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Item Q03
BOARD OF COUNTY COMMISSIONERS COUNTY of MONROE Mayor Michelle Lincoln,District 2 The Florida. Keys Mayor Pro Tem David Rice,District 4 p Craig Cates,District I James K. Scholl,District 3 Holly Merrill Raschein,District 5 Regular Meeting May 20, 2026 Agenda Item Number: Q3 26-7020 BULK ITEM: Yes DEPARTMENT: Community Services TIME APPROXIMATE: N/A STAFF CONTACT: Cathy Crane AGENDA ITEM WORDING: Ratification of Amendment No. 1 to the Agreement between Tranquility Bay Adult Day Care of Marathon, Corp., and Monroe County Board of County Commissioners (Monroe County Community Services) to exercise the first (1 st) of four (4) renewals commencing on 07/01/2026 through 06/30/2027, and to incorporate certain state-mandated language; funding is through apportioned Title IIIE funding pursuant to the Older American Act and the corresponding grant agreement/amendment (OAA Contract#AA2659 and Amendment#001). ITEM BACKGROUND: Monroe County Community Services (Social Services)receives grant funding from the Alliance for Aging, Inc. (the state-designated Area Agency on Aging for PSA-11, inclusive of Monroe County) to provide Facility-Based Respite, Caregiver, and Adult Day Care Services for elderly and/or disabled residents of Monroe County. Tranquility Bay Adult Day Care of Marathon, Corp. ("TB of Marathon"), is the only qualified and licensed entity that can provide Facility Based Respite and Adult Day Care services in the Lower and Middle Keys. Commencing on July 1, 2025, and pursuant to the original agreement between the parties, TB of Marathon has and continues to deliver these services and addresses the critical needs of this population. Services are provided on-site, with transportation arranged by the family or a designated provider. Amendment No. 1 to the original agreement exercises the first of four available one-year renewal options, extending the Agreement as of July 1, 2026, through June 30, 2027. The Amendment No. 1 also incorporates two additional state-mandated provision: (1) a requirement to comply with Chapters 39 and 415,Florida Statutes,regarding mandatory reporting of suspected abuse,neglect, or exploitation of children, elderly persons, or individuals with disabilities; and (2) a requirement to comply with the newly enacted Section 287.139, Florida Statutes, relating to the prohibition on the use of County funds for diversity, equity, and inclusion activities, as such term ("diversity, equity, and inclusion") is defined in the newly enacted Section 125.595(1)(b), Florida Statutes (See Chapter 2026- 043, Laws of Florida). Funding for services under the Agreement is provided through an apportioned allocation of Title IIIE funding pursuant to the Older American Act, administered by Alliance for Aging, Inc. via Contract #AA2659, as may be amended from time to time, for Adult Day Care and Facility-Based Respite services. Currently, the estimated available grant funds for these services across all service providers in Monroe County amounts to approximately $52,000.00; however, the expenditures under the Agreement with TB of Marathon are incurred on an as-needed/as-eligible basis. Historically, the annual value of the Agreement with TB of Marathon has not exceeded the value of$34,999.99, which is the authorized purchasing threshold for Directors pursuant to the Monroe County Purchasing Policy Manual. In addition, the County shall provide the required 10%match contribution through the County's General Fund based upon the final grant funding allocation. Funding amounts are estimations only and remain subject to increase, reduction, reallocation, or deobligation based upon grant funding availability,program needs,provider capacity, and amendments to Contract#AA2659. Pursuant to BOCC Resolution Nos. 233-2025 and 064-2015, the Director of Community Services is authorized to execute amendments or modifications to BOCC approved grant agreements that require no matching funds on behalf of the County, as well as sign vendor agreements or MOUs within the limits set forth in the purchasing policy (value of$34,999.99), however after such execution, the agreement or MOU must be ratified by the BOCC. Consistent therewith, this item seeks BOCC ratification of Amendment No. 1 to the Agreement with TB of Marathon. PREVIOUS RELEVANT BOCC ACTION: BOCC approved the original agreement(Item# 02) on 10/15/2025, retroactively effective as of July 1, 2025. INSURANCE REQUIRED: Yes. CONTRACT/AGREEMENT CHANGES: Renewal of Agreement for one year(07/01/2026- 06/30/2027) and to incorporate the required language to comply with Florida law. STAFF RECOMMENDATION: Approval. DOCUMENTATION: TB Marathon Amendment No I_lgl Apprd Prtl Executed Tranquility Bay Marathon 12962558- Renewal Acknowledgement 1-15-26 License (AHCA) 12024-11926 COI exempt M TB Marathon COI TB Marathon COI auto Item 02_Original Agreement with Tranquility Bay Adult Day Care of Marathon, Corp. FINANCIAL IMPACT: Effective Date: 07/01/2026 Expiration Date: 06/30/2027 Total Dollar Value of Contract: Not to exceed$52,000; that is the current total apportioned Title IIIE funding under OAA Contract#AA2659 (and Amendment#001, thereto) for Adult Day Care and Facility-Based Respite services for all of Monroe County, which is subject to adjustment through future amendments. Total Cost to County: Not to exceed $5,200; which is the current overall County 10% match obligation per OAA Contract#AA2659 (and Amendment#001, thereto). Current Year Portion: $0 or estimated amount not to exceed $34,999.99. Budgeted: Yes Source of Funds: OAA Grant Funds and County General Fund (10% Match Only) CPI: N/A Indirect Costs: $0.00 Estimated Ongoing Costs Not Included in above dollar amounts: $0.00 Revenue Producing: No Revenue Producing: No Grant: OAA Contract#AA2659; Amendment#001, and any subsequent amendments County Match: 10% Insurance Required: Yes AMENDMENT NO. I TO THE AGREEMENT BETWEEN MONROE COUNTY,FL and TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP. for In Facility Respite and Adult Day Care Services This Amendment No. I to the agreement between MONROE COUNTY, FLORIDA, and TRANQUILITY BAY ADULT DAY CARE OF MARATHON, CORP., for In Facility Respite and Adult Day Care Services dated July 1, 2025 ("Original Agreement"), is made this day of ' 2026 by and between Monroe County, Florida, acting through the Director of Community Services Department and ratified by Monroe County Board of County Commissioners (the "County"), and Tranquility Bay Adult Day Care of Marathon, Corp. (the "Tranquility Bay Marathon") both of whom agree as follows: W I T N E S S E T H: WHEREAS, Monroe County and Tranquility Bay Marathon entered into the Original Agreement for a period of time starting on July 1, 2025 and ending at 11:59pm on June 30, 2026, with the option to renew for four (4) one (I)-year renewals under the same terms and conditions; and WHEREAS, the parties desire to amend the agreement by adding two new terms and conditions as further set forth herein, and exercise the first (I') of four (4) renewals under those amended terms and conditions; and WHEREAS, the first provision that the parties desire to add to the agreement is the requirement to comply with Chapters 39 and 415, Fla. Stat., regarding mandatory reporting obligations for suspected abuse, neglect, or exploitation of a child, aged person, or person with disabilities; and WHEREAS, the second provision that the parties desire to add to the agreement is the requirement to comply with Section 287.139, Fla. Stat., relating to prohibited use of County funds for diversity, equity, and inclusion activities as same is defined in Section 125.595, Fla. Stat.; and WHEREAS, the parties through this amendment will exercise the first (I') of four (4) renewals with the new terms and conditions becoming effective immediately upon mutual signing of this amendment, and the new renewal term commencing on July 1, 2026 and extending through June 30,2027. NOW,THEREFORE,based on the promises and covenants herein contained, and mutual consideration deemed sufficient, the parties agree as follows: 1. The recitations referred to above are true and correct, and are hereby adopted and incorporated as if set forth in full.The parties seek to describe changes in the existing agreement in Page 1 of 3 following ways: 1) words in strike through type are deletions from existing text, 2) words in underline type are additions to existing text, and 3)asterisks(***) indicate existing text not shown, 2. The parties desire to amend the Original Agreement, specifically to add Section 43, "Florida Abuse Hotline," to read as follows: 43)Florida Abuse Hotline Contractor must immediately report any knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number 0-800-96-ABUSE or 1-800-962-2873), as,reguired by Chapters 39 and 415, Fla. Stat., as may be amended. 3. The parties desire to amend the Original Agreement, specifically to add Section 44, "Prohibited Activities regarding Diversity, Equity, and Inclusion,"to read as follows: 44) Prohibited Activities regarding Diversity, Equity, and Inclusion Effective January 1, 2027, in accordance with Section 287.139, Fla. Stat., as a condition precedent to any award of a contract or grant by the County,the Contractor must certify, and by signing this Agreement hereby certifies, that the Contractor does not and will not use county funds to require its employees,contractors,volunteers,vendors,or agents to ascribe to, study,or be instructed using materialsrelating to diversity, equiLy, and inclusion as defined in Section 125.5950), Fla. Stat., as may be amended from time to time. 4. The parties hereby exercise the first(1") of four(4) renewals. The renewal term will commence as of July 1, 2026 and extend through June 30, 2027. 5. This Amendment No. I will become effective immediately upon the later of the two signing dates between: the Director of Community Services Department (vested with authority to sign pursuant to BOCC Resolution Nos.233-2025 and 064-2015)and the Contractor's signing date. The Board of County Commissioners may ratify this amendment, and such effective date, at a following Commission meeting. 6. This agreement constitutes the entire understanding between the parties regarding this Amendment No. I to the agreement, and all other terms and conditions of the Original Agreement, not inconsistent herewith, shall remain in full force and effect, and are incorporated herein. [Signatures to follow] Page 2 of 3 IN WITNESS WHEREOF, the parties hereto have executed this Amendment No. I the day and year first above written. CONTRACTOR: TRANQUILITY BAY ADULT DAY CARE OF MARATHON, CORP. By: Si rrwrure Date 44�lt�0 Az/�,�s/ P 0 Print Name &Title STATE OF 0— COUNTY OF r1>4 The foregoing instrument was sworn to/affirmed and acknowledged before me by me ns of 03/physical presence or 0 online notarization, this 7-V day of A0*1C'I , 20 4, by 44,, A-ia, , President [or Authority Title] of TRANQUILITY BkY ADULT DAY CARE OF MARATHON,CORP., a Florida For profit Corporation. He/She is personally known to me/or has produced f (A--r1US1e--ED (type of identification)as identification. Signa 4 Notary Public YUMT ORMOA (P of Notary Public) BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY,FLORIDA Digitally signed by Cathy Crane Signed By: Cathy Crane Date:2026.05.01 10:53:59-04'00' Cathy Crane, Director and VSO Date Monroe County Community Services Dept. *Vested with authority to sign pursuant to BOCC Resolution Nos. 233-2025 and 064-2015 Ratified By: Michelle Lincoln, Mayor (Seal) Attest: Kevin Madok, Clerk As Deputy Clerk Approved as to legal form &sufficiency: �Eve M. Lewis Eve M.Lewis, Assistant County Attorney Page 3 of 3 4KH ca ��4 RON DESANTIS y� GOVERNOR 40 U w SHEVAUN L. HARRIS ud SECRETARY r�OF FLO oV,. January 15, 2026 LORENA M SANTANA, ADMINISTRATOR TRANQUILITY BAY ADULT DAY CARE OF MARATHON CORD 11524 OVERSEAS HIGHWAY UNIT 3 MARATHON, FL 33050 Dear Administrator: This is to acknowledge receipt of your renewal application and fees. The survey results and recommendation must be received from the field office before a license can be issued. Should you require additional information,please feel free to contact me at (850) 412-4476 or email me at Son'aoBradwell L>ahcaom doridaAcon�. Sincerely, Sonja Bradwell Health Services & Facilities Consultant Assisted Living Unit Division of Health Quality Assurance 2727 Mahan Drive • MS#30 �T �rarF Facebook.com/AHCAFlorida Tallahassee, FL 32308 X.com/AHCA-Fl- AHCA.MyFlorida.com _ 5, CAD WCI.`" r „a r F p ~ ar r Co 0 v o F4 o �� 404 a w O Z • "' N o CS C N tn W.4 ° U en }� W O .° 120 � A' q� c CRC U :_ W ¢ 'a v Q 4 C7 POO a~ ' z CMm `� C uQ 0 .9 � Q 0 Ch a ca LTJ 4 r ��PNciAl o * sT94 OF}l,O��O� BLAISE INGOGLIA STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW NON-CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 9/10/2025 EXPIRATION DATE: 9/10/2027 PERSON: LORENA M SANTANA EMAIL: TRANQUILITYBAYADULTDAYCAREKEYM@GMAIL. COM FEIN: 820609905 BUSINESS NAME AND ADDRESS: TRANQUILITY BAY ADULT DAY CARE OF MARATHON, CORP 11524 OVERSEAS HIGHWAY MARATHON, FL 33050 This certificate of election to be exempt is NOT a license issued by the Department of Business and Professional Regulation. To determine if the certificate holder is required to have a license to perform work or to verify the license of the certificate holder, go to www.myfloridalicense.com. IMPORTANT:Pursuant to subsection 440.05(13),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to subsection 440.05(11),F.S.,Certificates of election to be exempt issued under subsection(3)apply only to the corporate officer named on the notice of election to be exempt.Pursuant to subsection 440.05(12),F.S.,notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT E02208117 QUESTIONS?(850)413-1609 RULE 69L-6.012, F.A.C. REVISED 08/2025 cou 00 Kevin Madok, CPA Clerk of the Circuit Court& Comptroller— Monroe County, Florida oz COVNSy DATE: November 03, 2025 TO: Cathy Crane, Director Community Services FROM: Brynn Morey, Deputy Clerk SUBJECT: October 15, 2025 BOCC Meeting The following item has been executed and added to the record: 02 Ratification of Agreement between Tranquility Bay Adult Day Care of Marathon, Corp. and Monroe County Board of County Commissioners/Monroe County Community Services-Social Services Department In-Home Program to provide facility-based respite and adult daycare services to elderly and disabled residents of Monroe County for the contract period of July 1, 2025,through June 30, 2026. 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 AGREEMENT between MONROE COUNTY,FL and TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP. for In Facility Respite and Adult Day Care Services THIS AGREEMENT is made and entered into this I st day of July 2025, by and between the Monroe County, Florida, a political subdivision of the State of Florida, with principal offices located at 1100 Simonton Street, Key West, FL 33040 (the "County") and Tranquility Bay Adult Day Care of Marathon, Corp., a Florida corporation with principal offices located at 11524 Overseas Highway, Unit 3, Marathon, FL 33050 (the "Contractor") to provide in facility respite and adult day care services as subcontracted pursuant to Contract Number AA 2529, as well as Contract Number KZ 2597, both between Monroe County and Alliance for Aging,Inc., and future grants agreement(s) that directly fund these services. WHEREAS, the County provides services to the elderly and disabled population residing throughout Monroe County; and. WHEREAS, the County is a provider of services and sub-recipient of federal funding through the Older American Act (OAA), and state Binding through the Alzheimer's Disease Initiative(ADI)in the delivery of services to these vulnerable populations; and WHEREAS, the County has provided services to assist vulnerable populations and other eligible individuals to remain in their homes and maintain independence for over 30 years; and WHEREAS, the County desires to contract for In Facility (Facility-Based) Respite and Adult Day Care Services to support and further such objectives; and WHEREAS, the Contractor is qualified and licensed, and desires to provide services for the benefit of Monroe County residents; and WHEREAS, currently, the Contractor is the sole provider of these services in the Lower and Middle Keys region; and WHEREAS, the County hereby and pursuant to the Monroe County Code of Ordinances and its adopted Purchasing Policy Manual,exercises its option to waives its competitive solicitation procedures and/or request for price quotes, and enters into this Agreement directly with Contractor for services and pricing attached hereto and incorporated herein as"Exhibit A;" and WHEREAS, the nature of the services and documentation created by Contractor include HIPAA-protected information, therefore this Agreement includes a HIPAA Business Associate Addendum that is attached hereto and incorporated herein as"Exhibit B;"and WHEREAS, additional forms required by the grants that fund the Agreement are attached hereto and incorporated herein as`'Composite Exhibit C;" and WHEREAS, the former agreement between the parties approved by the Board of County Commissioners on August 21, 2024 entitled, '*Tranquility Bay Adult Day Care Corp (Marathon)[sic] Agreement#TBMAR 24-25"is hereby superseded and deleted in its entirety, and Page I of 25 this Agreement is expressly made effective as of July 1, 2025, for an initial term of one (1)year (July 1, 2025 through June 30, 2026), with an option to renew for four(4) additional one (])-year intervals; and WHEREAS, the Board of County Commissioners of Monroe County,Florida,find and determine that entering into this Agreement is in the best interest of the County. 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, "Exhibit A", "Exhibit B," and "Composite Exhibit C," all are attached hereto and incorporated herein as if set forth in full. In the event of a conflict between the aforementioned documents, any duly executed amendment to this Agreement (in reverse numerical order) will control, followed by "Exhibit A,""Exhibit B,"and "Composite Exhibit C,"in that order. The parties expressly agree that the former agreement between the parties approved by the Board of County Commissioners on August 21, 2024 entitled, "Tranquility Bay Adult Day Care Corp (Marathon)[sic] Agreement #TBMAR 24-25" is hereby superseded and deleted in its entirety, and this Agreement is expressly made effective as of July 1,2025. 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 services,materials,and equipment necessary as required to perform all aspects of the work described in '`Exhibit A." b) Contractor must supervise its workforce 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 term 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. Proof of such licenses shall be submitted to the County upon execution of this Agreement, if not previously submitted to the County. d) Contractor must complete such forms as County deems necessary in furtherance of its grant award(s) from the state or federal government(s). The forms may include, but are not limited to: `Certification Regarding Debarments, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Federally Funded Transactions'. e) Contractor must comply with Contract Number AA 2529, as well as Contract Number KZ 2597, both between Monroe County and Alliance for Aging, Inc.,and any future grants agreement(s) that directly fund these services. The parties expressly adopt herein the terms and conditions of said contracts as they are an essential part of this transaction.in addition to the general terms and conditions set forth herein, Contractor agrees to comply with the following state-mandated requirements and acknowledges all of the obligations passed down to it as a result of said grant contracts, as a sub-recipient of state-and federal-funding, and agrees to complete any additional forms and provide further assurances and attestations, in order to meet any requirements imposed by the U.S. Government and/or State Government, as applicable. These may include,but are not limited to: 1. Contract Document requirements pursuant to Section 287.058,Florida Statutes,as Page 2 of 25 amended. 2. Background Screening requirements, as applicable. The Contractor shall comply with and ensure all sub-subcontractors are in compliance with the requirements of s. 430.0402, F.S., and Chapter 435, F.S., as amended, regarding background screening for all persons who meet the definition of a direct service provider and who are not exempt from the Department's level 2 background screening pursuant to s. 430.0402(2)-(3), F.S. The Contractor must also comply with any applicable rules promulgated by the Florida Department and the Agency for Health Care Administration regarding implementation of s. 430.0402, F.S., and Chapter 435, F.S. 3. Establishing Grievance and Complaint Procedures. The Contractor must comply with and ensure sub-subcontractor and/or vendors comply with the Minimum Guidelines for Recipient Grievance Procedures, Appendix D, of the Handbook (DOEA Programs & Services Handbook — Alliance for Aging), to address complaints regarding the termination, suspension or reduction of services, as required for receipt of funds. The Contractor must develop and implement complaint procedures to process and resolve client, dissatisfaction with services. Complaint procedures shall address the quality and timeliness of services, County and Contractor complaints, or any other advice related to complaints other than termination, suspension or reduction in services that require the grievance process as described in Appendix D, of the Handbook (DOEA Programs & Services Handbook — Alliance for Aging). The complaint procedures shall include notification to all clients of the complaint procedure and include tracking the date, nature of complaint, the determination of each complaint, and the follow-up with the client to ensure satisfaction with the resolution. 4. Subject to Auditing. The Contractor acknowledges that it may be subject to audit(s) as required by Section 215.97, Fla. Stat., and/or 2 CFR Part Section 200.86 and Section 200.93. Contractor agrees to comply with all requests by government- authorized auditors. 5. Rate Increase Thresholds requirements.Rates may only increase from one contract year to the next at a rate consistent with the annual rate of inflation in the Consumer Price Index(CPI)percentage change for all items as determined by the Bureau of Labor Statistics for the 12-months prior to the Department of Elder Affairs' required Area Plan submission date and as per the Alliance for Aging policy incorporated herein by reference. See htt1 s:://W✓ ,_blS.ga��j./��(��urts/�;aaq� uai..nIl a t)rl. undex/a�uor�aC,rodm o'�u�r a�,,,.inda��x b ;tir�a 4:anw iuto /k. In order to receive any rate increase, Contractor must submit a written request to receive a rate increase as described in the previous paragraph. The written request must be received no later than September 1 for the new rate beginning in the following OAA Grant contract year(January 1)and/or ADI Grant contract year(July 1). Should the requested rate increase exceed 5% of the current year's rate, the Contractor must provide: A detailed written justification describing the reason(s) for the interim rate adjustment. This explanation shall include a detailed assessment of potential organizational and client impact. The written justification shall provide sufficient detail for the Alliance for Aging to review, identifying the service or commodity component(s)that are increasing Contractor's costs; Supporting documentation for the written justification; A current rate and a requested rate unit cost methodology; A simplified Unit Cost Methodology. Note: The parties expressly agree that this subparagraph is subject to change at any time,without invalidating this Agreement, pursuant to grant requirements, and the granting agency's rules, regulations, policies, and procedures. Page 3 of 25 6. Support of Correctional Work Programs requirements. The Contractor shall procure products and/or services required to perform this contract in accordance with section 946.515, F.S. IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES WHICH ARE THE SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED FROM THE CORPORATION IDENTIFIED UNDER CHAPTER 946, F.S., IN THE SAME MANNER AND UNDER THE SAME PROCEDURES SET FORTH IN SECTION 946.515(2) AND (4), F.S.; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE SUBSTITUTED FOR THIS AGENCY INSOFAR AS DEALINGS WITH SUCH CORPORATION ARE CONCERNED. 7. The PUR 1000 Form is hereby incorporated by reference and available at: lvd�Ir�//�vvM.,�uuyll�b�;�d ��;nu/alp�ar/r cba/1 11Dry 1"I_Tll�d(1(1(�...1ri� ;`. In the event of any conflict between the P1JR 1000 Form and any terms or conditions of any contract or agreement terms or conditions the contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in the PUR t000 Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence. 3) Contract.Amount Contractor will perform contract requirements with pricing pursuant to "Exhibit A." 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 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 expire or 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 This Agreement is expressly made effective as of July 1, 2025, for an initial term of one (1)year(starting on July 1,2025 and ending on June 30,2026). The parties may renew this Agreement for four(4)additional one(1)-year intervals. The BOCC hereby authorizes the County Administrator to execute such renewal administratively and without formal BOCC approval pursuant to the authority expressly provided herein and consistent with the County's Purchasing Policy Manual, as may be amended from time to time. Page 4 of 25 6) Contract Extension Beyond the Term In the event services are scheduled to end because of the expiration of this Agreement,the Contractor must continue the service upon the request of the County Administrator. The extension period will not extend for more than ninety(90)days beyond the expiration date of the existing contract. The Contractor will be compensated for the service at the rate(s) in effect when the County invokes this extension clause. 7) 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 rcndcred under this Agrcerne;nt 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. 8) 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 nor may the Contractor assign any monies due or to become due to him or her,without the previous written consent. 9) 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 Page 5 of 25 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 ninety (90) 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. 10) Remedies a) Damages 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. b) Correction If, in the judgment of the County, work provided by the Contractor does not conform to the requirement;of this Agreement,the County reserves the right to require that the Contractor correct all deficiencies in the work to bring the work into conformance without additional cost to the County, and / or replace any personnel who fail to perform is accordance with the requirements of this Agreement.The County is the sole judge of non-conformance under this paragraph. 11) 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 minimum, and any unique integration requirements of the County's network and information technology systems. 12) Insurance Requirements Contractor shall obtain and maintain at its own expense the insurance coverages listed within this paragraph prior to commencing service under this Agreement. All insurance requirements provided for in this Agreement shall be subject to annual review. Depending on the extent of contractual obligations incurred by the Contractor, the below insurances will be required. insurances can be altered via written waiver by County's Risk Manager, if required.The Contractor must keep in full force and effect the insurance described during the term of this Agreement. if the insurance policies originally purchased that meet the requirements are canceled, terminated, or reduced in coverage, then the Contractor must Page 6 of 25 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) WORKERS COMPENSATION AND EMPLOYER'S LIABILTIY INSURANCE. Where applicable, coverage to apply for all employees at the minimum statutory limits as required by Florida Law, and Employee's Liability coverage in the amount of S100,000.00 bodily injury by accident, S500,000.0 bodily injury by disease, policy limits, and S100,000.00 bodily injury by disease, each employee. b) COMPREHENSIVE AUTOMOBILE VEHICLE LIABILITY INSURANCE. Motor vehicle liability insurance, including applicable no-fault coverage, with limits of liability of not less than $300,000.00 per occurrence, combined single limit for Bodily Injury Liability and Property Damage Liability. If single limits are provided, the minimum acceptable limits are 850,000.00 per person, $100,000.00 per occurrence, and. S27,000.00 property datnage. Coverage shall include all owned vehicles, all non-owned vehicles, and all hired vehicles. c) COMMERC'IAL GENERAL LIABILITY. Commercial general liability coverage with limits of liability of not less than S300,000.00 per occurrence combined single limit for Bodily Injury Liability and Property Damage Liability. Such coverage must include, as a minimum: Premises Operations, Products and Completed Operations, Blanket Contractual Liability, and Personal Injury Liability. 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. d) 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. 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. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, 1100 SIMONTON STREET, KEY WEST, FLORIDA 33040, MUST BE NAMED AS ADDITIONAL INSURED AND CERTIFICATE HOLDER ONALL POLICIES EXCEPT WORKER'S COMPENSATION. In the event that the Contractor subcontracts any or all of the work in this project 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. 13) 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 Page 7 of 25 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 parry 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 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) Nothing contained lrcrein 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. Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this Agreement, this section will survive the expiration of the term of this Agreement or any earlier termination of this Agreement. 14) 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. 15) 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." 16) 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) Page 8 of 25 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. 17) 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 parry 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 ofthis 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. 18) 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. 19) Prompt Disclosure of Litigation/Investigations/Arbitration/Admin. 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 Page 9 of 25 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. 20) 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 'Tfd .��i �f rV bel M0 Ir k Monroe County CaraC) C,t.Yc,-d i1 1100 Simonton Street,Room 2-205 11 q (ke✓c�ec15, f���r `�r _� �a e--,t�iaxw¢ �� � ��c 'x� Key West, FL 33040 Email: TYaoc, a 0Ty - z1L ,r ��, a-,t),<� t'ecr lw".0,kA And (with copy to) Monroe County Attorney's Office 1111 12th Street, Suite 408 Key West, FL 33040 21) 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 custornary procedures required by the Circuit Court of Monroe County, Florida. 22) 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. 23) 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 tirne, Contractor must comply with all public records laws in accordance with Chapter 119, Florida Statutes. In accordance with state law,Contractor agrees to: Page 10 of 25 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 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. c) 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: P1.Jr113L1C� Ji(__'0 1�)5�.i)M 1N110F �" �1J�NTY,,,,, ,,,,,,,,,,,,,,,,,,,W,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,, ,,,,,,,,, ll�m �..V, OR PHONE: 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. 24) 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 six (6) after completion of the contract. Such records must be retained by Contractor for a minimum of six(6)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 Page I 1 of 25 transcriptions. The requirements set forth in this paragraph will survive the termination of this Agreement. 25) Third Party Beneficiaries Neither Contractor nor County intends to directly or substantially benefit a third party by this Agreement. Therefore, the Parties acknowledge that there are no third-party beneficiaries to this Agreement and that no third party is or will be entitled to assert a right or claim against either of them based upon this Agreement. 26) Uncontrollable Circumstances("Force Majeure") As used herein,"Force Majeure"means the occurrence of any event that prevents or delays the performance by either party of its obligations hereunder which are beyond the reasonable control of the non-performing party. Examples of"Force Majeure" include,but are not limited to, acts of God, natural disasters, or emergency governmental action. To invoke this paragraph, immediate written notice, consistent with the "Notice" provisions of this Agreement,must be sent by the non-performing party describing the circumstances constituting force majeure and proof that the non-performance or delay of performance is a direct and reasonable result of such cvent(s). Any claim for extension of time by Contractor pursuant to this paragraph will be made not more than Seventy-two (72) hours after the commencement of the delay. Otherwise, it shall be waived. The Contractor shall immediately report the termination of the cause for the delay within seventy-two: (72)hours after such termination. The County reserves its right to challenge the invocation by the Contractor within five(5)calendar days of receipt of said notice,in such case uninterrupted performance in required. However, in the event the invocation is accepted by the County, the Contractor must take all reasonable measures to mitigate any and all resulting damages, costs, delays, or disruptions to the Contractor's performance requirements under this Agreement. All obligations must resume when the circumstances of such event(s) have subsided, or other arrangements are made pursuant to a written amendment to this Agreement. 27) 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. 28) 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 Page 12 of 25 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." 29) Scrutinized Companies &Countries of Concern per F.S.287.135,215.473,& 287.138 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 consistdnt 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 297.135, 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 of this Agreement and may result in administrative sanctions and penalties by the Office of the Attorney General of the State of Florida. TRANQUILITY BAY ADULT DAY CARE OF MARATHON, CORP. 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: 401-e n k Title: VCep rr w5 i ;kC 147- Signature: Date: 30) 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 Page 13 of 25 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. 31) 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. 1.681-1.683, and 1.685-1686), 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, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 14, Article 11, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; 11) The Pregnant Workers Fairness Act(PWFA)pursuant to 42 U.S.C. 2000gg et 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. 32) 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 subvendors/subconsultants/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 term of the contract is a condition of the contract with the County. By entering into this Agreement, the Contractor becomes obligated to comply with the provisions of Section 448.095, Florida Statutes, "Employment Eligibility," as amended Page 14 of 25 from time to time. This includes,but is not limited to,utilization of the E-Verify System to verify the work authorization status of all newly hired employees, and requiring all subcontractors to provide an affidavit to Contractor attesting that the subcontractor does not employ, contract with,or subcontract with, an unauthorized alien. Contractor agrees to maintain a copy of such affidavit for the duration of this Agreement. Failure to comply with this paragraph will result in the termination of this Agreement as provided in Section 448.095, Florida Statutes, as amended, and Contractor may not be awarded a public 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. 33) Prohibited Telecommunications Equipment Section 889(b)of the John S.McCain National Defense Authorization Act for Fiscal Year 2019,Pub.1-No. 1 15-232,and 2 C.F.R. §200.216 prohibit the head of an executive agency on or after Aug.1.3,2020,from obligating or expending grant,cooperative agreement,loan, or loan guarantee funds on certain telecommunications products or from certain entities for national security reasons. 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,or as critical technology as part of any system,as such terms are used in 48 CFR §§ 52.204-24 through 52.204-26. By executing this Agreement, Contractor represents and certifies that Contractor and its applicable subcontractors must not provide or use such covered telecommunications equipment, system, or services for any scope of work performed for the County for the entire duration of this Agreement.If Contractor is notified of any use or provisions of such 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 CFR § 52.204-25(d)(2)to County. 34) Antitrust Violations; Denial or Revocation under Section 287.137, Florida Statutes Pursuant to Section 287.137, Florida Statutes, as may be amended, a person or an affiliate who has been placed on the antitrust violator vendor list (electronically published and updated quarterly by the State of Florida)following a conviction or being held civilly liable for an antitrust violation may not submit a bid, proposal, or reply for any new contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply 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 list at the time of entering this Agreement. False certification under this paragraph or being subsequently added to that list will result in termination of this Agreement, at the option of the County consistent with Section 287.137, Florida Statutes, as amended. 35) Respect of Florida In accordance with Subsection 413.036(3), Fla. Stat., if a product or service required for the performance of this Agreement is on the procurement list established pursuant to Subsection 413.035(2), Fla. Stat., then this statement applies: IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES THAT ARE THE SUBJECT OF, OR REQUIRED TO CARRY OUT, THIS CONTRACT SHALL BE PURCHASED Page 15 of 25 FROM A NONPROFIT AGENCY FOR THE BLIND OR FOR THE SEVERELY HANDICAPPED THAT IS QUALIFIED PURSUANT TO CHAPTER 413, FLORIDA STATUTES,IN THE SAME MANNER AND UNDER THE SAME PROCEDURES SET FORTH IN SECTION 413.036(1) AND (2), FLORIDA STATUTES; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE SUBSTITUTED FOR THE STATE AGENCY INSOFAR AS DEALINGS WITH SUCH QUALIFIED NONPROFIT AGENCY ARE CONCERNED. Additional information about the designated nonprofit agency and the products it offers is available at:[Itu) /henrv� r„r�. tea cta::�l'di�.�uiala a::�ug. 36) Compliance with Mandatory Federal Clauses A. FEDERAL COMPLIANCE The Contractor and its Subcontractors must follow the provisions,as applicable,as set forth in 2 C.F.R. §§200.318-327 and Appendix 11 to 2 C.F.R.Part 200,as amended,and is bound by all applicable state and federal laws and regulations. By submitting a proposal, and if selected entering into a contract, Contractor agrees to comply with the above laws arld regulations, as well as 2 CFR Part 300, 45 CFR Part 75, and 45 CFR Part 92. This is an. acknowledgement that federal financial assistance will be used to fund all or a portion of the contract. The Contractor will comply with all applicable federal law, regulations, executive orders, Department of Health and Human Services policies, procedures, and directives. B. EQUAL EMPLOYMENT OPPORTUNITY 1. During the performance of this contract,the Contractor agrees as follows: (a)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 setting forth the provisions of this nondiscrimination clause. (b) 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. (c) 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 Page 16 of 25 information. (d) The Contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (e) 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. (f) The Contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (g) In the event of the Contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended ill whole or in. part and the contractor may be declared ineligible for further Government contracts or federally assisted construction 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, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (h) The Contractor will include the portion of the sentence immediately preceding paragraph(1) and the provisions of paragraphs (1)through (8)in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The Contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however,that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request the United States to enter- such litigation to protect the interests of the United States. 2. The Contractor further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work:Provided,that if the applicant so participating is a State or local government, the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate in work on or under the contract. 3. The Contractor agrees that it will assist and cooperate actively with the administering agency and the Secretary of Labor in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and the rules, regulations, and relevant orders of the Secretary of Labor, that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for- securing compliance. Page 17 of 25 4. The Contractor further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, Government contracts and federally assisted construction contracts pursuant to the Executive Order and will carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part II, Subpart D of the Executive Order.In addition,the Applicant agrees that if it fails or refuses to comply with these undertakings, the administering agency may take any or all of the following actions:Cancel,terminate,or suspend in whole or in part this grant (contract, loan,insurance,guarantee);refrain from extending any further assistance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant;and refer the case to the Department of Justice for appropriate legal proceedings." C. COMPLIANCE WITH:THE Ct)PELAND"ANTI-KICKBACK°'ACT The Contractor shall comply with 1.8 U.S.C.. § 874,40 U.S.C.. § 3145,and the requirements of 29 C.F.R. Part 3 as may be applicable, which are incorporated by reference into this contract. The Contractor or Subcontractor shall insert in any subcontracts the clause above and such other clauses as Department of health and Human Services may by appropriate instructions require, and a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The Contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all these contract clauses. A breach of the contract clauses above may be grounds for termination of the contract, and for debarment as a contractor and subcontractor as provided in 29 C.F.R. § 5.12. D. COMPLIANCE WITH CONTRACT WORK HOURS & SAFETY STANDARDS ACT 1. The contractor or subcontractor must maintain regular payrolls and other basic records during the course of the work and must preserve them for a period of three (3)years after all the work on the prime contract is completed for all laborers and mechanics, including guards and watch persons, working on the contract. Such records must contain the name; last known address,telephone number, and email address; and social security number of each such worker; each worker's correct classification(s)of work performed;hourly rates of wages paid; daily and weekly number of hours actually worked; deductions made; and actual wages paid. 2. Records to be maintained under this provision must be made available by the contractor or subcontractor for inspection,copying,or transcription by authorized representatives of the Department of Homeland Security,the Federal Emergency Management Agency, and the Department of Labor, and the contractor or subcontractor will permit such representatives to interview workers during working hours on the job." E. RIGHTS TO INVENTIONS MADE UNDER A CONTRACT OR AGREEMENT If the Federal award meets the definition of`'funding agreement"under 37 CFR§401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that "funding agreement," the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to inventions Made by Nonprofit Organizations and Small Business Firms Under Page 18 of 25 Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. F. CLEAN AIR ACT The contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act, as amended, 42 U.S.C. § 7401 et seq. The contractor agrees to report each violation to Monroe County and understands and agrees that Monroe County will, in turn,report each violation as required to assure notification to the the Alliance on Aging, Inc., Florida Department of Elder Affairs, U.S. Department of Health and Human Services, and the appropriate Environmental Protection Agency Regional Office. The contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with federal assistance provided by Department of Health and Human Services. G. FEDERAL,WATER POI,I.,UTION CONTROL,ACT The contractor agrees to comply with all applicable standards,orders,or regulations issued pursuant to the Federal.Water Pollution Control Act, as amended,33 U.S.C. § 1251 et seq. The contractor agrees to report each violation to Monroe County and understands and. agrees that Monroe County will, in turn, report each violation as required to assure notification to the Alliance on Aging, Inc., Florida Department of F,Ider Affairs, U.S. Department of health and human Services, and the appropriate Environmental Protection Agency Regional Office. The contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with federal assistance provided by U.S. Department of Health and Human Services. H. SUSPENSION AND DEBARMENT The awarded contract is a covered transaction for purposes of 2 C.F.R. Part 180 and 2 C.F.R.Part 3000.As such,the contractor is required to verify that none of the contractor's principals (defined at 2 C.F.R. § 180.995) or its affiliates (defined at 2 C.F.R. § 180.905) are excluded(defined at2C.F.R. § 180.940)or disqualified(defined at 2 C.F.R. § 180.935). The contractor must comply with 2 C.F.R. Part 180, subpart C and 2 C.F.R. Part 3000, subpart C, and must include a requirement to comply with these regulations in any lower tier covered transaction it enters. This certification is a material representation of fact relied upon by Monroe County.If it is later determined that the contractor did not comply with 2 C.F.R. Part 180, subpart C and 2 C.F.R. Part 3000, subpart C, in addition to remedies available to Monroe County, the Federal Government may pursue available remedies, including but not limited to suspension and/or debarment. The Contractor agrees to comply with the requirements of 2 C.F.R. Part 180, subpart C and 2 C.F.R. Part 3000, subpart C throughout the period of the contract. The Contractor further agrees to include a provision requiring such compliance in its lower tier covered transactions. 1. BYRD ANTI-LOBBYING AMENDMENT,AS AMENDED,31 U.S.C. § 1352 Contractors who enter a contract of more than$100,000 shall file the required certification. 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 shall also disclose any lobbying with non-federal funds that takes place in connection with obtaining any federal award. Such disclosures are forwarded from tier to tier up to the recipient who in turn will forward the certification(s)to the federal agency. Page 19 of 25 J. RECOVERED MATERIALS CLAUSE In the performance of the awarded contract, the Contractor shall make maximum use of products containing recovered materials that are EPA-designated items unless the product cannot be acquired: a) Competitively within a timeframe providing for compliance with the contract performance schedule; b) Meeting contract performance requirements; or c) At a reasonable price. Information about this requirement, along with the list of EPA- designated items, is available at Comprehensive Procurement Guideline (CPG) Program US EPA. The Contractor also agrees to comply with all other applicable requirements of Section 6002 of the Solid Waste Disposal Act. The Contactor should,to the greatest extent practicable and consistent with the law, purchase,acquire,or use products and services that can be reused, refurbished, or recycled; contain recycled content, are biobased, or are energy and water efficient; and are sustainable. K. DOMESTIC PREFERENCE FOR PROCUREMENTS The Contractor should, to the greatest extent practicable and consistent with law, provide a preference for the purchase, acquisition,or use of goods,products,or materials produced in the United. States. This includes, but is not Limited to, iron,aluini.num, steel,cement,and. other manufactured products. For purposes of this clause: Produced in the United States means,for iron and steel products,that all manufacturing processes,froin the initial melting stage through the application of coatings, occurred in the United States. L. ACCESS TO RECORDS The Contractor agrees to provide Monroe County, Alliance on Aging, Inc., the Florida Department of Elderly Affairs, the U.S. Department of Health and Human Services Contract Administrator, the Comptroller General of the United States, or any of their authorized representatives access to any books, documents, papers, and records of the Contractor which are directly pertinent to this contract for the purposes of making audits, examinations, excerpts, and transcriptions. The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed. The Contractor agrees to provide the Federal Grant Administrator or his/her authorized representatives access to the work sites pertaining to the work being completed under the contract. M. FEDERAL FALSE CLAIMS ACT The Contractor acknowledges that 31 U.S.C. Chap.38(Administrative Remedies for False Claims and Statements)applies to the contractor's actions pertaining to this contract. N. 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. Disadvantaged Business Enterprise (DBE) Policy and Obligation: it is the policy of the COUNTY that DBEs, 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 contract. The COUNTY and its awarded Contractor agree to ensure that DBE's have the opportunity to participate in the performance of any awarded contract.In this regard,all recipients and Contractors shall take all necessary and reasonable steps in accordance with applicable federal and state laws and regulations to ensure that the DBE's have the opportunity to compete for and perform contracts. The COUNTY and the Contractor and subcontractors shall not discriminate on Page 20 of 25 the basis of race, color, national origin or sex in the award and performance of contracts, entered pursuant to this Agreement. Contractor and subcontractors will comply with the Rehabilitation Act of 1973, Section 504, 29 U.S.C. 794, regarding nondiscrimination. O. 2 C.F.R. § 200.321 CONTRACTING WITH SMALL AND MINORITY BUSINESSES, WOMEN'S BUSINESS ENTERPRISES, AND LABOR SURPLUS AREA FIRMS l. If the awarded Contractor, with the funds authorized by this Agreement, seeks to procure goods or services, then, in accordance with 2 C.F.R. §200.321, the awarded Contractor shall take the following affirmative steps to assure that minority businesses, women's business enterprises, and labor surplus area firms are used whenever possible: i.Placing qualified small and minority businesses and women's business enterprises on solicitation lists; ii. Assuring that small and minority businesses,and women's business enterprises are solicited whenever they are potential sources; iii.Dividing total requirements,when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; iv. Establishing delivery schedules,where the requirement permits,which encourage participation by small and minority businesses, and women's business enterprises; v. Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of" the Department of Commerce; and vi. Requiring the prime contractor, if subcontracts are to be let, to take the affirmative steps listed in paragraphs i. through v. of this subparagraph. 2. The requirement outlined in subparagraph a. above, sometimes referred to as "socioeconomic contracting," does not impose an obligation to set aside either the solicitation or award of a contract to these types of firms,no provide any preference in awarding. Rather, the requirement only imposes an obligation to carry out and document the six affirmative steps identified above. The "socioeconomic contracting" requirement outlines the affirmative steps that the Contractor must take;the requirements do not preclude the Contractor from undertaking additional steps to involve small and minority businesses and women's business enterprises. The requirement to divide total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises, does not authorize the Contractor to break a single project down into smaller components in order to circumvent the micro-purchase or small purchase thresholds so as to utilize streamlined acquisition procedures (e.g. "project splitting"). P. ENERGY EFFICIENCY Contractor will comply with the Energy Policy and Conservation Act (P.L. 94-163; 42 U.S.C. 6201-6422) and with all mandatory standards and policies relating to energy efficiency and the provisions of the state Energy Conservation Plan adopted pursuant thereto. Q. STATEMENT OF NO CONFLICT Neither the COUNTY nor any of its Contractor or their subcontractors shall enter into any contract, subcontract or arrangement in connection with the services or any services included or planned to be included in the services in which any member, officer or employee of the COUNTY or the locality during tenure or for two(2)years thereafter has any interest, direct or indirect. If any such present or former member, officer or employee Page 21 of 25 involuntarily acquires or had acquired prior to the beginning of tenure any such interest, and if such interest is immediately disclosed to the COUNTY, the COUNTY may waive the prohibition contained in this paragraph provided that any such present member,officer or employee shall not participate in any action by the COUNTY or the locality relating to such contract, subcontract or arrangement. The COUNTY shall insert in all contracts entered into in connection with the service or any property included or planned to be included in any service, and shall require its Contractor to insert in each of their subcontracts, the following provision: "No member, officer or employee of the COUNTY or of the locality during his/her tenure or for two(2)years thereafter shall have any interest, direct or indirect,in this contract or the proceeds thereof." The provisions of this paragraph shall not be applicable to any agreement between the COUNTY and its fiscal depositories or to any agreement for utility services the rates for which are fixed or controlled by a governmental agency. R. ENVIRONMF,NTAI..,POLICY ACT OF 1969 Contractor will comply with: environmental standards which may be prescribed pursuant to the National Environmental. Policy Act of 1969, 42 U.S.C. 4321-4347; environmental standards which may be prescribed pursuant to the Safe Drinking Water Act of 1974, 42 U.S.C. 300f= 3001-27, regarding the protection of underground water sources; Executive Orders: EO 11514 (NEPA); EO 11738 (violating facilities); EO 11988 (Floodplain Management); EO 11990 (Wetlands); and EO 12898 (Environmental Justice); Coastal Barrier Resources Act of 1977, 16 U.S.C. 3501-3510;will assure project consistency with the approved State program developed under the Coastal Zone Management Act of 1972, 16 U.S.C. 1451- 14674; and comply with the Fish and Wildlife Coordination Act of 1958, 16 U.S.C. 661-668. (Wild and Scenic Rivers Act of 1968, 16 U.S.C. 1271-1287, related to protecting components or potential components of the national wild and scenic rivers system not applicable). S. COPYRIGHT CLAUSE-LICENSE&DELIVERY OF WORKS SUBJECT TO COPYRIGHT The Contractor grants to Monroe County, a paid-up, royalty-free, nonexclusive, irrevocable,worldwide license in data first produced in the performance of this contract to reproduce, publish, or otherwise use, including prepare derivative works, distribute copies to the public,and perform publicly and display publicly such data. For data required by the contract but not first produced in the performance of this contract, the Contractor will identify such data and grant to Monroe County or acquires on its behalf a license of the same scope as for data first produced in the performance of this contract. Data, as used herein, shall include any work subject to copyright under 17 U.S.C. § 102, for example, any written reports or literary works, software and/or source code, music, choreography, pictures or images, graphics, sculptures, videos, motion pictures or other audiovisual works, sound and/or video recordings, and architectural works. Upon or before the completion of this contract, the Contractor will deliver to Monroe County data first produced in the performance of this contract and data required by the contract but not first produced in the performance of this contract in formats acceptable by Monroe County. T. UNAUTHORIZED ALIENS The awarded Contractor shall not employ an unauthorized alien. Monroe County shall consider the employment of unauthorized aliens a violation of the Immigration and Nationality Act(8 U.S.C. 1324 a)and the Immigration Reform and Control Act of 1986(8 U.S.C. 1101). Such a violation shall be cause for unilateral cancellation of this contract by the Monroe County. Page 22 of 25 U. NON-PROFIT TAX EXEMPTION REVOKED If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization reporting requirements(filing a Form 990 or Form 990-N)and has its tax exempt status revoked for failing to comply with the filing requirements of the 2006 Pension Protection Act or for any other reason,the Provider must notify the Monroe County in writing within thirty (30)days of receiving the IRS notice of revocation. V. PROHIBITION ON TRAFFICKING IN PERSONS The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons. W. TRANSPARENCY ACT Unless exempt under 2 CFR Part 170.110(b), the Contractor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. X. SUPPORT TO PERSONS WHO ARE DEAF OR IIARD-OF-I TEARING 1. The Contractor shall comply with section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794, as implemented by 45 C.F.R. Part 84 (hereinafter referred to as Section 504) and the American with Disabilities Act of 1990, 42 U.S.C. 12131, as implemented by 28 C.F.R. Part 35 (hereinafter referred to as ADA). 2. The Contractor shall, if' it employs 15 or more employees, designate a Single- Point-of-Contact (one per firm)to ensure effective communication with deaf or hard-of hearing clients or companions and/or caregivers in accordance with Section 504 and the ADA. The name and contact information for the Contractor's Single-Point-of-Contact shall be furnished to Monroe County within 14 calendar days of the effective date of this requirement. 3. The Single-Point-of-Contact shall ensure that employees are aware of the requirements, roles&responsibilities, and contact points associated compliance with Section 504 and the ADA. Further,employees of the Contractor shall attest in writing that they are familiar with the requirement of Section 504 and the ADA. This attestation shall be maintained in the employee's personnel file. 4. The Contractor's Single-Point-of-Contact will ensure that conspicuous Notices which provide information about the availability of appropriate auxiliary aids and services at no-cost to person who are deaf or hard-of-hearing or companions and/or caregivers are posted near-where people enter or are admitted within the agent locations. See link for further information: 1utll:asu.bogt/additional services offices/office cjvn..l t;ll /iirAlviidai w1; Cii L�If�ilhl:y/�1a mat::;�rnal Ilu'afd1 lea uL..n,g. 5. The Contractor-shall document the customer's or companion's and/or caregiver's preferred method of communication and any requested auxiliary aids/services provided in the client's record. Documentation, with supporting justification, must also be made if any request was not honored. The Contractor shall submit Compliance Reports monthly, not later than the 1 st day of each month, to the Monroe County Contractor Manager. 37) Merger; Amendment 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. Page 23 of 25 38) Interpretation The titles and headings contained in this Agreement are for reference purposes only and will not in any way affect the meaning or interpretation of this Agreement. All personal pronouns used in this Agreement include the other gender, and the singular includes the plural, and vice versa,unless the context otherwise requires. Terms such as"herein"refer to this Agreement as a whole and not to any particular sentence,paragraph,or section 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. 39) 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 the party preparing same does not apply herein clue to the joint,contributions of both parties. 40) Severahility; 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-enforcement 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. 41) 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. 42) Counterparts and Multiple Originals. This Agreement may be executed in multiple originals, and may be executed in counterparts, each of which is hereby deemed to be an original, but all of which, taken together, constitutes one and the same agreement. [Signature to follow] Page 24 of 25 IN WITNESS WHEREOF,County and Contractor have executed this Agreement as of the date first written above. CONTRACTOR: TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP. BY. Signalbre 10 CC Print Name&Title STATE OF FLORIDA COUNTY OF ./!or) gy F_ The foregoing instrument was sworn to/affirmed and acknowledpd before me by means of R physical presence or 0 online notarization,this day of Sedf%-Ur 20-1:5- by LCV,un Sn(47nnq, V. P [Authority Title]of TRANQUILITY BAY ADULT DAY CARE OF MARATHON, CORP.,a Florida Corporation. He/She is personally known to me/or has produced J 535 -5,&3 i.c? of identification)as identification. yJ 'Si�gnatureVT4tary Public YmEromGA (Print&Stamp Com E X P I MY 3, 3 ic FLAP`: d OUNTY COMMISSIONERS OF)kONROE COUNTY FLORIUA: By Mayor James X.Scholl Digitally signed by Cathy Crane Cathy Crane. Date:2025.09.30 09:27:18-0,VOO' Attest: Kevin Madok,Clerk Signed By: Cathy Crane,Director and VSO Monroe County Community Services Dept. *Vested with authority to sign pursuant to �As�ftu Clerk r k BOCC Resolution Nos.233-2025 and 064-2015 INS Approved as to legal form&sufficiency: CD Wigotally slgmd by Jerd-Lee MadaUghlIn Jenl-Lee.MacLaughlinDm 2025=6 1007-00'00' C;.) CD Jeni-Lee MacLaughlin `7 —7r FT-1 C—) --r! Monroe County Assistant County Attorney CA) M Page 25 of 25 "EXHIBIT A" Scope of Services & Pricing l. Introduction. The Contractor shall provide In Facility Based Respite and Adult Day Care Services for the County, specifically in the Middle Keys area. The Contractor will perform authorized services at "Tranquility Bay Adult Day Care of Marathon" located at 11524 Overseas Highway, Unit #3, Marathon, FL 33050 for the unit rate(s) specified herein. Only such services as are specifically authorized by the County,and properly documented,will be reimbursable.The services will be provided by the Contractor in accordance with DOEA definitions/specifications, by agencies that hold necessary licenses,and by individual workers qualified to perform such services as detailed in the most recent version of the Florida Department of Elder Affairs(DOEA),Alliance for Aging, Inc. (PSA-11), and in accordance with the Agency for Health Care Administration (AHCA)guidelines as required and any subsequent modifications thereto.The Contractor warrants that it is authorized by law to engage in the performance of the activities herein described, subject to the tcrms and conditions set forth in the contract documents. The provider shall at all times exercise independent, professional judgment and shall assume professional responsibility for the services to be provided. 2. Services. Contractor shall provide services, and deliver reports to the County, using the following standards, as a minimum requirement: a. The Contractor must provide said services under these terms and conditions stated in Contract Number AA 2529, as well as Contract Number KZ 2597, both between Monroe County and Alliance for Aging,Inc., and any future grants agreement(s)that directly fund these services.The parties expressly adopt herein the terms and conditions of said contracts as if set forth in full. Such terms and conditions are an essential part of this transaction; services must comport with"Facility-based respite care"and"Adult Day Care" as defined by DOER Handbook, and AHCA guidelines as noted above and any subsequent revisions thereto. b. The Contractor- has, and shall maintain throughout the term of the contract, appropriate licenses and approvals required to conduct its business,and that it will at all times conduct its business activities in a reputable manner. Proof of such licenses and approvals shall be submitted to the County annually and upon request. c. The Contractor will in all cases provide service within the timeframes agreed upon in the Activity Plan, required by the most recent version of the Florida Department of Elder Affairs (DOEA) Handbook and AHCA guidelines as noted above and any subsequent revisions thereto. d. The Contractor shall maintain adequate staffing levels to provide the services required under the contract. e. The personnel shall not be employees of or have any contractual relationship with the County. f. All personnel engaged in performing services under the contract shall be fully qualified, Level II background screened and, if required, be authorized or permitted under State and local law to perform such services. 1 g. The Contractor must address all programmatic requirements, including eVerify, and must provide reports that demonstrate proof of compliance with initial and routine employee background screening procedures. h. The Contractor must provide reports on routine dates of review for all required forms essential to its service delivery, and dates that reports are shared with the County for grant oversight and management purposes. i. The Contractor must provide reports on follow-up actions taken for identified issues. j. The Contractor must provide updated calendar(s) of events within ten (10) days of any change,and written updates on activities offered on a reasonable time schedule as required by the County. 3. Reimbursement Payments. Payments to the Contractor for services rendered pursuant to the Agreement: a. RESPITE SERVICES- The Contractor shall provide services during the term of this contract for the unit rates as agreed upon and that follow: S10.00/unit/one hour for service. Pursuant to the DOER Handbook, and AHCA guidelines, one(1) hour of actual client attendance at the facility is one(1)unit of facility- based respite Actual client attendance is defined as the time between the client's arrival at the facility and the time of departure from the facility.Time spent in transit to the facility is not counted in the daily attendance. A daily attendance log with time in and time out shall be maintained. b. ADULT DAY CARE SERVICES- The Contractor shall provide services during the term of this contract for the unit rates as agreed upon and that follow: 1. Unit of Service: One day, which is equal to eight(8)hours. Partial days must be reported in quarter increments, as follows: Up to 2 hours= 0.25 Days 2-4 hours=0.5 Days 4-6 hours=0.75 Days 6-8 hours= 1 Day 2. One day of actual client attendance is defined as the time between the time of arrival at the day care center and the time of departure from the day care center. c. The number of units of services performed for each client must be pre-authorized by the County in accordance with the Activity Plan. d. The Contractor shall submit to the County a weekly invoice, with supporting documentation acceptable to the Clerk. Acceptability to the Clerk is based on generally accepted accounting principles and such laws, rules, and regulations as may govern the Clerk's disbursement of funds. e. Upon Monroe County's receipt and thorough review and processing of said invoices, Monroe County Clerk's Office shall submit payment to the Contractor in accordance with the Florida Prompt Payment Act. f. County's performance and obligation to pay under- this agreement, is contingent upon annual appropriation by the Board of County Commissioners. 4. Site Visits.The Contractor agrees to cooperate and assist Monroe County's and Alliance for Aging, Inc.'s authorized representatives in the coordination of site visits to the Contractor's facility(ies). These site visits will occur periodically, and authorized representatives will conduct random open file evaluations and/or other contract monitoring activities during the Contractor's normal business 2 hours. S. Medicaid Waiver Provider of Choice. The Contractor must maintain approval status from the Alliance for Aging,Inc., as a Medicaid Waiver Provider of Choice, if applicable. 3 "EXHIBIT B" HIPAA Business Associate Addendum 1. PREAMBLE AND DEFINITIONS. 1.1 Pursuant to the Health Insurance Portability and Accountability Act of 1996, as amended ("HIPAA"), Monroe County, a political subdivision of the State of Florida, through its Board of County Commissioners, (the"County"), and Tranquility Bay Adult Day Care of Marathon, Corp., ("Business Associate"), agree to this Business Associate Addendum ("BAA") as of the effective date of the underlying agreement between the parties (the "Effective Date")that addresses the HIPAA requirements with respect to "business associates," as defined under the privacy, security, breach notification, and enforcement rules at 45 C.F.R. Part 160 and Part 164 ("HIPAA Rules"). A reference in this BAA to a section in the HIPAA Rules means the section as in effect or as amended. 1.2 This BAA is intended to ensure that Business Associate will establish and implement appropriate safeguards for the Protected Ilealth Information ("PHI") (as defined under the IIIPAA Rules) that Business Associate may receive, create, maintain, use, or disclose in connection with the functions,activities, and services that Business Associate performs for Covered.Entity. The functions, activities, and services that Business Associate performs for Covered Entity are defined in AGREEMENT between MONROE COUNTY, FL and TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP., for In Facility Respite and Adult Day Care Services(the "Underlying Agreement"). 1.3 Pursuant to changes required under the Health Information Technology for Economic and Clinical Health Act of 2009 (the "HITECH Act") and under the American Recovery and Reinvestment Act of2009("ARRA"),this BAA also reflects federal breach notification requirements imposed on Business Associate when "Unsecured PHI" (as defined under the HIPAA Rules) is acquired by an unauthorized party, and the expanded privacy and security provisions imposed on business associates. 1.4 Unless the context clearly indicates otherwise, the following terms in this BAA shall have the same meaning as those terms in the HIPAA Rules: Breach, Data Aggregation, Designated Record Set,disclosure,Electronic Media,Electronic Protected Health information(ePHI),Health Care Operations, individual, Minimum Necessary, Notice of Privacy Practices, Required By Law, Secretary, Security Incident, Subcontractor,Unsecured PHI, and use. 1.5 A reference in this BAA to the Privacy Rule means the Privacy Rule, in conformity with the regulations at 45 C.F.R. Parts 160-164 (the "Privacy Rule") as interpreted under applicable regulations and guidance of general application published by HHS, including all amendments thereto for which compliance is required, as amended by the HITECH Act,ARRA, and the HIPAA Rules. 2. GENERAL OBLIGATIONS OF BUSINESS ASSOCIATE. 2.1 Business Associate agrees not to use or disclose PHI,other than as permitted or required by this BAA or as Required By Law,or if such use or disclosure does not otherwise cause a Breach of Unsecured PHI. 2.2 Business Associate agrees to use appropriate safeguards, and comply with Subpart C of 45 C.F.R.Part 164 with respect to ePHI,to prevent use or disclosure of PHI other than as provided for by the BAA. 2.3 Business Associate agrees to mitigate,to the extent practicable, any harmful effect that is known to Business Associate as a result of a use or disclosure of PHI by Business Associate in Page 1 of 6 violation of this BAA's requirements or that would otherwise cause a Breach of Unsecured PHI. Page 2 of 6 2.4 The Business Associate agrees to the following breach notification requirements: (a) Business Associate agrees to provide notification of any Breach of Unsecured PHI of which it becomes aware, as required under 45 C.F.R. § 164.410, and any Security Incident of which it becomes aware, in violation of this BAA to individuals, the media (as defined under the HITECH Act), the Secretary, and/or any other parties as required under HIPAA,the HITECH Act,ARRA,and the HIPAA Rules,subject to the prior review and written approval by Covered Entity of the content of such notification. (b) In the event of Business Associate's use or disclosure of Unsecured PHI in violation of HIPAA, the HITECH Act, or ARRA, Business Associate bears the burden of demonstrating that notice as required under this Section 2.4 was made, including evidence demonstrating the necessity of any delay,or that the use or disclosure did not constitute a Breach of Unsecured PHI. 2.5 Business Associate agrees, in accordance with 45 C.F.R. §§ 164.502(e)(1)(ii) and 164.308(b)(2), if applicable, to require that any Subcontractors that create, receive, maintain, or transmit PHI on behalf of the Business Associate agree to the same restrictions, conditions, and. requirements that apply to the Business Associate with respect to such information. 2.6 Business Associate agrees to make available PHI in a Designated Record Set to the Covered Entity as necessary to satisfy Covered Entity's obligations under 45 C.F.R. § 164.524. (a) Business Associate agrees to comply with an individual's request to restrict the disclosure of their personal PHI in a manner consistent with 45 C.F.R. § 164.522, except where such use, disclosure, or request is required or permitted under applicable law. (b) Business Associate agrees to charge fees related to providing individuals access to their PHI in accordance with 45 C.F.R. § 164.524(c)(4). (c) Business Associate agrees that when requesting, using, or disclosing PHI in accordance with 45 C.F.R. § 164.502(b)(1)that such request, use, or disclosure shall be to the minimum extent necessary, including the use of a "limited data set" as defined in 45 C.F.R. § 164.514(e)(2), to accomplish the intended purpose of such request, use, or disclosure, as interpreted under related guidance issued by the Secretary from time to time. 2.7 Business Associate agrees to make any amendments to PHI in a Designated Record Set as directed or agreed to by the Covered Entity pursuant to 45 C.F.R. § 164.526, or to take other measures as necessary to satisfy Covered Entity's obligations under 45 C.F.R. § 164.526. 2.8 Business Associate agrees to maintain and make available the information required to provide an accounting of disclosures to the Covered Entity as necessary to satisfy Covered Entity's obligations under 45 C.F.R. § 164.528. 2.9 Business Associate agrees to make its internal practices, books, and records, including policies and procedures regarding PHI, relating to the use and disclosure of PHI and Breach of any Unsecured PHI received from Covered Entity, or created or received by the Business Associate on behalf of Covered Entity, available to Covered Entity (or the Secretary) for the purpose of Covered Entity or the Secretary determining compliance with the Privacy Rule(as defined in Section 8). 2.10 To the extent that Business Associate is to carry out one or more of Covered Entity's obligation(s) under Subpart E of 45 C.F.R. Part 164, Business Associate agrees to comply with the requirements of Subpart E that apply to the Covered Entity in the performance of such obligation(s). Page 3 of 6 2.1 1 Business Associate agrees to account for the following disclosures: (a) Business Associate agrees to maintain and document disclosures of PHI and Breaches of Unsecured PHI and any information relating to the disclosure of PHI and Breach of Unsecured PHI in a manner as would be required for Covered Entity to respond to a request by an individual or the Secretary for an accounting of PHI disclosures and Breaches of Unsecured PHI. (b) Business Associate agrees to provide to Covered Entity, or to an individual at Covered Entity's request, information collected in accordance with this Section 2.11, to permit Covered Entity to respond to a request by an individual or the Secretary for an accounting of PHI disclosures and Breaches of Unsecured PHI. (c) Business Associate agrees to account for any disclosure of PHI used or maintained as an Electronic Health Record (as defined in Section 5) ("EHR") in a manner consistent with 45 C.F.R. § 164.528 and related guidance issued by the Secretary from time to time; provided that an individual shall have the right to receive an accounting of disclosures of F1HR by the Business Associate made on behalf of the Covered Entity only during the three years prior to the date on which the accounting is requested from. Covered Entity or directly from the Business Associate,whichever is later. (d) In the case of an EHR that the Business Associate acquired on behalf of the Covered Entity as of January 1,2009,paragraph(c)above shall apply to disclosures with respect to PHI made by the Business Associate from such EHR on or after January 1, 2014. In the case of an EHR that the Business Associate acquires on behalf of the Covered Entity after January 1, 2009, paragraph(c) above shall apply to disclosures with respect to PHI made by the Business Associate from such EHR on or after the later of January 1,2011, or the date that it acquires the EHR. 2.12 Business Associate agrees to comply with the "Prohibition on Sale of Electronic Health Records or Protected Health information," as provided in Section I3405(d) of Subtitle D (Privacy) of ARRA, and the "Conditions on Certain Contacts as Part of Health Care Operations," as provided in Section 13406 of Subtitle D (Privacy) of ARRA and related guidance issued by the Secretary from time to time. 2.13 Business Associate acknowledges that, effective on the Effective Date of this BAA, it shall be liable under the civil and criminal enforcement provisions set forth at 42 U.S.C. § 1320d-5 and 1320d-6,as amended,for failure to comply with any of the use and disclosure requirements of this BAA and any guidance issued by the Secretary from time to time with respect to such use and disclosure requirements. 3. PERMITTED USES AND DISCLOSURES BY BUSINESS ASSOCIATE. 3.1 General Uses and Disclosures. Business Associate agrees to receive, create, use, or disclose PHI only in a manner that is consistent with this BAA,the Privacy Rule, or Security Rule(as defined in Section 5), and only in connection with providing services to Covered Entity;provided that the use or disclosure would not violate the Privacy Rule, including 45 C.F.R. § 164.504(e), if the use or disclosure would be done by Covered Entity. For example, the use and disclosure of PHI will be permitted for"treatment,payment, and health care operations," in accordance with the Privacy Rule. 3.2 Business Associate may use or disclose PHI as Required By Law. Page 4 of 6 3.3 Business Associate agrees to make uses and disclosures and requests for PHI: Consistent with Covered Entity's Minimum Necessary policies and procedures established by the Standard Operating Procedures adopted by in the Monroe County Social Services Department, as may be amended from time to time. 3.4 Business Associate may not use or disclose PHI in a manner that would violate Subpart E of 45 C.F.R. Part 164 if done by the Covered Entity. 4. OBLIGATIONS OF COVERED ENTITY. 4.1 Covered Entity shall: (a) Provide Business Associate with the Notice of Privacy Practices that Covered Entity produces in accordance with the Privacy Rule, and any changes or limitations to such notice under 45 C.F.R. § 164.520, to the extent that such changes or limitations may affect Business Associate's use or disclosure of PHI. (b) Notify Business Associate of any restriction on the use or disclosure of PHI that Covered. Entity has agreed to or is required to comply with under 45 C.F.R. § 164.522, to the extent that such restriction may affect Business Associate's use or disclosure of PHI under this BAA. (c) Notify Business Associate of any changes in or revocation of permission by an individual to use or disclose PHI, if such change or revocation may affect Business Associate's permitted or required uses and disclosures of PHI under this BAA. 4.2 Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would not be permissible under the Privacy and Security Rule if done by Covered Entity, except as provided under Section 3 of this BAA. 5. COMPLIANCE WITH SECURITY RULE. 5.1 Business Associate shall comply with the HIPAA Security Rule,which shall mean the Standards for Security of Electronic Protected Health Information at 45 C.F.R.Part 160 and Subparts A and C of Part 164, as amended by ARRA and the HITECH Act. The term "Electronic Health Record" or"EHR" as used in this BAA shall mean an electronic record of health-related information on an individual that is created, gathered,managed, and consulted by authorized health care clinicians and staff. 5.2 In accordance with the Security Rule, Business Associate agrees to: (a) Implement the administrative safeguards set forth at 45 C.F.R. § 164.308, the physical safeguards set forth at 45 C.F.R. § 164.310, the technical safeguards set forth at 45 C.F.R. § 164.312,and the policies and procedures set forth at 45 C.F.R. § 164.316,to reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that it creates, receives,maintains,or transmits on behalf of Covered Entity as required by the Security Rule. Business Associate acknowledges that, effective on the Effective Date of this BAA, (a) the foregoing safeguards, policies, and procedures requirements shall apply to Business Associate in the same manner that such requirements apply to Covered Entity, and(b)Business Associate shall be liable under the civil and criminal enforcement provisions set forth at 42 U.S.C. § 1320d-5 and 1320d-6, as amended from time to time, for failure to comply with the safeguards, policies, and procedures requirements and any guidance issued by the Secretary from time to time with respect to such requirements; Page 5 of 6 (b) Require that any agent, including a Subcontractor, to whom it provides such PHI agrees to implement reasonable and appropriate safeguards to protect the PHI; and (c) Report to the Covered Entity any Security Incident of which it becomes aware. 6. INDEMNIFICATION. The parties agree and acknowledge that except as set forth herein, the indemnification obligations contained under the Underlying Agreement shall govern each party's performance under this BAA. 7. TERM AND TERMINATION. 7.1 This BAA shall be in effect as of the date set forth in the underlying agreement, and shall terminate on the earlier of the date that: (a) Either party terminates for cause as authorized under Section 7.2. (b) All of the PHI received from Covered Entity,or created or received by Business Associate on behalf of Covered Entity, is destroyed or returned to Covered Entity. If it is not feasible to return or destroy PHI, protections are extended in accordance with Section 7.3. 7.2 Upon either party's knowledge of material breach by the other party,the non-breaching party shall provide an opportunity for the breaching party to cure the breach or end the violation; or terminate the BAA. If the breaching party does not cure the breach or end the violation within a reasonable timeframe not to exceed seven(7)days from the notification of the breach, or if a material term of the BAA has been breached and a cure is not possible,the non-breaching party may terminate this BAA and the Underlying Agreement,upon written notice to the other party. 7.3 Upon termination of this BAA for any reason,the parties agree that: Business associate shall return to Covered Entity all PHI received from Covered Entity, or created, maintained, or received by Business Associate on behalf of Covered Entity, that the Business Associate still maintains in any form. The PHI shall be returned in a format that is reasonably expected to preserve its accessibility and usability. Business Associate shall retain no copies of the PHI. 7.4 The obligations of Business Associate under this Section 7 shall survive the termination of this BAA. 8. MISCELLANEOUS. 8.1 The parties agree to take such action as is necessary to amend this BAA to comply with the requirements of the Privacy Rule, the Security Rule, HIPAA, ARRA, the HiTECH Act, the Consolidated Appropriations Act, 2021 (CAA-21), the HIPAA Rules, and any other applicable law. 8.2 The respective rights and obligations of Business Associate under Section 6 and Section 7 of this BAA shall survive the termination of this BAA. 8.3 This BAA shall be interpreted in the following manner: (a) Any ambiguity shall be resolved in favor of a meaning that permits Covered Entity to comply with the HIPAA Rules. Page 6 of 6 (b) Any inconsistency between the BAA's provisions and the HIPAA Rules, including all amendments,as interpreted by the HHS,a court,or another regulatory agency with authority over the Parties, shall be interpreted according to the interpretation of the HMS, the court, or the regulatory agency. (c) Any provision of this BAA that differs from those required by the HIPAA Rules, but is nonetheless permitted by the HIPAA Rules, shall be adhered to as stated in this BAA. 8.4 This BAA constitutes the entire agreement between the parties related to the subject matter of this BAA, except to the extent that the Underlying Agreement imposes more stringent requirements related to the use and protection of PHI upon Business Associate. This BAA supersedes all prior negotiations, discussions, representations, or proposals, whether oral or written. This BAA may not be modified unless done so in writing and signed by a duly authorized representative of bath parties. If any provision of this BAA, or part thereof, is found to be invalid,the remaining provisions shall remain in effect. 8.5 This BAA will be binding on the successors and assigns of the Covered.Entity and the Business Associate. However, this BAA may not be assigned, in whole or in part,without the written consent of the other party. Any attempted assignment in violation of this provision shall be null and void. 8.6 This BAA may be executed in two or more counterparts,each of which shall be deemed an original. 8.7 Except to the extent preempted by federal law, this BAA shall be governed by and construed in accordance with the same internal laws as that of the Underlying Agreement. [End of Addendum] Page 7 of 6 "COMPOSITE EXHIBIT C" Certification Rej!ardin2 Debarment Suspension, Inelipibility And Voluntary Exclusion Prospective Contractor's Covered Transactions (1) The prospective contractor of the County as sub-recipient of state and federal grant funding certifies, by submission of this document, that neither it nor its principals is presently debarred, suspended,proposed for debarment,declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the County's prospective contractor is unable to certify to the above statement, the prospective contractor shall attach an explanation to this form. PROSPECTIVE CONTRACTOR: YXY1 ►_Ut h y 1 N-y A r digit ally signed by Cathy Crane Cathy Crane pate:2025.09.30 09:28:04-04'00' By .- Signature 11 Recipient's Name lo 1� n&, Sa w TcZ.1i t" / V. efiN >e,01 Older Americans Act Contract No. 2529 Name and Title Division Contract Number . ) r-sI Li 0-yers" tt� l ul� S 7-e-3 Street Address I", / (a- City, State,Zip 09 /0cl /90,z Date ....... ..... CIVIL RIGHTS COMPLIANCE STATEMENT Civil Ri hg is Act of 1964,Title VI and VII A. The Provider hereby certifies that there will be no discrimination against any employee or person served on account of race, color, sex, religious background, ancestry, or national origin in its performance of the food service Contract. B. The Provider hereby certifies that it shall comply with Title VI of the Civil Rights Act of 1964 (42 USA 2000d) in regard to persons served, and the regulations issued pursuant thereto (45 CFR, Part 80). C. The Provider hereby certifies that it shall comply with Title VII of the Civil Rights Act of 1964 (42 USC 20003) in regard to employees or applicants for employment, and nay regulations issued pursuant thereto. D. It is expressly understood that upon receipt of evidence of such discrimination, the Monroe County, Alliance for Aging, Inc. and/or the Department of Elder Affairs shall have the right to terminate the agreement automatically and without penalty to any governmental entity. PROVIDE WRITTEN STATEMENT OF COMPLIANCE WITH THE ABOVE OR EXECUTE BELOW Q IZOZJ 1.2-02& Signature Date V l c16. f ISP Cj..j Print Name and Title DRUG-FREE WORK PLACE FORM The undersigned vendor in accordance with Florida Statute Section 287.087 hereby certifies that: (Name of Busine s) 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace,the business'policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs,and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the,statement specified in subsection (1), notify the employees that, as a condition of working on the commodities or contractual.services that are under bid,the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or polo contendere to, any violation of Chapter 893(Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. fi. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. (Si tore) ©ate: �� z�i �za STATE OF, ��� COUNTY OF: �40 V�Vo-e Subscribed and swom to(or affirmed)before me, by means of IR'physical presence or ❑ online notarization, on 0M 19 -W-Lg (date) by I.O R V-'a L (name of affiant). He/She is personally known to me or has produced Na -,.,e ULg v1 53G 5-,9>9 4�49_qtype �. as identification. YUNETORTEGA MY COMMISSION#HH 384104 —DA I a.••a?. EXPIRES. ay13,2027 NC]TAR Revised BOCC 81]W2022 A � t My Commission Expires: `fi I-, 1-z v FDADTivACK1Tnr UwED ACrrAIDC7 BACKGROUND SCREENING ATTESTATION OF COMPLIANCE - EMPLOYER AUTHORITY; ALL EMPLOYERS are required to annually submit this form attesting to compliance with the provisions of chapter 435 and section 430.0402 of the Florida Statutes. The term "employer" means any person or entity required by law to conduct background screenings, including but not limited to,Area Agencies on Aging/Aging and Disability Resource Centers, Lead Agencies, and Service Providers that contract directly or indirectly with the Department of Elder Affairs (DOEA), and any other person or entity which hires employees or has volunteers in service who meet the definition of a direct service provider. See §§ 435.02, 430.0402, Fla. Stat. A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services to the client and has access to the client's living areas, funds, personal property, or personal identification information as defined ins. 817.568. The term also includes, but is not limited to, the administrator or a similarly titled person who is responsible for the day-to-day operations of the provider,the financial officer or similarly titled person who is responsible for the financial operations of the provider, coordinators, managers, and supervisors of residential facilities, and volunteers,and any other person seeking employment with a provider who is expected to,or whose responsibilities may require hire or her to, provide personal care or services directly to clients or have access to client funds, financial matters, legal matters, personal property, or living areas." § 430.0402(l)(b), Fla. Stat.(2023). ATTESTATION As the duly authorized representative of: kCx vi r &- cCla.; Name o Employer) Located at ( ,. QVe Y C a-, -57 a Va-rhq--,i 1':(� O �a Street address / � Ci State Zip Code Under penalty of perjury, I, &--0 re-v7 a �YI i iA y7 e', (Name of Representative) hereby swear or affirm that the above-named employer is in compliance with the provisions of chapter 435 and section 430.0402 of the Florida Statutes, regarding level 2 background screening. Signature of Repr ntative Date DOEA Form 235,Attestation of Compliance-Employer,Effective July 1,2023,F.S. Form available at:litt-os://elderaffairs ory,/about-us/backzrrouiid-screeniii background-screening-clearinahouse- training-accessing-the-clearinghouse/ 1 7/18/25, 11:04 AM Detail by Entity Name I IV1SIral^,� raI' C C)R1:1ral'AI IC)11,�S WOND'1 ,...T "J! ... ,. ,..�. ..d Q llµiiloi n,�af_Coii,IGng!2ho�ahrh.,,, / S aIra Ihh_IR a raids / ��a,�chh_Ir I irn�irDy II[;) t iii III by IEE;iirvfl- Name Florida Profit Corporation TRANQUILITY BAY ADULT DAY CARE OF MARATHON, CORP EWj2g Information Document Number P17000018711 FEI/EIN Number 82-0609905 Date Filed 02/27/2017 State FL Status ACTIVE Last Event AMENDMENT Event Date Filed 07/02/2025 Event Effective Date NONE Principal Address 11524 OVERSEAS HIGHWAY UNIT 3 MARATHON, FL 33050 Changed: 12/22/2021 Mailing Address 11524 OVERSEAS HIGHWAY UNIT 3 MARATHON, FL 33050 Changed: 12/22/2021 Registered Agent Name&Address CRUZ, ROLANDO 11524 OVERSEAS HIGHWAY UNIT 3 MARATHON, FL 33050 Name Changed: 10/22/2019 Address Changed: 10/22/2019 Officer/Director Detail Name&Address Title P https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=TRANQUI... 1/3 7/18/25, 11:04 AM Detail by Entity Name CRUZ, ROLANDO 11524 OVERSEAS HIGHWAY UNIT 3 MARATHON, FL 33050 Title VP SANTANA, LORENA MARIA 11524 OVERSEAS HIGHWAY MARATHON, FL 33050 Title S SANTANA, AGUSTIN 11524 OVERSEAS HIGHWAY, UNIT 3 MARATHON, FL 33050 Title T AZAN CALA, MARLON 100980 OVERSEAS HWY KEY LARGO, FL 33037 Annual Reports Report Year Filed Date 2023 05/01/2023 2024 05/01/2024 2025 05/01/2025 Document Images �If/�Il/loll"a _ ir�¢irna�irlm¢,ir�� l�ii¢1rnr iiirlma�al¢ iiirn IF�ICIIF''��ainrlma�0 Viow uir na go in IPIDIF kxirn a ............... �Ita/�l a/loll a _ i ¢irna i ¢,irl� blow ulna go in IPIDIF''kxina J �I"a/�I�_/loll"a _ I VINµ,V I IFwIE',,:I �Ifwlf, blow lima go in IPIDIF''kxirna J Viow uirrna go in IPIDIH' kxirna blow lima go in IPIDIF''kxirna J �l"a/�I�_/l 111 _ I VINµ,V I IFwIE',,:I �Ifwlf, blow lima go in IPIDIF''kxirna J Viow uirrna go in IPIDIF kxirna ............... LIta/IC)L2Slll _ inoirndirn ,irI blow lima go in IPIDIF''kxirna J �I /l4�/l ll� _ I VINµ,V I IFwIE',,:I �Ifwlf, blow lima go in IPIDIF''kxirna J Viow uirrna go in IPIDIH' kxinat blow lima go in IPIDIF''kxirna J �Il/�I//llI 4V _ I VINµ,V 11 IFaIE',,:I �Ifalf, blow lima go in IPIDIF''kxirna J Viow uirrna go in IPIDIH' kxirna �Il/l//l l f 1�ai m¢1 �uaµl ir,�a ii� blow ulna go in IPIDIF''kxina J https://search.sunbiz.org/Inquiry/CorporationSearch/Search ResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=TRANQU I... 2/3 7/18/25, 11:04 AM Detail by Entity Name https://search.sunbiz.org/Inquiry/CorporationSearch/Search ResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=TRANQU I... 3/3 / r / / / / / ',- , / /N cdLTj / iir U ct aRJ�oo�rm L J o N in N N� `�(� /Gi / a U M lls Iluil flm ( , //oj°ii, / 6T.4C/1 U O 1 O U dlil s o f°o///r ( ) W121. � ([U v ^/ Orct cd l» a �i/ /o •� .�. of b a / r/1 ct / / // i I / / l / // / r / / / / / / / r S�0H CAI�14%' x RON DESANTIS GOVERNOR JASON WEIDA SECRETARY OF FUD January 8, 2025 Lucy Cruz, Administrator File Number: 12962309 Tranquility Bay Adult Day Care Corp License Number: 9217 100980 Overseas Hwy Provider Type: Adult Day Care Center Key Largo, FL 33037-2560 Application Number: 6708 RE: Facility located at 100980 Overseas Hwy, Key Largo Dear Administrator: The enclosed Adult Day Care Center license with license number 9217 and certificate number 4822 is issued for the above provider effective June 18, 2024 through June 17, 2026. The license is being issued for approval of the renewal application. The Agency no longer mails hard copies of licenses. Per Section 408.804(2), Florida Statutes, providers are required to print the license and post it in a conspicuous place readily visible to clients at the entrance of your facility. Review your certificate thoroughly to ensure that all information is correct and consistent with your records. If errors are noted, please contact the Assisted Living Unit. Please take a short customer satisfaction survey on our website at ahca.myflorida.com/survey/to let us know how we can serve you better. Additional licensure information can be found at bllll���oot-icia,co�-yi/assistecili'viti�,,. ........................................................................................................................................................., If you have any questions or need further assistance, please contact me at(850) 412-4476 or email me at.,S Sincerely, Sonja Bradwell Health Services & Facilities Consultant Assisted Living Unit Division of Health Care Policy and Oversight Agency for Healthcare Administration 2727 Mahan Drive * MS#30 Facebook.corn/AHCAFIorida Tallahassee, FL 32308 Sg X.com/AHCA FL AHCA.MyFlorida.com A Rai CERTIFICATE OF LIABILITY INSURANCE DATE M ODN /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 certi'tfcatte holder Is an ADDITIONAL INSURED,the policy(les)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 Moldier In Ileu of such endorsements), PRODUCER CONTACT Fabian Rodriguez Domino Insurance Inc PHONE (954)289.3500 A N 131155 sw 134 St suite 110 a,'""RIt . tabiant§dominoins.com INSURERS AFFORDING COVER AGE NAIC0 Miami FL 33186 INSURER A: Ategrity Specialty Insurance Company(1627) 1627 INSURED INSURER B: Tranquility Bay Adult Day Care INSURER C: 11524 overseas hwy INffiuRER D INSURER E: MARATHON FL 33050 INSURERF: COVERAGES CERTIFICATE NUMBER: 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. NOT ATHSTANDING 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. ADDLSUGR R18`R TY'P'E OF INSURANCE. NSOWVn LICY EF POLICY P LIMITS NUMBER. COMMERCIAL GENERALL►AB#LtTY EACHOCCURRENCE S 1,000,1000 CLAIMSJAADE rX a OCCUR. b_A=_F�,y",O RENIE nU S 100,000 ME D EXP Aa o"rerson), '',.$ 5.000 A X 01-C-PK-P20147831-0 07/26/2025 07/26/2026 PERSONAL aAOVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 'S 2,000,000 X POLICY O PRO- ❑. JECT LOC PRODUCTS-COMP/OP AGG S 2.000.000 OTHER r $ AUTC+MrmBILE LIABILITY COMBIN. IN L I I $ Ire accident ,,. ANY AUTO BODILY INJURY(Per persm) S _-- OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accent S UMBRELLA I" !OCCUR EACH OCCURRENCE f EXCESS LIAO CLAIMS-MADE AGGREGATE $ DED RETENTION$ S WORKERS COMPENSATION PER TA TE OTH- AND EMPLOYERS'LIABILITY ... .— YIN OFFICE IMEMBROPARTNEEDXECUTI4'E (� E.L.EACH ACCIDENT S OFFICERAAEMBER EXCLUDED? 1 y NIA (Mandatory in NH) E L.DISEASE-EA EMPLOYEE $ a describe Lander _... DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT S Errors or Ornissions 11000°'OOO 01-C-PK-P20147831-0 07/26/2025 07/26120261 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached it more space is required) Certificate Holders 30 Days Notice Of cancellation GL and PL Only- Auto & APPROVED BY RISK MANAGEMENT BY Q2',tL, C ,fc2 WC separate COI DATE 69.1015 WAIVER NAAX YES CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE, WILL BE DELIVERED IN MONROE COUNTY SOCC ACCORDANCE WITH THE POLICY PROVISIONS, 11D0 SIMON'TON STREET AUTHORIZED REPRESENTATIVE KEY WEST,FL33040 01988-2015 ACORD CORPORATION, All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD --- --- ------------------ Sranned with CamScaLnner°'! CERTIFICATE OF LIABILITY INSURANCE FTE(MM/DD/YYYY) 09/05/2025 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:Progressive Commercial Lines Customer and Agent Servicing Sebanda Insurance PHONE FAX 6401 BIRD RD,MIAMI,FL 33155 A/C No Ext:1-800-444-4487 A/C No): E-MAIL ro ressivecommercial email. ro ressive.com ADDRESS:P 9 @ P 9 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Progressive Express Insurance Company 10193 INSURED INSURER B: TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP 11524 Overseas Hwy,unit 3 INSURER C: Marathon,FL 33050 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 171349655483511808DO90525T201145 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. ILTR TYPE OF INSURANCE INSD SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- PRODUCTS-COMP/OP AGG $ POLICY JECT LOC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY Perperson) $100 000 A OWNED SCHEDULED AUTOS ONLY X AUTOS Y N 860928331 07/30/2025 07/30/2026 BODILY INJURY(Per accident) $300 000 HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $50,000 UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION YIN H- AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below See ACORD 101 for additional coverage details. $ A Y N 860928331 07/30/2025 07/30/2026 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is rest APPROVED BY RISK MANAGEMENT Auto Only.GL,WC,PL on separate C01 BY�Pb?..9� DATE 09.10.25 WAIVER N/A X YES - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MONROE COUNTY BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON STREET KEY WEST,FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ACC>R EP ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Sebanda Insurance TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP POLICY NUMBER 11524 Overseas Hwy,unit 3 Marathon,FL 33050 860928331 CARRIER NAIC CODE Progressive Express Insurance Company 10193 EFFECTIVE DATE:07/30/2025 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Additional Coverages Insurance coverage(s) Limits .5e................. ro.. c.t.io.......................................................................................................................................................................... Personal Injury Protection $10,000 w/$0 Ded-Named Insured Only Description of Location/Vehicles/Special Items Scheduled autos only ............................................................................................................................................................................................................ 2015 FORD TRANSIT 1 FBAX2CG1 FKA02992 Comprehensive $1,000 Ded Collision $1,000 Ded Additional Information Certificate holder is listed as an Additional Insured. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MONROE COUNTY, FLORIDA REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements,be waived or modified on the following contract. Contractor/Vendor: Tranquility Bay Adult Day Care of Marathon, Corp Project or Service: Social Services In-Home Program Contractor/Vendor 11524 Overseas Hwy, Unit 3 Address&Phone 4: Marathon, FL 33050 General Scope of Work: provide facility-based respite and adult day care services to elderly and disabled residents Reason for Waiver or Contractor claims eligibility for worker's compensation Modification: exemption. Policies Waiver or Modification will apply to: Worker's Compensation. Waiver contingent on State approval of attached application for exemption Signature of Contractor/Vendor: Date: 09/10/25 Approved Not Approved ❑ Risk Management Signature:_ Date: County Administrator appeal: Approved: _ F] Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: NOTICE OF ELECTION TO BE EXEMPT If this qpplioafion contains incomplete or inaccurate information, it may cause a delay in the Iissuance of your exemption, An officer electing an exemption under Chapteir 4410, IFllorida Statutes, is not entitled to benefits under this chapter. Section 1: APPLICANT INFORMATION First & Last Naime: LORENA M SANTANA VALID State Driver's License Number: State, FL Florida ID Niumber, Driver's ILiceinse(Expiration Date: 5/119/21031 Date of Birth, Email Address: TRANQLJILITYBAYADULTDAY�CARIEKE'Y1M@GiIMAIL,.C�OIM Section 2: NON-CONSTRUCTION INDUSTRYAPPLICANT(NO PEE REQUIRED) Officer of a Corporation Section 3: This section should be completed with information specnfiic,to your corporation or to the limited liabifity company in which you are a member. The name of the corporation or Hirrifted liability company listed on this application MUST match the name of the corporation or Iliimited liability company as registered with the Florida Diivision of Corporations. Narne of Corporation or LLC; TRANQUtt ILITY BAY ADULT DAY CARE OF FEIN: 820,60,9905 MARATHON, CORP Business Name (IBA): Phone!: 7865725498 ApplilC2nt'sAddiressof Record, 11524 OVERSEAS HIGHWAY City: MARATHON State: FL Zip 33050 County: MONROE Section 4: The corporation of,which you are an officer or IIiirnited Iliabillity company of which you are a member must be registered and in ACTIVE status with the Florida IDivisiion of Corporations. Applilcaints applying as ain officer of a corporation imust The listed as an officeir of the Corporation with the Florida IClivisliorn of Corporations.List the docuirnpint iniumber oin filie with the Florida Divislion of Corporations P171011010018711 Section THIS SECTION IS INGOT APPLICABLE TO MY BUSINESS. DBPR License Number: Additional DBPR License Number: Section 6: if you have submitted an electronic payment for this application„the transaction confirmation nu imber its listed in the following space: ,Confirmation Number: Application Number: E02208117 Section 7: N/A Are you affiliated 'with any corporation or limited Iliabiliity company othieir than the corporaflon or Ihinnitedl liability company to which this application applies? Section 8: CONSTRUCTION INDUSTRY AND NOWCONSTRUCTION INDUSTRY ILLC MEMBERS ONLY To Ibe&Hglible for a construction lindustry exemption or a non-construction limited Iliabillity company exemption,an applicant imust have the required owneirsNip of the corporation or limited liability company. Section 9.* I certify that any employees of the corporation or members of the limited Iiiabdifty company listed in Section 3 are coveired by workers" compensation insurance. Please identify the workers" compensation insurance carrier that covers any non-exempt ,employees. Carrier Name,: My business does not have any non-exempt employees; or, imy business is not required to obtain workers" complensation. Section 10: FRAUD NOTICE X Any person who, knowingly and with intent to iinjure, defraud, or deceive the department or any employer or employee, insurance company or any other person, files, a Notice of Election to be Exempt containing any false or misteading information ills guilty of a felony of the third degree. Attestation of applicant— By provJdJng imy nanne (bellow, I attest that II Ihiave read, understand and acknowledge the foregoing notice. C. I acknowledge that this Notice of Election to be Exempt does not exceed (limits for corporate Officers, iincluding any affiliated corporations as provided in Section 440,102, Florida Statutes. D� I certify I reviewed and understand the warkeirs' compensation coveragie and cornpiJance tutorial developed by the department, First Name: Last Naime,. Driver's License Number OR Identification Card Number, RENA SANTANA Note: The Division has 30 days to review your application to detieriOine if it meets the 61igibilfty requirements for the issuance of an exemption, The Division wflI1 either issue a Certificate,of Election to be Exempt or notify you that your application lis incomplete. The Division reviews and processes exemption applications iin the order they are received. Exemption information is reflected on the Exemption Search database the day fbHowing the, issluaince of the exemption,. A� CERTIFICATE OF LIABILITY INSURANCE DATE 09/05/2025 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 endorsements. PRODUCER NAME:Progressive Commercial Lines Customer and A ent Servicing Sebanda Insurance PHONE FAX 6401 BIRD RD,MIAMI,FL 33155 A/C No Ext:1-800-444-4487 A/C No): E-MAIL ADDRESS:progressivecommercial@email.progressive.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Progressive Express Insurance Company 10193 INSURED INSURER B TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP 11524 Overseas Hwy,unit 3 INSURER C: Marathon,FL 33050 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 171349655483511808DO90525T201145 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE❑OCCUR PREMISES(Ea RENTED MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRO- PRODUCTS-COMP/OP AGG POLICY JECT 0 LOC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ ANY AUTO BODILY INJURY Per erson ,100 000 A OWNED SCHEDULED Y N 860928331 07/30/2025 07/30/2026 AUTOS ONLY X AUTOS BODILY INJURY Per accident 300 000 AUTOS ONLY AUOTOS ONEY PR rr accdent AMAGE $50,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ pT $ WORKERS COMPE AND EMPLOYERS'NSATION LIABILITY ER Y/N TAT TE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $ See ACORD 101 for additional coverage details. $ A Y N 860928331 07/30/2025 07/30/2026 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is regi APPROVED BY RISK.MANAGEMENT Auto Only.GL,WC,PL on separate COI BY as,az.,` dd'IZ•4.r1- DATE 09.10.25 WAIVER N/A X YES CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MONROE COUNTY BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON STREET KEY WEST,FL 33040 AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ACC>" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Sebanda Insurance TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP POLICY NUMBER 11524 Overseas Hwy,unit 3 Marathon,FL 33050 860928331 CARRIER NAIC CODE Progressive Express Insurance Company 10193 EFFECTIVE DATE:07/30/2025 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Additional Coverages Insurance coverage(s) Limits ............................................................................................................................................................................................................ Personal Injury Protection $10,000 w/$0 Ded-Named Insured Only Description of Location/Vehicles/Special Items Scheduled autos only 20 ...1......................................................................................................................................................................................................... 5 FORD TRANSIT 1FBAX2CG1FKA02992 Comprehensive $1,000 Ded Collision $1,000 Ded Additional Information Certificate holder is listed as an Additional Insured. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements,be waived or modified on the following contract. Contractor/Vendor: Tranquility Bay Adult Day Care of Marathon, Corp Project or Service: Social Services In-Home Program Contractor/Vendor 11524 Overseas Hwy, Unit 3 Address&Phone#: y Marathon, FL 33050 General Scope of Work: provide facility-based respite and adult day care services to elderly and disabled residents Reason for Waiver or Contractor claims eligibility for worker's compensation Modification: exemption. Policies Waiver or Modification will apply to: Worker's Compensation. Waiver contingent on State approval of attached application for exemption Signature of Contractor/Vendor: Date: 09/10/25 Approved FV1 Not Approved Gaelan P Jones Digitally signed by Gaelan P Jones Risk Management Signature:_ Date:2025.09.10 16:41:59-04'00' Date: County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: NOTICE OF ELECTION TO BE EXEMPT If this application contains incomplete or inaccurate information, it may cause a delay in the issuance of your exemption. An officer electing an exemption under Chapter 440, Florida Statutes, is not entitled to benefits under this chapter. Section 1: APPLICANT INFORMATION First& Last Name: LORENA M SANTANA VALID State Driver's License Number: State: FL Florida ID Number: S535533976790 Driver's License Expiration Date: 5/19/2031 Date of Birth: 5/19/1997 Email Address: TRANOUILITYBAYADULTDAYCAREKEYM@GMAIL.COM Section 2: NON-CONSTRUCTION INDUSTRY APPLICANT (NO FEE REQUIRED) Officer of a Corporation Section 3: This section should be completed with information specific to your corporation or to the limited liability company in which you are a member. The name of the corporation or limited liability company listed on this application MUST match the name of the corporation or limited liability company as registered with the Florida Division of Corporations. Name of Corporation or LLC: TRANQUILITY BAY ADULT DAY CARE OF FEIN: 820609905 MARATHON, CORP Business Name (DBA): Phone: 7865725498 Applicant's Address of Record: 11524 OVERSEAS HIGHWAY City: MARATHON State: FL Zip 33050 County: MONROE Section 4: The corporation of which you are an officer or limited liability company of which you are a member must be registered and in ACTIVE status with the Florida Division of Corporations. Applicants applying as an officer of a corporation must be listed as an officer of the Corporation with the Florida Division of Corporations. List the document number on file with the Florida Division of Corporations. P17000018711 Section 5: THIS SECTION IS NOT APPLICABLE TO MY BUSINESS. DBPR License Number: Additional DBPR License Number: Section 6: If you have submitted an electronic payment for this application,the transaction confirmation number is listed in the following space: Confirmation Number: Application Number: E02208117 Section 7: N/A Are you affiliated with any corporation or limited liability company other than the corporation or limited liability company to which this application applies? Section 8: CONSTRUCTION INDUSTRY AND NON-CONSTRUCTION INDUSTRY LLC MEMBERS ONLY To be eligible for a construction industry exemption or a non-construction limited liability company exemption, an applicant must have the required ownership of the corporation or limited liability company. Section 9: 1 certify that any employees of the corporation or members of the limited liability company listed in Section 3 are covered by workers' compensation insurance. Please identify the workers' compensation insurance carrier that covers any non-exempt employees. Carrier Name: My business does not have any non-exempt employees; or, my business is not required to obtain workers' compensation. Section 10: FRAUD NOTICE A. Any person who, knowingly and with intent to injure, defraud, or deceive the department or any employer or employee, insurance company or any other person, files a Notice of Election to be Exempt containing any false or misleading information is guilty of a felony of the third degree. B. Attestation of applicant— By providing my name below, I attest that I have read, understand and acknowledge the foregoing notice. C. I acknowledge that this Notice of Election to be Exempt does not exceed limits for corporate officers, including any affiliated corporations as provided in Section 440.02, Florida Statutes. D. I certify I reviewed and understand the workers'compensation coverage and compliance tutorial developed by the department. First Name: Last Name: Driver's License Number OR Identification Card Number: LORENA SANTANA S535533976790 Note: The Division has 30 days to review your application to determine if it meets the eligibility requirements for the issuance of an exemption. The Division will either issue a Certificate of Election to be Exempt or notify you that your application is incomplete. The Division reviews and processes exemption applications in the order they are received. Exemption information is reflected on the Exemption Search database the day following the issuance of the exemption. A C> CERTIFICATE OF LIABILITY INSURANCE DATE A E(MWD IY 25 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 pollcy(les)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 endorsements . PRODUCER l Fabian Rodriguez Domino insurance Inc PHONE (854)289-3500 13155 sw 134 st suite 110 MAIL fabiant dominoins.Com FA aoDR INSURERS AFFORDING COVERAGE NAIC• Miami FL 33186 INSURER A: Ategrity Specialty Insurance Company(1627) 1627 INSURED INSURER B: Tranquility Bay Adult Day Care INSURER C 11524 overseas hwy INSURER D: INSURER E; MARATHON FL 33050 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE L Wliik POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1.000.000 CLAIMSMADE OCCURNTED 100,000 PREMISES aoccurrenc S MED EXP one son S 5,000 A X 01-C-PK-P20147831-0 07/26/2025 07/26/2026 PERSONAL&ADV INJURY $ 1,000,000 GEN"L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000.000 X LOC $ 2,000,QQ0 JTPOLICY OTHER S AUTOMfI BILE LIAINUTY C11MHINED SINGLE $ a accident ANY AUTO BODILY INJURY(Par person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Par accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per P accklent $ UMBRELIALIABHCLAIMS-MADE OCCUR EACH OCCURRENCE S __.. EXCESS UAB AGGREGATE S DED 1 1 RETENTION$ $ WORKERS COMPENSATION EA T OT AND EMPLOYERS'LIABILITY YIN _ _...._ ER ANYPROPRIETORIPARTNERIEXECUTIVE E L,EACH ACCIDENT $ 'OFFICERIMEMBEREXCLUDED? El NIA (Mandatory in NH) E L,DISEASE-EA EMPLOYEE $ kt yyeas,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ Errors or Omissions 110001-000 01-C-PK-P20147831-0 07/26/2025 07/26/2026 2.000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holders 30 Days Notice of cancellation APPROVED BY RISK MANAGEMENT GL and PL Only- Auto & WC separate COI DATE. 9.10.�5 ................ ....................................................... WAIVER N/AXYE5 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MONROE COUNTY BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON STREET AUTHORIZED REPRESENTATIVE KEY WEST,FL33040 01988.2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 0730/2025YYY� 07/30J2025 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 pollcy(les)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 endorsements. PRODUCER CONTACT NAME:Progressive mmerci I Lines Customer and A ent rvicin Se'banda Insurance 6401 BIRD RD,MIAMI,FL 33155 NC PHONE Ex*: - 4 FAX A O"iss:pTgressivecommerclal@emaii.pTgressive.com INSURERS AFFORDING COVERAGE NAIL 0 INSURER A:Progressive Express Insurance Company 10193 INSURED INSURER B TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP INSURER C 11524 Overseas Hwy,unit 3 Marathon,FL 33050 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 171349655483511808DO73025TI64536 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 ADDL SUB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIASILRY EACH OCCURRENCE CLAIMS-MADE[]OCCUR PREMISES(Es occurrence) MED EXP(Any oneperson) _ PERSONAL 6 ADV INJURY GEN L AGGRE ATE LIMIT APPLIES PER: GENERAL AGGREGATE PRO PRODUCTS-COMP/OP AGG POLICY JECT ❑LOC OTHER S AUTOMOBILE UABILnY Es eoddEerDitSINGLE LIMIT $ ANY AUTO E BODILY INJURY Per person) S100,000 A AAUUTOS ONLY X AUTOSULED N N 8M28331 071=025 07140/2026 BODILY INJURY Per accident) S300.000 HI D NONIWNED eracrJdeM $50 AU'CIS ONLY AUTOS ONLY 040 UMBRELLA LIAO OCCUR EACH OCCURRENCE $ EXCESS LIAS CLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION YM _pEEL Y AND EMPLOYERS'LIABILITY ti1B1U1J: ., ANYPROPRIETORIPARTNERtEXECUTIVE N f A E.L.EACH ACCIDENT S.. OFFICERIMEMBEREXCLUDED7 (Mandatary In NH) E.L.DISEASE-EA EMPLOYEE S Ir yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 3 Sae ACORD tOf for additional ooveraye deta0s. $ A N N t180925331 07/30/2025 07/30r2028 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be a1lacMd if ma*spec.*Is squired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TRANQUILITY BAY ADULT DAY CARE OF THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MARATHON,CORP ACCORDANCE WITH THE POLICY PROVISIONS. 11524 Overseas Hwy,unit 3 Marathon,FL 33050 AUTHORIZED REPRESENTATIVE 0 1 988-201 5 ACORD CORPORATION, All rights reserved. arnLan ac mnlcins► This Ar'nRn name and Innn urn raniatairad marks of Ar.nRD AGENCY CUSTOMER ID: LOC#: ACC>RV ADDITIONAL REMARKS SCHEDULE page I of I 160� AGENCY N"EDINSURED Sebanda Insurance TRANQUILITY BAY ADULT DAY CARE OF MARATHON,CORP 11524 Overseas Hwy,unit 3 POLICY NUMBER Marathon,FL 33050 860928331 CARRIER NAIC CODE I Progressive Express Insurance Company 10193 EFFECTIVE DATE:07/30/2025 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25- FORM TITLE: Certificate of Liability Insurance Additional Coverages Insuran.ce.c.ovnRIM ............................... Limits . ............................................................ ................. Personal injury Protection $10,404 w/$0 Ded-Named Insured Only Description of Location/Vehicles/Special Items Scheduled autos only Comprehensive $1,000 Ded Collision $1,000 Ded ACORD 1101 (2008/01) 02008 ACORD CORPORATION. AR rights reserved. The ACORD name and logo are registered marks of ACORD