#08-5128 (Sunshine Pharmacy, Inc.)
A G R E E MEN T 08-5128
for
Pharmacy Services
THIS AGREEMENT, made and entered into on this /4 f{., day of Ap.-, 'f
2009, by and between Sunshine Pharmacy, Inc., authorized to do business in the State of
Florida, whose business address is 5482 Rattlesnake Hammock Road, Naples, Florida 34113,
hereinafter called the "Contractor" and Collier County, a political subdivision of the State of
Florida, Collier County, Naples, hereinafter called the "County":
WITNESSETH:
1. COMMENCEMENT. This Agreement shall commence on the date of award by the
Board of County Commissioners for an initial term of twelve (12) months.
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 terms of two (2) years each. The County shall give the Contractor written
notice of the County's intention to extend the Agreement term not less than ten (10)
days prior to the end of the Agreement term then in effect.
2. STATEMENT OF WORK. The Contractor shall provide Pharmacy Services in
accordance with the terms and conditions of RFP #08-5128 and the Contractor's
proposal referred to herein and made an integral part of this agreement and Exhibit A,
Scope of Work, attached to and made an integral part of this Agreement.
This Agreement contains the entire understanding between the parties and any
modifications to this Agreement shall be mutually agreed upon in writing by the
Contractor and the County Project Manager or his designee, in compliance with the
County Purchasing Policy and Administrative Procedures in effect at the time such
services are authorized.
3. COMPENSATION. The County shall pay the Contractor for the performance of this
Agreement the aggregate of the units actually ordered and furnished at the unit price,
together with the cost of any other charges/fees submitted in the proposal, and set forth
in Exhibit B, attached to and made an integral part of this Agreement.
Any county agency may purchase products and services under this contract, provided
sufficient funds are included in their budget(s).
Page I of 10
Payment will be made upon receipt of a proper invoice and upon approval by the Project
Manager or his designee, and in compliance with Chapter 218, Florida. Statutes,
otherwise known as the "Local Government Prompt Payment Act".
4. ELECTRONIC BILLING. Contractor will invoice the County through the use of the
Pharmacy Benefit Manager, a web based software system operated by GeriScriptRX.
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.
6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if
mailed or faxed to the Contractor at the following Address:
Sunshine Pharmacy, Inc.
5482 Rattlesnake Hammock Road
Naples, Florida 34113
Attention: Delmer H. Parrish, President
Telephone: 239-775-6800
Facsimile: 239-775-7377
All Notices from the Contractor to the County shall be deemed duly served if mailed or
faxed to the County to:
Collier County Government Center
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.5., all permits
necessary for the prosecution of the Work shall be obtained by the Contractor. 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
Page 2 of 10
Payment will be made upon receipt of a proper invoice and upon approval by the Project
Manager or his designee, and in compliance with Chapter 218, Florida. Statutes,
otherwise known as the "Local Government Prompt Payment Act".
4. ELECTRONIC BILLING. Contractor will invoice the County through the use of the
Pharmacy Benefit Manager, a web based software system operated by RX America.
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.
6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if
mailed or faxed to the Contractor at the following Address:
Sunshine Pharmacy, Inc.
5482 Rattlesnake Hammock Road
Naples, Florida 34113
Attention: Delmer H. Parrish, President
Telephone: 239-775-6800
Facsimile: 239-775-7377
All Notices from the Contractor to the County shall be deemed duly served if mailed or
faxed to the County to:
Collier County Government Center
Purchasing Department - Purchasing Building
3301 Tamiami Trail, East
Naples, Florida 34112
Attention: Steve Carnell, Purchasing/GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
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.5., all permits
necessary for the prosecution of the Work shall be obtained by the Contractor. 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
Page 2 of 10
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 contract 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 immediately for cause; further the County may terminate this
Agreement for convenience with a thirty (30) day written notice. The County shall be
sole judge of non-performance.
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 $2,000,000
Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Contractors; Products and Completed Operations and Contractual Liability.
B. Business Auto Liability: Coverage shall have minimum limits of $300,000 Per
Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. 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.
D. Professional Liability: Coverage shall have minimum limits of $2,000,000 per
Page 3 of 10
Occurrence.
Special Requirements: Collier County shall be listed as the Certificate Holder and
included as an Additional Insured on the Comprehensive General Liability
Policy.
Current, valid insurance policies meeting the requirement herein identified shall
be maintained by Contractor during the duration of this Agreement. Renewal
certificates shall be sent to the County thirty (30) days prior to any expiration date.
There shall be a thirty (30) day notification to the County in the event of
cancellation or modification of any stipulated insurance coverage.
Contractor shall insure that all sub-Contractors comply with the same insurance
requirements that he is required to meet. The same Contractor shall provide
County with certificates of insurance meeting the required insurance provisions.
13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the
Contractor shall 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, 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.
14. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing and Human Services Department/Social Services
Program.
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 CONTRACT. This Contract consists of the attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Contractor's Proposal, Insurance Certificate, RFP #08-5128, Exhibit A, Scope
of Work, and Exhibit B, Pricing.
17. 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.
Page 4 of [0
18. 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, 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 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 contract held by the individual and/ or
firm for cause.
19. IMMIGRATION LAW COMPLIANCE. By executing and entering into this
agreement, the Contractor is formally acknowledging without exception or stipulation
that it is fully responsible for complying with the provisions of the Immigration
Reform and Control Act of 1986 as located at 8 use. 1324, et seq. and regulations
relating thereto, as either may be amended. 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.
20. 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.
21. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County
encourages and agrees to the successful proposer extending the pricing, terms and
conditions of this solicitation or resultant contract to other governmental entities at the
discretion of the successful proposer.
22. 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.
23. ADDITIONAL ITEMS/SERVICES. Additional items and/ or services may be added
to this contract upon satisfactory negotiation of price by the Contract Manager and
Contactor.
24. 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
Page 5 of 10
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.
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.
25. KEY PERSONNEl/PROJECT STAFFING: The proposer's personnel and management
to be utilized for this project shall be knowledgeable in their areas of expertise. The
County reserves the right to perform investigations as may be deemed necessary to
insure that competent persons will be utilized in the performance of the contract. Firm
shall not change Key Personnel unless the following conditions are met: (1.) Proposed
replacements have substantially the same or better qualifications and/ or experience.
(2.) that the County is notified in writing as far in advance as possible. Firm shall make
commercially reasonable efforts to notify Collier County within seven (7) days of the
change. The County retains final approval of proposed replacement personnel.
Page 6 of 10
-. ....-.
IN WITNESS WHEREOF, the Contractor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first
above written.
\. (SEA) ~,;i i ·
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BOARD OF COUNlY COMMISSIONERS
COLLIER COUNlY, FLORIDA
(J d
~ a
By: ~ ...t4.~
Donn FIala, ChaIrman
Sunshine Pharmacy, Inc.
Lfl
First Witness
By:
De I ~l(vl'51 p]rc~
Typed signature and title
Approved as to form and
legal sufficiency:
~1t ({/~~~L_
~~t County Attorney
.s~" iLf(. U-c ~L-
Print Name
Page7oflO
EXHIBIT A
SCOPE OF WORK
1. Each of the Contractor's pharmacists must possess a current license from the Florida State
Board of Pharmacy in accordance with Revised Statutes of the State of Florida, and shall
maintain said license in good standing for the duration of the contract.
2. The Contractor shall provide at no additional cost to the County, pharmacy services at
locations in areas which are not evacuated during a disaster, and be prepared to accept
telephonic requests from the County Emergency Operations Center and fill such requests.
Collier County Housing and Human Services Department/Social Services Program will be
responsible for the pick-up and delivery of any such prescriptions.
3. The Contractor must be able to fill outpatient prescriptions as needed each day for the
duration of the contract within the normal work hours of 8 am to 5 pm.
4. The Contractor shall be able to provide Generic equivalent drugs when one is available to
fill the prescriptions. Prescriptions are limited to a 30-day supply.
5. The Contractor shall provide electronic transfer of invoices (billing) to a local PC by-mail
at least monthly per Clerk of Court's Finance standards. Such electronic data transfer
capability shall be operational within two (2) months of contract start-up and the first billing
shall be forthcoming within eight (8) weeks after start up of contract. The Contractor shall
provide a contact name and phone number for technical assistance when file format
problems arise.
6. The Contractor shall allow Collier County Housing and Human Services
Department/Social Services Program direct Internet access to pharmacy data base for client
profiles, prior authorizations, overrides, add/ change client information, change eligibility
dates and ability to back date ending date, and contact name, telephone number and e-mail
address to advise of change of client's social security number.
7. The Contractor shall use File Transfer Protocol (FTP), or other HIP AA compliant
compatible programs to transfer encrypted client information (automatically) to pharmacy
database at least twice daily, without breaking security. Full file transfer shall be done
weekly. Contractor must comply with HIP AA 834 file format.
8. All of the Contractor's pharmacy locations shall be connected on a common network using
the same database in order to monitor patient information and manage the formulary. In
addition, all locations must be connected to the central system that contains client
information. All clients will be given a voucher to provide to the pharmacy. Any physician
can write a prescription; this includes Primary Care, specialists, emergency room physicians,
dentists, etc. Collier County Housing and Human Services/Social Services will not pay for
prescriptions if the client does not present a voucher which shows a valid begin and end date
of eligibility.
Page 8 of 10
9. Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996,
Contractor is expected to adhere to the same standards as the County and other HIP AA
covered entities regarding the protection and non- authorized disclosure of Protected Health
Information (PHI).
10. It is highly desirable that the Contract Manager be a pharmacist. The Contract Manager
for Sunshine Pharmacy, Inc. will be Del Parrish at telephone number 239-775-6800 and email
address sunshinedrug2@aol.com.
11. The Contractor shall identify rebates that are forthcoming and any savings realized from
manufacturers' rebates shall be credited against the County's monthly invoice.
12. Payments shall be made in accordance with the Local Government Prompt Payment Act
from a joint revolving account for the payment of services provided.
13. The Contractor shall fill all medications to patients for self-administration in accordance
with all applicable Federal, State and Local laws.
14. The Contractor shall update and make readily retrievable at any time, all outpatient and
drug data within the outpatient profile as each prescription is filled or refilled. The contractor
shall automatically monitor drug allergies and interactions according to data available for
each patient.
15. The Contractor shall provide monthly Utilization and Administrative reports including
number of prescriptions filled, covered individuals, utilizing individuals including physician
dispensing profiles and other reports.
16. The Contractor must immediately advise the County whenever abuse, drug seeking or
fraudulent behavior is suspected.
17. The Contractor shall provide to the County any manufacturer's no cost, discounted or
promotional health care items, which may be provided to them during the period of the
contract.
18. The Contractor shall be available for periodic site visits by Collier County staff, to any of
their locations, in order to monitor the quality of services provided.
19. The Contractor must respond within twenty-four (24) hours in writing via fax, email or
letter, to all questions presented by the Collier County Housing and Human Services
Department.
20. The Contractor shall provide outpatient-packaging materials, including labeling, that
meets all applicable laws and regulations.
Labeling for outpatient packaging shall include:
a. Patient Name
Page 9 of]O
b. Date of Dispensing
c. Prescription Number
d. Physician's Name
e. Instructions for Patient Use
f. Name and Strength of Drug
g. Number of Doses Dispensed
21. The contractor shall maintain all outpatient drug profiles on a computerized dispersing
system.
Each outpatient drug profile must include:
a. Patient Name
b. Address
c. Phone
d. Birth Date/Social Security Number
e. Sex
f. Allergies
g. Prescription Number
Drug data within each outpatient drug profile must include:
a. Drug Name
b. Drug Strengths
c. Amount Ordered
d. Amount Dispensed
e. Instructions for Use
f. Refills Authorized
g. Physician Information
h. Times and Dates Filled
Electronic invoice data must include, but may not be limited to:
a. Patient Name (Last, First, MI)
b. SSN
c. NABP #
d. Store #
e. RX#
f. Date Filled (MM/DD/CCYY)
g. Refill
h. Physician Name
1. Drug
J. NDC # and Description
k. Quantity
I. Days Supply
m. Generic (Y /N)
n. Amount Due
o. Billing Date
Page 10 of 1 0
Exhibit B
Sunshine
. Pharmacy
Cost of Services to the County:
The fixed prescription-dispensing fee will be as follows:
Brand Name Medications- AWP minus 19% plus $4.50
Generic Medications- AWP minus 30%
Sunshine
Phannac,
We are proud to offer the following drugs in 10 day
increments at no cost to our patient. Just present your
Rx and we will gladly fill it for free.
5482 Rattlesnake Hammock Rd.
Naples,FL34113
Phone: (239) 775-6800
1400 Gulfshore Blvd. Stc. 100
Naplcs,FL34102
Phone: (239) 262-2929
6350 Davis Blvd.
NapJes,FL34104
Phone: (239) 775-7207
13020 Livingston Rd.
Naples, FL 34105
Phone: (239) 384-5091
80 Wilson Blvd. South
Naples, FL 34117
Phone: (239) 775-6800
The following drugs are included:
. Amoxicillin . Ampicillin
. Cephalexin . Penicillinvk
. SMZ- TMP . Erythromycin
. Ciprot1oxacin
"'~"----.-_._--------,.._-----------_..- -.------------.--
04/14/2009 15:39
2395303750
SOLUTIONS
PAGE 02
fGUAR1D
.. INSURANCE
GROUP
Worke,J:S' ComR.ensation ~Iover'!! Liability Policy
NorGUARD Insurance Company - A Stock Company
Policy Number SUWC021076
R:.enewal of SUWC914328
NCCI No.[25844]
policy Information Page
[1]
Named Insured and Mailing Address
SUNSHINE PHARMACY INC
5482 Rattlesnake Hammock
Rd
Naples, FL 34:l13
Federal Empllover'S 10 59-3518172
Agency
PAYCHEX AGENCY, INC.
150 Sawgrass Drive
Rochester, NY 14620
Agency Code: NYPAYCIO
Insured is Corporation
[2] Policy Periocl
From March iE, 2009 to ~Iarch 18, 2010. 12:01 AM, standard time at the insul'ed's m"iling address.
[3] Coverage
A. Workers' Compensation Insurance - Part O"~ of this policy applies to the Workers' Compensation
Law of the followi ng ,;tates: 'Florida
EL Employer's Liability ]"surance - Part Two of this poliCY applies to work in ,each of the states listed
in item [3]A. The limits of our liability under Part Two are:
Bo;i1y Injury ilY Accident - e"ch accident $100,000
l;Io:!ily Injury JY Disease - each employee $100,000
Bodily Injury IlY Disease - policy limit $500,000
C. Other Sti:'lt€$ Insurance - Part -rhree of this policy applies to all states, eXI::;ept any state listed in
item [3]A. and the states of North Dakota, Ohio, Washington, and Wyoming.
D. This poiic\, includes these endorsements and schedules:
See E'xtenslon o~ Information Page - Schedule of Forms
[4] Premium
The Premium Basis and, :herefor-e, the pr~mium will be det€rmin~d by our Mlu1ual of Rules,
Classifications. Ratesl and Rating Plans. All required information is subject to verification and change
bv audit. (Continued on another page)
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! Total Estimated Cost; $ 21,268
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16 Souttl River StrEet. P,O" Box A-H. Wilkes~Barre, PA 18703-0020. w\"<Jw.guard"com
04/14/2009 15:39
2395303750
50LUTION5
PAGE 03
fGUARI)
. lNSUR. ANCE
GROUlP
Workers' Comoensa!;jpn 8!J..d EmP10yefs Liability Policv
-" NorGUARD Insurance Comp,my - A Stock Company
PoliCl,' Number SUWC021076
Renewal of SUWC914328
NCCI No.[25844]
Policy Information Page
Extension of Information Page
Sr;:hedule of Fc>rms
. WC 000404 . PENDING RATE CHANGE ENDORSEMENT
. WC 000414 " NOTlFICMION OF CHANGE IN OWNERSHIP ENDT
WC 000406~ - PREMIUM DISCOUNT ENDORSEMENT
we 000308 " PARTNEB S, OFFICERS 8<. OTHERS EXCL. END.
. WC 090402 " FL EXPEFJENCE RATING MOD. FACTOR ENDT.
. WC 090606 . fL EMPLOYMENT AND WAGE INFO.RELEASE ENDT
WC 990008 - Fl ADDENDUM
'. WC 090403A - FL TERF. RISK INS PROG REAUTH. ACT END'T
we 000001A - INFOR~IATION PAGE
we OOOOOCA - STAND,~RD POLICY
. WC 000419 - PREMIU~' DUE DATE ENDORSEMENT
;:C As part of GUARD's ongoing commitrnent to environmental responsibility throughout our operations,
we have cho~l~n not to rE:print those forms (marked with an asterisk) that hc;lve not changed and were
previously Siert to you. You can obtain a new copy of any of these forms by .c:!lccessing your account
information at GUARD's Policyholder Service Center (a selection available via our website at
www..guard.com). Pleas" be aware that you will be asked to enter your poliCY number, policy
inception date, and federal ID number in order to log on to this secure portion Of our site.
Alternatively, you can co -,tact: us via phone at 1-800-573-2465; our Customer ~~:)ervice Representatives
will either be dble to help you locate a document yourself or can send a copy to you. As always, we
tllank you for selecting GUARD as your insurer. We look forward to serving you!
~TFRNAI L1S~
MGA : 5UWC021076
Date : 02/161:2009
P(lge r 2-
Information page
we OOOQOIA
16 South River Stre"t.P.O. Box A.H. Wilkes.Barre, PA 18703-0020' www.guard.com
04/14/2009 16:39
2395303750
SOLUTIONS
PAGE 04
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1191 TWO. SCH5DtJl.E OF C()ljt!RAGiS Alii) COViJ(ED AutoS fiils policy provides only those coverages where a
charge is shown in the premium column beloW. Each of these coverages will apply only to thOS'. "autO" shown as
cC>\/ered 'autos". 'Autos" a"~ shown as covered 'autos' for a particular coverage by the entry c:"I one or more 01 the
svmbci. lro";rt>e CO~-RED ...UTO'S slll:tion of the Busines' Auto C!:!'1eraQe Form next to tM n~lm~- ;"-thP coverane
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COVERAGES '1YI'"_h1J1'S,,""e~R.C:D THE MOST WE WILL PAY FOR ANY ONE PRi'MIUM
AUTO$S~ltIl ~~~
...."... AllIO c-"... ACCIDENT OR LOSS
~~...=11,:~
LI,ABIUTY 7 8 9 S l,OOO,DOO $ 6.1D2.DO
PERSONAL lNJU~ PROTECTION 7 separately stutfJd In Q,3ct'I P,I.P. Enoorsement $ 563. DO
MEOICAL PAV~ENT5Ie.xPENS15 7 $ 5.DOO S 81.0D
S $
UNIM5URJ:D MOTORIST 7 , S 100,000 s 589.00
BOOIL'Y' lH.IuAY I
UNOERINSURs'O MOTORISTS S S
s I
PHYSiCAl.. DAMAGe; . 7 S "95,OD
COIWIPfl:EHeNSIVE COVERAGE ACTU,Q,1.. CASH VALue. STATED AMOUNT \1'01 liEU THREE:.
OR COST of REPAIR, WHICHEVER 15 LESS !.AINUS THE
PHYSICAL. DAMAGE. SPECIFIEC' OEDUCTI61.E IN I'TEM T...RE'E FOR EACH COVi;RED $
CAUSES OF LOSS COVERAGE ~AUTO". SEE ITEM FouR FOR: HIRED DR aOfl:ftOWEO
PHVSlCAL. OA~GE - '"AUTOS"',
COLLISION COVERAGE 7 S 1.519.DO
TOWING AND .....BOR 7 SSO for' each dlsablemol'lt of II prlviate POSSeJlgeI' tluto S 16:00
cARGO LIABILI"N SEE~"'CLE SCHEDULE $
MISCELlANEOUS PREMIUM S
In.ured is a(n): CORPORATION Operating as a(n): DELIVERS PRESCRIPTION MEDICINE
In retum fOr the payment Of the premium. and sUbj"ct to all tile term. of tnis poliCY. we agree with yOU to provll~e the
insurance as stated io this pol,icy
5482 AATTUiSNAKE HALIAMOCK RD
NAPLES, FL 34113-7454
ACKERMAN INS SERVlt;ES INC
NAPLES FL 34109-2110
09 !i90ll6-002 D06
(239)597.1096
59
~genCY Name:
Agency Address:
~
\
\
Estimated Basic Premium;
Estimated Surcnarg6(S):
Estimated Tax(esf:
E6timated "fotal Pren'1ium~
9,972.0D
99.72
$
$
$
$
10.011.72
.
"," countersigned By
i - Auth,crized Representative
g
EAS11$
.......
~
t""UIlED COPy
AC9 MP("- """ '11Yil1
91_'
98 _n.
04/14/200g 15: 3g
23%303750
50LUTIONS
PAGE 05
laJUUl"IJ/ .......,
04/1.4/2009 14:)9 FH . DATii lNlMlUOlVYYT1
~c::Hdf CEIRTIFICI\TE OF LIABILITY INSURANCE II)';j fflo 1/1 /l
8 Ss~ 04 14 09
I'fl.ClDUC'1iOR TIllS CIjf(TIFICATE IS ISSUED AS A iMTT_~_ OF I~ <)Rw.110~
ONLY AND CONFErtS NO RIGHTS UPON TKa CERTIFICATE
M4ii1SliiIOJ:' J:U,:l!I'IlJ:'aoQG Gro'l1p, Inc. HOLD!!I'l. Tlil$ CEI'lTIFlCA ~ OOES 'NQT AIMINIl; EX"l"EIID OR
1403 MIIclay ComIoBroe tlr.ive ALTER TliE COVERAGE AFFOODEC BY TliE POUCIES Sa-OW.
T&11~... FL 32312 I
Phone: BSO-8Q4-8222 1i'aX:850-1I94-B228 IIISUI'lERS AFFOI'lDlIIG COVEAAGE IIAIC .
INSI,IAI!D INSURIiRA: ~k Ame:ciCMIIIJ) Xns Ca. 3313B
lNSU'FlER B;
S"lI!b~"e I/h.llrmaey INSuFU!R c~
S4 Ra~~~!.D&k8 H...o~k - IN!UflEAO:
~1Ip1'" FL 4113 INGU,,~E:
tri~ POllCl'd 01' ~URANOE I-ISrEC SOW HAVE Bel=~ ISSUED TO T~ lNSUfU!:C NAMEO ..eo.....! fOR nl;;, POLlCY PERIOO INDlC"~, NOTWlTHS1ANg~NG
~v REQUIRE~eNT. T!RlrAott e,oNDtTlON OF ANY CCNm,u:;T OR c1't-le~ 1:l0C1JMeNiWIT~1 ~~sPECT TO WH'ICH 1MIS t:ERTIF1CA.TE: I'M" ee: JSSuED l)fl.
Ml'V PEftTAlN, iHS INSUM'NC& AFr:'OROW BY TMIi. POL lCLES Dl;SCR1B5C H1!AEIN IS $uaJl!OT TO .....Ll. THE 'liiRIAS. ~CLUStOt-lS ,Ap.JD COND1TlC:INS OF SUC~
POL.le~S_ A~I!;l!ATE I.IMITS SMO\I'lIIi M"V IolAVIi Beetl Jl;EDlJCED BY F'ilI10 CLjl,IMB.
LTO - ~.. OP INsUAAtl(~E F li'0L1Q"1 NU__ D'\<' n . - Ll"",,
~~1. UABILI'fY ~CH Occ.URfUl!NCE I,
- 3~I!Fl:C::I,I.L GENeRJ,J- LIA.BluTY ~~IiS(Ee oJ.:~"c!-) "
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. ~,~L&AD\fIIiJL;RY ,
GItNERAI. AI3GPtIiGAToi:; .
n~~~nt'M'PnPER: ~JCTS - t:lOR/1PIOI" AOO .
POL-ICY P,~--i Lee; .-
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ANV AUTO iEa 8~~llfJlll'l)
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.
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-
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~'L""LlTY AlITO D~LV ..Iii'" "C::ICENT .
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OTtll!:ll'lTI'tAN
/lUTO aNI. Y: .." ,
OfSa I UMI!IIII!LLII. u",:Il.llY EACH OCCURREN(;~ I
QCCUR 0 C .,\lMS MADIi ~GAT~ .
t- I
R ~D-UeT1E1LE. L- .
RETEiNTION . i ,
::=::=::'':.iri I I ----1wftV L1MIT~ I IO~.
TIN
AN" il"ROPIUETORIPAf\"fNERIEX1~CUTIU E,l.. EACH ^,~~iDGNT .
OFFICERlt-U!Lte'E;R EXCLUDED?
(MUld8tGrY In NH) ~:ISEA!:IE . EA EMF'lOYE.E $
~.na<<lbeUndllr
EC!1Ai.. PROVISIONS ~ItIQW' E_l.l::19E:...&;.POLIC'fUMIT $
"""'"
1\ proEc.l:Soiona..l LIlM'711416 OS/01/09 , OS/Ol/Og Ecb Cla;.m 2,000,000
LiabU:l...... B.~J;....lItO 2 000 000
lJtsCRlP'TICN Qf OPErv.TIO'NS I L.CI~~l1or1eJ WMICl.1!!1l t IXCWflIOfll5 ADD.!D BY aNtlOM:EME.NT IIIIISCIM. I"ftOVl'lllON:9
CERTIFICATE KOLDER
COVERAGES
Co1.J.:l.C!lr county :ace
3301. E TaU.ami ~.a:i.:.
JiIap1es l!'L "411Z
ACOIlO 25 (2009101)
CANCELLAl10N
IMOULD ANY OF tHE. ADOVIi tI~QD pow" tit CAHec;u..I!!D I!Il!li"OMnt~ DPI~TION'
COLLI:Ba DAn;; Tj,lnl.Cp'. 'f1oIIIIS8UIMC3iINSilLfRM. W1Lt.I5HDEAYQIt TO MAIL l1L-. DAYS mUTT''''
NOT1Cl TO 'TM1i o:IiFtTlAO.TIiHc:lLDIli:R lilA_I) TO TMI '-5'FT.InIT FAR..UIII:Iii 1'0 DO $0 8HALL
~ JtQOIUCJATtI)M Qf\ 1.,IABlUT't QII' .1'1.11"' I(II<<J UI"ON TI'tl! 1".IJ1It.~, 11'8 AOI!NTD OR
RliftJI: IINTll,rntl:8.
" M""lIl1!;MTA
I ~58"2009 ACORD CORI>OIlATION_ AI rights ,...rvod.
Btk. of ACORD
L118 ACORD "IIIm..nd toga .,. nlIli1l.tlJl1'8
04/14/2009 16:39
2395303750
SOLUTIONS
pa~e2 of:)
"",d~."" ,...~............ ~_.~~ .
PA?E
05
from:Tab1tna M Nlcaeio FaxlD',
ACORD. CEFmFICATE OF LIABILITY INSURANCE oP '10 TN \ I3A1'1i ~;oD{Y"/"m
SUNSS-Z 04 14109
PRODU(:F.R THIS C~IlTIF1CATE IS ISSUfD AS A MATTER OF INFORMATIO
ONLY AND Co!>lFfRS NO RIGHTS UPON THI" CfRTlFICAre
Aclt~:n. :InlSuranoe SCllrv'ic:.QC HOLDER. THIS CERTIFICATE D""S HOT AMENO. EXTfND OR
:1515 P::i.Pl!! Ri.dqt!! Rd. S~. 17 ALTfR THe cove~Ge AFFORDED 8Y THIO POLICies 81:LOW
NB.p~CS FL 34i09 INSURERS AFfoRDING COVERAGE: NAIC#
Fhone: 239-597-109E, F",,,:239,.591-9560
lNSUREf) IN!;Ij~RA; "" M'l1~;l. ]'~ I~~e e.o. 23119
INSURF.~ i~
SunshlDe "d~c.y I:t',C NS~f.~C:
5482 fiUlttl.l2llilnaJl;.~ HSllcv:ack aQ"d ~FU:RD:
Nap1.os na ;34113
INSlJRE.~E:
TI<E OOW"" OF ",SU.'NOo; ""'EO ,.LOW H''''' "UN ISSUEO TO ,HEIN'UR"O """ED MOV" ,OR lH" POlIOV ""Rloo INOIO/<,"O. NaTW~H.TANOINa
'NV REOUIR"'"NT, TERM OF< OONOITION '" ,NY OONTRACT OR On<ER oecUMENT wiTH ....FEOT TO WHIOH ,HIS OER;I"O/<"" ~,v BE ISSUED OR
~" PERTA"'- THE INSU.....",. ....FORCED B" rHE POWO'" O,,"CRIOW HEReiN I. SUBJECT,O "'-L TI<" TERM', "XC'USlO", 'NO OONalrlCN. of 'UOH
00~Llo~CIE5. A013REGA.TE UMITS SHOVlIN MAY rl\VE ~eEN fa)lJCl!:tl BY PAlO ClAIMS. !l~'
lttaA .!keD' t- ~llCy_eF= E. I POLIOYJolCPlRAflON
,TO IN TVPEaFtN.U..... "".J.VN_EO 0'"IE''''' OA1"'-'''''I1>O'''' ,,,...,.
~N'''''' ""Ill\,"" 'A.H OCC'J"""N'" · 2 000 000
A X 2'-L"~ERC'A1.0.'_'I"'UT'f '17_50.958906-3001 11/29/06 11/29/09 ,,",,","sJ..~~_~Q.,OOD_
_I-- CLAI"'''''''' ~ a.CU' .,.0 "'''''''Y '"' "...,," , '5,000
~. _ __._ .':"R'ONA,,~IN""".:'._ .2,000,OOL
>.-1 o.,,"'LAOO-_T' . 4 000 000
O":HG""~OATEU"TA~''''''1'R "00,,",CT:3.<0""IO..oO · 2,000,000
X I ~OLICY I 1 ~~g,: I -r LOC
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t"~ SctIEDI.lLECAUr'JS
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~~Ill
OODIL't 1f'"JURY
(i-'~r~"'t>I'\)
COVERAGES
,-
-
NON-OWNEC AUroS
BOOIL'r'I~I.ILlRY
(Plef~dl:lni)
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HFlE.r!:::NT10N ~
WORI(I;M1 COYPel4$1,no~ AND
EtIIPLOVER$' LIABLJTY
MY PI10~RI!:T('J"IP^i=r",':1'lli:tXWJT\VE
o""IGi=:RfMEMSE~ J:',xCUJOEC1
~~~~I1't'~6V\~ON~ ~IQ',"
OTl'lER
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AUTO(,):\l"V.~AGe\OE.NT ~
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Oil-'eRTI'~AN
AVTOOIolI_'V:
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,
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TMi/'UMl'TST ~
~^eCtDiNT $
E,l. mSii,4SEO:-EA EMPI.O'l"1 S
IH. [1tl~:ASE . ",oue'" UNIT S
A P%opcrty Co~~age
77.>>0-828906-3001
11/29/08
11129109
l::;oneent$
700,000
DESefllP11DN O'F OPERAl1Q"B r LO~"O'riISI \/EKlU.Em I 'E)toCLUSIDHt "ODED 'By 1;;MOCl~SW;:ME)lIT I sPECIAL PROVIalON&
~.~1eA&~ note eertif~e~ba holde~ 18 also li~~d as A~t~ona1 ~n~ured**
The cov@red. l.ooat..ions :i..oc:.uded ~:r:e:
Sunsbine MClIdj.cal Pha:c"l.'llAcy 6350 Da-.Ti..S D~vd, Napl.Qs P'L 341.04
S~nsh~ne $Qluticn~ 5480 ]tat~esnak~ Hammock Rd Naples FL 34113
sunahinc= Ph.a.rJMC.Y at Liviaqst.on 1:!020 LiV'inqa.t.on Rd ,; BO wili!lon Blvd S.
CoJ.lj:,er c:oun:t.y BOilrd of county
conuUsion.erllll
3301 ]!:, TamiAmi T>:aH
Naples FL 34J.12
CANCELLATlON
!3Hr;llA,O AN'" ~ T~ A~ DES(l.Rl&F..D pOL'lcrES UfO CANCEU!!.D ~FCRE"tHE !OOlIRATIO\II
DATE 'tHEItEOF. THE ISSUING INSURERWlLL E:NDEliVO_ TO MAll:!2....-0A.iS 'WRmt!fll
~0'T1CI! K1- THE CiRTIFll~."'~ HOlCEll: ~I TOTI4E I.~, l!!IUT IlAllURETD DO!lO SMALL
IMPOt.~ 11I0 ClBullIATION (A WU11LiT'l' OF AN'{ KtNC u,-ON THE INSUlIER, rfS AGI!!NT5 OR
REPReSlitlTjI,lTVU.
AUTHOll.lf!!." REPRESEIII'rATM
CERTIFICATE HOLDEI~
Br~~t A. Ackerman
@ ACORD CORPOR"TION 1
"CORD 25 2001108