBILE LIABILITY COM81NED SINGlE LIMIT
- lEa acel d.;=.nlj f
AUy AUTO
'-- i
ALL OWNED AUTOS DOJIL Y H'JJURY
- (Per perslJn) S
S<:HEDllED AUTO"
-
HIRED NJTOS BODIL Y II-IJUf;'i
- (P€'r acclder,l) $
HO~-.l.OV',,'NED AUTOS I
-
PROPERTI D,AI.1AGE $
(Oer accIdent)
GARAGE LIABILITY AUTO ON;' Y E.. ACClDEI.JT I $
=j ANY AUTO EAACC 1$ ^,-.-
U1HER lHAN
ALTO O/.ILY P.GG $
EXCESS I UldBRELLA LIABILITY EACH OCCUFiREI;CE $
o OCCUR o CLAIMS MADE AGGRECATE $
I $
R DEDUCTIBlE 1$
RETENTION $ 1$
WORllERS COMPENSATlON IT6~'ylm~ I I "ER I
AND EMPLOYERS' LIABILITY
Yltl 1$
AlJ'i PROPRIETORiPAATN"R/EXECUTIVE 0 E L EACH ACCIDENT
OFFICER/I.1EM8EP EXCLUDED? E L DISEASE. EA EMPLOYEE I $
(Mondotory In NHI
If yes, de5cnb~ under E L DISEASE. POLICY LIMIT 1$
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCAll0NS I VEHICLES I EXCLUSIONS ADDED BY EllDORSEMENT J SPECIAL PROVISIONS
Collier County Board of County Cormnissioners narned as additional insured.
CERTIFICATE HOLDER
CANCELLATION
SHOULD AllY OF THE MOVE DESCRIBED POLICIES BE CAtlCELLED BEFORE THE EXPIRATION
COLLI-3 DATE THEREOF, THE ISSUItJG INSURER WILL ElmEAVOR TO hlAIL ~ DAYS WRITTEN
NOTICE TO THE CERllFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
Collier County Board of IMPOSE NO OBLIGATION OR LIABILITY OF AllY Imm UPON THE INSURER, ITS AGENTS OR
County commissioners REPRESENTATIVES.
Attn: Lyn H. Wood AUTHORIZED REPRESENTATIVE
3301 Tamiarni Trail East sabrina Dulaney
Naoles FL 3411.2
ACORD 25 {2009/011
@1988.2009ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
From:Kristen Himmel FaxlD:
Page 30f3
Date:7f712009 03:43 PM Page:3 of 3
IMPORTANT
If the certificate holder is an ADDITIONAL Ir-.JSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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),
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon,
ACORD 2S (2009101)
~_~'\llIlnllllll!ilil.IlIiIIIMl.__1iIi'I -.q- ""'nr'l>".........._."'-';...~,"'"
eRbe
PRODUCER
CERTIFICATE OF LIABILITY INSURANCE
Bouchard-Fort Myers
8191 College Pkwy Suite 202
Fort Myers FL 33919
Phone: 239-489-3232 Fax:239-489-1084
INSURED
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
Dial-A-Nurse, Inc.
DeeMae Sell
599 9th Street North Suite 207
Naples FL 34102
COVERAGES
INSURER A:
INSURER B:
INSURER C:
Florida Retail Federation SIF
Evanston Insurance Com an
NAIC#
10700
35378
INSURER D:
INSURER E'
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~f; ~'S~[ ---,-...- - - -- - ---- -- . tRfd~~~rt6/~)- g~~If(t,t~b6~r-- -- --- ------------..- -------
TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
1-- DAMAGETCYRENTEU----- - -----
COMMERCIAL GENERAL LIABILITY , P~MISES (Ea occlJ[~n~"l__ $
f-- ~] CLAIMS MADE .~ OCCUR -_._._---~
M[O() ,E)(pJ~ny_ one pers."l1l_ $
f-- ------------------
i PE_RS_~N~L<I.~DV INJURY_ $
f-- ----,---',',._-',-...._._------ --------..-
~GENERALAGGREGATE $
1-- "-.---------- -----
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
II nPRO- r- -I LOC ---------- -------- --
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
f-- (Ea accident) $
ANY AUTO
i--- ---- - - - ---------
ALL OWNED AUTOS BODILY INJURY
'--- (Per person) $
SCHEDULED AUTOS
~ -...-
HIRED AUTOS BODILY INJURY
'--- $
NON-OWNED AUTOS (Per aCCident)
~ ---
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $
tJ OCCUR ~ CLAIMS MADE AGGREGATE S
-"-~
/ S
R DEDUCTIBLE ----vL S
I --- 1----- --_._--_.~.-
RETENTION $ I ! $
WORKERS COMPENSATION I I I ?ChQB'r'L1MITS- I IUJ~-
AND EMPLOYERS' LIABILITY Y / N -- ----------
A ANY PROPRIETOR/PARTNER/EXECUTiVe 052032524 01/01/09 01/01/10 E.L EACH ACCIDENT $ 100000
OFFICER/MEMBER EXCLUDED? ---------.-'----- ----- ----_._-,-'--~ ,"----
(Mandatory In NHI E.L. DISE~SIO_:E_Er,,!_L()Y.EOE $ 100000
~~~MtS~~6v':~?6~s below ___________________n_ --.--
E L, DISEASE - POLICY LIMIT $ 500000
OTHER I
B PROFESSIONAL LIAB I SM858989 07/07/09 07/07/10 PER CLAIM 1,000,000
AGGREGATE 3,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
* TEN DAYS WRITTEN CANCELLATION FOR NON PAYMENT * RE: CONTRACT #09-5227
COLLIER COUNTY SERVICES FOR SENIORS
CERTIFICA TE HOLDER
CANCELLATION
COLLIER COUNTY
BOCC
PURCHASING DEPT
3301 E TAMIAMI TRL
NAPLES FL 34112
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA TION
COLLIER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AU 0 ATIVE
ACORD 25 (2009/01)
988- 09 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
"","_""r~1rnr"n,-
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2009/01)
ORIGINAL DOCUMENTS CHECKLIST & ROUTING J:9 E 1 0 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Plint on pink paper. Attach to original documcnt. Original documcnts should be hand delivcrcd to the Board Office. The completed routing slip and oliginal
documents are to be forwarded to the Board OiTiee only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exc tion of the Chairman's si nature, draw a line throu h routin lines #1 throu'h #4, co lete the checklist, and forward to Sue Filson line #5).
Route to Addressee(s) Oft1ce Initials Date
(List in routin order)
1.
(The primary contact is the holder of the original document pending BCC approval. 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, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCe Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff Scott R. Teach, Deputy County Attorney
Contact
Agenda Date Item
A roved b the B
Type of Document
Attached
2.
3.
4. Scott R. Teach, Deputy County Atty.
County Attorney
SRT
7-31-09
5.
Clerk of Court's Office
b13\D
252-8400
16.E.1O
Two
Yes
(Initial)
SRT
N/A (Not
A licable)
Board of County Commissioners
SRT
SRT
SRT
SRT
SRT
6.
PRIMARY CONT ACT INFORMATION
Phone Number
-.
Agenda Item Number
I: Forms! County Forms! BCC Forms! Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
09-PRC-01264!5
Agreement 09-5227
Number of Original
Documents Attached
1.
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is
a ro riate.
Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and ossibl State Officials.)
All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is a licable.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si nature and initials are re uired.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Sue Filson in the BCC oflice within 24 hours ofBCC approval.
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 our deadlines!
The document was approved by the BCC on 6-23-09 and all changes made during the
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the chan es, if a licable.
2.
3.
4.
5.
6.
16 E 10 1
MEMORANDUM
Date:
August 4, 2009
To:
Joanne Markiewicz, Acquisitions Manager
Purchasing Department
From:
Martha Vergara, Deputy Clerk
Minutes & Records Department
Re:
Contract #09-5227 - Senior Services
Attached for your records, please find an one (1) original document referenced
above, (Agenda Item #16E10) adopted by the Board of County Commissioners
on Tuesday, June 23, 2009.
One original document has been kept by Minutes and Record's
Department for the Board's Official records.
If you should have any questions, please contact the Minutes and Records
Department at 252-7240.
Thank you.
16 E 10
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Always There Home Health Care, Inc., authorized to do business in the State of Florida,
whose business address is 317 North Collier Boulevard, Suite 201, Marco Island, Florida
34145, hereinafter called the If Vendor" and Collier County, a political subdivision of the State
of Florida, Collier County, Naples, hereinafter called the "Countylf:
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 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 Purchasing Policy and
Administrative 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 Appendix 1, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page I of 7
16EI0,t
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:
Always There Home Health Care
317 N. Collier Blvd., Suite 201
Marco Island, FL 34145
Attention: Janel Hanna Sine, Administrator
Telephone: 239-389-0170
Facsimile: 239-389-0164
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/ GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
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. 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 federat state, county or municipal
ordinance, rule, order or regulation, or of any governmental rule or regulation now in
Page 2 of7
16 E 10
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.
