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07/19/2017 AgreementKEVIN MADOK, CPA MONROE COUNTY CLERK OF THE CIRCUIT COURT & COMPTROLLER DATE: August 11, 2017 TO: Kathy M. Peters, CP County Attorney's Office FROM: Pamela G. Hancock, Deputy Clerk SUBJECT: July 19th BOCC Meeting Enclosed is a duplicate original of Item M8, Contract with interim Medical Examiner, Michael Steckbauer, M.D., for your handling. Should you have any questions, please feel free to contact me at ext. 3130. Thank you. cc: Finance File AGREEMENT FOR THE PROVISION OF MEDICAL EXAMINER SERVICES THIS AGREEMENT ( "Agreement ") is made and entered into as of 1S day of July, 2017 ( "Effective Date "), by and between the Board of County Commissioners of Monroe County, Florida (hereinafter "County "), and Michael Robert Steckbauer, M.D., Interim District 16 Medical Examiner of the State of Florida (hereinafter "Medical Examiner "). (Collectively, the County and Medical Examiner shall be referred to as the "Parties. ") WITNESSETH: WHEREAS, Chapter 406, F.S. establishes Medical Examiner Districts; and WHEREAS, the Medical Examiner was appointed by the State Attorney for Monroe County as the Interim Medical Examiner for District 16, encompassing Monroe County, to begin on July 1, 2017; and WHEREAS, Section 406.06(3), F.S. states that district medical examiners shall be entitled to "compensation and such reasonable salary and fees as are established by the board of county commissioners in the respective districts "; and WHEREAS, the fees to be set by the Medical Examiner have been established by Resolution No. 007 -2009, as amended and supplemented by Resolution Nos. 001 -2001 and 135- 2001; and WHEREAS, Section 406.08(1), F.S., states that "[flees, salaries and expenses may be paid from the general funds or any other funds under the control of the board of county commissioners ", and further provides that the district medical examiner shall submit an annual budget to the board of county commissioners; and WHEREAS, the Parties wish to enter into this Agreement in order to set the amount of compensation, including salaries, for the Medical Examiner's office during the period of time in which the Medical Examiner serves as the Interim Medical Examiner, as well as fees to be collected by the Medical Examiner during the term of this Agreement, and also to define other terms and conditions in the contractual arrangement between the Parties; NOW THEREFORE, IN CONSIDERATION of the premises and mutual covenants hereinafter contained, the Parties agree as follows: 1. CONTRACT PERIOD. This Agreement covers services provided during the period beginning on July 1, 2017, and shall continue and remain in effect through the last day on which the Medical Examiner serves as the Interim Medical Examiner, unless terminated earlier pursuant to paragraph 14 below. 2. SCOPE OF SERVICES. Medical Examiner shall provide the work plan, staffing and services as necessary to carry out the functions of the district medical examiner as set forth in Ch. 406, F.S., and Title I IG, F.A.C. The Medical Examiner agrees that he will serve as the 1 full time medical examiner for District 16, and shall reside in Monroe County, Florida, in order to be available in person on a regular basis during the term of this Agreement. These services shall include the completion of death certification, autopsy reports and related paperwork for all cases accepted during the term of this Agreement. The staff of the office shall be employed by and shall be directly responsible to the Medical Examiner, and shall include such positions necessary for the delivery of services under this Agreement. Services provided by the Medical Examiner and any member of his staff as an expert witness or private consultant on medical examiner cases are outside the Scope of Services of this Agreement. The Medical Examiner warrants and agrees that he is a practicing physician in pathology as required by Chapter 406, F.S. and holds the required licensure to perform the duties of the medical examiner in Monroe County. 3. AMOUNT OF AGREEMENT /PAYMENT. The annual amount of money set aside in the FY 2017 budget for the Medical Examiner's office, exclusive of fees generated by cremation approvals, is six hundred eighty -six thousand fifty -five dollars and no cents ($686, 055.00) ( "Budgeted Amount "), which on a monthly basis is fifty -seven thousand one hundred seventy -one dollars and twenty -five cents ($57,171.25) ( "Monthly Amount ") as shown on Attachment A to this Agreement, incorporated herein by reference. A) Compensation/Salaries and Operating Expenses: The County agrees to compensate the Medical Examiner for services based on his actual, reasonable and necessary costs and expenses, provided, however, that such compensation shall not exceed the Budgeted Amount except as provided in paragraph 3(E), below. At the beginning of this Agreement, within ten (10) days following execution of this Agreement by both parties, the County shall provide an initial payment equal to the Monthly Amount. Thereafter, through the term of this Agreement, the Medical Examiner may request reimbursement for payments made by the Medical Examiner. The request for reimbursement may be made as frequently as the Medical Examiner wishes. The Medical Examiner shall submit the request for reimbursement and supporting documentation to the County Administrator, describing the services performed or goods purchased, on a letter which must contain a notarized certification statement. An example of the reimbursement request cover letter is included hereto as Attachment B. The submission must be in a form satisfactory to the County Administrator and the Clerk of the Circuit Court (Clerk), and must identify expenditures incurred, with adequate supporting documentation, including receipts for paid bills and purchases. If the County Administrator approves the submission, he shall forward the same to the Clerk. If the County Administrator or Clerk determines that any expenditure is questionable, either of them shall return it to the Medical Examiner in writing with a written description of the deficiency(ies) and a request for further information. The County Administrator and Clerk shall approve any expenditure reasonably related to the delivery of services under Chapter 406 and this Agreement, to include at a minimum, but not be limited to, salary for the Medical Examiner in the amount of $23,833.33 per month, salaries for employees in the amount of $10,400.00 per month, and funds for locum tenens covering doctors in the amount of $1,500.00 per day at 2.33 days per month. The total of 2 reimbursement payments to the Medical Examiner for the fiscal year in the