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Backup Documents 09/25/2018 Item #16E 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 El TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FO i:' t1°� E,C1 Print on pink paper. Attach to original document. The completed routing slip and original documents are to be ji a ounty� Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the Cognty�4t rney Office no later than Monday preceding the Board meeting. SEP 2 e5 LLUJ **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already co��ftith the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward tikt$lc(M 199 Cforney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Risk Risk Management G 1/24( 2. County Attorney Office County Attorney Office /6/7I 71. 7),6) 4. BCC Office Board of County 1AS Commissioners -)t1-16)/ 61-9$- FIC ' 4. Minutes and Records Clerk of Court's OfficeC1/4//8 I);/° 5. Procurement Services Procurement Services PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Ana Reynoso Contact Information 239-252-8950 Contact/ Department Agenda Date Item was September 25,2018 ✓ Agenda Item Number 16.E.1. 17— Approved by the BCC Type of Document Amendment#7 c. Number of Original Attached Documents Attached PO number or account N/A 11-5776-NS Martha U. 11-5776-NS Martha U. number if document is Coburn,M.D.Florida Coburn,M.D.Florida to be recorded District 20th Medical District 20th Medic Examiner Examiner INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature STAMP OK `PY4'" 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be AR signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the AR document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's AR signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 09/25/2018 and all changes made during the meeting have been incorporated in the attached document. The County e Attorney's Office has reviewed the changes,if applicable. ..4 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the I7. Chairman's signature. 1 „ 16E1 MEMORANDUM Date: September 28, 2018 To: Ana Reynoso, Procurement Services From: Teresa Cannon, Sr. Deputy Clerk Minutes & Records Department Re: Amendment #7 to Contract #11-5776-NS "Medical Examiner Services" Contractor: Martha U. Coburn, M.D. Attached for your records is an original of the referenced document above, (Item #16E1) adopted by the Board of County Commissioners on Tuesday, September 25, 2018. The Board's Minutes & Records Department has kept an original as part of the Board's Official Records. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment 16Ei SEVENTH AMENDMENT 11-5776 AGREEMENT FOR MEDICAL EXAMINER SERVICES THIS AMENDMENT TO AGREEMENT FOR MEDICAL EXAMINER SERVICES ("Amendment") is entered into and is effective on this 1st day of October, 2018, by and between Marta U. Coburn, M.D., Florida District Twenty Medical Examiner for Collier County, Florida, doing business as District 20 Medical Examiner, Inc., a Florida for Profit Corporation (hereinafter called "Medical Examiner") and the Board of County Commissioners of Collier County, Florida(hereinafter called"County"), collectively referred to as the "parties." RECITALS: WHEREAS, the parties entered into an Agreement for Medical Examiner Services ("Agreement") dated September 27, 2011, a copy of which is attached hereto; and WHEREAS, the Sixth Amendment to the Agreement was approved by the Board on September 26, 2017, Agenda Item 16.E.2, and is scheduled to terminate on September 30, 2018; and WHEREAS, the parties wish to extend the term of the Agreement and to clarify their respective responsibilities for certain costs relating to customary versus extraordinary maintenance and services regarding the upkeep of the Medical Examiner's Facility. WITNESSETH: NOW, THEREFORE, in consideration of Ten Dollars ($10.00) and other good and valuable consideration exchanged amongst the parties, and in consideration of the covenants contained herein,the parties agree as follows: 1. All of the above RECITALS are true and correct and are hereby expressly incorporated herein by reference as if set forth fully below. 2. Section I of the Agreement is hereby amended by extending the term of the Agreement from October 1, 2018 through September 30, 2019. 3. Section III, Paragraph A of the Agreement is replaced in its entirety to now read as follows: "The County hereby agrees to compensate the Medical Examiner for services to be performed for the term of this Agreement, beginning on October 1, 2018, the amount of one million three hundred ninety-nine thousand eight hundred dollars ($1,399,800) by semimonthly payments ending September 30, 2019. In addition,the County will make payments on behalf of the Medical Examiner for County-allocated charges consisting of General, Property, and Liability insurances in total of thirty-four thousand six hundred dollars ($34,600). Any modifications to this Contract shall be in compliance with the County Procurement Ordinance and Procedures in effect at the time such modifications are authorized. 1 Amendment#7 to Contract 11-5776 I6E1 4. Except as modified by this Amendment, the Agreement shall remain in full force and effect. If there is a conflict between the terms of this Amendment and the Agreement, the terms of this Amendment shall prevail. IN WITNESS WHEREOF,the parties hereto have caused this Amendment to be executed by their appropriate officials, as of the date first above written. ATTEST: BOARD OF o• TY COM JONERS Crystal Kinzel, Acting Clerk of Courts COLLIE' 0 ► Y, FLO' . By. Deputy Clerktt ,s}as to Chairman's Andy Solis, Esq., Chairman �� e s nnature only. Approved s to Form and Legality: By: County Attorney gyp. ME CAL EXAMINER S Marta U. Coburn M.D. Medical Examiner Florida District Twenty 2 c` Amendment#7 to Contract 11-5776 "£g 6 El Client#: 9392 DISTRICT 1 ACORDcM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)9/04/2018 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER I CONTNAME: Richard Richard Caligiuri Bouchard Insurance(FTM) PHONE 239 489-3232 FAX 239 489-1084 8191 College Parkway,Suite 202 E-MAIL o,Ext): (A/c,No): ADDRESS: cicerts@bouchardinsurance.com Fort Myers, FL 33919 INSURER(S)AFFORDING COVERAGE NAIC# 239 489-3232 American Compensation Ins Co 45934 INSURER A: INSURED INSURER B:Lloyds of London District 20 Medical Examiner INSURER C: 3838 Domestic Avenue INSURER D: Naples, FL 34104 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 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 ADDLSUBW POLICY EFF POLICY EXP LTR _ TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY • EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE 0(Ea RENTED ence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION ACFL0010013 03/02/2018 03/02/2019 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? Y N/A ---- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 B Professional MEO108506817 11/30/2017 11/30/2018 $1,000,000/claim Liability $3,000,000/aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION COLLIER COUNTY BOARD OF COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN COMMISSIONERS ACCORDANCE WITH THE POLICY PROVISIONS. 3327 TAMIAMI TRAIL EAST NAPLES, FL 34112 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S917434/M917427 JENWO