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BRANCH OFFICE CLERK OF THE CIRCUIT COURT BRANCH OFFICE
3117 OVERSEAS HIGHWAY MONROE COUNTY 88820 OVERSEAS HIGHWAY
MARATHON,FLORIDA 33050 500 WHITEHEAD STREET PLANTATION KEY,FLORIDA 33070
TEL.(305)289-6027 KEY WEST,FLORIDA 33040 TEL.(305)852-7145
FAX(305)289-1745 TEL.(305)292-3550 FAX(305)852-7146
FAX(305)295-3660
MEMORANDUM
TO: Deanna Lloyd
Grants Manager •
FROM: Ruth Ann Jantzen, Deputy Clerk • 49/
DATE: March 4, 1999..
On January 13, 1999, the Board of County Commissioners
granted approval and authorized execution of a Contract between
Monroe County and The--=Gu dance7zC nic=of _th Midd1e:.Iceys,, for the
implementation of the Keys fo_:Recovery-progrAlif.
Enclosed please find a fully executed copy of the above
named contract for, return to The Guidance Clinic.
If you have any questions regarding the above, please do not
hesitate to contact this office.
cc: County Attorney
Finance
County Administrator, w/o document
File
s
KEYS TO RECOVERY FUNDS AGREEMENT
THIS AGREEMENT is made and entered this / 3 ' II
day of - 1,4NvAgi , 1999 by and
between MONROE COUNTY, a political subdivision of the State of Florida, whose address is 5100
College Road, PSB Wing II, Stock Island, Key West, FL 33040, hereinafter referred to as "COUNTY,"
and the GUIDANCE CLINIC OF THE MIDDLE KEYS, INC., whose address is 3000 41st Street, Ocean,
Marathon, FL 33050, hereinafter referred to as "GUIDANCE CLINIC."
WITNESSETH
WHEREAS, the GUIDANCE CLINIC has previously conducted the Keys to Recovery
Program with a subgrant of Anti-Drug Abuse Act Funds to the County, providing alternatives to
incarceration and recovery therapy for non-dangerous criminal offenders; and
WHEREAS, the GUIDANCE CLINIC is the sole provider of this social model program; and
WHEREAS, the program has shown a 57% success rate; and
WHEREAS, the COUNTY desires to continue to provide rehabilitative services and
residential facilities under this Program; and
WHEREAS, the COUNTY desires to fund the Program out of the Fine and Forfeiture Fund;
now therefore,
IN CONSIDERATION of the mutual understandings and agreements set forth herein, the
COUNTY and the GUIDANCE CLINIC agree as follows:
Section 1. TERM - The term of this Agreement is from October 1, 1998, through
September 30, 1999, the date of the signature by the parties notwithstanding, unless earlier
terminated as provided herein.
Section 2. SERVICES - The GUIDANCE CLINIC will provide rehabilitative services as
outlined in the Keys to Recovery attached hereto as Attachment A and made a part hereof.
Section 3. FUNDS - Payment is contingent upon availability of funding from the Fine
and Forfeiture Fund and shall not exceed the total sum of$68,482.
Section 4. BILLING AND PAYMENT
(a) The GUIDANCE CLINIC shall render to the COUNTY, at the close of each calendar
month, an itemized invoice properly dated, describing the services rendered, the cost of the
services, and all other information required by the Program Director. The original invoice shall be
sent to:
Ms. Deanna Lloyd, Grants Management �y
Public Service Building, Wing II
5100 College Road, Stock Island ,--
Key West, FL 33040 �-`
(b) Payment shall be made after review and approval by the COUNT WitIn t1{yty ( )
days of receipt of the correct and proper invoice submitted by GUIDANCE CLINI&
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Section 5. TERMINATION - This Agreement may be terminated by either party at any
time, with or without cause, upon not less than thirty (30) days written notice delivered to the other
party. The COUNTY shall not be obligated to pay for any services provided by the GUIDANCE
CLINIC after the GUIDANCE CLINIC has received notice of termination. In the event there is
any overpayment, the GUIDANCE CLINIC shall promptly refund those funds to the COUNTY or
otherwise use such funds as the COUNTY directs.
Section 6. ACCESS TO FINANCIAL RECORDS - The GUIDANCE CLINIC shall maintain
appropriate financial records which shall be open to the public at reasonable times and under
reasonable conditions for inspection and examination.
Section 7. AUDIT - The GUIDANCE CLINIC shall submit to the COUNTY an audit report
covering the term of this Agreement, within one-hundred twenty (120) days following the
Agreement's lapse or early termination and shall also comply with all provisions of the Agreement
incorporated in Section 4 of this Agreement.
Section 8. NOTICES - Whenever either party desires to give notice unto the other, it
must be given by written notice, sent by registered United States mail, with return receipt
requested, and sent to:
FOR COUNTY FOR GUIDANCE CLINIC:
Ms. Deanna Lloyd, Grants Management Dr. David Rice
Public Service Building Chief Executive Officer
5100 College Road, Stock Island 3000 41st Street, Ocean
Key West, FL 33040 Marathon, FL 33050
Either of the parties may change, by written notice as provided above, the addresses or
persons for receipt of notices.
Section 9. UNAVAILABILITY OF FUNDS - If funding cannot be continued at a level
sufficient to allow for the services specified herein, this Agreement may then be terminated
immediately, at the option of the COUNTY, by written notice of termination delivered in person or
by mail to the GUIDANCE CLINIC at its address specified above. The COUNTY shall not be
obligated to pay for any services provided by the GUIDANCE CLINIC after the GUIDANCE CLINIC
has received notice of termination.
Section 10. COMPLIANCE WITH LAWS AND REGULATIONS - In providing all services
pursuant to this Agreement, the GUIDANCE CLINIC shall abide by all statutes, ordinances, rules,
and regulations pertaining to, or regulating the provision of, such services, including those now in
effect and hereafter adopted, and particularly Article I, Section 3 of the Constitution of the State
of Florida and Article I of the United States Constitution, which provide that no revenue of the
state or any political subdivision shall be utilized, directly or indirectly, in aid of any church, sect or
religious denomination or in aid of any sectarian institution. Any violation of said statutes,
ordinances, rules, or regulations shall constitute a material breach of this Agreement immediately
upon delivery of written notice of termination to the GUIDANCE CLINIC. If the GUIDANCE CLINIC
receives notice of material breach, it will have thirty days in order to cure the material breach of
the contract. If, after thirty (30) days, the breach has not been cured, the contract will
automatically be terminated.
2
•
Section 11. ASSIGNMENTS AND SUBCONTRACTING - Neither party to this Agreement
shall assign this Agreement or any interest under this Agreement, or subcontract any of its
obligations under this Agreement, without the written consent of the other.
Section 12. EMPLOYEE STATUS - Persons employed by the GUIDANCE CLINIC in the
performance of services and functions pursuant to this Agreement shall have no claim to pension,
worker's compensation, unemployment compensation, civil service or other employee rights or
privileges granted to the COUNTY'S officers and employees either by operation of law or by the
COUNTY.
Section 13. INDEMNIFICATION - The GUIDANCE CLINIC agrees to hold harmless,
indemnify, and defend the COUNTY, its commissioners, officers, employees, and agents against
any and all claims, losses, damages, or lawsuits for damages, arising from, allegedly arising from,
or related to the provision of services hereunder by the GUIDANCE CLINIC.
Section 14. INSURANCE - The GUIDANCE CLINIC shall comply with the Monroe County
Risk Management Manual governing insurance requirements for contractors performing work for
Monroe County, Florida, incorporated in Attachment B.
Section 15. ENTIRE AGREEMENT
(a) It is understood and agreed that the entire Agreement of the parties is contained
herein and that this Agreement supersedes all oral agreements and negotiations between the
parties relating to the subject matter hereof as well as any previous agreements presently in effect
between the parties relating to the subject matter hereof.
(b) Any alterations, amendments, deletions, or waivers of the provisions of this
Agreement �a.N-be.valid only when expressed in writing and duly signed by the parties.
„, ,1 NE,SS;WHEROF, the parties to this Agreement have caused their names to be affixed
heret ,lyrproper officers thereof for the purposes herein expressed at Monroe County, Florida,
on th `dpiy and year first written above.
(SEAL) BOARD OF COUNTY COMMISSIONERS
ATTEST: .
OF MONROE COUNTY, FLORIDA
�:" .. : �-�->'
a •
By
Depu Jerk Mayor/Chairman
THE GUIDANCE CLINIC OF THE
MIDDLE KEYS, INC.
By
Witness hief Executive Officer
jconiiirecovery
r:>PROVED AS TO FOR
N A. HU TON
'^:ATE I C
3
ATTACHMENT "A"
• KEYS TO RECOVERY
1669 Overseas Highway
Marathon, FL 33050
(305) 743-8484
11-19-98
Description: Keys to Recovery is a 12 bed non-secure residential drug/alcohol treatment
program. Duration of the program is six months. Capacity is 12 beds.
Location: Upper floor of the building located at 1669 Overseas Highway.
Program: The program is divided into two phases.
-The initial phase (Intensive Treatment Component) is two months long
and focuses on intensive substance abuse treatment.
- The second phase (Employment Re-entry Phase) is four months long.
During this phase the client enters the work force with full-time day job.
He returns to KTR by 5:15 PM and continues to participate in the
treatment program.
Services: Prior to entry: Complete psychosocial and screening
Entry: Orientation; physical; TB, STD &Hepatitis B testing. AIDS
testing is available on a voluntary basis.
ITC Phase: Individual Counseling One hour per week
Group Counseling Fourteen hours per week
Educational Groups Three hours per week
Physical Ed Three hours per week
Drug Testing One test per week
12 Step Support Ten per week
ERC Phase: Individual Counseling One hour per week
Group counseling Six hours per week
Educational Groups As needed
Drug Testing One per week
12 Step Support Seven per week
Employment Maximum of 40 hours per week
Added services: Optional Acupuncture
Coordination with Public Health Services
Coordination with Psychological/Psychiatric Services
Coordination with Vocational Rehabilitation
Coordination with the Judicial System, Department of Corrections and
Public Defender
Access to Salvation Army
Alumni/Family groups
90 day Aftercare
1996 Edition
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
General Insurance Requirements
for
Other Contractors and Subcontractors
As a pre-requisite of the work governed, or the goods supplied under this contract(including the
pre-staging of personnel and material), the Contractor shall obtain, at his/her own expense,
insurance as specified in any attached schedules, which are made part of this contract. The
Contractor will ensure that the insurance obtained will extend protection to all Subcontractors
engaged by the Contractor. As an alternative, the Contractor may require all Subcontractors to
obtain insurance consistent with the attached schedules.
The Contractor will not be permitted to commence work governed by this contract (including
pre-staging of personnel and material) until satisfactory evidence of the required insurance has
been furnished to the County as specified below. Delays in the commencement of work,
resulting from the failure of the Contractor to provide satisfactory evidence of the required
insurance, shall not extend deadlines specified in this contract and any penalties and failure to
perform assessments shall be imposed as if the work commenced on the specified date and time,
except for the Contractor's failure to provide satisfactory evidence.
The Contractor shall maintain the required insurance throughout the entire term of this contract
and any extensions specified in the attached schedules. Failure to comply with this provision
may result in the immediate suspension of all work until the required insurance has been
reinstated or replaced. Delays in the completion of work resulting from the failure of the
Contractor to maintain the required insurance shall not extend deadlines specified in this contract
and any penalties and failure to perform assessments shall be imposed as if the work had not
been suspended, except for the Contractor's failure to maintain the required insurance.
The Contractor shall provide, to the County, as satisfactory evidence of the required insurance,
either:
• Certificate of Insurance
or
• A Certified copy of the actual insurance policy.
The County, at its sole option, has the right to request a certified copy of any or all insurance
policies required by this contract.
All insurance policies must specify that they are not subject to cancellation, non-renewal,
material change, or reduction in coverage unless a minimum of thirty (30) days prior notification
is given to the County by the insurer.
The acceptance and/or approval of the Contractor's insurance shall not be construed as relieving
the Contractor from any liability or obligation assumed under this contract or imposed by law.
Administration Instruction
#4709.3 14
1996 Edition
•
The Monroe County Board of County Commissioners, its employees and officials will be
included as "Additional Insured" on all policies, except for Workers' Compensation.
Any deviations from these General Insurance Requirements must be requested in writing on the
County prepared form entitled "Request for Waiver of Insurance Requirements" and
approved by Monroe County Risk Management.
Administration Instruction
#4709.3 15
•
1996 Edition
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
General Liability Insurance. Coverage shall be maintained throughout the life of the contract and
include, as a minimum:
• Premises Operations
• Products and Completed Operations
• Blanket Contractual Liability
• Personal Injury Liability
• Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$300,000 Combined Single Limit(CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its
provisions should include coverage for claims filed on or after the effective date of this contract.
In addition, the period for which claims may be reported should extend for a minimum of twelve
(12) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on
all policies issued to satisfy the above requirements.
GL1
Administration Instruction
#4709.3 54
1996 Edition
VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract requires the use of vehicles, the Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for:
• Owned,Non-Owned, and Hired Vehicles
The minimum limits acceptable shall be:
$100,000 Combined Single Limit(CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 50,000 per Person
$100,000 per Occurrence
$ 25,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on
all policies issued to satisfy the above requirements.
VL1
Administration Instruction
#4709.3 81
SWORN STATFMFi\tT j�Np R nRTlilstel`r�� �p 10 199�
F COj1NTY FT n>7In n
ETHICS CLAUSE.
•
• QVie)
P warrants that he/it
has not employed, retained
or othenvise 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 Count
mav, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or othenvise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
d/
(signature)
STATE OF ,,/_'/(.,rm.
COUNTY OF f1��flr
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixet.Wher
signature(name of individual signing) in the space provided above on this, of
199�
N TARY PUBLIC
My commission expires: ,
„e„""•;•t; Penelope R.Rice
?., tit ?* MY COMMISSION#CC568955 EXPIRES
August 22,2000
OMB MCP FORM I/4
P,„ BONDED 7HRU TROY FAIN INSURANCE,INC,
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 consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CAT>✓GORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
ATTACHMENT I
Expense Reimbursement Requirements
This document is intended to provide "basic" guidelines to Human Service Organizations, county
travellers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061
which is attached for reference.
A cover letter summarizing the major line items on the reimbursable expense -equest should also
contain a certified statement such as:
I certify that the attached expenses are accurate and in agreement with the records of this
organization. Furthermore, these expenses are in compliance with this organization's contract
with the Monroe County Board of County Commissioners.
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the Ievel of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to Stephanie Griffiths at 305-292-3528.
Payroll:
A certified statement verifying the accuracy and authenticity of the-payroll expenses.
If a Payroll Journal is provided, it should include:
Payroll Journal dates
employee name, salary, or hourly rate
hours worked during the payroll journal dates
withholdings where appropriate
check number and check amount
If a Payroll Journal is not provided the following must be listed:
check number, date, payee, check-amount
support for applicable payroll taxes
Original vendor invoices must be submitted for Worker's Compensation an:: :ia.bility insurance
coverage:
Telephone expenses:
A user log of pertinent information must be remitted: the party called, the caller, the telephone
number, the date, and the purpose of the call must be identified.
Telefax, fax, etc.:
A fax log is required. The log must define the sender, the intended recipient, the date, the number
called, and the reason,for sending the fax. .
Supplies, services, etc.:
For supplies or services ordered the County requires the original vendor invoice.
Rents, leases, etc.:
A copy of the rental agreement or lease is required. Deposits and advance p::_yments will not be
allowable expenses.
Postage, overnight deliveries, courier, etc.:
A log of all postage expenses as it relates to-the County contract is required for reimbursement.
For overnight or express deliveries, the original vendor invoice must be included.
Reproductions, copies, etc.:
A log of copy expenses' as it relates to the County contract is required for rc imbursement. The
log must define the date, number of copies made, source document, purpo:;e, and -ecipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the original vendor
invoice is required and a sample of the finished product.
Travel expenses: please refer to Florida Statute 112.061.
Travel expenses must be submitted on a State of Florida Voucher for Reimi- 'irsement of
Travel Expenses. Credit card statements are not acceptable documentation for r• .m_ irsement.
Airfare reimbursement requires the original passenger receipt portion of the airline t icket. A
travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the original vendor invoice. Fuel purchases should be
documented with original paid receipts.
Original taxi receipts should be provided. However, reasonable fares will be reimbursed without
receipts. Taxis are not reimbursed if taken to arrive at a departure point: for exol. ole, taking a
taxi from one's residence to the airport for a business trip is not reimbursable.
. Original toll receipto should be provided. However, reasonable tolls will be reimbursed without
receipts.
Parking is considered a reimbursable travel expense at the destination. Airport parking during a
business trip is not.
Lodging reimbursement requires a detail listing of charges. The original lodging invoice must be
submitted. The County will only reimburse the actual room and related bed tax. Room service,
movies, and personal telephone calls (see previous guidelines) are not allowable expenses. Per
diem lodging expenses may apply. Again, refer to Florida Statute 112.061.
Meal reimbursement is breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines
are that travel must begin prior to 6 am for breakfast reimbursement, before noon and end after
2pm for lunch reimbursement, and before 6pm and end after 8 pm for dinner reimbursement.
Mileage reimbursement is calculated at 20 cents per mile for personal auto mileage while on
, county business. Effective October 1, 1994, mileage will be reimbursed at 25 cents per mile. An
To,\ odometer reading must be included on the state travel voucher for vicinity travel. A mileage map
is attached for reference to allowable miles from various Florida destinations.
Mileage is not allowed from a residence or office to a point of departure: for example, driving
from one's home to the airport for a business trip is not a reimbursable expense.
.
Data processing, PC time, etc.:
The original vendor invoice is required for reimbursement. Intercompany allocations are not
considered reimbursable expenditures unless appropriate payroll journals for the charging
department (see Payroll above) are attached and certified.
The following expenses are not allowable for reimbursement:
penalties and fines
non-sufficient check charges
fundraising
contributions
capital outlay expenditures (unless specifically included in the contract)
depreciation expenses (unless specifically included in the contract)
SGRIFFITHS
WP 5 1\PROCEDUR\EXP REIM
ATTACHMENT B
HUMAN SERVICE ORGANIZATION LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, Florida 33040
(Date)
The following is a summary of the expenses for (Human Service Organization_name) for the time
period of to
Check # Payee Reason Amount
101 A Company rent $xxxx.xx
102 B Company utilities $xxxx.xx
103 D Company phones $xxxx.xx
104 Person A payroll $xx7-x.xx
105 Person B payroll $xx {x.xx
(A) Total $xxxx.xx
(B) Total priorpayments $xxxx.xx
(C) Total requested and paid (A+B) $xxxx.xx
._..(D) Total contract amount rxxxx.xx
Balance of contract (D - C)
•
I certify that the above checks have been submitted to the vendors as noted and that the expenses
are accurate and in agreement with the records of this organization. Furthermore, these expenses
are in compliance with this organization's contract with the Monroe County Board of County
Commissioners and will not be submitted for reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn and subscribed before me this _ day of 199_
Notary Public Notary Stamp
Mar-02-99 01s08P Risk Management 305 295 4364 P_02
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386 POMPTON AVE, P.O. SOX 206 - COMPANIES AFFORDING COVERAGE
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GD ] OUCYE1WCCTIVE POLICYEIpIRATION UMIT=
TYPE OF INSURANCE POLICY IIUMBER DATE(MMIDD/YT) GATE(YYIoO/YY! •
GENERALLurltm G NERALAGGREIATE i3,0 0 0, 0 0 0
X COMMERCIAL GENERAL LIABILITY
iPRODUCTS-COMP/OP AGO s3, 000, 0 0 0
csaMSMADE C 1 O UR PERSONALAAovINJURY 151, 000, 000
A OwNEFrsRCONTRAOTOR'sPROT OPS002727 .6/30/98 6/30/99 EACHOCCURRENCE S1, 000,000
FIRE DAMAGE * y one nA) $ 100, 000
MED DIP(Any one pereonl $ 1, 000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO71
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~- DATE PROPERTY DAMAGE s
• IMAWITt 14•1 . s AUTDGNLY-EA ACCIDENT $
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— ANY AUTO .-- _( LOLL- —
EACH ACCIDENT
AGGREGATE $
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WORKERS COMPENSATION AND RY)IMITS
EMPLOYERS'LIABILITY EL EACH ACCIDENT $
711E PROPRIETOR/ 1 INCL EL DISEASE_POUCY UMIT IPARTN CUT1vE [-' EL DISEASE-CA EMPLOYEE $
OFFICERS ARE: L — — '
OTHER
Professional $3, 000, 000 Aggregate
A Liability OPS002727 6/30/98 6/30/99 $1,000, 000 Ea. Claim
DESCRIPTION OF opEIATIONSILOCATIONWVEHICLE ISPCCIAL OMB
certificate Holder is added as Additional Insured, but only with respects to
operations of the Named Insured.
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ANY OF THE ABOVE DESCRIBED PgUGIF9 BE CANCELLED BEFORE THE
Monroe County of Commissioners, EKPIRAT1oN DATE THEREOF, THE IBSUING COMPANY WILL ENDEAVOR Yd MAIL
its Employees & Officials Q._DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
5100 College Road BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OFLIOATION ON UASIUTY
Key West, Florida 33040 OF ANY KIND UPON THE EMT
E COMPANY. ITS ARMS OR REPRESENTATIVES. -
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Mar-02-99 01 :08P Risk Management 305 295 4364 P.03
GUIDANCECL
MAO1111. CERTIF ��A 1°E OF INSURANCE ._ DATE(MMIDO1YY)
06/18/98
PRODUCER ONLY�MDFICATE IS CONFERS ISSUED
NO RIGHTS UPON THR E INFORMATION
POE & BROWN INC HOLDER. THIS .CERTIFICATE DOES NOT AMEND. EXTEND OR
220 SOUTH RIDGEWOOD AVENUE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW:
P 0 BOX 2412 COMPANIES AFFORDING COVERAGE _
DAYTONA BEACH, FL 3 211 S , COMPANY
-•- -- -- - — — - AZENITH INS CO --•- •--- . '-'
INSURED COMPANY
GUIDANCE CLINIC OF THE MIDDLE a — - _— _—_ -
KEYS COMPANY
3000 41ST OCEAN STRviET C —
MARATHON, FL 33050 COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE POUCIES 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 PERTA N, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LQUITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . , _ .
'POLICYEFFECTIVE POLICY EXPIRATION LIMITS •
coT T11PEOFINSURANCE POLICY NUMBER DATE(MMIDDITY) DATE(MM100IYY)
GENERAL LIABWTY • GENERAL AGGREGATE ;i
-- —
COMMERCIAL GENERAL LIASILITY PROD UCTS.COMPIOPAna's••
•CLAIMS MADE :OCCUR • PERSONAL L ADV INJURY IS _,__
_ i -
OWNER'S I CONTRACTOR'S PROT EACH OCCURRENCE ! •
• I FIRE DAMAGE(Any One Itq)_•
• —' --' --' — I ME D ExP(Any ono person) :!
AUTOMOWILE LIABILITY ,, COMBINEb SINGLE LIMIT I!
' ANY AUTO ,�-'n01'c C I • IS 'ACFM i __
ALL OWNED WIGS 1 P 1 BODILY INJURY(Par person)
i!
—SCHEDULED AUTOS vy J.l ______—
r/ -' •
HIRED AUTOS BODILY INJURY s
DATE_—_ - i (Per accident)
NON-OWNEOAUTOS / I —
W IVVER: iT,;• .. YFS.--4- PROPERTY DAMAGE I;
i
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT LS —„• „ .. ,
OTHER THAN AUTO ONLY:
ANY AUTO �.� —__
— -- '
EACH
ACCIDENT I
AGGREGATE '!
r A
exaEss LIABILITYEACH OCCURRENCE IS -- —
UMBRELLAFORM • AGGREGATE _ _ IS
— ! S
OTHER THAN UMBRELLA Pomo i
A WORKERS oOMPENSAT1ONAND 2621p :07/01/98 '07/01/99 „ STATUTORY LIMITS E __ _,
EMPLDYERS'LJABluTT I EACH ACCIDENT I li, 0 0 0-, 0 0 0 _
;THE PROPRIETORI INCL DISEASE=POLICY LIMIT r I� 000 1. ,.000
PARTNERSIEXECUTIVE DISEASE•EACWEMPLOYEEI'SZ 000 000
OFFICERS ARE: EXCL • ;
OTHER
I •
•
oESCRIP'TION of OPERATIONSILOCATIONEINEHIOLESISPECIALITEMS •
CERTIFICATE HOLDER �� CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE
MONROE COUNTY EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILLENDEAVORTOMAIL
RISK MANAGEMENT DEPT. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE LEFT.
PtT LIC SERVICE BUILDING BUT FAILURE TOMAILSUCH NOTICE SHALL IMPOSENOOBLIGATIONORLJABIUTY
5100 COLLEGE ROAD I it,:'op AN KIND UPON THE COMPANY. ITS AGE OR REPRESENTATIVES-
KEY WEST, FL 3 3 0+l0 war ..t ' ago 1,.0• ZED REPRESENTATIVE
ACORD 25-8 3/93 of 1 04 , M C432!AmmI' A _ L— -a. 041g1514651641. la 1993
--,! • If
Mar-02-99 01 :09P Risk Managernent 305 295 4364 P_04
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04/23/1998
,RODUCER (305)743-0494 FAX (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Inc.- eys Insurance Agency of Monroe Cou•ty, HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Marathon, FL 33050-0280 1 COMPANIES AFFORDING COVERAGE
cousPaNY - National Casualty
Ext: A ___
Attn: Lenia Lopez --- _.__.
INSURED ' COMPANY
The Guidance Clinic of the Middle Keys, Inc I B
3000 41st Street Ocean
Marathon, FL 33050 j
Co PY
5 i
1 COMPANY
0
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THIS IS TO CERTIFY THAT THE POLICIES OF INSU•'NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
CERTIFICATE MAYITHSTANDING ANY BE ISSUED OR MAY PERTAIN. E INSURANCE AFFORDED BYITHE POLY ICIES DESCT OR CRIBE HEREINER IIS SUBJECTT RES O ALL THE PECT TO TERMICH S I$
EXCLUSIONS AND CONDITIONS OF SUCH POLICIE•.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. r — _ —,-•,•• ___.
•POLICY EFFECTIVE•PO(MEXPPIDRATION: LIMITS
LTR NPE OF INSURANCE CY NUrIlER • DATE(MMIDDIYY) �)
GENERALLIAWLST •OENERALAGGREGATE ---T,i __..
COMMERCIAL GENERAL LIABILITY •
• :PRODUCTS-COMP/OP AGO I a
P CLAMS MADE i .OCCUR ' ;PERSONAL A ADV INJURY I a
' !owNER's 8 CONTRACTOR'S PILOT •EACH OCCURRENCE S• �.__.. •---'---•• ..•.--•--' ._.—....' •--•---... ...
FIRE DAMAGE Wy cos PM I a
.._.....__. ......._... _. MED EXP(A,ry one person) •R
Au70a0®ILE LuwanY •
:COMBINED SINGLE LIMIT ,a
'ANY AUTO •-1,000000
. ALL OWNED AUTOS '•BODILY INJURY I a
(Per poison)X SCHEDULED AUTOS CA00102531 . 03/21/1998 03/21/1999 • "'--- '-'--"" i"'------- •---- -_
A HIRED AUTOS BODILY INJURY
- .. • :(PerFcceenp I S 250 ded
NON•DVrNED AUio9 — — _....... .. _...
-.. -----..-. ---..__- ..-___ 'PROPERTY DAMAGE I$
.GARAGE LIABILITY AaoDnVED BY 1S dInF.MFFIT •AUTO ONLY_EAACCIDENT '$
OTHER THAN AUTO ONLY:
ANY AUTO . ._ ..
BY EACH ACCIDENT a
• AGGREGATEI S
EXCESS LIABILITY •
1 flATE • :EACH OCCURRENCE 'a
I ....---_.. •---_.. .._...___.... ...-- -
UMBRELLAFORM I lIMPttg: NSA _,� YES_ .AGGREGATE I•
OTHER THAN UMBRELLA FORM a ---
WORNERS COMPENAATION AND //,7T�� •TORY LIMITS:....._._
VA: ,fir,
ER "
1"-.....,
EMPLQYERB'LIABILITY :EL EACH ACCIDENT f-- --
THE PROPRIETOR/ INCL EL DISEASE-POLICY LINT ,$ _____
OFFICERS ARE. I ERSIEXECUTIVE �• EL DISEASF-EA EMPLOYEE:S
OFFICERS
OTHER •
DESCRiFfION OF OPERATIONSILOCATION5NENIFLESISPECIAL ITEMS
The below referenced certificate holder is also listed as additional insured on the policy.
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SHOULD
A
..... ANY OF THE ABOVEDESCRIBED POUpE88ECAN
EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Monroe County Board of County Commissioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSENOoSuGATTONORLNEILITY
Risk Management OF ANY RIND UPCN THE COI�IPANY,ITSAGER�,ORRE'I ENTATIYES•
5100 College Road I AuT O EDREPREBENT ,
Key
West, FL 33040 - Lar pr
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