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5th Renewal & Amendment 07/17/2002 CLERK OF THE CIRCUIT COURT MONROE COUNTY BRANCH OFFICE MARATIiON SUB COURTIiOUSE 3117 OVERSEAS lllGHWAY MARATIiON, FLORIDA 33050 TEL. (305) 289-6027 FAX (305) 289-1745 MONROE COUNTY COURTIiOUSE 500 WmTEHEAD STREET, SUITE 101 KEY WEST, FLORIDA 33040 TEL. (305) 292-3550 FAX (305) 295-3663 BRANCH OFFICE PLANTATION KEY GOVERNMENT CENTER 88820 OVERSEAS HIGHWAY PLANTATION KEY, FLORIDA 33070 TEL. (305) 852-7145 FAX (305)852-7146 MEMORANDUM DATE: August 7, 2002 TO: Sheila Barker, Director Administrative Services ATTN: Nancy Cohen Worker's Compensation Administrator Pamela G. Hanc~ Deputy Clerk CY FROM: At the July 17, 2002, Board of County Commissioner's Meeting the Board granted approval of the renewal of the worker's compensation Contract between Monroe County and Preferred Governmental Claim Solutions to provide Third Party Administration Services for the workers' compensation program for Monroe County. Enclosed is a duplicate original of the above mentioned for your handling. Should you have any questions please do not hesitate to contact this office. Cc: County Administrator w/o document County Attorney Finance File/ VED EN1iUL 0 8 2002 PGCS AMENDMENT TO SERVICE AGREEMENT RENEWAL This renewal of a Service Agreement is entered into by and between Monroe County, a Political subdivision of the State or Florida, whose address is 1100 Simonton Street, Key Fl. 33040, hereafter County, and Preferred Governmental Claims Solutions, a corporation, whose address is P.O. Box 16-6005, Altamonte Springs, F1. 32716, hereafter PGCS. The parties agree as follows: 1. The Service Agreement between the County and PGCS dated April 1, 1996, as amended on August 13, 1996 and renewed 8/11/1999 through September 30, 2002, is hereby renewed for one additional year term expiring on September 30, 2003. 2. Compensation for the one (1) year term is as follows: (a) Lost time claims $440.00 per claim and $130.00 for medical only per claim. (b) Administrative services fee in the amount of $3,000.00 per month, to include all claims handling as outlined in the April 1, 1996 Service Agreement. 3. Except for the renewal terms and amended compensation described in paragraphs 1 and 2, in all other respects the April 1, 1996 Service Agreement between the County and PGCS, as amended remains in full force and effect. 4. The County's performance and obligation to pay under this amendment is ~ent upon an annual appropriation by the BOCC. I.('/<<!~~~":' '~. This Amended Service Agreement Renewal will become effective October 1,2002. .,' "' /,\\;.,' i ", /' C.~:~5' ' Lf ,.\\" ;, ,'" ~f:;' \ :. '- ~ ~ t '... \ ' \" \' '. /,., ,,~,' ~,~, (SEAL) , ~'~:,>< .ATTE~~pANNY L. KOLHAGE, CLERK "<>~~a~ Date By By Title -y -.. l:::J ~ J'" ::0 (,"i ~ C ...- "'h rt1-:;s.:-:'.," (")' r- oo' ~?J2; ~ r- -< (") ..,- . ~ :;:: ..., .~ ... ~ ~ 1- I~- 02.. r-:> = = 1-.;) :P- c::: en , -.J -Tl - r rr1 o -0 :cr.: N -r. o ::0 ::;lJ rn (~) c; ::;0 CJ r 1":