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#11-5699 Assumption Agreement (Advance Medical of Naples, LLC) ASSUMPTION AGREEMENT This ASSUMPTION AGREEMENT is made and entered into as of +ewloct,� (( , 2012, by and between Advance Medical of Naples, LLC ("Advance") and Collier County, a political subdivision of the State of Florida("Collier County"). WHEREAS, on September 13, 2011, the Collier County Board of County Commissioners awarded Invitation to Bid (ITB) #11-5699, a two-part solicitation, to Advanced Medical Center, LLC with Part A to Dr. Gregory E. Leach, M.D., to provide medical director services for the County's health and wellness programs, and Part B to Advanced Medical Center, LLC, for employment physicals and drug testing services, a copy of which is attached hereto as Exhibit A, and hereinafter referred to as "Agreement"; and WHEREAS, Advance hereby represents to Collier County that by virtue of an asset purchase agreement, Advance is the successor in interest to Advanced Medical Center, LLC in relation to the Agreement; and WHEREAS, the parties wish to formalize Advance's assumption of rights and obligations under the Agreement effective as of the date first above written. NOW THEREFORE, in consideration of the mutual promises in this Assumption Agreement, and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged by the parties, it is agreed as follows: 1. Advance accepts and assumes all rights, duties, benefits, and obligations of the Contractor under the Agreement, including all existing and future obligations to pay and perform under the Agreement. 2. Advance will promptly deliver to Collier County evidence of insurance consistent with Attachment 3 of the Agreement. 3. Except as expressly stated, no further supplements to, or modifications of, the Agreement are contemplated by the parties. 4. Notice required under the Agreement to be sent to Contractor shall be directed to: CONTRACTOR: Advance Medical of Naples, LLC 1250 Pine Ridge Road Naples, FL 34108 Phone: 239-254-3104; Fax: 239-254-3105 Attention: Patricia Jackson, President 5. Collier County hereby consents to Advance's assumption of the Agreement. No waivers of performance or extensions of time to perform are granted or authorized. Collier County will treat Advance as the Contractor for all purposes under the Agreement. 1 IN WITNESS WHEREOF,the undersigned have executed and delivered this Assumption Agreement effective as of the date first above written. COLLIER COUNTY: ATTEST: . BOARD OF COUNTY COMMISSIONERS DWIQUIT. FROCK, Clerk COLLIER COUNTY, FLORID: _ . , _ ...., .....• ��� _. _ ._ lb, , k,i ,,,•---,,,,,.a'�_ - By Z..0 ._ , `' , Atte 4S.;tieglitilVtiffek . FRED W. _OYLE,CHAT-1 TO.. i Advaat,e Medical of Naples,LLC: i By: ' ' �, Attes �I�_ liI�g/IA- orporate Secr-tary Date: C 214 J1OI 2_ Date: CiI Dike I2 Approv- 0 as . orm and leg: su` . 111 By: Jill i Jeffre .P atzkow Coun . F mey 2 Coielr County A -inistrative Services Division Purchasing INVITATION TO BID Date: June 21, 2011 From: Jack Curran, Purchasing Strategist 239.252.6098 (Telephone) 239.252.6596 (FAX) JackCurran @colliergov.net (Email) To: Prospective Vendors Subject: "ITB-11-5699"--Two Part Solicitation: Part A "Medical Director for Collier County", Part B "Employment Physicals and Drug Testing" As requested by the Risk Management Department, the Collier County Board of County Commissioners Purchasing Department has issued this ITB for the purpose of obtaining fair and competitive responses. Please refer to the Public Notice included in this document for the opening date and time and any applicable pre-ITB conference. All questions regarding this ITB must be submitted online on the Collier County Purchasing Department E-Procurement website: www.colliergov.net/bid. All responses to questions will be posted on the website with electronic notification to all prospective vendors. We look forward to your participation in Collier County's competitive procurement process. cc: Gary Troy, Risk Management Jeff Walker, Director, Risk Management Note: All ITB responses submitted manually must be submitted as one original, and one exact duplicate copy, including any required forms. P.rdusrg Depamrnt•3327 Tama,m Toad East•Naples.Ronda 34112 4901•AWN cu'hergov netjq■,hasng 11-5699—"Medical Director for Collier Count& 1 Employment Physicals and Drug Testing" EXHIBIT A Invitation to Bid Index Public Notice 3 Exhibit I: Scope of Work, Specifications and Response Format 4 Exhibit II: General Bid Instructions 10 Exhibit III: Standard Purchase Order Terms and Conditions 16 Exhibit IV: Additional ITB Terms and Conditions 19 Attachment 1: Vendor Submittal -Vendor's Check List 25 Attachment 2: Vendor Submittal - Bid Response Form 26 Attachment 3: Vendor Submittal - Insurance and Bonding Requirements 28 Attachment 4: Vendor Submittal — Local Vendor Preference Affidavit 30 Attachment 5: Vendor Submittal — Immigration Affidavit 31 Attachment 6: Vendor Submittal -Vendor's Non-Response Statement 32 11-5699=Medical Director for Collier Count& 2 Employment Physicals and Drug Testing" Public Notice Sealed bid responses for Solicitation 11-5699, "Medical Director for CC/Employment Physicals & Drug Testing, will be received Manually only at the Collier County Government, Purchasing Department, 3327 Tamiami Traill E, Naples, FL 34112 until 2:330 p.m. Collier County local time on July 12th, 2011. Solicitation responses received after the stated time and date will not be accepted. Solicitation 11-5699-"Medical Director for Collier County and Employment Physicals & Drug Testing All questions regarding this ITB must be submitted online on the Collier County Purchasing Department E-Procurement website: www.colliergov.net/bid. All responses to questions will be posted on the website with electronic notification to all prospective vendors. All solicitation responses must be made on the official ITB response form included and only available for download from the Collier County Purchasing Department E-Procurement website noted herein. ITB Documents obtained from sources other than Collier County Purchasing may not be accurate or current. Collier County encourages vendors to utilize recycled paper on all manual bid response submittals. Collier County does not discriminate based on age, race, color, sex, religion, national origin, disability or marital status. BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA BY: /s/Steve Carnell Steve Carnell, C.P.M. Purchasing/General Services Director Publicly posted on the Collier County Purchasing Department website: www.collierqov.net/purchasinq and in the lobby of the Purchasing Building on June 21, 2011. 11-5699=Medical Director for Collier Count& 3 Employment Physicals and Drug Testing" Exhibit I: Scope of Work, Specifications and Response Format As requested by the Collier County Risk Management Department(hereinafter, the "Division or Department"), the Collier County Board of County Commissioners Purchasing Department (hereinafter, "County") has issued this Invitation to Bid (hereinafter, "ITB")with the intent of obtaining bids from interested and qualified firms in accordance with the terms, conditions and specifications stated or attached. The Vendor, at a minimum, must achieve the requirements of the Scope of Work and Specifications stated herein. Brief Description of Purchase The County is interested in receiving quotes from qualified vendors to provide Medical Director Services and pre-employment physicals for County employees. The County shall award a contract for both services to one vendor who provides the overall lowest, qualified and responsive quote for services identified in Part A and Part B of this solicitation. Part A: The Consultant shall provide Medical Director Services for the Collier County Occupational Health and Wellness Programs as may be required by the Collier County Manager's Agency and its participating agencies, located in Naples, Florida. These programs are be available to all Regular, Temporary and Seasonal Employees of the County Manager's Agency of Collier County and its participating agencies, which currently include, but are not limited to: County Attorney, Airport Authority, and Pelican Bay Services. This contract does not include the Collier County Sheriffs Staff and employees nor the Collier County Clerk of the Court's staff s they have separate contracts The County has a total of approximately one thousand nine hundred and sixty five (1965) employees. Part B: A comprehensive pre-employment physical and drug testing program to benefit Collier County and reduce liability to the County. This program will ensure the proper placement of employees based upon physical capabilities related to essential functions of County positions. Also included will be reassessment of appropriate County employees on a designated basis. This program will ensure the health of County employees and potential County employees Background The Bidder shall provide occupational medical services on an "as needed" basis as may be required by the Collier County Manager's Agency and its participating agencies, located in Naples, Florida. This program will be available to all Regular, Temporary and Seasonal Employees of the County Manager's Agency of Collier County and its participating agencies, which currently include, but are not limited to: County Attorney, Airport Authority, and Pelican Bay Services. This contract does not include the Collier County Sheriff's Staff and employees nor the Collier County Clerk of the Court's staff s they have separate contracts The County has a total of approximately one thousand nine hundred and sixty five (1965) employees. The location of the facility proposed to provide the occupational medical services will be one of the factors considered during the evaluation process. The County prefers the medical facility to be located within ten (10) miles from the Collier County Government Center, 3301 E. Tamiami Trail, Naples, Florida, with satellite facilities to be provided in areas within Lee or Collier County. The Bidder must provide all services listed in this Scope of Services. The County does not guarantee a specific quantity of work. 11-5699-Medical Director for Collier Count& 4 Employment Physicals and Drug Testing" Detailed Scope of Work Part A: The Consultant shall provide Medical Director Services for the Collier County Occupational Health and Wellness Programs as may be required by the Collier County Manager's Agency and its participating agencies, located in Naples, Florida. These programs are be available to all Regular, Temporary and Seasonal Employees of the County Manager's Agency of Collier County and its participating agencies, which currently include, but are not limited to: County Attorney, Airport Authority, and Pelican Bay Services. This contract does not include the Collier County Sheriffs Staff and employees nor the Collier County Clerk of the Court's staff s they have separate contracts. The County has a total of approximately one thousand nine hundred and sixty five (1965) employees. The Consultant must provide all services listed in this Scope of Services. The County does not guarantee a specific quantity of work. Services to be provided include, but are not limited to the following: 1. Review, recommend &approve standing medical orders& protocols. 