#09-5292 (Child Advocacy Council, Inc.
AGREEMENT #09-5292
For
Child Advocacy Agreement for Mandated Services
. -'1t,
THIS AGREEMENT, made and entered into on this -1-2"- day of December, 2009, by
and between the Collier County Child Advocacy Council, Ine. (hereinafter referred to as
the "CCCAC"), a not-for-profit Corporation, under agreement with the State of Florida,
Department of Children and Families, providing coordination of the Child Protection
Team of Collier County (hereinafter referred to as "CPT') authorized to do business in
the State of Florida whose business address is 1034 Sixth Avenue North, Naples,
Florida 34102, and Collier County, a political subdivision of the State of Florida, Collier
County, Naples, hereinafter call the "County":
1. COMMENCEMENT. The contract shall be for a one (1) year period,
commencing on October 1, 2009 and terminating on September 30, 2010. The
County may, at its discretion and with the consent of the CCCAC, renew the
Agreement under all of the terms and conditions contained in this Agreement for
two (2) additional twelve (12) month periods. The County shall give the CCCAC
written notice of the County's intention to extend the Agreement term not less
than ten (10) days prior to the end of the Agreement term then in effect.
2. SCOPE OF WORK: The CCCAC will provide the following services:
A. Provide medical examination and evaluation services for abused or
neglected children who are residents of Collier County pursuant to
Chapter 39, Florida Statutes, or conduct a medical records review in cases
where such a review can serve in place of a physical examination.
B. Possess, maintain and keep current any and all necessary license(s)
required by governmental authorities.
C. Maintain all financial records and reports relating to funds paid under
this Agreement.
D. Maintain books, records, documents and other evidence and
accounting procedures and practices that fully and properly reflect all
direct costs of any nature expended in the performance of the
Agreement.
E. Maintain adequate fiscal accounting procedures.
F. Allow inspection, review or audit of these records by County
personnel upon reasonable notice, subject to the confidentiality
requirements of Chapter 39, Florida Statutes.
G. Retain all books, records and other documents relative to this
Agreement for three (3) years after final payment.
H. When circumstances permit, give to the parents, legal guardian, or
legal custodian of any child examined for abuse or neglect a notice
requesting reimbursement to Collier County pursuant to Section
39.304(5), Florida Statutes. The CCCAC shall also provide a copy of
said notice to Collier County with certification by the case coordinator
that said notice was given. When circumstances do not permit the
CCCAC to give said notice to the parents, legal guardian or legal
custodian, CCCAC shall send, by regular U.S. Mail, the notice to the
parents, legal guardian or legal custodian. Circumstances which
would be deemed to not permit the CCCAC to give said notice
include those instances when a parent, legal guardian or legal
custodian is not present, or when CCCAC determines that giving said
notice may result in a confrontation between the CCCAC personnel
and the parents, legal guardian or legal custodian. The CCCAC shall
have the sole discretion to determine whether or not circumstances
permit giving said notice to the parents, legal guardian or legal
custodian. When CCCAC sends the notice to the parents, legal
guardian or legal custodian by regular u.s. Mail, CCCAC shall
provide a copy of said notice to Collier County with a certification by
the case coordinator that states such notice was mailed. Families with
medical insurance will be afforded the opportunity to file a claim with
their insurance company through receipt of a statement of expenses
that will be provided by the CCCAC. These families will be expected
to submit all insurance payments they receive to the County for
reimbursement of related medical expenses.
I. The CCCAC shall pay from its own account for the initial medical
examination costs to the providers of medical diagnosis and
evaluation services for each child abuse or neglect case. There shall be
a monthly invoice which shall reference a CPT case number for each
examination and evaluation, and which shall provide an indication of
whether each case is Medicaid eligible, denied, or pending Medicaid
eligibility determination.
09-5292 - Child Advocacy Agreement for 2
Mandated Services
J. The CCCAC shall maintain Medicaid provider status from DCF and
shall bill Medicaid for all investigation costs of the initial medical
examination and evaluation services for each eligible child abuse or
neglect case. The County shall not be required to pay for any costs for
the initial medical examination and evaluation in Medicaid eligible
cases. The CCCAC shall obtain from Medicaid a denial form for all
cases found not to be Medicaid eligible, and shall submit same to the
County at the time of billing pursuant to paragraph I, above. Each
denial form shall refer to a case number that corresponds to the
number on the medical examination invoice.
The CCCAC shall also use its best efforts to seek reimbursement from
appropriate state agencies for all sexual abuse examinations billed
during the term of this Agreement. If payment is denied by said
agencies, the CCCAC shall obtain from said state agencies a denial
notification, which shall also refer to a case number that corresponds
to the number on the examination invoice and promptly provide it to
the County.
K. Before execution of this Agreement, the CCCAC shall furnish the
County with copies of its current contracts between the CPT and its
medical provider(s), and copies of its contracts with OCF relating to
the CPT. Any amendments or new agreements executed during the
term of this agreement between CPT and its medical provider(s) or
DCF shall be immediately forwarded to the County.
L. The CCCAC shall act as an independent entity and not as an agent of
the County in operating the aforementioned service.
3. COMPENSATION. The County shall reimburse the CPT at the rate of two
hundred fifty dollars ($250.00) per examination for medical examination and
evaluation, plus actual x-ray and laboratory costs incurred in all non-Medicaid
eligible cases. The County shall also reimburse the CPT at the rate of seventy-five
dollars ($75.00) for a medical records review where such a review can serve in
place of a physical examination; however, the County shall in no instance be
required to pay for both a physical examination and a medical records review. If
any non-Medicaid eligible case involves sexual abuse, the CCCAC shall seek
payment from appropriate state agencies prior to seeking reimbursement from
the County. If appropriate state agencies do not pay for sexual abuse
examinations within thirty (30) days from the submission of the invoice to that
agency by the CCCAC, then CCCAC shall invoice the County, and said invoices
shall be paid by the County in accordance with Chapter 218, Florida Statutes,
also known as the "Local Government Prompt Payment Act" after receipt of a
09-5292 - Child Advocacy Agreement for 3
Mandated Services
written request for reimbursement and a copy of statement(s) provided the
County pursuant to the provisions of Section 2, Paragraph H & I above. If
reimbursement from state agencies is received by the CCCAC at any time after
the County has paid CPT invoices, CCCAC shall then reimburse the County for
any state agency monies so received. Said reimbursement shall reference the case
number for which the reimbursement is being provided.
County acknowledges that CPT will incur additional expenses for staff,
equipment and supplies to determine Medicaid eligibility and obtain payment
by Medicaid in eligible cases. The CPT will also incur similar additional
expenses in seeking reimbursement in sexual abuse cases. Because the County
will benefit from these expenses incurred by CPT to obtain Medicaid payment or
reimbursement from Crime Victims' Services, County agrees to pay the sum of
fifty dollars ($50.00) to CPT for reimbursement of CPT's administrative costs in
each Medicaid eligible case and each sexual abuse case for which Crime Victims'
Services reimbursement is obtained.
County shall Reimburse CCCAC for postage charges for statements sent to
parents, guardians or legal custodians pursuant to the provisions of Section 2,
Paragraph H, above.
Monthly payments will be made upon receipt of a proper invoice and in
compliance with Chapter 218 Florida Statutes, otherwise known as the "Local
Government Prompt Payment Act." Collier County reserves the right to
withhold and; or reduce an appropriate amount of any payments for work not
performed or for unsatisfactory performance of CCCAC requirements. The
County shall pay the CCCAC for the performance of this Agreement.
3. NOTICES. All notices from the County to CCCAC or CPT shall be deemed duly
served if mailed or faxed to the CCCAC and CPT at the following address:
Jacqueline Griffith Stephens, M.A.
Executive Director
Collier County Child Advocacy Council, Inc.
1036 Sixth Avenue North
Naples, FL 34102
Phone: 239-263-8383
Fax: 239-263-7931
All notices from CCCAC to the County shall be deemed duly served if mailed or
faxed to the County to:
09-5292 - Child Advocacy Agreement for 4
Mandated Services
Housing and Human Services Department
3301 Tamiami Trail East Bldg. H!211
Naples, Florida 34112
Attn: Marcy Krumbine, Director
Phone: 239-252-2273
Fax: 239-252-2638
The CCCAC 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.
4. NO PARTNERSHIP. Nothing herein contained shall create or be construed as
creating a partnership between the County and CCCAC or to constitute CCCAC
as an agent of the County.
5. SUBCONTRACTS. Any work or services subcontracts by the CCCAC shall be
specifically by written contract or agreements, and such subcontracts shall be
subject to each provision of this Agreement and applicable County, State, and
Federal guidelines and regulations. Prior to execution by the CCCAC of any
subcontract hereunder, such subcontracts must be submitted by the CCCAC to
Housing and Human Services for its review and approval. None of the work or
services covered by the Agreement, including but not limited to consultant work
or services, shall be subcontracted by the CCCAC or reimbursed by the County
without prior written approval of the Housing and Human Services Director or
her designee.
6. AMENDMENTS. The County may, at its discretion, amend this Agreement to
conform to changes required by Federal, State, or County guidelines, directives,
and objectives. Such amendments shall be incorporated by written amendment
as a part of this Agreement and shall be subject to approval of the County. Any
modifications to this contract shall be in compliance with the County Purchasing
Policy and Administrative Procedures in effect at the time such modifications are
authorized.
7. PERMITS; LICENSE; TAXES. In compliance with Section 218.80, F.S., all
permits necessary for the prosecution of the Work shall be obtained by CCCAC
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 CCCAC The CCCAC shall also be
solely responsible for payment of any and all taxes levied on the CCCAC In
addition, CCCAC 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
09-5292 - Child Advocacy Agreement for 5
Mandated Services
adopted. The CCCAC agrees to comply with all laws governing the
responsibility of an employer with respect to persons employed by CCCAC
8. NO IMPROPER USE. The CCCAC 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 effect or hereafter enacted or adopted. In the event of such
violation by the CCCAC or if the County or its authorized representative shall
deem any conduct on the part of the CCCAC to be objectionable or improper, the
County shall have the right to suspend the contract of the CCCAC Should
CCCAC 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 CCCAC further agrees not to commence operation during the
suspension period until the violation has been corrected to the satisfaction of the
County.
9. 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-
53, 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, andj or any employee of the firm from contact with County staff
for a specified period of time; b. Prohibition by the individual andj or firm from
doing business with the County for a specified period of time, including but not
limited to: submitting bids, RFP, andj or quotes; and, e. immediate termination of
any contract held by the individual andj or firm for cause.
10. TERMINATION. Should CCCAC be found to have failed to perform its 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.
11. NO DISCRIMINATION. The CCCAC agrees that there shall be no
discrimination as to race, sex, color, creed or national origin.
12. INSURANCE. The CCCAC 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
09-5292 - Child Advocacy Agreement for 6
Mandated Services
and Property Damage Liability. This shall include Premises and Operations;
Independent Contractors; Products and Completed Operations and
Contractual Liability.
B. Business Auto Liability: Coverage shall have minimum limits of $500,000
Per Occurrence, Combined Single Limit for Bodily Injury Liability and
Property Damage Liability. This shall include: Owned Vehicles, Hired and
Non-Owned Vehicles and Employee Non-Ownership.
C Workers' Compensation: Insurance covering all employees meeting
Statutory Limits in compliance with the applicable state and federal laws.
The coverage must include Employers' Liability with a minimum limit of
$500,000 for each accident.
Special Requirements: Collier County 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 CCCAC during the duration of this Agreement.
Renewal certificates shall be sent to the County 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.
CCCAC shall ensure that all subcontractors comply with the same insurance
requirements that he is required to meet. The same CCCAC shall provide
County with certificates of insurance meeting the required insurance
provisions.
12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the
CCCAC 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 CCCAC or
anyone employed or utilized by the CCCAC 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.
09-5292 - Child Advocacy Agreement for 7
Mandated Services
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on
behalf of the County by the Housing and Human Services Department.
14. CONFLICT OF INTEREST: CCCAC 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. CCCAC further
represents that no persons having any such interest shall be employed to perform
those services.
15. SUBJECT TO APPROPRIATION. lt is further understood and agreed by and
between the parties herein that this agreement is subject to appropriation by the
Board of County Commissioners.
IN WITNESS WHEREOF, the CCCAC 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. BROCK, Clerk
BOARD OF COUNTY COMMISSIONERS
COLLIER COl.j:NTY, FLORIDA
j: i,' <. ,,\;' />
By: I '//'''''lIo,;-Yt"fI(". ,-:,~><"i ~"':~--~~4<t
Donna Rala, Chairman
Date:
-.
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Colleen M. Greene
Assistant County Attorney
09-5292 - Child Advocacy Agreement for 8
Mandated Services
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09-5292 - Child Advocacy Agreement for 9
Mandated Services
COLLIER COUNTY CHILD ADVOCACY
COUNCIL, INC.
By:
Date:
I "LW~ ()~
ACORD,. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY)
12/22/2009
PRODUCER Phone: 239-262-7171 Fax: 239-262-5360 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lutgert Insurance - Naples ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 112500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Naples FL 34108
INSURERS AFFORDING COVERAGE NAIC#
--
INSURED !NSURERA: Scot tsdale Insurance Co.
Children's Advocacy Center INSURER B:
1036 6th Ave N --
Naples FL 34102 INSURER c: -..-
INSURER D:
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 Pg~!fJ{~~r,~~~N LIMITS
LTR N POLICY NUMBER 0
A ~NERAL LIABILITY OPS0084513 7/1/2009 7/1/2010 EACH OCCURRENCE $I 000 000
. X COMMERCIAL GENERAL LIABILITY ~~~~ISES Ea occurence\ 5300 000
X .1 CLAIMS MADE D OCCUR MED EX? (Anyone person) $5 000
X l':rNnn $'00 000 PERSONAL & ADV INJURY $I 000 000
I-- i GENERAL AGGREGATE $I 000 000
~'LAGG:nE LIMIT APnS PER: PRODUCTS - COMP/OP AGG 11 000 000
X POLICY ~~9;: LaC
~TOMOBILE LIABILITY , COMBINED SINGLE LIMIT $
i (Eaaccident)
I-- ANY AUTO l-
I-- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Perperson)
- 1---
- HIRED AUTOS BOalL Y INJURY
1
- NON-OWNED AUTOS (Per accident) .-
I -.-
- PROPERTY DAMAGE 1
(Per accident)
~"":,GE L1AB'L'TY , AUTO ONLY - EAACCIDENT $
ANY AUTO , OTHER THAN EAACC 1
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
, 1
==1 ~EDUCTIBLE $ --
RETENTION 1 $
WORKERS COMPENSATION AND _u I TVXg$IfJI~~ I IOJ~-
EMPLOYERS'L1ABlLlTY ,
ANY PROPRIETOR/PARTNER/EXECUTIVE ~L EACH Aee'OENT 1 -
OFFICERlMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
If yes, describe under EL DISEASE - POLICY LIMIT 1
SPECIAL PROVISIONS below
A OTHER OPS0084513 7/1/2009 7/1/2010 ,1,000,000
Professional Liability
DESCRIPTlON OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
~ertificate holder is additional insured with respect to General Liability.
CERTIFICATE HOLDER
Collier County BCC
Human Services Dept
3301 Tamiami Trail E
Naples FL 34112
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
ACORD 25(2001/08)
AUTHORIZED REPRESENTATIV~
I'
b
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)
ACORDm CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/DDfYYYY)
1/5/2010
PRODUCER Phone: 239-262-7171 Fax: 239-262-5360 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lutgert Insurance - Naples ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 112500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Naples FL 34108
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Scot tsdale Insurance Co.
Children1s Advocacy Center INSURERS: Florida Retail Federation
1036 6th Ave N
Naples FL 34102 INSURER c' --
INSURER 0:
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 ~l?~'~ POLICY NUMBER PJ>L1CY EFF~8!J:!.E POLlCYEXPlRATJON LIMITS
LTR OAT
A ~NERAL LIABILITY OPS0084513 7/1/2009 7/1/2010 I EACH OCCURRENCE $1 000 000
1L C'?rMERCIAL GENERAL LIABILITY -~~~~~~~?E~~~~nCe\ $}OO 000
X. CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $5 000
1L }{NOn. $'00 nnn PERSONAL & ADV INJURY $1 000 000
GENERAL AGGREGATE $1 000 000
-;l'~ AGG:EnE LIMIT APnS PER: PRODUCTS-COM~OPAGG $1 000 000
X POLlCY ~~9.,: LaC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Eaaccidenl)
-
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per parson)
- ,
- HIREDAUTOS BODILY INJURY
$
NON-QWNEDAUTOS (Par accident)
--
- , PROPERTY DAMAGE
(Per accident) $
RRAGE LIABILITY AUTO ONLY - EAACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY; AGG $
OESS/UMBRElLA LIABILITY I EACH OCCURRENCE $ -
OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ i $
B WORKERS COMPENSATION AND 052029767 1/1/2010 1/1/2011 I X I T~~}I~JI~S I iOJ,tI'
EMPLOYERS' LIABILITY I E_L. EACH ACCIDENT $1 000 000
ANY PROPRIETOR/PARTNERlEXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1 000 000
Ifyas, describe under E.L. DISEASE - POLICY LIMIT $1 000 000
SPECIAL PROVISIONS below
A OTHER OPS0084513 7/1/2009 7/1/2010 1" 000. 000
Professional Liability
DESCRIPTION OF OPERATIONS I LOCATIONS {VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
ertificate holder is additional insured with respect to General Liability.
CERTIFICATE HOLDER
Collier County Bee
Human Services Dept
3301 Tamiami Trail E
Naples FL 34112
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA TIV
b
ACORD 25 (2001/08)
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.:
~-PRC-01401 ~
I"\- (L.DJlIT~r\~ECEIVED:
vr I ,A. '- c
COUNTY I\TTClRNcl
FILE NO.:
Date:
December 1, 2009
REQUEST FOR LEGAL SERVICES
Sill
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2010 JMI-& Pl~ 3: 3b J-
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ROUTED TO:
DO NOT WRITE ABOVE THIS LINE
To:
Office of the County Attorney
Attention: Colleen Greene
From:
Lyn M. Wood, C.P.M., Contract Specialist _.Y: '.1.</
Purchasing Department, Extension 2667 ~l*Jv-
Re: Agreement: #09-5292 "Child Advocacy Agreement for Mandated
Services"
Contractor: Collier County Child Advocacy Council, Inc.
BACKGROUND OF REQUEST: .
//" -- -'\
This item was approved by the BCC on December 15, 20t/:rJf.C-... / '
Agenda Item 16.0.4 ~
--------.-
This item was previously submitted.
ACTION REQUESTED:
Agreement review and approval.
OTHER COMMENTS:
Colleen, please forward to the Chairman of the 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
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CHECKLIST FOR REVIEWING CONTRACTS
Entity Name: &'-~,..... ~~IVTf {'if,"" A"bVOPAO-Y 0"u,uu,-, {fUi!..
Entity name correct on contract?
Entity registered with FL Sec. of State?
_/Yes
_.JL"Yes
No
No
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 $ l MIL-
Products/CompI/Op Reqnired $
Personal & Advert Required $
Each Occurrence Required $
Fire/Prop Damage Required $
Automabile Liability
Bodily Inj & Prop Required $ S."I '""
Workers Compensation
Each accident Required $ se"l eO 0
Disease Aggregate Required $____
Disease Each EmpI 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
__v Yes
._No
_No
.......-:_No
No
Exp. Date ~ I, I{ 0
I I
l\ Exp. Date l ,
l I Exp. Date t r
{' Exp.Date II
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Performance Bond
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Does dollar amount match contract?
Agent registered in Florida?
..L... Y es - No
~Yes --- No
/Yes - No
Yes ......-:'.No
Yes No
-
Yes No
Yes No
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Indemnification
Does indemnification meet County standards?
Is County indemnifying other party"
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: ~l')LA:{u'-",t.,.C)
Chairman's signature block?
Clerk's attestation signature block?
County Attorney's signature block?
/' Yes No
-VYes No
~Yes No
~Yes No
~M.;;;";::RESo~"T;:';-
~Yes ..__No
~Yes ~____No
\/Yes No
Attachments
Are all required attachments included?
dYes
RCVie~e~ Initials: ,~~~
D"" .illT!v
04~COA-OT03O!222
MEMORANDUM
TO:
Ray Carter
Risk Management Department
FROM:
A
Lyn M. Wood, C.P.M., Contract Specialist J~
Purchasing Department 'J' ')
DATE:
December 22, 2009
RE:
Review of Insurance for Agreement: #09-5292 "Child Advocacy
Agreement for Mandated Services"
Contractor: Collier County Child Advocacy Council, Inc.
This item was approved by the BCC on December 15, 2009, Agenda Item
16.0.4
Please review the Insurance Certificates for the above-referenced agreement.
If everything is acceptable, please forward to the County Attorney for further
review and approval. Also, please advise me when it has been forwarded.
Thank you. If you have any questions, please contact me at extension 2667.
dod/LW
/}A'tt ftfcttm
DEe 2 3 2009
RISK HAJi4.GfMENT
C: Terri Daniels, Housing & Human Services
~:tik
I !i>1I {)
mausen 9
From:
Sent:
To:
Cc:
Subject:
RaymondCarter
Wednesday. January 06. 2010 2:23 PM
LynWood
DeLeonDiana; mausen_g; DanielsTerri
Contract 09-5292 "Child Advocacy Agreement for Mandated Services"
All I have approved the certificate of insurance provided by Collier County Child Advocacy Council, Inc. for contract 09-
5292 which 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
Under Florida Law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request. do not send
electronic mail to this entity. Instead, contact this office by telephone or in writing.
I
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Florida Non Profit Corporation
COLLIER COUNTY CHILD ADVOCACY COUNCIL, INC.
Filing Information
Document Number N14713
FEIIEIN Number 650049492
Date Filed 0411611986
State FL
Status ACTIVE
Effective Date 04109/1986
Principal Address
1036 6TH AVE N.
NAPLES FL 34102 US
Changed 0111012007
Mailing Address
1036 6TH AVE N.
NAPLES FL 34102 US
Changed 0111012007
Registered Agent Name & Address
DIAZ, SONIA
1036 6TH AVENUE NORTH
NAPLES FL 34106 US
Name Changed: 0110612010
Address Changed: 0110412008
Officer/Director Detail
Name & Address
Tille V
SMITH. TOM
1036 SIXTH AVE N
NAPLES FL 34102
Tille P
SUMMERS. DAN
1036 6TH AVE N.
NAPLES FL 34102 US
Title S
http://ccfcorp.dos.state.fl.us/scripts/cordet.exe?action=DETFIL&in~ doc _ number=N I 4713 ... 1/7/20 I 0
www.sunbiz.org - Department of State
Page 2 of2
DIAZ, SONIA
1036 6TH AVE N.
NAPLES FL 34102 US
Title T
SHEA, MOKEY
1036 6TH AVE N.
NAPLES FL 34102 US
Annual Reports
Report Year Filed Date
2008 01/04/2008
2009 01/16/2009
2010 01/06/2010
Document Images
01/06/2010" ANNUAL REPORT I
01/16/2009 -- ANNUAL REPORT I
01/04/2008 -- ANNUAL REPORT I
01/10/2007 -- ANNUAL REPORT I
02/13/2006 ANNUAL REPORT [
01/21/2005 -- ANNUAL REPORT [
01/29/2004 "ANNUAL REI'ORT I
01/24/2003 -- ANNUAL REPORT [
01/23/2002 -- ANNUAL REPORT [
01/29/2001 -- ANNUAL REPORT [
04/14/2000 -- ANNUAL REPORT [
03/11/1999 -- ANNUAL REPORT [
02/05/1998 -- ANNUAL REPORT I
02/13/1997 cc ANNUAL REPORT [
02/26/1996 -- ANNUAL REPORT I
04/12/1995 -- ANNUAL REPORT I
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i HUIT!!., i C'Jllt"ct IJ", I 1:'0(';1'11H'( '<.ealr.lF", I [ filill;:! Sel'!i!:" I lurrn'; ! fit-I!)
COIJ'/r.'ll,; ,Hid p"v,:vv PuliCii",
CopYI'lql!t -i;) )UU/ ";late of flir:(J;l, U,,'p;1rt'Ii"fll I!f St,It"
http://ccfcorp.dos.state.flus/scripts/cordet.exe?action=DETFIL&inq,,doc__number=NI47I3...117/20 1 0
MINUTES OF THE MEETING OF THE BOARD OF DIRECTORS OF THE COLLIER
COUNTY CHILD ADVOCACY COUNCIL, INC.
December 17,2009
A joint November/December Meeting of the Board of Directors of the Collier County Child Advocacy
Council. Inc. ("CAC") was held at noon on December 17, 2009 in the conference room of CAC,
Naples. Florida. The following Directors were present: Dan Summcrs. Jack Ullrich, Terry Kelly,
Mokie Shea and Sonia Bretzmann Diaz. The following Directors were absent: Tom Smith. Carrie
Williams. George Drobinski and Jim Goehler. Executive Dircctor Jaqueline Griffith Stephens. CFO
Stevcn Kissinger, and Development Director Jamie Brown were prescnt. The meeting was called to
order by Dan Summers at 12:27 P.M.
Consent Agenda: all items on the consent agenda were approved unanimously.
Treasurer Mokev Shea presented the Treasurer's and Finance Committee Reports w/Steven
Kissinger's input: The Treasurer reviewed the October and November tinancials with the Board and
discussed the Finance Committee's review of the Audit Report. The Treasurer and Finance Committee
were very pleased with the results of the A 133 "double audit," which were excellent and reflect strong
internal controls. Jack Ullrich moved to accept the Treasurer's report as presented, Terry Kelly
seconded the motion and all Directors approved.
Staff and Program Updates:
A. Development - Development Director Jamie Brown announced her resignation effective 01/08/10.
Jamie is leaving the CAC on pleasant terms to spend more time with her family. The Board
thanked Jamie for her contributions to the CAC and noted that she will be missed.
B. Holiday Programs - Several organizations. inc. the Assoc. of Golf Course Managers and Grey
Oaks Country Club have made generous donations of toys and funds to CAC holiday programs.
C. CPT, FSP. Advocacy/Education and SATP Programs - Jackie Stephens updated the Board on all
programs; all are busy and doing well.
New Business:
A. Motion for Resolution Giving Jackie Stephens authority to sign Contract #09-5292 "Child
Advoca(,v Agreement f;Jr Mandated Services" with Col/ier County - a motion was duly made by
.Jack Ullrich for a Board Resolution to give Jackie Stephens authority to sign Contract #09-5292
with the County on behalf of the CAC. Dan Summers moved to accept the Motion. Terry Kelly
seconded the Motion. and the Motion was unanimously approved by all Directors.
Old Business:
Naples Commercial Plaza - Dan Summers attended the annual mecting on behalf of the Board, and
was appointed to the NCP Association Board. The CAC learned at the meeting that reserves are
underfunded, and that the CAC should plan for a special assessment in thc future as a result.
Gala Committee - sponsorships to date exceed those of last year. No new reports.
(JollCommittee - 50% capacity. sponsorships are higher than projected based on last year's numbers.
There being no further business the meeting was adjourned at I :25 pm.
Sonia M. Diaz, Secretary
M:\])iaz\CCAC\1 2-27-09 CAe minutesJoint.Nov. Dec.Mtg.doc
RESOLUTION OF THE BOARD OF DIRECTORS OF THE COLLIER COUNTY
CHILD ADVOCACY COUNCIL, INC.
Upon Motion made and duly approved at the December] 7,2009 meeting of the Board of
Directors of the Collier County Child Advocacy Council, Inc. ("CAC"), the Board of Directors
hereby resolves to give Jackie Stephens authority to sign Contract #09-5292 "Child Advocacy
Agreement for Mandated Services" with Collier County on behalf of the CAe.
BY:~
......-:-::
Title: I ~~G(L
Board of Directors of the CAC
The foregoing instrument was acknowledged bcfore me this /f'# day of December, 2009 by
~ ~ _ ~ , who < As personally known to me or <_) has produced
as identiflcation and who did/did not take an oath.
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