Loading...
Backup Documents 05/27/2025 Item #16D 9 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 613 9 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Risk Risk Management 2. County Attorney Office County Attorney Office ' — '� � ��) 4. BCC Office Board of County 7D l F Commissioners 65 4,1fr/ Z7 4. Minutes and Records Clerk of Court's Office / T(14. / 5. Procurement Services Procurement Services PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Cole Chandler/Procurement Contact Information 239-252-8407 Contact/Department Agenda Date Item was May 27,2025 Agenda Item Number 16.D.9 Approved by the BCC Type of Document Amendment Number of Original 1 Attached Documents Attached PO number or account N/A 18-7470 VIP America of number if document is VIP America of Southwest Florida,LLC to be recorded Southwest Florida,LLC INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature STAMP OK N/A 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be CC signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the CC document or the fmal negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's CC signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on May 27,2025,and all changes made N/A is not during the meeting have been incorporated in the attached document. The County 104 an option for Attorney's Office has reviewed the changes,if applicable. 5 this line. 9. Initials of attorney verifying that the attached document is the version approved by the N/A is not BCC,all changes directed by the BCC have been made,and the document is ready for the w.hih an option for Chairman's signature. this line. 1609 FOURTH AMENDMENT TO AGREEMENT#18-7470 FOR SERVICES FOR SENIORS THIS FOURTH AMENDMENT, made and entered into on this g7 day of 2025, by and between VIP America of Southwest Florida, LLC (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): 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; and WHEREAS, on March 26, 2019, the County administratively approved the First Amendment to the Agreement amending Exhibit B-Fee Schedule to include Older American's Act under the grant column of Skilled Nursing line item#1. WHEREAS, on July 19, 2019, the County administratively approved the Second Amendment to the Agreement to add additional grant pass through documents to the Agreement as required by the grantor agency, Area Agency on Aging of Southwest Florida; and WHEREAS, on January 24, 2023, the County administratively approved the Third Amendment to the Agreement to increase the Cost Per Service Unit for Skilled Nursing, Enhanced Chore, Respite (In-Home), Personal Care, Chore, and Homemaking by ten percent (10%) in consideration of the Contractor's agreement to exercise the available renewal term under the Agreement, and as supported by an analysis of market increases. 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 Fourth Amendment as if fully set forth herein. 2. Upon execution of this Fourth 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 the 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. Page 1 of 2 FOURTH AMENDMENT TO AGREEMENT#18-7470 VIP America of Southwest Florida,LLC 1609 IN WITNESS WHEREOF, the Parties hereto, have each, respectively, by an authorized person or agent,have executed this Fourth 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 Y 0`1 1..A..4. pest as to Chairman's Ar„,..1%......ehr.6%.04-- urtaunders, man 'Dated: '�,'t� dO3- signature only , (SEAL) Contractor's Witnesses: CONTRACTOR: VIP America S t t Florida,LLC A 'v .���',�., By: First Witness ig ature ` M1cice 1 Ac.)a 714/-1 �iPo-,5. t n.D TType/print witness nameT Type/print and titleT Second itness Si/Ar— ,°-.41111 ren r� `TI ) Date YPe TT / rintw'i'Jtnness nameT P ro ed a o F and egality: Scott R.Teach Deputy County Attorney 4 ( -,, Page 2 of 2 �( FOURTH AMENDMENT TO AGREEMENT#18-7470 VIP America of Southwest Florida,LLC 16D9 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: VIP A h.e,rZct... rstAxt 1..hick/ �Loi-Ide L,C_ Address: /1L fp Prat-Ay- it VC- S /0 3 Port 1-1.d rf3 Ft 3 3 1 7-- Phone Number: 2,3c 62-9.0•- 99(4?� Authorized Representative's Name: A .!)L.?�,t�.r Authorized Representative's Title: a-6 Ope,a..-}.i Email Address: sa , e_ vl '�/4r+ n •ccw- AFFIDAVIT (Name of Authorized Representative),as authorized representative attest that or altrtchca. kwe # (Name of Nongovernmental Entity)does not use coercion for labor or services as defined in§ 87.06, Florida Statutes. Un r pen y f p ju , declare that I have read the foregoing Affidavit and that the facts stated in it are true. s—j, as (Signature of a horized ere ntative) Date STATE OF }'3 ,r % COUNTY OF /11g Sworn to(or affirmed)and subscribed before me,by means of j$physical presence or 0 online notarization this 13' day of M 4./ ,20).,by AA,r, J ivrp (Name of Affiant),who produced his Florida Driver's License as identification. MICHAELASCHE Notary Public(not required when digital) 1.i MY COMMISSION#HH435994 "- :o�' EXPIRES:December 21,2027 0/al /01JA 7 Commission Expires Personally Known 0 OR Produced Identification Nf Type of Identification Produced: Ur CONTRACT RENEWAL OR EXTENSION REQUEST FORM Version:2025.1 7 ® DATE(M1 D6 0) 9 AC RD CERTIFICATE OF LIABILITY INSURANCE 1/23/2025 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 NAME: GNP Brokerage US Inc. an ISU Network Member PHONE FAX 2001 57th Street (A/C,No,Ext): 718-851-5400 _ (NC,No):718-853-0164 E-MAIL Brooklyn NY 11204 ADDRESS:_. INSURER(S)AFFORDING COVERAGE