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:
~ Commercial General 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 Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
o?
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.
~e
Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
Special Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an Additional Lrisured 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. Renewal
certificates shall be sent to the County thirty (30) days prior to a[lY expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page3of7
16 E 10 ,
Vendor shall insure that all sub Vendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRA TION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 401'7
16 E 10 i
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 USe. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16 E 10
.~
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
ATTEST: .
. .,
Dwi htE Broek, Clerk of Courts
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: !jJ~ J~
Donna Fiala, Chairman
By:
Dated: l
(SEAL)
A-tttst... 'W_
11 "'at....' .'
Always There Home Health Care, Inc.
Vendor
'-i~a~,-rOR~
First Witness
1) 1,J\. "'-..O~ 'b.L GL G '")
tType/print witness namet
(~~.t!.. \2'f"
Second WItness!,)!
Byt~ ~1Jvh!6t
( Signature
~llfl~ \ ~li.Y\OQ ~~f
yped signature and title
(ll-kl v,lj ? or)"J
,
tType/print witness namet
~
. ounty Attorney
\)~ , ....""1
~ CA)iLJl/~eL
-
Print Name
L
Page 6 of7
16El0'~
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEE/UNIT OF SERVICE
Total Cost Reimbursemen t
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
From: Michael Koehne
Fax: (866) 792-8009
To: +12392526597
Fax: +12392526597
1
CERTIFICATE OF LIABILITY INSURANCE
Page 1 of 1
A CORD_
PRODUCER
Chapel Insurance Assoc., Inc.
Box ~010
Haddonfield NJ 08033
Phone: 856-795-7500 Fax:856-795-9877
INSURED
Always There Home Health
Care Ine .
317 North Collier Blvd
Marco ISland FL 34145
COVERAGES
DATE (MM/DDIYYYY)
ALWAY-3 07 07 09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A:
INSURER B:
INSURER C:
:~~_R~Ft D:
! INSURER E'
Amerie~ ~lternativ. lnau.:ruu:.
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM ORCONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRI6EO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POliCIES. AGGREGATE liMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS.
I ~ RATrON ---.....-
LTR NSRil TYPE OF INSURANCE POLICY NUMBER DATE MMI DATI!./MMlDDIYYi" LlWTS
GENERAL LIABILITY ! EACH OCCURRENCE ; $ 1, O()O ,.000
I---
A ~ COMMERCIAL GENERAL LIABILITY BG305188002 03/04/09 ; 03/04/10 PREMISES (E. oCC\j,!,nce) $1,000,000
f--- ~ CLAIMS MADE D OCCUR MED EXP (Any aile person} $50,000 n_
, PERSONAL & AOV INJURY $1~000,OOO
. . .- .-
, , GENERAL AGGREGATE $3,000,000
- __0" -
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG 53,000,000
I n PRO. 1----, ---... .----
POlICY JECT i LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANV AUTO (E9 acCident)
- i --. ~'-'
ALL OWNED AUTOS BODilY INJURY
- I $
SCHEDULED AUTOS (per person)
- --
HIRED AUTOS
I- I aODIL Y INJURY S
NON-OWNED AUTOS (Per accidenl)
~ .-.
! - -- PROPERTY DAMAGE $
I (Pe' acadenl)
GARAGE LIABILITY AUTO ONL Y - EA ACCIOENT $
~ ANY AUT~ ---- __0'0
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY , EACH OCCURRENCE S~,OOO,OOO
A c::::l OCCUR ~ CLAIMS MADE , HUS05043302 03/04/09 03/04/10 AGGREGA TE 51,000,000
--_._-~--. .- ._~~- .-. -
R DEDUCTIBLE ___no S
.n
S
RETENTION $ $
WORKERS COMPENSATION AND I TORY LIMITS T IUJ:t
EMPl.OYERS' LIABILITY
ANV PROPRIETORlPARTNERiEXECUTIVE E.L. EACH ACCIDENT $
-
OFFICERIt.IIEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~~Mi"~~v'i~\'5'NS below ..-- ..
E.L. DISEASE. POLICY LIMIT S
OTHER
A Professional HG305188001 03/04/09 03/04/10 Occurence 1,000,000
Liabilitv 1 Aqqreqate 3,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE81 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The Certificate Kolder :Is Named As An Additional Insured On The General
Liability Policy
CANCELLATION
COLLI -1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPlRATIO
DATE THEREOF, THE ISSUING INSURER WILL ENDeAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES,
AUTHORIZED REPRESENTATIVe
CERTIFICATE HOLDER
Co11ier County CCC
Diana De Leon
3301 Tamiami Trail East B1dg G
Naples FL 34112
ACORD 25 (2001108)
Michael Koehne
JUN 29 2009 11:16 FR
TO 12392526597
P.01/01
16 E 1 O.~
A CDRQ.
CERTIFICATE OF LIABILITY INSURANCE
THIS,CERTlFICATE IS ISSUED AS A. MA.TTER OF INFORMATION
ONL Y AND CONFERS NO RIGHTS UPON THE CEA11FICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
(;ER'nI'ICA'rl! NO. I OA fl!
Ai~C~].H"nOl::n ACl7Ei4":'
l;;/;;lf,i;;l009 ;'I i rn:.1:W~1
PRODUCER
R~~npQ~nt ~~.k S.~~~.. LLC
141GO D.11.. Pa~kway #500
Oa11.., TX 15254
(800) 632-5096 (972) 715-0959
:f'ax: (972) 404-44.50
INSURERS AFFORDING COVERAGE
INSURED: .::qL\ity Group Leasing I, It'lC: 1/,~/f:
ALI"A't~ nJii:RE HOMO: HEALTa CARE
31 i NOP-Tll COLLIER !lLVD ~UI'rE 201
MARCO I.%AND, n 3H45
T~39) 3~9-0170 Fax:
INSUR!A A'
INSURER B:
INSURERC:
INSURER 0:
INSURER "',
rc
i',"", (..
{ 11 ;1
THIi PO~IOla OF IN$UAANOE LIStEc IlfiLQW HAVE BEEN ISSUEll TO THE INSURED NAMI!D ABOVE FOR THE POLICY PI!RIOD INDtCATl!D. NOTWITHSTANDING
ANV REQUlRSlt:NT, TERM OR CONlIITION OF ANV CONTRACT OR OTHER DOCI.IUIENT WITH RESPECT TO WHICU THIS OEFlTl~ICATE MAV !IE l~lJ~D 01'1
r.lAY PERTAIN. THE INSUllANCe APfollDED BY TliE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERLIS. EXCLUSIONS AND CONOITIONS OF $l,I(;H
POLICIES. AQCiRI:QATE LIWTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
!~~R TYPE O~ lN$UA""Ce POLICY NUMBER PO ICY E~pI!CYIllE PO';icy. el<PI'UITIO LIMITS
..2fNERAL LIAIlILITV eACH OCCURRENce $
- Or.oMIiiR(;IAL GIiiNI;RAL LIABILITY FIRe CANACle tAllY aM Firel S
- CLAIMS MAOE 0 OOOUR IoM:D EXP (Anyon. o.....nl $
I- PE R50NAL & AD~ INJURY S
I-- GIiiNERALAGGREGATe S
nN1. AGGREGA"~ L1MII APPLieS PEF\: PRODUCTS. COMPIOP A~ $
POLICV n ~~~ n LOC
.!.UTDMOBft.e UABIUTV CDMBINEO SIN<J.LE LlIII:T S
ANY AUTO (Ell ...d""l)
-
- AU OWNl[O AuTOS 8001L Y INJURV
~
- SCHEDULED AUTOS (Per P"'.O'l)
- HIREC AUT06 ~ODILY INURY
"
- NON. OWNED AUTOS {P.~h' ./lC':ClljOlln
PROPIiiRTY DA....GE ~
\pe' aCClden:1
RACE I.IABIUTY AUTO ONLY. EA .ACCIDENT "
ANY AlJl'O OTHER THAN EA"ee S
Ai.-TO aNi. V: A(lCJ $
~CESS LIABILITY EACM OCCURRENCE &
I--- OCCuR D Cl,AlMIj r.olIllE At;GREGATe s
I-- &
I-- OEDuCTIIlU; s
AHE~mON " s
WORKERS COMPENSAnoN AND WC77779990\101 O~/01I?OI)9 04/0"/2010 x IwCl'iTAtU: I IO/,\i'
DlPLOYER9' LIABILITY :1 (){J (J (I 1.1 U
~.L eACH ACCII;ll;NT $
A E.L. DISEASE. e... EMI'LOYEE ~ ,0000(1)
. E.L. OIS~$~ ' PO~ICY ""IT " iOOl/UDO
RHeA LIMITS $
~IMlT$ $
1. rhi~ c~rtifica~e remains in effect, provided the =11~nt'a ~ccount is in ~OOd ~t~ndLnq wIth Equity
Group Leasing I, Inc. Coveruge is not proll r.'~(".l for iin~ employee for wrlicl1 ..l'w <, L~('nt is not report log
waqes to Equitr Grou, LeaSin2 I Inc. .1\~~hQ~ t" 100 of the emplo:r.:c:; of Equit~ Graul? I.,""I.~Lr)~ I,
InCl<.:<I:;cd to A WAYS H!Rt 1'10 E HEALtH r:.A , "'tf...crive 04/01/2009. ~. Prcj"C1; :rn;,O:CJ~()tl('l1:. C '$S.
CERTIFICATE HOLDER I I ADDITIONAl. INSURED: INSUIl~1I UiTTER: CANCELLATION
II,. .,
DATE TMEIll!O~, Ttl10 ISSUING INSURER WlL.L ENDEAVOR TO MAIL 19. DAYS WRITlf.N
COlli~[, Bee NOTICE TO THI! CERTIFICATE HOUlER NAMED TO TH!! LI!FT, BUT FAILURE TO tlO SO Stt"LL
ATTN D~ANA DELEON IMPOjE NO llHU~ATION 01'1 LWlILITV OF ANV 1(1110 UPON THIII\ISURl!lI. /11!; ....ENTIj OR
])01 Tamiami.a 'fr,'1Jl F.~~t REPREj""T.I,T1YES,
Nep1"'G. FL 34.11Z
.l,UTHORI21!D AI!PFlEIlI!NTATIYE .~
- . :,....
ACORD 2S.S (7/97) It> ACORD CORPOR"ATl"ON19S8
/
** TOTAL PAGE.01 **
16EIO
MEMORANDUM
Date:
August 14, 2009
To:
Rhonda Cummings, Purchasing
Contract Specialist
From:
Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re:
Contract #09-5227: "Services for Seniors"
Contractor: Maranatha Home Care, Inc.
d/b/a Premier Home Health Care of Florida
Enclosed is one original contract, referenced above (Agenda Item
#16EIO), approved by the Board of County Commissioners on Tuesday,
June 23, 2009.
The second contract will be kept in the Minutes and Records Department
as part of the Board's permanent records.
If you should have any questions, please contact me at 252-8406.
Thank you.
Enclosure
Date:
tt'V~
'..,:': !3cJ-' ~
~:;U'&:;.;~
wr.A ~~
(:1lt
.\1;, rr
Office of the County Attorney'"Dv-J- 1 ( (\
Jeff Klatzkow rl- P- ~ ':::> ~
Lyn M. Wood, C.P.M., Contract Specialist Jr, llt~ l ) 111
Purchasing Department, Extension 2667 'f.Jf ~ ~ cro 1 ')' ~
Contract: #09-5227 "Services for Seniors" 1 ~ ~ "',
Contractor: Maranatha Home Care, Inc. d/b/a Premier Home /' ~ A
Health Care of Florida ~}~:)/) 'I
16E10
I""J . ......- ... '-c:l ~ - \\ -09
f'\t S\.t.Uf n.' 'no: U W. (-, '0 -d
{,:-:r:::r[j).tVEE TI8ECEIVED:
\,...,; i I -j:""'" '_.'1 I j ;C
'>, \,1 -', !;.-' f
ITEM NO.: 01 ~ w.c~ 0 !;>'7<;
FILE NO.:
DO NOT WRITE ABOVE THIS LINE
ROUTED TO:
REQUEST FOR LEGAL SERVICES
July 24, 2009
To:
From:
Re:
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agenda
Item 16.E.10
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
MEMORANDUM
16EIO
TO: Ray Carter
Risk Management Department
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
J2Y
ft <'--~ 2)->r
DATE: July 24, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Maranatha Home Care, Inc. d/b/a Premier Home
Health Care of Florida
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
RE.G'EJ\JE.D
\lL 111~~f?J
~ ,
'Nr:..GEME~
P.\s\<- MP-.
C: Terri Daniels, Housing & Human Services
mausen_Q
16EIO
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Monday, July 27,200910:04 AM
LynWood
mausen_g; DeLeonDiana; DanielsTerri
Contract 09-5227 " Services for Seniors"
All, I have approved the certificate of insurance provided by Maranatha Home Care, Inc. d/b/a/ Premier Home Health
Care of Florida. The contract will now be forwarded to the County Attorney's Office for their review.
Thank you,
Ray
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
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Florida Profit Corporation
MARANATHA HOME CARE, INC.
Filing Information
Document Number GOl5??
FEI/EIN Number 592329885
Date Filed 11/08/1982
State FL
Status ACTIVE
Last Event CANCEL ADM OISS/REV
Event Date Filed 12/09/2008
Event Effective Date NONE
Principal Address
5440 PARK CENTRAL COURT
SUITE # 2
NAPLES FL 34109 US
Changed 12/09/2008
Mailing Address
360 HAMILTON AVENUE
SUITE 120
WHITE PLAINS NY 10601 US
Changed 12/09/2008
Registered Agent Name & Address
SCHWABE, ARTHUR
5440 PARK CENTRAL COURT
SUITE 2
NAPLES FL 34109 US
Name Changed: 11/06/2006
Address Changed: 12/09/2008
Officer/Director Detail
Name & Address
Title PO
SCHWABE, ARTHUR
360 HAMILTON AVENUE
WHITE PLAINS NY 10601
Title ST
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inCL doc _ number=G07577 &in... 6/2412009
www.sunbiz.org - Department of State
16 E 1 Qge2of2
SCHWABE, PAUL
360 HAMilTON AVENUE
WHITE PLAINS NY 10601
Annual Reports
Report Year Filed Date
2007 04/18/2007
2008 12/09/2008
2009 03/19/2009
Document Images
03/1 ~/2QQ9=.A.NNUAl REPORT
12!Q9/2008=BEINSIAIEMENI
04/18/2007 = ANNUAL REPORT
illQQ/~Q09 -- At'-jl~JL.A.hB~EQRT
02/03/2006 = ANNUAL REPORT
04/15/2005 = ANNUAlBE:PORT
Q5/Q4/2Q04.=.A.ritiUAlBEPORT
04/Q4/2Q03 -- AN N UA1J3E;P~RI
04/22/20Q2=ANNUALBEPORT
09/2g!2QQJ_= ANN VALRE:PORI
Q9/J5/2QQQ=-.A.t-tNUALREPORI
Q311111~99-- ANNUALI3EPQRI
03/23/1998 -- ANNUAlBEPORI
03/14/19JE=,LiNNUAl REPORT
Q1l1811~9Q -- ANNUAl.. REEQRT
04117/1995 -- ANNUAL REPORT
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16EIO
· p!!:n!!/}!!!f/!;7dCl
June 26, 2009
To: Collier County
SIGNATURE AUTHORIZATION LETTER
I, Arthur Schwabe, President and CEO of Maranatha Home Care, Inc. d/b/a
Premier Home Health Care of Florida, authorize Gregory Turchan, Chief
Operating Officer, to sign a Contract on behalf Maranatha Home Care, Inc. d/b/a
Premier Home Health Care of Florida.
~jk :Jkmk
Signed
UrfhlAY SchWtlbp f:!sidf/1fai'd eEl)
Printed Name and Title: I
-7/23/0C}
Date l '
c2f3-~I<d~ / 7-23-cfJ
~ ,'\LlCt; J. LOUSSERO d
ND1Aqy PUBliC SlATE OF NF.WYO~/{
:~'O 0';'/...06043539
"t; QIJALlF,icc.' j ,I~; '!."IL^'-/":"'" cr)' il,r'rv
. . """":. U 'I r",,"l.. \. 'j
O!l1M,ISSiiJN [Xi'IRU; JUi~Eig, 20i,~
360 Hamiiton Avenue, Suite 120, White Plains, New York W601 Phone 914-428-7722 Fax 914428-240L
16E10
PflE/!!!l!:!idtl
June 26, 2009
To: Collier County
SIGNATURE AUTHORIZATION LETTER
I, Arthur Schwabe, President and CEO of Maranatha Home Care, Inc. d/b/a
Premier Home Health Care of Florida, authorize Gregory Turchan, Chief
Operating Officer, to sign a Contract on behalf Maranatha Home Care, Inc. d/b/a
Premier Home Health Care of Florida.