aggregate including the advance shall not exceed the total amount approved by the Board of County Commissioners for the budget of the Medical Examiner for FY 2017. Any portion of the Budgeted Amount that is not actually used by the Medical Examiner shall be retained by the County at the end of the fiscal year, encumbered for the office, and added to the budget request for the next fiscal year. B) Budget: For each year beginning with FY 2019, the Medical Examiner shall submit a proposed budget for the upcoming fiscal year, no later than May 1 prior to the start of the fiscal year. The budget submission shall include a budget proposal for all services, and shall indicate the previous fiscal year's actual, current fiscal year estimated, and subsequent fiscal year's proposed revenue and expenses. C) The County shall only reimburse those expenses that are reviewed and approved as complying with this Agreement, state and federal laws and regulations, and Monroe County Code of Ordinances. D) The Medical Examiner's final request for reimbursement must be received no later than sixty (60) days following the termination of this Agreement. E) Any funds received by the Medical Examiner from the County must be used exclusively for the performance of services in accordance with paragraph 2 of this Agreement. Any funds received by the Medical Examiner from the County in connection with this Agreement must be placed in a segregated bank account used exclusively for the Medical Examiner's office, and the funds in the account shall not be commingled with personal funds belonging to the Medical Examiner. F) In the event of a disaster or occurrence unusual in nature or magnitude, the Medical Examiner may petition the Board of County Commissioners to increase the budget in order to allow for reimbursement of all additional extraordinary expenses and compensation due to the disaster. G) Fees: The fees to be charged by the Medical Examiner are shown on Attachment C, attached hereto. Any increase in fees to be charged by the Medical Examiner requires the prior written approval of the Board of County Commissioners. The Medical Examiner is responsible for billing and collection of fees. Any fees collected become and remain the property of the Medical Examiner and may be used for any lawful purpose. H) This Agreement is subject to annual appropriation by the Board of County Commissioners. 4. ACCOUNTING AND RECORDS; AUDITS. A) The Medical Examiner agrees to establish and maintain all books, records, and documents related to performance under this Agreement in accordance with generally accepted accounting principles consistently applied (GAAP). The County or its designee, the Florida Department of Law Enforcement, and the Auditor General for the State of Florida shall have reasonable and timely access to such records and reports for inspection or public records purposes, or for the purpose of conducting an audit, during the term of this Agreement and for 3 five (5) years following the termination of this Agreement. B) The County reserves the right to conduct an audit of the Medical Examiner's books and records related to performance of this Agreement. If an auditor employed by the County or Clerk determines that monies paid to the Medical Examiner pursuant to this Agreement were spent for purposes not authorized by this Agreement, the Medical Examiner shall repay the monies together with interest calculated thereon pursuant to Section 55.03, Florida Statutes, running from the date the monies were paid to the Medical Examiner. As used in this Agreement, the term "audit" means the activity of evaluating the adequacy and effectiveness of organization's risks and control processes regarding the: 1. Reliability and integrity of financial and operational information; 2. Effectiveness and efficiency of operations and programs; 3. Safeguard of assets; and 4. Compliance with laws, regulations, policies, procedures and contracts. Generally, audit scope may involve performance, operational, financial, compliance, and information technology reviews. C) The County reserves the right to conduct site visits, up to four (4) times per year. The site visits shall consist of an observation of non - medical activities and processes. The purpose of the site visits shall be to ensure compliance with contract terms and conditions and to inventory assets. The Medical Examiner agrees to cooperate with designated County staff in order to facilitate the site visits. 5. OFFICE/EQUIPMENT /FACILITY A) Any equipment or supplies purchased with funds supplied by the County shall be maintained at the County's Medical Examiner facility, located at 56639 Overseas Highway, Marathon, Florida. B) The County is the owner of the facility, equipment and supplies, including but not limited to capital assets, for which the County has provided funding (including but not limited to the facility, equipment, furniture, furnishings, and vehicles), other than personal items purchased with any salary paid to the Medical Examiner. The Medical Examiner is responsible to County for the safekeeping and proper use of the equipment and supplies entrusted to Medical Examiner's care. To the extent that equipment and supplies (including but not limited to capital assets) are titled, all titles will be held in the name of Monroe County. All equipment and supplies shall be relinquished to County upon termination of this agreement. C) All capital assets will be inventoried in accordance with Monroe County Administrative Instruction 4725. 1, a copy of which shall be provided to the Medical Examiner. An inventory of capital assets dated May 30, 2017 is attached hereto to this Agreement as Attachment D. For the purpose of this paragraph the definition of a "capital asset" means any item with an expected life of greater than one (1) year, in which the original value of the item is equal to or greater than one thousand dollars ($1,000.00). D) In regards to maintenance of the facility, the County is responsible for: 1. Maintenance and repairs to facility; 2 2. Utilities, to include normal waste refuse services, electric and water; and 3. Payment for telephone (land line), facsimile and data ( internet) service for the facility. And the Medical Examiner is responsible for: 1. Biohazardous waste collection and disposal services. 2. Janitorial services for the facility. 6. MODIFICATIONS AND AMENDMENTS. Any and all modifications and amendments of this agreement shall be approved by the County and Medical Examiner in writing. No modification or amendment shall become effective until approved in writing by both parties. 7. ASSIGNMENT. This Agreement may not be assigned. 8. INDEMNIFICATION. Medical Examiner hereby agrees to indemnify and hold harmless the County and any of its officers and employees from and against any and all claims, liabilities. litigation, causes of action, damages, costs, expenses - including but not limited to fees and expenses arising from any factual investigation. discovery or preparation for litigation - and the payment of any and all of the foregoing or any demands, settlements or judgments (collectively the "Claims ") arising directly or indirectly from any negligence or criminal conduct on the part of Medical Examiner, or subcontractors, in the performance of the terms of this Agreement except to the extent that, in the case of any act of negligence, Medical Examiner reasonably relied on material supplied by, or any employee of the County. 9. ANTI - DISCRIMINATION. Medical Examiner will not discriminate against any person on the basis of race, ethnicity, religion, sex, age, national origin, disability, pregnancy, sexual orientation, or any other characteristic which is not job- related, in recruiting, hiring, promoting, terminating or any other area affecting employment under this Agreement. Medical Examiner agrees to abide by all Federal and State laws regarding non- discrimination. 10. ANTI - KICKBACK. Medical Examiner warrants that he has not employed, retained or otherwise had acted on his behalf any former county officer subject to the prohibition in Section 2 of Ordinance No. 10 -1990 or any county officer or employee in violation of Section 3 of Ordinance No. 10 -1990, and that no employee or officer of the County has any interest, financially or otherwise, in Medical Examiner except for such interests permissible by law and fully disclosed by affidavit attached hereto. For breach or violation of this paragraph, the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former county officer or employee. 11. PUBLIC ENTITY CRIME. A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, any 5 may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, F.S., for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 12. COMPLIANCE WITH LAW. Medical Examiner shall comply with all federal, state, and local laws, ordinances, regulations and rules applicable to the services to be performed by each party under the terms of this Agreement. Medical Examiner shall maintain such licensure as is required by law to carry out the services in this Agreement. 13. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, Medical Examiner is an independent contractor and not an employee, agent or servant of the County or of the Florida Department of Law Enforcement. No statement in this Agreement shall be construed so as to find Medical Examiner or any of its employees, contractors, servants, or agents to be employees of the County or State, and they shall be entitled to none of the rights, privileges, or benefits of employees of County or State. The Medical Examiner may subcontract for performance of services as deemed necessary and shall be ultimately responsible legally, operationally, and financially for any such subcontracts; any subcontracts shall be of similarly licensed individuals. 14. TERMINATION. A) Should County determine that this agreement should be terminated for cause, it shall notify the Medical Examiners Commission and the Governor as soon as is feasible after the occurrence(s) that is(are) the basis for such termination. Recognizing that the Governor and Medical Examiners Commission have the sole authority to suspend or remove the Medical Examiner pursuant to Sections 406.06 and 406.075, Florida Statutes, the County may only terminate or reduce payment under this Agreement for failure of the Medical Examiner to fulfill the terms of this Agreement or other violations of the provisions of the Agreement. In this event, the County shall give written notice to the Medical Examiner of intent to terminate the Agreement, at least sixty (60) days in advance of the intended termination date, which notice shall specify cause. The notice may allow a time period during which the breach may be cured. The County shall pay Medical Examiner fair and equitable compensation for all expenses incurred prior to termination of the Agreement. B) The Medical Examiner may terminate this agreement with or without cause upon giving County sixty (60) days prior written notice. C) In the event that the Governor appoints a successor to the Medical Examiner named herein, this Agreement shall terminate on the day prior to the effective date of such successor's appointment. 15. INSURANCE. The Medical Examiner shall maintain and comply with the insurance requirements as specified below, which include Professional Liability insurance in accordance with FS 406.16. The cost of the insurance coverage is a cost within the Medical Examiner's Budget. R General Insurance Requirements As a pre- requisite of the work governed by this contract (including the pre- staging of personnel and material), the Medical Examiner shall obtain, at his/her own expense, insurance as specified below. The County shall reimburse the Medical Examiner for the cost of the specified Medical Professional Liability. The Medical Examiner shall require all Subcontractors to obtain insurance consistent with the schedules below; and provide proof of insurance in effect during term of subcontract to medical examiner and county upon request from the county. The Medical Examiner will not be permitted to commence work governed by this contract (including pre- staging of personnel and material) until satisfactory evidence of the required insurance has been furnished to the County as specified below. Delays in the commencement of work, resulting from the failure of the Medical Examiner to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the Medical Examiner's failure to provide satisfactory evidence. The Medical Examiner shall provide a certificate showing evidence of each type of coverage prior to start of this Agreement; shall maintain the required insurance throughout the entire term of this contract and any extensions; and shall notify the County at least thirty (30) days prior to any lapse or change in amount of coverage. Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced. Delays in the completion of work resulting from the failure of the Medical Examiner to maintain the required insurance shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work had not been suspended, except for the Medical Examiner's failure to maintain the required insurance. The Contractor shall provide, to the County, as satisfactory evidence of the required insurance, either: • Certificate of Insurance, or a Certified copy of the actual insurance policy. The County, at its sole option, has the right to request a certified copy of any or all insurance policies required by this contract. All insurance policies must specify that they are not subject to cancellation, non- renewal, material change, or reduction in coverage unless the insurer gives a minimum of thirty (30) days prior notification to the County. The acceptance and/or approval of the Medical Examiner's insurance shall not be construed as relieving the Medical Examiner from any liability or obligation assumed under this contract or imposed by law. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on all policies, except for Workers' Compensation. Any deviations from these General Insurance Requirements must be requested in writing on the County prepared form entitled "Request for Waiver of Insurance Requirements" and approved by Monroe County Risk Management. 7 General Liability. Prior to the commencement of work governed by this contract, the Medical Examiner 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 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. Vehicle Liability. Recognizing that the work governed by this contract requires the use of vehicles, the Medical Examiner, prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum, liability coverage for: 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 The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. Medical Professional Liability. Recognizing that the work governed by this contract involves the providing of professional medical treatment, the Medical Examiner shall purchase and maintain, throughout the life of the contract. Professional Liability Insurance which will respond to the rendering of, or failure to render medical professional services under this contract. The minimum limits of liability shall be: $500,000 per Occurrence /$1,000,000 Aggregate If coverage is provided on a claims made basis, an extended claims reporting period of four (4) years will be required. Workers' Compensation. Prior to the commencement of work governed by this contract, the Medical Examiner 8 shall obtain Workers' Compensation Insurance with limits sufficient to respond to Florida Statute 440. In addition, the Medical Examiner shall obtain Employers' Liability Insurance with limits of 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 the Medical Examiner has been approved by the Florida's Department of Labor as an authorized self - insurer, the County shall recognize and honor the Medical Examiner's status. The Medical Examiner may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Medical Examiner's Excess Insurance Program. If the Medical Examiner participates in a self - insurance fund, a Certificate of Insurance will be required. In addition, the Medical Examiner may be required to submit updated financial statements from the fund upon request from the County. 16. SEVERABILITY. If any provision of the Agreement shall be held by a court of competent jurisdiction to be invalid or unenforceable, the remainder of this Agreement or the application of such provision other than those as to which it is invalid or unenforceable, shall not be effected thereby; and each provision of the Agreement shall be valid and enforceable to the fullest extent permitted by law. 17. NOTICE. Unless specifically provided otherwise in this Agreement, any notice required or permitted under this Agreement shall be in writing and hand- delivered or mailed, postage prepaid by certified mail, return receipt requested, to the other party as follows: To County: Monroe County Administrator 1100 Simonton Street, 2 n Floor Key West, FL 33040 To Medical Examiner: Michael Steckbauer, M.D. 57560 Overseas Highway Marathon, FL 33050 18. CONSENT TO JURISDICTION. This Agreement, its performance, and all disputes arising hereunder, shall be governed by the laws of the State of Florida and both parties agree that a proper venue for any action shall be Monroe County. 19. REPORTS. The Medical Examiner provide the County with a monthly report, which shall be submitted on a monthly basis beginning with the Effective Date of this Agreement, which shall include, as a minimum the following: 9 • Number of cases reported and accepted. • Number of all autopsies performed. • List of cremation approvals, with, at a minimum, date of death, name of decedent and name of funeral home. • Hours of court activities for District 16 (by attorney conferences, deposition, and grand jury or court testimony). The activity report shall be submitted by the 10th day of the following month to the County Administrator. In addition, on an annual basis, the Medical Examiner shall submit a list of cases in which fees were collected, showing the type of fee and amount collected. 20. ENTIRE AGREEMENT. This Agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between Medical Examiner and the County. 21. Nothing in this Agreement shall preclude the Medical Examiner from engaging in the private practice of medicine or surgery pursuant to section 406.06(4), Florida Statutes, provided such practice does not interfere with the Medical Examiner's official duties under this Agreement. 22. GENERAL REQUIREMENTS OF COUNTY CONTRACTS: A) Code of Ethics. Both Parties agree that officers and employees of the County are required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. B) Public Records: Pursuant to F.S. 119.0701, the Medical Examiner, his employees and any contactors or subcontractors shall comply with all public records laws of the State of Florida, including but not limited to: i. Keep and maintain public records required by Monroe County in order to perform the service. ii. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Florida Statutes, Chapter 119 or as otherwise provided by law. iii. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the contractor 10 does not transfer the records to the public agency. iv. Upon completion of the contract, transfer, at no cost, to Monroe County all public records in possession of the contractor or keep and maintain public records required by the public agency to perform the service. If the contractor transfers all public records to the public agency upon completion of the contract, the contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the contractor keeps and maintains public records upon completion of the contract, the contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to Monroe County, upon request from the public agency's custodian of records, in a format that is compatible with the information technology systems of Monroe County. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY, AT (305) 292 -3470, bradle -b� riangmonroecounty- fl.g_ov c/o Monroe County Attorney's Office, 1111 12 St., Suite 408, Key West FL 33040. C) 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. Electronic signatures shall be recognized with equal validity as original signatures. I . ITNES S above written. u Ma WHEREOF, the parties hereto have executed this Agreement as of the date first Clerk Deputy Clerk l�J�= f�ess�s ZA NA 72 BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIVA 0 a• rn C) 7S O r n B o Mayor /Chairman v o MEDICAL EXAMINER MONROE COUNTY ATTORNEY APP VED S T, FpR(N� CYNTHIA L. HALL �� KK � ^ �'� ASSISTANT COUNTY ATTORNEY Date `�-- (f. - &6 B Michael R. Steckbauer, M.D., G r Zpl� 5 X 11 District 16 OFFICE OF THE MEDICAL EXAMINER Thomas R. Beaver, M.D. (Attachment A Medical Examiner PO Box 523207 Telephone: (305) 743 -9011 Marathon Shores, Florida 33052 Fax: (305) 743 -9013 Email: districtl6medicalexaminer @gmaii.com February 21, 2016 IF �+ Roman Gastesi, County Administrator Tina Boan, Budget Director FEB 2 3 2016 Office of Management and Budget i3 1100 Simonton Street, Suite 2 -213 y Key West, FL 33040 r Greetings, In the spirit of openness and transparency, I am offering a detailed budget for the projected expenditures of the Office of the Medical Examiner for Fiscal Year 2016- 2017.1 wish to note that none of the previous Medical Examiners have done this. The geography and demographics of Monroe County place unique challenges on the Medical Examiner. As a solo physician practice the Medical Examiner is on -call 24 hours a day, every day. The Medical Examiner may have to attend a °x death scene in Key West and another in Key Largo all in the same evening. The very nature of the duties and responsibilities of the Medical Examiner (FS406) defy budgetary predictability. In the preparation of this budget I have used the actual expenditures from 2015. I realize that there is a contract that specifies (and limits) the amount of money Monroe County spends for Medical Examiner services. That contract defines the Medical Examiner as an independent contractor and the financial risks are placed on the contractor. In 2015 Monroe County conducted a financial audit of the corporation contracted with the county. I am in receipt of a draft copy of the audit report. Although I do not agree with all of the assertions and recommendations, I have made significant changes some of which are reflected in this budget. I have been careful to extract any purchase not directly related to medical examiner operations. I have also restructured the benefits package offered to employees including the physician. I welcome the opportunity to personally discuss this budget. Sin erely, i om R. Beaver, M.D. Revenue Monroe County Income Cremationa Approvals Total Revenues Expenses Conferences & Meetings Continuing Education Dues and Subscriptions Insurances Janitorial and Cleaning Laboratory Fees Licenses and Fees Office Expenses Salaries and Wages Payroll Taxes Postage and Shipping Professional Services Small Medical Equipment SuppliesNaccines/Drugs Telephone Transportation Expense Travel Expense Uniforms Cable /Internet Waste Removal Total Expenses Thomas R Beaver MD PA Proposed 2016 - 2017 Budget Medical Examiner Office Monroe County Total Needed From Monroe County Monthly Stipend Notes: See attached document for details. 2016-2017 Proposed Budget 686,055.00 12,000.00 698,055.00 500.00 1,000.00 1,000.00 38,775.00 1,500.00 47,700.00 3,200.00 8,560.00 355,720.00 28,000.00 3,000.00 74,800.00 3,000.00 15,000.00 4,900.00 87,500.00 7,800.00 500.00 3.600.00 12,000.00 698,055.00 $ 686,055.00 $ 57,171.25 Note Number #1 #2 #3 #4 #5 #6 #7 #8 #9 #10 #11 #12 #13 #14 #15 #16 #17 #18 #i9 #20 #21 #22 11mk2f2112016Z:N- CLIENTSIThomas R Beaver MD PA%Budget 2016 - 2017 District 16 OFFICE OF THE MEDICAL EXAMINER Thomas R. Seaver, M.D. Medical Examiner PO Box 523207 Telephone: (305) 743 -9011 Marathon Shores, Florida 33052 Fax: (305) 743 -9013 Email: districtl6medicalexaminer @gmail.com Notes for Budget lines: Note 1: Total funds required from Monroe County for 2016 - 2017 Fiscal Year. Nate 2: Cremation Approvals 'it $50 /each which just covers the additional cost. The amount is an estimate which is based on historical data (cremations approved in 2015). Currently, legislation is being considered which would prohibit the Medical Examiner from charging this fee. Note 3: Medical Examiner conferences and meetings which includes Medical Examiner Commission meetings. Note 4: Annual Continuing Education costs required to maintain medical license and certifications. Note 5: Annual professional dues which includes dues for the American Medical Association, the Florida Medical Association, the Florida Association of Medical Examiners, the National Association of Medical Examiners, and the American Academy of Forensic Sciences. Note 6: Insurances includes Liability, Professional, Medical, and Workman's Compensation. Insurance premiums included with minimal increase for FY2017. Note 7: Janitorial and Cleaning services for building maintenance. Note 8: Laboratory Costs include blood testing, tissue testing, dental comparison and forensic anthropology. This is an estimate based on historical data. Toxicological testing is required on most autopsies. The cost is based on the number of tests and the complexity of the testing. I estimate a cost of $200 per case for FY2017. Note 9: Professional License and fee renewals for doctor and corporation. Note 10: Office Expenses are based on actual 2015 expenses. Almost all of the office supplies are purchased from Office Depot online. In preparation of this budget, I reviewed those purchases and I have been careful to exclude all items suggested in the Monroe County Audit. t District 16 OFFICE OF THE MEDICAL EXAMINER Thomas R. Beaver, M.D. Medical Examiner PO Box 523207 Telephone: (305) 743 -9011 Marathon Shores, Florida 33052 Fax: (305) 743 -9013 Email: district16medicalexaminer @gmaif.com Note 11: Salaries and Wages for 4 employees including 1 Doctor. The previous medical examiner, Dr. Hunt Scheurman, was paid an annual gross salary of $220,000.00. I am requesting that salary. I am on -call 24 hours per day, 7 days a week, and 52 weeks a year. ERi SalaryExpert lists the average salary of a Forensic Medical Examiner in Miami as $301,995. See attachment A. The other employees are hourly- workers and get paid overtime when they are on -call to assist me. I have estimated overtime based on historical data at 6 hours per week. The previous Medical Examiner paid hourly employees 10 hours per week overtime for a week on -call. Note 12: Payroll taxes including Social Security, Medicare, FUTA, and SUTA are based on salaries and wages. Note 13: Postage and Shipping includes sending toxicology specimens, reports, materials for scientific identification, and forensic anthropology. They are shipped via FedEx for security and timeliness. e 1 Note 14: Locum tenens doctors, accounting, answering service, and investigative analysis, legal services, radiation monitoring, and transcription services are all required to perform the functions of the medical examiner's office. When I am sick or leave the county I am required to provide a qualified physician for coverage. These doctors charge $1500 per day. This estimate is based on 4 weeks per year of physician coverage. Which leaves me to work and be on -call 337 days per year. A normal work year is 260 days. Note 15: Small medical tools and equipment includes scissors, scalpel handles, retractors, clamps, autopsy saw and blades. For example, scissors last about I month and cost $30. Saw blades are replaced every month and cost $80. Other small tools (listed above) must be replaced periodically. The autopsy saw needs yearly maintenance which is approximately $1000. I have been careful to exclude items suggested by the audit. Note 16: Supplies, Vaccines, Drugs, Needles, Protective Equipment, Body Bags, etc. costs are based on actual historical data. The Medical Examiner's office supplies body bags for body transport. Two bags are used for each case. One bag to bring the body to the office and one to release the body. Body bags cost between $14 and $45 depending on size and weight. I need to have a supply of at least 50 body bags in case of a mass fatality event. A plastic liner is also used for each case which costs $3.00. Body fluids are collected from each body by syringe and needle. Four syringes and needles are needed for each case. Disposable personal protective equipment for each person at the autopsy consists of hat, mask, face shield, gown, shoe covers, and gloves. I require all morgue staff to wear scrubs for their health and safety. Scrubs are laundered in the morgue. District 16 OFFICE OF THE MEDICAL EXAMINER Thomas R. Beaver, M.D. Medical Examiner PO Box 523207 Telephone: (305) 743 -9011 Marathon Shores, Florida 33052 Fax: (305) 743 -9013 Email: districtl6medica ►examiner @gmail.com Note 17: Telephones for the office, on -call phone costs are based on actual 2015 expenditures. All communication with the Medical Examiner is by telephone. It is critical that Law Enforcement, hospitals, and citizens be able to reach the Medical Examiner 24,17/365. These are landline phones, located in the facility, and three cell phones. An on -call phone for an investigator, an on -call phone for the physician, and a back -up on -call phone. Note 18: Removal of 250 bodies per year at a cost of $350 per body. The previous Medical Examiner paid $350 per body to the funeral home for transport. Note 19: Gas for travel to scenes, etc. is required as the Medical Examiner is requested and /or required to attend the body at every scene in the case of an out -of - hospital death. Also the Medical Examiner is sometimes required to respond to the hospital for suspicious cases. c_ ' Note 20: Uniforms, shirts, badges, etc. are supplied by the Medical Examiner for employees including new hires. Some of these items must be replaced periodically due to contamination with biohazardous materials. Note 21: Internet service as provided by Monroe county is slow and unreliable. Many times I have used my wireless service to keep the office functioning and staff working. For speed and redundancy reasons I maintain a wireless network for the office. Note 22: The Medical Examiner generates biohazardous material requiring specialized waste disposal similar to a hospital. Charges for this service are based on weight and amount which vary with caseload and case specifics. The amount budgeted is based on actual 2015 expenditures with no anticipated increase in FY 2017. Note: Costs of outside services such as laboratory, toxicology, medical waste, insurances, purchase of supplies, etc. are based on current costs with no increase included. This most likely is not a realistic position as costs increase annually in all facets of life. Attachment B (Request for Reimbursement Form) Monroe County Board of County Commissioners County Administrator 1100 Simonton St., 2 nd floor Key West, FL 33040 Date: The following is a summary of expenses for the Medical Examiner's office for the time period of to Check # Payee Reason Amount (A) Total $X,XXX.00 (C) Total requested $X,XXX.00 (D) Total budgeted amount in current FY $X,XXX.00 Balance of budgeted amount remaining $X,XXX.00 I certify that the above checks have been paid to the vendors as noted, and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this office's contract with Monroe County and will not be submitted for reimbursement to any other funding source. Michael R. Steckbauer, M.D., Medical Examiner Attachments (supporting documentation) Sworn and subscribed before me this day of , 2017, by who is personally known tome. Notary Public Notary Stamp Attachment C, Fee Resolut RESOLUTIONNO. 007 —2009 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA AUTHORIZING THE DISTRICT 16 MEDICAL EXAMINER OFFICE TO ESTABLISH FEES TO BE CHARGED TO THIRD PARTIES FOR SPECIFIC SERVICES AS SET FORTH IN EXHIBIT "A" ATTACHED HERETO AND MADE A PART OF THIS RESOLUTION WHEREAS, F. S. Chapter 406 establishes Medical Examiner Districts; and WHEREAS, F. S. 406.06(3) provides that the District Medical Examiners shall be entitled to compensation and such reasonable salary and fees as are established by the Board of County Commissioners in the respective Districts; and WHEREAS, on August 20, 2008, the Board of County Commissioners approved the Medical Examiner Agreement between the Monroe County and E. Hunt Scheuerman, M.D., to provide District 16 Medical Examiner services; and WHEREAS, in accordance with Section 3 of the Agreement, the Medical Examiner shall develop a schedule of reasonable and customary fees which shall be charged to third parties for specific services, and WHEREAS, the Medical Examiner Office has recommended the attached Fee Schedule for approval by the Board of County Commissioners; and WHEREAS, the Board of County Commissioners hereby desires that a fee schedule be established for use by the Medical Examiner Office; NOW THEREFORE; BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA; 1. That the Board hereby approves the attached Fee Schedule for use by the District 16 Medical Examiner Office. 2. It is agreed that the revenue received from the collection of such fees shall be retained and accounted for by the Medical Examiner and used for operating expenses, thus reducing the overall level of County funding required for Medical Examiner activities in subsequent years, as negotiated. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida at a regular meeting held on the 28 th day of January, A.D., 2009. Mayor George Neugent Yes Mayor Pro Tem Sylvia Murphy Yes Commissioner Kim Wigington Yes Commissioner Heather Carruthers Yes Commissioner Mario DiGennaro _ Yes BOARD OF COUNTY COMMISSIONERS L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA "C'eZ& BY: � I ty Clerk Mayor C � � V _ SCS © p La:. � r1C_;o © Q � .ViONPOE COUNTY ATTORNEY Ap -ROVED AS TO M• "ANN � ,T � rE H iUTTON CJUV District 16 Medical Examiner Office Fee Schedule 1. Reports and other paper work: EXHIBIT A a. Copy free to investigating agencies, SAO, PDO, family (2) b. All others $0.15 /page plus 1 hour administration time (currently $16.00) 2. Photographs (handled in accordance with FS 406.135): $20.04 (includes CD and time required to make copy of photos) 3. Microscopic Slides: a. Recuts from existing blocks I. $8.00 per slide 2. Physician time to review slides $75.00 b. Requests for slides from case without initial microscopic exam L $8.00 per slide 2. Physician time to select and tissue plus review slides $300.00 4. Approval of cremations, body donations and burials at sea — no charge 5. State cases, as per FS 406.08, are charged as follows: a. Body removal/ transportation - $ 150.00 b. Investigation and inspection (external examination only) - $ 800.00 c. Investigation and autopsy - $2400.00 6. Private autopsy performed by medical examiner, fee for facility and equipment use as well as for reimbursement for expendable supplies - $1000.00 7. Expert Witness Fees a. Criminal cases District 16 ME cases — no fee b. Civil cases District 16 ME cases — no fee c. Criminal cases, consultations etc. from outside District 16 -- Private practice as allowed under FS 406.06 d. Civil cases, from non - District 16 cases and others -- Private practice as allowed under FS 406.06 RESOLUTION NO. 001 — 2011 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA AMENDING RESOLUTION NO. 007 -2009 IN ORDER TO PROVIDE FOR A CREMATION APPROVAL FEE WHEREAS, on January 28, 2009, the Board of County Commissioners approved Resolution 007 -2009, authorizing the District 16 Medical Examiner Office to establish fees to be charged for third parties for specific services; and WHEREAS, S. 497.607, F.S., requires that a legally authorized person provide written authorization for a cremation; and WHEREAS, S.497.002(37) includes the medical examiner in the list of legally authorized persons; and WHEREAS, S. 406.08, F.S., specifies that certain agencies shall pay the fees for medical examiner services for bodies of persons who dies in their custody, that the state may pay all or part of fees for transportation services that might otherwise have been borne by the County, indicating that there are fees attributable to medical examiner services; and WHEREAS, S. 406.11(1)(c), F.S. requires the medical examiner to determine the cause of death when a body is to be cremated, regardless of which legally authorized person arranges for cremation; and WHEREAS, the state has not pre - empted the ability to locally determine fees to be charged for services related to cremation; and WHEREAS, the general rule regarding fees for services is that they must be related to the cost of providing that service, which would allow the fee to be set at the average cost of providing the service even though in some instances the actual cost may be slightly higher or lower than the fee. NOW THEREFORE; BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA; 1. Resolution No. 007 -2009 is hereby amended to add an eighth item to Exhibit A for Fees to be charged to Third Parties for Specific Services as follows: 8. Cremation Approval Fee $50.00 2. All other provisions of Resolution No. OQ7 -2009 and Exhibit A remain in full force and effect. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida at a regular meeting held on the 19th day of January A.D., 2011. Mayor Heather Carruthers Yes Mayor Pro Tern David Rice Yes Commissioner Kim Wigington Yes Commissioner George Neugent Yes Commissioner Sylvia Murphy Yes BOARD OF COU TY COMMISSIONERS � OF MONROE C N ,FLORIDA NY L. KOLHAGE, CLERK BY: 0.10,qa& Deputy Clerk Mayor MED Ex Fee Res Revising for Cremation Fees A- Pr ^ ��VD AST -r r. c\j c� u LL- MED Ex Fee Res Revising for Cremation Fees RESOLUTION NO. 135 _ 2011 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA AMENDING RESOLUTION NO. 007 -2009, AS AMENDED BY RESOLUTION NO. 001 -2011 IN ORDER TO PROVIDE FOR A STORAGE FEE FOR LONG -TERM STORAGE OF BODIES BY THE MEDICAL EXAMINER. WHEREAS, on January 28, 2009, the Board of County Commissioners approved Resolution 007 -2009, authorizing the District 16 Medical Examiner Office to establish fees to be charged for third parties for specific services; and WHEREAS, on January 19, 2011, the BOCC amended that resolution with resolution No. 001 -2011; and WHEREAS, S. 406.08, F.S., specifies that certain agencies shall pay the fees for medical examiner services for bodies of persons who dies in their custody, that the state may pay all or part of fees for transportation services that might otherwise have been borne by the County, indicating that there are fees attributable to medical examiner services; and WHEREAS, S. 406.58(2), F.S. specifically allows the anatomical board to collect storage fees for their storage services, recognizing that storage of a body for a lengthy time should be subject to fees; and WHEREAS, the state has not pre - empted the ability to locally determine fees to be charged for storage services; and WHEREAS, the Medical Examiner regularly experiences that storage is required for a number of days due to a high number of unexpected deaths, often of visitors whose families have to make arrangements for transport, or due to other reasons delaying the ability to have the body picked up by a funeral home, but that such short-term storage does not normally present problems; and WHEREAS, there are sometimes circumstances where there reasons unrelated to logistical problems which include that the families do not want to pay for the disposition of the body but the existence of assets precludes the County from processing the body as a pauper, leaving the long process of administration without probate to a funeral home to get paid to dispose of the body; and WHEREAS, it is intended that storage fees not be assessed to families who have to take a few days to iron out logistics to deal with the unexpected death of a loved one; and WHEREAS, it is intended to have storage fees assessed in situations that the body could have reasonably been claimed in a timely manner, but it was not and there are decedent assets which could be used to cover the costs of storage; and WHEREAS, it is intended that the Medical Examiner be able to charge for storage and charge fees which can be paid by a responsible party or sought through the administration without probate process; NOW THEREFORE; BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA; 1. Resolution No. 007 -2009, as amended by Resolution 001 -2011, shall be amended by adding to Established Fees to be charged to Third Parties for Specific Services the following fee: 9. Storage Fee $50.00 per day, commencing as of the 15` day of storage This fee may be waived by the Medical Examiner upon provision of an explanation to the County Administrator showing good reason for the waiver and upon the Administrator's approval of the waiver. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida at a regular meeting held on the 18th day of May , A.D., 2011. !�!" c � = C_ Mayor Heather Carruthers Yes - Mayor Pro Tern David Rice Yes _ p O Commissioner Kim Wigington Yes " - Commissioner George Neugent Yes Commissioner Sylvia Murphy Yes o f }l c n BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA DANNY L. 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It is not an insurance policy and is issued for informational purposes only. It confers no rights upon the certificate holder and does not create a contract between NORCAL Mutual Insurance Company ( NORCAL Mutual) and the certificate holder, nor does it amend, extend, or alter the policy's coverage. Notwithstanding any requirement or provision of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policy is subject to the provisions of the policy. The Insured is responsible for informing certificate recipients of any policy changes, including declination of issuance or cancellation before the expiration date. An Insured's failure to provide such notice imposes no obligation or liability of any kind upon NORCAL Mutual, its agents or representatives. Coverages and Limits of Coverage Provided Coverage A: Medical Professional Limits of Coverage: Liability Insurance - Claims Made Retroactive Date: 07/01/2017 $500,000 Each Claim limit $1,500,000 Aggregate Limit Per Policy Period Coverage B: Administrative Defense Limits of Coverage: Insurance - Claims Made Retroactive Date: 07/01/2017 $50,000 Each Administrative Proceeding or Employment - Related Civil Action Limit $50,000 Aggregate Limit Per Endorsement Period Coverage C: Information and Network Limits of Coverage: Security Insurance - Claims Made Retroactive Date: 07/01/2017 $100,000 Each Claim, Regulatory Privacy Proceeding, or Loss Limit $100,000 Aggregate Limit Per Endorsement Period By: NORCAL Mutual Insurance Company Date Issued: August 09, 2017 _ytti��� T. Scott Diener Kara M. Ricci BY V RISK MENf WA A YS_ CVAC Cc= AI HCPCOI -001 Page 1 of 1 12/01/2014 560 DAVIS STREET, SUITE 200, SAN FRANCISCO, CA 94111 -1966 DATE (MM /DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08/03/2017 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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 lieu of such endorsement(s). PRODUCER CONTACT NAME: NUTMEG INS AGENCY INC /PHS [( A PHON E ir u c f� (888) 925 -3137 FAX .No): (888) 443 -6112 76210775 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO, TX 78265 INSURED MICHAEL R. STECKBAUER, MD, M & M P.A. 2850 SW 154TH AVE DAVIE FL 33331 -2601 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICft INSURER A: The Hartford Casualty Insurance 29424 INSURER E: INSURER C : INSURER D: INSURER E: INSURER F: C OVERAGES CERTIFICATE NUMBER: tctVIZIUN rvurvlor-me THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUB WVD POLICY NUMBER POLICY EFF MM /DDM(YY POLICY EXP MM DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE F1 OCCUR DAMAGE RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ P LICY ❑ PRO ❑ LOC JECT $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS Per Oa PR O P ERTY DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION X STATUTE I IER 1OT H- $ E.L. EACH ACCIDENT $ 100 000 AND EMPLOYERS' LIABILITY Y/N A ANY PROPRI OFFICER/MEMBEREXCLUDED? NIA 76 WEG AA4UV7 07/01 /2017 07/01 /2018 E.L. DISEASE -EA EMPLOYEE $ 1 00,000 (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is requir ) Those usual to the Insured's Operations. PPR DATE E NAGEMENT fib* e 1 VCR I lr 1 G CO UNTY BOARD OF COUNTY OE MONRO COUNTY SHOULD ANY OF THE ABOVE DESCRIBED PO ICIES BE CANCELLED BEFORE THE COMMISSIONERS EXPIRATION DATE THER :OF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISION . AUTHORIZED REPRESENTATIVE 500 WHITEHEAD ST KEY WEST FL 33040 -6581 V r.7otV IJ ^V_I vv­ v.v+..v....- ..... ......... --. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD DAB CERTIFICATE OF LIABILITY INSURANCE RO0Z F8/3/2017 ATE (6fM;DDIYYYY) THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NUTMEG INS AGENCY INC /PHS CONTACT NAME PHONE PHO E Exp: A Nor (888) 443 -6112 E -MAIL ADDRESS: 210775 P: F: (888) 443 -6112 INSURER(S) AFFORDING COVERAGE NAIC# (� C PO BOX 2 CHARLOTTE NC 28229 INSURER A: Twin City Fire Ins Cc 29459 INSURED INSURER B: INSURER C: COMMERCIAL GENERAL LIABILITY MICHAEL R. STECKBAUER, MD, M & M INSURER D: FORENSICS P.A. INSURER E: 2850 SW 154TH AVE INSURER F: DAVIE FL 33331 wn�c. 1 MHURFR• REViSiO V Numncm: v 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. LVSR TYPE OFINSCRANCE ADOL SL'BR POLICYNUAIBER POLICY EFF M:V/DD/}'YYY' POLICYEXP L LLIIITS EACH OCCURRENCE s 3 0 0, 0 0 0 COMMERCIAL GENERAL LIABILITY 5 3 0 0 0 0 0 CLAIMS -MADE � OCCUR PREM SES Ea olccurrrence) I A General Llab 76 SBU IW6366 07/01/2017 07/01/2018 X X MED EXP (Any one person) slO, 000 PERSONAL 8 ADV INJURY s 3 0 0, 0 0 0 GENERAL AGGREGATE s GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG s 6 0 0 , 0 0 0 POLICY E PRO FX—] LOC JECT s OTHER: (EaM accide SINGLE LIMIT s 3 0 0, 0 0 0 AUTOMOBILE LIABILITY BODILY INJURY (Per person) $ ANY AUTO X BODILY INJURY (Per accident) $ A OWNED SCHEDULED 76 SBU IW6366 07/01/2017 07/01/2018 AUTOS ONLY AUTOS X HIRED X NON -OWNED PROPERTY DAMAGE (Peraccident) s AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 AGGREGATE s EXCESS LIAB CLAIMS -MADE s DED RETENTION $ WORKERS COMPE.V'SAT70:4' PER I OTH- STATUTE ER AND EMPLOY£RS'LIABILITY s ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A E.L. DISEASE- EA EMPLOYEE 5 (Mandatory in NH) ❑ E.L. DISEASE - POLICY LIMIT s If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non Owned Auto Endorsement SSO438, attached to this policy. EMEM n � Nl 4WAI/A Y CC LrCR1lrIliMIG nVLVG1� - -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Monroe County Board DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of County Commissioners 500 WHITEHEAD ST�.�,�j� KEY WEST, FL 33040 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD