Item C48
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: February 18, 2004
Division: County Administrator
Bulk Item: Yes X
No
Department: Fire Rescue
AGENDA ITEM WORDING: Approval of Contract Amendment with Professional Emergency Services,
Inc., to extend the existing agreement for six months, March 01, 2004 through August 31, 2004, to allow
parties sufficient time to determine the details of future operations.
ITEM BACKGROUND: The existing contract amendment between Professional Emergency Services,
Inc. and Monroe COUIity is due to expire on February 29,2004. Due to the fact that the existing relationship
has been altered to include air ambulance medical services, sufficient time is required to determine the
details of future operations, therefore, a six-month contract amendment has been prepared.
PREVIOUS RELEVANT BOCC ACTION: On January 19,2000, the Board granted approval and
authorized execution of a contract between Monroe County and Physician Resources, Inc. as Medical
Director/Fire Department Physician for Emergency Medical Services and Fire Departments, effective
January 01,2000 through January 01,2002.
On November 20,2001, the Board approved a Contract Addendum to extend the agreement for Medical
Director Services for an additional two year period, effective January 02,2002 through January 01,2004.
On April 17, 2002, the Board granted approval of an Agreement Addendum with Physician Resources, Inc.
to change the contractor's name to Professional Emergency Services, Inc., and reduce the annual contract
amount by $4,000.00.
On December 17, 2003, the Board granted approval of a Contract Amendment with Professional Emergency
Services, Inc. to extend the agreement for the two-month period January 02,2004 through February 29,
2004 in order to work out contract issues.
CONTRACT/AGREEMENT CHANGES: Extend the existing Agreement for six additional months
effective March 01, 2004 through August 31, 2004.
STAFF RECOMMENDATIONS: Approval.
TOTAL COST: $24,000.00
BUDGETED: Yes X
No
COST TO COUNTY: $24,000.00 SOURCE OF FUNDS: Ad Valorem Taxes
REVENUE PRODUCING: Yes
No X AMOUNT PER MONTH N/A Year
APPROVED BY: County Atty YES oMB/Puffl W-, /~k Man~~nt YES
DEPARTMENT HEAD APPROVAL: ~~~ 'L
~ 0, Martin~ 1\ _ _
DIVISION DIRECTOR APPROVAL: J ~~--J
James L. Roberts
DOCUMENT A TION: Included ~
DISPOSITION:
To Follow
Not Required - ('1/ I (/
AGENDA ITEM # l..,Y 0
Revised 1/03
CONTRACT AMENDMENT
THIS CONTRACT AMENDMENT entered this 18th day of February, 2004,
between the Board of County Commissioners of Monroe County (BOARD) and
Professional Emergency Services, Inc.
WHEREAS, the parties entered into an agreement on January 19,2000,
and thereafter amended said agreement on November 20,2001, on April 17,
2002, and on December 17,2003; and
" WHEREAS, said agreement as amended previously terminates February
29, 2004; and
WHEREAS, the parties recognize that the existing relationship has been
altered to include air ambulance medical services; and
WHEREAS, it is desired to extend the agreement for six months to allow
the parties sufficient time to determine the details of future operations; now
therefore
The parties agree as follows:
1. The contract dated January 19, 2000, as previously amended,
shall be extended through August 31, 2004, at the rate of $4,000.00 per
month.
2. All other provisions of the contract dated January 19, 2000, as
amended November 20,2001, April 17, 2002, and December 17,2003
not inconsistent herewith, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties have hereunto set their hands and
seal, the day and year first above written.
(SEAL)
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
ATTEST:
BY:
DANNYL.KOLHAGE,CLERK
Mayor
By:
Deputy Clerk
PROFESSIONAL EMERGENCY SERVICES, INC.
BY:
Sandra Schwemmer, D.O., FACOEP, FACEP
LOBBYING AND CONFLIcr OF INTEREST CLACSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed. retained
or otherwise ha~ act on his/its behalf any fonner 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, tenninate 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 fonner County officer or employee.
(signature)
Date:
STATE OF
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affJXed hisJber
signature (name of individual signing) in tbe space provided above on this
day of
,20_,
NOTARY PUBLIC
My corrnnission expires:
OMB - MCP FORM #4
PUBLIC ENTITY CRIME STATEMENT
II 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 ptovide any goods or services to a public entity, may not submit
a bid on a cqntract with a public entity for the construction or repair of a
public building or public work, may not submit bilds 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 CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
CONTRACT AMENDMENT
THIS CONTRACT AMENDMENT entered this 17th day of December,
2003, between the Board of County Commissioners of Monroe County
(BOARD) and Professional Emergency Services, Inc.
WHEREAS, the parties entered into an agreement on January 19, 2000,
and thereafter amended said agreement on November 20, 2001, and on April
17, 2002; and'
WHEREAS, said agreemenc as amended previously tercninates January
1,2004; and
\VHEREAS, the parties recog!"'.ize chat the existing relacionship has been
altered to include air ambulance medical services; and
\VHEREAS. it is desirec. to eX'::e;~c. the agreement for t';\..o monchs to <;!.llo"v
the parties sufficient time to determine the details of future operations; nO\v
therefore
The parties agree as follo\vs:
1. The contract dated January 19,2000, as previously amended,
shall be extended through February 29,2004, at the rate of $4,000,00
per month.
2, All other provisions of the contract dated January 19, 2000, as
amended November 20,2001, and April 17, 2002, not inconsistent
:.. _ herewith, shall remain in full force and effect,
:-; '-{N WITNESS WHEREOF, the parties have hereunto set their hands and
seal.',the ~ay and year first above written,
~
BOARD OF COUNTY COMMISSIONERS
OF MONROE CtU!TT~YLORID. A
/~., //f. ~
BY: ;4_. .~/u .
Mayor
- (SEAL)
ATTEST:
D~KO~
B}~
Depu Clerk
MONROE COUNTY ATT NEY
R
ENCY SERVICES, INC.
BY: fJjAJ/{) 3
Sandra Sch N'emmer, D.O., FACOEP, FACEP
AGREEMENT ADDENDUM
(or
MEDICAL DIRECTOR SERVICES
TInS AGREEMENT ADDE~TIUM is made and entered into this 17 th day
of Aoril , 2002, between the Board of County Commissioners, Monroe
County, Florida and Physician Resources, Inc.
WHEREAS, on January 19,2000, the parties entered into an agreement for the
period January 1, 2000 through January 1, :002; and
WHEREAS, on November 20, 200 I, the parties agreed to an agreement
" addendum for the period commencing January 2, 200: and ending January I, 2004; and
\\'HEREAS, it is desired to ret1ec: in this amendmem the corpcr:lte name change
of Physician Resources, Inc.; now therefore,
IT IS AGREED as follows:
1. CONTRACTOR: The agree;:1ef',t for Mdical Direc:or S~iices '.",ill be ber.veen :.
the Board of County Commissioners of~f()nroe County, Florida a.r:d Professional
Emergency Services, Inc.
2. COrvlPENSATION: As of AiJril 1, 2002, payment for services provided shall be
an annual fee of $48,000 DOLLARS; 54,000 invoiced and payable monthly,
3. In all other respects, the agreement between th~ parties dated January 1,2000, as
previously amended, not inconsistent herewith, shaIl remain in full force and effect.
IN' WITNESS WHEREOF, the parties have hereunto set their hands and seal, the
day and year first written above.
