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06/20/2018 Agreement DATE: July 25, 2018 TO: Debbie Lofberg Emergency Services FROM: Pamela G. Hancock, D.C. th SUBJECT: June 20 BOCC Meeting Attached is an electronic copy of Item C7, Contract with OneBlood, Inc., for procurement, storage, and distribution of blood components required for air ambulance transportation to meet required , for your handling. Trauma Star Medical Protocols Should you have any questions, please feel free to contact me at ext. 3130. Thank you. cc: County Attorney Finance File BLOOD AND BLOOD COMPONENTS SUPPLY AND SERVICES AGREEMENT Dated as of June b , 2018 By and Between ONEBLOOD, INC. ( "OneBlood ") and BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA d /b /a MONROE COUNTY FIRE RESCUE ( "County ") WPB_ACTIVE 8396191.3 "Components" shall mean transfusable human blood cellular and plasma products, all as more specifically described on Exhibit A attached hereto, and such other components, if any, as hereafter may be made available and mutually agreed to by the parties. "Confidential Information" shall have the meaning set forth in Subsection 11(h) of this Agreement. "County" shall mean the Board of County Commissioners of Monroe County, Florida d/b /a Monroe County Fire Rescue, located at the following locations (the "Locations "): Trauma Star Hangar Stock Island Fire Station #8 10100 Overseas Highway 5655 McDonald Ave Marathon, FL 33050 Key West, FL 33040 "Effective Date" shall mean the date on which this Agreement shall become effective and OneBlood shall commence providing Components to County hereunder, which shall be July 1, 2018. "FDA" shall mean the U.S. Food and Drug Administration, an agency of the U.S. government, together with any successor agency. "Federal Electronic Transactions Regulations" shall mean the federal standards for electronic transactions contained in the Federal Electronic Transactions Regulations, 45 C.F.R. Parts 160 and 162, as amended. "Federal Health Care Programs" shall mean the federal health care programs as defined in 42 U.S.C. Section 1320a- 7b(f), as amended. "Federal Privacy Regulations" shall mean the federal privacy regulations contained in 45 C.F.R. Parts 160 and 164, as amended. "Federal Security Regulations" shall mean the federal security standards contained in 45 C.F.R. Parts 160, 162 and 164, as amended. "Force Majeure" shall mean labor disturbances, riots, fires, earthquakes, floods, storms, lightning, epidemics, pandemics, war, disorders, hostilities, expiration or confiscation of properties, failure of and delays by carriers, interference by civil or military authorities, whether legal or de facto, and .whether purporting to act under some constitution, decree or law, or otherwise, acts of God, and all similar acts and occurrences beyond the reasonable control of a party. "GAO" shall mean the Comptroller General of the General Accounting Office of the United States. "HBV" shall mean hepatitis B virus. "HCV" shall mean hepatitis C virus. 2 "HHS" shall mean the Department of Health and Human Services of the United States. "HIPAA" shall mean the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, as codified at 42 U.S.C. § 1320d through d- 9, as amended. "HIPAA Requirements" shall mean HIPAA and any current and future regulations promulgated thereunder including, without limitation the Federal Privacy Regulations, the Federal Security Regulations, and the Federal Electronic Transactions Regulations. "HITECH" shall mean the Health Information Technology for Economic and Clinical Health Act of 2009, as codified at 42 U.S.C. § 17931, as amended. "HIV" shall mean human immunodeficiency virus. "Individually Identifiable Health Information" shall mean individually identifiable health information as defined in 42 U.S.C. Section 1320d(6), as amended. "Joint Commission" shall mean the independent not - for - profit organization known as the "Joint Commission" that accredits and certifies more than 15,000 health care organizations and programs in the United States. The Joint Commission was formerly known as the Joint Commission on Accreditation of Healthcare Organizations. "OneBlood" shall mean OneBlood, Inc., a Florida not - for - profit corporation, exempt from federal income taxation pursuant to Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, together with its successors and permitted assigns, if any. "Protected Health Information" shall mean protected health information, as defined in 45 C.F.R. Section 160.103, as amended. "Services" shall mean the basic services to be provided by OneBlood to County, as described in Section 2 of this Agreement and any additional services provided by OneBlood that may be more specifically set forth in one or more supplemental writings executed by OneBlood and County, which shall become part of this Agreement and subject to the terms hereof. "Standards" shall mean the relevant and applicable rules, regulations and guidelines governing the procuring, storage and preservation of the Components promulgated from time to time by the FDA Center for Biologics Evaluation and Review, the AABB and /or other regulatory agencies or other organizations. "Term" shall have the meaning set forth in Subsection 7(a) of this Agreement. 2. Basic Supply and Services. (a) Requirements Contract. Subject to the limitations set forth in Subsection 2(b) hereof, during the Term County shall obtain its requirements of Components from OneBlood, and OneBlood shall supply County with its requirements of Components. Components will be 3 supplied to County on an as- needed basis as such Components are requested by County and are available for delivery. During the Term County shall be precluded from obtaining Components from other suppliers; provided, however, that County shall be permitted to obtain any Component from a source other than OneBlood in any instance when County requests such Component from OneBlood and OneBlood is unable to provide the same in a timely manner (i.e., by the time when County reasonably requires such Component). (b) Provision of Components. Due to the unpredictable nature of the demands for Components, OneBlood is not able to guarantee County the availability of all or any portion of the Components to be supplied hereunder. OneBlood does agree, however, that (1) it will use its reasonable best efforts to supply all Components ordered by County in an expeditious fashion, and (2) at no time during the Term will OneBlood so conduct its operations that any other customer regularly receives preferential treatment in the allocation of Components. OneBlood has no reason to believe that, in the absence of special circumstances, it will be unable to provide any and all Components required by County in connection with its normal operations. (c) Components Supplied for Use at County Only. The parties acknowledge that as of the date hereof, OneBlood's charges for Components are lower than the corresponding charges of most other blood suppliers in the United States. OneBlood also has obligations to supply Components at approximately the same charges to a number of other health care facilities in OneBlood's service area. OneBlood therefore requires, and County specifically agrees, that Components supplied by OneBlood will not be used at any location other than County Locations in Monroe County, FL. (d) Storage. Until Components are used by County, County will provide appropriate temperature- controlled storage of such Components and otherwise comply with the Standards in all respects. County shall provide to OneBlood's Medical Director or his designee, upon request, reasonable access to the storage facilities and records maintained by County so that OneBlood can satisfy itself that all requirements for inspection and accreditation are being satisfied. (e) County Responsibilities. County shall be responsible for controlling orders for Components by its physicians and other personnel, and OneBlood shall not be responsible for verifying orders from County physicians or other personnel or for controlling the use of Components by them. In addition, where applicable, County will be responsible for the proper labeling of request forms and patient specimens. (f) Returns. County may return Components obtained from OneBlood and receive credit for the fees charged by OneBlood, as permitted under OneBlood's return policies in effect from time to time; provided, that all of the requirements listed below are met: (1) The returned unit has not been entered or modified. (2) The returned unit has documentation that, during County's custody, all rules and requirements of the FDA and the standards of the AABB have been met for the storage and handling of the unit. 4 (3) The returned unit must be acceptable for re- issue, provided that the same unit was delivered to County in an acceptable condition for issue. (4) The expiration date for the returned unit does not exceed the following limits: Red Blood cells — ten (10) days or more from the date of return. Notwithstanding the foregoing, selected special order units of Components, including but not limited to the following, are NOT returnable for credit: (1) Washed or deglycerolized red blood cells; (2) Pooled blood components; (3) Split units; (4) Plasma products; (5) Thawed products; and (6) Reconstituted components. Any Component that is returnable for credit and re -issue is a resource of the regional community serviced by OneBlood, and any such units will be immediately released to OneBlood upon request to enable OneBlood to respond to an imminent transfusion need for that Component by another customer of OneBlood. Returns and fee credits are subject to the conditions and limitations contained herein or in OneBlood's return policies in effect from time to time. OneBlood may change its return policies from time to time by providing County thirty (30) days' prior written notice of any such change. 3. OneBlood's Charges. As consideration for its providing Components under this Agreement, OneBlood shall be entitled to compensation as follows: (a) Charges. (1) Upon the issuance to County of a Component or Service, County shall become obligated to pay OneBlood's charges with respect to such Component as specified in Subsection 3(b) or 3(c) hereof, as applicable. OneBlood may allow County to return unused Components, but only in strict compliance with OneBlood's return policies in effect from time to time. OneBlood shall have the power to change its return policies from time to time by providing County the same notice that County would be entitled to receive concerning an increase in OneBlood's charges under Subsection 3 (b) of this Agreement. (2) OneBlood's charges shall be due from County irrespective of whether County can charge or collect from its patient or others for the Components or Services delivered. To the extent necessary for compliance with billing requirements of Medicare, Medicaid or other third party payors, OneBlood delegates and assigns to County OneBlood's rights to bill County's patients for Components and Services provided to them by OneBlood under this Agreement; provided, that OneBlood shall retain the right to bill County's patients directly for consultations by OneBlood's physicians concerning matters 5 such as transfusion reaction interpretations, antibody workup recommendations, etc., in circumstances where County is unable to bill for such physician services due to regulations of Medicare, Medicaid or other third party payors. (b) Charges for Components. The initial level of OneBlood's charges for Components and certain services shall be as set forth in Exhibit A attached hereto. However, OneBlood's charges for any or all of such Components and such services may be adjusted by OneBlood upon thirty (30) days' prior written notice to County of the new charges applicable to such Components or services. (c) Charges for Additional Services. The level of charges for additional items and services (i.e., items or services other than Components or certain services referenced in Subsection 3(b) above) shall be as provided to County by OneBlood in writing from time to time. The parties acknowledge that County is not obligated to procure any additional items or additional services from OneBlood; provided, however, that County will not obtain any such additional item or service from any other provider for its Locations in Marathon, Florida and Key West, Florida, except in the event that OneBlood is unable to provide such additional item or service. (d) Billing Policies; Interest on Overdue Amounts. During the Term OneBlood will bill County on the first day of each month for all charges incurred by County during the preceding month. All OneBlood charges are exclusive of any administrative fee charged by County to its patients or otherwise, and OneBlood shall have no input into the manner in which County prices any Component. When providing the monthly bill, OneBlood also shall provide County with the following: (1) a report summarizing County's use of all Components, by classification of each Component, during the preceding month; and (2) a report indicating the number of single units of Components provided to County during the preceding month. (e) Payments. OneBlood shall submit to County invoices that conform to all statutory requirements and all requirements specified by County, which are set forth on Exhibit B attached hereto (a "Proper Invoice "). County shall pay within 45 days of receipt of a Proper Invoice from OneBlood, in accordance with the Florida Local Government Prompt Payment Act, Section 218.74, Florida Statutes. Payments due from County and not made within 45 days shall bear interest from 30 days after the due date at the rate of 1 percent per month on the unpaid balance compounded monthly, in accordance with the Florida Local Government Payment Act. If OneBlood's invoice is past due more than sixty (60) days, OneBlood reserves the right to terminate this Agreement in accordance with Subsection 7(b)(3) or to suspend providing Components or Services until payment is received. (f) Sales Taxes. County, as a political subdivision of the State of Florida, is exempt from sales taxes; therefore, Components or Services provided to County under this Agreement shall be exempt from sales taxes. 6 BLOOD AND BLOOD COMPONENTS SUPPLY AGREEMENT THIS BLOOD AND BLOOD COMPONENTS SUPPLY AGREEMENT (this "Agreement "), made and entered into as of JunecV, 2018, and effective as of the Effective Date, as hereinafter defined, by and between ONEBLOOD, INC., a Florida not - for -profit corporation (as hereinafter defined, "OneBlood "), and BOARD OF COUNTY COMMISSIONSERS OF MONROE COUNTY, FLORIDA d/b /a MONROE COUNTY FIRE RESCUE (as hereinafter defined, "County "). WITNESSETH: WHEREAS, capitalized terms used herein and not otherwise defined shall have the respective meanings set forth in Section 1 hereof; and WHEREAS, OneBlood is engaged in the procurement, storage, and distribution of Components and in providing certain related Services; and WHEREAS, County desires to procure its requirements of Components and certain Services from OneBlood; and WHEREAS, OneBlood desires to provide such Components and certain related Services to County, subject to the terms and conditions hereinafter set forth. NOW, THEREFORE, in consideration of the premises and the mutual covenants herein set forth and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereby agree as follows: 1. Definitions. As used in this Agreement, the following capitalized terms shall have the respective meanings as follows: "AABB" shall mean AABB, formerly known as the American Association of Blood Banks, and any successor accrediting agency for blood banks. "Agreement" shall mean this Blood and Blood Components Supply Agreement, together with all written amendments hereto hereafter executed and delivered by the parties in the manner contemplated hereby. "Applicable Law" shall have the meaning set forth in Subsection 11(a) of this Agreement. "Cause" shall mean cause adequate to support a party's termination of this Agreement, which shall consist of the other party's failure, after the applicable notice and cure period, to perform or observe any material covenant or obligation contained in this Agreement. 1 4. Delivery. (a) Routine Delivery of Red Blood Cells and Plasma Components. OneBlood will be responsible for one routine delivery per week (Monday, Wednesday or Friday), if required, for red blood cells and plasma Components to County. Such routine delivery for red blood cells and plasma Components shall be without charge to County. (b) Emergency Delivery of Components. Emergency deliveries of Components to County (i. e., any delivery other than the routine deliveries contemplated by Subsection 4(a) above) will be accomplished by surface courier or commercial transport, whichever is quickest and safest, in OneBlood's discretion. Charges for such delivery shall be the responsibility of County. If a OneBlood, courier is used for any such emergency delivery, then OneBlood's charge therefor shall be as set forth in Exhibit A; however, if a third -party courier is engaged by OneBlood for an emergency delivery, then the charge to County will be whatever OneBlood is required to pay to the third -party courier. (c) Delivery Within County. After deliveries have been made to County in the manner contemplated by Subsections 4(a) and 4(b), the delivery of Components within County, between Locations, to its customers or otherwise, will be the sole responsibility of County. 5. Delay. Neither party shall be responsible for delays, failures or omissions hereunder due to Force Majeure or due to any other cause beyond such party's control that could not be overcome with the exercise of diligence or commercially reasonable efforts. The time for performance shall be deemed extended for a period equal to the duration of such event. This provision shall not excuse any delay in the payment of money. 6. Records. OneBlood shall keep at its office accurate, full and complete books, records and accounts in respect of all Components provided to County hereunder. During the Term, OneBlood, upon reasonable request and at reasonable hours, shall make such books and records available for inspection by County personnel. All books and records maintained hereunder shall be maintained in accordance with the Standards and all other regulatory and accrediting agency requirements to which OneBlood and/or County is subject. 7. Term and Termination. (a) Term. The term of this Agreement (the "Term ") shall commence on the Effective Date and, unless sooner terminated in accordance with Subsection 7(b), shall extend until 11:59 p.m. on the calendar day immediately preceding the fifth anniversary of the Effective Date. Notwithstanding the foregoing, the parties shall review this Agreement from time to time as contemplated by AABB standard 4.2.1, and the parties may by written instrument amend this Agreement pursuant to Subsection 13(c) to incorporate any needed changes on which both OneBlood and County shall agree. (b) Termination. This Agreement may be terminated as follows: (1) Either party hereto may terminate this Agreement with or without Cause upon one hundred eighty (180) days' prior written notice to the other party; provided, that the parties may not terminate this Agreement without Cause until after the 7 first anniversary of the Effective Date. In the event of such termination under this Subsection 7(b)(1), any and all charges outstanding at termination will be due and payable within thirty (30) days following the date of OneBlood's final invoice. (2) Either party hereto may terminate this Agreement for Cause that shall not have been cured within sixty (60) calendar days following the non - terminating party's receipt of written notice thereof specifying the Cause. In the event of such termination under this Subsection 7(b)(2), any and all charges outstanding at termination will be due and in accordance with Subsection 3(e). (3) This Agreement may be terminated immediately (A) by either County or OneBlood if any license that OneBlood needs in order to provide Components in the manner contemplated hereby should be suspended or revoked, (B) by either County or OneBlood if the other party shall fail to comply with a material requirement of Applicable Law as required by Subsection 11(a),(C) by either County or OneBlood if the other party shall be in breach of Subsection 11(c), or (D) by OneBlood if County shall be in breach of Subsection 3(e). In the event of such termination under this Subsection 7(b)(3), any and all charges outstanding at termination will be due and payable within thirty (30) days following the date of OneBlood's final invoice. (c) Survival of Obligations. All obligations of the parties for any period prior to termination or expiration of this Agreement that are intended to extend beyond the Term shall survive the termination of this Agreement, and any termination or expiration of this Agreement shall be without prejudice to any claims for damages or other rights against the other party that preceded or resulted from termination or expiration. 8. Disclaimer of Warranties. PURSUANT TO SECTION 672.316(5), FLORIDA STATUTES, THE PROCUREMENT, PROCESSING, STORAGE, DISTRIBUTION OR USE OF COMPONENTS IS DECLARED TO BE A SERVICE THAT DOES NOT CONSTITUTE A SALE OF A PRODUCT, WHETHER OR NOT ANY CONSIDERATION IS GIVEN THEREFOR, AND THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE SHALL NOT BE APPLICABLE. ONEBLOOD FURTHER DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, AS TO THE CONDITION OF COMPONENTS TO BE PROVIDED UNDER THIS AGREEMENT. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, ONEBLOOD SPECIFICALLY DISCLAIMS ANY IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. 9. Quality Assurance; Lookback. (a) Quality Assurance. OneBlood shall be responsible for and will maintain a quality assurance program to ensure the quality of the Components provided hereunder and its compliance with the rules and regulations to which it is subject. Without limiting the generality of the foregoing, OneBlood agrees that all Components provided to County hereunder shall have been tested in accordance with the relevant requirements of the FDA and the AABB provided hereunder shall be in compliance with any accreditation requirements of the Joint Commission. 8 OneBlood will promptly notify County when changes to the program have been made that could affect the safety of Components provided hereunder. (b) Lookback. In compliance with the applicable rules of the FDA and /or the accrediting standards of the Joint Commission, OneBlood hereby agrees: (1) to notify County within seventy -two (72) hours after OneBlood determines that a donor of Components tests repeat reactive for conditions requiring donor lookback, but only if such donor made previous donations from which Components were sent to County that still could remain in available inventory; (2) to notify County promptly if OneBlood should discover that certain potentially infectious Components have been made available to County; (3) to notify County within three (3) calendar days after OneBlood determines that it has supplied Components collected from a donor who tested negative at the time of the donation but subsequently tested reactive for HIV, HBV, or HCV on a later donation, or subsequently is determined by OneBlood to be at increased risk for transmitting HIV, HBV or HCV; and (4) to notify County, within forty -five (45) days after the initial test, of the results of any supplemental screening test for HIV, HBV or HCV, or any other follow - up testing required by the FDA, to complete the notification above in Subsection 9(b)(3). The purpose of such notification is to enable County to take proper health and safety steps to minimize further spread of infection. OneBlood shall comply with its obligations under the rules referenced in subsection (b) above in a manner consistent with its reasonable interpretation of such rules. Notification will be made by telephone followed up by written notification to be sent or given in the manner contemplated by Subsection 13(d) of this Agreement. 10. Insurance. Throughout the Term OneBlood and County shall each maintain at its own expense adequate levels of insurance. Without limiting the generality of the foregoing, OneBlood and County shall each procure and maintain in effect professional liability insurance with coverage of no less than $1,000,000 per occurrence and $3,000,000 annual aggregate. Each party shall, upon request, provide the other party with a certificate of insurance confirming such coverage and shall advise the other party promptly of the termination of such coverage or any material adverse modification of such coverage. If a party promptly notifies the other party that • ' the notifying party is unable to purchase (other than at a cost that the notifying party reasonably considers prohibitive) the insurance required of the notifying party by this Agreement, then the other party shall have the right to terminate this Agreement upon ten (10) days' notice to the notifying party. If the second party shall have received any such notice and shall not have terminated this Agreement, neither the second party nor any insurer for the second party thereafter shall have any right to make a claim against the notifying party based solely upon its failure to provide the insurance coverage required of it under this Agreement. 9 11. Compliance and Representations. (a) Compliance with Applicable Law. Both parties agree to comply with all applicable federal, state and local laws, statutes, regulations, codes, ordinances, rules and /or executive orders, as amended ( "Applicable Law "). In the event a party fails to comply with a material requirement of Applicable Law, the non - breaching party shall immediately notify the breaching party and the non - breaching party may immediately terminate this Agreement in accordance with Subsection 7(b)(3). (b) Regulatory Changes. Each party reserves the right to modify this Agreement, upon thirty (30) days' prior written notice to other party in the event that a change to any Applicable Law, government or AABB policy or program, Joint Commission standard or standard of care is proposed or adopted, which affects Components, rates or obligations hereunder; provided, however, the parties acknowledge and agree that any modification of this Agreement, except for an adjustment of charges for Components pursuant to Subsection 3(b) or a change to OneBlood's return policies, shall be set forth in a written amendment mutually agreed upon in accordance with Subsection 13(c). (c) Representations as to Federal Health Care Programs. Each of County and OneBlood represents and warrants to the other that the representing party (1) is not currently excluded, debarred, or otherwise ineligible to participate in Federal Health Care Programs; (2) does not employ any person who has been convicted of a criminal offense related to the provision of health care items or services but has not yet been excluded, debarred, or otherwise declared ineligible to participate in Federal Health Care Programs, and (3) is not, (A) to the best of its knowledge, under investigation, or (B) otherwise aware of any circumstances that, in either such case, reasonably could be expected to result in such party's being excluded from participation in the Federal Health Care Programs. This shall be an ongoing representation and warranty during the Term, and the representing party shall immediately notify the other party of any change in the status of this representation and warranty set forth in this Subsection 11(c). If either party shall be in breach of this representation and warranty or if it otherwise should breach any of its obligations in this Subsection 11(c), the other party shall have the right to terminate this Agreement immediately in accordance with Subsection 7(b)(3). (d) HIPAA and HITECH Requirements. Both parties agree to comply with any applicable HIPAA and HITECH Requirements. Without limiting the generality of the foregoing, the parties agree not to use or further disclose any Protected Health Information or Individually Identifiable Health Information in violation of any applicable HIPAA Requirements. To the extent that a party is covered by the HIPAA Requirements, such party will make its internal practices, books, and records relating to the use and disclosure of Protected Health Information available to HHS as required for determining compliance with the Federal Privacy Regulations. (e) Compliance with Applicable Laws and Standards. OneBlood will ensure that the Services to be provided will be provided in accordance with: (1) the applicable standards, if any, of the Joint Commission; (2) the applicable standards of the FDA and the AABB; and (3) to the extent material, all other applicable federal, state, county and city laws, ordinances, codes, regulations, and rules governing the Services provided by OneBlood under this Agreement. OneBlood further agrees, to the extent necessary to permit County to receive reimbursement for 10 Services rendered by OneBlood under this Agreement, to make available to the HHS, the GAO or their authorized representatives, the contract, and books, documents and records relating to the nature and extent of the costs hereunder for a period of four (4) years after the furnishing of Services under the Agreement. In addition, OneBlood hereby agrees that if Services hereunder involving a value or cost of $10,000 or more over a 12 -month period are to be provided to County by a subcontractor that is an affiliate of OneBlood, then OneBlood will cause such affiliated subcontractor, upon request, to make available to HHS, the GAO, or their authorized representatives the contract, books, documents, and records relating to the nature and extent of the costs thereunder for a period of four (4) years after the furnishing of Services thereunder. (f) Statement of Compliance. OneBlood's quality system is defined, documented, implemented and maintained in compliance with current good manufacturing requirements and AABB standards. OneBlood is accredited by the AABB in donor center activities and in immunohematology reference laboratory activities, accredited by the Centers for Medicare & Medicaid Services (CMS), licensed by the State of Florida Agency for Health Care Administration (AHCA), and licensed and registered by the FDA. OneBlood's laboratory director approves all methods used by each laboratory; where applicable, FDA - licensed or approved test kits and reagents are used. Performance of testing and interpretation of results are in accordance with manufacturer's instructions. As required by the Clinical Laboratory Improvement Amendments of 1988 (CLIA) rules in 42 C.F.R. Part 493, all testing personnel are qualified and deemed competent to perform high complexity testing, and the laboratory participates in a proficiency testing program for each tested analyte. OneBlood has agreements in place for outsourced activities and monitors compliance with these agreements through supplier qualification audits. (g) Statement of Compliance with Bacterial Detection Requirements. In compliance with AABB standard 5.1.5.1 for a method to detect bacteria in platelet components, all of OneBlood's platelets, pheresis and whole blood derived pre - pooled platelets are cultured using the Biomerieux BacT /Alert Microbial Detection System, an FDA - approved testing method. (h) Confidential Information. During the course of performing this Agreement, County may from time to time receive confidential information about OneBlood, and OneBlood may from time to time receive confidential information about County, including but not limited to, information about its business, customers, patients, patient records, practices, procedures, strategies, organization, financial data (including but not limited to charges for Components and Services) and other related information ( "Confidential Information "). Each party agrees that Confidential Information disclosed to, or otherwise received by, it will be treated in accordance with the following: (1) Each receiving party shall (A) hold in strict confidence the Confidential Information of the disclosing party; (B) not use or disclose any such Confidential Information to a third party for any purpose other than the limited purpose of performing its obligations under this Agreement without the prior express written consent of the disclosing party; and (C) disclose Confidential Information only as authorized or required by law or as may be authorized by the disclosing party or pursuant to a court order or, with respect to patient records, by written consent of the patient or the patient's representative; 11 (2) If OneBlood receives a public records request related to this Agreement pursuant to Chapter 119, Florida Statutes, then it shall immediately (not more than 48 hours after the receipt) notify County and shall have no obligation to disclose under this Agreement, as OneBlood is not subject to Chapter 119, Florida Statutes. If County receives a public records request related to this Agreement pursuant to Chapter 119, then it shall immediately notify OneBlood. OneBlood may object to the disclosure of any of its Confidential Information by County pursuant to such a public records request by promptly notifying County of such objection, in which case County shall reasonably cooperate in any lawful effort that OneBlood may wish to pursue to identify the records, or any parts thereof, that are confidential and exempt from disclosure by County. In any such challenge to the public records disclosure, OneBlood shall be solely responsible for all legal costs and fees associated with OneBlood's challenge to the public records disclosure and shall indemnify the County in the event attorney fees or costs are awarded to the party seeking the public records disclosure. (3) If a receiving party is served with a subpoena or other legal process (other than a public records request pursuant to Chapter 119) concerning Confidential Information of the disclosing party, then the receiving party shall, to the extent permitted by law, immediately (not more than 48 hours after the receipt) notify the disclosing party and shall reasonably cooperate with it in any lawful effort to contest the legal validity of such process which the disclosing party may wish to pursue. The disclosing party shall be solely responsible for all legal costs and fees and shall indemnify the receiving party in the event attorney fees or costs are imposed. (4) This subsection (h) does not affect a receiving party's right (A) to use or disclose information that is developed by the receiving party independently from the disclosing party's Confidential Information, as supported by the receiving party's written records; (B) to use or disclose information that is obtained without restriction by the receiving party from a third party who had a legal right to make such disclosure; (C) to use or disclose information that is publicly available other than through the fault or negligence of the receiving party; or (D) to disclose information in response to a valid public records request pursuant to Chapter 119, Florida Statutes, that is not exempt from disclosure, after compliance with subsection (2) above. (i) Public Records Compliance. County must comply with Florida public records laws, including but not limited to Chapter 119, Florida Statutes, and Section 24 of Article I of the Constitution of Florida. Nothing in this Agreement shall be deemed an admission or acknowledgement by OneBlood that it, as a private entity, is subject to such laws or constitutional provisions; however, OneBlood will provide to County such cooperation in complying with its statutory and constitutional obligations as is required by Applicable Law and set forth in this subsection (i). Failure to comply with the following provisions shall be deemed a material breach of this Agreement and shall constitute Cause for termination pursuant to Subsection 7(b)(2). (1) OneBlood shall keep such books and records as are required by Section 6 of this Agreement. 12 (2) A request to inspect or copy public records relating to this Agreement must be made directly to County, and OneBlood shall not directly respond to any such request. If County does not possess, and OneBlood does possess, the requested records, and County deems disclosure of information in response to a public records request to be required by Chapter 119, Florida Statutes, County shall immediately notify OneBlood of the request and that it has determined that disclosure is required. If OneBlood objects to such determination, it shall promptly notify County and provide the basis for its claim that such information is not subject to mandatory disclosure. If County maintains its initial determination that disclosure is required, then unless OneBlood takes, or notifies County that it will take, legal action to contest such determination, OneBlood will comply with County's request in accordance with the remainder of this subsection (h). (3) Subject to subsection (2), upon request from County's custodian of public records, OneBlood will provide County with a copy of the requested records or allow the records to be inspected or copied by County within a reasonable time at a cost to County that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law. (4) Both parties will 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 Term and following completion of this Agreement. 12. No Joint Venture, Employment, or Agency Relationship. Nothing contained herein shall be construed to create a joint venture, employer /employee, or principal /agent relationship between County and OneBlood. It is specifically agreed that OneBlood is and at all times shall remain an independent contractor rendering services to County. In performing their duties, OneBlood personnel shall take direction only from OneBlood supervisors and not from the staff or administration of County. 13. Miscellaneous. The following provisions shall govern this Agreement: (a) Requests. All requests for Components or Services hereunder not specifically required by this Agreement or OneBlood's standard operating procedures to be in writing may be made orally or by telephone. (b) Rules of Construction. The following rules of construction shall govern this Agreement: (1) Section and Subsection headings used in this Agreement are for convenience of reference only and in no way define, limit or describe the scope or intent of this Agreement or affect its provisions. (2) Whenever used herein, the singular shall include the plural, the plural the singular, and the use of any gender shall include all genders. 13 (3) The parties shall be deemed to have participated equally in the preparation of this Agreement, and this Agreement shall not be construed more strictly against one party than against the other. (c) Entire Agreement; Modification of Agreement. This Agreement represents the entire understanding and agreement between the parties with respect to the subject matter hereof, and supersedes all of the negotiations, understandings and representations (if any) made by and between such parties and all prior oral and written agreements between the parties (including their predecessor legal entities) with respect to the subject matter hereof. Without limiting the generality of the foregoing, as of the Effective Date this Agreement shall supersede any and all other existing agreements between OneBlood or any of its predecessor legal entities, on the one hand, and County or any of its predecessor legal entities, on the other hand. In the event of any discrepancy between the terms of this Agreement and the terms of any Business Associate Agreement that may be executed between the parties hereto, the terms of this Agreement shall control and supersede the terms of the Business Associate Agreement, except that both agreements shall be interpreted in a manner that enables the parties to comply with HIPAA and HITECH. None of the terms or provisions hereof may be amended, supplemented, waived or changed orally, but only by a writing signed by OneBlood and County and making specific reference to this Agreement; provided, that OneBlood may change its return policies and its charge levels in Exhibit A by providing notice to County as set forth herein; and provided, further, that the amendment of this Agreement to include an additional facility owned or controlled by County (and the resulting amendment of the definition of "County" in Section 1) shall also require the execution of a joinder in this Agreement by such new facility's administration. (d) Notices. Except as otherwise expressly provided in this Agreement, any notice or other communication required or permitted to be given hereunder shall be in writing and effective upon receipt. Such notices shall be personally delivered, sent by registered or certified U.S. mail, postage prepaid with return receipt requested, sent via a nationally recognized delivery service, or sent by facsimile or electronic mail with confirmation. Notices shall be addressed to the parties at the following addresses, but either party may change its notice address by providing written notice to the other in accordance with this Subsection. If to OneBlood: OneBlood, Inc. 8669 Commodity Circle Orlando, Florida 32819 Attn: John E. Murphy, Jr. Chief Financial & Administrative Officer Facsimile: (407) 248 -5095 E -mail: j ohn.murphy@oneblood.org If to County: Monroe County Fire Rescue 49063` Street Ocean, Suite 120 Marathon, FL 33050 Attn: Debbie Lofberg Executive Administrator Facsimile: (305) 289 -6007 E -mail: lofb erg- debbie @monroecounty -fl . gov 14 (e) Invalid Provision. The invalidity or unenforceability of any term or provision of this Agreement or the non - applicability of any such term or provision to any person or circumstance shall not impair or affect the remainder of this Agreement, and the remaining terms and provisions hereof shall not be invalidated, but shall remain in full force and effect and shall be construed as if such invalid, unenforceable or non - applicable provisions were omitted. (f) Applicable Law and Binding Effect. This Agreement shall be construed and enforced in accordance with the laws of the State of Florida applicable to agreements to be executed and performed wholly within said state. The parties further agree that in any dispute between them relating to this Agreement, exclusive jurisdiction shall be in the trial courts located within Orange County, Florida, any objections as to jurisdiction or venue in such court being expressly waived. (g) Attorneys' Fees. If any litigation or controversy arises out of or in connection with this Agreement between the parties hereto, the prevailing party in such litigation or controversy shall be entitled to recover from the other party or parties all reasonable attorneys' fees, expenses and suit costs, including those associated with any appellate or post judgment collection proceeding. (h) Waiver. No failure or delay on the part of either party in exercising any right or remedy under this Agreement shall operate as a waiver. No provision of this Agreement may be waived except specifically and in writing. (i) Assignment. Neither party may assign this Agreement without first obtaining the prior written consent of the other party. (j) Survival. Any provisions of this Agreement creating obligations extending beyond the term of this Agreement shall survive the expiration or termination of this Agreement, regardless of the reason for such termination. (k) No Use of Name. Neither party will use the name of the other party, or of any of its employees, for promotional or advertising purposes without prior written permission from the other party. (1) No Referrals Required; Fair Market Value. The parties expressly agree that nothing contained in this Agreement is intended or shall be construed as an inducement to refer or admit any patients to, or order any goods or services from the other party. Neither party will knowingly or intentionally conduct itself in a manner which violates any federal or state anti - kickback statute, the criminal and civil False Claims Act, any federal or state self - referral statute, federal law or regulation, or which could reasonably result in such a violation. All amounts paid under this Agreement are expressly intended to reflect and do reflect fair market value for services rendered. (m) OFCCP Compliance. The parties shall abide by the requirements of the U.S. federal regulations set forth in 41 CFR §§ 60- 1.4(a), 60- 300.5(a) and 60- 741.5(a). These regulations prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin. Moreover, 15 these regulations require that covered prime contractors and subcontractors take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability. (n) Counterparts. This Agreement may be executed in any number of counterparts, each of which when so executed and delivered, shall be an original, but such counterparts shall together constitute but one and the same instrument. Signatures to this Agreement transmitted by facsimile transmission, by electronic mail in "portable document format" (.pdf) form, or by any other electronic means intended to preserve the original graphic and pictorial appearance of a document, will have the same effect as physical delivery of the paper document bearing the original signature. (o) 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 OneBlood agree to participate, to the extent reasonably required by the other party and at the other party's expense, 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 OneBlood specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. (p) Nondiscrimination. County and OneBlood 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 by a party has occurred, this Agreement may be terminated by the other party pursuant to Subsection 11(a) and in accordance with Subsection 7(b)(3). Each of County and OneBlood agrees to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These may include but may not be limited to the following: 1) Title VI of the Civil Rights Act of 1964 (PL 88 -352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681 -1683, and 1685- 1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s.794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101 -6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92 -255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd -3 and 290ee -3), as amended, relating to confidentiality of alcohol and drug abuse patient 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 14, Article II, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, and the subject matter of, this Agreement. 16 (q) Covenant of No Interest. Each of County and OneBlood covenants that it presently has no interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that its only interest is to perform and receive benefits as recited in this Agreement. (r) Code of Ethics. County agrees that officers and employees , of 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. (s) No Solicitation/Payment. Each of County and OneBlood warrants that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. If the breach or violation of this subsection (s) by either party shall constitute a violation of Applicable Law, then the non - breaching party shall have the right to terminate this Agreement immediately pursuant to Subsection 11(a) and in accordance with Subsection 7(b)(3). (t) Non - Waiver of immunity. The participation of County and OneBlood in this Agreement and the acquisition of any commercial liability insurance coverage, self - insurance coverage, or local government liability insurance pool coverage shall not be deemed to extend County's liability beyond the limits established in Section 768.28, Florida Statutes, as amended. OneBlood's potential liability to pay any damages to County shall be limited to the same extent that County's liability to OneBlood is limited by the preceding sentence. (u) 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 County, when performing their respective functions under this Agreement within the territorial limits of 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 County. (v) Non - Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the County. (w) 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 County and OneBlood agree that neither County nor OneBlood 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 17 and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. (x) No Personal Liability. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, director, officer, agent or employee of County or OneBlood, in his or her individual capacity; and no member, officer, agent or employee of County or OneBlood shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. (Signatures appear on the following page) 18 IN WITNESS WHEREOF, the parties hereto, acting through their officers or representatives thereunto duly authorized, have executed and delivered this Agreement as of the day and year first above written. "ONEBLOOD" ONEBLOOD, INC., a Florid. • - for - profit corporation By: John urphy, Jr. Chie ancial and Administrative Officer �p 6r "" 0 p� ,�� ` N. tf � - W BOARD OF COUNTY COMMISSIONERS _ _- C IN MADOK, CLERK OF MONROE COUNTY, FLORIDA @. ' s o% / . J e N o., cou Itv ‘, f f /`- - By : By: (� Print Name: Pa r►-i CI a- C • +44L'^ c„• 4.-1' Print Name: Dav i ci ki c.� Deputy Clerk Mayor /Chairperson ROE COU TY ATTORNEY . 7 RREpA• , +. . _ .. A - . ' eOUNTY ATTORNEY p ate ri 26 I zt r- C+ : r=-- F C O C� C?: Cpl.° d 19 EXHIBIT LIST FOR BLOOD AND BLOOD COMPONENTS SUPPLY AND SERVICES AGREEMENT Exhibit A Identity and Initial Charges for Components and Certain Services Exhibit B Invoice Requirements • 20 EXHIBIT A Identity and Initial Charges for Components and Certain Services OneBlood Fee List Effective January 4, 2018 Item # Item Description Fee 20201 Red Blood Cells Leukoreduced $230.00 23400 Plasma (Liquid) 59.00 51004 Non - Crossmatch Set Up 44.00 51201 ABO Group & Rh Type 34.00 51355 Transportation Fees - Priority Shipment Services Area — 06 202.00 > Hialeah Distribution Hub to Trauma Star Hangar in Marathon, FL 51356 Transportation Fees - Priority Shipment Services Area — 07 271.00 > Hialeah Distribution Hub to Stock Island Fire Station #8 in Key West, FL 53150 Zika Fees — RBC 7.52 • A -1 • • EXHIBIT B Invoice Requirements . An invoice that is substantially sim to the following example shall be deemed a Proper Invoice under Section 3(e): • 1 r One$10od,tnc. fiuotee - IUl00000000419111 . I 8669 Commadity Circle Date ' ' - 2/2912016 • Orlan do F4 34849 pew 1; Sp to • • k. Bill To: Strip. To: ' ' Local Regional Hospital {, Local Regional Hospital a Accounts Payable 123 Main Street 1 PD Box 7052 Orlando, FL 33819 • 3 € Atlanta, GA 30791 -7052 ( ' f euictuse order au cusku..so Requisition tdembsr SFdt3+i.2 Method m Paiderd Tas - Rec1 Stiinoe W ata4.1ee M , k o.. € ? �4GG Net30 . 2,29/2010 794,580 £ Ordeeed Strapped Stem Member • CPE Ya1e, De4cr on , - '3isooeset - Joie Rico •,,ERt. Price'. ;�: 2 2 34522 P7737 Aahesaris PL� U ;Oids dine) LeukoraMOd Grad $0.05 3700.4 34.20000 • 1 ?-w 3B81eeEe213tEaDse847108 f • i 3SS035818065322aE_2452171i8 t 3 3 3 51213 CSNTest 50.60 ' 380.70 3276.00 ? _ i..45471178 1 . ..E 31647350 ` 4 4 31024 11631, ^a�?4•C5 ?ut3ed Py4effi Leu4aM • 50.00 5505.W 52.020.G0 f • • !- LY23651e62GY14 ;e 275647c55 �, 247=51E0 57 - 3247030 111.3501 3'047039 . . ' pierzisetccutio 5'277:547036 1' 1 20273 F50f034 R. Grits ausalogcra lerion!dueed 50 5360.70 3300130 ` - 12. 171E0382.'5U004 - x 1 1 2*'"2 Red Calls LeukoreducesItaradiXed SD 00 33`0.70 5350 p l , t V , ? ( '.amraml r1t1J includar $ q g t. Patient \ua< 2. Omie • • .1. Isar Galt.. - • tr r 5 1 . 2 5 4 1r F j . • 1. . 1 1. • 3 4 • i t • i Subtotal • 54,140.00 f,• Pease Rered Paymn'2to 50.00 ` P.O. Box 028042 .. r ax _ ., .. 50.00 . 4 Orlando, FL 32552.5343 Freight 40.20 1 3 1 Emilaocounts.ReceevablebOreStaod era s Trade Dincotmt 50.00 enemy which OneE'eod. tnc. rta0mrrend Aetna Lade may vary. i . B -1 - Client#: 1617398 1310NEBLO ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDIYYYY) 7/24/2018 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: McGriff Insurance Services PHONE 4 07 691 -9600 FAX 888- 635 -4183 PO Box 4927 E-MAIL Ext): (A /C, No): Orlando, FL 32802 -4927 ADDRESS: 407 691 -9600 INSURER(S) AFFORDING COVERAGE NAIL # INSURER A : Allied World Surplus Lines no Comp 24319 INSURED INSURER B : Allied World Assurance Company US, Inc 19489 OneBlood Inc INSURER C : Liberty Mutual Fire Insurance Company 23035 8669 Commodity Circle INSURER D : Liberty Insurance Corporation 42404 Orlando, FL 32819 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 18/19 Master BAI BWS REVISION NUMBER: 2 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. LT R TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM /DD/YYYY) (MMIDD /YYYY) A COMMERCIAL GENERAL LIABILITY * * 03072867 01/27/2018 01/27/2019 EACH OCCURRENCE 01,000,000 CLAIMS-MADE X OCCUR PREMISES nce) 5100,000 MED EXP (Any one person) s5,000 X Professional Liab* PERSONAL &ADVINJURY 0 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: 03072867 01/27/2018 01/27/2019 GENERAL AGGREGATE $ 3,000,000* X POLICY JEC LOC PRODUCTS - COMP /OP AGG $1,000,000 OTHER: s*Agg all Clms C AUTOMOBILE LIABILITY * * AS2651291931018 01/27/2018 01/27/2019 COMBIaccidNED ent) SINGLE LIMIT S 1 r 000 r 000 _ (Ea X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMAGE 5 AUTOS ONLY AUTOS ONLY (Per accident) B UMBRELLA LIAB * OCCUR 03072868 01/27/2018 01/27/2019 EACH OCCURRENCE $10,000,000 x EXCESS LIAB * CLAIMS -MADE AGGREGATE $10,000,000 DED X RETENTION $NIA $ D WORKERS COMPENSATION * WA765D291931028 07/01/2018 07/01/2019 STATUTE OTH AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $500,000 OFFICER /MEMBER EXCLUDED? N N / A -APP 0 E BY K ' -• NA ME' (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below / ;�?l. BY . 'J- l �� / .�.. _ r E.L. DISEASE - POLICY LIMIT 6500,000 DATE (4 -I r WAIVER N/All YES__ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: All Blood Drives through Policy Period. (See below if specific location identified) *General Liability Coverage: Additional Insured, Primary Non - Contributory status is granted with respect to General Liability if required by written contract per endorsement "Blanket Additional Insureds Coverage Under All Insuring Agreements" Form #v2614(7/2012) (See Attached Descriptions) CERTIFICATE HOLDER _ CANCELLATION Monroe County Board SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West, FL 33041 AUTHORIZED REPRESENTATIVE 101-'4 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S20678953/M20371381 MOCO DESCRIPTIONS (Continued from Page 1) *General Liability Coverage: Blanket Waiver of Subrogation status is granted with respect to General Liability if required by written contract per endorsement "Waiver of Subrogation for Additional Insured(s) form #v2478 (8/2010) *Automobile Liability: Additional Insured status is granted with respect to Auto Liability if required by written contract per endorsement "Designated Insured For Covered Autos Liability" Per Endorsement #CA2048 02 99. *Automobile Liability: Blanket Waiver of Subrogation status is granted with respect to Auto Liability if required by written contract per endorsement "Waiver of Transfer of Rights of Recovery Against Others To Us" Per Endorsement #AX1210 02 05 B. *Workers Compensation: Blanket Waiver of Subrogation status is granted with respect to Workers Compensation if required by written contract per endorsement "Waiver of Right to Recover from Others Endorsement" Per Endorsement #WC000313. *Regarding Professional /General Liability Policy and Excess /Umbrella Liability Policy: Professional Liability is Claims Made; General Liability is Occurrence RE: Blood for emergency release needs. SAGITTA 25.3 (2016/03) 2 of 2 #S20678953/M20371381