HomeMy WebLinkAbout12/10/2025 Agreement
DATE: December 16, 2025
TO: Bryan Cook, Senior Director
Employee Services
Kelly Cummings, Budget Administrator
Employee Services
FROM: Brynn Morey, Deputy Clerk
SUBJECT: December 10, 2025 BOCC Meeting
The following item has been executed and added to the record.
C7. Approval of an agreement with ClearTrack HR, Inc, which provides service for the County's
Benefits Administration Software System. This system provides electronic management of
benefits eligibility, enrollment, data file feed to carriers, compliance, reporting, and other related
processes. This agreement reflects the continuation of services until terminated by either party.
The contractor has performed in a satisfactory manner and that the contract manager has
verified satisfactory performance
Should you have any questions please feel free to contact me at (305) 292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY
500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway
Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070
Benefit Administration System & Consulting Agreement
and entered into as of this 10th day of
December 2025 , by and between ClearTrack HR, LLC, a foreign limited liability corporation
WHEREAS, on August 30, 2018, the County entered into a Benefit Consulting Agreement with
ClearTrack for the provision of services identified in Exhibit A to that Agreement, including the
development of an online benefits enrollment platform to be utilized by members of the County
health plan in selecting their County health plan benefits; and
WHEREAS, pursuant to that Agreement, ClearTrack developed and built a platform exclusively
for the County, to facilitate selection of health plan choices and other benefits by all of the Health
Plan members; and
WHEREAS, the platform was rolled out and used during the Open Enrollment period of 2018;
and
WHEREAS, pursuant to that Agreement, ClearTrack also provided assistance to County staff
with the online member enrollment services, and also provided technical support both for the
members and County staff as well as services to maintain the database; and
WHEREAS, on January 29, 2019, the County entered into Amendment No. 1 to the Benefit
Consulting Agreement, to continue the services from month-to-month, up to the compensation
limit in the contract (not to exceed $49,999.99); and
WHEREAS, on July 15, 2020, the County entered into the Benefit Consulting Agreement, to
continue the services for five years, up to the compensation limit in the contract; and
WHEREAS, on August 20, 2025, the County entered into Renewal Offer to the Benefit
Consulting Agreement, to continue the services until December 31, 2025
WHEREAS, the County is considering its options for online employment enrollment and
unenrollment services, but wishes to continue to engage the services of ClearTrack in the
meantime, to continue this highly beneficial platform as well as the technical support and
database services necessary to support the platform and facilitate member use; and
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WHEREAS, ClearTrack has represented that it is willing to continue with a contractual
relationship to provide these services; and
WHEREAS, section 2-346 of the Monroe County Code of Ordinances (MCC) defines the term
department as determined by the required process under the Monroe County Purchasing Policies
WHEREAS, MCC section 2-347(e)(3) further provides that when goods or services are only
available from a sole source as documented by the requesting department, then the purchase may
be exempt from competitive bidding requirements; and
WHEREAS, because ClearTrack developed and hosts the current online platform, it is the only
vendor that can continue providing the online enrollment and unenrollment of health plan
members, as well as technical support for the platform and continued maintenance of the
populated database;
NOW THEREFORE, in consideration of the mutual promises and covenants contained herein,
the parties hereby agree as follows:
1.0 Description of Services. The services to be performed by ClearTrack HR for the County
shall include the services referenced in the body of this Agreement and those listed on
Exhibit A, attached hereto and made a part hereof. In the event of a conflict between
the body of this Agreement and Exhibit A, the Parties agree that the terms in the body
of this Agreement shall control. The services to be performed may only be modified as
agreed upon by the parties in writing. The parties further agree that ClearTrack HR is
an independent contractor and is not an employee of Monroe County. ClearTrack HR
has the right to determine the means and methods to be used in accomplishing and
providing the services to be rendered hereunder.
2.0 Duties required of the County. The County shall provide ClearTrack HR with any and
all information related to its benefit program that ClearTrack HR may reasonably
request in order to perform the services contemplated hereunder including, but not
limited to, accurate and timely information related to the County and the plans and
products subject to the services. Furthermore, the County shall distribute in a reasonable
manner communication material related to the services being offered by ClearTrack HR.
ClearTrack HR will not independently verify or authenticate information provided by
the County or on
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completeness of such information and other documentation furnished to ClearTrack
HR.
3.0 Term. This Agreement shall commence on January 1, 2026 (the and
remain in effect for a period of three (3) years (the Following the Initial
Term, the Agreement may be renewed for additional one (1) year period upon mutual
written agreement of the parties. The parties may continue to extend the Agreement in
successive one (1) year increments for as long as mutually agreed.
4.0 Fees for Services Performed. The fees to be paid to ClearTrack HR are those outlined
in Exhibit A. The County agrees to timely pay all fees, costs, and expenses arising out
of or resulting from the services in accordance with the Florida Local Government
Prompt Payment Act
5.0 Expenses. The County will not be responsible for direct expenses associated with
6.0 Indemnification.
a.The parties acknowledge that ClearTrack HR is not named as a fiduciary with
respect to any plan for which it may provide services. The parties agree that
ClearTrack HR is not nor shall become a fiduciary of any insurance plan as the
result of providing the services anticipated by this Agreement.
b.In order to provide the services identified herein, it may be necessary for
information of a personal nature that may be protected by various privacy laws.
ClearTrack HR advises that the County consult with legal counsel as to laws that
performing the services anticipated by this Agreement. The County warrants that
this Agreement does not violate any privacy notice issued by the County, a benefit
program the County maintains, or any applicable law.
c.Neither ClearTrack HR nor the County shall have any liability for any failure
or delay in performance of obligations under this Agreement because of
circumstances beyond reasonable control, including without
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limitation, acts of God, fires, floods, earthquakes, acts of war or terrorism, civil
disturbances, sabotage, accidents, unusually severe weather, governmental
actions, power failures, computer/network viruses that are not preventable through
generally available retail products, catastrophic hardware failures, or attacks on
servers.
d. The Parties further agree, notwithstanding any other terms or conditions
contained here, that neither ClearTrack HR nor the County shall have any
liability for indirect, special, punitive, consequential or incidental damages,
including, without limitation loss of profits.
e. Except to the extent prohibited by law, the County will indemnify, defend, and
hold harmless ClearTrack HR, its directors, officers, and associates from and
against any and all claims and/or lawsuits brought by any person, entity or
governmental authority from and against any and all judgments, settlements,
costs, penalties, and expenses (including reasonable attorneys' fees and expenses)
resulting from or arising out of criminal conduct, negligence, or fraud on the part
of the County or any of the directors, officers, or associates (acting alone
or in collusion with others) in connection with this Agreement, except to the
extent such claim or lawsuit arises from a wrongful act or wrongful omission that
ClearTrack HR, pursuant to rights under this Agreement, specifically directed the
County to engage in or which arises from criminal conduct, negligence, or fraud
associates (acting alone or in collusion with others).
f. Except to the extent prohibited by law, ClearTrack HR will indemnify, defend,
from and against any and all claims and/or lawsuits brought by any person, entity
or governmental authority against any and all judgments, settlements, costs,
penalties, and expenses (including reasonable attorneys' fees and expenses)
resulting from or arising out of criminal conduct, negligence, or fraud on the part
of ClearTrack HR or any of its directors, officers, or associates (acting alone or
in collusion with others) in connection with this Agreement, except to the extent
such claim or lawsuit arises from a wrongful act or wrongful omission that the
County, pursuant to rights under this Agreement, specifically directed
ClearTrack HR to engage in or which arise from criminal conduct, negligence,
associates (acting alone or in collusion with others).
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7.0 Confidentiality.
7.1 To the maximum extent allowed by law and specifically in accordance with Florida
public records law, ClearTrack HR will retain in confidence all information and
technical data derived from or disclosed to ClearTrack HR by the County, the
Employees, the representatives, or the agents, which is not generally
known to the public, hereinafter referred to as Examples of
Confidential Information include, but are not limited to, information or data disclosed
in oral, written, graphic, or machine-readable form or in forms otherwise embodying or
displaying such information which is visible or audible to ClearTrack HR by virtue of
ClearTrack HR having an employee, subcontractor, or agent visiting or performing
services at a facility controlled by the County or one of the subsidiaries, agents
or subcontractors; or by having access to the systems including, but not limited
to, employee information, which may constitute personally identifiable information.
Examples of personally identifiable information include, but are not limited to,
individual names, addresses, phone numbers, email addresses, employment
identification card numbers, or other similar information. ClearTrack HR shall use all
Confidential Information solely to perform its obligations under this Agreement. The
disclosure of Confidential Information is subject to privacy laws. This obligation of
confidentiality shall not, however, apply to information that: (a) is or becomes available
in the public domain through no wrongful act or omission of ClearTrack HR; (b) is
already in ClearTrack rightful possession without an obligation of confidentiality
prior to disclosure by the County; (c) is rightfully disclosed to ClearTrack HR by a third
party without an obligation of confidentiality that is known to ClearTrack HR; (d) is
independently developed by ClearTrack HR; or (e) is required to be disclosed by law or
pursuant to any order of a court of competent jurisdiction or regulatory order properly
served on ClearTrack HR.
a. ClearTrack HR agrees to regard and preserve as confidential all records and other
information including but not limited to participant demographic and benefit
election information and any materials developed exclusively for the County.
ClearTrack HR will not, without written authority from the County, disclose to
others during the term of this Agreement or thereafter, any such records or other
information except as required by applicable law.
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b. Upon Termination of this Agreement, each party shall promptly return to the
other party all copies of materials involving confidential information in the other
c. Public Records Requirements:
Pursuant to F.S. 119.0701 and the terms and conditions of this contract, the CONTRACTOR is
required to:
(1) Keep and maintain public records that would be required by the County to perform
the service.
(2) Upon receipt from the custodian of records, provide the County with a copy
of the requested records or allow the records to be inspected or copied within a reasonable
time at a cost that does not exceed the cost provided in this chapter or as otherwise
provided by law.
(3) Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed except as authorized by law for the
duration of the contract term and following completion of the contract if the
CONTRACTOR does not transfer the records to the County.
(4) Upon completion of the contract, transfer, at no cost, to the County all public records
in possession of the CONTRACTOR or keep and maintain public records that would be
required by the County to perform the service. If the CONTRACTOR transfers all public
records to the County upon completion of the contract, the CONTRACTOR shall destroy
any duplicate public records that are exempt or confidential and exempt from public
records disclosure requirements. If the CONTRACTOR keeps and maintains public
records upon completion of the contract, the CONTRACTOR shall meet all applicable
requirements for retaining public records. All records stored electronically must be
that is compatible with the information technology systems of the County.
(5) A request to inspect or copy public records relating to a County contract must be made
directly to the County, but if the County does not possess the requested records, the County
shall immediately notify the CONTRACTOR of the request, and the CONTRACTOR
must provide the records to the County or allow the records to be inspected or copied
within a reasonable time.
If the CONTRACTOR does not comply with the request for records, the County shall
enforce the public records contract provisions in accordance with the contract, notwithstanding
the option and right to unilaterally cancel this contract upon violation of this provision
by the CONTRACTOR. A CONTRACTOR
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who fails to provide the public records to the County or pursuant to a valid public records request
within a reasonable time may be subject to penalties under section119.10, Florida Statutes.
The CONTRACTOR shall not transfer custody, release, alter, destroy or otherwise dispose of
any public records unless or otherwise provided in this provision or as otherwise provided by
law.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE
CUSTODIAN OF PUBLIC RECORDS, GAELAN JONES AT PHONE# 305-292-3470
JONES-GAELAN@MONROECOUNTY-FL.GOV, MONROE COUNTY
OFFICE 1111 12TH Street, SUITE 408, KEY WEST, FL 33040.
8.0 Miscellaneous.
8.1 Governing Law. Any action, suit, or proceeding arising under or in
connection with this Agreement must be commenced within two (2) years after the
claim or cause of action arises. This Agreement shall be governed in all respects
by the laws of the state in which the County is located, without regard to conflicts
of law.
8.2 Assignment. Neither party may assign (voluntarily, by operation of law, or
otherwise) this Agreement (or any rights or obligations contained herein) without
the prior written consent of the other party, whose consent shall not be unreasonably
withheld. Any permitted assignee shall assume all obligations of its assignor under
this Agreement. Any purported assignment or transfer in violation of this section
shall be void.
8.3 Entire Agreement. This Agreement is the entire agreement between the parties.
This Agreement supersedes all prior or contemporaneous oral or written
communications, proposals, and representations with respect to the subject matter
covered by this Agreement. The terms and conditions of this Agreement can only
be modified via a written agreement signed by all parties.
8.4 Counterparts. This Agreement may be executed by the parties in separate
counterparts each of which when so, executed and delivered shall be an original, but
all such counterparts together shall constitute but one and the same instrument.
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8.5 Notices. Any notice, communication or payment required under this
Agreement shall be addressed as follows:
Client: Vendor:
Monroe County BOCC ClearTrack HR, LLC
1100 Simonton Street 19 Biltmore Drive
Suite 2-268 Huntsville, AL 35806
Key West, FL 33040 Attn: Contracting Department
Attn: Maddox-
natalie@monroecounty-fl.gov
8.6 In the event ClearTrack HR or the County institutes legal
proceedings related to this Agreement against the other party the prevailing party
in such proceedings shall be entitled to recover from the other party (in addition
to any damages or other relief granted as a result of such litigation) all costs and
expenses incurred therein, including reasonable fees and courts costs.
8.7 HIPAA and HITECH Compliance. ClearTrack HR and the County shall
comply with all federal and state laws and regulations governing the privacy and
security of health information, including without limitation, the Health Insurance
Portability and Accountability Act (HIPAA), Health Information Technology for
Economic and Clinical Health Act (HITECH), and their related regulations, and
shall remain in compliance with these laws and regulations, and any other
applicable laws, rules or regulations pertaining to the services, as they may be
amended from time to time. The parties shall execute whatever additional
documents or agreements may be necessary to comply with these laws and
regulations.
9.0 Provisions Required by 2 CFR part 200.
9.1 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 with
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CONTRACTOR 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
two (2) calendar notice and provide the CONTRACTOR with an opportunity
to cure the breach that has occurred. If the breach is not cured within 24 hours of
notice, 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, including the cost of corrective work. 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 recoup monies
paid under this Agreement, including the right to sue for breach of contract and
Ordinance, located at Section 2-721 et al. of the Monroe County Code.
9.2 Termination for Convenience. The COUNTY may terminate this Agreement
for convenience,
If the COUNTY terminates this agreement with the CONTRACTOR, COUNTY
shall pay CONTRACTOR the sum due the CONTRACTOR under this
agreement prior to date of termination.
9.3 Equal Employment Opportunity, No Discrimination. During the performance of this
Agreement, the CONTRACTOR agrees as follows:
1. The contractor will not discriminate against any employee or applicant for employment
because of race, color, religion, sex, sexual orientation, gender identity, or national
origin. The contractor will take affirmative action to ensure that applicants are
employed, and that employees are treated during employment, without regard to their
race, color, religion, sex, sexual orientation, gender identity, or national origin. Such
action shall include, but not be limited to the following: Employment, upgrading,
demotion, or transfer, recruitment or recruitment advertising; layoff or termination;
rates of pay or other forms of compensation; and selection for training, including
apprenticeship. The contractor agrees to post in conspicuous places, available to
employees and applicants for employment, notices to be provided by the contracting
officer setting forth the provisions of this nondiscrimination clause.
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2. The contractor will, in all solicitations or advertisements for employees placed by or
on behalf of the contractor, state that all qualified applicants will receive consideration
for employment without regard to race, color, religion, sex, sexual orientation, gender
identity, or national origin.
3. The contractor will not discharge or in any other manner discriminate against any
employee or applicant for employment because such employee or applicant has
inquired about, discussed, or disclosed the compensation of the employee or applicant
or another employee or applicant. This provision shall not apply to instances in which
an employee who has access to the compensation information of other employees or
applicants as a part of such employee's essential job functions discloses the
compensation of such other employees or applicants to individuals who do not
otherwise have access to such information, unless such disclosure is in response to a
formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or
action, including an investigation conducted by the employer, or is consistent with the
contractor's legal duty to furnish information.
4. The contractor will send to each labor union or representative of workers with which
it has a collective bargaining agreement or other contract or understanding, a notice to
be provided by the agency contracting officer, advising the labor union or workers'
representative of the contractor's commitments under section 202 of Executive Order
11246 of September 24, 1965, and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
5. The contractor will comply with all provisions of Executive Order 11246 of
September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary
of Labor.
6. The contractor will furnish all information and reports required by Executive Order
11246 of September 24, 1965, and by the rules, regulations, and orders of the
Secretary of Labor, or pursuant thereto, and will permit access to his books, records,
and accounts by the contracting agency and the Secretary of Labor for purposes of
investigation to ascertain compliance with such rules, regulations, and orders.
7. In the event of the contractor's non-compliance with the nondiscrimination clauses of
this contract or with any of such rules, regulations, or orders, this contract may be
canceled, terminated or suspended in whole or in part and the contractor may be
declared ineligible for further Government contracts in accordance with procedures
authorized in Executive Order 11246 of September 24, 1965, and such other sanctions
may be imposed and remedies invoked as provided in Executive Order 11246 of
September 24,
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1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise
provided by law.
9.4 OTHER FEDERAL CONTRACT REQUIREMENTS. The CONTRACTOR
and its subcontractors must follow the provisions as set forth in Appendix II to Part 200,
as amended, including but not limited to:
A. Contractor agrees to comply with all applicable standards, orders or regulations
issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water
Pollution Control Act as amended (33 U.S.C. 1251-1387) and will reports violations
to FEMA and the Regional Office of the Environmental Protection Agency (EPA).
B. Rights to Inventions Made Under a Contract or Agreement. If the Federal award
meets the definition of under 37 CFR §401.2 (a) and the recipient
or sub recipient wishes to enter into a contract with a small business firm or nonprofit
organization regarding the substitution of parties, assignment or performance of
recipient or sub recipient must comply with the requirements of 37 CFR Part 401,
implementing regulations issued by the awarding agency.
C. Debarment and Suspension (Executive Orders 12549 and 12689)A contract
award (see 2 CFR 180.220) must not be made to parties listed on the government wide
exclusions in the System for Award Management (SAM), in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986
otherwise excluded by agencies, as well as parties declared ineligible under statutory
or regulatory authority other than Executive Order 12549.
D. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)Contractors that apply or bid
for an award exceeding $100,000 must file the required certification. The certification
is attached to this Agreement as Exhibit D. Each tier certifies to the tier above that it
will not and has not used Federal appropriated funds to pay any person or organization
for influencing or attempting to influence an officer or employee of any agency, a
member of Congress, officer or employee of Congress, or an employee of a member
of Congress in connection with obtaining any Federal contract, grant or any other
award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non-
Federal funds that takes place in connection with obtaining any Federal
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award. Such disclosures are forwarded from tier to tier up to the non-Federal award.
10 days
following execution of this Agreement by the County.
Other Federal Requirements:
E. Americans with Disabilities Act of 1990 (ADA) The CONTRACTOR will
comply with all the requirements as imposed by the ADA, the regulations of the
Federal government issued thereunder, and the assurance by the CONTRACTOR
pursuant thereto.
F. Disadvantaged Business Enterprise (DBE) Policy and Obligation - It is the policy
of the COUNTY that as defined in 49 C.F.R. Part 26, as amended, shall have
the opportunity to participate in the performance of contracts financed in whole or in
part with COUNTY funds under this Agreement. The DBE requirements of
applicable federal and state laws and regulations apply to this Agreement. The
to participate in the performance of this Agreement. In this regard, all recipients and
contractors shall take all necessary and reasonable steps in accordance with
opportunity to compete for and perform contracts. The COUNTY and the
CONTRACTOR and subcontractors shall not discriminate on the basis of race, color,
national origin or sex in the award and performance of contracts, entered pursuant to
this Agreement.
G. The Contractor shall utilize the U.S. Department of Homeland E- Verify
system to verify the employment eligibility of all new employees hired by the
Contractor during the term of the Contract and shall expressly require any
subcontractors performing work or providing services pursuant to the Contract to
likewise utilize the U.S. Department of Homeland E- Verify system to verify
the employment eligibility of all new employees hired by the subcontractor during the
Contract term.
9.2 ClearTrack HR warrants that he/it has not employed, retained or otherwise had act
on his/its behalf any former County officer or employee in violation of Section 2 of Monroe
County Ordinance No. 10-1990 or any County officer or employee in violation of Section
3 of Monroe County Ordinance No. 10-1990.
For breach or violation of this provision the County may, in its discretion, terminate this
contract without liability and may also, in its discretion, deduct from the contract or
purchase price, or otherwise recover, the full amount of any fee, commission, percentage,
gift, or consideration paid to the former County officer or employee.
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9.3 The County and ClearTrack HR understand and agree that County officers and
employees are required to comply with the standards of conduct for public officers and
employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to,
compensation; misuse of public position, conflicting employment or contractual
Ethics), available at: https://www.monroecounty-fl.gov/210/Policies-Procedures.
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EXHIBIT A
FEE SCHEDULE
CLEARTRACK HR is providing rollover/open enrollment platform services on a continuing
basis. The fees shall be in the amounts set forth below.
$5.00 PEPM
Online Benefit Administration and
*5% Annual Escalator
Enrollment System
Based on current fee schedule
**Customized Programming/Scripting/ Reports
***EDI Files Based on current fee schedule
****ACA Service- Forms 1095C Based on current fee schedule
File format for custom data feeds is due (3) three weeks prior to open enrollment date.
*Annual Increase: The annual fees shall be in the amounts set forth above, and the pricing and
st
fees specified herein will increase by 5% on each annual anniversary (January 1) of the
agreement based on Effective Date.
**Customized programming must be mutually agreed upon in writing prior to the
commencement of any work. A defined Scope of Work and corresponding cost estimate shall
be executed for all custom data or reporting requests, as well as for the creation or modification
of carrier EDI files.
***New or Changes to Electronic Data Files
****Addition of ACA Services: In the event the parties agree to add ACA services to this Agreement, the
fees for such services shall be set forth in a written amendment mutually executed by the parties. The
applicable rates shall be established at the time of amendment by mutual agreement, and no fees shall apply
unless expressly documented in the amendment.
Monthly PEM charge will be billed to Client on first of each month with payment due by the
tenth. Invoice will be delivered via e-mail address provided for billing. Fees are subject to
change if additional services are requested by the client.
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EXHIBIT B
Approved by OMB
0348-0046
Disclosure of Lobbying Activities
Complete this form to disclose lobbying activities pursuant to 31
U.S.C. 1352 (See reverse for public burden disclosure)
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract _X_ a. initial filing
_X_ a.
X_ b. grant bid/offer/application b. material change
c. cooperative agreement
b. initial award
d. loan For material change
c. post-award
only: Year quarter
e. loan guarantee
Date of last report
f. loan insurance
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee,
X Prime Subawardee Enter Name and Address of Prime:
Tier , if Known:
N/A
Monroe County Board of County
Commissioners 1100 Simonton Street
Key West, FL 33040-3110
Congressional District, if known: FL26
Congressional District, if known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
U.S. Department of Justice
Office of Justice Programs
Bureau of Justice CFDA Number, if applicable: 16.738
Assistance
8. Federal Action Number, if known: 9. Award Amount, if known:
BJA-2018-13626 $ 13,982
10. a. Name and Address of Lobbying b. Individuals Performing Services (including
Registrant address if different from No. 10a)
(last name, first name, MI):
(if individual, last name, first name, MI):
N/A
N/A
11. Information requested through this form
Signature:
is authorized by title 31 U.S.C. section 1352.
This disclosure of lobbying activities is a
Print Name:
material representation of fact upon which
reliance was placed by the tier above when
Title:
this transaction was made or entered into.
This disclosure is required pursuant to 31
Telephone No.: Date:
U.S.C. 1352. This information will be reported
to the Congress semi-annually and will be
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available for public inspection. Any person
who fails to file the required disclosure shall
be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each
such failure.
Authorized for Local
Federal Use Only
Reproduction Standard
Form - LLL (Rev. 7-97)
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INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING
ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime
Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a
previous filing, pursuant to title 31
U.S.C. section 1352. The filing of a form is required for each payment or agreement to make
payment to any lobbying entity for influencing or attempting to influence an officer or employee
of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with a covered Federal action. Complete all items that apply
for both the initial filing and material change report. Refer to the implementing guidance published
by the Office of Management and Budget for additional information.
1.Identify the type of covered Federal action for which lobbying activity is and/or has
been secured to influence the outcome of a covered Federal action.
2.Identify the status of the covered Federal action.
3.Identify the appropriate classification of this report. If this is a followup report caused by
a material change to the information previously reported, enter the year and quarter in
which the change occurred. Enter the date of the last previously submitted report by this
reporting entity for this covered Federal action.
4.Enter the full name, address, city, State and zip code of the reporting entity. Include
Congressional District, if known. Check the appropriate classification of the reporting
entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the
tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards
include but are not limited to subcontracts, subgrants and contract awards under grants.
5.
name, address, city, State and zip code of the prime Federal recipient. Include
Congressional District, if known.
6.Enter the name of the federal agency making the award or loan commitment. Include
at least one organizational level below agency name, if known. For example,
Department of Transportation, United States Coast Guard.
7.Enter the Federal program name or description for the covered Federal action (item 1). If
known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants,
cooperative agreements, loans, and loan commitments.
8.Enter the most appropriate Federal identifying number available for the Federal action
identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB)
number; grant announcement number; the contract, grant, or loan award number; the
application/proposal control number assigned by the Federal agency). Included prefixes,
-DE-90-
9.For a covered Federal action where there has been an award or loan commitment by the
18
Federal agency, enter the Federal amount of the award/loan commitment for the prime
entity identified in item 4 or 5.
10.(a) Enter the full name, address, city, State and zip code of the lobbying registrant under
the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4
to influence the covered Federal action.
(b)Enter the full names of the individual(s) performing services, and include full address if different
from
10(a). Enter Last Name, First Name, and Middle Initial (MI).
11.The certifying official shall sign and date the form, print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a
collection of information unless it displays a valid OMB control Number. The valid OMB control
number for this information collection is OMB No. 0348-0046.
19
Public reporting burden for this collection of information is estimated to average 10 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget,
Paperwork Reduction Project (0348- 0046), Washington, DC 20503
20
EXHIBIT
Insurance
As a pre-requisite of the work and services governed, or the goods supplied under this contract
(including the pre-staging of personnel and material), the Contractor shall obtain, at his/her own
expense, insurance as specified in Attachment 1, which are made part of this contract. The
Contractor will ensure that the insurance obtained will extend protection to all Subcontractors
engaged by the Contractor. Alternatively, the Contractor may require all Subcontractors to obtain
insurance consistent with the attached schedules.
The Contractor will not be permitted to commence work governed by this contract (including
pre- staging of personnel and material) until satisfactory evidence of the required insurance
has been furnished to the County as specified below. Delays in the commencement of work,
resulting from the failure of the Contractor to provide satisfactory evidence of the required
insurance, shall not extend deadlines specified in this contract and any penalties and failure
to perform assessments shall be imposed as if the work commenced on the specified date
and time, except for the failure to provide satisfactory evidence.
The Contractor shall maintain the required insurance throughout the entire term of this contract
and any extensions specified in the attached schedules. Failure to comply with this provision
may result in the immediate suspension of all work until the required insurance has been
reinstated or replaced. Delays in the completion of work resulting from the failure of the
Contractor to maintain the required insurance shall not extend deadlines specified in this
contract and any penalties and failure to perform assessments shall be imposed as if the work
had not been suspended, except for the failure to maintain the required insurance.
The Contractor will be held responsible for all deductibles and self insured retentions that
may be contained in the Insurance policies.
The Contractor shall provide, to the County, as satisfactory evidence of the required insurance,
either:
Certificate of
Insurance or
A Certified copy of the actual insurance policy.
The County, at its sole option, has the right to request a certified copy of any or all insurance
policies required by this contract.
All insurance policies must specify that they are not subject to cancellation, non-renewal, material
change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given
to the County by the insurer.
The acceptance and/or approval of the insurance shall not be construed as relieving
the Contractor from any liability or obligation assumed under this contract or imposed by law.
The Monroe County Board of County Commissioners, its employees and officials will be
included as on all policies, except for
Any deviations from these General Insurance Requirements must be requested in writing on the
approved by Monroe County Risk Management Department.
ATTACHMENT 1
WORKERS COMPENSATION
Prior to the commencement of work governed by this contract, the Contractor will obtain
Compensation Insurance with limits sufficient to respond to applicable
Compensation state statutes and the requirements of Chapter 440, Florida Statutes.
In addition, the Contractor will obtain Liability Insurance with limits of not less
than:
$100,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy
limits
$100,000 Bodily Injury by Disease, each employee
Coverage will be maintained throughout the entire term of the contract.
Coverage will be provided by a company or companies authorized to transact business in the State
of Florida.
If the Contractor has been approved by the Department of Labor, as an authorized
self-insurer, the County may recognize and honor the status. The Contractor
may be required to submit a Letter of Authorization issued by the Department of Labor and a
Certificate of Insurance, providing details on the Contractor's Excess Insurance Program.
If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required.
In addition, the Contractor may be required to submit updated financial statements from the fund
upon request from the County.
GENERAL LIABILITY
Prior to the commencement of work governed by this contract, the Contractor will obtain
Commercial General Liability Insurance. Coverage will be maintained throughout the life of
the contract and include, as a minimum:
Premises Operations
Products and Completed Operations
Blanket Contractual Liability
Personal Injury Liability
The minimum limits acceptable is:
$500,000 Combined Single Limit (CSL)
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy,
its provisions should include coverage for claims filed on or after the effective date of this
contract. In addition, the period for which claims may be reported should extend for a minimum
of twelve
(12) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners will be named as Additional Insured on
all policies issued to satisfy the above requirements.
BUSINESS AUTOMOBILE LIABILITY
Recognizing that the work governed by this contract requires the use of vehicles, the Contractor,
prior to the commencement of work, shall obtain Business Automobile Liability Insurance.
Coverage will be maintained throughout the life of the contract and include, as a minimum, liability
coverage for:
Owned, Non-Owned, and Hired
Vehicles The minimum limits acceptable is:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable are:
$200,000 per Person
$300,000 per Occurrence
$100,000 Property Damage
The Monroe County Board of County Commissioners will be named as Additional Insured on
all policies issued to satisfy the above requirements.
CYBER LIABILITY
Prior to the commencement of work governed by this contract, the Contractor will obtain Cyber
Liability Insurance. Coverage will be maintained throughout the life of the contract and include
the following coverages:
Data Breach
Network Security Liability
Internet Media
Network Extortion
Regulatory Proceedings
PCI Fines and Costs
The minimum limit acceptable is:
$
EXHIBIT
(Required Additional State and Local Clauses)
The following clauses are added into the attached Agreement as if fully set forth therein:
1.F.S. 287.0582, F.S. and Monroe County Purchasing Policy (required for all
contracts for purchases of services or goods > 1 year):
performance and obligation to pay under this contract is contingent upon an
annual appropriation by the BOCC.
2.Public Entity Crime Statement (required for all procurement documents and
contracts by F.S. 287.133 and Monroe County Purchasing Policy): A person
or affiliate who has been placed on the convicted vendor list following a conviction
for public entity crime may not submit a bid on a contract to provide any goods or
services to a public entity, may not submit a bid on a contract with a public entity
for the construction or repair of a public building or public work, may not submit
bids on leases of real property to public entity, may not be awarded or perform
work as a CONTRACTOR, supplier, subcontractor, or CONTRACTOR under a
contract with any public entity, and may not transact business with any public entity
in excess of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the convicted
maintained by the Florida Department of Management Services, as defined in F.S.
287.133.
By entering in this Agreement, the vendor acknowledges that it has read the above
and states that neither the vendor nor any Affiliate has been placed on the
convicted vendor list within the last 36 months.
3.Scrutinized companies (F.S. 287.135):
a.This contract is terminable at the option of the awarding body if the company is
found to have been placed on the Scrutinized Companies that Boycott Israel List
as that term is defined in F.S. 287.135 or is engaged in a boycott of Israel.
4.Human Trafficking (F.S. 787.06): Whenever a contract is executed, renewed, or
extended between a nongovernmental entity and a governmental entity, the
nongovernmental entity must provide an affidavit signed by an officer or a
representative of the nongovernmental entity under penalty of perjury, attesting to
that the nongovernmental entity does not use coercion for labor or services. A copy
of the affidavit is attached.
Њ
5.Foreign Entities Affidavit (F.S. 287.138):
a.Beginning 1/1/2024, a governmental entity may not accept a bid or proposal from,
or enter into a contract with, an entity which would grant the entity access to
individual personal identifying information ("PII") unless the entity provides an
affidavit signed by an officer or representative under penalty of perjury attesting
that the entity does not meet any of the criteria in F.S. 287.138(2)(a)-(c):
Entity owned by a country of concern (China, Russia, Iran, North
Korea, Venezuela, Syria)
Controlling interest by government of foreign country of concern;
Entity organized under the laws of or has principal place of business
in foreign country of concern.
b.Beginning 7/1/2025, a governmental entity cannot renew a contract with an entity
which would grant the access to PII unless the entity provides the affidavit.
c.Beginning 7/1/2025, a governmental entity cannot extend or renew a contract with
an entity meeting the above criteria if the contract would give access to PII to that
entity.
The affidavit is attached.
Ћ
AFFIDAVIT ATTESTING TO NONCOERCIVE CONDUCT
FOR LABOR OR SERVICES
Dmfbsusbdl!IS!MMD
Entity/Vendor Name: ____________________________________________________
93.232:465
Vendor FEIN: ___________________
Ifbuifs!NdGbsmboe-!DFP
(Name and Title)
2:!Cjmunpsf!Esjwf
Address: ______________________________________________________________
46917
IvoutwjmmfBM
City: _______________________ State: _________________ Zip: _______________
367.767.872:
Phone Number: ________________
indgbsmboeAdmfbsusbdlis/dpn
Email Address: _____________________________________
As a nongovernmental entity executing, renewing, or extending a contract with a
government entity, Vendor is required to provide an affidavit under penalty of perjury
attesting that Vendor does not use coercion for labor or services in accordance with
Section 787.06, Florida Statutes.
As defined in Section 787.06(2)(a), coercion means:
1.Using or threating to use physical force against any person;
2.Restraining, isolating, or confining or threating to restrain, isolate, or confine
any person without lawful authority and against her or his will;
3.Using lending or other credit methods to establish a debt by any person when
labor or services are pledged as a security for the debt, if the value of the labor
or services as reasonably assessed is not applied toward the liquidation of the
debt, the length and nature of the labor or service are not respectively limited
and defined;
4.Destroying, concealing, removing, confiscating, withholding, or possessing any
actual or purported passport, visa, or other immigration document, or any other
actual or purported government identification document, of any person;
5.Causing or threating to cause financial harm to any person;
6.Enticing or luring any person by fraud or deceit; or
7.Providing a controlled substance as outlined in Schedule I or Schedule II of
Section 893.03 to any person for the purpose of exploitation of that person.
As a person authorized to sign on behalf of Vendor, I certify under penalties of perjury
that Vendor does not use coercion for labor or services in accordance with Section
787.06. Additionally, Vendor has reviewed Section 787.06, Florida Statutes, and agrees
to abide by same.
Ifbuifs!NdGbsmboe
Certified By: __________________________________________________________,
who is authorized to sign on behalf of the above referenced company.
Authorized Signature:____________________________________
Print Name:____________________________________________Ifbuifs!NdGbsmboe
DFP
Title:__________________________________________________
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