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HomeMy WebLinkAbout7. 1st Amendment 05/20/2026 GVS COURTq c o: A Kevin Madok, CPA - �o ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida �z cooN DATE: May 28, 2026 TO: Fire Chief RL Colina Monroe County Fire Rescue Mayor Bruce Halle Fire & Ambulance District 1 Board of Governors Cheri Tamborski Monroe County Fire Rescue FROM: Liz Yongue, Deputy Clerk SUBJECT: May 20, 2026 BOCC Meeting The following item has been executed, redacted, and added to the record: C12/1-12 Amendment No. 1 to the Agreement with Life Extension Clinics, Inc., d/b/a Life Scan Wellness Centers, for Annual Firefighter Physical Examinations, to be executed by the Mayor and Chairman of the BOG, to extend the term for one year(from May 27, 2026 to May 27, 2027), modify other provisions including pricing per exam, and authorize the County Administrator to execute all other necessary documents; the total estimated cost is $50,000.00 budgeted in FY26 using funds from Funds 001, 101, 141, 148, and 404. 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 AMENDMENT NO. I to the AGREEMENT between MONROE COUNTY(BOCC&BOG) and LIFE EXTENSION CLINICS,INC.d/b/a LIFE SCAN WELLNESS CENTERS for Annual Firefighter Physical Examinations This Amendment No. 1 to the agreement between Monroe County, a political subdivision of the State of Florida, acting through its Board of County Commissioners, with principal offices located at 1100 Simonton Street, Key West, FL 33040, the Board of Governors of the Fire and Ambulance District 1 of Monroe County, Florida, a municipal services taxing unit established under Florida law and codified in Section 22-129, Monroe County Code of Ordinances, with the same principal address as listed above (hereinafter both collectively referred to as "County"), and Life Extension Clinics,Inc. d/b/a Life Scan Wellness Centers, a Florida corporation with principal offices located at 1011 North MacDill Avenue, Tampa, Florida 33607 (the "Contractor") for Annual Firefighter Physical Examinations dated May 27, 2025 ("Original Agreement"), is made this 20th day of May ,20 26 by and between the County, and the Contractor, both of whom agree as follows: WITNESSETH: WHEREAS, on May 27, 2025, the parties entered into the Original Agreement, and the County entered said agreement by and through the County Administrator exercising her contracting authority pursuant to the Board of Governor's Resolution No. 494-2023 and Monroe County Ordinance No. 026-2023, amending Section 22-129, Monroe County Code of Ordinances, codifying the County Administrator's approval process for contracts of a certain value; and WHEREAS, due to the professional nature of the services and pursuant to the Monroe County Code of Ordinances and its adopted Purchasing Policy Manual, the County waived its competitive solicitation procedures and/or request for price quotes, and entered into the Original Agreement for medical services specifically annual firefighter physical examinations; and WHEREAS, pursuant to the Original Agreement, the parties agreed to an initial term commencing on May 27, 2025 and going through May 27, 2026, with the option to extend for up to three (3) successive one (1)year periods (each a"Renewal Term"); and WHEREAS, the parties desire to exercise the option to renewal for one (1) year commencing on May 27,2026 and going through May 27,2027,as well as to amend the agreement to provide for an updated pricing schedule to replace "Composite Exhibit B" of the Original Agreement with"Composite Exhibit B-1," attached hereto and incorporated herein; and WHEREAS, additionally, the parties desire to update the general terms and conditions to comply with a new state mandated contract provision; and Page 1 of 4 Document Ref:BWZE5-WS27K-GAMNJ-AXATH WHEREAS,the parties have determined that this Amendment No. 1 is desired and necessary to continue such services. NOW, THEREFORE,based on the promises and covenants herein contained,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 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 exercise the option to renew the agreement for one (1) year commencing on May 27, 2026 and going through May 27, 2027. Subsequent renewals may be authorized administratively subject to the terms and conditions contained in Section 5, "Contract Term," of the Original Agreement. 3. The parties desire to amend the Original Agreement by modifying the pricing and ordering that was originally set forth pursuant to "Composite Exhibit B,"by replacing that exhibit in its entirety with"Composite Exhibit B-1,"attached hereto and incorporated herein. Any section of the Original Agreement that references "Composite Exhibit B"will be read to state"Composite Exhibit B-1." The parties desire to authorize the new price schedule and provide for future orders, as needed / as requested by the County, authorizing the County Administrator to sign the order form securing physical exam appointments ahead of time, subject to the authority vested in the County Administrator pursuant to the Board of Governor's Resolution No. 494-2023 and Monroe County Ordinance No. 026-2023 (i.e. orders must not exceed the total value of $100,000.00 without the prior formal approval of the Monroe County Board of County Commissioners/Board of Governors). 4. The parties desire to amend the Original Agreement, specifically to add Section 38, "Prohibited Activities regarding Diversity, Equity, and Inclusion," as a new state mandated contract provision to read as follows: 38) Prohibited Activities regardine 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 materials relating to diversity, equity, and inclusion as defined in Section 125.595(1), Fla. Stat., as may be amended from time to time. 5. This agreement constitutes the entire understanding between the Contractor and the County regarding this Amendment No. 1 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 4 Document Ref:BWZE5-WS27K-GAMNJ-AXATH IN WITNESS WHEREOF, the parties hereto have executed this Amendment No, I the day and year first above written, CONTRACTOR: LIFE EXTENSION CLINICS, INC. d/b/a LIFE SCAN WELLNESS CENTERS By:_ ro W- W L ewt(0 Sqpiaturc CEO STATE OF Pj cl r( ,4-,-- Print Name& Title COUNTY OF The foregoing rostra neat was sworn to/affirmed an acknowledged be-fore me by means of El physical presence or Y1 online notarization, this 0 a�® day of r 20' by:FQ president [or Authority Title] of LIFE EXTENAI �N_�CLII�ICS, INC, D/B/A LIFE SCAN WELLNESS CENTERS, a Florida For profit Corporation, He/She is personally known to me/or has produced (type of identification) as identification, Notary Public State of Florida jannifer L Connelly My commission HH 392664 Si*naireof1Ntaryl)Mubfic Expires 413012027 np Commissioned of (Print & Stat he lie Notary Public) [County Signatures to follow] Page 3 of 4 Document Ref:BWZE5-WS27K-GAMNJ-AXATH Amendment No. 1 to Agreement between . COUNTY, FL and • _ MONROE � - LIFE EXTENSION CLINICS,INC. d/b/a LIFE SCAN WELLNESS CENTERS .fog' Annual Firefighter Physical Examinations s BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY,FLORIDA: , 1 I I rifilw A )1 By: l f r► Michelle Lincoln Mayor e e i L'n co BOARD OF GOVERNORS,FIRE AND AMBULA E DISTRIC OF MONROE COUNTY,FLORIDA: : 004.0, 'f.), By: ' ‘ Chairman Bruce Halle 0 23 106 -j. . evin Madok, Clerk 1 by •~ oar �;. Y .- . s.Deputy Cler :. :•. ~ Approved as to legal form& sufficiency: v',,,; • ly gy:E M.Lewis Eve IVI. LeA1i S DDigitalate:2026si.04.2ned0b 16:43:3ve7 04:00' 4 Eve M. Lewis,Assistant County Attorney: 91_ 1-Tel :. Page 4 of 4 1 Document Ref:BWZE5-WS27K-GAMNJ-AXATH:,;: i I I I I • P "COMPOSITE EXHIBIT B-1" Quote Date Sent: 04-17-2026 Prepared for Monroe Co. Fire Rescue Exp. Date: 2026-12-31 Marathon, FL Member Exams:#TBD RFP 53-23 NAME PRICE QTY SUBTOTAL Comprehensive Hands On Physical $540.00 1 $540.00 Ilull�alll,.itit.;� II ute�^��<.��inl II"^ill I' II��i.r,�ll.aiu+�rh��ir II III�i;�y;�leirr� �I"V :::gel-iavII(;1IIJ I lisal kl-i SSe S1111"I1011I:S $540.00 Total Per Person $540.00 This quotation is subject to the following terms and conditions: 1. While our pricing is listed on a per-patient basis for transparency,please note that departments will be billed per day of service. Each scheduled day includes up to 9 patient slots,and we staff and travel our clinical teams accordingly.This structure ensures operational efficiency and cost-effectiveness,especially when departments request extended service periods(e.g.,4 weeks or 20 days).If you do not meet the requirements to fill a day or week please discuss with scheduling 2. Minimum of 5 days or 45 appointments to come on site. Can combine multiple departments or use self pay spouses and retirees to get to this number. 3. Pricing subject to annual increase up to 5% Additional Info: We have added partnered with a radiologists and cardiologists across the country to provide reads for all US images,pricing is listed in optional tests section of this quote. Detailed scope of work can be found on page 2 Additional testing that can be added to the exam is listed on page 3 &4 Active 1/1/2026- 12/31/2026 Document Ref:BWZE5-WS27K-GAMNJ-AXATH P Public Safety Physical Exam(NFPA 1582 Compliant) Medical&Occupational/Environmental Questionnaire Included Comprehensive Hands-On Physical Exam Included Vital Signs:Height,Weight,Blood Pressure, Pulse Included Behavioral Health Eval-Epworth Sleep,PCL-5,PHQ-9 Included Back Health Evaluation Included Urinalysis Included Audiogram Included Titmus Occupational Vision Exam Included Breast Exam with Self-Exam education Included Personal Consultation with review of testing results Included Laboratory Tests: Comprehensive Metabolic Panel,Blood Chemistry Included Complete Blood Count,Hematology Panel Included Hemoccult Stool Test for Colon Cancer Screening Included Total Lipid Panel Included Thyroid Test TSH Included Glucose Included Hemoglobin Al C Included Men: PSA(Prostate cancer marker)and Testosterone Included Women:CA-125 Included Ultrasound Screenings(Early Detection of Heart Disease and Cancer): Echocardiogram (Heart Ultrasound) Included Carotid Arteries Ultrasound Included Aorta and Aortic Valve Ultrasounds Included Liver Ultrasound Included Gall Bladder Ultrasound Included Kidneys Ultrasound Included Spleen Ultrasound Included Bladder Ultrasound Included Thyroid Ultrasound Included Men: Prostate and Testicular Ultrasounds Included Women:Ovaries and Uterus Ultrasounds Included Cardiopulmonary Testing&Fitness Eval l 1583&1AFF WFI) Cardiac Stress Test(Treadmill with 12 lead,sub-maximal) Included EKG,12 Lead Included Document Ref:BWZE5-WS27K-GAMNJ-AXATH Public Safety Physical Exam(NFPA 1582 Compliant) Spirometry,PFT with OSHA Respirator Medical Clearance Included Fitness tests for muscular strength&endurance Included VO2 Max Calc for Aerobic Capacity Included Body Weight and Composition Included Personal Fitness Rx Included OPTIONAL TESTS AVAILABLE Chest X-Ray,2 view with radiologist review(included) $92.70 Lumbar X-Ray,2 view with radiologist review $92.70 Hazmat Cholinesterase $85.35 Hazmat Heavy Metals $8,35 Lithium Ion Battery Exposure Panel-Lithium,Cobalt,&Manganese $131.00 iFit Stool test-Colon Cancer screening $57.00 Hepatitis A Titer $44.00 Hepatitis B Screening Test $68.48 Hepatitis B Titer $44.00 Hepatitis C Screening Test $68.48 HIV Test,Gen 4 $32.66 PPD TB Skin Test $27.00 QuantiFeron Gold TB Blood Test $84.00 Tdap(Tetanus,Diphtheria,Pertussis)Titer $36.00 MMR Titer $113.00 Varicella Titer $76.00 Polio Titer $83.00 Nicotine $79.00 Vitamin D $26.00 Document Ref:BWZE5-WS27K-GAMNJ-AXATH OPTIONAL TESTS AVAILABLE OSHA Respirator Mask Fit Testing (PortaCount)per Mask $48.46 Drug Screen,I CUP $57.95 Drug Rescreen with confirmation $68.48 Medical Review Officer(MRO) as indicated/secondary review $153.90 Phlebotomist(Blood Draw) Fee $25.00 Labs Drawn without Appointment $100.00 Form Fee-Add'I forms needing to be filled out by APRN (per form) $50.00 Secure Wifi if not provided by department(per week) $50.00 Guardian Fitness,Nutrition,&Mental Health App Subscription-Per Member for the entire year,please $35.00 ask for more info regarding the app and its benefits Document Ref:BWZE5-WS27K-GAMNJ-AXATH 2026 Department Scheduling And Additional Testing Agreement 1AFF,SCAN Wellueee Ceotera Monroe County Fire Point of Contact Billing Address Cara Johnson, Executive Administrator 7280 Overseas Highway (0) 305-289-6004 (C) Marathon, FL 33050 johnson-cara@monroecounty-fl.gov Blood Draw Location Fire Chief RL Colina 56633 Overseas Hwy (0) (C) Crawl Key, FL 33050 colina-rl@monroecounty-fl.gov Physicals Location Invoice POC Station#13 Name: Cheri Tamborski 390 Key Deer Blvd Email: tamborski-cheri@monroecounty-fl.gov Big Pine Key, FL 33043 • • ® i I 1 1111 a ` k Collection Type:X Life Scan On-Site Dates of Blood Draw: Times: 8:30am to 11:30am Tues, May 26—Thurs, May 28 Iy Villl"'lll : Senup 1 saint.,, uge au� be sent to anio llnii::::!!u, Ilaussdoin usrllnsu,s EMS (Jo hill u°uu°:i (111'suiS, allll spssuuuu°ueunsusrliillll 3EI ik-,kcu;p u.ulli (u:u:uuu°lieu'Its uu) at II uu s Au:;adeimy each, of puns 3 days . ` Set-Up: 7:30am Start: 8:30am Dates of Physicals: Appts: 8:30am, 11:30am, 2:30pm Mon,June 22—Fri,June 26 Members: 90 Days: 10 Mon,July 6—Fri,July 10 9 appts available per day. Yes Test/Lab Price CITY Notes X FFD $540 90 Send to Cara &Colina X On-Site Blood Draw $25 90 • • ® ® `iI 11 ` • Members who do not participate in the on-site blood draws will need to bring their script to a local Lab Corp. For accurate results, blood draws need to be performed between 45 days and 10 days prior to scheduled physicals. IIroeii,.u.uou:uJeu s nieie,Cl LSO fast W I"1110u.oa S Iliu„li,au' tO IhroIIooiil diilau ul! 3 private rooms (10 x 10 is sufficient), one room needs to have a treadmill with at least a 15% incline. Each room should have a trash can and a small table and two chairs if possible. Our staff will need to connect to the WiFi to chart findings during the exam. If your WiFi requires a password to gain access, please provide it here. WiFi Password: If WiFi is inadequate or not provided, a $50 fee per week is applicable. VP LIFE SCAN WELLNESS CENTERS Saving the Lives of A m erica 's Heroes Document Ref:BWZE5-WS27K-GAMNJ-AXATH 2026 Department Scheduling And Additional Testing Agreement 1AFF,SCAN WO.—Center. Non-Diagnostic Ultrasound: Imaging performed for screening purposes only,without clinical interpretation or diagnosis. CLIENT AGREEMENT: Agreement must be signed and returned a minimum of 60 days prior to scheduled physicals. If dates of physicals are not confirmed a minimum of 60 days prior to, Life Scan Wellness reserves the right to release the dates. While our pricing is listed on a per-patient basis for transparency, please note that departments will be billed per day of service. Each scheduled day includes up to 9 patient slots, and we staff and travel our clinical teams accordingly.This structure ensures operational efficiency and cost-effectiveness, especially when departments request extended service periods(e.g., 4 weeks or 20 days). As an authorized representative, I have reviewed and agree to these terms, dates, additional tests, labs, and pricing. Representative Name and Title Representative Signature Signed Date Jennifer Connelly—Administrative Director Life Scan Representative Name and Title LIFE SCAN WELLNESS CENTERS Saving the Lives of A m erica 's Heroes Document Ref:BWZE5-WS27K-GAMNJ-AXATH i i i / i CERTIFICATE of SIGNATURE Ill II:.1:lk!. I)OC::;VJIMI I`I1 (;C:MII'II I11)Il5YfsI1 11'F1,II11111 .01"I BWZE5-WS27K-GAMNJ-AXATH 23 APR 2026 16:10:07 UTC SIGNER TIMESTAMP SIGNATURE TODD LEDUC 23 APR2026 16:04:27 I.1W1111... \1111 W11:1) Law,; TODD.LEDUC@LIFESCANWELLNESS.COM 23 APR 2026 16:09:36 )II��I`Illf.) 23 APR 2026 16:10:07 !1)I)II ens; 99 45 224.116 I....(X;/s,H01111 BOCA RATON, UNITED STATES RECIPIENT VERIFICATION 1 1w��au1 �n a uu u1:1:) 23 APR 2026 16:09:36 .r ® Signed with PandaDoc u,Al°II 1011 1 10 Corporate Resolution for LIFE EXTENSION CLINICS, INC. We,the undersigned,being all of the directors of this Corporation, consent and agree that the following corporate resolution was made on January 10, 2025. We do hereby consent to the following decision: Corporate Resolution of Signing Authority Now,therefore, it is resolved,that the Corporation shall: Grant Todd LeDuc, Deputy CEO, Signing Authority to execute Client Contracts, Contract Amendments, and Contract Renewals on behalf of the Corporation. The Officers of this Corporation are hereby authorized to perform the acts to carry out this Resolution. We,the undersigned directors of the Corporation constituting a quorum of the Board,consent and agree to all of the above on this 10 day of January 2025. MichaeAJernran-a 11-1-WZO-25— Director Sig ur Printed Name Date fe-a n-Patbuci a-J-Qhn-snn VI-Q12025— Di ct Vg/nature Printed Name Date The Secretary of the Corporation certifies that the above is a true and correct copy of the Resolution that w s duly d at a meeting of the Board of Directors. Je-an-Patri-ci-o-J-o-b-n-son 1/1-Q12 02— cre ary ignature Printed Name Date DATE dMIWDOPf"YYYR �t+�'�►lr L> CERTIFICATE O �.IABILITi Y AN 120126 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND, CONIFERS 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 DUDES NOT CONSTITUTE A CONTRACT (BETWEEN THE ISSUING IN URER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)midst 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 rciAONNrT�wCT Certificate Department Slihle Insurance Group Inc. PHONE FAX 1 I321 II Duglas Ave A C No Exr:4t17.8Ero dB62 ears Nn,�407-38 �3 BtD Altamonte Springs FL 32714 ADDRESS!`SS! Certiricate:s@sihie.com INSAJRE11'ISI AFFORDING COVERAGE NIAIC# INSURER Hartford Underwriters Insurance Company 30104 INSURED LIFEExT-01 INSURER 1a MSIG Specialty Insurance USA Inc 34886 Life Extension Clinics Inc. INSURER c:Palomair Excess and Surplus Insurance Company 167 4 dba Life Scan Wellness Centers 1011 N MacDill Ave INSURER 1D Tampa,FL 33607 INSURER E INSURER IF: COVERAGES CERTIFICATE NUMBER!990871 38 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=THI 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 PCLICIiRRB,LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IN'SR A[DOL SUBR POLICY EFF POLICY EXP' LTR TYPE OF INSURANCE POLLCY INUMBER IMMIODIYYYYI (Mishboroi LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 21SBMi 11111012025 1111012026 EACH OCCURRENCE $11,000,000 CLAIMS-MADE F OCCUR PREMISIES Ea occurrence $11,000,000 MELD EXIP(Amy,crone pereran) $IO0,000, PERSONAL S AOV INJURY $11,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,0100,000 POLICY�JJ T �LO�C PRO DUCTS.COMP'NOP AGG $2,OQDtr,000 OTHERr $ a AUTOMOEIILELrAABNLITY Y Y' HNCD1000254-03 302021T 312/2'027 QCGM". 1SINGLELIMIT $11,OO10,000 (Ea eccrd€reC ANY AUTO aaODILY INSURTY(Par parearr'I $ OWNED SCHEDULED BOGILY'INSURTY(Per ar Ndla } $ AUTOS ONLY AUTOS X HIRED NON-OWNED Pill PFR'TY DAMAGE $, AUTOS ONLY AUTOS ONLY 1� are�ddr r t $ A X UMBRELLALIAB OCCUR 21SBMBA9 TH 11111 1202S 1111012026 EACH OCCURRENCE $1„000,000 EXCESS LIAR CLAIMS-MAIDT AGGREGATE $1„000,000 LDEIC I X RIETENTION$in,rinin $ WORKEasCOrMIPENrSATION PIER CDI1i6• AND EMPLOYERS"LIABIIL,ITY YIN SPIER ER AB�NYPN'TOP,rRITE'tOPi ARTYNERIEXE'CUT'IVIE "'" E.L EACH ACCIDENT $ OFEIICERNEM SIER1ExCLURDEID1 N I'A (Mandatory In NH)i E.L DISEASE.EA EMPLOYEE $ Ua dlrii irrm Under C'RIIPTIION OF OPERKI'li below E.L.DISEASE.P01.11CY LIMIT` $ C cybe,Loably ESN0,040350230 6125A2025 2612026 E n 4Dc�arrrence A ErruP�Ynv�art I'rrrcrR a Loa 21 SBMBAOFTH 111/1012025 11 V10J20D 6 Eadi Clain 25„000 AIn+rdDArra 25„0001 aEsSCRIPTION Of OPERATIONS B'LOCATIONS V VEHICLES(ACORD I Adrllrriamalll Remarks Schedule,may be aftached It more apace Is required) Monroe County Board is included as an additional insured on the General)(liability and Auto liability as req'Iuired by tIN1e written contract. A Waiver of Subrogation applies when repined by written �ntract to the General l Liability and Automobile Liability(policies In favor of Mlonroe County Board. AP ETI, T' DATE,..,®.,....4._,. .26 WARS Ni*_XY — CERTIFICATE HOLDER CANCELLATION SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE ALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. MDnrce County Board 11O0 Simonton Street AIN r iXFnR1PPR'SPNTATIVE Key West FL 33040 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/01 ) The ACCIRD name and logo,are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY., PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST' OTHIERS This endorsement modifies insurance provided under the following: BU&INESS AUTO COVERAGE FORM With respect to coverage provided by this,endorsement,the provisions of the Coverage Form applly unless modified by the endorsement, SCHEDULE Narne(s) Of Person(s) Or Organization(s): Any person or organization you are required to include on this, (policy by written contract or written agreement in effect during this pollicy period and executed prior to the "loss", Additional Premium $Included Section IV — Business Auto Conditions, A. Loss Conditions, 5, Transfer Of Rights Of Recovery Against Others To Us does not apply to the person(s) or organization s) shown in the Schedule,but only to the extent that subrogation is waived prior to the ",accident" or the "loss" under a written contract or written agreement with that person or organization. We will retain the additional premium shown albove, regardless,of any early termination of this endorsement of this Policy. JA5203U S 01-191 lincludes copyrighted material of Insurance Services Office, Inc., Page 1 of I with its permission 21SBMBA9FTH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE HARTFORD BLANKET ADDITIONAL INSURED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. A. The following is added to Section C.WHO IS AN INSURED: Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written contract or written agreement, or when required by a written permit issued by a state or governmental agency or subdivision or political subdivision that such person or organization be added as an additional insured on your Coverage Part, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. However, no such person or organization is an additional insured under this provision if such person or organization is included as an additional insured by any other endorsement issued by us and made a part of this Coverage Part. The insurance afforded to such additional insured will not be broader than that which you are required by the contract, agreement, or permit to provide for such additional insured. The insurance afforded to such additional insured only applies to the extent permitted by law. The limits of insurance that apply to additional insureds are described in Section D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS. a. Vendors Any person(s) or organization(s) (referred to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard". (1) The insurance afforded to the vendor is subject to the following additional exclusions: This insurance does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Form SL 30 32 06 21 Page 1 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE HARTFORD (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or"property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Paragraphs (d) or(f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessors Of Equipment (1) Any person or organization from whom you lease equipment; but only with respect to their liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence"which takes place after you cease to lease that equipment. c. Lessors Of Land Or Premises (1) Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) Any'occurrence"which takes place after you cease to lease that land or be a tenant in that premises; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors (1) Any architect, engineer, or surveyor, but only with respect to liability for"bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; (b) In the performance of your ongoing operations performed by you or on your behalf; or (c) In connection with "your work" and included within the "products-completed operations hazard", but only if: (i) The written contract, written agreement or permit requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for"bodily injury" or"property damage" included within the "products-completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services, including: (i) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (ii) Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by an insured, if the "bodily injury", "property Form SL 30 32 06 21 Page 2 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE li-, HARTFORD damage", or"personal and advertising injury" arises out of the rendering of or the failure to render any professional service. e. State Or Governmental Agency Or Subdivision Or Political Subdivision Issuing Permit (1) Any state or governmental agency or subdivision or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (b) "Bodily injury" or"property damage" included within the "products-completed operations hazard". f. Any Other Party (1) Any other person or organization who is not in one of the categories or classes listed above in Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations performed by you or on your behalf; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products-completed operations hazard", but only if: (i) The written contract, written agreement or permit requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by an insured, if the "bodily injury", "property damage", or "personal and advertising injury" arises out of the rendering of or the failure to render any professional service described in Paragraphs f.(2)(a) or f.(2)(b) above. Form SL 30 32 06 21 Page 3 of 3 ©2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THUS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY. THE HARTFORD �o��U��� o�� CANCELLATION ������U U ��U|�� �o� �����U�U����� HOLDER(S) n��* n n��u~ �*n ����nm��u~u~�.