2. Review and authorize the use of respirators for employees based on OSHA medical questionnaire, PFT results, and OSHA Respiratory Standards. 3. Review and evaluate audiometric testing results. 4. Authorize medical prescriptions and medical supplies. 5. Authorize medical prescriptions required pre-placement medical testing. 6. Consult and recommend pre-placement evaluation criteria &findings. 7. Consult on work related injuries & illnesses. 8. Conduct"fitness for duty"evaluations. 9. Medical Review Officer(MRO): review and consultation of drug related tests. 10. Reports and Records: All medical reports shall be the sole property of Collier County and may not be used or reproduced in any form without the explicit written permission of the County. The Consultant shall maintain complete records on each individual examined/treated. Such records shall remain confidential in compliance with all HIPPA regulations and will be made available only to the County's representative and/or the individual. No information, record, report or data derived, compiled, obtained, prepared or developed by the Consultant from work performed pursuant to the contract may be released, disseminated or disclosed without written consent of the County. All medical reports and records shall be formally transferred to the County by the Consultant within five (5)working days after the receipt of a contract termination notice. 11. Anticipated Medical Director Services for the Wellness Program include, but are not limited to: a. Review&approve the health screen follow-up intervention protocol. b. Consult on the basic preventative physical exam. Part B: A comprehensive pre-employment physical and drug testing program to benefit Collier County and reduce liability to the County. This program will ensure the proper placement of employees based upon physical capabilities related to essential functions of County positions. Also included will be reassessment of appropriate County employees on a designated basis. This program will ensure the health of County employees and potential County employees. Specific requirements include: 11-5699—"Medical Director for Collier Count& 5 Employment Physicals and Drug Testing" 1. The Occupational Medical Services Program will be designed to provide the medical services listed. Desired hours of operation are from 8:00 a.m. to 5:00 p.m., five (5) days a week, Monday through Friday, staffed with currently trained and qualified medical personnel. The County prefers a program that will also provide weekend and extended hours of operation. 2. Clinical Activities: The following are the activities that shall be required of the successful Bidder. This list includes the core function and major emphasis of clinical activities to be performed. Lab results, medical findings and recommendations are to be reviewed with the examinee. a. Pre-Placement Employment Physical: A basic occupational and medical history is reviewed with an occupational physical exam. (A Respirator Medical Clearance Evaluation may also be required based on job classification.) The medical determination of ability to work is assessed based on the job classification specifications. A vision exam (near & far acuity, color, depth perception) will be conducted with this physical at no charge. Ancillary tests to determine medical clearance (i.e., drug testing, blood alcohol, CBC, lipid panel) are reimbursed per fee schedule. b. Pre-Placement Physical W/CDL Physical: The candidate's medical history is reviewed. (A Respirator Medical Clearance Evaluation may also be required based on job classification.) The medical examiner, conducts a physical that evaluates the candidate's medical condition for employment and CDL medical certification. The physician completes the pre-employment physical form and the Department of Transportation medical physical form. Laboratory results are reviewed. A vision screen and urine dipstick is conducted at no additional charge. The DOT card is issued. c. Respirator Medical Clearance Evaluation: A respiratory health questionnaire and medical history is reviewed by a physician, nurse practitioner or physician's assistant. The physical examination with interpretation of spirometry and ancillary tests will assess the ability to wear a respirator. A vision exam will be included at no charge. Spirometry testing is included. Ancillary tests at the published fee schedule can augment this physical assessment. d. CDL Physical (DOT): The Department of Transportation Medical Examination Report for commercial driver fitness determination is conducted in accordance with DOT regulations and requirements. A Medical Examiners Certificate (DOT Card) will be issued after successful completion of this physical. e. Fitness for Duty Examination: The selected vendor shall perform any fitness for duty examinations requested by the County Occupational Health Nurse or County Human Resources Department. The fitness for duty examination content shall be determined by the physician, nurse practitioner or physician's assistant based on the job classification requirements. A complete medical report shall be forwarded to the County Occupational Health Nurse within one(1)working day of the examination. f. Asbestos Medical Examinations and Consultations: The selected vendor shall provide medical examinations and consultations following the requirements of the Asbestos Standard CFR 1926.1101. This examination shall include a Respirator Medical Clearance Evaluation. g. Laboratory Work: The following tests shall be performed for an all-inclusive fee: 1. Comprehensive Metabolic Panel with Lipids 2. Complete Blood Count(CBC)w/Platelet, Auto Differential 3. Urinalysis Chemistry: • Creatinine • BUN • PPD Testing w/Reading • Chest x-ray(2-view) 11-5699=Medical Director for Collier Count& 6 Employment Physicals and Drug Testing" • Chest x-ray(4-view) • Chest CT w/contrast • Chest CT without contrast • Audiometric Screening Test(pure tone air only)with interpretation • Pulmonary Function Test(with interpretation) • Drug Screen; HRS 5 or NIDA 5 panel w/MRO • Blood Alcohol Test • Hepatitis Panel Test • Hepatitis A Vaccination Series • Hepatitis B Vaccination Series • Hepatitis Titer(if previously immunized) • HIV 1 &2 Antibody Test • Heavy Metals Test • Pre-exposure Rabies Vaccination Series • Rabies Titer(if previously immunized) • Tetanus/diphtheria Vaccination • Tdap Vaccination • EKG • Cardiac Stress Test(with interpretation) • Functional Capacity Evaluation h. Medical Services Not Listed: Medical services (labs, tests, immunizations, etc) not listed in this document shall be permitted upon review and authorization by the County Occupational Health Nurse. Pricing for such services shall not exceed the usual and customary rate as listed by the County's health claim administration provider for zip code 34112. i. Pre-employment Physical Examinations: Pre-employment examinations will usually be scheduled on short notice. Appointments may be requested for the same day or the following business day. The medical examination and review of the collected medical and occupational history must be performed by a licensed physician, nurse practitioner or physician's assistant, preferably experienced in occupational health. Routine measurements, laboratory specimens and x-rays may be taken by paramedical personnel. Written confirmation of the examination results must be provided to the County Occupational Health Nurse, or designated person, within twenty-four (24) hours. This confirmation must identify any concerns and/or accommodation recommendations. j. Reports and Records: All medical reports shall be the sole property of Collier County and may not be used or reproduced in any form without the explicit written permission of the County. The successful Bidder shall maintain complete records on each individual examined/treated. Such records shall remain confidential in compliance with all HIPPA regulations and will be made available only to the County's representative and/or the individual. No information, record, report or data derived, compiled, obtained, prepared or developed by the selected Bidder from work performed pursuant to the contract may be released, disseminated or disclosed without written consent of the County. All medical reports and records shall be formally transferred to the County by the successful Bidder within five (5) working days after the receipt of a contract termination notice. 11-5699-Medical Director for Collier Count& 7 Employment Physicals and Drug Testing" Award Criteria ITB award criteria is as follows: • All questions on the Bid document shall be answered as to price(s), time requirements, and required document submissions. • Award shall be based upon the responses to all questions on the Bid Response Page(s). • Further consideration may include but not be limited to, references, completeness of bid response and past performances on other County bids/projects. • Prices will be read in public exactly as input on the electronic bid response form or written on the manually submitted Bid Response Page(s) at the time of the bid opening; however, should an error in calculations occur whenever unit pricing and price extensions are requested, the unit price shall prevail. Mathematical miscalculations may be corrected by the County to reflect the proper response. • The County's Purchasing Department reserves the right to clarify a vendor's proposal prior to the award of the solicitation. • It is the intent of Collier County to award to the lowest, qualified and responsive vendor based on adding the price of all items, quantities and descriptions on the vendor price sheet. Each price will be added together to determine the lowest total of all described services. With that in mind: All line item prices must be completed in order to be considered for an award. • Simile Awardee shall be determined by: o The County will add all line items together in order to determine a bidders's overall price total. o The County shall make a single award based on the overall lowest total to the bidder who is deemed the lowest, qualified and responsive. • The contract will be in the form of a standard County Purchase Order. Term of Contract The contract term, if an award(s) is/are made is intended to be one(1)year with three (3)one(1) year renewal options. Prices shall remain firm for the initial term of this contract. Requests for consideration of a price adjustment must be made on the contract anniversary date, in writing, to the Purchasing Director. Price adjustments are dependent upon budget availability and program manager approval. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing structure. Projected Timetable Event Date Issue Solicitation Notice June 21, 2011 Last Date for Receipt of Written Questions July 6, 2011, 10:00AM, Naples Local Time Addendum Issued Resulting from Written Questions or Pre- , Proposal Conference TBD 11-5699=Medical Director for Collier Count& 8 Employment Physicals and Drug Testing" Solicitation Deadline Date and Time July 12, 2011, 2:30PM, Naples Local Time Anticipated Evaluation of Submittals July 20, 2011 Anticipated Board of County Commissioner's Contract September 2011 Approval Date Vendor Required Documents Attachment 1: Vendor's Check List Attachment 2: Bid Response Form Attachment 3: Insurance and Bonding Requirements Attachment 4: Local Vendor Preference Affidavit Attachment 5: Immigration Affidavit Certification and the Company's E-Verify profile page or memorandum of understanding. 11-5699=Medical Director for Collier Count& 9 Employment Physicals and Drug Testing" Exhibit II: General Bid Instructions 1. Purpose/Objective As requested by the Collier County departments or divisions identified in Exhibit 1, the Collier County Board of County Commissioners Purchasing Department (hereinafter, the County) has issued this Invitation to Bid (hereinafter, the"ITB", or"Bid")with the sole purpose and intent of obtaining bid responses from interested and qualified firms in accordance with the terms, conditions, and specifications stated and/or attached herein/hereto. The successful vendor will hereinafter be referred to as the"Vendor" All bids must be submitted on the Bid form furnished by the County noted in Attachments 1, 2, 3, 4, and 5 of this ITB. No bid will be considered unless the Bid form is properly signed. Vendor is responsible to read and follow the instructions very carefully, as any misinterpretation or failure to comply with these instructions could lead to the bid submitted as being rejected as non-responsive. 2. Pricing Vendors must provide unit'prices using the unit of measured specified by the County. All prices will remain firm for a period of one hundred and eighty (180)calendar days from date of bid opening. After award by the Board of County Commissioners, prices may only be adjusted as outlined in Exhibit I: Term of Contract. 3. Alternate Bid Pricing In the event that alternate pricing is requested, it is an expressed requirement of the bid to provide pricing for all alternates as listed. The omission of a response or a no-bid or lack of a submitted price will be the basis for the rejection of the submitted bid response. All bids responses received without pricing for all alternates as listed will be considered technically non-responsive and will not be considered for award. 4. Equal Product Manufacturer's name, brand name and/or model number are used in these specifications for the purpose of establishing minimum requirements of level of quality, standards of performance and/or design required, and is in no way intended to prohibit the bidding of other manufacturer's items of equal or similar material. An equal or similar product may be bid, provided that the product is found to be equal or similar in quality, standard of performance, design, etc. to the item specified. Where an equal or similar is bid, the Bid must be accompanied with two (2) complete sets of factory information sheets (specifications, brochures, etc.) and test results, if applicable, of unit bid as equal or similar. Equal product samples, if required for evaluation, and at no cost to the County, must be submitted with Bid. Unless otherwise directed in the solicitation, the bid will not be considered unless samples are delivered to specified address by bid due date. The County shall be sole judge of equality or similarity, and its decision shall be final in the best interest. 11-5699—"Medical Director for Collier Count& 10 Employment Physicals and Drug Testing" 5. Discounts Any discounts or terms must be shown on the Bid form. Such discounts, if any, may be considered in the award of tie bids. In no instance should payment terms less than fifteen (15) calendar days be offered. 6. Exceptions Vendors taking exception to any part or section of these specifications shall indicate such exceptions on a separate sheet entitled "EXCEPTIONS TO SPECIFICATIONS." Failure to indicate any exceptions to the specifications shall be interpreted as the Vendors intent to fully comply with the specifications as written. The County, at its sole discretion, shall determine if the exceptions are material in nature, and if the Vendor's exceptions may be declared grounds for rejection of bid proposal. 7. Addenda The County reserves the right to formally amend and/or clarify the requirements of the bid specifications where it deems necessary. Any such addendum/clarification shall be in writing and shall be distributed electronically to all parties who received the original bid specifications prior to the deadline for submission of Bids. All changes to this ITB will be conveyed electronically through a notice of addendum or questions and answers to all vendors registered under the applicable commodity code(s)at the time when the original ITB was released, as well as those vendors who downloaded the ITB document. Additionally, all addendums are posted on the Collier County Purchasing Department E-Procurement website: www.collieraov.net/bid. Before submitting a bid response, please make sure that you have read all, understood clearly and complied completely with any changes stated in the addenda as failure to do so may result in the rejection of your submittal. 8. Bid Submission All paper bids shall be submitted to the County Purchasing Director, Collier County Government, Purchasing Department, 3327 Tamiami Trl E, Naples, FL 34112, by the date and time as stated in the Legal Notice. The County assumes no responsibility for bid responses received after the due date and time, or at any office or location other than that specified herein, whether due to mail delays, courier mistakes, mishandling, inclement weather or any other reason. Late bid responses shall be returned unopened, and shall not be considered for award. Vendors must submit one(1) paper copies with one copy clearly labeled "Master," and one(1) compact disks (CD's) with one copy of the proposal on each CD in Word, Excel or PDF. List the Solicitation Number and Title on the outside of the box or envelope. All bids sent by courier service must have the bid number and title on the outside of the courier packet. Vendors who wish to receive copies of bids after the bid opening may view and download same from the Collier County Purchasing Department Internet bid site. 9. Questions If the vendor should be of the opinion that the meaning of any part of the Bid Document is doubtful, obscure or contains errors or omissions it should report such opinion to the Purchasing Agent before the bid opening date. Direct questions related to this ITB only to the Collier County 11-5699—"Medical Director for Collier Count& 11 Employment Physicals and Drug Testing" Purchasing Department Internet website: www.collieraov.net/bid. Questions will not be answered after the date noted on the ITB. Vendors must clearly understand that the only official answer or position of the County will be the one stated on the Collier County Purchasing Department E-Procurement website. For general questions, please call the referenced Purchasing Agent identified in the Public Notice. 10. Protests Any actual or prospective respondent to an Invitation to Bid, who has a serious and legitimate issue with the ITB shall file a written protest with the Purchasing Director prior to the opening of the bid or the due date for acceptance of bid. All such protests must be filed with the Purchasing Director no later than 11:00 a.m. Collier County time on the advertised date for the opening of the bid or the acceptance date for the Request for Proposals. 11. Rejection and Waiver The County reserves the right to reject any and all bids, to waive defects in the form of bid, also to select the bid that best meets the requirements of the County. Vendors whose bids, past performance or current status do not reflect the capability, integrity or reliability to fully and in good faith perform the requirements denoted may be rejected as non- responsive. Bids that do not meet all necessary requirements of this solicitation or fail to provide all required information, documents or materials may be rejected as non-responsive. 12. Local Vendor Preference(LVP) The County is using the Competitive Sealed Quotation methodology of source selection for this procurement, as authorized by Ordinance Number 87-25, and Collier County Resolution Number 2008-181 establishing and adopting the Collier County Purchasing Policy. The Collier County Board of County Commissioners has adopted a Local Preference"Right to Match" policy to enhance the opportunities of local businesses to receive awards of Collier County purchases. A"local business" is defined as a business that has a valid Business Tax Receipt, formerly known as an Occupational License issued by either Collier or Lee County for a minimum of one (1)year prior to a Collier County quote or proposal submission that authorizes the business to provide the commodities or services to be purchased, and a physical business address located within the limits of Collier or Lee Counties from which the vendor operates or performs business. Post Office Boxes are not verifiable and shall not be used for the purpose of establishing said physical address. In addition to the foregoing, a vendor shall not be considered a "local business" unless it contributes to the economic development and well-being of either Collier or Lee County in a verifiable and measurable way. This may include, but not be limited to, the retention and expansion of employment opportunities, the support and increase to either Collier or Lee County's tax base, and residency of employees and principals of the business within Collier or Lee County. Vendors shall affirm in writing their compliance with the foregoing at the time of submitting their quote or proposal to be eligible for consideration as a"local business" under this section. When a qualified and responsive non-local business submits the lowest price quote, and the quote submitted by one or more qualified and responsive local businesses is within ten percent (10%) of the price submitted by the non-local business, then the local business with the apparent lowest quote offer(i.e. the lowest local vendor) shall have the opportunity to submit an offer to match the 11-5699=Medical Director for Collier Count& 12 Employment Physicals and Drug Testing" price(s) offered by the overall lowest, qualified and responsive vendor. In such instances, staff shall first verify if the lowest non-local vendor and the lowest local vendor are in fact qualified and responsive vendors. Next, the Purchasing Department shall determine if the lowest local vendor meets the requirements of Section 287.087 F.S. If the lowest local vendor meets the requirements of 287.087, F.S., the Purchasing Department shall invite the lowest local vendor to submit a matching offer to the Purchasing Department which shall be submitted within five (5) business days thereafter. If the lowest local vendor submits an offer that fully matches the lowest quote from the lowest non-local vendor tendered previously, then award shall be made to the local vendor. If the lowest local vendor declines or is unable to match the lowest non local quote price(s), then award will be made to the lowest overall qualified and responsive vendor. If the lowest local vendor does not meet the requirement of Section 287.087 F.S. and the lowest non-local vendor does, award will be made to the vendor that meets the requirements of the referenced state law. Vendor must complete and submit with its quote response the Affidavit for Claiming Status as a Local Business which is included as part of this solicitation. Failure on the part of a Vendor to submit this Affidavit with their quote response will preclude said Vendor from being considered for local preference under this solicitation. A Vendor who misrepresents the Local Preference status of its firm in a quote submitted to the County will lose the privilege to claim Local Preference status for a period of up to one (1)year. The County may, as it deems necessary, conduct discussions with any of the competing vendors determined to be in contention for being selected for award for the purpose of clarification to assure full understanding of, and responsiveness to solicitation requirements. 13. Immigration Affidavit Certification Statutes and executive orders require employers to abide by the immigration laws of the United States and to employ only individuals who are eligible to work in the United States. The Employment Eligibility Verification System (E-Verify) operated by the Department of Homeland Security(DHS) in partnership with the Social Security Administration (SSA), provides an Internet-based means of verifying employment eligibility of workers in the United States; it is not a substitute for any other employment eligibility verification requirements. The program will be used for Collier County formal Invitations to Bid (ITB)and Request for Proposals (RFP) including professional services and construction services. Exceptions to the program: • Commodity based procurement where no services are provided. • Where the requirement for the affidavit is waived by the Board of County Commissioners Vendors/Bidders are required to enroll in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Vendors are also required to provide the Collier County Purchasing Department an executed affidavit certifying they shall comply with the E-Verify Program. The affidavit is attached to the solicitation documents. If 11-5699—"Medical Director for Collier Count& 13 Employment Physicals and Drug Testing" the BidderNendor does not comply with providing both the acceptable E-Verify evidence and the executed affidavit the bidder's/vendor's proposal may be deemed non-responsive. Additionally, vendors shall require all subcontracted vendors to use the E-Verify system for all purchases not covered under the"Exceptions to the program" clause above. For additional information regarding the Employment Eligibility Verification System (E-Verify) program visit the following website: http://www.dhs.aov/E-Verify. It shall be the vendor's responsibility to familiarize themselves with all rules and regulations governing this program. Vendor acknowledges, and without exception or stipulation, any firm(s) receiving an award shall be fully responsible for complying with the provisions of the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et mg,and regulations relating thereto, as either may be amended and with the provisions contained within this affidavit. Failure by the awarded firm(s)to comply with the laws referenced herein or the provisions of this affidavit shall constitute a breach of the award agreement and the County shall have the discretion to unilaterally terminate said agreement immediately. 14. Lobbying All firms are hereby placed on NOTICE that the County Commission does not wish to be lobbied either individually or collectively about a project for which a firm has submitted a bid. Firms and their agents are not to contact members of the County Commission for such purposes as meetings of introduction, luncheons, dinners, etc. During the bidding process, from bid opening to final Board approval, no firm or its agent shall contact any other employee of Collier County with the exception of the Purchasing Department. 15. Certificate of Authority to Conduct Business in the State of Florida (Florida Statute 607.1501) In order to be considered for award, firms submitting a response to this solicitation shall be required to provide a certificate of authority from the Florida Department of State Divisions of Corporations in accordance with the requirements of Florida Statute 607.1501 (www.sunbiz.org/search.html). A copy of the document shall be submitted with the solicitation response and the document number shall be identified. Firms who do not provide the certificate of authority at the time of response shall be required to provide same within five(5) days upon notification of selection for award. If the firm cannot provide the document within the referenced timeframe, the County reserves the right to award to another firm. 16. General Information When it is deemed by the County that a bid cannot be awarded as originally intended, the County reserves the right to award this bid through an approach which is the best interest of the County. Alternate bids will not be considered unless authorized by the ITB. In case of identical bids tying as low bid, the County shall ask vendors to submit certification that they have a drug-free workplace in accordance with Section 287.087 Florida Statutes. Should all vendors provide said certification; the County will give local vendor preference. 11-5699-Medical Director for Collier Count& 14 Employment Physicals and Drug Testing" 17. Bid Award Process Award of contract will be made by the Board of County Commissioners in public session. Awards pertaining to the Collier County Airport Authority will generally be made by that agency's approval Board. Award shall be made in a manner consistent with the County's Purchasing Policy. Award recommendations will be posted outside the offices of the Purchasing Department as well as on the Collier County Purchasing Department website on Wednesdays and Thursdays prior to the County Commission meetings. Any actual or prospective respondent who desires to formally protest the recommended contract award must file a notice of intent to protest with the Purchasing Director within two (2)calendar days (excluding weekends and County holidays) of the date that the recommended award is posted. Upon filing of said notice, the protesting party will have five (5) days to file a formal protest and will be given instructions as to the form and content requirements of the formal protest. A copy of the "Protest Policy" is available at the office of the Purchasing Director. 11-5699=Medical Director for Collier Count& 15 Employment Physicals and Drug Testing" Exhibit III: Standard Purchase Order Terms and Conditions 1. Offer delivery; provided that risk of loss prior to This offer is subject to cancellation by the actual receipt of the goods by the COUNTY COUNTY without notice if not accepted by nonetheless remain with VENDOR. VENDOR within fourteen(14)days of issuance. b) No charges will be paid by the COUNTY for packing, crating or cartage unless otherwise 2. Acceptance and Confirmation specifically stated in this Purchase Order. This Purchase Order (including all documents Unless otherwise provided in Purchase attached to or referenced therein) constitutes Order, no invoices shall be issued nor the entire agreement between the parties, unless payments made prior to delivery. Unless otherwise specifically noted by the COUNTY on freight and other charges are itemized, any the face of this Purchase Order. Each delivery of discount will be taken on the full amount of goods and/or services received by the COUNTY invoice. from VENDOR shall be deemed to be upon the c) All shipments of goods scheduled on the terms and conditions contained in this Purchase same day via the same route must be Order. consolidated. Each shipping container must be consecutively numbered and marked to No additional terms may be added and Purchase show this Purchase Order number. The Order may not be changed except by written container and Purchase Order numbers must instrument executed by the COUNTY. VENDOR be indicated on bill of lading. Packing slips is deemed to be on notice that the COUNTY must show Purchase Order number and objects to any additional or different terms and must be included on each package of less conditions contained in any acknowledgment, than container load (LCL) shipments and/or invoice or other communication from VENDOR, with each car load of equipment. The notwithstanding the COUNTY'S acceptance or COUNTY reserves the right to refuse or payment for any delivery of goods and/or return any shipment or equipment at services, or any similar act by VENDOR. VENDOR'S expense that is not marked with Purchase Order numbers. VENDOR agrees 3. Inspection to declare to the carrier the value of any All goods and/or services delivered hereunder shipment made under this Purchase Order shall be received subject to the COUNTY'S and the full invoice value of such shipment. inspection and approval and payment therefore d) All invoices must contain the Purchase Order shall not constitute acceptance. All payments are number and any other specific information as subject to adjustment for shortage or rejection. identified on the Purchase Order. Discounts All defective or nonconforming goods will be of prompt payment will be computed from the returned pursuant to VENDOR'S instruction at date of receipt of goods or from date of VENDOR'S expense. receipt of invoices, whichever is later. Payment will be made upon receipt of a To the extent that a purchase order requires a proper invoice and in compliance with series of performances by VENDOR, the Chapter 218, Fla. Stats., otherwise known as COUNTY prospectively reserves the right to the "Local Government Prompt Payment cancel the entire remainder of the Purchase Act," and, pursuant to the Board of County Order if goods and/or services provided early in Commissioners Purchasing Policy. the term of the Purchase Order are non-conforming or otherwise rejected by the 5. Time Is Of the Essence COUNTY. Time for delivery of goods or performance of services under this Purchase Order is of the 4. Shipping and Invoices essence. Failure of VENDOR to meet delivery a) All goods are FOB destination and must be schedules or deliver within a reasonable time, as suitably packed and prepared to secure the interpreted by the COUNTY in its sole judgment, lowest transportation rates and to comply shall entitle the COUNTY to seek all remedies with all carrier regulations. Risk of loss of available to it at law or in equity. VENDOR any goods sold hereunder shall transfer to agrees to reimburse the COUNTY for any the COUNTY at the time and place of expenses incurred in enforcing its rights. 11-5699—"Medical Director for Collier Count& 16 Employment Physicals and Drug Testing" VENDOR further agrees that undiscovered VENDOR shall indemnify and hold harmless the delivery of nonconforming goods and/or services COUNTY from any and all claims, including is not a waiver of the COUNTY'S right to insist claims of negligence, costs and expenses, upon further compliance with all specifications. including but not limited to attorneys'fees, arising from, caused by or related to the injury or death 6. Changes of any person (including but not limited to The COUNTY may at any time and by written employees and agents of VENDOR in the notice make changes to drawings and performance of their duties or otherwise), or specifications, shipping instructions, quantities damage to property (including property of the and delivery schedules within the general scope COUNTY or other persons), which arise out of or of this Purchase Order. Should any such change are incident to the goods and/or services to be increase or decrease the cost of, or the time provided hereunder. required for performance of the Purchase Order, an equitable adjustment in the price and/or 11. Warranty of Non-Infringement delivery schedule will be negotiated by the VENDOR represents and warrants that all goods COUNTY and VENDOR. Notwithstanding the sold or services performed under this Purchase foregoing, VENDOR has an affirmative obligation Order are: a) in compliance with applicable laws; to give notice if the changes will decrease costs. b) do not infringe any patent, trademark, Any claims for adjustment by VENDOR must be copyright or trade secret; and c)do not constitute made within thirty (30) days from the date the unfair competition. change is ordered or within such additional period of time as may be agreed upon by the VENDOR shall indemnify and hold harmless the parties. COUNTY from and against any and all claims, including claims of negligence, costs and 7. Warranties expense, including but not limited to attorneys' VENDOR expressly warrants that the goods fees, which arise from any claim, suit or and/or services covered by this Purchase Order proceeding alleging that the COUNTY'S use of will conform to the specifications, drawings, the goods and/or services provided under this samples or other descriptions furnished or Purchase Order are inconsistent with VENDOR'S specified by the COUNTY, and will be of representations and warranties in section 11 (a). satisfactory material and quality production, free from defects and sufficient for the purpose If any claim which arises from VENDOR'S breach intended. Goods shall be delivered free from any of section 11 (a) has occurred, or is likely to security interest or other lien, encumbrance or occur, VENDOR may, at the COUNTY'S option, claim of any third party. These warranties shall procure for the COUNTY the right to continue survive inspection, acceptance, passage of title using the goods or services, or replace or modify and payment by the COUNTY. the goods or services so that they become non-infringing, (without any material degradation 8. Statutory Conformity in performance, quality, functionality or additional Goods and services provided pursuant to this cost to the COUNTY). Purchase Order, and their production and transportation shall conform to all applicable 12. Insurance Requirements laws, including but not limited to the Occupational The VENDOR, at its sole expense, shall provide Health and Safety Act, the Federal commercial insurance of such type and with such Transportation Act and the Fair Labor Standards terms and limits as may be reasonably Act, as well as any law or regulation noted on the associated with the Purchase Order. Providing face of the Purchase Order. and maintaining adequate insurance coverage is a material obligation of the VENDOR. All 9. Advertising insurance policies shall be executed through No VENDOR providing goods and services to the insurers authorized or eligible to write policies in COUNTY shall advertise the fact that it has the State of Florida. contracted with the COUNTY for goods and/or services, or appropriate or make use of the 13. Compliance with Laws COUNTY'S name or other identifying marks or In fulfilling the terms of this Purchase Order, property without the prior written consent of the VENDOR agrees that it will comply with all COUNTY'S Purchasing Department. federal, state, and local laws, rules, codes, and ordinances that are applicable to the conduct of its business. By way of non-exhaustive example, 10. Indemnification this shall include the American with Disabilities Act and all prohibitions against discrimination on 11-5699=Medical Director for Collier Count& 17 Employment Physicals and Drug Testing" the basis of race, religion, sex creed, national This Purchase Order may be terminated at any origin, handicap, marital status, or veterans' time by the COUNTY upon 30 days prior written status. Further, VENDOR acknowledges and notice to the VENDOR. This Purchase Order without exception or stipulation shall be fully may be terminated immediately by the COUNTY responsible for complying with the provisions of for breach by VENDOR of the terms and the Immigration Reform and Control Act of 1986 conditions of this Purchase Order, provided that as located at 8 U.S.C. 1324, et seq. and COUNTY has provided VENDOR with notice of regulations relating thereto, as either may be such breach and VENDOR has failed to cure amended. Failure by the awarded firm(s) to within 10 days of receipt of such notice. comply with the laws referenced herein shall constitute a breach of the award agreement and 19. General the County shall have the discretion to a) This Purchase Order shall be governed by unilaterally terminate said agreement the laws of the State of Florida. The venue immediately. Any breach of this provision may for any action brought to specifically enforce be regarded by the COUNTY as a material and any of the terms and conditions of this substantial breach of the contract arising from Purchase Order shall be the Twentieth this Purchase Order. Judicial Circuit in and for Collier County, Florida 14. Force Majeure b) Failure of the COUNTY to act immediately in Neither the COUNTY nor VENDOR shall be response to a breach of this Purchase Order responsible for any delay or failure in by VENDOR shall not constitute a waiver of performance resulting from any cause beyond breach. Waiver of the COUNTY by any their control, including, but without limitation to default by VENDOR hereunder shall not be war, strikes, civil disturbances and acts of nature. deemed a waiver of any subsequent default When VENDOR has knowledge of any actual or by VENDOR. potential force majeure or other conditions which c) All notices under this Purchase Order shall will delay or threatens to delay timely be sent to the respective addresses on the performance of this Purchase Order, VENDOR face page by certified mail, return receipt shall immediately give notice thereof, including all requested, by overnight courier service, or by relevant information with respects to what steps personal delivery and will be deemed VENDOR is taking to complete delivery of the effective upon receipt. Postage, delivery and goods and/or services to the COUNTY. other charges shall be paid by the sender. A party may change its address for notice by 15. Assignment written notice complying with the VENDOR may not assign this Purchase Order, requirements of this section. nor any money due or to become due without the d) The Vendor agrees to reimbursement of any prior written consent of the COUNTY. Any travel expenses that may be associated with assignment made without such consent shall be this Purchase Order in accordance with deemed void. Florida Statute Chapter 112.061, Per Diem and Travel Expenses for Public Officers, 16. Taxes employees and authorized persons. Goods and services procured subject to this e) In the event of any conflict between or Purchase Order are exempt from Florida sales among the terms of any Contract Documents and use tax on real property, transient rental related to this Purchase Order, the terms of property rented, tangible personal purchased or the Contract Documents shall take rented, or services purchased (Florida Statutes, precedence over the terms of the Purchase Chapter 212), and from federal excise tax. Order. To the extent any terms and /or conditions of this Purchase Order duplicate 17. Annual Appropriations or overlap the Terms and Conditions of the The COUNTY'S performance and obligation to Contract Documents, the provisions of the pay under this Purchase Order shall be Terms and/or Conditions that are most contingent upon an annual appropriation of favorable to the County and/or provide the funds. greatest protection to the County shall govern. 18. Termination 11-5699-Medical Director for CoAier Count& 18 Employment Physicals and Drug Testing° Exhibit IV: Additional ITB Terms and Conditions 1. Additional Items and/or Services During the contract term, Collier County reserves the right to add related items and/or services upon negotiation of a satisfactory price by the Project Manager and Vendor. 2. Conflict of Interest Vendor shall provide a list of any businesses and/or organizations to which the firm has any affiliation or obligations within the past five(5)years; whether paid or donated, which could be construed by the County as a conflict of interest. Disclosure of any potential or actual conflict of interest is subject to County staff review and does not in and of itself disqualify a firm from consideration. These disclosures are intended to identify and or preclude conflict of interest situations during contract selection and execution. 3. Vendor Performance Evaluation Collier County has implemented a Vendor Performance Evaluation System for all contracts awarded in excess of$25,000. To this end, vendors will be evaluated on their performance upon completion/termination of agreement. 5. Use of Subcontractors Bidders on any service related project, including construction, must be qualified and directly responsible for 100% or more of the solicitation amount for said work. 6. Deductions for Non-Performance The County reserves the right to deduct a portion of any invoice for goods not delivered, or services not performed in accordance with requirements, including required timeframe. The County may also deduct, or chargeback the Vendor the costs necessary to correct the deficiencies directly related to the Vendor's non-performance. 7. Offer Extended to Other Governmental Entities Collier County encourages and agrees to the successful vendor extending the pricing,terms and conditions of this solicitation or resultant contract to other governmental entities at the discretion of the successful vendor. 8. Environmental Health and Safety All Vendors and Sub vendors performing service for Collier County are required and shall comply with all Occupational Safety and Health Administration (OSHA), State and County Safety and Occupational Health Standards and any other applicable rules and regulations. Vendors and Sub vendors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site.All firewall penetrations must be protected in order to meet Fire Codes. Collier County Government has authorized OSHA representatives to enter any Collier County facility, property and/or right-of-way for the purpose of inspection of any Vendor's work operations. This provision is non-negotiable by any department and/or Vendor. 11-5699=Medical Director for Collier Count& 19 Employment Physicals and Drug Testing" All new electrical installations shall incorporate NFPA 70E Short Circuit Protective Device Coordination and Arc Flash Studies where relevant as determined by the engineer. All electrical installations shall be labeled with appropriate NFPA 70E arch flash boundary and PPE Protective labels. 9. Standards of Conduct The Vendor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Vendor shall supply competent employees who are physically capable of performing their employment duties. The County may require the Vendor to remove an employee it deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment on Collier County projects is not in the best interest of the County. 10. Licenses The Vendor is required to possess the correct professional and other licenses, and any other authorizations necessary to perform the required work pursuant to all applicable Federal, State and Local Law, Statute, Ordinances, and rules and regulations of any kind. Additionally, copies of all the required licenses must be submitted with the bid response indicating that the entity bidding, as well as the team assigned to the County account, is properly licensed to perform the activities or work included in the ITB documents. Failure on the part of any vendor to supply this documentation with their bid response may be grounds for deeming vendor non-responsive. A Vendor with an office within Collier County is required to have an occupational license. All State Certified contractors who may need to pull Collier County permits or call in inspections must complete a Collier County Contractor License registration form and submit the required fee. After registering the license/registration will need to be renewed thereafter to remain "active" in Collier County. Questions regarding professional licenses should be directed to Contractor Licensing, Community Development and Environmental Services at(239) 252-2431, 252-2432 or 252-2909. Questions regarding required Business Tax Receipt(formerly known as Occupational Licenses) should be directed to the Tax Collector's Office at(239) 252-2477. 11. Protection of Property The Vendor shall ensure that the service is performed in such manner as to not damage any property. In the event damage occurs to any property as a direct result of the Vendor or their Sub vendor in the performance of the required service, the Vendor shall repair/replace, to the County's satisfaction, damaged property at no additional cost to the County. If the damage caused by the Vendor or their Sub vendor has to be repaired/replaced by the County, the cost of such work will be deducted from the monies due the Vendor. 11-5699-Medical Director for Collier Count& 20 Employment Physicals and Drug Testing" 12. 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, the current Collier County Ethics Ordinance 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. 13. Invoice and Payments Payments are made in accordance with the Local Government Prompt Payment Act, Chapter 218, Florida Statutes. Vendor's invoices must include: • Purchase Order Number • Description and quantities of the goods or services provided per instructions on the County's purchase order or contract. Invoices shall be sent to: Board of County Commissioners Clerk's Finance Department ATTN: Accounts Payable 3299 Tamiami Trl E Ste 700 Naples FL 34112 Collier County, in its sole discretion, will determine the method of payment for goods and/or services as part of this agreement. Payment methods include: • Traditional—payment by check, wire transfer or other cash equivalent. • Standard—payment by purchasing card. Collier County's Purchasing Card Program is supported by standard bank credit suppliers(i.e. VISA and MasterCard), and as such, is cognizant of the Rules for VISA Merchants and MasterCard Merchant Rules. Collier County cautions vendors to consider both methods of payment when determining pricing as no additional surcharges or fees will be considered (per Rules for VISA Merchants and MasterCard Merchant Rules). The County will entertain bids clearly stating pricing for standard payment methods. An additional separate discounted price for traditional payments may be provided at the initial bid submittal if it is clearly marked as an "Additional Cash Discount." Upon execution of the Contract and completion of each month's work, payment requests shall be submitted to the Project Manager on a monthly basis by the Contractor for services rendered for that prior month. Services beyond sixty (60) days from current monthly invoice will not be considered for payment without prior approval from the Project manager. All invoices must be submitted within the fiscal year the work was performed. (County's fiscal year is October 1 - September 30.) Invoices submitted after the close of the fiscal year will not be accepted (or processed for payment) unless specifically authorized by the Project Manager. Payments will be made for articles and/or services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six(6) months after completion of contract. Any untimely submission of invoices beyond the specified deadline period 11-5699—"Medical Director for Collier Count& P1 Employment Physicals and Drug Testing" is subject to non-payment under the legal doctrine of"laches"as untimely submitted. Time shalt be deemed of the essence with respect to the timely submission of invoices under this agreement. In instances where the successful contractor may owe debts (including, but not limited to taxes or other fees)to Collier County and the contractor has not satisfied nor made arrangement to satisfy these debts, the County reserves the right to off-set the amount owed to the County by applying the amount owed to the vendor or contractor for services performed of for materials delivered in association with a contract. Invoices shall not reflect sales tax. After review and approval, the invoice will be transmitted to the Finance Division for payment. Payment will be made upon receipt of 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 payment for work not performed or for unsatisfactory performance of Contractual requirements. 14. Insurance Requirements The Vendor shall at its own expense, carry and maintain insurance coverage from responsible companies duly authorized to do business in the State of Florida as set forth in Attachment 3 of this solicitation. The Vendor shall procure and maintain property insurance upon the entire project, if required, to the full insurable value of the scope of work. The County and the Vendor waive against each other and the County's separate Vendors, Contractors, Design Consultant, Subcontractors agents and employees of each and all of them, all damages covered by property insurance provided herein, except such rights as they may have to the proceeds of such insurance. The Vendor and County shall, where appropriate, require similar waivers of subrogation from the County's separate Vendors, Design Consultants and Subcontractors and shall require each of them to include similar waivers in their contracts. Collier County shall be responsible for purchasing and maintaining, its own liability insurance. Certificates issued as a result of the award of this solicitation must identify"For any and all work performed on behalf of Collier County." The General Liability Policy provided by Vendor to meet the requirements of this solicitation shall name Collier County, Florida, as an additional insured as to the operations of Vendor under this solicitation and shall contain a severability of interests provisions. Collier County Board of County Commissioners shall be named as the Certificate Holder. The "Certificate Holder' should read as follows: Collier County Board of County Commissioners Naples, Florida The amounts and types of insurance coverage shall conform to the minimum requirements set forth in Attachment 3, with the use of Insurance Services Office (ISO)forms and endorsements or their equivalents. If Vendor has any self-insured retentions or deductibles under any of the below listed minimum required coverage, Vendor must identify on the Certificate of Insurance the nature and amount of such self- insured retentions or deductibles and provide satisfactory evidence of financial responsibility for such obligations. All self-insured retentions or deductibles will be Vendor's sole responsibility. 11-5699-Medical Director for Collier Count& 22 Employment Physicals and Drug Testing" Coverage(s) shall be maintained without interruption from the date of commencement of the Work until the date of completion and acceptance of the scope of work by the County or as specified in this solicitation, whichever is longer. The Vendor and/or its insurance carrier shall provide 30 days written notice to the County of policy cancellation or non-renewal on the part of the insurance carrier or the Vendor. The Vendor shall also notify the County, in a like manner, within twenty-four(24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Vendor from its insurer and nothing contained herein shall relieve Vendor of this requirement to provide notice. In the event of a reduction in the aggregate limit of any policy to be provided by Vendor hereunder, Vendor shall immediately take steps to have the aggregate limit reinstated to the full extent permitted under such policy. Should at any time the Vendor not maintain the insurance coverage(s) required herein, the County may terminate the Agreement or at its sole discretion shall be authorized to purchase such coverage(s) and charge the Vendor for such coverage(s) purchased. If Vendor fails to reimburse the County for such costs within thirty (30) days after demand, the County has the right to offset these costs from any amount due Vendor under this Agreement or any other agreement between the County and Vendor. The County shall be under no obligation to purchase such insurance, nor shall it be responsible for the coverage(s) purchased or the insurance company or companies used. The decision of the County to purchase such insurance coverage(s) shall in no way be construed to be a waiver of any of its rights under the Contract Documents. If the initial or any subsequently issued Certificate of Insurance expires prior to the completion of the scope of work, the Vendor shall furnish to the County renewal or replacement Certificate(s) of Insurance not later than ten (10) calendar days after the expiration date on the certificate. Failure of the Vendor to provide the County with such renewal certificate(s) shall be considered justification for the County to terminate any and all contracts. 15. Collier County Information Technology Requirements All vendor access will be done via VPN access only. All access must comply with current published County Manager Agency (CMA) policies. Current policies that apply are CMAs 5402, 5403 and 5405. These policies will be available upon request from the Information Technology Department. All vendors will be required to adhere to IT policies for access to the County network. Vendors are required to notify the County in writing twenty-four(24) hours in advance as to when access to the network is planned. Included in this request must be a detailed work plan with actions that will be taken at the time of access. The County IT Department has developed a Technical Architecture Requirements Document that is required to be filled out and submitted with your bid response. This document can be found on the Collier County Purchasing Department website: www.colliergov.net/purchasing. On the left hand side of the menu, click on CC Technical Requirements. If this document is not submitted with your bid response, your bid response may be deemed non-responsive. 16. Security and Background Checks If required, Vendor/Contractor/Proposer shall be responsible for the costs of providing background checks by the Collier County Facilities Management Department, and drug testing for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four(4)years. 11-5699=Medical Director for Collier Count& 23 Employment Physicals and Drug Testing" 17. Direct Material Purchase The County reserves the right to require Vendor to assign some or all of its agreements with material suppliers directly to the County. Any such goods and/or materials purchased by the County pursuant to such an assignment of a material supply agreement shall be referred to as "County Furnished Materials"and the responsibilities of both the County and the Vendor relating to said materials shall be governed by the terms and conditions of this solicitation. Additionally, the County at its sole option may choose to purchase some or all of the goods and/or materials from other suppliers. In either instance the County may require the following information from the Vendor: • Required quantities of material. • Specifications relating to goods and/or materials required for job including brand and/or model number or type if applicable • Pricing and availability of goods and/or materials provided under Vendor's agreements with material suppliers 18. Grant Compliance The purchase of any goods and/or services that are funded through Federal Grant Appropriations, the State of Florida, or any other public or private foundations shall be subject to the compliance and reporting requirements of the granting agency. 11-5699-Medical Director for Collier Count& 24 Employment Physicals and Drug Testing" 16Y CON.rity Administrative Services Di■ sion Purchasing Attachment 1: Vendor's Check List IMPORTANT: THIS SHEET MUST BE SIGNED BY VENDOR. Please read carefully, sign in the spaces indicated and return with bid. Vendor should check off each of the following items as the necessary action is completed: 1. The Bid has been signed. 2. The Bid prices offered have been reviewed. 3. The price extensions and totals have been checked. 4. The payment terms have been indicated. 5. Any required drawings, descriptive literature, etc. have been included. 6. Any delivery information required is included. 7. If required, the amount of bid bond has been checked, and the bid bond or cashiers check has been included. 8. Addendum have been signed and included, if applicable. 9. Affidavit for Claiming Status as a Local Business, if applicable. 10. Immigration Affidavit and company's E-Verify profile page or memorandum of understanding. 11. Copies of licenses, equipment lists, subcontractors or any other information as noted in this ITB. 12. The mailing envelope must be addressed to: Purchasing Director Collier County Government Purchasing Department 3327 Tamiami Trail E Naples FL 34112 The mailing envelope must be sealed and marked with: • Solicitation: ITB 11-5699—Medical Director for Collier County&Employment Physicals and Drug Testing • Opening Date: July 12th, 2011 @ 2:30PM 13. The bid will be mailed or delivered in time to be received no later than the specified opening date and time. (Otherwise bid cannot be considered.) ALL COURIER DELIVERED BIDS MUST HAVE THE BID NUMBER AND TITLE ON THE OUTSIDE OF THE COURIER PACKET. Company Name Signature&Title Date 11-5699=Medical Director for Collier Count& 25 Employment Physicals and Drug Testing" C air County Administrative Services Division Purchasing Attachment 2: Vendor Submittal -Bid Response Form FROM: Board of County Commissioners Collier County Government Center Naples, Florida 34112 RE: Solicitation: 11-5699 — "Medical Director for Collier County and Employment Physicals & Drug Testing Dear Commissioners: The undersigned, as Vendor, hereby declares that the specifications have been fully examined and the Vendor is fully informed in regard to all conditions pertaining to the work to be performed for as per the scope of work. The Vendor further declares that the only persons, company or parties interested in this Bid or the Contract to be entered into as principals are named herein; that this Bid is made without connection with any other person, company or companies submitting a Bid; and it is all respects fair and in good faith, without collusion or fraud. The Vendor proposes and agrees if this Bid is accepted, to contract, either by a County issued purchase order or formal contract, to comply with the requirements in full in accordance with the terms, conditions and specifications denoted herein, according to the following unit prices: ***SEE FOLLOWING PAGES*** Any discounts or terms must be shown on the Bid Response Form. Such discounts, if any, will be considered and computed in the tabulation of the bids. In no instance should terms for less than fifteen (15) days payment be offered. Prompt Payment Terms: % Days; Net_Days Bid Response is as follows: Electronic Submittal of all quotes via E-Procurment www.colliergov.net/bid Note: If you choose to bid manually, please submit an ORIGINAL and ONE COPY of your bid response pages. The undersigned do agree that should this Bid be accepted, to execute a formal contract, if required, and present the formal contract to the County Purchasing Director for approval within fifteen (15) days after being notified of an award. 11-5699—"Medical Director for Collier Count& 26 Employment Physicals and Drug Testing" IN WITNESS WHEREOF, WE have hereunto subscribed our names on this day of , 2011 in the County of , in the State of Firm's Complete Legal Name Address City, State, Zip Florida Certificate of Authority Document Number Federal Tax Identification Number Telephone Number FAX Number Check one of the following: ❑ Sole Proprietorship ❑ Corp or P.A. State of ❑ Limited Partnership ❑ General Partnership Signature/Title Type Name of Signature Date Additional Contact Information Send Payments To: (REQUIRED ONLY if different from above) Firm's Complete Legal Name Address City, State, Zip Contact Name Telephone Number FAX Number Email Address 11-5699=Medical Director for Collier Count& 27 Employment Physicals and Drug Testing" Cotter County Admitrsbatre Services Winn Purchasing Attachment 3: Vendor Submittal -Insurance and Bonding Requirements Insurance/Bond Type Required Limits 1. ®Worker's Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government Compensation Statutory Limits and Requirements 2. ® Employer's Liability $500.000 single limit per occurrence 3. ®Commercial General Bodily Injury and Property Damage Liability(Occurrence Form) patterned after the current $500.000 single limit per occurrence ISO form 4. ® Indemnification To the maximum extent permitted by Florida law,the ContractorNendor/Consultant 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 ContractorNendor/Consultant or anyone employed or utilized by the ContractorNendor/Consultant 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. 4. ®Automobile Liability $ 500.000 Each Occurrence; Bodily Injury&Property Damage, Owned/Non-owned/Hired;Automobile Included 5. ® Other insurance as noted: ® Medical Professional Liability $250,000 Per Occurrence • $ 250,000 Per Physician and in the aggregate • $750,000 Per Physician and in the aggregate • $5,000,000 each claim and in the aggregate 0 Medical Malpractice $1,000,000 Per Occurrence 6. Shall be submitted with proposal response in the form of certified funds, cashiers'check or an irrevocable letter of credit, a cash bond posted with the County Clerk, or proposal bond in a sum equal to 5%of the cost proposal.All checks shall be made payable to the Collier County Board of County Commissioners on a bank or trust company located in the State of Florida and insured by the Federal Deposit Insurance Corporation. 7. ❑ Performance and For projects in excess of$200,000, bonds shall be submitted with the Payment Bonds executed contract by Proposers receiving award, and written for 100%of the Contract award amount, the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner; provided, however, the surety shall be rated as"A-"or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5%of the reported policy 11-5699=Medical Director for Collier Count& Y8 Employment Physicals and Drug Testing" holders'surplus, all as reported in the most current Best Key Rating Guide, published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New York 10038. 8. ® Vendor shall ensure that all subcontractors 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. 9. ® Collier County must be named as"ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability where required. 10. ® The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR Collier County Government, OR Collier County. 11. ® Thirty(30) Days Cancellation Notice required. Vendor's Insurance Statement We understand the insurance requirements of these specifications and that the evidence of insurability may be required within five (5) days of the award of this solicitation. Name of Firm Date Vendor Signature Print Name Insurance Agency Agent Name Telephone Number 11-5699=Medical Director for Collier Count& 29 Employment Physicals and Drug Testing" Co :ter County Administrative Services Division Purchasing Attachment 4: Vendor Submittal—Local Vendor Preference Affidavit Solicitation: 11-5699—"Medical Director for Collier County&Employment Physicals& Drug Testing (Check Appropriate Boxes Below) State of Florida (Select County if Vendor is described as a Local Business ❑Collier County ❑ Lee County Vendor affirms that it is a local business as defined by the Purchasing Policy of the Collier County Board of County Commissioners and the Regulations Thereto. As defined in Section XI of the Collier County Purchasing Policy; A"local business"is defined as a business that has a valid occupational license issued by either Collier or Lee County for a minimum of one(1) year prior to a Collier County bid or proposal submission that authorizes the business to provide the commodities or services to be purchased, and a physical business address located within the limits of Collier or Lee Counties from which the vendor operates or performs business. Post Office Boxes are not verifiable and shall not be used for the purpose of establishing said physical address. In addition to the foregoing, a vendor shall not be considered a"local business"unless it contributes to the economic development and well-being of either Collier or Lee County in a verifiable and measurable way. This may include, but not be limited to,the retention and expansion of employment opportunities, the support and increase to either Collier or Lee County's tax base, and residency of employees and principals of the business within Collier or Lee County. Vendors shall affirm in writing their compliance with the foregoing at the time of submitting their bid or proposal to be eligible for consideration as a"local business"under this section. Vendor must complete the following information: Year Business Established in ❑Collier County or❑ Lee County: Number of Employees(Including Owner(s)or Corporate Officers): Number of Employees Living in ❑Collier County or❑ Lee (Including Owner(s)or Corporate Officers): If requested by the County, vendor will be required to provide documentation substantiating the information given in this affidavit. Failure to do so will result in vendor's submission being deemed not applicable. Vendor Name: Date: Address in Collier or Lee County: Signature: Title: STATE OF FLORIDA ❑ COLLIER COUNTY ❑ LEE COUNTY Sworn to and Subscribed Before Me, a Notary Public, for the above State and County, on this Day of , 20 Notary Public My Commission Expires: (AFFIX OFFICIAL SEAL) 11-5699—"Medical Director for Collier Count& 30 Employment Physicals and Drug Testing" Co ter Cowsty Adrnirmbabte Services Diviabn Purchasing Attachment 5: Vendor Submittal—Immigration Affidavit Solicitation: 11-5699—Medical Director for Collier County&Employment Physicals&Drug Testing This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal Invitations to Bid(ITB's)and Request for Proposals(RFP)submittals. Further, Vendors/Bidders are required to enroll in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Failure to include this Affidavit and acceptable evidence of enrollment in the E-Verify program. may deem the Vendor/Bidder's proposal as non-responsive. Collier County will not intentionally award County contracts to any vendor who knowingly employs unauthorized alien workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e)Section 274A(e)of the Immigration and Nationality Act("INA"). Collier County may consider the employment by any vendor of unauthorized aliens a violation of Section 274A(e)of the INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A(e)of the INA shall be grounds for unilateral termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws(specifically to the 1986 Immigration Act and subsequent Amendment(s))and agrees to comply with the provisions of the Memorandum of Understanding with E- Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify), operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the Vendor's/Bidder's proposal. Company Name Print Name Title Signature Date State of County of The foregoing instrument was signed and acknowledged before me this day of ,20 ,by who has produced as identification. (Print or Type Name) (Type of Identification and Number) Notary Public Signature Printed Name of Notary Public Notary Commission Number/Expiration The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein,the truth and accuracy of this affidavit to interrogatories hereinafter made. 11-5699=Medical Director for Collier Count& 31 Employment Physicals and Drug Testing" Colter County Administrative Servroes Division Purchasing Attachment 6: Vendor Submittal -Vendor's Non-Response Statement The sole intent of the Collier County Purchasing Department is to issue solicitations that are clear, concise and openly competitive. Therefore, we are interested in ascertaining reasons why prospective Vendors did not wish to respond to this ITB. If your firm is not responding to this ITB, please indicate the reason(s) by checking any appropriate item(s) listed below and return this form via email or fax to the Purchasing Agent listed on the first page or mail to: Collier County Purchasing Department, 3327 Tamiami Trail East, Naples, Florida 34112. We are not responding to this ITB for the following reason(s): Solicitation: 11-5699—Medical Director for Collier County&Employment Physicals &Drug Testing ❑ Services requested not available through our company. ❑ Our firm could not meet specifications/scope of work. ❑ Specifications/scope of work not clearly understood (too vague, rigid, etc.) ❑ Project is too small. ❑ Insufficient time allowed for preparation of response. ❑ Incorrect address used. Please correct mailing address: ❑ Other reason(s): Firm's Complete Legal Name Address City, State, Zip Telephone Number FAX Number Signature/Title Type Name of Signature Date: 11-5699=Medical Director for Collier Count& 32 Employment Physicals and Drug Testing" Aco® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) I■ti....../ 9/10/2012 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. 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). PRODUCER I CONTACT NAME: Dee Lewis Lutgert Insurance Naples INC.No.E>d):239-262-7171 I FAX Ne1:239 262 5360 PO Box 112500 E-MAIL Naples FL 34108 ADDRESS: INSURER(S)AFFORDING COVERAGE ' NAIC# INSURER A:FCCI Insurance Company 00178 INSURED ADVAN 11 INSURER B: I Advanced Medical of Naples, LLC INSURER C: 1250 Pine Ridge Road INSURER D: . Naples FL 34108 INSURER E: ■ INSURER F: • COVERAGES CERTIFICATE NUMBER: 1288027007 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE (ADDLISUBR POLICY EFF 1 POLICY EXP I LTR I INSR WVD POLICY NUMBER IMM/DD/YYYY):IMMIDD/YYYY) LIMITS A I GENERALUABIUTY I GL0013746 /1/2012 6/1/2013 I EACH OCCURRENCE I$1.000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY I PREMISES(Ea occurrence) S100.000 CLAIMS-MADE X , OCCUR MED EXP(Any one person) I$5,000 PERSONAL BADV INJURY ; $1,000,000 '—1 I GENERAL AGGREGATE 1 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG I SINCLUDED I7 oR0- IX i POLICY JECT f LOC $ A 'AUTOMOBILE LIABIUTY CA0021260 /1/2012 /1/2013 COMBINED SINGLE LIMIT (Ea accident) 51.000.000 ANY AUTO BODILY INJURY(Per person) ■S I I ALL OWNED SCHEDULED BODILY INJURY(Per ac AUTOS AUTOS accident) S ' IX ❑ X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) 1 ' S UMBRELLA UAB 1 I OCCUR I EACH OCCURRENCE I S h EXCESS UAB I CLAIMS-MADE AGGREGATE 15 I I DED I RETENTIONS I _ ■ I S ' WORKERS COMPENSATION 1 1 i WIC STATU- I 10TH-I I AND EMPLOYERS'UABIUTY YIN TORY IMITS l =R I ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT !$ OFFICER/MEMBER EXCLUDED? I N/A i I (Mandatory in NH) , E.L.DISEASE-EA EMPLOYEES S If yes,describe under I I I I DESCRIPTION OF OPERATIONS below ; E.L.DISEASE-POLICY LIMIT .S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Collier County is names as additonal insured with regard to General Liability only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Collier County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 3327 E Tamiami Trail East Naples FL 34112 AUTHORIZED REPRESENTATIVE Ala. 4...Lb ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOY 'S LLYBILITY INSURANCE POLICY WC 00 00 01 A Comp Options Insurance Company, Inc. diA OptaComp INFORMATION PAGE Insurer: Comp Options Insurance Company, Inc.dba OptaComp I POLICY NO. 0C-0C-WC-0004208-00 P. O. Box 44291 Jacksonville. FL 32231-4291 Prior Policy No.: OC-OC-WC-0002706-00 Phone Number: (888)2074215 Ownership Type: LLC 1. The Insured and Mailing Address Advance Medical of Naples. LLC DBA Name: Same as Insured 1250 Pine Ridge Road Naples, FL 34103 Other workplaces not shown above: 2. The policy period is from 04;01.2012 To 04,01;2013 12:01 A.M at the insured's mailing address. 3.A.Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: Florida B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C.Other States Insurance: Part Three of the policy applies to the states, if any,listed here: None D. This policy includes these endorsements and schedules: WC 000000A WC 00 00 01 A WC 000406A WC 00 04 14 WC 09 03 03 WC090403A WC 09 06 06 WC 99 06 02 WC 99 06 04 WC 99 06 06 WC 99 06 07 4. The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Code No. Premium Basis Rate Per Estimated Total Estimated $100 of Annual Annual Remuneration Remuneration Premium Refer to attached Classification Schedule Total Estimated Annual Premium: $11,258 Minimum Premium: $232 Expense Constant: $200 I _ 9 Countersigned by: Page I of 3 A° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/29/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS t CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. 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). PRODUCER -CONTACT NAME: Dee Lewis Lutgert Insurance-Naples vHONE FAx PO Box 112500 EMAIL No.Exit 239-262-7171 I INC.No1:239-262-536D Naples FL 34108 ASS: INSURER(S)AFFORDING COVERAGE NAIC a INSURER A FCC?Insurance Company 10178 INSURED ADVAN11 INSURER B: Advance Medical of Naples, LLC INSURER C: 1250 Pine Ridge Road INSURER D: Naples FL 34108 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:159361664 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1NSR ADOL SUBR EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIOOWYYY) UMITS A GENERAL LIABILITY GL0013746 5/1/2012 5/1/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) 5100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 PERSONAL d ADV INJURY $1,000 000 GENERAL AGGREGATE $2,000,000 GEN1 AGGREGATE UMIT APPUES PER: 1-12487 fl LOC PRODUCTS SINCLUDED '� I POLICY S A AUTOMOBILE UABBJTY CA0021260 -6/112012 611/2013 leant SINGLE I LIMIT $1,000,000 — ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) S X HIRED AUTOS x AUTOS OWNED PROPERTY DAMAGE S (Per accident) S UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE S DED I I RETENTION S - WORKERS COMPENSATION $ AND EMPLOYERS'LUABBJTY I T LIM S I I ER Y I N ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? a N/A E.L.EACH ACCIDENT $ (Mandatory In NH) I dsacnbe uMsr E.L.DISEASE-EA EMPLOYEE S DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY UMIT_$ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space is required) Collier County is names as additonal insured with regard to General Liability only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Collier County Board of County Commissioners ACCORDANCE WITH WIITH DATE hE POUCY PROVISIONSE � DELIVERED IN 3327 E Tamlami Trail East Naples FL 34112 AUTHORIZED REPRESENTATIVE 7c7.a. 4....z,87- ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ACORDA, CERTIFICAL OF LIABILITY INSURAN.. : DATE GIN ,; ' '' PRODUCER Serial$ 103887 THIS CERTIFICATE IS ISSUED AS A MATTER OR INFORMATION ROYLANCE 3 ASSOCIATES,INC. ONLY AND CODERS NO RIGHTS UPON THE CERTIFICATE 7232 SAND LAKE RD,SUITE 302 HOL CER. THIS CERTFCCATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ORLANDO,FL 32819 INSURERS AFFORDING COVERAGE NAIC9 INSURED MUM A MAG Mutual Insurance Com •anv 42817 ADVANCED MEDICAL CENTER.LLC BEURER e: 1250 PINE RIDGE ROAD MANIC: NAPLES,FLORIDA 34109 I LINER O: IHLIIIm E: COVERAGES THE POUCIES OF INSURANCE LISTED BELOW NAVE 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 POUCES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS CF SUCH POUCES,AGGREGATE LMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IYPEOFDWRAICE POUCY NEMER T t Lars GENERAL LI JTY EACH 000UAa9/Ce I$ JCOWAYNCOL GENERAL UABLUTY EADaIe�ISH CLAUSMAOE ❑OCCUR MID EIP Pew wp ,ii) 8 PERSONA.a ADP INJURY S GEIERN.AGGREGAII $ GEUL MORMON MET APPLESPER: PROOUGTS•COMNOPAGD I MUM'Fla Floc + ; COMM SINGLE ULET $ AIYAUTO IEa sexdup AU.VANED AUTOS M SCHEDULED AUTOS Oar Passel = ..- PIROALTOS SCOW INJURY NOI CMMlDAVLOe som/dap ... mormirode GARAGE LNRUTY AUTO ONLY•EA ACCIDENT I _ R ANY AUTO OTHER THAN EsACC s ALTO ONLY; ALTO S 100:811011111131/1 UAIIUTY EACH OCCURRENCE 'S OCCUR OPALS MAOE AGGREGATE _E • DEDUCTIBLE RETIBIUOr 1 S IMP UNEUTY rAMe 17I !° ' Y EL EACH $ µ OpP�FaIC�INULLEINDREXCLUDED, BDISEASE•EA EMPLOYEE S SPILIAL IOIKLIasr EL DISEASE•POLICY L14N I A OTIRE PSL-160265602 2/19/12 2/19113 $250,000 EACH CLAIM/ PROFESSIONAL.LIABIUTY/ $750,000 AGGREGATE CLAIMS MADE FORM OpCRPNOD OF OPIRAVONSLOCATIONSNORDLESRDICLUINONS ADORD SY ENDORSEIMINTAPICIAL PROVISIONS SPECIALTY: ORGANIZATION COVERAGE WITH SEPARATE LIMITS RETROACTIVE DATE: 2/19/10 ADDITIONAL NAMED ORG: ADVANCE MEDICAL OF NAPLES,LLC EMPLOYEE COVERAGE SHARE IN ORGANIZATION LIMITS-JILL M ANDERSON ARID,CINDY BROWN ARNP,DEENA KRISHNA ARNP,VIDA NEUFELD ARNP,JANICE MASCITTI-MAZUR ARNP,SARAH UNDSAY ARNP. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE MOPE DESCRIBED POUCES RE CANCELLED BEFORE TIE PXPEAION DATE mow.THE I mUMD INSUIM!WILL EIOEAVOR TO MAIL 10 OATS WINDER COLLIER COUNTY GOVT NOTICE TO THE CERTIFICATE HOLDER NAMEO TO THE LEFT,Out FALA E TO DO SO SHALL 3301 E TAMIAMI TRAIL.BLD F,ONESOURCE NAPLES,FL 34112 SAPOSE NO OBIDAITOH OR LMIUTY OF ANY HIND UPON.TRE INSURE*.ITS AWNS OR IEPRESEHMTNES. AUTHORS RIPROE TATTVE OF ROYLANCE s ASSOCMTSS.INC. ACORD 25(2001118 ®ALGID CORPORATION ma