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Backup Documents 10/23/2012 Item #16E 2 16 E2 MEMORANDUM Date: November 2, 2012 To: Diana De Leon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Contract #12-5920: "Third Party Administrator for Property, Casualty and Workers Compensation" Contractor: Johns Eastern Company, Inc. Attached is an original copy of the contract referenced above (Item #16E2) approved by the Board of County Commissioners on Tuesday, October 23, 2012. The second original will be held on file with the Minutes and Record's Department with the Board's Official Records. If you have any questions, please contact me at 252-8411. Thank you. Attachment 16E2 co ier County Purchasing Department 3327 Tamiami Trail East Naples, Florida 34112 Administrative Services Division Telephone: (239)252-8941 Purling FAX: (239)252-6700 Email: RhondaCummings a(�,colliergov.net www.colliergov.net/purchasinq Memorandum Subject: Contract#12-5920 "Third Party Administrator for Property, Casualty and Workers Compensation" Date: October 23, 2012 From: Diana DeLeon for Rhonda Cummings, FCCN, CPPB, Procurement Strategist To: Ray Carter, Manager Risk Finance This Contract was approved by the Board of County Commissioners on October 23, 2012 agenda item 16.E.2. The County is in the process of executing this contract with Johns Eastern Company, Inc. Please review the Insurance Certificate(s) for the referenced Contract. • If the insurance is not in order please contact the vendor/insurance company to obtain a proper certificate. Once you receive the proper certificate(s), please acknowledge your approval and send to the County Attorney's office via the attached Request for Legal Services. • If the insurance is in order please acknowledge your approval and send to the County Attorney's office via the attached Request for Legal Services. If you have.afiy questions, please contact • at t ab e referenced information. I surance Approved : t 'Irr ' /Cl/30k' Manager 'isk Fin- ce Signature Date REC'!VED OCT 24 2012 RISK MANAGEMENT (Please route to County Attorney via attached Request for Legal Services) G/Acquisitions/AgentFormsandLetters/RiskMgmtReviewofl nsurance4/15/2010/16/09 16E2 AGREEMENT12-5920 for Third Party Administrator for Property, Casualty and Workers Compensation THIS AGREEMENT, made and entered into on this aT-4 day of O -c 10 'r- 2012, by and between Johns Eastern Company, Inc., authorized to do business in the State of Florida, whose business address is 6015 Resource Lane, Lakewood Ranch, FL 34202, (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. COMMENCEMENT. The contract shall be for a three (3) year period commencing upon issuance of the Notice to Proceed in the form of a letter from the Contract Manager and replaces all prior agreements between the County and the Contractor. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for two (2) additional one (1) year periods. Fees for each of the renewals shall be presented by the Contractor to the County no later than ninety (90) days prior to renewal and are subject to approval by the Board of County Commissioners. The County shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. 2. STATEMENT OF WORK. The Contractor shall provide third party administration services in accordance with the terms and conditions of RFP #12-5920 and the Contractor's proposal referred to herein and made an integral part of this agreement. This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Contractor and the County Project or Contract Manager or his designee, in compliance with the County Purchasing Policy and Administrative Procedures in effect at the time such services are authorized. 3. COMPENSATION. The County shall pay the Contractor for the performance of this Agreement the following compensation: Page 1 of 11 16E2 PROPERTY CASUALTY(NORMAL CLAIMS FEES) January 1, 2013 through December 31, 2013 $ 49,500 (annual fee) January 1, 2014 through December 31, 2014 $ 49,500 (annual fee) January 1, 2015 through December 31, 2015 $ 49,500 (annual fee) The annual fees represented above include the takeover of all old claims X Yes No Field investigation fees (first ten (10) per year included; if greater than ten provide fee). 500 or$85/hr+ $ expenses _(per investigation if greater than 10 per year) WORKERS' COMPENSATION $ 39,500 January 1, 2013 through December 31, 2013 (annual fee) $ 39,500 January 1, 2014 through December 31, 2014 (annual fee) $ 39,500 January 1, 2015 through December 31, 2015 (annual fee) The annual fees represented above include the takeover of all old claims. _X Yes No Field investigation fees (first ten (10) per year included; if greater than ten $500 or$85/hr+ provide fee). $ expenses (per investigation if greater than 10 per year) Medical review and audit services charge $ 14.00 (per review and service audit) CATAS i'ROPHE PROPERTY CLAIMS SERVICES- FEE SCHEDULE Full Repair Cost Service Fee $ 0.01 - $ 2,500.00 $387.00 2,500.01 - 5,000.00 485.00 5,000.01 - 7,500.00 572.00 7,500.01 - 10,000.00 681.00 10,000.01 - 15,000.00 864.00 15,000.01 - 20,000.00 1,012.00 20,000.01 - 25,000.00 4.5% of Loss - $1,025 minimum 25,000.01 - 35,000.00 4% of Loss - $1,200 minimum Page 2 of 11 16E2 35,000.01 - 50,000.00 3.5% of Loss - $1,400 minimum 50,000.01 - 100,000.00 3%of Loss - $1,750 minimum Over 100,000.00 2.0% of Loss - $3,000 minimum 1. Full Repair Cost -Agreed cost to repair or replace before applying depreciation, deductible, or other clauses limiting coverage. 2. Denials charged at$600 plus expenses. 3. In addition to the schedule, the following charges will be made: a.All miles driven at$0.445 per mile. b. Outside fees, reports, telephone, and other direct expense, at cost. c.Administrative/Set up fee - $50.00 d. Drive time charged and mileage (both prorated when possible)when loss is more than 20 miles from our base of operation. 4. We will limit our office-based adjusting and administrative fees for a catastrophic occurrence generating 20 or more exposures to$10,000.All field work would be handled based on the above Catastrophe Rate Schedule. PROPERTY FEE SCHEDULE Full Repair Cost $0.01 - $500.00 Full Adjustment 500.01 - 1,000.00 $225.00 1,000.01 - 2,500.00 256.00 2,500.01 - 5,000.00 379.00 5,000.01 - 7,500.00 465.00 7,500.01 - 10,000.00 559.00 10,000.01 15,000.00 669.00 15,000.01 - 20,000.00 825.00 20,000.01 - 30,000.00 980.00 30,000.01 - 40,000.00 4.5%of Loss - $995 minimum 40,000.01 - 55,000.00 3.5% of Loss - $1,350 minimum 55,000.01 - 70,000.00 3.0% of Loss - $1,400 minimum 70,000.01 - 90,000.00 2.5% of Loss - $1,650 minimum 90,000.01 - 110,000.00 2.0% of Loss - $1,750 minimum 110,000.01 - 150,000.00 2.0% of Loss - $1,800 minimum 150,000.01 - ABOVE 2.0% of Loss - $2,200 minimum Page 3 of 11 16E2 2.0% of Loss - $3,000 minimum 1. Above fees include local telephone, file creation, copying, and secretarial support. 2. Full Repair Cost-Agreed cost to repair or replace before applying depreciation, deductible, or other clauses limiting coverage. 3. In addition to the schedule, the following charges will be made: a. All miles driven at the current Florida Statutes Section 112.061 rate. b. Photos-$1.00 each c. Outside fees, reports, telephone, and other direct expense, at cost. 4. These schedules do not apply to catastrophes. 5. All assignments handled by General Adjuster will be billed at the full adjustment rate. 6. Subrogation efforts charged on an hourly basis. DATA CAPTURE AND CHECK ISSUANCE SERVICES Fee per data capture and check issuance from January 1, 2013 through December 31, 2013 Fee per data capture and check issuance from January 1, 2014 through $ 60 December 31, 2014 (per data capture and check issuance) Fee per data capture and check issuance from January 1, 2015 through $ 60 December 31, 2015 (per data capture and check issuance) Do the annual fees represented above include the takeover of all old claims? $ 60 (per data capture and check issuance) X Yes No Payment will be made upon receipt of a proper invoice and upon approval by the Project Manager or his designee, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". 3.1 Payments will be made for 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 is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this agreement. 3.2 TRAVEL AND REIMBURSABLE Travel and Reimbursable Expenses must be approved in advance in writing by the County. Travel expenses shall be reimbursed as per Section 112.061 Fla. Stats. Page 4 of 11 16E2 Reimbursements shall be at the following rates: Mileage $0.445 per mile Breakfast $6.00 Lunch $11.00 Dinner $19.00 Airfare Actual ticket cost limited to tourist or coach class fare Rental car Actual rental cost limited to compact or standard-size vehicles Lodging Actual cost of lodging at single occupancy rate with a cap of no more than$150.00 per night Parking Actual cost of parking Taxi or Airport Actual cost of either taxi or airport Limousine limousine Reimbursable items other than travel expenses shall be limited to the following: telephone long-distance charges, fax charges, photocopying charges and postage. Reimbursable items will be paid only after Contractor has provided all receipts. Contractor shall be responsible for all other costs and expenses associated with activities and solicitations undertaken pursuant to this Agreement. 4. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. 5. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or faxed to the Contractor at the following Address: Johns Eastern Company, Inc. 6015 Resource Lane, Lakewood Ranch, FL 34202 Telephone (941) 907-3100; Fax (813) 402-7914 Email: badkins©johnseastern.com Beverly Adkins, AIC, AIM, Executive Vice President All Notices from the Contractor to the County shall be deemed duly served if mailed or faxed to the County to: Collier County Government Center Purchasing Department 3327 Tamiami Trail, East Naples, Florida 34112 Page 5 of 11 16E2 Attention: Joanne Markiewicz, Interim Purchasing & General Services Director Telephone: 239-252-8975 Facsimile: 239-252-6480 The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 6. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 8. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the contract of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 9. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non-performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Contract Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery Page 6 of 11 1 E2 against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 10. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 11. INSURANCE. The Contractor shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. B. Business Auto Liability: Coverage shall have minimum limits of $500,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-Ownership. C. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $500,000 for each accident. D. Professional Liability: Shall be maintained by the Consultant to ensure its legal liability for claims arising out of the performance of professional services under this Agreement. Consultant waives its right of recovery against County as to any claims under this insurance. Such insurance shall have limits of not less than $1,000,000 each claim and in the aggregate. Special Requirements: Collier County Government shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. Renewal certificates shall be sent to the County ten (10) days prior to any expiration date. There shall be a thirty (30) day notification to the County in the event of cancellation or modification of any stipulated insurance coverage. Contractor shall ensure that all subContractors comply with the same insurance requirements that he is required to meet. The same Contractor shall provide County with certificates of insurance meeting the required insurance provisions. 12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall indemnify and hold harmless Collier County, its officers and Page 7 of 11 16E2 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 Contractor or anyone employed or utilized by the Contractor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Risk Management Department. 14. CONFLICT OF INTEREST: Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perfoim those services. 15. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the following component parts, all of which are as fully a part of the contract as if herein set out verbatim: Contractor's Proposal, Insurance Certificate, RFP #12-5920 Specifications/Scope of Services and Addenda. 16. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this agreement is subject to appropriation by the Board of County Commissioners. 17. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the individual and/or firm for cause. 18. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement, the Contractor is formally acknowledging without exception or stipulation that it is 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 seq. and regulations relating thereto, as either may be amended. Failure by the Contractor to comply with the laws referenced herein Page 8 of 11 16E2 shall constitute a breach of this agreement and the County shall have the discretion to unilaterally terminate this agreement immediately. 19. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful proposer extending the pricing, terms and conditions of this solicitation or resultant contract to other governmental entities at the discretion of the successful proposer. 20. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 21. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this contract in compliance with the Purchasing Policy. 22. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 23. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 24. KEY PERSONNEL/PROTECT STAFFING: The Contractor's personnel and management to be utilized for this project shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent. persons will be utilized in the performance of the contract. The Contractor shall assign as many people as necessary to complete the required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet the requirements of the Agreement The Contractor shall not change Key Personnel unless the following conditions are met: (1) Proposed replacements have substantially the same or better qualifications and/or experience. (2) that the County is notified in writing as far in advance as possible. The Contractor shall Page 9 of 11 16E2 make commercially reasonable efforts to notify Collier County within seven (7) days of the change. The County retains final approval of proposed replacement personnel. 25. ORDER OF PRECEDENCE: In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the Agreement shall take precedence over the terms of all other Contract Documents. 26. ASSIGNMENT: Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. *******************Remainder of page intentionally left blank****************************** Item# Agenda j 0 )6,73 (_ Date Date Rec• Deputy Clerk Page 10 of 11 16E2 IN WITNESS WHEREOF, the Contractor and the County, have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date and year first above written. BOARD OF COUNTY COMMISSIONERS ATTEST: COLLIER COUNTY, FLORIDA Dwight E. Brock, Clerk of Courts I C.,, ,,A1 B k_91. ) , ate:' c � {t, Z 12 D Fred W. Coyle, Chairman Att AL) es to 1 Johns Eastern Company, Inc. Contractor wLe, By: I ' L . rst Witness Sid ature TType/print witness nameT Q (iC4^- � eXt(. I d1kirn, EV P Sec nd Witnes Typed sfgnature and title 1 C.v a 4 Pret. L).rte' YP P TT rint witness namet Approved as to form and legal sufficiency: /I* Assistant County Attorney colleen m. &veeilS2-- Print Name Page 11 of 11 ____..., 1 6TEEF,a M F A�°ROY CERTIFICATE OF LIABILITY INSURANCE 1 10!24!12 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 pollcy(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 941-924-3808 NAME: Al Purmort Insurance, Inc. 941-924-8799 (PATNA).Ext):941-924-3808 FAX 3340 Bee Ridge Road ouc,No):941-924-8799 Sarasota, FL 34239 ADDRESS: Al Purmort PRODUCER JOHNE-1 CUSTOMER ID•: INSURER(S)AFFORDING COVERAGE ! NAIC• INSURED Johns Eastern Company Inc INSURER A:Cincinnati Insurance Co 10677 PO Box 110259 INSURER B:Zen it h Insurance Corn pany 13269 Lakewood Ranch,FL 34211-0004 INSURER C:Federal Insurance Com pony 20281 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 PERTAN, 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSR wvn POLICY NUMBER IMM/DDNYYY) IMM/DDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 02/01/12 02/01/13 DAMAGE IC RENTED 100,000 A X COMMERCIAL GENERAL LIABILITY X CAP5177615 PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 A X Blanket Addtl Ins FORM#GA210 02/01/12 02/01/13 GENERAL AGGREGATE $ 2,000,000 GENE AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 —1 POLICY X JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIM IT $ A X ANY AUTO CAP5177615 02/01/12 02/01/13 (Ea accident) BODILY INJURY(Per person) $ 500,000 ALL OWNED AUTOS *UMBRELLA FOLLOW FOR BODILY INJURY(Per accident) $ 1,000,000 SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ 100,000 X NON-OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 A CAP51776151FOLLOW FOR 02/01/12 02/01/13 DEDUCTIBLE $ X RETENTION $ $ HOW WC STATU- 0TH- ANDEMPSCOMPELI COMPENSATION X TORY LIMES W- AND EMPLOYERS'LIABILITY B ANY PROPRIEPORIPARTNER/EXECUTIVE Y!N M1099001 FL$�AOS 01/01/12 01/01/13 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? ❑ N!A (Mandatory In NH) E .DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , C DO,Crime,FIducixy 82117112 05/01/12 05/01/13 D&O&Cri me 5,000,000 C &Kidnap&Ransom Fiduc&Kid 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Collier County Board of County Commissioners is named as an additional Insured for General Liability. CERTIFICATE HOLDER CANCELLATION COLLCO3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Collier County Board of County , Commissioners AUTHORIZED REPRESENTATIVE Purchasing Department ( �I_ 3327 Tamiami Trail East f 'y a ty 61r INariac F1 1.4112 - O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 16E , -L,„_AIJONINS EASTERN COMPANY, INC. Claim Adjusters and Third Party Administrators ADDENDUM VIII to SERVICE CONTRACT FOR WORKERS'COMPENSATION,LIABILITY AND COMMERCIAL PROPERTY CLAIMS HANDLING This is the Eighth Addendum to the Agreement entered into between Johns Eastern Company, Inc., hereinafter called the SERVICE AGENT, and COLLIER COUNTY, hereinafter called the EMPLOYER,dated the 1st day of October 2000. Section 5 of the Agreement shall be amended and remuneration to be paid there under as follows: 5. Compensation for the Service Agent. For performing its services under this Agreement,the Service Agent shall be entitled to the following compensation: a. Fees for claims handling for the Employer for workers' compensation exposures whose dates of loss fall between October 1,2012 and December 31, 2012 will be a minimum and deposit of$10,375.00. This minimum and deposit will be billed on October 1,2012. This fee contemplates handling 40 workers' compensation exposures for the three month period. There will be no charge for report only exposures. If the number of exposures exceeds 40,the fees will be$1,195.00 per lost time exposure and $170.00 per medical only exposure. If Employer requires Service Agent to enter report only claims,the fee would be$25.00 per report.If the Employer enters the report only claims via the Service Agent's online system,there is no charge. The workers' compensation rates will be a one-time charge over the life of the contract. The above fee covers all claims management/administration and data processing services outlined in the proposal.All years are subject to audit. b. Fees for claims handling for the Employer for exposures other than workers' compensation whose dates of loss fall between October 1,2012 and December 31, 2012 will be a minimum and deposit of$9,825.00 to be billed on October 1, 2012. 16E2 This above minimum and deposit contemplates handling 17 automobile BI, automobile PD,crime, errors&omissions, GL/BI, GL/PD, Property Building and Property Contents claims. If the number exceeds 17 then fees will be as follows: Auto Collision per exposure $226.00 Auto Comprehensive per exposure $226.00 Auto Bodily Injury per exposure $710.00 Auto Prop Damage per exposure $452.00 Crime per exposure $579.00 Errors&Omissions per exposure $1,023.00 General Liability/BI per exposure $710.00 General Liability/PD per exposure $452.00 Property Building per exposure $483.00 Property Contents per exposure $483.00 The above fees cover all claims management/administration and data processing services previously outlined in this proposal. All years are subject audit. c. The Service Agent understands that there are certain liability exposures (i.e. property damage, small property claims, automobile physical damage, etc.) that the Employer prefers to handle in house. The Service Agent's responsibility would be limited to data capture and check issuance. Charges for those exposures would be $60.00 per exposure. The fee would cover entering all pertinent data into the AIM system, and issuing appropriate checks. If the Employer chooses to enter these exposures into Service Agent's system and issue appropriate checks in-house, we would charge an annual administrative fee of$2,500.00,which includes all loss reporting,data transfer to STARS, and technical support. *Data capture in Service Agent's system requires manual payment information entry. d. Allocated expenses are charged to file. Fees for any field investigation will be $95.00 per hour, $0.50 per mile and $1.00 per color photograph. Fees for field work for first party property claims will be billed at the current attached Property Rate Schedule. Mileage charges will be incurred only for time and travel occurring within Employer's boundaries. There will be no charge for travel time to or from the Employer. If a catastrophe occurs, there will be numerous exposures under one occurrence. We will limit our office-based claims handling fees for any catastrophe-caused multiple exposure occurrences to 20 exposures. All fieldwork would be handled based on the current attached Catastrophe Rate Schedule. .. 