Loading...
#09-5227 (Health Force) 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 Eleven Ash, Inc. d/b/ a Health Force, authorized to do business in the State of Florida, whose business address is 5276 Summerlin Commons Way, Suite 702, Fort Myers, Florida 33907, 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 associated 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: Eleven Ash, Inc. d/b/ a Health Force 5276 Summerlin Commons Way, Suite 702 Ft. Myers, FL 33907 Attention: Charlene Miller Telephone: 239-275-4747 Facsimile: 239-275-4210 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: ~. ~ ~(~L- . --;1:J.? Ie 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. 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 Additio~t 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 use. 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. . } , A TTES1':' Dwi -'ht E. B:rock/C1e..rk of Courts "^, ........,; .,-- BOARD OF COUNTY COMMISSIONERS COLLIER C UNTY, FLORIDA " By::: " . Dat~ \"::},. .' " (~~. ): (..> l::: .-; ~ . .... . te CINt.... . ....... ... tt By: Donna Fiala, Chairman Eleven Ash, Inc. d/b/a Health Force \y~~ ClAutJ QL~A~ t1i;};7;;iame~ Second WItness ik( \ -1YJ/2Jr/fj~ M /j) rti1fJ- tTy~ witness namet Vendor ~~ By: Signature a:J1 lent /J1.//u I/dh1lhIS&.dvL Typed signature and title Approved as to form and legal sufficiency: ~~ J Assistant County Attorney Co\\OO16Yeervz- 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 26 2009-12.42PM----Insurance Office No 4761,-P. 1/2 DA1'I! IUIIIIlDIYYYY) 06/26/2009 THIS CERTIFJCATE 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 BV THE POUCIES BELOW. AC1JBlt CERTIFICATE OF LIABILITY INSURANCE PRODUCER (813)637-8877 FAX (813)637-8484 Insurance Office of America, Inc. 4915 W. Cypress Street Suite 100 'faJq)B, FL 33607 II\ISURED Elevel'l Ash, Inc. D8A:Health Force 5276 Summerlin Commons Way Suite #102 Fort Myers. FL 33907 INSURERS AFFORDING COVERAGE HAlC # INSURE!U: United Nationa' Ins Co 13064 V ~B: AmCDMP, Inc. a.. , ~..... 4"'c:I'i1 '"7 IN&URER C: INSURER 0; INSI,IRERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED MOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH nus CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORCED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LllJIrrS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - TYPE OF INSURANCE POUCV NUM8ER POLICY EFFEC11VE POI.ICV EXPIRATION ulllIS GDlSRAL LlABILJrY AHBOS99055 12/21/2008 12/27/2009 EACH OCCURRENCE $ 3.000.o0oi X COMMERCIAl. GENERAl LlABlllTY DAMAGE TO AeN'rEO $ 100.0001 - :J ClAIMS MADE [!] OCCUR 10.0001 MeD EXP (Any_~ $ A X X Professional Liab PERSONAl. & ADV INJURY $ 3.000.o0oi X Hired/Non-OWned GENEAAL AOOREOATE . 5.000 .0001 GEN'l AGGRE~TE UUIT APPLIES PER; PRODUCTS-COMP~PAGG $ 3.000.004] Xl POLICy n ~~8r n LOC AUTOMOBIlE UABlUTY COMBINED SINGLE LlMrT t-- $ NrfAUTO CEII~O t-- ALL OWNEO AUTOS BODIl V INJURY t-- $ SCHEOULEO AUTOS [per peraon) t-- HIRED AUTOS BOOR. Y INJURY - (per accIclentl $ NOH-OWNED AlITOS - PROPERTY DAMAOE $ (Pet-J GARAlJE LIABIUTY AIJT(] ONLY - EA ACCIDENT $ ~ Nrf AlITO otHER 'I'IiAN eA ACC S AlITO ONL V: AGG I EXCESSIUU!lHEUA UABlUTY EACI1 OCCURRENCJ;; . P OCCUR D ClAIMS MADE AGGREGATE $ $ R DEDUCTIBLE . RETENTION $ $ I WORKERS CDMPEHSA110N AND WCV7070446 12/24/2008 12/24/2009 X I WCSTATU- I ION EMPLOYERS' UABIUlY E.L EACH ACCIDENr $ 1.000.ooCl B Nrt Pt{oPRlETORlPARTNERlEXECUTIVE OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1.OOO.OOCl 1f~~\nkIr IU. olswe . POLICY LIMIT $ 1 OOO,OOel SPECIAL PROvISIONS below OT!l~ ~OI'''__'_''.''~'''''~"'''''''''''_''''''''''- Co er County BeC 1S A a1t1onal I ured with respects to General Liability. . I ~ , , ! I /1 I ! I I CERTIFIC Collier County BeC 3301 E. Tamiami Trail Napl es. Fl 34112 SHOULD ANY OF THE ABOV!l DESCRIBED POLICIES BE CANCELLED BEFORE THe EXI'IRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAlL ~ DAYS WRITT!H N<mc:::E TO THE CER1lFJ<;ATE IlOLD!R NAMED TO THE LI!FT, BUT FAlLUlU!i TO JIAlL SUCH NOTICE SIY\LL IMPOSE NO 08UGATlON OR LlAlllLITY OF ANY ICIND UI>ON 'J1iE INSURER, ITS AGENTS OR REPRESENTAtIVES. A~ REPRESENTATlIIE ./ Sam Potter BRlDGR //- ?-- @ACORDCORPORATlON1988 ACORD 25 (2001/08) FAX: (239) 252-6597 Jun.26, 2009-12:42PM-Insurance Office No. 4761-P, 2/2 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 poneles may require an endorsement A statement on this certificate does not confer rights to the certificate holder In Deu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not CQnstitute s contrsot between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it afffrmatlvely or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) ITEM Nr6i4>t.L:'-O\;:S"\ FILE ~O.: ROUTED TO: , ;.F;('!= (jC 'rLlc DATE RECEIVED: VI !\.J~ \....Jt 1,- ("()i i~JTV iHT(lC'j\IFV ...I\.~ '.'. ; l i , , , ....)1 i i..,_l ....",rc;'" ,~, ~,' ~. ,-., 3 J ", ; i ...; .....i .---~---- DO NOT WRITE ABOVE THIS LINE fa 0-. . V%\' REQUEST FOR LEGAL SERVICES y-\i ^ / S0Ji ~~ y ~ ~ - .,A t/ ~t(5J o Xif ~ 1:, ~\) ~O-( f~~ tJ 1 rJt' rf / \-~'l~O~'V IjJ , ) :~. 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: Eleven Ash, Inc. d/b/a Health Force ACTION REQUESTED: BACKGROUND OF REQUEST: This Contract was approved by the BCC on June 23, 200 , Agend,r;/- .'J Item 16.E.10 ~ This item has not been previously submitted. \ ~b}iI ~ Contract review and approval. OTHER COMMENTS: C: Terri Daniels, Housing & Human Services / J.~'d1 ~lY1&- fIG .CID~ 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. RLS # oct - f ~ - 0/ r:J 'IS- CHECKLIST FOR REVIEWING CONTRACTS d/ ~ t tt 1ft A/.. T'H FOIL{ ~ I Entity Name: t1Jl\f f tJ 4.5 1-1) llU(!. Entity name correct on contract? Entity registered with FL Sec. of State? 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 M, t L- Products/Compl/Op Required $ Personal & Advert Required $ Each Occurrence Required $ Fire/Prop Damage Required $ Automobile Liability Bodily Inj & Prop Required $ I 'M..I I Workers Compensation Each accident Required $ ..f~T. &-1"1'1 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: V Yes ~Yes Yes ~Yes Provided $ S M., L Provided $ ~ ItA I L- Provided $ t I Provided $ I ( Provided$ t",p,O Provided $ ~~1 Provided $ Provided $ Provided $ , I M.IL 1\.' Exp Date Exp Date Yes Provided $ Provided $ 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? -L Yes Yes Performance Bond Bond requirement referenced in contract? Ifattached, 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? /Yes ,""",Yes V Yes ~Yes tJ nt\~1 '1A.:D U."t T ~~ ~Yes V Yes /Yes Attachments Are all required attachments included? VYes VYes \..-"" Yes No No No No ~No No Exp. Date 1"2-/ Z-'l.1 fJtf Exp. Date ( \ , Exp. Date \ , Exp. Date . , Exp. Date , , Exp Date t"z'/zl\ J tJq I ( Exp Date lJ./ ,),'11 hq Exp Date t ( Exp Date I ' No Exp. Date Exp. Date Exp Date_ No No No --1L-.No Yes No Yes Yes No No No No No No No No No No "- . .f> ReViewer Imtlals: ~ Date: '1 ! If' loq 04-COA-Ol 301222 MEMORANDUM TO: Ray Carter Risk Management Department FROM: Lyn M. Wood, C.P.M., Contract Specialist Purchasing Department DATE: June 25, 2009 RE: Review Insurance for Contract: #09-5227 "Services for Seniors" Contractor: Eleven Ash, Inc. d/b/a Health Force 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 RECEIVED C: Terri Daniels, Housing & Human Services mausen_9 From: Sent: To: Cc: Subject: RaymondCarter Monday, June 29,20091:17 PM LynWood; DeLeonDiana DanielsTerri; mausen_9 Contract 09-5227 "Services for Seniors" All, I have reviewed and approved the certificate{s) for the following vendors under contract 09-5227: 1. Arcadia Health services, Inc. d/b/a Arcadia Health Care 2. Executive Healthcare Solutions, LLC d/b/a Brightstar Healthcare 3. Eleven Ash. Inc. d/b/a Health Force The contract s will now be forwarded to the county attorney's office for their review. Thank you, Ray ~ CaJr.t.c.h. Manager Risk Finanace Office 239-252-8839 Cell 239-821-9370 1 Jul, 1, 2009 1:13~M Health Force No.4016 P,2 ~HEALTH ~!Yrm[](][clE THE PROFESSIONAL HOME CARE PEOPLE ,. 5276 Summerlin Commons Way, Suite 702 Fort Myers, Florida 33907 (239) 275-4747 Fax: (239) 275-4210 , . June 30. 2009 To Whom It May Concern: Charlene Miller has :full authority to sign all contracts, legal docwnents and any paperwork pertaining to Eleven Ash Inc. dba Health Force, Any questions or concerns please contact me at 239-275-4747. Sincerely '-fLfhu<-t ler-J;~ Nancy Me Gann President ~ ~I go /oc; ~(). !vItur,~ .tJa1~ cy--.. ~ ....uln.nu....... ...111I.....11.111111'411......" lONE ~ ; TINA MARIE MA i .: . ~",,\\'''''I, Comi'n# 000697628 ~ ..' ~ :'fl . i $. El!Plres 7f23/2011 ! ~ F1Qrtdll NolBry Aun., In(; 5 !.I. ~":. n,:.1 S II U,,, 'I'." ... ,.., r ,. ..., C 11.'11I1 II ~HEALTH ~[?WJ[R]CC/E THE PROFESSIONAL HOME CARE PEOPLE '" 5276 Summerlin Commons Way, Suite 702 Fort Myers, Florida 33907 (239) 275-4747 Fax: (239) 275-4210 June 23, 2009 To Whom It May Concern: Charlene Miller has full authority to sign all contracts, legal documents and any paperwork pertaining to Eleven Ash Inc. dba Health Force. Any questions or concerns please contact me at 239-275-4747. ~. Sincerely /l~ 1JLcl1~ Nancy Mc Gann President Www.sunbiz.org - Department of State Page I of2 Home Contact Us E-Filing Services Document Searches Forms Help Previous on List Next on List Return To List IEntity Name Search No Events No Name History Detail by Entity Name Florida Profit Corporation ELEVEN ASH, INC. Filing Information Document Number P93000034439 FEI/EIN Number 650410505 Date Filed 05/13/1993 State FL Status ACTIVE Principal Address 5276 SUMMERLIN COMMONS WAY #702 FT MYERS FL 33907 US Changed 03/17/2009 Mailing Address 5276 SUMMERLIN COMMONS WAY #702 FT MYERS FL 33907 US Changed 03/17/2009 Registered Agent Name & Address MCGANN, NANCY 5276 SUMMERLIN COMMONS WAY 702 FORT MYERS FL 33907 US Name Changed: 09/23/1997 Address Changed: 03/17/2009 Officer/Director Detail Name & Address Title PVD MCGANN, NANCY 5276 SUMMERLIN COMMONS WAY #702 FORT MYERS FL 33907 Title ST MCGANN, NANCY 5276 SUMMERLIN COMMONS WAY #702 FORT MYERS FL 33907 http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inq doc number=P930000344... 6/23/2009 Www.sunbiz.org - Department of State Annual Reports Report Year Filed Date 2007 01/08/2007 2008 01/07/2008 2009 03/17/2009 Document Images 03/J7!2009=ANNUAI",Rf::PORT OJ/0712008=_ANNl,JAI",BEPQRI 01108/2007 =ANNl,JALREPQRJ 01/13/200Q_ -- ANNUAL REPORT 01/04/2005.::.::ANN UAI",R.f::.PORT 01116/2004=ANNl,JALBEPORI 03/03/2003 =.::ANNUAL REPORT 05/0J/2002 -- ANNUAL REPORT 02/05/2001_==.ANNl,JAI",Rf::PQRI 03/3QI2QQO'::=uANNl,JAI",...REE'QRI Q.3/Ql/19B9...::::..At'-JJ.Jlj}\LRI;PQBI 09/03/1B98_=ANNUAL REPORT 09/23/199L= ANNUAL REPORT 02/05IlllilI-=-ANNUAL REPORT 04!3Q/J.BB6 =ANNUAL REPORT 02/0Q/199Q.:: ANNUAL REPORT Page 2 of2 I Note: This is not official record. See documents if question or conflict. Previous on List Next on List Return To List No Name History IEntity Name Search Submit I No Events I Home I Contact us I Document Searches I E-Filing Services I Forms I HelD I Copyright and Privacy Policies Copyright @ 2007 State of Florida, Department of State. http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inq doc number=P930000344... 6/21/2009