Item O05 0.5
t, BOARD OF COUNTY COMMISSIONERS
County of Monroe Mayor Sylvia Murphy,District 5
The Florida Keys l'U � � Mayor Pro Tern Danny Kolhage,District 1
�pw° Michelle Coldiron,District 2
Heather Carruthers,District 3
David Rice,District 4
County Commission Meeting
April 17, 2019
Agenda Item Number: 0.5
Agenda Item Summary #5365
BULK ITEM: Yes DEPARTMENT: Risk Management
TIME APPROXIMATE: STAFF CONTACT: Maria Slavik(305) 295-3178
No
AGENDA ITEM WORDING: Approval to Advertise a Solicitation for Proposals for Insurance
Consulting Services (Risk Management and Workers' Compensation).
ITEM BACKGROUND: The County is currently contracted with Interisk Corporation to provide
consulting services on in as needed basis in regard to Risk Management and Workers' Compensation
Programs. The current contract with Interisk was entered into on 8-20-2014 with an effective date of
October 1, 2014. The agreement was amended to extend the agreement on 10-1-2017.
PREVIOUS RELEVANT BOCC ACTION: First Amendment to Interisk Agreement, approved
12-13-2017.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval to Advertise.
DOCUMENTATION:
2019 RFP Insurance Consultant 3.29.2019
FINANCIAL IMPACT:
Effective Date: TBD —the RFP asks for a 3-year agreement with 2 options to renew for 1 year
each with mutual agreement of the parties. If approved, the new contract would take effect on
October 1, 2019.
Expiration Date: Initial term: September 30, 2022
Total Dollar Value of Contract: TBD—current cost is $49,800 per year.
Total Cost to County:
Current Year Portion: $49,800.00
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Budgeted: Yes
Source of Funds: Internal Service Fund/Primarily Ad Valorem
CPI: N/A
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: No If yes, amount:
Grant: N/A
County Match: N/A
Insurance Required: Yes
Additional Details:
None
REVIEWED BY:
Cynthia Hall Completed 04/01/2019 10:29 AM
Bob Shillinger Completed 04/01/2019 3:51 PM
Budget and Finance Completed 04/01/2019 3:53 PM
Kathy Peters Completed 04/01/2019 4:21 PM
Board of County Commissioners Pending 04/17/2019 9:00 AM
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MONROE COUNTY
REQUEST FOR PROPOSALS
FOR
INSURANCE CONSULTING SERVICES
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BOARD OF COUNTY COMMISSIONERS
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Mayor Sylvia J. Murphy, District 5
Mayor Pro Tern, Danny L. Kolhage, District 1
Michelle Coldiron, District 2
Heather Carruthers, District 3
David Rice, District 4
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CLERK OF THE CIRCUIT COURT RISK MANAGEMENT
Kevin Madok Maria Slavik, Risk Administrator
Ir-
WORKERS' COMPENSATION CD
Mark Gongre, Workers' Compensation
Administrator
Bid opening date: May 23, 2019 (3 pm)
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TABLE OF CONTENTS
NOTICE OF REQUEST FOR COMPETITIVE SOLICITATION
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SECTION ONE - Instruction to Proposers 0
SECTION TWO - Draft Agreement
EXHIBIT A - Scope of Services (n
SECTION THREE - County Forms and Insurance Forms
ATTACHMENTS
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1. Questionnaire
2. Schedule of Insurance Coverages
3. Combining Statement of Net Position as of September 30, 2018 for
Internal Service Fund — Risk Management a.
4. Combining Statement of Revenue, Expenses and Changes to Net
Assets as of September 30, 2018 for Internal Service Fund — Risk
Management aU)
5. Combining Statement of Cash Flows as of September 30, 2018 for
Internal Service Fund — Risk Management
6. Loss Runs for Workers' Compensation for last two years
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NOTICE OF REQUEST FOR COMPETITIVE SOLICITATION
NOTICE OF REQUEST FOR PROPOSALS
NOTICE IS HEREBY GIVEN that on Thursday, May 23, 2019, at 3:00 P.M.,
the Monroe County Purchasing Office will receive and open sealed responses for the
following:
INSURANCE CONSULTING SERVICES
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MONROE COUNTY, FLORIDA
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Pursuant to F.S. 50.0211(3)(a), all published competitive solicitation notices can be
viewed at: www.floriapublicnotices.com, a searchable Statewide repository for all
published legal notices. Requirements for submission and the selection criteria may be
requested from DemandStar by Onvia at www.demandstar.com OR
www.monroecounty i s.c or call toll-free at 1-800-711-1712. The Public Record
is available at the Monroe County Purchasing Office located in the Gato Building, 1100
Simonton Street, Room 2-213, Key West, Florida.
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All responses must be sealed and must be submitted to the Monroe County Purchasing
Office.
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Publication Dates
Citizen: Sat., 04/20/19
Keys Weekly: Thur., 04/25/19
News Barometer: Fri., 04/26/19 �s
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SECTION ONE: INSTRUCTION TO PROPOSERS
1. OBJECTIVE OF THE REQUEST FOR PROPOSAL
Monroe County is seeking a contractor that will provide Insurance Consulting Services
as set out in the Scope of Services — Exhibit A. The contract awarded is anticipated to
be for a period of three initial years, with two (2) additional 1-year terms at the mutual 0
agreement of the parties. The County's current consultant is Interisk Corporation
(Tampa). (n
2. CALENDAR
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Expected dates are as shown below. The County reserves the right to modify the dates U
as necessary.
Date Activity U)
April 20, 2019 RFP Release Date IL
May 10, 2019 Deadline for Vendor Questions
May 15, 2019 Addendum Release Date
May 23, 2019 Bid Opening — 3:00 PM. No late bids will be accepted U)
May 31, 2019 Selection Committee Ranking Meeting
June 19, 2019 Monroe County BOCC Meeting — Bid Award
October 1, 2019 Contract Effective Date-
3. BACKGROUND INFORMATION
Monroe County ("County") is a non-chartered county and a political subdivision of the
State of Florida. The County is a linear set of islands, approximately 120 miles in
length, stretching from Key West to mainland Florida. County population is
approximately 77,000 (source: United States Census Bureau). Approximately one-third
of the county's population is located in the city of Key West, which is the County seat.
However, County buildings and employees are spread throughout the Florida Keys.
The five-member Board of County Commissioners (BOCC) is the legislative and
governing body for the County. Each County Commissioner is elected County-wide.
The Commission annually elects a chairperson (Mayor). The BOCC has all the powers a.
of a body corporate, including the powers to contract; to sue and be sued; to acquire,
purchase, hold, lease and convey real estate and personal property; to borrow money
and to generally exercise the powers of a public authority organized and existing for the
purpose of providing community services to citizens within its territorial boundaries. In
order to carry out this function, the county is empowered to levy taxes to pay the cost of
operations.
The BOCC appoints a County Administrator, who is responsible for all day-to-day
administration of the County. The BOCC also appoints a County Attorney, who is
responsible for legal services for the County.
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4. DESCRIPTION OF CURRENT INSURANCE PROGRAM
Risk: The cornerstone of Monroe County's property and casualty insurance program is
a primary property program with a $5 million-dollar limit and $1 million-dollar deductible
for named windstorms (currently through Lloyd's of London); separate multiple wind and
flood policies with $1 million limits on each; and an excess policy in the amount of$230
million. General and vehicle liability with a policy limit of up to $5 million per occurrence
and a $200,000 self-insured retention is provided through a policy from the Florida 0
League of Cities/Florida Municipal Insurance Trust. The County also has other
separate policies as shown in Attachment 2. Risk is administered by Risk Management, (n
within the County Attorney's Office.
Of note, the County is the only County in Florida to operate its own assisted living
facility (Bayshore Manor), and the County runs its own air ambulance program using U
helicopters owned by the Monroe County Sheriff but staffed with Monroe County Fire
Rescue paramedics and flight nurses.
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Workers' compensation: The County's workers' compensation insurance program a.
covers not only employees of the Monroe County Board of County Commissioners, but
also employees of the five constitutional officers within the County (Clerk, Sheriff, Tax
Collector, Supervisor of Elections, and Property Appraiser), as well as Land Authority U)
and, by statute, Fire Rescue volunteers (approximately 1700 covered individuals). The
County's workers compensation program is self-insured, with a $500,000 self-insured
retention as well as excess coverage in excess of that limit. The County also maintains
Employer's Liability policy in the amount of up to $1 million per occurrence.
Workers' compensation is housed within the Employee Services and utilizes the
services of a Third-Party Administrator (currently Relation Insurance).
Both: The County maintains internal service funds for funding its self-insured property
and casualty insurance program and its workers' compensation coverages.
The County's operating budget is approximately $ 344 million.
5. SCOPE OF THE WORK TO BE PROVIDED BY PROPOSER
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The scope of services are described in Exhibit A of this document.
6. OTHER REQUIREMENTS
The firm selected must enter into a Business Associate Agreement that will certify
that all staff members, independent contractors, subcontracted work, if any, all
service providers it uses, engages or manages, comply with Health Insurance
Portability and Accountability Act (HIPAA) privacy and security rules.
Proposals received from firms that have contractual relationships that would preclude
the firm from being unbiased in the services provided to the County will not be
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selected. The proposer must disclose whether it receives commissioners or fees
from, or has any contractual relationships with, any persons or entities that provide
coverage or other services in the areas of workers' compensation or risk
management.
The Proposer must warrant that it has not employed or retained a company or
person, other than a bona fide employee, contractor or subcontractor, working in its
employ, to solicit or secure a contract with the County and that it has not paid or 0
agreed to pay any person, company, corporation, individual or firm any fee,
commission, percentage, gift or other consideration contingent upon or resulting from (n
an award or contract with the County, other than a bona fide employee, contractor or
subcontractor of the proposer.
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The firm and its employees who are responsible and accountable for the county's U
account and subcontractors, if any, must have all necessary current licenses issued
by the Florida Department of Insurance. Proper documentation shall be attached to
the proposal in Tab 6.
The County will not consider any insurance company, insurance agency, insurance
broker, third party administrator, or officer, director, agent or employee of any of the
foregoing. If a proposer is a consultant and is not a broker but accepts fees or U)
commissions, that proposer is not precluded from bid consideration but must disclose
the fees and commissions received within the past 12 months and the source.
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The County will not consider any consulting firm owned or controlled by an insurance
company, insurance sales organization, third party administrator or any consulting
firm which owns or controls any insurance company, insurance sales organization, or
third-party administrator.
7. COMPENSATION AND PAYMENT TERMS
• The County is requesting that the Respondent quote a fixed annual fee that
encompasses the entire scope of services requested in Exhibit A.
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• The contractor shall submit to the County an invoice with supporting
documentation acceptable to the Clerk on a schedule as set forth in the contract.
Acceptability to the Clerk is based on generally accepted accounting principles
and such laws, rules and regulations as may govern the Clerk's disbursal of
funds.
• The contractor will submit such invoice monthly for services provided during
the preceding month. The invoice will include a record of employee time
worked and differentiate time worked at the rate for the different
classification.
• Upon receipt of the contractor's invoice in the proper form as stipulated
above and upon acceptance by the Clerk, Monroe County will make
payment in accordance with the Florida Local Government Prompt Payment
Act, Section 218.70, Florida Statutes.
8. REQUESTS FOR ADDITIONAL INFORMATION OR CLARIFICATION
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Request for additional information or clarification relating to the specifications of this
Request for Proposals shall be submitted in writing directly to:
Maria Slavik, Risk Administrator
Monroe County
1111 12t" St., Suite 408 0
Key West, FL 33040
Slavik-maria@monroecounty-fl.gov �s
Facsimile (305)
All requests for additional information must be received no later than 3:00 p.m. May 10,
2019. Any requests received after that date and time will not be answered. U
All questions regarding the RFP received prior to the deadline will be answered to the
best of the County's ability and will be distributed to all interested Proposers in the form
of an Addendum to this RFP on Demand Star on or before May 15, 2019. Oral IL
requests for additional information will not be answered.
All addenda are a part of the contract documents and each Proposer will be bound by U)
such addenda, whether or not received by him/her. It is the responsibility of each
Proposer to verify that he/she has received all addenda issued before responses are
opened.
9. NUMBER OF COPIES OF PROPOSALS REQUIRED; BID OPENING DATE;
DELIVERY LOCATION.
See also Notice of Request for Competitive Solicitation.
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Vendors shall submit a total of six (6) documents (three (3) signed originals plus three
(3) complete copies) and one (1) complete document saved, electronically tabbed and
indexed in Adobe Acrobat file (pdf) format delivered on a current common electronically 0
saved form (i.e., flash drive, etc.) of the proposal, in a sealed envelope. The envelope
shall be clearly marked on the outside with:
"Requests for Proposals for Insurance Consulting Services", and shall be
addressed to:
Monroe County Purchasing Department,
1100 Simonton Street, Room 2-213,
Key West, FL 33040.
The proposal must be received on or before 3:00 P.M. local time on May 23, 2019. No
proposals will be accepted after 3:00 P.M.
Hand delivered Proposals may request a receipt. Faxed or e-mailed proposals shall be
automatically rejected. It is the sole responsibility of each Proposer to ensure its
proposal is received in a timely fashion. Vendors should be aware of the fact that
overnight delivery services to the Florida Keys often take more than one day.
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10. FORMAT AND CONTENT OF PROPOSALS
The proposal submitted in response to this Request for Proposals (RFP) shall be
printed on 8-1/2" x 11" white paper and bound; shall be clear and concise, tabulated,
and provide the information requested herein. Statements submitted without the
required information will not be considered. Responses shall be organized as indicated
below. The Proposer should not withhold any information from the written response in 0
anticipation of presenting the information orally or in a demonstration, since oral
presentations or demonstrations may not be solicited. Each Proposer must submit (n
adequate documentation to certify the Proposer's compliance with the County's
requirements. Proposer should focus specifically on the information requested.
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Format. The proposal, at a minimum, shall include the following: U
A. Cover Page,
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A cover page that states "Requests for Proposals for Insurance Consulting a.
Services". The cover page should contain Proposer's name, address, telephone
number, and the name of the Proposer's contact person.
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B. Tabbed Sections a
A
Tab 1. General Information Behind this tab, the Proposer shall supply the following
information:
(a) An overview of the firm's experience.
(b) The length of time the firm has been providing Insurance Consulting Services
(c) Statement of the firm's commitment to higher education of its consultants within
the insurance and risk management disciplines.
(d) Other experience.
(e) Description of reference material and computer software specific to workers'
compensation and risk management. 0
(f) Resumes of all key members of the account team that will be assigned as
consultants including professional designations.
(g) 3-5 customer references along with their telephone numbers, addresses and
names of the persons who can be contacted to provide a reference. (Florida
government clients will be preferred, and current clients of the firm will be
preferred over former.) (Monroe County Code section 2-347(h)(5)(f).)
(h) Credit references (3-5), including name, current address and current telephone
number. (Monroe County Code section 2-347(h)(5)(g).)
(i) Financial information for the past three (3) years for the Proposer, and for any
entity that is a subsidiary to the Proposer, if named separately as a provider.
(Monroe County Code section 2-347(h)(5)(h).)'
' See also Section 10 of this RFP, Treatment of Confidential and Trade Secret Information.
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Tab 2. Relevant Experience
Behind this tab, the Proposer shall describe any relevant experience, including a record
of performance and professional accomplishments by Proposer and employees,
including professional accomplishments, and any work with large companies or
government entities.
The Proposer shall provide a list of similar contracts or agreements currently in force to 0
include: >
Name and full address (n
Telephone number of client contact
Date of initiation and completion of contract
Summary of the services and geographical area served 0
Tab 3. Services, Approach and Availability of Service to County
(a) The Proposer shall describe the approach and methodology he/she will take
to accomplish the services described in Exhibit A. This shall include information on
schedule and availability, staffing, whether sub-contractors are used, and any other U)
relevant information explaining how the services will be accomplished.
(b) The Proposer should describe the delivery of each service listed in the
Scope of Services (Exhibit A) in this RFP and how this will be accomplished. The
Proposer should respond in detail and avoid a general overall response.
Tab 4. Litigation
In accordance with Section 2-347(h) of the Monroe County Code, the Proposer must
provide the following information:
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(1) A list of the person's or entity's shareholders with five (5) percent or more of the
stock or, if a general partnership, a list of the general partners; or, if a limited
liability company, a list of its members; or, if a solely owned proprietorship,
names(s) of owner(s);
(2) A list of the officers and directors of the entity;
(3) The number of years the person or entity has been operating and, if different, the
number of years it has been providing the services, goods, or construction
services called for in the bid specifications (include a list of similar projects);
(4) The number of years the person or entity has operated under its present name
and any prior names;
(5) Answers to the following questions regarding claims and suits:
a. Has the person, principals, entity, or any entity previously owned,
operated or directed by any of its officers, major shareholders or directors,
ever failed to complete work or provide the goods for which it has
contracted? If yes, provide details;
b. Are there any judgments, claims, arbitration proceeding or suits pending
or outstanding against the person, principal of the entity, or entity, or any
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entity previously owned, operated or directed by any of its officers,
directors, or general partners? If yes, provide details;
c. Has the person, principal of the entity, entity, or any entity previously
owned, operated or directed by any of its officers, major shareholders or
directors, within the last five (5) years, been a party to any lawsuit,
arbitration, or mediation with regard to a contract for services, goods or
construction services similar to those requested in the specifications with
private or public entities? If yes, provide details; 0
d. Has the person, principal of the entity, or any entity previously owned,
operated or directed by any of its officers, owners, partners, major (n
shareholders or directors, ever initiated litigation against the county or
been sued by the county in connection with a contract to provide services,
goods or construction services? If yes, provide details;
e. Whether, within the last five (5) years, the owner, an officer, general U
partner, principal, controlling shareholder or major creditor of the person or
entity was an officer, director, general partner, principal, controlling
shareholder or major creditor of any other entity that failed to perform
services or furnish goods similar to those sought in the request for a.
competitive solicitation.
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Tab 5. Other Information a
A
Proposer shall provide any additional information which will present evaluators with 0
insight about the knowledge, skills and abilities of the Proposer.
If the Proposer cannot fully comply with any of the terms contained in the draft contract,
shown in Section Two, all deviations to the terms must be spelled out in this section, i.e.
Tab 5.
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Tab 6. Forms and Licenses
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Proposer shall complete, execute and attach the forms listed below, which are located 0
in Section Three in this RFP, as well as a copy of a business tax receipt from the Tax
Collector office and shall include them in this section, i.e. Tab 6:
Forms U)
Submission Response Form (from Section Three of this RFP)
Questionnaire (Attachment 1)
Lobbying and Conflict of Interest Ethics Clause
Non-Collusion Affidavit
Drug Free Workplace Form
Public Entity Crime Statement
11. TREATMENT OF CONFIDENTIAL AND TRADE SECRET INFORMATION
All Proposals received as a result of this RFP are subject to Florida's public records
laws contained in Chapter 119, Florida Statutes and will be made available for
inspection by any person in accordance with Florida Statutes. Any Proposer asserting
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that any portion of its Proposal is confidential or exempt from disclosure under
Florida's public records laws must specifically identify the portions of the Proposal
asserted to be confidential and must provide specific citations of the Florida Statutes
that establish the confidentiality or exemption.
All material that is designated as exempt from Chapter 119 must be submitted in a
separate envelope, clearly identified as "PUBLIC RECORDS EXEMPT" with your
name and the Proposal name marked on the outside. If that material is requested 0
through a public records request, the County will notify the Proposer of the request and
give the Proposer five (5) calendar days to obtain a court order blocking the production (n
of the material. If a court order is not issued during that time to block the production, the
material will be produced.
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By your designation of material in your Proposal as "Public Records Exempt", you U
agree to defend and hold harmless the County from any claims, judgments, damages,
costs, and attorney's fees and costs of the challenger and for costs and attorney's fees
incurred by the County by reason of any legal action challenging your designation.
Please be advised that the designation of an item as exempt from disclosure as a Public
Record may impact the ability of the Evaluating Body to adequately assess a Proposal
and may therefore affect the ultimate award of the contract. U)
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12. DISQUALIFICATION OF PROPOSER
A. NON-COLLUSION AFFIDAVIT: Any person submitting a proposal in
response to this invitation must execute the enclosed NON-COLLUSION
AFFIDAVIT. If it is discovered that collusion exists among the Proposers,
the proposals of all participants in such collusion shall be rejected, and no
participants in such collusion will be considered in future proposals for the
same work.
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B. PUBLIC ENTITY CRIME: A person or affiliate who has been placed on the 0
convicted vendor list following a conviction for a public entity crime may
not submit a proposal on a contract to provide any goods or services to a
public entity, may not submit a proposal on a contract with a public entity
for the construction or repair of a public building or public work, may not
submit Proposals on leases or perform work as a contractor, supplier, a.
subcontractor, or contractor under a contract with any public entity, and
may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, for CATEGORY TWO for a period of
36 months from the date of being placed on the convicted vendor list.
Category Two: $25,000.00
C. DRUG-FREE WORKPLACE FORM: Any person submitting a bid or
proposal in response to this invitation must execute the enclosed DRUG-
FREE WORKPLACE FORM and submit it with his/her proposal. Failure to
complete this form in every detail and submit it with the bid or proposal
may result in immediate disqualification of the bid or proposal.
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D. LOBBYING AND CONFLICT OF INTEREST ETHICS CLAUSE: Any
person submitting a bid or proposal in response to this invitation must
execute the enclosed LOBBYING AND CONFLICT OF INTEREST
CLAUSE and submit it with his/her bid or proposal. Failure to complete
this form in every detail and submit it with the bid or proposal may result
in immediate disqualification of the bid or proposal.
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13. EXAMINATION OF RFP DOCUMENTS
A. Each Proposer shall carefully examine the RFP and other contract
documents, and inform himself/herself thoroughly regarding any and all
conditions and requirements that may in any manner affect cost,
progress, or performance of the work to be performed under the contract. U
Ignorance on the part of the Proposer shall in no way relieve him/her of
the obligations and responsibilities assumed under the contract.
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B. Should a Proposer find discrepancies or ambiguities in, or omissions a.
from, the specifications, or should he be in doubt as to their meaning, he
shall at once notify the County.
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14. GOVERNING LAWS AND REGULATIONS
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The Proposer is required to be familiar with and shall be responsible for complying with
all federal, state, and local laws, ordinances, rules, professional license requirements
and regulations that in any manner affect the work. Knowledge of business tax
requirements and the responsibility for paying the tax in Monroe County and
municipalities within Monroe County are the responsibility of the Proposer.
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15. SIGNATURE OF PROPOSALS
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Signature of the Proposer: The Proposer must sign the response forms in the space
provided for the signature. If the Proposer is an individual, the words "doing business as
or "Sole Owner" must appear beneath such signature. In the case of a
partnership, the signature of at least one of the partners must follow the firm name and
the words "Member of the Firm" should be written beneath such signature. If the
Proposer is a corporation, the title of the officer signing the Response on behalf of the a.
corporation must be stated along with the Corporation Seal Stamp and evidence of his
authority to sign the Response must be submitted. The Proposer shall state in the
response the name and address of each person having an interest in the submitting
entity.
16. MODIFICATION OF RESPONSES
Written modification will be accepted from Proposers if addressed to the entity and
address indicated in the Notice of Request for Proposals and received prior to Proposal
due date and time. Modifications must be submitted in a sealed envelope clearly
marked on the outside with the Proposer's name and "Modification to Proposal -
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Monroe County Proposal for Insurance Consulting Services". If sent by mail or by
courier, the above-mentioned envelope shall be enclosed in another envelope
addressed to the entity and address stated in the Notice of Request for Competitive
Solicitation. Faxed or e-mailed modifications shall be automatically rejected.
17. PROPOSER SOLELY RESPONSIBLE FOR COST OF PROPOSAL
The Proposer is solely responsible for all costs of preparing and submitting the
response, regardless of whether a contract award is made by the County.
18. RECEIPT AND OPENING OF RESPONSES
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Responses will be received until the designated time and will be publicly opened. 0
Proposers' names shall be read aloud at the appointed time and place stated in the
Notice of Request for Competitive Solicitations. Monroe County's representative
authorized to open the responses will decide when the specified time has arrived, and
no responses received thereafter will be considered. No responsibility will be attached
a.
to anyone for the premature opening of a response not properly addressed and
identified. Proposers or their authorized agents are invited to be present. W
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The County reserves the right to reject any and all responses and to waive technical
errors and irregularities as may be deemed best for the interests of the County.
Responses that contain modifications are incomplete, unbalanced, conditional, obscure,
or that contain additions not requested or irregularities of any kind, or that do not comply
in every respect with the Instruction to Proposer and the contract documents, may be
rejected at the option of the County.
19. EVALUATION CRITERIA
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Award shall be made to the responsible proposer whose proposal is determined to be
the most advantageous to the County, taking into consideration the evaluation criteria
set forth below:
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Experience and Qualifications 30 points
Ability to provide all required services 30 points
Cost of services 35 points
Location of firm 5 points
Total 100 points
Total points earned are on a scale of 1 — 100 points
1 = lowest 100 = highest
A Selection Committee will be analyzing proposals and providing recommendations to
the County Administrator who will ultimately make a recommendation to the Board of
County Commissioners regarding which individual or firm should be hired.
20. AWARD OF CONTRACT
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A. The County reserves the right to award separate contracts for the services
based on geographic area or otherwise, and to waive any informality in any response,
or to re-advertise for all or part of the work contemplated. It is possible that one or more
Proposers will be chosen.
B. The County reserves the right to reject all proposals.
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21. INSURANCE REQUIREMENTS
The Proposer shall be responsible for all necessary insurance coverage as indicated
below. Certificates of Insurance must be provided to Monroe County within fifteen (15)
days after award of contract, with Monroe County BOCC listed as additional insured as
indicated. If the proper insurance forms are not received within the fifteen (15) day U
period, the contract may be awarded to the next selected Proposer. Policies shall be
written by companies licensed to do business in the State of Florida and having an
agent for service of process in the State of Florida. Companies shall have an A.M. Best
rating of VI or better and a financial rating of A- from A.M. Best. The required insurance a.
shall be maintained at all times while Proposer is providing service to County, and the
vendor to whom a contract is awarded shall provide updated certificates of insurance to
demonstrate that the appropriate coverages are current and in force as necessary. U)
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Workers' Compensation
Statutory Limits
Employers' Liability Insurance
Bodily Injury by Accident $100,000
Bodily Injury by Disease, policy limits $500,000
Bodily Injury by Disease, each employee $100,000
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General Liability, including
Premises Operation
Products and Completed Operations
Blanket Contractual Liability 0
Personal Injury Liability
Expanded Definition of Property Damage
$300,000 Combined Single Limit
a.
If split limits are provided, the minimum limits acceptable shall be:
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$200,000 per person
$300,000 per occurrence
$200,000 property damage
Vehicle Liability
(Owned, non-owned and hired vehicles) $100,000 Combined Single Limit
If split limits are provided, the minimum limits acceptable shall be:
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$50,000 per person
$100,000 per occurrence
$25,000 property damage
Professional Liability $300,000 per Occurrence
$500,000 Aggregate
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Monroe County shall be named as an Additional Insured on the General Liability
policy and Vehicle Liability Policies. �s
22. INDEMNIFICATION
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The Proposer to whom a contract is awarded shall defend, indemnify and hold harmless U
the County as outlined below.
The Proposer covenants and agrees to indemnify, hold harmless and defend Monroe
County, its commissioners, officers, employees, agents and servants from any and all a.
claims for bodily injury, including death, personal injury, and property damage, including
damage to property owned by Monroe County, and any other losses, damages, and
expenses of any kind, including attorney's fees, court costs and expenses, which arise U)
out of, in connection with, or by reason of services provided by the Proposer or any of
its Subcontractor(s), occasioned by the negligence, errors, or other wrongful act or
omission of the Proposer, its Subcontractor(s), their officers, employees, servants or
agents.
In the event that the service is delayed or suspended as a result of the Vendor's failure
to purchase or maintain the required insurance, the Vendor shall indemnify the County
from any and all increased expenses resulting from such delay.
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The first ten dollars ($10.00) of remuneration paid to the Proposer is consideration for
the indemnification provided for above. The extent of liability is in no way limited to,
reduced, or lessened by the insurance requirements contained elsewhere within this 0
agreement.
23. EXECUTION OF CONTRACT
a.
The Proposer will be required to execute a contract with the County for the services
provided for in this RFP. The Proposer with whom a contract is negotiated shall be
required to return to the County one (1) executed counterpart of the prescribed Contract
together with the required certificates of insurance. A Draft of the contract is attached in
Section Two.
If the Proposer cannot fully comply with any terms contained in the draft contract, shown
in Section Two, all deviations to the terms must be spelled out in Tab 5, Other
Information.
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24. AMERICANS WITH DISABILITIES ACT.
Individuals covered by the Americans with Disabilities Act of 1990 in need of
accommodations to attend public bid openings or meetings should contact Monroe
County Administrator's office at (305) 292-4443 at least three days prior to the date for
the bid opening or meeting.
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SECTION TWO: DRAFT AGREEMENT
MONROE COUNTY
CONTRACT FOR
INSURANCE CONSULTING SERVICES
THIS AGREEMENT ("Agreement") is made and entered into this day of 0
by MONROE COUNTY ("COUNTY"), a political subdivision of the
State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040 and (n
("CONTRACTOR"), whose address is
This Agreement shall consist of this contract document, the Request for Proposal (RFP)
issued by Monroe County for these services, and the Proposal submitted by the U
Contractor in response to the RFP, all of which are incorporated by reference.
Section 1. SCOPE OF SERVICES U)
CONTRACTOR shall do, perform and carry out in a professional and proper manner
certain duties as described in the Scope of Services — Exhibit A—which is attached
hereto and made a part of this agreement. U)
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CONTRACTOR shall provide the scope of services in Exhibit A for COUNTY.
CONTRACTOR warrants that it is authorized by law to engage in the performance of
the activities herein described, subject to the terms and conditions set forth in these
Agreement documents. The CONTRACTOR shall at all times exercise independent,
professional judgment and shall assume professional responsibility for the services to
be provided. Contractor shall provide services using the following standards, as a
minimum requirement:
A. The CONTRACTOR shall maintain adequate staffing levels to provide the
services required under the Agreement resulting from this RFP process.
B. The personnel shall not be employees of or have any contractual
relationship with the County. To the extent that Contractor uses U
subcontractors or independent contractors, this Agreement specifically
requires that subcontractors and independent contractors shall not be an
employee of or have any contractual relationship with County.
C. All personnel engaged in performing services under this Agreement shall a.
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be fully qualified, and, if required, to be authorized or permitted under
State and local law to perform such services.
Section 2. QUALIFICATIONS NECESSARY OF CONTRACTOR
The CONTRACTOR must warrant that it does not have contractual relationships that
would preclude the firm from being unbiased in the services provided to the County.
The CONTRACTOR must provide a list annually, listing any contractual relationship
between the CONTRACTOR and any persons or business entities that provide
services in the areas of Workers' Compensation and/or Risk Management.
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The CONTRACTOR must provide an adequate staff of experienced personnel,
capable of and devoted to the successful accomplishment of work to be performed
under any contract with the County. The CONTRACTOR must assign specific
individuals to the key positions. Once assigned to work under any contract with the
County, key personnel shall not be moved or replaced without prior written
notification to the County.
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The following persons will provide the services under this Agreement:
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Any change to the above listed personnel requires notification to the County, in
writing, within three (3) business days after implementation of the change.
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The CONTRACTOR must warrant that it has not employed or retained a company or a.
person, other than a bona fide employee, contractor or subcontractor, working in its
employ, to solicit or secure a contract with the County and that it has not paid or
agreed to pay any person, company, corporation, individual or firm other than a bona U)
fide employee, contractor or subcontractor, working in its employ any fee,
commission, percentage, gift or other consideration contingent upon or resulting from
the award or making of a contract with the County.
The firm and its employees who are responsible and accountable for the county's
account and subcontractors, if any, must have all necessary current licenses issued
by the Florida Department of Insurance. Proper documentation shall be attached to
the contract.
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The CONTRACTOR must warrant that it is not owned or controlled by an insurance
company, insurance sales organization, third party administrator or any consulting
firm which owns or controls any insurance company, insurances sales organization,
or third-party administrator.
Section 3. COUNTY'S RESPONSIBILITIES
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The County shall provide the information required by the Contractor to perform the
Scope of Services.
Section 4. TERM OF AGREEMENT
4.1 The initial Agreement term (the Initial Term) shall be for three (3) years beginning
the day of 2019 (the effective date).
4.2 Thereafter, this Agreement may be renewed, at the mutual agreement of the
parties, for two (2) additional terms of one year each.
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Section 5. COMPENSATION
Compensation to CONTRACTOR shall be $ per year.
Section 6. PAYMENT TO CONTRACTOR
By entering into this Agreement, the CONTRACTOR warrants that it understands
that the Contract price represents the full compensation for all services under 0
this Agreement, and further warrants that it will not retain any compensation of
any kind, including but not limited to commissions, fees, and other payments, �s
from any entity that supplies Workers' Compensation or Risk Management
services to the COUNTY, including but not limited to carriers, third party
administrators or providers. The CONTRACTOR understands and agrees that in
the event of breach of this provision, the Agreement is voidable, and U
CONTRACTOR will disgorge any and all compensation earned to that point in
time and will waive any right to any additional compensation from that point
forward. U)
6.1 Payment will be made according to the Florida Local Government Prompt
Payment Act Section 218.70 Florida Statutes. Any request for payment must be
in a form satisfactory to the Clerk of Courts for Monroe County (Clerk). The U)
request must describe in detail the services performed and the payment amount
requested. The CONTRACTOR must submit invoices to the appropriate offices
marked Group Insurance. The respective office supervisor and the Director of
Employee Services, who will review the request, note his/her approval on the
request and forward it to the Clerk for payment.
6.2 This Agreement is contingent upon annual appropriation by Monroe County
Board of County Commissioners.
6.3 The compensation listed in Section 5 will be payable in monthly installments.
The CONTRACTOR will submit such invoices monthly for services provided
during the preceding month.
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Section 7. CONTRACT TERMINATION
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Either party may terminate this Agreement with or without cause upon ninety (90) days'
notice to the other party in accordance with Section 9 of this Agreement. The County
shall pay CONTRACTOR for all work performed through the date of termination.
a.
Section 8. NOTICES
Any notice required or permitted under this Agreement shall be in writing and hand
delivered or mailed, postage prepaid, to the other party by certified mail, returned
receipt requested, to the following:
To the COUNTY: Risk Management Administrator
1111 12t" St., Suite 408
Key West, Florida 33040
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With a copy to: Monroe County Attorney
1111 12t" St., Suite 408
Key West, FL 33040
To the CONTRACTOR:
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Section 10. RECORDS �s
CONTRACTOR shall maintain all books, records, and documents directly pertinent to
performance under this Agreement in accordance with generally accepted accounting
principles consistently applied. Each party to this Agreement or their authorized U
representatives shall have reasonable and timely access to such records of each other
party to this Agreement for public records purposes during the term of the agreement
and for four years following the termination of this Agreement. If an auditor employed
by the COUNTY or Clerk determines that monies paid to CONTRACTOR pursuant to
this Agreement were spent for purposes not authorized by this Agreement, the
CONTRACTOR shall repay the monies together with interest calculated pursuant to
Section 55.03 of the Florida Statutes, running from the date the monies were paid to U)
CONTRACTOR.
Pursuant to F.S. 119.0701, Contractor and its subcontractors shall comply with all public
records laws of the State of Florida, including but not limited to:
a. Keep and maintain public records required by Monroe County in order to
perform the service.
b. 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.
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c. 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
a.
contractor does not transfer the records to the public agency.
d. 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
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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, r ley-
r c rceccu ty jL cv, c/o Monroe County Attorney's Office, 1111
12t" St., Suite 408, Key West FL 33040.
Section 11. EMPLOYEES SUBJECT TO COUNTY ORDINANCE NOS. 010 AND
020-1990
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The CONTRACTOR warrants that it has not employed, retained or otherwise had act on
its behalf any former County officer or employee subject to the prohibition of Section 2
of Monroe County Ordinance No. 010-1990 or any County officer or employee in
violation of Section 3 of Ordinance No. 020-1990. For breach or violation of this a.
provision the COUNTY may, in its discretion, terminate this agreement without liability
and may also, in its discretion, deduct from the agreement or purchase price, or
otherwise recover the full amount of any fee, commission, percentage, gift, or U)
consideration paid to the former County officer or employee.
Section 12. CONVICTED VENDOR
By signing this agreement, CONTRACTOR represents that the execution of this
Agreement will not violate the Public Entities Crime Act (Section 287.133, Florida
Statutes). Violation of this section shall result in termination of this Agreement and
recovery of all monies paid hereto, and may result in debarment from County's
competitive procurement activities.
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 an Agreement with a public
entity for the construction or repair of a public building or public work, may not perform
work as a CONTRACTOR, supplier, subcontractor, or CONTRACTOR under
Agreement with any public entity, and may not transact business with any public entity U)
in excess of the threshold amount provided in Section 287.017 of the Florida Statutes, a.
for the Category Two for a period of 36 months from the date of being placed on the
convicted vendor list.
Section 13. GOVERNING LAW, VENUE, INTERPRETATION, COSTS AND FEES
This Agreement shall be governed by and construed in accordance with the laws of the
State of Florida applicable to Agreements made and to be performed entirely in the
State.
In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of this Agreement, the COUNTY and CONTRACTOR
agree that venue shall lie in the appropriate court or before the appropriate
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administrative body in Monroe County, Florida.
Section 14. SEVERABILITY
If any term, covenant, condition or provision of this Agreement (or the application
thereof to any circumstance or person) shall be declared invalid or unenforceable to any
extent by a court of competent jurisdiction, the remaining terms, covenants, conditions
and provisions of this Agreement, shall not be affected thereby; and each remaining 0
term, covenant, condition and provision of this Agreement shall be valid and shall be
enforceable to the fullest extent permitted by law unless the enforcement of the (n
remaining terms, covenants, conditions and provisions of this Agreement would prevent
the accomplishment of the original intent of this Agreement. The COUNTY and
CONTRACTOR agree to reform the Agreement to replace any stricken provision with a
valid provision that comes as close as possible to the intent of the stricken provision. U
Section 15. ATTORNEYS FEES AND COSTS
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The COUNTY and CONTRACTOR agree that in the event any cause of action or a.
administrative proceeding is initiated or defended by any party relative to the
enforcement or interpretation of this Agreement, the prevailing party shall be entitled to
reasonable attorney's fees, and court costs, as an award against the non-prevailing U)
party. Mediation proceedings initiated and conducted pursuant to this Agreement shall
be in accordance with the Florida Rules of Civil Procedure and usual and customary
procedures required by the Circuit Court of Monroe County.
Section 16. BINDING EFFECT
The terms, covenants, conditions, and provisions of this Agreement shall bind and inure
to the benefit of the COUNTY and CONTRACTOR and their respective legal
representatives, successors, and assigns.
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Section 17. AUTHORITY
Each party represents and warrants to the other that the execution, delivery and
performance of this Agreement have been duly authorized by all necessary County and
a.
corporate action, as required by law.
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Section 18. ADJUDICATION OF DISPUTES OR DISAGREEMENTS
COUNTY and CONTRACTOR agree that all disputes and disagreements shall be
attempted to be resolved by meet and confer sessions between representatives of each
of the parties. If the issue or issues are still not resolved to the satisfaction of the
parties, then any party shall have the right to seek such relief or remedy as may be
provided by this Agreement or by Florida law. This Agreement shall not be subject to
arbitration.
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Section 19. COOPERATION
In the event any administrative or legal proceeding is instituted against either party
relating to the formation, execution, performance, or breach of this Agreement,
COUNTY and CONTRACTOR agree to participate, to the extent required by the other
party, in all proceedings, hearings, processes, meetings, and other activities related to
the substance of this Agreement or provision of the services under this Agreement.
COUNTY and CONTRACTOR specifically agree that no party to this Agreement shall 0
be required to enter into any arbitration proceedings related to this Agreement.
Section 20. NONDISCRIMINATION
COUNTY and CONTRACTOR agree that there will be no discrimination against any
person, and it is expressly understood that upon a determination by a court of U
competent jurisdiction that discrimination has occurred, this Agreement automatically
terminates without any further action on the part of any party, effective the date of the
court order. The parties agree to comply with all Federal and Florida statutes, and all
local ordinances, as applicable, relating to nondiscrimination. These include but are not a.
limited to: 1) Title VI I of the Civil Rights Act of 1964 (PL 88-352) which prohibits
discrimination in employment on the basis of race, color, national origin; 2) Title IX of
the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685- U)
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 29-255), 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 ss. 3601 et seq.), as U)
amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The 0
Americans with Disabilities Act of 1990 (42 USC s. 1201), as may be amended from
time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County
Code Chapter 13, Article VI, which prohibits discrimination on the basis of race, color,
sex, religion, national origin, ancestry, sexual orientation, gender identity or expression,
familial status or age; and 11) any other nondiscrimination provisions in any Federal or
state statutes which may apply to the parties to, or the subject matter of, this
Agreement.
Section 21. COVENANT OF NO INTEREST
COUNTY and CONTRACTOR covenant that neither presently has any interest, and
shall not acquire any interest, which would conflict in any manner or degree with its
performance under this Agreement, and that only interest of each is to perform and
receive benefits as recited in this Agreement.
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Section 22. CODE OF ETHICS
The parties understand and 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 0
disclosure or use of certain information.
Section 23. NO SOLICITATION/PAYMENT
The COUNTY and CONTRACTOR warrant that, in respect to itself, it has neither
employed nor retained any company or person, other than a bona fide employee U
working solely for it, to solicit or secure this Agreement and that it has not paid or
agreed to pay any person, company, corporation, individual, or firm, other than a bona
fide employee working solely for it, any fee, commission, percentage, gift, or other
consideration contingent upon or resulting from the award or making of this Agreement.
For the breach or violation of the provision, the CONTRACTOR agrees that the a.
COUNTY shall have the right to terminate this Agreement without liability and, at its
discretion, to offset from monies owed, or otherwise recover, the full amount of such U)
fee, commission, percentage, gift, or consideration.
Section 24. NON-WAIVER OF IMMUNITY 0
Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the
COUNTY and the CONTRACTOR in this Agreement and the acquisition of any
commercial liability insurance coverage, self-insurance coverage, or local government
liability insurance pool coverage shall not be deemed a waiver of immunity to the extent
of liability coverage, nor shall any Agreement entered into by the COUNTY be required
to contain any provision for waiver.
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Section 25. NON-RELIANCE BY NON-PARTIES
No person or entity shall be entitled to rely upon the terms, or any of them, of this
Agreement to enforce or attempt to enforce any third-party claim or entitlement to or
benefit of any service or program contemplated hereunder, and the COUNTY and the
CONTRACTOR agree that neither the COUNTY nor the CONTRACTOR or any agent,
officer, or employee of either shall have the authority to inform, counsel, or otherwise
indicate that any particular individual or group of individuals, entity or entities, have
entitlements or benefits under this Agreement separate and apart, inferior to, or superior
to the community in general or for the purposes contemplated in this Agreement.
Section 26. ATTESTATIONS
CONTRACTOR agrees to execute such documents as the COUNTY may reasonably
require, including, but not being limited to, a Public Entity Crime Statement, an Ethics
Statement, and a Drug-Free Workplace Statement, Lobbying and Conflict of Interest
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Clause, and Non-Collusion Agreement.
Section 27. EXECUTION IN COUNTERPARTS
This Agreement may be executed in any number of counterparts, each of which shall be
regarded as an original, all of which taken together shall constitute one and the same
instrument and any of the parties hereto may execute this Agreement by signing any
such counterpart. An electronic signature may be used to execute the Agreement. 0
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Section 28. SECTION HEADINGS �s
Section headings have been inserted in this Agreement as a matter of convenience of
reference only, and it is agreed that such section headings are not a part of this
Agreement and will not be used in the interpretation of any provision of this Agreement. U
Section 29. INSURANCE POLICIES
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29.1 General Insurance Requirements for Other Contractors and a.
Subcontractors.
As a pre-requisite of the work governed, the CONTRACTOR shall obtain, at his/her own
expense, insurance as specified in any attached schedules, which are made part of this U)
contract. The CONTRACTOR will ensure that the insurance obtained will extend a
protection to all Subcontractors engaged by the CONTRACTOR. As an alternative, the
CONTRACTOR may require all Subcontractors to obtain insurance consistent with the
attached schedules; however CONTRACTOR is solely responsible to ensure that said
insurance is obtained and shall submit proof of insurance to COUNTY. Failure to
provide proof of insurance shall be grounds for termination of this Agreement.
The CONTRACTOR will not be permitted to commence work governed by this contract
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 CONTRACTOR to provide satisfactory evidence of the required insurance, shall not
extend deadlines specified in this contract and any penalties and failure to perform 0
assessments shall be imposed as if the work commenced on the specified date and
time, except for the CONTRACTOR's failure to provide satisfactory evidence.
The CONTRACTOR shall maintain the required insurance throughout the entire term of
this contract and any extensions specified in the attached schedules. Failure to comply
with this provision may result in the immediate suspension of all work until the required
insurance has been reinstated or replaced and/or termination of this Agreement and for
damages to the COUNTY. Delays in the completion of work resulting from the failure of
the CONTRACTOR 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 CONTRACTOR's failure
to maintain the required insurance.
The CONTRACTOR shall provide, to the COUNTY, as satisfactory evidence of the
required insurance, either:
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• 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 a minimum of thirty (30) days
prior notification is given to the County by the insurer.
The acceptance and/or approval of the Contractor's insurance shall not be construed as
relieving the Contractor from any liability or obligation assumed under this contract or
imposed by law.
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The Monroe County Board of County Commissioners, its employees and officials will be
included as "Additional Insured" on general liability and vehicle liability policies.
29.2 General Liability Insurance Requirements For Contract Between
County And Contractor a.
(Note: amounts of coverage are subject to change in final contract)
Prior to the commencement of work governed by this contract, the CONTRACTOR shall
obtain General Liability Insurance. Coverage shall be maintained throughout the life of A
the contract and include, as a minimum:
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• Premises Operations
• Bodily Injury Liability
• Expanded Definition of Property Damage
The minimum limits acceptable shall be:
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$300,000 Combined Single Limit (CSL)
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If split limits are provided, the minimum limits acceptable shall be:
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$200,000 per Person
$300,000 per Occurrence
$200,000 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.
29.3 Vehicle Liability Insurance requirements
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The minimum limits acceptable shall be owner and non-owned and hired vehicles:
$100,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limit is:
$50,000 per Person
$100,000 per Occurrence
$25,000 Property Damage
29.4 Workers' Compensation Insurance Requirements 0
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Prior to commencement of work governed by this contract, the CONTRACTOR shall (n
obtain Workers' Compensation Insurance with limits sufficient to respond to the
applicable state statutes.
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In addition, the CONTRACTOR shall obtain Employers' Liability Insurance with limits of U
not less than:
$100,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits a.
$100,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract. U)
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Coverage shall be provided by a company or companies authorized to transact
business in the state of Florida.
29.5 Professional Liability Requirements
Recognizing that the work governed by this contract involves the furnishing of advise or
services of a professional nature, the Contractor shall purchase and maintain,
throughout the life of the contract, Professional Liability Insurance which will respond to
damages resulting from any claim arising out of the performance of professional
services or any error or omission of the Contractor arising out of work governed by this 0
contract.
The minimum limits of liability shall be:
$300,000 per occurrence and $500,000 aggregate
Section 30. INDEMNIFICATION
The CONTRACTOR does hereby consent and agree to indemnify and hold harmless
the COUNTY, its Mayor, the Board of County Commissioners, appointed Boards and
Commissions, Officers, and the Employees, and any other agents, individually and
collectively, from all fines, suits, claims, demands, actions, costs, obligations, attorneys
fees, or liability of any kind arising out of the sole negligent actions of the
CONTRACTOR or substantial and unnecessary delay caused by the willful
nonperformance of the CONTRACTOR and shall be solely responsible and answerable
for any and all accidents or injuries to persons or property arising out of its performance
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of this contract. The amount and type of insurance coverage requirements set forth
hereunder shall in no way be construed as limiting the scope of indemnity set forth in
this paragraph. Further the CONTRACTOR agrees to defend and pay all legal costs
attendant to acts attributable to the sole negligent act of the CONTRACTOR.
At all times and for all purposes hereunder, the CONTRACTOR is an independent
contractor and not an employee of the Board of County Commissioners.
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As used in this section, the term "Contractor" shall include any subcontractors used by
the Contractor. (n
Section 30. Federal Contract Clauses. A portion of the funds used to pay for these
services are expected to come from federal awards, as that term is defined in 2 CFR
part 200. Therefore, the following federal contract clauses from 2 CFR part 200 are U
incorporated in and made part of this Agreement:
a. Debarment and Suspension (Executive Orders 12549 and 12689)—
A contract award (see 2 CFR 180.220) will not be made to parties
listed on the governmentwide exclusions in the System for Award a.
Management (SAM), in accordance with the OMB guidelines at 2
CFR 180 that implement Executive Orders 12549 (3 CFR part 1986
Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), 0
"Debarment and Suspension." SAM Exclusions contains the names
of parties debarred, suspended, or otherwise excluded by agencies,
as well as parties declared ineligible under statutory or regulatory
authority other than Executive Order 12549.
b. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors that
apply or bid for an award exceeding $100,000 must file the required
certification. Each tier certifies to the tier above that it will not and has
not used Federal appropriated funds to pay any person or
organization for influencing or attempting to influence an officer or
employee of any agency, a member of Congress, officer or employee
of Congress, or an employee of a member of Congress in connection
with obtaining any Federal contract, grant or any other award
covered by 31 U.S.C. 1352. Each tier must also disclose any
lobbying with non-Federal funds that takes place in connection with
obtaining any Federal award. Such disclosures are forwarded from
tier to tier up to the non-Federal award.
M
c. Americans with Disabilities Act of 1990 (ADA) — Contractor will
comply with all the requirements as imposed by the ADA, the
regulations of the Federal government issued thereunder, and the
assurance by the CONTRACTOR pursuant thereto.
d. Disadvantaged Business Enterprise (DBE) Policy and Obligation - It
is the policy of the COUNTY that DBE's, as defined in 49 C.F.R. Part
26, as amended, shall have the opportunity to participate in the
performance of contracts financed in whole or in part with COUNTY
funds under this Agreement. The DBE requirements of applicable
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federal and state laws and regulations apply to this Agreement. The
COUNTY and its CONTRACTOR agree to ensure that DBE's have
the opportunity to participate in the performance of this Agreement.
In this regard, all recipients and contractors shall take all necessary
and reasonable steps in accordance with applicable federal and state
laws and regulations to ensure that the DBE's have the opportunity
to compete for and perform contracts. The COUNTY and the
CONTRACTOR and subcontractors shall not discriminate on the 0
basis of race, color, national origin or sex in the award and
performance of contracts, entered pursuant to this Agreement. (n
e. The Contractor shall utilize the U.S. Department of Homeland
Security's E-Verify system to verify the employment eligibility of all
new employees hired by the Contractor during the term of the
Contract and shall expressly require any subcontractors performing
work or providing services pursuant to the Contract to likewise utilize
the U.S. Department of Homeland Security's E-Verify system to U)
verify the employment eligibility of all new employees hired by the a.
subcontractor during the Contract term.
f. No Obligation by Federal Government. The federal government is U)
not a party to this contract and is not subject to any obligations or
liabilities to the non-Federal entity, contractor, or any other party
pertaining to any matter resulting from the contract.
g. Program Fraud and False or Fraudulent Statements or Related Acts.
The Contractor acknowledges that 31 U.S.C. Chapter 38
Ir-
(Administrative Remedies for False Claims and Statements) applies
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to the Contractor's actions pertaining to this contract.
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IN WITNESS WHEREOF, the parties hereto have caused these presents to be
executed on the day of 20_.
(Seal) Monroe County Board of County
Commissioners
Attest: Kevin Madok, Clerk 0
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By: By:
Deputy Clerk Mayor
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(Corporate Seal) Contractor:
Witness:
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By: By:
Printed Name: Printed Name:
Title:
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EXHIBIT A
SCOPE OF SERVICES
SPECIFICATIONS
The County desires to enter into a contractual partnership with the selected Contractor
for insurance consulting services to include those services necessary to assist the 0
County in achieving its goals as outlined in this RFP. The selected Contractor will
represent, market and service the Property and Casualty and workers' compensation �s
needs of the County to include:
• Providing expert insurance consultation and assistance, including
evaluation of SIR, deductibles and risk financing alternatives
• Identifying needs and creating solutions to address those needs in all
areas of Risk management for a public sector entity
• Insurance market analysis for all lines of insurance
• Placement of coverage, TPA (third-party administrative) claims services,
and appraisal services when requested by the County
• Providing operational efficiency, responsiveness and resourcefulness in U)
support of all Monroe County Insurance and Risk Management
operations
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SPECIFIC REQUIREMENTS:
1. License and Staffing.
The company must:
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• Have experience providing Property & Casualty insurance consulting
services.
• Be licensed to conduct and transact business in the State of Florida.
• Be in good standing to communicate and cooperate with the State of
Florida's Department of Insurance.
All assigned key professional staff must be properly licensed to conduct and transact
business in the State of Florida. a.
An Account Executive must be appointed to oversee and administer the contract and
serve as the point of contact on issues related to the contract and to the insurance
obtained under the contract.
2. Marketing
Subject to final approval by Risk Management, the insurance consultant will: organize,
develop and present to underwriters, all necessary data for marketing of the County's
risk finance plans: review the marketing plan documents with Risk Management for
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approval to proceed prior to going to the market; negotiate and present to Risk
Management best risk finance / insurance policy terms, conditions and premium rates;
evaluate the underwriter(s) and prepare a report to discuss underwriter financial
stability and service commitment to clients; review and advise on policy language for
proper application to risk; meet with Risk Management to present marketing results for
policy renewal(s) no later than one-hundred twenty (120) days prior to renewal of
coverage. The marketing report for each renewal will include summaries of current
program versus renewal options including all terms, conditions, premium rates, 0
markets quoting and/or declination to quote and reasons; underwriter(s) ratings and
insurance consultant's recommendations. (n
• Provide ongoing review and advice to Monroe County staff on market trends
and pricing.
• Canvass the insurance market for appropriate carriers or reinsurers.
• The consultant is required to deliver to Risk Management at least 120-
days prior to each policy(s) expiration or anniversary date, completed
underwriter's applications for Risk Management review and approval. U)
• Create, analyze underwriting information and prepare underwriter a.
applications for submission to the worldwide insurance marketplace.
• Provide advice to Risk Management of the quotations of insurance
premiums and coverages obtained from insurance markets to meet the U)
County's needs; this must include at least three competitive quotes from
reputable carriers.
• Develop renewal proposals in conformity with the timeframe specified by
the County's Board and staff.
• Arrange access to underwriters and negotiate coverage terms in the best
interest of the County.
• Bind approved coverage and confirm placement in writing.
• Monitor the financial strength of the insurers providing the County's
coverages and inform the County of adverse developments in that status.
• Review and be responsible for the accuracy and correctness, prior to
delivery of excess/reinsurance coverage documents and/or pricing policies,
including all changes and endorsements.
• Invoice excess/reinsurance premiums, net of any commission, with U
appropriate written explanation regarding the manner in which the premium
was computed.
• Risk Management requires, through its insurance consultant, policy delivery
within 90-days of inception dates or renewal dates
• Monitor existing policies for renewal dates and provide Risk Management
with timely recommendations and service to include obtaining and
presenting renewal quotations and alternative coverage quotations if
renewal is not possible or desirable, in order to facilitate the continuity of
coverage. For each line of insurance, insurance consultant must approach
the market no later than 120 days prior to the expiration of coverage
• On an annual basis, prepare an analysis of Monroe County's estimated
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future obligations associated with the County's risk management program
for use by the County's external auditors as part of the annual review of the
County's financial reports as part of the preparation of the comprehensive
annual financial report (CAFR).
3. Risk Management:
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Provide support to Risk Management in development and maintenance of risk
financing plans that enable the County to succeed in it is over-all financial planning (n
and budgeting. Coordinate with actuarial efforts and provide comprehensive
information on market conditions and trends. Support innovative design of and
alternatives for most cost-effective risk financing methods.
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• Turn-key evaluation: Within thirty (30) days from the start of the contract,
provide a review of existing risk management operations and a
comprehensive analytical report detailing current status and highlighting
recommended changes.
• Advise Risk Management regarding "gaps" in coverage and/or inadequate
coverage.
• Review and advise Risk Management on appropriate program changes, U)
such as self- insured retention, deductibles, and coverage alternatives
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• Review and provide advice Risk Management on alternative risk financing
techniques.
• Advise Risk Management regarding excess insurance and reinsurance
terms and conditions.
• Interpret and provide written clarification concerning specific coverage
issues as needed.
• Review contracts as requested to comment on insurance requirements,
hold-harmless and indemnification language, subrogation and other risk
transfer provisions therein and obtain revisions to the County's insurance
policies as required.
• Issue all certificates of insurance in order to meet the needs of the Board.
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• Provide assistance to the County member agencies and departments with
specialty insurance, bonds or other coverage needs.
• Maintain accurate exposure data and provide an annual report by member
agency and department.
• Prepare a written report to the Board on the annual coverage
renewal and other insurance issues as needed (Annual evaluation).
• Produce an annual insurance consultant services report within 45 days of
the end of the fiscal year for Monroe County. This report is to include (but
not be limited to): a schedule of policies in force; respective policy
premiums, losses, fees earned or waived; development and trends in the
markets addressing each coverage and recommendations for change or
enhancement of the County's risk management program.
• Provide reserve estimates for all lines of business, and the basis of their
computation in a form which is satisfactory to Risk Management for year-
end audit purposes.
• Develop, implement, and monitor procedures to assist the County in
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capturing and preparing timely reports of value of property.
4. Claims:
The insurance consultant will assist Risk Management with the following:
• Provide detailed loss data both developed from the insurers and/or from
Insurance consultant's own RMIS data base on a monthly basis with an
annual recap of all losses.
• Assist Risk Management with analysis of the loss data collected and any (n
recommendations for handling.
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S. Disaster Reimbursement: U
The County has a contract with Adjuster's International d/b/a Goodman Gable Gould to
serve as the County's public adjuster. The consultant awarded this contract will work
with Goodman Gable Gould (as necessary) to do the following:
• Assist in providing information for the development of the claims submitted
by the public adjuster;
• Assist County in tracking and reconciling insurance payments received, so U)
that those amounts can be reduced from any FEMA reimbursements.
• Work with the County to ensure that properties for which the County has
received FEMA payments maintain insurance coverage in the future.
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6. Workers' Compensation:
The consultant shall:
• From time to time, assist in drafting RFPs or RFQs for the procurement of
third-party administrator or other services related to the workers'
compensation program;
• On an annual basis, prepare an analysis of Monroe County's estimated U
future obligations associated with the County's workers' compensation
program for use by the County's external auditors as part of the annual
review of the County's financial reports as part of the preparation of the
comprehensive annual financial report (CAFR). a.
• Analyze and monitor incident trends on an ongoing basis. Recommend,
provide, or assist in procuring, preventive solutions designed to reduce
rates of workplace injury and illness throughout the County.
7. Trainina and Education:
• The insurance consultant shall be capable of providing training services to
the County's Risk Management unit on insurance and risk management
topics, and where agreed, conduct seminars for key operating personnel in
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county departments.
• Identify continuing educational opportunities related to the referenced lines
of coverage in this RFP to the Risk Management staff.
• Provide ongoing review and advice to Monroe County staff on market
trends, business news, industry developments and items of interest related
to Risk Management in the public sector. 0
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SECTION THREE: COUNTY FORMS AND INSURANCE FORMS
RESPONSE FORM
RESPOND TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
c/o Purchasing Department
1100 Simonton Street
GATO BUILDING, ROOM 2-213
1100 SIMONTON STREET .2
KEY WEST, FLORIDA 33040
I acknowledge receipt of Addenda No. (s)
I have included: E
Lobbying and Conflict of Interest Clause ❑ Non-Collusion Affidavit ❑
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Drug Free Workplace Form ❑ Public Entity Crime Statement ❑
In addition, I have included a current copy of the following professional licenses and business tax receipts: U)
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If the applicant is not an individual (sole proprietor), please supply the following information:
APPLICANT ORGANIZATION:
(Registered business name must appear exactly as it appears on www.sunbiz.om) U)
Any applicant other than an individual (sole proprietor) must submit a printout of the "Detail by Entity Name"
screen from Sunbiz,and a copy of the most recent annual report filed with the Florida Department of State,
Division of Corporations.
• We request respondents to quote a fixed annual fee that encompasses the entire Scope of Services CL
CL
requested in Exhibit A. <
Fee for services included in contract: $ per year for Years 1-3 of the contract. The
fee is an all-inclusive cost. No additional costs or fees will be paid, including but not limited to travel costs, per diems,
telephone charges,facsimile charges, and postage charges. cv
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Mailing Address: Telephone:
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Fax:
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Date:
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Signed: Witness:
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(Print Name)
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(Title)
STATE OF:
N
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on
(date) by (name of affiant). He/She is personally known
to me or has produced (type of identification)as
identification.
NOTARY PUBLIC
My Commission Expires:
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LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
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(Company)
"...warrants that he/it has not employed, retained or otherwise had act on his/her behalf
any former County officer or employee in violation of Section 2 of Ordinance No. 010- U
1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010-
1990. For breach or violation of this provision the County may, in its discretion,
terminate this Agreement without liability and may also, in its discretion, deduct from the
Agreement or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or IL
employee."
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0
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(Signature)
Date:
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STATE OF: T
COUNTY OF:
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Subscribed and sworn to (or affirmed) before me on
(date) by (name of affiant). He/She is personally known
to me or has produced (type of identification)as U)
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identification.
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NOTARY PUBLIC
My Commission Expires:
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NON-COLLUSION AFFIDAVIT
I, of the city of according to
law on my oath, and under penalty of perjury, depose and say that
1. 1 am of the firm
of the bidder
making the Proposal for the project described in the Request for Proposals
for and that I executed
the said proposal with full authority to do so; U)
2. The prices in this bid have been arrived at independently without collusion,
consultation, communication or agreement for the purpose of restricting
competition, as to any matter relating to such prices with any other bidder or
with any competitor; U)
3. Unless otherwise required by law, the prices which have been quoted in a.
this bid have not been knowingly disclosed by the bidder and will not
knowingly be disclosed by the bidder prior to bid opening, directly or
indirectly, to any other bidder or to any competitor; and U)
0
4. No attempt has been made or will be made by the bidder to induce any
other person, partnership or corporation to submit, or not to submit, a bid for
the purpose of restricting competition; and
5. The statements contained in this affidavit are true and correct, and made
with full knowledge that Monroe County relies upon the truth of the
statements contained in this affidavit in awarding contracts for said project.
(Signature)
0
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Date:
STATE OF:
IL
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on
N
(date) by (name of affiant). He/She is personally known
to me or has produced (type of identification)as
identification.
NOTARY PUBLIC
My Commission Expires:
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DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statutes Section 287.087 hereby
certifies that:
(Name of Business)
0
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace (n
and specifying the actions that will be taken against employees for violations of such
prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the business'
policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation,
and employee assistance programs, and the penalties that may be imposed upon
employees for drug abuse violations.
3. Gives each employee engaged in providing the commodities or contractual services that
are under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notifies the employees that, as a condition a.
of working on the commodities or contractual services that are under bid, the employee
will abide by the terms of the statement and will notify the employer of any conviction of,
or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or U)
of any controlled substance law of the United States or any state, for a violation
occurring in the workplace no later than five (5) days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse
assistance or rehabilitation program if such is available in the employee's community, or
any employee who is so convicted.
6. Makes a good faith effort to continue to maintain a drug-free workplace through
implementation of this section.
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As the person authorized to sign the statement, I certify that this firm complies fully with
the above requirements.
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(Signature)
Date:
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STATE OF:
IL
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to me or
has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission Expires:
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PUBLIC ENTITY CRIME STATEMENT
"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 CONTRACTOR under a contract with any 0
public entity, and may not transact business with any public entity in excess of the
threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO (n
for a period of 36 months from the date of being placed on the convicted vendor list."
I have read the above and state that neither (Respondent's
name) nor any Affiliate has been placed on the convicted vendor list within the last 36 U
months.
U)
(Signature)
Date: U)
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0
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on cv
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(date) by (name of affiant). He/She is personally known to me or has
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produced (type of identification) as
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identification.
NOTARY PUBLIC
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My Commission Expires:
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MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION MANUAL
Indemnification and Hold Harmless 0
For
Other Contractors and Subcontractors �s
The Contractor covenants and agrees to indemnify and hold harmless Monroe County
Board of County Commissioners from any and all claims for bodily injury (including
death), personal injury, and property damage (including property owned by Monroe U
County) and any other losses, damages, and expenses (including attorney's fees) which
arise out of, in connection with, or by reason of services provided by the Contractor or
any of its Subcontractor(s) in any tier, occasioned by negligence, errors, or other
wrongful act of omission of the Contractor or its Subcontractors in any tier, their
employees, or agents.
In the event the completion of the project (to include the work of others) is delayed or U)
suspended as a result of the Contractor's failure to purchase or maintain the required
insurance, the Contractor shall indemnify the County from any and all increased
expenses resulting from such delay.
The first ten dollars ($10.00) of remuneration paid to the Contractor is for the
indemnification provided for above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance
requirements contained elsewhere within this agreement.
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WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
WORKER'S COMPENSATION AND RISK MANAGEMENT CONSULTING SERVICES
BETWEEN
MONROE COUNTY, FLORIDA
AND 0
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Prior to the commencement of work governed by this contract, the Contractor shall
obtain Workers' Compensation Insurance with limits sufficient to respond to the
applicable state statutes.
In addition, the Contractor 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 U)
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Coverage shall be maintained throughout the entire term of the contract.
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Coverage shall be provided by a company or companies authorized to transact
business in the state of Florida.
If the Contractor has been approved by the Florida's Department of Labor as an
authorized self-insurer, the County shall recognize and honor the Contractor's status.
The Contractor may be required to submit a Letter of Authorization issued by the
Department of Labor and a Certificate of Insurance, providing details on the
75
Contractor's Excess Insurance Program.
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If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be
required. In addition, the Contractor may be required to submit updated financial
statements from the fund upon request from the County. U)
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GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
WORKERS' COMPENSATION AND RISK MANAGEMENT CONSULTING SERVICES
BETWEEN
MONROE COUNTY, FLORIDA
AND
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Prior to the commencement of work governed by this contract, the Contractor shall
obtain General Liability Insurance. Coverage shall be maintained throughout the life of
the contract and include, as a minimum:
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• Premises Operations
• Products and Completed Operations
• Blanket Contractual Liability
• Personal Injury Liability
• Professional Liability
• Expanded Definition of Property Damage
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The minimum limits acceptable shall be:
0
300 000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 200,000 _ per Person
$ 300,000 per Occurrence
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$_ 200,000 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.
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MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION MANUAL
WAIVER OF INSURANCE REQUIREMENTS
There will be times when it will be necessary, or in the best interest of the County, to 0
deviate from the standard insurance requirements specified within this manual.
Recognizing this potential and acting on the advice of the County Attorney, the Board of (n
County Commissioners has granted authorization to Risk Management to waive and
modify various insurance provisions.
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Specifically excluded from this authorization is the right to waive: U
• The County as being named as an Additional Insured — If a letter from the
Insurance Company (not the Agent) is presented, stating that they are unable or
unwilling to name the County as an Additional Insured, Risk Management has a.
not been granted the authority to waive this provision.
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• The Indemnification and Hold Harmless provisions
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Waiver of insurance provisions could expose the County to economic loss. For this
reason, every attempt should be made to obtain the standard insurance requirements.
If a waiver or a modification is desired, a Request for Waiver of Insurance
Requirement form should be completed and submitted for consideration with the
proposal.
After consideration by Risk Management and if approved, the form will be returned, to
the County Attorney who will submit the Waiver with the other contract documents for
execution by the Clerk of the Courts.
Should Risk Management deny this Waiver Request, the other party may file an appeal
with the County Administrator or the Board of County Commissioners, who retains the
final decision-making authority.
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VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR CONTRACT BETWEEN
MONROE COUNTY, FLORIDA
AND
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Recognizing that the work governed by this contract requires the use of vehicles, the
Contractor, 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:
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• Owned, Non-Owned, and Hired Vehicles a.
The minimum limits acceptable shall be:
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$100,000 Combined Single Limit (CSL)
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If split limits are provided, the minimum limits acceptable shall be:
$50,000 per Person
$100,000 per Occurrence
$25,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional
Insured on all policies issued to satisfy the above requirements.
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PROFESSIONAL LIABILITY
INSURANCE REQUIREMENTS
FOR CONTRACT BETWEEN
MONROE COUNTY, FLORIDA
AND
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Recognizing that the work governed by this contract involves the furnishing of advice or
services of a professional nature, the Contractor, shall purchase and maintain,
throughout the life of the contract, Professional Liability Insurance which will respond to
damages resulting from any claim arising out of the performance of professional
services or any error or omission of the Contractor arising out of work governed by this
contract. U)
The minimum limits of liability shall be:
$300,000 per occurrence/$500,000 aggregate U)
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MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION MANUAL
WAIVER OF INSURANCE REQUIREMENTS
There will be times when it will be necessary, or in the best interest of the County, to 0
deviate from the standard insurance requirements specified within this manual.
Recognizing this potential and acting on the advice of the County Attorney, the Board of (n
County Commissioners has granted authorization to Risk Management to waive and
modify various insurance provisions.
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Specifically excluded from this authorization is the right to waive: U
• The County as being named as an Additional Insured — If a letter from the
Insurance Company (not the Agent) is presented, stating that they are unable or
unwilling to name the County as an Additional Insured, Risk Management has a.
not been granted the authority to waive this provision.
and U)
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• The Indemnification and Hold Harmless provisions
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Waiving of insurance provisions could expose the County to economic loss. For this
reason, every attempt should be made to obtain the standard insurance requirements.
If a waiver or a modification is desired, a Request for Waiver of Insurance
Requirement form should be completed and submitted for consideration with the
proposal.
After consideration by Risk Management and if approved, the form will be returned, to
the County Attorney who will submit the Waiver with the other contract documents for
execution by the Clerk of the Courts.
Should Risk Management deny this Waiver Request, the other party may file an appeal
with the County Administrator or the Board of County Commissioners, who retains the
final decision-making authority.
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MONROE COUNTY, FLORIDA
Request For Waiver
of
Insurance Requirements
It is requested that the insurance requirements, as specified in the County's Schedule of
Insurance Requirements, be waived or modified on the following contract: 0
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Contractor:
Contract for: U)
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Address of Contractor:
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Phone:
Scope of Work: U)
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Reason for Waiver:
Policies Waiver
will apply to:
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Signature of Contractor: U)
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Approved Not Approved
Risk Management:
Date:
County Administrator appeal:
Approved Not Approved
Date:
Board of County Commissioners appeal:
Approved Not Approved
Meeting Date:
BIDDER SIGNATURE
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INSURANCE REQUIREMENTS FOR SUBMITTING PROPOSALS
Workers' Compensation Statutory Limits
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Employer's Liability $100,000 Bodily Injury by Acc.
$ 500,000 Bodily Inj. by Disease, policy Imts (n
$ 100,000 Bodily Inj. by Disease, each emp.
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General Liability, including $ 300,000 Combined Single
Limit
Premises Operation
Products and Completed Operations
Blanket Contractual Liability a.
Personal Injury Liability
Expanded Definition of Property Damage
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Vehicle Liability $50,000 per Person
(Owned, non-owned and hired vehicles) $ 100,000 per Occurrence
$ 25,000 Property Damage
$ 100,000 Combined Single
Limit
Professional Liability $300,000 per Occurrence and
Including errors and omissions $500,000 Aggregate
The Monroe County Board of County Commissioners shall be named as
Additional insured on general liability and vehicle liability policies.
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Attachments
ATTACHMENT 1
QUESTIONNAIRE
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Organization Name:
Primary Contact/Representative:
Title:
�s
Address:
City, State, Zip Code:
Telephone Number:
Fax Number: U)
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E-mail Address:
0
Yes No
1. Does the firm have any contractual relationships that would
preclude the firm from being unbiased in the services provided
to the County?
2. Is the firm an insurance company, insurance agency,
insurance broker, third party administrator, or employee of
any of the foregoing?
3. If the answer to the preceding question is yes, do you
accept fees or commissions?
4. Is the firm an insurance consultant?
5. If the answer to the preceding question is yes, do you
accept fees or commissions from any insurance company,
insurance agency, insurance broker, third party
administrator, or employee of the foregoing?
6. Is the firm owned or controlled by an insurance company,
insurance sales organization, third party administrator or
any consulting firm which owns or controls any insurance
company, insurance sales organization, or third party
administrator?
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7. Please list any contractual relationships between the firm and any persons
or business entities that provide services in the areas of workers'
compensation and/or risk management. (Add additional pages if
necessary.)
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8. If the County changes from the current consultant as a result of this RFP the
successful firm will need to have a transition plan. Please describe your
transition plan.
0
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9. Describe your client service approach and how you respond to client
requests. Include what you consider non-urgent/routing requests and
urgent requests.
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10.If required, would you attend the Board of County Commissioner meetings
a.
to provide any recommendations and supporting documentation for
approval?
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11. Detail the ability of the firm to monitor regulatory and legislative developments at
both the State and Federal level and how this will be communicated to the County.
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12 How do you measure client satisfaction? U
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The Representative stated below is the authorized agent of the Proposer and is
authorized to bind the company upon acceptance by the County. Deviations from
the requested program have been stated. Coverage(s) or services will be issued
as proposed.
Name of firm:
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Signature Date
Print name:
Title: U)
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ATTACHMENT 2
Schedule of Insurance Coverages
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INSURANCE Policy Period Annual Premium
• Excess Policy—FMIT 10/1/18—10/1/19 $209,611
• AD&D Policy—Hartford 10/1/16—10/1/19 $9,600
• TPA—Relation Insurance Services 10/1/16—10/1/21 $73,000 0
• Airport Liability—Arthur J Gallagher 7/27/18—7/27/19 $35,905
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• Airport Public Officials—Darwin 7/27/18—7/27/19 $10,025
• Bayshore Manor Assisted Living Facility— 4/30/18-4/30/19 $13,924
Arthur J. Gallagher
• CrimePolicy—Travelers 10/1/17—10/1/20 $6,576
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• Florida Municipal Insurance Trust—FLOC 10/1/18—9/30/19 $262,165
0
• Leased Vehicles Policy—Porter Allen 10/1/18—9/30/19 $38,455
CL
CL
• Pollution Liability Policy—Marsh USA 5/1/17—5/1/20 $71,492
C)
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• Professional Liability Policy—Marsh USA 4/26/18—4/26/19 $15,500
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• Property Policy—Marsh USA 5/29/18—5/29/19 $753,097
• Portable Equipment Policy—VFIS 10/1/18—9/30/19 $1,454 x 4
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• Apparatus-VFIS 10/1/18—10/1/19 $17,301 x 4
• Weatherization Policy—Lloyds of London 4/22/18—4/22/19 $1,750
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• Windstorm Policy—Citizens 5/29/18—5/29/19 $809,775
• Flood Insurance Policy—NFIP Various annual policies $393,615
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ATTACHMENT 3
Combining Statement of Net Position as of September 30, 2018 for Internal
Service Funds — Risk Management
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MONROE COUNTY, FLORIDA-BOARD OF COUNTY COMMISSIONERS
COMBINING STATEMENT OF NET POSITION
INTERNAL SERVICE FUNDS-RISK MANAGEMENT
SEPTEMBER 30,2018
Risk
Management
Fund 6
ASSETS
Current Assets:
Cash and Cash Equivalents $ 1,078,464
Investments 5,625,914
Accounts Receivable, Net 44,559
Due from Other Governmental Units -
Due from Constitutional Officers -
0
Interest Receivable 12,293
Total Current Assets 6,761,230
Noncurrent Assets:
Land and Other Nondepreciable Assets -
Capital Assets, Net of Accum. Depreciation 23,989
Total Noncurrent Assets 23,989 LL
Total Assets 6,785,219
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0
DEFERRED OUTFLOWS OF RESOURCES
Related to Pensions 148,170
0
LIABILITIES CL
C
Current Liabilities: CL
Accounts Payable 92,648
Accrued Wages and Benefits Payable 12,815
Claims and Judgments Payable 3,776,208 cy
Due to Other Governmental Units -
Ci
Accrued Comp.Absences Payable 7,647
Total Current Liabilities 3,889,318
Noncurrent Liabilities:
Accrued Comp.Absences Payable 30,587
OPEB Liability 46,000 L)
Net Pension Liability 207,372
Total Noncurrent Liabilities 283,959
Total Liabilities 4,173,277
DEFERRED INFLOWS OF RESOURCES LL
Related to Pensions 30,260
Related to OPEB 7,806
Total Deferred Inflows of Resources 38,066 cv
NET POSITION
Investment in Capital Assets 23,989
Unrestricted 2,698,057
Total Net Position $ 2,722,046
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ATTACHMENT 4
Combining Statement of Revenue, Expenses and Changes in Net Position as 0
of September 30, 2018 for Internal Service Funds — Risk Management
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MONROE COUNTY, FLORIDA-BOARD OF COUNTY COMMISSIONERS
COMBINING STATEMENT OF REVENUES, EXPENSES,AND
CHANGES IN NET POSITION
INTERNAL SERVICE FUNDS-RISK MANAGEMENT
FOR THE YEAR ENDED SEPTEMBER 30,2018
Risk U)
Management
Fund
Operating Revenues:
Charges for Services $ 1,972,306
Miscellaneous 1,077
Total Operating Revenues 1,973,383 U)
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Operating Expenses:
Personnel Services 384,061
Operations 2,855,577
Depreciation and Amortization 1,577
Asserted and Paid Claims 2,125,637 U)
Total Operating Expenses 5,366,852 IL
LL
Operating Income(Loss) (3,393,469)
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Non-Operating Revenues(Expenses):
Investment Income 59,768
Insurance Recoveries 3,513,864 @
Total Non-Operating Revenues(Expenses) 3,573,632
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CL
Income(Loss) Before Transfers 180,163
Other Financing Sources(Uses): cy
Transfers to Other Funds (510,554)
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Change in Net Position (330,391)
Net Position-October 1 2,890,559
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Restatement-Change in Accounting Principle 161,878
Net Position-October 1, restated 3,052,437
Net Position-September 30 $ 2,722,046
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ATTACHMENT 5
Combining Statement of Cash Flows as of September 30, 2018 for Internal
Service Funds — Risk Management
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MONROE COUNTY, FLORIDA-BOARD OF COUNTY COMMISSIONERS
COMBINING STATEMENT OF CASH FLOWS
INTERNAL SERVICE FUNDS-RISK MANAGEMENT
FOR THE YEAR ENDED SEPTEMBER 30,2018
U)
Risk 0
Management >
Fund
Operating Activities:
Cash Received for Services $ 2,210,595
Cash Received from Insurance Recoveries 3,513,864 U)
Cash Payments to Suppliers for Goods and Svcs (2,783,051) U
Cash Payments for Employee Services (409,193)
Cash Payments for Claims (194,905)
Cash Received from(Paid to)Other Sources -
Other Operating Revenue 1,742
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Net Cash Provided by(Used in)
Operating Activities 2,339,052 IL
LL
Noncapital Financing Activities:
Transfers to Other Funds (510,554) U)
Net Cash Provided by(Used in) Noncapital
Financing Activities (510,554)
0
Capital and Related Financing Activities:
Acquisition of Capital Assets (1,531) CL
CL
Net Cash Provided by(Used in)Capital and
Related Financing Activities (1,531)
Investing Activities:
Investment Income 59,768 Ci
Proceeds from Sales and Maturities of Investments (1,729,758)
Purchase of Investment Securities 213,987
Net Cash Provided by(Used in) Investing Activities (1,456,003)
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Net Increase(Decrease) in Cash and
Cash Equivalents 370,964
Cash and Cash Equivalents:
October 1 707,500
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September30 $ 1,078,464 IL
LL
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MONROE COUNTY, FLORIDA-BOARD OF COUNTY COMMISSIONERS
COMBINING STATEMENT OF CASH FLOWS(CONTINUED)
INTERNAL SERVICE FUNDS
FOR THE YEAR ENDED SEPTEMBER 30,2018
Risk 0
Management y
Fund
Reconciliation of Operating Income(Loss)
to Net Cash Provided by(Used in)
Operating Activities: U)
Operating Income(Loss) $ (3,393,469)
Adjustments to Reconcile Operating Income(Loss)
to Net Cash Provided by(Used in)Operating
activities:
Depreciation and Amortization 1,577
Nonoperating Income-Insurance Recoveries 3,513,864 IL
LL
Change in Assets, Liabilities,and Deferrals:
(Increase) Decrease in Accounts Receivable 238,289 U)
(Increase) Decrease in Due from Other Gov't Units -
(Increase) Decrease in Due fm Constitutional Ofcrs -
(Increase) Decrease in Interest Receivable 665
Increase(Decrease)in Accounts Payable 72,526
Increase(Decrease)in Accrued Wages/Benefits 1,226 CL
CL
Increase(Decrease)in Claims/Judgments Payable 1,930,732
Increase(Decrease)in Due to Other Gov't Units - M
Increase(Decrease)in Due to Constitutional Ofcrs -
Increase(Decrease)in Comp.Absences Payable (4,974) cv
Increase(Decrease)in OPEB Liability (35,308) Ci
Increase(Decrease)in Pension Liability 48,163 M
Increase(Decrease)in Deferred Outflows (58,741)
Increase(Decrease)in Deferred Inflows 24,502
Total Adjustments 5,732,521
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Net Cash Provided by(Used in) d>
Operating Activities $ 2,339,052
Noncash Investing, Capital,and Financing Activities:
(Loss)on Disposition of Assets $ -
Change in Fair Value of Investments $ - IL
LL
Cash Reconciliation:
Unrestricted $ 1,078,464
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ATTACHMENT 6
Loss Runs for Workers' Compensation for Past Two Years
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Packet Pg. 2520
Monroe County BOCC
W/C Claims 2017 and 2018
Claim Claim
Type Outstanding Status
Claim Number Code Event Date Reserves Total Paid to Date Total incurred Code Accident Description
Knee(LT):while performing physical evaluation exercise,vertical
jump,left knee made a loud popping noise,knee became very
WCO222016131320 M 42660 0 350.62 350.62 C painful.
Head:while investigating an offense,hit his head on a low lying
WCO222016131321 M 42661 0 338 338 C branch.
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WCO222016131438 M 42662 0 24105.64 24105.64 C Eyes:temporary loss of vision while working in unit Charlie. a
Back:while on a ladder unbolting exhaust fan,leaning over,had
WCO222016131437 M 42669 0 269.74 269.74 C to apply force to loosen bolt,felt muscle strain.
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Knee(LT):was assisting a march man to the transport van,when
the march man lost his balance and began to stumble,as she
WCO222016131429 M 42673 0 312 312 C attempted to help him,felt a pop in knee.
Knee(RT):stepped into hole in grassy area,twisting knee behind
WCO222016131554 M 42682 0 5133.49 5133.49 C knee backwards.
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ILL
WCO222016131609 M 42691 0 2556.15 2556.15 C Ear(RT):hearing loss in right ear.
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Neck,Shoulder(RT):while performing ream roll of 24'ground U)
WCO222016131657 M 42693 0 17449.41 17449.41 C ladder,the ladder struck head and shoulder with helmet on.
4�
Face:fainted and fell from a standing position,made contact with >
WCO222016131611 M 42695 0 449.37 449.37 C the wall and floor causing a laceration above his right eye.
CL
CL
Back:while lifting a patient from floor in a confined space,felt a
pain in lower back,by the time he got home,pain was worse and
WCO222016131643 M 42695 0 3132.93 3132.93 C had difficulty walking up stairs.
Cd
Cd
WCO222016131653 BLT 42697 0 20165.85 20165.85 C Knee:running during swat pistol qualifications.
4�
WCO222016131652 M 42698 0 2739.7 2739.7 C Arm,Hand:subject slammed door on his arm,hand.
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Thumb(LT):was checking a used razor and it broke,then got a
WCO222016131678 M 42704 0 1071 1071 C laceration on left thumb. cy
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WCO222016131697 BLT 42708 0 20505.71 20505.71 C Elbow(LT):during pt,felt a tearing sensation in left elbow area.
Neck:wheel exploded,broke while using pneumatic grinder.
WCO222016131758 M 42711 0 1677.53 1677.53 C Cutting disc. �8
Face,Knee,Leg:while attempting to restrain an inmate,the
inmate kicked backwards striking right knee and upperthigh area,
WCO222016131778 BLT 42715 0 5955.05 5955.05 C also punched with closed fist several times in right lowerjaw area.
Face:when conducting the required hour for shower,recreation
inmate refused to exit the shower area,when ordered to cuff, 4�
WCO222016131782 M 42715 0 2080.59 2080.59 C inmate threw a cup of coffee mixed with urine at the IW's face.
Finger(RT):repairing light.glove had a small hole and got super
WCO222016131781 M 42717 0 316.73 316.73 C glue on skin,
After searching the U-Haul Det.Hill went to exit;he slipped off the
U-Haul to the ground injuring RT Wrist trying to brake the fall.RT
WCO222016131806 M 42723 0 2898.17 2898.17 C Wrist Sprain&RT Hand Pain
Packet Pg. 2521
Monroe County BOCC
W/C Claims 2017 and 2018
Lower Back Strain-While removing a patient who was not
breathing from the back of a truck to perform CPR;family member
was assisting.Family member let go and patient slipped and felt
WCO222016131815 M 42725 0 594.82 594.82 C pain in lower back.
RT Foot/Ankle Sprain:While moving the recyclables cart it rolled
WCO222016131829 LT 42725 0 6482.45 6482.45 C over foot/ankle.
Hip,Knee(RT):responding to back up to prevent escape,subject
WCO222016131852 M 42732 0 824 824 C was taken down to the ground,felt pain to the right side of leg.
a�
Traveling northbound on Us1 in patrol vehicle,vehicle came into
WCO222016131864 M 42735 0 1500.64 1500.64 C his lane and struck him,his vehicle flipped and slid on its roof.
Knees,Ankle(RT):stepped off of curve and twisted R ankle,as
WCO222017131873 LT 42739 0 9342.11 9342.11 C she was stepping down,fell on both knees.
Head:bent over to pick up bag by dumpster,when lifted head,hit
WCO222017131890 M 42739 0 747.12 747.12 C it on knob of dumpster,causing head to bleed.
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Headache,Dizzy:CPR to the victim,assisted in the removal of
WCO222017131962 M 42751 1997.08 8502.92 10500 O the victim from a manhole.
Lungs:while retrieving the victims from a manhole,was exposed
WCO222017131963 LT 42751 7495.61 33880.24 41375.85 O to fumes and assisted in evaluating of the area. U)
Exposure:while retrieving victim from a manhole,was exposed to
fumes and provided CPR to the victim.Trouble breathing and 4�
WCO222017131964 M 42751 0 6393.62 6393.62 C dizzy. >
0
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WCO222017131993 LT 42752 0 14480.11 14480.11 C Back:while removing tire,the IW pulled or sprain his back.
Finger(RT),Back:escorting inmate to the ground,hurt right pinky Cd
WCO222017131995 BLT 42755 0 3755.16 3755.16 C and lower back.
Cd
Foot(LT):took down inmate to the ground and landed on left side
WCO222017131996 M 42755 0 2489.05 2489.05 C and put weight on left foot.
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WCO222017132080 M 42762 0 10 10 C Foot(LT),Cheek:walking,tripped and fell.
Eye(LT):received a small laceration next to the left eye while
WCO222017132146 M 42762 0 10 10 C tracking a wanted subject.
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Thumb(LT):while escorting a uncooperative inmate,was bitten 0.
WCO222017132097 M 42767 0 184 184 C on the left thumb.
Shoulder(RT):lifting 5 gal bucket of paint onto desk,missed and Cd
WCO222017135073 BLT 42773 8.13 61109.55 61117.68 R hit desk,right shoulder yanked back.
Lungs:wmie on scene or structure Tire,ooservea some trees tnat
caught on fire as well as the initial residence,was displaying
flames after fire was put out,attempted to get the attention of the
firefighters and during this time,inhaled a large amount of smoke
WCO222017132194 LT 42777 0 34487.48 34487.48 C in the immediate area of where he was,immediately started
Back:bent over to pick up a garbage bag and felt a strong pain
WCO222017132197 M 42779 0 10723.3 10723.3 C on her back.
WCO222017132213 M 42780 0 144.83 144.83 C Ankle(RT):twisted ankle by table in the breakroom.
Packet Pg. 2522
Monroe County BOCC
W/C Claims 2017 and 2018
Right shoulder and Back; Claimant was lifting trash bags and
performing regular duties associated with his maintenance
WCO222017135967 M 42780 0 10 10 C department position.
Knees:dealing with a combative suspect,escorted the suspect to
floor,causing him to landed on both knees,right knee is still
WCO222017132274 M 42781 0 199.07 199.07 C giving him trouble while walking.
Finger(LT):dealing with a combative suspect,escorted suspect
WCO222017132615 M 42781 0 1515.24 1515.24 C to floor causing injury to left index finger.
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Hand,Arm,Knee(LT):missed step up going into fuel key office,
WCO222017132312 M 42783 0 6496.06 6496.06 C caught self with left hand and arm.
Exposure,Hands:while restraining a subject,blood transferred to
WCO222017132288 M 42785 0 1531.5 1531.5 C bare hands.Open wounds.
U
Forearm(RT):was bitten by a combative patient at the Guidance
Clinic,the patient was being held down in order for the clinic to
WCO222017132248 M 42786 0 1391.17 1391.17 C administer 2 shots.
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WCO222017132328 LT 42788 0 2582.46 2582.46 C Finger(RT):shooting rifle,blast impacted middle finger. 0.
Back:while worming up for DTC,was closing hi-knee relays and
WCO222017132285 M 42790 0 516.33 516.33 C felt his back pop. U)
Back:was conducting a traffic stop,the driver became
confrontational,he attempted to handcuff the driver,and pulled a @
WCO222017132330 M 42794 0 1535.32 1535.32 C muzzle in back. >
0
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CL
Face,Nose:tripped and fell on concrete sidewalk,face planted CL
WCO222017132327 LT 42795 0 6922.08 6922.08 C concrete,grasses cut his nose and face.
Arms,Leg(LT):fell backwards on sidewalk trying to avoid dogs Cd
WCO222017132394 M 42795 0 608.74 608.74 C while delivering meals.
Cd
WCO222017132600 M 42800 0 10 10 C Chest:Had chest pains
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Exposure:possible exposure to BBP while in work van where
WCO222017132426 M 42802 0 97 97 C coworker vomited blood and had seizure.
4�
WCO222017132427 M 42802 0 0 0 C Had a seizure.
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Bilateral knee,right elbow,right palm:Was walking on sidewalk in
front of senior center returning to work from lunch.Root from a
WCO222017132429 M 42802 0 495.55 495.55 C tree caught my shoe and sent me forward onto knees.
C38
Hips,buttocks,thigh:misjudged last step leading to the baggage
house on the ramp and felt pain in her right upper leg/buttocks Cd
WCO222017132509 M 42806 0 0 0 C area
Eye:Blowing debris off roadway when a gust of wind blew a piece
WCO222017132510 M 42808 0 10 10 C of debris into eye
Eye:On suicide watch serving food when inmate threw a cup of
WCO222017132542 M 42822 0 547 547 C urine in face
WCO222017132983 M 42838 0 25.43 25.43 C Positive TB test.
Packet Pg. 2523
Monroe County BOCC
W/C Claims 2017 and 2018
WCO222017132732 M 42845 0 219.15 219.15 C Foot(LT):dropped motorcycle during training session.
Knee(LT):while working a homicide,stepped into a dip in the
WCO222017132725 LT 42849 0 8963.94 8963.94 C gavel and left knee popped,pain and swelling to the knee area.
Head,Leg:Opening truck hood when it opened and struck on
WCO222017132769 M 42853 0 3385.96 3385.96 C head causing to fall back and cut leg
a�
WCO222017132798 M 42856 0 16488.97 16488.97 C Employee was blowing grass off Pavilion,lost balance and fell
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WCO222017132828 M 42861 0 5023.17 5023.17 C Thumb(RT):stuck by open and used syringe needle.
0
Forearm(LT):subject was attempting to fight with nurse,the IW
WCO222017132833 M 42862 0 916.07 916.07 C restrained her hands and the subject leaned over and bit her arm.
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Under Arm:Slipped while retrieving equipment from apparatus
WCO222017132838 M 42863 0 982.47 982.47 C and fell resulting in a laceration on armpit
Leg(RT):while unloading a truck,fell backwards onto a broken
WCO222017132860 M 42865 0 344.04 344.04 C toilet,injuring his right leg/calf. U)
0
Leg(LT):while doing a zone improvement,cleaning up
underneath bridge,large amount of garbage was picked up,he >
overextended left leg and felt pain in left calf,tried putting ice on it
but pain and swelling have gotten worse,making it difficult to put L-
WCO222017132974 M 42878 0 437.95 437.95 C weight on the leg and walk. CL
Knee(RT):slipped and hyperextended knee during defensive
WCO222017133012 M 42882 0 1319.34 1319.34 C from football tackle.
Cd
Cd
Buttocks,Waist,Hips:while removing tools from a truck,the IW �}
WCO222017133039 M 42887 0 1995.3 1995.3 C slipped an fell injuring buttocks,waist and hips.
4�
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WCO222017133095 M 42894 0 762.39 762.39 C Back:Pulled back muscle lifting generator on/off truck
0
WCO222017133251 BLT 42907 0 17984.19 17984.19 C Groin:Lifted heavy desk
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WCO222017133208 LT 42909 0 47826.12 47826.12 C Head,Neck,Face:MVA Collision with another vehicle 0.
Shin(Left),Thigh(Left),Chest,Forearm:MVA Collision with
WCO222017133211 M 42909 0 2368.49 2368.49 C another vehicle
Cd
Leg(RT):felt a little pain in right leg,went to doctor to get checked 4)
WCO222017133269 M 42913 0 1160.88 1160.88 C and was told that he has tendomy.
4�
WCO222017133291 M 42924 0 709.83 709.83 C Ankle:Stepping off truck and foot landed wrong,rolled ankle
Hand:While working in the habitat area a monitor lizard lunged
WCO222017133287 M 42927 0 167 167 C and bit top of knuckle and inside of index finger
Packet Pg. 2524
Monroe County BOCC
W/C Claims 2017 and 2018
Both Arms;while breaking up a fight between inmates,the
WCO222017133320 M 42929 0 275.93 275.93 C employee was exposed to a high risk inmate(HIV)on both arms.
WCO222017133321 M 42933 0 1387.29 1387.29 C Knees:Tripped over a chair and fell to the ground
Right Shoulder; While mopping,lifting and doing regular chores,
WCO222017133629 SILT 42933 0 30620.93 30620.93 C right shoulder started burning
a�
Foot(RT):cut right foot upper area on a board with nails sticking
WCO222017133328 M 42936 0 89.55 89.55 C out.
Head,back; Stood up from chair and collapsed(passed out).
Employee was feeling dizzy and has been under a lot of stress
WCO222017133362 M 42940 0 30 30 C lately
Back of Right Foot;While operating brush hog,pushed brake
WCO222017133402 M 42947 0 1156.29 1156.29 C and hurt foot.
4�
Left shoulder;while picking wood debris to place in chipper, V)
employee tweaked his left arm and shoulder area,causing pain
WCO222017133459 SILT 42955 0 63393.15 63393.15 C the following day.
WCO222017133464 M 42955 0 320 320 C Index Finger(Left):Cut left index finger on electrical panel V)
bacK anu rvecK; vvnue arrecung arrest,employee assisieu in aV)
securing arrestee in rear of patrol vehicle. I was bent over and
leaning into rear compartment to lift arrestee into position. The
following day,employee began to feel pain and discomfort in neck
WCO222017133622 SILT 42958 0 130064.85 130064.85 C and back >
0
L-
CL
Hand(RT):while attempting to contain a stray dog,the dog CL
WCO222017133552 M 42965 0 326 326 C became startled and bit right hand causing 3 punctures.
Ears; right ear felt like it closed up after residential audible alarm
call and progressively got worse as day continued,resulting in Cd
WCO222017133582 M 42969 0 262.04 262.04 C popping noises,sharp pain,hearing blockage,and bleeding.
Cd
Oi
Right Eye; Foreign matter in eyes,employee removed his safety
glasses to wipe sweat from face and debris from frame of glasses
WCO222017133700 M 42972 0 529.62 529.62 C fell,entering his right eye.
75
V)
r—
Chest; Chest X-ray&CT scan revealed congestive heart failure,
WCO222017134079 LT 42972 109361.13 201177.02 310538.15 O symptoms chest pain,different breathing,wheezing,chest rattling
Face; While making poached eggs for the clients,employee
removed the container from the microwave,opened the lid and
WCO222017133696 M 42980 0 594.36 594.36 C the eggs exploded on her face.
V)
Left Shoulder; While on Alpha/Bravo shifts and mandated to
remain at assigned post,Deputy injured his left shoulder/upper
arm while laying down to sleep for the night. Deputy was sleeping �8
on a personally owned inflatable mattress and heard his shoulder
pop and pain immediately followed. The pain has progressively Cd
WCO222017133905 M 42987 0 1465.05 1465.05 C gotten worse as the days have gone by.
Shoulder,Elbow:The day after hurricane Irma was working
WCO222017134646 M 42989 0 0 0 C recovery and slipped on mud/silt landing on arm/shoulder (�
4�
Upper body,ribs,shoulder:the IW fell through an ADA ramp
WCO222017133906 LT 42994 0 81587.95 81587.95 C railing,landing on the pavement.
Shoulder(Right):When stopped by ATF agents was put in an arm
WCO222017133822 LT 42996 0 66731.76 66731.76 C bar causing pain in right shoulder
Packet Pg. 2525
Monroe County BOCC
W/C Claims 2017 and 2018
WCO222017133913 LT 42996 189975.35 198285.05 388260.4 O Heart:Post storm clean up activities and experience heart attack
Ongoing symptoms since Hurricane Irma;Nasal congestions,
WCO222017134938 M 42996 0 1405.27 1405.27 C nausea,headaches and migraines
Tooth:while eating a noon meal provided by the emergency
operations staff,his lower left crown molar cap dislodged, 8)
WCO222017133871 M 42998 0 10 10 C exposing the undertooth which now is sensitive and painful.
a�
Surer: 308837:3, 1222429.4 1531266,7 �
U)
0
Claim Claim GS
Type Outstanding Status
Claim Number Code Event Date Reserves Total Paid to Date Total incurred Code Accident Description
U)
Wrist(Right):Head butted by an inmate in the upper torso and
WCO222017134081 M 43014 0 586.23 586.23 C during the altercation injured right wrist IL
LL
Face,Ear(Left),Knees,Hand(Right):Was punched in the face
WCO222017134019 BLT 43017 0 23508.43 23508.43 C and fell during a fight with an inmate U)
0
WCO222017134084 LT 43024 42260.26 84739.74 127000 OL Heart:Started feeling pressure in chest >
0
L-
CL
Lower Back:MVA Stopped in a turning lane and was struck by CL
WCO222017134248 M 43027 0 5846.39 5846.39 C another vehicle
Lungs:Coughing,wheezing,sinus pressure,headaches, Cd
WCO222017134350 M 43027 0 259.38 259.38 C congestion
Cd
Back,Hip; Assist nurse with getting into wheelchair,hurt back
WCO222017134187 M 43030 0 4460.51 4460.51 C and right hip
U)
r-
0
WCO222017134282 M 43033 0 1115.75 1115.75 C Hypertension
Neck and Back; Employee was stopped in the turn lane in front of (�
87801 n Overseas Hwy in Islamorada. A vehicle traveling
southbound in the left lane of travel sideswiped her patrol car,
WCO222017134245 M 43035 0 1774.46 1774.46 C employee suffered pain in the neck and back.
U)
r-
WCO222017134385 M 43041 0 0 0 C Annual Physical,Positive TB Test
Due to air being blown,employee started to have an asthma
WCO222017134338 M 43045 0 563.35 563.35 C attack
C38
WCO222017134352 M 43052 0 486.15 486.15 C Bicep:closing trailer door,had to lift to close,head his bicep pop.
Cd
Thigh(Left):On police issued motorcycle passing a roofing pick
up traveling in the opposite direction and a wooden pallet came
WCO222017134400 LT 43055 0 28226.87 28226.87 C off the pickup shattered and debris struck left leg �
Hand(RT):was traveling northbound on SR5 on issued police
motorcycle,as a roofing pickup was passing him from the 4�
opposite direction,a wood pallet came off the pickup and struck hi
motorcycle,causing damage to the front of the motorcycle and
WCO222017134401 M 43055 0 1051.8 1051.8 C injury to his right hand.
Back:Stepped from sidewalk into parking lot with gear and felt
WCO222017134430 LT 43058 0 282.89 282.89 C very sharp pain in lower left back
WCO222017134527 BLT 43059 5086.27 8963.73 14050 O Ears:Hearing loss due to years of working around jets
Packet Pg. 2526
Monroe County BOCC
W/C Claims 2017 and 2018
WCO222017134509 M 43066 0 377.89 377.89 C Foot(Right):Tramped on nail while loading garbage on truck
WCO222017134471 M 43067 0 1314.71 1314.71 C Left eye; Spit in left eye
Hand:Cut by a bio hazard object in an inmates property bag while
WCO222017134554 M 43069 0 126 126 C processing them out
Knees,Nose,Neck; Employee fell over a traffic cone,Employee
landed on her knees first,as her body went down her tazer broke,
WCO222017134565 M 43078 0 3281.58 3281.58 C her hands and nose hit the pavement which jarred her neck.
U)
Shoulder:Noticing pain in shoulder area when exerting,most a
WCO222017134672 BLT 43079 0 61063.28 61063.28 C recent while moving refrigerator from substation from hurricane
WCO222017134649 M 43090 0 0 0 C Annual physical positive PPD
Left ankle,left knee; During mandatory PE,the employee was
U)
running and tripped over a sidewalk and fell injuring her left knee
WCO222017134687 M 43096 0 440 440 C and left ankle
Shoulder:Felt sharp pain in shoulder when racked back gun
WCO222018134756 BLT 43103 21628.69 66371.31 88000 O during qualifying at the range
Ear; DOL is estimated. Occurred over a period of 20 years. U)
Employee has developed hearing loss in right ear due to
exposure to noise of one big server. Ringing and tender to noise
WCO222018137852 M 43104 550 0 550 O in that right ear.
Ankle(LT),Back:while stepping off the back of a vehicle,fell
U)
WCO222018134834 M 43106 0 40 40 C backwards twisting his left ankle and falling onto his lower back. U)
Back:tweaked back during defensive tactics drills,stretched back a
out after ceasing the DT drill per instruction and was able to
continue with the rest of the ARMS without issue.When got home M
WCO222018134778 M 43120 0 766.76 766.76 C back was a little sore.
L-
WCO222018134793 M 43124 0 256 256 C Employees left wrist popped during movement of turbo draft CL
CL
Knees,Legs;while in the process squatting and kneeling to
remove the metal lock,employee strained her knees and lower
WCO222018134836 BLT 43129 14456.03 21543.97 36000 O legs
WCO222018134943 M 43142 0 5868.62 5868.62 C Fingers:Cut,puncture,scrape-Object being lifted/handled
WCO222018135121 M 43161 0 4583.72 4583.72 C Back:Picking up property bags from shelf and hurt mid bank Cd
Elbow(Right),Knee(Right),Lower Back:Due to uneven elevator
WCO222018135176 M 43172 0 347.39 347.39 C tripped and fell into elevator
U)
r-
Left knee:while cleaning graffiti,employee slipped and fell,
injuring his left knee. Employee drove himself to Mariners
WCO222018135193 LT 43173 747.9 9789.94 10537.84 R Hospital prior to reporting the incident.
4�
Knees,Elbow,Forehead:EE was walking in her office,she
WCO222018135253 BLT 43174 0 25412.09 25412.09 C tripped an fell over the wheel on the filing cabinet.
Back,Arm(Right):Tripped with the vacuum cord and fell landing
WCO222018135204 M 43175 1679.4 1820.6 3500 O flat on back
Cd
WCO222018135296 M 43182 1858.27 8891.73 10750 O Back:injured his back while jumping out of his truck.
Back;while bending down,putting away the trays on cart,
WCO222018135347 M 43182 0 202 202 C Employee felt sharp back pain.
WCO222018135308 M 43185 0 212 212 C Knees:Tripped over humidifier tub and fell landing on both knees
Knee(Left):While cleaning the vacuum pole fell off hitting left
WCO222018135311 M 43186 0 3874.84 3874.84 C knee
Packet Pg. 2527
Monroe County BOCC
W/C Claims 2017 and 2018
Foot(RT):during training,EE jumped and twisted her right foot as
WCO222018135314 M 43187 0 485.3 485.3 C shelanded.
Ankle(Right):While stepping out of trucktwisted right ankle due
WCO222018135451 M 43199 0 439.02 439.02 C to loose gravel
U)
WCO222018135465 M 43201 0 713.76 713.76 C Back,Shoulders:MVA Rear ended
a�
Ribs:On location where suspect was barricaded when suspect
WCO222018135532 M 43202 0 497.05 497.05 C emerged and tackled to the ground injuring right rib cage
U)
WCO222018135968 BLT 43202 17642.51 21457.49 39100 O Heart:Unable to perform stress test due to heart arrhythmia afib
0
WCO222018135541 M 43213 0 791.06 791.06 C Knee(Left),Ribs,Elbow(Left):Tripped and fell in parking lot
U)
Arms:came in contact with a poison tree,causing allergic reaction
WCO222018135701 M 43213 0 330.38 330.38 C on both arms.
WCO222018135591 M 43215 0 4889.51 4889.51 C Over heated during SWAT Training U)
0
WCO222018135600 M 43220 0 337.97 337.97 C Throat,chest; broke CD and debree went into mouth >
0
L_
CL
CL
WCO222018135612 M 43222 0 268.33 268.33 C Knee(LT):the EE fell off the ladder,injuring let knee.
Cd
WCO222018135618 M 43223 0 796.58 796.58 C Respiratory:During training developed SOB/Cardiac issues (78
Cd
0i
Thumb(Left):Exposure,stopped a car and in the process of
checking the vehicle was exposed to an EPI pen that has not
WCO222018135649 M 43228 0 1304.38 1304.38 C been used
75
U)
r_
0
WCO222018135651 M 43228 0 302.6 302.6 C Back,Neck:MVA Rear-ended in patrol car
Elbow(Left),Lower Back:Slipped and fell stepping off rescue
WCO222018135740 M 43231 0 203.3 203.3 C cutting left elbow and injuring lower back
U)
WCO222018135705 M 43236 0 116 116 C Forearm(Left):Pushed and scratched on her left forearm
Eye(Right):Washing parts with solution and chemical splashed Cd
WCO222018135796 M 43244 0 221 221 C into right eye
Eye(RT):poked her right eye wit ha straw as she was exiting her
WCO222018135779 M 43245 0 212 212 C vehicle. CY
4�
Hand; While trying to handcuff the subject,employee got a small
WCO222018135840 M 43246 0 972.09 972.09 C scratch/laceration which was bloody/sweaty.
Middle Finger(Left):Heading by the inner door at main control
WCO222018135793 M 43248 0 817.26 817.26 C and got middle left hand finger stuck in door
Packet Pg. 2528
Monroe County BOCC
W/C Claims 2017 and 2018
Wrist(Right),Knees:Walked around corner and fell on the
WCO222018135839 M 43250 8285.79 55874.44 64160.23 O ground
Heat exhaustion:was taken via rescue to Mariners then
WCO222018135848 M 43251 0 7872.4 7872.4 C transferred to Baptist.
Knee,Face(LT):put car in reverse instead of park,vehicle rolled
WCO222018135855 M 43251 0 2682.66 2682.66 C down hill and pushed the EE between door.
Left shoulder;while attempting to place a male subject in a
custody,male resisted while employee was holding his arm to
gain compliance. during this time the male subject kept pulling
WCO222018135852 BLT 43254 14640.17 55359.83 70000 O and pushing causing pain in left shoulder area.
U)
WCO222018135923 M 43258 0 2229.37 2229.37 C Light headed,nausea,passed out.
0
Finger(RT):during a search of a car,the EE's right index finger
WCO222018135930 M 43263 794.95 2455.05 3250 O was pricked by a needle.
U)
Cardiac:After completing drill was taken to Mariners Hospital due
WCO222018135932 M 43264 0 4467.13 4467.13 C to low blood pressure
Ankle(RT):was directed to the residence where the dog lived,
dogs were in the back yard and not visible,the dog had already
bitten a juvenile down the street prior to arrival,when she got out U)
of her car,the dog charged at her and bit ankle,bite did not break a0
the skin due to boot but caused bruising and swelling to right
WCO222018136050 M 43267 0 107.63 107.63 C ankle.
4�
0
Right ankle; During training at the station,employee injured his L-
CL
WCO222018135957 M 43270 0 913.55 913.55 C right ankle CL
Shoulder,Arm,Neck,Chest(LT):while shoveling,the EE injured
WCO222018136041 BLT 43284 60448.72 109085.85 169534.57 O his left side of shoulder,arm,neck and chest.
Cd
Cd
Forearm(LT):the ladder slipped away,causing the EE to fall, �*'}
WCO222018136034 M 43287 0 270.3 270.3 C injuring his left forearm.
4�
U)
WCO222018136089 M 43290 0 245.93 245.93 C Wrist(LT):while arresting inmate,received a cut to wrist.
0
WCO222018136048 M 43292 0 172.8 172.8 C Knee(Left):Due to use of force with an inmate injured left knee
4�
U)
Leg(Right):Remembers bumping into a board with nails on it and
WCO222018136059 M 43293 0 468.41 468.41 C must have cut calf at that time with out realizing
Foot(Left),Ankle(Left),Knee(Left):Baggage belt from golf cart
WCO222018136072 M 43296 0 457.12 457.12 C got caught on left foot causing left leg to hit the floor while driving
Cd
4i
Left arm,Left shoulder;While working in the attic with the
electrical wires employee injured his left arm and shoulder due to t)
WCO222018136101 BLT 43299 5349.18 61650.82 67000 O the pulling and tugging on the wires
Eyes:During pepper spray training developed and allergic
WCO222018136105 M 43302 3019.75 130.25 3150 O reaction in both eyes
Groin; Injured worker was lifting 80lbs concrete mix during the
day,later in the evening he felt pain in left side groin area. He
WCO222018136160 M 43308 0 57.18 57.18 C reported he underwent hernia surgery 22 months prior.
Foot(LT):while cleaning up,EE stepped on an unknown sharp
WCO222018136178 M 43314 0 2189.65 2189.65 C object with his left foot.
Packet Pg. 2529
Monroe County BOCC
W/C Claims 2017 and 2018
Right shoulder; after physical training,the employee felt pain to
WCO222018136221 M 43319 0 209.8 209.8 C his right shoulder,and cannot lift arms over head.
WCO222018136217 M 43322 0 95.42 95.42 C Upper Back:While practicing was struck and blacked out
Arm(LT):came to a scene of a motorcycle accident and turned
the person over to administer CPR,EE robbed his left arm on the
blood of the person in the accident,said that he will be seeking U)
WCO222018136277 M 43331 0 89.55 89.55 C medical attention after his shift is over.
f�
a�
fad
WCO222018136346 M 43332 0 89.55 89.55 C Face:EE was spit on face while restraining a suspect.
Cardiac; During training,employee felt dizziness,EKG showed
WCO222018136310 M 43334 0 855.2 855.2 C cardiac issues,was taken via rescue Fisherman Hospital.
Multiple body parts:While getting into transport van missed step, (�
WCO222018136449 M 43343 0 270.3 270.3 C slipped and fell injuring right side of body
WCO222018136504 M 43353 0 2951.29 2951.29 C Abdomen; MVA
t�
WCO222018136661 M 43361 0 177.43 177.43 C Forearm(LT):the EE was bitten by a spider on forearm. Uy
Sum: 198447 69 7250341 928481199
IL
Total Sum: 50728519 1947463,5 2454748.69
Ll-
U)
U)
0
0
L-
91
CS8
Cd
CS
Cd
U)
r-
0
U)
r—
IL
Ll-
CS8
Cd
Packet Pg. 2530