16E2 e. Provider Bill Review/Cost Containment Services will be billed at a rate of $5.95 per bill and 30% of all savings over and above Fee Schedule reductions. Retrospective bill review/hospital bill audits and out-of-network negotiated bills will be billed at a rate of 35% of savings over and above Fee Schedule savings. All other terms and conditions of the original contract remain unchanged. IN WITNESS WHEREOF, the Service Agent, Johns Eastern Company, Inc., and the Employer, Collier County, have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date and year first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS Dwight E. I 'nerk of Courts COLLIER COUNTY, FLORIDA N. n Ili I Veputy Clerk By g1 ■ ■_ Fred Coyle, Chairman 4 Dated: I t, -I(Z Attest as to Chair 1 n laure JOHNS EASTERN COMPANY, INC. C L � �Z�,1�' By: itn ss Signa re B ver y Ad s, Executive Vic resident V 11/ 2iQ oev.,11 Aa14 ,� Witness Sig�—e Typed/Printed Signature Approved as to form and legal sufficiency: 0/1262,DVI jAVAL.J2— Coleen Green Assistant County Attorney 16E2 µ4 Sk JOHNS EASTERN COMPANY. INC. Insurance adjusters P.O. Box 110239 * Lakewood Ranch, FL 34211 Tel: (941)907-3100 * FAX: (941)907-7226 *TOLL FREE 1-800-749-3044 PROPERTY RATE SCHEDULE Full Repair Cost Appraisal Only Full Adjustment $ 0.01-$ 500.00 $180.00 $225.00 500.01- 1,000.00 205.00 256.00 1,000.01- 2,500.00 334.00 379.00 2,500.01- 5,000.00 397.00 465.00 5,000.01- 7,500.00 517.0o 559.00 7,500.01-10,000.00 617.00 669.00 10,000.01 - 15,000.00 715.00 825.00 15,000.01-20,000.00 850.00 980.00 20,000.01 -30,000.00 n/a 4.5%of Loss- $ 995 minimum - 30,000.01 -40,000.00 n/a 3.5%of Loss-$1,350 minimum 40,000.01 -55,000.00 n/a 3.0%of Loss-$1,400 minimum 55,000.01-70,000.00 n/a 2.5%of Loss- $1,650 minimum 70,000.01-90,000.00 n/a 2.0%of Loss- $1:750 minimum 90,000.01- 110,000.00 n/a 2.o%of Loss-$1,800 minimum 110,000.01-150,000.00 n/a 2.0%of Loss- $2,200 minimum 150,000.01-ABOVE n/a 2.0%of Loss- $3,000 minimum 1. Above fees include local telephone, file creation, copying, and secretarial support. 2. Full Repair Cost - Agreed cost to repair or replace before applying depreciation,deductible, or other clauses limiting coverage. 3. In addition to the schedule,the following charges will be made: a. All miles driven at$0.50 per mile. b. Photos-$1.00 each c. Outside fees,reports,telephone,and other direct expense,at cost. d. Drive time charged (prorated when possible) when loss is more than 20 miles from our office. 4. These schedules do not apply to catastrophes. 5. All assignments handled by General Adjuster will be billed at the full adjustment rate. 6. Subrogation efforts charged on an hourly basis. 16E . JOHNS EASTERN COMPANY. INC. Insurance adiusters, P.O. Box 110239 * Lakewood Ranch, FL 34211 Tel: (941) 907-3100 * FAX: (941) 907-7226*TOLL FREE 1-800-749-3044 CATASTROPHE FEE SCHEDULE Full Repair Cost Service Fee $ 0.01- $ 2,500.00 $387 2,500.01- 5,000.00 485.00 5,000.01 —7,500.00 572.00 7,500.01- 10,000.00 681.00 10,000.01-15,000.00 864.00 15,000.01—20,000.00 1,012.00 20,000.01—25,000.00 4.5%of Loss- $1,025 minimum 25,000.01—35,000.00 4%of Loss-$1,200 minimum 35,000.01—50,000.00 3.5%of Loss- $1,400 minimum 50,000.01 - 100,000.00 3%of Loss-$1,750 minimum Over 100,000.00 2%of Loss— $3,000 minimum 1. Full Repair Cost — Agreed cost to repair or replace before applying depreciation,deductible,or other clauses limiting coverage. 2. In addition to the schedule,the following charges will be made: a. All miles driven at$0.50 per mile. b. Photos-$1.00 each c. Outside fees,reports,telephone,and other direct expense,at cost. d. Administrative/Set up fee-$35.00 e. Drive time charged (prorated when possible) when loss is more than 20 miles from our base of operation.