�� n n��n� n �* CERTIFICATE n���� n u~ This policy ia subject hm the following additional Conditions: A. If this policy is cancelled by the Cmmpany, other than for non-payment of premimm, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate hm|der(a) vvith mailing addresses on file with the agent o(record or the Company. B. If this policy is cancelled by the company for non-payment of prerniurn, or by the inaured, notice of such oonoeUohon will be provided within ten (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent o(record or the Company. If notice is rnai|ed, proof of mailing to the last known mailing address of the certificate holder(s) on 0e with the agent of record or the Company will be sufficient proof o(notice. Any notification rights provided by this endorsement apply only to active certificate ho|der(s)who were issued a certificate o(insurance applicable to this policy's term. Failure to provide such notice to the certificate ho|der(s) vviU not amend or extend the date the cancellation becomes eKeutive, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents orrepresentatives. Form SL90 13 10 18 Page 1 of C2818. The Hartford THIS ENDORSEMENT CHANGES THE POLICY.PLEASE(READ IT CAREFULLY. ADDITIONAL INSURED - SCHEDULED This endorsement modifies insurance provided undler the following, BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless miodlified by the endorsement. SCHEDULE. Name Of Additional Insured Person(s)Or OrgannIzation(s): Any person or organization you are required to include as an additional insured on this policy by written contract or written agreement in effect during this policy period and executed prior to the Loss" A. SECTION III—COVERED AUTOS LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured is emended)to include as an"'insured`.'the person(s)or organization(s) shown in the Schedule" but only with,respect to their liability for"bodily injury"'or"property damage"to which this insurance applies, caused in whole or in part„ by an,"accident"" resulting from the ownership, maintenance or use of a covered"auito". However,the insurance afforded to such""insured" 1. Only applies to the extent permitted by law; and 2. If coverage(provided to the"insured" is required by a contract or agreement, the insurance afforded to such"insured"will not be broader than that which you are rewired by contract or agreement to provide such"insured". B. SECTION III- COVERED AUTOS LIABILITY COVERAGE, E. Exclusions is amended to include: This insurance does not apply to. "Bodily injury or"'property damage"for which the Person(s) or Nirganiation(s)shown in the Declarations or Schedule is obligated)to pay damages by reason of the assumption of liability in a contract or agreement C. SECTION 11—COVERED AUTOS LIABILITY ITY COVERAGE,C.Limits Of Insurance is amended to include: The most we will pay on behalf of the"insureds"shown in the Schedule is the amount of insurance;. 1. required by the contract or agreement you have entered into with the"insured"; or 2. Available under the applicable Limits of Insurance shower in the Declarations; whichever is less. Thies endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. MSES 14910 016 21 Page 1 of 1 2021 M IG(Holdings(Ul. .A.),Inc. All rights reserved Includes copyrighted materdal of Insurenoe services offence„Inc.,with its pernndssion_ 21 SBMBA9FTH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THE HARTFORD AMENDMENT OF OTHER INSURANCE CONDITION - PRIMARY OR PRIMARY AND NON-CONTRIBUTORY WHEN REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT This endorsement modifies insurance provided under the following: UMBRELLA LIABILITY SUPPLEMENTAL POLICY Except as otherwise stated in this endorsement, the terms and conditions of the Supplemental Policy apply. A. The following is added to Section C.WHO IS AN INSURED: Any person or organization with whom you agreed, because of a written contract, written agreement or because of a permit issued by a state or political subdivision, to provide insurance such as is afforded under this Supplemental Policy, but only with respect to your operations, "your work" or facilities owned or used by you. a. This provision does not apply: (1) Unless the written contract or written agreement has been executed, or the permit has been issued prior to the "bodily injury", "property damage", or"personal and advertising injury"; and (2) Unless the limits of liability specified in such written contract, written agreement or permit are greater than the limits shown for"underlying insurance"; or (3) Beyond the period of time required by the written contract or written agreement. b. In no event shall any coverage afforded to any such person or organization apply to any claim or "suit" to which "underlying insurance" does not apply. Coverage provided by this Supplemental Policy for any such additional insured will follow the provisions, exclusions and limitations of the "underlying insurance". B. Solely as with respect to the insurance afforded to any person or organization qualifying as an additional insured under Section A. above, Paragraph 7. Other Insurance in Section E. CONDITIONS is deleted and replaced by the following: 7. Other Insurance a. This Supplemental Policy shall apply in excess of all "underlying insurance" whether or not valid and collectible. It shall also apply in excess of other valid and collectible insurance (except other insurance purchased specifically to apply in excess of this insurance)which also applies to any loss for which insurance is provided by this Supplemental Policy. These excess provisions apply, whether such other insurance is stated to be: (1) Primary; (2) Contributing; (3) Excess; or (4) Contingent. b. However, the following provisions apply to other insurance available to any person or organization qualifying as an additional insured under Section C. WHO IS AN INSURED, as amended by Section A. of this endorsement and who is also an additional insured under the Business Liability Coverage scheduled in the "underlying insurance": (1) Primary Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit to provide primary insurance to the additional insured, then, after the "underlying insurance" is exhausted, this insurance will be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Paragraph c. below. Form SU 30 24 10 18 Page 1 of 2 ©2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) THIS ENDORSEMENT CHANNGES THE POLICY. PLEASE READ, IT CAREFULLY. THE HARTFORD (2) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement, or permit to provide insurance to, the additional ins,uired that is primary and nior�cointribuitory, then, after the "underlying inisuirancle"' is exhausted, this insiurance wi:[I be primary and we will not seek contribution, from the additional insured's own insurance Paragraphs (1) and (2), do not apply to other insurance on which the additional insured qualifies as an additional insured pursuant to the terms, of that policy or has been added as an additional insured by endorsement. c. Method Of Sharing If aN of the other insurance permits contribution by equal shares, we wili follow this method also. Under this approach each !insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains,, whichever comes first. If any of the other insurance does not permit contribution, by equal shares, we wifl contribute by llim,its. Under this method!!, each inisuirer's, share is based on the ratio of its applicable limit of insurance to, the total applicable lim,its,of insurance of all insurers. C. Paragraph, D.6. How Limits Apply To Additional Insured is deleted and replaced by the following: How Limits Applly To Additional Insureds a. If you have agreed in a Written contract, written agreement or permit that another person or organization be added as an additional insured on the Business Liability Coverage scheduled in the "'underlying insurance" and such person or organization also qualifies as an, additional insured under this Supplemental Policy, the most we will pay on behalf of such linsuredl is the lesser of. (1) The limits of insurance specified in the written conitiract, written agreement or permit, less any amounts payable by any"underlying insurance"; or (2) The Limits of Insurance shown in the Umbrella Liability Supplemental Policy Declarations. b. Such amount shall be a part of ands not in addition, to, the Limits of Insurance shown in the Ulmbrellla Liability Supplemental Policy Declarations and described in other provisions of this Section. Form, SU 30 24 10 18 Page 2 of 2 @ 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inic., with its permission) 74/2/2026 E(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Certificate Department She Insurance Group Inc. PHONE FAX 1021 Douglas Ave A/C No Ext: 407-869-0962 A/c,No):407-389-3580 E-MAltamonte Springs FL 32714 ADDRESS: Certificates@sihle.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Hartford Underwriters Insurance Company 30104 INSURED LIFEEXT-01 INSURERB: MSIG Specialty Insurance USA Inc 34886 Life Extension Clinics Inc. INSURERC: Palomar Excess and Surplus Insurance Company 16754 dba Life Scan Wellness Centers 1011 N MacDill Ave INSURERD: Tampa FL 33607 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:990879638 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y Y 21SBMBA9FTH 11/10/2025 11/10/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY� PE� LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y HN01000294-03 3/2/2026 3/2/2027 COMBINED SINGLE LIMIT $1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLALIAB OCCUR 21SBMBA9FTH 11/10/2025 11/10/2026 EACH OCCURRENCE $1,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$1 n nnn $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICE R/M EMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Cyber Liability ESNO040389230 6/26/2025 6/26/2026 Each Occurrence A Employment Practices Lia 21SBMBA9FTH 11/10/2025 11/10/2026 Each Claim 25,000 Aggregate 25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County Board is included as an additional insured on the General liability and Auto liability as required by the written contract. A Waiver of Subrogation applies when required by written contract to the General Liability and Automobile Liability policies in favor of Monroe County Board. AP 5M My WAIM WA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD '­N CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) AcoR®- 4% 0611612026 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT nda Groves 0.E.Wilson Insurance,Inc. lair, bin PHONE 7127 535-0524 � p72 536 9828 .._2 PO Box 1429 r Fca cirtda oe il^son com Largo,FL 33779 _. _ 1NSyREl"lsl a"FEt ,t11Gq_g9VERk9E NAIC# ..__.._. _. ..... __...... ..... ....,.�nI .I�:R�g.a.,: Admiral Insurance Company 24856 INSURED INSURER Life Extension Clinics,lnc.dba Life Scan Wellness Centers INSURERG; LS Wellness,PLLC 11954URF,RP, 1011 N.MacDill Ave. 1:r11,1?RR :.Iw __.....................__- _... .m , Tama FL 33607 I,IhLSURER F COVERAGES CERTIFICATE NUMBERLIFEEXT2022 REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,. ...____________________________________ ______________________________.. _._.. 1NSR i4DDL SUB''' POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED .................. ......._................................. .........................._ � ............................................ � MED EXP A�r,,y ane,�erson $ PERSONAL&ADV INJURY $ G�E N'L AGGREGATE LIMIT APPLIES PER; ENERAL A(�fzRECATF._ ,,,. POLICY JE® ❑ LOC PRO CTS .gQMPIOP AGG $ _.. OTHER, 5 AUTOMOBILE LIABILITY COMBINED SI'.NGLE.UMIT $ ANY AUTO BODILY INJURY(Per person} $ ALL OWNED SCHEDULED ........ ......... .............. .. AUTOS AUTOS aEel ' ,.T BODILY NON-OWNED If"y PROPERTY DAMAGE $ HIREDAUTOS AUTOS t W ..," .e6..IfGGLd00.1_............................. . ..._ UMBRELLA LIAB ,......, OCCUR WAMM W EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED .RETENTION$ $ WORKERS COMPENSATION PER OTH- ANO EMPLOYERS'LIABILITY YIN _ ST. UT"E. .... .EI m...m..... .m......... ...........m ANY PROP METOR1PARTNEMXEC4.1R"NVE❑ NIA EL EACH ACCIDENT $ (,)PFICERIMEMBER Ek,CLIJ0E0? ...... ........� (Mandatory In NH) E-L DISEASE-EA EMPLOYEE'$ " es„describe und(u RIPTION OF 7PF:RA IONS W ws E_L DISEASE-POLICY LIMIT $ A Medical Professional Liability X E0000037691-09 05/31/2025 05/31/2026 3,000,000 Aggregate Retroactive Date:5/31/2001 2,000,000 Each Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Medical Professional Liability Additional Coverages: Sexual Abuse $1,000,000 Each Claim/$1,000,000 Aggregate Network Securi &Data Privacy Liability$ CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West,FL 33040 AUTHORIZED REPRESENTATIVE <SMK> c O 1988 2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CDATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE Acct# 3045439 F05/21/2026 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 AON RISK SERVICES SOUTH, INC NAME: PHONE 3550 LENOX ROAD NORTHEAST, SUITE 1700 A/CC No, o Ext: 844-398-0470 FAX No: E-MAIL ts eo ATLANTA,GA 30326 ADDRESS: cer @p PIease.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Indemnity Insurance Company of North America 43575 INSURED INSURER B Life Extension Clinics,Inc. dba Life Scan Wellness Centers,LS Wellness PLLC INSURER C 1011 N MacDill Ave Tampa,FL 33607 INSURER D INSURER E: 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PE LOC �l„ k ' PRODUCTS-COMP/OP AGG $ OTHER: ,P ""'"`""` $ AUTOMOBILE LIABILITY ,. -� - �"�"""� COMBINED SINGLE LIMIT �- Ea accident $ ANY AUTO 526.26 .. .,,,,,„,,, __tea, BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED WAMMPROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1000000 A OFFICER/MEMBEREXCLUDED? ❑ N/A C7430381A 01/01/2026 01/01/2027 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1000000 If yes,describe under 1000000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Insurance Compliance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 100085-FX Duluth GA 30096 AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) AC"RfY CERTIFICATE OF LIABILITY INSURANCE 05/22/2026 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CON TACT Clna Groves O,E.Wilson Insurance,Inc. PHONE 727 535- 524 FAx 727 536-9828 O Box 1429 E-MAIL cinda@oewilson.com Largo, FL 33779 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Landmark A erican Insurance Company 33138 INSURED INSURER B Life Extension CIInlcs,lnc.dba Life Scan Wellness Centers INSURERC: 1011 N. Mac III Ave. INSURER D: Tampa, FL 33607 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBERLIEEX2022 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGMISE TO RENTED $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO- ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Fa acc den ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS PRidn $ l $ UMBRELLA LIAB OCCUR � EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE y -AGGREGATE $ DED I I RETENTION ReIj 5,262�„�:,6­ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN www STATUTE FIR ANY PROPRIETOR/PARTNER/EXECUTIVE El NIA EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Medical Professional Liability X L M876383 05/31/2026 05/31/2027 3,000,000 Aggregate Retroactive ate:5/31/2001 2,000,000 Each Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Medical Professional Liability A itional Coverages: Sexual Abuse $1,000,000 Each ClaI 1$1,000,000 Aggregate Network Securit 8< Data Privacy Liability$ CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE 0 '<SM > )� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD