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Home My WebLink About6. 05/27/2025 Agreement Monroe County Purchasing Policy and Procedures ATTACHMENT D.5 COUNTY ADMINISTRATOR CONTRACT,SUMMARY FORM FOR CONTRACTS $100,000.00 and Under Contract with- Life Eztensi.,Clinics,Inc dba Life Scan Wellness Centers-. Con tract 9 Effective Date: Upon signature(no later than 05.28.2025) Expiration Date: 0527.2020'' Contract Purpose/Description: Annual physical examinations from Life Extension Clinics, Inc.for Monroe County Fire Rescue personnel in accordance i with NFPA 1582.The fee for each physical exam is$524.80 for a total contract cost not to exceed$100,000.00 The County will be billed as-used per the unit cost listed in"Composite Exhibit B" the projected expenses for this year are�belowi $100,000 based on last year's usage;This Agreement can be extended for up to three(3)successive one(1)year periods. Contract is Original Agreement Contract Amendment/Extension Renewal Contract Manager: Cheri Tamborski ' 305.289.6088 M FR/Stop 14A 141 11500 148 12000 101 11001 148 14000 CONTRACT COSTS 404 63100 Total Dollar Value of Contract: $ up to 100,000.00 Current Year Portion: $ up to 100,000.00 (must be$100,000.00 or less) ; (If multiyear agreement then requires BOCC approval,unless the iowl aini Jilin v 4111it unl is slflQl Q1Q1Ql.Q1Q1 or lw�kk). Budgeted? Yesv No� Grant: $N/A County Match: $ N/A Fund/Cost Center/Spend Category: See above funds/cost centers to be charged based upon participation ADDITIONAL COSTS Estimate.? Ongoing !'costs: $TBD/yr For: Renewable(3 more 1-yr terms,subject to BOCC approval for dollar threshold) (Not included in dollar value above) (e.g.maintenance,utilities,janitorial,salaries,etc.) Insurance Required: YES 0 NO ❑ CONTRACT REVIEW Reviewer Date In Department Head Signature: R.L. Colina Digitally 20250523ned yR.L.32-0 Date'.2025.05.23 11'.OB'.32-04'00' Eve M. Lewis Digitally signed by Eve M Lewis County Attorney Signature: Date.2025.052311.49.19-04'00' Jaclyn Flatt Digitally signed by Jaclyn Flatt Risk Management Signature: Date.2025.052712.18'.05-04'00' Purchasing Signature: Lisa Abreu Digitally 20250527ned yLisa Abreu Date'.2025.05.27 13'.37'.01-04'00' John Quinn Digitally signed by John Quinn OMB Signature: Date'.2025.05.27 14'.00'.30-04'00' Comments: Revised BOCC 4/19/2023 Page 84 of 105 AGREEMENT between MONROE COUNTY, FL and LIFE EXTENSION CLINICS, INC. d/b/a LIFE SCAN WELLNESS CENTERS for Annual Firefighter Physical Examinations THIS AGREEMENT is made and entered into this ,of PK 2021:_, by and between the Monroe County, Florida, a political subdivision of the State of Florida, with principal offices located at I100 Simonton Street, Key West, FL 33040 (the "County") and Life Extension Clinics, Inc. d/b/a Life Scan Wellness Centers, a Florida corporation with principal offices located at 1011 North MacDill Avenue, Tampa, Florida 33607 (the "Contractor")to provide annual physical examinations. Now therefore,in exchange for good and sufficient consideration,the parties hereby agree to the following terms and conditions: 1) The Contract Documents The contract documents consist of this Agreement, the Scope of Services, attached and incorporated herein as"Exhibit A,"and the Quote and Scheduling Form for said services, attached and incorporated herein as "Composite Exhibit B." In the event of a conflict between the aforementioned documents,any duly executed amendment to this Agreement will control, followed by"Exhibit A,"then"Composite Exhibit B,"in that order. 2) The Work/Services The Contractor must perform all work for the County required by this Agreement, and as set forth below: a) Contractor will furnish all labor, materials, and equipment necessary as indicated in"Exhibit A"and"Composite Exhibit B." b) Contractor must supervise the work force to ensure that all workers conduct themselves and perform their work in a safe and professional manner. c) Contractor must comply with any and all Federal, State, and local laws and regulations now in effect,or hereinafter enacted during the tern of this Agreement, which are applicable to the Contractor, its employees, agents or subcontractors, if any, with respect to the work and services described herein. Contractor shall maintain throughout the term of this Agreement,appropriate licenses. 3) Contract Amount Contractor will perform contract requirements with pricing and ordering pursuant to "Composite Exhibit B,"attached hereto and incorporated herein.Payment of an undisputed invoice submitted by the Contractor will be processed within 30 business days after being stamped as received, or otherwise as provided in accordance with the Florida Prompt Payment Act,Section 218.735,Fla.Stat.,as amended.County is exempt from payment of Florida State Sales and Use taxes. Contractor shall not be exempted by virtue of the County's exemption from paying sales tax to its suppliers for materials used to fulfill its obligations under this contract, nor is Contractor authorized to use the County's Tax Exemption Number in securing such materials.Contractor shall be responsible for any and all taxes, or payments of withholding, related to services rendered under this Agreement. Additionally, the Contractor is to submit to the County invoices with supporting Page i of 13 documentation that are acceptable to the Monroe County Office of Clerk and Comptroller (County Clerk). Acceptability to the County Clerk is based upon generally accepted accounting principles and such laws,rules and regulations as may govern the disbursal of funds by the County Clerk. 4) Agreement Subject to Funding The County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County Commissioners. In the event that the County funds on which this Agreement is dependent are withdrawn,this Agreement is terminated, and the County has no further obligation under the terms of this Agreement to the Contractor beyond that already incurred by the termination date. 5) Contract Term The contract period commences as of the date written on the first page of this Agreement, but no later than May 28,2025 and will expire on May 27,2026.The initial contract period is for one (1)year("Initial Term"). A renewal of this Agreement may be accomplished in one(1)year intervals by the County Administrator exercising her administrative approval authority vested pursuant to the Monroe County Purchasing Policy,so long as all renewals are made expressly subject to the same terms and conditions as provided herein. This Agreement may be extended for up to three (3) successive one (1) year periods (each a "Renewal Term"). Notwithstanding the above—any renewal authorized a mi i trativel must not g2gledthe total v lue of$100,000.00 without the prior formal a roval of the Monroe County Board of County Commissioners. As used herein the "total value" is calculated by adding the value of each administratively roved renewal plus any value- added amendments after the Monroe Count Board of Coun Commissioners" most recent formal approval. 6) Independent Contractor This Agreement does not create an employee/employer relationship between the Parties. It is the intent of the Parties that the Contractor is an independent contractor under this Agreement and not the County's employee for any purposes, including but not limited to, the application of the Fair Labor Standards Act minimum wage and overtime payments, Federal Insurance Contribution Act, the Social Security Act, the Federal Unemployment Tax Act, the provisions of the Internal Revenue Code, the State Worker's Compensation Act, and the State Unemployment Insurance law. The Contractor will retain sole and absolute discretion in the judgment of the manner and means of carrying out Contractor's activities and responsibilities hereunder provided, further that administrative procedures applicable to services rendered under this Agreement will be those of Contractor, which policies of Contractor will not conflict with County, State,or United States policies, rules or regulations relating to the use of Contractor's funds provided for herein. The Contractor agrees that it is a separate and independent enterprise from the County, that it had full opportunity to find other business, that it has made its own investment in its business,and that it will utilize a high level of skill necessary to perform the work. This Agreement must not be construed as creating any joint employment relationship between the Contractor and the County and the County will not be liable for any obligation incurred by Contractor, including but not limited to unpaid minimum wages and/or overtime premiums. 7) Assignment and Subcontracting Contractor must not transfer or assign the performance required by this Agreement without the prior written consent of the Board of County Commissioners. This Agreement,or any portion thereof,must not be subcontracted without the prior written consent of the County Page 2 of 13 nor may the Contractor assign any monies due or to become due to him or her,without the previous written consent. 8) Termination a) Termination for Cause and Remedies: In the event of breach of any contract terms, the County retains the right to terminate this Agreement. The County may also terminate this Agreement for cause should Contractor fail to perform the covenants - herein contained at the time and in the manner herein provided. In the event of such termination, prior to termination, the County shall provide Contractor with seven (7) calendar days' written notice and provide the Contractor with an opportunity to cure the breach that has occurred. If the breach is not cured, the Agreement will be terminated for cause. if the County terminates this Agreement with the Contractor,County shall pay Contractor the sum due the Contractor under this Agreement prior to termination, unless the cost of completion to the County exceeds the funds remaining in the contract;however,the County reserves the right to assert and seek an offset for damages caused by the breach. The maximum amount due to Contractor shall not in any event exceed the spending cap in this Agreement. In addition, the County reserves all rights available to recuperate monies paid under this Agreement,including the right to sue for breach of contract and including the right to pursue a claim for violation of the County's False Claims Ordinance,located at Section 2-721 et al.of the Monroe County Code. b) Termination for Convenience: The County may terminate this Agreement for convenience,at any time,upon thirty(30)days' written notice to Contractor. If the County terminates this Agreement with the Contractor, County shall pay Contractor the sum due as of the appointed termination date, unless the cost of completion of the remaining work under the Agreement exceeds the funds remaining in the contract. The maximum amount due to Contractor shall not exceed the spending cap in this Agreement. 9) Remedies The County reserves the right to recover any ascertainable actual damages incurred as a result of the failure of the Contractor to perform in accordance with the requirements of this Agreement, or for losses sustained by the County resultant from the Contractor's failure to perform in accordance with the requirements of this Agreement. 10) Data Management;Data Security Standards.Contractor must agree to comply with the County's written demands regarding cooperation (and any applicable financial responsibilities) for timely data breach incident reporting, response activities/fact- gathering,public and other governmental agency notification requirements, severity level assessment, and after-action reporting, consistent with Sections 282.3185(5) & (6), and 501.171,Fla. Stats.,as amended from time to time. And specifically in the context of data breaches that involve Protected Health Information pursuant to Health Insurance Portability and Accountability Act (HIPAA), Contractor must comply with all requirements of the Health Information Technology for Economic and Clinical Health Act (HITECH); Section 105 of Title I of the Genetic Information Nondiscrimination Act of 2008 (GINA); and 45 C.F.R. Parts 160, 162 and 164 and Final Omnibus Rule eff. March 26, 2013). To ensure safety of personal data, Contractor must comply with the 2016 European Union's General Data Privacy Regulation(GDPR) that became effective in the European Union on May 25,2018,and any more recently revised version thereof.For any system integration between the County's network systems and that of the Contractor, the Contractor hereby agrees to comply with ISO/IEC 27001 for its internal system, at a Page 3 of 13 minimum, and any unique integration requirements of the County's network and information technology systems. 11) Insurance Requirements Prior to commencing services hereunder, Contractor shall obtain and maintain at its own expense the insurance coverages as required by the County's Risk Manager. All insurance requirements provided for in this Agreement shall be subject to annual review. If the insurance policies originally purchased that meet the requirements of the Risk Manager are canceled, terminated, or reduced in coverage, then the Contractor must immediately substitute complying policies so that no gap in coverage occurs. Copies of current policy certificates shall be filed with the Monroe County Risk Department whenever acquired, amended, and annually during the term of this Agreement. Prior to execution of this Agreement, Contractor shall furnish the County Certificates of Insurance indicating the minimum coverage limitations in the following amounts: a) CERTIFICATES OF INSURANCE. Original Certificates of Insurance shall be provided to the County at the time of execution of this Agreement and certified copies provided if requested. Unless a waiver is granted by the County's Risk Manager, each policy certificate shall be endorsed with a provision that not less than thirty(30)calendar days'written notice shall be provided to the County before any policy or coverage is canceled or restricted.The underwriter of such insurance shall be qualified to do business in the State of Florida. If requested by the County Administrator, the insurance coverage shall be primary insurance with respect to the County, its officials,employees,agents,and volunteers. Failure of Contractor to comply with the insurance requirements of this section shall be cause for immediate termination of this Agreement. Unless a waiver is granted by the County's Risk Manager "MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, 1100 SIMONTON STREET, KEY WEST, FLORIDA 33040" MUST BE NAMED AS ADDITIONAL INSURED AND CERTIFICATE HOLDER ON ALL POLICIES EXCEPT WORKER'S COMPENSATION. In the event that the Contractor subcontracts any or all of the work in to any third party,the Contractor specifically agrees to identify the County as an additional insured on all insurance policies required by the County. In addition,the Contractor specifically agrees that all agreements or contracts of any nature with his subcontractors shall include the County as additional insured. 12) Indemnification&Hold Harmless a) The parties agree that one percent (1%) of the total compensation paid to Contractor for the work or services under this Agreement constitutes specific consideration to Contractor for the indemnification to be provided under the Agreement. Notwithstanding any minimum insurance requirements prescribed elsewhere in this Agreement,the Contractor shall defend, indemnify,and hold the County,and the County's elected and appointed officers and employees,harmless from and against any claims, actions or causes of action, any litigation, administrative proceedings,appellate proceedings,or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption,and any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with:(A)any activity of the Contractor or any of its employees,agents,contractors or other invitees during the term of this Agreement; (B) the negligence or recklessness, intentional wrongful misconduct, errors or other wrongful act or omission of the Contractor or any of its employees,agents,sub-contractors or other Page 4 of 13 invitees; or(C)the Contractor's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the County or any of its employees,agents,contractors or invitees(other than the Contractor). b) In the event that the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance,the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the County by virtue of any deficiency or ambiguity in specifications provided by or to the Contractor, the Contractor agrees and warrants that the Contractor shall hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action on the County's behalf. c) Nothing contained herein is intended,nor may it be construed, to waive County's rights and immunities under the common law or Section 768.28, Florida Statutes, as amended from time to time; nor will anything included herein be construed as consent to be sued by any third parties in any matter arising out of this Agreement. This section will survive the expiration of the term of this Agreement or any earlier termination of this Agreement. 13) No Personal Liability No covenant or agreement contained herein shall be deemed to be a covenant or agreement 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 Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. 14) Discriminatory Vendor List Contractor hereby acknowledges its continuous duty to disclose to the County if the Contractor or any of its affiliates,as defined by Section 287.134(1)(a),Florida Statutes,are placed on the Discriminatory Vendor List. Pursuant to Section 287.134(2)(a),Florida Statutes: "An entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity;may not submit a bid,proposal,or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor,supplier,subcontractor,or consultant under a contract with any public entity;and may not transact business with any public entity." 15) County Suspended Vendor List The eligibility of persons to bid for an award of County contract(s),or enter into a contract, may be suspended pursuant to sec.2-347(1)of the Monroe County Code of Ordinances. In the event an eligible person is suspended by the County after the contract is awarded,or a suspended person is employed to perform work (e.g. subcontractor in a bid or contract) pursuant to a County contract,same shall constitute a material breach of the contract.The County, in its sole discretion, may terminate the contract with no further liability to the contractor beyond payment of the portion of the contract price that may be due for work satisfactorily completed up to the date of termination,and hereby reserves all other rights and remedies available at law or in equity. Page 5 of 13 16) Prohibition on Conflict of Interest,Gratuities,Kickbacks,and Collusion The statements contained in this paragraph are true and correct, and made with the full knowledge that Monroe County relies upon the truth of the statements contained herein in awarding the contract for this Project. a) Conflict of Interest.Contractor covenants that it presently has no interest and will not acquire any interest that would conflict in any manner or degree with the performance of services required. Each party hereto covenants that there is no conflict of interest or any other prohibited relationship between the County and itself. b) Gratuities.Contractor hereby certifies that it has not offered,given,or agreed to give any Monroe County employee a gratuity, favor, or anything of monetary value in connection with any decision, approval,disapproval, recommendation, preparation of any part of the Project or award of this contract. c) Kickbacks. Contractor certifies that it has not given payment, gratuity, or offer of employment to be made by or on behalf of a Sub-contractor under a contract to Contractor or higher tier sub-contractor or any person associated therewith, as an inducement of the award of a subcontract or order. d) Non-Collusion Statement. By signing this Agreement, Contractor certifies under penalty of perjury that the price proposed by Contractor was arrived at independently without collusion, consultation, or communication for the purpose of restricting competition;and no attempt has been made to induce another person or entity to submit a proposal,or not submit,for the purpose of restricting competition in the award of this Project. e) Contract Clause. The prohibitions on conflict of interest, gratuities, kickbacks, and collusion prescribed in this paragraph must be conspicuously set forth in every contract and subcontract and solicitation initiated by Contractor in its performance of this Agreement. 17) Ethics Clause pursuant to Monroe County Ordinance No.010-1990 By signing this Agreement, the Contractor warrants that he/she/it has not employed, retained or otherwise had act on his/her/its behalf any former County officer or employee in violation of Section 2-149, Monroe County Code of Ordinances,or any County officer or employee in violation of Section 2-150, Monroe County Code of Ordinances. 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 pursuant to Subsection 2-152(b),Monroe County Code of Ordinances. 18) Prompt Disclosure of Litigation, Investigations, Arbitration, or Administrative Proceedings Throughout the term of this Agreement, the Contractor has a continuing duty to promptly disclose to the County, in writing, upon occurrence, all civil or criminal litigation, investigations, arbitration, or administrative proceedings relating to or affecting Contractor's ability to perform under this Agreement. If the existence of such causes the County concern that the Contractor's ability or willingness to perform the Agreement is jeopardized, the Contractor may be required to provide the County with reasonable assurances to demonstrate its ability to perform as required hereunder, and that its employees/agents have not or will not engage in conduct similar in nature to the conduct alleged in such proceeding. Page 6 of 13 19) Notice All written correspondence to the County shall be dated and signed by an authorized representative of the Contractor. Any written notices or correspondence required or contemplated under this Agreement shall be sent by U.S. Mail, certified, return receipt requested,postage pre-paid,or by courier with proof of delivery.Notice is deemed received by Contractor when hand delivered by national courier with proof of delivery or by U.S. Mail upon verified receipt or upon the date of refusal or non-acceptance of delivery. Notice shall be sent to the following persons: FOR COUNTY: FOR CONTRACTOR: County Administrator Jennifer Conn ft Monroe County Life Scan Wellness Center 1100 Simonton Street,Room 2-205 1011 N Macdill Ave Tampa FL 33607 Key West,FL 33040 EMai.l:.1 nnifer gnne 11 rawu line s,corn And(with copy to) Monroe County Attorney's Office 1111 12th Street, Suite 408 Key West,FL 33040 20) Choice of Law and Venue The parties expressly agree that the only laws that apply to this Agreement are those of the State of Florida and United States of America, without regard to choice of law principals. The parties waive the privilege of venue and agree that all litigation between them in the state courts will take place exclusively in the Sixteenth Judicial Circuit in and for Monroe County, Florida, and that all litigation between them in the federal courts will take place exclusively in the United States District Court in and for the Southern District of Florida, or United States Bankruptcy Court for the Southern District of Florida, whenever applicable. This Agreement shall not be subject to arbitration. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the Circuit Court of Monroe County,Florida. 21) Attorney's Fees and Costs County and Contractor 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 Agreement, 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, at all levels of the court system, including in appellate proceedings. 22) Public Records County is a public agency subject to Chapter 119, Florida Statutes,as amended from time to time. To the extent Contractor is a Contractor acting on behalf of the County pursuant to Section 119.0701, Florida Statutes, as amended from time to time, Contractor must comply with all public records laws in accordance with Chapter 119, Florida Statutes. In accordance with state law,Contractor agrees to: a) Keep and maintain all records that ordinarily and necessarily would be required by the County in order to perform the services. b) Upon request from the County's custodian of public records,provide the County with a copy of the requested records or allow the records to be inspected or copies Page 7 of 13 within a reasonable time at a cost that does not exceed the costs provided in Chapter 119,Florida Statutes, or as otherwise provided by law. 0 Ensure that public records that are exempt,or confidential and exempt,from public records disclosure are not disclosed except as authorized by law for the duration of the Agreement term and following completion of the Agreement if the Contractor does not transfer the records to the County. d) Upon completion of the services within this Agreement,at no cost,either transfer to the County all public records in possession of the Contractor or keep and maintain public records required by the County to perform the services. If the Contractor transfers all public records to the County upon completion of the services,the Contractor must 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 services, the Contractor must meet all applicable requirements for retaining public records. All records stored electronically must be provided to the County, upon request from the County's custodian of public records, in a format that is compatible with the information technology systems of the County. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT THE COUNTY'S CUSTODIAN OF PUBLIC RECORDS AT: MONROE COUNTY ATTORNEY'S OFFICE, 1111 12TH STREET, SUITE 408,KEY WEST, FL 33040, EMAIL: PUBLICRECORDS MONROECOUNTY- FL.GOV, OR PRONE: 305-292-3470. If Contractor does not comply with this section, the County will enforce the Agreement provisions in accordance herewith and may unilaterally cancel this Agreement in accordance with state law. 23) Audit Rights The Contractor must maintain accurate books,records,documents and other evidence that sufficiently and properly reflect all direct and indirect costs of any nature expended in the performance this Agreement,in accordance with generally accepted accounting principles. County reserves the right to audit the records of the Contractor for the commodities and/or services provided under the contract at any time during the performance and term of the contract and for a period of five(5)after completion of the contract. Such records must be retained by Contractor for a minimum of five (5) years following the close of the Agreement,or the period required for this particular type of project by the General Records Schedules maintained by the Department of State, whichever is longer. The Contractor agrees to cooperate with the County and agrees to submit to an audit as required by the County,or other authorized representative(s)of the State of Florida.The Contractor must allow the County or such other auditing agency to have access to and inspect the complete records of the Contractor in relation to this Agreement at any and all times during normal business hours for the purposes of conducting audits or examinations or making excerpts or transcriptions. The requirements set forth in this paragraph will survive the termination of this Agreement. Page 8 of 13 24) Public Entity Crimes Statement Pursuant to Section 287.133(2)(a), Florida Statutes, as amended from time to time, Contractor hereby certifies that neither it nor its affiliate(s) have been placed on the convicted vendor list following a conviction for a public entity crime.If placed on that list, Contractor agrees: to immediately notify the County and is prohibited from providing any goods or services to a public entity; it may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work; it may not submit bids on leases of real property to a public entity; it may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and, it may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for Category TWO ($35,000), as may be amended, for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. 25) Foreign Gifts and Contracts The Contractor must comply with any applicable disclosure requirements in Section 286.101,Florida Statutes. Pursuant to Section 286.101(7)(b),Florida Statutes: "In addition to any fine assessed under[§ 286.101(7)(a), Florida Statutes], a final order determining a third or subsequent violation by an entity other than a state agency or political subdivision must automatically disqualify the entity from eligibility for any grant or contract funded by a state agency or any political subdivision until such ineligibility is lifted by the Administration Commission [Governor and Cabinet per §14.202, Florida Statutes] for good cause." 26) Scrutinized Companies and Countries of Concern per Sections 287.135, 215.473, & 287.138, Florida Statutes Contractor hereby certifies that it: a) has not been placed on the Scrutinized Companies that Boycott Israel List,nor is engaged in a boycott of Israel;b)has not been placed on the Scrutinized Companies with Activities in Sudan List nor the Scrutinized Companies with Activities in the Iran Terrorism Sectors List (formerly the Iran Petroleum Energy Sector List); and c) has not been engaged in business operations in Cuba or Syria. if County determines that Contractor has falsely certified facts under this paragraph,or if Contractor is found to have been placed on a list created pursuant to Section 215.473,Florida Statutes, as amended, or is engaged in a boycott of Israel after the execution of this Agreement, County will have all rights and remedies to terminate this Agreement consistent with Section 287.135, Florida Statutes, as amended. The County reserves all rights to waive certain requirements of this paragraph on a case-by-case exception basis pursuant to Section 287.135, Florida Statutes, as amended. Beginning January 1, 2024, the County must not enter into a contract that grants access to an individual's personal identifying information to any Foreign Country of Concern such as: People's Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People's Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolas Maduro, or the Syrian Arab Republic, unless the Contractor provides the County with an affidavit signed by an authorized representative of the Contractor, under penalty of perjury, attesting that the Contractor does not meet any of the criteria in subparagraphs(2)(a)-(c)of Section 287.138, Florida Statutes, as may be amended. Beginning January 1, 2025, the County must not extend or renew any contract that grants access to an individual's personal identifying information unless the Contractor provides the County with an affidavit signed by an authorized representative of the Contractor, under penalty of perjury, attesting that the Contractor does not meet any of the criteria in subparagraphs(2)(a)-(c)of Section 287.138, Florida Statutes, as may be amended. Violations of this Section will result in termination Page 9 of 13 of this Agreement and may result in administrative sanctions and penalties by the Office of the Attorney General of the State of Florida. LIFE EXTENSION CLINICS, INC. D/BIA LIFE SCAN WELLNESS CENTERS,is not owned by the government of a Foreign Country of Concern,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. Under penalties of perjury,I declare that I have read the foregoing statement and that the facts stated in it are true. Printed Name: Todd LeDuc Title:CEO May 23,2025 Date: 27) Noncoercive Conduct for Labor or Services As a nongovernmental entity submitting a proposal, executing, renewing, or extending a contract with a government entity, Contractor is required to provide an affidavit under penalty of perjury attesting that Contractor does not use coercion for labor or services in accordance with Section 787.06, Florida Statutes. As an authorized representative of Contractor, I certify under penalties of perjury that Contractor does not use coercion for labor or services as prohibited by Section 787.06. Additionally, Contractor has reviewed Section 787.06,Florida Statutes,and agrees to abide by same. 28) Nondiscrimination The Contractor 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 Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. Contractor agrees to comply with all Federal and Florida statutes,and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination in employment on the basis of race, color, religion, sex or national origin; 2)Title IX of the Education Amendment of 1972, as amended (20 USC ss. 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 s. 794), which prohibits discrimination on the basis of disability; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 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, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. 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 s. 12101 Note), as may be amended from time to time, Page 10 of 13 relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 14, Article II, which prohibits discrimination on the basis of race, color, sex, religion, d national origin,ancestry,sexual orientation, gender identity or expression, familial status or age; 11)The Pregnant Workers Fairness Act(PWFA)pursuant to 42 Us.C.2000gg ct seq.;and 12)Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to,or the subject matter of,this Agreement. 29) E-Verify Requirements Effective January 1, 2021, public and private employers, contractors and subcontractors must require registration with,and use of the ]E-verify system in order to verify the work, authorization status of all newly hired employees. Contractor acknowledges and agrees to utilize the U.S. Department of Homeland Security's E-Verify System to verify the employment eligibility of, a,) All persons employed by Contractor to perform employment duties within Florida during the term of the contract; and b) All persons (including subvendorsfsubconsultant /subcontractors) assigned by Contractor to perform work pursuant to the contract with the County. The Contractor acknowledges and agrees that use of the U.S.Department of homeland. Security's E-Verify System during the terra of the contract is a condition of the contract with the County• with the By entering into this Agreement, the Contractor becomes obligated igaEligibility,"'eo oplly amended provisions of Section 44&0 5, Florida Statutes, "Employment from time to time.This includes,but is not limited to,utilization of the E-Verify System to verify the 'work authorization status to Contractor tly hired or attesting hla�tlte,subcontractor does and requiring all subcontractors to provide an affidavit not employ,contract with,or subcontract with,an unauthorized alien.Contractor agrees to affidavit for the duration. of this Agreement• Failure to comply maintain a copy of such ination of this agreement as provided in Section with this paragraph will result in the term tor may not be awarded a public 4411.0' 5, Florida Statutes, as amended, and Contrac contract for at least one (1) year after the date on which the Agreement was terminated. Contractor will also be liable for any additional costs to County incurred as a result of the termination of this Agreement in accordance with this Section. Upon executing this Agreement,Contractor will provide proof of enrollment in E-verify to the County. 30) Prohibited Telecommunications Equipment Contractor represents and certifies that it and its applicable subcontractors do not and will not use any equipment,system,or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, y em,O 24 through as critical ethnology as part of any system,as such terms are used in 48 CFE its By executing this Agreement,s� not Contrnts and certifies actor such covered ateleeommiomricat�ons applicable subcontractors mu provide or equipment, system, or services �If Contractr any or�s notified of e f work any useed or the County for the or provisions of such entire duration of this Agreement covered telecommunications equipment,system,or services by a subcontractor at any tier or by any other source, Contractor must promptly report the information in 40 CFI. 52.204-25(d)(2)to County. es 31) Antitrust violations; Denial or Revocation under Sectioneem amended, person o tatut ate Pursuant to Section 287.1.37,Florida statutes,a a blished and who has been placed the antitrust fFlorida iolator vendor list following a convictolectronically n or being helducivilly able updated quarterly by thee State o ) Page 11 of 13 for an antitrust violation may not submit a bid, proposal,or reply for any new contract to or services to a public entity; may not submit a bid,proposal,or reply provide any goods for a new contract with a public entity for the construction or repair of a public building or public work*may not submit a bid,proposal, or reply on new leases of real property to a. public entity;may not be awarded or perform work as a contractor,supplier,subcontractor, or consultant under a new contract with a public entity.;and may not transact new business with a public entity, By entering this Agreement, Contractor certifies neither it nor its affiliate(s) are on the antitrust violator vendor listm subsequentlye of entering this added to that list result reement False certification under this paragraph or being at in termination of this Agreement, at the option of the County consistent with Section 287.137,'Florida Statutes,as amended.. 32) Merged Amendment M This agreement constitutes the entire Agreement between the Contractor and the County,. and negotiations and oral understandings between the parties are merged herein. This Agreement can be supplemented and/or amended only by a written document executed by both the Contractor and authorized designees of the County. 33) Interpretation The titles and headings contained in this Agreement are for reference purposes only an personal will not in any way affect the meaning or interpretationthis atheesingular inlcludes the pronouns used in this Agreement include the other gender, and plural,and vice versa,unless the context otherwise requires. Terms such a "herein"s rfto r to this Agreement as a whole and not to any particular sentence, paragraph, ph ec where they appear,unless the context otherwise requires. Whenever reference is made to a section or article of this Agreement,such reference is to the section or article as a whole, including all subsections thereof,unless the reference is made to a particular subsection or subparagraph of such section or article, Any reference to "days" means calendar days, unless otherwise expressly stated. 34) joint Preparation It is acknowledged that each party to this Agreement had the opportunity to be represented by counsel in the preparation of this Agreement and accordingly the rule that a contract will be interpreted strictly against time party preparing same does not apply herein due to the joint contributions of both parties. 35) geverability;Waiver of Provisions Any provision in this Agreement that is prohibited or unenforceable in any jurisdiction will, as to that jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof or affecting the validity or enforceability of such provisions in any other jurisdiction.The non-enforcemcnt of any provision by either party will not constitute a waiver of that provision nor will it affect the enforceability of that provision or of the remainder of this Agreement. 36) Signatory Authority Upon request, the Contractor must provide the County with copies of requisite documentation evidencing that the signatory for Contractor has the authority to enter into this Agreement. 37) Counterparts and Multiple Ori*finals. This Agreement may be executed in multiple originals, and may be executed in Page 12 of 13 counterparts, each of which Is hereby deemed to be an original, but all of which, taken together, constitutes one and the same agrcclllellt. IN WITNESS WHEREOF, County and Contractor have CYCCllted this Agreement as of the date lust written above. CONTRACTOR: Life Extension Clinics, Inc.d/b/a Life Scan Wellness Centers By: s� Siallature... ^ Todd LeDuc CEO Print Name &Title STATE OF FLORIDA COUNTY OF_ l I(L56o l,�A / The foregoing instrument was sworn to/aftirnma)d acknowledged before me by means of P] physical presence or ❑ online notarizatiori,thl 2.� day of QAM 202,5 by , President [or Authority Title] of LIFE EXTENSION C ICS, INC, D/B/A LIFE SCAN WELLNESS CENTERS,a Florida For profit Corporation. I-Ie/She is E z ovally kllo4u'll to 111C/or has produced (type of identification) as identification. C;��11� - �mm KNotarySi-ntt r ofNt�%,A' Public ublic State of Floridanifer L Connellymmission FIH 392884ires 4/30/2027 (Print& Stamp Commissioned Name ofN t� y Public) MONROE COUNTY, FLORIDA: BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY & BOARD OF GOVERNORS, FIRE AND AMBULANCE DISTRICT 1, MONROE COUNTY Digitally,.Ago dbyChOstineHurley y: Christine Hurley Date:2025 t15.21 1733:41-04'00' Christine Hurley, AICP Monroe County Administrator Approved as to legal form & suffiCiency: 11,,J,.0[ vqc,Ad by Eve hi Lewis Eve M. Lewis Oaly 1,.4y5,05o22,5:4205 J. Eve M. Lewis, Assistant County Attorney Pacre 13 Df 1 66EXHIBIT A99 Scope of Services The Life Scan Wellness Program is an integrated medical approach to tfiref ter ex ams diseases that combines an annual physical with potential lifesaving, early detection testing for such as heart disease,stroke,cancer,diabetes,and aneurysms. n Life � � m as the well benefit of ultrasound imaging assessments of the g diet and nutritional analysis, a as cardio-pulmonary testing, extensive laboratory blood profiles, cated state-of-the-art fitness evaluation, and a personalizedhat llness ane the lan. Life foundationcof'virtu lly sophistrevery medical tests identify and analyze specific markers disease, visualizes the health of the internal organs, and heart, and evaluates the function of the vascular system. 1. The medical examination provides invaluable health status assessments of both the individual and department-wide.The medical evaluation is intended to identify whether an individual is physically and mentally abe to perform and essential duties e working without undue risk of harm to self or others, monitor environment of uniformed personnel,detect patterns of disease in the workforce that h t might indicate underlying work-related health concerns, provide ica information on the entire workplace,and inform uniformed personnel of their occupationalal. hazards and health status.This medical evaluation complies with federal,state, pro and local health and safety requirements. The Nurse Practitioner has a thorougal understanding of the public service officer positions including essential job tasks,physic demands, psychosocial stressors, various environmental exposures and the effects of medical conditions on essential job tasks. 2. The ultrasound technician conducts a thorough evaluation'of each patient's internal organ and provides the patient with copies of still images(sonograms t dia bst c apses. the patient's primary physician for further evaluation n oh, �: Ultrasound scanning is a noninvasive, safe and painless method that uses sound waves to create real time images of the inside of intera�aor organs as�resgthatheund scans and public service searching for abnormalities in the major g It also aids officers can adequately perform essential job exposure the fob entails su�h* exposure to track the yearly effects of the environmental ex P to toxic fumes, irritants, particulates, biological hazards, scan�onducted heated gases.The following provides a comprehensive list and description of each by the ultrasound technician at LIFE SCAN Wellness Centers. 3. LIFE SCAN Wellness Center's fitness analysis conducted n top physical colndition to ensure inical Exercise Physiologist makes certain that public safety officers a better on-the-job performance and overall a state of-the-art integrated evaluation, and includes diet and nutritional analysis, personalized wellness plan to create an onulmona officer and firefighter.LCFESCANs cardio-pry customized fitnessrtevaluation ness rprotocols are andards as specifically chosen to meet the current NFP�hensive list and tdecrition off the O ss standards. The following provides a comp assessments conducted.. at L1FEAN Wellness, e Centers, including descraibed by rthe encePApwl��h. NFPA standards as well as the 14 essentiallob tasks s necessitate the conduction of these assessments. "COMPOSITE EXHIBIT B" ELI�NESS CEN-rERS �"�. tie ,d ues o " � er1ca Is Heroes Sailing LIFE SCAN WELLNESS CENTERS QUOTE: City&Stater Department", Monroe County Fire Rescue Contact: Cara Johnson 2025 Marathon, FL 33050 Date:05.08.2025 0//I�e %%//// ,/,////c Iw,rlt?u1 +1>�` "li ,� Pubiic Safety Physical Exam(NFF'A 1582 compliant) Included fuVedicaY ccupaYionalPEnvironmental Cuestionnaire Included Comprehensive 1 lands Cn Physical Exarru Included Blood Pressure Pulse fi%' %// r//'f, 'f'p included Vital Signs hlerght vr�reught „ ,�� /%// , �;� f�ii// ARM I eluded �1„/,,,,, Sack Health Evaluation Included Urinalysis included Audiollram Included Titmus occupational Vision Exam Ynoluded Breast Exam with Self-Exam education lncluddd Personal Consrrltatron with review of testing results Laboratory Tests: lncludel Comprehensive Metabolic Panel, Blood Chemistry Included Complete Blood Count, Hematology Panel Included Hemoccult Stool Test for Colon Cancer Screening included Total.Lipid Panel Included Thyroid Test TSH Included Glucose included Hemoglobin A1C Included tten PSA(Prostate cancer marker)and Testosterone Included Women'.CA-125 Ultrasound Screenings (Early Detection of Heart Disease and Cancer): Included Echocardio; ram(Heart Ultrasound) included Carotid Art ties Ultrasound Included Aorta and.Aorlic Valve Ultrasounds Included Liver Ultrasound Included Gall Bladder Ultrasound Included Kidneys Ultrasound Included Spleen Ultrasound Included Bladder Ultrasound Included Thyroid Ultrasound included Men:Prostate and Testicular Ultrasounds included women-Ovaries and Uterus Ultrasounds Cardiopulmonary Testing 8&Fitness Eval fNFPA 1583&lAFF WFI) Included Cardiac Stress Test(Treadrnill with 12 lead,sub-maximal) Included EKG,12 Lead included Spirometry,PFT with OSHA Respirator tvtedic-at Clearance Included Fitness tests for muscular strength&endurance included, V02 Max Ca%c for Aerobic Capacity included Body Weight and Compoifuon Included Personal Fitness Rx $499.80 LIFE SCAN PLtBLfC SAFETY PHYSICAL FOAM BASIC COST Each Mandatory Life can NFPA Proprietary EMR System with L�ha'vaoral Health Assessments $25.00 $624.80 0t,01 Life Scan bl j� nter c;ostper phySiCal t_tne Item Cost OPTIONAL TESTS AVAILABLE $89,76 Chest X-Ray view with radiologist review(included) $89,76 Lumbar X-Ray,2 view with radiologist review $82.62 Hazmat Cholinesterase $82.62 Hazrnat Heavy Metals $42.84 Hepatitis A Titer $66.30 Hepatitis B Screening'Test $42.84 Hepatitis B Titer $66.30 Hepatitis C Screening Test $31.62 HIV Test,Gen 4 $26.52 PPD TB Skin Test $81.60 QuantiFeron Gold TB Blond Test $35.70 Tdap(Tetanus,Diphtheria, Pertussis)Titer $46.92 CS'I-IA Respirator Ivfask Fit Testing(PortaCount $56.10 Drug Screen, I CUP $66.30 Drug Rescreen with con firmafioi, $31.62 ASO $77.52 Nicotne $122.40 CPFT Cardioputmonary Test i// Al/%/%/ a/j / /i $24.48 Phlekaotortaat(Blood Draw)Fee ,lr, / n //r a��/„ ' is ,„ //ii ,,,,�/'!��l'%/i�'�''/�i��%'///%✓G�;l0�l��n�o ,�.'a�%f%//�r `. '�r'avr,Irirnil Jl�/.>rlr'!. IIIIInIrrlUnl 451 dapr(� r p ointments. Pricing subject to annual i rcin is will be billed. on 9 patients per day,45 per week.All scheduled appointments 90 2025 Department Scheduling And Additional Testing Agreement Monroe County Fire Scripts; Schedule&Roster POC Billing&Supply Shipping Address 7280 Overseas Highway Cara.Johnson,,Executive Administrator Marathon,FL 33050 (0)305-289-60104 (C) Life Scan Base Price: $525.00 Johnson-cara@monroecounty-fl.gov Piggyback—Clearwater Fire Fire Chief R.L.Colina invoices POC (0) (C) Name: Col itla-rl c monroecoun Email: X Life Scan On-Site Ou-Site Blood Draw Add ress 56633 Overseas Hwy 8:30am to 11:30am Crawl Key,FL 33050 On-Site Draw Dates Wed,May 28—Fri,May 30 all specimens will be Send 1 centrifuge to be sent to another location where EMS will do blood draws, picked up(courier p/u)at Fire Academy each of the 3 days Members who do not participate in the on-site blood draws will need to bring their script to a local Lab Corp. For accurate results,blood draws need to be performed between 45 days and 10 days prior to scheduled physicals. ""Rein isider,mernbers need to mast 10 hours prior to blood draw* Location for PhysiGca Members: 180 Total Days:20 Station#13 Set-Up: 7:30 am Start: 8:30am 390 Key Deer Blvd Dates of Physicals Big pine Key,FL 33043 Mon,June 9—Fri,June 13 FFD POC Mon,June 16—Fri,June 20 Deputy Chief RL Colina Mon,June 23—Fri,June 27 colina-rl monroecounty-fl.gov Mon,July 7—Fri,July 11 Requirement for Physicals: 3 private rooms(10 x 10 is sufficient),one room needs to have a treadmill with at least a 15%incline. Each room should have a trash can and a small table and two chairs if possible. OUr staff will need to connect to the WiFi to chart findings during the exam.if your WiFi requires a password to gain access,please provide it here. WiFi Password: 1f WiFi is not provided, a$20 fee per day is applicable. .rrzarr z q� 't l wr�a .l o ct of� ys i al are zp� l � � physicals V reloasthedalm prior tzr„ Life Scan Wellness xzs z vu te Irt t M v mit eoiifirriret'i crezrwuzur 111 0['0 da.5 yes T est/Lab Price T' Notes X FFD Send to Cara&Colima X On-Site Draw $2 8 1.80 CLIENT AGREEMENT,, As an authorized representative, I have reviewed and agree to these terms,dates, additional tests,labs,and p4resetatafi;ve ...�-. 1-1 V-C �+w+L Naine and Title Fire Chief R.L. Colina LITE SCAN WEL�LNESS CENTERS vi a Ives o e ° , 's heroes Life Extension Clinics Inc. - Small Contract for Annual PhysicalExaminations—Legal Stamped 5.22.25 Final Audit Report 2025-05-23 Created: 2025-05-23 By: Rebecca Knecht(rbecca.knecht@lifescanwellness.com) Status: Signed Transaction ID: CBJCHBCAABAAXOZnLxJUgowugZnvg2lwuFbalsawzlEk "Life Extension Clinics Inc. - Small Contract for Annual Physical Exam inations—Legal Stamped 5.22.25" History &e Document digitally presigned by Eve M. Lewis(lewis-eve@monroecounty-fl.gov) 2025-05-22-8:42:05 PM GMT Ll Document created by Rebecca Knecht(rebecca.knecht@lifescanwellness.com) 2025-05-23-1:68:47 PM GMT Document emailed to todd.leduc@lifescanwellness.com for signature 2025-05-23-2:01:17 PM GMT Email viewed by todd.leduc@lifescanweliness.com 2025-05-23-2:09:03 PM GMT 6o Signer todd.leduc@lifescanwellness.com entered name at signing as Todd LeDuc 2025-05-23-2:16:40 PM GMT &e Document e-signed by Todd LeDuc(todd.leduc@lifescanwellness.com) Signature Date:2025-05-23-2:16:42 PM GMT-Time Source:server Agreement completed. 2025-05-23-2:16:42 PM GMT Adobe Acrobat Sign Corporate Resolution for LIFE EXTENSION CLINICS,INC. We,the undersigned,being all of the directors of this Corporation,consent and agree that the following corporate resolution was made on January 10,2025. We do hereby consent to the following decision: Corporate Resolution of Signing Authority Now,therefore,it is resolved,that the Corporation shall: Grant Todd LeDuc, Deputy CEO,Signing Authority to execute Client Contracts,Contract Amendments,and Contract Renewals on behalf of the Corporation. The Officers of this Corporation are hereby authorized to perform the acts to carry out this Resolution. We,the undersigned directors of the Corporation constituting a quorum of the Board,consent and agree to all of the above on this 10 day of January 2025. Director Sig a Printed Name Date heein-Px-dAielehime 1/10/2025 D ct gnature Printed Name Date ,r The Secretary of the Corporation certifies that the above is a true and correct copy of the Resolution that w s duly d at a meeting of the Board of Directors. w, J e -P tri.cia hn,s n V-1012:025 Ncre a ignature Printed Name Date Y 'N CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) AcoR®- 4% OV1612026 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Cinda Groves O.E.Wilson Insurance,Inc. lairNN EII�727)535-0524 Lp� �ff?7)mj§-98 PO Box 1429 E MAIL clrldw(aroWilDn corn _ _._ _� Largo,FL 33779 ...... ....._I_Fl S AFF R ING COVERAGE NAIL# ... _ jN&RgR a; Admiral Insurance Company 24856 INSURED INSURER 8:, .................................. Life Extension Clinics,lnc.dba Life Scan Wellness Centers INSURER c LS Wellness,PLLC ) 1011 N.MacDill Ave. � 6�.� _ ...............__....� Tama FL 33607 INs RER.F. COVERAGES CERTIFICATE NUMBERLIFEEXT2022 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,. ................... ...............................................�__....._ kNSR ADDL SUER POLICY EFP POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUM iB,ER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ .�........ —_.............. ......... ... ........................... DAMAGE TO RENTED CLAIMS-MADE OCCUR ..P.,k�.�.(�3.AGG6dL[.2tic.�. $ ............................................ MED EXP�Any oneperso0. $ PERSONAL&ADV INJURY $ OEr:h9 LAl".rGR'..E—aa"�'`�.PE®T APPLIES PER: .ENERAL.A„,(', REATF .... ...., ...., Poucy p� ROQUCTS nUE10P AGG $ OTHER $ AUTOMOBILE LIABILITY COMDIN1",1,-r"I'.NGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ k ........... ._ .............. ALL OWNED SCHEDULED AUTOS AUTOS 6rc BODILY INJURY(Per accident) $ NON-OWNED '1 T PROPERTY DAMAGE . $ ... HIREDAUTOS AUTOS (. ',,„-" L3GCW� .. ..................................... UMBRELLA LIAB ,......, OCCUR WOW W EACH OCCURRENCE...... $ EXCESS LIAB CL,gIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION ER OTH- P AND EMPLOYERS'LIABILITY YIN TTUT ANY PROPF&tkOWPAR"TNERIEXECVTV'E E,L EACH ACCIDENT ""....".""_ $ O5FII,ERNME4fiER EXCLUCED ❑ NIA "" (Mandatory In NH) I E..L.DISEASE-EA.EMPLOYEE $ " e�s describe uJrader =. RIPTI{N F IP'F"",RANI N" G w6s E..t DISEASE,POLICY LIMIT $ A Medical Professional Liability X E0000037691-09 05/31/2025 05/31/2026 3,000,000 Aggregate Retroactive Date:5/31/2001 2,000,000 Each Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Medical Professional Liability Additional Coverages: Sexual Abuse $1,000,000 Each Claim/$1,000,000 Aggregate Network Securi &Data Privacy Liabili $1,000,000 Each Claim/$1,000,000 Aggregate CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West,FL 33040 AUTHORIZED REPRESENTATIVE <SMK> ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACORO' CERTIFICATE OF LIABILITY INSURANCE °ATE`M'"'°°"""' 0312812025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Cinda Groves -NAME.-_—..—_— �....._.� ........ � �. 0.E.Wilson Insurance,Inc. PHONE 727 535-0524 N 727L536„9828 PO Box 1429 zO I . _cindaloewlkson.con Largo,FL 33779 INSURER(S)AFFoRPING coVERAGE....... NAIG# INSURE,R8;Admiral Insurance Company 24856 INSURED INSURER B;... .............. Life Extension Clinics,lnc.dba Life Scan Wellness Centers ICI ) „„„„„„„„„„„„_ LS Wellness,PLLC 1011 N.MacDill Ave. IN UI39R E: Tampa,FL 33607 1 INSURER F COVERAM CERTIFICATE NUMBERLIFEEXT2022 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ........................... . .... .......... ''.INSR LIE TYPE OF INSURANCE ADDL.SU8R POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED _...... CLAIMS-MADE E]OCCUR PpFnntS S,.I ,gG�er e)m ".............................. _. EXP(8Qy.„an�pe„ra01 PERSONAL&ADV INJURY $ GE.N L AGGaREG.ATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ........ PRO- POLICY _. PRO- LOC PRODUCT -COMPlOPAGG S „ .�� JECT "H m:R. $ AUTOMOBILE LIABILITY COMSMIED SINGtE LIMI'P $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED tI:aKBWt. AUTOS .AUTOS Cw B mm._ ODILY INJURY(Per accident) $ h, �. _,...�.,.�.. ...... NON-OWNED Y 4 �'"R.'OPEI'+.'iY DAMAGE $ HIREDAUTOS ....... AUTOS ............... .- DA $ UMBRELLA LIAB WAN" rft-- OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS•MAOE AGGREGATE $ QED R T NTI N $ WORKERS COMPENSATION PER .. OTH- AND EMPLOYERS'LIABILITY °'� " T """" """""°°' YIN .................... . ...... ANY PROPRIETOWPARTNERIEXEM)TIV'E E L EACH ACCIDENT $ OFFsCER)MEMSER EXCLU,C FD ❑ NIA _...._.............................. (Mandatory In NH) E,L. DISFASF„,-EA FMmPLOYEITITITITIT II yes deschbe vndef IDESCRIPTION OF OPERATIONS bma w^ E.I. DISEASE-POLICY LIMIT $ A Medical Professional Liability E0000037691-08 05/31/2024 05131/2025 2,000,000 Aggregate Retroactive Date:5/31/2001 2,000,000 Each Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Medical Professional Liability Additional Coverages: Sexual Abuse $1,000,000 Each Claim/$1,000,000 Aggregate Network Security&Data Privac Liabili $1 000,000 Each Claim/$1 000,000 Aggregate CERTIFICATE HOLDER, CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West,FL 33040 AUTHORIZED REPRESENTATIVE ' <SMK> ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD DATE(MMIDDIYYYY) OF LIABILITY INSURANCE o31z81zozeHl Acc1#' 3045439 CERTIFICATE AMEND,. EXTEND OR ALTER THE COVEItA ISSUING �'ED. CERTIFICATE lIC S ISSUED AS A MATTER OF INFO TION -1— AND Ct_NI ERo NCI RIGHTS NIERAGI THE ORD ND BY THE P R. THIS W. THIS CERTIFICATE CER AND AN CERTIFICATE LATE HOLDER. A CONTRACT BETWEEN THE NOT AFFiR INSVELY OR NEGATIVELY --------- BELOW. DOESCERTIFICATE PRODUCER,OF INSDER. must have ADDITIONAL INSURED proTrisions or be endorIn REPRESENTATIVE OR IMPORTANT. if the N IS WAIVED,tltsub subject to the fermis land Condit o INSURED,the plallicy, c) s of the policy, SUBROGATION I older in lieu of such endorsement(s). S Uh certain policies may require an endorsement. A statement o does not confer rl ITts to the certificate ON AC FAx certificate Awc No) ,M1AM�.. PHONE 844 398 0470 PRODUCER AON RISK SERVICES SOUTH1 INC EMAIL �erls� eoplease Conk .. � 3 ()I_ENO7 ROAD NORTHEAST,SUITE 1700 gDDRs GA 30326 IN R l..... h America �� 4ATLANTA, Indemn SURER S AFI ORDIN!G COVERAGro Iai�3aIFaERA tyInsurance Company of Nort INSURE VMk',UbxER, ., Life ExtensiorE Clinics.Inc. dtra Life Scan Wellness Centers,LS Wellness PLLC INS RER_D . 1011 N MacD111 Ave INSURER E ...INSURER..",. .�, m ....... Trampea FL 33607 F: REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: THIS CONDITION OF ANY OONTRAt T CR OTHER OOriEREBN ISSUBT TOTALOL THEI TERMS, THIS IS TO C ERTI'FY Tk1AT T'I1E POLICgE3 OF INSURAFIORM OR OOE LISTED LCIVIU HAVE 6EEla gSUED TO y"NE uCRl6E( INAME& MOVE FOR Tq lE F OLICY PERIOD 9E DE INCb9CATED� NCTWITt�aSUEDSANDING ANY RECERTAIN, T AFFORDED BY 1`k{E POLICBY RAID CLAgM�. ... SAND CONDITION3'OF SUCH POLICIES M aM r... . THE INSURANCE 11 EECLUSIONE MAY BE ISSUED OR MAY PERT NUMBER EDUC LIMITS MAY IlA'�E BEEN Ry.POM1.ICY Ems, I M�� CER'TiFgCA LYMNTS SF40WVN.��_ m...,..IADDLI�aUaift POLICY' 5.... - ENSR TYPE OF INSURANCE EACH OC I wRREN�� LfR, I �SANIxu''w"d R �1`h ELF m LIABILITY ! 1 FROM} E 1e'�crre'fl5r"I $m.., I COMMERCIAL GENERAL i "/ S i w � I MED EXP fAru one�uraa^s�rnD ,w.. .. J CLAIMS-MADE m OCCUR f ER�07iAL - &ADVINJURY S .. ENFRAL otGGREGAf F ..., EOEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY e .,JECT c MI1 I g C,LyMU4fiIE0 rIIVIL'w G �.. ,... R BODILY INJURY Per p Drt"iFR: I I" ( person) I$ AUTOMOBILE LIABILITY r acad... $ i BODILY INJURY(Pe ANY AUTO r8mt ,v .PR7�`PETTY DAMA�G.+E' $ a._ ALL OWNED I SCHEMA iw:L'R i Per s�rrlarKrl AUTOS I AUTOS I �!" .�...... '� m 5 Y NEON"OVMEO 0�`--• HIRED AUTOS I ..�AUTOS I'7N+ �. ...� 'AP Mi ,;d UFPRR.... I i UMBRELLA LIAB OCCUR f I l ,43RE ATE�. .. DIMS MADE,. I Dr�u iaL r ErcaTE w S x � $ Ta)T ! F EXCESS LIAR OIH I 1000000 N 12/31/2024 01/01/2026 nLLIDLNw �$1 WORKERS COMPENSATION A ILI ., i 100000 E L DIS h4 I AND EMPLOYERS'LIABILITY Y 1 N E L EA EASO EA&"MPL"Du'ELi$ 1000000 „ N [NIA C72818763 � � "' 'ANY PROPREBER AcLiubrBE,,Et:OTd'VE '�""�,� I E L.DHS. . 0 A �OF'andot';TYin46FRF,.XCq.�iJl"i'EL"1^a _J I 1 BA+�E-PO�L�ICYLwM9t .3 }(MOndaltrr!I'in NH) � i ya, meascrbe linde�r .0 SCRIP'IIE3N OF OPDRATIONS Wow I 1 i P wired) DESCRIPTION OF OPERATIONS i I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if mores ace is required) POLICY VALID IN FLORIDA ELLATION m. CANC --� LATE OLDER CERTIFI H . _ I SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board IN EA EXPIRATION 'DATE THEREOP,CCORDANCE WITH THE POLICY PROVISIONS, WILL BE DELIVERED 1100 Simonton Street Key West FL 33040 AUTHORIZED REPRESENTATIVE .�� ce %( 88-241 At kD CORPORATION. Al9 rights reserved,... ACORD 1 CORD name and logo are registered marks of ACOR 25(206103) The A DATE(MMIDD/YYYY) AC R" CERTIFICATE OF LIABILITY INSURANCE 5/27/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). '.PRODUCER CONTACT NAME Certificate Department Sihle Insurance Group Inc. PHONE FAX 1021 Douglas Ave. c N�. Is3l,407 869 5490 fi ? N�) 407 38 � Q E-MAIL Altamonte Springs FL 32714 ADDRESS: 0.pdidi te, sI#wle poin INSURERO RIDING COVERAGE NAIC# w a S AFFO ,_ INSURERA:Hartford Underwriters Insurance Company 30104 LIFEEXT.... .. _ INSURED 01 INSURER,B MSIGSpeclalty Insurance USA Inc _. 34886 Life Extension Clinics Inc. dba Life Scan Wellness Centers INSURER Palomar Excess and Surplus ur Insance Company 16754 1011 N MacDill Avenue INSURERD Tampa FL 33607 INSURER E: T' ..... .... INSURER F COVERAGES CERTIFICATE NUMBER:1968624437 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ®.,. LTR: TYPE OF INSURANCE .. M12: POLICY NUMBER dydNIAOOr"fE" �PpLICY E,JY[P LIMITS INSR: . AODIL StJBR POLICY MIMJ- dYYYY -.-.-.. LIABILITY Y d1SB;MBASF'I`H 11/10/2024 11111/2025 EACH OCCURRENCE $1,000,000 „. I .,tiNl4GL'1°Ct' FNdFi ,...... ..................... m A X-.-. COMMERCIAL LAIMS-MADEE� X...1 OCCUR 1 I„4M„E9roNW' E,„�E;F,o, adrrencst] i$1.000,000 (Any one person) $10,000 PERSONAL -- 1,000,0-- -- I I ADV INJURY $ 00 ,.. ...� LE y WAW( ...� IL.00:, j � � ¢ } PRODUCTS COMP/OP AGG $2„000 000 ENERALAGGREGATE $20 GEN POAGCREGATE LIMIT APPLIES PER � GENERAL 00 000 1 X 1 OTHER_ $ B AUTOMOBILE LIABILITY Y N HN01000294-2 3/2/2025 3/2/2026 COMBWED9INGLE LIMIT S 1,000.000 M�,,,,, i 1 LLB acC�1x^st0.1 ANY AUTO i BODILY INJURY(Per person) S w .. . ..... ,.,.. ,m.. .,. .. ,,....„ „T. OWNED SCHEDULED BODILY INJURY(Per accident) $ X AUTOS ONLY ,�,„,.AUTOS1 HIRED i ..., - (AUTOS ONLY �._X_.-�AUTOS ONLDY �,(PeOr ac cdent)pMAGE 1$ ....s UMBRELLALIAB OCCUR 21SBMBA9FTH 11/10/2024 11/10/2025 EACH OCCURRENCE 1$1 000000 A 1 X DED RETENT CLAIMS MADE'. I AGGREGATE $1 000 000 EXCESS LIAB ; WORKERS COMPENSATION ANYPROPRIETOR/PARTNER/EXECUTIVE 1NIA j E„L�EATCH AC �lE7 H AND EMPLOYERS'LIABILITY Y/N CIDENT $ OFFICER/MEMBER EXCLUDED. — --- (Mandatory in NH) E L DISEASE EA EMPLOYEE,S If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT$ C Cyber Liability PLMCBS2YANEQNE002 6/26/2024 6/26/2025 Each Occurrence 1 $2,000.000 A EPLI 21SBMBA9FTH 11/10/2024 11/10/2025 Aggregate Limit $25.000 J DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Network Security Incident&Privacy Incident$2,000,000 Each Claim Limit of Liability$10,000 deductible is applicable CERTIFICATE HOLDER CANCELLATION' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Policy Number HN01000294-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER SFER OF RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s)Of Person(s) Or Organization(s): Any person or organization you are required to include on this policy by written contract or written agreement in effect during this policy period and executed prior to the"loss". Additional Premium Is Included Section IV — Business Auto Conditions, A. Loss Conditions, 5., Transfer Of Rights Of Recovery Against Others To Us does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a written contract or written agreement with that person or organization. We will retain the additional premium shown above, regardless of any early termination of this endorsement of this Policy. JA5203US 01-19 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE HARTFORD BLANKET ADDITIONAL INSURED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. A. The following is added to Section C.WHO IS AN INSURED: Additional Insureds When Required By Written Contract,Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written contract or written agreement, or when required by a written permit issued by a state or governmental agency or subdivision or political subdivision that such person or organization be added as an additional insured on your Coverage Part, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. However, no such person or organization is an additional insured under this provision if such person or organization is included as an additional insured by any other endorsement issued by us and made a part of this Coverage Part. The insurance afforded to such additional insured will not be broader than that which you are required by the contract, agreement, or permit to provide for such additional insured. The insurance afforded to such additional insured only applies to the extent permitted by law. The limits of insurance that apply to additional insureds are described in Section D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS. a. Vendors Any person(s) or organization(s) (referred to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the"products-completed operations hazard". (1) The insurance afforded to the vendor is subject to the following additional exclusions: This insurance does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Form SL 30 32 06 21 Page 1 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc.,with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE HARTFORD (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or"property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Paragraphs (d) or(f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessors Of Equipment (1) Any person or organization from whom you lease equipment; but only with respect to their liability for "bodily injury", "property damage" or"personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence"which takes place after you cease to lease that equipment. c. Lessors Of Land Or Premises (1) Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. (2) With respect to the insurance afforded to these additional insureds,this insurance does not apply to: (a) Any'occurrence"which takes place after you cease to lease that land or be a tenant in that premises; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors (1) Any architect, engineer, or surveyor, but only with respect to liability for"bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; (b) In the performance of your ongoing operations performed by you or on your behalf; or (c) In connection with "your work" and included within the "products-completed operations hazard", but only if: (1) The written contract, written agreement or permit requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for"bodily injury" or"property damage" included within the "products-completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services, including: (i) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (ii) Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by an insured, if the "bodily injury", "property Form SL 30 32 06 21 Page 2 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THEW' HARTFORD damage", or"personal and advertising injury" arises out of the rendering of or the failure to render any professional service. e. State Or Governmental Agency Or Subdivision Or Political Subdivision Issuing Permit (1) Any state or governmental agency or subdivision or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit. (2) With respect to the insurance afforded to these additional insureds,this insurance does not apply to: (a) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (b) "Bodily injury" or"property damage" included within the"products-completed operations hazard". f. Any Other Party (1) Any other person or organization who is not in one of the categories or classes listed above in Paragraphs a. through e. above, but only with respect to liability for"bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations performed by you or on your behalf; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products-completed operations hazard", but only if: (i) The written contract, written agreement or permit requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by an insured, if the "bodily injury", "property damage", or "personal and advertising injury" arises out of the rendering of or the failure to render any professional service described in Paragraphs f.(2)(a) or f.(2)(b) above. Form SL 30 32 06 21 Page 3 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE ' HARTFORD NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for non-payment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the company for non-payment of premium, or by the insured, notice of such cancellation will be provided within ten (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s)who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. Form SL 90 13 10 18 Page 1 of 1 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED EC - SCHEDULED This endorsement modifies insurance provided under the following. BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): Any person or organization you are required to include as an additional insured on this policy by written contract or written agreement in effect during this policy period and executed prior to the "loss". A. SECTION II—COVERED AUTOS LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured is amended to include as an "insured"the person(s)or organization(s)shown in the Schedule, but only with respect to their liability for"bodily injury"or"property damage"to which this insurance applies, caused in whole or in part, by an "accident' resulting from the ownership, maintenance or use of a covered "auto". However, the insurance afforded to such"insured": 1. Only applies to the extent permitted by law; and 2. If coverage provided to the "insured" is required by a contract or agreement, the insurance afforded to such "insured"will not be broader than that which you are required by contract or agreement to provide such "insured". B. SECTION II -COVERED AUTOS LIABILITY COVERAGE, B. Exclusions is amended to include: This insurance does not apply to: "Bodily injury" or"property damage"for which the Person(s)or Organization(s)shown in the Declarations or Schedule is obligated to pay damages by reason of the assumption of liability in a contract or agreement C. SECTION II—COVERED AUTOS LIABILITY COVERAGE, C. Limits Of Insurance is amended to include: The most we will pay on behalf of the"insured"shown in the Schedule is the amount of insurance: 1. Required by the contract or agreement you have entered into with the"insured"; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. MSES 14910 06 21 Page 1 of 1 ©2021 MSIG Holdings(U.S.A.),Inc. All rights reserved Includes copyrighted material of Insurance Services Office, Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, THEi�!' HARTFORD AMENDMENT OF OTHER INSURANCE CONDITION - PRIMARY OR PRIMARY AND NON-CONTRIBUTORY WHEN REQUIRED BY WRITTEN. CONTRACT OR WRITTEN AGREEMENT This endorsement modifies insurance provided under the following: UMBRELLA LIABILITY SUPPLEMENTAL POLICY Except as otherwise stated in this endorsement, the terms and conditions of the Supplemental Policy apply, A. The following is added to Section C.WHO IS AN INSURED: Any person or organization with whom you agreed, because of a written contract, written agreement or because of a permit issued by a state or political subdivision, to provide insurance such as is afforded under this Supplemental Policy, but only with respect to your operations, "your work" or facilities owned or used by you. a. This provision does not apply: (1) Unless the written contract or written agreement has been executed, or the permit has been issued prior to the "bodily injury", "property damage", or"personal and advertising injury"; and (2) Unless the limits of liability specified in such written contract, written agreement or permit are greater than the limits shown for"underlying insurance"; or (3) Beyond the period of time required by the written contract or written agreement. b. In no event shall any coverage afforded to any such person or organization apply to any claim or "suit" to which "underlying insurance" does not apply. Coverage provided by this Supplemental Policy for any such additional insured will follow the provisions, exclusions and limitations of the "underlying insurance". B. Solely as with respect to the insurance afforded to any person or organization qualifying as an additional insured under Section A. above, Paragraph 7. Other Insurance in Section E. CONDITIONS is deleted and replaced by the following: 7. Other Insurance a. This Supplemental Policy shall apply in excess of all "underlying insurance" whether or not valid and collectible. It shall also apply in excess of other valid and collectible insurance (except other insurance purchased specifically to apply in excess of this insurance) which also applies to any loss for which insurance is provided by this Supplemental Policy. These excess provisions apply, whether such other insurance is stated to be: (1) Primary; (2) Contributing; (3) Excess; or (4) Contingent. b. However, the following provisions apply to other insurance available to any person or organization qualifying as an additional insured under Section C. WHO IS AN INSURED, as amended by Section A. of this endorsement and who is also an additional insured under the Business Liability Coverage scheduled in the "underlying insurance": (1) Primary Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit to provide primary insurance to the additional insured, then, after the "underlying insurance" is exhausted, this insurance will be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Paragraph c. below. Form SU 30 24 10 18 Page 1 of 2 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE All HARTFORD (2) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement, or permit to provide insurance to the additional insured that is primary and non-contributory, then, after the "underlying insurance" is exhausted, this insurance will be primary and we will not seek contribution from the additional insured's own insurance. Paragraphs (1) and (2) do not apply to other insurance on which the additional insured qualifies as an additional insured pursuant to the terms of that policy or has been added as an additional insured by endorsement. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. C. Paragraph D.6. How Limits Apply To Additional Insured is deleted and replaced by the following: How Limits Apply To Additional Insureds a. If you have agreed in a written contract, written agreement or permit that another person or organization be added as an additional insured on the Business Liability Coverage scheduled in the "underlying insurance" and such person or organization also qualifies as an additional insured under this Supplemental Policy, the most we will pay on behalf of such insured is the lesser of: (1) The limits of insurance specified in the written contract, written agreement or permit, less any amounts payable by any"underlying insurance"; or (2) The Limits of Insurance shown in the Umbrella Liability Supplemental Policy Declarations. b. Such amount shall be a part of and not in addition to the Limits of Insurance shown in the Umbrella Liability Supplemental Policy Declarations and described in other provisions of this Section. Form SU 30 24 10 18 Page 2 of 2 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) 2018 Edidan 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 f' llowin contract. ContractorNendor. _ �Y� { .I Project or Service: ContractorNendor k ,a Address&Phone#: .., m .,_ General Scope of Work: Reason for Waiver or Modification: _ Policies Waiver or Modification will apply to: Signature of Contractorr Date: 25 Approved w Not Approved_/ Risk Management Signature: Date: County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Administrative Instruction 7500.7 104