Item G3BOARD OF GOVERNORS OF
FIRE AND AMBULANCE DISTRICT
AGENDA ITEM SUMMARY
Meeting Date: January 16, 2013 Division:___ Emergency Services ,
Bulk Item: Yes X No Department: Fire Rescue
289 -
Staff Contact Person: Il M Napoli ext. 6010
AGENDA ITEM WORDING: Approval of an Amendment to the Gila LLC dlbla Municipal Services
Bureau ("MSB") Agreement with Monroe County Board of Governors of Fire and Ambulance District 1
("County") for collections of outstanding account receivables from ground and air ambulance transports.
ITEM BACKGROUND: On October 1, 2010 the County entered into an Agreement between the
Monroe County Board of County Commissioners and the Board of Governors Fire and Ambulance
District 1 of Monroe County with Gila LLC d/b/a Municipal Services Bureau (MSB). The original
agreement provides for two additional one (1) year terms, with approval of the District's governing
Board. Monroe County Board of Governors Fire and Ambulance District 1 approved the first renewal
option effective from October 1, 2011 through September 30, 2012 with Gila LLC d/b/a Municipal
Services Bureau (MSB). The Agreement as renewed subsequently expired on September 30, 2012. The
amendment to the Agreement between MSB and the County will extend the agreement on a month -to -
month basis to allow the County an opportunity to assess its future needs with respect to ground and air
ambulance collections.
PREVIOUS RELEVANT BOCC ACTION: On October 1, 2010 the County entered into a new service
agreement between Gila LLC d/b/a Municipal Services Bureau (MSB) and Monroe County Board of
County Commissioners and Monroe County Board of Governors Fire and Ambulance District 1 effective
October 1, 2010 for the collection of outstanding ground and air ambulance account receivable balances.
On September 21, 2011 the Board of County Commissioners and Monroe County Board of Governors
Fire and Ambulance District 1 approved the first renewal option effective from October 1, 2011 through
September 30, 2012 with Gila LLC d/b/a Municipal Services Bureau (MSB). The Agreement as renewed
subsequently expired on September 30, 2012.
CONTRACT/AGREEMENT CHANGES: Agreement will be on a month -to -month basis until
terminated by either party by providing ten days written notice.
STAFF RECOMMENDATIONS: Approval.
TOTAL COST: $4 300.001 ear INDIRECT COST: BUDGETED: Yes x No
*Estimate based on average amount paid over the past year to MSB for glound ambulance collections.
COST TO COUNTY: See above SOURCE OF FUNDS: 13001-530-340and 1t00t 530340
REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year
APPROVED BY: County Ariy �%� OMB/Purchasing Risk Management
DOCUMENTATION: Included X Not Required
DISPOSITION: AGENDA ITEM #
MONROE COUNTY BOARD OF GOVERNORS
OF FIRE AND AMBUALNCE DISTRICT 1
Contract with: Gila LLC d/b/a
CONTRACT SUMMARY
Contract #�
Municipal Services Effective Date: 10/01/2012
Bureau (MSB) Expiration Date: -
Contract Purpose/Description:
Retroactively renew and extend Agreement on a month -to -month basis for collections of
outstanding account receivables from ground and air ambulance transport_
Contract Manager: Mary Napoli
(Name)
for BOCC meeting on 01/16/2013
6010 Emergency Services / Sto
(Ext.) (Department/Stop #)
Agenda Deadline: 01/02/2013
CONTRACT COSTS
Total Dollar Value of Contract: $ $41,300.00/ year Current Year
Portion: $
Budgeted? Yes® No ❑ Account Codes: 13 001-5 3 O-3 4o w w
Grant: $ 11001-53 0-340 - r
County Match: $
w w w r
ADDITIONAL COSTS
Estimated Ongoing Costs: $ Iyr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
I Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments: A 5
CONTRACT REVIEW
Changes
Date In Needed �� Rev'e er
/-A-8 Yes[:] No2---.- mil`
AYI� Yes[:] No
a I (a- Yes❑ No[A qi
OMB Form Revised 2/27/01 MCP #2
Yes No❑
14
Date Out
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Current COI next page.
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4 Af%-Il a r-f%D
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MWDDNYYY)
3107/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lleu of such endorsement(sj.
PRODUCER
Wortham Insurance & Risk Mgt
TACT
E:
PH2NE , 512 453-0031 FAX
AJC No Ext . Alc Na ; 512 453-0041
221 West Sth St #1400
Austin, TX 78701
512 453-0031
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC A
INSURER A: Hartford Casualty Insurance Co.
29424
INSURED
Gila, LLC dba:
Municipal Service Bureau & Gila Group
8325 Tuscany Way, Building 4
Austin, TX 78754
INSURER B :
INSURER C :
INSURER D
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
S L WVD SUB
POLICY NUMBER
M! EFF 1NMOfDDIYYYYPY LIMITS
A
GENERAL LIABILITY
65UUNJW4586
3/0112012 031012013 EACH OCCURRENCE $1,000,9000
X COMMERCIAL GENERAL LIABILITY
0 f a , $ 300 000
P ��
CLAIMS -MADE 5x]OCCUR
MED EXP (Any one parson) S10,000
PERSONAL a ADV INJURY $1 000 000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMPIOP AGG s2,000,000
7 POUCYF_1 PRD LOC JE
_
S
A
AUTOMOBILE LIABILITY
65UUNJW4586
310112012 03/01/201 Ea aercdenl SINGLE LIMIT 1,0009000
ANY AUTO
BODILY INJURY (Par person) 5
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident) $
H RED AUTOS V NON -OWNED
AUTOS
PROPERTY DAMAGE $
Par accident
F
$
A
X
UMBREf_LA LIAB
X
OCCUR
65RHUJW1423
3/01/2012 03/0112013 EACH OCCURRENCE S6,000,000
EXCESS UAS
CLAIMS -MADE
AGGREGATE $5000 000
❑ED I X1 RETENTION S10,000
$
A
WORKERS COMPENSATION
65WEZU1313
3101l2012 03l011201 )[ WC STATU- OTH-
T 1r= R
AND EMPLOYERS, LIABILITYlim-l-lulT,
YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
E L EACH ACCIDENT $1 000 000
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
N I A
E L DISEASE - EA EMPLOYEE S1 O00000
If yas, describe under
DESCRIPTION OF OPERATIONS below
El DISEASE - POLICY LIMIT 151,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addition! Remarks Schedule, if more space Is reel
Forms and Endorsements Schedule:
Commercial General Liability Coverage a Form #HG0001 0605 Ail }� -
Commercial Automobile Broad Form Endorsement #HA9916 0910 F-4'�'.r.�
f
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CERTIFICATE HOLDER CANCELLATION
RE
Monroe County Board of County SH
THE SHOULD EXPIRATION DATE ABOVE THEREOF, DESCRIBED NOTICE I 1MES LL BE CANCELLED
tEEL VEREO� N
Commissioners ACCORDANCE WITH THE POLICY PROVISIONS.
490 63rd Street Ocean
Marathon, FL 33060 AUTHORIZED REPRESENTATIVE
S
QD 1933-2010 ACORO CORPORATION. All rlgntS reserved-
ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S2942391M293194 14UT
AMENDMENT TO AGREEMENT BETWEEN THE BOARD OF COUNTY COMMISSIONERS
AND THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT I OF MONROE
COUNTY, FLORIDA, AND GILA CORPORATION d/b/a MUNICIPAL SERVICES BUREAU
FOR COLLECTION OF OUTSTANDING AMBULANCE ACCOUNTS
THIS AMENDMENT to agreement, dated the day of 2012, is entered into by
and between the Board of County Commissioners and the Board of Governors of Fire and
Ambulance District 1 of Monroe County, Florida (hereinafter collectively called the County),
and Gila LLC dlbla Municipal Services Bureau (hereinafter called MSB).
WHEREAS, on September 15, 2010, the County entered into an agreement with MSB
for collections of outstanding accounts receivables from ground and air ambulance transports
("Agreement"); and
WHEREAS, the Agreement was subsequently renewed on October 19, 2011; and
WHEREAS, this Agreement as renewed subsequently expired on September 30, 2012,
but
WHEREAS, the parties wish to extend the agreement on a month -to -month basis to
allow the County an opportunity to assess its future needs with respect to ground and air
ambulance collections;
NOW, THEREFORE, in consideration of the mutual covenants contained herein the
parties agree to the amended agreement as follows:
1. Paragraph 3 of the Agreement is amended and replaced with the following: "The
Agreement dated September 15, 2010, as subsequently renewed, is retroactively
renewed as of October 1, 2012 and extended on a month to month basis."
2. The first sentence in paragraph 4 of the Agreement is amended to read as follows:
"This agreement shall continue, month to month, until terminated by either party by
providing ten (10) days written notice in accordance with paragraph 11."
3. In all other respects, the provisions of the Agreement dated September 15, 2010, as
subsequently renewed, remain in full force and effect.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
1N WITNESS WHEREOF, the parties have set their hands and seal on the day and year first
above written.
(SEAL) Board of County Commissioners
Attest: Amy Heavilin, Clerk of Monroe County
Deputy Clerk
(SEAL)
Attest: Amy Heavilin, Clerk
Deputy Clerk
(CORPORATE SEAL)
Attest:
By
Secretary
Print Name
Date:
Mayor/Chairman
Board of Governors, Fire and
Ambulance District No. 1
Mayor/Chairman
Gila LLC dlbla Municipal Services Bureau
r 1 111 L U101110
Date: '- 2.0 11Z
OR TWO WITNESSES (only necessary if the President does not sign)
(1)
(1)
Print Name
Date:
(2)
(2)
Print Name
Date:
� f.
F-0am
AGREEMENT BETWEEN
THE BOARD OF COUNTY COMMISSIONERS
AND
THE BOARD OF GOVERNORS
FIRE AND AMBULANCE DISTRICT 1
OF MONROE COUNTY, FLORIDA
AND
GILA CORPORATION dlbla MUNICIPAL SERVICES BUREAU
FOR COLLECTION OF OUTSTANDING AMBULANCE ACCOUNTS
THIS AGREEMENT, ("AGREEMENT") is made and entered into this 15t1' day of September
2010, by and between the Board of County Commissioners and the Board of Governors of Fire
and Ambulance District 1 of Monroe County, Florida, therein referred to collectively as the
"COUNTY") and Gila Corporation dlbla Municipal Services Bureau therein referred to as
"MSB").
WITNESSETH:
WHEREAS, MSB represents that it wishes to provide services as hereinafter more specifically
enumerated to the COUNTY for collections of said outstanding accounts receivables from ground
and air ambulance transports; and
WHEREAS, the COUNTY wishes to enter into an Agreement with MSB for collecting various
uncollected ground and air ambulance accounts receivables;
NOVA, THERFORE, in consideration of the promises contained herein, the parties agree as
follows:
1. DEBT COLLECTION SERVICES --- MSB will mail notices, telephone or otherwise contact
debtors with outstanding accounts with the COUNTY in order to attempt to collect those monies
owed by the Debtors. Demand for payment of each collection item will be in a non -threatening
manner and will comply with all applicable Federal, State and local laws, riles and regulations.
As payment of collection items are collected by MSB, it shall be remitted to the COUNTY by the
fifteenth of the month for the previous month's activity. Each remittance shall include a statement
for the commission due and shall be accompanied by a dated report which, as to each collection
time included in the remittance, shall state the name of the person from whom it was collected,
the amount remitted and identifying account number.
2. RESPONSIBILITY OF THE COUNTY — The COUNTY will provide, in addition to the
names and last known addresses of the Debtors, all information regarding the date(s) of the
alleged debt(s), the amount of such debt(s) and the date the judgment was entered against the
debtor, if applicable. The information supplied to MSB by the COUNTY must be in an ANSI file
format which is acceptable to MSB and shall be provided not less frequently than monthly. The
COUNTY will update and correct any information it has provided MSB as soon as it is
practicable. The COUNTY will notify MSB of any payment of other satisfaction of judgment
made directly to the COUNTY. The COUNTY may provide this information in either hard copy
or electronically,
3. CONTRACT PERIOD AND RENEWAL - The effective date of this Agreement shall be
October 1, 2010 through September 30, 2011. This Agreement may be renewed annually for one
(1) year terms, not to exceed two (2) renewals, subject to approval of the Fire Chief of Monroe
County Fire Rescue, the Office of Management and Budget and the Monroe County Board of
County Commissioners and the Monroe County Board of Governors Fire and Ambulance
District 1.
4. CONTRACT TERMINATION — Either party may terminate this agreement by providing
ninety (90) days written notice. Upon notice of termination MSB shall take all steps necessary to
close out any accounts with an open balance and will be responsible for complying with all
provisions of this contract until the tenmination date. MSB will not assume new accounts after
such notice of termination. MSB will be paid for its services through the termination date and
MSB will not incur any expenses after notice of termination except those necessary to properly
wind up its obligations under this contract and properly perform this contract. All money received
on accounts, by MSB, after the termination date will be forwarded to the COUNTY without
regular compensation being paid to MSB. MSB will further cooperate with any successor, debt
collection service provider by turning over all records and any other documents or equipment in
hard copy to useable electronic for»at to the COUNTY or the debt collection service provider.
MSB will pay the COUNTY all funds due and owing to it as of the termination date of this
contract. The provision for MSB to turn over documents and to provide all funds due and owing
the COUNTY will survive the termination of this contract.
5. CAPABILITY TO PROVIDE SERVICE -- MSB represents that it is an established debt
collection service provider licensed to do business in the State of Florida and capable of
providing all services required pursuant to this contract and that MSB has all necessary permits,
occupational licenses or any other license or permits required to provide services under this
agreement required by any local, state, government or the federal government. MSB further
represents that it has experience with debt collection practices and it has the requisite financial
resources, personnel and experience to perform all services required under this agreement.
5. REPORTS — MSB shall provide the COUNTY with monthly aging reports by the twenty-first
day of the following month reflecting the status of all accounts that are currently active and
MSB's collection results as of the last day of the previous month. This report will include the
following information:
a. Debtor's Name
b. Debtor's Account Number
c. Amount paid on the account during the preceding month including amounts received by
COUNTY as reported to MSB.
d. Unpaid balance of account
e. Amount of commission due Agency.
The COUNTY has the absolute right to audit any and all financial records of MSB pertaining to
the collection activities carried on by MSB pursuant to this contract. MSB shall retain such
records not provided to the COUNTY for a period of three (3) years after the termination of this
contract unless such records are required for pending litigation then such records shall be
maintained until at least ninety (90) days after the conclusion of litigation including appeals.
7. VALID DEBTS - The COUNTY agrees that accounts placed with MSB for collection are
valid and legally enforceable debts and are not disputed or subject to any bankruptcy proceedings,
unless otherwise disclosed in writing by the COUNTY.
8. COMMISSION RATES — For all accounts referred by the COUNTY to MSB for collection for
which the COUNTY is paid, regardless of whether payment is accepted directly by the COUNTY
or by MSB on the COUNTY'S behalf, the COUNTY will pay to MSB a twenty-five (25) percent
rate on the gross amount collected.
Service will be provided on a contingency fee basis with no up -front or additional costs
associated with the services.
The following services will be provided at no additional costs: On line access to accounts, bi-
lingual collection notices and staff, letter creation and distribution, background
checks/fingerprints scans for all current and future MSB employees, National Skip tracking
services, toll -free telephone numbers for debtors, independent security audit, and electronic
interface (in-house programmers).
The COUNTY will not be responsible to MSB for any commissions or fees for payments
returned to the COUNTY or MSB for insufficient funds.
9. NOTIFICATION OF COLLECTION — The COUNTY will immediately notify MSB of
accounts referred to MSB for collection that have been paid or disputed by the Debtors directly to
the COUNTY whenever that payinent or dispute occurs. MSB agrees that once an account is
placed, that the COUNTY is to receive all commission due in the event that monies are collected.
By the fifteenth of each month, MSB will provide a detailed reporting to the COUNTY to
identify all accounts known to be collected during the prior month and to remit ironies collected
on the County's behalf. MSB is required to invoice the COUNTY for commissions due; the
COUNTY agrees to review the invoice and forward payment to MSB in accordance with the
Florida Local Government Prompt Payment Act.
MSB makes no warranties or representation, expressed or implied, about the amount of funds that
will be collected, and MSB shall have no liability for any amounts uncollected. The only liability
of MSB will be to forward any funds collected to the COUNTY subjected to MSB collecting its
commission amount.
10. LEGAL ACTION - MSB shall make no settlement for less than the total principal amount
owed without prior approval of the COUNTY.
MSB may not affect any debtor's credit history as a result of unsuccessful collection efforts.
MSB will place accounts for litigation only with prior written consent of County.
MSB agrees that if the continued collection of an account would damage the reputation of the
COUNTY or if suit is seriously threatened or filed, the COUNTY may request, in writing, the
immediate return of the account.
If the COUNTY has been given legal authorization to write-off obligations which have been
referred to MSB, MSB will not collect any fees from the COUNTY relative to the accounts which
have been withdrawn from MSB's collection efforts.
11. NOTICES — All notices specified pursuant to this contract shall be sent to the following:
COUNTY: Monroe County Emergency Services
490 63'd Street Ocean
Marathon, Fl 33050
MSB: Municipal Services Bureau
6505 Airport Blvd., Suite 100
Austin, TX 78752
12. INDEPENDENT CONTRACTOR — Neither MSB, nor any of its employees, agents, or
subcontractors are employees of the COUNTY. MSB is solely responsible and liable for any
action taken or made by MSB its' employees, agents or subcontractors.
13. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT of 1996
(HIPAA) — MSB will carry out its obligations under this contract in compliance with the privacy
regulations pursuant to Public Law 104-191 of August 21, 1996, known as the Health Insurance
Portability and Accountability Act of 1996, Subtitle F — Administrative Simplification, Section
261, cat .seq., as amended (""HIPAA"), to protect the privacy of any personally identifiable
protected health information (PHI) that is collected, processed or learned as a result of the
Collection services provided hereunder.
In conformity therewith, MSB agrees that it will:
a. Not use or further disclose PHI except as permitted under this contract or required by law;
b. Use appropriate safeguards to prevent use or disclosure of PHI except as permitted by this
contract;
c. To mitigate, to the extent practicable, any hanmful effect this is known to MSB of a use or
disclosure of PHI by MSB in violation of this contract;
d. Report to Monroe County any use or disclosure of PHI not provided for by this contract of
which MSB becomes aware,
e. Ensure that any agents or subcontractors to whom MSB provides PHI, or who have access
to PHI, agree to the same restrictions and conditions that apply to MSB with respect to such
PHI;
f. Make PHI available to Monroe County and to the individual who has a right to access as
required under HIPAA within 30 days of the request by Monroe County regarding the
individual;
g. Incorporate any amendments to PHI when notified to do so by Monroe County;
h. Provide an accounting of all uses or disclosures of PHI made by MSBH as required under
HIPAA privacy rule within sixty (60) days;
i. Make their internal practices, books and records relating to the use and disclosure of PHI
available to the Secretary of the Department of Health and Human Services for purposes of
determining MSB's and Monroe County's compliance with HIPAA; and
j. At the termination of the contract, return or destroy all PHI received from, or created or
received by MSB on behalf of Monroe County, and if return is infeasible, the protections of
this contract will extend to such PHI.
The specific uses and disclosures of PHI that may be made by MSB on behalf of Monroe County
include:
a. Preparation of invoices and reminder notices and documents pertaining to collections of
overdue accounts to patients and others who are responsible for payment of the services
provided by Monroe County;
b. Uses required for the proper management of MSB as a business associate.
c. Other uses or disclosures of PHI as permitted by the HIPAA privacy rule.
Notwithstanding any other provisions of this contract may be tenninated by Monroe County if
MSB has violated a term or provisions of this contract pertaining to MSB's material obligations
under the HIPAA privacy rule, or if MSB engages in conduct which would, if committed by
Monroe County, result in a violation of the HIPAA privacy rule by Monroe County.
14. INDEMNIFICATION - MSB covenants and agrees to indemnify, hold harmless and defend
the Monroe County Board of County Commissioners and the Monroe County Board of
Governors District 1, its commissioners, officers, employees, agents and servants from any and
all claims for bodily injury, including death, personal injury, and property damage, including
damage to property owned by Monroe County, and any other losses, damages, and expenses of
any kind. including attorneys fees, court costs and expenses, which arise out of, in connection
with, or by reason of services provided by MSB or any of its Subcontractors in any tier,
occasioned by the negligence, errors, or other wrongful act or omission of MSB or its
Subcontractor(s) in any tier, their officers, employees, servants or agents.
In the event that the service is delayed or suspended as a result of MSB's failure to purchase or
maintain the required insurance, MSB shall indemnify the County from any and all increased
expenses resulting from such delay.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements
contained elsewhere within this agreement.
This indemnification shall survive the expiration or earlier termination of the Agreement. (See
Attachment A) .
15. INSURANCE - During the term of this Agreement, MSB must keep in force and affect the
following insurance:
Worker's Compensation- Prior to the commencement of work governed by this contract, MSB
shall obtain worker's Compensation Insurance with limits sufficient to respond to Chapter 440 ,
Florida Statutes. In addition. MSB shall obtain Employer's Liability Insurance with limits not less
than:
$100,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$100,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the
state of Florida.
If MSB has been approved by the Florida's Department of Labor, as an authorized self -insurer,
the Collllt) shall recognize and Honor MSB's status. MSB izzay be required to SLibinit a Letter of
Authorization issued by the Department of Labor and a Certificate of Insurance, providing details
on MSBss Excess Insurance Program.
If MSB participates in a self-insurance fund, a Certificate of Insurance will be required. In
addition, MSB may be required to submit updated financial statements from the fund upon
request from the County.
General Liabili-- Prior to the commencement of work governed by this contract, MSS shall
obtain General Liability Insurance. Coverage shall be maintained throughout the life of the
contract and include as a minimum:
Premises Operations
Products and Completed Operations
Blanket Contractual Liability
Personal Injury Liability
Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its
provisions should include coverage for claims filed on or after the effective date of this contract.
In addition, the period for which claims may be reported should extend for a minimum of twelve
( 12) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
Professional Liability Insurance -- Recognizing that the work governed by this contract involves
the furnishing of advice or services of a professional nature, MSB shall purchase and maintain,
throughout the life of the contract, Professional Liability Insurance which will respond to
damages resulting from any claim arising out of the performance of professional services or any
error or omission of MSB arising out of work governed by this contract.
The minimum limits of liability shall be:
$250,000 per Occurrence/$500,000 Aggregate
Monroe County shall be named as an Additional insured on all policies.
The provisions of Attachment B are attached and incorporated into this agreement.
16. PAYMENTS - Payments shall be made by the COUNTY pursuant to the Florida Local
Government Prompt Payment Act after the completion of the rendered services and proper
invoicing by MSB.
17. CONTINGENCY- Monroe County's performance and obligation to pay under this
Agreement is contingent upon an annual appropriation by the Board of County Commissioners.
18. SECTION HEADINGS - Section headings have been inserted in this Agreement as 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.
19.OWNERSHIP OF THE PROJECT DOCUMENTS - The documents prepared by
MSB for this Project belong to the COUNTY and may be reproduced and copied
without acknowledgement or permission of MSB.
20. SUCCESSORS AND ASSIGNS - MSB shall not assign its right hereunder, except its right to
payment, nor shall it delegate any of its duties hereunder without the written consent of the
COUNTY. MSB will not employ any subcontractor to perform any duties under this agreement
unless such fact is made known to the COUNTY and prior written permission is granted. The
COUNTY shall have the right to prohibit a subcontractor from performing any part of the
contract; such right shall be reasonable exercised. Subject to the provisions of the immediately
preceding sentence, each party hereto binds itself, its successors, assigns and legal representatives
to the other and to the successors, assigns and legal representatives of such other party.
21. NO THIRD PARTY BENEFICIARIES - Nothing contained herein shall create any
relationship, contractual or otherwise, with or any rights in favor of, any third party.
22. PUBLIC ENTITIES CRIMES - A person or affiliate who has been placed on the convicted
vendor list following a conviction for public entity crime may not subunit a bid on contracts 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 MSB, supplier,
subcontractor, or MSB 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 of the
Florida Statutes, for CATEGORY TWO for a period of 35 months from the date of being placed
on the convicted vendor list.
By signing this Agreement (including Attachment C), MSB represents that the execution of this
Agreement will not violate the Public Entity Crimes Act (Section 287.133, Florida Statutes).
Violation of this section shall result in termination of this Agreement and recovery of all monies
paid hereto, and may result in debarment from COUNTIES competitive procurement activities.
In addition to the foregoing, MSB further represents that there has been no determination, based
on an audit, that it or any subcontractor has committed an act defined by Section 287.133, Florida
Statutes, as a "public entity crime" and that it has not been formally charged with committing an
act defined as a "public entity crime" regardless of the amount of money involved or whether
CONUSULTANT has been placed on the convicted vendor list.
MSB will promptly notify the COUNTY if it or any subcontractor is formally charged with an act
defined as a "public entity crime IQ or has been placed on the convicted vendor list.
23. MAINTENANCE OF RECORDS - MSS 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 its 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 four years
following the termination of this Agreement. If an auditor employed by the COUNTY or County
Clerk determines that monies paid to MSB pursuant to this Agreement were spent for purposes
not authorized by this Agreement, the MSB shall repay the monies together with interest
calculated pursuant to Sec. 55.03, of the Florida Statutes, running from the date the ironies were
paid by the COUNTY.
24. GOVERNING LAW, VENUE, INTERPRETATION, COSTS AND FEES - 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.
In the event that any cause of action or administrative proceeding is instituted for the enforcement
or interpretation of this Agreement, COUNTY and MSB agree that venue shall lie in Monroe
County, Florida, in the appropriate court or before the appropriate administrative body. The
Parties waive their rights to a trial by jury. This Agreement is not subject to arbitration.
25. SEVERABILITY - If any tern, covenant, condition or provision of this Agreement for 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 Agreement, shall not be affected thereby; and each remaining 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 terns, covenants, conditions and
provisions of this Agreement would prevent the accomplishment of the original intent of this
Agreement. The COLTNTY and MSB 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.
26. ATTORNEY' S FEES AND COSTS - The COUNTY and MSS 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 attorneys 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.
27. BINDING EFFECT - The terms, covenants, conditions, and provisions of this Agreement
shall bind and inure to the benefit of the COUNTY and MSB and their respective legal
representatives, successors, and assigns.
28. AUTHORITY - 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.
29. CLAIMS FOR FEDERAL OR STATE AID - MSB 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.
30. ADJUDICATION OF DISPUTES OR DISAGREEMENTS - COUNTY and MSB 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 15 days
after the first 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.
31. 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 MSB 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 MSB specifically
agree that no party to this Agreement shall be required to enter into any arbitration proceedings
related to this Agreement.
32. NONDISCRIMINATION - MSS and COUNTY 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 tenninates
without any further action on the part of any party, effective the date of the court order. MSB or
COUNTY 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 V1 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 91-6 16), 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 Chapter 13, Article VI,
which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry,
sexual orientation, gender identity or expression, familial status or age; 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.
33. COVENANT OF NO INTEREST - MSS and COUNTY covenant that neither presently has
any interest, and shall not acquire any interest, which would conflict in any manner or degree
with its performance under this Agreement, and that only interest of each is to perform and
receive benefits as recited in this Agreement.
34. CODE OF ETHIC'S - 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. (Attachment D).
35. NO SOL.,ICITATIONIPAYMENT - MSB and COUNTY 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 firth, 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, MSS 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.
36. PUBLIC ACCESS - MSB and COUNTY 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 inade or received by MSS and
COUNTY in connection with this Agreement; and the COUNTY shall have the right to
unilaterally cancel this Agreement upon violation of this provision by MSB.
37. NON -WAIVER OF IMMUNITY - Notwithstanding the provisions of Sec. 768.28, Florida
Statutes, the participation of MSB and the COUNTY 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 deeined 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.
38. 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.
39. LEGAL OBLIGATIONS AND RESPONSIBILITIES — no 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.
40. 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 MSB and the
COUNTY agree that neither MSB nor the COUNTY 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.
41. ATTESTATIONS AND TRUTH IN NEGOTIATION — Coincident with execution of this
Agreement, MSB agrees to execute a Public Entity Crime Statement, Ethics Statement, and a
Drug -Free Workplace Statement (Attachments C-E).
It
42. NO PERSONAL LIABILITY - No covenant or agreement contained herein shall be deemed
to be a covenant or agreement of any member, officer, agent or employee of Monroe 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.
43. 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 signing any such counterpart.
IN WITNESS WHEREOF, each party hereto has caused this Agreement to be executed by its
duly authorized representative.
Attest: DANNY L. KOLHAGE, CLERK
Deputy Clerk
Attest: DANNY L. KOLHAGE, CLERK
By: 0 ajjAi C - aq-�"Ir
Deputy Clerk
WITNESS:
Print Name: A ichae1 E . Epstein, CFO
Print Name and Title
MON ROE COUNTYBOARD OF COUNTY
COMMISSIONERS
*Mayolrkhain-nan
BOARD OF GOVERNORS,
MONROE COUNTY FIRE AND
AMBULANCE DIS ICT 1
r
yo
Mayor/Chairman
GILA CORPORATION INC. dlb a
MUNICIPAL SERVICES BUREAU
By:
Date: 7 .2 9 .2 010
Title: CEO
MOfVROE COUNTY ATTORNE
A ROV D QS T F M:
YMTHIA L. ALL
HSSIST ��1T COUNTY ATTORNEY
'1i
MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
Indemnification and Hold Harmless
for
Other Contractors
The Contractor covenants and agrees to indemnify, hold harmless and defend the Monroe
County Board of County Commissioners and the Monroe County Board f Governors District 1,
its commissioners, officers, employees, agents and servants from any and all claims for bodily
injury, including death, personal injury, and
property damage, including damage to property owned by Monroe County, and any other losses,
damages. and expenses of any kind, including attorneys fees, court costs and expenses, which
arise out of, in connection with, or by reason of services provided by the contractor or any of its
Subcontractors in any tier, occasioned by the negligence, errors, or other wrongful act or
omission of the contractor or its Subcontractor(s) in any tier, their officers, employees, servants or
agents.
In the event that the service is delayed or suspended as a result of the contractor failure to
purchase or maintain the required insurance, MSS shall indemnify the County from any and all
increased expenses resulting from such delay.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements
contained elsewhere within this agreement.
This indemnification shall survive the expiration or earlier termination of the Agreement
7.29.2010
Date
TCS
Attachment A
(1 of 1)
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Gila Corporation dlbla Municipal Services Bureau
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers' Compensation Insurance with limits sufficient to respond to Florida Statute
440.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not
less than:
$1 002000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$100,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in
the state of Florida.
If the Contractor has been approved by the Florida's Department of Labor, as an
authorized self -insurer, the County shall recognize and honor the Contractor's status. The
Contractor may be required to submit a Letter of Authorization issued by the Department
of Labor and a Certificate of Insurance, providing details on the Contractor's Excess
Insurance Program.
If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be
required. In addition, the Contractor may be required to submit updated financial
statements from the fund upon request from the County.
WC 1
Attachment B
la
(1 o f 3)
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONRO E COUNTY, FLORIDA
AND
Gila Corporation dlbla Municipal Services Bureau
Prior to the commencement of work governed by this contract, the Contractor shall obtain
General Liability Insurance. Coverage shall be maintained throughout the life of the
contract and include, as a minimum:
• Premises Operations
■ Products and Completed Operations
Blanket Contractual Liability
■ Personal Injury Liability
Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
An Occurrence Form policy is preferred. If coverage 16
is provided on a Claims Made
policy, its provisions should include coverage for claims filed on or after the effective
date of this contract. In addition, the period for which claims may be reported should
extend for a minimum of twelve ( 1 2) months following the acceptance of work by the
County.
The Monroe County Board of County Commissioners shall be named as Additional
Insured on all policies issued to satisfy the above requirements.
GLI
Attachment B
14
(? o f 3)
PROFESSIONAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Gila Corporation d/b/a Municipal Services Bureau
Recognizing that the work governed by this contract involves the furnishing of advice or
services of a professional nature, the Contractor shall purchase and maintain, throughout
the life of the contract, Professional Liability Insurance which will respond to damages
resulting from any claim arising out of the performance of professional services or any
error or omission of the Contractor arising out of work governed by this contract.
The minimum limits of liability shall be;
$250,000 per Occurrence/$ 5 00,000 Aggregate
PRol
(3 of 3)
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted bidder list folio" ing a
conviction for public entity crime may not 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 bidder, supplier,
subbidder, 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 bidder list."'
By executing this form, I acknowledge that I/my company is in compliance with the
above.
STATE OF Texas
(Signatur Cont actor)
COUNTY OF Travis
Date 7.29.2010
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
Bruce Cummings who after first being sworn b , name of
Y me�
individual signing) affixed his/her signature in the space provided above an this
2 9th
day of July
My c mmission expire /go"
NOTARY PUBLIC
,20 10
WW UORA �.ID% flELGA�
MOmas
KO[ARY PIfBIxIL
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A michnient C
16
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE No. 10--1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
Gila Corporation d/b/a Municipal Services Bureau 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 Ordinance No. 10-1990 or any County officer or employee in
violation of Section 3 of 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 ficer or employee.
( S igna e
Date: 7 .2 9 .2 0 l O
STATE OF Texas
COUNTY OF Travis
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
Bruce Cummings who, after first being sworn by me, affixed
his/her signature (name of individual signing) in the space provided above on this
2 9th day of July
z L4--�q'q X-0 V-
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
.20 to .
A ttachnient D
T
ARY PRIM SIT
Mai
C0400"aN EXPIRES
06-1S-20 14
pow
DRUG -FREE WORKPLACE FORM
The undersigned contractor in accordance with Florida Statute 287.087 hereby certifies
that:
Gila Corporation d/b/a Municipal Services Bureau
(Name of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace
and specifying the actions that will be taken against employees for violations of such
prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the business"s
policy of maintaining a drug -free workplace, any available drug counseling,
rehabilitation, and employee assistance programs, and the penalties that may be imposed
upon employees for drug abuse violations.
3. Gives each employee engaged in providing the commodities or contractual services
that are under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notifies the employees that, as a condition
of working on the commodities or contractual services that are under bid, the employee
will abide by the terms of the statement and will notify the employer of any conviction
of, or plea of guilty or nolo contendre to, any violation of Chapter 893 (Florida Statutes)
or of any controlled substance law of the United States or any state, for a violation
occurring in the workplace no later than five (5) days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse
assistance or rehabilitation program if such is available in the employee's community, or
any employee who is so convicted.
6. Makes a good faith effort to continue to maintain a drug -free workplace through
implementation of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with
the above requirement
Contr ctor s Sig ature
7.29.2010
Date
OMB -- MCP FORM #5
Attaclir lent E
is
J
ti
ACQRDCERTIFICATE OF LIABILITY INSURANCE OP ID WI BA-DATE(MMIDDrfM)
GILAC-1 02 25 10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PIA -Pathfinder/ LL D Ins Grp HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1160 Dairy Ashford, Suite 220 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston TX 77079
Phone-, 281--556-9999 Fax:281-556--9609 INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURER A Hartford Lloyds Insurance Comp 38253
INSURER B Hartford Casualty Insurance Co 29424
Gila Corporation dba Municipal Services Bureau INSURER C Federal Insurance Company
6505 Airport Blvd.. Suite 100 INSURER Hartford -Twig City Fire iris. c
29459
Austin TX 78752
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICAI
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE h
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
7INSR TYPE OF INSURANCE POLICY NUMBER POUCY DATE M FFECTY MID
DATE MMIRAIMGENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 61 SBQRS B 50 0 03/01/10 03/01/11
CLAIMS MADE �OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER
POLICYF--] JECT LOC
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEOULE❑ AUTOS
K HIRED AUTOS
X NON -OWNED AUTOS
q
61SBQRSBSOO
UPI'
03/01/101 03/01/11
GARAGE UABRJTY
ANY AUTO
EXCESSIUMBRELLA UASIUTY
A OCCUR 0 CLAIMS MADE 61SBQRS8500 03/01/10 03/01/11
HDEDUCTIBLE
X RETENTION $10 0 0 0
WORKERS COMPENSATION AND
B EMPLOYERS' UAINUTY 61 WE CRT 7 8 4 7 03/01/10 03/01/11
ANY PROPRIETORIPARTNERIEXECUTWE
OFFICERIMEMBER EXCLUDED7
If yyas, describe under
5PECIAL PROVISIONS below
OTHER
C. Professional Liab 8197-6649 03/01/10 03/01/11
D Crime OOEBO241339-10 03/01/10 03/01/11
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate holder is named as Additional Insured with respects on
policies as required by written contract. This certificate replac
all previously issue certificateds for the certificate holder as p
Subject to policy terms, conditions and exclusions.
CERTIFICATE HOLDER
Monroe County Board of County
Commissioners
490 63rd Street Ocean
Marathon FL 33050
ACORD 25 (2001108)
CANCELLATION
MONRO-- 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIC
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO OO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES.
AU 0 REPRE ENTATIVE
'-D. NOTWITHSTANDING
AY BE ISSUED OR
:ONDITIONS OF SUCH
LIMITS
EACH OCCURRENCE $10 0 0 0 0 0
PREMISES Ea occurance
S 1000000
MED EXP (Any one person)
$1 0 0 0 0
PERSONAL 8 A0V INJURY
$exc 1 uded
GENERAL AGGREGATE *
$ 2 0 0 0 00 0
PRODUCTS - COMPIOP AGG
$ 2 0 0 0 0 0 0
COMBINED SINGLE LIMIT
(Ea actldent)
1 000000
BODILY INJURY
S
(Par person)
BODILY INJURY
$
(Par aeddent)
PROPERTY DAMAGE
$
(Per aoddant)
AUTO ONLY - EA ACCIDENT
i
OTHER THAN EA ACC
S
AUTO ONLY AGG
S
EACH OCCURRENCE
s 4000000
AGGREGATE
$4 0 0 0 0 0 0
i
i
i
TORY LIMITS ER
E.L. EACH ACCIDENT
$1000000
E.L. DISEASE - EA EMPLOYEE1
i 1000000
E.L DISEASE - POLICY LIMIT $ 10 0 0 4 0 0
Limit 2000000
Limit 1000000
all
a s any and
artains.
0 ACORD CORPORATION 1988
RENEWAL AGREEMENT
91 : This AGREEMENT dated the day of �' , 2011, by and between
the Board of County Commissioners and the Board of Governors of Fire and Ambulance District 1 of Monroe
County, Florida, hereinafter called the "County" and Gila LLO d/b1a Municipal Services Bureau, hereinafter
called MSB,
WITNESSETH
WHEREAS, the parties hereto did enter into an agreement dated October 1, 20 10 for collections of
outstanding account receivables from ground and air ambulance transports; and
WHEREAS, said agreement provided an option to the County to renew the contract for two additional
one (1) year terms, not to exceed two (2) renewals; and
WHEREAS, the County has elected to exercise said first one (1) year renewal option for the continuation
of collections of outstanding account receivables from ground and air transports; now therefore
IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as
follows:
1. The County elects to renew the contract for an additional year pursuant to paragraph 3 of the
agreement entered into on October 1, 2010.
2. The effective date of this amendment is October 1, 2011 and shall extend through
September 30, 2012, under the same terms and conditions of the contract dated
October 1, 2010.
3. All other terms and conditions of the contract dated October 1, 2010 shall remain in full
force and effect.
Attest: DANNY L. ROLHAGE, CLERK.
e
By. N .
eptay Clerk
WlTNES S :
MO OE COUNTY ATTORN
APPROVED AS TO FM .
