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#18-7470 (Maranatha Home Care, Inc.) ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 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 f / 4. BCC Office Board of County Commissioners At7, s1Z7)25 4. Minutes and Records Clerk of Court's Office l ' , y las i1 54> 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.10 Approved by the BCC Type of Document Amendment Number of Original 1 Attached Documents Attached PO number or account N/A 18-7470 Maranatha Home Care, number if document is Maranatha Home Care, Inc. to be recorded Inc. 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 final 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 C 4 an option for Attorney's Office has reviewed the changes,if applicable. 7� 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 ihji an option for Chairman's signature. 5 this line. FOURTH AMENDMENT TO AGREEMENT#18-7470 FOR SERVICES FOR SENIORS THIS FOURTH AMENDMENT, made and entered into on this o97 day of 2025,by and between Maranatha Home Care,Inc.d/b/a A Better Health Care(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 21, 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 February 2, 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 Maranatha Home Care,lnc.d/b/a A Better Health Care ./* 3 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 a• 1r 4 ' 44.AA6,4,1,� By: $y: J� '�,�,,•;' � .., Att st as to Chairman's /44„,././...."404.11114"-- . __ aunders,Chairman Dated: J97` �1 DI))-Ds:;ratt nlY ,, • (SEAS},iLv,,if g; • i!ION or Witnesses: CONTRACTOR: Contractor's Maranatha Home Care, Inc. d/b/a A Better Health Care First Witness BYT` �,,' ` Signature h!fULQ- Neyta.hi 1 l J1 �L0.Y�OS �lC'S�er�'/C C� TType/print witness nameT YSVO•K\n a./� 1 TType/print signature and titleT Second Witness SIS/a.5 \a Ki 4 -Q-\ r-6 Date TType/print witness nameT A oved a t., Fo .nd egality: • Scott R.Tea Deputy County Attorney Page 2 of 2 FOURTH AMENDMENT TO AGREEMENT#18-7470 ��' vvv��, Maranatha Home Care,Inc.d/b/a A Better Health Care AO 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: Pr Sctitt I_lecal+h Address: 5 'yc ii-Ibrk 1065 f�� c�-+hD / hg� f JUV 1 - Phone Number: cR1A a84 7700 Authorized Representative's Name: Or, 1' ush0,. ax. koio.s Authorized Representative's Title: pcei-}-- Email Address: MRQK1OS RO phhc• cdn _ �,f,, _ AFFIDAVIT I, 1—�L. l �i✓1Q 1`Qon,es (Name of Authorized Representative),as authorized representative attest that Rambia-4h4 I-Eor►ie.(cs,,z. (Name of Nongovernmental Entity)does not use coercion for labor or services as defined in§787.06,Florida Statutes. Under plalty of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true. (114<-61.--Y\-1 I s/2S (Signature of authorized representative) Date STATE OF e/J�il, COUNTY OF ya2k Sworn to(or affirmed)and subscribed before me,b means of 0 physical presence or 0 online notarization this day of,(l,2024,by/naer Name of Affiant),who produced his Florida Driver's License as id ti catic SrEPHAIVfE NOTARY pusuc, O B E t Pu c not required when digital) --NNE Tr / Ae9istrati STATE OF NEw yORK QualifiedN . 018E6/52725 CommissionExpires Commissionxpires ,ens County December 20 Personally Known [!OR Produced Identification 0 Type of Identification Produced: CONTRACT RENEWAL OR EXTENSION REQUEST FORM Version:2025.1 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ‘...----- 2/4/2025 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: Miller&Miller Insurance Agency Inc PHONE Margie Lagazon FAX 720 Commerce Street fA/c.No.ExtE 914-741-6400 (A/c,No):914-741-6407 Thornwood NY 10594 E-MAIL ADOREss: MargieL@Miller-Ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:ALLIED WORLD SPECIALTY INS CO 16624 INSURED PREMI-4 INSURER B:Great American Insurance Co. 22136 Maranatha Home Care Inc DBA A Better Health Care INSURER C: 2375 Tamiami Trail N, Suite 300 INSURERD: Naples FL 34103 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1474443042 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 SUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y 03127171 2/2/2025 2/2/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $100,000 X Prof Claims Made MED EXP(Any one person) $5,000 X Sexual Abuse PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGO $1,000,000 OTHER: Prof Aggregate Limit $3,000,000 A AUTOMOBILE LIABILITY N N 03127171 2/2/2025 2/2/2026 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILYINJURY(Peraccident $ AUTOS ONLY AUTOS ) x HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ A UMBRELLA LIAB OCCUR 03127172 2/2/2025 2/2/2026 EACH OCCURRENCE $3,000,000 X EXCESS LIAB X CLAIMS-MADE AGGREGATE $3,000,000 DED X RETENTION$in,nnn Follow Form $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Crime-Employee Theft SAAE8200810300 2/2/2025 2/2/2026 Limit $50,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) *Policies shown are subject to terms,conditions,exclusions,sublimits and deductibles not listed on this certificate. We recommend that requests for policy copies be directed to the Named Insured shown above.* Collier County Board of County Commissioners,or Board of County Commissioners in Collier County,or Collier County Government is included as an additional insured under the captioned Commercial General Liability and Automobile Liability policies on a primary and non-contributory basis if and to the extent required by written contract. 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 East Naples FL 34112 AUTHORIZED RE ESENTATIVE I ,_...... (14.01-(2-0_56 N. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `...�� 6/28/2024 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 NAME: Alliant Insurance Services, Inc. PHONE Shannon Falvey FAX 32 Old Slip (NC.No.Extl: 757-201-8999 (A/C,No): New York NY 10005 ADDRESS: shannon.falvey@alliant.com INSURER(S)AFFORDING COVERAGE NAIC# License#:0C36861 INSURERA:Safety National Casualty Corpo 15105 INSURED PREMHOM-04 INSURER B Maranatha Home Care Inc.dba A Better Health Care 2375 Tamiami Trail INSURER C: North Naples, FL 34103 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1182749686 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 INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-JECT LOC PRODUCTS-COMP/OP AGG $ 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$ $ A WORKERS COMPENSATION LDC4068308 6/30/2024 6/30/2025 X STATUTE EOTH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $$1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $$1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Current Coverage 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 East Naples FL 34112 AUTHORIZED REPRESENTATIVE i' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A Better HealthCARE Private Home Health & Care Management November 6th, 2024 To Whom It May Concern: At the request of Collier County,this letter serves to authorize President Dr. Marshalina Ramos, DNP,to sign on behalf of Marantha Home Care Inc., doing business as A Better Health Care. Thank you for your continued partnership. Sincerely, ArtkAkr Scd4.wa bat Arthur Schwabe 2375 Tamiami Trail N 300•Naples•Florida •34103 Phone: (239)659-1122 •Fax(239) 659-1123