SY2010 06/17/2009
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
July 1, 2009
TO:
Community Services
A TTN:
Dotti Albury
In-Home Services Programs
FROM.'
Pamela G. Hanc~,,-
Deputy Clerk C.JJ
At the June 17, 2009, Board of County Commissioners' meeting the Board granted
approval and authorized execution of the following:
Contract between Monroe County and S.T.E.P.S in the Right Direction, Inc., a 501(c)(3)
home health agency, to provide direct in-home services for the elderly and disabled as provided
under grants to Monroe County from the Alliance for Aging (e.g., CCE and OAA) and the
Department of Children & Families (e.g., CCDA).
{ontract between Monroe County and Hospice of the Florida Keys, Inc. d/b/a Visiting
Nurse Association, to provide direct in-home services for the elderly and disabled as provided
under grants to Monroe County from the Alliance for Aging (e.g., ADI, CCE, and OAA) and the
Department of Children & Families (e.g., CCDA).
Enclosed are two duplicate originals of each of the above-mentioned for your handling.
Should you have any questions, please do not hesitate to contact our office.
cc: County Attorney
Fina~
File
'. '!f{ 2~O'Jc1f-
THIS AGREEMENT, made and entered into this .111-- day of June. ~~ A.D.,
by and between MONROE COUNTY, FLORIDA, a political subdivision of the State of Florida
(hereinafter called the -Owner" or "County"), and Hospice of the Florida Keys, Inc. d/b/a
Visiting Nurse Association, (hereinafter called the -Contractor").
CONTRACT
WHEREAS, the County provides In-Home services to the elderly and disabled residing
throughout Monroe County; and
WHEREAS, the County receives funding from the Alliance for Aging, Inc., the Florida
Department of Children and Families, and the Florida Agency for Health Care Administration
for the purposes of providing in-home services countywide; and
WHEREAS, the County has provided in-home services to assist the vulnerable elderly
and/ or disabled residents to remain in their homes and maintain independence for over 25 years;
and
WHEREAS, the County desires to contract for in-home services to ensure that such
services are available throughout the County; and
WHEREAS, Contractor is qualified and desires to provide in-home services;
NOW THEREFORE, in consideration of the mutual covenants and provisions contained
herein, the parties agree as follows: That the parties hereto, for the consideration hereinafter set
forth, mutually agree as follow:
1. THE CONTRACT
The contract between the Owner and the Contractor, of which this agreement is a part, consists
of the contract documents, which are as follows: This agreement and any amendments executed
by the parties hereafter, together with the response to RFP and all required insurance
documentation. In the event of a discrepancy between the documents, precedence shall be
determined by the order of the documents as just listed.
2. SCOPE OF THE WORK
The Contractor shall provide In-Home Services for the County. The Contractor warrants that it
is authorized by law to engage in the performance of the activities herein described, subject to
the terms and conditions set forth in these contract documents. The provider shall at all times
exercise independent, professional judgment and shall assume professional responsibility for the
services to be provided. Contractor shall provide services using the following standards, as a
minimum requirement:
A. The Contractor shall maintain adequate staffing levels to provide the services
required under this contract.
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B. The personnel shall not be employees of or have any contractual relationship with
the County. [IF APPROPRIATE: To the extent that Contractor uses
subcontractors or independent contractors, this contract specificallY requires that the level of
independence normallY exercised by such subcontractors and independent contrat:tors be
curtailed and that they be supervised by the Contractor.)
C. All personnel engaged in performing services under this contract shall be fully
qualified, and, if required, to be authorized or permitted under State and local
law to perform such services.
3. PAYMENTS TO THE CONTRACTOR
A. The Contractor shall submit to the county an invoice with supporting
documentation acceptable to the Clerk on a weekly basis. Acceptability to
the Clerk is based on generally accepted accounting principles and such
laws, rules and regulations as may govern the Clerk's disbursement of
funds.
B. Upon Monroe County's receipt of said invoices Monroe County Clerk's
Office shall submit payment to the Contractor no later than four weeks
after receipt of invoice(s).
4. TERM OF CONTRACT
The term of this contract is for one year, commencing on the ~day of July. 2009,
and ending on the 30th day of June ,_2010. The County shall have the option to renew
this agreement for two (2) additional one-year periods. The contract amount agreed to herein may
be adjusted annually in accordance with the percentage change in the Consumer Price Index
(CPI) for all urban consumers (CPI-V) for the most recent 12 months available.
5. CONTRACTOR'S RESPONSIBILITIES
A. The Contractor will perform only authorized in-home services in the homes of
elderly and/or disabled residents in the Areas 1, 2, 3 and 4 for the unit rate(s)
specified herein. Only those in-home services that are specifically authorized by
the County as documented by the Social Services Department will be
reimbursable. In-Home Services will be provided by the Contractor
in accordance with DOEA definitions/specification, by agencies that hold
necessary licenses, and by individual workers qualified to perform such services
as detailed in Florida Department of Elder Affairs (DOEA) 2008 Client
Services J\tfanual and the Home and Community Based Services, Draft
handbook, January 2003, the State of FL Department of Children & Families
(DCF) CFOP 140-8, Community Care for Disabled Adults (CCDA), and in
accordance with the Agency for Health Care Administration (AHCA) guidelines
as required and any subsequent modifications thereto.
B. The in-home services Contractor will provide under these terms and conditions
are ~respite care, X homemaker, ~ personal care, X chore, _
_emergency home repair/housing improvement, and _material aid as
defmed by DOEA in the 2003 and 2008 handbooks, DCF CFOP 140-8 for
CCDA, and AHCA guidelines as noted above and any subsequent revisions
thereto.
C. The Contractor will provide in-home services durin~~~.~~~ of this contract
for the unit rates as agreed upon and that follow: $.f(}.~t~t for respite care,
$20.00/unit for homemaker, $25.00/unit for personal care, $25.00/unit for
chore, $ unit for emergency home repair/housing improvement, and t
/unit for material aid. A unit for each service is defmed by DOEA in the 2003
and 2008 draft handbooks, DCF CFOP 140-8 for CCDA, and AHCA
guidelines as noted above and any subsequent revisions thereto. The number
of units of services performed for each client must be preauthorized by the
County
The Contractor will be reimbursed for all necessary travel for client's needs.
This can include travel to and in between client homes, from V.N .A. offices,
shopping for clients, etc. However, travel from worker's homes at the start of
the work day and travel to worker's homes at the end of the work day will not
be reimbursed.
D. The Contractor will provide the in-service(s) detailed in "B" above for the
unit rate agreed upon in "c" above in geographic Areas Xl, X2, X 3, and
X 4 in order to ensure that in-home services are available countywide.
E. The Contractor will in all cases provide in-home services within the
time frames required by DOEA as defined by DOEA in the 1998 and 2003
handbooks, DCF CFOP 140-8 for CCDA, and AHCA guidelines as noted
above and any subsequent revisions thereto. The Contractor agrees that the
County Administrator will designate representatives to visit the
Contractor's facility (ies) periodically to conduct random open file
evaluations and other contract monitoring activities during the Contractor's
normal business hours.
F. The Contractor has, and shall maintain throughout the term of this
contract, appropriate licenses and approvals required to conduct its
business, and that it will at all times conduct its business activities in a
reputable manner. Proof of such licenses and approvals shall be
submitted to the County upon request.
G. .The Contractor must maintain approval status from the Alliance for
Aging, Inc., as a Medicaid Waiver Provider of Choice.
6. CONTRACTOR'S FINANCIAL RECORDS
Contractor shall maintain all books, records, and documents directly pertinent to
performance under this Agreement in accordance with generally accepted accounting
principles consistently applied. Each party to this Agreement or their authorized
representatives shall have reasonable and timely access to such records of each other
party to this Agreement for public records purposes during the term of the Agreement and
for six years following the termination of this Agreement. If an auditor employed by the
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County or Clerk determines that monies paid to Contractor pursuant to this
Agreement were spent for purposes not authorized by this Agreement, the Contractor
shall repay the monies together with interest calculated pursuant to Sec. 55.03, FS, running
from the date the monies were paid to Contractor.
7. PUBLIC ACCESS
The County and Contractor shall allow and permit reasonable access to, and inspection of,
all documents, papers, letters or other materials in its possession or under its control subject to the
provisions of Chapter 119, Florida Statutes, and made or received by the County and
Contractor in conjunction with this Agreement; and the County shall have the right to
unilaterally cancel this Agreement upon violation of this provision by Contractor.
8. HOLD HARMLESS AND INSURANCE
The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board
of County Commissioners of Monroe County from any and all claims for bodily injury
(including death), personal injury, and property damage (including property owned by Monroe
County) and any other losses, damages, and expenses (including attorney's fees) which
arise out of in connection with, or by reason of services provided by the
Contractor or any of its Subcontractor(s) in any tier, occasioned by the negligence,
errors, or other wrongful act of omission of the Contractor or its Subcontractors in any tier,
their employees, or agents.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements
contained elsewhere within this agreement.
Prior to execution of this
of
each attached hereto and incorporated as part of this contract document, and
all other requirements found to be in the best interest of Monroe County as may be
imposed by the Monroe County Risk Management Department.
Non-Waiver of Immunity. Notwithstanding he provisions of Sec. 286.28, Florida Statutes, the
participation of the County and the Contractor in this Agreement and the acquisition of any
commercial liability insurance coverage, self-insurance coverage, or local government liability
insurance pool coverage shall not be deemed a waiver of immunity to the extent of
liability coverage, nor shall any contract entered into by the County be required to contain any
provision for waiver.
9. INDEPENDENT CONTRACTOR
A t all times and for all purposes under this agreement the Contractor is an
independent contractor and not an employee of the Board of County Commissioners of Monroe
3
County. No statement contained in this agreement shall be construed so as to fmd the Contractor
or any of his employees, contractors, servants, or agents to be employees of the
Board of County Commissioners of Monroe County.
10. NONDISCRIMINATION
County and Contractor agree that there will be no discrimination against any person, and it
is expressly understood that upon a determination by a court of competent jurisdiction
that discrimination has occurred, this Agreement automatically terminates without any further
action on the part of any party, effective the date of the court order. Contractor agrees to
comply with all Federal and Florida statutes, and all local ordinances, as applicable,
relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil
Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race, color or
national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss.
1681- 1683, and 1685- 1686), which prohibits discrimination on the basis of sex; 3) Section
504 of the Rehabilitation Act of 1973. as amended (20 USC s. 794). which prohibits
discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975. as amended
(42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug
Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination
on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service
Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to
confidentiality of alcohol and drug abuse patent records; 8) Title VIII of the Civil Rights
Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the sale,
rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s.
1201 Note), as maybe amended from time to time, relating to nondiscrimination on
the basis of disability; 10) Monroe County Code Ch. 13, Art. VI, prohibiting
discrimination on the bases of race, color, sex, religion, disability, national origin, ancestry,
sexual orientation, gender identity or expression, familial status or age; and 11 )Any other
nondiscrimination provisions in any Federal or state statutes which may apply to the parties to,
or the subject matter of, this Agreement.
11. ASSIGNMENT /SUBCONTRACT
The Contractor shall not assign or subcontract its obligations under this agreement, except
in writing and with the prior written approval of the Board of County Commissioners of
Monroe County and Contractor, which approval shall be subject to such conditions and provisions
as the Board may deem necessary. This paragraph shall be incorporated by reference
into any assignment or subcontract and any assignee or subcontractor shall comply with
all of the provisions of this agreement. Unless expressly provided for therein, such approval
shall in no manner or event be deemed to impose any additional obligation upon the board.
12. CO~fPLIANCE WITH LAW
In providing all services/goods pursuant to this agreement, the Contractor shall abide by all
statutes, ordinances, rules and regulations pertaining to, or regulating the provisions of, such
services, including those now in effect and hereinafter adopted. Any violation of said statutes,
4
ordinances, rules and regulations shall constitute a material breach of this agreement and shall
entitle the Board to terminate this contract immediately upon delivery of written notice
of termination to the contractor. The contractor shall possess proper licenses to perform work in
accordance with these specifications throughout the term of this contract.
13. DISCLOSURE AND CONFLICT OF INTEREST
The Contractor represents that it, its directors, principles and employees, presently have
no interest and shall acquire no interest, either direct or indirect, which would conflict in
any manner with the performance of services required by this contract, as provided in Sect.
112.311, et. seq., Florida Statutes. County agrees that officers and employees of the County
recognize and will be 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 use of certain information.
Upon execution of this contract, and thereafter as changes may require, the Contractor shall
notify the County of any financial interest it may have in any and all programs in Monroe
County which the Contractor sponsors, endorses, recommends, supervises, or requires for
counseling, assistance, evaluation, or treatment. This provision shall apply whether or not such
program is required by statute, as a condition of probation, or is provided on a voluntary basis.
The County and Contractor warrant that, in respect to itself, it has neither employed nor retained
any company or person, other than a bona fide employee working solely for it, to solicit or
secure this Agreement and that it has not paid or agreed to pay any person, company,
corporation, individual, or firm, other than a bona fide employee working solely for it, any fee,
commission, percentage, gift, or other consideration contingent upon or resulting from the award
or making of this Agreement. For the breach or violation of the provision, the Contractor agrees
that the County shall have the right to terminate this Agreement without liability and, at its
discretion, to offset from monies owed, or otherwise recover, the full amount of such fee,
commission, percentage, gift, or consideration.
14. ARREARS
The Contractor shall not pledge the County's credit or make it a guarantor of payment or surety
for any contract, debt, obligation, judgment, lien, or any form of indebtedness. The Contractor
further warrants and represents that it has no obligation or indebtedness that would impair its
ability to fulfill the terms of this contract.
15. NOTICE REQUIREMENT
Any notice required or permitted under this agreement shall be in writing and hand delivered or
mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to the
following:
5
FOR COUNTY:
Monroe County Administrator
1100 Simonton Street
Key West, FL 33040
and
County Attorney
PO Box 1026
Key West, Fl. 33041-1026
FOR CONTRACTOR:
Hospice of the Florida Keys, Inc. d/b/a Visiting Nurse
Association 1319 William Street
Key West, FL 33040
16. TAXES
The County is exempt from payment of Florida State Sales and Use taxes. The Contractor
shall not be exempted by virtue of the County's exemption from paying sales tax to its
suppliers for materials used to fulfill its obligations under this contract, nor is the Contractor
authorized to use the County's Tax Exemption Number in securing such materials. The
Contractor shall be responsible for any and all taxes, or payments of withholding, related to
services rendered under this agreement.
17. TERMINATION
The County may terminate this contract for cause with seven (7) days notice to the
contractor. Cause shall constitute a breach of the obligations of the Contractor to perform the
services enumerated as the Contractor's obligations under this contract.
A. Either of the parties hereto may terminate this contract without cause by
giving the other party sixty (60) days written notice of its intention to do so.
18. GOVERNING LAW. VENUE. INTERPRETATION. COSTS. AND FEES
A. This Agreement shall be governed by and construed in accordance with
the laws of the State of Florida applicable to contracts made and to be performed
entirely in the State.
B. In the event that any cause of action or administrative proceeding is
instituted for the enforcement or interpretation of this Agreement, the County
and Contractor agree that venue will lie in the appropriate court or before the
appropriate administrative body in Monroe County, Florida.
C. The County and Contractor agree that, in the event of conflicting
interpretations of the terms or a term of this Agreement by or between any of
them the issue shall be submitted to mediation prior to the institution of any other
administrative or legal proceeding.
D. Severability. If any term, covenant, condition or provISIon of this
Agreement (or the application thereof to any circumstance or person) shall be
declared invalid or unenforceable to any extent by a court of competent
jurisdiction, the remaining terms, covenants, conditions and provisions of this
6
Agreement. shall not be affected thereby; and each remammg term, covenant,
condition and provision of this Agreement shall be valid and shall be
enforceable to the fullest extent permitted by law unless the enforcement of
the remaining terms, covenants, conditions and provisions of this Agreement
would prevent the accomplishment of the original intent of this Agreement. The
County and Contractor agree to reform the Agreement to replace any stricken
provision with a valid provision that comes as close as possible to the intent
of the stricken provision.
E. Attorney's Fees and Costs. The County and Contractor agree that in the
event any cause of action or administrative proceeding is initiated or
defended by any party relative to the enforcement or interpretation of
this Agreement, the prevailing party shall be entitled to reasonable
attorney's fees, court costs, investigative, and out-of-pocket expenses, as an
award against the non-prevailing party, and shall include attorney's fees, courts
costs, investigative, and out-of-pocket expenses in appellate proceedings. Mediation
proceedings initiated and conducted pursuant to this Agreement shall be in
accordance with the Florida Rules of Civil Procedure and usual and customary
procedures required by the circuit court of Monroe County.
F. Adjudication of Disputes or Disagreements. County and Contractor
agree that all disputes and disagreements shall be attempted to be resolved
by meet and confer sessions between representatives of each of the parties. If
no resolution can be agreed upon within 30 days after the fUst meet and confer
session, the issue or issues shall be discussed at a public meeting of the Board of
County Commissioners. If the issue or issues are still not resolved to the
satisfaction of the parties, then any party shall have the right to seek such relief
or remedy as may be provided by this Agreement or by Florida law.
G. Cooperation. In the event any administrative or legal proceeding is
instituted against either party relating to the formation, execution, performance, or
breach of this Agreement, County and Contractor agree to participate, to the
extent required by the other party, in all proceedings, hearings, processes,
meetings, and other activities related to the substance of this Agreement or
provision of the services under this Agreement. County and Contractor
specifically agree that no party to this Agreement shall be required to enter into any
arbitration proceedings related to this Agreement.
19. BINDING EFFECT
The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the
benefit of the County and Contractor and their respective legal representatives, successors,
and assigns.
20. AUTHORI1Y
Each party represents and warrants to the other that the execution, delivery and performance of
this Agreement have been duly authorized by all necessary County and corporate action,
as required by law.
7
21. CLAIMS FOR FEDERAL OR STATE AID
Contractor and County agree that each shall be, and is, empowered to apply for, seek, and obtain
federal and state funds to further the purpose of this Agreement; provided that all
applications, requests, grant proposals, and funding solicitations shall be approved by each
party prior to submission.
22. PRIVILEGES AND IMMUNITIES
All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules
and pensions and relief, disability, workers' compensation, and other benefits which apply to the
activity of officers, agents, or employees of any public agents or employees of the County, when
performing their respective functions under this Agreement within the territorial limits of
the County shall apply to the same degree and extent to the performance of such functions and
duties of such officers, agents, volunteers, or employees outside the territorial limits of the County.
23. LEGAL OBLIGATIONS AND RESPONSIBILITIES
Non-Delegation of Constitutional or Statutory Duties. This Agreement is not intended to,
nor shall it be construed as, relieving any participating entity from any obligation or
responsibility imposed upon the entity by law except to the extent of actual and timely
performance thereof by any participating entity, in which case the performance may be
offered in satisfaction of the obligation or responsibility. Further, this Agreement is not
intended to, nor shall it be construed as, authorizing the delegation of the constitutional or
statutory duties of the County, except to the extent permitted by the Florida constitution, state
statute, and case law.
24. NON-RELIANCE BY NON-PARTIES.
No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to
enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or
program contemplated hereunder, and the County and the Contractor agree that neither the
County nor the Contractor or any agent, officer, or employee of either shall have the authority to
inform, counsel, or otherwise indicate that any particular individual or group of individuals,
entity or entities, have entitlements or benefits under this .Agreement separate and apart, inferior
to, or superior to the community in general or for the purposes contemplated in this Agreement.
25. ATTESTATIONS
Contractor agrees to execute such documents as the County may reasonably require, to include a Public
Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace Statement.
26. NO PERSONAL LIABILIlY
No covenant or agreement contained herein shall be deemed to be a covenant or agreement of
any member, officer, agent or employee of 1-10nroe County in his or her individual capacity, and no
member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or
be subject to any personal liability or accountability by reason of the execution of this Agreement.
27. EXECUTION IN COUNTERPARTS
This Agreement may be executed in any number of counterparts, each of which shall be
regarded as an original, all of which taken together shall constitute one and the same
instrument and any of the parties hereto may execute this Agreement by singing any such
counterpart.
8
28. SECTION HEADINGS
Section headings have been inserted in this Agreement a s a matter of convenience of
reference only, and it is agreed that such section headings are not a part of this Agreement
and will not be used in the interpretation of any provision of this Agreement.
29. MUTUAL REVIEW
This agreement has been carefully reviewed by the Contractor and the County. Therefore,
this agreement is not to be construed against any party on the basis of authorship.
IN WITNESS WHEREOF the parties hereto have executed this Agreement on the day
afld:~~te first written above in four (4) counterparts, each of which shall, without proof or
. ft.Cc~tifi!trig:for the other counterparts, be deemed an original contract.
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:G~~ERK
Deputy Clerk
BOARD OF COUNlY COMMISSIONERS
OF M~ROE COUNlY, FLORIDA
By: #-".~. KJoIAc.'~
Mayor/ Chairman
(SEAL)
HOSPICE OF THE FLORIDA KEYS, INC
d/b/a VISITING NURSE ASSOCIATION
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:~~e: · ~~t;; LKO
Attest:
By:
WITNESS
By:
WITNESS
Title:
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®
�R CERTIFICATE OF LIABILITY INSURANCE OP ID HOSPIC3
DATE (MM/DD/YYYY)
06/29/09
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Bouchard -Clearwater
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
101 Starcrest Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 6090
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-6090
Phone : 727-447-6481 Fax : 727-449-1267
INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURER A: American Alternative Ins Co 19720
INSURER B: Zenith Insurance Company 13269
Hospice of the Florida Keys
- - -- -
Greq Wheeler
INSURER c: -
1319 William St
Key West FL 33040-4736
INSURER D:
- - -- -
I INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L POLICY EFFECTIVE FIPOLICY EXPIRATION
LTR 1NSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YYYY DATE MM/DD/YYYY LIMITS
GENERAL LIABILITY1
EACH OCCURRENCE
$ 1 , OOO , OOO
A X COMMERCIAL GENERAL LIABILITY VHHHHG305144203
03/10/09 ' 03/10/10 PRREMSESO(E-aoccccuErence)
$ 1,000,000
X CLAIMS MADE OCCUR
MED EXP (Any one person)
$ 50,000
RETRO DATE 3/10/88
PERSONAL & ADV INJURY
$ 1 , 000 , 000
GENERAL AGGREGATE
$3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
%Z__
PRODUCTS - COMP/OP AGG
$ 3,000,000
X POLICY PRO-
JECT LOC +
Em Ben
1,000,000
AUTOMOBILE LIABILITY
.� COMBINED SINGLE LIMIT
$ 1 000 000
ANY AUTO (Ea accident)
, ,
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
X HIRED AUTOS 1VHHHHG305144203
03/10/09 ! 03/10/10 '' BODILY INJURY
X NON -OWNED AUTOS
(Per accident)
i
$
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
EA ACC
OTHER THAN
$
AUTO ONLY: AGG
$
EXCESS / UMBRELLA LIABILITY
EACH OCCURRENCE
s2,000,000
A OCCUR X CLAIMS MADE VHHHHU505007903
03/10/09 03/10/10 AGGREGATE
$2,000,000
DEDUCTIBLE
$
X RETENTION $ 0
$
WORKERS COMPENSATION
X TORY LIMITS ER
AND EMPLOYERS' LIABILITY Y / N
B ANY PROPRIETOR/PARTNER/EXECUTIV� '', Z830825717
07/01/09 07/01/10 E.L. EACH ACCIDENT
$ 100,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$ 10 0 , 0 0 0
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 500 , 000
OTHER
A DIRECTORS &OFFICER VHHHHD405010703
03/10/09 03/10/10 Liability
3,000,000
DED $2500
Aggregate
3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is included as additional insured as their interest may
appear as respects general liability subject to policy conditions, terms and
exclusions.
Gt:K 111-IGA I t HULUEK CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
MONROEC DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Monroe County 1100 Simonton REPRESENTATIVES.
Key West FL 33040
AUTg��D grr+RffATIVE
ACORD 25 (2009/01) +0-T9-88-20--69 ACORD CORPORATION_ All riaht_s reserved
The ACORD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
HIRED AUTO AND NON -OWNED AUTO LIABILITY
This endorsement modifies insurance provided under the following:
HOSPICE AND HOME HEALTH CARE LIABILITY COVERAGE FORM
The following coverage is added, an other terms and conditions remain as is unless otherwise stated in
this endorsement.
A. HIRED AUTO AND NON -OWNED AUTO LIABILITY
The insurance provided under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE applies
to "bodily injury" or *property darnage':
1. - Arising out of the maintenance or use of a "hired auto". or
2. Arising out of the use of a "non -owned auto",
by you or your "employees" or "Volunteer workers" in the course of your business operations.
Use includes operation and 16Wing and unloading".
B. With respect to the insurance provided by this endorsement:
I. The following exclusions in Exclusions Applicable to Coverage A. do not apply: Contractual
Liability; Liquor Liability, Employer's Liability; Aircraft, Auto or Watercraft; Mobile Equipment; and
Damage To Property
Z The following exclusions are added to paragraph Z. Exclusions Applicable to Coverage A:
This insurance does not apply to:
a. "Bodily injury" or 'property damage" for which the insured is obligated to pay damages by
reason of the assumption of liability in a contract or agreement.
This exclusion does not apply to liability for damages assumed in a contract or agreement that
is an insured contract, provided the'bodly injury" or "property damage" occurs subsequent
to the execution of the contract or agreement-
b. "Bodily injury" to:
(1) An 'employee" of the insured arising out of and in the. course of:
(a) Employment by the insured; or
(b) Performing duties related. to your business operations; or
(2) Your 'Volunteer worker'; or
(3) The spouse, child, parent, brother or sister of that "employee' or 'Volunteer worker" as a
consequence of paragraph (1) or (2) above.
This exclusion applies:
(1) Whet w the insured may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay the
damages because of the injury.
This exclusion does not apply to liability assumed by the insured under an 'insured contract".
C. 'Property damage" to:
(1) Property owned or being transported by, or rented or loaned to the insured; or
COpyright, AmericanAtlenrettve kmainc,e corporation, 2004.
HGL302 (08/05) Indudes copyrighted n uieriai of the Insurance services orrice, Im. with th pennssion. Page 1 of 3
(2) Property in the care, custody or control of th6insured.
This exclusion does not apply to property owned by a patient.
d. "Bodily injury" or 'properly damage" resulting from the handling of property:
(1) Before it is moved from the place where it is accepted by the insured for movement into
or onto the "hired auto" or "non -owned auto", or,
(2) After it is moved from the "non -owned auto" to the place where it is fmally delivered by the
insured.
e. "BodAy injury" or "property damage" resulting from the movement of property by a mechanical
device (other than a hand truck) unless the device is attached to the "hired auto" or "non -
owned auto."
C. For the purposes of this endorsement only, WHO IS AN INSURED (SECTION 11) is replaced by the
following:
Each of the following is an insured under this insurance to the extent set forth below:
1. You.
Z With respect to a "rion-owned auto", any partner or "executive officer" of yours, but only while the
"non -owned auto" is being used in your business operations.
3. Any other person or organization while using a "hired auto" or a- "non -(awned auto" with your
permission, but only if their use is within the scope of your permission. With respect to 'loading
and unloading", only you or your 1employees' or "volunteer workers" are insured.
4. Any other person or organization, but only with respect to their liability because of acts or
omissions of an insured under paragraphs 1., Z or 3. above.
None of the following is an insured:
1. Any person engaged in the business of his or her employer with respect to 'bodily injury" to any
co -"employee" or co -"volunteer worker" of such person injured in the course of employment;
2. If you are an individual, you with respect to any "auto" owned by you or a member of your
househ old.
3. Any partner or 'iexecutive officer" with respect to any "auto" owned by such partner or officer or a
member of his or her household;
4. Any person while employed in or otherwise engaged in performing duties related to the conduct
of an "auto business", other than an "auto business" you operate;
5. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the owner of a "ron-
owned auto" or any agent or "employee* of any such owner or lessee;
6. Any person or organization with respect to the conduct of any current or past partnership or joint
venture that is not shown as a Named Insured in the Declarations.
D. The following changes apply to UNITS OF INSURANCE (SECTION III):
1. Subparagraph 2.c. is amended to react:
C. Damages under COVERAGE B" COVERAGE C and the HIRED AND NON -OWNED AUTO
UABIUTY COVERAGE
Z Subparagraph 5-a. is amended to read:
a. Damages under COVERAGE A, COVERAGE B and the HIRED AND NON -OWNED AUTO
I-i MILITY COVERAGE
E. For the purposes of this endorsement only, the definition of 'insured contract" in DEFINITIONS
HGE.302 0$/ Copyright, American Alternative Insurance Corporation, 2oo5.
( � Includes copyrighted rrraterial of the Insurance Services omce. inc. with Its permission. Page 2 of 3
MUM cops
(SECTION VI) is amended by the addition of the following:
9. "Insured contract" means that part of any contract or agreement entered into, as part of your
business operations, pertaining to the rental or tease, by you or any of your "employees", of any
"auto". However, such contract or agreement shall not be considered an 'insured contract" to the
extent that it obligates you or any of your'"employees" to pay for "property damage" to any "auto"
rented or teased by you or any of your "employees".
F. For the purposes of this endorsement only, the following are added to DEFINITIONS (SECTION VI):
I. "Auto business" nos the business or occupation of selling, repairing, servicing, storing, or
parking "autos".
2. "tired auto" means any "auto" you lease, hire, rent or borrow. This does not include any "auto"
you tease, hire, rent or borrow from any of your "employees", your "volunteer workers", your
partners or your lexecutive officers", or members of their households.
3. 'Non -owned auto" means any "auto" you do not own, lease, hire, rent, or borrow which is used in
connection with your business operations. This includes "autos" owned by your "employees",
your 'Volunteer workers", your partners or your ' executive officers", or members of their
households, but only while used in your business operations. "Non -owned auto" does not
include any "auto" owned by a patient or a client.
Copyright, Americ8n NWTnafive Insurance Corporaf3on, M.
HGL302 (08/05) Includes copyrigtdodmaterial of the insurance. Services Office. Inc. with its permission. Page 3 of 3
VVSUM Copf
JE�?,Fb* CERTIFICATE OF LIABILITY INSURANCE OP ID 1C
DATE(MM/DDM-YY)
1
HOSPI-3
06/26/09
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Bouchard -Clearwater
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
101 Starcrest Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 6090
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-6090
Phone: 727-447-6481 Fax: 727-449-1267
INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURER A: American Alternative Ins Co 19720
INSURER B:
Hospice of the Florida Keys
Gregg Wheeler
1319 William
INSURER C:
St
Key West FL 33040-4736
INSURER D:
-- - -
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD' - -- - -- —
LTR IINSR TYPE OF INSURANCE POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION -- _ -
DATE MM/DD/YYYY DATE MWDD/YYYY LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1 , 000 , 000
A X COMMERCIAL GENERAL LIABILITY VHHHHG305144203
03/10/09 03/10/10 PRE ISES(���aaocccuEence)
$1,000,000
X CLAIMS MADE OCCUR
MED EXP (Any one person)
- -
$ 50 , 000
RETRO DATE 3/10/88 PERSONAL &ADV INJURY
$ 1 , 000 , 000
GENERAL AGGREGATE
s3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s3,000,000
X POLICY JET - LOC
Emp Ben
1,000,000
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS 1�
(Per person)
HIRED AUTOS
NON -OWNED AUTOS
ITT! BODILY INJURY
(Per accident)
$
- -
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS / UMBRELLA LIABILITY
EACH OCCURRENCE
s2,000,000
A OCCUR CLAIMS MADE VHHHHU505007903
03/10/09 03/10/10 AGGREGATE
s2,000,000
$
DEDUCTIBLE
X RETENTION $ Q
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIV
OFFICER/MEMBER EXCLUDED?
E.L. EACH ACCIDENT
$
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
--
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
A DIRECTORS &OFFICER VHHHHD405010703
03/10/09 03/10/10 Liability
3,000,000
DED $2500
Aggregate
3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is included as additional
insured as their interest may
appear as respects general liability subject
to policy conditions, terms and
exclusions.
vL_-r%IIrwr%I E. nvwV.rc GANGtLLA1IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
MONROEC DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Monroe County 1100 Simonton REPRESENTATIVES.
Key West FL 33040 AugWaTIVE
ACORD 25 (2009/01) 988-20 9 ACORD CORPORATION All rink+a racarvarl
The ACORD name and logo are registered marks of ACORD