(SEAL)
BOARD OF COUNTY CO~fM1SSIONERS
OF MONF,OYJtumY, FLORID; 3'
~uycVChairman 25?-~:
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ATIEST'~LERK
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Dep ty Clerk
S;mdra Schwemmer, D,O" FACOEP, FACEP
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CONTR.l.cr ADDENDUM
THIS CONTRA,CT ADDE~TICJ'7\( is m:ld~ .u:d e:::ered into this 2Cch day of
Nove::1ber . 2001, be:..ve~n t~e Boare:: ofCol:nty Commissicners ofMonrce
COl.:nty, Florida, and Physici:m R~sQl:rc.:s. [r:c,. in crder tc a~er:d th~ agreerr.er:t bet".veer:
the parties ~ated January I, 20CO, J..S fcllc\vs:
1. ~: This CONIRACT ,.iDDE~ulfi\.[ sh.1!! be::2me e:7'.:ctive Oi: hnuarj 2,
20C: and sbll expire on January 1. :0(.1
.... Cc)r:lcensa.tion~ PaY~~:1t :cr s~~,,-:c~s prcvicc:d sh2.~: b~ 2.f: J.n~uJ.l r~~ cr'" 55: Gl~\='
DOlL~~S, S..!,.333 33 jr.voic~~ 1::": p.::.'::c[e I::C:::.'-:I:;
In all ather respec:s, t::e .:l:;:-~~",~:",,: l:e~'.ve~:: :i':e p.1:-::es C3.:ec hnuary !, 2000 ..
r~:7:.1::l.s in ft.:ll fc rc~ az:c e:::c:.
IN Vv1Th"ESS \.VHEREOF, t::e pries have here~r::c set :::e:r hancs a:1c seai, u.1e
day and year first written above.
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~EST: DANNY L.
BOARD OF CO~TY COM~tISSrONERS
OF MONROE (tilT", FLORlDA
~ L:l:. c r/ C Q:l i r.1"..1n
OLHA.GE, CLERK
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Ph~(SICl:1?F7' ~iC ~
S:l::drJ. S.:hwe:::m::r. 0,0, FACOEP. FACEP
l\'IEDICAL DIRECTOR/FIRE DEPART\tENT PHYSICIAN
CONTR-\CT
THIS CONTR-\CT, made and ente:-.:d inta this ~ day of Janu:lrv , 2000, by and
between the Board of County Commissione:-s. Monroe COllnty, Florida. hereinafter
..
..referred to as the "COUNTY" and Ph;:sician Resources. Inc" herein3fter referrd to ::15 the
. "Medical Dire~tor", also referred to as (he "Fire DepJ.rtme:ll PhysiciJ.n".
"
\.Y1T:\ESSETH:
..,
\VHEREAS tJ..e COL~ITY ;",-v.;,";~<:: ~~,a JT"C e:.1c"~~c" m"'~ic"l "a..';c~s ""t.;,.~.,.,'~:'
" ,.. I." ;-O'-J ,._...... ...._.. ", l. =_,1..- ~....._ ..... ...\".....1 ... :-- 4.;)~""\'"
.
to Chapter 40 I, Florida St:ltutes, in the following geog:-a~hic are:lS: CO\I,( K~y Cbr.nel
(mm4) to Channel 2 bridge (mmn,5) 3.nci from T3vernier Creel<. Bridge (mm90,5) to South
Bay Harbor Drive and Lobster Lar:e (~m95); also k.llown ~..s the Lower and Micdle Keys
Fire and Ambulance District, and Soutl1 Bay Harbor Drive and Lobster Lane (rr:m95) to
the Dade County line on US I (mm 113) and north on SR9J5 to the intersection of Card
Sound Road, Municipal Service Taxing District 6, in regards to Key Largo Volur.te:::r Fire
Department; and
WHEREAS, the COtJNTY is required to employ (,r contr:l.ct with a Medical
Director who shall be a licensed physician; a corporation, association or pannership
composed of physicians; or physicians employed by any hc.spiral which delivers in-
hospital emergency medical serJices a;:d which employs PI' contracts with physicians
speci tically for that purpose; and
WHEREAS the COUNTY cheoses to contrJct with a Medical Director for the
,
purpose of providing direction to the Fire and Emergency Medical Services;
~,ledical Din:ctor Contract - E;\IS
WHEREAS, legislation requiring the establislunent of tr:luma systems requires
close interaction between the EMS system and hospitals; and
\VHEREAS, the Medical Directur is licensed in the State of Florida and desires to
provide professional services as the Munroe County Medical Director according to the
.,
..terms and conditions stated herein,
NO\V THEREFORE, in consider:llicn of the rnu':u:lI understandings and
agr=ements set forth herein, the COl'0-ry ar:d i\kc::c3,! Directcr agree as f01!o\vs:
"
1, Term.
This Contract shall become effective on Januarv 1.2000. and shall run through Janua!'; I.
2002. and shall be renewable thereafter at the ootion of the COUNTY for an additional two
- .
(2) year period.
t.
2. Termination.
(a) This Contract may be terminated by the Medical Director, with or without
cause, upon not less than ninety (90) days written notice deli vered to the
COUNTY.
(b) The COUNTY may tenninate this Contract in whole or in part, upon not
less than thirty (30) days mitten notice, ddivered to the terminated party or,
at the option of the COUNTY I immediately in the event that any party fails
to fulfill any of the te:77',S, ur:.~e~3tJndlngSJr covenants of this Contract.
3. Purpose.
The purpose of this Contract is to assure compliance of the COlJNTY in medical direction
of its Fire and Emergency Medical Services System,
Medical Director Contract - E~IS
2
4. Duties :and Responsibilities.
The Medical Director shall be responsible: to the Fire and Emergency ~kdical Service
Departments of the Division of Public SJ.fety 3I1d report to the Emergency tvkdical
Services Chief.
, The MedicJ.I Orrector shJ.ll adhere to the r-=sponsihilities ~.5 se: forth in Florid::. StJ.tutes
401, Mdtc:lI Directors, Florida Ad~ir;is,r:lLive Code 6~E-2, Er7lerg~:1CY l'vkdicJ.I Ser"ic~s.
l'v12dicJ.I Direction, and i'Luion:.l1 Fir~ ?:-Jt~'.::icn :\ssoc:::ltior. 1532. Thes~ i::d'..lc~
sl..:~e:-vising and assuming dir~::: res;cc:sicili:~: ror the medic::.i perforrn.:lr.c~ of the
Er..erge:1cy Medic:lI Tec:-...'1iciJ.ns, PJ..:::':7.~::i..:s :Jet:: Fir~:::Z!1ters ccer::.~ir.:z for ::-:.::t
- . -
Emergency Medic:lI Ser""ices syste~. T:1~ 0-k..:ic:lI direc~or s::::.ll perfor::-'I dl..:ti~s ir:c:t.:c:ir;-g:
advising, consulting, training, counse:ing, aed overse::ing of services, but not including
administrative and managerial functior.s,
The Medical Director or designee will provide formal training with lect1.:.re topics and d::.tes
which will allow e3.ch Monroe County EMT, Paramedic ;:,nd Firefighter to fulrill the
continuing education requirements for hi-annual St3.te of :?lcrida re-certification,
Annually, the Professional Education Program will be e';raluat~d for content, location and
dates.
The Medical Director will be availabk for consulting and ac':ising on all EMS activities
undertaken by the career and volunteer e:nergency response depari:r:1er.ts of Monroe
County as requested by the Count:", T~e Lvkdic:JI Director shall be aV:Ji!:Jble 24 hours a
day for emergency consultation from s:;s~em fire-EMS provic:.er. He/She shall carry a
pager and be supplied a portJ.ble radio by the Division of P~blic Sdety. He/She shall
respond in a timely manner to any pages from the EMSProv:der. In the event the MedicJ.l
Director is unavailable, he/she shall appoint a similarly qualified physician to cover aU
r=sponsibilities, The Medical Director may appoint a qualified individual to perform
MedicJI Dire-:tor ConC:-Jct - E~,lS
}
certain duties and responsibilities as outline in this agreement, upon approval of the EMS
Chief.
PROTOCOLS
Tne Medical Dir,ector shall provide an annual document~d review 0 f the pre-hospit.:ll
tre:ltment protocols and when necess:lry, the E?vfS provide:" 3.::c the Medic::ll Director shall
. jointly approvl:;'each protocol revision prier to implement,HioD. These protocols 5h:111 be
developed with consideration to the fis.::J.~ irr:.p:J.ct of such protocols on the par<:icip.:lting
ag~ncies and the citizens of Monroe Ccur.cy.
At such time as the County de~emlir.es ,-~.lt ir::Fk::J.e~t..::.tion c:" ~;:s;.: Lif~ S~;,~cr:
..
protocols is appropriate and fe:lSible for:1 par:ic'J.iar vclu:\tee: r~:e cepar:r::e:1L tte rr"e~i;:~~'
director, assistants, and/or designe~ will assist in implem~:ntat:on anc appropri::l.te in-
servicing of the medical treatment proteeds,
Deviations, from these protocols, sh:;.1! te reviewe.':! by tb: medic:ll director and appropri:1Ce
corrective action shall be suggested to the EMS provider. Notification to State and loc:ll
agencies shall be completed in accordance with the apprqpria:e laws,
QUALITY ASSUR.\NCE
The Medical Director shall establish a quality assur:mce committee to provide for quality
assurance review of all emergency medical technicians and paramedics ogerating under
hislher supervision and function as an integra! part of the Cour.c:," QU:llit:1 Assurance
program,
The Medical Director and/or each appolnte~ at' tb~ medical ci:'~ctor's staff shall audit the
performance of system personnel by use of a qualicy assurance: program to include but not
limited to a prompt review of patient care records, direct observation, and comparison 0 f
performance standards for drugs, equipment, system protocols and procedures. The
Medic:l1 Director Concr:lct - E;-..tS
,
~
Medical Director or appointee shall not be required to provide direct patient care during
these activities.
LOCAL DISASTERS
In the event ofa local disaster or impending emergency situation with L~e possibility of
,
," multiple casualties, the Medic:J.l Director or an appointe:= :;hall be avaibble for emergency
consul tltion.
COST CONTAINME:\T ! EQl'IP:YIE:'>iT & PROCEDCRES
d .
....
Tne Medical Director shall periadic;!l:y :~';ic"v all ;clicies ar:.::: prcce:::t.:res ~()r cost ."
effecti veness, Providing state 0 f the a~ fire mc emerge=il9 medical ser".rlces to the ci tizer.s
of Monroe County in the most cost effective mJ..'1l1er shall be a top priority 0 f the Medical
Director,
.!
The Medical Director will consult and advise on all medlit:al equipment to be carried and
utilized by a participating volunteer fire department an~N any other emergency response
agency. Specifically, if the Couney e!ects to implement ~se of Automatic External
Defibrillators (AED's), the Medical Director will develop the required protocols, and in
cooperation with the County EMS office, implement the necessary training,
INFECTIOUS DISEASE EXPOSt'RE POLICY
The Medical Director shall assist in devdoping an infectious disease exposure policy th;!c
complies with State and Federal requirements. The Medical Director shall assure that a
comprehensive plan exists for prorr.s:t m~cical review of :111 possible infectious exposures
reported by Monroe County E~IS p~:-3on..'1e! and members of the participating volunteer
fire department, and for post-exposur: medic:l.1 follow-tip when indicated.
Medica! Director Contract - EMS
5
The Medical Director or designee shall be available to assist in the in-servicing of the
individual volunteer fire department reg:l!ding the exposure policy.
The Medical Director or designee shall be available for consultations with field persormel
"
,to determine th~' significance of any body fluid exposure and to suggest appropriate action
. for such an expbsure.
.'
"
STATE INVOLVEMENT
,"
,'-s
The Medical Director shall become involved in the Florida Association of EMS Medical':::'
Directors and preferably an equivalent Fire Association.
5.
Insurance.
.'
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i!
The insurance requirements for Agreements/Contracts whi,:h supply goods or services to
the County are incorporated by reference, submitted in Request for Qualifications, and
include the following:
. Indemnification and Hold Harmless Provisions
. General Insurance Requirements
. Workers' Compensation Provisions
6. Compensation.
(a) Payment for services provided shall be an annual fee of $56,000
DOLLARS, ($4,667) invoiced and payab'lc: monthly~
(b) The annual fee may be revised, based on future modifications to the
County's emergency response areas of responsibility, through a written
Medical Director. Contract - EMS
6
Certificate Holder
RISK MANAGEMENT
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS
1100 SIMONTON STREET
KEY WEST, FL 33040
Administratcr
Issue Date 10/1/03
Florida League of Cities, Inc.
Public Risk Services
P ,0, Box 530065
Orlando, Florida 32853~065
COI/E.....CES
THIS IS TO CERTIFY THAT TttE AGREEMENT BELOW HAS BEEN ISSUED TO THE DeSIGNATED ""-EMBER FOR THE COVERAGE PERIOD INDICATED NOTWlTHSTAHDING ANY ReaUIREM N
TERM OR CONOITtOH OF Al4Y CONTRACT OR QTHE.R DOCUMENT WITH RESPECT TO WHICH TkIS CERTIFICATE MAY BE Issueo OR MAY PERTAIN. THE COVERAGE AFFOROED By TH: T,
AGREEMENT oeSCRI8ED HEREIN IS SuBJECT TO All. THE TERMS, eXCLUSIONS AND CONOlTlQNS OF SUCH AGREEMENT
: COVERAGE PROVIDED BY: FLORIDA MUNICIPAL INSURANCE TRUST
. AGREEMENT NUMBER: FMIT OJ86 I COVERAGE PERIOD: FROM lOll/OJ] COVERAGE PERIOD: TO 1011/04 12:01 AM Standard Time
TYPE OF COVERAGE _ LIABILITY TYPE OF COVERAGE - PROPERTY
General Liability
o C"mprehenslve General LiabliLty. Bodily Injury, Property Damage and
Personal Injury
o Errors and OmiSSions Liab,iLty
~ Supplemental Employment Practice
o Employee Benerrts Program Administration Liability
o Medical Attendants'iMedical Ollectors' MaJpraC:lce Liability
~ Broad Form Property Damage
o Law Enforcement liability
[3J Underground. ExplOSion 3. C,,"apse Hazard
Limits of Liability
. Cymbined Single limit
Deductible N1A
Automobile Liability
o All owned Autos (Pnvate Passenger)
o All owned Autos (Other than Private Passenger)
o Hired Autos
o Non-Owned Autos
Limits of Liability
. Combined Single Limit
Oeductible N1A
Automobile/Equipment. Deductible
o Buildings
o Basic Form
o Spec:al Ferm
o Per.sonal Property
o Basic Form
o Special Form
o '''greed Amount
o Deductible N1A
o C",nsurance N/A
o Blanket
o Specific
o Replacement Cyst
o Actual Casn Value
o Miscellaneous
o Inland Marine
o ElectroniC Data Processing
o Bend
o
!
.,
Limits of Liability on File with Administrator
TYPE OF COVERAGE. WORKERS' COMPENSA nON
o Statutory Wor1<ers' Compensation
o Employers Liability $1.000,000 Each Accident
$1.000.000 By Disease
$1,000,000 Aggregate By Disease
o Deductible N/A
o
Other
o Physical Damage N1A - Comprehensive, Auto N/A . Collision. Auto N1A - Miscellaneous Equipment
. The Iimll of liability is $5.000,000 (combined Single limit) bodily injury andlor property damage each occulT8nce in excess of a self-insured retention of $
100.000. This limit is solely for any liabolity resulting from entry of a claims bill pursuant to Sedlon 768.28 (5) Flonda Statutes or liabolity imposed pursuant to
Federal Law or actions outside the State of Flonda.
Description of OperatlonsiLocationslVehictesiSpecial Items
RE: 2000 1 T 60ston Whaler, 10# 85J8
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATKlN ONLY ANO CONFER$ NO R1CHTS UPON THE CERTlFICA TE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVEIUtGE AFFORDED 8Y THE AGReeMENT ABOVE.
DESIGNATED MEMBER
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS
1100 SIMONTON STREET
KEY WEST, FL 33040
FMIT-CERT (101961
CANCELLA TKlNS
SHOULD N<Y PART OF THE .ABOVE DESCRIBED ACREEMENT BE CAHCEUED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO ....,L.5 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED ABOVE. BUT FAILURE TO ....,L
SUCH NOTICE SHAlL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
PROGRAAl. ITS ACENTS OR REPRESENTATIVES
\\~clR~~
AUTHORIZEO REfRESENTATfVE