1. 06/22/1995 Agreement
mann!, lL. kolbagt
BRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
MEMORANDUM
TO: Paula Rodriguez, Director
Human Resources
Attn: Christine Diaz
FROM:
Isabel C. DeSantis, Deputy Clerk~. C. P:
August 3, 1995
DA TE:
At the June 22, 1995 Commissioner's meeting, the Board granted approval and
authorized execution of a Contract between Monroe County and Dr. Michael Burton to
provide physical examinations and drug testing services.
Attached hereto is fully-executed duplicate original of the subject Agreement for return
to the Physician.
Should you have any questions concerning the above, please do not hesitate to contact
me.
cc: County Attorney
County Administrator, w/o document
Finance
jRisk Management, w/o document
. File
CONTRACT
THIS CONTRACT is entered into by Monroe County, a political subdivision of the
State of Florida, hereafter COUNTY, whose address is Public Service Building, 5100 College
Road, Stock Island, Key West. FL 33040, and MICHAEL D. BURTON, D.O., whose address is
-"
1446 Kennedy Drive, Key West. FL 33040, hereafter PHYSICIAN. ;;:_ ~ 0
Z -' fT1
=- Z 0
1. The PHYSICIAN represents that he and his associates ~c9 ~ill piavide"T
~ ~r r-
services under this agreement are professionally qualified to provide PhY~I:..exa~nd:::
z......... ~'v
-._' ""'0 :'1
drug testing services. The PHYSICIAN also represents that he has sufficiet<lResouras to g
~ _ ~ :1J
diligently carry out the services described in his February 5, 1995, pror5bsaL atta~ed ',~
hereto as Exhibit A and incorporated herein, and that all professional licenses needed to
perform any aspect of the services are held by the physicians named in the proposal.
2.
The PHYSICIAN must commence work within
(p()
days of the
effective da1e of this contract. The project is essential to the County's public function of
providing governmental services efficiently by persons capable of performing their
assigned tasks effectively. Therefore, time is of the essence in completing each task.
3. The PHYSICIAN must carry out the services according to the specifications
of Exhibit A.
The COUNTY shall pay to the PHYSICIAN the fees described in Exhibit A upon
receipt of invoices and documentation of the completion of services.
4. The contract has no value or benefit to the COUNTY if not satisfactorily
completed. Therefore, the PHYSICIAN I S failure to satisfactorily complete any task
releases the COUNTY from the obligation to pay the PHYSICIAN any compensation for
that task or service. Nothing in this paragraph releases the PHYSICIAN from the
obligation to compensate the COUNTY from damage suffered because of the
PHYSICIAN'S failu~e to satisfactorily complete any task or service.
Requests for payment must be in a form satisfactory to the County Clerk and
contain an original invoice and documentation and certification of services. Payment
shall be made within 15 days of the determination that the task was satisfactorily
completed unless the COUNTY'S obligation to compensate the PHYSICIAN the contract
price is terminated under another paragraph of this contract. The PHYSICIAN may not
receive the final payment until all outstanding work product reports have been turned
over as provided in paragraph 7.
The COUNTY shall also pay the PHYSICIAN whatever reasonable expenses were
incurred in performing tasks under this contract, but only to the extent and amounts
allowed by Sec. 112.061, FS. Reimbursement payment requests must be submitted with
the request for payment for the task that made necessary the expenses. All requests for
the payment of reimbursable expenses must be in a form satisfactory to the County Clerk
and be supported by whatever documentation the Clerk may require. The COUNTY
does not have any obligation to reimburse the PHYSICIAN for expenses if The COUNTY'S
obligation to compensate the PHYSICIAN for the project or task(s) terminates under
another section of this contract.
5. The PHYSICIAN may not receive compensation under this agreement for
any work performed that is not described in Exhibit A unless the work is approved in
writing by the Board of County Commissioners.
6. If delay in the completion of the project or an individual project task
occurs and the delay is not caused by the PHYSICIAN, then the PHYSICIAN is entitled to
an extension of time equal to the length of delay but not to any additional
compensation. This paragraph applies even if the delay was caused by the COUNTY.
7. If the COUNTY decides to abandon the project or fails to appropriate
funds, the COUNTY must immediately notify the PHYSICIAN in writing. The PHYSICIAN must
2
cease all work on the project upon receipt of the COUNTY'S abandonment or
nonappropriation letter. The PHYSICIAN must also turn over to the COUNTY all project
work product - whether complete or not. The COUNTY must pay the PHYSICIAN for any
task or service rendered which remains unpaid, plus any outstanding reimbursable
expenses.
8. The PHYSICIAN warrants that all the work required under this contract will
be performed in a competent and professional manner. The PHYSICIAN warrants the
completeness and accuracy of all work constituting the project and the project task.
The PHYSICIAN must, without additional compensation, promptly correct any errors,
omissions, deficiencies or conflicts in the services or tasks.
9. Each party agrees to be liable for its own negligence, errors or omissions
under this contract.
10. The PHYSICIAN must have insurance of the amount and type described in
Exhibit B unless waived by Risk Management per Administrative Instruction 4709. Exhibit B
is attached and incorporated into this contract.
11. The PHYSICIAN may only use qualified personnel to carry out the project
and project tasks. At the time of the execution of this contract, the parties expect that
the following individuals will perform the tasks at the locations indicated.
Name
Dr. Michael Burton
Dr. William Chambers
Dr. John Deagle
Location
Lower Keys
Middle Keys
Upper Keys
12. The PHYSICIAN may not assign or subcontract its obligations under this
contract - other than the receipt of money - without the written consent of the COUNTY.
13. Records of the contracted tasks and records of the accounts between the
COUNTY and the PHYSICIAN must be kept on a generally recognized accounting basis
and must be available to the COUNTY or its authorized representative during normal
3
business hours. The PHYSICIAN must keep the records for five years following the
provisions of services.
14. The PHYSICIAN is an independent contractor. Nothing in this contract may
create a contractual relationship with, or any rights in favor of , any third party including
subcontractors or materialmen of the PHYSICIAN. The PHYSICIAN'S use of a
subcontractor or subcontractors to carry out the project, a project task, or any portion of
the work, will not in any way relieve the PHYSICIAN of its obligations under this contract
even though the subcontractor was approved by the COUNTY.
15. The PHYSICIAN acknowledges that all records, data, and documents
created as part of the project. if applicable, are public records under Chapter 119,
Florida Statutes, except to the extent they are exempted pursuant to statute as
determined by the County Attorney. Records which have no exemption must be made
available at a reasonable place and time upon the request of a member of the public.
Failure to do so is a breach of this contract entitling the COUNTY to treat the contract as
terminated on the date of the violation of Chapter 119, Florida Statutes, with the
COUNTY'S obligation to pay extending only to work completed as of that date. The
PHYSICIAN may charge reasonable fees for preparing and copying those records, data
and documents.
1 6. Either party may terminate this contract because of the failure of the other
party to perform its obligations under the contract. If the COUNTY terminates this
contract because of the PHYSICIAN'S failure to perform, then the COUNTY must pay the
PHYSICIAN the amount due for all work and tasks satisfactorily completed as determined
by the COUNTY'S Director of Human Resources up to the date of the PHYSICIAN'S failure
to perform but minus any damages, both incidental and consequential, the COUNTY
suffered as a result of the PHYSICIAN'S failure. The damage amount must be reduced by
4
the amount saved by the COUNTY as a result of the contract termination. The PHYSICIAN
is liable for any additional amount necessary to adequately compensate the COUNTY if
the amount due the PHYSICIAN is insufficient to compensate the COUNTY for the
damage it suffered.
17. This contract represents the parties' final and mutual understanding. It
replaces any earlier agreements or understandings, whether written or oral. This contract
cannot be modified or replaced except by another signed contract.
18. Nothing in this contract should be read as modifying the applicable
statute of limitations. The waiver of the breach of any obligation of this contract does
not waive another breach of that or any other obligation.
19. The PHYSICIAN warrants that he has not employed, retained or otherwise
had act on his behalf any former COUNTY officer or employee subject to the prohibition
of Section 2 of Ordinance No. 010-1990 or any COUNTY officer or employee in violation of
Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the
COUNTY may, in its discretion, terminate this contract without liability and may also, in its
discretion, deduct from the contract or purchase price, or otherwise recover, the full
amount of any fee, commission, percentage, gift. or consideration paid to the former
COUNTY officer or employee.
20. This contract is governed by the laws of the State of Florida. Venue for any
disputes arising under this contract shall be in Monroe County, Florida.
21. The PHYSICIAN agrees that he will not unlawfully discriminate against any
of his employees or applicants for employment because of their race, color, religion, sex,
national origin or disability. The PHYSICIAN must insert a provision similar to this
paragraph in any subcontracts awarded under this contract except those for the
purchase of commercial supplies and raw materials.
5
22. All communication between the parties should be through the following
individuals:
Monroe County
Director of Human Resources
Public Service Building
5100 College Road, Stock Island
Key West, FL 33040
(305)292-4537
Physician
Michael D. Burton, D.O.
1446 Kennedy Drive
Key West. FL 33040
(305)294-8900
24. This contract takes effect on the date of the signature of the last party to
sign.
IN WITNESS WHEREOF each party has caused this agreement to be executed by
its duly authorized representative.
(SEAL)
Attest: DANNY L. KOLHAGE, CLERK
B~o.kLC. ~
Deputy Clerk
(}#~P~;,y
Witness
/'"
tJ/i/dJe n g.LtM;] .4h?
ness
jconburton
6
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
cS~-F~
By
Mayo halrman
DATE: ~~Lf\L ~"2-.' /qq-f; ..
MICHAEL D. BURTON, D.O.
KEY WEST FAMILY MEDICAL CENTER
T
Exhibit A
MICHAEL D. BURTON, D.O.
KEY WEST FAMILY MEDICAL CENTER
February 5, 1995
TO: The Board of County Commissioners
of Monroe County, Florida
FROM: Michael D.Burton, D.O.
RE: REQUEST FOR PROPOSAL: Physical Examination Services
and Drug Testing Services for County Employees and
Job Applicants.
As per your request, the following bid is presented with
some additional information, suggestions, and qualifica-
tions.
1. Physical Exam and Collection Sites: Geographic Locations
a) Lower Keys: Dr. Michael D. Burton
Key West Family Medical Center
1446 Kennedy Drive
Key West, FL 33040
b) Middle Keys: Dr. William Chambers
2855 Overseas Highway
Marathon, FL 33050
c) Upper Keys: Dr. John Deagle
90290 Overseas Highway, Suite 106
Tavernier, FL 33070
2. Medical Review Officer - for Drug Testing
Michael D. Burton, D.O.
Key West Family Medical Center
1446 Kennedy Drive
Key West, FL 33040
3 . Ph y sic alE x am i n a t ion 5, a tal 1 1 0 cat ion s :
a)
b)
c)
d)
Post-Offer Employment Exam
Post Incident/Accident Exam
Reasonable Suspicion Exam
Fitness for Duty Exam
$35.00
$35.00
$35.00
$35.00
Not requested but available, are
medical examinations for the
Department of Transportation/D.O.T. $35.00
regulations.
(included are dipstick urine analysis)
1446 KENNEDY DRIVE KEY WEST. FLORIDA 33040 TELEPHONE (305) 294-8900
Page 2
4. The Request for Proposals/Scope of Services requests urine
drug testing. While your request was not specific, the State
of Florida "Drug Free Workplace" legislation (Florida Adminis-
trative Code 10E-18) will accomplish your goals. The urine
drug panel "HRS-10" is widely used and is supported by strict
guidelines and legislation. In general, State licensed HRS
Laboratories, charge per urine sample, irrespective of
positive or negative test results, a "bundled" test. Separate
charges for initial and confirmation tests are possible, but
may be more costly and in rare use.
Price for a HRS-10 panel urine drug test
$45.00
a) This includes site collection, all lab testing
(irrespective of positive or negative results)
and Medical Review Officer evaluation and
reporting. This price is not dependent on the
reason for the testing. i.e. post job offer,
reasonable suspicion, follow-up if post incident
or test results - positive or negative.
b) There are several reasons to avoid the ".!dllbundled"
tests. The HRS labs are required to run confirma-
tion tests on all samples exceeding the initial
"cut off" drug levels. The confirmation test
uses different methodologies and different "cut off"
levels for reporting. The lawful use of a prescrip-
tion medicine on the test list will be detected and
reported to the MRO as positive by the lab. The MRO
would then find the lawful use and report to the Human
Resources Director a negative urine drug test (i.e.
lawful use is reported as a negative test). However,
Monroe County would get a bill for the "initial test"
and the second "confirmation test", thereby telling
the employer that the employee was testing positive.
The employer is, however, prohibited from having
that information under Florida statues, but in
effect that information received by the employer by
bi 11 ing practices.
We do have experience in the drug testing environment
and would be glad to tailor your specific needs and
provide additional insight when needed.
c) To comply with the bid request -
Price for"initial" HRS 10 panel drug test only
$40.00
$75.00
Price for each "confirmation" test
Page 3
5. Florida HRS testing allows for and requlres Blood alcohol
testing.
Blood Alcohol Testingj
Florida state HRS Guidelines
6. Federal "NIDA"jDOT testing allows for
and requires Breath Alcohol Testing
Breath Alcohol Testingj
Federal Guidelines
$40.00 per test
$30.00 per test
7. After hours collections of specimens. $100.00
Hopefully, an extremely rare occurrence
and in general needed for post-accident
and alcohol related testing only.
QUALIFICATIONS
Employment physicals should be thorough and substantive to
be cost effective. The selection of the clinicians who perform
tho see x am i n at ion s i s imp 0 r tan t . Pas t ex per i en c e i n c 1 u des
training in the U.s. Armed Services and duty stations at
recruit depots where physical examinations and compliance
standards a daily routine. Each proposed site currently
provides those examination services to numerous employers
within Monroe County, a few are listed in the following drug
testing information.
The Key West Family Medical Center currently provides a
collection site and Medical Review Officer function to:
Monroe County Sheriff Department
City Electric System
Florida Keys Aqueduct
Dion's Oil Company
Independent U.S. Coast Guard licensed captains
and collection sites for:
U.S. Post Office
Florida Department of
Law Enforcement
Monroe County School Board:
Transportation Department
General Dynamic Aircraft Service
Federal Express
Scotty's
J. Byron's
K-Mart
I. H.O. P.
Silver Eagle Distributors
Alterman Freight
Tarmac
Winn Dixie Supermarkets
.. .and numerous others...
Benson Electric
Biscayne Chemical
Convalescent Center
First Union Bank
First National Bank
Europa Cruise Lines
Go ld CoastjSysco Foods
Holsum Bakery
J. C. Penney Co.
O.M. I .
Shoney's
Sheraton Suites
Suddath Van Lines
Publix Supermarkets
Page 4
Additionally, the Key West Family Medical Center processes
urine drug testing samples for the following laboratories:
Smith Kline Beecham Laboratories (four locations)
National Reference Laboratories - Nashville, TN
Roche Biomedical Laboratory - Memphis, TN
Medpath - Teterboro, New Jersey
Consulab - Miami, FL
Nichols Institute - San Diego, CA
Eagle Forensic Laboratory - Pompano Beach, FL
PDLA laboratory - South Plainfield, NJ
MedExpress - Memphis, Tennessee
National Center for Forensic Science - Baltimore, MD
The three sites in this submitted proposal are active local
clinicians with a history of expertise in the requested areas
and committed to improving the Florida Keys.
If we can be of service or respond to questions, please let me
know.
Sincerely,
ton, D.O.
MDB:ea
"
"
EXHIBIT B
April 22, 199J
I sll'rinling
MONROE COUNTY, FLORIDA
I,
"--.-'
Request For W~"ver
of
Insurance Requirements
\.J
It is requested that thc insurance requirements, as specified in thc' County's Schedule of Insurance
Requirements, be waived or modified on the following contract.
Contractor:
Michael D. Burton. D.o.
s G~ VI'c.GS ./ htUt J
Tt'JTINct S<<VIIE$
(J
Contract for:
f1 t! bi e4-L
Address of Contractor:
MICW)'-EL O. BURTON, D.O.
KEY WEST FAMILY MEDICAL CTR
1446 KFNNFOV ORIVF
KEY WEST. FL 33040
Scope of Work:
('JD;) -2?~- ?f~o
Ihy5ic,f{ e~~ s, cPdMJ -hJn";cf -
~tf.o<. c.cu~ ef'\-l l01ee 's' ~
-P;/L
Job 1flic~.
Phonc:
Reason for Waivcr:
~:tSI't.I~~ M....;..I~;~
3r;tlc (o/{...), c.{,(t<tt~l'Jt
.
t'\ ~ I f il4 c..c. ,'/oJ .s lo(.,(""" '-L
$ :l5""~ pvo /f 5'0, Vt10
, ~
:)
AS ~t'Qw~i --f t7 "--
Signature of Contractor:
~;./;.-G7 /~c.k~ ~ I;"'J'-CA~~ ~~t:24"t-t.~~"~
0, Burton, D.O.
Risk Managcment
Date
County Administrator appeal:
Approved:
Not Approved:
Date:
Board of County Commissioners nppeal:
Approved:
Not Approved:
Meeting Date:
.~
WAIVER
;
^pril 22. I 'J')]
1st I'rin'ing
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
, FOR
CONTRACT PHYSICAL EXAMS/DRUG TESTING SERVICES
BETWEEN
MONROE COUNTY, FLORIDA
AND
MICHAEL D. BURTON, D.O.
Prior to the commencement of work governed by this contract, the Contractor shall ohtain
Workers' Compensation Insurance with limits sullicicnt to respond to Florida Statute 440,
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
$JOO,OOO Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$100,000 BodiJy Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the
state ofI.Jorida and the company or companies must maintain a minimum rating of A-VI, as
assigned by the AM. Best Company.
If the Contractor has been approved by the Florida's Department of Labor, as an authorized self-
insurer, the County shall recognize and honor the Contractor's status. The Contractor may be
required to submit a Letter of Authorization issued by the Department of Labor and a Certificate
of Insurance, providing details on the Contractor's Excess Insurance Program.
I f the Contractor participates in a self-insurance fund, a Certificate of I nsurance will be required.
In addition, the Contractor may be required to submit updated financial statements from the fund
upon request from the County,
AdRlinistrath'c Ire.w1.1ion
114709,1
WCI
81
^priI22. 199J
J sl I'rinlin!~
MEI>ICAL PROri'ESSIONAL LIABILITY
INSURANCE REQUII~EMENTS
FOR
CONTRACT PHYSICAL EXAMS/DRUG TESTING SERVICES
BETIVEEN
MONROE COUNTY, FLORIDA
AND
MICHAEL D. BURTON, D.O.
Recognizing that the work governed by this contract involves the providing of professional
medical treatment, the Contractor shall purchase and maintain, throughout the life of the contract,
Professional Liability Insurance which will respond to the rendering of, Of' failure to render
medical professional services under this contract.
The minimum limits of liability shall be:
$500,000 per Occurrence/$l,OOO,OOO Aggregate
Ifcoverage is provided on a claims made basis, an extended claims reporting period of four (4)
years will be required.
^umini!'lralivc Ino;trudion
114709.1
MEDI
65
,\pfll 22. 19'.1.1
Isll'rullillg
MONROE COUNTY, FLORIDA
. ..<.
Rcqucst foOl' Waivcr
of
I n~u ranec Rcqu i rCll1cnts
Rt'CCiV('Ci
'Ag!1it. 8.' Loss Comrol o,e Ie;,
{,,",'" 5-'7-7(, ~..<:...
,.-'.;l, I._ _...~._._______._...___.__.___
,:'.'I!ll' _~__..________.__.
It is requested lI1!ltthc insurance requiremenls. as spcclf'icd in the County's Schedule of Insumnce
RcqllirelllclllS. be waived or Illodiried on tlie f'ollo\\illg contract,
Conlractor:
Dr. Michael D. Burton, D.O.
Conlract for:
Physical Examinations & Druq Testinq
Address of Contractor:
1446 Kennedy Drive
Key West, FL 33040
Phone:
(305)294-8900
,
.
Scope of' Work:
Reason for
J:h~9.ical Examinations & Druq Testinq Services
Waiver: Current county contract is with myself,Michael
fr';---Burton, D.O., [;[;#495 69 0389. I maintal.'n medical
malpractice insurance in amounts specified by the
l'L .LUL waiver request. Wor]{er I r3 COfRPOnoati~~~W
quired only if the contracting entity has or~
Inore ellll'luYt:es. The ori~1.l'ial aid roq1:lost gj..d not
specify this as a requirement.
Signature of Contractor:
~el D. Burt.n. D.O.
Approved Y- __ Not Approved
C)~r;J;}:;Q', ~
_ _ _~__. - 1, ~
5 . t'l l/
'-~ /I 01'\
I<.isk fyLllllIgell1cll(
Datc
COllnl~' 1\ d 111 i n islrator il["lpe:i1:
^pproved:
NOI ^pprovcd:
Dnle:
lJoard of COllllly COlllllllssioners i1["lpeal:
^p["lrovcd,
Not ^pproved:
Meeting Dale:
WAIVER
cc ~ tfr./~ fes&Jv~
r/G.#
I
CERTIFICATE OF INSURANCE
This Certificate is issued as a matter of information only and confers no rights upon the
Certificate Holder, This Certificate does not amend, extend or alter the coverage afforded by
the policy listed below: f' ~ _
NAMED INSURED AND ADDRESS: \\"r~ RECf1'IED
Michael Burton, 0.0, - \C~) ;i MJ.!.\~? n 1997
1446 Kennedy Drive cl'/ \.)\)
Key West, FL 33040 )-- '\ ('.mmN ~..c.w:n\strator
COMPANY AFFORDING COVERAGE:
Gulf Atlantic Insurance Company
P,O, Box 12200
Tallahassee, FL 32317-2200
This is to certify that the policy of insurance listed below has been issued to the insured named
above and is in force at this time,
TYPE OF INSURANCE:
MEDICAL PROFESSIONAL LIABILITY INSURANCE
POLICY NUMBER:
MPL0000638
RETROACTIVE DATE:
11/19/1990
POLICY PERIOD:
FROM: 01/01/1997
TO: 01/01/1998
LIMITS OF LIABILITY:
$250,000 / $750,000
Each Claim/Annual Aggregate
CANCELLATION: Should the above-described policy be canceled before the expiration date
thereof, the issuing Company will endeavor to mail written notice to the below-named
Certificate Holder, but failure to mail such notice shall impose NO obligation or liability of any
kind upon the Company,
3/17/97
DATE ISSUED
,~0"')'WED ~RIS ~1 ~!^r,p~rNT
. '. rU- '
, +q-qj
Lj\lE _.____
WAIVER: N!A ~_ '
#~ d qd~
Kathleen 8, Atkins
fA A f1 Authorized Representative
6L~.~
Ce' ~
NAME AND ADDRESS OF CERTIFICATE HOLDER:
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
ATTN DEPT OF ADMINISTRATION
5100 COLLEGE RD
KEY WEST, FL 33040
3~7
GAIC CI REV 1.3 1/97
CERTIFICATE OF INSURANCE
This Certificate is issued as a matter of information only and confers no rights upon the
Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by
the policy listed below:
NAMED INSURED AND ADDRESS:
/
~,~
_\~
LL'
~Vf~__ r~
Michael Burton, D.O.
1446 Kennedy Drive
Key West, FL 33040
1'i~1\!fR: Nt"
COMPANY AFFORDING COVERAGE:
Gulf Atlantic Insurance Company
P.O. Box 12200
Tallahassee, FL 32317-2200
This is to certify that the policy of insurance listed below has been issued to the insured named
above and is in force at this time.
TYPE OF INSURANCE:
MEDICAL PROFESSIONAL LIABILITY INSURANCE
POLICY NUMBER:
MPL0000638
RETROACTIVE DATE:
11/19/1990
POLICY PERIOD:
LIMITS OF LIABILITY:
FROM: 01/01/1998
TO: 01/01/1999
$250,000 / $750,000
Each Claim/Annual Aggregate
CANCELLATION: Should the above-described policy be canceled before the expiration date
thereof, the issuing Company will endeavor to mail written notice to the below-named
Certificate Holder, but failure to mail such notice shall impose NO obligation or liability of any
kind upon the Company.
3/13/98
DATE ISSUED
~ d tfd;,w
Kathleen 8, Atkins
Authorized Representative
NAME AND ADDRESS OF CERTIFICATE HOLDER:
MONROE COUNTY RISK MANAGEMENT
MED STAFF CREDENTIALlNG
5100 COLLEGE RD #203
KEY WEST, FL 33040
PATti
INITIAL
3lrl~
GAIC CI REV 1,31/97