Sig~jhu1 /JJu~
drfhtA.r Schwahe r~/c;IJf,JaV\cI CllJ
Printed Name and Title: I
7/23/01
Date l
360 Hamilton Avenue, SUite 120, White Plains, New York 1()601 Phone 9144281722 Fax 914-42B2404
16E10
tJ/22'!'
RLS# t)c(-Iu-
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: Mltlt.A.tJATI4I1 '/ft'J'Nf..I!AIJ.f. . INt!. d.fp/4. fJP.€'M.lffi.HI')C'C..I{-u'L.TIIC!ARf.. ()F
/ I , FU'/Lrpf#
~Yes No
~Yes No
Entity name correct on contract?
Entity registered with FL Sec. of State?
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &/or Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ I ""-l ....
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ l M.l L.
Workers Compensation
Each accident Required $.5'\4\1. ~'M,1
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $ f OMtL
Aggregate Provided $ t I
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:f{I'~SS ~e.,
~Yes
~Yes
Yes
~Yes
Provided $
Provided $
Provided $
Provided $
Provided $
3t"r..\L
jl
I \M.L L.
tl
re, t1fJO
Provided $ l M.l \
Provided $ . f'tlt', et?o
Provided $ I I'
Provided $ I'
No
No
-LNo
No
Exp. Date
Exp. Date
Exp. Date
Exp. Date
Exp. Date
Z("t.-/ID
,f
< I
..
II
Exp Date :;. f'Z< 110
Exp Date 2.{tP(lD
Exp Date , (
Exp Date I ,
ExpDate ~/z..JID
Exp Date ' J
-0es
Provided $
Provided $
Provided $ IF> M.l L
Required $
-
County required to be named as additional insured?
County named as additional insured?
~Yes
V Yes
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
/Yes
Yes
Performance Bond
Bond requirement referenced in contract?
If attached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary: I.. 'r~ f'F
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
~Yes
V'" Yes
~es
~Yes
A-urlH'A.tM 7/"1V
~Yes
V'" Yes
~Yes
Attachments
Are all required attachments included?
/Yes
No
Exp. Date
Exp. Date _
Exp Date 2/"Z- /I/)
No
No
No
~o
Yes
No
Yes
Yes
?i 'f( J ()~
~~
No
No
No
No ~
Reviewer lnitials:
Date: 'f
04-COA- 030/ 22
16EIO
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Maranatha Home Care Inc. d/b/ a Premier Home Health Care of Florida, authorized to do
business in the State of Florida, whose business address is 5440 Park Central Court, Naples,
Florida 34109-6003, hereinafter called the "Vendor" and Collier County, a political
subdivision of the State of Florida, Collier County, Naples, hereinafter called the "County":
WIT N E SSE T H:
1. COMMENCEMENT. This Agreement shall commence on July 1, 2009 and shall
terminate on June 30, 2012.
2. ST A TEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 and the Vendor1s 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 Purchasing Policy and
Administrative 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 Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice 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".
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.
Page 1 of7
16EIO
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:
Maranatha Home Care, Inc. djbj a Premier Home Health Care of Fla.
5440 Park Central Court
Naples, FL 34109-6003
Attention: Gregory Turchan, COO
Telephone: 239-597-7118
Facsimile: 239-597-7624
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
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, PurchasingjGS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.
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. 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
Page 2 of7
16EIO
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.
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:
~. Commercial General 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 Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
~' 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.
~peciaI Requirements: Collier County Government shall be listed as the
Certificate Holder and included as an Additio~l 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. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Page 3 of7
16EIO
Vendor shall insure that all sub Vendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
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, 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.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing 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 attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
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, 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. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
16EIO
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 US.c. 1324, et seq. and regulations relating thereto, as either
may be amended. 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 upon satisfactory negotiation of price by the Contract Manager and
Vendor.
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.
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.
Page 5 of7
16EIO
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first above
written.
By: ( .
I. "
Datecl:> ".
>/~)_':""'".c.~ ,
;~i.':~>'
~ ';" ;~.~/ ".'
BOARD OF COUNTY COMMISSIONERS
COLLIER COU TY, FLORIDA
~d~
By:
ATTEST:
Dwight E. Brock, Clerk of Courts
Donna Fiala, Chairman
Maranatha Home Care, Inc. d/b/a
Premier Home Health Care of Florida
4 "L ,:,,~ ~.)
~V~$J
Irst WItness
.~ V' kvl2 <:)
tType print witness namet
~~
Second Witness
By:
en~
Gregory Turchan, COO
Typed signature and title
.VPY{-4te Gd~
tTypej print witne s namet
Approved as to form and
le~fficiency:
~f)pj~
-i\s3i~taII~ County Attorney
btfl'l~1
S t4# 12 k~;tL.
Print Name
Item #
~lR8D
Page 6 of7
16EIO
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEE/UNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE* $30.00 per Hour $27.00
Emergency Alert Response System $ 1.11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
* Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
~
PRO
16E
CERTIFICATE OF LIABILITY INSURANCE
OP 10 GR
FREMI-4 07/23/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Miller & Miller Insurance
720 Commerce street
Thornwood NY 10594
Phone: 914-741-6400 Fax:914-741-6407
INSURED
Maranatha Home Care Inc
DBA Fremier Home Health Care
of Florida
5440 Fark Central Court, Ste 2
Naples FL 34108
INSURERS AFFORDING COVERAGE
INSURER A Col umbia Casual ty CO
INSURERB National Continental Ins
INSURER C. Hartford Fire Insurance CO
INSURERD Commerce & Industry Ins Co
162
19410
INSURER E
Allied World Hat' 1 As,Suranr::eCo
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS V
LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYYYY) b2f~crMMIDDIYYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000/
r-- 02/02/09 02/02/10 UAMA\jt:: $ 50 ,000
A X X COMMERCiAl GENERAL LIABILITY HMA2097466454-1 PREMISES lEa occuranca)
I- ::::J CLAIMS MADE o OCCUR
MED EXP (Anyone parson) $ 5,000
r--
A X Frofessional Liab HMA2097466454-1 02/02/09 02/02/10 PERSONAl & mv INJURY $1,000,000
CLAIMS MADE GENERAL AGGREGATE $ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMPIOP AGG $3,000,000
n n PRO- nLOC
POLICY JECT V
AUTOMOBILE LIABILITY $1,000,000 .,/
I- COMBINED SINGLE LIMIT
B ANY AUTO CNYOO070829939 02/02/09 02/02/10 lEa accident)
I-
AlL OWNED AUTOS BODIL Y INJURY
I- (Par parson) $
SCHEDULED AUTOS
l-
X HIRED AUTOS BODIL Y INJURY
I- (Per aCCIdent) $
X NON-OWNED AUTOS
I- 02/02/09 02/02/10
C Fidelity Coverage 16BDDBP3248 PROPERTY DAMAGE
Limit $50,000 (Per aCCl dent) $
GARAGE LIABILITY AUTO ONLY - EAACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONL Y AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $10,000,000
A o OCCUR ~ CLAIMS MADE HMC2097466468-1 02/02/09 02/02/10 AGGREGATE $ 10,000,000
$
H DEDUCTIBLE $
X RETENTION $10,000 .,7 $
WORKERS COMPENSATION . 1_ WC STATU- I IU~~ ./
AND EMPLOYERS' LIABILITY X TORY LIMITS
YIN
D ANY PROPRIETOR/PARTNER/EXECUTIVE 0 WC5317307 02/19/09 02/19/10 E L. EACH ACCIDENT $500,000 ~
OFF ICERAvlEMBER EXCLUDED?
(Mandotory In NH) E.L. DISEASE - EA EMPLOYEE $500,000
If yes. describe under E.L. DISEASE - POLICY LIMIT $500,000
SPEC IAL PROVISIONS below
OTHER
E Excess Liability C008983002 1/ 02/02/09 02/02/10 EachClaim 10,000,000
Aggregate 10,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDO~MENT I SPECIAL PROVISIONS
Collier County Government is named as additional insured AS PER WRITTEN
CONTRACT.*Folicies shown are subject to terms, conditions, exclusions,
sublimits and deductibles not listed on this certificate. We recommend that
requests for policy copies be directed to the Named Insured shown above. *
CERTIFICATE HOLDER
Collier County Government
3301 Tamiami Trail East
ales FL 34112
ACORD 25 (2009/01)
/
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
COLLIE? DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. rrs AGENTS OR
REPRESENTATIVES,
AUTH ED PR SENTATlVE
@1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
I M PORT ANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s). authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2009/01)