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1st Renewal & Amendment 01/22/2020 4V.S CART„. Kevin Madok, CPA h$o�•.�':;: •,�= Clerk of the Circuit Court& Comptroller—Monroe County, Florida \�ECO�: DATE: January 27, 2020 TO: Chief James Callahan Fire Rescue/EMS Cheri Tamborski Executive Administrator 1 FROM: Pamela G. Hanc.%/11.C. SUBJECT: January 22nd BOCC Meeting Attached is an electronic copy the following item(s) for your handling: C7/H2 1st Renewal and Amendment to the Bound Tree Medical, LLC Agreement. 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 • 1st RENEWAL AND AMENDMENT OF AGREEMENT BETWEEN THE BOARD OF COUNTY COMMISSIONERS,AND THE BOARD OF GOVERNORS FIRE AND AMBULANCE DISTRICT 1 OF MONROE COUNTY, FLORIDA,AND BOUND TREE MEDICAL, LLC FOR THE PURCHASE OF MEDICAL SUPPLIES AND PHARMACEUTICALS THIS 1st RENEWAL and AMENDMENT(hereinafter"RENEWAL")to the contract for the purchase of medical supplies and pharmaceuticals is made and entered into this 20th day of November 2019 by and between the Monroe County Board of County Commissioners and the Board of Governors Fire and Ambulance District 1 of Monroe County,Florida,hereinafter referred to as "COUNTY" and Bound Tree Medical LLC, hereinafter referred to as "CONTRACTOR". WITNESSETH: WHEREAS, on December 1, 2016, the parties entered into an agreement whereby the Contractor is to provide medical supplies and pharmaceuticals to the County; and WHEREAS,the original agreement had an initial three-year term beginning December 1, 2016 through November 30, 2019 with two one-year options for renewal subject to the approval of the County, and WHEREAS, pursuant to the terms of the original agreement the parties desire to renew the agreement for another one-year term, and WHEREAS, the parties also wish to amend the original agreement to incorporate federal provisions such that federal funding may be applied to purchases made under this agreement in the event of an emergency or natural disaster; NOW THEREFORE, in consideration of the mutual promises and covenants contained in this RENEWAL,the parties agree: SECTION 1. The parties' December 1, 2016 agreement, a copy of which is attached and incorporated into this renewal as Exhibit A,is hereby renewed for a one-year term beginning December 1, 2019 and terminating November 30,2020. SECTION 2. Paragraph 3 of the original agreement is amended to read; CONTRACT TERMINATION • A. Termination for Convenience: The COUNTY may terminate this Agreement for convenience, at any time, upon sixty (60) days' notice to CONTRACTOR. If the COUNTY terminates this agreement with the CONTRACTOR, COUNTY shall pay CONTRACTOR the sum due the CONTRACTOR under this agreement prior to termination, unless the cost of completion to the COUNTY exceeds the funds Page 1of10 remaining in the contract. The maximum amount due to CONTRACTOR shall not exceed the spending cap in this Agreement. In addition, the COUNTY reserves all rights available to recoup monies paid under this Agreement,including the right to sue for breach of contract and including the right to pursue a claim for violation of the COUNTY's False Claims Ordinance, located at Section 2-721 et al. of the Monroe County Code.Either of the parties hereto may cancel this Agreement without cause by giving the other party sixty(60)days written notice of its intention to do so to the other party;however,this provision may not be exercised during hurricane season(June 1 to November 30) unless both parties mutually agree to terminate. In the event of termination,the COUNTY shall owe for all goods and services delivered prior to the date of termination. B. Termination for Cause and Remedies: In the event of breach of any contract terms,the COUNTY retains the right to terminate this Agreement. The COUNTY may also terminate this agreement for cause with CONTRACTOR should CONTRACTOR fail to perform the covenants herein contained at the time and in the manner herein provided. In the event of such termination, prior to termination, the COUNTY shall provide CONTRACTOR with five (5) calendar days' notice and provide the CONTRACTOR with an opportunity to cure the breach that has occurred. If the breach is not cured, the Agreement will be terminated for cause. If the COUNTY terminates this agreement with the CONTRACTOR, COUNTY shall pay CONTRACTOR the sum due the CONTRACTOR under this agreement prior to termination,unless the cost of completion to the COUNTY exceeds the funds remaining in the contract; however, the COUNTY reserves the right to assert and seek an offset for damages caused by the breach. The maximum amount due to CONTRACTOR shall not in any event exceed the spending cap in this Agreement. In addition, the COUNTY reserves all rights available to recoup monies paid under this Agreement, including the right to sue for breach of contract and including the right to pursue a claim for violation of the COUNTY's False Claims Ordinance, located at Section 2-721 et al. of the Monroe County Code. In the event that the CONTTRACTOR shall be found to be negligent in any aspect of service, the COUNTY shall have the right to terminate this Agreement after five(5) days written notification to the CONTRACTOR. SECTION 3. Paragraph 5 of the original agreement is amended to read; 5. PRICING is set forth in the Medical Supply Discount Off List and Pricing Worksheet (Attachment A—Nov 2019). This will be inserted in the contract which outlines both a discount in the form of a percentage off list and pricing on specified numbered items. SECTION 4. Subparagraph 8.C. of the original agreement is amended to read; C. Quantities.The quantities listed on the Medical Supply Discount Off List and Pricing Worksheet Attachment A — Nov 2019 are estimated quantities for one 1 year. The COUNTY shall not be required to purchase any minimum or maximum quantities during the term of any award resulting from this specification The COUNTY may purchase as little as zero percent 0 or exceed as much as one hundred percent 100 of the forecasted or estimated quantities. Page 2 of 10 SECTION 5. Subparagraph 9.I. of the original agreement is amended to read; I. Contract Prices. Contract prices from Medical Supply Discount Off List and Pricing Worksheet Attachment A—Nov 2019 shall be firm and shall not be amended after the RENEWAL is executed. Any attempt by the CONTRACTOR to amend said prices unilaterally shall constitute default as outlined in the contract. Prices quoted shall include all shipping costs, shipped F.O.B. Marathon. Florida or to the facility location specified by the requestor or the purchase order. All taxes of any kind and character payable on account of the work done and materials furnished under the award shall be paid by the CONTRACTOR and shall be deemed to have been included in the price. The COUNTY is exempt from all state and federal sales use transportation and excise taxes. Contract prices shall include all royalties and costs arising from patents, trademarks and copyrights in any way involved in the work.Whenever the CONTRACTOR is required or desires to use any design, device, material or process covered by letters of patent or copyright the CONTRACTOR shall indemnify and save harmless the COUNTY, its officers, agents, and employees from any and all claims of infringement by reason of the use of any such patented design,toll,material,equipment or process,to be performed under the contract and shall indemnify the said COUNTY,its officers,agents,and employees for any costs, expenses, and damage which may be incurred by reason of any infringement at any time during the prosecution or after the completion of the work. SECTION 6. Subparagraph 9.J. of the original agreement is amended to read; J. Contract Provisional Prices off List Price. Contract pricing for items not included on Medical Supply Discount Off List and Pricing Worksheet Attachment A—Nov 2019 and sold to the County at a discounted percentage rate off the list price issued by CONTRACTOR shall be firm and shall not be amended after the RENEWAL is executed. Any attempt by the CONTRACTOR to amend said prices shall constitute default as outlined in the contract. COUNTY will verify items by a printout from the CONTRACTOR's online catalog showing both the"list price"and"your price", the latter being the COUNTY price. SECTION 7. Subparagraph 9.L. of the original agreement is amended to read; L. Price Escalation. The County will allow a price escalation provision for items on the Medical Supply Discount Off List and Pricing Worksheet Attachment A—Nov 2019 with this award.The original CONTRACTOR prices on Medical Supply List Pricing Worksheet Attachment A — Nov 2019 shall be firm for a one (1) year minimum period. A price escalation/de-escalation will be allowed one (1) year after the beginning of the award period and at one (1) year intervals thereafter provided the CONTRACTOR notifies the COUNTY in writing of any requested price changes at least sixty 60 days prior to those changes taking effect This request must be accompanied by a certified letter from the CONTRACTOR's supplier showing the price increase to the contractor.The price increase to the County shall be limited to the percentage increase to the CONTRACTOR as stated in this letter accompanied by a certified letter from the CONTRACTOR supplier showing the price increase to the contractor.The price increase to the County shall be limited to the Page 3 of 10 percentage increase to the CONTRACTOR as stated in this letter. At the sole discretion of the County,the County may waive the requirement that the price increase be accompanied by a certified letter from the CONTRACTOR supplier showing the price increase to the contractor. Any such waiver shall be in writing and signed by the Battalion Chief of Administration. If at the point of exercising the price escalation provision, market media indicators show that the prices have decreased and that the CONTRACTOR has not passed the decrease on to the COUNTY,the COUNTY reserves the right to place the CONTRACTOR in default cancel the contract and remove the CONTRACTOR from the COUNTY's CONTRACTOR list for a period of time deemed suitable to the COUNTY. SECTION 8. Subparagraph 9.M. of the original agreement is amended to read; M. Invoicing. The CONTRACTOR shall furnish the COUNTY complete itemized invoices for the goods received.Invoices are to reflect the prices stipulated on the purchase order and as outlined on the Medical Supply Discount Off List and Pricing Worksheet Attachment A—Nov 2019.Invoices are also to reflect the provisional price discount in the form of a percentage at which the CONTRACTOR will sell these items off its list price. The COUNTY will not accept an aggregate invoice. As part of the award process the COUNTY may request a sample invoice Invoices shall contain but not limited to the following information: o Invoice number o Company name o Purchase order number o Location and dates of delivery o Cost of items as stated on the contract and extended price to reflect total cost for number of items received SECTION 9. The following FEDERAL CONTRACT REQUIREMENTS are hereby added to the Agreement as paragraphs 15, 16, 17 and 18 and shall read as follows: 15. PUBLIC RECORDS -Pursuant to F.S. 119.0701 and the terms and conditions of this contract,the CONTRACTOR is required to: (a) Keep and maintain public records that would be required by the County to perform the service. (b) 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. (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the CONTRACTOR does not transfer the records to the County. (d) Upon completion of the contract,transfer,at no cost,to the County all public records in possession of the Contractor or keep and maintain public records that would be required by the County to perform the service. If the CONTRACTOR transfers all public records to the County upon completion of the contract, the CONTRACTOR shall destroy any duplicate public records that are exempt or Page 4 of 10 confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to 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. (e) 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 CONTRACTOR of the request, and the CONTRACTOR must provide the records to the County or allow the records to be inspected or copied within a reasonable time. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS,BRIAN BRADLEY, AT(305)292-3470 16.MAINTENANCE OF RECORDS-CONTRACTOR shall maintain all books,records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Records shall be retained for a period of seven years from the termination of this agreement or for a period of three years from the submission of the final expenditure report as per 2 CFR §200.333, whichever is greater. Each party to this Agreement or its authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for four years following the termination of this Agreement. If an auditor employed by the COUNTY or Clerk determines that monies paid to CONTRACTOR pursuant to this Agreement were spent for purposes not authorized by this Agreement, or were wrongfully retained by the CONTRACTOR, the CONTRACTOR shall repay the monies together with interest calculated pursuant to Sec. 55.03,of the Florida Statutes,running from the date the monies were paid by the COUNTY. 