Backup Documents 10/08/2019 Item #16E 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 6 r
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County.
Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney
Office no later than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with
the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
//4-21. Risk Risk Management /4/4-
2.
. County Attorney Office County Attorney Office ` J'�9
4. BCC Office Board of County \s /
Commissioners ' ((So '
4. Minutes and Records Clerk of Court's Office
icA4,4 a;3.
5. Procurement Services Procurement Services
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event
one of the addressees above,may need to contact staff for additional4r missing information.
Name of Primary Staff Jessica Suarez/PURCHASING Contact Information 239-252-8407
Contact/ Department
Agenda Date Item was October 8th 2019 17 Agenda Item Number 16.E.4
Approved by the BCC
Type of Document AMENDMENT Number of Original 2
Attached Documents Attached
PO number or account N/A 16-6646 NAPLES
number if document is NAPLES PHYSICIAN
to be recorded PHYSICIAN HOSPITAL
HOSPITAL ORGANIZATION
ORGANIZATION
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column, whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK N/A
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name; Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JS
signed by the Chairman,with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the JS
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JS
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 10/08/2019 and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes, if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the Oe N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the an option for
Chairman's signature. this line.
16E4
MEMORANDUM
Date: October 14, 2019
To: Jessica Suarez, Purchasing Tech
Procurement Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Agreement #16-6646, Amendment No. 1
"Onsite Health Advocacy Coaching Services"
Contractor: Naples Physician Hospital Organization, Inc.
d/b/a Community Health Partners
Attached, is an original copy of the contract referenced above, (Item #16E4)
approved by the Board of County Commissioners on Tuesday, October 8, 2019.
The second original contract has been held in the Minutes and Records Department
for the Board's Official Record.
If you have any questions, please contact me at 252-8406.
Thank you.
Attachment
FIRST AMENDMENT TO AGREEMENT# 16-6646 16 E 4
FOR
ONSITE HEALTH ADVOCACY COACHING SERVICES
dAr
THIS AMENDMENT, made and entered into on this Spembor-2019, by and
between Naples Physician Hospital Organization, Inc. d/b/a Community Health Partners (the
"Contractor") and Collier County, Florida a political subdivision of the State of Florida, (the
"County"):
WHEREAS, on October 11, 2016, (Agenda Item 16.E.12), the County entered into
Agreement# 16-6646 (the"Agreement") with Contractor to provide onsite health advocacy coaching
services to members covered under the Collier County Group Health Plan; and
WHEREAS, the parties desire to restate and amend the Agreement term to coincidence
with pricing provided in the Exhibit B-Fee Schedule for January 1, 2021 — December 31, 2022,
attached to the Agreement.
NOW, THEREFORE, in consideration of the mutual promises and covenants herein
contained, it is agreed by the parties as follows:
Words Struck—Through are deleted; Words Underlined are added
1. AGREEMENT TERM. The Agreement shall be from January 1, 2017 through December 31,
2022 . ., -=, - _ . e. - . : ... . . . ., . ., . - . . _ .
from a or until all outstanding Purchase Orders issued prior to the expiration of the Agreement
period have been completed or terminated.
term prior to the end of the Agreement term then in effect.
The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the
terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The
County Manager, or his designee, shall give the Contractor written notice of the County's intention to
extend the Agreement term prior to the end of the Agreement term then in effect.
* * * * *
Page 1 of 2
Amendment to Agreement# 16-6646
CAS
16E4
IN WITNESS WHEREOF, the parties have executed on the date and year first written
above by an authorized person or agent.
BOARD OF COUNTY COMMISSIONERS
ATTEST ., .. ,, COLLIER COUNTY,FLORIDA
Crystalsi nzel,Comptroller and al...kik Clerkottouirts4. 100I
;A4 4S1Will W iam L. McDaniel, Jr., Chairman
Dated: '' ! •
Att=' ::..,,411a an s_
tignature only.
Naples Physician Hospital Organization, Inc.
d/b/a Community Health Partners
Contractor
O-1Crt. i �c .6_0 By: \ �_
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Page 2 of 2 AY
Amendment to Agreement# 16-6646 ID