#09-5227 (Millenium House of SWFL)
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
Millennium House of Southwest Florida, Inc., authorized to do business in the State of
Florida, whose business address is 8951 Bonita Beach Road, Suite 297, Bonita Springs, Florida
34135, 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 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
ass6ciated with the Work or portions thereof, which are applicable during the
performance of the Work.
Page 1 of7
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:
Millennium House of SW Florida, Inc.
8951 Bonita Springs Road, Suite 297
Bonita Springs, FL 34135
Attention: Cindi Ryerson
Telephone: 239-992-5513
Facsimile: 239-992-2238
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.
~,
~
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.
r/.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 sub Vendors 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. Broc~;.~l~rk of Courts
". \" .;;, .'t:,
BOARD OF COUNTY COMMISSIONERS
COLLIER COU , FLORIDA
~cl~
By:
Date
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attalttiote .. . ','
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By:
Donna Fiala, Chairman
Millennium House of SW Florida, Inc.
Vendor
~.f:LC4' ,~{;~
First Witness
By:
{11tiA $I f~
Signat
Dla~~ O"cL.c(Ct
tTypefprint witness namet 1
~ck ~y
Second Witness
~ t fVD' K. '1< R.2)O(\ A::i (l\l (\l ") t-rJc r
Typed signature and title ~/",,-e(L
Eyenda. ;;],a.ves.-
tTypefprint witness namet
Approved as to form and
legal sufficiency:
c~~
Assistant County Attorney
Colleen GreenJL
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
OA~ (MWDlltfY)
CERTIFICATE OF LIABILITY INSURANCE 06/26/2009
PRODUCSA Serial # 153615 THIS CER1'1FICATE IS IssueD AS A MATTER OF INFOftMATlON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CONDON MEEK HOLDER. THIS coeRnflCATE DOES NOT AMeND. EXTEND OR
1211 COURT STREET AL lEA THE COVERAGE AF'FORDED BY TI-IE POLICIES BELOW.
CLEARWATER FL 33756 INSURl:RS AFFORDING COveRAl3E NAIC#
II\ISURED INSURER A: FRANK WINSTON CRUM INSURANCE INC. 1/" f}fJ
INSURER B:
FrankCrum 1-800-277-1620 INSURER c.
100 S MISSOURI AVENUE INSURER 0:
CLEARWATER FL 33756 INBUR~R e:
THe POLICIES OF INSURANCE lISTED BllI.OW WAVE BEEN ISSUED TO THE INSURED NAMED ABOVE fOR THIi POLICY PERIOD INDICATED. NoTWl11fSTANDING
ANY fteQUI~NT, TERM OR CONDITION OF ANY CONTRACT OF OTHER DOCUMENT WITH IlESPECT TO WHlCW THIS CER11F1CATI! MAY BE ISsueD OR.
MAY PERTAI~, TWE INSURANce AFJ'ORDED BY THe POLICIES DESCRIBeD tliOR.EIN IS SUBJecT TO All THe Tl:RMS. IOXCLUSIONS ANO CONDmONS OF SUCH
POLICIES. AGGRliGATE l.MTS SHOWN MAY HAVE seal RI1DUCED IY PAID CLAIMS.
INSiR AIIIrL TYPE OF INSURANCE POlICV NUMBER t1ATEIMMlDDIYYI I L1NfT8
LTR _D DAn! ....;.wDirn
~LIABIU'l"r !ACH OCCI.lRRENCE $
- 51o\~CIAL GENEIV.l UABIUTY FIRe DAMAGE ,..... on. h) $
- CLAIMe p,Ll,g1' DoCCUR MED EXP Ihrw """ ..ftO~1 S
PERsotW. &.NN NJURY $
llENERAl. AGGRE~TE I
n~~rrAPPUEn PRODUCTS. cO/.tPlOF> AQQ S
POUe'Y I'RO-ECT Lo(;
~OM(lIln.E UABILl'I'Y COIoEINEO SINGLE LILlIT S
~..cIdonl)
- mYl\JJTO
- ALl. O~ AUTOS eOOIL Y INJURY S
SCHj;g~D AUTO:; (Per pert~nl
-
- HIRED AUTOS BOI;lIl.YIUJRY $
0'<< aca_
- ~WNEOAUTOS
PROPeRTY l;WIAaE $
lPor_dill'O
~E L1AI!IIU'I'Y AUTO O!oLY - EoO.ACelDEiNT S
~:~ AUTO ~ERTHAN EA A,CC S
AUTO ONL"t" AGG S
=:i:S1l/ UMIIRELLA u.-un EACH ocCURRENOE $
OCCUR DCl.ANSLlMlE AllllREGATI! $
... S
=i~LX:Y1QLE /' $
RETENTIoN S $
Y/O_ COMPENlIATION AND I we STAID J I cmlER
A EMPLOvaw'lJAIlUTT we 9 0000 0000 0110112009 0110112010 X TORY UMlTS
ANY PROPAETORI PARnlEA/DEeunvE
OFFlci!I\/ MEMBER EXCLUDED7 E.L EACH ACCIDENt $ 1 000 000
Ir_ d.ocrIbI- E.L OISEiI$E. EA.ELlPLOYEE $ 1 000 000
BP6CIAL pROVlSlONll bolo.
E.L OISl5ABE - POUCY L1~ $ 1 000 000
OTHER
DI!SCIIPTlON DF OPERATIO...' I LDCATlONlII V!HlQJilllI EXCLU.OII$ ADQED BY ENtJOIlSIMSif , Bl'EClAL PIlOVIiIONa
EFFECTIVE 09/15/2005, COVERAGE IS FOR 100% OF THE EMPLOYEES OF FRANKCRUM LEASED TO MILLENNIUM HOUSE
SOUTHWEST FLORIDA, INC. (CLIENT) FOR WHOM THE CLIENT IS REPORTING HOURS TO FRANKCRUM. COVERAGE IS NOT
EXTENDED TO STATUTORY EMPLOYEES.
/'
CE:RTIFlCA TE HOLDER
CANCELLATION
SHOUUl ANY OF THE AllCVE DESCRIBE!) POUCII!S BE CANCEl.LI!itl BEf'QIE THI! I!XPIRATION
DATE THEREOf, THI! lSSUlNli INSUflII!R. W1LJ. ~otiAVOR TO MAIl. 30 DAVS WRITtEN NOl1CE
TO 1'tlE CERTIfICATe HOLDER NAMIlO TO THIi LEFT, BUT I'An.URE 10 DO 8HAI.L Il\IPOSE
BOARD OF COUNTY COMMISSIONERS NO OBUOATlON OR UAIilIUTY OF ANY I<IND UPON TIlE INSURER. ITS AGENTll OR
COLLIER COUNTY REPRESENTATIIISS-
3301 E TAMIAMI TRAIL AUTHOAW!D IlEPRe.sENTATIV&
NAPLES FL. 34112 rr' K-;'C..tc?'
~OO/~OOrtJ
UJnJ:]
b())())~IJ7.1 \I\I~ flC'fll C!flfl7/07/0("'
06/25/2009 THU 14:24 FAX 239 261 7574
Oswald Trippe and Company, Inc
4089 Tamiami Trail North A203
Naples FL 34103
Phone: 239-261-042B Fax:239-261-7574
INSURED
PRODUCER
COVERAGES
1;:l]001/002
ACORDN
OP ID TD I DATE (MMIDDIYYVY)
MILL 13 06/25/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
CERTIFICATE OF LIABILITY INSURANCE
INSURERS AFFORDING COVERAGE
NAIC#
11.IQ(;
Mi~lennium House SW FL Inc
Cin!,iy Ryerson
8951 Bonita Beach Rd. #297
Bonita Springs FL 34135
INSURER A;
INSURER B:
INSURER C:
INSURER D:
INSURER E:
Western World Insurance Co
THE POLICIES OF INSURANCE LISTED BELOWHIl,VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
Am REQUIREMENT, TERM OR CONomON OF AtfY CONTRACT OR OTHER DOCUMENT \IVITH 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,
NSRJ: TYPE OF INSURANCE POLICY NUMBER 'D~'4E iMMIDD1YYI- lih~N LIMITS
LTR DATE CMMJD
GENERAL LIABIUlY EACH OCCURRENCE $1,000,000,,1"
I--
A '-~ pMMERCIAL GENERAl LIABILITY NPP118S844 03/20/09 03/20/10 . P~EM;SES CEa occur';;'",,) $50,000
1-- CLAIMS MADE [iJ OCCUR MEO EXP (Anyone person) $ 1 r 000
PERSONAL & M:JV INJURY $ 1, 000 i 000
~-
X Prof Liab include GENERAL AGGREGATE $ 2 r 000 r 000 ..
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ Included
I nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
r-- $
ANY AUTO (Ea accident)
!---
ALL OVl.tlEO AUTOS BODilY INJURY
!--- $
SCHEDULED AUTOS (Per person)
'--
HIRED AUTOS BODILY INJURY
-- $
NON-O'M'lED AUTOS (Per accident)
--
-- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
F~ ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESSJUMBRELlA LIABILITY EACH OCCURRENCE $
:J OCCUR o CLAIMS MADE AGGREGATE $
$
=i DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORY LIMITS I IU~~-
EMPLOYERS' LIABILITY
AtfY PROPRIETORIPARTNERlEXECUTlVE E.L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $
If yes, descnbe under E. L DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
*10 day notice is required for nonpayment of premium.
Renewal of Contract #06-3823 "Provide Adult Day Care and In-Home Care
Services (Collier County Services for Senior)"
Certificate holder is named as addi tiial insured with respect to the
general HabiH ty .
CERTIFICA TE HOLDER
Collier County
Board of County Commissioners
3301 East Tamiami Trail
Naples FL 34112
CANCELLATION
COL3 301 SHOULD Am OF THE ABOve DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
ACORD 25 (2001f08)
@ACORDCORPORATION1988
-------_.~----:-------~-_.-_._._~----~~----
06/25/2009 THU 14:24 FAX 239 261 7574
1dJ002/002
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)
ITEM No.:01-.pec"O'?S~
~~ ""\ \" \0C\.
@A1E.'jt:~~~/[:D';
, i Vi. ii', ,i'ltJ
1: 1 . \ .
FILE NO.:
.... i
'1 ~. , ;.?
\ \ i . ~-
ROUTED TO:
DO NOT WRITE ABOVE THIS LINE
REQUEST FOR LEGAL SERVICES
1-'\
Date: June 26, 2009
To:
Office of the County Attorney
Jeff Klatzkow
c..~
-z.. - ~~
-,. ~ . oCf
Cft1b
rIS.~
From:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department, Extension 2667
Re:
Contract: #09-5227 "Services for Seniors"
Contractor: Millenium House of SW Fla., Inc.
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Age
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
Entity Name:
RLS # tJf - ItL- tJ/ ~S9
CHECKLIST FOR REVIEWING CONTRACTS
M'L..LeNN ~/-IWI ~<':'f:- StJa'eJ//&.s:r H."lUl>I',~ INC!..
Entity name correct on contract?
Entity registered with FL Sec. of State?
~Yes
~Yes
No
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 $ \ 't\A { L- Provided $ 7- "^-l L
Products/Compl/Op Required $ Provided $ (,v4-"Ubt~'i
Personal & Advert Required $ Provided $ \ Hit I L
Each Occurrence Required $ Provided $ II
Fire/Prop Damage Required $ Provided $ ,i;"() I r:f) 0
Automobile Liability ftR
Bodily Inj & Prop Required $ ~~~ $. Provided $ ~
Workers Compensation ,<-
Each accident Required $ S7'kr. \..\1LI16 Provided $ (k-\r L.
Disease Aggregate Required $ Provided $ \ I
Disease Each Empl Required $ Provided $ I I
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:
~Yes
"""'-Yes
V Yes
V Yes
No
No
No
No
Exp. Date
Exp. Date
Exp. Date
Exp. Date
Exp. Date
S{"l-" !l~
/ I'
L I
( I
( ,
Exp Date
NIp
.
Exp Date l/, 121'1 ()
Exp Date / I I'
Exp Date I '
Exp Date
Exp Date
Yes
No
Provided $
Provided $
Exp. Date
Exp. Date
Required $
Provided $
Exp Date_
County required to be named as additional insured?
County named as additional insured?
-LYes
V Yes
No
No
Indemnification
Does indemnification meet County standards?
Is County indemnifying other party?
vYes
Yes
No
---LNo
Performance Bond
Bond requirement referenced in contract?
Ifattached, expiration date of bond
Does dollar amount match contract?
Agent registered in Florida?
Yes
No
Yes
Yes
No
No
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?
~Yes
---L Yes
v'Yes
--u:- Yes
No
No
No
No
V Yes
~Yes
-----LL- Y es
No
No
No
Attachments
Are all required attachments included?
~es
No "- .
Reviewer Initials: lIJ.i!!.C--
Date: f'J I {,lo9
04-COA-O 1 <130/122
MEMORANDUM
TO:
Ray Carter
Risk Management Department
~
~~~~~ -t lf
FROM:
Lyn M. Wood, C.P.M., Contract Specialist
Purchasing Department
1-'1
June~, 2009
DATE:
RE: Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: Millenium House of SW Fla., Inc.
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
C: Terri Daniels, Housing & Human Services
DATE RECEIVED
JUN 30 2009
IUSl tWWiEHOO
mausen_9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Thursday, July 02, 2009 3:28 PM
LynWood; DeLeon Diana
DanielsTerri; mausen_9
Contract 09-5227 Services for Seniors
All, I have approved the certificate of insurance provided by Millenium House of SW Fla., Inc. for contract 09-5227. 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
DeLeon Diana
From:
Sent:
To:
Subject:
Cindi Ryerson [cryerson@embarqmail.com]
Friday, June 26, 2009 8:32 PM
DeLeon Diana
Millennium House
Diana,
Millennium House does not use private vehicles for the transportation of our clients to or from Millennium
House. Millennium House does not own a shuttle bus for this purpose. Therefore, myself or my employees do
not carry business liability insurance on our vehicles. We will assist families in giving them resources for
transportation to our center. All of our families do transport their family member to our center that live in
Naples.
Cindi Ryerson
Millennium House
992-5513
1
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Detail by Entity Name
Florida Profit Corporation
MillENNIUM HOUSE SOUTHWEST FLORIDA INC,
Filing Information
Document Number P00000077735
FEI/EIN Number 651055880
Date Filed 08/10/2000
State Fl
Status ACTIVE
Principal Address
8951 BONITA BEACH RD STE 297
BONITA SPRINGS Fl 34135
Changed 03/03/2003
Mailing Address
8951 BONITA BEACH RD STE 297
BONITA SPRINGS Fl 34135
Changed 03/03/2003
Registered Agent Name & Address
RYERSON, CINDI K
1466 XAVIER AVE S
FORT MYERS Fl 33919 US
Name Changed: 03/30/2004
Address Changed: 03/03/2003
Officer/Director Detail
Name & Address
Title P
RYERSON, CINDI
1466 XAVIER AVE S
FORT MYERS Fl 33919
Annual Reports
Report Year Filed Date
2007 01/06/2007
2008 01/27/2008
2009 OS/27/2009
http://www . sunbiz.org/ scripts/ cordet.exe ?action= D ETFIL&inq_doc number= P000000777... 6/23/2009
:vww.sunbiz.org - Department of State
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Document Images
05/27/2009 :=-ANNUAL REPORT
0112 712P0!3:=-ANNu ALRE;POR T
01/06/2.007 :=-ANNuAI,.REPORT
04/03L2.006-- ANNUAL REPORT
03('J1J2.Q0!5.::_ANNUAL..R.E;P_QRI
Q31:JQ/2.QP4:=-ANNUALB.E;PQRI
Q610~12.QO:L- Reg.Ag~nLChang~
0310312.003 ::ANJ'.lUA.L.-'=SE~QBT
~~2.4/2002:-ANNUALREPORT
04/02/2001 -- ANNUAL REPORT
12/1l!312.00~.::- Reg .Ag~!1LC.l]gog~
08/1OL2.000.::- Dotlle$ILc:EmfiJ
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Note: This is not official record. See documents if question or conflict.
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