17. EQUAL EMPLOYMENT OPPORTUNITY During the performance of this Agreement,the CONTRACTOR,in accordance with Equal Employment Opportunity (30 Fed. Reg. 12319, 12935, 3 C.F.R. Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, Amending Executive Order 11246 Relating to Equal Employment Opportunity, and implementing regulations at 41C.F.R. Part 60 (Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor). See 2 C.F.R. Part 200, Appendix II, ¶ C, agrees as follows: A. The CONTRACTOR will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The CONTRACTOR will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race,color,religion,sex,sexual orientation,gender identity,or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The CONTRACTOR agrees to post in conspicuous places, Page 5 of 10 available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. B. The CONTRACTOR will, in all solicitations or advertisements for employees placed by or on behalf of the CONTRACTOR, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation,gender identity,or national origin. C. The CONTRACTOR will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant.This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge,in furtherance of an investigation,proceeding,hearing,or action,including an investigation conducted by the employer,or is consistent with the CONTRACTOR's legal duty to furnish information. D. The CONTRACTOR will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting officer, advising the labor union or workers' representative of the contractor's commitments under section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. E. The CONTRACTOR will comply with all provisions of Executive Order 11246 of September 24, 1965,and of the rules,regulations,and relevant orders of the Secretary of Labor. F. The CONTRACTOR will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,regulations, and orders. G. In the event of the CONTRACTOR 's non-compliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled,terminated or suspended in whole or in part and the CONTRACTOR may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965,or by rule,regulation,or order of the Secretary of Labor, or as otherwise provided by law. H. The CONTRACTOR will include the portion of the sentence immediately preceding subparagraph (A) and the provisions of paragraphs (A) through (G) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor Page 6 of 10 or vendor. The CONTRACTOR will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for non-compliance; provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the contractor may request the United States to enter into such litigation to protect the interests of the United States. 18. CODE OF FEDERAL REGULATION -The CONTRACTOR and its subcontractors must follow the provisions as set forth in 2 C.F.R. §200.326 and 2 C.F.R. Part 200, as amended including but not limited to: A. Davis-Bacon Act, as amended (40 U.S.C. §§3141-3148). When required by Federal program legislation, which includes emergency Management Preparedness Grant Program, Homeland Security Grant Program, Nonprofit Security Grant Program, Tribal Homeland Security Grant Program, Port Security Grant Program and Transit Security Grant Program, all prime construction contracts in excess of$2,000 awarded by non-Federal entities must comply with the Davis-Bacon Act (40 U.S.C. §§3141- 3144, and §§3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction").In accordance with the statute,contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. If applicable,the COUNTY must place a current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The COUNTY must report all suspected or reported violations to the Federal awarding agency. When required by Federal program legislation, which includes emergency Management Preparedness Grant Program, Homeland Security Grant Program, Nonprofit Security Grant Program, Tribal Homeland Security Grant Program, Port Security Grant Program and Transit Security Grant Program(it does not apply to other FEMA grant and cooperative agreement programs, including the Public Assistance Program), the contractors must also comply with the Copeland "Anti-Kickback" Act (40 U.S.C. §3145),as supplemented by Department of Labor regulations(29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States").As required by the Act, each contractor or subrecipient is prohibited from inducing,by any means,any person employed in the construction,completion,or repair of public work,to give up any part of the compensation to which he or she is otherwise entitled. The COUNTY must report all suspected or reported violations to the Federal awarding agency. (i) CONTRACTOR. The CONTRACTOR shall comply with 18 U.S.C. § 874,40 U.S.C. § 3145, and the requirements of 29 C.F.R.pt. 3 as may be applicable,which are incorporated by reference into this Agreement. (ii) Subcontracts. The CONTRACTOR or subcontractor shall insert in any subcontracts the clause above and such other clauses as the FEMA may by appropriate instructions require, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts.The prime CONTRACTOR shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all of these contract clauses. Page 7 of 10 (iii) Breach. A breach of the contract clauses above may be grounds for termination of the contract, and for debarment as a contractor and subcontractor as provided in 29 C.F.R. § 5.12. B. Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, which includes all FEMA grant and cooperative agreement programs, all contracts awarded by the COUNTY in excess of$100,000 that involve the employment of mechanics or laborers must comply with 40 U.S.C.§§ 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. §3702 of the Act, each contractor must compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. C. Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of"funding agreement" under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that "funding agreement," the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. D. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387). Contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. §§7401-7671q) and the Federal Water Pollution Control Act as amended(33 U.S.C. §§1251-1387)and will report violations to FEMA and the Regional Office of the Environmental Protection Agency(EPA).The Clean Air Act(42 U.S.C. 7401-7671q.)and the Federal Water Pollution Control Act(33 U.S.C. 1251-1387),as amended—applies to Contracts and subgrants of amounts in excess of$150,000. E. Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR 180.220) must not be made to parties listed on the governmentwide exclusions in the System for Award Management(SAM),in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. F. Byrd Anti-Lobbying Amendment(31 U.S.C. 1352) Contractors that apply or bid for an award exceeding$100,000 must file the required certification.Each tier certifies to Page 8 of 10 the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non-Federal award. G. Compliance with Procurement of recovered materials as set forth in 2 CFR§200.322. CONTRACTOR must comply with section 6002 of the Solid Waste Disposal Act, as amended, by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency(EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition,where the purchase price of the item exceeds$10,000 or the value of the quantity acquired during the preceding fiscal year exceeded$10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. H. Americans with Disabilities Act of 1990, as amended (ADA) —The CONTRACTOR will comply with all the requirements as imposed by the ADA, the regulations of the Federal government issued thereunder, and the assurance by the CONTRACTOR pursuant thereto. I. Disadvantaged Business Enterprise (DBE) Policy and Obligation - It is the policy of the COUNTY that DBE's,as defined in 49 C.F.R.Part 26, as amended,shall have the opportunity to participate in the performance of contracts financed in whole or in part with COUNTY funds under this Agreement. The DBE requirements of applicable federal and state laws and regulations apply to this Agreement.The COUNTY and its CONTRACTOR agree to ensure that DBE's have the opportunity to participate in the performance of this Agreement. In this regard,all recipients and contractors shall take all necessary and reasonable steps in accordance with 2 C.F.R. § 200.321(as set forth in detail below), applicable federal and state laws and regulations to ensure that the DBE's have the opportunity to compete for and perform contracts.The COUNTY and the CONTRACTOR and subcontractors shall not discriminate on the basis of race, color, national origin or sex in the award and performance of contracts, entered pursuant to this Agreement. 2 C.F.R. § 200.321 CONTRACTING WITH SMALL AND MINORITY BUSINESSES, WOMEN'S BUSINESS ENTERPRISES, AND LABOR SURPLUS AREA FIRMS a. If the CONTRACTOR, with the funds authorized by this Agreement, seeks to subcontract goods or services, then, in accordance with 2 C.F.R. §200.321, the CONTRACTOR shall take the following affirmative steps to assure that minority businesses, women's business enterprises, and labor surplus area firms are used whenever possible. b. Affirmative steps must include: (1) Placing qualified small and minority businesses and women's business enterprises on solicitation lists; Page 9 of 10 (2) Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; (3) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses,and women's business enterprises; (4) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; (5) Using the services and assistance,as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce. (6) Requiring the Prime contractor, if subcontractor are to be let, to take the affirmative steps listed in paragraph(1) through(5) of this section. J. The CONTRACTOR shall utilize the U.S. Department of Homeland Security's E- Verify system to verify the employment eligibility of all new employees hired by the Contractor during the term of the Contract and shall expressly require any subcontractors performing work or providing services pursuant to the Contract to likewise.utilize the U.S.Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the Contract term. SECTION 10. In all other respects,the parties' December 1,2016 agreement remains in full force and effect. r;°r{�:;- :! WITNESS WHEREOF, each party hereto has caused this Extension to be executed by its duly 7 �` aaufh kd representatives. C,10 L r \� ,SF;Akr L' BOARD OF COUNTY COMMISSIONERS "`ri Va ''' ,,Attest:2EVIN MADOK CLERK OF MONROE �' -_' a' r Y r �W COUNTY,FLORIA C7 By By: �.• - Deputy Clerk ra 4tfi L qv-bog-G. yor = T-I BOUND TREE MEDICAL,LLC BOARD OF GOVERNORS OF MERE ANC = AMBULANCE DISTRICT 1 OF MONRGL o . COUNT FLORIDA By: !: 07f (Signature) By: Rhiannon Greene/Senior VP of Pricing Mayor/Chairperson Name and Title Date: MO E COU ATTO NEY 10/31/2019 �ED PEDRO J.MERCADO ASSIST ' ' Date /�____ Page 10 of 10 Attachment A - Nov. 2019 Item List for Monroe County Medical Supplies and Pharmaceuticals RFP-91-0-2016,Renewal 1 Vendor Name. Item ID Item Description ® Price t New Price [[ABBOTT _JE6251 Glucose Test Strips,Precision Xtra Capillary 50/bx 12bx/cs ._-- 1BX $ 22.22 1$ 22.22 I COVIDIEN 177268 SMART CAPNOLINE PLUS NON INTUBATED,ORAL NASAL W/02 TUBING, EA 1$ 9.84 I$ 9.84 1 L___ _ __ ___ ___ ____ _ ADULT/INTERMEDIATE 100EA/BX _ _ -------��--�� AQUABILITI _ -I600-10 _ IV Flush Syringe,Normal Saline,10 ml,Prefilled 12 cc Syringe,Sterile 100ea/bx EA I$ 0.36 1$ 0.35 1 --�-'-----------;4bx/cs --j---I INTERSURGICAL 2114-87302 Ii-gel 02 Resus Pack,MED Adult,incl size 4 i-gel 02,Lube,Strap,for Pts 50-90 kg EA $ 23.59 $ P23.59__1I� INCORPORATED 6ea/cs _ I__- CONMED CORPORATION 1354431 INTRAVENOUS(IV)DRESSING TRANSPARENT ADULT 100/BX 5BX/CS VENI-GARD BX I$ 38.02 $ 38.02 1 _ __ _ --1,- _j IIMS LIMITED�Y`_--� 1373369 1NALOXONE 2MG 2ML LUER JET 1029B 10EA/CS ^,A EA I$ 42.70 $ 42.70_1 j 30-04 _J*SEE NOTES* 400 mcgSpray,4.1 gm Bottle,90 metered doses ]EA 1$ 175.09 $ 175. 9 I 0 EVUS PHARMACEUTICALS �04 AMBU__.. I2144-KV033 King Vision Video Laryngoscope Blade,Channeled,Disp,l8mm,w/White LED,Digital EAI$ 27.99 $ 27.99 1 CMOS Camera l0ea/cs i INTERSURGICAL 2114-87301 i-gel 02 Resus Pack,SM Adult,incl size 3 i-gel 02,Lube,Strap,for Pts 30-60 kg 6ea/cs lEA 1$ 23.59 $ 23.59 INCORPORATED I 1 PFIZER INC.(HOSPIRA) 1374921 ,EPINEPHRINE 1:10000 1MG 10ML LIFESHIELD SYRINGE 1019A 10EA/BX IBX $ 59.90 •$ 61.70 1 INTERSURGICAL 2114-87303 li-gel 02 Resus Pack,LG Adult,incl size 5 i-gel 02,Lube,Strap,for Pts 90 plus kg 6ea/cs EA 1$ 23.59 1$ 23.59 I INCORPORATED 1 ' 1 I 1 CAPITAL WHOLESALE DRUG 10047-22 !LTD QTY-USE 0409-0047-22 Solu-Medrol,125mg,2m1 ACT-O-VIAL 25ea/bx IEA1$ 10.251$ 11.82 15TRYKER I236086 IDEFIB/PACING/ECG PADS ADULT W/QUIK-COMBO CONNECTOR 2FT LEAD,LP12, IPR-I$ 22.06 I$ 25.74 1 I I LP15 1/PR 10PR/BX 5BX/CS LPFIZER INC.(HOSPIRA) 4755-02 IONDANSETRON 4MG 2ML VIAL 25EA/BX _._IBx..J$ 13.25 1.$ ry 20_87 LPFIZER INC.(HOSPIRA) 16695-02 1AMIDATE(ETOMIDATE)40MG,20ML VIAL 10EA/BX 1BX 1$ 79.90 1$ 79.90 i CURAPLEX i330-86100 j,Curaplex Alcohol Prep Pad,Large,Sterile 100/BX 10BX/CS IBX 1$ 2.13$ 2.52 1 CONMED CORPORATION IC32716 ;ELECTRODES 5/STRIP 12BX/CS ICS^I$ 104.38 1$ 104.38 1 IMS LIMITED 371006 _(ATROPINE 1MG 10ML LUER JET 1006B 10EA/PK JEA !$ 10.69 1$ 10.69 1 AMSINO INTERNATIONAL INC 35108306 1INTRAVENOUS(IV)ADMINISTRATION SET NEEDLE FREE 1 Y SITE 1 VALVE 10 DROP 83 'EA 1$ 1.75 I$ 1.75 i AMSINO INTERNATIONAL INC C944304 EXTENSION WITH AMSAFE NEEDLELESS INJECTION SITE 8 IN 100/CS 1EA L$ 1.46 $ 1.46 PFIZER INC.(HOSPIRA) f376637 1SODIUM BICARBONATE 8 4/LIFESHIELD SYRINGE 1035A 10EA/BX _�BX ,$ 110.201$ 113_51_i i Hikma Pharmaceuticals USA Inc]0376-25 I DIPHENHYDRAMINE 50MG/ML 1ML SDV 2035-BENADRYL 25 VIALS/PK jEA I$ 1.03 1$ 1.271 IFRESENIUS 10616-03 1AMIODARONE 150MG 3ML VIAL [EA 1$ 1.90 j$ 1.90 (CURAPLEX 11841-14000 t Curaplex Tourniquet 1"x 18",Blue,Rolled,Latex-Free 250/BG 2BG/CS 1BG 1$ 20.38 j$ 22.25 j PFIZER INC.(HOSPIRA) 1371104 1C4 DIAZEPAM 5MG/ML 2ML LUER LOCKING CARPUJECT 10/BX CS04 1 BX 1$ 282.99 1$ 317.68 J ISTRYKER '230107 IDEFIB/PACING/ECG PADS PEDI W/QUIK-COMBO CONNECTOR FOR LP15,LP12,LP10, PR ;$ 26.97 1$ 31.47 I LPS 1_'-_-.. I.. ;AMBU 520-211 jBVM,SPUR II,ADULT W/MEDIUM ADULT MASK,INDIVIDUALLY BOXED 12/CS 'EA 1$ 10.05 1$ 10.05 f.__. -_. 'PFIZER INC.(HOSPIRA)__.._ 375204 -IQUELICIN 200MG 10ML VIAL*REFRIGERATION REQUIRED*25EA/BX BX $ 723.75 $ 745.49(CURAPLEX 161411 Curaplex Paramedic Shears,Black 7.25 in 50pr/bx 1PR ;$ 0.78 1$ 0.78 1 1SPACELABS HEALTHCARE 1850-80424 Pressure Infuser,UNIFUSOR,1000m1 Infusion Cuff w/Aneroid Gauge and EA $ 11.97 1$ 11.97 iThumbwheel Valve 24ea/cs 1 I LAERDAL MEDICAL CORP. TL980010 1Extrication Collar,Stifneck Select,Adult,Adjustable,Nasal Cannula Hook jEA 1$ 5.20 1$ 5.20 L. B.BRAUN MEDICAL,INC__ 1358001 - I IV Solution,Sodium Chloride 0.9%500m1 Bag 24ea/cs BBraun L8001 I EA $ 2.30 $ 2.49' ,AMBU 2144-KV031 1King Vision Video Laryngoscope Blade,Standard,Disp,13mm,w/White LED,Digital TEA I1$ 27.99 1$ 27.99 1 i1_ ;CMOS Camera 10ea/bx -_ -_ 1 CURAPLEX 116353 [Curaplex Multi-Trauma Dressing,,12 in x 30 in,Sterile,50ea/cs IEA ($ 1.01 1$ 1.01 1 BAXTER HEALTHCARE-DMG 1.18-280842EA !Dopamine 400MG/D5W 250MI Bag 18EA/CS ]EA 1$ 13.09 1$ 13.09 1 LNEPHRON PHARMACEUTICALS 19501-25 ALBUTEROL 0.083% 2.5MG/3ML 25VIALS/BX 1BX I$ 3.65 I$ 3.65 I NICE-PAK 1285484 GERMICIDAL WIPES EXTRA LARGE 81N X 141N 65 UB 6TUB CS SANI-CLOTH HB TB [B.BRAUN MEDICAL,INC 1.7800-09 11V Solution,Sodium Chloride 0.9%1000m1 Bag 12ea/cs E8000 • EA-1$ 2.35 1,$ 2.48 DYNAREX CORPORATION 11360-07546 jAmmonia Inhalant,Ampules 10/bx _ BX }$ 2.301$ 2.30 SMITHS MEDICALASD,INC. 1532002 ,VENTILATION CIRCUIT DISPOSABLE WITH PEEP VALVE10/BG - IEA 1$ 19.57-1$ -19.57_1 IBEMIS MANUFACTURING 595410 SUCTION CANISTER WITH PREATTACHED 6 FT TUBING GREEN 1200cc 48/CS jEA I$ 6.29 1$ 6.29 COMPANY L I_. .. .._.-..____...__1---Y-.-�, I J PFIZER INC.(HOSPIRA) 371113 1.C4 MIDAZOLAM 10MG,2ML VIAL(5MG/ML)10/BOX CS13(VERSED) BX 1$ 14.99 $ 15.45 PFIZER INC.(HOSPIRA) 1377515 !DEXTROSE 50%25GM,50MLANSYR SYRINGE 1013C 10EA/BX IBX 1$ 78.90 '$ 95.84 j -- _ LAERDAL MEDICAL CORP. 020500 (Endotracheal Tube Holder,Thomas,Adult,for ET/SGA Tubes 6.5mm ID to 21mm OD IEA $ 2.78 $ 2.78 1 MEDSOURCE INTERNATIONAL 533-MS-GZCS4BG !Conforming stretch bandage,gauze,4 in.,sterile,12r1/bg 8bg/cs BG 1$ 3_;_ .25 1$ 3.25 L {___ .__. _____j •AMSINO INTERNATIONAL INC 35608306 IV Ad min Set,Pediatric 83 in,60 Drop,1 Y-Site,1 Valve 50ea/cs ` jEA I$ 1.92 1$ 1.92 1 [Cambridge Sensors USA,LLC I952000 COLD PACK INSTANT 5.5IN X 10 IN 24/CS RAPID COLD CS $ 26.47 I$ 26.47 BAXTER HEALTHCARE-DMG 356612 CURAPLEX INTRAVENOUS(IV)EXTENSION SET NEEDLE FREE WITH 2 Y SITES 43 IN 48/CS EA $ 2.63 $ 2.63 INTERLINK 30061M5 Curaplex Burn Sheet,60 inch x 90 inch,Sterile 50ea/cs lEA $ 2.09 $ 2.09 ADI MEDICAL 667000 BODY BAG BASIC VINYL STRAIGHT ZIPPER 6 GAUGE 36 IN X 90 IN 10/CS EA4$ 6.47 I$ 6.47 AMBU 2442-21403 BVM,SPUR II,PEDIATRIC,COLLAPSED,DISP,WITH MASK AND EXPIRATORY HEPA EA $ 29.39 I$ 29.39 I FILTER,12EA/CSAMBU I 1BECTON DICKINSON 11641-76618 ISafety Needle,BD Eclipse,18 ga x 11/2 in.,100/bx 12bx/cs BX $ 27.72 1$ 27.72 kONMED CORPORATION I231620 ELECTRODES PEDIATRIC 3/PK 10PK/BX 20BX/CS HUGGABLE BX $ 5.26($ 5.26 1 CARDINAL HEALTH 2231-91110 Salem Gastric Sump Tube,10 Fr,36 inch 50ea/cs EA r_$ 1.99 I$ 1.99 BAUSCH HEALTH US LLC J464631 INSTA-GLUCOSE 31GM 2064 EA '$ ~_M 3.59'$ 3.59 'PFIZER INC.(HOSPIRA) '371100 [C4 LORAZEPAM 2MG 1ML VIAL 10/BOX*REFRIGERATE**CSO1 BX 1$ 21.74 I$ 22.83 'IMS LIMITED 1373304 Calcium Chloride 1gm,10m1 Luer Jet 101OB jEA 1 10.99 4$ 10.99 I BECTON DICKINSON 1629663 SYRINGE ONLY LUER LOCK 60CC 40/BX 4BX/CS BECTON DICKINSON 309653 BX I$ 21.85 '$ 21.85 1)EMERGENCY PRODUCTS& 3176-07705 HAND-E HAND HOLD DEVICE YELLOW _T � ($EA I$ 16.99 I$ 16.99 I RESEARCH MEDSOURCE INTERNATIONAL 533-MS-SC08EA i Suction Catheter,8 Fr,coiled,w/whistle tip and thumb control port,sterile,disp,LF EA $ 0.20 E$ 0.20 1._ SOea/cs 'SMITHS MEDICAL ASD,INC. 350534 ISTOPCOCK 4 WAY WITH SWIVEL AND MALE LUER LOCK 50/CS EA 1$ 1.19 $ 1.19 CURAPLEX 533-MS-YK10EA -I-Curaplex Yankauer Suction Bulb Tip Only with Control Vent,Sterile 50ea/cs EA 1$ 0.80 1$ 0.80 I (WATER-JELTECHNOLOGIES ,710206 (BURN DRESSING WATER-JEL 2 IN X B IN 60/CT __ __ !EA 1$ _ 2.79 1$ 2.79 I CURAPLEX 1301-100EA 1 Curaplex Oxygen Nasal Cannula,Adult,Conventional,Clear,Flared Prongs,7 ft !EA $ 0.31 I$ 0.31 ___ __)tubing,50ea/cs __ ___ _ ___ __ 1 r DYNAREX CORPORATION 540047 jP PREPARATION RAZORS 50/BX 5BX/CS GALLANT 4251(250EA/CS) �� EA -$ 0.37 I$ 0.37 CURAPLEX 301-439EA ]Curapl ex High efficiency HEPA filter,w/port,hydrophobic paper,TV greater than lEA I$ 2.39I$ 2.391 11500m1 50ea/cs 1_ [PFIZER INC.(HOSPIRA) 10074553401 SODIUM BICARBONATE 4.2%10ML INFANT LIFESHIELD,1043A 10EA/BX BX 1$ _116.50 1$ 120.00 I BAXTER HEALTHCARE-DMG 1358437 IV Solution,Sodium Chloride 0.9%100m1 Bag,Singles 96ea/cs EA f 1.85 1-$ 2.08J (CURAPLEX 301-200EA Curaplex Select Nebulizer,Small-volume,Hand-held,T-piece,Mouthpiece,Flextube, EA j$ 0.65 I$ 0.65 7 ft Tubing 50/cs __ ___ ___ _ _ 1_ MEDSOURCE INTERNATIONAL 533-MS-SC12EA Suction catheter,12 Fr,coiled,w/whistle tip and thumb control port,sterile,disp,LF EA 1$ 0.20 1$ 0.20 150ea/cs MEDSOURCE INTERNATIONAL'I(533-MS-SC34EA (Suction Catheter,14 Fr,coiled,w/whistle tip and thumb control port,sterile,dL isp, F IEA {$ 2 0. 0 I,-5--0.20 {_ _.._. ._._...._v.__I MEDSOURCE INTERNATIONAL 533-MS-SC18EA Suction catheter,18 Fr,coiled,w/whistle tip and thumb control port,sterile,disp,LF I TEA $ 0.20 $ 0.20 I j __ 50ea/cs___ _ _____ _____ ____ _____ _ _ i 1 _ GREAT PLAINS BALLISTICS 021410 'AIR FLOW MONITOR BAAM 100/CS `l EA j$ 6.471$ 6.47 CARDINAL HEALTH 2114-31412 1NG Tube,Levin,12 Fr,Clear,48 inch,Markings 18,22,26 and 30 in,Open Distal End, EAI$ 1.06 $ 1.06 .MEDSOURCE INTERNATIONAL 533-MS-SCOSEA 'Suction Catheter,6 Fr,coiled,w/whistle tip and thumb control port,sterile,disp,LF JEA 1$ I 0.20 $ 0.20 ISOea/cs I , __I -_-----�.__.._- _------------.. --- LAERDAL MEDICAL CORP. 260201 }EXTRICATION COLLAR BABY NO NECK 50/CS STI FN ECK lEA $ 5.55 I$ 5.55 FRESENIUS I0424-05 FLUMAZENIL O.SMG,SML VIAL 10 VIALS/BX ROMAZICON _ _ _ LEA '$ 9.15 I$ 9.15 j WEST CHESTER HOLDINGS, 1295561 SLEEVE WHITE GAUNTLET,ELASTIC OPENINGS,18 IN 200/CS SEA I$ 0.20 1$ 0.201 INC:.__ ._....__-•.--_.._.____ .._..._.I_.. ....,-...1.--....._.._.._. ADI MEDICAL II D4808 SUCTION TUBING ONLY 1/41N X 6 FT 50/CS [-EA '$ 0.60 $ 0.60 1 MEDICAL SUPPLY SOLUTIONS, I N55251 rUD Saline,Modudose,3m1,Sodium Chloride 0.9%,for Inhalation,Easy Open EA 1$ 0.11 $ 0.13 INC 1._.,__...._._._.___._._1Twist/Pu11100ea/bx10bx/c .__._._. i__.__..._._...._. I CARDINAL HEALTH . I2114-33018 NG Tube,Levin,18 Fr,Clear,48 inch,Markings 18,22,26 and 30 in,Open Distal End, jEA I$ 1.06 1$ 1.06 1 i 50ea/cs 1 j 1 ,CARDINAL HEALTH I2114-32216 ING Tube,Levin,16 Fr,Clear,48 inch,Markings 18,22,26 and 30 in,Open Distal End, IEA '$ 1.06 $ 1.061 I50ea/cs _! ' 1 I I CURAPLEX 301-B3030EA (Curaplex Select GreenLine/D Laryngoscope Blade,MAC 3,Fiber Optic,MED Adult, IEA $ 3.89 $ 3.89 L-. w___._ ---�_--__ i Disposable 20ea/cs __. I�__I CURAPLEX �1301-B3130EA Curaplex Select GreenLine/D Laryngoscope Blade,MILLER 3,Fiber Optic,MED Adult, lEA $ 3.89 I$ 3.89 - Disposable 20ea/cs I TELEFLEX LLC 020603 'MASK NON-REBREATHER PARTIAL HIGH CONCENTRATION,100%02,ADULT 50/CS IEA {$ 1.10 $ 1.10 i ! - TELEFLEX LLC - 021002 AIRWAY BERMAN CHILD SIZE 160MM 50/BX BULK 121802 IEA )$ 0.16 j$ 0.17 TELEFLEX LLCW 021003 )AIRWAY BERMAN SMALL ADULT SIZE 3 80MM 50/BX BULK 121803 EA $ 0.16 j$ 0.17 TELEFLEX LLC 021004 1AIRWAY BERMAN MEDIUM ADULT SIZE 4 90MM 50/BX BULK N/S EA $ 0.16 $ 0.17 TELEFLEX LLC 021005 AIRWAY BERMAN LARGE ADULT SIZE 5 100MM 50/BX BULK 121805 EA $ 0.16 $ 0.17 PFIZER INC.(HOSPIRA) 0409-4350-03 Diltiazem 100mg ADD-vantage Vial,Non-Refrig,(ADD-vantage diluent required-sold BX i$ 147.90 $ 152.40 separately)10EA/BX 11 DYNAREX CORPORATION 083501P Dressing,Abdominal,Combine Pad,Sterile,5 in x 9 in 20/pk 20pk/cs PK '$ 2.15!$ 2.15 DYNAREX CORPORATION 10635 bandage,Ace-type,Dynarex,elastic,latex-free,6in 50ea/cs EA__ $ 0.91 $ 0.91 MEDLINE INDUSTRIES,INC. 1072-80347-__ Wash Basin,Rectangular,6 Quart,Graphite,50ea/cs EA $ 0.68 $ 0.68 CURAPLEX 1124-03680 LTD QTY-use 1124-32400-Curaplex Triangular Bandage,Polypropylene 240ea/cs EA I$ 0.27 1$ 0.27 . 'PFIZER INC.(HOSPIRA) 11312-30 -1C2 HYDROMORPHONE 2MG/ML 1ML CPJ 10/BX ._._._I13X..._.$ 27.69 $ 28.52 DYNAREX CORPORATION 1350-14547 Triple Antibiotic Ointment,0.9gm Foil Pack 144/bx 12bx/cs [BX I$ 11.89 $ 11.89 PFIZER INC.(HOSPIRA) I1632-01 �VECURONIUM 10MG 10ML VIAL(POWDER)10EA/BX 'BX 1--$ 88.80 I$ 88.80 . . 1.13.BRAUN MEDICAL,INC 1633-05305 1Syringe Only,5cc,Luer Lock,100ea/bx 20bx/cs lEA 1$ 0.08 1$ 0.1E IB.BRAUN MEDICAL,INC 1633-10010 Syringe Only,10cc,Luer Lock,100ea/bx 12bx/cs !EA I$ 0.09 1$ 0.13 PFIZER INC.(HOSPIRA) 1893-01. C2 Morphine Sulfate,10mg/ml,1mIPF CRI 10/bx 1BX j$ 24.09 $ 24.09 1 ICURAPLEX 2021-14630 ICuraplex Select Nasopharyngeal Airway,14 Fr,3.0mm,Latex Free PVC 10ea/bx lEA 1$ 2.29.$ 2.29 i I I I I l- ----1--- -1-- 1 I CURAPLEX 12021-14635 iCuraplex Select Nasopharyngeal Airway,16 Fr,3.5mm,Latex Free PVC 10ea/bx .1 EA I$ 2.29 T219 1 I 1 -1--- CURAPLEX 12021-14640 1Curaplex Select Nasopharyngeal Airway,18 Fr,4.0mm,Latex Free PVC 10ea/bx lEA 1$ 2.29 $ 2.29 1 CURAPLEX- 12021-14650 Curaplex Select Nasopharyngeal Airway,20 Fr,5.0mm,Latex Free PVC 10ea/bx EA i$ 2.29 1$ 2.29 1 I I CURAPLEX 12021-14655 -1-Curaplex Select Nasopharyngeal Airway,22 Fr,5.5mm,Latex Free PVC 10ea/bx EA 1$ 2.29 1$ 2.29 1 i I 1 i -1--- I --; CURAPLEX 12021-14660 Curaplex Select Nasopharyngeal Airway,24 Fr,6.0mm,Latex Free PVC 10ea/bx i EA 1$ 2.29 1$ 2.29 I CURAPLEX 12021-14665 1Curaplex Select Nasopharyngeal Airway,26 Fr,6.5mm,Latex Free PVC 10ea/bx 1EA 1$ 2.29 1$ 2.29 1 CURAPLEX .2021-14670 1Curaplex Select Nasopharyngeal Airway,28 Fr,7.0mm,Latex Free PVC 10ea/bx --1EA 1$ iiif 2.29 1 1 I I 1 1 I . ICURAPLEX 12021-14675 jCuraplex Select Nasopharyngeal Airway,30 Fr,7.5mm,Latex Free PVC 10ea/bx lEA 1$ 2.29 $ 2.29; L _I , , , ........__ IVLR TRADING CO.,INC 209936 !HAND CLEANSER FOAMING ALCOHOL BASED 9 OZ 24/CS ALCARE PLUS !EA 1$ 9.97 1$ 9.97 i rEIRAPLEX 12112-38004 1Curaplex Endotracheal Tube with Stylette,4.0mm,Uncuffed bOea/bx 10bx/cs IEA i$ 1.52 1$ 1.52 1 I i I I ;CARDINAL HEALTH i 2114-71114 i NO Tube,Levin,14 Fr,Clear,48 inch,Markings 20,24,28 and 32 in,Open Distal End, 1EA !$ 1.06 $ 1.11 1 1 i I50ea/cs I-- --t- -, CARDINAL HEALTH ._12211-65950 1SUCTION TUBING CONNECTOR Y TYPE STERILE 50/CS ICS i$ 74.33j$ 74.331 AMBU 12442-54402 IBVM,SPUR II,NEONATE,INFANT WITH OXYGEN RESERVOIR TUBE 12/CS _ti-A" Is 13.28 1$ 13.28 I MEDIQUE PRODUCTS 1i5711 Hydrogen Peroxide,Topical Solution,16 oz Bottle,12ea/cs 1EA 1$ 0.98 1$ 0.9-8-1 1LAERDAL MEDICAL CORP. 1260202 1EXTRICATION COLLAR PEDIATRIC 50/CS STIFNECK 1EA 1-$- 5.59 1$ 5.59 I 1SPACELABS HEALTHCARE 2614-32016 lBP Cuff,SoftCheck,Child,Disposable,Vinyl,Single Tube with HP/Bayonet Fitting ;EA 1$ 2.29 1$ 2.29 1 t......_ 15ea/bx 1 1 SPACELABS HEALTHCARE I2614-63516 1BP Cuff,SoftCheck,Adult,Disposable,Vinyl,Single Tube with HP/Bayonet Fitting- 1EA 1$ -3-.-4-71-$-3.47 1 1 I I5ea/bx 1SPACELABS HEALTHCARE 12614-81416 1BP Cuff,SoftCheck,Infant,Disposable,Vinyl,Single Tube with HP/Bayonet Fitting !EA I$ 1.95 $ 1.95 I 15ea/bx I , -"' 1SPACELABS HEALTHCARE 12614-82616 1BP Cuff,SoftCheck,SM Adult,Disposable,Vinyl,Single Tube with HP/Bayonet Fitting t EA 1$ 2.56 FT-2-.5-6-1 I I 15ea/bx 1 ! ._...i I 1COVIDIEN 12722-76800 CO2 Sampling Line,Microstream Filterline Set,Adult/Pediatric,14ft long,Airway lEA 1$ 8.89 1$ 8.89 1 I !Adapter 25ea/bx i , I ....,,- WELCH ALLYN,INC.. 12733-57505 'Probe Covers,Braun ThermoScan Pro 4000 Thermometer,Disposable 200/bx 25bx/cs 1BX 1$ 14.79 1$ 14.79 i 1 1 1 1 .DUKAL CORP. 12-76-8506E1G 1Gauze sponge,basic economy,2 in x 2 in,12 ply,non-sterile,200/13g 40bg/cs 1BG 1$ 0.92 1$ 0.92 I 1 , I 1DYNAREX CORPORATION 1279-33438X Gauze sponge,sterile,4 in x 4 in,12 ply,2/pk,25pk/bx 24bx/cs 1BX 1$ 1.75 I$ 1.75.! .._ 'MEDEGEN MEDICAL 1290116 i BIOHAZARD BAG RED 7-10 GAL 23 X 23 1.2MIL 500/CS 1EA 1-$ 0.09 I$ 0L09 I I 1 i 1 i 1PRODUCTS ; 1 -i- ' 3M HEALTH CARE 1291860 !Particulate Respirator,N95,REG Size,Cup,Blue,Nosefoam,Fluid Resistant,Disp,LF i BX !$ 19.53 i$ 19.92 1 IANSELL HEALTHCARE 1297750 1Gloves,Freeform-EC,SM,Extended Cuff,Nitrile,Latex Free,Powder Free 50/bx BX 1$ 8.50 1$ 8.51- TRODUCTS LLC ! 10bx/cs 1 I I ; -A-- - IAN SELL HEALTHCARE 1297755 iGloves,Freeform EC,MED,Extended Cuff,Nitrile,Latex Free,Powder Free 50/bx IBX i$ 8.50 1$ 8.51 1 1PRODUCTS LLC IlObx/cs FANSELL HEALTHCARE 1297760 i Gloves,Freeform EC,LG,Extended Cuff,Nitrile,Latex Free,Powder Free 50/bx i BX ;$ 8.50 1$ 8.51 1 1PRODUCTS LLC 1110bx/cs i -4---1- I I -r 1ANSELL HEALTHCARE 1297770 ;Gloves,Freeform EC,XL,Extended Cuff,Nitrile,Latex Free,P6wder Free 50/bx f ax i$ 8.50 1$ 8.51 I i 1 PRODUCTS LLC ; ilObx/cs 1 1 1 : --; 1CURAPLEX 1301-133010EA 1Curaplex Select GreenLine/D Laryngoscope Blade,MAC 1,Fiber Optic,Infant, 'EA 1$ 3.89 $ 3.89 1 1 I Disposable 20ea/cs 1 1 1CURAPLEX 1301-B3020EA Curaplex Select GreenLine/D Laryngoscope Blade,MAC 2,Fiber Optic,Child, lEA 1$ 3.89 1$ 3.89 I 1 I L !Disposable 20ea/cs 1 1 1 ! . 1CURAPLEX 4- ,301-B3040EA 1 1Curaplex Select GreenLine/D Laryngoscope Blade,MAC 4,Fiber Optic,LG Adult, -TEA 1$ 3.891$ 3.89 1 I Disposable 20ea/cs $ 0 i 1CURAPLEX 1301-B3100EA Curaplex Select GreenLine/D Laryngoscope Blade,MILLER 0,Fiber Optic,Neonate, lEA i$ 3.89 I ,=•.,Q-..' Disposable 20ea/cs J I i -, I CURAPLEX 1301-B3110EA I Curaplex Select GreenLine/D Laryngoscope Blade,MILLER 1,Fiber Optic,Infant, EA 1$ 3.89 $ 3.89 I I iDisposable 20ea/cs 1 i tICURAPLEX 1301-133120EA 1Curaplex Select GreenLine/D Laryngoscope Blade,MILLER 2,Fiber Optic,Child, EA 1$ 3.89 1$ 3.89 1 1 _ 1 _ ___Jpisposable 20ea/cs I L . --1 I CURAPLEX 1301:13-31-40EA 1Curaplex Select GreenLine/D Laryngoscope Blade,MILLER 4,Fiber Optic,LG Adult, IBA -1'$ 3.89 rs 3.89 I 1 1 1Disposable 20ea/cs I - [SMITHS MEDICAL ASD,INC. 1353042 'CATHETER INTRAVENOUS(IV)LATEX FREE 16 GAUGE X 1.25 IN 50/BX 200/CS '----1EA I$ 1.80 1$ 1.80 i 1 I 1; )PROTECTIV 'SMITHS MEDICAL ASD,INC. 353048 -1CATHETER INTRAVENOUS(IV)LATEX FREE 14 GAUGE X 1.25 IN 50/BX 200/CS lEA 1$ 1.80 1$ 1.80 1 1 PROTECTIV 1 1 I ,......,_ __ 1, _ 1 .,.. - -... .. . - --- - . . SMITHS MEDICAL ASD,INC. 1353050 +(CATHETER INTRAVENOUS(IV)22 GAUGE X 1 IN 50/BX 200/CS PROTECTIV 'TEA j$ 1.80 $ 1.80] SMITHS MEDICAL ASD,INC. 1353055 (°(CATHETER INTRAVENOUS(IV)LATEX FREE 18 GAUGE X 1.25 IN 50/BX 200/CS EA 1$ 1.80 $ 1.80 1PROTECTIV SMITHS MEDICAL ASD,INC. [353056 CATHETER INTRAVENOUS(IV)LATEX FREE 20 GAUGE X 1.25 IN 50/BX 200/CS EA $ 1.80 $ 1.80 PROTECTIV III PFIZER INC.(HOSPIRA) 379094 C2 FENTANYLO.OSMG/ML2MLSDV 25/BX BX !$ 33.00 $ 33.99 ',PFIZER 138001 [Curaplex Endotracheal Tube with Stylette,2.5mm,Uncuffed 10ea/bx 10bx/cs EA $ 1.52 $ 1.52 CURAPLEX 38002 Curaplex Endotracheal Tube with Stylette,3.0mm,Uncuffed 10ea/bx l0bx/cs EA j$ 1.52 1$ 1.52 CURAPLEX 38003 Curaplex Endotracheal Tube with Stylette,3.5mm,Uncuffed 10ea/bx 10bx/cs EA I$ 1.52 I$ 1.52 I CURAPLEX 38005 Curaplex Endotracheal Tube with Stylette,4.5mm,Uncuffed 10ea/bx lobx/cs EA $ 1.52 $ 33214 1CURAPLEX 38011 Curaplex Endotracheal Tube with Stylette,5.0mm,Cuffed 10ea/bx lobx/cs EA i$ 1.52 $ 1.52 CURAPLEX ._ w. 38012 Curaplex Endotracheal Tube with Stylette,5.5mm,Cuffed 10ea/bx 10bx/cs EA $__.. 1.52 $ 1.52 CURAPLEX 38014 Curaplex Endotracheal Tube with Stylette,6.5mm,Cuffed 10ea/bx 10bx/cs EA $ 1.52 $ 1.52 CURAPLEX 38015._._. Curaplex Endotracheal Tube with Stylette,7.0mm,Cuffed 10ea/bx lobx/cs EA 1$ 1.52 $ 1.521 ICURAPLEX 38016 Curaplex Endotracheal Tube with Stylette,7.5mm,Cuffed loea/bx lobx/cs EA 1$ 1.52 $ 1.52 CURAPLEX 38017 Curaplex Endotracheal Tube with Stylette,8.0mm,Cuffed 10ea/bx 10bx/cs EA 1$ 1.52{$T�1.52 ICURAPLEX 38018 Curaplex Endotracheal Tube with Stylette,8.5mm,Cuffed 10ea/bx 10bx/cs EA $ 1.52 $ 1.52 CURAPLEX 38020 Curaplex Endotracheal Tube with Stylette,9.0mm,Cuffed 10ea/bx 10bx/cs EA f$ ___..1.52I$$---- 1.52 I [-HARTWELL MEDICAL LLC 4162 [Convenience Bag,BioHoop,50cc-2000cc,Emesis and Hazardous Waste Bag,No Hook EA $ 1.52TTT-$ 1.55 I 12ea/pk40pk/cs NICE-PAK 440128 LUBRICATING JELLY PDI STERILE,2.7GM 144/BX 12BX/CS BX 1$ 9.67 I$ 9.67'" j t DMS 5060220 Restraint Strap,Orange,2 pc,5 ft,Nylon,Metal Push Button Buckle,Loop Ends EA $ 7.39 $ 7.3931 CURAPLEX_ _w 51150 LTD QTY-Curaplex NPA 12F 3.0mm,Latex Free PVC 1/EA 10EA/BX 10BX/CS �E 1 A 1$ 1.151$ 1.151 QMED CORPORATION 533764 Ventilator Circuit,Universal,Portable,Adult,72 in,Disp,for use w/PB 2800 Series, lEA 1$ 5.50 1$ 5.73 HT50 15/cs I 1 MEDSOURCE INTERNATIONAL 533-MS-SC16EA Suction catheter,16 Fr,coiled,w/whistle tip and thumb control port,sterile,disp,LF EA 1$ 0.20 $ 0.20 50ea/cs BEMIS MANUFACTURING 592041 SUCTION CANISTER DISPOSABLE RED TOP 800cc 100/CS EA 1$ 2.93,$ 2.93 COMPANY __ _ CURAPLEX 64250 Curaplex Sharps Solo,Sharps container with one time lockable seal,6.5 in 24ea/cs EA $ 1.35 $��1.35 SUN MED 792-9-0212-72EA ET Tube Introducer 15 Fr x 70 cm,straight tip,flex,disp,sterile 10ea/bx EA $ 4.79 $ 4.79 1 TELEFLEX LLC D4244 'AIRWAY BERMAN LARGE CHILD 70MM 50/BX BULK MIIII$ 0.16 $ 0.17 MORRISON MEDICAL D6411 HEAD BLOCKS STICKY FOAM-PAIR PR I$ 5.02 $ 5.02 PRODUCTS I DYNAREX CORPORATION F165200 BANDAGE ADHESIVE CLOTH 1 IN X 3 IN 100/BX 24BX/CS BX 1$ 2.25 $ 2.25 1 DYNAREX CORPORATION F165631 TAPE ADHESIVE CLOTH SURGICAL 1 IN X 10 YDS 12/BX 12BX/CS BX $ 7.70'$ 7.70 DYNAREX CORPORATION F165632 TAPE ADHESIVE CLOTH SURGICAL 2 IN X 10 YDS 6/BX 12BX/CS BX $ 7.70 $ 7.70 I CURAPLEX ' PU80000 Curaplex VACUUM SPLINT SET,DISPOSABLE EA 1.$ 285.00 $ 285.00 TELEFLEX LLC ISE/121950 AIRWAY BERMAN INFANT 50MM INDIVIDUALLY WRAPPED 50/BX EA I$ 0.33 $ 0.36 Discontinued Items Vendor Name Item ID Item Description UoM Price LEONHARD LANG USA,INC. 492-12394PK 1*DC*MFG USE 2745-10108 Paper,LP11,LP12 and LP15,Size 108 mm x 23 m roll, PK 1$ 9.59 15rolls/pk,LifePak _1 PFIZER INC.(HOSPIRA) 0641142035 I"'DC*-USE 103-10* MFG EPINEPHRINE 1:1000 1MG 1MLAMPULE 2043 25ea/bx EA $ 3.52 CURAPLEX 14756M5 DC*USE 8888268086 Curaplex Nasogastric Tube,8Fr 280ea/cs EA IL 2.35 ASCENSIA DIABETES CARE 1175965 *DC*MFG LANCETS FINGERSTIX 200/BX 6BX/CS BX $ 33.00 ADI MEDICAL !1880-92078 *DC*USE 1841-14000 Tourniquet,Latex Free,1 in x 18 in,Light Gray,100/bx lobx/cs BX $ 8.15 MYLAN SPECIALTY LP 125021-301-02 *DC-USE 0542-02 ADENOSINE 6MG,2ML VIAL 10ea/bx EA $ 3.93 ISPACELABS HEALTHCARE 12614-24216 *DC*BP Cuff,SoftCheck,LG Adult,Disposable,Vinyl,Single Tube w/HP/Bayonet EA $ -3.95 I. __...� FittinN 5/b MYLAN SPECIALTY LP 303-05 l*DC-USE 660-05 Metoprolol 5mg,5m1 Vial,l0ea/bx EA $ 1.32 CURAPLEX 3173-08715 *DC-NO SUB*Curaplex DUAL LADDER LOCK 7 FT LOOPLOCK SAME LENGTH EA $ 4.16 �_ ORANGE PLASTIC DISP RESTRAINT IASTELLAS PHARMA.US,INC. 1371255 I*DC*USE 0301-68 ADENOCARD 12MG 4ML ANSYR SYRINGE 1002C TEA 1$ 85.52 1 - CAPITAL WHOLESALE DRUG 1375016 I*DC*USE 911316 ASPIRIN CHILDRENS CHEWABLE ORANGE FLAVOR 81MG 36/BT a IBT i$ 1.40 I 24BT/CS 1 _I_ . NICE-PAK 541231 *DC-NO SUB*TINCTURE OF BENZOIN SWABSTICKS INDIVIDUALLY WRAPPED BX 1$ 10.151 I �.�.[50PK/BX 10BX/CS EXP: {WATER-JEL TECHNOLOGIES I711216 j*DC-USE 1522-21620*BURN FACE MASK WATER-JEL 20EA/CS__�.__........_,r._.._.,_�.I EA $ 13.33 WATER-JEL TECHNOLOGIES 1713036 DC USE 1522-36304 MFG DC BURN WRAP IN FOIL POUCH 3 FT X 2.5 FT 4EA/CS IEA 1$ 54.00 I _ IP3630-4 MACO INTERNATIONAL _ IA865118 �l DC*LARYNGOSCOPE HANDLE FIBEROPTIC SMALL GREEN SYSTEM }IEA IT_ 32.29 DYNAREX CORPORATION 1F1654�� *DC*BT_M USE 1330-86100 ALCOHOL_PREP PADS LARGE 100/BX 10BX/CS_ _ --IBX -t$~� 2.13 I MEDSOURCE INTERNATIONAL jK4036 *DC*-USE 32762*PENLIGHT DISPOSABLE EACH WITH PUPIL GAUGE 300EA/CS IEA I$ 0.751 Potential Subs • Vendor Name Item ID Item Description ® PrkL.e. fCURAPLEX 12745-10108 Curapl ex ECG Chart Paper,Therma1,108mm,Red Grid,for Physio-Control LP11,LP12, iRL I$ 1.84 . LP15 1/RL60RL/CT 1 ( . (BPI LABS,LLC 1103 10 Epinephrine lmg,lml ampule lea l0ea/pk }EA I$ 13.89 CARDINAL HEALTH 8888268086 SALEM GASTRIC SUMP TUBE 8 FR,24 IN 10/CS TEA I$ 7.44 CARDINAL HEALTH-PHARMA f 0542-02 Adenosine 6mg,2mI Vial 10ea/bx iEA 1$ 3.93 I FRESENIUS :660-05 I Metoprolol 5mg,5mIvial_._.. _ .lEA 1$ 1.587 SAGENT PHARMACEUTICALS, 0301-68 m Adenosine 12mg,4ml Luer Lock Syringe l0ea/bx iEA $ 26.28 IGERI-CARE 1911316 tAspirin 81mg Chewable,Orange Flavor 36/Bottle _ 1BT $ 0.791 (WATER-JEL TECHNOLOGIES 11522-21620 Burn Dressing,Facial,Water-Jel,12 inch 16 inch L4 Ms!EA._si...$ 13.33J WATER-JEL TECHNOLOGIES 1522-36304 E Burn Wrap,Water Gel,Foil Pouch lea 4ea/cs — lEA I$ 54.00 1 ,CURAPLEX 132762 1Curaplex Disposable Penlight 6/pk,60pk/cs {PKI$ 4.50 A��...111411 ® CERTIFICATE OF LIABILITY INSURANCE DATE(M2/D/2519 ) O tvtsnots 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 w this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). m PRODUCER CONTACT NAME: M 1. Aon Risk Services Northeast, Inc. PHONE FAX Columbus OH Office (ANC.No.Ext): (866) 283-7122 (A/C.No.): (800) 363-0105 ri 445 Hutchinson Avenue E-MAILDSS: _ Suite 900 Columbus OH 43235 USA INSURER(S)AFFORDING COVERAGE NAIC H INSURED INSURER A: Medmarc Casualty Ins Co 22241 Sarnova, Inc., Bound Tree Medical, LLC INSURER B: Hartford Fire Insurance Co. 19682 5000 Tuttle Crossing Blvd. Dublin OH 43016 USA INSURERC: Sentinel Insurance Company, Ltd 11000 INSURERD: Hartford Casualty Insurance Co 29424 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570079659291 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, Limits shown are as requested INSR TYPE OF INSURANCE INSD SWVD POLICY NUMBER POLICY W POLICY EXP LIMITS B X COMMERCIAL GENERAL LIABILITY Y 33UUNVG3435 12/01/2019 12/01/2020 EACHOCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $300,000 MED EXP(Any one person) $10,000 PERSONAL 8ADV INJURY 51,000,000 GENERAL AGGREGATE $2,000,000 rn GEN'LAGGREGATE LIMIT APPLIES PER rn POLICY I X IJECT LOC PRODUCTS-COMP/OPAGG Excluded rn r 0 OTHER: 0 C AUTOMOBILE LIABILITY Y 33 UUN VG3435 12/01/2019 12/01/2020 COMBINED SINGLE LIMIT $1,000,0D0 (Ea accident) X ANY AUTO BODILY INJURY(Per person) G SCHEDULED BODILY INJURY(Per accident) Z OWNED AUTOS a AUTOS ONLY PROPERTY DAMAGE i0 HIRED AUTOS NOAUTOS ONLY (Per accident) w ONLY t 0 X UMBRELLA!JAB X OCCUR 33RHUVG1892 12/01/2019 12/01/2020 EACH OCCURRENCE $10,000,000 V EXCESS LIAR CLAIMS-MADE AGGREGATE $10,000,000 DUD X RETENTION $10,000 ~ WORKERS COMPENSATION AND PER STATUTE I re- EMPLOYERS' LIABILITY j _ - Y/N ANY PROPRIETOR I PARTNER/ E.L.EACH ACCIDENT EXECUTIVE OFFICER/MEMBER N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT A Products Liab 190H380015 12/01/2019 12/01/2020 Aggregate Limit $10,000,000 Claims Made Agg Deductible $150,000=_ Per Occ Limit $10,000,000 B nelL DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) gki: RE: Account No. 104754. Monroe County BOCC is included as Additional Insured in accordance with the policy provisions of the y General Liability and Automobile Liability policies. APPR*VI D i ; ‘. ,-EMENT BY ._ teLmail.ww...ISP -.... . . 9 DATE WAIVER NIA Y'S_._ vie atiftenne CERTIFICATE HOLDER CANCELLATION 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 BOCC AUTHORIZED REPRESENTATIVE 1111 12th St., Suite 408 Key west FL 33040 USA Ar M � ia 0 ©1988-2015 ACORD CORPORATION.All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACO AGENCY CUSTOMER ID: 570000037575 LOC#: ACCARCP ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk Services Northeast, Inc. sarnova, Inc., Bound Tree Medical, LLC POLICY NUMBER See certificate Numbe 570079659291 CARRIER NAIC CODE See certificate Numbe 570079659291 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER • INSURER • INSURER • INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR ADDL SUBR POLICY NUMBER LIMITS LTR TYPE OF INSURANCE INSD wVD EFFECTIVE EXPIRATION DATE DATE (MM/DD/YYYY) (MMASD/1'YYY) OTHER A Products Liab 190H380015 12/01/2019 12/01/2020 Per Occ $50,000 Claims Made Deductible ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. _ ..The ACORD name and logo are registered marks of ACORD Exhibit A CONTRACT BETWEEN THE BOARD OF COUNTY COMMISSIONERS AND THE BOARD GOVERNORS FIRE AND AMBULANCE DISTRICT 1 OF MONROE COUNTY,FLORIDA AND BOUND TREE MEDICAL,LLC FOR THE PURCHASE OF MEDICAL SUPPLIES AND PHARMACEUTICALS THIS CONTRACT, hereinafter "CONTRACT" or "AGREEMENT", is made and entered into this 1st day of December, 2016 by and between the Monroe County Board of County Commissioners and Board of Governors Fire and Ambulance District 1 of Monroe County, Florida, hereinafter referred to as "COUNTY", and Bound Tree Medical, LLC, hereinafter referred to as"CONTRACTOR". WITNESSETH: WHEREAS, the COUNTY advertised a notice of request for proposals for medical supplies and pharmaceuticals. WHEREAS,the successful Proposer was Bound Tree Medical, LLC, and; WHEREAS, this CONTRACTOR represents that it is capable and prepared to provide such services, and; WHEREAS, the COUNTY intends to enter into an agreement to furnish medical supplies and pharmaceuticals at set pricing and; WHEREAS,this contract is an"Agreement" between both parties, NOW,THEREFORE, in consideration of the promises contained herein,the parties agree as follows: 1. CONTRACT DOCUMENTS — This contract consists of the Agreement, the CONTRACTOR'S response to the Request for Proposals (RFP), and the documents referred to in the Agreement as a part of this Agreement. In the event of any conflict between any of the contract documents, the one imposing the greater burden on the CONTRACTOR will control. 2. CONTRACT PERIOD AND RENEWAL - The effective date of this Agreement shall be December 1, 2016 through November 30, 2019, with two one-year options for renewal, subject to the approval of the Monroe County Board of County Commissioners and the Board of Governors of Fire and Ambulance District 1. 3. CONTRACT TERMINATION - This Agreement may be terminated for any reason by either party on 30-day written notice without cause. If the CONTRACTOR fails to fulfill the terms of this Agreement, or attachments, properly or on time, or otherwise violates the provisions of the agreement or of applicable laws or regulations governing the use of . . iria WI Any attempts by the CONTRACTOR to furnish the COUNTY with other than first quality materials shall constitute default as outlined in this specification. E. Refrigeration. Maintaining a specific temperature range throughout the shipping process is essential to the quality of healthcare products. Only materials which have been properly shipped in a temperature-controlled environment shall be accepted by the COUNTY. F. Expiration Dates. All merchandise shall have a minimum expiration date of 18 months from date of shipment, and date must be displayed on the package. 9. CONDITIONS: A. Authorization. All orders shall be placed via Monroe County by individual Purchase Orders generated by the County's electronic ordering software, Operative IQ, or as "Open" Purchase orders, at the County's election. B. Furnishing Items. Contract items are to be furnished on an "as needed, when needed basis"during the life of the contract. C. Delivery. Materials ordered shall be delivered within three (3) business days after receipt of order. Failure to do same shall be considered breach of contract or default, and the COUNTY shall utilize its options as stated within the proposal specification. D. Backorders. In the event an item is not immediately available at the time of an order, or is not able to be delivered within three (3) days, the County shall have the option of purchasing the item from another vendor. E. Penalties. The COUNTY reserves the right to increase or decrease quantities shown without penalty. F. Addition/Deletion. The COUNTY reserves the right to add or delete any item from this proposal or resulting contract when deemed to be in the interest of the COUNTY. G. Samples. When required, samples shall be labeled with the CONTRACTORS' name and item number and shall be furnished free of charge. Samples not destroyed will be returned upon request at the CONTRACTOR'S expense. H. Substitution. The CONTRACTOR shall not substitute items for like items without the approval of the COUNTY. Any violation of such procedure may result in a possible cancellation of the contract. All approved substitutes shall be annotated as such on the CONTRACTOR'S shipping document(s). I. Contract Prices. Contract prices from Medical Supply Discount Off List and Pricing Worksheet (Attachment A) shall be firm and shall not be amended after the contract is executed. Any attempt by the CONTRACTOR to amend said prices unilaterally shall constitute default as outlined in the contract. Prices quoted shall include all shipping costs, shipped F.O.B Marathon, Florida or to the facility location specified by the requestor or the purchase order. All taxes of any kind and character payable on account of the work done and materials furnished under the award shall be paid by the CONTRACTOR and shall be deemed to have been included in the price. •The COUNTY is exempt from all state and federal sales, use, transportation, and excise taxes. Contract prices shall include all royalties and costs arising from patents, trademarks, and copyrights in any way involved in the work. Whenever the CONTRACTOR is required or desires to use any design, device, material or process covered by letters of patent or copyright, the CONTRACTOR shall indemnify and save harmless the COUNTY, its officers, agents, and employees from any and all claims of infringement by reason of the use of any such patented design, toll, material, equipment or process, to be performed under the contract, and shall indemnify the said COUNTY, its officers, agents and employees for any costs, expenses and damage which may be incurred by reason of any infringement at any time during the prosecution or after the completion of the work. J. Contract Provisional Prices off List Price. Contract pricing for items not included on Medical Supply Discount Off List and Pricing Worksheet (Attachment A) and sold to the County at a discounted percentage rate off the list price issued by CONTRACTOR shall be firm and shall not be amended after the contract is executed. Any attempt by the CONTRACTOR to amend said prices • shall constitute default as outlined in the contract. COUNTY will verify items by a printout from the CONTRACTOR's online catalog showing both the "list price" and "your price", the latter being the COUNTY'S price. K. Contract Changes. No changes, over the contract period, shall be permitted unless prior written approval is given by the Monroe County Board of Commissioners and the Board of Governors of Fire and Ambulance District 1. No CONTRACTOR shall assign the contract or any rights or obligations there under to a subcontractor without the prior written approval of the Monroe County Board of Commissioners and the Board of Governors of Fire and Ambulance District 1. L. Price Escalation. The County will allow a price escalation provision for items on the Medical Supply Discount Off List and Pricing Worksheet(Attachment A) with this award. The original CONTRACTOR prices on Medical Supply List Pricing Worksheet (Attachment A) shall be firm for a one (1) year minimum period. A price escalation/de-escalation will be allowed one (1) year after the beginning of the award period and at one (1) year intervals thereafter, provided the CONTRACTOR notifies the COUNTY, in writing of any requested price changes at least sixty (60) days prior to those changes taking effect. This request must be accompanied by a certified letter from the CONTRACTOR'S supplier showing the price increase to the contractor. The price increase to the County shall be limited to the percentage increase to the CONTRACTOR as stated in this letter. If, at the point of exercising the price escalation provision, market media indicators show that the prices have decreased, and that the CONTRACTOR has not passed the decrease on to the COUNTY, the COUNTY reserves the right to place the CONTRACTOR in default, cancel the contract, and remove the CONTRACTOR from the COUNTY's CONTRACTOR list for a period of time deemed suitable to the COUNTY. M. Invoicing. The CONTRACTOR shall furnish the COUNTY complete itemized invoices for the goods received. Invoices are to reflect the prices stipulated on the purchase order, and as outlined on the Medical Supply Discount Off List and Pricing Worksheet (Attachment A). Invoices are also to reflect the provisional price discount in the form of a percentage at which the CONTRACTOR will sell these items off its list price. The COUNTY will not accept an aggregate invoice. As part of the award process, the COUNTY may request a sample invoice. Invoices shall contain, but not limited to the following information: o Invoice number o Company name o Purchase order number o Location and dates of delivery o Cost.of items as stated on the contract and extended price to reflect total cost for number of items received. N. Payment. Full payment will be made by the COUNTY after receipt and acceptance of materials/services and proper invoices in accordance with the Florida Local Government Prompt Payment Act, Section 218.70 et al. O. Ordering. CONTRACTOR will provide web-based online ordering website designed specifically for service. P. Disaster Recovery. CONTRACTOR must have a proven Disaster Support Program in place and shall provide the COUNTY with emergency numbers for these situations. These numbers will be updated immediately if the contact number changes. 10. INDEMNIFICATION — CONTRACTOR shall indemnify and hold the COUNTY and Monroe County and Monroe County Fire and Ambulance District 1 harmless for any negligence on its part or faulty or improper workmanship, for all work performed under this contract, including all costs of collection, reasonable attorney fees, claim costs, and as per "Attachment I". All property or equipment being directly maintained or repaired by CONTRACTOR shall be considered in its care, custody, and control while such work is in progress and until physical control of such property or equipment is restored to the COUNTY. 11. INSURANCE — The Proposer will comply with the insurance requirements listed in Attachment Ito the RFP. 12. ADDITIONAL REQUIRED STATEMENTS/VERIFICATIONS/ AFFIDAVITS. Attached hereto in Attachments Attachment A—Medical Supply Discount Off List and Pricing Worksheet Attachment B—Submission Proposal Response Form Attachment C—Non-Collusion Affidavit Attachment D—Lobbying and Conflict of Interest Attachment E—Drug Free Workplace Attachment F—Public Entity Crime Statement Attachment G—Local Preference (if applicable) Attachment H—Scope of Services Response Form Attachment I—Request for Waiver of Insurance Requirements (if applicable) 13. Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County Commissioners of Monroe County, Florida. 14. Venue for any litigation arising under this contract must be in a court of competent jurisdiction in Monroe County,Florida. This Agreement is not subject to arbitration. 'p, ` ren. SS WHEREOF, each party hereto has caused this contract to be executed by its duly .(lt�or ' + resentative. I¢ 0 1,, A . p.:- I 3 . 0 BOARD OF COUNTY COMMISSIONERS W • _.'l ' MADOK , OF MONROE COUNTY,FLORIDA v_,.. ,...„'ATI 9ry4 , By: a By:A4. he-k5e4b Clerk of Court Mayor BOUND TREE MEDICAL,LLC: ' BOARD OF GOVERNORS OF FIRE AND . AMBULANCE DISTRICT 1 OF MONROE COUNTY,FL /la • , "74"°"4",W4‘. By: /V l LL ?r>:''r I id- • BY: Print Name and Title Mayor/Chairperson Date: I I /1 I001(� r _ SECTION FOUR: ATTACHMENTS AND FORMS Attachment A Medical Supply Discount Off List and Pricing Worksheet Attachment B Submission Proposal Response Form Attachment C Non-Collusion Affidavit Attachment D Lobbying and Conflict of Interest Attachment E Drug Free Workplace Attachment F Public Entity Crime Statement Attachment G Local Preference Attachment H Scope of Services Response Form Attachment I Insurance Requirements, Indemnification/Hold Harmless, and Request for Waiver of Insurance Requirements Attachment A Medical Supply Discount Off List and Pricing Worksheet DISCOUNT OFF LIST PRICE PERCENTAGE 25%*with exclusions attachec inn GATBGORY . I f f M;DESCRWnON BRAND. :EST.°UNITS UNIT, WENDED . # ` ' •r , SPECIFIED QTY.; PRICE ICE I (V/N) 1 AIRWAY ENDOTRACHEAL TUBE CUFFED WITH STYLETTE 5.0 10/BX FLEXI-SET Y 2 BX S15.20$30.40 2 AIRWAY ENOOTRACHEAL TUBE CUFFED WITH STYLETTE 5.5 10/BX FLEXI-SET T 2 BX 31520 Z0.40 3 AIRWAY ENDOTRACHEAL TUBE CUFFED WITH STYLETTE 6.5 10/8X FLEXI-SET 'I 2 BX 5t520$30,40 4 AIRWAY ENDOTRACHEAL TUBE CUFFED WITH STYLETTE 7.0 10/BX FLEXI-SET Y 2 BX $15.20$30.40 S AIRWAY ENDOTRACHEAL TUBE CUFFED WITH STYLETTE 7.5 10/BX FLEXI-SET Y 2 BX S15.20$30A 6 AIRWAY ENDOTRACHEAL TUBE CUFFED WITH STYLETTE 8.0 10/BX FLEXI-SET Y 2 BX StS�$30-d0 7 AIRWAY ENDOTRACHEAL TUBE CUFFED WITH STYLETTE 8.510/BX FLEXI-SET -'f 2 BX S15.20 S30 d0 8 AIRWAY ENDOTRACHEAL TUBE CUFFED WITH STYLETTE 9.0 10/BX FLEXI-SET Y 2 BX S1520 $30.40 9 AIRWAY ENDOTRACHEAL TUBE HOLDER ADULT 100/CS THOMAS 'I 70 EAT8 $19.1.80 10 AIRWAY ENDOTRACHEAL TUBE UNCUFFED WITH STYLETTE 2.5 10/6X FLEXI-SET Y 1 BX $15.20$15.20 11 AIRWAY ENDOTRACHEAL TUBE UNCUFFED WITH STYLETTE 3.0 10/BX FLEXI-SET Y 1 BX 515.20$1510 12 AIRWAY ENDOTRACHEAL TUBE UNCUFFED WITH STYLETTE 3.5 10/BX FLEXI-SET 'I 1 BX mug$IS a0 13 AIRWAY ENDOTRACHEAL TUBE UNCUFFED WITH STYLETTE 4.0 10/8X FLEXI-SET Y 1 BX 5t5.20$15.20 14 AIRWAY ENDOTRACHEALTUBE UNCUFFED WITH STYLETTE 4.5 10/BX FLEXI-SET Y 1 BX $15.20 S15..0 15 AIRWAY ET TUBE DISP.INTRODUCER,BLUE STARIGHT TIP 15 FRENCH X 70 CM,ADULT Y 50 EA $4.79$23930 16 AIRWAY IGEL 02 RESUS PAK ADULT SIZE 3 YELLOW HOOK RING BY INTERSURGICAL Y 20 EA 3a59$471.80 17 AIRWAY IGEL 02 RESUS PAK ADULT SIZE 4 YELLOW HOOK RING BY INTERSURGICAL Y 30 EA S23.59 S707.70 18 AIRWAY IGEL 02 RESUS PAK ADULT SIZE 5 YELLOW HOOK RING BY INTERSURGICAL ' 20 EA $23.59 $471.80 T 19 AIRWAY KING VISION VIDEO LARYNGOSCOPE BLADE,CHANNELED,DISP.18 MM,W/WHITE LED,DIGITAL CMOS CAMERAL 10EA/BK Y 1 BX $279.90 5279.90 20 AIRWAY KING VISION VIDEO LARYNGOSCOPE BLADE,STANDARD,DISP.13 MM,W/WHITE LED,DIGITAL CMOS CAMERAL 10EA/BK 7 1 BX 327990 2279S0 21 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MAC#1 GREENLINE Y 10 EA $310$3190 22 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MAC#2 GREENLINE Y 10 EA $3.89$3890 23 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MAC#3 GREENLINE Y 20 EA 5J.88 S77.30 24 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MAC It 4 GREENLINE Y 20 EA $3.89 S77-S0 25 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MILLER#0 GREENLINE Y 10 EA ass S38.90 Attachment A Medical Supply Discount Off List and Pricing Worksheet ITEM CATEGORY ITEM.DESCRIPTION BRAND EST. UNITS UNIT EXTENDED II SPECIFIED QTY. PRICE PRICE. (V/N) . 26 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MILLER 41 GREENLINE y 10 EA $3.83 WO 27 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MILLER#2 GREENLINE _k 10 EA $189 IWO 28 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MILLER#3 GREENLINE Y 20 EA Eta$17.30 29 AIRWAY LARYNGOSCOPE BLADE DISP.FIBEROPTIC STAINLESS STEEL MILLER#4 GREENLINE y 20 EA an 3377.30 30 AIRWAY LARYNGOSCOPE HANDLE,GREENLINE FIBER OPTIC,PENLITE CHROME PLATED BRASS 2 AA BATTERIES y 12 EA i322 33£17AS 31 AIRWAY LUBRICATING JELLY 2.7 GRAM,FOIL PACK,STERILE,WATER SOLUBLE,MINI PACK 144/BX Y 3 BX say 329.sx 32 AIRWAY NASDGASTRIC TUBE,08FR RUSH LEVINE N 12 EA 3235 S28.29 33 AIRWAY NASOGASTRIC TUBE,10FR RUSH LEVINE N 12 EA $1.93123.11 34 AIRWAY NASOGASTRIC TUBE,12FR RUSH LEVINE N 12 EA $1.0331212 35 AIRWAY NASOGASTRIC TUBE,I4FR RUSH LEVINE N 12 EA SUS 312.72 36 AIRWAY NASOGASTRIC TUBE,16FR RUSH LEVINE N 12 EA $1.03\332.72 37 AIRWAY NASOGASTRIC TUBE,18FR RUSH LEVINE N 12 EA 51.118 512I2 38 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 12 FRENCH 10/BX RUSCH N 2 BX $11.5D$7331) 39 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 14 FRENCH 10/BX RUSCH N 2 BX $2299$453D 40 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 16 FRENCH 10/8X RUSCH N 2 BX S222)345.30 41 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 18 FRENCH 10/BX RUSCH N 2 BX $22.9}345.30 42 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 20 FRENCH 10/8X RUSCH N 2 8X $22113145.30 43 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 22 FRENCH 10/BX RUSCH N 2 BX $22A?315.1) 44 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 24 FRENCH 10/8X RUSCH N 2 BX i2L93!OM 45 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 26 FRENCH 10/BX RUSCH N 2 BX Q293$43.30 46 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 28 FRENCH 10/BX RUSCH N 2 BX $229154130 47 AIRWAY NASOPHARYNGEAL AIRWAY-NPA-LATEX FREE PVC 30 FRENCH 10/8X RUSCH N 2 BX $221►M$15.90 48 AIRWAY ORAL AIRWAY,100MM PURPLE BERMAN y 50 EA 5113 SSA 49 AIRWAY ORAL AIRWAY,50MM TURQUOISE BERMAN Y 20 EA $1.33 3&61 50 AIRWAY ORAL AIRWAY,60MM BLACK BERMAN y 20 EA as$ 51 AIRWAY ORAL AIRWAY,70MM WHITE BERMAN Y 30 EA 31i3 3'4.ICJ 52 AIRWAY ORAL AIRWAY,80MM GREEN BERMAN y 30 EA rata 3A.5D S3 AIRWAY ORAL AIRWAY,90MM YELLOW BERMAN y 50 RIO WO) 54 AIRWAY SUCTION CANISTER DISPOSABLE RED TOP 800cc Y 27 EA $293 379.11 55 AIRWAY SUCTION CANISTER WITH PREATTACHED 6 FT TUBING GREEN 1200cc 48/CS _y 2 CS 5331.92$6Q?84 Attachment A Medical Supply Discount Off List and Pricing Worksheet tneM CATEGORY REM DESCRIPTION BRAND EST. UNITS UNIT EXTENDED * SPECIFIED QTY. PRICE PRICE (V/N) 56 AIRWAY SUCTION CATHETER,12FR,COILED,GRADUATED,FROSTED SURFACE,KINK RESISTANT Y 24 EA S*19 51.58 57 AIRWAY SUCTION CATHETER,14FR,COILED,GRADUATED,FROSTED SURFACE,KINK RESISTANT Y 24 EA 5019 SUS, 58 AIRWAY SUCTION CATHETER,16FR,COILED,GRADUATED,FROSTED SURFACE,KINK RESISTANT Y 24 EA 3019 Me 59 AIRWAY SUCTION CATHETER,18FR,COILED.GRADUATED,FROSTED SURFACE,KINK RESISTANT Y 24 EA S019 SEW 60 AIRWAY SUCTION CATHETER,6FR,COILED,GRADUATED,FROSTED SURFACE,KINK RESISTANT Y 24 EA S019 5153 61 AIRWAY SUCTION CATHETER,8FR,COILED,GRADUATED,FROSTED SURFACE,KINK RESISTANT Y 24 EA 5919 S4.56 62 AIRWAY SUCTION TIP YANKAUER,BULB TIP WITH CONTROL VENT,STERILE CURAPLEX Y 75 EA SOW 35775, 63 AIRWAY SUCTION TUBING ONLY 1/4 IN X 6 FT 50/CS Y 1 CS 330(0 533.03 64 AIRWAY BAAM AIR FLOW MONITOR Y 10 EA 5847 S617), '65 AIRWAY END TIDAL CO2 SMART CAPNOLINE PLUS OXYGEN,ORIDION ADULT/INTERMEDIATE Y 200 EA 3984 11,98M 66 AIRWAY FILTERLINE SET,NON HUMIDIFIED,INTUBATED,ADULT/PEDIATRIC ORIDION MICROSTREAM Y SD EA Sa89 $444.53 67 BANDAGES/DRESSINGS BANDAGE ADHESIVE FLEXIBLE Latex free 1 IN X 3 IN,LF 100/BX Johnson and Johnson 11 18 BX 3225 u23) 68 BANDAGES/DRESSINGS BANDAGE ELASTIC LATEX FREE 6 IN X 5 YARDS 10RLS/BX Y , 7 BX S910 56313, 69 BANDAGES/DRESSINGS BANDAGE TRIANGULAR WITH TWO PINS 51 IN X 36 IN X 36 IN 12/BX Y 3 8X 33(9 S30), , 70 BANDAGES/DRESSINGS BANDAGE,MULTI-TRUAMA DRESSING,121N X 30IN,STERILE,2SEA/CS Y 6 CS7S S112S} 71 BANDAGES/DRESSINGS BURN DRESSING WATER JEL Z IN X 6 IN Y 20 EA 5279 SS;1} 72 BANDAGES/DRESSINGS BURN DRESSING WATER JEL 4 IN X 4 IN Y 20 EA Si 59 t318) 73 BANDAGES/DRESSINGS BURN DRESSING WATER JEL 8 IN X 18 IN Y 20 EA $4(0 S810 74 BANDAGES/DRESSINGS BURN DRESSING WATER JEL BLANKET 3FT X 2.5FT Y 12 EA 554(9 5848)3 75 BANDAGES/DRESSINGS BURN DRESSING WATER JEL FACIAL Y 10 EA 5'3 c3 $13333, 76 BANDAGES/DRESSINGS BURN SHEET,BLUE,60IN X 96 IN,STERILE Y 12 EA 32(4 3443 77 BANDAGES/DRESSINGS COLD PACK INSTANT 5.5 IN X 10 IN 24/CS RAPID COLD Y 12 CS _ �ir S31Td!` 78 BANDAGES/DRESSINGS CONFORMING STRETCH BANDAGE,GAUZE,4 IN STERILE,12 RL/BG Y 40 BG S318 5127.2) 79 BANDAGES/DRESSINGS DRESSING,ABDOMINAL PADS STERILE 51N X 9IN 25/BX Y + 32 BX 5269 S86,/3 80 BANDAGES/DRESSINGS GAUZE SPONGE NON STERILE 12 PLY 2 IN X 2 IN 200/BG Y 24 BG Sf 92 S2293 81 BANDAGES/DRESSINGS GAUZE SPONGE,BASIC ECONOMY,4 IN x 4 IN,12 PLY,STERILE,2/PK,25PK/BX _Y 36 BX Si 75 Me 82 BANDAGES/DRESSINGS GAUZE,CONFORMING STRETCH STERILE 41N X 4.1 VD 12RLS/BG Y 40 BG 5318 S12T,2) 83 BANDAGES/DRESSINGS HYDROGEN PEROXIDE 3%16 OZ Y 36 EA 3458 $3i23 84 BANDAGES/DRESSINGS TAPE ADHESIVE CLOTH 1 IN X 10 YARDS 12/BX Y 36 BX $170 3277.23, 85 BANDAGES/DRESSINGS TAPE ADHESIVE CLOTH 2 IN X 10 YARDS 6/BX Y 36 BX 5'r 70 3T7.2) Attachment A Medical Supply Discount Off List and Pricing Worksheet ITEM CATEGORY {TENT DESCRIPTION (RAND EST. LINTS UNIT EMENDED t SPECIFIED QTY. PRICE PRICE MN) 86 BANDAGES/DRESSINGS TRAUMA EMS SHEARS,BLACK 71/4 in,SAFETY BANDAGE TIP,FULLY AUTOCLAVABLE,SURGICAL STAINLESS STEEL BLADES Y I 32 EA 5I.78 5�.06 ^ 87 BANDAGES/DRESSINGS TRIPLE ANTIBIOTIC OINTMETN,UNIT DOSE 1/32 OZ 144/BX S 6 BX MOB$1134 88 BREATHING BAG VALVE MASK NEONATE/INFANT RESUSCITATOR SPUR II WITH OXYGEN RESERVOIR TUBE Y 24 EA 51328 S313.72 89 BREATHING BAG VALVE MASK W/MEDIUM ADULT MASK SPUR II DISP,INDIVIDUALLY BOXED 1 48 EA 510•cs St3LMM ` 90 BREATHING BAG VALVE MASK,COLLAPSED SPUR II PEDIATRIC,DISP,WITH MASK AND EXPIRATORY HEPA FILTER,AMBU Y 24 EA - V9 5T'�� _ 91 BREATHING CPAP OS BREATHING CIRCUIT W/MEDIUM MASK N 26 EA 541.50$1.O79.00 92 .BREATHING HEPA VENT FILTER,HIGH EFFICIENCY W/PORT,HYDROPHOBIC PAPER TIDAL VOLUME RANGE>500 ml Y 100 EA 32 23103 93 BREATHING VENTILATION CIRCUIT DISP KIT,W/EXHAUST COLLECT/PEEP VALVE,FOR DEMAND VERSION OF PARAPAC/VENTIPAC ►N 10 EA 1 ram5195.70 - 94 BREATHING VENTILATION CIRUIT,SINGLE LIMB,PORTABLE,6 FT PATIENT TUBE,1/8 IN AND 1/4 IN ID FOR USE WITH EAGLE UNIVENT N 100 EA 5550$5'2Ga - 95 DIAGNOSTIC BLOOD PRESSURE CUFF DISP ADULT FOR USE WITH LIFEPAK MONITORS } 160 EA 43A7 S55523 _ 96 DIAGNOSTIC BLOOD PRESSURE CUFF DISP CHILD FOR USE WITH LIFEPAK MONITORS Y 6 EA 3223 St374 _ 97 DIAGNOSTIC BLOOD PRESSURE CUFF DISP INFANT FOR USE WITH LIFEPAK MONITORS Y 6 EA 5125 511.70 r 98 DIAGNOSTIC BLOOD PRESSURE CUFF DISP LARGE ADULT FOR USE WITH UFEPAK MONITORS S 50 EA pm 5197-1) 99 DIAGNOSTIC BLOOD PRESSURE CUFF DISP SMALL ADULT FOR USE WITH LIFEPAK MONITORS 3 50 EA 52.56$129G) .. 100 DIAGNOSTIC DEFIB/PACING/ECG PADS ADULT W/QUIK-COMBO CONNECTOR 2FT LEAD,UfePak 12,LifePak 15 Y 40 EA 322.%$332k0 101 DIAGNOSTIC DEFIB/PACING/ECG PADS PEDI W/QUIK-COMBO CONNECTOR FOR LifePak 12&LifePak 10&LifePak 5 y 20 EA 32697 55394) 102 DIAGNOSTIC ELECTRODES 5/STRIP 50/BX 12BX/CS 5 30 CS 5104.36 53•T31110 103 DIAGNOSTIC ELECTRODES PEDIATRIC 3/PK 10PK/BX HUGGABLE j 2 BX $526 SL032 104 DIAGNOSTIC GLUCOSE TEST STRIPS,CAPILLARY,50/BX PRECISION XTRA ' 48 BX 52222 S1,055.55 105 DIAGNOSTIC _LANCETS,FINGERSTIX 200/BX S 4 BX 5332 5132l) 106 DIAGNOSTIC PAPER LP11,LP12,LP15 SIZE 108 MM X 23M ROLL,5 ROLLS/BX LIFEPAK S 75 BX 392 571923 ~ 107 DIAGNOSTIC PENUGHTS DISPOSABLE 6/PK S 18 PK $4,$S1776 108 DIAGNOSTIC RAZORS PREPARATION 50/BX GALLANT S 4 BX $132$7130 109 DIAGNOSTIC THERMOSCAN PRO4000 EAR THERMOMETER COVERS j 4 BX 314.72 59.16 110 DIAGNOSTIC TINCTURE OF BENZOIN SWABSTICKS INDIVIDUALLY WRAPPED SOPK/BX S 15 BX $10.15 S152.25 111 IMMOBIUZATION RESTRAINT DUAL LADDER LOCK 7 FT LOOPLOCK SAME LENGTH ORANGE PLASTIC DISP Y 200 EA $4.16$02.03 _ 112 IMMOBIUZATION RESTRAINT STRAP SEAT BELT BUCKLE LOOP END 2 PIECES 5 FT DISP. 5 7.36 24 EA S7.3g 511 113 IMMOBILIZATION EXTRICATION COLLAR,BABY NO-NECK S 1 10 EA 55.55 sSWIG _ 114 IMMOBILIZATION EXTRICATION COLLAR ADJUSTABLE PEDIATRIC STIFNECK PEDI-SELECT LAERDAL Y 10 EA 35.99 555.90 115 IMMOBILIZATION EXTRICATION COLLAR ADJUSTABLE,ADULT NASAL CANNULA HOOK STIFNECK SELECT LAERDAL T 250 EA 5523 SL 3O0.00 Attachment A Medical Supply Discount Off List and Pricing Worksheet ITEM CATEGORY ITEM DESCRIPTION 1 BRAND EST. UNITS UNIT EXTENDED g SPECIFIED,QTY. -PRICE PRICE (V/N) 116 IMMOBIUZATION HAND-E HAND HOLD DEVICE YELLOW Y 20 EA 5'681 533180_ 117 IMMOBIUZATION HEAD BLOCKS STICKY FOAM-PAIR S 200 PR SSG' S1,41q,41 118 IMMOBILIZATION VACUUM SPLINT SET DISPOSABLE S 5 SETS Si8S{.1 51423 119 INFECTION CONTROL BIOHAZARD WASTE BAG,1.2MIL,RED W/BLACK PRINT,23 IN X 23 IN,7-10 GAL j 500 EA WC. $4, , 120 INFECTION CONTROL BODY BAG BASIC VINYL STRAIGHT ZIPPER 6 GAUGE 36 IN X 90 IN 10/CS ] 75 EA 564; $43525 121 INFECTION CONTROL EMBAGS,EMESIS BAG 1500 mt.,50/pk j 1 PK 576CO 5%01_ 122 INFECTION CONTROL GERMICIDAL WIPES EXTRA LARGE SANI-CLOTH HB Y 100 TB 3772 S720I 123 INFECTION CONTROL GLOVES LATEX FREE POWDER FREE EXTENDED CUFF NITRILE EXTRA LARGE 50/BX 10BX/CS FREEFORM EC S 400 BX 3551 slum_ 124 INFECTION CONTROL GLOVES LATEX FREE POWDER FREE EXTENDED CUFF NITRILE LARGE 50/BX 10BX/CS FREEFORM EC Y 300 BX MO S255119 125 INFECTION CONTROL GLOVES LATEX FREE POWDER FREE EXTENDED CUFF NITRILE MEDIUM 50/BX 108X/CS FREEFORM EC S 200 BX Sa54 51?4100 126 INFECTION CONTROL GLOVES LATEX FREE POWDER FREE EXTENDED CUFF NITRILE SMALL 50/BX 10BX/CS FREEFORM EC Y 10 BX $554 555ff 127 INFECTION CONTROL HAND CLEANSER FOAMING ALCOHOL BASED 9 OZ 24/CS ALCARE PLUS y 4 _ CS 823123 SH57.12_ 128 INFECTION CONTROL RESPIRATOR N95 REGULAR SIZE 20/8X 68X/C5 3M Y 3D EA 5'953 $56a93 129 INFECTION CONTROL SLEEVE COVER 200/CS PPE Trauma sleeves Y 3 CS 344(1 5123.44 130 INFECTION CONTROL TRANSPORTABLE SHARPS CONTAINER,SHUTTLE W/LOCKING MECHANISM,11/2 IN D X 61/2 IN L j 50 EA I 5145 P250` 131 INFECTION CONTROL WASH BASIN,6 QUART,ROSE 50 EA/CS Y 50 EA S465 53401_ 132 IV ADMINISTRATION ALCOHOL PREP PADS LARGE 100/BX T 4 BX 5213 5352 133 IV ADMINISTRATION BD ECLIPSE SAFETY NEEDLE 18 G 100/BX ..Y 4 BX 52'72 $11188_ 134 IV ADMINISTRATION INTRAVENOUS(IV)ADMINISTRATION SET NEEDLE FREE 1 Y SITE 1 VALVE 10 DROP 83 IN 50/CS FS 20 CS 3117g0 ;1 ty'0$_ 135 IV ADMINISTRATION INTRAVENOUS(IV)ADMINISTRATION SET NEEDLE FREE 1 Y SITE 1 VALVE 60 DROP 83 IN 50/CS Y 5 CS $96(4 516144 136 IV ADMINISTRATION INTRAVENOUS(IV)DRESSING TRANSPARENT ADULT 100/BX 58X/CS VENI-GARD S 10 BX 536C2 538L20 137 IV ADMINISTRATION INTRAVENOUS(IV)EXTENSION SET NEEDLE FREE WITH 2 Y SITES 43 IN 48/CS INTERLINK 3 4 CS $12624 35006 138 IV ADMINISTRATION IV EXTENSION set WITH AMSAFE NEEOLELESS INJECTION SITE 8 IN 100/CS S 4 CS 5146 CO $556/i 139 IV ADMINISTRATION PRESSURE INFUSOR,1000 CC INFUSION CUFF W/THUMBWHEEL VALVE AND ANEROID GAUGE S 10 EA 5'19 $111'1_ 140 IV ADMINISTRATION SALINE FLUSH 0.9%,10 ML PREFILLED 12 ML LUER LOCK SYRINGE,100EA/BX 3 4 BX 536 CO NUM r 141 IV ADMINISTRATION SYRINGE ONLY LUER LOCK 10CC 100EA/BX S 2 BX $4 CO $1346 142 IV ADMINISTRATION SYRINGE ONLY LUER LOCK 60CC 40/BX BECTON DICKINSON S 5 BX 52155 5199.25 143 IV ADMINISTRATION SYRINGE ONLY,BD,5 CC,LUER-LOK TIP,STERILE, Y 2 BX 5'1C4 $2100 r 144 IV ADMINISTRATION TOURNIQUET,LATEX FREEE,1 IN X 18 IN,PRE-ROLLED 250/BG 10BG/CS T 10 CS 581 50 551 SOO 145 IV CATHETERS CATHETER INTRAVENOUS(IV)LATEX FREE 16 GAUGE X 1.25 IN 50/ax PROTECTIV S 2 BX 3l4C. 513101 Attachment A Medical Supply Discount Off List and Pricing Worksheet ITEM CATEGORY ITEM DESCRIPTION BRAND EST. UNITS.UNIT EXTENDED It' SPECIFIED QTY. PRICE PRICE (YIN) 146 IV CATHETERS CATHETER INTRAVENOUS(IV)LATEX FREE 18 GAUGE X 1.25 IN 50/BX PROTECTIV T 20 BX 390.03 51,370.)) 147 IV CATHETERS CATHETER INTRAVENOUS(IV)LATEX FREE 20 GAUGE X 1.25 IN 50/BX PROTECTIV T 20 BX =03 3f,37D:)]_ 148 IV CATHETERS CATHETER INTRAVENOUS(IV)LATEX FREE 22 GAUGE X 1 IN 50/BX PROTECTIV T 20 BX $90.93 s(,3)0.)') 149 IV CATHETERS CATHETER INTRAVENOUS(IV)LATEX FREE 14 GAUGE X 1.25 IN 50/BX PROTECTIV T 2 BX S9Q6) Sian r 150 IV COMPONENTS STOPCOCK 4 WAY W/SWIVAL AND MALE LUER LOCK _T ) 25 EA 51,13 321173 151 IV SOLUTIONS SODIUM CHLORIDE 0.9%1000ML 14EA/CS �T 20 CS �.93 saa}) 152 IV SOLUTIONS SODIUM CHLORIDE 0.9%100ML SINGLES 96EA/CS T 1 CS $177.63 $177.B3 153 IV SOLUTIONS SODIUM CHLORIDE 0.9%500ML 24EA/CS BAXTER N 40 CS SAD 52,23$33 154 MEDICATIONS ADENOCARD 12MG 4ML ANSYR SYRINGE 4 50 EA $36.52 54.275.)) 155 MEDICATIONS ADENOCARD 6MG/2ML ANSYR SYRINGE T 25 EA 3393 339.25 156 MEDICATIONS ALBUTEROL0.083%2.SMG/3ML25VIALS/BX ? 4 BX n.63 31433 157 MEDICATIONS AMIDATE/ETOMIDATE Lifeshield prefilled sym 40MG/20 ML T 40 EA 57.9) $3111.3) 158 MEDICATIONS AMIODARONE 150MG 3ML VIAL ti' 85 EA 51.9} 51B1.53 159 MEDICATIONS AMMONIA INHALANTS 10/BX T 10 BX 52.33 3Z1,}) 160 MEDICATIONS ANECTINE 200 MG,10 ML VIAL*REFRIGERATE*10EA/BX v 40 EA 528.113 51,15133 161 MEDICATIONS ASPIRIN CHILDREN'S CHEWABLE ORANGE FLAVOR 81MG 36/BT T 30 BT 51.4) 3Q2.}) 162 MEDICATIONS ATROPINE 1MG/10ML ANSYR PREFILLED SYRN. T 80 EA SHIN s3r.23 163 MEDICATIONS CALCIUM CHLORIDE 1GM 10ML ANSYR SYRINGE T 60 EA $10.43 $850,$) 164 MEDICATIONS DEXTROSE 50%50ML ANSYR SYRINGE T 44 EA 37.89 S347.161 165 MEDICATIONS DIAZEPAM SMG/ML 2ML LUER LOCKING CARPUJECT 10/8X T 10 BX 523213 52,329.93` 166 MEDICATIONS DILTIAZEM 100MG ADD-VANTAGE VIAL,NON-REFRIG,(ADD-VANTAGE DILUENT REQUIRED-SOLD SEPERATELY) T 10 EA $14.73 3147.93 167 MEDICATIONS DIPHENHYDRAMINE 50MG/ML 1ML BENADRYL 9 2s EA $1.93 S25.75-1 168 MEDICATIONS DOPAMINE400MG/D5W 250ML 12/CS T 62 EA $13.10 $311.53� 169 MEDICATIONS EPINEPHRINE 1:10001MG 1ML AMPULE v 75 EA 13.52 $254.337 170 MEDICATIONS EPINEPHRINE 1:100001 MG 10 ML LIFESHIELD SYRINGE 4 200 EA 36.99 51,198.)7` 171 MEDICATIONS FENTANYL,CLASS II,0.05MG/MI,2ML VIAL 7 20 EA S.;) 13313,3 172 MEDICATIONS FLUMAZENIL 0.5MG,SML VIAL 10 VIALS/BX ROMAZICON 4 3 EA M.I5 327.45 173 MEDICATIONS HYDROMORPHONE,DILAUDID CLASS II,2 MG/ML,1ML CARPUJECT T 30 EA 127.93 $33173 ~174 MEDICATIONS INSTA-GLUCOSE 31GM 12/CS T 4 CS $13.13 5172.32 175 MEDICATIONS LORAZEPAM 2MG 1ML VIAL 10/BOX•REFRIGERATE'• T 2 8X 521.7S� 313.53 Attachment A Medical Supply Discount Off List and Pricing Worksheet • ITEM CATEGORY REM DESCRIPTION BRAND EST. UNITS UNIT EXTENDED SPECIFIED QTY. PRICE PRICE- (Y/N) 176 MEDICATIONS METOPROLOL,5MG/SML VIAL Y 10 EA 3'52 41520 177 MEDICATIONS MIDAZOLAM"VERSED**5MG/ML 2ML VIAL 10/BOX Y 6 BX 514 E9 OEM 178 MEDICATIONS MORPHINE 10MG/ML 1ML Carpujet 10/BX Y 10 BX 524.64 $240.80' 179 MEDICATIONS NALOXONE 2MG 2ML LUER JET Y 70 EA S42.70 32.9k0 180 MEDICATIONS NITROGLYCERIN SOMG/D5W 250ML BTL Y 30 EA $i4.BA $4 .70; 181 MEDICATIONS NITROGLYCERIN LINGUAL SPRAY,400MCG/SPRAY,60 DOSES 12EA/CS Y 20 EA 3175.CO 33,501.80 182 MEDICATIONS ONDANSETRON,4 MG,2ML VIAL 25 EA/BX Y 40 EA 9.53 321.20 183 MEDICATIONS PANCURONIUM 1MG/1OML VIAL Y 70 EA 510.I'A S7110.0 184 MEDICATIONS QUELICIN 200MG 10ML VIAL•REFRIGERATION REQUIRED' Y 40 EA SZS,S$ 51,158,0 185 MEDICATIONS SODIUM BICARBONATE 4.2%10ML INFANT LIFESHIELD Y 10 EA S1',6S 5116.50 186 MEDICATIONS SODIUM BICARBONATE 8.4%LIFESHIELD SYRINGE Y 35 EA 51".C'2 $385.70 187 MEDICATIONS SOLU-MEDROL,125 MG,2 ML VIAL 25EA/BX Y 25 EA 5102S $25625 188 MEDICATIONS SALINE,UNIT DOSE MODUDOSE,3ML,0.9%NACL INHALER,EASY OPEN TWIST AND PULL 100 EA/BX Y 10 BX 51'.00 $110.C4 +189 MEDICATIONS VECURONIUM 10MG/10ML VIAL 10EA/BX Y 40 EA SAHEB 5355.2i! 190 OXYGEN DEUVERY TUBING CONNECTOR FITS TUBING FROM 7/32 TO 7/16 IN DIAMETER 5 IN 1 50/PK Y 2 PK 574$3 $148.66 191 OXYGEN DELIVERY NEBULIZER,SMALL VOLUME,HAND HELD WITH TEE,MOUTHPIECE,FLEXTUBE,7FT TUBING 50EA/CS Y 2 CS _ S 2.50 MA 192 OXYGEN DELIVERY OXYGEN MASK,ADULT,ELONGATED,HIGH CONCENTRATION,PARTIAL NON-REBREATHING METAL NOSE CUP 50 EA/CS Y I 8 CS 555.00 SKIN 193 OXYGEN DELIVERY OXYGEN NASAL CANNULA,ADULT,CONV.STYLE,CLEAR FLARED NASAL PRONGES,7 FT TUBING,SOEA/CS 'Y 1 6 CS 51450 WO Attachment B SUBMISSION PROPOSAL RESPONSE FORM SET PRICING FOR MEDICAL SUPPLIES AND PHARMACEUTICALS Proposer's Name and Mailing Address: Bound Tree Medical, LLC 5000 Tuttle Crossing Blvd Dublin, OH 43016 Telephone and Fax Numbers: I have included: • Proposal/Tabbed Sections ✓ • Medical Supply Discount Off List and Pricing Worksheet (Attachment A) • Submission Proposal Response Form (Attachment Ii) 1/ • Non-Collusion Affidavit (Attachment C) • Lobbying and Conflict of Interest Clause Form (Attachment D) • Drug Free Workplace Form (Attachment E) • Public Entity Crime Statement (Attachment F) • Local Preference Form (Attachment G) y! • Scope of Services Response Form (Attachment H) • Insurance Requirements,Indemnification/Hold Harmless, and Request for Waiver of Insurance Requirements (Attachment I) ►/ (Check mark items above, as a reminder that they are included). I state that I am authorized to submit this proposal. (' STATE OF Ohio ignature of Proposers) COUNTY OF Franklin Vice President Date 9/06/2016 PERSONALLY APPEARED BEFORE ME,the undersigned authority, la; L d n o 1. G t t h who,after first being sworn by me,(name of individual signing)affi )#.1 • mature in the space provided above on this 6th day of��'_a••`.y_ �� 20 16 La61.(r4 Davld Et*II My commission e= NOTARY PUBLI- r' s,NII/II'%" Attachment C NON-COLLUSION AFFIDAVIT 1, Rhiannon Greene ,according to law,on my oath,and under penalty of perjury,depose and say that: 1. I am Vice President ,ofthe firm of Bound Tree Medical, LLC the bidder/responder making the proposal for the project described in the Notice of Request for Competitive Solicitations for: Medical Supplies and Pharmaceuticals and I executed the said proposal with full authority to do so. 2. The prices in this proposal have been arrived at independently without collusion,consultation,communication or agreement for the purpose of restricting competition,as to any matter relating to such prices with any other bidder/responder or with any competitor. 3. Unless otherwise required by law, the prices which have been quoted in this proposal have not been knowingly disclosed by the bidder/responder and will not knowingly be disclosed by the bidder,'responder prior to the opening of the responses, directly or indirectly,to any other bidder/responder or to any competitor. 4. No attempt has been made or will be made by the bidder/responder to induce any other person,partnership or corporation to submit,or not to submit,a proposal for the purpose of restricting competition. 5. Th ents contained in this affidavit are true and correct,and made with full knowledge that Monroe County relies upon e truth of statements contained in this affidavit in awarding contracts for said project. •lliel 09/06/2016 (Signature ofBidder/Responder) (Date) Rhiannon Greene, Vice President Print Name/Title STATE OF: Ohio COUNTY OF: Franklin PERSONALLY APPEARED BEFORE ME,the undersigned authority, Yt 0 V\, 6 I' Q (name of individual signing Affidavit),who,after first being sworn by me,affixed his/her signature in the space provided above on this 6th day of September 20 16 Y 0.1,0 M Commissigif = �, ' David Mello II ' Allf&Ab �i=_ NOTARY ' IC fteu6fa teM d ON0 Attachment D LOBBYING AND CONFLICT OF INTEREST FORM SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MVIONROE COUNTY.FLORIDA ETHICS CLAUSE Rhiannon Greene, Vice President warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10- 1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision, the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover,the full amount of any fee,commission,percentage,gift, or consideration paid to the former County officer or employee. (Signature) Date: 9/06/2016 STATE OF: Ohio COUNTY OF: Franklin �j 1 fl PERSONALLY APPEARED BEFORE ME,the undersigned authority, ? C, K*or Cyu1n t (name of individual signing Affidavit), who, after first being sworn by me, affixed his/her signature in the space provided above on this 6th day of September 20 16 . My Commission Expires: - 1 a O a fr / � , '�. A. 114f*'L : ., ' NOT; 'Y PUBLIC David Zitello II '•� .�:-•i ,ice°.� Attachment E DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: Bound Tree Medical, LLC (Name of Business) I. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation,and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection(1). 4. In the statement specified in subsection(1), notifies the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of,or plea of guilty or nolo 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. Imposes a sanction on,or requires the satisfactory participation in,a drug abuse assistance or rehabilitation program if such is available in the employee's community,for any employee who is so convicted. 6. Makes a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign the statement,I certify that this firm complies fully with the above requirements. Bidder's Signature Rhiannon Greene, Vice President 9/06/2016 Date ott�IAtNeito i %= David Mello II Nol.ri,s>tastmoaado Attachment F PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work,may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017,Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." I have read the above and state that neither Bound Tree Medical, Lt,C (Proposer's name) nor any Affiliate has been placed on the convicted vendor list within the last 36 months. (Signature) Rhiannon Greene, Vice President Date: 9/06/2016 STATE OF: Ohio COUNTY OF: Franklin Subscribed and sworn to(or affirmed)before me on the 6th day of September ,20 16 , by �k i d IA'I\or, ( rQ n (name of individual signing Affidavit). He/She is personally known to me or has produced (type of identification)as identification. My Commission Expires: $' �� d" o /�` -4•V / $ � flf/_—°IC,% David_ZZte110 II NOTARY % .BLIC -. s gNolypidomedow %�Salo° Attachment G **Not Applicable LOCAL PREFERENCE FORM ** A. Vendors claiming a local preference according to Ordinance 023-2009 must complete this form. Name of Bidder/Responder Date: 1. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector dated at least one year prior to the notice or request for bid or proposal? (Please furnish copy.) 2. Does the vendor have a physical business address located within Monroe County from which the vendor operates or performs business on a day to day basis that is a substantial component of the goods or services being offered to Monroe County? List Address: Telephone Number: B. Does the vendor/prime contractor intend to subcontract 50%or more of the goods,services or construction to local businesses meeting the criteria above as to licensing and location?_ If yes,please provide: Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the . subcontractor dated at least one year prior to the notice or request for bid or proposal. 2. Subcontractor Address within Monroe County from which the subcontractor operates: Telephone Number Address Address Print Name: Signature and Title of Authorized Signatory for Bidder/Responder STATE OF COUNTY OF On this day of , 20 , before me, the undersigned notary public, personally appeared , known to me to be the person whose name is subscribed above or who produced as identification,and acknowledged that he/she is the person who executed the above Local Preference Form for the purposes therein contained. My commission expires: Notary Public (Seal) Print Name **This Form is only required if Local Preference is applicable pursuant to Sec.2-349,Monroe County Code. Attachment H - Scope of Services Response Form 12016 The Proposer will be evaluated on compliance with the below service requirements. By submitting a proposal,the Proposer agrees that these provisions will be part of the agreement between the parties. YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) QUAUTY ASSURANCE PROVISIONS Ordered Supplies/Receiving: A system of test inspections shall be used to assure quality and quantity of materials received by County. Materials will be promptly inspected and any discrepancies from the purchase order and/or the supplier's invoice shall be reported immediately by the x Monroe County Logistics Specialist to the Supplier and shall be corrected within a two(2)business day time frame when the County has made that report within normal working hours of 8 am to 5 pm Monday through Friday. Material Safety Data Sheet(MSDS): Any items delivered must be accompanied by a MSDS. The MSDS will be maintained by the County and must include the following information: 1. The Chemical name and the common name of the x toxic substance. 2. The hazards or other risks in the use of the toxic substance,including: a) The potential for fire,explosion,corrosively x and reactivity; b) The known acute and chronic health effects of risk from exposure,including the medical conditions which are generally recognized as being aggravated by exposure to the toxic substance;and c) The primary routes of entry and symptoms of overexposure. 3. The proper precautions,handling practices, necessary personnel protective equipment,and x Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) other safety precautions in the use of,or exposure to,the toxic substances,including appropriate emergency treatment in the case of overexposure. 4. The emergency procedure for spills,fires,disposal x and first aid. 5. A description,in lay terms,of the known specific potential health risks posed by the toxic substance intended to alert any person reading this information. 6. The year and month,if available,that the information was compiled and the name, address,and emergency telephone number of the manufacturer responsible for preparing the information. Supply Time: I Proposers must be able to supply contracted requested supplies within a three(3)business day time frame of • normal request of supplies when the County has made X that request within normal working hours of 8 am to 5 pm Monday through Friday. Natural or Man-Made Emergencies: During emergency(natural or man-made emergencies) situations,Proposers must be able to supply requested supplies on a next day basis,twenty-four(24)hours a day seven(7)days a week. PROPOSER'S LIAB ILITY Warranty: It shall be the Proposer's responsibility to submit at the time of shipment the original manufacturer's warranty for the materials supplied. Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply,but with specified deviations comply comply (please detail deviations below) Defects: Upon un-packaging and discovering defects to materials shipped by Supplier,any medical supplies and/or pharmaceuticals requiring replacement shall be finalized within five(5)working days of reporting the defect. • (See also information required behind Tab 2 regarding warranties and replacements.) Guarantee: The material(s)supplied shall be guaranteed to be free from defect of composition,conception and workmanship for a minimum period of 120 days from the date of acceptance by the County.Any parts or :{ portions found not in accordance with this specification will be rejected by the County and returned to the Proposer at the Proposer's expense for immediate replacement. Quality: -----The materials to be furnished shall be currently in production and shall be of the manufacturer's standard x or better quality. Quantities: The quantities listed on the Medical Supply Discount Off List and Pricing Worksheet(Attachment A)are estimated quantities for one(1)year and are for cost comparison only. Any reference to forecasted or estimated quantities within the proposal documents is intended to inform the proposers of approximate x annual requirements.The County shall not be required to purchase any minimum or maximum quantities during the term of any award resulting from this specification.The County may purchase as little as zero percent(0%)or exceed as much as one hundred percent(100%)of the forecasted or estimated quantities. Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) Packaging: Only Materials that are packaged In the original factory fresh packaging shall be accepted.No materials that have been re-packaged or that are in the adulterated or damaged packages shall be accepted at the receiving location,nor shall after-market materials be accepted at the receiving location.Any attempts by the Proposers to furnish the County with other than first quality materials shall constitute default as outlined in this specification. Refrigeration: Maintaining a specific temperature range throughout the shipping process is essential to the quality of healthcare products. Proposer has the ability to ship products in a proper temperature-controlled environment. Only materials which have been properly shipped in a temperature-controlled environment shall be accepted by the COUNTY. Expiration Dates: Where applicable,all merchandise shall have a minimum expiration date of 18 months from date of shipment,and date must be displayed on the package. CONDITIONS Authorization: Proposer has the ability to handle orders placed by the electronic ordering software Operative IQ. (All orders shall be placed via Monroe County by individual Purchase Orders generated by the County's electronic ordering software,Operative IQ,or as"Open"Purchase orders.) Furnishing Proposal Items: Contract items are to be furnished on an"as needed, when needed basis"during the life of the contract. x Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) Delivery: Materials ordered shall be delivered within three(3) business days after receipt of order.Failure to do same x shall be considered breach of contract or default,and the County shall utilize its options as stated within the contract. Backorders: In the event an item is not immediately available at the time of an order,and able to be delivered within three (3)days,the County shall have the option of purchasing x the item from another vendor. Penalties: The County reserves the right to increase or decrease quantities shown without penalty. Samples(Medical Supplies only): From time to time,either at the stage of the Proposal or subsequently while the contract is in force,the Proposer may wish to recommend an alternative to an item listed on MedicalSupply Discount Off List and Pricing Worksheet(Attachment A). In those situations, the County may require the Proposer or the Proposer may elect to submit a sample for Inspection,to ensure x that the alternative is of similar quality. Such samples shall be labeled with the Proposer's name and item number and shall be furnished free of charge. The vendor can determine whether the sample should be returned or destroyed. Samples not destroyed will be returned upon request at the Proposer's expense within ten days following receipt of the sample. Substitution: No items will be substituted without the prior written approval of the County. Any violation of such procedure may result in a possible cancellation of the x contract. All approved substitutes shall be annotated as such on the Proposer's shipping document(s). Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) Proposal Prices: Proposal prices quoted on Medical Supply Discount Off List and Pricing Worksheet(Attachment A)shall be firm and shall not be amended after the dates and time of x the proposal opening. Any attempt by the Proposer to amend said proposal prices shall constitute default as outlined in this specification. Shipping Costs: Prices quoted in the Proposal and Proposal Response form shall include all shipping costs,shipped F.O.B x Marathon,Florida or to the facility location specified by the requestor or the purchase order. Taxes: All taxes of any kind and character payable on account of the word done and materials furnished under the award shall be paid by the Proposer and shall be deemed to have been included in the proposal. The County is exempt from all state and federal sales,use, transportation,and excise taxes. Infringement: Proposal prices must include all royalties and costs arising from patents,trademarks,and copyrights in any way involved in the work. Whenever the Proposer is required or desires to use any design,device,material or process covered by letters of patent or copyright,the Proposer shall indemnify and save harmless the County, its officers,agents,and employees from any and all x claims of infringement by reason of the use of any such patented design,toll,material,equipment or process, to be performed under the contract,and shall indemnify the said County,its officers,agents and employees for any costs,expenses and damage which may be incurred by reason of any infringement at any time during the prosecution or after the completion of the work. Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) Award Changes: No changes,over the contract period,shall be permitted unless prior written approval is given by the County and,where applicable,confirmed by the Monroe County Board of Commissioners. Assignment: No Proposer shall assign the contract or any rights or obligations thereunder to a subcontractor without the written consent of the County and approval of the Monroe County Board of Commissioners. Price Escalation: The County will allow a price escalation provision with this award. The original proposal prices quoted on Medical Supply Discount Off List and Pricing Worksheet (Attachment A)shall be firm for a one(1)year minimum period. A price escalation/de-escalation will be allowed one(1)year after the beginning of the award period and at one(1)year intervals thereafter, provided the Proposer notifies the County,in writing of any requested price changes at least sixty(60)days prior to those changes taking effect. This request must be accompanied by a certified letter from the Proposer's supplier showing the price increase to the contractor.The price increase to the County shall be limited to the percentage Increase to the Proposer as stated in this letter. If,at the point of exercising the price escalation provision,market media indicators show that the prices have decreased,and that the Proposer has not passed the decrease on to the County,the County reserves the right to place the Proposer in default,cancel the contract,and remove the Proposer from the County's proposer list for a period of time deemed suitable to the County. Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) Invoicing: The Proposer shall furnish the County complete itemized invoices for the goods received. Invoices are to reflect the prices stipulated on the purchase order and as outlined on the Medical Supply Discount Off List and Pricing Worksheet(Attachment A). Invoices are also to reflect the provisional price discount in the form of a percentage at which the Proposer will sell these items off its list price. The County will not accept an aggregate invoice. As part of the award process,the County may request a sample invoice. Invoices shall contain, but not limited to the following information: • Invoice number • Company name • Purchase order number • Location and dates of delivery • Cost of items as stated on Proposal Response and extended price to reflect total cost for number of items received. Prompt Payment Act: The Proposer agrees to accept payment per the terms of the Florida Local Government Prompt Payment Act. Normal processing time is approximately 30 days from presentation of the invoice. Ordering: Proposers will provide web-based online ordering website designed specifically for service. x Disaster Recovery: Proposers have a proven Disaster Support Program in place and can demonstrate previous experience in disaster recovery supply chain management and shall x provide the County with emergency numbers for these situations.These numbers will be updated immediately if the contact number changes. Attachment H - Scope of Services Response Form 12016 YES NO YES SERVICE REQUIREMENT can cannot Can comply, comply comply but with specified deviations (please detail deviations below) Indemnification and Insurance Requirements: The Proposer can comply with the insurance requirements outlined in Attachment Ito the RFP,or has submitted a Request for Waiver(also found in Attachment I). Also,the Proposer can comply with the indemnification and hold harmless requirements(also found in Attachment I). • A CERTIFICATE OF LIABILITY INSURANCE °A'E(M�°0 01/13/2017 17 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(les)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 412. certificate does not confer rights to the certificate holder in lieu of such endorsement(s). r, PRODUCER CONTACTNAME: -o Aon Risk Services Northeast, Inc. PHONE (866) 283-7122 FAX (600) 363-0105 L. Columbus OH office (A/C.No.Ext): (A/C.No.): 445 Hutchinson Avenue E-MAIL Suite 900 ADDRESS: _ Columbus OH 43235 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Fire insurance Co. 19682 Sarnova, Inc., Bound Tree Medical, LLC INSURER B: Hartford Casualty Insurance Co 29424 5000 Tuttle Crossing Blvd. Dublin OH 43016 USA INSURER C: Sentinel Insurance Company, Ltd 11000 INSURER D: Medmarc Casualty Ins Co 22241 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570065283042 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. Limits shown are as requested INSR 'ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYW) `(MMIDD1yYYa LIMITS A X COMMERCIAL GENERAL LIABILITY Y 33UUNVG3435 12/01/2016 12/01/2017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE nOCCUR DAMAGETORENIED $300,000 PREMISES(Ea occurrence) MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY S1,000,000 i GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S2,000,000 m 1 POLICY nJEC I I LOC PRODUCTS-COMP/OPAGG eN Excluded el co OTHER: o C Y 33 UUN VG3435 12/01/2016 12/01/2017 COMBINED SINGLE LIMIT to LIABILITY 51,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) O — OWNED SCHEDULED BODILY INJURY(Per accident) - « AUTOS ONLY AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE A ONLY AUTOS ONLY (Per accident) _ - --- . --- O i_ tti a) B X UMBRELLA LIAB X OCCUR 33RHUVG1892 12/01/2016 12/01/2017 EACH OCCURRENCE' $10,000,000 U ,— EXCESS LIAB CLAIMS-MADE AGGREGATE 1 S10,000,000 DED X RETENTION$10,000 WORKERS COMPENSATION AND PER STATUTE OTH- EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER I EXECUTIVE (�( E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? I I N I A (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE It yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT _ D Products Liab 160H380015 12/01/2016 12/01/2017 Aggregate Limit 510,000,000 claims Made SIR Aggregate 5150,000 MI SIR applies per policy terms & conditions Per Occ Limit S10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Re: Account No. 104754. Monroe County BOCC is included as Additional Insured in accordance with the policy provisions of the General Liability and Auto Liability policies. NI Aft CEMENT/ 7 DA WAIV R N/AEG YES— X_ CERTIFICATE HOLDER CANCELLATION 1 �j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE lie- . EXPIRATION DATE THEREOF, NOTICE WILL.BE DELIVERED IN ACCORDANCE WITH THE . POLICY PROVISIONS. Monroe County BOCC AUTHORIZED REPRESENTATIVE 1111 12th St. suite 408 Hin Key west FL 33040 USA IBIA. e_Q4 .c am. , .�,.a M IIi 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000037575 LOC#: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services Northeast, Inc. Sarnova, Inc., Bound Tree Medical, LLC POLICY NUMBER See Certificate Number: 570065283042 CARRIER NAIC CODE See Certificate Number: 570065283042 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURERS)AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. INSR ADDL SUBR POLICY NUMBER POLICY POLICY LIMITS DATE LTR TYPE OF INSURANCE INSD WVD EFFECTIVE DATEEXPIRATION (MM/DD/YYYY) (MM/DD/YYYY) OTHER p Products Liab 160H380015 12/01/2016 12/01/2017 SIR Per 550,000 Claims Made occurrence SIR applies per policy terms & conditions ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:SARNINC-01 BDICKSON LOC#: A`OR Er ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Thompson Flanagan Executive Liability Group 5000 Tuttle Inc. Tree Medical,LLC POLICY NUMBER P.O.BOX 8023 SEE PAGE 1 Dublin,OH 43016 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Named Insureds 1.Sarnova,Inc. FEIN:262386055 2.Bound Tree Medical Products,Inc. FEIN:731646550 3.Tri-Anim Health Services, Inc. FEIN:952959155 4.Bound Tree Medical,LLC FEIN:311739487 5.Sarnova HC LLC FEIN:262549813 6.Emergency Medical Products Inc. FEIN:391164909 7.Cardiovascular Concepts,Inc. FEIN:751835412 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD