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#18-7470 (Summit Home Respiratory Services, Inc.) SECOND AMENDMENT TO AGREEMENT#18-7470 FOR SERVICES FOR SENIORS THIS SECOND AMENDMENT, made and entered into on this 7 day of Mai/ 2025, by and between Summit Home Respiratory Services, Inc. d/b/a Summit Home Healthcare Products (the "Contractor")and Collier County, a political subdivision of the State of Florida, (the "County" or"Owner"): WHEREAS, on December 11, 2018 (Agenda Item 16.D.13), the County entered into an Agreement with the Contractor to provide comprehensive in-home and out of home services to the elderly in Collier County with an annual estimated cost of$550,000; and WHEREAS, on July 19, 2019, the County administratively approved the First Amendment to the Agreement amending Exhibit B-Fee Schedule with Exhibit B-1 Products List and added additional grant pass through documents to be included in the Agreement as required by the grantor agency, Area Agency on Aging of Southwest Florida; and WHEREAS, the Parties have exhausted all renewals, and the term of the Agreement is operating under an administrative extension and currently set to expire on June 9,2025; and WHEREAS,the Parties desire to extend the term of the Agreement for one additional year to provide continued services while the County is soliciting a new contract. NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the Parties as follows: 1. The above recitals are hereby incorporated into this Second Amendment as if fully set forth herein. 2. Upon execution of this Second Amendment,the term of the Agreement shall be extended for one year,through and including June 9, 2026,unless terminated earlier as authorized under the terms of tlhe Agreement. 3. All fees will remain the same during the extension period. 4. Except as amended herein,all other terms and conditions of the Agreement,which is incorporated herein by reference, shall remain unchanged. (SIGNATURE PAGE TO FOLLOW) Page 1 of 2 SECOND AMENDMENT TO AGREEMENT# 18-7470 Summit Home Respiratory Services,Inc.d/b/a Summit Home Healthcare Products IN WITNESS WHEREOF,the Parties hereto, have each,respectively,by an authorized person or agent,have executed this Second Amendment on the date and year first written above. ATTEST: Crystal K. Kinzel, Clerk of the Circuit BOARD OF COUNTY COMMISSIONERS Court and Comptroller COLLIER COUNTY, FLORIDA By: Attest as to Chairman's u L. Saunders, airman Dated:, �,' i3 S�)bb signature only (SEAfr Contractor's Witnesses: CONTRACTOR: Summit Home Respiratory Services, Inc. /419/ d/b/a Summit Home Healthcare Products F rst Witness By: e4MOng ".—? ,b4111 Si re TType/print witness nameT ---Artie ) PREyr,e,Ji ACED TType/print signature and titleT Second Witness 4/A5/202i-- y Date TType/print witness nameT proved a tt F an Legality: Scott R. Teach Deputy County Attorney Page 2 of 2 SECOND AMENDMENT TO AGREEMENT# 18-7470 0..)ieffi Summit Home Respiratory Services, Inc.d/b/a Summit Home Healthcare Products AFFIDAVIT REGARDING LABOR AND SERVICES Effective July 1, 2024, pursuant to§787.06(13), Florida Statutes,when a contract is executed, renewed,or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services. Nongovernmental Entity's Name: w T �o�nE i 51!xBKCc�v sTQ„Z�g�i„� pgASv„a►n y„� pE Address: IObS lwytNcss Lr+02, N Ai cs1 FL 34110 Phone Number: Z51 5q , sWp Authorized Representative's Name: '3Arose, `Drav k Authorized Representative's Title: Pa svEaT CEn Email Address: 3d3 esvrn.h►1�{�0.0 �.t I AFFIDAVIT I, JAM4 6D& D (Name of Authorized Representative),as authorized representative attest that Summit((o st&s larium Scevrw,T.vc, (Name of Nongovernmental Entity) does not use coercion for labor or services as defined in§787.06, Florida Statutes. Under penalty of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true. 4//1 0 (Si ture of authorized representative) Date STATE OF rLo2=DA COUNTY OF CotLIcre.. Sworrtto(or affi med)and subscribed before me, by means of IVphysical presence or0 online notarization this 2'5 day of / rI) ,20(95,by Id (Name of Affiant),who produced their as identification o are per nay nown to m OP Notary Public <6 RAMONACORT *** Commhdon 1«HH 228116 Commission Expires ,'EofFO Expires June 13,2026 Personally Known Q )R Produced Identification Type of Identification Produced: CONTRACT,RENEWAL,OR EXTENSION REQUEST FORM Version:2025.1 Ao CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/13/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED'the policy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT David R.Mettler Integrated Insurance Services,Inc. PH-1 ONn,Fyr).(239)549-5420 FAX(Aic No):(239)549-7905 1639 Cape Coral Parkway E,#203 Mass, dave@integratedinsfl.com Cape Coral,FL 33904 INSURER(S)AFFORDING COVERAGE NAIC a INSURER A: Hanover Insurance Company INSURED INSURER B: Technology Insurance Company Summit Home Respiratory Services,Inc. INSURER C: DBA:Summit Home Healthcare Products INSURER D: 1085 Business Lane,Unit 2 INSURER E: Naples,FL 34110 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR wvn POLICY NUMBER IMM/DD/YYYY) (MM/DDJYYYY). LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY PRFMISFS(Ea occurrence.) $100,000 CLAIMS-MADE I X I OCCUR X ZHJ 9287527 15 09/27/2024 9/27/2025 MED EXP(Any one person) $5,000 _ X Products/Compl.Ops. PERSONAL&ADV INJURY $1,000,000 X Professional Liability GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIESLI7 PER. PRODUCTS-COMP/OP AGG $3,000,000 1I POLICY PRO- I I JFCT I 'LOC - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT -- (pa accident) $1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS X ZHJ 9287527 15 09/27/2024 09/27/2025 BODILY INJURY(Per accident) $ .._ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS e accidep)) $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000 A EXCESS LIAB CLAIMS-MADE X UHJ D534845 07 09/27/2024 09/27/2025 AGGREGATE $2,000,000 DED RETENTION$ $ WORKERS COMPENSATION WC S,TATU- OTH- AND EMPLOYERS'LIABILITY Y/N X T(1Rv 1 IMITF FR B OFFICER/MEMBEER ANY /EXCLUDED?ECUTIVI�( N/A TWC4475642 09/27/2024 09/27/2025 E.L.EACH ACCIDENT $1,000,000 (Mandatory In NH) I I E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Crime/Employee Dishonesty X ZHJ 9287527 15 09/27/2024 09/27/2025 Per Occurrence $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Sales of Medical Supplies. Collier County Board of County Commisioners,OR,Board Of County Commissioner in Collier County,OR Collier County Government,OR,Collier County included as an additional Insured under the captioned Comercial General Liability and AutomobileLiability Policies on a primary and non-contributory basis if and to the extent required by written contract for ay and all work performed on behalf of Collier County. Sales of medical supplies. Collier County Services for Seniors,Solicitaton/Contract No.18-7470 CERTIFICATE HOLDER CANCELLATION Collier County Board of County Commisioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3295 Tamiami Trail East ACCORDANCE WITH THE POLICY PROVISIONS. Naples,FL 34112 AUTHORIZED REPRESENTATIVE • � ""- - I ' ' ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD