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#09-5227 (Bidwell Home Care Services, LLC) 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 Bidwell Home Care Services, LLC, d/b/a Home Instead Senior Care, authorized to do business in the State of Florida, whose business address is 10621 Airport Pulling Road, Suite 8, Naples, Florida 34109, hereinafter called the "Vendor" and Collier County, a political subdivision of the State of Florida, Collier County, Naples, hereinafter called the "County": WIT N E SSE T H: 1. COMMENCEMENT. This Agreement shall commence on July I, 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: Bidwell Home Care Services, LLC, dba Home Instead Senior Care 10621 Airport Pulling Road, Suite 8 Naples, FL 34109 Attention: Susan Bidwell Telephone: 239-596-2030 Facsimile: 239-596-9532 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.s., 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 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. 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.e. 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. ATTEST: Dwight E. Br<?~k, Clerk of Courts ~. 1". ~ t .l ~ r "! BOARD OF COUNTY COMMISSIONERS COLLIER OUNTY, FLORIDA ~d~ By: Dateq;" ,"', . ~EA~) ;':~., . AttjS,t", to ~.~,~,; f,' .::. \lo!]llll,IJ...........' . . , .I . ~, ..:....,.....< '.' (/1 ", ," .". , .. ~d.'::\t.,.i By: Donna Fiala, Chairman Bidwell Home Care Services, LLC d/b/a Home Instead Senior Care Vendor ~L~. ~..~- First itnes;-' / By: " ~..~ Signature U lc),. "'- c:'" b.JL~o", t~e/ print witness nam~t ~d4.! b4tu 3 Second Witness .Brenda. 'Rea i/~ (~ tType/print witness namet ~ 6lJW~lJ Typed signature and title Approved as to form and legal sufficiency: ?;# R Lt A&Gi~~tut+ County Attorney t;)qlo'l ""'I 5coif R.. 7~ Print Name Page 6of7 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 PRODUCER THIS CBUIRCA TE IS ISSUED AS A MA TTffi OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CBUIRCA TE HOLDER. THIS CERTIRCA TE DOES NOT AMEND, EXTEND OR AL Tffi THE COVERAGE AFFORDED BY THE POUCIES BaOW. ACORDTM CERTIFICATE OF LIABILITY INSURANCE Lockton Risk Services P.o. Box 410679 Kansas City, MO 64141-0679 INSURERS AFFORDING COVERAGE INSURED Bidwell Service Care LLC dba Home Instead Senior Care; Bidwell Home Care 16520, South Tamiami Trail, #203 INSURER A: First Specialty Insurance Company INSURER B: INSURER C: INSURER D: INSURER E: Ft ers, FL 33908 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 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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~ ~~ POLICY NUMBER POUCY EFFECTIVE POUCY EXPIRATION LIMITS A ~ERAL LlABlUTY Ii'CP114005638903 01/14/2009 01/14/2010 EACH OCCURRENCE $ 1 nnn nnn' "'-- 3MMERCIAL GENERAL LIABILITY ~:~%'fs T~aR;~J~~ncel $ ~nn nnn - CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 1 n nnn X PERSONAL & ADV INJURY $ 1 nnn nnn - ,,/ - GENERAL AGGREGATE $ ? nnn nnn ~'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $? nnn nnn I" 'POLICY n- ~~gr n LOC A ~OMOBlLE LIABILITY !FCP114005638903 01/14/2009 01/14/2010 COMBINED SINGLE LIMIT / (Ea accident) $ 1,000,000 f--- ANY AUTO f--- ALL OWNED AUTOS BODILY INJURY (Per person) $ f--- SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY (Per accident) $ lL.- NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) ~RAGE LIABILITY AUTO ONLY. EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCE!SSIUM8RB.lA LIABILITY FUM114009342000 01/14/2009 01/14/2010 EACH OCCURRENCE $ 1 nnn nnn ~' OCCUR D CLAIMS MADE AGGREGATE $ 1 nnn nnn $ R DEDUCTIBLE $ RETENTION $1 () ()()() $ WORK8'lS COMPENSATION AND I T~~-1I~~s I TOJbl- BoIPLOY8'lS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E, L, EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ ~/Eecf~~s~~i~~~g~s below - E.L. DISEASE - POLICY LIMIT $ A OTHER FCP114005638903 01/14/2009 01/14/2010 ~ach Professional Professional Incident $1,000,000 Liability ~ro Liab Aggregate $2,000,000 DESCRIPTION OF OPffiA TIONS I LOCATIONS I V8-lICLES I EXCLUSIONS ADDBJ BY a1DORSBoI eIT I S~L PROVISIONS Certificate Holider is listed as Additional Insured as respects to Work Performed by Named Insured. Reference #09-5227; Title: Collier County Services for Seniors Coverage for incidents arising out of Non-Medical Professional Services for Bodily Injury, Property Damage and Personal & Advertising Injury, CERTIRCA TE HOLDER CANCaLA TION SHOULD ANY OF THE ABOVE DESCRIBBJ POLICIES BE CANC8l.8) Be'ORE THE EXPIRATION Collier County DATE THBti)F, THE ISSUING INSURfR WIll. a1DEAVOR TO MAIL Ul-- DAYS WRITTaI Board of County Commissioners NOTICE TO THE CSUIACA TE HOLDER NAMBJ TO THE lEFT, BUT FAILURE TO DO SO SHAll. 3301 E. Tamiami Trail IMPOSE NO OBIJGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR RS'RESeITA TIVES. Naples, Fr. 34112 AUTHORIZED REPRESeITATIVE I 0,-_ jJ~ ACORD 25 (2001/08) D8#7380299 QACORD CORPORATION 1988 719432 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) FILE NO.: IH''-.r> LlJ 1'1:.f:~(,\,~: elf: 'l'H(: ~_: l I ! ~ -" '-- .1 ;..,.- COl Jill Y /\TT()fili~E RECEIVED: ~ r.. ~. '3 v/..l~ ~\~ 17ne:R~ 15 ~ l. ); z>J~'1 ./ ~ b t;tj ~o~ 2? )< /\ /1) S&J S) ITEM NO.: 0Cr-?aL" ()\~y(J1 ROUTED TO: DO NOT WRITE ABOVE THIS LINE REQUEST FOR LEGAL SERVICES 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" Contractor: Bidwell Home Care Services, LLC d/b/a Home Instead Senior Care BACKGROUND OF REQUEST: This Contract was approved by the BCC on June 23, 2009, Agen Item 16.E.10 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 # tJq - ,IJ;ec - ~ (()- ~ t, CHECKLIST FOR REVIEWING CONTRACTS Entity Name: 11 IlJJuf:..l. t.- iferv,;.. L'/'1t.e<C. S c~ V{ CY.- L U! oLf b i ^ ~lt. , NoS T ~Al:> SEN( DR... l!Il1f. E. Entity name correct on contract? Yes Entity registered with FL See, of State? ~ Yes Insurance Insurance Certificate attached? Insured registered in Florida? Contract # &/or Project referenced on Certificate? Certificate Holder name correct (BCC)? Commercial General Liability General Aggregate Required $ I t\\l L- Products/CompIlOp Required $ Personal & Advert Required $ Each Occurrence Required $ Fire/Prop Damage Required $ Automobile Liability Bodily Inj & Prop Required $ \ W\.l L- Workers Compensation Each accident Required $ Disease Aggregate Required $ Disease Each Empl Required $ Umbrella Liability Each Occurrence Provided $ , tv.1 L Aggregate Provided $ I M ll- Does Umbrella sufficiently cover any underinsured portion? Professional Liability Each Occurrence Required $ Per Aggregate Required $ Other Insurance Each Occur Type: Provided $ -Z M.l L. Provided $ \ r Provided $ t M l L- Provided $ I' Provided $ 3 "0. oW , Provided $ t Iv\. l L Provided $ ,s-/5lo. ()t:lO Provided $ I ~ Provided $ I ' Exp Date Exp Date ~Yes Provided $ t ~,"- Provided $ 2- M. \ L Required $ Provided $ County required to be named as additional insured? County named as additional insured? ~Yes ~Yes Indemnification Does indemnification meet County standards? Is County indemnifying other party? ~Yes Yes Performance Bond Bond requirement referenced in contract? If attached, expiration date of bond Does dollar amount match contract? Agent registered in Florida? 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? -L Yes -L Yes ~Yes ~Yes ~\~ \ ~Yes ~Yes ~Yes Attachments Are all required attachments included? LYes No No ~Yes ~Yes ~Yes ~Yes No No No No Exp. Date -t / 1"1 I d-tJtlJ Exp. Date I it Exp. Date l , Exp. Date I ( Exp. Date I . ExpDate l/'4/"ZLJ(f) ( , Exp Date III \4 /,ztJ/t? Exp Date I I, Exp Date ' , \ II Li ('Z-l11 /) , I' No Exp. Date '(I Lf {Ut(;J Exp. Date I , Exp Date_ No No No ~No Yes No Yes Yes No No No No No No No No No No <::::... Reviewer Initials: ~ Date. f,/3tf'/W 04-COA-OI0301122 MEMORANDUM FROM: Lyn M. Wood, C.P.M., Contract Specialist Purchasing Department ~ .)Jf~ J~/S( TO: Ray Carter Risk Management Department DATE: June 25, 2009 RE: Review Insurance for Contract: #09-5227 "Services for Seniors" Contractor: Bidwell Home Care Services, LLC d/b/a Home Instead Senior Care 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 RECE\VED jUN 1. 5 '2.009 ;;;J:i 0/'J1/0~ C: Terri Daniels, Housing & Human Services mausen_9 From: Sent: To: Cc: Subject: RaymondCarter Monday, June 29,200910:32 AM LynWood; DeLeon Diana DanielsTerri; mausen_9 Contract 09-5227 "Services for Seniors" All, I have approved the certificate(s) of insurance as provided by Bidwell Home Care Services, LLC d/b/a Home Instead Senior Care. The contract will now be forwarded to the county attorney's office for their review. Thank you, Ray ~~ Manager Risk Finanace Office 239-252-8839 Cell 239-821-9370 1 www.sunbiz.org - Department of State Page 1 of2 Home Contact Us E-Fi/ing Services Document Searches Forms Help Previous on List Next on List Return TQJ,.ist IEntity Name Search No Events No Name History Detail by Entity Name Florida Limited Liability Company BIDWELL HOME CARE SERVICE LLC Filing Information Document Number L07000059780 FEIIEIN Number 260188884 Date Filed 06/06/2007 State FL Status ACTIVE Effective Date 06/06/2007 Principal Address 10621 AIRPORT PULLING RD, #8 NAPLES FL 34109 Changed 06/12/2007 Mailing Address 10621 AIRPORT PULLING RD, #8 NAPLES FL 34109 Changed 06/12/2007 Registered Agent Name & Address BIDWELL, WILLIAM J JR. 1912 EMPRESS COURT NAPLES FL 34110 US Manager/Member Detail Name & Address TitleMS, BIDWELL, SUSAN C 1912 EMPRESS COURT NAPLES FL 34110 Title M R. BIDWELL, WILLIAM J JR. 1912 EMPRESS COURT NAPLES FL 34110 Annual Reports Report Year Filed Date 2008 07/11/2008 http://www. sun biz. org/ scripts/ cordet. exe ?action= D ETFIL&inCL doc _ num ber= L0700005 97... 