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FY2020 10/16/2019 JG�R counra��l o;4"'7.4..,:•,, Kevin Madok, CPA Clerk of the Circuit Court&Comptroller—Monroe County, Florida DATE: November 12, 2019 TO: Janet Gunderson Herbener Senior Grant&Finance Analyst FROM: Pamela G. Hanc.( ''I.C. SUBJECT: October 16th BOCC Meeting Attached are electronic copies of the following items for your handling: C18 Agreement with Guidance/Care Center for the Community Transportation for Disadvantaged Program in the amount of$41,225.00 and Baker Act Transportation Service Program in the amount of$165,000.00 for Fiscal Year 2020. C20 Grant Award of$133,334.00 from FDLE for the Residential Substance Abuse Treatment Program with a 25%match requirement of$33,334.00; and granted approval and authorized execution of an Agreement with Guidance/Care Center in the amount of$133,334.00 for the project entitled, "Men's Jail In-House Drug Abuse Treatment Program", for the project period of January 1, 2019 through December 31, 2019. Should you have any questions, please feel free to contact me at(305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070 305-294-4641 305-289-6027 305-852-7145 305-852-7145 AGREEMENT This Agreement is made and entered into this 16th day of October 2019, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Guidance/Care Center, Inc., a Florida 501(c)(3) not-for-profit corporation, hereinafter referred to as"PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established to provide transportation services to the citizens of Monroe County, and WHEREAS, it is a legitimate public purpose to provide transportation services to the residents of Monroe County, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: FUNDING 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and providing services, shall reimburse the PROVIDER for providing transportation services as billed by the PROVIDER for clients qualifying for such services under applicable state and federal regulations and eligibility determination procedures. The cost shall not exceed a total reimbursement of TWO HUNDRED SIX THOUSAND TWO HUNDRED TWENTY-FIVE DOLLARS ($206,225.00), during the fiscal year 2020, payable as follows: a) The sum of ONE HUNDRED SIXTY-FIVE THOUSAND DOLLARS ($165,000.00) for Baker Act/Marchman Act transportation services pursuant to Chapter 394, Florida Statutes; and b) The sum of FORTY-ONE THOUSAND TWO HUNDRED TWENTY-FIVE DOLLARS ($41,225.00), for Community Transportation Coordinator-related transportation services to residents of Monroe County. 2. TERM. This Agreement shall commence on October 1, 2019, and terminate September 30, 2020, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT. Payment for Baker Act and Marchman Act transportation services shall be made according to the rate schedule set forth in Attachment D and in accordance with Attachment A, as applicable, subject to the maximum amounts set forth in Paragraph 1. a. above. Billing Summary Forms, certified monthly financial and service load reports will be made available to the Board to validate the delivery of services under this contract. The monthly financial report is due in the office of the Clerk of the Board no later than the 15th day of the following month. After the Clerk of the Board pre-audits the certified report, the Board shall reimburse the Provider for its monthly expenses. However, the total of said monthly payments in the aggregate sum shall not exceed the total amount shown in Paragraph 1, above, during the term of this agreement and are subject to examination, approval and audit by the Clerk. To preserve client confidentiality required by law, copies of individual client bills and records shall not be available to the Board for reimbursement purposes but shall be made available only under controlled conditions to qualified auditors for audit purposes. The organization's final invoice must be received within thirty days after the termination date of this contract shown in Paragraph 2 above. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a notarized certification statement. An example of a reimbursement request cover letter is included as Attachment B. 4. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, Guidance Care Center—Transportation:Baker Act and CTD FY20;page 1 1 this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 5. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. Funding under this agreement shall not be used to purchase capital assets. RECORDKEEPING 6. RECORDS AND RIGHT TO AUDIT. PROVIDER shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for four years following the termination of this Agreement. If an auditor employed by the County or Clerk determines that monies paid to PROVIDER pursuant to this Agreement were spent for purposes not authorized by this Agreement, the PROVIDER shall repay the monies together with interest calculated pursuant to Sec. 55.03, F.S., running from the date the monies were paid to PROVIDER. Right to Audit. Availability of Records. The records of the parties to this Agreement relating to the Project, which shall include but not be limited to accounting records (hard copy, as well as computer readable data if it can be made available; general ledger entries detailing cash and if applicable trade discounts earned, insurance rebates and dividends; any other supporting evidence deemed necessary by County or the Monroe County Office of the Clerk of Court and Comptroller (hereinafter referred to as "County Clerk") to substantiate charges related to this agreement, and all other agreements, sources of information and matters that may in County's or the County Clerk's reasonable judgment have any bearing on or pertain to any matters, rights, duties or obligations under or covered by any contract document (all foregoing hereinafter referred to as "Records") shall be open to inspection and subject to audit and/or reproduction by County's representative and/or agents or the County Clerk. County or County Clerk may also conduct verifications such as, but not limited to, counting employees at the job site, witnessing the distribution of payroll, verifying payroll computations, overhead computations, observing vendor and supplier payments, miscellaneous allocations, special charges, verifying information and amounts through interviews and written confirmations with employees, Subcontractors, suppliers, and contractor's representatives. The County Clerk possesses the independent authority to conduct an audit of Records, assets, and activities relating to this Project. The right to audit provisions survives the termination of expiration of this Agreement. In addition, if PROVIDER is required to provide an audit as set forth in in Section 8(e) below, the audit shall be prepared by an independent certified public accountant (CPA) with a current license, in good standing with the Florida State Board of Accountancy. 7. PUBLIC ACCESS. The County and PROVIDER shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the County and PROVIDER in conjunction with this Agreement; and the County shall have the right to unilaterally cancel this Agreement upon violation of this provision by PROVIDER. This provision shall survive any termination or expiration of the contract. The PROVIDER is encouraged to consult with its advisors about Florida Public Records Law in order to comply with this provision. Pursuant to F.S. 119.0701 and the terms and conditions of this contract, the PROVIDER is required to: 1) Keep and maintain public records that would be required by the County to perform the service. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 2 2 2) Upon receipt from the County's custodian of records, provide the County 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 this chapter or as otherwise provided by law. 3) 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 PROVIDER does not transfer the records to the County. 4) Upon completion of the contract, transfer, at no cost, to the County all public records in possession of the PROVIDER or keep and maintain public records that would be required by the County to perform the service. If the PROVIDER transfers all public records to the County upon completion of the contract, the PROVIDER shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the PROVIDER keeps and maintains public records upon completion of the contract, the PROVIDER shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the County, upon request from the County's custodian of records, in a format that is compatible with the information technology systems of the County. 5) A request to inspect or copy public records relating to a County contract must be made directly to the County, but if the County does not possess the requested records, the County shall immediately notify the PROVIDER of the request, and the PROVIDER must provide the records to the County or allow the records to be inspected or copied within a reasonable time. If the PROVIDER does not comply with the County's request for records, the County shall enforce the public records contract provisions in accordance with the contract, notwithstanding the County's option and right to unilaterally cancel this contract upon violation of this provision by the PROVIDER. A PROVIDER who fails to provide the public records to the County or pursuant to a valid public records request within a reasonable time may be subject to penalties under section119.10, Florida Statutes. The PROVIDER shall not transfer custody, release, alter, destroy or otherwise dispose of any public records unless or otherwise provided in this provision or as otherwise provided by law. IF THE PROVIDER HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE PROVIDER'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY AT PHONE# 305-292-3470 BRADLEY- BRIANOMONROECOUNTY-FL.GOV, MONROE COUNTY ATTORNEY'S OFFICE 1111 12TH Street, SUITE 408, KEY WEST, FL 33040. 8. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the County the following (items (a)-(j) must be provided prior to the payment of any invoices): (a) IRS Letter of Determination and GUIDESTAR printout indicating current 501(c)(3) status; (b) Proof of registration with the Florida Department of Agriculture, as required by Florida Statute 496.405, and the Florida Department of State, as require by Florida Statute 617.01201, or proof of exemption from registration as per Florida Statute 496.406. (c) List of the Organization's Board of Directors of which there must be at least 5 and for each board member please indicate when elected to serve and the length of term of service; (d) Evidence of annual election of Officers and Directors; (e) Unqualified audited financial statements from the most recent fiscal year for all organizations that expend $150,000 a year or more; if qualified, include a statement of deficiencies with Guidance Care Center—Transportation:Baker Act and CTD FY20;page 3 3 corrective actions recommended/taken; audit shall be prepared by an independent certified public accountant (CPA) with a current license, in good standing with the Florida State Board of Accountancy. If the PROVIDER receives $100,000 or more in grant funding from the County: a. The CPA that prepares the audit must also be a member of the American Institute of Certified Public Accountants (AICPA); b. The CPA must maintain malpractice insurance covering the audit services provided and c. The County shall be considered an "intended recipient" of said audit. (f) Copy of a filed IRS Form 990 from most recent fiscal year with all attached schedules; (g) Organization's Corporate Bylaws, which must include the organization's mission, board and membership composition, and process for election of officers; (h) Organization's Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol-free workplace provisions, and equal employment opportunity provisions; (i) Specific description or list of services to be provided under this contract with this grant (see Attachment C); (j) Annual Performance Report describing services rendered during the most recently completed grant period (to be furnished within 30 days after the contract end date.) The performance report shall include statistical information regarding the types and frequencies of services provided, a profile of clients (including residency) and numbers served, and outcomes achieved (see Attachment H); (k) Cooperation with County monitoring visits that the County may request during the contract year; and (I) Other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may request during the contract year. RESPONSIBILITIES 9. SCOPE OF SERVICES. The Provider, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in rendering counsel in the matter of mental health and guidance to the citizens of the Monroe County, Florida. The Provider shall provide Baker Act transportation services in compliance with Florida Statutes Chapter 394. Baker Act and Marchman Act transportation services which are covered under this agreement may be subcontracted but are subject to the rates set forth in Attachment D, and the limitations above. The subcontractor shall be subject to all of the conditions of this contract, including but not limited to insurance and hold-harmless requirements, as is the Provider. 10. ACCESS TO FUELING FACILITIES. The County shall provide access to the Provider's vehicles at all County fueling facilities. The County shall grant the Provider a license for the use of the real property and its improvements for each fueling site. The Provider agrees that only those individuals authorized by the County to use the fueling sites designated in this agreement shall have twenty-four-hour access to said sites, and that they shall either be maintained open or access otherwise provided to them by a uniform key system on such a twenty-four-hour basis. The County shall bill the Provider for fueling and other related services and materials utilized by the Provider at the fueling sites within the County's immediate control and as previously set forth in this agreement. Said billing by the County to the Provider shall include an administrative surcharge, as adopted by the Monroe County Board of County Commissioners annually, for processing, servicing, and handling. The Provider shall reimburse the County within thirty (30) days of the date of issuance of the bill. Access to the Fuel Sentry System shall be provided by an electronic memory key, which shall be issued by the County to all authorized designated users of the fueling sites, and as contemplated by this Agreement. For purposes of uniformity, the Monroe County Fleet Management Department shall be responsible for establishing a uniform electronic key system for use by both the County and Guidance Care Center—Transportation:Baker Act and CTD FY20;page 4 4 the Provider under this agreement and shall establish and maintain policies and procedures for identification, control, and distribution of all keys issued. 11. ATTORNEY'S FEES AND COSTS. The County and PROVIDER agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an award against the non- prevailing party, and shall include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. 12. BINDING EFFECT. The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the County and PROVIDER and their respective legal representatives, successors, and assigns. 13. CODE OF ETHICS. County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. 14. NO SOLICITATION/PAYMENT. The County and PROVIDER warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the PROVIDER agrees that the County shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. 15. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee, agent or instrumentality of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. COMPLIANCE ISSUES 16. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 17. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 18. NON-DISCRIMINATION. The COUNTY and PROVIDER agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. The COUNTY and PROVIDER agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Guidance Care Center—Transportation:Baker Act and CTD FY20;page 5 5 Title VII of the Civil Rights Act of 1964 (PL 88-352), which prohibits discrimination in employment on the basis of race, color, religion, sex, and national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC §§ 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC § 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC §§ 6101-6107), which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, §§ 523 and 527 (42 USC §§ 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 §§ 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC §§ 12101), as amended from time to time, relating to nondiscrimination in employment on the basis of disability; 10) Monroe County Code Chapter 14, Article II, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. AMENDMENTS, CHANGES, AND DISPUTES 19. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 20. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. County and PROVIDER agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. The PROVIDER and County staff shall try to resolve the claim or dispute with meet and confer sessions to be commenced within 30 days of the dispute or claim. 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. Any claims or dispute that the parties cannot resolve shall be decided by the Circuit Court, 16th Judicial Circuit, Monroe County, Florida. 21. 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 PROVIDER 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 PROVIDER specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. ASSURANCES 22. COVENANT OF NO INTEREST. County and PROVIDER 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. 23. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 6 6 24. NON-WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the County and the PROVIDER in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the County be required to contain any provision for waiver. 25. ATTESTATIONS. PROVIDER agrees to execute such documents as the County may reasonably require, to include a Public Entity Crime Statement, an Ethics, Statement, and a Drug- Free Workplace Statement. 26. AUTHORITY. Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. INDEMNIFICATION AND INSURANCE 27. INDEMNIFICATION, HOLD HARMLESS AND INSURANCE REQUIREMENT. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims and causes of action for medical malpractice, medical negligence, bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. Insurance Requirement Limits Worker's Compensation Statutory Limits Employer Liability $1,000,000 Each Accident General Liability $1,000,000 Each Occurrence $3,000,000 General Aggregate Vehicle Liability (Owned, hired and Non- owned Vehicles) $1,000,000 Combined Limit All insurers shall have an A.M. Best rating of VI or better and shall be licensed to do business in the state of Florida. The Certificate of Insurance shall include Monroe County as Certificate Holder. 28. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the County, when performing their respective functions under this Agreement within the territorial limits of the County shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the County. 29. NO PERSONAL LIABILITY. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 7 7 30. LEGAL OBLIGATIONS AND RESPONSIBILITIES: Non-Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the County, except to the extent permitted by the Florida constitution, state statute, and case law. 31. 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 PROVIDER agree that neither the County nor the PROVIDER 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. GENERAL 32. 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. 33. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: Grants Administrator and Monroe County Attorney 1100 Simonton Street PO Box 1026 Key West, FL 33040 Key West, FL 33041 For PROVIDER Sharon Crippen, Senior Vice President Guidance/Care Center 1205 Fourth Street Key West, FL 33040 Copies of all default notices, notices of breach, termination, legal claim, or indemnity copied to: WestCare Foundation, Inc. Attn: Executive Vice President 1711 Whitney Mesa Drive Henderson, Nevada 89014 34. GOVERNING LAW, VENUE, INTERPRETATION, COSTS, AND FEES. This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the County and PROVIDER agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 8 8 The County and PROVIDER agree that, in the event of conflicting interpretations of the terms or a term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding. 35. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 36. 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 term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The County and PROVIDER 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. 38. CLAIMS FOR FEDERAL OR STATE AID: PROVIDER and COUNTY agree that each shall be, and is, empowered to apply for, seek, and obtain federal and state funds to further the purpose of this Agreement. Any conditions imposed as a result of funding that effect the Scope of Services will be provided to each party. 37. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. [THIS SPACE INTENTIONALLY LEFT BLANK WITH SIGNATORY PAGE TO FOLLOW] Guidance Care Center—Transportation:Baker Act and CTD FY20;page 9 9 "m't rat, ,�j , S REOF, the parties hereto have caused these presents to be executed as of the ay t7..."') ,aRo. r S ; en above. f, =>- v�,f BOARD OF COUNTY COMMISSIONERS ;fr sf MONROE COUNTY, FLORIDA o K (1� ADOK, CLERK OF o X'l By By yor/Chairman Deputy Clerk Guidance/Care Center, Inc., a Florida 501(c)(3) not-for-profit corporation Atarkt/ (Federal ID No.5Ct— I�5 83Z .t ) Witnetl I.� " �� Director Witness Guidance/Care Center, Inc., a Florida 501(c)(3) not-for-profit corporation MONROE COUNTY ATTORNEY P ST F CI-IRISTINE LIMBERT-BARROWS ASSISTANT COUN TT RNEY DATE: I 1 N'> tom Q t ... Guidance Care Center—Transportation:Baker Act and CTD FY20;page 10 ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service and Community-Based Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from the Monroe County Code of Ordinances and State laws and regulations. A cover letter (see Attachment B) summarizing the major line items on the reimbursable expense request needs to also contain the following notarized certified statement: "I certify that the above checks have been submitted to the vendors as noted and that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source." Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and paid payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: pay period, check amount, check number, date, payee, and support for applicable paid payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 11 11 A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel and Meal Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel reimbursement requests must be submitted and will be paid in accordance with Monroe County Code of Ordinances and State laws and regulations. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting, a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Mileage reimbursement shall be at the rate established by ARTICLE XXVI, TRAVEL, PER DIEM, MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving from one's home to the airport for a business trip is not a reimbursable expense. Meal reimbursement shall be at the rates established by ARTICLE XXVI, TRAVEL, PER DIEM, MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 12 12 ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for (Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending 05/28/01 XXX.XX (A) Total $ X,XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X,XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) State of County of This instrument was acknowledged before me this day of (month), (year), by (name of officer or agent, title or officer or agent) of (name of entity). Personally Known Produced Identification: Type of ID and Number on ID (Seal) Signature of Notary Name of Notary(Typed, Stamped or Printed) Notary Public, State of Guidance Care Center—Transportation:Baker Act and CTD FY20;page 13 13 ATTACHMENT C Specific description and list of services to be provided under this contract: Baker Act/Marchman Act transportation services and Community Transportation Coordinator related services. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 14 14 ATTACHMENT D Copy of the Sub-Contract for Baker Act transportation services and proof of automobile insurance. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 15 15 Yif sTURE VENDOR SERVICE AGREEMENT THIS VENDOR SERVICE AGREEMENT (the "Agreement")is effective as of this 1st day of October, 2019 ("Effective Date") between Guidance/Care Center, Inc. a Florida not-for-profit corporation ("WestCare") and Caribbean Transfers, Inc. dba Key Lime Taxi ("Vendor"). Vendor and WestCare collectively hereafter the "Parties" and individually the "Party". The Parties agree as follows: 1. Services to be Performed. Vendor will provide the services set forth on Exhibit A ("Services), which exhibit is attached hereto and incorporated herein by and through this reference. 2. Term. This Agreement shall commence on the Effective Date and shall expire on September 30, 2020 ("Term"). Foregoing notwithstanding, either party may terminate this Agreement at any time, with or without cause, upon not less than twenty (20) days written notice to the other party. If either Party breaches the obligations set forth in this Agreement,the non-breaching Party may terminate this Agreement upon not less than five (5) days prior written notice and retain its right to all damages caused by the breach (unless otherwise provided herein) and subsequent termination. Upon expiration or termination of this agreement, neither party shall have any further obligation hereunder except for(i) obligations due and owing which arose prior to the date of termination, and (ii) obligations, promises or covenants contained herein which expressly extend beyond the term of this agreement. 3. Performance Standards. Vendor shall comply with all applicable laws, codes, ordnances, and regulations of the Unites States and the State of Florida. Additionally,and without limiting the foregoing, Vendor shall take all commercially reasonable care in the delivery of Services under this Agreement. 4. Compensation. In full consideration for the performance of the Services set forth in Section 1, including for any rights granted or relinquished by the Vendor under this Agreement, WestCare shall pay Vendor the rate set forth in Exhibit B based on the specific Service(s)provided pursuant to this Agreement("Fee Rate"). Services provided pursuant to this Agreement are to be documented and invoiced by Vendor in writing at the end of each calendar month of service. All written invoices are due by the last day of the month for that month's service. Compensation shall be payable on the last day of the following calendar month following WestCare's receipt and acceptance of Vendor's written accurate invoice. Vendor acknowledges and agrees that, except as provided in this Section or as otherwise set forth in Exhibit B, it shall not be entitled to, and WestCare shall not be obligated to pay, any monies or other compensation for the Services provided and rights granted under this Agreement. WCGCC VSA Page 1 of 14 16 5. Intentionally Deleted. 6. Confidential Information. Both parties hereto shall treat as confidential all information relating to either party's operations or the general business affairs or any of the operations or general business affairs of the party(including the party's parent, affiliate or subsidiary companies) which the other party may observe or which may be disclosed as a result of the party's performance under this MOU. Neither party shall not disclose any information, including without limitation any information contained in this MOU,to third parties or use any such information for any purpose other than the performance under this MOU,without the prior written consent of the other party. Additionally,the Parties agree to abide by all State and Federal laws, rules and regulations, HIPAA and 42 C.F.R., Part 2. Both parties agree not to divulge any information concerning any individual client to any unauthorized person or agency without the written consent of the client and participant. This Section 6 shall survive the termination of the Agreement. 7. Indemnification. Vendor shall indemnify, defend and hold WestCare (including without limitation WestCare's affiliates, subsidiaries' officers, directors, employees, representatives, independent contractors and agents) harmless for, from and against any and all losses, expenses, costs, liabilities, damages, claims, suits and demands (including without limitation attorney's fees and costs) arising from or attributable to the acts or omissions of Vendor (including but not limited to Vendor's officers, directors, employees, representatives, sub-contractors and agents). 8. Insurance. Vendor shall be solely responsible,at Vendor's sole cost and expense,for maintaining its own liability insurance, including any workers compensation insurance required under applicable law. At no time shall WestCare be liable for any insurance obligation of Vendor. 9. Representations and Warranties. Vendor hereby represents, covenants and warrants to WestCare as a material part of the consideration for WestCare agreeing to enter into the Agreement, as follows: (i) Vendor is a corporation, duly organized and validly existing under the law; (ii) the execution of this Agreement has been duly authorized by all necessary corporate action on behalf of Vendor; and (iii) Vendor has obtained and currently holds all licenses, permits and approvals of all governmental authorities necessary or appropriate to perform Vendor's obligations under the this Agreement. 10. Intellectual Property. Neither party to this Agreement shall be deemed to be granted any right, title or interest in or to the trademarks, trade names, service marks, copyrights, patents or other intellectual property of the other Party. WestCare and Vendor expressly acknowledge and agree that neither party is granted under this Agreement the right to use, refer to or incorporate in any materials, including without limitation marketing materials, the name,logos,trademarks,or copyrights of the other Party. 11. Intentionally Omitted. GCC VSA Page 2of14 17 12. Notice. Any notices to either party under this Agreement shall be in writing and delivered by hand or sent by nationally recognized messenger service, or by registered or certified mail, return receipt requested, to the address set forth herein or to such other address as that party may hereafter designate by notice. Notice shall be effective when received, which shall be no greater than one (1) business day after being sent by a nationally recognized messenger service or three(3)days after being sent by mail. If to WestCare: Guidance/Care Center, Inc. Attn: Maureen Dunleavy 3000 41st Street Ocean Marathon,Florida 33050 with a copies of any legal notice,notice of demand,notice of breach, demand for indemnity,claim,assertion of damage or notice of default to: WestCare Foundation, Inc. • Attn: Executive Vice President 1711 Whitney Mesa Drive Henderson,Nevada 89014 If to Vendor: Caribbean Transfers,Inc. dba Key Lime Taxi Attn: Margaret Scholl 30886 Hammock Drive Big Pine Key,FL 33043 13. Miscellaneous. (a) Time is of the essence of this Agreement. (b) This Agreement, together with all documents incorporated herein by reference, if any, constitutes the entire agreement between the Parties. There are no terms, conditions or provisions,either oral or written between the parties other than those contained in this Agreement. (c) No amendment to this Agreement shall be enforceable, unless in writing and signed by the Parties. (d) Whenever the context may require, any pronouns used in this Agreement shall include the corresponding masculine, feminine or neuter forms, and the singular form of nouns and pronouns shall include the plural and vice versa. Captions contained in this Agreement are inserted only as a matter of convenience and in no way define, limit, extend or describe the scope of this Agreement or of any provision herein. (e) This Agreement may be executed in one or more counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same GCC VSA Page 3 of 14 18 agreement. Any such counterpart signature pages may be attached to the body of one agreement to form a complete integrated whole. (f) Any term or provision of this Agreement which now or hereafter is declared contrary to any law, order, ordinance, requirement ruling or regulation of any governmental authority, whether federal, state or local, whether now in force or enacted or promulgated in the future, or which is otherwise invalid, shall be deemed stricken from this Agreement without impairing the validity of the remainder of this Agreement. (g) This Agreement shall be governed by and construed in accordance with the law of the State of Florida. The venue for any dispute arising under this Agreement shall be a court of competent jurisdiction in Monroe County, State of Florida. (h) Neither Party hereto shall be entitled to recover special damages in the nature of lost profits or consequential damages. (i) The Parties to this Agreement are acting as independent contractors and independent employers. Nothing contained,in this Agreement shall create or be construed as creating a partnership,joint venture or agency relationship between the parties. Neither Party shall have the authority to bind the other Party in any respect. (j) In the event of any action or proceeding to compel compliance with, or with respect to any breach of this Agreement, the prevailing party shall be entitled to recover all reasonable costs and reasonable expenses of such action or proceeding including without limitation its reasonable attorneys' fees and costs incurred in connection therewith regardless of whether any formal legal action is commenced or whether such fees and costs are incurred at or in connection with trial or appellate proceedings. (k) Vendor shall perform all of the Services under this Agreement in compliance with all applicable federal, state and local laws, ordinances, rules, regulations, codes or orders. (1) Any failure by either Party at any time, to enforce or require the other Party's compliance with any of the terms and conditions of this Agreement shall not constitute a waiver of such terms and conditions in any way, or the right of the non-defaulting party at any time to avail itself of any and all remedies it may have for any breach of said terms and conditions including without limitation any right to terminate this Agreement. The remedies of the parties provided for in this Agreement shall be cumulative with all other remedies that either Party may have against the other party at law or in equity. (m) All of the covenants and agreements contained in this Agreement shall be extended to and be binding upon the successors and assigns of the Parties. GCC VSA Page4of14 19 (n) Neither Party may assign this Agreement in whole or in part or assign, pledge or otherwise transfer either party's obligations hereunder except with the prior written consent of the non-assigning party, which consent shall not be unreasonably withheld. (o) The Vendor shall not subcontract any portion of the Services contemplated by this Agreement without the prior written consent of WestCare, which consent may be given or withheld in WestCare's sole and absolute discretion. (Signature Page to follow) GCC VSA Page 5 of 14 20 SIGNATURE PAGE IN WITNESS WHEREOF, the Parties, by their duly authorized representatives, have executed this Service Agreement as of the Effective Day noted above. "WestCare" "Vendor" GUIDANCE/CARE CENTER,INC. CARIBBEAN TRANSFERS, INC. DBA KEY LIME a Florida 501c3 no -for-p ofit corporation TAXI, By: B Name: Craig-Knierim Name: Mars --p� Its: Deputy COO Its: e tU v Date: /3 ,2019 Date:�Pfj-, /3— ,2019 GCC VSA Page 6 of 14 • 21 i f Exhibit A Services • GCC will supply Vendor with two Ford Crown Victoria vehicles Ford (White) n/a 4-door- Donation KW Baker 2010 Crown 2FABP7BVOAX118953 cage from BA4 Act Victoria MCSO Ford n/a 4-door- Donation KW Baker 2011 Crown from 2FABP7BV6BX113807 cage BAS Act Victoria MCSO • Maintenance specifications: one vehicle to be stations at the GCC Key West office and the other in Marathon at GCC headquarters. GCC will pay for the fuel and maintenance of the two vehicles used for Baker Act and Marchman Act transportation. Vendor will complete daily inspections each time the vehicles are driven as noted on the inspection forms which will be submitted to GCC with trip verification. GCC will coordinate the maintenance for both vehicles above. • GCC will maintain insurance on both of the vehicles.Vendor will be named as an "additional insured"for these two cars.All Vendor drivers operating GCC vehicles will hold a minimum of a Class E Florida Driver's License and be approved for GCC insurance coverage by the Transportation Coordinator. Upon execution of this agreement, Vendor will fax/email to GCC's Transportation Coordinator a current list of drivers— including a copy of the driver's license and social security number for each driver—for approval to operate GCC vehicles. Prior to adding a driver,Vendor will fax or email to GCC's Transportation Coordinator,or designee,a copy of the driver's license, social security number and signed"Request for Check of Driving Record"form. GCC will initiate procedures to add the driver to GCC vehicle insurance Vendor cannot use the driver for BA/MA transports until it has received written notification that the driver has been added to the GCC insurance coverage. • All drivers and escorts are required to have a background screen, a minimum 3-year clean driving record and submit to drug screen. Additionally,Vendor will fax a copy of picture identification and social security number for each driver and escort to GCC's Transportation Coordinator or designee.Vendor cannot use the escort for BA/MA transports until it has received written notification that the escort has been approved by GCC.All BA/MA approved drivers must read and sign the acknowledgement of reading and receiving, attached hereto as.Attachment 1 Transportation Protocol. GCC VSA Page 7 of 14 22 • Vendor will report and document accidents involving GCC vehicles and incidents involving clients to the proper authorities and immediately thereafter contact the site director at GCC.Following an accident, GCC Vehicle Incident Protocol must be followed. A Vehicle Incident Kit,attached hereto as Attachment 4,has been provided for each vehicle with instructions.Additionally,anyone involved in an accident with a GCC vehicle MUST BE DRUG TESTED as soon as possible following the incident. Drug testing forms are included in the kit. • Any citations received while driving a GCC vehicle will be the responsibility of the driver.Refusal or failure to accept responsibility for citations may result in removal of driving privileges. • All drivers will be required to complete an orientation and verbal de-escalation training within 30 days of approval to drive. GCC will provide details for accessing the training. All BA/MA approved drivers must read and sign the acknowledgement of completing the assigned training,attached hereto as Attachment 5. • Vendor will follow the transportation protocol and complete the documentation provided as Attachment 1-3 herein. • Vendor,upon approval of drivers,will issue an identification badge. GCC VSA Page 8 of 14 23 Exhibit B Compensation Pursuant to the terms and conditions set forth in this Agreement,and pursuant to the invoice requirement set forth in Section 4 herein,WestCare shall pay Vendor the following fee structure established for the Term of the Agreement: MS jy Estimated# Client PickupPoint Client Drop-off Point s-Pa ent Roundtrips * p �� Key West Key West $115 Marathon Marathon $115 450 Key West Marathon $145 Marathon Key West $145 Marathon Key Largo $145 Key Largo Marathon $145 40 Marathon Miami-Dade County $385 Key Largo Miami-Dade County $385 40 Key West Miami-Dade County $385 GCC Preauthorization Required for All Trips Below *Approval for below fees will be granted only when the Marathon BA/MA vehicle is engaged with another BA/MA trip that would preclude anotherpickup within a reasonable period of time Estimated# Car Client Pickup Client Drop-off Elan3e payment Roundtrips Location Point Point 5 Key West Marathon &North Marathon $145 5 Marathon Key West Marathon $145 (-Art l bea—ri 2 Key West Marathon&North Key Largo $225 Tat.nSfe45 3 Key West Marathon&North Miami-Dade County $385 mS GCC Preauthorization Required for All Trips Below Estimated# Client Pickup Point Client Drop-off Point _Elan ess ayment* 1 Key Largo Avon Park(Area) $770 Marathon Avon Park(Area) $770 Cct-c--bbe,, r1 Key West Avon Park(Area) $770 -1'n;n s e i5 1 Key Largo Up-State(McClenny Area) $1,200 rrt j • Marathon Up-State(McClenny Area) $1,200 Key West Up-State(McClenny Area) $1,200 Timely payment for services rendered is endured by adherence to the following invoicing procedures. • . Vendor will submit one.statement/invoice per month pursuant to the procedure set forth in Section 4 herein to the attention of the GCC Marathon Site Director. GCC VSA Page 9 of 14 24 Attachment 1 Guidance/Care Center Transportation Protocol: The Transportation of Baker Act and Marchman Act Clients (See Attached) GCC VSA Page 10 of 14 25 ATTACHMENT 1 GUIDANCE /CARE CENTER TRANSPORTATION PROTOCOL: THE TRANSPORTATION OF BAKER ACT AND MARCHMAN ACT CLIENTS A. Client Related Rules: 1. Confidentially of a client and client related information shall be maintained at all times. 2. Each client shall be treated with respect and dignity at all times. 3. No information with client information shall leave the clinic unless part of a client transfer packet to a designated.facility. (No driver/escort shall maintain a personal copy of the Transportation Record and Payment Authorization Sheet.) 4. Client transportation within Monroe County may be conducted with a driver and an escort when deemed appropriate or necessary. 5. A female client requires a female escort or a female driver. 6. A client must be observed for any unusual behaviors including hurting self/others or sudden medical conditions. Respond to a medical emergency by calling 911. If a client is violent during transport and poses a threat to safety, stop the vehicle and call 911. Notify the Nurse on Duty of any unusual situation at (305)434-7660 ext. 31123 7. At the time of pick up for a Baker Act or Marchman Act client, a driver must obtain the Baker Act or Marchman Act paper work from the Pick Up facility. If the original paper work is not available the driver must immediately report this information to the G/CC Nurse on Duty for further instructions. 8. Only one client may be transported at a time 9. a client may only be transported in the back seat of the vehicle 10. A parent is not allowed to travel in the Baker Act vehicle with a Baker Act or Marchman Act minor. • When a parent or other responsible party reports he/she plans to follow the Baker Act vehicle,the Baker Act driver advises the parent/party that our primary responsibility is to the child and ensuring the safety of the child therefore following our vehicle as a method of direction is not encouraged. 11. Drivers, Escorts and Clients are not to smoke in the car at any time. 12. Clients are not to be placed in handcuffs or any type of restraints for any reason by a driver or escort—or to be placed in the vehicle by others (i.e. Law Enforcement) in handcuffs or any type of restraints 13. A client's movement is not to be impeded with any physical restraint unless directed by a nurse/MD/law enforcement officer. 14. If a client must use a public facility, the client must be escorted to the restroom and the driver must remain outside the restroom door until the client leaves the restroom. The driver will remain in conversation with client while the client is in the restroom. THIS SHOULD HAPPEN ONLY UNDER MOST EXTREME CIRCUMSTANCES. 15. A client shall not be left alone in the vehicle during the trip for any reason. 16. A client shall be under the observation of the driver or escort at all times during the transport. 17. Client is encouraged to use restroom facilities prior to departure. If the trip is Rvsd/md 9.2019 26 generated from Key West and a stop is required, G/CC may be used for that purpose. 18. A client may not use aluminum/metal cans. Items for drinking shall be provided only in a plastic container. 19. Clients may not have any metal utensils, glass or other hard products such as pencils or pens. 20. A client may not shop during a stop. All efforts should be made to avoid stops. If a stop is required, it should be short and without delay. B. Coordination of Transportation Rules: 1. Transportation arrangements for Baker Act and Marchman Act clients are under the direction of the Unit Nurse on Duty/G/CC per contractual arrangement Caribbean Transfers, Inc. No other agency is authorized to contact Caribbean Transfers, Inc. directly for transportation. 2. Final decision for a driver to transport is made by the nurse on duty. The nurse may request a BAL be conducted or send a drivers/escort home if he/she has a concern. 3. A driver shall not be permitted or required to drive more than 12 hours in any one 24- hour period, or drive after having been on duty for 16 hours in any one 24-hour period. 4. All trips will be made within the approved fee structure. 5. All trips will be made using the closest vehicle and the shortest distance unless preauthorization is obtained from the Unit Nurse on Duty at the G/CC. 6. Clients may be picked up at only approved locations. The G/CC Nurse on Duty will communicate the pick up location. Approved locations will include: a. Hospitals b. Detention Facility c. Schools d. Anchors Away e. Any G/CC site f. Or otherwise authorized by the G/CC IP Unit Coordinator 7. DePoo Hospital: Pick-up /drop-off is located in the rear next to the handicap parking. Upon arrival, call the nurse's station directly from the vehicle at 305-294-5531 x8330. Hospital staff will escort the client to/from the building. 8. Pick-up/drop-off is at the ER entrance. Upon arrival, call 305-294-5531 x3202. a. Hospital staff will escort the client to/from the building. 9. At G/CC: Use the telephone call box next to the elevator. 10.At G/CC, staff members shall place the client in the vehicle for departure and will assist the client from the vehicle at time of arrival. 11.The facility responsible for the departing client for a trip longer than 2 hours shall provide a brown bag snack. All minors shall be supplied with a snack for any trip over 1 hour. 12.When a driver reports a client is too dangerous to transport, the nurse on duty shall work with the Sheriff's department to transport the client 13.If a client absconds at time of or during transport, immediately contact 91.1 and report the information to the G/CC Nurse on Duty. Do not go after the client. 14.Neither Drivers nor Escorts are permitted to physically restrain a client. Rvsd/md 9.2019 -2- 27 15."Jail Hold" clients from the Monroe County Detention Facility shall be picked tip from the Sallyport area only. To access the Sallyport area, the driver must drive the car within 1 foot of the Sallyport entrance. If the door does not open, the escort must use the speaker mounted on the wall next to the Sallyport entrance to request entrance. Once inside, Detention Facility staff will bring the client to the car. When the client is inside the car and the doors are locked, the Sallyport area exit doors will open. 16.The driver/escort must determine from the Pick Up facility if the client has been searched and encourage staff to conduct a search prior to transport. If the client is not searched prior to transport, the driver must communicate this information to the Duty Staff Member prior to opening the client door at the Designation point. 17.Driver/escort MUST respond to the pick up point within a maximum time-frame of 1 hour and.15 minutes. C. Reimbursement related rules 1. All cancelled and otherwise diverted trips will be reported on the Transportation Record and Payment Authorization Sheet. 2. Transportation Record and Payment Authorization Sheets and a Statement of services rendered will be faxed to the IP Unit Coordinator on the first and sixteenth of each month. 3. G/CC does not reimburse Vendor for cancelled trips. Compensation to the drivers/escorts for cancelled trips is at the discretion of Vendor. 4. If the driver arrives without the Baker or Marchman Act paperwork, Vendor will obtain the paper work without charge_to the G/CC. D. Dress Code 1. Drivers must wear their Vendor issued ID badge at all times 2. All clothing worn by the driver must be clean and in good condition, and the driver must have good standards of personal hygiene. As a minimum standard, drivers should wear trousers and a shirt which has a full body and sleeves. Knee length shorts may be worn, 3. Footwear for all drivers shall fit around the heel and toe of the foot. Sneakers are acceptable. 4. The following are deemed to be unacceptable: (a) Clothing that is not kept in a clean condition, free from holes and rips. (b)Words or graphics on any clothing that is of an offensive or suggestive nature or which might offend. (c) Drivers not having either the top or bottom half of their bodies suitably clothed. (d) The wearing of hoods or other clothing that obscures the drivers vision or their identity I acknowledge I have received and read the above BA/MA Transportation Protocol. Driver/Escort Signature Date Printed Name Rvsd/md 9.2019 -3- 28 GUIDANCE / CARE CENTER, INC DRIVER / ESCORT APPLICATION AND REQUEST FOR CHECK OF DRIVING RECORD DRIVER APPLICATION. ESCORT APPLICATION '******DRIVER APPLICANTS MUST SUBMIT A COPY OF THEIR DRIVER LICENSE WITH THIS APPLICATION******' I HEREBY AUTHORIZE GUIDANCE /CARE CENTER, INC. to obtain a report of my driving record as needed to evaluate my job application: The report may be procured by HRH of Orlando and may include an assessment of my insyurability under the company's insurance coverage. By signing this disclosure, i hereby authorize the company to pocure such report and additional reports about me on an annualy basis, or as it deems appropriate, to evaluate my ongoing insurability. Name of Applicant: Driver's License Number: Social Security Number: Date of Birth: Signature of Applicant Date Signed: Phone Number: • *******DRIVER APPLICANTS MUST SUBMIT A COPY OF THEIR DRIVER LICENSE WITH THIS APPLICATION******* GCC Authorization Signature: Printed Name • Date: 29 GUIDANCE / CARE CENTER, INC RA / MA DRIVER APPROVAL TO: KF .I I►A E-TAXI.-- Cc � t b h f__'1t r1^ T l b'(Is f'a s, 7 Please add the following driver to the approved list. APPROVAL DATE: NAME: PHONE: Vendor will contact the driver and advise of the pay rate per trip, and determine, if necessary, the hours the driver is available. This information will be passed on to dispatchers and the driver will be added to the call list. THE DRIVER ABOVE IS AUTHORIZED TO DRIVE THE KEY WEST OR MARATHON BAKER VEHICLE GCC Authorization Signature: t,; wtcc, u. PRINTED NAME: DATE: 30 Attachment 2 Transportation Record and Payment Authorization Sheet (See Attached) GCC VSA Page 11 of 14 31 ATTACHMENT 2 GUIDANCE/CARE CENTER 3000 41ST ST. Ocean Marathon, FL 33050 Voice 305-434-7660 • Fax 305-434-9040 TRANSPORTATION RECORD AND PAYMENT AUTHORIZATION SHEET Transportation Type: o Baker Act o Marchman Act Date: Client Name: DOB: Time Called: Time of Pick Up: Time of Drop Off: Time van returned to Duty: Vehicle: KW vehicle Mar vehicle Place of Pick Up: (Where did you pick up the Client:Facility Name/City) Authorized Staff Signature at Pick Up Facility: Time: Destination: (Where did you take the Client: Facility Name/City) Authorized Staff Signature at Designation Facility: Time: (Staff member accepting client) Driver Name: Escort Name: Beginning Miles: Pick Up Miles: Drop Off Miles: Ending Miles: FOR GlCC USE ONLY:�� Amount to be paid: Unit Director Signature: \\westcare.local\dfsredirection$\FL-GCC\maureen.kempaWly Documents\Contracts\Transportation\Attachment 2-auth sheet VSA Baker Act.doc RVSD0912 32 Attachment 3 Statement (See Attached) GCC VSA Page 12 of 14 33 �.. r4 S + s a3 � t :*� `, r c" _ t:—Vfnl "snr..1"' ak, vOZAt , 4 ,-:. .- fi;II ^ r.. °' 1+ "7 ` ; ko t � r�r^- �a�� < '� � 's : +2 ,f , , •t ` fi ,f ar ,d t c ,. L.ds` ` , " - 5P1"'_"{" . syts ?r,- 1f a ia�'� 4< 6,,,i. � . S',nY rR*n°s��?� f T,acaijbrt`rt � �k^. 8�°{+ 5� ;e 1 �:% .x ,�?- d a&, � ?x . "{Nw nL�_ quJ is _d /y, i a�K #..} •i,.L'y^ y(�� 3 � :;:t 'Ps1 '}ti1 lie -il ` - p � „ S / g� � t . 51. ..n_ ` ,xwla4.....,,. L. y.H. o . n4Lt,,. ..r.„¢ .. ..p„, 13 + f...n,....:< . % 4iu_ _i ..„, „.,. r„4_„„ , ry ,.S �,._ ,. „, ,¢ ........Caribbean Transfers, Inc. 30886 Hammock Dr. Big Pine Key, FL 33043 TO: Lisa Marciniak- Site Director Guidance/Care Center 3000 41st St. Ocean Marathon, FL 33050 The following is a breakdown of trips FROM To DATE FROM TO FEE SUBMITTED BY DATE 34 ----------- ilkkSICARE, Vehicle Inspection Report Date: Check to see if the GAS Card Name: is with the Vehicle Make: Model: License Plate: Inspect each line item, marking the appropriate box with an XXXX ..." Inspection Line items ' In working condition May require ' Immediate Misc. Notes No immediate future Attention . Attention is - attention needed Lights i , Wiper Blades Windshield/Glass Damage : . 1 i Check Engine light ' , ... .. i Tire Condition ...._ . _ . • .i Body Dania e g Brakes "check pedal with engine T I started in park" i , , Turning Signals 1 Born Mileage start finish 35 Attachment 4 Vehicle Incident Kit (See Attached) GCC VSA Page 13 of 14 36 Vehicle Incident Kit Contents: Vehicle Incident- Protocol and Reporting Policy Vehicle Incident Report Form Vehicle Incident- Passenger/Witness Statement Forms* Vehicle Incident Traffic Diagram Disposable Camera 12 Pens Fe N• *Number of Statement Forms Required is to equal vehicle passenger capacity plus an additional two for other witnesses. **Drivers are responsible for making sure this kit is complete at all times. 37 Vehicle Incident Protocol and Reporting Policy (Vehicle Incident Kit Copy) DO IMMEDIATELY: 1. Immediately after the incident, examine and question persons for bodily injury and then examine vehicle for damage. 2. If there is an accident involving another vehicle or if persons involved require immediate medical attention, call 911 or 311 accordingly. 3. If involved persons do not report injury,authorities still need to be contacted and a police report requested.If the request for a police report is declined,the reason and dispatcher name and badge number need to be noted. 4. After authorities have been called,your supervisor needs to be called. DO NOT: 1. DO NOT admit fault if you are truly not at fault. 2. DO NOT leave the scene of an accident. 3. DO NOT drive the vehicle if you feel it is unsafe. 4. DO NOT drive the vehicle if you feel physically incapable of driving safely. 5. DO NOT discuss the incident with anyone other than law enforcement authorities,your supervisors, or a claims adjuster from York Claims Service Inc. GATHER INFORMATION&COMPLETE INCIDENT REPORT: 1. An incident will be defined as any occurrence that resulted in damage to the vehicle and/or injury to any person.Damage to a vehicle will be defined as anything that resulted in the property not being left in the same condition as before the incident. 2. Locate and complete the Vehicle Incident Form,complete all the information requested regarding incident and parties involved and take photos of damage with camera provided. 3. All passengers and other available witnesses,if applicable,need to complete the statement form. 4. After police report has been completed(if it was not declined),persons have been cared for (if injury occurred),and vehicle is operational,return to the office, 5. Any and all vehicle incidents must also be reported electronically upon return to the office by attending supervisor by transferring information from Vehicle Incident Form.The incident report.will be completed online by logging into the Westcare Intranet at. https://secure.westcare.coin/intra/. '6. An additional email must also be sent by the attending supervisor to the following management staff summarizing the incident and action taken;Program Director/Coordinator, Area Director and/or Vice President, and Michael Lavin, Sr:VP of Operations. 7. Supervisor will await further instructions by Program Director/Coordinator and/or Area Director/Vice President and Michael Lavin, Sr.VP of Operations. MANDATORY DRUG TEST The driver of the vehicle involved MUST immediately take a drug test upon completion of the Vehicle Incident Report Form.The driver's supervisor will provide the documents needed for the designated laboratory. Approved by Senior Management 7/2009 38 Page 1 of 3 Westcare Vehicle Incident Report Form This form is to be completed by driver immediately after a vehicle incident,when all persons involved have been checked for injury and provided medical attention(if applicable), and while all parties are still present Basic Information: • Incident Date and Time: Incident Location: Were Authorities called?Yes(No If no,explain why? If yes,was a police report request,granted?Yes/No If yes,list police report number and attending officer name: If no,list reason why it was declined? Dispatcher Name and Badge Number: Was citation issued?Yes or No If yes,to whom: Westcare Vehicle Information: Year/Make/Model: is VIN: Plates: State: Description of Damage: Please take pictures of damage with disposable camera provided in Vehicle Incident Kit, Driver Information: Driver Name and Job Title: Driver License Number: State: Involved Party l: Year/Make/Model: Role in Incident:. Description of Damage: Please take pictures of damage with disposable camera provided in Vehicle Incident Knit. Insurance Company: Claims Phone: • Policy# License# State: Driver Name: Phone: Injured?Yes or No If yes,explain: Passenger 1 Name: License# State: Injured?Yes or No If yes,explain: 39 IIf Page 2 of 3 Passenger 2 Name: .. License# State: Injured?Yes.or No If yes,explain: Passenger 3 Name: License# State: Injured?Yes or No If yes,explain: (Attach sheet if more passengers present) • Involved Party 2: Year/Malce/Model: • Role in Incident: Description of Damage: Please take pictures of damage with disposable camera provided in Vehicle Incident Kit. Insurance Company: Claims Phone: Policy# License# State: Driver Name: Phone: Injured?Yes or No If Yes,explain: Passenger 1 Name: _ License# State: Injured?Yes or No If yes,explain: Passenger 2 Name: License# State: Injured?Yes or No If yes,explain: Passenger 3 Name: License# State: Injured?Yes or No If yes,explain: (Attach sheet if more parties involved) • Passengers Present inWestcare Vehicle: All passengers must complete a Vehicle Incident Passenger Statement Form. 1, Staff or Client Name: Injured?Yes or No .<i If Yes,explain: 2. Staff or Client Name: Injured?Yes or No If Yes,explain: 3. Staff or Client Name: Injured?Yes or No If Yes,explain: 4. Staff or Client Name: Injured?Yes or No If Yes,explain: r.. 40 i + Page 3 of 3 5. Staff or Client Name: Injured?Yes or No If Yes,explain: 6. Staff or Client Name: Injured?Yes or No If Yes,explain: _ --- 7. Staff or Client Name: Injured?Yes or No If Yes,explain: 8. Staff or Client Name: Injured?Yes or No If Yes,explain: (Attach sheet if more passengers present) Detailed Exolanation of Incident: i". Was this a preventable incident?Yes or No Explain why or why not: I confirm the information provided in this report is as accurate to my knowledge and as thorough as possible. i<. Name: Signature: *This report must be sent to the attending supervisor as promptly as possible.Attending supervisor must complete and submit an electronic incident report via the Westcare Intranet and email management. **The Driver of the Westearo vehicle must take a drug test,as required by company policy,immediately after the vehicle incident and attending supervisor needs to know the time of completion. Approved by Senior Management 7/2009 41 Westeare Vehicle Incident Passenger/Witness Statement Form Name: Are you Westcare Staff,a Westcare Client,or Other? Are you a Driver,Passenger or Other Witness? • If Other Witness,please list Contact Information: Address: City: St: Zip Phone: ( ' ) Incident Date and Time: Incident Location: Westcare Vehicle Make/Model: • Description of Incident/Event: • . is Are you injured?Yes or No If yes,please explain: • I was offered medical evaluation: Yes or No • If yes,I:Accepted or Declined Signature: I certify that the above information is as accurate to my knowledge and as thorough as possible. Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. • Thank you for your cooperation. Approved by Senior Management 7/2009 SL. 42 • Westcare Vehicle Incident Passenger/Witness Statement Form Name: Are you Westcare Stag a Westcare Client,or Other? Are you a Driver,Passenger or Other Witness? If Other Witness,please list Contact Information: Address: City: St: Zip • • Phone: ( ) Incident Date and Time: Incident Location: • Westcare Vehicle Make/Model: • Description of Incideni/Event: • '• • • 1 Are you injured?Yes or No If yes,please explain: I was offered medical evaluation:Yes or No • If yes,I:Accepted or Declined Signature: I certify that the above information is as accurate tomy knowledge and as thorough as possible. i Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. Thank you for your cooperation. Approved by Senior Management 7/2009 S.L. 43 Westeare Vehicle Incident.Passenger/Witness.Statement Form 14.11 • Name: Are you Westcare Staff,a Westcare Client,or Other? Are you a Driver,Passenger or Other Witness? If Other Witness,please list Contact Information: Address: City: St: Zip Phone:( ) Incident Date and Time: Incident Location: Westcare Vehicle Make/Model: . Description of Incident/Event: • ». Axe you injured?Yes or No If yes,please explain: _. I was offered medical evaluation:Yes or No If yes,I:Accepted or Declined Signature: �< I certify that the above information is as accurate to my knowledge and as thorough as possible. Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. Thank you for your cooperation. Approved by Senior Management 7/2009 S.L. 44 Westcare Vehicle Incident Passenger/Witness Statement Form Name: Are you Westcare Staff a Westcare Client,or Other? Are you a Driver,Passenger or Other Witness? If Other Witness,please list Contact Information: Address: City: St: Zip Phone:( ) Incident Date and Time: Incident Location: Westcare Vehicle Make/Model: Description of Incident/Event: Are you injured?Yes or No If yes,please explain: I was offered medical evaluation:Yes or No i.: If yes,I:Accepted or Declined Signature: n= ,° I certify that the above information is as accurate to my knowledge and as thorough as possible. Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. • Thank you for your cooperation. Approved by Senior Management 7/2009 S.L. 45 Additional Sheet for More Information f• i). 46 Approved by Senior Management 7/2009 •....;.:',.;..',. ..',".:.;,'.1:::;'...•;:i'Ati:',:i.1±:1,:•:.::.!:..':.'.':.....:::::';.•: .... .._ .. . . :. . ..-.... ; Z+(,) . • . . I P • i I • i • . . . . . . . • --:---- • I . . • . • • . . • , . • • ., dommo...mrs.0016.11 1 . . , . I - i . . • . 1 . 1 ' .• . . 1 . ...T.- -..,- •momilm•••• I I ' 4 ....IMMO. INIIMIMI. •.•• •mr . . ' : . • . li vt...... • i • • . . r '. , • 4 . . . . :701111100............. . . . . t . . • / l . , ... • . • ' , I. . 1 . . • , , . 1 v iaS6 1 4 . et • - i . iii virml . . . !m LSI " . I IP:s CP 414_.. •E _,GP ..E-1 I , . . .6% • 4) .1.2; Llt 101 Eimi 1=4 V ' • .... .._ • • 1- . . Attachment 5 De-Escalation Training Acknowledgement Form (See Attached) GCC VSA Page 14 of 14 48 GUIDANCE/CARE CENTER,INC. 3000 4161 STREET, OCEAN MARATHON, FL 33050 (v) 305/434-7660/(f)305/434-9040 I acknowledge I have completed DE-ESCALATION TRAINING http://www.binc.com/videos/search?a=De+Escalation+Traininc+Video&$view=detail&mi d=AC9FB1689A985EE5E794AC9FB1689A985EE5E7948FORM VRDGAR Driver/Escort Signature Date Printed Name 49 GUIDANCE/CARE CENTER, INC. BA/ MA DRIVER TRAINING ACKNOWLEDGEMENT I acknowledge I have completed GUIDANCE/CARE CENTER'S BA/MA DRIVER ORIENTATION including: • De-Escalation • Proper completion of trip documentation(trip sheets) • Pre-trip vehicle inspections and reporting • Incident Reporting • Accident Reporting • Citations • Driver Protocols • Professionalism Driver/Escort Signature Date Printed Name Facilitator Signature Date Printed Name 50 ATTACHMENT E PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list followir ngr a coesnvict aion public for public entity crime may not submit a bid on a contract to provide any goods of a entity, may not submit a bid on a contract with a public entity for the construction or repair may public building or public work, may not submit bids on leasesofreal oprty yr to public not be awarded or perform work as a CONTRACTOR, supplier, subcontractor, or CONTRACTORentity in under f a contract with any public entity, and may not transact business with any p of 36 months the threshold amount provided in Section 287.017, for CATEGORY TWO for a period from the date of being placed on the convicted vendor list. �. I have read the above and state that neither i(Respondent's name) nor any Affiliate has been placed on the convicted vendor list within the last 36 months. (Signature) Date: Oil ill TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) State of 14 o a,1 County of ,/�'�d/ le This instrument was acknowledged before me this / day of OC KLM (month), q (year), by ,n/l0Aiiii? cAt .e4 1/t/ (name of officer or agent, title or officer or agent) of pAl` ��4a (name of entity). t Personally Known Produced Identification: Type of ID and Number on ID (Seal) • �v "� Notary Public State of Florida � �/�� , Maryanne L Johnson ' cif F`, o` My Commission GG 175345 Sig re of Notary ' OF Pp* Expires 01/15/2022 Name of otary(Typed, Stamped or Printed) Notary Public, State of f'l J Guidance Care Center—Transportation:Baker Act and CTD FY20;page 16 ATTACHMENT F SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE „ SL d4c- (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. 010-1990 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 employee." (Signature)Date: \oI TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) State of qa-U £ t o County of ,/f/?/4/ This instrument was acknowledged before me this / day of geie�f/`e4 (month), (year), by §b{,t ip 1 • )�a_L (name of officer or agent, title or officer or agent) of Ej� {/,Q I AQ AI (name of entity). Personally Known Produced Identification: Type of ID and Number on ID ova Notary Public State of Florida . (Seal) $ on 7 My Commissi n GGs175345 ora Expires 01/15/2022 n Sign re of Notary 6 titaA 4A,A4Q Name of Notary(Typed, Stamped Notary Public, State of 1 Guidance Care Center—Transportation:Baker Act and CTD FY20;page 17 54 ATTACHMENT G DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: 6am,1 C ceJ C C Ltit—c. • (Name of Business) 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform 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. Give 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), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose 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. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign the statement, certify that this firm complies fully with the above requirements. Date:nature) e [41 Date: 1� TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) t State of P ct£\ County of 1/14i Yt This instrument was acknowledged before me this ( day of Oast-e V-6K (month), (9•Cliq (year), (name of officer or agent, title or officer or agent) of a/UV-OM-Lc,/ name of entity). Personally Known Produced Identification. T f b r Juvotay,. Notary Public State of Florida (Seal) Maryanne L Johnson Q My Commission GG 175345 �osw,o,9 Expires 01/15/2022 ignature otary Name of Notary(Typed, Stamped or Printed) Notary Public, State of Pi 01/1-d-PA.- Guidance Care Center—Transportation:Baker Act and CTD FY20;page 18 SS ATTACHMENT H FY2020 Annual Performance Report (For year October 1, 2019=September 30, 2020) Agency Name Point of Contact POC Phone/Email Grant Amount ... _ Per Section 8 of your contract, it is required that you fill out the entire form and answer every question. Narrative on the FY2020 Performance (i.e. successes, challenges, etc.): Questions: 1. Please list services and client information below for the program/activities funded by the Monroe County award. TotI s � .w `z<; Nu er`'of rsons in al Num?eigf(Clien s Target Population Target Population Served in FY202� s.. _w.. TotalYALUndifplioitedbientizSiebed4 2. What were the measurable outcomes (including numbers) accomplished in FY2020? Please base these outcomes on the services you identified in Question#1. 3. What number and percentage of your clients/participants were at or below the federal poverty level in FY2020; and/or 200%; and/or another standard used by your organization? 4. Were all the awarded funds used in FY2020? If not, please explain. 5. What is the number of FTEs working on the program(s)funded by the award in FY2020? 6. Were the awarded funds used as match in FY2020? If so, please list matching sources. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 19 56 7. What area of Monroe County did you serve in FY2020? 8. How many total FTEs in your organization? 9. Volunteers: hours of program service were contributed by volunteers in FY2020. 10. What was the CEO/Executive Director(or highest paid title) compensation in FY2020? (Please breakdown between salary and benefits.) 11. What is your organization's fiscal year? For the following questions, please use the number as reported on your FY2020 IRS Form 990. If your FY2020 IRS Form 990 is not yet prepared, please provide an estimate for the following questions. 12. What were your organization's total expenses in FY2020? 13. What was your organization's total revenue in FY2020? 14. What was the organization's total in grants and contracts for FY2020? 15. What was the organization's total donations and in-kind (fundraising) in FY2020? 16. What percentage of your expenses are program service expenses' versus management and general expenses2 in FY2020 as reported on your IRS Form 990? • 1 Program service expenses are defined as expenses needed to run your programs. 2Management and general expenses encompass expenses such as human resources,salaries of those not working directly with programs,legal services,accounting services, insurance expenses,office management,auditing,and other centralized services. Guidance Care Center—Transportation:Baker Act and CTD FY20;page 20 57 Page 1 of 2 l 40 DATE(MM/DDIYYYY) A V CERTIFICATE OF LIABILITY INSURANCE 07/03/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on . this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT ' NAME: Willis of Florida, Inc. PHONE FAX c/o 26 Century Blvd (A/C.No.Ext): 1-877-945-7378 (NC,No): 1-888-467-2378 E-MAIL certificates@willis.com P.O. Box 305191 ADDRESS: Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Allied World Surplus Lines Insurance Compa 24319 INSURED INSURERS: Berkshire Hathaway Homestate Insurance Com 20044 Guidance/Care Center, Inc. PO Box 94738 INSURERC: Las Vegas, NV 891934738 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W11965825 ' REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER (MMIDDIIYYYY) (CY EFF MMIDD/YYCY YY) LIMITS LTR INSD MD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1,000,000 A MED EXP(Any one person) $ ' 20,000 Y 5088-0878-00 07/01/2019 07/01/2020 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO- JECT X LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y 5091-0193-00 07/01/2019 07/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A — — X EXCESSLIAB CLAIMS-MADE 5090-0223-00 07/01/2019 07/01/2020 AGGREGATE $ 2,000,000 DED X RETENTION$10,000 $ WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY B ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? n N/A WEWC010197 02/26/2019 02/26/2020 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,desrxibe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liab. 5088-0878-00 07/01/2019 07/01/2020 Each Occurrence $1,000,000 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) SEE ATTACHED APP''t �+BY Pt: .. , I 6Y 11�1 wluf, 4 i / DATEwr �� - CERTIFICATE HOLDER , 1 CELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners AUTHORIZED REPRESENTATIVE Attn: Risk Management 1100 Simonton Street '-- '.l.-7 Rey West, ,FL 33040 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD SR ID: 18199640 BATCH: 1269537 et • AGENCY CUSTOMER ID: LOC#: AR ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Willis of Florida, Inc. Guidance/Care Center, Inc. PO Box 94738 POLICY NUMBER Las Vegas, NV 891934738 USA See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE:See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Monroe County Board of County Commissioners is Additional Insured under the General Liability and Automobile Liability as required by written contract. INSURER AFFORDING COVERAGE: Allied World Surplus Lines Insurance Company NAIC#: 24319 POLICY NUMBER: 5088-0878-00 EFF DATE: 07/01/2019 EXP DATE: 07/01/2020 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Abuse & Molestation Per Occurrence $1,000,000 Aggregate $3,000,000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 18199640 BATCH: 1269537 CERT: W119.65825 ct