Item P2 P2
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE �� i Mayor Holly Merrill Raschein,District 5
The Florida Keys Mayor Pro Tern James K.Scholl,District 3
Craig Cates,District 1
Michelle Lincoln,District 2
' David Rice,District 4
Board of County Commissioners Meeting
August 21, 2024
Agenda Item Number: P2
2023-2806
BULK ITEM: No DEPARTMENT: Solid Waste
TIME APPROXIMATE: STAFF CONTACT: Cheryl Sullivan
AGENDA ITEM WORDING: A Public Hearing to consider Approval of a Resolution adopting the
Final Residential Solid Waste Collection, Disposal, and Recycling non-ad valorem special assessment
rates for fiscal year 2024/2025. The final rate will increase by $91.43 per year(20%) to $548.58 per
household/unit.
ITEM BACKGROUND:
The resolution sets the final residential solid waste, collection service rates for the upcoming Fiscal
Year 2024-25. The proposed rate is $548.58 per household/unit an increase of$91.43 /year. The total
rate is proposed to increase from $457.15 to $548.58 (adjustment of 20%), which includes for the
residential collection portion of the rate to increase from $220.58 to $264.70.; the residential disposal
portion from $177.43 to $212.91, and the residential recycle portion from $59.14 to $70.97. This
proposed increase in the special assessment rate is needed to; 1) offset the Consumer Price Index (CPI)
increase adjustments to the Franchisees and disposal contractors (for amended and negotiate contract
extension); 2) Support collection and haul-out cost for the increase of illegal dumping; 3) to ensure the
fund balance remains healthy.
PREVIOUS RELEVANT BOCC ACTION:
The Board adopted the following rates: FY24 $457.15 Resolution No. 2023-1227 FY 23 $446
Resolution No. 239-2022 FY 22 $413 Resolution No. 270-2021 FY 21 $407 Resolution No. 232-2020
FY 20 $402 Resolution No. 233-2019 FY 19 $394 Resolution No. 227-2018 FY 18 $386 Resolution
No. 229-2017 FY 17 $386 Resolution No. 169-2016 (The BOCC reduced this assessment by $18 from
$404 to $386 in 2016 for FY 17 as a result of the Yard Waste contract.) FY 16 $404 Resolution No.
194-2015 FY 15 $404 Resolution No. 197-2014
INSURANCE REQUIRED:
No
CONTRACT/AGREEMENT CHANGES:
N/A
2801
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
Resolution Adopting Final Residential S\YRate fbrFY 25-migocd.pdf
FINANCIAL IMPACT:
The total annual solid waste assessment revenue to be collected within Monroe County,the City of Marathon,the
City of Layton, and the City of Key Colony Beach for the upcoming fiscal year is estimated to be$19,310,016.00
based upon the the rate of$548.58 per residential dwelling unit. The revenue generated will support the Solid Waste
services for Monroe County,the City of Marathon,Layton, and Key Colony Beach.
2802
RESOLUTION NO. -2024
A RESOLUTION OF THE BOARD OF
COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA,ADOPTING THE
FINAL RESIDENTIAL SOLID WASTE
COLLECTION,DISPOSAL AND RECYCLING
RATES FOR THE FISCAL YEAR 2024-2025
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA, as follows:
Section 1. The Board hereby adopts the following tentative rates for Collection of
Residential Solid Waste:
1. For each single family home - $264.70 per annum;
2. For each mobile home- $264.70 per annum;
3. For each multi-family unit- $264.70 per annum.
Section 2. The Board hereby adopts the following tentative rates for Disposal of Residential
Solid Waste:
1. For each single family home - $212.91 per annum;
2. For each mobile home- $212.91 per annum;
3. For each multi-family unit- $212.91 per annum.
Section 3. The Board hereby adopts the following tentative rates for Recycling of
Residential Solid Waste:
1. For each single family home - $70.97 per annum;
2. For each mobile home- $70.97 per annum;
3. For each multi-family unit- $70.97 per annum.
Section 4. The Board hereby adopts the following tentative rates for Fiscal year 2024-2025:
1. For each single family home - $548.58 per annum;
2. For each mobile home- $548.58 per annum;
3. For each multi-family unit- $548.58 per annum.
Section 5. The Board hereby directs the Monroe County Clerk to transmit this
executed Resolution to the Monroe County Property Appraiser and Monroe County Tax
Collector.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida,
at a meeting of said Board held on the 21 st day of August 2024.
Mayor Holly Merrill Raschein, District 5
Mayor Pro Tem James K. Scholl, District 3
Commissioner Craig Cates, District 1
Commissioner Michelle Lincoln, District 2
Commissioner David Rice, District 4
2803
(SEAL) BOARD OF COUNTY COMMISSIONERS
Attest: KEVIN MADOK, CLERK OF MONROE COUNTY, FLORIDA
BY: BY:
As Deputy Clerk Mayor
MONROE COUN'rY ATTORKFY
CHRESTINE LIMBERr•BARROWS
A SSISTANT COUNTY ATTORNEY
DATE _6_124...................
2804
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AMENDED AND RESTATED CONTRACT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
AND
THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1
AND
ANTONIO GANDIA, M.D.
TO SERVE AS MEDICAL DIRECTOR FOR MONROE COUNTY FIRE RESCUE
THIS CONTRACT is made and entered into this 9th day of August 2024, by and between the
Monroe County Board of County Commissioners, The Board of Governors of Fire and
Ambulance District I of Monroe County, Florida, hereinafter collectively referred to as the
"COUNTY," and Antonio Gandia, M.D.I hereinafter referred to as "MEDICAL DIRECTOR".
WITNESSETH:
WHEREAS, COUNTY provides fire and/or emergency medical services pursuant to Chapter 401,
F.S. and Chapter 64J-I, FAC; and
WHEREAS,COUNTY is required to employ or contract with a MEDICAL DIRECTOR who shall
be a Florida licensed physician, Board Certified in Emergency Medicine with added qualification
in Emergency Medical Services (EMS) and pre-hospital care experience, or a business entity that
employs or contracts with similarly qualified physicians; and
WHEREAS, COUNTY has determined it to be in the best interests of the residents of and visitors
to Monroe County to contract with MEDICAL DIRECTOR for the purpose of providing direction
to the Fire and Emergency Medical Services; and
WHEREAS, MEDICAL DIRECTOR desires to provide professional services according to the
terms and conditions stated herein.
NOW THEREFORE, in consideration of the mutual understandings and Contracts set forth
herein, COUNTY and MEDICAL DIRECTOR agree as follows:
1. Term
This Contract shall become effective on August 9, 2024, and shall run for an initial term of six (6)
months, through February 8, 2025 (Initial Term). The agreement may thereafter be renewed an
additional number of times as the mutual written agreement of the parties.
2. Compensation
2.1 Ground Ambulance
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MEDICAL DIRECTOR shall be paid at a rate of $63,945.00 annually to provide ground
ambulance medical direction. Payments shall be made monthly in arrears by COUNTY pursuant
to the Florida Local Government Prompt Payment Act after receipt of proper invoice submitted
by MEDICAL DIRECTOR.
2.2 Air Ambulance
a. MEDICAL DIRECTOR shall be paid at a rate of$60,637.50 annually to provide air ambulance
medical direction. Payments shall be made monthly in arrears by COUNTY pursuant to the Florida
Local Government Prompt Payment Act after receipt of proper invoice by MEDICAL DIRECTOR.
Note: This payment is contingent upon COUNTY's decision to continue to operate air ambulance
services under its ALS license, and if, for any reason, COUNTY decides not to continue to operate
air ambulance EMS service under its ALS license, then MEDICAL DIRECTOR shall have no
responsibility to serve as MEDICAL DIRECTOR for the air ambulance service and COUNTY
shall have no liability for this portion of MEDICAL DIRECTOR's compensation.
2.3
If required, physician "peer to peer'' services for collection of denied medical claims will be paid,
subject to administrative review, at a rate of $250.00+hour in order to collect funds that would
otherwise be unpaid.
2.4
COUNTY will reimburse MEDICAL DIRECTOR for any direct expenses associated with
meetings required by COUNTY or Monroe County Sheriff's Office. For the purpose of this
paragraph, the term "direct expenses" means per diem or subsistence allowances, transportation
costs or mileage allowances, and miscellaneous travel expenses, as those terms are defined by
Section 1 12.061, Florida Statutes. All compensation shall be according to County Ordinance and
State law.
2.5
a. MEDICAL DIRECTOR will be provided a county phone and any other equipment required as
approved by the Chief of Fire Rescue.
b. COUNTY will reimburse MEDICAL DIRECTOR for the yearly application fee required for
renewal of the County's Drug Enforcement Administration (DEA) certificate, if the MEDICAL
DIRECTOR has paid the application fee in advance on behalf of the COUNTY.
2.6
Invoices received from MEDICAL DIRECTOR shall be reviewed and approved by COUNTY
Fire Chief or his designee, indicating that services have been rendered in conformity with the
Contract, and then will be sent to the Finance Department for payment.
2.7
In order for both parties to close their books and records, MEDICAL DIRECTOR must clearly
state "FINAL INVOICE" on MEDICAL DIRECTOR's final and last billing to COUNTY. This
certifies that all services have been properly performed and all charges and costs have been
invoiced to Monroe COUNTY. Since this account will thereupon be closed, any and other future
charges if not properly included in this final invoice are waived by MEDICAL DIRECTOR.
2.8
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Nothing in this Contract prohibits MEDICAL DIRECTOR from billing any third party
for medical services rendered outside the scope of this Contract that may arise during or
after the term of this Contract.
3. Purpose
The purpose of this Contract is to assure compliance of COUNTY in Medical Direction of
Monroe County Fire Rescue in accordance with the provisions of F.S., Chapter 401, and FAC
Chapter 64J-1.004.
4. Duties and Responsibilities.
4.1
MEDICAL DIRECTOR shall be responsible to Monroe County Fire Rescue and report
directly to the Fire Chief, and/or his/her designee.
4.2
MEDICAL DIRECTOR shall adhere to the responsibilities as set forth in Chapter 401, F.S., and
Rule 64J-1.004, FAC; the applicable rules of any government agency implementing said chapter;
and any duties upon written notice from the Florida Department of Health that such additional
duties are required of MEDICAL DIRECTOR. These include supervising and accepting
responsibility for the medical performance of all certified/license response personnel functioning
within the scope of their official duties while on duty with Monroe County Fire Rescue (MCFR),
including, but not limited to, members of volunteer fire department under contract with
COUNTY and/or Monroe County Fire and Ambulance District 1. While these duties will
typically occur within the geographical borders of unincorporated Monroe County and the City of
Layton, they also include duties performed at the Key West International Airport, during mutual
performed during mutual aid to requesting municipalities outside those geographical borders and
while transporting patient to out of county medical facilities. For the purpose of this Contract,
MEDICAL DIRECTOR is the individual who meets the licensing and registration requirements
of Chapter 401, F.S. and FAC Chapter 64J-1.004.
4.3
MEDICAL DIRECTOR shall be knowledgeable with the standards set by National Fire Protection
Association, and in particular, Standard1582: Standard on Comprehensive Occupational Medical
Program for Fire Departments.
4.4 Standards of Care
MEDICAL DIRECTOR shall establish and maintain standards of care for EMS providers.
4.4.1
MEDICAL DIRECTOR shall gather agency input in the review and development of standards of
care on an annual basis and establish and revise agency performance standards as necessary.
4.4.2
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Develop pre-hospital practice parameters for Fire Rescue Personnel of all levels. The parameters
shall be developed with consideration to budgetary and staffing limitations and the fiscal impact
on MCFR and the citizens of Monroe County.
4.5 Patient Advocate
MEDICAL DIRECTOR shall be a patient advocate in the fire rescue system and shall ensure that
all aspects of the EMS systems are developed to place the needs of the patient first.
4.6 Protocols and Standing Orders.
4.6.1
MEDICAL DIRECTOR shall develop, revise, implement, and maintain basic and advanced life
support protocols and standing orders under which MCFR personnel will function under medical
control.
4.6.2
MEDICAL DIRECTOR shall review and revise existing protocols and standing orders to ensure
that they meet nationally accepted standards of practice for use by all system providers, which
permit specified ALS and BLS procedures when communication cannot be established with a
supervising physician, or when any delay in patient care would threaten the life or health of the
patient. These standards include, but are not limited to, Advanced Cardiac Life Support (ACLS),
Basic Trauma Life Support (BTLS), and Pediatric Advanced Life Support (PALS). In addition to
medical treatment, protocols shall address determination of patient destination.
4.6.3
MCFR shall publish and distribute,at its own cost,all protocols and standing orders. The protocols
and standing orders shall be published in a form consistent with agency Standard Operating
Procedures. Copies of the protocols and standing orders will be maintained on all MCFR
ambulances(air and ground)and ALS engines,and will be distributed to certified/licensed response
personnel. Personnel copies may be provided electronically. MCFR shall obtain and retain a
receipt from each personnel member verifying receipt of the protocols and any changes. These
receipts may be electronic, and shall state clearly that each person is individually accountable and
obligated to follow all rules, regulations and protocols. All protocols and standing orders shall
become public domain upon implementation.
4.6.4
MEDICAL DIRECTOR shall develop, review, and revise, when necessary, Trauma Transport
Protocols(TTP)for submission to the Florida Department of Health, Bureau of Emergency Medical
Services for approval in accordance with Rule 643-2, FAC.
4.6.5
MEDICAL DIRECTOR shall develop enhanced protocols for specialty procedures or services
including but not limited to aeromedical (Trauma Star)transport.
4.6.6
MEDICAL DIRECTOR shall conduct an on-going review of all protocols and standing orders as
may be necessary to ensure reliable service delivery,appropriate patient care, and the maintenance
of the current standard of care. This shall include, at a minimum, a comprehensive annual review
and written approval of all protocols and standing orders. While conducting the annual review,
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MEDICAL DIRECTOR shall take into consideration the results of quality assurance reviews,
review of current medical literature, and input from MCFR response personnel. Changes shall be
developed with consideration to budgetary limitations and the fiscal impact on MCFR and the
citizens of Monroe County. The annual review shall be completed, and all proposed changes
forwarded to the Fire Chief, prior to the end of each Fiscal Year.
4.6.7
MEDICAL DIRECTOR shall ensure that appropriate training for new protocols and standing
orders is conducted prior to implementation; shall ensure compliance with protocols and standing
orders by all MCFR personnel; and ensure that additional training is conducted for any identified
needs.
4.7 Availability.
MEDICAL DIRECTOR or his/her previously approved designee shall be available twenty-four
(24)hours a day,seven(7)days a week for medical direction to MCFR personnel in order to resolve
problems, system conflicts,and provide services in an emergency as that term is defined in Section
252.34(3), F.S.
4.8 Trauma Scorecard Methodologies.
MEDICAL DIRECTOR shall ensure that all certified/licensed response personnel are trained in
the use of the trauma scorecard methodologies, as provided in Chapter 64J-2.004, FAC, for adult
trauma patients and 64J-2.005, FAC, for pediatric trauma patients.
4.9 Aeromedical Operations
4.9.1
MEDICAL DIRECTOR shall participate in Trauma Star safety and quality assurance committees,
and shall attend quarterly meetings to review safety policies, procedures, unusual occurrences,
safety issues,and audit compliance with safety policies and procedures.
4.9.2
Be knowledgeable with aeromedical requirements of patients and evaluate each patient in person,
by telephone, or by delegated written protocol prior to each interfacility transfer flight for the
purpose of determining that the aircraft, flight and medical crew,and equipment meet the patient's
needs.
4.10 Oversight of Medical Qualifications And Proficiency of MCFR Personnel
4.10.1
MEDICAL DIRECTOR shall ensure initial and continued medical qualifications and proficiency
of MCFR personnel.
4.10.2
MEDICAL DIRECTOR shall establish and periodically update the minimum personnel training
standards and certification requirements for all MCFR personnel who provide emergency medical
care. Such standards shall include the requirements for orientation and initial training, continuing
medical education, standards for professional conduct and evaluation standards and procedures.
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MEDICAL DIRECTOR shall ensure that all field personnel meet the initial requirements and
continuously comply with established standards to attain and maintain approval to operate within
the MCFR system.
4.10.4
MEDICAL DIRECTOR shall establish procedures for issuance, renewal, suspension, and
revocation of practice privileges for MCFR personnel in concert with the Fire Chief, to include a
process for remediation. The procedures shall contain due process provisions and all such
provisions shall be approved, in advance, by the Fire Chief.
4.10.5
MEDICAL DIRECTOR shall provide for direct observation of field level providers while
performing their duties that meets or exceeds Section 401.265, F.S., and Rule 64J-1.004, FAC.
4,11 Quality Assurance
4.11.1
MEDICAL.., DIRECTOR, in coordination with MCFR, shall develop, implement, and maintain an
effective patient care Quality Assurance System to assess the medical performance of all
certified/licensed MCFR response personnel.
4.11.2
MEDICAL DIRECTOR shall develop, implement, and supervise a formal patient care Quality
Assurance System in accordance with Section 401.265(2), F.S. and Rule 64J-1.004, FAC, to
include the formation and supervision of a quality assurance committee.
4.11.2.1
The purpose and tone of the quality assurance review process shall be positive and educational;
however, MEDICAL DIRECTOR may, at any time and without limitation, conduct a quality
assurance review investigation or audit to ensure that MCFR personnel comply with the Protocols
and Standard of Care.
4.11.2.2
The method and extent of the investigation employed during any given quality assurance review
shall be determined by MEDICAL DIRECTOR in consultation with the Fire Chief. As a result of
said investigation, MEDICAL DIRECTOR may require remedial training of MCFR personnel
and/or revocation of practice privileges. Remedial training may be conducted by MEDICAL
DIRECTOR, MCFR personnel, or other personnel at MEDICAL DIRECTOR's discretion.
4.11.3
MEDICAL DIRECTOR or designee may also conduct special audits in response to observations
or customer feedback provided by patients, family members, caregivers, bystanders, crew
members, physicians and hospital personnel.
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MEDICAL DIRECTOR may also develop procedures for routine auditing of EMS system
performance and adherence to protocols on individual EMS incidents and overall EMS system
compliance.
4.11.5
MEDICAL DIRECTOR or designee shall review, in conjunction with MCFR battalion chiefs or
their designees, patient care reports on an ongoing basis; review all protocol deviations and initiate
or recommend corrective action. MEDICAL DIRECTOR or designee shall review at least 40
patient care reports per month. MCFR shall provide electronic copies of patient care reports.
4.11.6
MEDICAL DIRECTOR shall periodically visit and communicate with the hospital emergency
departments to exchange information and review the quality of care provided by the MCFR
personnel.
4.11.7
MEDICAL DIRECTOR shall participate in field activity and system monitoring to include the
following:
4.11.7.1
Ride along and observe field activity as a crew member on a rescue as needed.
System monitoring, shall include visiting fire stations when needed to discuss issues with MCFR
personnel.
4.l 1.8
MEDICAL DIRECTOR shall document in a quarterly status report to the Fire Chief, evidence of
the following required activities:
4,11.8.1
Reporting on issues identified with MCFR personnel; and
4.11.8.2
Communicating with hospital emergency department staff, and other medical and public safety
personnel for quality assurance and education activities.
4.12 Educational Programs
4.12.1
MEDICAL DIRECTOR shall participate in educational programs at all levels, to include all
certified/licensed response personnel.
4.12.2
MEDICAL DIRECTOR or designee shall oversee a minimum of ten(10)hours a year of continuing
medical education related to pre-hospital care or teaching or a combination of both.
4.12.3
MEDICAL DIRECTOR shall actively participate in the development and presentation of EMS
continuing education programs by identifying educational topics, presenting lectures and providing
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other educational opportunities for the enhancement of the fire rescue system. MCFR shall pay the
actual direct cost of any course materials, instructors, and certificates.
4.12.3.1
Education should be geared to reach the specific needs of the audience. As some providers are
volunteers, consideration shall be given to scheduling some training on nights or weekends.
4.12.3.2
Course content should include system-specific issues and items resulting from audit and review.
4.12.4
Where MEDICAL DIRECTOR is not the presenter, and training services are conducted by other
COUNTY personnel and/or are subcontracted to an outside provider, MEDICAL DIRECTOR will
ensure the quality of the Continuing Medical Education(CME)training provided to EMS personnel
by:
4.12.4.1
Reviewing and approving all curriculum and courses for continuing education units (CEU's) prior
to MCFR personnel being trained;
4.12.4.2
Monitoring and auditing at least one (1) class session of every CME course held in which
MEDICAL DIRECTOR is issuing CME; and
4.12.4.3
Evaluating the educational effectiveness of instruction, courses and programs in consultation with
the CME contractor.
4.12.5
MEDICAL DIRECTOR shall maintain necessary and appropriate instructor certifications and
participate as Medical Director for educational programs sponsored by MCFR such as ACLS,
PALS, BTLS, etc.
4.12.6
Upon proof of completion, MEDICAL DIRECTOR shall sign documents and approve CME to
those EMT's and EMT-P's that have completed a minimum of 30 hours of biannual recertification
training, as set forth in Section 401.2715, F.S.
4.13 Agency Liaison
4.13.1
MEDICAL DIRECTOR shall participate in interagency discussions about specific issues or
problems as necessary.
4.13.2
MEDICAL DIRECTOR shall notify MCFR of any pertinent concerns regarding patient care raised
by other agencies and provide advice on a resolution. MEDICAL DIRECTOR shall also notify
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other agencies of any concerns regarding patient care, raised either by MCFR or MEDICAL
DIRECTOR.
4.13.3
MEDICAL DIRECTOR shall develop and maintain liaisons with the local medical community:
hospitals, emergency departments, mental health agencies, physicians, providers, ambulance
services, and other agencies impacting MCFR.
4.13.4
MEDICAL DIRECTOR shall assist in resolution of problems involving the delivery of pre-hospital
care and other services in accordance with Rule 64.1-1.004, FAC.
4.13.5
MEDICAL DIRECTOR shall interact with and inform local government officials on an as needed
basis.
4.13.6
MEDICAL DIRECTOR shall participate in the Florida EMS Medical Director's Association or a
statewide physician's group involved in pre-hospital care,
4.13.7
MEDICAL DIRECTOR shall be an active member of at least one national emergency medicine
constituency group such as the National Association of EMS Physicians, the American College of
Emergency Physicians, etc.
4.13.8
MEDICAL DIRECTOR shall interact with county, regional, state, and federal authorities,
regulators and legislators to ensure standards, needs, and requirements are met, and resource
utilization is optimized.
4.13.9
MEDICAL DIRECTOR shall participate in grant application process for system funding,
expansion, and research.
4.14 Stress Management Programs.
MEDICAL DIRECTOR shall participate in stress management programs for providers within the
system, as needed.
4.15 Community Access to Healthcare Initiatives.
MEDICAL DIRECTOR, in conjunction with MCFR, shall coordinate community access to
healthcare initiatives as needed.
4.16 EMT Oversight.
4.16.1
In accordance with Rules 64J-1.004 (g) and (h), FAC, assume direct responsibility for: the use of
an automatic or semi-automatic defibrillator; the use of a glucometer;the administration of aspirin;
the use of any medicated auto injector; the performance of airway patency techniques including
airway adjuncts, not to include endotracheal intubation; and on routine interfacility transports, the
monitoring and maintenance of non-medicated I.V.s by an EMT.
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4.16.2
MEDICAL DIRECTOR shall ensure that all EMTs are trained to perform these procedures; shall
establish and/or maintain written protocols for performance of these procedures; and shall provide
written evidence to the Florida Department of Health documenting compliance with provisions of
these administrative rules.
4.17 Disaster Assistance and Planning
4.17.1
MEDICAL DIRECTOR shall be available for consultation andlor response during a disaster
situation occurring in Monroe County.
4.17.2
MEDICAL DIRECTOR shall function as a liaison between field EMS operations, hospitals, and
public health agencies during disaster situations.
4.17.3
MEDICAL DIRECTOR shall provide specific information to assist in the mitigation of the EMS
aspects during a disaster situation.
4.17.4
MEDICAL DIRECTOR shall cooperate in planning, updating, and following applicable sections
of the Monroe County Comprehensive Emergency Management Plan, including, but not limited to,
participation in disaster drill and emergency management drills.
4.18 Controlled Substances, Medical Equipment and Supplies.
4.18.1
In accordance with F.S., Chapter 401 and Rule 64J-1.004(4)(c), FAC, MEDICAL DIRECTOR
shall possess proof of current registration as a medical director with the U.S. Department of Justice,
DEA, to provide controlled substances to an EMS provider. The DEA registration shall include
each address at which controlled substances are stored. Proof of such registration shall be
maintained on file with MCFR, which shall maintain the copies and make them readily available
for inspection. MCFR will forward all renewal documents as received from DEA to MEDICAL
DIRECTOR in order to ensure continuous registration and will reimburse MEDICAL DIRECTOR
for the cost of such registration. Copies of physician license and registrations must be provided to
MCFR.
4.18.2
MEDICAL DIRECTOR shall formulate and ensure adherence to detailed written procedures to
cover the purchase, storage, use, and accountability for medications, fluids, and controlled
substances used by MCFR personnel, in accordance with Chapters 499 and 893, F.S., and Rule
64J-1.021, FAC.
4.18.3
MEDICAL DIRECTOR shall ensure and certify that security procedures of all MCFR providers
for medications, fluids and controlled substances are in accordance with Chapters 499 and 893,
F.S., and Rule 64J-1.021„ FAC.
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MEDICAL DIRECTOR shall establish a list of mandatory equipment, medications and medical
supplies that must be on board a Rescue or ALS Engine for it to respond to EMS incidents.
4.18.5
MEDICAL DIRECTOR shall advise MCFR on appropriate staffing, structural requirements,
equipment and supplies necessary to ensure that the air ambulance complies with Rule 64J-1.005,
FAC, and Section 401.251(4), F.S.
4.18.6
MEDICAL DIRECTOR shall conduct an on-going and comprehensive review of all EMS medical
equipment, medications and medical supplies as may be necessary to ensure reliable service
delivery in the fire rescue System and excellence in patient care.
4.18.6.1
In conducting the review, MEDICAL DIRECTOR shall take into consideration the results of
Quality Assurance Reviews, review of medical literature, input from interested physicians, and
MCFR personnel.
4.18.6.2
MEDICAL DIRECTOR, in conjunction with MCFR, shall complete the comprehensive review of
all EMS System medical supplies and equipment and present the proposed changes to the Fire
Chief for approval prior to the end of each Fiscal Year.
4.l 8.7
MEDICAL DIRECTOR shall ensure that the following criteria are met prior to activating new
medical equipment or supplies within the EMS System:
4.18.7.1
Proposed medical equipment or supplies have been thoroughly researched, supported by medical
literature, a field evaluation completed when applicable,and the analysis of available system data;
4,18.7.2
All Protocols related to the medical equipment or supplies have been evaluated and updated as
appropriate, to ensure consistency and accuracy; and
4.18.7.3
Protocols, supporting documents and implementation instructions are distributed to MCFR
personnel prior to training or implementation, and training has been completed, if necessary, prior
to implementation.
4.19 Infectious Disease Control Policy
4.19.1
MEDICAL DIRECTOR shall formulate, monitor, evaluate and update as necessary, a policy
complying with all applicable laws and rules necessary to control exposure of MCFR personnel to
infectious diseases. This policy shall cover protective measures to be taken on incidents,
inoculation procedures and recommendations, record keeping, follow up care recommendations as
well as storage and disposal policies for contaminated materials.
4.19.2
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MEDICAL DIRECTOR shall be available, in conjunction with the MCFR Infection Control
Officer, for consultation from field personnel to determine the significance of any body fluid
exposure and suggest appropriate action for such an exposure in accordance with Monroe County
Fire Rescue's existing Workers' Compensation policies and procedures.
4.20
This Contract is a professional services contract based on the qualifications of Dr. Gandia and the
services required hereunder shall be performed by MEDICAL DIRECTOR. or under his/her
supervision. Any additional personnel necessary for the fulfillment of the services required under
this Contract shall be secured at MEDICAL DIRECTOR's sole expense and such personnel shall
be fully qualified and, if required, authorized, or permitted under State and local law to perform
such services.
5. Insurance
COUNTY shall maintain in full force and effect for the term of this Contract, and any subsequent
renewals, professional and General Liability Insurance with minimum limits of$1,000,000.00 per
occurrence. The Professional and General Liability certificate will specify coverage for "EMS
oversight medical direction".
COUNTY will provide certificate or proof of such insurance to MEDICAL DIRECTOR on an
annual basis. Medical Director will be provided thirty (30) days notice of cancellation, change in
policy limits, and/or any restrictions placed on coverage of the insurance provided by COUNTY
during the term of this Contract. COUNTY will be responsible for the payment of any deductible
and/or self-insured retention in the event of a claim.
The Contractor shall be responsible for all necessary Workers' Compensation and Vehicle Liability
insurance coverage. Certificates of Insurance must be provided to Monroe County within fifteen
(15) days after award of contract, with Monroe County BOCC listed as additional insured as
indicated. Policies shall be written by insurers admitted and licensed to do business in the State of
Florida and having an agent for service of process in the State of Florida. Companies shall have
an A.M. Best rating of VI or better. The required insurance shall be maintained at all times while
Respondent is providing service to County.
Prior to commencement of work governed by this contract, the CONTRACTOR must obtain:
Worker's Compensation Insurance with limits sufficient to respond to applicable state statutes.
In addition,the Respondent must obtain Employer's Liability insurance with limits of not less than:
$500,000 Bodily Injury by accident,
$500,000 Bodily Injury by Disease policy limits,
and $500,000 Bodily Injury by Disease, each employee.
Coverage must be maintained throughout the entire term of the contract.
Workers' compensation and employers' liability insurance can be waived by the County upon
receipt of information showing that the MEDICAL DIRECTOR is exempt under state statute.
Prior to commencement of work governed by this contract, the CONTRACTOR must obtain:
Vehicle Liability Insurance which shall cover owned, non-owned and hired vehicles. The
minimum acceptable limits shall be$300,000 Combined Single Limit (CSL). If split limits are
provided, the minimum limits acceptable shall be:
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$100,000 per Person
$300,000 per Occurrence
$50,000 Property Damage
Monroe County Board of County Commissioners shall be named as an Additional insured
on Vehicle Liability policies.
6. Termination
6.1 Early termination may occur as follows:
A. This Contract may be terminated by MEDICAL DIRECTOR, with or without cause, upon
not less than ninety (90) days written notice delivered to COUNTY.
B. COUNTY may terminate this Contract in whole or in part and without cause, upon not less
than ninety (90)days written notice, delivered to MEDICAL DIRECTOR.
C. COUNTY may terminate this Contract immediately in the event that MEDICAL
DIRECTOR fails to fulfill any of the terms, understandings or covenants of this Contract.
6.2 At such time as this Contract is terminated,whether at the natural ending date or at an earlier
time, MEDICAL DIRECTOR shall:
A. Stop work on the date and to the extent specified.
B. Terminate and settle all orders and subcontracts relating to the performance of the work.
C. Transfer all work in process, completed work,and other materials related to the terminated
work to COUNTY.
D. Continue and complete all parts of that work which have not been terminated, if any.
7. Payments
Payments shall be made by COUNTY pursuant to the Florida Local Government Prompt
Payment Act after the completion of the rendered services and proper invoicing by MEDICAL
DIRECTOR.
8. ContinQency
COUNTY's performance and obligation to pay under this Contract is contingent upon an annual
appropriation by the Board of County Commissioners.
9. Section Headings
Section headings have been inserted in this Contract as a matter of convenience of reference only,
and it is agreed that such section headings are not a part of this Contract and will not be used in the
interpretation of any provision of this Contract.
10. Ownership of the Proiect Document
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Any documents submitted by MEDICAL DIRECTOR for this professional services contract
belong to COUNTY and may be reproduced and copied without acknowledgement or permission
of MEDICAL DIRECTOR.
11. Successors and Assigns
MEDICAL DIRECTOR shall not assign its right hereunder, except its right to payment, nor shall
it delegate any of its duties hereunder without the written consent of COUNTY. Subject to the
provisions of the immediately preceding sentence, each party hereto binds itself, its successors,
assigns and legal representatives to the other and to the successors, assigns and legal
representatives of such other party.
12. No Third Party Beneficiaries
Nothing contained herein shall create any relationship, contractual or otherwise, with or any
rights in favor of, any third party.
13. Public Entities Crimes
13.1
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 contracts to provide any goods or services to a public
entity, may not submit a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real property to public entity,
may not be awarded or perform work as a contractor, supplier, subcontractor, or MEDICAL
DIRECTOR 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 of the F.S., for
CATEGORY TWO for a period of 36 months from the date of being placed on the convicted
vendor list.
13.2
By signing this Contract, MEDICAL DIRECTOR represents that the execution of this Contract
will not violate the Public Entity Crimes Act (Section 287.133, F.S.). Violation of this section
shall result in termination of this Contract and recovery of all monies paid hereto, and may result
in debarment from COUNTY's competitive procurement activities.
13.3
In addition to the foregoing, MEDICAL DIRECTOR further represents that there has been no
determination, based on an audit, that it or any SUBCONTRACTOR has committed an act
defined by Section 287.133, F.S., as a"public entity crime"and that it has not been formally
charged with committing an act defined as a"public entity crime" regardless of the amount of
money involved or whether CONSULTANT has been placed on the convicted vendor list.
13.4
MEDICAL DIRECTOR will promptly notify COUNTY if MEDICAL DIRECTOR or any
subcontractor is formally charged with an act defined as a"public entity crime"or has been
placed on the convicted vendor list.
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14. Records
MEDICAL DIRECTOR shall maintain all books, records, and documents directly pertinent to
performance under this Contract in accordance with generally accepted accounting principles.
Upon ten (10) business days written notice to the other party, representatives of either party shall
have access, at all reasonable times, to all the other party's books, records, correspondence,
instructions, receipts, vouchers and memoranda(excluding computer software) pertaining to work
under this Contract for the purpose of conducting a complete independent fiscal audit. MEDICAL
DIRECTOR shall retain all records required to be kept under this Contract for a minimum of five
years, and for at least four years after the termination of this Contract. Storage of medical records
required by Federal or State statute in excess of the times stated herein and subsequent to the
termination of this Contract shall be revisited by the parties at such time as any transition period is
established to accommodate the termination of this Contract. MEDICAL DIRECTOR shall keep
such records as are necessary to document the provision of services under this contract and
expenses as incurred, and give access to these records at the request of COUNTY, the State of
Florida or authorized agents and representatives of said government bodies. It is the responsibility
of MEDICAL DIRECTOR to maintain appropriate records to insure a proper accounting of all
collections and remittances. MEDICAL DIRECTOR shall be responsible for repayment of any
and all audit exceptions which are identified by the Auditor General for the State of Florida, the
Cleric of Court for Monroe County, the Board of County Commissioners for Monroe County, or
their agents and representatives.
15. Governine Law, Venue, Interpretation,Costs, and Fees
This Contract shall be governed by and construed in accordance with the laws of the State of Florida
applicable to contracts made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is instituted for the enforcement
or interpretation of this Contract,COUNTY and MEDICAL DIRECTOR agree that venue shall lie
in Monroe County, Florida, in the appropriate court or before the appropriate administrative body.
The Parties waive their rights to a trial by jury. This Contract is not subject to arbitration.
16. Severability
If any term, covenant, condition or provision of this Contract (or the application thereof to any
circumstance or person) shall be declared invalid or unenforceable to any extent by a court of
competent jurisdiction,the remaining terms, covenants,conditions and provisions of this Contract,
shall not be affected thereby; and each remaining term, covenant, condition and provision of this
Contract shall be valid and shall be enforceable to the fullest extent permitted by law unless the
enforcement of the remaining terms, covenants, conditions and provisions of this Contract would
prevent the accomplishment of the original intent of this Contract. COUNTY and MEDICAL
DIRECTOR agree to reform the Contract to replace any stricken provision with a valid provision
that comes as close as possible to the intent of the stricken provision.
17. Attorney's Fees and Costs
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COUNTY and MEDICAL DIRECTOR agree that in the event any cause of action or administrative
proceeding is initiated or defended by any party relative to the enforcement or interpretation of this
Contract, the prevailing party shall be entitled to reasonable attorney's fees, court costs,
investigative, and out-of-pocket expenses, as an award against the non-prevailing party, and shall
include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate
proceedings. Mediation proceedings initiated and conducted pursuant to this Contract shall be in
accordance with the Florida Rules of Civil Procedure and usual and customary procedures required
by the circuit court of Monroe County.
18. Binding Effect
The terms, covenants,conditions,and provisions of this Contract shall bind and inure to the benefit
of COUNTY and MEDICAL DIRECTOR and their respective legal representatives, successors,
and assigns.
19. Authority
Each party represents and warrants to the other that the execution,delivery and performance of this
Contract have been duly authorized by all necessary County and corporate action, as required by
law.
20. Claims for Federal or State Aid
MEDICAL DIRECTOR and COUNTY agree that each shall be, and is, empowered to apply for,
seek, and obtain federal and state funds to further the purpose of this Contract; provided that all
applications, requests, grant proposals, and funding solicitations shall be approved by each party
prior to submission.
21. Adjudication of Disputes
COUNTY and MEDICAL DIRECTOR agree that all disputes shall be attempted to be resolved by
meet and confer sessions between representatives of each of the parties. If the issue or issues are
still not resolved to the satisfaction of the parties, then any party shall have the right to seek such
relief or remedy as may be provided by this Contract or by Florida law.
22. Cooperation
In the event any administrative or legal proceeding is instituted against either party relating to the
formation, execution, performance, or breach of this Contract, COUNTY and MEDICAL
DIRECTOR agree to participate, to the extent required by the other party, in all proceedings,
hearings, processes, meetings, and other activities related to the substance of this Contract or
provision of the services under this Contract. COUNTY and MEDICAL DIRECTOR specifically
agree that no party to this Contract shall be required to enter into any arbitration proceedings related
to this Contract.
23. Nondiscrimination
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MEDICAL DIRECTOR and COUNTY agree that there will be no discrimination against any
person,and it is expressly understood that upon a determination by a court of competent jurisdiction
that discrimination has occurred, this Contract automatically terminates without any further action
on the part of any party, effective the date of the court order. MEDICAL DIRECTOR and
COUNTY agree to comply with all Federal and F.S.,and all local ordinances,as applicable,relating
to nondiscrimination. These include but are not limited to: l) Title VI of the Civil Rights Act of
1964 (PL 88-352), which prohibits discrimination on the basis of race, color or national origin; 2)
Title IX of the Education Amendment of 1972, as amended (20 USC §§ 1681-1683, and 1685-
1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act
of 1973, as amended (20 USC § 794), which prohibits discrimination on the basis of handicaps; 4)
The Age Discrimination Act of 1975, as amended (42 USC §§ 6101-6107), which prohibits
discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-
255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive
Alcohol Abuse and Alcoholism Prevention,Treatment and Rehabilitation Act of 1970(PL 91-616),
as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The
Public Health Service Act of 1912, §§ 523 and 527(42 USC §§ 690dd-3 and 290ee-3),as amended,
relating to confidentiality of alcohol and drug abuse patent records; 8)Title Vill of the Civil Rights
Act of 1968(42 USC §§ 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental
or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC §§ 1201), as
amended from time to time, relating to nondiscrimination in employment on the basis of disability;
10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on the basis of
race,color, sex, religion,national origin,ancestry, sexual orientation,gender identity or expression,
familial status or age;and 11)any other nondiscrimination provisions in any federal or state statutes
which may apply to the parties to, or the subject matter of, this Contract.
24. Covenant of No Interest
MEDICAL DIRECTOR and COUNTY covenant that neither presently has any interest, and shall
not acquire any interest, which would conflict in any manner or degree with its performance under
this Contract, and that only interest of each is to perform and receive benefits as recited in this
Contract.
25. Code of Ethics
MEDICAL DIRECTOR agrees that officers and employees of COUNTY recognize and will be
required to comply with the standards of conduct for public officers and employees as delineated
in Section 112.313, F.S., regarding, but not limited to, solicitation or acceptance of gifts; doing
business with one's agency; unauthorized compensation; misuse of public position, conflicting
employment or contractual relationship; and disclosure or use of certain information.
26. No Solicitation/Payment
MEDICAL DIRECTOR and COUNTY warrant that, in respect to itself, it has neither employed
nor retained any company or person,other than a bona fide employee working solely for it,to solicit
or secure this Contract and that it has not paid or agreed to pay any person, company,corporation,
individual, or firm, other than a bona fide employee working solely for it, any fee, commission,
percentage, gift, or other consideration contingent upon or resulting from the award or making of
this Contract. For the breach or violation of the provision, MEDICAL DIRECTOR agrees that
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COUNTY shall have the right to terminate this Contract without liability and, at its discretion, to
offset from monies owed, or otherwise recover, the full amount of such fee, commission,
percentage, gift, or consideration.
27. Public Access
MEDICAL DIRECTOR and COUNTY shall allow and permit reasonable access to,and inspection
of, all documents, papers, letters or other materials in its possession or under its control subject to
the provisions of Chapter 119, F.S., and made or received by MEDICAL DIRECTOR and
COUNTY in connection with this Contract; and COUNTY shall have the right to unilaterally
cancel this Contract upon violation of this provision by MEDICAL DIRECTOR.
28. Non-Waiver of Immunity
Notwithstanding the provisions of Section 768.28, F.S., the participation of MEDICAL
DIRECTOR and COUNTY in this Contract and the acquisition of any commercial liability
insurance coverage,self-insurance coverage, or local government liability insurance pool coverage
shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract
entered into by COUNTY be required to contain any provision for waiver.
29. Privileges and Immunities
All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules
and pensions and relief, disability, workers' compensation, and other benefits which apply to the
activity of officers, agents, or employees of any public agents or employees of COUNTY, when
performing their respective functions under this Contract within the territorial limits of COUNTY
shall apply to the same degree and extent to the performance of such functions and duties of such
officers, agents, volunteers, or employees outside the territorial limits of COUNTY.
30. Legal Obli rations and Responsibilities
This Contract is not intended to, nor shall it be construed as, relieving any participating entity from
any obligation or responsibility imposed upon the entity by law except to the extent of actual and
timely performance thereof by any participating entity, in which case the performance may be
offered in satisfaction of the obligation or responsibility. Further, this Contract is not intended to,
nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of
COUNTY, except to the extent permitted by the Florida constitution, state statute, and case law.
31. Non-Reliance by Non-Parties
No person or entity shall be entitled to rely upon the terms, or any of them, of this Contract to
enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or
program contemplated hereunder, and MEDICAL DIRECTOR MEDICAL DIRECTOR and
COUNTY agree that neither MEDICAL DIRECTOR nor COUNTY or any agent, officer, or
employee of either shall have the authority to inform, counsel, or otherwise indicate that any
particular individual or group of individuals, entity or entities, have entitlements or benefits under
this Contract separate and apart, inferior to, or superior to the community in general or for the
purposes contemplated in this Contract.
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32. Attestations and Truth in Negotiation
MEDICAL DIRECTOR agrees to execute such documents as COUNTY may reasonably require,
including a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace
Statement. Signature of this Contract by MEDICAL DIRECTOR shall act as the execution of a
truth in negotiation certificate stating that wage rates and other factual unit costs supporting the
compensation pursuant to the Contract are accurate, complete, and current at the time of
contracting.
33. No Personal Liability
No covenant or Contract contained herein shall be deemed to be a covenant or Contract of any
member,officer,agent or employee of COUNTY in his or her individual capacity,and no member,
officer, agent or employee of COUNTY shall be liable personally on this Contract or be subject to
any personal liability or accountability by reason of the execution of this Contract.
34. Execution of Counterparts
This Contract may be executed in any number of counterparts, each of which shall be regarded as
an original,all of which taken together shall constitute one and the same instrument and any of the
parties hereto may execute this Contract by signing any such counterpart.
35. Amendments and Assignments.
No amendment or assignment of this Contract shall be valid without the prior written consent from
COUNTY.
36. Independent Contractor.
At all times and for all purposes hereunder, MEDICAL DIRECTOR is an independent contractor
and not an employee of the Board of County Commissioners of Monroe County. No statement
contained in this Contract shall be construed as to find MEDICAL DIRECTOR or any of its
employees,contractors, servants or agents to the employees of the Board of County Commissioners
of Monroe County, and they shall be entitled to none of the rights, privileges or benefits of
employees of Monroe County.
37. Compliance with Law.
In carrying out its obligations under this Contract, MEDICAL DIRECTOR shall abide by all
statutes,ordinances,rules and regulations pertaining to or regulating the provisions of this Contract,
including those now in effect and hereafter adopted. Any violation of said statutes, ordinances,
rules or regulations shall constitute a material breach of this Contract and shall entitle COUNTY
to terminate this Contract immediately upon delivery of written notice of termination to MEDICAL
DIRECTOR.
38. Licensing and Permits.
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MEDICAL DIRECTOR shall have, prior to commencement of work under this Contract and at all
times during said work, all required licenses and permits whether federal, state, county or
municipal.
39. Signatures of Parties Required.
THIS CONTRACT SHALL NOT BE EFFECTIVE UNTIL EXECUTED BY BOTH PARTIES
AND RECEIVED IN FINAL EXECUTED FORM BY AN AUTHORIZED REPRESENTATIVE
OF MEDICAL DIRECTOR AT ITS PRINCIPAL PLACE OF BUSINESS.
40. County Authority.
By execution hereof the signer below hereby certifies that signer is duly authorized to execute this
Contract on behalf of the COUNTY.
41. Federal and State Tax.
COUNTY is exempt from payment of Florida State Use and Sales Taxes. COUNTY will sign an
exemption certificate submitted by MEDICAL DIRECTOR. MEDICAL DIRECTOR will not be
exempted from paying state sales tax to its suppliers for materials used to fulfill contractual
obligations with COUNTY, nor is MEDICAL DIRECTOR authorized to use COUNTY's Tax
Exemption Number in securing such materials.
42. Florida Public Records law (F.S. 119.0701).
RECORDS- ACCESS AND AUDITS: Pursuant to F.S. 119.0701, Contractor and its
subcontractors shall comply with all public records laws of the State of Florida, including but not
limited to:
a. Keep and maintain public records required by Monroe County in order to perform the service.
b. Upon request from the public agency's custodian of public records, provide the public agency
with a copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in Florida Statutes, Chapter 119 or
as otherwise provided by law.
c. Ensure that public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of the
contract term and following completion of the contract if the contractor does not transfer the records
to the public agency.
d. U'pon completion of the contract, transfer, at no cost, to Monroe County all public records in
possession of the contractor or keep and maintain public records required by the public agency to
perform the service. If the contractor transfers all public records to the public agency upon
completion of the contract,the contractor shall destroy any duplicate public records that are exempt
or confidential and exempt from public records disclosure requirements. If the contractor keeps
and maintains public records upon completion of the contract, the contractor shall meet all
applicable requirements for retaining public records. All records stored electronically must be
provided to Monroe County, upon request from the public agency's custodian of records, in a
format that is compatible with the information technology systems of Monroe County.
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IF THE CONTRACTOR HAS Q . ESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING
TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC
RECORDS, BRIAN BRADLEY, AT (305) 292-3470, bradley-
b i c - , c/o Monroe County Attorney's Office, 1111 121
St., Suite 408, Key West FL 33040.
43. Public Entity Crime Statement (required for all procurement documents and contracts
by F.S. 287.133 and Monroe County Purchasing Policy): 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 provide any goods or services to a public entity, may not submit a bid on a
contract with a public entity for the construction or repair of a public building or public work, may
not submit bids on leases of real property to public entity, may not be awarded or perform work as
a CONTRACTOR, supplier, subcontractor, or CONTRACTOR 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 CAT[°.GORY "1'°'WO for a period of 36 months from the date of
being placed on the convicted vendor list. As used herein, the term "convicted vendor list" means
a list maintained by the Florida Department of Management Services, as defined in F.S. 287.133.
By entering in this Agreement, the vendor acknowledges that it has read the above and states that
neither the vendor nor any Affiliate hays been placed on the convicted vendor list within the last 36
months.
44. Ethics Clause(required for all contracts by Monroe County Ordinance No. 10-1990): By
entering in this Agreement, the vendor warrants that helit has not employed, retained or otherwise
had act on his/her behalf any former County officer or employee in violation of Section 2 of
Ordinance No. 0 10-1990 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 Agreement without liability and may also, in its discretion, deduct from the Agreement 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.
45. E-verify requirement(required by F.S. 448.095): Beginning January 1, 2021, every public
employer, contractor, and subcontractor shall register with and use the E-Verify system to verify
the work authorization status of all newly hired employees. By entering into this Agreement, the
vendor certifies that it registers with and uses the E-Verify system. If the contractor enters into a
contract with a subcontractor, the subcontractor must provide the contractor with an affidavit
stating that the subcontractor does not employ, contract with, or subcontract with an unauthorized
alien. The contractor shall maintain a copy of such affidavit for the duration of the contract.
46. Human Trafficking (F.S. 787.06): Whenever a contract is executed, renewed, or extended
between a nongovernmental entity and a governmental entity, the nongovernmental entity must
provide an affidavit signed by an officer or a representative of the nongovernmental entity under
penalty of perjury, attesting to that the nongovernmental entity does not use coercion for labor or
services. A copy of the affidavit is attached.
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47. Foreign Entities Affidavit (F.S. 287.138):
a. Beginning i/1/2024, a governmental entity may not accept a bid or proposal from, or enter
into a contract with, an entity which would grant the entity access to individual personal
identifying information ("PIl") unless the entity provides an affidavit signed by an officer
or representative under penalty of perjury attesting that the entity does not meet any of the
criteria in P.S. 287.138(2)(a)-(c):
• Entity owned by a country of concern (China, Russia, Iran, North Korea,
Venezuela, Syria)
• Controlling interest by government of foreign country of concern;
• Entity organized under the laws of or has principal place of business in
foreign country of concern.
b. Beginning 711/2025, a governmental entity cannot renew a contract with an entity which
would grant the access to P11 unless the entity provides the affidavit.
c. Beginning 711/2025,a governmental entity cannot extend or renew a contract with an entity
meeting the above criteria if the contract would give access to PH to that entity.
The affidavit is attached.
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IN WITNESS WHEREOF, each party hereto has caused this contract to be executed by its duly
authorized representative.
(SEAL) BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FL
ATTEST: Kevin Madok , CLERK
1
By: By: �.
Deputy Clerk Kevin Wilson
Acting County Administrator
BOARD OF GOVERNORS OF
FIRE AND AMBULANCE DISTRICT I,
OF MONROE COUNTY, FLORIDA
By:
Kevin Wilson
Name and Address of Respondent:
Antonio Grandia, M.
By: BY:
Signatu a ondent
Witness
TArvrn��?� 64tidt'k 010
Print Name and Title
Date: $ 1z l ZAP
Approved by MONROE COUNTY on ......................... 2024.
Approved as to form and legal sufficiency:
Monroe County Attorney's Office 8-12-2024
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SECTION TWO:
FORMS
Attachment A Non-Collusion Affidavit
Attachment B Public Entity Crime Statement
Attachment C Drug Free Workplace Form
Attachment D Lobbying& Conflict of Interest Clause Sworn Statement under Ordinance
No. 10-1990 (Ethics Clause)
Attachment E Indemnification and Hold Harmless
Attachment F Insurance Documents
Attachment G Affidavit
Attachment H Affidavit
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NQN-COLLUSION AFFIDAVIT
I, An y—cr>,r o v WA , of the city of.
C d according to law on my oath, and under
penalty of perjury, depose and say that;
1) I am ?� ,the respondent making the
Proposal for the ero ecctt described as ollows:
2) The prices in this proposal have been arrived at independently without collusion,
consultation, communication or Contract for the purpose of restricting competition, as to any
matter relating to such prices with any other respondent or with any competitor;
3) Unless otherwise required by law,the prices which have been quoted in this proposal
have not been knowingly disclosed by the respondent and will not knowingly be disclosed by the
respondent prior to proposal opening,directly or indirectly, to any other respondent or to any
competitor; and
4) No attempt has been made or will be made by the respondent to induce any other
person, partnership or corporation to submit, or not to submit, a proposal for the purpose of
restricting competition; and
5) The statements contained in this affidavit are true and correct, and made with full
knowledge that Monroe County relies upon the truth of the statements contained in this affidavit
in awarding contracts for said project.
STATE OF KLO IL' 4 A
00f Respondent)
COUNTY OF _"(F 81)
Date
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
to GiAobf4 who, after first being sworn by me, (name of
individual signing) affixed his/her signature in the space provided above on this
1.2 day of QLk A-S-` , 20_°�T ......
M commission expires:
f` c�ER:s.recRszi
Y p �r ,, rtUry Mipd�•Su:e w F;�n�
NOTARY PUBLIC
*4:Jim 141M.wr26.202d
OMB-MCP FORM#1
Attachment A
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PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crime may not submit a proposal on a contract to provide any goods or services to a
public entity, may not submit a proposal on a contract with a public entity for the construction or
repair of a public building or public work, may not submit proposals on leases of real property to
public entity, may not be awarded or perform work as a bidder, supplier, subbidder,or
RESPONDENT 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, Florida Statutes, for
CATEGORY TWO for a period of 36 months from the date of being placed on the convicted
vendor list."
By executing this form, I acknowledge that I/my company is in compliance with the above.
STATE OF �o A Liz K
�l D
(Signature of Respondent)
COUNTY OF Mar`' Ro g� IZ� Zo
Date
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
A Wro 0 ti 0 qPtJDI k who,after first being sworn by me, (name of
individual signing)affixed his/her signature in the space provided above on this
Th day of 5 E ,20
My commission expires:
NOTARY PUBLIC
R-- ,,,.r,,,�cas+a
oo�c.lute d f cnu
u f,P D*.i h4��l6l l i
W Cam.ELK*0 36.301.3
Attachment B
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DRUG-FREE WORKPLACE FORM
The undersigned Respondent in acco dance with Florida Statute 287.087 hereby certifies that:
(Name of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for violations of such prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of
maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee
assistance programs, and the penalties that may be imposed upon employees for drug abuse
violations.
3. Gives each employee engaged in providing the commodities or contractual services that are
under proposal a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notifies the employees that, as a condition of
working on the commodities or contractual services that are under proposal, the employee will
abide by the terms of the statement and will notify the employer of any conviction of, or plea of
guilty or nolo contendre to, any violation of Chapter 893 (Florida Statutes) or of any controlled
substance law of the United States or any state, for a violation occurring in the workplace no later
than five(5)days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is
so convicted.
6. Makes a good faith effort to continue to maintain a drug-free workplace through implementation
of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
Resp ture
Dfite
OMB-MCP FORM#5
Attachment C
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LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
4'4>0d;15k warrants that he/it has not employed, retained or
otherwise had act on his/its behalf any former 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,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,
7777
e, gift, or c 'deration paid to the former County officer or employee.
ignature)
Date: jil '-q-W3:m"
STATE OF A R
COUNTY OF AZ E-
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
Q iJ'Ta i is �i ti / K who,after first being sworn by me, affixed his/her
Signature(name of individual signing) in the space provided above on this T day of
u-sLkST , 20 .
NOTARY PUBLIC ".�'" "'w"xftne'
my wr 26.2026
My commission expires:
OMB-MCP FORM 44
Attachment D
MONROE COUNTY, FLORIDA
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RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
Indemnification and Hold Harmless
for
Other Bidders and Subbidders
The Bidder covenants and agrees to indemnify and hold harmless Monroe Board of County
Commissioners, its servants,agents and employees from any and all claims for bodily injury
(including death), personal injury, and property damage(including property owned by Monroe
County)and any other losses, damages, and expenses(including attorney's fees)which arise out
of, in connection with, or by reason of services provided by the Bidder or any of its Subbidder(s)
in any tier, occasioned by the negligence,errors,or other wrongful act or omission of The Bidder
or its Subbidders in any tier,their employees, or agents.
In the event the completion of the project(to include the work of others) is delayed or suspended
as a result of the Bidder's failure to purchase or maintain the required insurance,the Respondent
shall indemnify the County from any and all increased expenses resulting from such delay.
The first ten dollars($10.00)of remuneration paid to the Respondent is for the indemnification
provided for above.
The extent of liability is in no way limited to,reduced,or lessened by the insurance requirements
contained elsewhere within this Contract.
7zo� —
ent's Signature
t
Ida e
TCS
Attachment E
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VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MONROE COUNTY, FLORIDA
AND
ANTONIO GANDIA, M.D.
Recognizing that the work governed by this contract requires the use of vehicles,the Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for:
Owned,Non-Owned,and Hired Vehicles
The minimum limits acceptable shall be:
$300,000 Combined Single Limit(CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
VL2
Attachment F
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
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FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MONROE COUNTY,FLORIDA
AND
ANTONIO GANDIA,M.D.
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers' Compensation Insurance with limits sufficient to respond to the applicable state
statutes.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less
than:
$500,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$500,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the
state of Florida.
If the Contractor has been approved by the Florida's Department of Labor, as an authorized self-
insurer,the County shall recognize and honor the Contractor's status. The Contractor may be
required to submit a Letter of Authorization issued by the Department of Labor and a Certificate
of Insurance, providing details on the Contractor's Excess Insurance Program.
If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required.
In addition,the Contractor may be required to submit updated financial statements from the fund
upon request from the County.
WC2
Attachment F
3$
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MONROE COUNTY, FLORIDA
REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS
It is requested that the insurance requirements,as specified in the County's Schedule of Insurance Requirements,be
waived or modified on the following contract. l
ContractorNendor: y►S1M t D C"74 N di1G4 ►M 0
Project or Service:
ContractorNendor
Address&Phone#: ��'�'� W �7iµ' &C , O GY/ ►., t+�►"/�
General Scope of Work: �Vl p ti-�,iy(� it }'
Reason for Waiver or Ala c -
Modification:
Policies Waiver or
Modification will apply to: c r
Signature of ContractorNendor:
Date: Approved Not Approved
Risk Management Signature:
Date:
County Administrator appeal:
Approved: Not Approved: ..............
Date:
Board of County Commissioners appeal:
3
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Antonio Gandia, M.D.
1080 S.W. 42"d Avenue
Deerfield Beach, FL 33442
August 12, 2024
To whom it may concern,
As an independent contractor, I am not required to carry Worker's Compensation
insurance pursuant to the Florida Statutes (less than 4 employees).
I also do not carry any commercial vehicles and do not carry general liability insurance.
Please contact me if you have any questions.
Sincerely,
nWi
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AFFIDAVIT ATTESTING TO NONCOERCIVE CONDUCT
FOR LABOR OR SERVICES
Entity/Vendor Name: 4yifMiQ 6 4 OJi
Vendor FEIN:
Vendor's Authorized Representative:
(Name and Title)
Address: Lv 20
City:*3e_.r4;r—l.J State: 12 Zip:
Phone Number:
Email Address: Mgt'-L • 60P)n
As a nongovernmental entity executing, renewing, or extending a contract with a
government entity, Vendor is required to provide an affidavit under penalty of perjury
attesting that Vendor does not use coercion for labor or services in accordance with
Section 787.06, Florida Statutes.
As defined in Section 787.06(2)(a), coercion means:
1. Using or threating to use physical force against any person;
2. Restraining, isolating, or confining or threating to restrain, isolate, or confine
any person without lawful authority and against her or his will;
3. Using lending or other credit methods to establish a debt by any person when
labor or services are pledged as a security for the debt, if the value of the labor
or services as reasonably assessed is not applied toward the liquidation of the
debt, the length and nature of the labor or service are not respectively limited
and defined;
4. Destroying, concealing, removing, confiscating, withholding, or possessing any
actual or purported passport, visa, or other immigration document, or any other
actual or purported government identification document, of any person;
5. Causing or threating to cause financial harm to any person;
6. Enticing or luring any person by fraud or deceit; or
7. Providing a controlled substance as outlined in Schedule I or Schedule II of
Section 893.03 to any person for the purpose of exploitation of that person.
As a person authorized to sign on behalf of Vendor, I certify under penalties of perjury
that Vendor does not use coercion for labor or services in accordance with Section
787.06. Additionally, Vendor has reviewed Section 787.06, Florida Statutes, and agrees
to abide by same.
Certified By: h.Tim�b
who is authorized to sign on beh f th Bove referenced company.
Authorized Signature:
Print Name: rvVL
Title:
Attachment G
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FOREIGN ENTITIES AFFIDAVIT F.S. 287.138
1, Aj�?,,a � )Li of the city of according to
law on my oath, and under penalty of perjury, depose and say that:
a. I am 1e111 WP"1V '4�" Nc' :0, of the firm of
("Entity"), the bidder
making the Proposal for the projecrt,described in the Request for Proposals for
P Ir-,0l and that I executed the said
proposal with full authority to do so;
b. In accordance with section 287.138, Florida Statutes, the Entity is not owned by
the government of a Foreign Country of Concern, as that term is defined in F.S.
287.138, is not organized under the laws of nor has its Principal Place of Business
in a Foreign Country of Concern, and the government of a Foreign Country of
Concern does not have a Controlling Interest in the entity.
c. The statements contained in this affidavit are true and correct, and made with full
knowledge that Monroe County relies upon the truth of the statements contained
in this affidavit in awarding contracts for said project.
(Signature) !
Date:
STATE OF: k to A
COUNTY OF: Ma N R,atE
Subscribed and sworn to (or affirmed) before me, by means of❑ physical presence or ❑
online notarization, on tiLk'r V-5r 1J, A�24 (date) by
A N-To N c0 G,A 4 h.s A (name of affiant). /She is personally known to me
or has produced .. . ... . .. ........ . (type
of identification) as identification. G� G.. t k,'
NOTARY PUBLIC
My Commission Expires:
]cndoa
cAV Cwm.Eire W
Attachment H
34
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CISSkIA' YVile Ri,6646'BY LAW
EXPIRATION DATE°.JANUARY 31,2025
Your license number is ME 5=7,Please use it In 80 Correspondence with your hoartlfoouncit.Each licensee Is solely rospormfbla for n00fytnp
am Department in writing of the OCenaee'a current mailRig address and pxaosce location address.If you have not recelved your renewal notice 90
days prior to the explreion date shown on this license,please visit www.FLH90OZwme.gov and cM*'Renew A License'to renew online.
The Medical Quality Assurance Or&*Services Portal gives you the abily to manape your license to perform address updates,name changes,
request duplicate licensee aril much more.
Ire alnuple. Log onto your MOA Online Services socount today at htlpJA%eallhsourCeI Select the Account LCgin'buttm to acceu s your
account. For changes to your name,address or to request duplicate looms,choose your selection!horn the dropdown list under'Manage My
License. Your profession will open for renews!90 days prior to,yotr expiration date. When the renewal cycle opens for your pofesskx%Ora
'Renew My Lioerree'header vA automatically display on your!tense Dashboard.
ARE YOU RENEWAL READY? GROUNDS FOR DISCIPLINE
The Dent of HeoM will now review You ehoutd be knilar with Ow Oroumb for
your oailrufng edua6w moords of the Owpma bond fn Section 450.002t U
W"of loorme reneKel, Florida SWuht%end to the wadtae"act for
tine pofaaston In wt*ch you are tioensed.
To loam more,pines vW t Florida Stadrtes can be aoossaed of
www.FL wWk44aurc godAYRR www.isgstete. mm"es
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AMENDED AND RESTATED CONTRACT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
AND
THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1
AND
ANTONIO GANDIA, M.D.
TO SERVE AS MEDICAL DIRECTOR FOR MONROE COUNTY FIRE RESCUE
THIS CONTRACT is made and entered into this 9th day of August 2024, by and between the
Monroe County Board of County Commissioners, The Board of Governors of Fire and
Ambulance District I of Monroe County, Florida, hereinafter collectively referred to as the
"COUNTY," and Antonio Gandia, M.D.I hereinafter referred to as "MEDICAL DIRECTOR".
WITNESSETH:
WHEREAS, COUNTY provides fire and/or emergency medical services pursuant to Chapter 401,
F.S. and Chapter 64J-I, FAC; and
WHEREAS,COUNTY is required to employ or contract with a MEDICAL DIRECTOR who shall
be a Florida licensed physician, Board Certified in Emergency Medicine with added qualification
in Emergency Medical Services (EMS) and pre-hospital care experience, or a business entity that
employs or contracts with similarly qualified physicians; and
WHEREAS, COUNTY has determined it to be in the best interests of the residents of and visitors
to Monroe County to contract with MEDICAL DIRECTOR for the purpose of providing direction
to the Fire and Emergency Medical Services; and
WHEREAS, MEDICAL DIRECTOR desires to provide professional services according to the
terms and conditions stated herein.
NOW THEREFORE, in consideration of the mutual understandings and Contracts set forth
herein, COUNTY and MEDICAL DIRECTOR agree as follows:
1. Term
This Contract shall become effective on August 9, 2024, and shall run for an initial term of six (6)
months, through February 8, 2025 (Initial Term). The agreement may thereafter be renewed an
additional number of times as the mutual written agreement of the parties.
2. Compensation
2.1 Ground Ambulance
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MEDICAL DIRECTOR shall be paid at a rate of $63,945.00 annually to provide ground
ambulance medical direction. Payments shall be made monthly in arrears by COUNTY pursuant
to the Florida Local Government Prompt Payment Act after receipt of proper invoice submitted
by MEDICAL DIRECTOR.
2.2 Air Ambulance
a. MEDICAL DIRECTOR shall be paid at a rate of$60,637.50 annually to provide air ambulance
medical direction. Payments shall be made monthly in arrears by COUNTY pursuant to the Florida
Local Government Prompt Payment Act after receipt of proper invoice by MEDICAL DIRECTOR.
Note: This payment is contingent upon COUNTY's decision to continue to operate air ambulance
services under its ALS license, and if, for any reason, COUNTY decides not to continue to operate
air ambulance EMS service under its ALS license, then MEDICAL DIRECTOR shall have no
responsibility to serve as MEDICAL DIRECTOR for the air ambulance service and COUNTY
shall have no liability for this portion of MEDICAL DIRECTOR's compensation.
2.3
If required, physician "peer to peer'' services for collection of denied medical claims will be paid,
subject to administrative review, at a rate of $250.00+hour in order to collect funds that would
otherwise be unpaid.
2.4
COUNTY will reimburse MEDICAL DIRECTOR for any direct expenses associated with
meetings required by COUNTY or Monroe County Sheriff's Office. For the purpose of this
paragraph, the term "direct expenses" means per diem or subsistence allowances, transportation
costs or mileage allowances, and miscellaneous travel expenses, as those terms are defined by
Section 1 12.061, Florida Statutes. All compensation shall be according to County Ordinance and
State law.
2.5
a. MEDICAL DIRECTOR will be provided a county phone and any other equipment required as
approved by the Chief of Fire Rescue.
b. COUNTY will reimburse MEDICAL DIRECTOR for the yearly application fee required for
renewal of the County's Drug Enforcement Administration (DEA) certificate, if the MEDICAL
DIRECTOR has paid the application fee in advance on behalf of the COUNTY.
2.6
Invoices received from MEDICAL DIRECTOR shall be reviewed and approved by COUNTY
Fire Chief or his designee, indicating that services have been rendered in conformity with the
Contract, and then will be sent to the Finance Department for payment.
2.7
In order for both parties to close their books and records, MEDICAL DIRECTOR must clearly
state "FINAL INVOICE" on MEDICAL DIRECTOR's final and last billing to COUNTY. This
certifies that all services have been properly performed and all charges and costs have been
invoiced to Monroe COUNTY. Since this account will thereupon be closed, any and other future
charges if not properly included in this final invoice are waived by MEDICAL DIRECTOR.
2.8
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Nothing in this Contract prohibits MEDICAL DIRECTOR from billing any third party
for medical services rendered outside the scope of this Contract that may arise during or
after the term of this Contract.
3. Purpose
The purpose of this Contract is to assure compliance of COUNTY in Medical Direction of
Monroe County Fire Rescue in accordance with the provisions of F.S., Chapter 401, and FAC
Chapter 64J-1.004.
4. Duties and Responsibilities.
4.1
MEDICAL DIRECTOR shall be responsible to Monroe County Fire Rescue and report
directly to the Fire Chief, and/or his/her designee.
4.2
MEDICAL DIRECTOR shall adhere to the responsibilities as set forth in Chapter 401, F.S., and
Rule 64J-1.004, FAC; the applicable rules of any government agency implementing said chapter;
and any duties upon written notice from the Florida Department of Health that such additional
duties are required of MEDICAL DIRECTOR. These include supervising and accepting
responsibility for the medical performance of all certified/license response personnel functioning
within the scope of their official duties while on duty with Monroe County Fire Rescue (MCFR),
including, but not limited to, members of volunteer fire department under contract with
COUNTY and/or Monroe County Fire and Ambulance District 1. While these duties will
typically occur within the geographical borders of unincorporated Monroe County and the City of
Layton, they also include duties performed at the Key West International Airport, during mutual
performed during mutual aid to requesting municipalities outside those geographical borders and
while transporting patient to out of county medical facilities. For the purpose of this Contract,
MEDICAL DIRECTOR is the individual who meets the licensing and registration requirements
of Chapter 401, F.S. and FAC Chapter 64J-1.004.
4.3
MEDICAL DIRECTOR shall be knowledgeable with the standards set by National Fire Protection
Association, and in particular, Standard1582: Standard on Comprehensive Occupational Medical
Program for Fire Departments.
4.4 Standards of Care
MEDICAL DIRECTOR shall establish and maintain standards of care for EMS providers.
4.4.1
MEDICAL DIRECTOR shall gather agency input in the review and development of standards of
care on an annual basis and establish and revise agency performance standards as necessary.
4.4.2
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Develop pre-hospital practice parameters for Fire Rescue Personnel of all levels. The parameters
shall be developed with consideration to budgetary and staffing limitations and the fiscal impact
on MCFR and the citizens of Monroe County.
4.5 Patient Advocate
MEDICAL DIRECTOR shall be a patient advocate in the fire rescue system and shall ensure that
all aspects of the EMS systems are developed to place the needs of the patient first.
4.6 Protocols and Standing Orders.
4.6.1
MEDICAL DIRECTOR shall develop, revise, implement, and maintain basic and advanced life
support protocols and standing orders under which MCFR personnel will function under medical
control.
4.6.2
MEDICAL DIRECTOR shall review and revise existing protocols and standing orders to ensure
that they meet nationally accepted standards of practice for use by all system providers, which
permit specified ALS and BLS procedures when communication cannot be established with a
supervising physician, or when any delay in patient care would threaten the life or health of the
patient. These standards include, but are not limited to, Advanced Cardiac Life Support (ACLS),
Basic Trauma Life Support (BTLS), and Pediatric Advanced Life Support (PALS). In addition to
medical treatment, protocols shall address determination of patient destination.
4.6.3
MCFR shall publish and distribute,at its own cost,all protocols and standing orders. The protocols
and standing orders shall be published in a form consistent with agency Standard Operating
Procedures. Copies of the protocols and standing orders will be maintained on all MCFR
ambulances(air and ground)and ALS engines,and will be distributed to certified/licensed response
personnel. Personnel copies may be provided electronically. MCFR shall obtain and retain a
receipt from each personnel member verifying receipt of the protocols and any changes. These
receipts may be electronic, and shall state clearly that each person is individually accountable and
obligated to follow all rules, regulations and protocols. All protocols and standing orders shall
become public domain upon implementation.
4.6.4
MEDICAL DIRECTOR shall develop, review, and revise, when necessary, Trauma Transport
Protocols(TTP)for submission to the Florida Department of Health, Bureau of Emergency Medical
Services for approval in accordance with Rule 643-2, FAC.
4.6.5
MEDICAL DIRECTOR shall develop enhanced protocols for specialty procedures or services
including but not limited to aeromedical (Trauma Star)transport.
4.6.6
MEDICAL DIRECTOR shall conduct an on-going review of all protocols and standing orders as
may be necessary to ensure reliable service delivery,appropriate patient care, and the maintenance
of the current standard of care. This shall include, at a minimum, a comprehensive annual review
and written approval of all protocols and standing orders. While conducting the annual review,
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MEDICAL DIRECTOR shall take into consideration the results of quality assurance reviews,
review of current medical literature, and input from MCFR response personnel. Changes shall be
developed with consideration to budgetary limitations and the fiscal impact on MCFR and the
citizens of Monroe County. The annual review shall be completed, and all proposed changes
forwarded to the Fire Chief, prior to the end of each Fiscal Year.
4.6.7
MEDICAL DIRECTOR shall ensure that appropriate training for new protocols and standing
orders is conducted prior to implementation; shall ensure compliance with protocols and standing
orders by all MCFR personnel; and ensure that additional training is conducted for any identified
needs.
4.7 Availability.
MEDICAL DIRECTOR or his/her previously approved designee shall be available twenty-four
(24)hours a day,seven(7)days a week for medical direction to MCFR personnel in order to resolve
problems, system conflicts,and provide services in an emergency as that term is defined in Section
252.34(3), F.S.
4.8 Trauma Scorecard Methodologies.
MEDICAL DIRECTOR shall ensure that all certified/licensed response personnel are trained in
the use of the trauma scorecard methodologies, as provided in Chapter 64J-2.004, FAC, for adult
trauma patients and 64J-2.005, FAC, for pediatric trauma patients.
4.9 Aeromedical Operations
4.9.1
MEDICAL DIRECTOR shall participate in Trauma Star safety and quality assurance committees,
and shall attend quarterly meetings to review safety policies, procedures, unusual occurrences,
safety issues,and audit compliance with safety policies and procedures.
4.9.2
Be knowledgeable with aeromedical requirements of patients and evaluate each patient in person,
by telephone, or by delegated written protocol prior to each interfacility transfer flight for the
purpose of determining that the aircraft, flight and medical crew,and equipment meet the patient's
needs.
4.10 Oversight of Medical Qualifications And Proficiency of MCFR Personnel
4.10.1
MEDICAL DIRECTOR shall ensure initial and continued medical qualifications and proficiency
of MCFR personnel.
4.10.2
MEDICAL DIRECTOR shall establish and periodically update the minimum personnel training
standards and certification requirements for all MCFR personnel who provide emergency medical
care. Such standards shall include the requirements for orientation and initial training, continuing
medical education, standards for professional conduct and evaluation standards and procedures.
4.10.3
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MEDICAL DIRECTOR shall ensure that all field personnel meet the initial requirements and
continuously comply with established standards to attain and maintain approval to operate within
the MCFR system.
4.10.4
MEDICAL DIRECTOR shall establish procedures for issuance, renewal, suspension, and
revocation of practice privileges for MCFR personnel in concert with the Fire Chief, to include a
process for remediation. The procedures shall contain due process provisions and all such
provisions shall be approved, in advance, by the Fire Chief.
4.10.5
MEDICAL DIRECTOR shall provide for direct observation of field level providers while
performing their duties that meets or exceeds Section 401.265, F.S., and Rule 64J-1.004, FAC.
4,11 Quality Assurance
4.11.1
MEDICAL.., DIRECTOR, in coordination with MCFR, shall develop, implement, and maintain an
effective patient care Quality Assurance System to assess the medical performance of all
certified/licensed MCFR response personnel.
4.11.2
MEDICAL DIRECTOR shall develop, implement, and supervise a formal patient care Quality
Assurance System in accordance with Section 401.265(2), F.S. and Rule 64J-1.004, FAC, to
include the formation and supervision of a quality assurance committee.
4.11.2.1
The purpose and tone of the quality assurance review process shall be positive and educational;
however, MEDICAL DIRECTOR may, at any time and without limitation, conduct a quality
assurance review investigation or audit to ensure that MCFR personnel comply with the Protocols
and Standard of Care.
4.11.2.2
The method and extent of the investigation employed during any given quality assurance review
shall be determined by MEDICAL DIRECTOR in consultation with the Fire Chief. As a result of
said investigation, MEDICAL DIRECTOR may require remedial training of MCFR personnel
and/or revocation of practice privileges. Remedial training may be conducted by MEDICAL
DIRECTOR, MCFR personnel, or other personnel at MEDICAL DIRECTOR's discretion.
4.11.3
MEDICAL DIRECTOR or designee may also conduct special audits in response to observations
or customer feedback provided by patients, family members, caregivers, bystanders, crew
members, physicians and hospital personnel.
4.1 1.4
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MEDICAL DIRECTOR may also develop procedures for routine auditing of EMS system
performance and adherence to protocols on individual EMS incidents and overall EMS system
compliance.
4.11.5
MEDICAL DIRECTOR or designee shall review, in conjunction with MCFR battalion chiefs or
their designees, patient care reports on an ongoing basis; review all protocol deviations and initiate
or recommend corrective action. MEDICAL DIRECTOR or designee shall review at least 40
patient care reports per month. MCFR shall provide electronic copies of patient care reports.
4.11.6
MEDICAL DIRECTOR shall periodically visit and communicate with the hospital emergency
departments to exchange information and review the quality of care provided by the MCFR
personnel.
4.11.7
MEDICAL DIRECTOR shall participate in field activity and system monitoring to include the
following:
4.11.7.1
Ride along and observe field activity as a crew member on a rescue as needed.
System monitoring, shall include visiting fire stations when needed to discuss issues with MCFR
personnel.
4.l 1.8
MEDICAL DIRECTOR shall document in a quarterly status report to the Fire Chief, evidence of
the following required activities:
4,11.8.1
Reporting on issues identified with MCFR personnel; and
4.11.8.2
Communicating with hospital emergency department staff, and other medical and public safety
personnel for quality assurance and education activities.
4.12 Educational Programs
4.12.1
MEDICAL DIRECTOR shall participate in educational programs at all levels, to include all
certified/licensed response personnel.
4.12.2
MEDICAL DIRECTOR or designee shall oversee a minimum of ten(10)hours a year of continuing
medical education related to pre-hospital care or teaching or a combination of both.
4.12.3
MEDICAL DIRECTOR shall actively participate in the development and presentation of EMS
continuing education programs by identifying educational topics, presenting lectures and providing
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other educational opportunities for the enhancement of the fire rescue system. MCFR shall pay the
actual direct cost of any course materials, instructors, and certificates.
4.12.3.1
Education should be geared to reach the specific needs of the audience. As some providers are
volunteers, consideration shall be given to scheduling some training on nights or weekends.
4.12.3.2
Course content should include system-specific issues and items resulting from audit and review.
4.12.4
Where MEDICAL DIRECTOR is not the presenter, and training services are conducted by other
COUNTY personnel and/or are subcontracted to an outside provider, MEDICAL DIRECTOR will
ensure the quality of the Continuing Medical Education(CME)training provided to EMS personnel
by:
4.12.4.1
Reviewing and approving all curriculum and courses for continuing education units (CEU's) prior
to MCFR personnel being trained;
4.12.4.2
Monitoring and auditing at least one (1) class session of every CME course held in which
MEDICAL DIRECTOR is issuing CME; and
4.12.4.3
Evaluating the educational effectiveness of instruction, courses and programs in consultation with
the CME contractor.
4.12.5
MEDICAL DIRECTOR shall maintain necessary and appropriate instructor certifications and
participate as Medical Director for educational programs sponsored by MCFR such as ACLS,
PALS, BTLS, etc.
4.12.6
Upon proof of completion, MEDICAL DIRECTOR shall sign documents and approve CME to
those EMT's and EMT-P's that have completed a minimum of 30 hours of biannual recertification
training, as set forth in Section 401.2715, F.S.
4.13 Agency Liaison
4.13.1
MEDICAL DIRECTOR shall participate in interagency discussions about specific issues or
problems as necessary.
4.13.2
MEDICAL DIRECTOR shall notify MCFR of any pertinent concerns regarding patient care raised
by other agencies and provide advice on a resolution. MEDICAL DIRECTOR shall also notify
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other agencies of any concerns regarding patient care, raised either by MCFR or MEDICAL
DIRECTOR.
4.13.3
MEDICAL DIRECTOR shall develop and maintain liaisons with the local medical community:
hospitals, emergency departments, mental health agencies, physicians, providers, ambulance
services, and other agencies impacting MCFR.
4.13.4
MEDICAL DIRECTOR shall assist in resolution of problems involving the delivery of pre-hospital
care and other services in accordance with Rule 64.1-1.004, FAC.
4.13.5
MEDICAL DIRECTOR shall interact with and inform local government officials on an as needed
basis.
4.13.6
MEDICAL DIRECTOR shall participate in the Florida EMS Medical Director's Association or a
statewide physician's group involved in pre-hospital care,
4.13.7
MEDICAL DIRECTOR shall be an active member of at least one national emergency medicine
constituency group such as the National Association of EMS Physicians, the American College of
Emergency Physicians, etc.
4.13.8
MEDICAL DIRECTOR shall interact with county, regional, state, and federal authorities,
regulators and legislators to ensure standards, needs, and requirements are met, and resource
utilization is optimized.
4.13.9
MEDICAL DIRECTOR shall participate in grant application process for system funding,
expansion, and research.
4.14 Stress Management Programs.
MEDICAL DIRECTOR shall participate in stress management programs for providers within the
system, as needed.
4.15 Community Access to Healthcare Initiatives.
MEDICAL DIRECTOR, in conjunction with MCFR, shall coordinate community access to
healthcare initiatives as needed.
4.16 EMT Oversight.
4.16.1
In accordance with Rules 64J-1.004 (g) and (h), FAC, assume direct responsibility for: the use of
an automatic or semi-automatic defibrillator; the use of a glucometer;the administration of aspirin;
the use of any medicated auto injector; the performance of airway patency techniques including
airway adjuncts, not to include endotracheal intubation; and on routine interfacility transports, the
monitoring and maintenance of non-medicated I.V.s by an EMT.
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4.16.2
MEDICAL DIRECTOR shall ensure that all EMTs are trained to perform these procedures; shall
establish and/or maintain written protocols for performance of these procedures; and shall provide
written evidence to the Florida Department of Health documenting compliance with provisions of
these administrative rules.
4.17 Disaster Assistance and Planning
4.17.1
MEDICAL DIRECTOR shall be available for consultation andlor response during a disaster
situation occurring in Monroe County.
4.17.2
MEDICAL DIRECTOR shall function as a liaison between field EMS operations, hospitals, and
public health agencies during disaster situations.
4.17.3
MEDICAL DIRECTOR shall provide specific information to assist in the mitigation of the EMS
aspects during a disaster situation.
4.17.4
MEDICAL DIRECTOR shall cooperate in planning, updating, and following applicable sections
of the Monroe County Comprehensive Emergency Management Plan, including, but not limited to,
participation in disaster drill and emergency management drills.
4.18 Controlled Substances, Medical Equipment and Supplies.
4.18.1
In accordance with F.S., Chapter 401 and Rule 64J-1.004(4)(c), FAC, MEDICAL DIRECTOR
shall possess proof of current registration as a medical director with the U.S. Department of Justice,
DEA, to provide controlled substances to an EMS provider. The DEA registration shall include
each address at which controlled substances are stored. Proof of such registration shall be
maintained on file with MCFR, which shall maintain the copies and make them readily available
for inspection. MCFR will forward all renewal documents as received from DEA to MEDICAL
DIRECTOR in order to ensure continuous registration and will reimburse MEDICAL DIRECTOR
for the cost of such registration. Copies of physician license and registrations must be provided to
MCFR.
4.18.2
MEDICAL DIRECTOR shall formulate and ensure adherence to detailed written procedures to
cover the purchase, storage, use, and accountability for medications, fluids, and controlled
substances used by MCFR personnel, in accordance with Chapters 499 and 893, F.S., and Rule
64J-1.021, FAC.
4.18.3
MEDICAL DIRECTOR shall ensure and certify that security procedures of all MCFR providers
for medications, fluids and controlled substances are in accordance with Chapters 499 and 893,
F.S., and Rule 64J-1.021„ FAC.
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MEDICAL DIRECTOR shall establish a list of mandatory equipment, medications and medical
supplies that must be on board a Rescue or ALS Engine for it to respond to EMS incidents.
4.18.5
MEDICAL DIRECTOR shall advise MCFR on appropriate staffing, structural requirements,
equipment and supplies necessary to ensure that the air ambulance complies with Rule 64J-1.005,
FAC, and Section 401.251(4), F.S.
4.18.6
MEDICAL DIRECTOR shall conduct an on-going and comprehensive review of all EMS medical
equipment, medications and medical supplies as may be necessary to ensure reliable service
delivery in the fire rescue System and excellence in patient care.
4.18.6.1
In conducting the review, MEDICAL DIRECTOR shall take into consideration the results of
Quality Assurance Reviews, review of medical literature, input from interested physicians, and
MCFR personnel.
4.18.6.2
MEDICAL DIRECTOR, in conjunction with MCFR, shall complete the comprehensive review of
all EMS System medical supplies and equipment and present the proposed changes to the Fire
Chief for approval prior to the end of each Fiscal Year.
4.l 8.7
MEDICAL DIRECTOR shall ensure that the following criteria are met prior to activating new
medical equipment or supplies within the EMS System:
4.18.7.1
Proposed medical equipment or supplies have been thoroughly researched, supported by medical
literature, a field evaluation completed when applicable,and the analysis of available system data;
4,18.7.2
All Protocols related to the medical equipment or supplies have been evaluated and updated as
appropriate, to ensure consistency and accuracy; and
4.18.7.3
Protocols, supporting documents and implementation instructions are distributed to MCFR
personnel prior to training or implementation, and training has been completed, if necessary, prior
to implementation.
4.19 Infectious Disease Control Policy
4.19.1
MEDICAL DIRECTOR shall formulate, monitor, evaluate and update as necessary, a policy
complying with all applicable laws and rules necessary to control exposure of MCFR personnel to
infectious diseases. This policy shall cover protective measures to be taken on incidents,
inoculation procedures and recommendations, record keeping, follow up care recommendations as
well as storage and disposal policies for contaminated materials.
4.19.2
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MEDICAL DIRECTOR shall be available, in conjunction with the MCFR Infection Control
Officer, for consultation from field personnel to determine the significance of any body fluid
exposure and suggest appropriate action for such an exposure in accordance with Monroe County
Fire Rescue's existing Workers' Compensation policies and procedures.
4.20
This Contract is a professional services contract based on the qualifications of Dr. Gandia and the
services required hereunder shall be performed by MEDICAL DIRECTOR. or under his/her
supervision. Any additional personnel necessary for the fulfillment of the services required under
this Contract shall be secured at MEDICAL DIRECTOR's sole expense and such personnel shall
be fully qualified and, if required, authorized, or permitted under State and local law to perform
such services.
5. Insurance
COUNTY shall maintain in full force and effect for the term of this Contract, and any subsequent
renewals, professional and General Liability Insurance with minimum limits of$1,000,000.00 per
occurrence. The Professional and General Liability certificate will specify coverage for "EMS
oversight medical direction".
COUNTY will provide certificate or proof of such insurance to MEDICAL DIRECTOR on an
annual basis. Medical Director will be provided thirty (30) days notice of cancellation, change in
policy limits, and/or any restrictions placed on coverage of the insurance provided by COUNTY
during the term of this Contract. COUNTY will be responsible for the payment of any deductible
and/or self-insured retention in the event of a claim.
The Contractor shall be responsible for all necessary Workers' Compensation and Vehicle Liability
insurance coverage. Certificates of Insurance must be provided to Monroe County within fifteen
(15) days after award of contract, with Monroe County BOCC listed as additional insured as
indicated. Policies shall be written by insurers admitted and licensed to do business in the State of
Florida and having an agent for service of process in the State of Florida. Companies shall have
an A.M. Best rating of VI or better. The required insurance shall be maintained at all times while
Respondent is providing service to County.
Prior to commencement of work governed by this contract, the CONTRACTOR must obtain:
Worker's Compensation Insurance with limits sufficient to respond to applicable state statutes.
In addition,the Respondent must obtain Employer's Liability insurance with limits of not less than:
$500,000 Bodily Injury by accident,
$500,000 Bodily Injury by Disease policy limits,
and $500,000 Bodily Injury by Disease, each employee.
Coverage must be maintained throughout the entire term of the contract.
Workers' compensation and employers' liability insurance can be waived by the County upon
receipt of information showing that the MEDICAL DIRECTOR is exempt under state statute.
Prior to commencement of work governed by this contract, the CONTRACTOR must obtain:
Vehicle Liability Insurance which shall cover owned, non-owned and hired vehicles. The
minimum acceptable limits shall be$300,000 Combined Single Limit (CSL). If split limits are
provided, the minimum limits acceptable shall be:
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$100,000 per Person
$300,000 per Occurrence
$50,000 Property Damage
Monroe County Board of County Commissioners shall be named as an Additional insured
on Vehicle Liability policies.
6. Termination
6.1 Early termination may occur as follows:
A. This Contract may be terminated by MEDICAL DIRECTOR, with or without cause, upon
not less than ninety (90) days written notice delivered to COUNTY.
B. COUNTY may terminate this Contract in whole or in part and without cause, upon not less
than ninety (90)days written notice, delivered to MEDICAL DIRECTOR.
C. COUNTY may terminate this Contract immediately in the event that MEDICAL
DIRECTOR fails to fulfill any of the terms, understandings or covenants of this Contract.
6.2 At such time as this Contract is terminated,whether at the natural ending date or at an earlier
time, MEDICAL DIRECTOR shall:
A. Stop work on the date and to the extent specified.
B. Terminate and settle all orders and subcontracts relating to the performance of the work.
C. Transfer all work in process, completed work,and other materials related to the terminated
work to COUNTY.
D. Continue and complete all parts of that work which have not been terminated, if any.
7. Payments
Payments shall be made by COUNTY pursuant to the Florida Local Government Prompt
Payment Act after the completion of the rendered services and proper invoicing by MEDICAL
DIRECTOR.
8. ContinQency
COUNTY's performance and obligation to pay under this Contract is contingent upon an annual
appropriation by the Board of County Commissioners.
9. Section Headings
Section headings have been inserted in this Contract as a matter of convenience of reference only,
and it is agreed that such section headings are not a part of this Contract and will not be used in the
interpretation of any provision of this Contract.
10. Ownership of the Proiect Document
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Any documents submitted by MEDICAL DIRECTOR for this professional services contract
belong to COUNTY and may be reproduced and copied without acknowledgement or permission
of MEDICAL DIRECTOR.
11. Successors and Assigns
MEDICAL DIRECTOR shall not assign its right hereunder, except its right to payment, nor shall
it delegate any of its duties hereunder without the written consent of COUNTY. Subject to the
provisions of the immediately preceding sentence, each party hereto binds itself, its successors,
assigns and legal representatives to the other and to the successors, assigns and legal
representatives of such other party.
12. No Third Party Beneficiaries
Nothing contained herein shall create any relationship, contractual or otherwise, with or any
rights in favor of, any third party.
13. Public Entities Crimes
13.1
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 contracts to provide any goods or services to a public
entity, may not submit a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real property to public entity,
may not be awarded or perform work as a contractor, supplier, subcontractor, or MEDICAL
DIRECTOR 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 of the F.S., for
CATEGORY TWO for a period of 36 months from the date of being placed on the convicted
vendor list.
13.2
By signing this Contract, MEDICAL DIRECTOR represents that the execution of this Contract
will not violate the Public Entity Crimes Act (Section 287.133, F.S.). Violation of this section
shall result in termination of this Contract and recovery of all monies paid hereto, and may result
in debarment from COUNTY's competitive procurement activities.
13.3
In addition to the foregoing, MEDICAL DIRECTOR further represents that there has been no
determination, based on an audit, that it or any SUBCONTRACTOR has committed an act
defined by Section 287.133, F.S., as a"public entity crime"and that it has not been formally
charged with committing an act defined as a"public entity crime" regardless of the amount of
money involved or whether CONSULTANT has been placed on the convicted vendor list.
13.4
MEDICAL DIRECTOR will promptly notify COUNTY if MEDICAL DIRECTOR or any
subcontractor is formally charged with an act defined as a"public entity crime"or has been
placed on the convicted vendor list.
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14. Records
MEDICAL DIRECTOR shall maintain all books, records, and documents directly pertinent to
performance under this Contract in accordance with generally accepted accounting principles.
Upon ten (10) business days written notice to the other party, representatives of either party shall
have access, at all reasonable times, to all the other party's books, records, correspondence,
instructions, receipts, vouchers and memoranda(excluding computer software) pertaining to work
under this Contract for the purpose of conducting a complete independent fiscal audit. MEDICAL
DIRECTOR shall retain all records required to be kept under this Contract for a minimum of five
years, and for at least four years after the termination of this Contract. Storage of medical records
required by Federal or State statute in excess of the times stated herein and subsequent to the
termination of this Contract shall be revisited by the parties at such time as any transition period is
established to accommodate the termination of this Contract. MEDICAL DIRECTOR shall keep
such records as are necessary to document the provision of services under this contract and
expenses as incurred, and give access to these records at the request of COUNTY, the State of
Florida or authorized agents and representatives of said government bodies. It is the responsibility
of MEDICAL DIRECTOR to maintain appropriate records to insure a proper accounting of all
collections and remittances. MEDICAL DIRECTOR shall be responsible for repayment of any
and all audit exceptions which are identified by the Auditor General for the State of Florida, the
Cleric of Court for Monroe County, the Board of County Commissioners for Monroe County, or
their agents and representatives.
15. Governine Law, Venue, Interpretation,Costs, and Fees
This Contract shall be governed by and construed in accordance with the laws of the State of Florida
applicable to contracts made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is instituted for the enforcement
or interpretation of this Contract,COUNTY and MEDICAL DIRECTOR agree that venue shall lie
in Monroe County, Florida, in the appropriate court or before the appropriate administrative body.
The Parties waive their rights to a trial by jury. This Contract is not subject to arbitration.
16. Severability
If any term, covenant, condition or provision of this Contract (or the application thereof to any
circumstance or person) shall be declared invalid or unenforceable to any extent by a court of
competent jurisdiction,the remaining terms, covenants,conditions and provisions of this Contract,
shall not be affected thereby; and each remaining term, covenant, condition and provision of this
Contract shall be valid and shall be enforceable to the fullest extent permitted by law unless the
enforcement of the remaining terms, covenants, conditions and provisions of this Contract would
prevent the accomplishment of the original intent of this Contract. COUNTY and MEDICAL
DIRECTOR agree to reform the Contract to replace any stricken provision with a valid provision
that comes as close as possible to the intent of the stricken provision.
17. Attorney's Fees and Costs
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COUNTY and MEDICAL DIRECTOR agree that in the event any cause of action or administrative
proceeding is initiated or defended by any party relative to the enforcement or interpretation of this
Contract, the prevailing party shall be entitled to reasonable attorney's fees, court costs,
investigative, and out-of-pocket expenses, as an award against the non-prevailing party, and shall
include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate
proceedings. Mediation proceedings initiated and conducted pursuant to this Contract shall be in
accordance with the Florida Rules of Civil Procedure and usual and customary procedures required
by the circuit court of Monroe County.
18. Binding Effect
The terms, covenants,conditions,and provisions of this Contract shall bind and inure to the benefit
of COUNTY and MEDICAL DIRECTOR and their respective legal representatives, successors,
and assigns.
19. Authority
Each party represents and warrants to the other that the execution,delivery and performance of this
Contract have been duly authorized by all necessary County and corporate action, as required by
law.
20. Claims for Federal or State Aid
MEDICAL DIRECTOR and COUNTY agree that each shall be, and is, empowered to apply for,
seek, and obtain federal and state funds to further the purpose of this Contract; provided that all
applications, requests, grant proposals, and funding solicitations shall be approved by each party
prior to submission.
21. Adjudication of Disputes
COUNTY and MEDICAL DIRECTOR agree that all disputes shall be attempted to be resolved by
meet and confer sessions between representatives of each of the parties. If the issue or issues are
still not resolved to the satisfaction of the parties, then any party shall have the right to seek such
relief or remedy as may be provided by this Contract or by Florida law.
22. Cooperation
In the event any administrative or legal proceeding is instituted against either party relating to the
formation, execution, performance, or breach of this Contract, COUNTY and MEDICAL
DIRECTOR agree to participate, to the extent required by the other party, in all proceedings,
hearings, processes, meetings, and other activities related to the substance of this Contract or
provision of the services under this Contract. COUNTY and MEDICAL DIRECTOR specifically
agree that no party to this Contract shall be required to enter into any arbitration proceedings related
to this Contract.
23. Nondiscrimination
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MEDICAL DIRECTOR and COUNTY agree that there will be no discrimination against any
person,and it is expressly understood that upon a determination by a court of competent jurisdiction
that discrimination has occurred, this Contract automatically terminates without any further action
on the part of any party, effective the date of the court order. MEDICAL DIRECTOR and
COUNTY agree to comply with all Federal and F.S.,and all local ordinances,as applicable,relating
to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of
1964 (PL 88-352), which prohibits discrimination on the basis of race, color or national origin; 2)
Title IX of the Education Amendment of 1972, as amended (20 USC §§ 1681-1683, and 1685-
1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act
of 1973, as amended (20 USC § 794), which prohibits discrimination on the basis of handicaps; 4)
The Age Discrimination Act of 1975, as amended (42 USC §§ 6101-6107), which prohibits
discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-
255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive
Alcohol Abuse and Alcoholism Prevention,Treatment and Rehabilitation Act of 1970(PL 91-616),
as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The
Public Health Service Act of 1912, §§ 523 and 527(42 USC §§ 690dd-3 and 290ee-3),as amended,
relating to confidentiality of alcohol and drug abuse patent records; 8)Title Vill of the Civil Rights
Act of 1968(42 USC §§ 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental
or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC §§ 1201), as
amended from time to time, relating to nondiscrimination in employment on the basis of disability;
10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on the basis of
race,color, sex, religion,national origin,ancestry, sexual orientation,gender identity or expression,
familial status or age;and 11)any other nondiscrimination provisions in any federal or state statutes
which may apply to the parties to, or the subject matter of, this Contract.
24. Covenant of No Interest
MEDICAL DIRECTOR and COUNTY covenant that neither presently has any interest, and shall
not acquire any interest, which would conflict in any manner or degree with its performance under
this Contract, and that only interest of each is to perform and receive benefits as recited in this
Contract.
25. Code of Ethics
MEDICAL DIRECTOR agrees that officers and employees of COUNTY recognize and will be
required to comply with the standards of conduct for public officers and employees as delineated
in Section 112.313, F.S., regarding, but not limited to, solicitation or acceptance of gifts; doing
business with one's agency; unauthorized compensation; misuse of public position, conflicting
employment or contractual relationship; and disclosure or use of certain information.
26. No Solicitation/Payment
MEDICAL DIRECTOR and COUNTY warrant that, in respect to itself, it has neither employed
nor retained any company or person,other than a bona fide employee working solely for it,to solicit
or secure this Contract and that it has not paid or agreed to pay any person, company,corporation,
individual, or firm, other than a bona fide employee working solely for it, any fee, commission,
percentage, gift, or other consideration contingent upon or resulting from the award or making of
this Contract. For the breach or violation of the provision, MEDICAL DIRECTOR agrees that
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COUNTY shall have the right to terminate this Contract without liability and, at its discretion, to
offset from monies owed, or otherwise recover, the full amount of such fee, commission,
percentage, gift, or consideration.
27. Public Access
MEDICAL DIRECTOR and COUNTY shall allow and permit reasonable access to,and inspection
of, all documents, papers, letters or other materials in its possession or under its control subject to
the provisions of Chapter 119, F.S., and made or received by MEDICAL DIRECTOR and
COUNTY in connection with this Contract; and COUNTY shall have the right to unilaterally
cancel this Contract upon violation of this provision by MEDICAL DIRECTOR.
28. Non-Waiver of Immunity
Notwithstanding the provisions of Section 768.28, F.S., the participation of MEDICAL
DIRECTOR and COUNTY in this Contract and the acquisition of any commercial liability
insurance coverage,self-insurance coverage, or local government liability insurance pool coverage
shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract
entered into by COUNTY be required to contain any provision for waiver.
29. Privileges and Immunities
All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules
and pensions and relief, disability, workers' compensation, and other benefits which apply to the
activity of officers, agents, or employees of any public agents or employees of COUNTY, when
performing their respective functions under this Contract within the territorial limits of COUNTY
shall apply to the same degree and extent to the performance of such functions and duties of such
officers, agents, volunteers, or employees outside the territorial limits of COUNTY.
30. Legal Obli rations and Responsibilities
This Contract is not intended to, nor shall it be construed as, relieving any participating entity from
any obligation or responsibility imposed upon the entity by law except to the extent of actual and
timely performance thereof by any participating entity, in which case the performance may be
offered in satisfaction of the obligation or responsibility. Further, this Contract is not intended to,
nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of
COUNTY, except to the extent permitted by the Florida constitution, state statute, and case law.
31. Non-Reliance by Non-Parties
No person or entity shall be entitled to rely upon the terms, or any of them, of this Contract to
enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or
program contemplated hereunder, and MEDICAL DIRECTOR MEDICAL DIRECTOR and
COUNTY agree that neither MEDICAL DIRECTOR nor COUNTY or any agent, officer, or
employee of either shall have the authority to inform, counsel, or otherwise indicate that any
particular individual or group of individuals, entity or entities, have entitlements or benefits under
this Contract separate and apart, inferior to, or superior to the community in general or for the
purposes contemplated in this Contract.
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32. Attestations and Truth in Negotiation
MEDICAL DIRECTOR agrees to execute such documents as COUNTY may reasonably require,
including a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace
Statement. Signature of this Contract by MEDICAL DIRECTOR shall act as the execution of a
truth in negotiation certificate stating that wage rates and other factual unit costs supporting the
compensation pursuant to the Contract are accurate, complete, and current at the time of
contracting.
33. No Personal Liability
No covenant or Contract contained herein shall be deemed to be a covenant or Contract of any
member,officer,agent or employee of COUNTY in his or her individual capacity,and no member,
officer, agent or employee of COUNTY shall be liable personally on this Contract or be subject to
any personal liability or accountability by reason of the execution of this Contract.
34. Execution of Counterparts
This Contract may be executed in any number of counterparts, each of which shall be regarded as
an original,all of which taken together shall constitute one and the same instrument and any of the
parties hereto may execute this Contract by signing any such counterpart.
35. Amendments and Assignments.
No amendment or assignment of this Contract shall be valid without the prior written consent from
COUNTY.
36. Independent Contractor.
At all times and for all purposes hereunder, MEDICAL DIRECTOR is an independent contractor
and not an employee of the Board of County Commissioners of Monroe County. No statement
contained in this Contract shall be construed as to find MEDICAL DIRECTOR or any of its
employees,contractors, servants or agents to the employees of the Board of County Commissioners
of Monroe County, and they shall be entitled to none of the rights, privileges or benefits of
employees of Monroe County.
37. Compliance with Law.
In carrying out its obligations under this Contract, MEDICAL DIRECTOR shall abide by all
statutes,ordinances,rules and regulations pertaining to or regulating the provisions of this Contract,
including those now in effect and hereafter adopted. Any violation of said statutes, ordinances,
rules or regulations shall constitute a material breach of this Contract and shall entitle COUNTY
to terminate this Contract immediately upon delivery of written notice of termination to MEDICAL
DIRECTOR.
38. Licensing and Permits.
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MEDICAL DIRECTOR shall have, prior to commencement of work under this Contract and at all
times during said work, all required licenses and permits whether federal, state, county or
municipal.
39. Signatures of Parties Required.
THIS CONTRACT SHALL NOT BE EFFECTIVE UNTIL EXECUTED BY BOTH PARTIES
AND RECEIVED IN FINAL EXECUTED FORM BY AN AUTHORIZED REPRESENTATIVE
OF MEDICAL DIRECTOR AT ITS PRINCIPAL PLACE OF BUSINESS.
40. County Authority.
By execution hereof the signer below hereby certifies that signer is duly authorized to execute this
Contract on behalf of the COUNTY.
41. Federal and State Tax.
COUNTY is exempt from payment of Florida State Use and Sales Taxes. COUNTY will sign an
exemption certificate submitted by MEDICAL DIRECTOR. MEDICAL DIRECTOR will not be
exempted from paying state sales tax to its suppliers for materials used to fulfill contractual
obligations with COUNTY, nor is MEDICAL DIRECTOR authorized to use COUNTY's Tax
Exemption Number in securing such materials.
42. Florida Public Records law (F.S. 119.0701).
RECORDS- ACCESS AND AUDITS: Pursuant to F.S. 119.0701, Contractor and its
subcontractors shall comply with all public records laws of the State of Florida, including but not
limited to:
a. Keep and maintain public records required by Monroe County in order to perform the service.
b. Upon request from the public agency's custodian of public records, provide the public agency
with a copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in Florida Statutes, Chapter 119 or
as otherwise provided by law.
c. Ensure that public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of the
contract term and following completion of the contract if the contractor does not transfer the records
to the public agency.
d. U'pon completion of the contract, transfer, at no cost, to Monroe County all public records in
possession of the contractor or keep and maintain public records required by the public agency to
perform the service. If the contractor transfers all public records to the public agency upon
completion of the contract,the contractor shall destroy any duplicate public records that are exempt
or confidential and exempt from public records disclosure requirements. If the contractor keeps
and maintains public records upon completion of the contract, the contractor shall meet all
applicable requirements for retaining public records. All records stored electronically must be
provided to Monroe County, upon request from the public agency's custodian of records, in a
format that is compatible with the information technology systems of Monroe County.
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IF THE CONTRACTOR HAS Q . ESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING
TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC
RECORDS, BRIAN BRADLEY, AT (305) 292-3470, bradley-
b i c - , c/o Monroe County Attorney's Office, 1111 121
St., Suite 408, Key West FL 33040.
43. Public Entity Crime Statement (required for all procurement documents and contracts
by F.S. 287.133 and Monroe County Purchasing Policy): 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 provide any goods or services to a public entity, may not submit a bid on a
contract with a public entity for the construction or repair of a public building or public work, may
not submit bids on leases of real property to public entity, may not be awarded or perform work as
a CONTRACTOR, supplier, subcontractor, or CONTRACTOR 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 CAT[°.GORY "1'°'WO for a period of 36 months from the date of
being placed on the convicted vendor list. As used herein, the term "convicted vendor list" means
a list maintained by the Florida Department of Management Services, as defined in F.S. 287.133.
By entering in this Agreement, the vendor acknowledges that it has read the above and states that
neither the vendor nor any Affiliate hays been placed on the convicted vendor list within the last 36
months.
44. Ethics Clause(required for all contracts by Monroe County Ordinance No. 10-1990): By
entering in this Agreement, the vendor warrants that helit has not employed, retained or otherwise
had act on his/her behalf any former County officer or employee in violation of Section 2 of
Ordinance No. 0 10-1990 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 Agreement without liability and may also, in its discretion, deduct from the Agreement 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.
45. E-verify requirement(required by F.S. 448.095): Beginning January 1, 2021, every public
employer, contractor, and subcontractor shall register with and use the E-Verify system to verify
the work authorization status of all newly hired employees. By entering into this Agreement, the
vendor certifies that it registers with and uses the E-Verify system. If the contractor enters into a
contract with a subcontractor, the subcontractor must provide the contractor with an affidavit
stating that the subcontractor does not employ, contract with, or subcontract with an unauthorized
alien. The contractor shall maintain a copy of such affidavit for the duration of the contract.
46. Human Trafficking (F.S. 787.06): Whenever a contract is executed, renewed, or extended
between a nongovernmental entity and a governmental entity, the nongovernmental entity must
provide an affidavit signed by an officer or a representative of the nongovernmental entity under
penalty of perjury, attesting to that the nongovernmental entity does not use coercion for labor or
services. A copy of the affidavit is attached.
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47. Foreign Entities Affidavit (F.S. 287.138):
a. Beginning i/1/2024, a governmental entity may not accept a bid or proposal from, or enter
into a contract with, an entity which would grant the entity access to individual personal
identifying information ("PIl") unless the entity provides an affidavit signed by an officer
or representative under penalty of perjury attesting that the entity does not meet any of the
criteria in P.S. 287.138(2)(a)-(c):
• Entity owned by a country of concern (China, Russia, Iran, North Korea,
Venezuela, Syria)
• Controlling interest by government of foreign country of concern;
• Entity organized under the laws of or has principal place of business in
foreign country of concern.
b. Beginning 711/2025, a governmental entity cannot renew a contract with an entity which
would grant the access to P11 unless the entity provides the affidavit.
c. Beginning 711/2025,a governmental entity cannot extend or renew a contract with an entity
meeting the above criteria if the contract would give access to PH to that entity.
The affidavit is attached.
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IN WITNESS WHEREOF, each party hereto has caused this contract to be executed by its duly
authorized representative.
(SEAL) BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FL
ATTEST: Kevin Madok , CLERK
1
By: By: �.
Deputy Clerk Kevin Wilson
Acting County Administrator
BOARD OF GOVERNORS OF
FIRE AND AMBULANCE DISTRICT I,
OF MONROE COUNTY, FLORIDA
By:
Kevin Wilson
Name and Address of Respondent:
Antonio Grandia, M.
By: BY:
Signatu a ondent
Witness
TArvrn��?� 64tidt'k 010
Print Name and Title
Date: $ 1z l ZAP
Approved by MONROE COUNTY on ......................... 2024.
Approved as to form and legal sufficiency:
Monroe County Attorney's Office 8-12-2024
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SECTION TWO:
FORMS
Attachment A Non-Collusion Affidavit
Attachment B Public Entity Crime Statement
Attachment C Drug Free Workplace Form
Attachment D Lobbying& Conflict of Interest Clause Sworn Statement under Ordinance
No. 10-1990 (Ethics Clause)
Attachment E Indemnification and Hold Harmless
Attachment F Insurance Documents
Attachment G Affidavit
Attachment H Affidavit
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NQN-COLLUSION AFFIDAVIT
I, An qn.-t r o v WA , of the city of.
C d according to law on my oath, and under
penalty of perjury, depose and say that;
1) I am ?� ,the respondent making the
Proposal for the ero ecctt described as ollows:
2) The prices in this proposal have been arrived at independently without collusion,
consultation, communication or Contract for the purpose of restricting competition, as to any
matter relating to such prices with any other respondent or with any competitor;
3) Unless otherwise required by law,the prices which have been quoted in this proposal
have not been knowingly disclosed by the respondent and will not knowingly be disclosed by the
respondent prior to proposal opening,directly or indirectly, to any other respondent or to any
competitor; and
4) No attempt has been made or will be made by the respondent to induce any other
person, partnership or corporation to submit, or not to submit, a proposal for the purpose of
restricting competition; and
5) The statements contained in this affidavit are true and correct, and made with full
knowledge that Monroe County relies upon the truth of the statements contained in this affidavit
in awarding contracts for said project.
STATE OF KLO IL' 4 A
00f Respondent)
COUNTY OF _"(F 81)
Date
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
to GiAobf4 who, after first being sworn by me, (name of
individual signing) affixed his/her signature in the space provided above on this
1.2 day of QLk A-S-` , 20_°�T ......
M commission expires:
f` c�ER:s.recRszi
Y p �r ,, rtUry Mipd�•Su:e w F;�n�
NOTARY PUBLIC
*4:Jim 141M.wr26.202d
OMB-MCP FORM#1
Attachment A
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PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crime may not submit a proposal on a contract to provide any goods or services to a
public entity, may not submit a proposal on a contract with a public entity for the construction or
repair of a public building or public work, may not submit proposals on leases of real property to
public entity, may not be awarded or perform work as a bidder, supplier, subbidder,or
RESPONDENT 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, Florida Statutes, for
CATEGORY TWO for a period of 36 months from the date of being placed on the convicted
vendor list."
By executing this form, I acknowledge that I/my company is in compliance with the above.
STATE OF �o A Liz K
�l D
(Signature of Respondent)
COUNTY OF Mar`' Ro g� IZ� Zo
Date
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
A Wro 0 ti 0 qPtJDI k who,after first being sworn by me, (name of
individual signing)affixed his/her signature in the space provided above on this
Th day of 5 E ,20
My commission expires:
NOTARY PUBLIC
R-- ,,,.r,,,�cas+a
�l�c.sate d f cnu
cpµ ftio i j*�l6ll i
W Cam.ELK*0 36.301.3
Attachment B
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DRUG-FREE WORKPLACE FORM
The undersigned Respondent in acco dance with Florida Statute 287.087 hereby certifies that:
(Name of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for violations of such prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of
maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee
assistance programs, and the penalties that may be imposed upon employees for drug abuse
violations.
3. Gives each employee engaged in providing the commodities or contractual services that are
under proposal a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notifies the employees that, as a condition of
working on the commodities or contractual services that are under proposal, the employee will
abide by the terms of the statement and will notify the employer of any conviction of, or plea of
guilty or nolo contendre to, any violation of Chapter 893 (Florida Statutes) or of any controlled
substance law of the United States or any state, for a violation occurring in the workplace no later
than five(5)days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is
so convicted.
6. Makes a good faith effort to continue to maintain a drug-free workplace through implementation
of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
Resp ture
Dfite
OMB—MCP FORM#5
Attachment C
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LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
4'4>0d;15k warrants that he/it has not employed, retained or
otherwise had act on his/its behalf any former 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,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,
7777
e, gift, or c 'deration paid to the former County officer or employee.
ignature)
Date: jil '-q-W3:m"
STATE OF A R
COUNTY OF AZ E-
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
Q iJ'Ta i is �i ti / K who,after first being sworn by me, affixed his/her
Signature(name of individual signing) in the space provided above on this T day of
u-sLkST , 20 .
NOTARY PUBLIC ".�'" "'w"xftne'
my wr 26.2026
My commission expires:
OMB-MCP FORM 44
Attachment D
MONROE COUNTY, FLORIDA
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RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
Indemnification and Hold Harmless
for
Other Bidders and Subbidders
The Bidder covenants and agrees to indemnify and hold harmless Monroe Board of County
Commissioners, its servants,agents and employees from any and all claims for bodily injury
(including death), personal injury, and property damage(including property owned by Monroe
County)and any other losses, damages, and expenses(including attorney's fees)which arise out
of, in connection with, or by reason of services provided by the Bidder or any of its Subbidder(s)
in any tier, occasioned by the negligence,errors,or other wrongful act or omission of The Bidder
or its Subbidders in any tier,their employees, or agents.
In the event the completion of the project(to include the work of others) is delayed or suspended
as a result of the Bidder's failure to purchase or maintain the required insurance,the Respondent
shall indemnify the County from any and all increased expenses resulting from such delay.
The first ten dollars($10.00)of remuneration paid to the Respondent is for the indemnification
provided for above.
The extent of liability is in no way limited to,reduced,or lessened by the insurance requirements
contained elsewhere within this Contract.
7zo� —
ent's Signature
t
Ida e
TCS
Attachment E
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VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MONROE COUNTY, FLORIDA
AND
ANTONIO GANDIA, M.D.
Recognizing that the work governed by this contract requires the use of vehicles,the Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for:
Owned,Non-Owned,and Hired Vehicles
The minimum limits acceptable shall be:
$300,000 Combined Single Limit(CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
VL2
Attachment F
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
30
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FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MONROE COUNTY,FLORIDA
AND
ANTONIO GANDIA,M.D.
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers' Compensation Insurance with limits sufficient to respond to the applicable state
statutes.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less
than:
$500,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$500,000 Bodily 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 of Florida.
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.
If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required.
In addition,the Contractor may be required to submit updated financial statements from the fund
upon request from the County.
WC2
Attachment F
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MONROE COUNTY, FLORIDA
REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS
It is requested that the insurance requirements,as specified in the County's Schedule of Insurance Requirements,be
waived or modified on the following contract. l
ContractorNendor: y►S1M t D C"74 N di1G4 ►M 0
Project or Service:
ContractorNendor
Address&Phone#: ��'�'� W �7iµ' &C , O GY/ ►., t+�►"/�
General Scope of Work: �Vl p ti-�,iy(� it }'
Reason for Waiver or Ala c -
Modification:
Policies Waiver or
Modification will apply to: c r
Signature of ContractorNendor:
Date: Approved Not Approved
Risk Management Signature:
Date:
County Administrator appeal:
Approved: Not Approved: ..............
Date:
Board of County Commissioners appeal:
3
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Antonio Gandia, M.D.
1080 S.W. 42"d Avenue
Deerfield Beach, FL 33442
August 12, 2024
To whom it may concern,
As an independent contractor, I am not required to carry Worker's Compensation
insurance pursuant to the Florida Statutes (less than 4 employees).
I also do not carry any commercial vehicles and do not carry general liability insurance.
Please contact me if you have any questions.
Sincerely,
nWi
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AFFIDAVIT ATTESTING TO NONCOERCIVE CONDUCT
FOR LABOR OR SERVICES
Entity/Vendor Name: 4yifMiQ 6 4 OJi
Vendor FEIN:
Vendor's Authorized Representative:
(Name and Title)
Address: Lv 20
City:*3e_.r4;r—l.J State: 12 Zip:
Phone Number:
Email Address: Mgt'-L • 60P)n
As a nongovernmental entity executing, renewing, or extending a contract with a
government entity, Vendor is required to provide an affidavit under penalty of perjury
attesting that Vendor does not use coercion for labor or services in accordance with
Section 787.06, Florida Statutes.
As defined in Section 787.06(2)(a), coercion means:
1. Using or threating to use physical force against any person;
2. Restraining, isolating, or confining or threating to restrain, isolate, or confine
any person without lawful authority and against her or his will;
3. Using lending or other credit methods to establish a debt by any person when
labor or services are pledged as a security for the debt, if the value of the labor
or services as reasonably assessed is not applied toward the liquidation of the
debt, the length and nature of the labor or service are not respectively limited
and defined;
4. Destroying, concealing, removing, confiscating, withholding, or possessing any
actual or purported passport, visa, or other immigration document, or any other
actual or purported government identification document, of any person;
5. Causing or threating to cause financial harm to any person;
6. Enticing or luring any person by fraud or deceit; or
7. Providing a controlled substance as outlined in Schedule I or Schedule II of
Section 893.03 to any person for the purpose of exploitation of that person.
As a person authorized to sign on behalf of Vendor, I certify under penalties of perjury
that Vendor does not use coercion for labor or services in accordance with Section
787.06. Additionally, Vendor has reviewed Section 787.06, Florida Statutes, and agrees
to abide by same.
Certified By: h.Tim�b
who is authorized to sign on beh f th Bove referenced company.
Authorized Signature:
Print Name: rvVL
Title:
Attachment G
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FOREIGN ENTITIES AFFIDAVIT F.S. 287.138
1, Aj�?,,a � )Li of the city of according to
law on my oath, and under penalty of perjury, depose and say that:
a. I am 1e111 WP"1V '4�" Nc' :0, of the firm of
("Entity"), the bidder
making the Proposal for the projecrt,described in the Request for Proposals for
P Ir-,0l and that I executed the said
proposal with full authority to do so;
b. In accordance with section 287.138, Florida Statutes, the Entity is not owned by
the government of a Foreign Country of Concern, as that term is defined in F.S.
287.138, is not organized under the laws of nor has its Principal Place of Business
in a Foreign Country of Concern, and the government of a Foreign Country of
Concern does not have a Controlling Interest in the entity.
c. The statements contained in this affidavit are true and correct, and made with full
knowledge that Monroe County relies upon the truth of the statements contained
in this affidavit in awarding contracts for said project.
(Signature) !
Date:
STATE OF: k to A
COUNTY OF: Ma N R,atE
Subscribed and sworn to (or affirmed) before me, by means of❑ physical presence or ❑
online notarization, on tiLk'r V-5r 1J, A�24 (date) by
A N-To N c0 G,A 4 h.s A (name of affiant). /She is personally known to me
or has produced .. . ... . .. ........ . (type
of identification) as identification. G� G.. t k,'
NOTARY PUBLIC
My Commission Expires:
]cndoa
aAV Cwm.Eire W
Attachment H
34
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EXPIRATION DATE°.JANUARY 31.2025
Your license number is ME 5=7,Please use it In 80 oorrespondenoe with you hoardkuundt Each licensee Is solely respormfble for no"AV
the Department in writing of the Boarme's current rm tg address and practice location address.If you have not recelved yor renewal rolioe 90
days prior to the expiraton date shown on this license,please visit www.FLHoodZwme.gov and click'Renew A License'Io renew online.
The Medical Quality Assurenoe Online Services Portal gives you the aNgy to manage your license to perform address updates,name changes.
request duplicate licensee and much more.
Ire slmple. Log onto your MOA Online SerAoea socotat today at htlpJA%eaithsourooQov/. Select the Account Login'butte to access your
account. For changes to your name,address or to request dup0cate 0oensas,choose your selection!horn the dropdown list under'Manage My
License. Your profession will open for renewal 90 days prior to,yotr expiration date. When the renewal cycle opens for you imofessbn,the
'Renew My License'header will automatically display on your kanse Dashboard.
ARE YOU RENEWAL READY? GROUNDS FOR DMOPLINE
The Dent of Health wll now review You should be knilar*0 the Orounde for
your oa*ufng education records of the Dtwpme bond fn Secean 450.002t U
W"of loonse renewal, Florlds Shelutes,and In the wadloo"ace for
the pubseb,In which you are OowmWd.
To loam more,please vhh Florida Standas can ba aooesaW at
www.FL wWk44curoe gorlAYRR wrrw.isg steta.A.us►St""
DocuSign Envelope ID:7D929ADB-2E2C-4600-B477-3AAC87EF8FBF
MONROE COUNTY
THIRD RENEWAL OF STANDBY AGREEMENT FOR
EMERGENCY FEEDING SERVICES
THIS THIRD RENEWAL AGREEMENT ("Agreement"), is made and entered into as of
this 20th day of October, 2024 ("Effective Date") by and between NationsMarket LLC,
1801 NW 66th Avenue, Suite 100, Plantation, FL 33313 (hereinafter referred to as
"Contractor") and Monroe County Board of County Commissioners (BOCC), (hereinafter
referred to as "County") (collectively, "Parties") in accordance with the terms and
conditions of the original agreement executed October 20, 2020, together with a
subsequent amendment and renewals.
WHEREAS, in the event of an emergency or major disaster, including but not limited to
storms, natural and man-made disasters, acts of terrorism or other declared State of
Emergency, the County will need to provide feeding services for its emergency workers,
including Monroe County employees and other authorized personnel when in the County
performing essential work in order to be able to provide County services and to support
response and recovery efforts, and
WHEREAS,these emergency workers will beworking throughout Monroe County and in or
near the County Emergency Operations Center in Marathon, Florida, and therefore
feeding services are expected to be required throughout Monroe County in orderto restore
and provide County services and provide the necessary response and recovery services;
and
WHEREAS, Contractor is located in Plantation, Florida and is willing and able to provide
feeding services during future emergencies or major disasters, should the County need
feeding services for its emergency workers in the event of an emergency or major
disaster; and
WHEREAS, Contractor and County entered into an Original Agreement with Lean Culinary
Services, LLC. (d.b.a. DeliverLean), after they were awarded the contract pursuant to a
request for proposals initiated by the County, for the provision of emergency feeding
services for a period of two years which expired October 20, 2022;and
WHEREAS, Contractor and County entered into the First Renewal Agreement on October
19, 2022 which extended the Original Agreement by one year and expires October 20,
2024; and
WHEREAS, Contractor and County entered into a First Amendment of the original
agreement on December 7, 2022 which reflects Contractor's name change as Lean
Culinary Services was acquired by NationsMarket LLC.; and WHEREAS, Contractor
and County entered into a Second Renewal Agreement on October 20, 2023, which
extended the Agreement by one year, with an expiration date of October 19, 2024; and
WHEREAS, Contractor and County desire to renew the agreement for one (1) additional
1
2877
DocuSign Envelope ID:7D929ADB-2E2C-4600-B477-3AAC87EF8FBF
year as provided in the original agreement;
NOW THEREFORE, in consideration of the promises, and other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties
hereby agree as follows:
1. Paragraph 3.0 of the original agreement is amended to reflect that the term of the
Agreement has been extended for an additional one (1)year period, terminating on
October 19, 2025.
2. All other terms and conditions of the Original Agreement entered into on October
20, 2020, as well as the First Renewal entered into on October 20, 2022, First
Amendment entered into on December 7, 2022, and Second Renewal entered into
on October 20, 2023 not inconsistent herewith, shall remain in full force and effect.
IN WITNESS WHEREOF, the Parties have caused their respective duly authorized
representatives to execute this Agreement as of the date first written above.
(SEAL) BOARD OF COUNTY COMMISSIONERS
ATTEST: KEVIN MADOK, CLERK OF MONROE COUNTY, FLORIDA
By: By:
As Deputy Clerk Mayor
NATIONSMARKET, LLC
G"* A
By:
Glenn Parker, CEO
Approved as to form and legal sufficiency:
Monroe County Attorney's Office 5-14-2024
ajda�4. gw
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