#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:
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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
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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:
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DO NOT WRITE ABOVE THIS LINE
fa 0-. .
V%\'
REQUEST FOR LEGAL SERVICES y-\i ^
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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;
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~
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...111I.....11.111111'411......" lONE ~
; TINA MARIE MA i
.: . ~",,\\'''''I, Comi'n# 000697628 ~
..' ~ :'fl .
i $. El!Plres 7f23/2011 !
~ F1Qrtdll NolBry Aun., In(; 5
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~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
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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.
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