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#19-7596 (Arden Courts-Lely Palms of Naples, LLC) GENERAL SERVICE AGREEMENT (NON-SOLICITATION) # 19-7596 for Services for Seniors Program-Additional Services-Respite Facility &Adult Day Care THIS AGREEMENT, made and entered into on this es(�Tit• day of A pi t L 20 by and between Arden Courts-Lely Palms of Naples FL, LLC d/b/a Arden Courts of Lely Palms authorized to do business in the State of Florida, whose business address is 6125 Rattlesnake Hammock Rd, Naples, Florida 34113 (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. AGREEMENT TERM. The Agreement shall be for a three (3 ) year period, commencing ❑■ upon the date of Board approval or[1 on and terminating on three(3 ) year(s) from that date or until all outstanding Purchase Order(s) issued prior to the expiration of the Agreement period have been completed or terminated. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for two (2 ) additional one ( 1 ) year(s) periods. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. COMMENCEMENT OF SERVICES. The Contractor shall commence the work upon issuance of a • Purchase Order n . 3. STATEMENT OF WORK. The Contractor shall provide services/products in accordance with the terms and conditions of this Agreement, ■ Exhibit A — Scope of Services, attached to this Agreement n Exhibit B— Fee Schedule, attached to this Agreement and made an integral part of this Agreement. Services/products acquired through this Agreement have been authorized through the approval of a n Single Source Waiver, ❑ Solc Source Waiver, n Exemption from the Competitive Procc.A, • Other: Collier County Procurement Ordinance No. 2017-08, Section 12, Subsection 1: Reserved Rights Page 1 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) 3.1 This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 3.2 The execution of this Agreement shall not be a commitment to the Contractor to order any minimum or maximum amount. The County shall order items/services as required but makes no guarantee as to the quantity, number, type or distribution of items/services that will be ordered or required by this Agreement. 4. THE AGREEMENT SUM. per County fiscal year, based on units/service -e =- '_' - - - = attached hcrcto and the price methodology as defined in Section 4.1. Payment will be . .--• ' - . ._. • '. -. - • otherwise known as the "Local Government Prompt Payment Act". III The County shall pay the Contractor for the performance of this Agreement based on Exhibit B- Fee Schedule, attached hereto and the price methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the County's Contract Administrative Agent/Project Manager, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". ❑ The County shall pay the Contractor for t - =- -- - - - A 0 ---- . . •- - .. - - . .- . .- --. . e._. ..^ -... -- •.. 4. ..-. -- ...:- - •••': - . . 2:- ^- ..- _ . ' -... �.. A_...-• A .-. • - .' ._ . Prompt Payment Act". 4.1 Price Methodology (as selected below): I .. . -e A • -- • -e e - • - e.- .. e . _ e•-. ; - - - +seized- ISI Time and Materials: The County agrees to pay the contractor for the amount of labor time spent by the contractor's employees and subcontractors to perform the work(number of hours times hourly rate), and for materials and equipment used in the project (cost of Page 2 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) materials plus the contractor's markup). This methodology is generally used in projects in which it is not possible to accurately estimate the size of the project, or when it is expected that the project requirements would most likely change. As a general business practice, these contracts include back-up documentation of costs; invoices would include number of hours worked and billing rate by position (and not company (or subcontractor) timekeeping or payroll records), material or equipment invoices, and other reimbursable documentation for the project. delivered (i.c. installation price per ton, delivery price per package or carton, etc.). The invoice must identify the unit price and the number of units received (no contractor inventory or cost verification). 4.2 Any County agency may obtain services under this Agreement, provided sufficient funds are included in their budget(s). 4.3 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of the Agreement. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. 4-4 ❑ -- - _ - _-- must be approved in advance in writing by the County. Travel expenses shall be reimbursed as per Section 112.061 Fla. Stats. Reimbursements shall be at the following rates: Mileage $0744.5-pe +le 8Fe .,t $6709 L nch $11.00 Dinner $4-91-00 Airfare • . .. •. - -- •--• -_ : . _ • claw fare Rehr Actual rental cost limited to compact or Lock*ng A.. -. .. : •- - - - _ - _....- .. - - Parking Actual cost of parking Taxi or Airport Limousine Actual cost of either taxi or airport limousine items will be paid only after Contractor has provided all receipts. Contractor shall be undertaken pursuant to this Agreement. Page 3 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) 5. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531C. 6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or emailed to the Contractor at the following: Company Name: Arden Courts of Lely Palms Address: 6125 Rattlesnake Hammock Road Naples, Florida 34113 Authorized Agent: Shyrlee R. Stagner, Executive Director Attention Name & Title: Telephone: (239) 417-8511 E-Mail(s): Shyrlee.Stagner@hcr-manorcare.com All Notices from the Contractor to the County shall be deemed duly served if mailed or emailed to the County to: Board of County Commissioners for Collier County, Florida Division Director: Kristi Sonntag Division Name: Community and Human Services Division Address: 3339 Tamiami Trail East Naples, Florida 34112 Administrative Agent/PM: Louise Pelletier Telephone: (239) 252-2696 E-Mail(s): Louise.Pelletier@colliercountyfl.gov The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 8. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor. The County will not be obligated to pay for any permits obtained by Subcontractors. Page 4 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition. the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 9. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever. County facilities for any improper. immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance. rule. order or regulation. or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct. or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct. or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 10. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement. the County may terminate said Agreement for cause: further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be the sole judge of non-performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County. including. but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race. sex color. creed or national origin. 12. INSURANCE. The Contractor shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of $ 1.000,000 Per Occurrence, $2.000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations: Independent Contractors; Products and Completed Operations and Contractual Liability. wusinrcci Auto Le-Milt-: Coverage -trail have minimum limit- of R .I. Coverage �i lug have 11111111 i Ium ..+ of $ Per Occurrence. Combined Single Limit for Bodily injury-Liability and hai2.e 5 of I7 General Service Agreement tion-Solicitation+12017-003(Ver 2) C1\° Property Damage uiuhinlity.. 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. The coverage must include Employers' Liability with a minimum limit of $ 1.000,000 for each accident. D. 11_ Professional Liability/Abuse Liability: Shall be maintained by the Contractor to ensure its legal liability for claims arising out of the performance of professional services under this Agreement. Contractor waives its right of recovery against County as to any claims under this insurance. Such insurance shall have limits of not less than $ 1,000,000 each claim and aggregate. E. [I : Coverage shall have minimum-limits of$ per claim. F. IN! : Coverage shall have minimum limits•o --per claim. Special Requirements Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR. Collier County Government shall be listed as the Certificate Holder and included as an "Additional Insured" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Contractor's policy shall be endorsed accordingly. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County thirty (30) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: thirty (30) days prior written notice. or in accordance with policy provisions. Contractor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors comply with the same insurance requirements that the Contractor is required to meet. 13. INDEMNIFICATION. To the maximum extent permitted by Florida law. the Contractor shall defend, indemnify and hold harmless Collier County, its officers and employees from any and all liabilities. damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees. whether resulting from any claimed breach of this Agreement by Contractor. any statutory or regulatory violations, or from personal injury, General Service Agreenient Non-Solicitation P2017-004(Vcr.2) property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 13 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 14. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Community and Human Services Division 15. CONFLICT OF INTEREST. Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 16. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: n Insurance Certificate(s), ❑■ Exhibit A Scope of Services, ❑� Exhibit B Fee Schedule, n subscquent quotes, and ❑■ Other Exhibit/Attachment: Federal Contract Provisions, Grant Assurances and Certifications . 17. APPLICABILITY. Sections corresponding to any checked box expressly apply to the terms of this Agreement. 18. 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. 19. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the Page 7 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any Agreement held by the individual and/or firm for cause. 20. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(b) as stated as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone: (239) 252-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, Page 8 of 17 General Service Agreement Non-Solicitation#2017-004(Ver 2) the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 21. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful Contractor extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful Contractor. 22. PAYMENTS WITHHELD. The County may decline to approve any Application for Payment, or portions thereof, because of defective or incomplete work, subsequently discovered evidence or subsequent inspections. The County may nullify the whole or any part of any approval for payment previously issued and the County may withhold any payments otherwise due to Contractor under this Agreement or any other Agreement between the County and Contractor, to such extent as may be necessary in the County's opinion to protect it from loss because of: (a) defective Work not remedied; (b) third party claims failed or reasonable evidence indicating probable fling of such claims; (c) failure of Contractor to make payment properly to subcontractors or for labor, materials or equipment; (d) reasonable doubt that the Work can be completed for the unpaid balance of the Contract Amount; (e) reasonable indication that the Work will not be completed within the Contract Time; (f) unsatisfactory prosecution of the Work by the Contractor; or (g) any other material breach of the Contract Documents. If any conditions described above are not remedied or removed, the County may, after three (3) days written notice, rectify the same at Contractor's expense. The County also may offset against any sums due Contractor the amount of any liquidated or unliquidated obligations of Contractor to the County, whether relating to or arising out of this Agreement or any other Agreement between Contractor and the County. 23. ❑ CLEAN UP. Contractor agrees to keep the Project site clean at all times of debris, rubbish and waste materials arising out of the Work. At the completion of the Work, 24. STANDARDS OF CONDUCT: PROJECT MANAGER, SUPERVISOR, EMPLOYEES. The Contractor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Contractor shall supply competent employees who are physically capable of performing their employment duties. The County may require the Contractor to remove an employee it Page 9 of 17 General Service Agreement Non-Solicitation#2017-004(Ver 2) deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment on Collier County projects is not in the best interest of the County. 25. I I WARRANTY, Contractor expressly warrants that the goods, materials and/or - -. e . - - - .._ -. _ --r A _ ...__.. the Contract Documents shall be applied, installed, connected, erected, used, cleaned Documents. lf, within one (1) y ar after final completion, any Work is found to be defective or not in conformance with the Contract Documents, Contractor shall correct it promptly after for replacement or repair of adjacent materials or Work which may be damaged as a result of such replacement or repair. These warranties are in addition to those implied warranties to which the County is entitled as a matter of law. 26. I I _ A ! - - e . • -- - -..-.,.... -:._ - .--. : -, ,. _:.-.0 • . -.._... _ - - • ___...C. requires any portion of the Work to be specifically inspected, tested or approved, and furnish to the County the required certificates of inspection, testing or approval. All 27. n _._ ,A._. _-. ., _ - .. __- _. to replace such loss or damage-shall be deducted from any amounts due to Contractor. B. Contractor shall not load nor permit any part of any structure to be loaded in any Work or adjacent property to stresses or pressures that will endanger it. - -- • -•- - _ _ - -- -- - -- Page 10 of 17 General Service Agreement Non-Solicitation#2017-004(Ver 2) immediately notify the County. The County shall rc establish the benchmarks and 28. SUBMITTALS AND SUBSTITUTIONS. Any substitution of products/materials form specifications shall be approved in writing by the County in advance. 29. CHANGES IN THE WORK. The County shall have the right at any time during the progress of the Work to increase or decrease the Work. Promptly after being notified of a change, Contractor shall submit an estimate of any cost or time increases or savings it foresees as a result of the change. Except in an emergency endangering life or property, or as expressly set forth herein, no addition or changes to the Work shall be made except upon modification of the Purchase Order by the County, and the County shall not be liable to the Contractor for any increased compensation without such modification. No officer, employee or agent of the County is authorized to direct any extra or changed work orally. Any modifications to this Agreement shall be in compliance with the County Procurement Ordinance and Procedures in effect at the time such modifications are authorized. 30. 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. 31. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 32. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 33. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 34. ❑ - .- _:- __ : '_ :- :--_ _ -: -- _: -.._. :this project shall be knowledgeable in their ar as of expertise. The County reserves the Page 11 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) persons will be utilized in the performance of the Agreement. The Contractor shall assign dates. The Contractor shall not change Key Personnel unless the following conditions arc met: (1) Proposed replacements have substantially the same or better qualifications pe+-eel- ■� AGREEMENT STAFFING. The Contractor's personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Contractor shall assign as many people as necessary to complete required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet required services. 35. I 1 - - e • - _ . .— - . -4. . .. . -- - _ - of any of the Contract Documents, the terms of solicitation the Contractor's Proposal, and/or the County's Board approved Executive Summary, the Contract Documents shall take precedence. I-11 ORDER OF PRECEDENCE (Grant Funded). In the event of any conflict between or among the terms of any of the Contract Documents and/or the County's Board approved Executive Summary, the terms of the Agreement shall take precedence over the terms of all other Contract Documents, except the terms of any Supplemental Conditions shall take precedence over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the more strict or costly obligation under the Contract Documents upon the Contractor at County's discretion. 36. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. 37. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to Page 12 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) maintain records on each employee and make them available to the County for at least four(4) years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPS@colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of$500 per incident. 38. ❑ SAFETY. All Contractors and subcontractors performing service for Collier County arc State and County Safety and Occupational Health Standards and any other applicable damage to any persons or property within and around the work site. Collier County Government has authorized the Occupational Safety and Health negotiable by any division/department and/or Contractor. All applicable OSHA inspection criteria apply as well as all Contractor rights, with one exception. Contractors do not have the right to refuse to allow OSHA onto a project that is being performed on Collier County Property. Collier County, as the owner of the property where thc project is taking place shall be thc only entity allowed to refuse accesv to the project. However, this decision shall only be made by Collier County's Risk Management Division Safety Manager and/or Safety Engineer. (Intentionally left blank-signature page to follow) Page 13 of 17 General Service Agreement Non-Solicitation 112017-004(Ver.2) IN WITNESS WHEREOF, the parties hereto, by an authorized person or agent, have executed this Agreement on the date and year first written above. ATTEST: BOARD OF COUNTY COMMISSIONERS ,,Aran COLLIER COUNTY, FLORIDA Cryst y.ineai,;et,rk of Courts & Cb'•�troIIer''y Ott,A1L11.—l _LL e By: 44.41>if._ , Chairman Dated: qq C A ttest as to Chairman's Arden Courts-Lely Palms of Naples FL, LLC Contractor's n Pses7' d/b/a Arden Courts of Lely Palms Contractor __ By: \�` �c � Contractor's Fir t Witness ( 1ature Ne nee_ AA/ Seri(Pi(1/e n-e TType/print signature and title TType/print witness ne1' Contractor's Second Witness TType/print witness namet Approved as to Form and Legality: ,f', CX.a.A.t County al'torne Jenr:i.k. I- G Pe tt i a Print Name Page 14 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) Exhibit A Scope of Services 0 following this page (pages 1 through 2) fI this exhibit is not applicable Page 15 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) EXHIBIT A SCOPE OF SERVICES 19-7596 "Respite Facility & Adult Day Care" Collier County and CHS shall be used interchangeably. Contractor,Provider, and Vendor Agency shall be used interchangeably. The purpose of this award is for the provision of facility respite services and for the provision of adult day care to be delivered to Collier County persons sixty years and older under CCE, OAA and to qualified persons eighteen years or older under ADI. Unless otherwise stated, minimum hours of availability for adult day care are 8:00 am to 5:00 p.m. Monday through Friday,except for federal and state holidays.The hours for Respite Facility services and emergency respite would be available 24 hours/day, 365 days/year. Definitions,standards, and requirements of these services are included in the Department of Elder Affairs' Handbook(DOEA Handbook). The Contractor shall adhere to all requirements of Request for Proposal(RFP)419-7529, in addition to maintaining adherence with the guidelines referenced in the current DOEA Handbook. Lack of knowledge of all requirements of a service listed in the proposal SHALL NOT relieve the Contractor of liability and obligations under the agreement. Collier County Community&Human Services(CHS)division shall lead all service authorization and coordination. To comply with the requirements of the ADI, CCE, and OAA Programs, clients entering the service system will be assessed and prioritized by CHS. Upon determination of the service level to be provided, the CHS will offer the client a listing of service vendors for the specific service(s)outlined within their care plan. Upon the determination of the service, the service levels, and the selected Contractor, CHS will contact the vendor agency,and authorize the service, number of hours, and frequency. In keeping with the state policy of client choice of service providers, Collier County does not guarantee a minimum or maximum number of clients that will be referred,nor a minimum or maximum number of service hours that will be requested during the contract period. CHS shall send the agreed-upon Service Authorization to the chosen provider. These "service authorizations" or "service orders" must contain necessary client information, such as street address, telephone number, and services or items needed, as well as the name and telephone number of the CHS case manager authorizing the service. The County may do so through a competitive and publicly announced selection process,which shall be coordinated through the County's Procurement Division. Services shall be provided in the mariner described in the then current DOEA manual and outlined herein. Services covered by this agreement include, but are not limited to (should funding for additional Senior Services be identified,the County reserves the right to add to the resultant agreements the services, descriptions, rates, etc. by way of a contract addendum): 1. Adult Day Care: A day program of therapeutic social and health activities and day services provided to adults who have functional impairments, in a Florida state licensed, protective environment that provides activities as a non-institutional environment as possible. Provides a safe environment for seniors who need daily supervision and can engage with other seniors. Monday-Friday, 8am-5pm 2. Facility Respite Services: a nursing facility that provides 24-hour care/365 days and is licensed as a State of Florida Licensed Nursing home. The facility will provide 24/7 nursing care and supervision for days authorized by CHS to assist the senior's caregiver with respite services. 3.Establish protocols for contacting CHS Case Managers in emergency or unusual circumstances and include the documentation requirements(oral and written) in the Service Provider Application. Page 1 of 2 4. Provide disaster response protocols, plans and services: In the event of a natural disaster(hurricane,tropical storm,tornado, flood,heat wave,etc.),the provider will have staff available to serve those clients in critical need of services, as designated by the CHS Case Managers. 5. Establish a client grievance process: Each service provider agency must have a policy addressing client grievances and/or complaints. 6. Establish and provide staff training: All services provided with funding from DOEA require service delivery personnel to have general pre-service orientation and training specific to the service being provided. CHS is responsible for provision of the pre-service training on program and billing requirements to the vendors who are awarded the Proposal. Pre-service orientation also must include: • An overview of the aging process • An overview of the aging network • Communication techniques with the elderly • Observation of abuse, neglect, exploitation and incident reporting • Client confidentiality. NOTE:All"hands-on"service personnel must receive training emphasizing the necessity of Universal Precautions. Aides must have documentation of successful completion of 40 hours required training, and CNAs must have on file a copy of their State of Florida certification. In-service training hours and topics are to be provided at the discretion of the service provider agency and shall meet state requirements. 7. Compile and report program service delivery statistics and other data as identified by CHS. These are reported to the Area Agency on Aging and Department of Elder Affairs in accordance with the reporting requirements developed by the Department. CHS is responsible for entry of data in the Client Information and Registration Tracking System (CIRTS), which generates payment to the service provider agency. 8. Maintain complete and accurate records: Service delivery logs,at a minimum,must be legible and contain the name of client,type/s of services and date/s and hour/s of delivery.The client/caregiver must sign the log at the time of each service visit. The service worker must sign and date the log upon completion and submit it to the service provider agency. 9. Provide complete,clear and accurate invoices: Invoices must be submitted monthly by the following the week once the services have been provided and shall include the services provided.The service week is defined as Monday through Sunday. Monthly invoices will include: • Vendor name • Vendor address • Vendor telephone number • Client name • Services authorized and the service dates •Number of service hours, cost per hour and total cost • Person preparing the report and the date it was prepared 10. Prepare for annual on-site compliance audits by CHS Monitoring Unit team as directed by the CHS Division and/or grant requirements. Page 2 of 2 Exhibit B Fee Schedule INfollowing this page (pages 1 through ) ❑ this exhibit is not applicable Page 16 of 17 General Service Agreement Non-Solicitation#2017-004(Ver.2) EXHIBIT B-FEE SCHEDULE #19-7596 "Services for Seniors Program-Additional Services-Respite Facility Services &Adult Day Care ARDEN COURTS- LELY PALMS OF NAPLES FL, LLC Item Services Grant Service Cost Per Service In-Kind 10% Reimbursement Rate Unit Unit(Cost your Service Unit(Cost Per Unit(Amount company charges your company the County will for the service) charges for the reimburse your service) company for a given service) 1 Respite CCE Per Hour $10.417 $1.04 $9.38 (Facility Based) ADI* OAA *The ADI program does not require an in-kind match contribution • Prices shall remain firm for the initial term of this contract. • Adult Day Care and Skilled Nursing services will not be provided under this Agreement. Other Exhibit/Attachment Description: Federal Contract Provisions, Grant Assurances and Certifications Irl following this page (pages 1 through 24 ) this exhibit is not applicable Page 17of17 General Service Agreement Non-Solicitation#2017-004(Ver.2) Collier County Solicitation 19-7598 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS U.S.DEPARTMENT OF HEALTH AND HUMAN SERVICES (ADMINISTRATION ON AGING) AND FLORIDA DEPARTMENT OF ELDER AFFAIRS CFDA 93.0XX(CSFA 65.010) The supplemental conditions contained in this section are intended to cooperate with, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract,the Supplemental Conditions shall govern. Contractor means an entity that receives a contract. The services performed by the awarded Contractor shall be in compliance with the provisions of Title 45 CFR Part 75; and/or, 2 CFR Part 200; and/or Title 45 Chapter XIII Part 1321 and/or other applicable regulations.It shall be the awarded Contractor's responsibility to acquire and utilize the necessary manuals and guidelines that apply to the work required to complete this project. In general, 1)The contractor(including all subcontractors)must insert these contract provisions in each lower tier contracts(e.g. subcontract or sub-agreement); 2)The contractor(or subcontractor)must incorporate the applicable requirements of these contract provisions by reference for work done under any purchase orders, rental agreements and other agreements for supplies or services; 3) The prime contractor is responsible for compliance with these contract provisions by any subcontractor,lower-tier subcontractor or service provider. FEDERAL STATUTORY AUTHORITY Older Americans Act of 1965 (OAA), as amended(42 U.S.0 § 3001 et seq.,as amended by Public Law 114-144; 106-501; Section 20.41) OLDER AMERICANS ACT PROGRAM FUNDS OAA, Title III, Section 307(a)(10) OAA, Title III B -Supportive Services; Title 45 Public Welfare (45 CFR 1321) Chapter XIII Office of Human Development Services,Department of Health and Human Services Part 1321-65 Grants to State and Community Programs on Aging; Part 1321.67 Service Contributions FLORIDA STATUTORY AUTHORITY TITLE XXX(Social Welfare);Chapter 430 (Elder Affairs) CONTRACT COMPLIANCE OVERVIEW Under the Florida Department of Elder Affairs Older Americans Act,the contractor must comply with the contract documentation, conform to state and AAA. policies, and comply with federal and state statutory and regulatory requirements. (Ref - Department of Elder Affairs Programs and Services Handbook, Chapter 4,Page 22;July 2018: Older Americans Act.). The contractor will comply with the intent of Title III to provide for formula grants to State agencies on aging to stimulate the development or enhancement of comprehensive and coordinated community-based systems resulting in a continuum of services to older persons with special emphasis on older individuals with the greatest economic or social need, with particular attention to low-income minority individuals. (Ref-Title 45 CFR 1321) (Ref: Florida Dept.of Elder Affairs'Home and Community-Based Services Handbook) FCk-1/Revised 01-1d-19 10/1/2019 8:03 AM p. 19 Collier County Solicitation 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS U.S.DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL CONTRACT PROVISIONS >$100,000 Administrative, Contractual,or Legal Remedies(Ref.41 U.S.C. 1908,2 CFR§200 Appendix II(A) Unless otherwise provided in this contract, all claims, counter-claims, disputes and other matters in question between the local government and the contractor, arising out of or relating to this contract, or the breach of it, will be decided by arbitration, if the parties mutually agree, or in a Florida court of competent jurisdiction. Access to Records and Reports(Reference; 2 CFR§200.333,2 CFR§200.336) The contractor/vendor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three years after the date of termination or expiration of this contract,except in the event of litigation or settlement of claims arising from the performance of this contract, in which case the Contractor agrees to maintain same until the Purchaser, the Grantor Administrator,the Comptroller General,or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. Furthermore, the County shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement of its Contractors. Byrd Anti-Lobbying Amendment(31 U.S.0 1352)(Reference 2 CFR§ 200 Appendix II(J) Vendors must certify it will not and has not used Federal appropriated funds have been paid or will be paid,by or to any person or organization for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation,renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. The certification includes any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Civil Rights The contractor or a subcontractor who is the recipient of Federal funds(or assumes others with whom it arranges to provide services or benefits in connection with any of its programs and activities or assures others with whom it arranges to provide services or benefits to participants or employees)must comply with Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, or national origin (45 CFR 80), and Statutes and Regulations enforced by the Office of Civil Rights, U.S. Department of Health and Human Services, as follow: • Section 504 of the Rehabilitation Act of 1973, as amended (29 USC § 794), prohibits discrimination against otherwise qualified individuals on the basis of disability in programs and activities receiving financial assistance from 1-IHS 45 CFR. 84 and/or programs or activities conducted by HHS 45 CFR 85 in the provision of benefits and under the ADA that does not: a. Exclude a person with a disability from a program or activity; b. Deny a person with a disability the benefits of a program or activity; c. Afford a person with a disability an opportunity to participate in or benefit from a benefit or service that is not equal to what is afforded others; d. Provide a benefit or service to a person with a disability that is not as effective as what is provided others; e. Provide different or separate benefits or services to a person with a disability unless necessary to provide benefits or services that are as effective as what is provided others;or, f. Apply eligibility criteria that tend to screen out persons with disabilities unless necessary for the provision of the service,program or activity. (Ref; Florida Dept.of Eider.4ffir 'Home and Communffy-Based Services Handbook) FCP-2/Revised 01-14-19 10/1/2019 8'03 AM p.20 Collier County Solicitation 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS Section 508 of the Rehabilitation Act of 1973,as amended,(29 USC § 794(d))prohibits discrimination on the basis of disability in electronic and information technology as they relate to programs and activities conducted by HHS. The Age Discrimination Act of 1975,as amended(42 USC § 6101)prohibits discrimination on the basis of age in programs or activities receiving Federal financial assistance 45 CFR 90;and/or programs or services receiving HHS financial assistance 45 CFR 91; • Title II of the Americans with Disabilities Act(28 CFR Part 35),relating to Nondiscrimination on the Basis of Disability in State and Local Government Services 2010 ADA Standards for Accessible Design; • The Drug Abuse Office and Treatment Act of 1972(P.L.92-255),as amended,relating to nondiscrimination on the basis of drug abuse; • The Comprehensive Alcohol Abuse and Alcoholism Prevention,Treatment and Rehabilitation Act of 1970(P.L.91-616),as amended,relating to nondiscrimination on the basis of alcohol abuse or alcoholism;(g) §523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3),as amended,as relating to confidentiality of alcohol and drug abuse patient records; • Section 1908 of the Public Health Service Act(42 USC§ 300w-7)prohibits discrimination on the basis of age,race,color, national origin,disability,sex(gender),or religion in programs,services,and activities funded by Preventative 1-lealth and Health Services Block Grants. • Federal"health Care Conscience Protection Statutes(42 USC § 300a-7;42 USC § 300a-7;42 USC§ 238n and the Weldon Amendment(Continuing Appropriations Resolution,Pub. L.No. 113-164, Sec. 101(a)(Sept. 19,2015);Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws,which prohibit recipients of certain Federal funds from discriminating against certain health care providers who refuse to participate in certain health care services on religious or moral grounds. • Section 1557 of the Affordable Care Act prohibits discrimination on the basis of disability by entities that operate a health program or activity. • 45 CFR 80.The contractor must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. Clean Air Act and Federal Water Pollution Control Act (Applicable to contracts containing federal funds and over$100,000.) The Contractor shall comply with all applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended(42 United States Code(U.S.C.)7401,et seq.),Section 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations,2 CFR Part 1500_The Contractor shall report any violations of the above to the Agency. Computer Use and Social Media Policy The Florida Department of Elder Affairs has implemented a Social Media Policy, in addition to its Computer Use Policy,which applies to all employees, contracted employees, consultants,OPS and volunteers,including all personnel affiliated with third parties,such as,but not limited to,contractors and subcontractors. Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media. Social Media includes,but is not limited to Wogs,podcasts,discussion forums,Wilds,RSS feeds, video sharing,social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flick" and YouTube. This policy is available on the Department's website at: http://eIderal'fatatc.au$/do ea/financial.ohp Debarment and Suspension (Reference 2 CFR§200 Appendix 11(1) Contract awards that exceed the small purchase threshold and certain other contract awards shall not be made to parties listed on the government wide Excluded Parties List System in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1986 Comp., p. 189) and 12689 (3 CFR Part 1989 Cornp., p. 235), "Debarment and Suspension." The Excluded Parties List System in SAM contains the names of parties debarred,suspended,or otherwise excluded (Ref. .Florida t7ept ofElder Afairs'Home and Cornmenity-Based Services Handbook) FCF-3/1kevised 01-14-19 10/1/2019 8:03 AM p.21 Collier County Solicitation 19-759 EXHIBIT LA FEDERAL CONTRACT PROVISIONS by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The successful bidder, by administering each lower tier subcontract that exceeds $25,000 as a "covered transaction",must verify each lower tier participant of a"covered transaction"under the project is not presently debarred or otherwise disqualified from participation in this federally assisted project.The Contractor shall comply with these provisions before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The Contractor shall complete and sign the Certifications and Assurances Attachment prior to the execution of this contract. Diversity(Reference 2 CFR§200.321) The County is dedicated to fostering the continued development and economic growth of small, minority-, women-, and service-disabled veteran business enterprises. All contracting and subcontracting opportunities afforded by this solicitation/contract are strongly encouraged to contribute as both Contractors and Sub- Contractors. Firms may be required to submit documentation addressing diversity and describing the efforts being made to encourage the participation of small, minority-, women-, and service-disabled veteran business enterprises. Information on Certified Minority Business Enterprises (CMBE) and Certified Service-Disabled Veteran Business Enterprises(CSDVBE)is available from the Office of Supplier Diversity at: ham://dms.mvflorida.com/other programs/office of supplier diversity osdl Energy Policy and Conservation Act- (Reference 2 CFR§ 200 Appendix II(1-1) The contractor shall comply with any mandatory standards and policies relating to energy efficiency which are contained in the Florida state energy conservation plan issued in compliance with the Energy Policy and Conservation Act(Pub. L.94-163, 89 Stat, 871,42 U.S.0 Section 6201) Equal Employment Opportunity(Appendix II,2 CFR Part 200;Executive Order 11246,Equal Employment Opportunity, as amended by Executive Order 11375 and others, and Department of Labor 41 CFR Part 60; Dept. of Health and Human Services 45 CFR Part 80; 45 CFR Part 92,if applicable). The Contractor shall not discriminate against any employee or applicant for employment because of race,age,creed,color,sex or national origin. The Agency will take affirmative action to ensure that applicants are employed,and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action shall include,but not be limited to,the following: Employment upgrading,demotion,or transfer;recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Contractors must insert a similar provision in all subcontracts, except subcontracts for standard commercial supplies or raw materials. E-verify,Presidential Executive Order 12989; Florida Executive Order Number 11-116 Vendors/Contractors/Subcontracts: 1. Agree to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by Contractor during the contract term; and 2. Contractor shall include in related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the state contract utilize the E-verify system to verify employment eligibility of all new employees hired by the Subcontractor during the contract term. HIPAA Privacy Rules,4 CFR Part 160 and Suparts A and E of part 164 The Third Party subrecipient will comply with HIPAA requirements to appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. Immigration and Nationality Act The Contractor shall not employ an unauthorized alien.The Agency will consider the employment of un- authorized aliens a violation of the Immigration and Nationality Act(8 U.S.C. 1324a) and the Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this contract by the Agency. .Florida Deg.of Elder Affairs'Home and Community-.based Services Handbook) FCP-4/Revised 01-14-19 10/112019 8:03 AM p 22 Collier County Solicitation 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS No Government Obligation to Third Parties-The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the non-Federal entity, contractor, or any other party pertaining to any matter resulting from the contract." Nondiscrimination The Contractor will I.not discriminate against any person in the provision of services or benefits under this contract or in employment because of age,race,religion, color, disability,national origin,marital status or sex in compliance with state and federal law and regulations. 2.Assumes others with whom it arranges to provide services or benefits in connection with any of its programs and activities are not discriminating against clients or employees because of age,race, religion,color,disability,national origin, marital status or sex. And 3, Assures others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes,regulations,guidelines, and standards. Pension Protection Act of 2006 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked for failing to comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason,the Contractor must notify the Agency in writing within thirty(30) days of receiving the IRS notice of revocation. Procurement of Recovered Materials(Reference 2 CFR§ 200.322) Contractor and subcontractor agree to comply with Section 6002 of the Solid Waste Disposal Act,as amended by the Resource Conservation and Recovery Act, and the regulatory provisions of 40 CFR Part 247. (1)In the performance of this contract,the Contractor shall make maximum use of products containing recovered materials that are EPA designated items unless the product cannot be acquired (i) Competitively within a timeframe providing for compliance with the contract performance schedule; (ii) Meeting contract performance requirements; or (iii) At a reasonable price. (2) Information about this requirement is available at EPA's Comprehensive Procurement Guidelines web site,_littp://www.epa-gov/. The list of EPA-designate items is available at https//www.epa.gov/smmlcomprehensive-procurement-guideline-cpg-program. Program Fraud and False or Fraudulent Statements of Related Acts The contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements)applies to the contractor's actions pertaining to this contract. Termination for Cause and Convenience See County's Standard Terms and Conditions. Trafficking in Persons The Contractor and subcontractors shall comply with Title 2 CFR Part 175 and 2 CFR§175.15 provisions applicable to a private entity,as defined in 2 CFR 175.25. Transparency Act Unless exempt under 2 CFR§ 170.11 0(b),the Contractor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CPR Part 170. (Ref. .Florida,Dept,ofElder Affairs'Home and Community-Based Services Handbook) FCS'-5/Revised 01-14-19 10/1/2019 8:03 AM p.23 Colllar County Solicitation 19-7596 EXHIBIT LA FEDERAL CONTRACT PROVISIONS STATE CONTRACT PROVISIONS Administrative Procedures Act,Section 120.57(2),F.S. Additional procedures for particular cases. In a matter initiated as a result of agency action proposing to determine the substantial interests of a party, the party's timely petition for hearing may challenge the proposed agency action based on a rule that is an invalid exercise of delegated legislative authority or based on an alleged unadopted rule, Data Integrity and Safeguarding Information, Uniform Electronic Transaction Act, Section 668.50,F.S.; Public Records Law,Chapter 119,Section 29,P.S The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor employees that request system or information access and ensuring that user access has been removed from ail terminated employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities.All data and software shall be routinely backed up to ensure recovery from losses or outages of the computer system. The security over the backed-up data is to be as stringent as the protection required of the primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance for Agreements,Grants,Loans,and Cooperative Agreements prior to the execution of this contract. Discriminatory Vendors List,Section 287.134,F.S. In accordance with Section 287.134, Florida Statutes, an entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity,may not be awarded or perform work as a contractor, supplier,subcontractor, or consultant under a contract with any public entity,and may not transact business with any public entity. Equal Employment Opportunity The Contractor shall not discriminate against any employee or applicant for employment because of race, age, creed, color, sex or national origin. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, age, creed, color, sex, or national origin. Such action shall include, but not be limited to,the following: Employment upgrading, demotion, or transfer;recruitment or recruitment advertising; layoff or termination;rates of pay or other forms of compensation;and selection for training,including apprenticeship.Contractors must insert a similar provision in all subcontracts,except subcontracts for standard commercial supplies or raw materials. Inspections(Meals) The Contractor must agree to notify the Nutrition Provider within 24 hours of any sanitation inspection and provide a copy of the report. Inspector General Cooperation,Section 20.055(5),F.S. The Parties agree to comply with Section 20.055(5),Florida Statutes,for the inspector general to have access to any records, data and other information deemed necessary to carry out his or her duties and incorporate into all subcontracts the obligation to comply with Section 20.055(5),Florida Statutes. Interest of Members of Congress No member of or delegate to the Congress of the United States shall be admitted to any share or part of this contract or to any benefit arising therefrom. (Ref: Florida Dept.of Elder Affairs'Home and Community-sosed Services Handbook) FCP-6/Revised 01-14-19 10/1/2019 8:03 AM p.24 Collier County Solicitation 19-7596 EXHIBIT I.A FEDERAL CONTRACT PROVISIONS Interest of Public Officials No member,officer,or employee of the public body or of a local public body during his tenure or for two years thereafter shall have any interest,direct or indirect,in this contract or the proceeds thereof For purposes of this provision, public body shall include municipalities and other political subdivisions of States; and public corporations,boards,and commissions established under the laws of any State. No member,officer,or employee of the MPO or of a local public body during his tenure or for two years thereafter shall have any interest,direct or indirect,in this contract or the proceeds thereof, Lobbying No funds received pursuant to this Agreement may be expended for lobbying the Legislature,the judicial branch or a state agency. • (Ref: Florida Dept.of Elder Affairs'Home and Community-Based Services Handbook) FCP-7/Revised 01-14-19 10/1/2019 8;03 AM p,25 [X1111311 I.l GRANTC 1.LR I II IC;A"1"IONS ANI..) ASSI_JR.ANCI;S GRANT CERTIFICATIONS AND ASSURANCES THE FOLLOWING DOCUMENTS NEED TO BE RETURNED WITH SOLICITATION DOCUMENTS BY DEADLINE TO BE CONSIDERED RESPONSIVE. Page Certification and Form GCA 2-6 Attachment III-Certifications and Assurances(A-J) A. Debarment and Suspension Certification(29 CFR Part 95 and 45 CFR Part 75) B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93) C. Nondiscrimination&Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 80) D. Certification Regarding Public Entity Crimes, section 287.133. F.S. E. Association of Community Organizations for Reform Now(ACORN)Funding Restrictions Assurances(Pub. L. 111-117) F. Scrutinized Companies Lists and No Boycott of Israel Certification, section 287.135.F.S. G. Certification Regarding Data Integrity Compliance for Contracts,Agreements,Grants,Loans and Cooperative Agreements H. Verification of Employment Status Certification I. Records and Documentation J. Certification Regarding Inspection of Public Records GCA- 7-9 Attachment IV—Assurances Non-Construction Programs GCA- 10-13 Attachment V—Civil Rights Compliance Checklist GCA- 14 Attachment VII—Background Screening Affidavit of Compliance- Employer GCA- 15 Conflict of Interest Certification GCA - 16 Anticipated DBE,M/WBE or VETERAN Participation Statement GCA- 17 Bid Opportunity List for Commodities and Contractual Services and Professional Consultant Services EXB. 1.B GRANT ASSURANCES AND CERTIFICATIONS ATTACHMENT III CERTIFICATIONS AND ASSURANCES Agency will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In performance of this contract, Contractor provides the following certifications and assurances: A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 751 B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 931 C. Nondiscrimination & Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 801 D. Certification Regarding Public Entity Crimes.section 287.133.F.S, E. Association of Community Organizations for Reform Now(ACORN) Funding Restrictions Assurance )Pub. L. 111-1171 F. Scrutinized Companies Lists and No Boycott of Israel Certification.section 287.135.F.S, G. Certification Regarding Data Integrity Compliance for Contracts. Agreements.Grants. Loans.and Cooperative Agreements H. Verification of Employment Status Certification I. Records and Documentation J. Certification Regarding Inspection of Public Records A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS—PRIMARY COVERED TRANSACTION. The undersigned Contractor certifies,to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred,suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a Federal department or agency; 2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements,or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity(Federal, State,or local)with commission of any of the offenses enumerated in paragraph A.2. of this certification;and/or 4. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State,or local)terminated for cause of default. The undersigned shall require that language of this certification be included in the documents for all subcontracts at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients and contractors shall provide this certification accordingly. GCA-2 EXB. 1.B GRANT ASSURANCES AND CERTIFICATIONS B. CERTIFICATION REGARDING LOBBYING—CERTIFICATION FOR CONTRACTS,GRANTS,LOANS, AND COOPERATIVE AGREEMENTS. The undersigned Contractor certifies,to the best of its knowledge and belief,that: No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant, loan, or cooperative agreement. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that language of this certification be included in the documents for all subcontracts at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients and contractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. C. NON- DISCRIMINATION& EQUAL OPPORTUNITY ASSURANCE(29 CFR PART 37 AND 45 CFR PART 80). -As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following laws: 1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability, political affiliation,or belief,and against beneficiaries on the basis of either citizenship/status as a lawfully admitted immigrant authorized to work in the United States or participation in any WIA Title I-financially assisted program or activity. 2. Title VI of the Civil Rights Act of 1964(Pub.L. 88-352),as amended,and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services(45 CFR Part 80),to the end that,in accordance with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. GCA-3 EXB. 1.B GRANT ASSURANCES AND CERTIFICATIONS 4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services(45 CFR Part 91),to the end that,in accordance with the Act and the Regulation,no person in the United States shall,on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Agency. 5. Title IX of the Education Amendments of 1972 (Pub.L. 92-318), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial assistance from the Agency. 6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment practices, including job application procedures, hiring, firing, advancement, compensation, training, and other terms, conditions, and privileges of employment. It applies to recruitment, advertising,tenure, layoff, leave, fringe benefits,and all other employment-related activities. 7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed above. This assurance applies to Contractor's operation of the WIA Title I—financially assisted program or activity,and to all contracts Contractor makes to carry out the WIA Title I—financially assisted program or activity. Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial enforcement of the assurance. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients and contractors shall provide this assurance accordingly. D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES,SECTION 287.133,F.S. Contractor hereby certifies that neither it,nor any person or affiliate of Contractor,has been convicted of a Public Entity Crime as defined in section 287.133,F.S., nor placed on the convicted vendor list. Contractor understands and agrees that it is required to inform Agency immediately upon any change of circumstances regarding this status. E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW(ACORN)FUNDING RESTRICTIONS ASSURANCE(Pub. L. 111-117). As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act,2010,Division E,Section 511 (Pub. L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub.L. 111-117 are available under the conditions provided by Pub.L. 111-117. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers(including subcontracts, sub-grants and contracts under grants,loans and cooperative agreements)and that all sub- recipients and contractors shall provide this assurance accordingly. F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION,SECTION 287.135,F.S. In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized Companies that Boycott Israel List and that it is not participating in a boycott of Israel. GCA-4 EXB. 1.B GRANT ASSURANCES AND CERTIFICATIONS If this Contract is in the amount of$1 million or more, in accordance with the requirements of section 287.135, F.S., Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it does not have business operations in Cuba or Syria. Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in the Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties and attorney fees and costs,including any costs for investigations that led to the finding of false certification. GCA-3 If Contractor is unable to certify any of the statements in this certification,Contractor shall attach an explanation to this Contract. G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,AGREEMENTS, GRANTS,LOANS,AND COOPERATIVE AGREEMENTS 1. The Contractor and any Subcontractors of services under this contract have financial management systems capable of providingcertain information,including: (1)accurate,current,and complete disclosure of the financial results of each grant-funded project or program in accordance with the prescribed reporting requirements; (2)the source and application of funds for all contract supported activities; and(3)the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. 2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor is dependent for data that is to be reported,transmitted,or calculated have been assessed and verified to be capable of processing data accurately, including year-date dependent data. For those systems identified to be non-compliant,Contractors will take immediate action to assure data integrity. 3. If this contract includes the provision of hardware, software,firmware,microcode,or imbedded chip technology, the undersigned warrants that these products are capable of processing year-date dependent data accurately. All versions of these products offered by the Contractor(represented by the undersigned)and purchased by the state will be verified for accuracy and integrity of data prior to transfer. 4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly,the Contractor agrees to immediatelymake required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the state, and without interruption to the ongoing business of the state,time being of the essence. 5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency,including emergencies arising from data integrity compliance issues. H.VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Agency,Contractor certifies the use of the U.S.Department of Homeland Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform employment duties pursuant to this contract,and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this Contract utilize the E-verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract term. GCA-5 Collier County Solicitation 19-7596 BXB. LB GRANT ASSURANCES AND CERTIFICATIONS The Contractor shall require that the language of this certification be included in all sub-agreements, sub-grants,and other agreements/contracts and that all Subcontractors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A-110), I. RECORDS AND DOCUMENTATION The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all contract related records and documentation.The Contractor shall ensure the collection and maintenance of all program related information and documentation on any such system designated by the Agency. Maintenance includes valid exports and backups of all data and systems according to Agency standards. J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS 1. In addition to the requirements of sections 10.1 and 10,2 of the Standard Contract, sections 119.0701(3)and(4) F.S., and any other applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the Agency and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to Chapter 119,F.S., concerning this contract or services performed thereunder. a. Notwithstanding section 119.0701, F.S.,or other Florida law,this section is not applicable to contracts executed between the Agency and state agencies or subdivisions defined in section 768.28(2),F.S. 2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions for any person, corporation, foundation,trust,association, group, or other organization, all the financial, business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest Florida,Inc.)are public records. Section 119.07,F.S,states that every person who has custody of such a public record shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances. Additionally,I certify this organization does does not provide for institutional memberships. Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are available for inspection if applicable,as stated above. By execution of this contract, Contractor must include these provisions (A-J)in all related subcontract agreements(if applicable). By signing below,Contractor certifies that the representations outlined in parts A through J above are true and correct. 4 �, _� (7 'awr �z��D "CSS�C 1..��}1C j 1�°t�/1 tll/lrtiG�- tab gni, re .Zall ti ks • thorned Representative "greet Address (13 L,Aaa-s viNS r. cam, L i(5 Contractor 1 Date City, State,Lip code GCA-6 10/1/2019 9;03 AM p.31 EXHIBIT 1.B GRANT CERTIFICATIONS AND ASSURANCES ATTACHMENT IV ASSURANCES--NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average forty-five(45)minutes per response,including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project(0348-0043), Washington,DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program.If you have questions please contact the awarding agency.Further,certain federal awarding agencies may require applicants to certify to additional assurances. If such is the case,you will be notified. 1. Has the legal authority to apply for federal assistance,and the institutional,managerial and financial capability (including funds sufficient to pay the non-federal share of project cost)to ensure proper planning,management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate,the state,through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest,or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970(42 U.S.C. §4728-4763)relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration(5 C.F.R. 900, Subpart F). 6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a)Title VI of the Civil Rights Act of 1964(P.L. 88-352)which prohibits discrimination on the basis of race,color or national origin; (b)Title IX of the Education Amendments of 1972, as amended(20 U.S.C. §1681-1683, and 1685-1686),which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973,as amended(29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e)the Drug Abuse Office and Treatment Act of 1972(P.L. 92-255),as amended,relating to nondiscrimination on the basis of drug abuse;(f)the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism;(g) §523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s)which may apply to the application. GCA-7 EXHIBIT 1.B GRANT CERTIFICATIONS AND ASSURANCES 7. Will comply, or has already complied,with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of federal participation in purchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §1501-1508 and 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with federal funds. 9. Will comply,as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C. §276a to 276a-7),the Copeland Act (40 U.S.C. 276c and 18 U.S.C. §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §327-333), regarding labor standards for federally assisted construction sub-contracts. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973,as amended,(P.L.93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974(16 U.S.C. §469a-1 et seq.). 14. Will comply with P.L.93-348 regarding the protection of human subjects involved in research,development,and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research,teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. §4801 et seq.),which prohibits the use of lead-based paint in construction or rehabilitation of residence structures. GCA-8 Collier County Solicitation 10-7596 EXHIBIT LB GRANT CERTIFICATIONS AND ASSURANCES 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and 2 CFR Part 200. 18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this program. ,GN It- : `- ROWED CERTIFYING OFFICIAL, TITLE APPLICA T ORGANIZATION DATE SUBMITTED ,tom. + , 176 ..-1R—VA GCA-9 1011/2019 8:03 AM P.34 Collier County Solicitation 19-7596 STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST Program/Facility Name: County: AAA/Contractor Address: Com Ieted$y: -_ of Q 5 L ,t),State,Zip Code: 3 Date--t-8.—v1 Telephone: 7 J t PART I:READ HE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFOR'1ATION WHICH WILL HELP YOU COMPLETE THIS FORM. 1. Briefly describe the geographic area served by the program/facility arid the type of service provided: For questions 2-5,please indicate the following: Total# White Black Hispanic Other Female Disabled Over A 2,Population of area served Source of data 3.Staff currently employed Source of data 4.Clients currently enrolled/registered Source of data 5.Advisory/Governing Board if applicable Source of data PART II: USE A SEPARATE SHEET OF PAPER FOIL ANY EXPLANATIONS REQUIRING MORE SPACE. 1. Is an Assurance of Compliance on file with DOEA? N/A YU NO Voll 2. Compare the staff composition to the population. Is staff representative of the population? N/A yE) NO 0 Ns El 3. Are eligibility requirements for services applied to clients and applicants without regard to race,color, national origin,sex, age,religion or disability? N/A Y NO 4. Are all benefits,services and facilities available to applicants and participants in an equally effective manner regardless of race,sex,color,age,national origin,religion or disability? N/A X S NO ❑ ❑ 5. For inpatient services,are room assignments made without regard to race,color,national origin or disability? N/A XE5 NO 114, 6. Is the program/facility accessible to non-English speaking clients? N/A YE,S NO ❑ ❑ 7. Are employees, applicants and participants informed of their protection against discrimination? If YES, how? Verbal i1;1 Written Q1 Poster❑ N/A XrS NO ❑ i n 8. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. NUMBER 1 10/1/2019 8:03 AM p.35 Collier County Solicitation 19-7506 9. Is the program/facility physically accessible to mobility,hearing, and sight-impaired individuals? N/A . XE,S NO ❑ ❑ PART Irr:THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO EXPLAIN 10. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any necessary modifications? YES NO 11. Is there an established grievance procedure that incorporates due process in the resolution of complaints? YE NO 12. I-las a person been designated to coordinate Section 504 compliance activities? YES NO 13, Do recruitment and notification materials advise applicants,employees and participants of nondiscrimination on the basis of disability? YIE4S NO 14, Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired individuals? YES NO PART IV:FOR.PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF S50,000.00 OR MORE. 15. Do you have a written affirmative action plan? If NO,explain. `R NO DOER LtSF.ONLY Reviewed By In Compliance: YES ❑ NO* Q Program Office *Notice of Corrective Action Sent / / Date Telephone Response Due /_/_ On-Site ❑ Desk Review ❑ Response Received / / Revised August 2010,Page 2 of 2 GCA 11 2 10/1/2019 8:03 AM p.38 INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST 1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a specific target population such as adolescents, describe the target population. Also, define the type of service provided. 2. Enter the percent of the population served by race and sex. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.) 3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of your summary. 4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their percent by race,sex and disability. Include the date that enrollment was counted. 5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory or governing board, leave this section blank. 6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the contract language for DOEA recipients and their sub-grantees,45 CFR 80.4(a). 7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the population is Hispanic,is there a comparable percentage of Hispanic staff? 8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability in the population, the program/facility has the responsibility to determine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled persons,45 CFR 80.3 (b)(6). 9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on-site record analysis of persons who applied but were denied services or employment,45 CFR 80.3 (a)and 45 CFR 80.1 (b)(2). 10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services, physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting rooms,reception areas,restrooms and other facilities must also be equally available to all clients,45 CFR 80.3 (b). 11. For in-patient services,residents must be assigned to rooms,wards,etc.,without regard to race,color,national origin or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a different race,color,national origin,or disability,45 CFR 80.3 (a). 12. The program/facility and all services must be accessible to participants and applicants, including those persons who may not speak English. In geographic areas where a significant population of non-English speaking people live, program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the provision of services,45 CFR 80.3 (a). GCA- 12 3 13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their participants, beneficiaries or any other interested parties. This should include information on their right to file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S.Department of HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in a public area of the facility,45 CFR 80.6(d). 14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement, termination,etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found,failure to conciliate,failure to cooperate,under review,etc. 15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities,water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals. 16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self- evaluation to identify any accessibility barriers. Self-evaluation is a four step process: a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. b. Modify policies and practices that do not meet Section 504 requirements. c. Take remedial steps to eliminate any discrimination that has been identified. d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.),45 CFR 84.6. 17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7(b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material,notices for hearings,newspaper ads, and other appropriate written communication,45 CFR 84.8(a). 20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services,45 CFR 84.52(d). 21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and maintain a written affirmative action compliance program in accordance with Executive Order 11246,41 CFR 60 and Title VI of the Civil Rights Act of 1964,as amended. DOEA Form 10I-B,Revised August 2010 GCA-13 4 Collier County Solicitation 19-7596 PIT*POW 1 BACKGROUND SCREENING. ELDER AFFAIRS Affidavit of Compliance - Employer i spa:�,�r��rxsts AUTHORITY: This form is required annually of all employers to comply with the attestation requirements set forth in section 435.05(3), Florida Statutes. The term "employer" means any person or entity required by law to conduct background screening, including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability Resource Centers, Lead Agencies, Long-Term Care Ombudsman Program, Serving Health Insurance Needs of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires employees or has volunteers in service who meet the definition of a direct service provider. See §§ 435.02,430.0402,Fla.Stat, ➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services to the client and has access to the client's living area, funds, personal property, or personal identification information as defined in s. 817.568. The term Includes coordinators, managers, and supervisors of residential facilities;and volunteers." §430,0402(1)(b), Fla.Stat. ATTESTATION: -1-0 a v— ib: As the duly authorized representative of tit Employer1 ame located at1-\75OA71-11T 1�1\ktivL c 1V4U , ' Street Address City State ZIPcode I, L bJl iZ do hereby affirm under penalty of perjury ame of Representative that the above named employer is in compliance with the provisions of Chapter 435 and section 4 30.0402,Florida Statutes, regarding level 2 background screening. Signatu —.Nor sen'ative Date STATE OF FLORIDA,COUNTY OF CAM(' Sworn to (or affirmed) and subscribed before me this -�S7 day of OC,- J2e , 20 /9 , by \.-ee. S-4-a9 (Name of Representative)who is personally known to me or produced t 10Y\(lCl Qx\\WY L en5-t as proof of identification. a/4C Print,T i re CrTgu� 4 tory bile Notary Public Expires 05/70/2022 DOEA Form 235,Affidavit of Compliance-Employer,Effective April 2012 Section 435.05(3),F,S, Form available at:http;//elderaffeirs,state.fl,usJenelish/backgroundscreenine.php 10/1/2019 8J:13 AM p.39 Collier County Solicitation 19-759E J.XlIIBIT l.0 GRANT CERTIFICATIONS AND ASSURANCES sCOZLLER COUhIT lr • Conflict of Interest. Certification _L9 9 Collier County Solicitation No. I, • �— t • k An , hereby certify that to the best of my knowledge, neither I or my spouse, .ependenchild, general partner, or any organization for which I am serving as an officer, director, trustee, general partner or employee, or any person or organization with whom I am negotiating or have an arrangement concerning prospective employment has a financial interest in this matter. I further certify to the best of my knowledge that this matter will not affect the financial interests of any member of my household. Also, to the best of my knowledge, no member of my household; no relative with whom I have a close relationship; no one with whom my spouse, parent or dependent child has or seeks employment; and no organization with which 1 am seeking a business relationship nor which 1 now serve actively or have served within the last year are parties or represent a party to the matter. I also acknowledge my responsibility to disclose the acquisition of any financial or personal interest as described above that would be affected by the matter, and to disclose any interest 1, or anyone noted above, has in any person or organization that does become involved in, or is affected at a later date by, the conduct of this mat er. _NA • - 'gm, +�L Signat e Position Date Privacy Act Statement Title I of the Ethics in Government Act of 1978 (5 U.S.C. App.),Executive Order 12674 and 5 CFR Part 2634, Subpart I require the reporting of this information. The primary use of the information on this form is for review by officials of The Justice Department to determine compliance with applicable federal conflict of interest laws and regulations. Additional disclosures of the information on this report may be made: (1) to a federal, state or local law enforcement agency if the Justice Department becomes aware of a violation or potential violation of law or regulations; (2) to a court or party in a court or federal administrative proceeding if the government is a party or in order to comply with a judge-issued subpoena; (3) to a source when necessary to obtain information relevant to a conflict of interest investigation or decision; (4) to the National Archives and Records Administration or the General Services Administration in records management inspections; (5)to the Office of Management and Budget during legislative coordination on private relief legislation; and(6) in response to a request for discovery or for the appearance of a witness in a judicial or administrative proceeding, if the information is relevant to the subject matter. This confidential certification will not be disclosed to any requesting person unless authorized by law. See also the OGE/GOVT-2 executive branch-wide Privacy Act system of records. GCA T 15 • • 10/1/2019 8:03 AM p.40 Collier County Solicitation 19-759@ E.XIHI.BIT]..8 GRANT CERTIFICATIONS AND ASSURANCES • COWER COUNTY ANTICIPATED DISADVANTAGED,MINORITY,WOMEN OR VETERAN PARTICIPATION STATEMENT state,will be rarified. Unvfable statuses wdl require the PRIME to I:Thei prelude a revised starternent or prv:ide swim documentation that validates a skaanls. • µ#•• 5 !�•t • ! Y � fba. � -. 0 �a ii45.4P Wtn�A CONTRACTDOLLAR AMO UNT 4 a 3 .� : SIC — 07�I' � ` L It 225160 S THE FaM4E A.FtORIRA.CERTIFIED DESAPV• Acta, ETERAN Y IS 7tt£itCY]VITY 0E1115 CONTRACT._ MIHORTYVOJI WOMEN BUSINESS ENTERPRISE? (C?$F.,It41Jj�ylLYBEI OR NAVE JI +Intl.DIS,ADVANTAC€D OBE? Y t0/ CCJNSLRVCTIDN3 Y N` BM USACERT/FICI-MN PROM TNES ALLBWSINESS Meg? V .v CONSULTATION? Y TG AOMIN(FCRAEOtf? A SERIACE DISARM,VETERAN. WEE? Y �r�}1' OTa•6.ER? Y tq SOS BAR Y 15TEM 5&IeMISJION.ARD/I5mM_ Y N IFYES,REVISION NUMSE- . hM � r ° � knoya y.S C p�l_"+,a GAN'g"��,,,�fj?A: ,�Sa�^� a+`m f r C" r w � �. 4t14'. 11 .A. M � ,, 'S A' G a..., 'og 7'r 1�V. �� ' "ft at _ '.r l� :<Yili;rn �7 ': .fit)-•147. :e'rW� D8£ M/WBE SVBCOIQTAArCTOR OR SEPTUM TYPE OF WORK OR Mr/rimy CO.r* sunfse PPLIER PERCENT OF CONTRACT VETERAN MAmE SPECIALTY 1Sree.fielowry DOLLAR iThrouArT Q(IEEARS TOTALS: � • '4' e5, frAAN'UI 1405 e: w"' n� 'w.. !.3i '..d,R7.v T"" Wim' 'y^4 . yJ T jr NAME OF sueMIT•iER OATE TITLE OFF SUHMETTER MAIL ADDRESS OR [ PPRIM�E tS1JEMMITTTERI 2_39 TBUFJPt OPIE NUMBER �'/] ��Jry(`/`�/( c+'{FAX/NUMBfE$ 1 •s1.11 `-''2Fo•FE:r h i i ` a kpcypacedDsearMetpartidpationin€rderally-fundedcantract. The anticipated DEEct MBE amount is.Vtllxrelary and oil I not become part of the contactual terms.'ahs5ortn must be submitted it time of response to a SCMCitation,.tf andWheat a yarded e county amatract.the prime twill be asked to update the irifumaation for thR.EFj*won 0am-a ides. w tux>.. .r c:':::•.'-.. fi ru^ wt^'•µ tAS 5;i.:wZ= aE. Hispanic Ameticon HA tIr Subeant.Asia",American SAA Pion-Minor WOrnenn ►BMW 17 + d si . :. py:lY-YfG?- ' -x 74.741 6,7':. � 5 DEPARTMENT CUNT ... COWER CONTRACT 11 #VAlr-or PO]REQP GRANT'.PFIOC'AAtaAfCONTRACr.. ACCEPTED BY: DATR: GCA-16 P 41 10/1/2019 8:03 AM Collier County Solicitation 19-7596 1.;X.I[.IBIT LB GRANT CERTIFICATIONS AND A.SSURANC. .S COLLIER C/70.01(11f ka 4COMPLFw.NCEPORN: rat)OPPORTUNITY LIST FOR GoMMoOrES MVO CONTRACTUAL SEMMES AND PROFESSIONAL CONSULTANT SERVICES tt is She pclicle of causer County&of 4411 car usinesres nod rninorraly.+erndors,owned in Imide cf Fadtnsd Iaegnkat*las(C931 et of 47$6ratcs�F§i mast have Thu anwvraurs as me on conVnetraarth federat endialst'arr gmrR 4x8imrnce. Prime Cord ractor/PrI rne consultant: Lxi .� _ addrnnandphoneNumbar '7—S Q V =s ] i Nfh..e1-,---S -P.._--s 4 1L3 Procurement flurnherfAduernteernentNumber 19 .--r-PH p The ii t below is intended to be a Iistogoffuns that are,or attempting to,participate Dole propact numbered aba.ta.The hst must ani the Earn bid* or wanting ar prime,as well a6 subs and s>uppiers gondol/for pa pation,. Prime uIM actocs and convufants mast prOlide.adinvmatlorr for llurirbrors 2,2,3,and a;and,l.nriald provide any Won:otion they have for Numbers 5,5.7,and a.This form roust be asr hoiittra i avid...die bed package. ~ 7 1_Federal raw ID Numbs: �1-l L I I CO g,'t1i'�-� tide 17. M aril GreM rownipts 2. Pion Name. s r !. • "rL>! c ,ctt.y.tl rieu-DBE tis than 5 1 minion a.Piss amtaer: // � Il— g 1 ( Jam-- „nommen S2-5 nation Y-,i C O_ilYiiae—fv — between S 5-10 million ( C. .12.-c) 7_ —Befallen majors 510-25 majors1 1„- L ..{l L3 AtbcOleuWtars 'ti J FFare tben:5 15 miRian 5.Year Mon Established 1 Cl. 1 .Z - 1 2.Federal Tarr ISD Member_ Q El ... D®e 8. Annual Gross Receipts 2_Fern Nara,: P6ert-O SE Less Than$1 nano 3,V larvae mintier; ttebareen 51-1.Pei Pian d Address 'Between$5-10 Pnirkm 7_ Sraanaitractor Between S 2038 million 5obcnatsul art More than 515 million S.Year Firm Established: 1_Federal Tac i NuMber. .5.Ei DISE a, Annual. 'Cir Sbece ptc 2. Arm Name: Nara-D8R Less than S 1 mn>3Son 3.Phone Number Between S 2-3;Woo 4_Address Between$5-10 mitlior, 7_Eisubcontractor Between$10-2.s.million subconsultaatt Moretti=515 m61ipn 5.Year HMI Established; 1.Federai Tax tO Number — 6_[J OBE a.Annual Gross Receipts .. 2.firm Name: Non-D8e cess dtan'S S carrion Phone Dt arr br5" Between 52-5 rrr lige Address ersureen$.x10 carillon A. 7_a Siibmistractor aiiween 510-15.Mallon Suhcomtdtanr Mone than s asmation 5_.year Firm established: GCA-17 p 42 10/1/2019 8:03 AM ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 3/4/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Hylant Group Inc-Toledo PHONE FAX 811 Madison Ave LA/c.No,Ext1:419-254-5442 (A/C,No):419-254-5133 _ Toledo OH 43604 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Insurance Co of the State of PA 19429 INSURED MANOR-1 HCR ManorCare, Inc. INSURER 6: and its subsidiaries INSURERC: P.O. Box 10086 INSURER D: Toledo OH 43699-0086 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:569773714 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE NW SD VD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE J OCCUR PRS c ED PREMISES((Eaa occurrence) ence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ I OTHER: $ A AUTOMOBILE LIABILITY CA2991921 6/1/2019 6/1/2020 COMBINED SINGLE LIMIT $1,000,000 A CA2991922 6/1/2019 6/1/2020 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N .STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A — (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A HIRED CAR PHYSICAL CA2991921 6/1/2019 6/1/2020 $500 Ded.Comp. A DAMAGE-$50,000 CA2991922 6/1/2019 6/1/2020 $1,000 Ded.Coll. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Hired Car Physical Damage applies to autos leased for a period not to exceed 30 days. Additional Insured/Loss Payee applies to all lessors. RE: Arden Courts of Lely Palms#449;6125 Rattlesnake Hammock Road;Naples,FL 34113 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Collier County Board of County Commissioners 3327 Tamiami Trail East Naples FL 34112-4901 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ,4coRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) L....,----' 9/20/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT AIG Captive Management PHONE FAX 30 Main Street, Suite 330 (A/c.No.Ext):419-255-1020 (A/C,No):419-259-6001 Burlington VT 05401-1687 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:ProMedica Indemnity Corp INSURED HCRMANO-04 INSURER B: ProMedica Health System Inc. HCR ManorCare, Inc. and its subsidiaries INSURERC: Mail Stop Code: MSC-S29932 INSURER o: 100 Madison Ave INSURERE: Toledo OH 43604 INSURER F: COVERAGES CERTIFICATE NUMBER:1935012917 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR .JNSD WVD POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y HCR00119 10/1/2019 10/1/2020 EACH OCCURRENCE $1,000,000 DAMAGE RENTE CLAIMS-MADE I J OCCUR PREM SESO(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $3,000,000 POLICY PRO L LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY - (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVENIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Healthcare Professional Liability HCR00119 10/1/2019 10/1/2020 Each Claim 1,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage extends to operations conducted on behalf of the Named Insured at ALL locations.Employees&Volunteers are included as Additional Insureds while acting on the behalf of the Insured.Medical Directors&Hospice Team Physicians,while acting in the capacity as a Medical Director,are included as Insureds as required by written contract. Collier County Board of County Commissioners are included as Additional Insureds,but only as required by written contract. RE: Arden Courts of Lely Palms#449;6125 Rattlesnake Hammock Road;Naples,FL 34133 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Collier County Board of County Commissioners 3327 Tamiami Trail East Naples FL 34112-4901 AUTHORIZED REPRESENTATIVE ei4rd,,,,,...,(27 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A 0CERTIFICATE OF LIABILITY INSURANCE DATE{SiAMiODfYYYT1 5r1r2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE- HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OP INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement s. PRODUCER N.,£: , Hylant Group Inc-Toledo Pio" ;419-254-5442 IA,c,Nol:419-2545133 811 Madison Avenue sanit. Toledo OH 43604 Aopass: INSURERS)AFFORDING COVERAGE NAIC N • INSURER A:Safe National Casua Cor. 15105 INSURED HCRMANOA4 INSURER 6: —" ProMedlca Health System, Inc. &HCR ManorCare, Inc INSURER c: Attn: Heather Allred INSURER D Mall Stop Code:MSC-S29932 100 Madison Ave. Toledo OH 43604 INSURER E: INSURER COVERAGES CERTIFICATE NUMBER:647848530 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. WHICH THIS CERTIFICATENMAYM BE ISSUED OR MAY PTHSTDING ANY ERTAIN, THE INSURANCE AFFORDEDUIREMENT,TERM OR CONDITION BY THE POLANY LIIC ECTS DER OSCRIBED HEREIN IS SUBJECT TO ALLTHER DOCUMENT WITH RESPECT THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I SR •r•L'r•- Pot Y EFF PO EXP LIMITS LTR TYPE OP INSURANCE • INSD ►r POLICY NUMBER ,IHIDO a �Or u I-COMMERCIAL GENERAL LIAB1LITY EACH OCCURRENCE CLAIMSNADE I OCCUR PR 1 ES a Occu �ce $ MED EXP(Any one pera._ # PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEM-AGGREGATE LIMIT APPLIES PER POLICY L.J 28iLi LOC PRODUCTS-COMP/OP AGO S — $ . OTHER: rMBI� D51N ELI0.�1 $ AUTOMOBILE LIABIUTY (En eECldantl BODILY INJURY(Per person) i ANY AUTO '—'-. OWNED SCHEDULES BODILY INJURY per ecEIC¢MI S AUTOS ONLY _AUTOS PR TY DAMAGE $ HIRED NONAVtNED AUTOS ONLY AUTOS ONLY {Per tide i if--`J EACH OCCURRENCE 5 UM@R>=L1J1L1AB _OCCUR EXCESS UAE ,CLAIMS-MADE AGGREGATE i i DEO, RETENTIONS ftft A WORKERS COMPENSATION SP4058002 1/1/2018 1)1/2021 X sTR'rUTE • OT - AND EMPLOYERS'LIABILITY YIN EL.EACH ACCIDENT i 2,OOB4O00 ANYPROPR1ETORIPARTNERIEXECUTIVE NIA OFFICER/MEMBERENCLUDe09 E.L.DISEASE-EA EMPLOYEE S 2,000,000 (Mandatory In NH) R yyes dascAbe Vit der EL,DISEASE-POLICY LIMIT i 2,000,000 DESL�RIPTION OF OPERATIONS below --- • DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addltienal Remarks Schedule,may be attached If more ewe Is required) Florida Excess Self-Insured Statutory Workers'Compensation and Employers Liability limits apply excess of a$1,000,000 Self-Insured Retention. Named Insureds per attached schedule RE' Arden Courts of Lely Palms#449:6125 Rattlesnake Hammock Road;Naples,FL 34113 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Collier County Board of County Commissioners 3327 Tamiami Trail East AUTHORIZLO REPRESENTATIVE Naples FL 34112-4901 -I �i/+�Y`(J-� J • ©'— 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD