#09-5227 (Summit Home Respiratory Services, Inc.)
A G R E E MEN T 09-5227
for
Services for Seniors
THIS AGREEMENT, made and entered into on this 23rd day of June, 2009, by and between
Summit Home Respiratory Services, Inc., d/b/a Summit Home Healthcare Products,
authorized to do business in the State of Florida, whose business address is 1467 Railhead
Boulevard, Naples, Florida 34110, hereinafter called the "Vendor" 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 July 1, 2009 and shall
terminate on June 30, 2012.
2. STATEMENT OF WORK. The Contractor shall provide Services for Seniors in
accordance with the terms and conditions of ITQ #09-5227 and the Vendor's proposal
referred to herein 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 Vendor and the County Contract
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 Vendor 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 as set forth
in Appendix I, Contract Rate Caps, attached hereto and made an integral part hereof.
Payment will be made upon receipt of a proper invoice and upon approval by the
Contract Manager or his designee, and in compliance with Section 218.70, Fla. Stats.,
otherwise known as the "Local Government Prompt Payment Act".
4. SALES TAX. Vendor 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.
Page lof7
5. NOTICES. All notices from the County to the Vendor shall be deemed duly served if
mailed or faxed to the Vendor at the following Address:
Summit Home Respiratory Services, Inc. dba Summit Home Healthcare Products
1467 Railhead Blvd.
Naples, FL 34110
Attention: Constance G. DeVozza
Telephone: 239-596-5000
Facsimile: 239-596-5017
All Notices from the Vendor 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 Vendor 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.
6. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating
a partnership between the County and the Vendor or to constitute the Vendor as an
agent of the County.
7. 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 Vendor. 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 Vendor. The Vendor shall also be solely responsible for payment of any
and all taxes levied on the Vendor. In addition, the Vendor 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 Vendor agrees to comply with all laws
governing the responsibility of an employer with respect to persons employed by the
Vendor.
8. NO IMPROPER USE. The Vendor 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
Page 2 of7
effect or hereafter enacted or adopted. In the event of such violation by the Vendor or if
the County or its authorized representative shall deem any conduct on the part of the
Vendor to be objectionable or improper, the County shall have the right to suspend the
contract of the Vendor. Should the Vendor 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 Vendor further agrees not to commence operation during the
suspension period until the violation has been corrected to the satisfaction of the
County.
9. TERMINATION. Should the Vendor 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 sole judge of
non-performance.
10. NO DISCRIMINATION. The Vendor agrees that there shall be no discrimination as to
race, sex, color, creed or national origin.
11. INSURANCE. The Vendor shall provide insurance as follows:
A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000
Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Vendors; Products and Completed Operations and Contractual Liability.
/'
B. Business Auto Liability: Coverage shall have minimum limits of $1,000,000 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.
/
Special Requirements: Collier County Government 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 Vendor 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.
Page 3 of7
Vendor shall insure that all subVendors comply with the same insurance
requirements that he is required to meet. The same Vendor shall provide County
with certificates of insurance meeting the required insurance provisions.
12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Vendor
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 Vendor or anyone employed or utilized by the
Vendor 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. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf
of the County by the Housing and Human Services Department.
14. CONFLICT OF INTEREST: Vendor 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. Vendor further represents that no
persons having any such interest shall be employed to perform those services.
15. 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: Vendor's Proposal, Insurance Certificate, and ITQ #09-5227 Specifi-
cations/Scope of Services.
16. 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.
17. 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 andj 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.
18. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
Page 4 of7
responsible for complying with the provisions of 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. Failure by the Vendor 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.
19. 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.
20. 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.
21. ADDITIONAL ITEMS/SERVICES. Additional items and/ or services may be added to
this contract upon satisfactory negotiation of price by the Contract Manager and
Vendor.
22. 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 Vendor 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 Vendor 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.
Page 5 of7
IN WITNESS WHEREOF, the Vendor 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.
BOARD OF COUNTY COMMISSIONERS
COLL~UNfY' FLORIDA
By: .~ d~
Donna Fiala, Chairman
Summit Home Respiratory Services, Inc.
d/b/a Summit Home Healthcare Products
Vendor
7;7. -! ~
First Witness
/J1r /1); tJe?
tType/print witness namet
-~ 4!..- ..dJ-rP~
~ S cond Witness
a
I . ()
By: . ~Cf ~ !!J,#J~
Signature
CJJ.ck/lre (;..~tizZIl
Typed signature and title
'WlC( "',.C', ~~L-~,....
I
tType/print witness namet
Approved as to form and
legal sufficiency:
~J/-P)~
A~3iS*Yt County Attorney
~pk
,,5 4, If f2 ~ed-...
Print Name
Page 6 of7
APPENDIX 1
CONTRACT RATE CAPS
SERVICE
MAXIMUM FEEIUNIT OF SERVICE
Total Cost Reimbursement
Adult Day Care (CCE) $10.00 per Hour $ 9.00
CHORE $20.00 per Hour $18.00
Enhanced CHORE'" $30.00 per Hour $27.00
Emergency Alert Response System $ 1. 11 per Day $ 1.00
Homemaker $20.00 per Hour $18.00
Personal Care $22.22 per Hour $20.00
Respite (In-Home) $20.00 per Hour $18.00
Respite (In- Facility)ADI $10.00 per Hour $ 10.00
Skilled Nursing $38.89 per Hour $35.00
Specialized Med Equipment 100% cost 90% of cost
Facility Respite (24 Hours) $138.90 per 24hr. $125.00 per 24hr.
'" Enhanced Chore requires two (2) or more workers performing multiple tasks at the same time.
Page 7 of7
JUN-05-2009 11:03
Integrated Insurance
239 549 7905
P.007
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE IIlMIDDIYYYY)
TII 06/0512009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Integrated Ins. Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1316 SE 46th Lane #1 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
Cape Coral FL 33904 INSURERS AFFORDING COVERAGE NAIC#
INSURED Summit Home Respiratory Services, Inc. INSURER A: Campmed Casualtv & Indemnity Co. ;7140
1467 Rail Head Blvd. INSURER B: TechnoloQY Insurance Co. t!n1w
INSURER C'
Naples FL 34110 INSURER D
INSURER E
COVERAGES
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 Am 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~: r:.r:z~ POUCY NUIIBEft POL.ICY """ECTIVE POUCY EXPIRATION LIMITS
~NERAL LlABl1JTY EACH OCCURRENCE $ 1,000,000 .,-
A ..!. 3MMERCIAL GENERAL LIABILITY 28CMCFL.138 09/27/08 09/27/09 DAMAGE TO RENTED $ 50,000
- CLAIMS MADE ~ OCCUR MEDEXPIAnvon.~~1 $
X Products/CampI. Ops I ~AL & ADV INJURY $ 1,000000
~ Professional liability GENERAL AGGREGATE $ 2,000,000 ,/./
n'L AGGRn LIMIT APr~t PER. PRODUCTS. COMP/OP AGG $ 2,000,000 ./
POLICY ~~9,: X LOC
~TOMOBlLE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea aCCident)
--
-- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
--
- HIRED AUTOS BODILY INJURY
$
NON.OWNED AUTOS (Per accident)
-
PROPERTY DAMAGE $
(Pet aCCident)
RRAGE LIABILITY AUTO ONL Y . EA ACCIDENT $
ANY AUTO OTHeR THAN EA ACC $
AUTO ONLY' AGG $
OESSlUMSREl.LA UABIl.ITY I EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$ --
[~ DEDUCTIBLF: $
RETENTION $ $
WOftKEftS COMPENSA l10N AND X I WC STATU- 10J.tt.
B EMPl.OY!RS" UABlLlTY TWC3200066 06/05/09 06/05/10 E.L. EACH ACCIDENT $ 500,000
ANY PROPRIETDRIPARTNERIEXECUTIVE $ 500.000
OFFICERIMEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE
~~:~~!~~v':~~~S ""I"'" E L DISEAse. POLICY LIMIT $ 500,000
OTHER
DESCRlPl10N OF OPERATIONS / LOCA110NS / VEHICLES I EXCl.USIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Sales of medical supplies.
Certificate Holder is an Additional Insured with respects to the policies noted on this certificate.
Bid: #ITQ #09.5227
Title: Collier County Services for Seniors
CERTIFICATE HOLDER
CANCELLATION
Collier County
Board of County Commissioners
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIl. ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEI'T, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABIIJTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ftEl'ftESENTATlYES.
AUTHORIZPf RE~E NTATIVE
,JL 1\. -?f/7ZiilJ-
Naples, FL
ACORD 2S (2001/08)
@ACORDCORPORATION 1988
TOTAL P.007
o 1I'.:t: ,.,t'" -, \ \. \OC\,
ITEM NO.: CA -i JI!..C.-~ D~id/ l/>$! V) ,~C~~~D
V. L ~ <so tlJI)!,Ji'r A./IO,ciNEY'
FILE NO.: (&V" ~ i
ROUTED TO V~ t.l~fV1 ZGj) :7 F,: 213
REQUEST'- LEGAL SERVICES
sr 'yf
"'1/'
Date: June 25,2009
To: Office of the County Attorney
Jeff Klatzkow
From: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re:
Contract: #09-5227 "Services for Seniors"
~~)b1
tl>
Contractor: Summit Home Respiratory Services, Inc. d/b/a Summit
Home Healthcare Products
BACKGROUND OF REQUEST: '~..
This Contract was approved by the BCC on June 23, 2009, Agenrr(:../.~...~
Item 16.E.10 ('In
This item has not been previously submitted.
ACTION REQUESTED:
Contract review and approval.
OTHER COMMENTS:
Please forward to BCC for signature after approval. If there are any
questions concerning the document, please contact me. Purchasing would
appreciate notification when the documents exit your office. Thank you.
C: Terri Daniels, Housing & Human Services
RLS # ()f - Aet!. - O/~'1:J...
CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: SUI-it I r ~ K f~~ Pfl2l/7?)~Y -..fE R..UIc...~c" / /~ ct/i>/a..
. Sti~A1I' tbm't /ftIlL T/Il'ARZ l~tJr)(.J:(.!:fS
EntIty name correct on contract? ~y es _No
Entity registered with FL Sec. of State? ~ es No
Insurance
Insurance Certificate attached?
Insured registered in Florida?
Contract # &lor Project referenced on Certificate?
Certificate Holder name correct (BCC)?
Commercial General Liability
General Aggregate Required $ I MIL
Products/CompVOp Required $
Personal & Advert Required $
Each Occurrence Required $
FirelProp Damage Required $
Automobile Liability
Bodily Inj & Prop Required $ W Al vU) Provided $
Workers Compensation
Each accident Required $
Disease Aggregate Required $
Disease Each Empl Required $
Umbrella Liability
Each Occurrence Provided $
Aggregate Provided $
Does Umbrella sufficiently cover any underinsured portion?
Professional Liability
Each Occurrence Required $
Per Aggregate Required $
Other Insurance
Each Occur Type:
Required $
County required to be named as additional insured?
County named as additional insured?
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
--.L Yes
-./ Yes
V Yes
~Yes
Provided $ "2-Ml L-
Provided $ II
Provided $ I 1M1.....
Provided $ ,.
Provided $ SO)60D
Provided $f~().fJ'Q
Provided $ l ('
Provided $ l '
Exp Date
Exp Date
Yes
Provided $
Provided $
Provided $
/Yes
-.L. Yes
~Yes
Yes
Yes
Signature Blocks
Correct executor name in signature block?
Correct title of executor?
Executor authorized to sign for entity?
Proper number of witnesses/notary?
Authorization for executor to sign, if necessary:
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
Attachments
Are all required attachments included?
Yes
Yes
-L Yes
---L Y es
V Yes
V Yes
~ft,~Ili<l<V- ~~\ ':> "'\.Il-r
~Yes
-L Yes
V Yes
hes
No
No
No
No
Exp. Date ~
Exp. Date \. ,
Exp. Date l ,
Exp. Date I ,
Exp. Date I ,
Exp Date -
Exp Date bfs-I (t?
Exp Date / I,
Exp Date ( /
No
Exp. Date
Exp. Date
Exp Date_
No
No
No
~No
No
No
No
No
No
No
No
No
No
No
No ~
Reviewer Initials: c!-
Oate: f/3i?6tJC?
04-COA- 103 /222
MEMORANDUM
TO: Ray Carter
Risk Management Department
FROM: Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
jlV
, /~{~
;~
DATE: June 25, 2009
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Summit Home Respiratory Services, Inc. d/b/a
Summit Home Healthcare Products
This Contract was approved by the BCC on June 23, 2009, Agenda Item
16.E.10
Please review the Insurance Certificates for the above referenced contract. If
everything is acceptable, please forward to the County Attorney for further
review and approval. Also, will you advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LMW
.t:? -.
IF ."" ,.,
. '-' t:: I
. I/S"
il'AI .c'
V'V 2/.;
RIS" v 2009
~GC4tctv7
~~;t
. ~/z>'k9
U/~Aut.P1~L //
~#~~4
C: Terri Daniels, Housing & Human Services
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Friday, June 26, 2009 7:22 AM
DeLeon Diana
LynWood; DanielsTerri; mausen_g
Contract 09-5227 "Services for Seniors"
All, I have approved the following contracts this morning:
1. United Senior Services, LLC d/b/a Visiting Angels of Naples
2 Summit Hnm~ R~""ir~tnry S~rvic~", Inc. d/b/a Summit Home Healthcare Products
3. Care Club of Collier County, Inc.
The Contracts will now be forwarded to the County Attorney's Office for their review.