YNTHIA L. HALL
ASSIS NT COUNTY ATTORNEY
Date 8—S-2v y
BOARD OF GOVERNORS of MONROE
COUNY, FLORIDA
Mayor/Chauman
G A C DB/A MUNICIPAL SERVICES
PU A
Authorized Signat-ure
-d 0r6
Print Name & TitIe
MONROE COUNTY BOARD OF GOVERNORS
OF FIRE AND AMBUALNCE DISTRICT 1
Contract with: Gila LLC dlbla
CONTRACT SUMMARY
Contract #
Municipal Services Effective Date: 10/01/2011
Bureau (MSB) Expiration Date: 09/30/2012
Contract Purpose/Description:
First Renewal of agreement dated 10/1/2011 for collections of outstanding; account
receivables from ground and air ambulance transport.
Contract Manager: Camille Dubroff 6010
(Name)
for BOG meeting on /0/017///
�hxtj
Aizenda Deadline
CONTRACT COSTS
Emergency Services / Sto
(Department/Stop #)
Total Dollar Value of Contract: $ $4,300.001 year Current Year
Portion: $
Budgeted? YesX No Account Codes: 13001-530-340 -
Grant: $ 11001-530-340 -
County Match: $ - - - -
ADDITIONAL COSTS
Estimated Ongoing Costs: $ lyr For:
(Not included in dollar value above)(eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
14
Changes Date Out
Date In Needed view
Division Director �---/-// YesO No[�' s��
Risk Manage ent �5 ` ' I' Yes❑ N��
O.M.B./Purc'hasing YesO NoEf
County Attorney � �I Yes❑ No
Comments: 0
OMB Form Revised 2. 27/01 MCP #2
Client#: 84884
14GILACOR
ACORD. CERTIFICATE
F LIAfiVL4?iER1SUR NCE DATE (MMIDOIYYYY)
1
3/07/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR
ATION ONLY AND CONFERS NO RIGHT UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT OR NEGATI
LY AM AFFORDED Y THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE CE DOES NOT
ONST TVELY
CQN��EETWEEN E ISSUING G SURER(SGE
L�T� i )t AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFIC 'TE HOLDER.
IMPORTANT: if the certificate holder Is an ADDITIONAL i
SURED, the poiic ies a endorse . if SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain oilcles m require M- tatement n this certificate does not confer rights to the
P Y+ P Y q
certificate holder in lleu of such endorsement(s).
RISK NIANAGEMF�IT
PRODUCER
TACT
N E.
Wortham insurance & Risk Mgt
PHONE
H No Extm. 512 453-0031 FAX No) 512 453-0041
LAI221
West Sth St #1400
, E-MAIL
ADDRESS. wpage c@wortham austin.com
Austin, TX 78701
512 453-0031
INSURER(S) AFFORDING COVERAGE NAIC a
INSURER A. Hartford Underwriters Ins Co 30104
INSURED
INSURER B . Sentinel Insurance Co Ltd 11000
Gila, LLC dba:
C •Hartford Casualty Insurance Coy T 29424
Service Bureau & Gila Group
_
[IINSURERMunicipal
6505 Airport Boulevard, Suite 100
NSURER D I ------- --- ----� ----_----._ �.._.__.__ _____�__.� __. ___ _._
Austin, TX 78752
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT
TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
ALL THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADOL
LTR TYPE OF INSURANCE NSR
SUER POLICY EFF POLICY EXP
0 POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS
A GENERAL LIABILITY
65UUNJW4586 3101/2011 03101/2012 EACH OCCURRENCE
51 000 000
X COMMERCIAL GENERAL LIABILITY
PREM`$E EeEnccTuErence}
s 300 000
CLAIMS -MADE X OCCUR
MED EXP (Any oneperson)
S10,000
PERSONAL & ADV INJURY
51 000 000
GENERAL AGGREGATE
$2,000�000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMPIOP AGG
5 2,000,000
7 POLICY EECT LOC
B AUTOMOBILE LIABILITY
65UUNJW4586 3/01/2011 03/01/201 COMBINED SINGLE LIMIT
IEs accident)
$110001000
ANY AUTO
BODILY INJURY (Per person)
S
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident) 5
X HIRED AUTOS x NON OWNED
AUTOS
PROPERTY TY DAMAGE
$
5
C X
UMBRELLA LIAR OCCUR
65RHUJW1423 3/01 /2011 03/01/2012 EACH OCCURRENCE
s4,000,000
EXCESS LI?AB i CLAIMS -MADE
AGGREGATE
54 oao OOO
DIED F XT RETENTION 510 000
$
C WORKERS COMPENSATION 65WEZU1313 3101/2011 03/011201 we STATU- OTH-
AND EMPLOYERS' LIABILITYIQRY-LIMITS
1�
ANY PROPRIETORIPARTNERIEXECUTIVE-Y — E L EACH ACCIDENT si 006 000
OFFICERIMEMBER EXCLUDED? ` N N 1 A
(Mandatory in NH) EL DISEASE - EA EMPLOYEE
51,000,000
If yes, descr be under
DESCRIPTION OF OPERATIONS be ow E L. DISEASE -POLICY LIMIT
LL1,0001000
i
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, AddltIonal Remarks Schedule, If more space is required)
4
}
General Liability, Auto Liability, and Umbrella include blanket additional insured and blanket waiver of
r
•. ��°
subrogation when required by written contract. Workers Compensation includes blanket waiver of subrogation
when required by contract. Insurercannot change or cancel coverage without the insurer first
giving 30 days written notice to Certificate Holder of such change, cancellation or termination. Subject to
policy terms, conditions and exclusions.
CERTIFICATE HOLDER CANCELLATION
Monroe County Board of County SHE U E.]IP RAD ANY TONH DARE VTHEREOFBED
. E NO�ICEIEINILL LICS BECBE CDELIVEREDO NE
Commissioners ACCORDANCE WrrH THE POLICY PROVISIONS
490 63rd Street Ocean
Marathon, FL 33050 AUTHORIZED REPRESENTATIVE
@AAA P-MAS
(9 1988-2010 AGGRO CORPORATION. All rignts reserved.
ACORD 25 (2010!05) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S2143841M214323 14LJT