#09-5227 (VIP America 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
VIP America of Southwest Florida, LLC, authorized to do business in the State of Florida,
whose business address is 45 North Alabama Road, Suite 3, Lehigh Acres, Florida 33936,
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 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:
VIP America of Southwest Florida, LLC
45 N. Alabama Road, Suite 3
Lehigh Acres, FL 33936
Attention: Gilbert White, President
Telephone: 239-303-2422
Facsimile: 239-303-2922
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:
IA.
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 Additional".htsured 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.
By:,
Dat~d: t.;
t' (EiBAL ,>,' ':;
f.,_ }:.. ' j -"\i
.e.."..-.\___,
'f,,~... ~~.J",-t
If I , ,"""'. ",: \...
~')j . &ll ~\.J
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: (f~- ~~
Donna Fi la, Chairman
ATTEST:
Dwight E. Brock, Clerk of Courts
VIP America of Southwest Florida, LLC
~!~
First Witness
Vendor
By:A~OU ~
Signature
GrQ.te Wi) l+t(
tTypejprint witness namet
~/k-_
'---"" econd Witness
i1JW+ Whiie ) Pres,'den+-
Typed signature and title
_m()..t~t \.W.dSOD
tTypej p . t wi~ess namet
Approved as to form and
legal sufficiency:
BY:
Jeff. right, Assistant County Attorney
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
ACORQu CERTIFICATE OF LIABILITY INSURANCE I OA TE (MMlDOIYYYY)
06/29/2009
PRODUCER (561)776-0660 FAX (561) 776-0670 THIS CERTIFICATE IS ISSUED AS A MATTER OF INfORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO !:tIGHTS UPON THE CERTIFICATE
Abacoa Town Center HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1200 University Blvd., Ste 200
Jupiter, FL 33458 INSURERS AFFORDING COVERAGE NAIC#
-.....-
INSURED VIP Amerlca, LlC & JCOL, LLC INSURER A: Ace American Insurance Co""any _. , .....
2500 S. Kanner Hwy lNSURER B:
Suite 1 INSURER C:
Stuart, FL 34994 INSURER 0:
--
INSURER E:
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
POI..ICIES. AGGREGATEtlMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
I~ ~tg~ POUCY EFFECTIVE POLICY EXPIRATION -
TYPE OF INSURANCE POLICY NUMBER UMITS
GENERAL LIABILITY CRLG23591261001 09/11/2008 09/11/2009 EACH OCCURRENCE $ 1,000.000
X COMMERCIAl. GENERAl LIA8ILITY DAMAGE TO RENTED $ 100,OOCl
- =J CLAIMS MADE o OCCUR
MED EXP (Any on. person) $ Excluded
A - PERSONAL a. AOV INJURV=i+ 1,000,OOCl
- 000 . OOCl
GENERAL AGGREGATE 3
- -~,.>- l,OOO,OOCl
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
"I .nPRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY ~BINED SINGLE LIMIT
- $
ANY AUTO a accident) 1,000,000
- -
All. OWNED AUTOS CRlG23591261001 09/11/2008 09/11/2009 BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
A X- .
HIRED AUTOS BODlLY INJURY
X- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(pet accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==1 ANY AUTO --
OTHER THAN EAACC $
AUTO ONLY: AGG S
EXceSSIUMBRELLA UABllITY EACH OCCURRENCE $
:=J OCCUR D CLAIMS MADE -
AGGREGATE $
$
==1 DEDUCTIBLE $
--
RETENTION $ $
WORKERS COMPENSATION AND I ~~~ffi);J~T IOlt
EMPLOYERS' LIABILITY E.L, EACH ACCIDENT $
ANY PROPRIETORlPARTNERiEXECUTlVE
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
Ii ~' describe under
S ECIAL PROVISIONS below E.L, DISEASE - POllCVlIMIT $
~HER & Molestation CRLG23591261001 09/11/2008 09/11/2009 Aggregate Limit $ 300,000
use
A
DESCRlPTlON OF OPERATIONS / LQCAT1ON$ {VEHICLES {EXCLUSIONS AO~ 8YENDORSEMEHT {SPECIAL PROVISIONS /
~e: ITQ# 09-5227 Collier County Services or Seniors
.ertificate Holder is Additional Insured with respects to General Liability
'. 10 DAYS NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM
/
;./
Collier County
Board of County Commissioners
Naples, FL
SHOLJLD ANY OF THE ABOVE DESCRI8ED POl.lCIES BE CANCELLED BEFORE THE
EXl'lRATlON DATE TlfEREOF. THE ISSUlNG INSURER WIl.I. ENDEAVOR TO MAIL
30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
BUT FAILURE TO MAlL SUCH NOTICE SHALl.. IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KlNDUPON TlfE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE fl, ~~
Sean Thomas/BECKP JIIv-.
ACORD 25 (2001/08)
C>ACORD CORPORATION 1988
< .
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)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured Endorsement Number
VIP America, LLC; JCOL, LLC 3
Policy Symbol I Policy Number I Policy Period Effective Date
CRL G23591261 001 09/11/08 to 09/11/09 09/11/08
Issued By (Name of Insurance Company)
ACE American Insurance Company
NON-OWNED AUTOMOBILE LIABILITY ENDORSEMENT
It is agreed that:
1. The Declarations is amended by adding the following:
a. The Premium is amended to add the following:
Coverage
Non-Owned Automobile Liability
Additional Premium
$1,664.
b. The section providing the General Liability Coverage Part Limits of Insurance is amended to add the
following:
Non-owned Automobile Each Accident Limit: $500,000. each accident
Non-owned Automobile Aggregate Limit:
$500,000.
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
2. Section I, Insuring Agreements, of the General Liability Coverage Part is amended at subsection A1 by
adding the following immediately after the first sentence:
Bodily Injury and Property Damage Liability includes "bodily injury" or "property damage" arising out of the use
of a "non-owned automobile" by any natural person, other than you, in the course of your business.
3. Solely for purposes of coverage provided by this endorsement only, the Additional Exclusions section of the
General Liability Coverage Part is amended as follows;
a. The Additional Exclusions titled Contractual Liability, Liquor Liability, Aircraft, Automobile Or Watercraft,
Damage To Property, Damage To Your Product, Damage To Your Work, Damage To Impaired Property
Or Property Not Physically Injured, and Recall Of Products, Work Or Impaired Property, are deleted in
their entirety.
b. The following Additional Exclusions are added:
. Contractual Liability
"Bodily injury" or "property damage" for which the "insured" is obligated to pay damages by reason of
the assumption of liability in a contract or agreement. This exclusion does not apply to liability for
damages:
(1) That the "insured" would have in the absence of the contract or agreement; or
(2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or
"property damage" occurs subsequent to the execution of the contract or agreement.
PF-14487c (11/06) AH, LTC & FAC @ ACE USA, 2006 Page 1 of 3
Not Approved in Louisiana
Includes copyrighted material of Insurance Services Office, Inc., with its permission
. Bodily Injury to Your Employees
"Bodily injury" to:
(1) An "employee" of the "insured" arising out of and in the course of:
(a) Employment by the "insured"; or
(b) Performing duties related to the conduct of the "insured's" business; or
(2) The spouse, child, parent, brother or sister of that "employee" as a consequence of
paragraph (1) above.
This exclusion applies:
(1) Whether the "insured" may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay the damages
because of the injury.
This exclusion does not apply to:
(1) Liability assumed by the "insured" under an "insured contract"; or
(2) "Bodily Injury" to domestic "employees" not entitled to workers compensation benefits.
. Damage to Property
"Property damage" to:
(1) Property owned or being transported by, or rented or loaned to the "insured"; or
(2) Property in the care, custody or control of the "insured".
4. Solely for the purposes of coverage provided by this endorsement, Section III, Exclusions, of the General
Liability and Professional Liability General Policy Provisions is amended by deleting in its entirety
subparagraph C, Employers Liability.
5. Solely for the purposes of coverage provided by this endorsement, the Who Is An Insured section of the
General Liability Coverage Part is deleted in its entirety and replaced by the following:
Each of the following is an "insured" under this insurance to the extent set forth below:
1. You.
2. Any partner or "executive officer" of yours, but only while such "non-owned automobile" is being used in
your business.
3. Any other person or organization, but only with respect to their liability because of acts or omissions of an
"insured" under paragraphs 1 or 2 above.
None of the following is an "insured":
1. Any person engaged in the business of his or her employer with respect to "bodily injury" to any co-
"employee" of such person injured in the course of employment;
2. Any partner or "executive officer" with respect to any "automobile" owned by such partner or officer or a
member of his or her household;
3. Any person while employed in or otherwise engaged in performing duties related to the conduct of an
"automobile business", other than an "automobile business" you operate;
4. The owner of a "non-owned automobile" or any agent or "employee" of any such owner or lessee;
5. Any person or organization with respect to the conduct of any current or past partnership or joint venture
that is not shown as a Named Insured in the Declarations.
6. Solely for the purposes of this endorsement, Section I, Definitions, of the General Liability and Professional
Liability General Policy Provisions is amended by adding the following definitions:
PF-14487c (11/06) AH, LTC & FAC @ACE USA, 2006 Page 2 of 3
Not Approved in Louisiana
Includes copyrighted material of Insurance Services Office, Inc., with its permission
1. "Automobile business" means the business or occupation of selling, repairing, servicing, storing or
parking "automobiles".
2. "Non-owned automobile" means any "automobile" you do not own, lease, hire, rent or borrow which is
used in connection with your business. This includes "automobiles" owned by your "employees", your
partners or your "executive officers", or members of their households, but only while used in your
business or your personal affairs.
7. Solely for the purposes of this endorsement, the Limits of Insurance section of the General Liability Policy is
amended by adding the following subsections:
. The Non-owned Automobile Liability Each Accident Limit set forth in the Declarations, is the most we will
pay for the sum of all "bodily injury" and "property damage" resulting from of anyone "automobile"
accident arising from the use, other than by you, of a "non-owned automobile" in the course of your
business.
. The Non-owned Automobile Aggregate Limit set forth in the Declarations, is the most we will pay for the
sum of all "bodily injury" and "property damage resulting from all "automobile" accidents arising out of the
use, other than by you, of a "non-owned automobile" in the course of your business.
All other terms and conditions of the policy remain unchanged.
Authorized Representative
PF-14487c (11/06) AH, LTC & FAC @ACE USA, 2006 Page 3 of 3
Not Approved in Louisiana
Includes copyrighted material of Insurance Services Office, Inc., with its pennission
I DATE (MMlDDNY)
.AC1JBDrM CERTIFICATE OF LIABILITY INSURANCE 05/11/09
PRODUCER 1-800-472-0072 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Paychex Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
150 Sawgrass Dr AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Rochester, NY 14620 INSURERS AFFORDING COVERAGE, .IIttU
INSURED INSURER A ILLINOIS NATIONAL INSURANCE COMPANY ~ :J. J., 'f, 1";
Paychex Business Solutions, Inc. , ~
VIP AMERICA LLC INSURER Be
INSURER C
911 Panorama Trail South
Rochester. NY 14625 INSURER D
877-266-6850 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF 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.
iNSR POLICY EFFECTIVE I POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMSER DATE (MMIDDIYY) DATE (MMlDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
-
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone lire) $
- ~ CLAIMS MADE [J OCCUR
MEO EX? (Anyone person) $
-
PERSONAL & ADV INJURY $
-
GENERAL AGGREGATE $
~
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $
I nPRO-n
POLICY JECT LOC
~OMDBILE LIABILITY I COMBINED SINGLE LIMIT t I
! (Ea accident) $
ANY AUTO I
I-- I .
ALL OW"lED AUTOS BODILY INJURY
I-- (Per person) $
SCHEDLlLED AUTOS
I--- I
HIRED AUTOS ! BODILY INJURY
r-- I (per accidem) [$
NON.OWNED AUTOS
f-- i PROPERTY DAMAGE
- I I $
i (Per accident)
~~GE LIABILITY I I AUTO ONLY. EA ACCIDENT $
ANY AUTO I I $
I , OTHER THAN AUTO EA ACC
ONLY AGG $
EXCESS LIABILITY I EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE I AGGREGATE $
$
'~ DEDUC f1BLE $
RETENTION $ $
A WORKERS COMPENSATION AND EMPLOYERS' 25890435 06/01/09 06/01/10 1 WC STATU- I I OTH-
LIABILITY X TORY LIMITS ER ./'
E.L. EACH ACCIDENT $ 1.000.000
EL DISEASE - EA EMPLOYEE $1,000.000
E.L DISEASE - POLICY LIMIT $ 1.000.000
. OTHER
$
$
$
DESCRIPTION OF OPERATIONSlLOCATlONSlVEHICLESlEXCLUSIONS ADDED BY ENDDRSEMENTISPECIAL PROVISIONS
WORKERS COMPENSATION COVERAGE IS PROVIDED TO ONLY THOSE EMPLOYEES LEASED TO, BUT NOT SUBCONTRACTORS OF THE NAMED INSUR D
CERTIFICATE HOLDER 1 I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
VIP AMERICA LLC THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION
2500 KANNER WAY SUITE 1 OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
STUART, FL 34994 AUTHORIZED REPRESENT A TIVE ~~~A
USA
ACORD 25-S (7/97)
DISGRO
11880315
@ ACORD CORPORATION 1988
ITEM NO.:
\)V~ ~\,\c~
DATE RECEIVED:
FILE NO.:
ROUTED TO: () 9-P ~C- - ~ J~55
DO NOT WRITE ABOVE THIS LINE
REQUEST FOR LEGAL SERVICES
Date:
July 1, 2009
r",_')
From:
Office of the County Attorney
Jeff Klatzkow
Lyn M. Wood, C.P.M., Contract Specialist utt-
Purchasing Department, Extension 2667
\
Contract: #09-5227 "Services for Seniors"
=r~~ ~~~ -z..~~
'_'_-.J
.-..-..
, .
,- ~
...-...~
~:-~ C'
"-- -.
=::: -+-
::;~:.
:_'-:0: n:
1"'-'"
~~
, <
To:
;
r\,)
,~~,)
--.
--.
en
I.D
Re:
Contractor: VIP America of SW Florida, LLC.
BACKGROUND OF REQUEST:
This Contract was approved by the BCC on June 23, 2009, Agenda
Item 16.E.10
This item has not been previously submitted.
OTHER COMMENTS:
\
\
\
\
"
ACTION REQUESTED:
\
Contract review and approval.
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.
9ft - ~ +Sly--JZ,t;vr .
r/~ ~ Mr, Whl~4.-
~,~ M~ ?). g
j
'-
~"
(Pres~~
c: Terri Daniels, Housing & Human Services
MEMORANDUM
TO:
FROM:
Ray Carter
Risk Management Department
Lyn M. Wood, C.P.M., Contract Specialist /._
Purchasing Department ~\
July 1, 2009
DATE:
RE:
Review Insurance for Contract: #09-5227 "Services for Seniors"
Contractor: VIP America of SW Florida, LLC.
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
mausen_g
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Thursday, July 02, 2009 2:56 PM
LynWood; DeLeon Diana
DanielsTerri; mausen_9
Contract 09-5227 Services for Seniors
All, I have approved the Certificate(s) of Insurance provided by VIP America of SW Florida, LLC 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
www.sunbiz.org - Department of State
Page 1 of2
Home
Contact Us
E-Filing Services
Document Searches
Forms
Help
Previous on List
Next on List
Return To List
IEntity Name Search
No Events
No Name History
Detail by Entity Name
Florida Limited Liability Company
VIP AMERICA OF SOUTHWEST FLORIDA, LLC
Filing Information
Document Number L09000031164
FEIIEIN Number NONE
Date Filed 03/31/2009
State FL
Status ACTIVE
Effective Date 03/31/2009
Principal Address
45 N. ALABAMA ROAD, STE 3
LEHIGH ACRES FL 33936
Mailing Address
45 N. ALABAMA ROAD, STE 3
LEHIGH ACRES FL 33936
Registered Agent Name & Address
BRECHBILL, MARK
215 SOUTH FEDERAL HIGHWAY, STE 100
STUART FL 34994 US
Manager/Member Detail
Name & Address
Title MGR
WHITE, GILBERT
45 N. ALABAMA ROAD, STE 3
LEHIGH ACRES FL 33936
Annual Reports
No Annual Reports Filed
Document Images
Q3/3JJ2Q09-=:E!QJida Limited Liability
I Note: This is not official record. See documents if question or conflict.
~(lvious on List
Next on List
Return To List
[Entity Name Search
No Events
No Name History
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&in~ doc _ number=L090000311... 6/25/2009
www.sunbiz.org - Department of State
Page 2 of2
Submit I
I Home I Contact us I Document Searches I E-Filing Services I Forms I Help I
Copyright and Privacy Policies
Copyright @ 2007 State of Florida, Department of State.
http://www . sunbiz. orgl scri ptsl cordet. exe ?action= D ETFIL&in'L doc _ number= L090000 311... 6/25/2009