6/22/2009 www.sunbiz.org - Department of State Page 2 of2 200B 04/15/2009 Document Images (M/J5{;ZQQ9==ANNUAL REPORT 07l11/200a =~_ANNLJALBEPORT 06/013/2007 =--FIQrida Limited Liability I Note: This is not official record, See documents if question or conflict. View image in PDF format View image in PDF format View image in PDF format Previous on I,.ist Next on list Return To list No Events No Name History /Entity Name Search Submit I I Home I Contact us I Document Searches I E-Filing Services I Forms I Help I Copyright and Privacy Policies Copyright i9 2007 State of Florida, Department of State. http://W\\w.sunbiz.org/scripts/cordet.exe?action=DETFIL&inCL doc _ number=L070000597 ... 6/22/2009 JUN/26/2009/FRI 02:04 PM BIDWELL FAX No, 2375969532 p, 002 PD n~MI ~rTrll>~" w. "OUl" KLmdnn. k.. Cfr"ir_tlllI Gcqr&o: ~Alldcfcr. lit"" ClilliNt',,,, Joh,. D. H;uo:ebnoll NisN~n TIIQmlllI S. P~lCOl'l' Charlt~ It Winl>. M1,.;t)~/(rt:" tr ~"'ffll' .dt~' ('91~ P.O. Bo.~ '88. Ulkdlll\d. rL 33802-1198&. "'\I'\I'J/u/ll1,iIIWlliil'g<.Mm Tclclllmm(86') 665-6000 Gr 1"800-~'2- i648' '~QK (56:>:;666-19:13 tII:kIl 11 IJ .... II lh.l.UT ceRTIFICATe OF INSURANce RE: 0520-32582 ISSUED TO: Collier County Housing and Human Services Building H Nllpll!S, FL 34112 Attn:3301. Tamlaml Trail East Producer: Janis I.lnda Russell Company: Russell Insurance Agency, Inc::. Address: 1750 Carlisle Farms Drive traverse City, M149686-0000 Phone: (231) 932-7603 This Is to certify that Bidwell Service Care, LLC. Home Instead Senior Care 16520 S. Tamlaml Trail, SIJlte 203 Ft, Myers F. being subject to the provisions of the Florida Workers' Compensation law, has secured the payment of any workers' compensation benefits dye by insuring tI1eir risk with the Florid<l Ret<lll Federiiltion Self Insurers Fl.Ind. POUCY NUM6eR: 0520-32582 we Statutory I.lmltl;--State of Florida Employers Liiilbility EFFECTIVE DATE: JanlJary 14, 2009 500,000 (Each Accident) SOO,OOO (Dlsease--each employee) 500,000 (Dlsease--Pollcy l.Jmlt) EXPIRATION DATE: Januarv 14. 2010 This certificate Is not a policy and of Itself does not afford any Insurance. Nothing contained In this certlflcate shall be construed as amending, extending, or altering coverage not <lfforded by the polley shown above or affording Insurance to any insured not named above. The policy of Insurance listed above has been Issued to the named Insured for the polley period Indicated. Notwithstanding any requirement, term or condition of any contract or other document to which this certificate may pertain. the Insurance made available by the described policy in this certificate is subject to only the terms, exc:!usions iilnd conditions of such policy. Piilid cliilims miilY have reduced the shown limits. If the polley descrtbed above Is cancelled before the expiration date Indicated, the Issuing company will endeavor to mall 30 days' written notice to the certificate holder niilmed iilbove, althol.lgh if c:ancelliiltion is for nonpayment of premil.lm, then the issuing cOmpany will endeavor to m.!lll JJ:2 days' written notice to the cettlflci!lte holder. In i!lny event, the Issuing company, Its agents, and representatIves accept no obligation or liability of any kInd for failure to mall such notice. Date: Junf':;>1i ;>009 ~ })-c--- Summit, Administrator Florida Retail ,F<<Iel'lllion Self InslIrers Fund