Resolution 515-1991
.~
II'
RESOLUTION NO. 515 -1991
C 0"\
c.:^ \"~
c '<'-:.:.:,'
r , c__
t~
C. (""-
CY' N
C. /- -',
l."... ~jJ
c.::.1
c.:,
W
.-l .-
- 9'
l.I-
A RESOLUTION OF THE MONROE COUNTY BOARD OF
COMMISSIONERS AUTHORIZING THE EXECUTION OF
A CONTRACT BY AND BETWEEN THE GUIDANCE
CLINIC OF THE MIDDLE KEYS AND MONROE COUNTY
TO PROVIDE FOR THE CONTINUATION OF THE
ANTI-DRUG ABUSE GRANT RESIDENTIAL / WORK
RELEASE PROGRAM
WHEREAS, Monroe County has been awarded $51,750.00 in
Anti-Drug Abuse Grant monies to provide funding for the
continuation of the Residential/Work Release Program; and
WHEREAS, the Residential/Work Release Program is
designed to offer drug offenders a rehabilitation program
and to assist these individuals in gaining employment; and
WHEREAS, the Guidance Clinic of the Middle Keys was
awarded the contract for the 1990-1991 Residential/Work
Release Program during the open bid process in November,
1990; and
WHEREAS, the Guidance Clinic of the Middle Keys has an
established program structure, including staffing
requirements and other operational specifics; and
WHEREAS, Monroe County has received notice that the
Office of Justice Programs staff has approved a sole source
request to contract the Guidance Clinic of the Middle Keys,
Inc., for services on the referenced grant, now therefore,
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONER OF
MONROE COUNTY, FLORIDA, that:
1. The Board of County Commissioners waives the county
purchasing policy procedures and grants sole source
approval to the Guidance Clinic of the Middle Keys; and
that
2. The Mayor of the board is hereby authorized to
execute a contract by and between the Guidance Clinic
of the Middle Keys, Inc., and Monroe County.
PASSED AND ADOPTED by the Board of County Commissioners
of Monroe County, Florida, at a regular meeting of said
Board held on the 20th day of November, A.D. 1991.
Mayor Harvey Yes
Mayor Pro Tern London No
Commissioner Jones Yes
Commissioner Cheal Yes
Commissioner Stormont Yes
BOARD OF COUNTY COMMISSIONERS
OF M~E>E C~UN~Y ~
DANNY L. :KOLHAGE, Clerk By: "~~A.I -,...... - ~ .~ ~ ~ ~
(Seal) ~.t.. ~ ."
Attest: ._ ,,~JJ.",
Cler
I.r-:','." ,.. .,~ .-".,. "
" ",' / ,#
By A:' '.. ~ ' /~-
_ ~"'/l/i/tJ I .-
f /
THE GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.
ANTI-DRUG ABUSE ACT FUNDS AGREEMENT
THIS AGREEMENT is made and entered this 20th day of
November , 1991, by and between MONROE COUNTY,
a political subdivision of the State of Florida, whose
address is 5100 College Road, PSB - Wing II, Stock Island,
Key West; Florida 33040, hereinafter referred to as
"COUNTY," and THE GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.,
a non-profit organization; whose address is 3000 41st Street
- Ocean, Marathon, Florida 33050, hereinafter referred to
as "GUIDANCE CLINIC."
WIT N E SSE T H:
WHEREAS, the Department of Community Affairs had
awarded a subgrant of Anti-Drug Abuse Act Funds to the
County for a Pilot ReSidential/Work Release Program; and
WHEREAS, the COUNTY is in need of an implementing
agency to provide professional services to drug offenders in
a Residential/Work Release Program; and
WHEREAS, the GUIDANCE CLINIC is the most responsible
and qualified bidder; and
WHEREAS, the COUNTY has agreed to disperse the
Anti-Drug Abuse Act Funds to the GUIDANCE CLINIC in
accordance with the Pilot Residential/Work Release
Application for the Anti~Drug Abuse Act Funds.
NOW, THEREFORE, in consideration of the mutual
understandings and agreements set forth herein, the COUNTY
and the GUIDANCE CLINIC agree as follows:
SECTION 1. TERM. The term of this Agreement
is from November 15 , 1991, through November 14,
1992, the date of the signature by ~he parties
notwithstanding, unless earlier t~rminated as provided
herein.
SECTION 2. SERVICES. The GUIDANCE CLINIC will
provide professional services as outlined in the proposal
requirements of the Request For Proposal Anti-Drug Abuse
Intervention Program and the Pilot Residential Work Release
Program Application for Anti-Drug Abuse Funds, attached and
made a part hereof.
SECTION 3. FUNDS. The total project budget to
be expended by the GUIDANCE CLINIC in performance of the
services set forth in Section 2 of this agreement shall be
the total sum of SIXTY-NINE THOUSAND AND NO/100 DOLLARS .
($69,000.00). The total sum represents federal support in
the amount of FIFTY-ONE THOUSAND SEVEN HUNDRED FIFTY AND
NO/I00 DOLLARS ($51,750.00) and local matching funds of
SEVENTEEN THOUSAND TWO HUNDRED FIFTY AND NO/I00 DOLLARS
($17,250.00). All funds shall be distributed and expended
in accordance with the Project Budget Narrative submitted as
a part of the Application for Anti-Drug Abuse Act Funds.
SECTION 4. . INCORPORATION BY REFERENCE. The
provisions of that certain document entitled "State of
Florida Department of Community Affairs, Division of
Emergency Management, Bureau of Public Safety Management
Subgrant Application for Anti-Drug Abuse Act Funds" and all
laws, rules and regulations relating thereto are
incorporated by reference.
SECTION 5. IMPLEMENTING AGENCY BOUND. The
GUIDANCE CLINIC, as an implementing agency under the
COUNTY's Anti-Drug Abuse Residential/Work Release Program,
shall be bound by all the provisions of the documents
incorporated by reference in Section 4 of this Agreement.
Additionally, the GUIDANCE CLINIC shall be bound by all
laws, rules, and regulations relating to the COUNTY's
performance under the Department of Community Affairs Grant
Program.
SECTION 6. BILLING AND PAYMENT.
(a) The GUIDANCE CLINIC shall render to COUNTY, at
the close of each calendar month, an itemized invoice
properly dated, describing the services rendered must be
submitted in detail sufficient for a proper preaudit and
postaudit thereof, and all other information as required by
the COUNTY'S Finance Department. The original invoice shall
be sent to:
Office of Management and Budget
Monroe County
5100 College Road
PSB - Wing II - Room 209
Stock Island
Key West, Florida 33040
(b) PaYment shall be made after review and
approval by COUNTY within thirty (30) days of receipt of the
GUIDANCE CLINIC invoice.
SECTION 7. TERMINATION. This Agreement may be
terminated by either party at any time, with or without
cause, upon not less than thirty (30) days' written notice
delivered to the other party. The COUNTY shall not be
obligated to pay for any services provided by the GUIDANCE
CLINIC after the GUIDANCE CLINIC has received notice of
termination. In the event there are any unused Anti-Drug
Abuse Act Funds, the GUIDANCE CLINIC shall promptly refund
those funds to the COUNTY or otherwise use such funds as the
COUNTY directs.
SECTION 8. ACCESS TO FINANCIAL RECORDS. The
GUIDANCE CLINIC shall maintain appropriate financial records
which shall be open to the public at reasonable times and
under reasonable conditions for inspection and examination
and which comply. with the Agreement incorporated in Section
4 of this Agreement.
SECTION 9. AUDIT. The GUIDANCE CLINIC shall
submit to the COUNTY an audit report covering the term of
this Agreement within one-hundred twenty (120) days
following the Agreement's lapse or early termination and
shall also comply with all provisions of the Agreement
incorporated in Section 4 of this Agreement.
SECTION 10. NOTICES. Whenever either party
desires to give notice unto the other, it must be given by
written notice, sent by registered United States mail, with
return receipt requested, and sent to:
FOR THE COUNTY:
Pamela S. Womack
Director, Office of Mgmt. & Budget
5100 College Road
PSB - Wing II - Room 209
Stock Island
Key West, Florida 33040
FOR THE GUIDANCE CLINIC:
David P. Rice, Ph.D.
The Guidance Clinic of the~iddle Keys
3000 41st Street - Ocean_
Marathon, Florida 33050
Either of the parties may change, by written notice as
provided above, the addresses or persons for receipt of
notices.
SECTION 11. UNAVAILABILITY OF FUNDS. If the
COUNTY shall learn that funding from Florida Department of
Community Affairs cannot be obtained or cannot be continued
at a level sufficient to allow for the services '
specified herein, this Agreement may then be terminated
immediately, at the option of the COUNTY, by written notice
of termination delivered in person or by mail to the .
GUIDANCE CLINIC at its address specified above. The COUNTY
shall not be obligated to pay for any services provided by
the GUIDANCE CLINIC after the GUIDANCE CLINIC has received
notice of termination.
SECTION 12. COMPLIANCE WITH LAWS AND REGULATIONS.
In providing all services pursuant to this Agreement, the
GUIDANCE CLINIC shall abide by all statutes, ordinances,
rules, and regulations pertaining to, or regulating the
provisions of, such services, including those now in effect
and hereafter adopted. Any violation of said statutes,
ordinances, rules, or regulations shall constitute a material
breach of this Agreement immediately upon delivery of written
notice of termination to the GUIDANCE CLINIC. If the
GUIDANCE CLINIC receives notice of material breach, it will
have thirty (30) days in order to cure the material breach of
the contract. If, after thirty (30) days, the breach has not
been cured the contract will automatically be terminated.
SECTION 13. ASSIGNMENTS. Neither party to this
Agreement shall assign this Agreement, nor any interest
arising herein, without the written consent of the other.
SECTION 14. EMPLOYEE STATUS. Persons employed
by the GUIDANCE CLINIC in the performance of services and
functions pursuant to this Agreement shall have no claim to
pension, worker's compensation, unemployment compensation,
civil service or other employee rights or privileges granted
to the COUNTY's officers and employees either by operation of
law or by the COUNTY. The GUIDANCE CLINIC warrants that it
has not employed, retained or otherwise had act on its behalf
any former County officer or employee subject to the
prohibition of Section 2 of Ordinance No. 010-1990 or any
County officer or employee in violation of Section 3 of
Ordinance No. 010-1990. For breach or violation of this
provision the County may, in its discretion, terminate this
contract without liability and ma~ also, in its discretion,
deduct from the contract, or otherwise recover, the full
amount of any fee, commission, percentage, gift, or
consideration paid to the former County officer or employee.
SECTION 15. INDEMNIFICATION. The GUIDANCE
CLINIC agrees to hold harmless, indemnify, and defend the
COUNTY, its commissioners, officers, employees, and agents
against any and all claims, losses, damages, or lawsuits for
damages, arising from, allegedly arising from, or related to
the provision of services hereunder by the GUIDANCE CLINIC.
SECTION 16. ENTIRE AGREEMENT.
(a) It is understood and agreed that the entire
Agreement of the parties is contained herein and that this
Agreement supersedes all oral agreements and negotiations
between the parties relating to the subject matter hereof as
well as any previous agreements presently in effect between
the parties relating to the subject matter hereof.
(b) Any alterations, amendments, deletions, or
waivers of the provisions of this Agreement shall be valid
only when expressed in writing and duly signed by the
parties. . .
IN WITNESS WHEREOF, the parties to this Agreement have
caused their names to be affixed hereto by the proper
officers thereof for the purposes herein expressed at
, Monroe County, Florida, on the
date and year first written above.
BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA
By
(Seal)
Attest: DANNY L. KOLHAGE, Clerk
DAVID P. RICE, Ph.D.
The Guidance Clinic of the
~~
_~ ~m~
/ itness
... .
j. . '.IV. PROPO:
\,
1:QUlREMENTS
(1) To provide Statement of Qualification to include a de-
scription of the staff organization of the firm God faciliey.
(2) To provide diagnostic services, psychosocial assess-
ments, CAse manAgement services, trackinq, and shor~-ce~
coun~elin9 in a residential drug treatment program.
(3) To provide employment assessment and assist in the CQor-
aination of appropriate employment reforral.
I
(4) Establi$h fiscal con~rol and fund accounting procedures
to assure proper disbursement and accounting of subgrane
funds and required.non-federal expenditures.
, .
(5) Submit at a minimum: Quarterly Performance Repores,
Annual Perfor.mance Report and Monthly Financial Claim Re-
ports.. .
(6) Retention of all records/financial documents for a mini-
mum of . three years.
(7) Thirty day commenoement of project upon award of con-
tract by ~he Monroe County BOArd of County Commi$sion~rs.
,
(8) Provide full disclosure reqarding administrative ac-
tions against the individual or firm by the seate of Florida.
(9) A m1nim~ of three (3) ~eds shall be providea.
(lO) Co~plete Non~CollusiQn Affidavit. See attached copy.
(ll) Assurance of the bidder's ability ~o meet criteria for
contracting with a local governmen~ unic if selec~ed, which
includes: .
a. : TO provide proof of Protessional Liability Insurance
with minimum limits of $1,000,000 ana General Li~ility
wi~h minimum limits of $1,000,000
b. ' Indemnification and Hold Harmless. Vendor agree$ ~o
indemnify and hold Monroe County harmless from any and
all. clatms, liabili~y, losses and caUSes of ac~ion
which may arise out of the fulfillment of the a9r~e-
ment. The Vendor agrees to pay all claims and losses
and shall defend all suits filed due to the neglig~nt
acts, errors, or omissions of its cmployee~ and/or
agents, including rela~ed cour~ co~ts.
4
t'"., I
~.' \. .
e. Statement on Public Entity Crimes. At the ~ime of
contract finalization, ehe Vendor will supply a no~a-
rized SWORN STATEMENT UNDER Section 133(3)(j), FLORIDA
S'rA'lVrES ON PUSLIC ~I'fi CRIMES.
5
,
, ,
I' )
(
".
.....
~ ilJ 't '-;L., :. 1\..1 "" U. ".L
t"..:..
....
,.'
,"ORN STATEMD\T Ur-:OER SECTI0~ W.13J(J)(u),
FLORIDA STATUTES. ON PUlSUC ENTITY ClUMES
nUs FOR.\f MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUDLIC OR OTHER OFFICER
AUTHORIZED TO ADMlNlSTER OATHS.
nus swom statement is suntiucd wilh Bid, Proposal or Conlnct No.
tor Anti-Drug Abuse Intervention Program
, " -
2. 1'hiS sworn statemenl is sublllitted by The, Guidance .Clinic of the Middle Kevs, Inc.
lUIDtI of enlSty luDlDJWIlI swom ~ta&emeqt)
b. ft.l..f_ . 3000 41st St. Ocean, Marathon, FL 33050
wbose usmess ~ess 1.1_
1.
and
(If appUc:a1)le) its. Fedcn1 ~ploye.r l:1ent:i&:atioll Number (FmN) is 59-1458324
(It the entity bas DO FEIN, mClude the Soci.a1 Security Number of the individual signing this ,~'Q:n
stateccnt:
.)
3.
David p, ~ice, Ph.D.
My name is
(please prilu name ollDdiriduaJ sipiDaJ
cctity named above is Chief Executive Officer
I understand that a .public entity aime. as dc:1iDed in Paragraph 287.133(1)(g), ~"ridp Statutes.
means a \'iolauon of any state or.fcdc:a1l&w by a person With respect to and c1ircClly retate4 to tllc
transactiOn at busmess with any public: enul}' or with an agency or political SUbdivision of any other
state or With me United Stat~, inc1UdU1I, but COt limited to. any bid or contract tor goods or
services to be prcMdtd to any public entity or an agency or political subdivision ot an)' Ot~er state
or of the Unlled SEates and involving 3J1tfU'USt, !laud, theft, bribery, collusion, racUcluring,
colUpi!'3cy, or material misteprc:s~tation.
and my relationship to the
4.
$. I undenta:1d that '"co:wictcd. or '"COnviction- as detlnec1 ill Pa:alfaph 281.133(1)(b),.Eorida St3tUt~.
means a findfn~ ot guilt or a conViCtion of a public eatity cOme, wim or WithOut an adju4iC3tion of
gui11, in all)' federal or stlte trial coun of "record relating to chules brou,Dt by Indictment or
intomution alter July 1, 1989, as i\ result of a jury ven1iCl, conjury trial, 0: e:wy ot a plea ot guilty
or nolo c:ontenc!ere.
6. I unde~Und that 3n .atlIlfatc. as c1ct!ned in Paragraph 287.133(1)(3), Florida Staant$. means:
1. A predee:ssor or suc:ccssor of a person COnvicted ot a public entity crime: or
2. An entity under the: control of any natura) pe%Son wbo is active in the managemect ot the
entity and who has bee.u com;cted of a public entity crime. The term .atmiate. iD=lu~ tllO$e
omeen. dir~ors, executives. partners, shareholders. employees, membca. .uc1 agents who are active
in the manalcment of an affiliate. The ownczship by ODe person ot sUres C4DSlitutiAl a controlling
lnterC$t in another person, or a pooling ot eqUipmellC or income among persons when not for fair
m;srJcer value under an ann's 1eneth agreement, sball be a prima lade: CLSe that one penon controls
:anOther person. A person who kDowin:ly enters into a jOint VCDtur!: wiUl a person who has been
convicted of a public CQt:;y crime in Floric:1a dUflJl1 the preceding 36 ."lOntl'.,s shaU be considered 3n
aCfiliate.
7. A underst:md that I .person- as detiued in P3fagrapb 287.133(1)(e), FlOrida $tatl1f~s me3ns any
natural pe~on or enti~ organized under the J3W1 of any st.ne or ot the UnlleG SUtl~ wit" the I~gal
power to enter into a binding COntract and whiCh bids or :lpplie.s to bid on COntr:u:'tS for the: prOvision
of !!ond.s or service:. let b~' a pUblic entity, or which o:herwLsc tnns:lCtS or :applies to :!':UUJCt business
~ith a pl:!>!ic entity. The tcr:n "?enon" incl~~t".s those oCtlcers, directors, e~eculi\'es, parl:'ler~,
~h3reh()iders. employees. mcmtlers, and acentS wh~ ale ~ctjyc in m3D3,crnenl oC :In entity.
8. B3sed 0:\ inform.uian ~nd belie!. lhe S~Ic:me:\l whic:h J l'I~yc m:srked below is true in r~liltion 10 Ilu:
eflli[}' sUllInming In::; !worn $IalC",CI:I. r Plc.us(' illdiauc Whid15turt'men! Applies.}
I :~
---L ~ell . eatny SubmlUlnl tbis sworn Ultt:rMnt, DOr lay oftlccn on. eJCCCUlI\'CS. . '
partners, Slu","u\I,den. empl~ecs. members, or aJefttS wbo arc actlYC i.1! manatc:mc:nl ot Ole catity.
nor any ,'fihale ot the enliry have M~n cb.afJed with aDd convicted ot 3 public enllt). crimc
subsequent to July 1. 1m.
- The entity lubD'lltune tbls SWOrD s~temenl. or One or more ot the octlC4:tS. directors. (
executives. palmers. sharchoJdcn. empJoycc:.1. members, or agents who Irc 3ctl\ll: in management .of
the CSldty. or an IttUi.1te of the "liry h:U been charleel with &Dd coaYic:tc4 of a public eatity crime
SUbscqucnllO Jwy 1~ 1989. ~ [PIMM 1cuUcala wb&cb 44dltfonaj statemCDt applJes.J
.-
, 'There has bClen a procccdinl c:onCClDiDI the muric:tion before a hearing' officer or
tbe Slare or Roricla. Division ot Administrative HearinlS. The anal order cIuered by lbe
heuiA. otJk:er did not place the ~D or atfi1i.1lC 011 the canYiacd vCDdor list. [Pk:ase
attada I COP1 or me ao.1 order.) .
_ The person or a.mtialC was p~ OD Ule corlYiaccl vendor list. There has bc.cn a
.NbSequenr procee41nC belore a hcariD& omcer Of l.Iac Swe at Florida, 'Division . of
A4ministr2tive Hc:ari1igs. The tina1 orc1et CDtered by Ulc hearing of1ia:r dctermi:Icd thaI it
was in the public inrcrest to remove tho penon or aff'f1iAte from the mnviaed vendor lisL
[please actach a mp1 or the tmat order.). .
_ The pczscn or af:lliatc ~ nOl bc:cJ: placed Q.a the .convicted vendor list. [PleASe
deseribe Any aC'don mk.ell by or pcDdln. Mill the JlqArr:m.cnt or GcnenalSemces.j
,{[)d:~~
t lst&J1A&ureJ
o:uc:
/2-11c-C/1
STATE OF
Florida
l'fonroe
(
COL"Nn" OF
PERSONAU.Y APPEARED BEFORE ME. the lUldorsipcd &UU1ority,
David P. Rice, Ph.D.
(eam. ot Jndbidua! stl'ft1n&J
in me space provfd=1 above on this
who. atw ftrst bemg.swom -by me. L~ his/her sign~turt
lfo
day or ~c.. 19 q, ~
\
~~~k
- NOTAR~ PUBU(~
. .
My coccU.ssioQ expires: tn r.: r-:;': or <, ,c ..~: CT ;C!..C~ID,!\
~~,L;:'.~ ';j\~/G~;,~;L\L;~f;s. ?ui~5:'4
NOTARY 'U8L'Co STATt OF' FlORIDA
MY COMMfSSION EA;>.'d:S M:~R. 2. 19t1.
eOHDED '"1111 "O1'~.." ,."....0 IIHDE".IIIfEII.,
.
.
For;;l PUR 7068 (Rev. 1118!))
c
11
DELIVERY INVOICE
.lsti1lul
Company. ST. PAUL FIRE & MARINE INSURANCE COMPANY
I
N
S THE GUIDANCE CLINIC OF THE
U MIDDLE KEYS, INC.
R P.O. BOX 2646
E MARATHON SHORES FL 33050
D
Policy Inception/Effective Date: 06/30/91
Agency Number: 3902006
Transaction Type:
POLICY IS NEW
Transaction number: 001
Processing date: 09/23/91 09:46
Policy Number: FG06800081
A THE INSURANCE EXCHANGE
G 1518 WASHINGTON ST
E COLUMBIA SC 29201
N
T
Policy
Number
Description
Amount
Surtax/
Surcharge
FG06800081
FG06800081
FG06800081
GENERAL LIABILITY POLICY
MEDICAL PROFESSIONAL LIABILITY POLICY
PREMIUM PAYMENT PLAN SERVICE CHARGE
$5,275.00
$9,930.00
$426.00
40724 Ed. 12-90 Printed in U.S.A.
Page 1
INSURED COPY
PROfESSIONAL L1AE
'ROTECTION COVERAGE SUMMARY
.I!6lul
. This Coverage Summary shows the limits and
extent of coverage under your Professional
Liability Protection.
Limits Of Coverage
Your employees and volunteer workers
share in the limits of liability.
Each person limit
$ 1.000.000
$ 1.000.000
Total limit
Profession:
MENTAL HEALTH AND SUBSTANCE ABUSE INPATIENT AND OUTPATIENT COUNSELING
(CLASS CODES 73714/99024/99027)
Who's Protected Under This Agreement
Class Code
Individuals
Retroactive date
Deductible
Class Code
Organizations
THE GUIDANCE CLINIC OF THE
MIDDLE KEYS. INC.
Retroactive date
06/30/86
Deductible
$ 0
Name of Insured
THE GUIDANCE CLINIC OF THE
Policy Number FG06800081 Effective Date 06/30/91
Processing Date 09/23/91 09: 46 001
43544 Ed.1-85 Printed in U.S.A. Coverage Summary
cSt.Paul Fire and Marine Insurance Co.1985 All Rights Reserved
Page 1 of 2
HEAlfH CARE FACI lMMERCIAL GENERAL LIABILITY
PROTECTION COVERAGE SUMMARY
This Coverage Summary shows the limits of
coverage that apply to your Health Care Facility
Commercial General Liability Protection. It also
lists those endorsements, if any, that must have
certain information shown for them to apply.
.sstiliul
Limits Of Coverage
Deductibles
Each event limit.
Fire damage limit
Medical expenses limit
$1,000,000
$50,000
$5,000
Personal injury and
advertising injury limit.
$1,000,000
Total limit.
$1,000,000
The Limits Of Coverage section explains
how these limits apply.
The following deductibles apply only if
deductible amounts are shown.
Bodily injury deductible.
Personal injury and
advertising injury deductible.
Total deductible.
The Deductibles section explains how these
deductibles apply.
Type of Facility: MENTAL HEALTH AND SUBSTANCE ABUSE INPATIENT AND OUTPATIENT
COUNSELING
IMPORT ANT NOTE
Retroactive Date: 06-30-86
The retroactive date applies only if the Health
Care Facility Commercial General Liability
Protection - Claims-Made insuring agreement is
a part of this policy.
However, if no date is shown above and the
claims-made agreement applies, we'll consider
the retroactive date to be the same as the
beginning date of this policy.
Named Endorsement Table
Important Note: Only endorsements that must have certain information shown for them to apply are
named in this table. The required information follows the name of each such endorsement. Other
endorsements may apply. If so, they're listed on the Introduction, along with these endorsements.
Name of Insured
THE GUIDANCE CLINIC OF THE
Policy Number FG06800081 Effective Date 06/30/91
Processing Date 09/2 3 / 91 09 : 46 001
43657 Ed.1-86 Printed in U.S.A.
eSt.Paul Fire and Marine Insurance Co.1985
Coverage Summary
Page