~~
Manager Risk Finanace
Office 239-252-8839
Cell 239-821-9370
1
JU':1 24 09 11:34a
Summit Home Respirator~
9415965017
p. 1
Summit Home Respiratory Services, Ine
d.b.a. Summit Home Healthcare Products
1467 RAIL HEAD BLVD,
NAPLES, FL 34110
PHONE (800) 395-6940 PHONE: (888) 731-0404
FAX: (800) 853-2858
FAX
DATE:
Cover page
6-24-09
PAGES 3
Including
TO: _Diana De Leon
COMP ANY : _Collier County Purchasing Department
FAX:
239-252-6597
FROM:
_Constance G. De V ozza , Chief Operating Officer
SUBJECT/REF: _Request for Waiver of Proof of Automobile Ins. Contract #09-
5227 "Collier County Services for Seniors"
COMMENTS:
_Thank you for your help. Have a great day!
Confidential Notice
The documents accompanying this f...,simile transmission contllin Icgllily privileged eonfidentiallnfonnation that belones to
the sender. Tlte infonnntlon is intended only for the use of the individulli or entity named above. If you are not the intended
n.clplent, you are hercby notified that any disdosure, copying, distribution, or the taking of any action in reliance of the
contents oftltis transmission Is strictly prohibited. If you have l'eeelved this facsimile transmission in error, please notil)' us at
the above telephone uumber immediately to arrRuge for the return of the origlnlli document to us. Thank you.
Jun .24 09 11: 34a
Summit Home Respirator~
9415965017
p.2
Summit Home Respiratory Services, Inc.
d.b.a. Summit Home Healthcare Products
1467 RAIL HEAD BLVD.
NAPLES, FL 34110
Phone: (800) 395-6940
(888) 731-0404
FAX (800) 853-2858
Lyn M. Wood, Contract Specialist
Collier County Purchasing Department
3301 East Tamiami Trail
Naples, Florida 34110
Re: Contract #09-5227 "Collier County Services for Seniors"
Dear Ms. Wood,
Summit was asked to attach proof of Auto Liability Insurance to this contract. Our company
does not have any company owned vehicles so we are asking for this requirement to be
waived.
I have attached "About Us" to this letter. It will tell you more about our business and how
we work very hard to provide the best products at the very best possible price to Medicaid
Waiver Program recipients throughout the State of Florida. All products are shipped, most
next day throughout Florida.
Thank you in advance for your consideration in this matter. We look forward to another
great year. Please call me in can be of further assistance,
Sincerely,
~<<~ UH;-7?-
Constance G. De V ozza
Chief Operating Officer
.Jun 24 09 11: 34a
Summit Home Respirator~
9415965017
p.3
SUMMIT
HOME HEAL THCARE PRODUCTS
1467 RAIL HEAD BLVD.
NAPLES, FL 34110
PHONE (888) 731-0404
(800) 395-6940
FAX (800) 853-2858
(888) 697-9868
ABOUT US
~ Established medical supply company located in S. W. Florida since 1983.
~ Affiliated with Medicaid Waiver Program throughout the state of Florida for over 15
years. Sold DME portion of business in 2005 to concentrate solely on Medicaid
Waiver Program.
~ Have signed referral agreements with over one hWldred agencies throughout Florida.
Currently participate with Aged or Disabled Adult Waiver, Alzheimer's Disease
Waiver, Consumer Directed Waiver, Developmental Services Waiver, Family
Supportive Living Waiver, Nursing Home Diversion Waiver, PAC Waiver and
Traumatic Brain and Spinal Cord Injury Waiver.
~ November 2008, company added d.b.a. to company name to better reflect current
operation. Summit Home Respiratory Services lIic. will be d.b.a. Summit Home
Healthcare Products.
~ Currently have a total of twelve knowledgeable staff members dedicated solely to the
Waiver Program. We work closely with case managers and clients to answer
questions or concerns and assure correct and efficient shipping and billing of
products ordered.
~ Computerized UPS and FEDEX shipments to assure accurate and fast delivery of
products. FREE EXPRESS DELIVERY on all orders, Orders received by 4 p.m.
will arrive at client's home the next day. Florida panhandle requires 2nd day delivery.
~ Orders are electronically billed with Month End Expenditure Reports sent within two
business days of end of month, or billed via invoice with mailing of such on a weekly
basis.
~ Four toll-fTee numbers to speak with our staff or to fax orders/other communications.
~ Catalog containing pictures, descriptions and pricing of consumable supplies and
specialized medical equipment. We supply as many catalogs as needed.
~ November 2008, published first "'Additional Product List" to help agencies cut costs.
Some prices lowered and some great new products offered at the lowest possible
pnces.
~ We maintain a large warehouse stocked with most supplies. We also maintain a large
catalog library used by us to assist case managers in locating needed specialty items.
~ Free Sample Program available for most incontinent products.
~ We have continued to maintain the same or lower price levels since 1999.
PHONE (239) 596-5000
SUMMIT
HOME RESPIRATORY SERVICES, INC.
1467 RAIL HEAD BLVD.
NAPLES, FL 34110
FAX (239) 596-5017
June 1,2009
I, Keith E. Glisch, President/CEO of Summit Home Respiratory Services, Inc. d.b.a.
Summit Home Healthcare Products, in my absence, transfer my administrative power to
Constance G. DeVozza, Summit's Chief Operating Officer.
Ms. DeVozza will be listed on all bank accounts as an additional signer. I also give her
the authority to sign any agreement necessary for the day to day operation of the
company whether I am present or not.
~s:~~
Keith E. Glisch
President/CEO
State of
4/U'.b1J
County of & /ll..R f'L,
Th~ing instrument was Sign~ and aCknOWledgt before me this L day
of -L, , 2009, byW-o/~/~ t1; ...l ~.tzA personally
known to me.
0~~J-n;&"
Notary Public Signature
lL(b/J tJ ;--/
Public
E / Jh/ll~ /J!
Printed Name of No
,~I\Y "II
~" .......~(i; ELAINE M. NELSON
>4-...~ * MY COMMISSION' 00 470181
<p~.. EXPIRES: September 11, 2009
..~" OFF\."~'" BOnded Thru Budget Notary Services
:D "'/71J / 1/
Notary Commissio
- www.sunbiz.org - Department of State
Page 1 of2
Home
Contact Us
E-Filing Services
Document Searches
Forms
Help
Previous on List
Next on List Return To Ll.~t
IEntity Name Search
Submit I
Events
No Name History
Detail by Entity Name
Florida Profit Corporation
SUMMIT HOME RESPIRATORY SERVICES, INC.
Filing Information
Document Number G60163
FEI/EIN Number 592321210
Date Filed 09/20/1983
State FL
Status ACTIVE
Last Event AMENDMENT
Event Date Filed 12/06/1993
Event Effective Date NONE
Principal Address
1467 RAIL HEAD BLVD.
NAPLES FL 34110 US
Changed 03/01/1999
Mailing Address
1467 RAIL HEAD BLVD,
NAPLES FL 34110 US
Changed 03/01/1999
Registered Agent Name & Address
GLlSCH, KEITH
25 LAS BRISAS WAY
NAPLES FL 34108 US
Name Changed: 06/23/1992
Address Changed: 05/08/1997
Officer/Director Detail
Name & Address
Title PRES
GLlSCH, KEITH
25 LAS BRISAS WAY
NAPLES FL 34110
Annual Reports
Report Year Filed Date
2007 04/05/2007
http://www. sunbiz.org/scripts/cordet.exe?action=D ETFIL&ino doc num her=GnO 1 nl&in
hI? 1 I? ()()Q
. www.sunbiz.org - Department of State
Page 2 of2
2008 04/25/2008
2009 04/13/2009
Document Images
04/.'1.3l2Q09==-6Nt''-L.JALBEPORI
Q4!25!2QQ8..=__ANNL.JALJiEP_QFU
Q4!Q512QQZ_~~ANNL.JAL..RE.E'.QJrr
04/05/2006 -- ANNUAL REPORT
04/18/2005 -- ANNUAL REPORT
04/.30/2004 -- ANNUAL REPORT
~4!1]!2QQ::3-- ANNUAL REPORT
05/01/21)02-- ANNUAL REPORT
Q5/\>-2/200 J_=:ANNL.JAL.RE:PORI
0912_912QQO -- ANNUAL REPORT
Q3/()1J1999 ==..ANNL.JAL.RE:PQRI
05/(J811998 -~mANNL.JAlREPQRJ
05/08(199T~=ANNl,JAL REPORT
05/01J199Q.~-.ANNUAL REPORT
05101/1995=__ANNl,JAL. REPORT
View image in PDF format
I Note: This is not official record. See documents if question or conflict.
PrElyipl.ll:>on List
Next..Q!LList
Return To List
IEntity Name Search
I::VElnt~
No Name History
I Horne I Contact us I Document Searches I E-Filing Services I Forms I Help I
Copyright and Privacy Policies
Copyright rg 2007 State of Florida, Department of State.
http://www.sunbiz.org/scripts/cordet.exe?action=D ETFIL&ina doc num her=GnO 1 ni&in
fl/?inOOQ