NAIC# License#:1045961 INSURER A:PHILADELPHIA INDEMNITY CO. 18058 INSURED ALTECAR-01 INSURER B: BEAZLEY USA SERVICES INC VIP America, LLC 2500 S. Kanner Hwy. Suite 3 INSURER C:CFC Underwriting Limited Stuart FL 34994 INSURER D: _ _ _- INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:603932280 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. IPOLICY EFF POLICY EXP NSR ADDTYPE OF INSURANCE INSD WVDSUBR POLICY NUMBER (MM/DD//YYYY) (MM/DD/YYYY) LIMITS LTR INSD WVD A X COMMERCIAL GENERAL LIABILITY PHPK2587080-003 8/1/2024 8/1/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL R ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY I JECOT J LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A I AUTOMOBILE LIABILITY PHPK2587080-003 8/1/2024 8/1/2025 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO I BODILY INJURY(Per person) $ OWNED 1 SCHEDULED i BODILY INJURY(Per accident) $ AUTOS ONLY I AUTOS y X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB OCCUR PHPK2587080 8/1/2024 8/1/2025 EACH OCCURRENCE $5,000,000 EXCESS LIAB X I CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- :AND EMPLOYERS'LIABILITY STATUTE ER Y/N 1 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 Professional Liability 1 I PHPK2587080-003 8/1/2024 8/1/2025 Annual Aggregate 3,000,000 B Crime 1 V35C69240201 1 9/1/2024 9/1/2025 Annual Aggregate 5,000,000 C j Cyber Liability IESN0140097435 9/21/2024 9/21/2025 Annual Aggregate 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is listed as additional insured subject to written contact. Additional named insureds: VIP America of Southwest Florida, LLC VIP America of Central Florida,LLC 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 3295 Tamiami Trail E. AUTHORIZED REPRESENTATIVE Naples FL 34112 /Jf /n� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1609 DATE(MM/DD/YYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 11/12/2024 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 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 GIGA Solutions, Inc. PHONE FAX 101 Plaza Real South IA/c.No.Extl: 888-581-0807 (A/C,No): Ste 201 E-MAIL certs@gigasolves.com Boca Raton FL 33432 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Ascendant Commercial Insurance Incor orated 13683 VIPAMER-01 INSURER B VIP AMERICA OF SOUTHWEST FLORIDA, LLC 14440 METROPOLIS AVE#103 INSURERC: Fort Myers FL 33912 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:654580705 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 NAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR I POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER i(MM/DD/YYYY) (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ DAMAGE TO RENTED CLAIMS-MADE L OCCUR PREMISES(Ea occurrence) _ $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES?ER: GENERAL AGGREGATEPO- $ POLICY JECT LOC '� PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO 'i 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 LIAR —_� { CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC-76407-4 11/10/2024 11/10/2025 X I PER OTH- AND EMPLOYERS'LIABILITY _ STATUTE ER Y/N ANYPROPR;ETOR/PARTNER/EXECUTIVS E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) ! E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,descrbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Collier County Board of County Commissioners,OR,Board of County Commissioners in Collier County,OR,Collier County Goverment,OR,Collier County is Additional Insured and Primary ar.d Non-contributory with respect to Workers Compensation and Employers'Liability as required by written contract for any and all work performed on behalf of Collier County. 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 3295 Tamiami Trail E. Naples FL 34112 AUTHORIZED REPRESENTATIVE t 0 4.4144,C . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registerea marks of ACORD 1 6 D 9 AcaRD 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 3295 Tamiami Trail E. AUTHORIZED REPRESENTATIVE Naples FL 34112 (144414( 0 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD : : Greater• i 6 0 9 • • • Companies October 30, 2023 To whom it may concern: Let this letter serve as full authorization for Ashley Skipper,VP of Operations of VIP America of Southwest Florida, LLC,to transact in any way with Collier County. Please feel free to contact me with any questions or concerns at mkochen@gnyservices.com or at(914) 752-2117. Sincerely, Michael Kochen Chief Executive Officer Greater Health Alliance LLC dba Greater Companies STATE OF TEXAS COUNTY OF TRAVIS ) The foregoing instrument was acknowledged before me by means of online notarization, this 30th day of October 2023, by Michael Kochen, as Chief Executive Officer of Greater Companies, who is personally known to me or who has produced a Driver's License as identification on behalf of Greater Health Alliance LLC d/b/a Greater Companies. T-Vrnia (92"\Not ry blic State and County Aforesaid (NOTARIAL SEAL) Print Name:Jennifer Jo Thomas My commission expires: 09/20/2025 \��s���l'I+��n,,,, My commission number: 133341819 ��j,�pRY p`9 / Jennifer Jo Thomas _r,io , a\, Notarized online using audio-video communication =f t ID NUMBER 41111I. 133341819 7 ll11DIII 11�,\ COMMISSION M ISS O 20.PORE EXPIRES • s a Access • • • Access Greater • • Pinnacle ••.. V I P • t a • • • • • ••• • O Concierge • • • Nursing NY Nursing • : : HomeCare ... America A COMPANY A OREATRR COMPAN'. A GREATER COMPAN, A GREATER COMPAN, A GREATER COMPANY