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10/15/2003 FINANCIAL AGREEMENT FOR LOCAL MATCH Fiscal Year 2003-2004 AGREEMENT BETWEEN FLORIDA HEAL THY KIDS CORPORATION "FHKC" AND MONROE COUNTY fA This Agreement is made and entered into this /5 day of {f)vr, 2003 by and between Momoe County, hereinafter called "Momoe County" and the Florida Healthy Kids Corporation hereinafter called 'FHKC', a Florida not-for-profit corporation under the provisions of Chapter 617, Florida Statutes. WHEREAS, the Florida Legislature enacted Chapter 624.91, Florida Statutes, creating the Florida Healthy Kids Corporation, a Florida not-for-profit corporation organized to facilitate a program to provide comprehensive health insurance coverage and preventative health care services to Florida children; WHEREAS, the 2003-2004 General Appropriations Act and other substantive legislation directed the FHKC to develop and implement a local match policy for the continuation of emollment of non- Title XXI eligible emollees in the FHKC program; WHEREAS, FHKC's implementing statute and the 2003-2004 General Appropriations Act provides for the provision of local matching funds from the participating county through a specified formula and that said local match must be secured to cover the costs of emollees who do not qualify for Title XXI federal matching funds in the participating county by a Financial Agreement with local contributors to provide the required local match on an agreed periodic basis; WHEREAS, Momoe County has agreed to participate in the FHKC program for Momoe County by providing funds to be applied to the local match for Momoe County for the continuation of coverage for non-Title XXI eligible emollees; NOW THEREFORE, in consideration of the premises and as an inducement to FHKC to continue a FHKC program for non-Title XXI eligible emollees in Momoe County: I. Momoe County agrees to provide matching funds for the provision ofthe FHKC program in Momoe County as follows: A. Momoe County agrees to provide local matching funds in the amount of THIRTY-EIGHT THOUSAND, FOUR HUNDRED, NINETY-THREE, AND NO/lOO DOLLARS ($38,493.00) for the period of July 1, 2003 through June 30, 2004. 2003-2004 Financial Agreement Page I of3 Revised: 5/2002 B. Monroe County understands that FHKC will continue the enrollment of non- Title XXI eligible enrollees only in those counties that meet their local match requirement as specified by the FHKC Board of Directors. C. Monroe County agrees to be invoiced on a monthly basis for one-twelfth of the local match amount listed in paragraph I. A. D. Monroe County agrees to remit payment within thirty (30) days of receipt of an invoice from FHKC. II. FHKC, in consideration of the funds paid by Monroe County under this Financial Agreement for the FHKC program, FHKC agrees as follows: A. To provide comprehensive health insurance coverage to each participant who has paid the required premium and has met the other eligibility standards for enrollment established by FHKe. B. To invoice Monroe County on a scheduled basis in accordance with paragraphs I.e. and I.B. Invoice shall be sent to: NAME: David P. Owens ADDRESS: 1100 Simonton Street; Key West, FL 33040 CONTACT NUMBER: 305-292-4482 III. The Parties agree that the non-payment of local matching funds may result in the termination of coverage for non-Title XXI eligible enrollees in Monroe County or other actions deemed appropriate by the FHKC Board of Directors at the sole discretion of the FHKC. IV. Monroe County understands that FHKC will commence the expenditure of state funds to continue a FHKC program in Monroe County based upon the assurances by Monroe County to provide local matching funds, to assume the responsibilities and duties set forth herein and to provide the local matching funds in accordance with the terms hereof. In the event the local matching funds provided herein are not forthcoming in the amounts and upon the dates scheduled, FHKC is entitled to enforce the obligations of this agreement in accordance with the laws of the state of Florida and in such event shall be entitled to additional reimbursement for its costs and attorneys fees necessarily incurred in order to enforce the completion of the obligations herein. It is understood that the intent of this provision is to protect the children who will receive health insurance benefits through the FHKC program in Monroe County and who will thereafter rely upon the continuation of the program. V. The parties agree that the provisions ofthis agreement are not subject to assignment without the express written consent of the other party. VI. Any amendments to this Agreement shall be in writing and approved by both parties. 2003-2004 Financial Agreement Page 2 of3 Revised: 5/2002 VII. This Agreement shall be in effect from the date of its execution by both parties, and shall remain in effect until all obligations under this Agreement have been satisfied. IN WITNESS WHEREOF, the Parties have caused this agreement to be executed by their undersigned officials as duly authorized. DONE this Ie::; th day of ()c l , 2003. LOCAL MATCH PROVIDER )ft;:c,>> ~ Witness.': FLORIDA HEALTHY KIDS CORPORATION ~~~ Executive Director , I ~./ ~ ", L (ltfftI . ~~'3<L / ltness t- '"" l"o..> c::::::. -" CJ 0 <<::;) C,.o.) - 2' .l> r- :::l::i ..., 2:: ~ t'T1 or-:t: 0 f"'l::ll:-< '< C")' r- - " 0("). Go,') c::> C:;o~ ;0 :e. 0 -tC")r- -0 :::0 :<:-1=:::: :x ,." ." ::t>< N C") r- .. ..-. 1> .-... - ::'':;; '-0 --_J 2003-2004 Financial Agreement Page 3 of3 Revised: 5/2002