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FY2022 1st Amendment 01/21/2022 Kevin Madok, cpA Clerk of the Circuit Court& Comptroller— Monroe County, Florida DATE: January, 29, 2022 TO: Janet Guiidersoii Senior Gratit & Fliiaiice Aiia]N,st FROM: Pamela G. Hance O*'. SLTBJECT: jaiivaiy 21" BOCC Mee6iig Attached is aii electronic copy ot'die lolloimig item lor your limidlilig: C 15 1st Amcii(Imcm to the Agreement mfli die Guidance/Care Center (G/C0 l'or Traiisportatioii Senices to incorporate traiisportation protocols for Baker Act/Marcliiiiaii Act clients and to establish trip rates for the transportation senlices to be provided by G'ICC effective December 1, 2021. Should you lia%,c any' questions please Feel tree to contact nie at (305) 292-3550. CC: County'Atfoniey, 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 AMENDMENT 1 TO AGREEMENT WITH GUIDANCE/CARE CENTER, INC. FOR TRANSPORTATION SERVICES THIS AMENDMENT is made and entered into this 21s' day of January 2022, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "COUNTY," and Guidance/Care Center, Inc., a Florida 501(c)3 not-for-profit corporation, hereinafter referred to as "PROVIDER". WHEREAS, the PROVIDER is a not-for-profit corporation and is the Designated Receiving Facility under the County's Designated Receiving System Plan in accordance with Chapter 397, Florida Statutes for the provision of coordinated, comprehensive system of care for coexisting mental and substance abuse disorders and for the provision of Baker Act/Marchman Act transportation services pursuant to Chapter 394, Florida Statutes; and WHEREAS, it is a legitimate public purpose to provide Baker Act/Marchman Act transportation services pursuant to Chapter 394, Florida Statutes and Community Transportation Coordinated-related services to residents of Monroe County; and WHEREAS, the COUNTY and PROVIDER entered into an Agreement ("Agreement") on November 17, 2021, for the PROVIDER to implement said transportation services under the program; and WHEREAS, the PROVIDER entered into a Vendor Service Agreement on October 6, 2021, with Caribbean Transfers, Inc., dba Key Lime Taxi, as set forth in Attachment D of the Agreement with COUNTY, for the provision of Baker Act/Marchman Act Transportation services for the period of October 1, 2021, through December 31, 2021; and WHEREAS, Caribbean Transfers, Inc., provided notification confirming that effective November 30, 2021, it discontinued providing Baker Act/Marchman Act Transportation Services under the Vendor Service Agreement; and WHEREAS, upon the discontinuation of the services per the agreement between the PROVIDER and Caribbean Transfers, Inc., the PROVIDER assumed the responsibility for the provision of Transportation of the Baker Act/Marchman Act Clients effective December 1, 2021, since the PROVIDER has been unable to procure an alternative vendor; and WHEREAS, the cumulative sum of Baker Act/Marchman Act services for the period of October 1, 2021 through September 30, 2022 remain unchanged and shall not exceed $165,000; and WHEREAS, an amendment is needed to reflect the change in the agreement; and NOW THEREFORE IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. Effective December 1, 2021, Guidance/Care Center has established Transportation Guidelines/Protocol and Trip Rates according to rate schedule (attached hereto as "Exhibit 1") for the provision of transporting Baker Act /Marchman Act Clients. 2. In all other respects the Agreement dated November 17, 2021, remains in full force and effect. In WITNESS WHEREOF each party hereto has caused this contract to be executed by its duly authorized representative. [THIS SPACE INTENTIONALLY LEFT BLANK WITH SIGNATORY PAGE TO FOLLOW] 1 {, WHEREOF, the parties hereto have caused these presents to be executed as of the day aria ritten above. . a� BOARD OF COUNTY COMMISSIONERS F MADOK, CLERK OF MONROE COUNTY, FLORIDA a,. y !�s Deputy Clerk Mayor/C r an f 3 f MONROE COUNW ATTORNEYGuidance/CareCenter, Inc., Florida�o '-� , 1(c)( ) not-for-profit corporation ASSISTAN-FC A t (Federal ID No. .. I _.. y 4 , r- 001 _ Guidaince/ are Center, Inc., a Florida 501(c)(3) not-for-profit corporation TO BE COMPLETED BY NOTARY(in accordance with State notary requirements) State o County of The foregoing Instrument was acknowledged bof re me, by means of 0 physical presenceor online notarization, this ____ ay o c (month),_ 1 ye r), by ® (name of officer or agent, title of officer or en ) o j5d"Aance I Cart Cer4er,In c® (name entity). Personally Kno n Produced ificatio ; Type of ID andNumber on I aas Cigna of No � N® Public Sub a F Inc" Nu men htw Notaryt r�._r_i_�t_o_ ) y Cs 2247 Notary Public, to o I 2 EXHIBIT 1 WESTCARE • GCC has 3 vehicles for use for Baker Act Transportation Vehicle Make FDOT Control# Passngr Seats& Location of Model Year and Type & VIN# w/c positions Funding Source Veh# vehicle Dodge n/a Donation from 2014 Charger 2C3CDXAG8EH194807 4-W/ca e MCSO BA9 MA Baker Act Dodge n/a Donation from 2013 Charger 2C3CDXAG6DH646798 4-W/cage MCSO BA8 KW Baker Act Ford Crown n/a Donation from Key Largo Baker 2011 Victoria 2FABP7BV6BX113807 4-W/ca e MCSO BA6 Act • Maintenance specifications: one vehicle to be stationed at the GCC Key West office, one vehicle will be stationed at the GCC Key Largo office and the other in Marathon at GCC headquarters. GCC pays for the fuel and maintenance of the two vehicles used for Baker Act and Marchman Act transportation. Drivers will complete daily inspections each time the vehicles are driven as noted on the inspection forms which will be submitted to GCC Transportation Coordinator with trip verification. GCC Transportation Coordinator coordinates the maintenance for all vehicles above. • GCC will maintain insurance on all vehicles. All drivers operating GCC vehicles will hold a minimum of a Class E Florida Driver's License and be approved for GCC insurance coverage by the Transportation Coordinator. Upon execution of this agreement, Vendor will fax/email to GCC's Transportation Coordinator a current list of drivers— including a copy of the driver's license and social security number for each driver—for approval to operate GCC vehicles. Prior to adding a driver, Vendor will fax or email to GCC's Transportation Coordinator, or designee, a copy of the driver's license, social security number and signed "Request for Check of Driving Record" form. GCC will initiate procedures to add the driver to GCC vehicle insurance Vendor cannot use the driver for BA/MA transports until it has received written notification that the driver has been added to the GCC insurance coverage. • All drivers are required to have a background screen, a minimum 3-year clean driving record and submit to drug screen per GCC policy and procedures. All BA/MA approved drivers will be GCC employees and follow all policy and procedures including reading and sign the acknowledgement of Attachment 1 Transportation Protocol. • Vendor will report and document accidents involving GCC vehicles and incidents involving clients to the proper authorities and immediately thereafter contact the site director at GCC. Following an accident, GCC Vehicle Incident Protocol must be followed. A Vehicle Incident Kit, attached hereto as Attachment 2, has been provided for each 5 vehicle with instructions. Additionally, anyone involved in an accident with a GCC vehicle MUST BE DRUG TESTED as soon as possible following the incident. Drug testing forms are included in the kit. • Any citations received while driving a GCC vehicle will be the responsibility of the driver. Refusal or failure to accept responsibility for citations may result in removal of driving privileges. • All drivers will be required to complete an orientation and verbal de-escalation training within 30 days of approval to drive. GCC will provide details for accessing the training. All BA/MA approved drivers must read and sign the acknowledgement of completing the assigned training, attached hereto as Attachment 3. All GCC staff are required to wear an identification badge when driving a Baker Act vehicle. Rate Structure Estimated# Client PickupPoint Client Drop-off Point Trip Rate Roundtri s p p Key West Key West $160 Marathon Marathon $160 Key West Marathon $220 645 Marathon Key West $220 Marathon Key Largo $220 Key Largo Marathon $220 Key Largo Key West $345 Key West Key Largo $345 55 Marathon Miami-Dade County $470 Key Largo Miami-Dade Count $470 10 Key West Miami-Dade Count $470 6 Attachment 1 Guidance/Care Center Transportation Protocol The Transportation of Baker Act and Marchman Act Clients ATTACHMENT 1 GUIDANCE /CARE CENTER TRANSPORTATION PROTOCOL: THE TRANSPORTATION OF BAKER ACT AND MARCHMAN ACT CLIENTS A. Client Related Rules: 1. Confidentially of a client and client related information shall be maintained at all times. 2. Each client shall be treated with respect and dignity at all times. 3. No information with client information shall leave the clinic unless part of a client transfer packet to a designated facility. (No driver/escort shall maintain a personal copy of the Transportation Record and Payment Authorization Sheet.) 4. Client transportation within Monroe County may be conducted with a driver and an escort when deemed appropriate or necessary. 5. A female client requires a female escort or a female driver. 6. A client must be observed for any unusual behaviors including hurting self/others or sudden medical conditions. Respond to a medical emergency by calling 911. If a client is violent during transport and poses a threat to safety, stop the vehicle, and call 911. Notify the Nurse on Duty of any unusual situation at (305) 434-7660 ext. 31123 7. At the time of pick up for a Baker Act or Marchman Act client, a driver must obtain the Baker Act or Marchman Act paperwork from the Pickup facility. If the original paperwork is not available, the driver must immediately report this information to the G/CC Nurse on Duty for further instructions. 8. Only one client may be transported at a time 9. a client may only be transported in the back seat of the vehicle 10. A parent is not allowed to travel in the Baker Act vehicle with a Baker Act or Marchman Act minor. • When a parent or other responsible party reports he/she plans to follow the Baker Act vehicle, the Baker Act driver advises the parent/party that our primary responsibility is to the child and ensuring the safety of the child therefore following our vehicle as a method of direction is not encouraged. 11. Drivers, Escorts and Clients are not to smoke in the car at any time. 12. Clients are not to be placed in handcuffs or any type of restraints for any reason by a driver or escort— or to be placed in the vehicle by others (i.e., Law Enforcement) in handcuffs or any type of restraints 13. A client's movement is not to be impeded with any physical restraint unless directed by a nurse/MD/law enforcement officer. 14. If a client must use a public facility; the client must be escorted to the restroom and the driver must remain outside the restroom door until the client leaves the restroom. The driver will remain in conversation with client while the client is in the restroom. THIS SHOULD HAPPEN ONLY UNDER MOST EXTREME CIRCUMSTANCES. 15. A client shall not be left alone in the vehicle during the trip for any reason. 16. A client shall be under the observation of the driver or escort at all times during the transport. 17. Client is encouraged to use restroom facilities prior to departure. If the trip is Rvsd/md 12.1.21 - 1 - 8 generated from Key West and a stop is required, G/CC may be used for that purpose. 18. A client may not use aluminum/metal cans. Items for drinking shall be provided only in a plastic container. 19. Clients may not have any metal utensils, glass or other hard products such as pencils or pens. 20. A client may not shop during a stop. All efforts should be made to avoid stops. If a stop is required, it should be short and without delay. B. Coordination of Transportation Rules: 1. Transportation arrangements for Baker Act and Marchman Act clients are under the direction of the Unit Nurse on Duty/G/CC 2. Final decision for a driver to transport is made by the nurse on duty. The nurse may request a BAL be conducted or send a drivers/escort home if he/she has a concern. 3. A driver shall not be permitted or required to drive more than 12 hours in any one 24- hour period or drive after having been on duty for 16 hours in any one 24-hour period. 4. All trips will be made within the approved fee structure. 5. All trips will be made using the closest vehicle and the shortest distance unless preauthorization is obtained from the Unit Nurse on Duty at the G/CC. 6. Clients may be picked up at only approved locations. The G/CC Nurse on Duty will communicate the pickup location. Approved locations will include: a. Hospitals b. Detention Facility c. Schools d. Anchors Away e. Any G/CC site f. Or otherwise authorized by the G/CC Transportation Coordinator 7. DePoo Hospital: Pick-up / drop-off is located in the rear next to the handicap parking. Upon arrival, call the nurse's station directly from the vehicle at 305-294-5531 x8330. Hospital staff will escort the client to/from the building. 8. Pick-up / drop-off is at the ER entrance. Upon arrival, call 305-294-5531 x3202. a. Hospital staff will escort the client to/from the building. 9. At G/CC: Use the telephone call box next to the elevator. 10.At G/CC, staff members shall place the client in the vehicle for departure and will assist the client from the vehicle at time of arrival. 11.The facility responsible for the departing client for a trip longer than 2 hours shall provide a brown bag snack. All minors shall be supplied with a snack for any trip over 1 hour. 12.When a driver reports a client is too dangerous to transport, the nurse on duty shall work with the Sheriffs department to transport the client 13.If a client absconds at time of or during transport, immediately contact 911 and report the information to the G/CC Nurse on Duty. Do not go after the client. 14.Neither Drivers nor Escorts are permitted to physically restrain a client. 15."Jail Hold" clients from the Monroe County Detention Facility shall be picked up from the Rvsd/md 12.1.21 -2 - 9 Sallyport area only. To access the Sallyport area, the driver must drive the car within 1 foot of the Sallyport entrance. If the door does not open, the escort must use the speaker mounted on the wall next to the Sallyport entrance to request entrance. Once inside, Detention Facility staff will bring the client to the car. When the client is inside the car and the doors are locked, the Sallyport area exit doors will open. 16.The driver/escort must determine from the Pickup facility if the client has been searched and encourage staff to conduct a search prior to transport. If the client is not searched prior to transport, the driver must communicate this information to the Duty Staff Member prior to opening the client door at the Designation point. 17.Driver/escort MUST respond to the pickup point within a maximum time-frame of 1 hour and 15 minutes. C. Dress Code 1. Drivers must wear their GCC issued ID badge at all times 2. All clothing worn by the driver must be clean and in good condition, and the driver must have good standards of personal hygiene. As a minimum standard, drivers should wear trousers and a shirt which has a full body and sleeves. Knee length shorts may be worn, 3. Footwear for all drivers shall fit around the heel and toe of the foot. Sneakers are acceptable. 4. The following are deemed to be unacceptable: (a) Clothing that is not kept in a clean condition, free from holes and rips. (b) Words or graphics on any clothing that is of an offensive or suggestive nature or which might offend. (c) Drivers not having either the top or bottom half of their bodies suitably clothed. (d) The wearing of hoods or other clothing that obscures the driver's vision or their identity I acknowledge I have received and read the above BA/MA Transportation Protocol. Driver/Escort Signature Date Printed Name Rvsd/md 12.1.21 -3 - 10 Attachment 2 Vehicle Incident Kit 11 .......................... i Vehicle Incident Kit Contents: Vehicle Incident- Protocol and Reporting Policy Vehicle Incident Report Form Vehicle Incident- Passenger/Witness Statement Forms* Vehicle Incident Traffic Diagram Disposable Camera 12 Pens Number of Statement Forms Required is to equal vehicle passenger capacity plus an additional two for other witnesses. "Drivers are responsible for making sure this kit is complete at all times. 12 Vehicle Incident Protocol and Reporting_Policy (Vehicle Incident Kit Copy) DO IMMEDIATELY: l. Immediately after the incident, examine and question persons for bodily injury and then examine vehicle for damage. 2. If there is an accident involving another vehicle or if persons involved require immediate medical attention, call 911 or 311 accordingly. 3. If involved persons do not report injury, authorities still need to be contacted and a police report requested. If the request for a police report is declined, the reason and dispatcher name and badge number need to be noted. 4. After authorities have been called, your supervisor needs to be called. DO NOT: 1. DO NOT admit fault if you are truly not at fault. 2. DO NOT leave the scene of an accident. 3. DO NOT drive the vehicle if you feel it is unsafe. 4. DO NOT drive the vehicle if you feel physically incapable of driving safely. 5. DO NOT discuss the incident with anyone other than law enforcement authorities, your supervisors, or a claims adjuster from York Claims Service Inc. GATHER INFORMATION & COMPLETE INCIDENT REPORT: 1. An incident will be defined as any occurrence that resulted in damage to the vehicle and/or injury to any person. Damage to a vehicle will be defined as anything that resulted in the property not being left in the same condition as before the incident. 2. Locate and complete the Vehicle Incident Form, complete all the information requested regarding incident and parties involved and take photos of damage with camera provided. 3. All passengers and other available witnesses, if applicable, need to complete the statement form. 4. After police report has been completed (if it was not declined), persons have been cared for (if injury occurred), and vehicle is operational, return to the office. 5. Any and all vehicle incidents must also be reported electronically upon return to the office by attending supervisor by transferring information from Vehicle Incident Form. The incident report.will be completed online by logging into the Westcare Intranet at https://secure.westeare.com/intra/. 6. An additional email must also be sent by the attending supervisor to the following management staff summarizing the incident and action taken; Program Director/Coordinator, Area Director and/or Vice President, and Michael Lavin, Sr. VP of Operations. 7. Supervisor will await further instructions by Program Director/Coordinator and/or Area Director/Vice President and Michael Lavin, Sr. VP of Operations. MANDATORY DRUG TEST The driver of the vehicle involved MUST immediately take a drug test upon completion of the Vehicle Incident Report Form. The driver's supervisor will provide the documents needed for the designated laboratory. Approved by Senior Management 712009 13 Page I of 3 Westcare Vehicle Incident Report Form This form is to be completed by driver immediately after a vehicle incident, when all persons involved have been checked for injury and provided medical attention(if applicable), and while all parties are still present. Basic Information: Incident Date and Time: Incident Location: Were Authorities called? Yes/No If no, explain why? If yes, was a police report request granted? Yes /No If yes, list police report number and attending officer name: If no, list reason why it was declined? Dispatcher Name and Badge Number: Was citation issued? Yes or No If yes,to whom: Westcare Vehicle Information: Year/Make/Model: VIN: Plates: State: Description of Damage: Please take pictures of damage with disposable camera provided in Vehicle Incident Kit. Driver Information: Driver Name and Job Title: Driver License Number: State: Involved Party I Year/Make/Model: Role in Incident: Description of Damage: Please take pictures of damage with disposable camera provided in Vehicle Incident Kit. i Insurance Company: Claims Phone: Policy# License# State: Driver Name: Phone: Injured? Yes or No If yes, explain: Passenger I Name: License# State: Injured? Yes or No If yes, explain: 14 Page 2 of 3 Passenger 2 Name: License# State: Injured? Yes or No If yes, explain: Passenger 3 Name: License# State: Injured? Yes or No If yes, explain: (Attach sheet if more passengers present) Involved Party 2: Year/Make/Model: Role in Incident: Description of Damage: Please take pictures of damage with disposable camera provided in Vehicle Incident Kit. Insurance Company: CIaims Phone: - Policy# License# State: Driver Name: Phone: Injured? Yes or No If Yes, explain: Passenger 1 Name: License# State: Injured? Yes or No If yes, explain: Passenger 2 Name: License# State: Injured? Yes or No If yes, explain: Passenger 3 Name: License# State: Injured? Yes or No If yes, explain: (Attach sheet if more parties involved) Passengers Present in Westcare Vehicle: All passengers must complete a Vehicle Incident Passenger Statement Form. 1. Staff or Client Name: Injured? Yes or No If Yes, explain: 2. Staff or Client Name: Injured? Yes or No If Yes, explain: 3. Staff or Client Name: Injured? Yes or No If Yes, explain: 4. Staff or Client Name: Injured? Yes or No If Yes, explain: 15 Page 3 of 3 S. Staff or Client Name: Injured? Yes or No If Yes, explain: 6. Staff or Client Name: Injured? Yes or No If Yes, explain: 7. Staff or Client Name: Injured? Yes or No If Yes, explain: S. Staff or Client Name: Injured? Yes or No If Yes, explain: (Attach sheet if more passengers present) Detailed Explanation of Incident: Was this a preventable incident? Yes or No Explain why or why not: I confirm the information provided in this report is as accurate to my knowledge and as thorough as possible. Name: Signature: *This report must be sent to the attending supervisor as promptly as possible. Attending supervisor must complete and submit an electronic incident report via the Westcare Intranet and email management. **The Driver of the Westcare vehicle must take a drug test, as required by company policy,immediately after the vehicle incident and attending supervisor needs to know the time of completion. Approved by Senior Management 712009 16 Westcare Vehicle Incident Passenizer/Witness Statement Form Name: Are you Westcare Staff, a Westcare Client, or Other? Are you a Driver, Passenger or Other Witness? If Other Witness, please list Contact Information: Address: City: St: Zip Phone: { ) Incident Date and Time: z Incident Location: Westcare Vehicle Make/Model: Description of Incident/Event: _ Are you injured? Yes or No If yes,please explain: I was offered medical evaluation: Yes or No If yes, I: Accepted or Declined Signature: I certify that the above information is as accurate to my knowledge and as thorough as possible. Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. Thank you for your cooperation. Approved by Senior Management 712009 S.L. 17 Westeare Vehicle Incident Passenger/Witness Statement Form Name: Are you Westcare Staff, a Westeare Client, or Other? Are you a Driver, Passenger or Other Witness? If Other Witness,please list Contact Information: Address: City: St: Zip Phone: Incident Date and Time: 4 Incident Location: Westcare Vehicle Make/Model: Description of Incident/Event: Are you injured? Yes or No If yes,please explain: I was offered medical evaluation: Yes or No If yes, I: Accepted or Declined Signature: I certify that the above information is as accurate to my knowledge and as thorough as possible. Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. Thank you for your cooperation. Approved by Senior Management 712009 S. L. 18 Westcare Vehicle Incident Passenger/Witness Statement Form Name: Are you Westcare Staff, a Westcare Client, or Other? Are you a Driver, Passenger or Other Witness? If Other Witness,please list Contact Information: Address: City: St: Zip Phone: - Incident Date and Time: Incident Location: Westcare Vehicle Make/Model: Description of Incident/Event: Are you injured? Yes or No If yes,please explain: I was offered medical evaluation: Yes or No If yes, I: Accepted or Declined Signature: I certify that the above information is as accurate to my knowledge and as thorough as possible. Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. Thank you for your cooperation. - Approved by Senior Management 712009 S.L. 19 Westeare Vehicle Incident Passenger/Witness Statement Form Name: Are you Westeare Staff, a Westeare Client, or Other? Are you a Driver, Passenger or Other Witness? If Other Witness,please list Contact Information: Address: City: St: Zip Phone: Incident Date and Time: Incident Location: Westcare Vehicle Make/Model: Description of Incident/Event: Are you injured? Yes or No If yes,please explain: I was offered medical evaluation: Yes or No If yes, I: Accepted or Declined Signature: I certify that the above information is as accurate to my knowledge and as thorough as possible. Signature Date This form will be forwarded to attending supervisor to be part of the Vehicle Incident Report. Thank you for your cooperation. Approved by Senior Management 712009 S. L. 20 Additional Sheet foir More Information 21 Approved by Senior Management 7/2009 N Traffic Diagramsw+E s i Intersection Highway/Street I Z 3 �4 5 - Attachment 3 Guidance/Care Center Baker Act/Marchman Act Training Acknowledgment 23 GUIDANCE/CARE CENTER, INC. BA/ MA DRIVER TRAINING ACKNOWLEDGEMENT I acknowledge I have completed GUIDANCE / CARE CENTER'S BA/ MA DRIVER ORIENTATION including: • De-Escalation • Proper completion of trip documentation (trip sheets) • Pre-trip vehicle inspections and reporting • Incident Reporting • Accident Reporting • Citations • Driver Protocols • Professionalism Driver/Escort Signature Date Printed Name Facilitator Signature Date Printed Name 24 -', WESTFOU-01 SE72ASCOTT ,d►coRo. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �•� 6/30/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Deidre Williams NAME: AssuredPartners, Lake Mary PHONE FAX 300 Colonial Center Parkway,Suite 270 (A/C,No,Ext): (A/C,No): Lake Mary,FL 32746 E-MAILADDRESS:deedee.williams@assuredpartners.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Allied World Surplus Lines Insurance Company 24319 INSURED INSURER B:Vanta ro Specialty Insurance Company 44768 Guidance Care Center Inc. INSURERC:Continental Divide Insurance Company 35939 PO Box 94738 INSURER D: Las Vegas,NV 89193-4738 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MWDD/YYYY MWDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE j OCCUR 5088087802 7/1/2021 7/1/2022 DAMAGE TO RENTED 1,000,000 PREMISES Ea occurrence $ APPROVED BY RISK MANAGEMENT MED EXP(Any oneperson) $ 20,000 BY �� r J � r PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: DATE 1/20/2022 GENERAL AGGREGATE $ 3,000,000 POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 3,000,000 JECT WAVER PIMA_YES_ OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO 5091019302 7/1/2021 7/1/2022 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 X EXCESS LIAB CLAIMS-MADE 5090022302 7/1/2021 7/1/2022 AGGREGATE $ 3,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N WEWC214974 2/26/2021 2/26/2022 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,UUU If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liabili 5088087802 7/1/2021 7/1/2022 Aggregate 3,000,000 A Professional Liabili 5088087802 7/1/2021 7/1/2022 Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) INSURER AFFORDING COVERAGE: Allied World Surplus Lines Insurance Company POLICY NUMBER: 5088-0878-02 EFF DATE: 07/01/2021 EXP DATE:07/01/2022 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Abuse&Molestation Per Occurrence $1,000,000 Aggregate $3,000,000 SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Management 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) 83 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:WESTFOU-01 SE72ASCOTT LOC#: 1 A 0 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Assured Partners, Lake Ma Guidance Care Center Inc. Mary PO Box 94738 POLICY NUMBER Las Vegas,NV 89193-4738 EE PAGE 1 CARRIER NAIC CODE EE 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 Description of Operations/Locations/Vehicles: INSURER AFFORDING COVERAGE: Houston Casualty Company POLICY NUMBER: H2ONGP203970-00 EFF DATE: 09/21/2020 EXP DATE: 09/21/2021 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Network Security Liability Per Claim: $5,000,000 Aggregate: $5,000,000 Monroe County Board of County Commissioners is Additional Insured under the General Liability and Automobile Liability as required by written contract. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are84egistered marks of ACORD