07/15/2020 Agreement .
4,
4 Kevin Madok, CPA
Clerk of the Circuit Court&Comptroller—Monroe County, Florida
DATE: July 22, 2020
TO: Bryan Cook, Director
Employee Services
ATTN: Natalie Maddox, Administrator
Employee Benefits
FROM: Pamela G. Banc(GI .C.
SUBJECT: July 15th BOCC Meeting
Attached is an electronic copy of the following item for your hautdling:
C3 Five year Contract for$64,800.00 annually/$324,000.00 over five years with
CleartrackHR, Inc. for continuation of the County's Benefits Administration System which
provides electronic management of benefits eligibility,enrollment,data file feeds to carriers,
compliance,reporting and other related processes; and approval to waive hard copy signature in
the submitted proposal.
Should you have any questions please feel free to contact me at (305) 292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145
BENEFIT CONSULTING AGREEMENT
15th
THIS AGREEMENT("Agreement") is made and entered into as of this fist- day of
July June.2020 ("Effective Date"), by and between ClearTrack HR, LLC, 305A Quality
Circle, Huntsville, Alabama 35806, a foreign limited liability corporation authorized
to do business in the State of Florida ("ClearTrack HR" or "ClearTrack" or
"Contractor"), and Monroe County Board of County Commissioners ("County" or
"BOCC") (collectively, the"Parties").
WHEREAS, on August 30, 2018, the County entered into a Benefit Consulting
Agreement with ClearTrack for the provision of services identified in that
Agreement, including the development of an online benefits enrollment platform to
be utilized by members of the County health plan ("Health Plan") in selecting their
County health plan benefits; and
WHEREAS, pursuant to that Agreement, with subsequent amendments and
renewals, ClearTrack developed and built a platform exclusively for the County,
to facilitate selection of health plan choices and other benefits by all of the Health
Plan members; and
WHEREAS, the platform was rolled out and used during the Open Enrollment
periods of 2018 and 2019; and
WHEREAS, pursuant to that Agreement, ClearTrack also provided assistance to
County staff with the online member enrollment services, and also provided
technical support both for the members and County staff as well as services to
maintain the database; and
WHEREAS, on or about November 20, 2019, the County issued a Request for
Proposals (RFP), seeking a vendor for the provision of web-based benefit
administration services including an online enrollment system; and
WHEREAS, following submission of proposals with a deadline of January 28, 2020,
a selection committee met to review the proposals, and ultimately ranked ClearTrack
as the top ranked proposer and has recommended to the Board of County
Commissioners that a contract be awarded to ClearTrack; and
WHEREAS, the parties now wish to memorialize their arrangement in the form of this
Agreement; and
NOW THEREFORE, in consideration of the mutual promises and covenants
contained herein, the parties hereby agree as follows:
1.0 Description of Services. The services to be performed by ClearTrack HR for
the County shall include the services referenced in the body of this
Agreement and those listed on Exhibit A, attached hereto and made a part
hereof. In the event of a conflict between the body of this Agreement and
Exhibit A, the Parties agree that the terms in the body of this Agreement
shall control. The services to be performed may only be modified as agreed
upon by the parties in writing. The parties further agree that ClearTrack HR
is an independent contractor and is not an employee of Monroe County.
ClearTrack HR has the right to determine the means and methods to be
used in accomplishing and providing the services to be rendered hereunder.
2.0 Duties required of the County. The County shall provide ClearTrack HR with
any and all information related to its benefit program that ClearTrack HR
may reasonably request in order to perform the services contemplated
hereunder including, but not limited to, accurate and timely information
related to the County and the plans and products subject to the services.
Furthermore, the County shall distribute in a reasonable manner
communication material related to the services being offered by ClearTrack
HR. ClearTrack HR will not independently verify or authenticate information
provided by the County or on the County's behalf. The County shall solely
be responsible for the accuracy and completeness of such information and
other documentation furnished to ClearTrack HR.
3.0 Term. This Agreement is effective and will remain in effect for five (5)
years from the Effective Date.
4.0 Fees for Services Performed. The fees to be paid to ClearTrack HR are
those outlined in the Employee Benefit Enrollment Overview proposal from
ClearTrack HR to Monroe County attached as Exhibit B, with the clarification
that there shall be no charge for Additional EDI files for currently existing files
(Blue Cross Blue Shield, Envision Rx, Delta Dental, and Vision Service
Plan). The County would only pay the Additional EDI file charge of $1,500
per file if additional files are added. The County agrees to timely pay all fees,
costs, and expenses arising out of or resulting from the services in
accordance with the Florida Local Government Prompt Payment Act. This
Agreement is subject to annual appropriation by the Monroe County Board of
County Commissioners.
2
5.0 Expenses. The County will not be responsible for direct expenses
associated with ClearTrack HIR's services other than those specifically
referenced in this Agreement.
L,Q Indemnification.
a. The parties acknowledge that ClearTrack HIR is not named as a
fiduciary with respect to any plan for which it may provide services.
The parties agree that ClearTrack HIR is not nor shall become a
fiduciary of any insurance plan as the result of providing the services
anticipated by this Agreement.
b. In order to provide the services identified herein, it may be
necessary for ClearTrack HIR to receive from the County, or from
the County's agent, information of a personal nature that may be
protected by various privacy laws. ClearTrack HIR advises that the
County consult with legal counsel as to laws that may impact the
County or the County's plan(s). The County warrants that the
County or the County's agent have the right and authority to
disclose certain protected health information to ClearTrack HIR for
ClearTrack HR's use in performing the services anticipated by this
Agreement. The County warrants that ClearTrack HIR's use of this
information to perform the services anticipated by this Agreement
does not violate any privacy notice issued by the County, a benefit
program the County maintains,or any applicable law.
c. Neither ClearTrack HIR nor the County shall have any liability for any
failure or delay in performance of obligations under this Agreement
because of circumstances beyond reasonable control, including
without limitation, acts of God, fires, floods, earthquakes, acts of war or
terrorism, civil disturbances, sabotage, accidents, unusually severe
weather, governmental actions, power failures, computer/network
viruses that are not preventable through generally available retail
products, catastrophic hardware failures, or attacks on servers.
d. The Parties further agree, notwithstanding any other terms or
conditions contained here, that neither ClearTrack HR nor the County
shall have any liability for indirect, special, punitive, consequential or
incidental damages, including, without limitation loss of profits.
e. Except to the extent prohibited by law, the County will indemnify,
defend, and hold harmless ClearTrack HR, its directors, officers, and
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associates from and against any and all claims and/or lawsuits brought
by any person, entity or governmental authority from and against any
and all judgments, settlements, costs, penalties, and expenses
(including reasonable attorneys' fees and expenses) resulting from or
arising out of criminal conduct, negligence, or fraud on the part of the
County or any of the County's directors, officers, or associates (acting
alone or in collusion with others) in connection with this Agreement,
except to the extent such claim or lawsuit arises from a wrongful act or
wrongful omission that ClearTrack HR, pursuant to rights under this
Agreement, specifically directed the County to engage in or which
arises from criminal conduct, negligence, or fraud on the part of
ClearTrack HR or any of ClearTrack HR's directors, officers or
associates (acting alone or in collusion with others).
f. Except to the extent prohibited by law, ClearTrack HR will indemnify,
defend, and hold harmless the County, the County's directors,
officers, and associates from and against any and all claims and/or
lawsuits brought by any person, entity or governmental authority
against any and all judgments, settlements, costs, penalties, and
expenses (including reasonable attorneys' fees and expenses)
resulting from or arising out of criminal conduct, negligence, or fraud
on the part of ClearTrack HR or any of its directors, officers, or
associates (acting alone or in collusion with others) in connection with
this Agreement, except to the extent such claim or lawsuit arises from
a wrongful act or wrongful omission that the County, pursuant to rights
under this Agreement, specifically directed ClearTrack HR to engage in or
which arise from criminal conduct, negligence, or fraud on the part of the
County or any of the County's directors, officers or associates (acting alone
or in collusion with others).
7.0 Confidentiality.
7_1 To the maximum extent allowed by law and specifically in accordance
with Florida public records law, ClearTrack HR will retain in confidence all
information and technical data derived from or disclosed to ClearTrack HR
by the County, the County's Employees, the County's representatives, or the
County's agents, which is not generally known to the public, hereinafter
referred to as "Confidential Information." Examples of Confidential
Information include, but are not limited to, information or data disclosed in
oral, written, graphic, or machine-readable form or in forms otherwise
embodying or displaying such information which is visible or audible to
ClearTrack HR by virtue of ClearTrack HR having an employee,
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subcontractor, or agent visiting or performing services at a facility controlled
by the County or one of the County's subsidiaries, agents or subcontractors;
or by having access to the County's systems including, but not limited to,
employee information, which may constitute personally identifiable
information. Examples of personally identifiable information include, but are
not limited to, individual names, addresses, phone numbers, email
addresses, employment information, financial information, social security
numbers, drivers' license or other identification card numbers, or other
similar information. ClearTrack HR shall use all Confidential Information
solely to perform its obligations under this Agreement. The disclosure of
Confidential Information is subject to privacy laws. This obligation of
confidentiality shall not, however, apply to information that: (a) is or becomes
available in the public domain through no wrongful act or omission of
ClearTrack HR; (b) is already in ClearTrack HR's rightful possession without
an obligation of confidentiality prior to disclosure by the County; (c) is
rightfully disclosed to ClearTrack HR by a third party without an obligation of
confidentiality that is known to ClearTrack HR; (d) is independently
developed by ClearTrack HR; or (e) is required to be disclosed by law or
pursuant to any order of a court of competent jurisdiction or regulatory order
properly served on ClearTrack HR.
a. ClearTrack HR agrees to regard and preserve as confidential all
records and other information including but not limited to participant
demographic and benefit election information and any materials
developed exclusively for the County. ClearTrack HR will not,
without written authority from the County, disclose to others during
the term of this Agreement or thereafter, any such records or other
information except as required by applicable law.
b. Upon Termination of this Agreement, each party shall promptly return
to the other party all copies of materials involving confidential
information in the other party's possession or control.
c. Public Records Requirements:
Pursuant to F.S. 119.0701 and the terms and conditions of this contract,
the CONTRACTOR is required to:
(1) Keep and maintain public records that would be required by the County
to perform the service.
(2) Upon receipt from the County's custodian of records, provide the County
with a copy of the requested records or allow the records to be inspected or
5
copied within a reasonable time at a cost that does not exceed the cost
provided in this chapter or as otherwise provided by law.
(3) Ensure that public records that are exempt or confidential and exempt
from public records disclosure requirements are not disclosed except as
authorized by law for the duration of the contract term and following completion
of the contract if the CONTRACTOR does not transfer the records to the
County.
(4) Upon completion of the contract, transfer, at no cost, to the County all
public records in possession of the CONTRACTOR or keep and maintain
public records that would be required by the County to perform the service. If
the CONTRACTOR transfers all public records to the County upon completion
of the contract, the CONTRACTOR shall destroy any duplicate public records
that are exempt or confidential and exempt from public records disclosure
requirements. If the CONTRACTOR keeps and maintains public records upon
completion of the contract, the CONTRACTOR shall meet all applicable
requirements for retaining public records. All records stored electronically must
be provided to the County, upon request from the County's custodian of
records, in a format that is compatible with the information technology systems
of the County.
(5) A request to inspect or copy public records relating to a County contract
must be made directly to the County, but if the County does not possess the
requested records, the County shall immediately notify the CONTRACTOR of
the request, and the CONTRACTOR must provide the records to the County or
allow the records to be inspected or copied within a reasonable time.
If the CONTRACTOR does not comply with the County's request for records,
the County shall enforce the public records contract provisions in accordance
with the contract, notwithstanding the County's option and right to unilaterally
cancel this contract upon violation of this provision by the CONTRACTOR. A
CONTRACTOR who fails to provide the public records to the County or
pursuant to a valid public records request within a reasonable time may be
subject to penalties under section119.10, Florida Statutes.
The CONTRACTOR shall not transfer custody, release, alter, destroy or
otherwise dispose of any public records unless or otherwise provided in this
provision or as otherwise provided by law.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF
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PUBLIC RECORDS, BRIAN BRADLEY AT PHONE# 305-292-3470
BRADLEY-BRIAN@MONROECOUNTY-FL.GOV, MONROE COUNTY
ATTORNEY'S OFFICE 1111 12TH Street, SUITE 408, KEY WEST, FL
33040.
UMiscellaneous.
BA Governing Law. Any action, suit, or proceeding arising under or
in connection with this Agreement must be commenced within two (2)
years after the claim or cause of action arises. This Agreement shall be
governed in all respects by the laws of the state in which the County is
located, without regard to conflicts of law.
8®2 Assign ent. Neither party may assign (voluntarily, by operation of
law, or otherwise) this Agreement (or any rights or obligations contained
herein) without the prior written consent of the other party, whose
consent shall not be unreasonably withheld. Any permitted assignee
shall assume all obligations of its assignor under this Agreement. Any
purported assignment or transfer in violation of this section shall be void.
®3 Entire Agreement. This Agreement is the entire agreement between
the parties. This Agreement supersedes all prior or contemporaneous
oral or written communications, proposals, and representations with
respect to the subject matter covered by this Agreement. The terms and
conditions of this Agreement can only be modified via a written
agreement signed by all parties.
8.4 Counts . This Agreement may be executed by the parties in
separate counterparts each of which when so, executed and delivered
shall be an original, but all such counterparts together shall constitute but
one and the same instrument.
8.5 Notices. Any notice, communication or payment required under
this Agreement shall be addressed as follows:
Monroe County BOCC ClearTrack HR, LLC
1100 Simonton Street 305A Quality Circle
i Suite 2-268 Huntsville, AL 35806
Key West, FL 33040 Attn: Contracting Department
Attn: Maddox
natalie@monroecounty-fl.gov
8_6 Attorneys' Fees. In the event ClearTrack HR or the County
institutes legal proceedings related to this Agreement against the
other party the prevailing party in such proceedings shall be entitled to
recover from the other party (in addition to any damages or other relief
granted as a result of such litigation) all costs and expenses incurred
therein, including reasonable attorneys'fees and courts costs.
8_7 HIPAA and HITECH Compliance. ClearTrack HR and the County
shall comply with all federal and state laws and regulations governing
the privacy and security of health information, including without
limitation, the Health Insurance Portability and Accountability Act
(HIPAA), Health Information Technology for Economic and Clinical
Health Act (HITECH), and their related regulations, and shall remain in
compliance with these laws and regulations, and any other applicable
laws, rules or regulations pertaining to the services, as they may be
amended from time to time. The parties shall execute whatever
additional documents or agreements may be necessary to comply with
these laws and regulations.
9.0 Provisions Reguired by 2 CFR part 200.
9.1 Termination for Cause and Remedies. In the event of breach of any
contract terms, the COUNTY retains the right to terminate this
Agreement. The COUNTY may also terminate this agreement for cause
with CONTRACTOR should CONTRACTOR fail to perform the
covenants herein contained at the time and in the manner herein
provided. In the event of such termination, prior to termination, the
COUNTY shall provide CONTRACTOR with two (2) calendar days'
notice and provide the CONTRACTOR with an opportunity to cure the
breach that has occurred. If the breach is not cured within 24 hours of
notice, the Agreement will be terminated for cause. If the COUNTY
terminates this agreement with the CONTRACTOR, COUNTY shall pay
CONTRACTOR the sum due the CONTRACTOR under this agreement
prior to termination, unless the cost of completion to the COUNTY
exceeds the funds remaining in the contract; however, the COUNTY
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reserves the right to assert and seek an offset for damages used by
the breach, including the cost of corrective work. The maximum amount
due to CONTRACTOR shall not in any event exceed the spending cap in
this Agreement. In addition, the COUNTY reserves all rights available to
recoup monies paid under this Agreement, including the right to sue for
breach of contract and including the right to pursue a claim for violation
of the COUNTY's False Claims Ordinance, located at Section 2-721 et
al. of the Monroe County Code.
9.2 Termination for Convenience. The COUNTY may terminate this
Agreement for convenience, at any time, upon ninety (90) days' notice
to CONTRACTOR. If the COUNTY terminates this agreement with the
CONTRACTOR, COUNTY shall pay CONTRACTOR the sum due the
CONTRACTOR under this agreement prior to date of termination.
9.3 Equal Emoloyment 012portuniiy, No Discrimination. During the
performance of this Agreement, the CONTRACTOR agrees as follows:
1. The contractor will not discriminate against any employee or applicant for
employment because of race, color, religion, sex, sexual orientation,
gender identity, or national origin. The contractor will take affirmative
action to ensure that applicants are employed, and that employees are
treated during employment, without regard to their race, color, religion,
sex, sexual orientation, gender identity, or national origin. Such action
shall include, but not be limited to the following: Employment, upgrading,
demotion, or transfer, recruitment or recruitment advertising; layoff or
termination; rates of pay or other forms of compensation; and selection for
training, including apprenticeship. The contractor agrees to post in
conspicuous places, available to employees and applicants for
employment, notices to be provided by the contracting officer setting forth the
provisions of this nondiscrimination clause.
2. The contractor will, in all solicitations or advertisements for employees
placed by or on behalf of the contractor, state that all qualified applicants
will receive consideration for employment without regard to race, color,
religion, sex, sexual orientation, gender identity, or national origin.
3. The contractor will not discharge or in any other manner discriminate
against any employee or applicant for employment because such employee
or applicant has inquired about, discussed, or disclosed the compensation
of the employee or applicant or another employee or applicant. This
provision shall not apply to instances in which an employee who has
access to the compensation information of other employees or applicants
as a part of such employee's essential job functions discloses the
9
compensation of such other employees or applicants to individuals who do
not otherwise have access to such information, unless such disclosure is in
response to a formal complaint or charge, in furtherance of an investigation,
proceeding, hearing, or action, including an investigation conducted by the
employer, or is consistent with the contractor's legal duty to furnish
information.
4. The contractor will send to each labor union or representative of workers
with which it has a collective bargaining agreement or other contract or
understanding, a notice to be provided by the agency contracting officer,
advising the labor union or workers' representative of the contractor's
commitments under section 202 of Executive Order 11246 of September
24, 1965, and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
5. The contractor will comply with all provisions of Executive Order 11246 of
September 24, 1965, and of the rules, regulations, and relevant orders of
the Secretary of Labor.
6. The contractor will furnish all information and reports required by
Executive Order 11246 of September 24, 1965, and by the rules,
regulations, and orders of the Secretary of Labor, or pursuant thereto, and
will permit access to his books, records, and accounts by the contracting
agency and the Secretary of Labor for purposes of investigation to
ascertain compliance with such rules, regulations, and orders.
7. In the event of the contractor's non-compliance with the
nondiscrimination clauses of this contract or with any of such rules,
regulations, or orders, this contract may be canceled, terminated or
suspended in whole or in part and the contractor may be declared
ineligible for further Government contracts in accordance with procedures
authorized in Executive Order 11246 of September 24, 1965, and such other
sanctions may be imposed and remedies invoked as provided in Executive
Order 11246 of September 24, 1965, or by rule, regulation, or order of the
Secretary of Labor, or as otherwise provided by law.
9.4 OTHER FEDERAL CONTRACT REQUIREMENTS. The
CONTRACTOR and its subcontractors must follow the provisions as set
forth in Appendix II to 2 CFR Part 200, as amended, including but not
limited to:
A. Contractor agrees to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q)
and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251-
1387) and will reports violations to FEMA and the Regional Office of the
10
Environmental Protection Agency (EPA).
B. Rights to Inventions Made Under a Contract or Agreement. If the
Federal award meets the definition of "funding agreement" under 37 CF
01.2 (a) and the recipient or sub recipient wishes to enter into a contract
with a small business firm or nonprofit organization regarding the
substitution of parties, assignment or performance of experimental,
developmental, or research work under that "funding agreement," the
recipient or sub recipient must comply with the requirements of 37 CFR
Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small
Business Firms Under Government Grants, Contracts and Cooperative
Agreements," and any implementing regulations issued by the awarding
agency.
C. Debarment and Suspension (Executive Orders 129 and 12 )—A
contract award (see 2 CFR 180.220) must not be made to parties listed on
the government wide exclusions in the System for Award Management
(SA ), in accordance with the OMB guidelines at 2 CFR 180 that
implement Executive Orders 1 (3 CFR part 1986 Comp., p. 18 ) and
169 (3 CFR part 1989 Comp., p. 2 ), "Debarment and Suspension."
SAM Exclusions contains the names of parties debarred, suspended, or
otherwise excluded by agencies, as well as parties declared ineligible under
statutory or regulatory authority other than Executive Order 1 .
D. Byrd Anti-Lobbying Amendment (31 U.S.C. 135 �—Contr ctors that
apply or bid for an award exceeding $100,000 must file the required
certification. The certification is attached to this Agreement as Exhibit D.
Each tier certifies to the tier above that it will not and has not used Federal
appropriated funds to pay any person or organization for influencing or
attempting to influence an officer oremployee of any agency, a member of
Congress, officer oremployee of Congress, or an employee of a member
of Congress in connection with obtaining any Federal contract, grant or any
other award covered by 31 U.S.C. 12. Each tier must also disclose any
lobbying with non-Federal funds that takes place in connection with
obtaining any Federal award. Such disclosures are forwarded from tier to
tier up to the non-Federal award. ClearTrack will submit Exhibit ID to the
County's Benefits office within 10 days follawina execution of this
Agreement by the County.
Other Federal eguirements:
E.Americans with Disabilities Act of 10 (A A) — The CONTRACTOR
will comply with all the requirements as imposed by the ADA, the
regulations of the Federal government issued thereunder, and the
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assurance by the CONTRACTOR pursuant thereto.
F. Disadvantaged Business Enterprise (DBE) Policy and Obligation - It is
the policy of the COUNTY that DBE's, as defined in 49 C.F.R. Part 26, as
amended, shall have the opportunity to participate in the performance of
contracts financed in whole or in part with COUNTY funds under this
Agreement. The DBE requirements of applicable federal and state laws
and regulations apply to this Agreement. The COUNTY and its
CONTRACTOR agree to ensure that DBE's have the opportunity to
participate in the performance of this Agreement. In this regard, all
recipients and contractors shall take all necessary and reasonable steps
in accordance with applicable federal and state laws and regulations to
ensure that the DBE's have the opportunity to compete for and perform
contracts. The COUNTY and the CONTRACTOR and subcontractors shall
not discriminate on the basis of race, color, national origin or sex in the
award and performance of contracts, entered pursuant to this Agreement.
G. The Contractor shall utilize the U.S. Department of Homeland Security's
E- Verify system to verify the employment eligibility of all new employees
hired by the Contractor during the term of the Contract and shall expressly
require any subcontractors performing work or providing services pursuant
to the Contract to likewise utilize the U.S. Department of Homeland
Security's E- Verify system to verify the employment eligibility of all new
employees hired by the subcontractor during the Contract term.
9.5 ClearTrack HR warrants that he/it has not employed, retained or
otherwise had act on his/its behalf any former County officer or employee in
violation of Section 2 of Monroe County Ordinance No. 10-1990 or any County
officer or employee in violation of Section 3 of Monroe County Ordinance No.
10-1990.
For breach or violation of this provision the County may, in its discretion,
terminate this contract without liability and may also, in its discretion, deduct
from the contract or purchase price, or otherwise recover, the full amount of
any fee, commission, percentage, gift, or consideration paid to the former
County officer or employee.
9.6 The County and ClearTrack HR understand and agree that County
officers and employees are required to comply with the standards of conduct
for public officers and employees as delineated in Section 112.313, Florida
Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing
business with one's agency; unauthorized compensation; misuse of public
position, conflicting employment or contractual relationship; and disclosure or
12
use of certain information, or the County's gift policy, set forth in Section 1.06
of the County's Personnel Policies and Procedures Manual (Code of Ethics),
available at: h Ltt,p�a..I.IA MlZ,.,monroecountyLfiL,,qgli,12-IQ jic�es--Procedures.
9.7 Insurance Requirements. At or prior to execution of this Agreement, all
of the insurance coverages listed in Exhibit E, Insurance Checklist, will be
obtained and certificates of insurance will be provided to Monroe County Board
of County Commissioners. Monroe County Board of County Commissioners
will be listed as an additional insured on the following coverages: liability
(general, vehicle, and cyber).
The insurance coverages will be maintained in force at all times throughout the
contract term. If any policies expire or lapse during the term, new certificates
of insurance will be provided by the vendor to the County.
9.8 A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a contract
to provide any goods or services to a public entity, may not submit a bid on a
contract with a public entity for the construction or repair of a public building or
public work, may not submit bids on leases of real property to public entity,
may not be awarded or perform work as a CONTRACTOR, supplier,
subcontractor, or CONTRACTOR under a contract with any public entity, and
may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, for CATEGORY TWO for a period of 36
months from the date of being placed on the convicted vendor list. By entering
into this Agreement, ClearTrack warrants that it has read the above and states
that neither ClearTrack nor any Affiliate has been placed on the convicted
vendor list within the last 36 months.
[THE BALANCE OF THIS PAGE IS INTENTIONALLY BLANK]
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IN WITNESS WHEREOF, the parties have caused this Agreement to be executed
the date set forth below.
(t) \. :Ales hereby agree and consent to the terns and conditions of the
t and acknowledge such by executing the Agreement below.
...01, � Monroe County Board of County
��•!edok,CPA,Clerk of Courts Commissioners
C onara
luau
As Deputy Clerk yor
Date: (teal is .2, 1-
R°Witnessed: ClearTrack H LLC
By: By: 11e0*h0.1W Ss
Print Name: Heather McFaiand, CEO
Date: Date: May 20, 2020
APPROVED AS TO FORM AND CONTENT
MONROE COUNTY ATTORNEY'S OFFICE
Digitally signed by Cynthia L.Hall
i• 1'at DNcnaCyn[FIa L Hall o-Mnce o ,
nty130CC ou ena'l hall-
cymmaelnon,oecounryn.go.,
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Date 202007101309:01 Oa 00'
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EXHIBIT A
CLEARTRACK HR SCOPE OF SERVICES
CLEARTRACK HR shall provide the following checked services to the County under this
Agreement:
Services
0 Call center—Enrdirrwot 0 Traditional anciii-iteracWe
assistance materials
0 Onsde onie-on-one meetings 0 Enrollment pllaffomri(Halix)
0 Gfoup rneebrigs 0 Enrollment platform(Selerix)
0 Enrollment platform user support E3 Dependent Ehgibility verification
Enroflment Soludons
CK Open enrollment 0 Year-round status changes
C? New hire enrollment 0 Dependem verification
0 Acquisitions(it applicable)
8"effl sad mInistration
C3 Benefit efigibifty 0 Carrier File-Interface
0 Rehires Development
13 Termimations 0 ScheduW EDI Ses to carriers
* Life event changes throughout ft yeaf
* Premium billing and 0 Integration with WbMirne ACA
reconoilabon compliance suite
0 Standard and custom teporls for U Pre-ento,11ment data audit
adminWenng berieffis
Effective Communication
• BeneM fairs 0 Benefit Summary Books
• Wabinar meating presentations 0 Benefits guide and workbook
• Online Calendar Enroament Custom
Scheduling call ceiftr prcMts
0 Open enfogment announcement 0 Branded on enrollment
letter scrisens
• Open enrollment poster (81 Berieft
• Payron stuffers, Staternents/Coninna tip
ris
• to call recordings E3 Preparirg for open enrollment
E3 Text and email messages benefit Workbo*
E3 5mployee and management CI PMt and Fuffillment
surveys 0 Interactive NU Booklets
13 Total Compensation Statements E3 Enrollment Guides
0 Emp"DoWon Tooft 0 Corporate memoing
0 Video 0 Family Medical Leave
a Web portalls, 13 nnancial PlannkV Tools
0 Emal and Call R"nders E3 Soda I Wxffa
0 Wellirbess;EngagiameM 0 Dealip and Uoy*tlitng
15
EXHIBIT B
FEE SCHEDULE
CLEARTRACK HR is providing open enroillment platform services on a one-time basis. The
fees shall be in the amounts set forth below.
Web-based Enrollment Platform (includes 4 EDI e
Additional EDI files Al §Ppyff fil I
Online Benefit Administration and Enrollment System $3.00 PEPM
(includes tech n ica I/softwa re su ®port)
**Total estimated expenses are based on enrollment of 1400 employees. Actual cost will be
calculated based on actual number of benefit eligible employees during open enrollment, but
are capped at no more than five (5) months.
*** Call center support does not include benefit consulting and/or assistance with enrollment of
benefits.
""Estimated expenses calculated based on 4 EDI files (4 are included). At present, Monroe
County does not believe that an additional EDI file is required. However, if it is, the cost per
additional EDI file will be $1500.
Invoicing_and_Payments. The invoice shall be sent to the County o the 11t (first) day of each
month. Invoices will be delivered via e-mail to the address provided by the County and are due
and payable in accordance with the Florida Local Government Prompt Payment Act.
If any additional services are requested by the Monroe County BOCC, the County will request
a quote and ClearTrack will provide a quote. The additional services will be provided only after
written approval of the County to the quote. Examples would be customized programing or
development outside the scope of the Benefit Administration System. Monroe County BOCC
must authorize all additional services and fees, in writing, prior to work being performed.
16
EXHIBIT
Approved by OMB
0348-0046
Disclosure of Lobbying Activities
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
See reverse for public burden disclosure
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a.contract X a.bid/offer/application X a.initial filing
b.grant b.initial award b.material change
c.cooperative agreement c.post-award
d.loan For material change only:
e.loan guarantee Year quarter
f.loan insurance Date of last report
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee,
X Prime Subawardee Enter Name and Address ofPrime:
Tier ,if own:
N/A
Monroe County Board of County Commissioners
1100 Simonton Street
Key West,FL 33040-3110
Congressional District, linown:FL26 Congressional District,if known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
U.S. Department of Justice
Office of Justice Programs
Bureau of Justice Assistance CFDA Number,if applicable:16.738
. Federal Action Number,f own: 9. Award Amount,if own
BJA-201 -13626 $13,982
10.a.Name and Address of Lobbying Registrant b. Individuals Performing Services (including address i
(f individual, last name,first name, ): different from No. 10a)
(last name,first name, f):
N/A /A
11.Information requested through this form is authorized by
title 31 U.S.C. section 1352. This disclosure of lobbying Signature:
activities is a material representation of fact upon which
reliance was placed by the tier above when this transaction print Name:
was made or entered into. This disclosure is required
pursuant to 31 U.S.C.1352.This information will be reported Title:
to the Congress semi-annually and will be available for public
inspection. Any person who fails to file the required
disclosure shall be subject to a civil penalty of not less than Telephone No.: Date:
$10,000 and not more than$100,000 for each such failure.
FederalUse Only Authorized for Local Reproduction
Standard Form-LLL(Rev.7-97)
Jr
INSTRUCTIONS FOR COMPLETION OF SF-LLL,DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,
at the initiation or receipt of a covered Federal action,or a material change to a previous filing,pursuant to title
31
U.S.C. section 1352.The filing of a form is required for each payment or agreement to make payment to any
lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of
Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with a
covered Federal action.Complete all items that apply for both the initial filing and material change report.Refer
to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been
secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material
change to the information previously reported,enter the year and quarter in which the change occurred.
Enter the date of the last previously submitted report by this reporting entity for this covered Federal
action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional
District,if known.Check the appropriate classification of the reporting entity that designates if it is,or
expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first
subawardee of the prime is the 1 st tier.Subawards include but are not limited to subcontracts,subgrants
and contract awards under grants.
5. If the organization filing the report in item 4 checks"Subawardee,"then enter the full name,address,
city,State and zip code of the prime Federal recipient.Include Congressional District,if known.
6. Enter the name of the federal agency making the award or loan commitment. Include at least one
organizational level below agency name, if known. For example, Department of Transportation,
United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action(item 1).If known,enter
the full Catalog of Federal Domestic Assistance(CFDA) number for grants, cooperative agreements,
loans,and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item
1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement
number;the contract,grant,or loan award number;the application/proposal control number assigned by
theFederal agency).Included prefixes,e.g.,"RFP-DE-90-001"
9. For a covered Federal action where there has been an award or loan commitment by the Federal
agency, enter the Federal amount of the award/loan commitment for the prime entity identified in
item 4 or5.
10. (a)Enter the full name, address,city, State and zip code of the lobbying registrant under the Lobbying
Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered
Federal action.
(b)Enter the full names of the individual(s)performing services,and include full address if different
from 10(a).Enter Last Name,First Name,and Middle Initial(MI).
11. The certifying official shall sign and date the form,print his/her name,title,and telephone number.
18
EXHIBIT
1
(ro be J with each bid or offer exceading S 100,000)
Cleartrack HR, LLC evathm to
to any perx= for 'ngueuing or attempting to iodham an oMm or"IoM of
Mambu, ,or an employee of
in commfion with fte ,ft making of
f my Federal loan,to enft6g udo of any coopentive e8remonak ,
mead,metulwtw,or X f
.If any ftm&odw fun Federal qVtopriaW firt
cc to iaftwawe an offim or employee of my agency,a Member of
an oWxw or=Vbyee of Coupvsa,or an employee of a Member of Congress in comitc6on with
FabaW S to Repmtvhth as
°
. t Idee bmgwp of
t "
i a
G MANNUI ftVro5enfSfi0Q Of
h=aCtion Was Made or entered We.subnission ofeds certificasm is a preveqwsite for makim cc
Apt of 1 to f t to a civil peashy
f not hm tbas St & t mm t
The , Cleartrack H , LLC
accuracy of ach atsteamat of its"r1ification and dixkxtwv,if any. In aAMico, the ConnacW
wWmftm13 and t of t US.C. '1'7S is t ,
dewkmm,if v
t
Sipature Of
e 6
Heather McFarland
June 9, 2020
EXHIBIT
INSURANCE
PROFESSIONAL LIABILITY INSURANCE REQUIREMENTS
FOR
CONTRACT f)j!,ne
,TWEE
MONROE COUNTY, FLORIDA
,r-j 6;ai!M
Recognizing nizing that the work governed by this contract involves the furnishing of advice or service,
of a professional nature, the Contractor will purchase and maintain„ throughout the life of the
contract, Profemional Liability Insurance which will respond to damages restrltincl IMF)) any claairta
a€ruin; out of the performance of professional services or any error or ornission or the Contractor
arising out of work governed by this contract.
Tire miniraatr€aa hrna t� of lialailiLy are:
$300,000 per Occt€once/S500,000 Aggregate
If cove ra-c is pro%1cled on a€cIaaina, €z de has is,dan e x ten cled c I miens report in period of loan (4)
years will be required.
FBI
,.,
2018 Umon
WORKERS' COMPENSATION INSUIUNCE REQUIRENIENTS
FOR
CONTR=&CT &"e
BETWEEN
MONROE COUNTY, FLORIDA,
AID
Prior to the commencement of work governed by this conLract,the Contractor will obtain Workers'
Compensation Insurance %xvith ]mils sufficient to respond to applicable Workers' Compensation
state statutes and the require irien[IS of Chapter 440, Florida Statutes.
In addition, dic Contractor will obtain Employers' Liability LnSUI-4nce with limits of riot le%s
thaw
$100,000 Bodily Injury by Accident
.5-500,000 Bodily Injury by Disease, pcihcy limits
$100,000 Bodily Injury by Discaso,each employee
CcYv'era-0fir ..,ill be maintairied throughom the mire term orthe conlracL,
0
Cm cragc will be provided by a company or companic,,mahorized to tnms: ict busiwo, in the State
11 dic C0111 I lvor has been 'If"'prDved by the Florida's [kpm-mlent of'ha hot" its '111 "Wthmc i/'ed
the Counly rniv recolswc, i4ad hono'. till` cowradov 5, slillus. The c0iltiac'(01' m�t y h c'
C, 11c"atc
,ed io submit ,,, L,,ntcr of Amho6zation', R,,woed by 0'K" De"p"Onlem o[ 1-abor arW a
n", dciails on the Contrac.t�iv� 11'1"C"" hv,'urzulce pro�-','v.mw ol ln�lmmlcc' prm idi
(h, colmactol pallltl-ip"lte 1l'! d Wlf-iftSdl, CI I'LlUd- 'V Ucldhci�!(" of 111 >iPl'tsC'Rc wdl [ lcquhe(!
In addinon" the Corn'i('JN 111W, hC 1C( .M � 10 S1(1mm, 11)(1 ILd 11n,mcInI (rom ihc lund
h`�JLICM h'0111 lhu' Coml(v.
WC1
Admilnisirafi%(:ID', Wdi)tl'1500 7
X7
�d7k�E:ti�tat�rt
M
NTRAC� 14
,TW __
MONROE COUNTY, FLORIDA
Prior to the caw€artaenc rnent of work governed by this contract, (lie Comractor wili obtain Cyber
Liability Imurance. Coverage will be rwintained thrrsughOrct the life of the contract and include
(lie following Coverages:
6, Idatas...beach
Ncm,ork SCCUrity Liability
Internet Media
Nct�vork Extortion
Regulatory Proceedings
PCI Fines tmd Casts,
The mimes urn fronts acc pttabl is:
CI..I
ClIentV.-2145969 04CLEAT 1
aA IM VYyl
ACORD. CERTIFICATE OF LIABILITY INSURANCE04)00f2020
TWS CERTIFICATE 15ISSUED AS ER OF INFORMATION Y 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. IS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING ING INS ER( ),AUTHORQED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
I SPORTANT.If Lhe CerfifiCall,ttelder It A-3-6-1-7-10N AL INSURED,the policy(ie )rust have ADDinONAL INSURED ogrovislons or be endorsed,
If SUBROGATION 15 WAIVED,subject to the tenns and conditions of th&pokey,certain policies may require an endorsement.A statement an
this corlificate does not confew fiesta holder in Neu IMP each endoreerrrent(e),
PRODUCER
drif€6TI �rrlC Services �� :919 716-077 A wm: 19X169912
NC
3201 rdeCh9 f Ct, taste 200 AR
qf'
P. .Box 31125 ra a rAa3 re COVERAGE sC I
Ra RA:
CIearTrack HR LLC
306A Quality Circle NW
I@E$4} Rru:
Huntsville,ville,AL 358D6 bAISU R F:
DIMMIR r
COVERAGES— CERTIFICATE Eft: REVISION EJ ER:
THIS IS TO CERYIFY" THAT THE POLICIES OF INSURANCE L,IS?"E€?BELOW HAVE SEEN ISSUED TO THE WSi REO MANIED ABOVE FOR THE 6'4JLICYPEI2IED
INDICATED, NOT4W"THSTANDING ANY REQUIREMEI,,TERM OR CONDITION OF ANY CONTRACTOR EITHER DOCUMENT MATH RESPECT TO V tECH THIS
CERTIFICATE MAY RE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY T'ME POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS....
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOYM MAY RAVE BEEN REDUCED BY PAD
" C"
LA.'IM...�S
�
SYW �bI5 °rT -
€mes
_ ________
caMMFkcrAL cemsk&LLIAefv EACH cCCURn_*11-"---- ,--""cc �
_ _m.m_..m..m.»...
C r,ks.aA OCCUR a� .
! 4PROVED RISC MANAGEMENT l '_--____
. S I PEIIs4-DNAL&L�AtrrlNnxxr 3
GEM1 AGGREGATE LVAIT AAPUER PER �E7t 6t,4CeCaRES�f4 ME
FRO. -23-2020 R
POUCv �;T icau # l cacc Ts-c �xaPA<
_..... .
orraEsa .._ .... ..._._..�...�,...a....�,._.m..,_¢,w.
€AUTONOUILE UABILITx ' 4 f ss a:.�k.a'. w ..�........ ,. ._.......�.. .,..,_m:n....�R a��, ,.m....._..................��
_....._ANY AUTO € CDILY INJURY qF6, r�tsnb T �P
OVMED SC.E.ULEO t�?{51LY VdAJRY tP�d��a,e¢ •���
AUTOS ONLY
piA
�......,.a, rdE1 Y C} P.4 CIV. tIn E..TY......_....a .._......_... ........® ».s.._.,.._.._..._.
AUTOS am£.Y AUTOS OMY I � I�,�:?;.,",'s","':S6!,P�d......�,_.-„--�,�,___
ULRBARL LL4 EXCESS LIARUL:inaAH � H C@9RR�4�mE
ICLAWS-MADE' I IfcECAr .._..n._..n._..n._..n. g_______________________
WORKERS COMPENSATION
,���� 5 ...,,..T................................................................ ,�,�,�,�,�,�,�,�w�,�,�,�,�,�,�,�,�,�,�..�.�„�w..�YS� ��w�:.e 6ti
AND EMIN.OVERTUADrdrY -
9 ANY PROPRIETZ RIPARTHE6RANECktMV12 ]4
OFFICEPMEMUREXCOJOEOT NIA - ..........................m....-_ -.
N&Admo Ws 14,q E.L.CDISEASE EAi.MPLOYEE $................................... .......
`e'y
tymY. r d
EFRr?'T94 GPrGPE.FY,A' EL OI - SE PQUC:°@.hqT $. ..m...,.. ._
A Professional w LC1T110f 1 . _ 1B31f202 0113V2021 1,000,DOD Each Claim
L.tillty .., 3,000,000 Aggregate
L` A&P'rr6 l E TRCN iLCrCATtC�W 3Y@ta CES{ACdEC tA9.AVIA -0 Rrorwks Schedule,my La Oftched IF mom wpce Is mW l
Policy Number:L: Y774239
Professional Services ErrocAggregate$3,000,000 Each Claim 1,000,000 Ded:$6,000 Refire Date 01131118
Technology Services Error:Aggregate$3,000,000 Each Claims 1,000,000 Ded: 5, 00 Retro Date 01131115
Media Activities Error.Aggregate$3,000,000 Each Claim 1,000,00 d•. ,000 Retro Cate 01131118
etwork Security Error:Aggregate ,000, 00 Each Claim 1,000,000 Ded:$5,000 Retro,Date 0113/118
{See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
961rPi County Board County SHOULD ANY F TIME ABOVE DESCRIBED POLICIESE CArdCELLED BEFORE
THE EXPIRATION DATE THERE , NOTICE WLL SS DELIVERED IN
Commissioners ACCORDANCE VAITH THE POLICY PROVISIONS,
'i 100 Simonton Street Suite 2-268 —-
Key West,FL330 0 AU REPRESENTATAM
0 19 5.2 15 ACCIRD,CORPORATION.All rights reserved,
AC RD 2 (2016103) 1 of 2 The ACORID name and logo are registered Turks of ACORD
$52554643SIM25545338 Cam
RegulatoryMatter:Aggregate$3,000,000 Each Claim 1,0 ,000 :$5,000 Retro Date 01131118
Privacy reach:Aggregate$3,000,000 Each Claim i,000,000 Ded:$5,000
Data Assets Corruption:Aggregate S3,000,000 Each Claim 1,000,000 Ded:$5,000
Cyber Extortion Threat;Aggregate$3,000,000 Each Claims 1,000,000 Ded:65,000
Electronic Business Interruption.Aggregate$1,000,000 Each Claims 1,000,000
Cyber Crime.Aggregate$100,000 Each Claim$100,000 Ded.K000
i
SAGITTA 2s.3(201sw) 2 of 3
#S26 35d 255 3S
I OAT I I-MMSb'D,-NY—"I
CERTIFICATE OF LIABILITY INSURANCE 0410812020
THIS CETRIFICAf�'IS ISSUED—AS A MATTER—OF IN'R0RM'A-'-T1'0N-0"'N-'LY A—NO CO-N—FER—S R-O"—RIG-H—TSUP'—ON LF-'CA-TF--HDL. roE—,L
FIT TLTHIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
PO�ICIES BELOW,THIS CERTIF4ATE OF INSURANCE DOES NOT CONSTIT LITI E A CONTRACT BETWEEN THE ISSUING INSURER(3)m
AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATEHOLDER.
t-h to hololor la an ADDITIONAL IN RED, the psificylise)must be endorsed,If SUBROGATIONIS WAIVED,
e`-c`o-rtN1-c-a-------------------- ED-
Subjirct toft fin nns and consfition*of the policy,Conant policies may require an ordorsernent.A statement on this canificata does not
confer rightli to the cottifleato holder In lieu of such ondoirseenerithR.
W Dot
MCGRIFF INSURAMCE SERVICES INCJPHS
73438
Krame (886)467,8730 FAX (888) 4 3V-IT-
222 (AM,No,FWI,
The HwOord Business SerAce Center
3600 Vaserrion Bvd AIL
San Antonio,TX 78215 1 -ADDRESC
MULVERLS)AFFORDING COVERAGE
'I'-N-FJA'2—RA—� —TwinQly Fire—kisurance CompaiTy- 29459
CLEARTRACK HR.LLC Ins
305 QUALITY CIR NVV#A
INTURERC
HUNTSVILLE AL 31W15,4142 P!=—---
INSURER 0
RIVER F
COVERAGES CERTIFICATE REVISION NUMBEW
0,—80,0WHAVE-BEEN—ISSUED TO THE—MSURED NAMED-A80VE F—ORIME P—OLCYPERIOD
1NDK,'ATE0.N0TVWT HST ANDgNG ANY REQUIREMENT,TERM OR CONDITION OF ANY coNTRAcT art o'wER oocumENT NTH RESPECT TO VM-tCH TH 8
CERTINCATE MAY BE ISSUCO OR MAY PERTAIN, ME msuRANce AmRrco Ity ME, POLICIES OFSCRUIED HEREN IS SLON-CT TO ALL ,14E
TERMS,EXCLUSIONS AND CONDITIONS OF SuCK POLICIES 1-HoN'S SHOYYN MAY NAVr BEEN REDUCED BY PMD CLAN&
' 00-
TYPE QF INSURANCE A-00-L pou U cy� 'xwy wy 00—FMUSY a UMTS
I1TRg-ri- - ; l.
- -W
QwrCL;L N9AL LIA k ,
$2.000,000, tAM&-WW0E? OCCVR i
51'000'000l
X General Liabtili MV EXP(An�ww pwwM
A x C22 SBA RS,9035 01f12f202O s DIAZI-421 PERSANAC 4 AQV NJURY
Wf,fit AGGREGATE UM IT APPLIES PER
pm:cy ,JECT E u'x PROOUCTS COMP OPA00 $4000 000
no
lorrerr
Avmiel",ILE LIASIL17Y COMBINED SINGLE UU.T $2,000000
ANY AV LO GODILY INJURY mix,psml
ALL O%%KE"CP SC14ECULED
L3
A AU'i AUTOS X 22 SBA RS9035 0111212020 gi1R 2r2021 900ILY INJURY IA.,-W.rak
NO GWNED
OCCUR SAr-moccuRseNcp
LIMORMeLLAU"All
FXCGSS UAG CLAIMS-
MADE ACCAEOATe
PENSATION
u-
bAKEI'IS 'IeR
ANG EMPLOYARS'LIAMITY
W COM
A i-1-zCH ACCIDENT
PROPMETORIPAR7,NEA-EXECUTIVE WA
FOICIRMPMMER LLMSF0 2YC7 !L OWASEEA!Lh!n -a
ININ."'Alwy 1.MI !L -.1
Ii Y.V,angibe wdo E L EMEASE. POUCY Vicff
EMPI MENT PRACTICES
22SEBAR-539035 tOl/1212020 01112r2.021 , A gtheg
Each CIabm Limit
ale Limit
LIABILITY I I........... .............................
PVERICLES IACONO MI.AddAI.-I 5s4.4.1a,r"Ay b-dndtod 9 kg,vqYok,m)
LT.hLAw vsuaal to Me Insumd's Operations.Certificate riolder is an addihonal irmted per he Business Lability Coverage Fom SS0008 attached to this P
F 'Ar-EUL0,61NE-- CANCE.LA—II'lo—tL----'—E.-----E.--l-�--
Morwoe County SHOU HE LD ANY OF T ABOVE DESCRIBED POLICIES BE CANCELLED
Board of County Connass ners REF THE EXPIRATION DATE 7HERECIF,NOTCE WILL BE DELIVERED
sio �E
1100 SIMONTON ST ISTE 2-268 [_rtl AIDE RDANC E WITH THE POLCY PROVISIORS.
KEY WE ST FL 33040-3110 AUTMORaM REPRESENYAM0V
0 1908-2015 ACORD CORPORATION,All rights reserved.
ACORD 26(201SM3) The ACORE name and logo are registered marks ofACORD
DATE JMW0w'ywf
CERTIFICATE LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A NiATTER OF INFO TIONt ONLY AND CONFERS NO MIGHTS UPON THE CERTIFICATE etas EFL..
t IS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTENO OR ALTFR THE COVERAGE AFFORDED BY THE
POUCI S BELOW.'THIS CERTIFICATE OF INSURANCE DOES NOT CONS'n"E A CONTRACT BETWEEN THE ISSUINO INSUlRERQS&,
AUTHORIZED REPRESENTATNTE OR P OSUC R,AND THE CERTIFICATE HOLDER.
IMPORTATdT: tt the cartiftato holder is an ADDITIONAL INSURED, tha polkirfles(east t be endorsed. If SUOROGATEONIS WAIVED
subject to the tNrm n aend canditio"s of khe poEcy,carUl n polldes mpy requIre an tr€dorsom 11L A statement on UI certificate doom not
confer r®gIPts to the cortiftats holder In Hen of such on udomoarrarrt(s)- I
Mt;baRIFF tINS3URANCE Ia FVIL S IN6":II=P9S
Z22P tit 'PrIoNd (6 @s(4S-8730 A� (88aT)443-6112
No VAlt ¢dear
The Hartford Business Senrce Center
3600 fAisernan Blvd SAIL _
INSeRERoo APPORDINa COVERAGE HAWN
sL c INUARAA: Hadtttrd Accident and indem l,ty ConirmIty 22357
f&Far and Enterprises,enr
305A QUALITY GIH IUVV � --
aG
4ilTrdTSViLLL AL d06-4542
IPd�U6fl C3`e
I SOAs—r.E: ... m
9FI'�Pdlfr T.:
COVERAGES CERTIFi ATC NUMBER: REVISION NUMBER:
TH!S 6 TO CERTF Y'I'LIAT THE POL LIES OF INaSUPANCE LisTCo BEL('.)W UAVE 6E`N ISSUED TO THE INSURE NAMED ABOVE FOR THE POLICY EROD
INDICATED nOTAbTFIS1i%NDiAG ARY REQt.SOENIE AT',TERM,OR CON€DlU04 OF ANY CONTRACT OP OTHER OCT urcEN'T MITI RC PECI'TO V ttCH THO
CEENTIPICATE MAY HE..ISSUED OR WN PERYA.RA, THE INSURANCE Ar roRoFo By n4L, PC3r_'-CIES DESCRIBED HEREIN IS SUBJECT TO ALL 1
TERMS,EXCLUSIONS S AND G00&INTVIi S OF SUCH POLATES.LIMITS SHOM MAY PAVE BEEN REDUCED BY PAID CLANS
INSA rype 0 WSI9RANCE fnDOL NC:=L.IGV.ESL+ R �R�LEC�� I EX "Imlys
Lye —WE—BUD— jammoff—un
COMAAERCiALGENICRAL UA.ILITY 6.ANI M 'tdf AE CC.L
LL WS-MAC6 C,'C.t:;li7d. ttXAtYArr4"TLn HENS
ME is E74E IAIY a+ gW-11
' PEFiuSC 6.ACJV id+fi.JLbRY
G£NL AGCRE GATE 4.NtIT Af�pLd'E`€P"•EfY' G Nrir Air,AG,GREr.AM-
P ROD UCTS COMP.Of`ArG
kU7f5RdC�.fL.i„l4&�IL11`Y —--------- GC3.b4€.,'iT#9C5 S4h4LE LlP,d IY
,AtsY AUTO ,BODILY IN.AMY Pw(' pxnsc++)
r A'Lid ;LUGS ,"pN,`d 4t+,rIJPi'a dRmr iadmn)
....® Hibx (] I Iw Ca'rftR rH PROPFIRm(D MACE _..-.
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