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SY2021-2023 1st Amendment 06/15/2022 Kevin Madok, cpA A., Clerk of the Circuit Court& Comptroller— Monroe County, Florida DATE: No%'eniber 7, 2022 TO: Sheii-I Gral uii, Director Social Scnices Lourdes Francis, Administrator FROM: Pmiiela G. flancoc '*C. SUBJECT: 0ctober 19" BOCC Meetiliff Attached is mi electronic copy ol'the I'011owing item I'Or your handling: C I I I st Amendment to renew the Annual Agreement between Tranquility Bay Adult Day Care (Key Largo) and Monroe County to continue to provide Facility-Based Respite Services to elderly and disabled citizens residing throughout Monroe County in an amount, not to exceed, $80,000.00 for the period of July 1, 2022 through June 30, 2023. Should you lia%,c any questions please feel free to contact me at (305) 292-3550. CC: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY 500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070 AMENDMENT I TO TRANQUILITY BAY ADULT DAY CARE (KEY LARGO) AGREEMENT #TB-21-22 THIS 1ST AMENDMENT TO AGREEMENT, made and entered into this 15th day of June,. 2022 by and between MONROE COUNTY, FLORIDA,/Monroe County Social Services a political subdivision of the State of Florida (hereinafter called the "Owner" or "County"), and Tranquility Bay Adult Day Care(Contractor). WITNESSETH WHEREAS,the County provides Services to the elderly and disabled residing throughout Monroe County;and WHEREAS, the County receives funding from the Alliance for Aging, Inc., the Florida Agency for Health Care Administration, and the Monroe County Board of County Commissioners for the purposes of providing Social Services Countywide;and WHEREAS, the County has provided Services to assist the vulnerable elderly and/or disabled residents to remain in their homes and maintain independence for over 30 years; and WHEREAS, the County desires to renew the agreement for Facility-Based Respite Services to ensure that such services are available throughout the County;and WHEREAS, Tranquility Bay Adult Day Care is qualified and desires to provide Services; and WHEREAS, the parties find that it would be mutually beneficial to enter into this 1st renewal agreement; NOW THEREFORE, in consideration of the mutual covenants and provisions. contained in this Renewal and in the Original Agreement, the parties agree as follows; Section 1. In accordance with Paragraph 4 of the Original Agreement, the County exercises the option to renew the Original Agreement for the one year. This term will commence on July 1, 2022 and end on June 30"', 2023 Section 2. Except as set forth in section 1 of this Renewal, in all other respects, the terms and conditions set forth in the original Agreement dated July 21s`, 2021 remain in full force and effect. 1 AMENDMENT 1 TO TRANQUILITY BAY ADULT DAY CARE (KEY LARGO) AGREEMENT #TB-21-22 RN WITNESS WHEREOF, the parties hereto have set their hands and seals the day and year first above written. Tranquility Bay Adult Day Care Monroe County Board of County Commissioners Lucy Cruz, President BY: 4k BY: MAYOR DATE:® _ DATE: June 15, 2022 I . ST: Kevin Madok, Clerk $s James D. Dlgitally signed by James D.Molenaar r Molenaar Date:2022.06.15 17:02:30-04'00' �• "/ k l ..p.// ..,.....,.. ,. .m. ,. Approved as to Form and Legal Sufficiency Y James D. Molenaar As Deputy Clerk Asst. County Attorney MONROE COUNTY ATTORNEY'S OFFICE 2 710/21/2022 E(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Hiliary Gonzalez Sebanda Insurance Corp A/CNN Ext: (305)665-0016 OE FAX No): (888)979-8772 6401 SW40TH ST E-MAIL-ADDRESS: C g onza h lez sebandainsurance.com INSURER(S)AFFORDING COVERAGE NAIC# MIAMI FL 33155-4825 INSURERA: Nautilus Ins Co 25011 INSURED INSURER B: Progressive Express Ins Co 10193 TRANQUILITY BAY ADULT DAY CARE CORP INSURER C: 100980 Overseas Hwy INSURER D: INSURER E: Key Largo FL 33037 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAM CLAIMS-MADE � OCCUR P R E MA SESOEa occurrDence $ 100,000 MED EXP(Any one person) $ 5,000 A Y TKHKH-Z 10/18/2022 10/18/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 300 000 Ea accident ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y 04188365-0 10/19/2022 10/19/2023 BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident PIP $ 10,000 UMBRELLA LIAB OCCUR A1rRk, EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ w DED RETENTION$ "'�"' $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y ""' m STATUTE OR ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ (Mandatory in NH)EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Sexual Abuse Or Molestation Each Event: $100,000 A TKHKH-Z 10/18/2022 10/18/2023 Aggregate: $300,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County BOCC is named as an Additional Insured in respects to the General Liability and Automobile Liability. Scheduled Vehicles&Drivers: 2016 Ford T-350 Transit W 1 FBVU4XVOGKA06130 2016 Nissan Quest JN8AE2KP7G9150788 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 1100 SIMONTON STREET AUTHORIZED REPRESENTATIVE KEY WEST FL 33040 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: ACOOR" ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Sebanda Insurance Corp TRANQUILITY BAY ADULT DAY CARE CORP POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Lucy Cruz Raidel Dickinson ACORD 101 (2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD