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FY 18/19 Grant Agreement MB Community Health Center, Inc. 020/g_306/2_ MIAMI BEACH CITY OF MIAMI BEACH FISCAL YEAR 2018-2019 GRANT AGREEMENT PROJECT No.: 2019-CMB-02 This GRANT AGREEMENT is made and entered into this 13 day of IVc eyn , 2018 by and between the City of Miami Beach Florida (hereinafter the "City"), and the Miami Beach Community Health Center, Inc. (hereinafter the "Grantee"). This Agreement is effective October 1, 2018, the "Effective Date." ARTICLE I /GRANT DESCRIPTION GRANTEE: Miami Beach Community Health Center, Inc. GRANTEE CONTRACT ADMINISTRATOR: Sorangely Menjivar ADDRESS: 710 Alton Road CITY, STATE, ZIP: Miami Beach, FL 33139 PHONE, FAX, E-MAIL: (305)538-8835, (305) 938-4044 Sora ng elym@m bchc.corn GRANT AMOUNT: $22,000 PROJECT DESCRIPTION: See Exhibit 1 hereto GRANT PROJECT BUDGET: See Exhibit 2 hereto GRANT TERM: October 1, 2018 — September 30, 2019 EXPENDITURE DEADLINE: September 30, 2019 PROJECT COMPLETION DATE: September 30, 2019 FINAL REPORT DEADLINE: October 15, 2019 FINAL REIMBURSEMENT REQUEST DEADLINE: October 15, 2019 SIGH IN WITNESS WHEREOF re a.rt.es hereto have executed this Agreement. FOR CITY: City of Miami Beach, Florida ATTEST: By: Rafael E. Granado, City Clerk m., Jit y L. I orales, City Manager �yv r I1� 131ir �....B/ q1��. \ s (lk Date ff\\ L� IP coPP1 fir' 9E FOR GRANTEE: LL/. 26ififi`Eseach Community Health Center, Inc. FedealID # 59-11829984 ATTEST:By: A r Authorized Signature ' SoranjeitNg/Givar(O0 iaaL1431LIOW.r CfJA&e Print Name and Title Print Name and Title / O1Z9Iis ( 0124 hi Date Date APPROVED AS TO FORM&LANGUAGE &FO EXECUTION �� c° li9(`g City Attorney Date NK- Page 2 AIAAA I BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beech,Florida 33139,www.mlarniceechtl Dow OFFICE OF BUDGET AND PERFORMANCE IMPROVEMENT Grants Management Tel 305-673-7510, Fax: 786-394-4675 October 26. 2018 Miami Beach Community Health Center, Inc. c/o Ms. Sorangely Menjivar 710 Alton Road. Miami Beach, FL 33139 Re: FY 18/19 Citywide Grant Agreement,City of Miami Beach Miami Beach Community Health Center, Inc. Dear Ms. Menjivar: Please find attached one(1)original grant agreement awarded to Miami Beach Community Health Center, Inc. for Fiscal Year 2018-19 for signature. Please return two(2)hardcopy originals to my attention for execution to the following mailing address: City of Miami Beach c/o Judy Hoanshelt Grants Management Division, 3rd Floor 1700 Convention Center Drive Miami Beach, FL 33139 Also, please provide us with the Certificate of Insurance as referenced in the attached agreement, Item 17. We will send you an executed copy for your records once available. If you have any questions, please do not hesitate to contact me at (305) 673-7510, or at my email address judyhoanshelt@miamibeachtl.gov. Sincerely,/JI Ju Hoanshel`^" t tiCalail Director, Grants Management Division Attachment: One(I) Original Agreement JH/ea ARTICLE II/GENERAL CONDITIONS 1. PARTIES: The parties to this Agreement are the Grantee listed in Article I, and the City, a municipal corporation organized under the laws of the State of Florida. The City has delegated the responsibility of administering this Grant to the City Manager or the City Manager's authorized designee (the"Contract Administrator"). 2. PROJECT DESCRIPTION: The Grantee may only use the Grant for the purposes that are specifically described in the Project Description, attached hereto as Exhibit 1. Any modification to Exhibit 1, Project Description, shall not be effective unless approved by a written amendment to this Agreement signed by the City and Grantee. Grantee agrees that all funding provided by the City pursuant to this Agreement will be used exclusively for goods or services to be provided within the City of Miami Beach. 3. GRANT PROJECT BUDGET: Subject to the availability of City funds, the maximum amount payable to Grantee for goods or services rendered under this Agreement shall not exceed the Grant Amount as set forth in Article I of this Agreement. Grantee agrees that should available City funding be reduced, the amount payable under this Agreement will be reduced at the sole option of the City of Miami Beach. All of the grantee's expenditures are subject to the terms of this Agreement, and as specified in the Grant Project Budget, attached hereto as Exhibit 2. Any modification to Exhibit 2, Project Budget, shall not be effective unless approved, in writing, by the City and Grantee. Notwithstanding the foregoing, no modification to the project budget shall exceed the Grant Amount set forth in Article I of this Agreement. Any request by Grantee to modify Exhibit 2, Project Budget, shall be made in writing, using City approved forms, detailing and justifying the need for such changes. 4. REPORTS:This Grant has been awarded with the understanding that the activities and services contemplated under the Project Description will mutually contribute to the enhancement of services available to City residents, businesses, and visitors. As a condition of disbursements of grant funds, and to demonstrate that the Grant is fulfilling, or has fulfilled, its purpose, the Grantee must submit quarterly reports to the Contract Administrator by the following dates: January 15^, April 15", July 15", and the final report by October 15^, New Grant awards will not be released to the Grantee until all Final Reports for previously awarded grants are received. The City may withhold any future payments of the Grant, or the award of any subsequent Grant, if it has not received all reports required to be submitted by Grantee, or if such reports do not meet the City's reporting requirements. Any reports may be disseminated by the City without the prior written consent of the Grantee. All quarterly reports must be submitted on the Exhibit 3, Grant Quarterly Status Report Form, detailing Grantee's compliance at the time of a partial reimbursement request. Page 3 5. REIMBURSEMENT REQUESTS: Reimbursement requests may be submitted to the City at any time during the Grant Term. All reimbursement requests must be made after expenditures have occurred. All reimbursement requests for funds must be submitted on Exhibit 4, Grant Reimbursement Request Form.All reimbursement requests must be submitted prior to October 151h, 2019. Grantee shall provide the City with copies of all receipts, invoices, cancelled checks(with copies of both front of back) and proof of expenditures of Grant monies. Grantee shall provide the City with and shall categorize all receipts, invoices, cancelled checks, and other documentation, according to the categories set forth in the grant budget. Invoices and checks must be directly related to expenses for Grant-funded activities taking place within the 2019-20 Fiscal Year. 6. AMOUNT OF GRANT AND PAYMENT SCHEDULE: The total amount of the Grant is set forth in Article I, subject to the restrictions set forth herein. In awarding this Grant, the City assumes no obligation to provide financial support of any type whatsoever in excess of the total Grant amount. Cost overruns are the sole principal responsibility of the Grantee. The Grant funds will only be remitted to the Grantee once the Mayor and City Commission have approved the grant award, and once all parties have executed this Agreement. 7. GRANT RESTRICTIONS: Grant funds awarded pursuant to this Agreement may not be used for the following expenditures: remuneration of City employees for services rendered as part of a project funded by this Grant; debt reduction; social and/or fundraising events; cash prizes; lobbying or propaganda materials; charitable contributions; or events not open to the public. 8. NO GUARANTEE OF FUNDING: The grantee acknowledges that the receipt of this grant does not imply a commitment on behalf of the City to continue or provide funding beyond the terms specified in this Agreement. 9. PROGRAM MONITORING AND EVALUATION: The City Manager or the City Manager's designee may monitor and conduct an evaluation of the Project under this Grant, which may include, with or without limitation,visits by City representatives to Grantee's offices and/or the site of any project funded by this Grant, to observe Grantee's programs, procedures, and operations, or to discuss the Grantee's programs with Grantee's personnel; and/or requests for submittal of additional documentation or written reports, prior to the Project completion date, evidencing Grantee's progress on the Project. 10. BANK ACCOUNTS AND BONDING: Grantee shall maintain all monies received pursuant to this Agreement in an account with a bank or savings and loan association that is located in Miami-Dade County. The Grantee shall provide the City with the name of the bank or savings and loan association, as well as the name and title of all individuals authorized to withdraw or write checks on Grant Funds. 11. ACCOUNTING AND FINANCIAL REVIEW: Funded activities by this Grant must take place during the City's fiscal year for which the Grant is approved (October 1 —September 30).The GRANTEE Page 4 shall keep accurate and complete books and records of all receipts and expenditures of Grant funds, in conformance with reasonable accounting standards. These books and records, as well as all documents pertaining to payments received and made in conjunction with this Grant, including, without limitation, vouchers, bills, invoices, receipts and canceled checks, shall be dated within the fiscal year for which they are approved and retained in Miami-Dade County in a secure place and in an orderly fashion by the Grantee for at least three (3) years after the Expenditure Deadline specified in in this Agreement. These books, records, and documents may be examined by the City, and/or its authorized representatives, at the Grantee's offices during regular business hours and upon reasonable notice. Furthermore,the City may, at its expense, audit or have audited, all the financial records of the Grantee, whether or not purported to be related to this Grant. Grantee costs or earnings claimed under this Agreement may not also be claimed under any other Agreement from the City of Miami Beach or from any other entity. Any claim for double payment by Grantee shall be a material breach of this Agreement. 12. PUBLICITY AND CREDITS: The Grantee must include the City logo and the following credit line in all publications related to this Grant: "This Project is funded in whole or in part by a grant from the City of Miami Beach." Grantee's failure to comply with this paragraph may preclude future grant funding from the City, in the same manner as if Grantee defaulted under this Agreement. 13. LIABILITY AND INDEMNIFICATION: Grantee shall indemnify and hold harmless the City and its officers, employees, agents, and contractors, from and against any and all actions (whether at law or in equity), claims, liabilities, losses, expenses, or damages, including, without limitation, attorneys' fees and costs of defense,for personal, economic, or bodily injury,wrongful death, or loss of or damage to property, which the City or its officers, employees, agents and contractors may incur as a result of claims, demands, suits, causes of action or proceedings of any kind or nature arising out of, relating to, or resulting from the performance of this Agreement by the Grantee or its officers, employees, agents, servants, partners, principals or contractors. Grantee shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits, or actions of any kind or nature in the name of the City, where applicable, including appellate proceedings, and shall pay all costs, judgments, and attorneys'fees which may issue thereon. Grantee expressly understands and agrees that any insurance protection required by this Agreement, or otherwise provided, shall in no way limit its obligation, as set forth herein, to indemnify, hold harmless, and defend the City or its officers, employees, agents, and contractors as herein provided. If the Grantee is a government entity, this indemnification shall only be to the extent and within the limitations of Section 768.28, Florida Statutes, subject to the provisions of that Statute whereby the Grantee entity shall not be held liable to pay a personal injury or property damage claim or judgment by any one person which exceeds the sum of $200,000, or any claim or judgment or portions thereof, which, when totaled with all other claims or judgments paid by the government entity arising out of the Page 5 same incident or occurrence, exceed the sum of$300,000 from any and all personal injury or property damage claims, liabilities, losses or causes of action which may arise as a result of the negligence of the Grantee entity. 14. ASSIGNMENT: The Grantee shall not be permitted to assign this Grant, and any purported assignment will be void, and shall be treated as an event of default pursuant to this Agreement. 15. COMPLIANCE WITH LAWS: The Grantee agrees to abide by and be governed by all applicable Federal, State, County and City laws, including but not limited to Miami-Dade County's Conflict of Interest and Code of Ethics Ordinance, as amended, which is incorporated herein by reference as if fully set forth herein, and Chapter 2, Article VII of the City Code, as amended, which is incorporated herein by reference as if fully set forth herein. 16. DEFAULT/TERMINATION PROVISIONS: In the event the Grantee shall fail to comply with any of the provisions of this Agreement,the City Manager or the City Manager's designee may terminate this Agreement and withhold or cancel all or any unpaid installments of the Grant upon giving five (5) calendar days written notice to the Grantee, and the City shall have no further obligation to the Grantee under this Agreement. Further, in the event of termination,the Grantee shall be required to immediately repay to the City all portions of the Grant which have been received by the Grantee, as of the date that the written demand is received. Any uncommitted Grant funds which remain in the possession or under the control of the Grantee as of the date of the Expenditure Deadline specified in this Agreement must be returned to the City within fifteen (15) days after the Expenditure Deadline. If such funds have been committed but not expended, the Grantee must request in writing from the City Manager an extension of the Expenditure Deadline which, if approved, shall be for a period not to exceed one (1) year. Grant funds which are to be repaid to the City pursuant to this Section are to be repaid upon demand by delivering to the City Manager a certified check for the total amount due, payable to the City of Miami Beach, Florida. These provisions shall not waive or preclude the City from pursuing any other remedies that may be available to it under the law. Notwithstanding the provisions of this Section, and without regard to whether City has exercised the Default provisions thereof, the City reserves the right, at its sole and absolute discretion, to discontinue funding of the Grant if it is not satisfied with the progress of the Projector the content of any required written report. In the event of discontinuation of the Grant or at the close of the Project, any unexpended Grant Funds shall be immediately returned to the City, except where the City Manager has agreed in writing to alternative use of the unused/unexpended Grant Funds. Page 6 17. INSURANCE REQUIREMENTS: A. Verification of Coverage Grantee shall provide the required insurance certificates, endorsements or applicable policy language effecting coverage required by this Section, as follows. All certificates of insurance and endorsements are to be received prior to any work commencing. However, failure to obtain the required coverage prior to the work beginning shall not waive the Grantee's obligation to provide them. The City of Miami Beach reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. i. Workers Compensation Insurance as required by Florida Statute, Chapter 440, and Employer's Liability Insurance with limits of no less than $1,000,000 per accident for bodily injury or disease. H. Commercial General Liability on a comprehensive basis, including products and completed operations, contractual liability, property damage, bodily injury and personal & advertising injury combined single limit of $1,000,000 per occurrence for bodily injury and property damage. City of Miami Beach must be shown as an additional insured with respect to this coverage. iii. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in connection with the work, in an amount not less than $500,000 combined single limit per occurrence for bodily injury and property damage. iv. Medical Malpractice Insurance in the name of the provider, in an amount not less than $1,000,000. B. Additional Insured Status The City of Miami Beach must be covered as an additional insured with respect to liability arising out of work or operations performed by or on behalf of the Grantee. C.Waiver of Subrogation Grantee hereby grants to City of Miami Beach a waiver of any right to subrogation which any insurer of the Grantee may acquire against the City of Miami Beach by virtue of the payment of any loss under such insurance. Grantee agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City of Miami Beach has received a waiver of subrogation endorsement from the insurer. Page 7 D.Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City of Miami Beach Risk Management Office. E. Special Risks or Circumstances The City of Miami Beach reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. Certificate Holder Certificate holder must read: CITY OF MIAMI BEACH C/O: HR Department/Risk Management Division 1700 Convention Center Drive Miami Beach, FL 33139 F. Compliance with the foregoing requirements shall not relieve the grantee of its liability and obligation under this section or under any other section of this Agreement. 18. NO WAIVER: No waiver of any breach or failure to enforce any of the terms, covenants, conditions or other provisions of this Agreement by either party at any time shall in any way affect, limit, modify or waive either party's right thereafter to enforce or compel strict compliance with every term, covenant, condition or other provision hereof. 19. WRITTEN NOTICES: Any notices required under this Agreement will be effective when delivered to the City in writing and addressed to the City Contract Administrator. Any notices required under this Agreement will be effective when delivered to the Grantee in writing and addressed to the Grantee Contract Administrator. 20. CAPTIONS USED IN THIS AGREEMENT: Captions, as used in this Agreement, are for convenience of reference only and should not be deemed or construed as in any way limiting or extending the language or provisions to which such captions may refer. 21. CONTRACT REPRESENTS TOTAL AGREEMENT: This contract, including its special conditions and exhibits, represents the whole and total agreement of the parties. No representations, except those contained within this agreement and its attachments, are to be considered in construing its terms. No modifications or amendments may be made to this Agreement unless made in writing signed by both parties and approved by appropriate action by the Mayor and City Commission, Page 8 22. CITY CONTRACT ADMINISTRATOR: All contract related questions, reports and requests for reimbursements to be submitted to the City Contract Administrator listed below. Judy Hoanshelt Director, Grants Management Division City of Miami Beach Office of Budget and Performance Improvement 1700 Convention Center Drive Miami Beach, FL 33139 Tel: 305-673-7510/ 305-673-7000 ext. 6183 Fax: 786-394-4675 Email: judvhoanshelt(c miamibeachfl.00v ARTICLE III/ MISCELLANEOUS PROVISIONS 23. The Grant awarded herein is the result of a finding by the City, based on representatives, documents, materials and other information supplied by Grantee,that the Grantee is performing a public purpose through the programs, projects, and/or services recommended for support. As such, use of Grant funds for any program component not meeting this condition will be considered a breach of the terms of this Agreement and will allow the City to seek remedies including, but not limited to, those outlined in this Grant Agreement. 24. The Grantee also accepts and agrees to comply with the following Special Conditions: The Grantee hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.) prohibiting discrimination on the basis of race, color, national origin, handicap, or sex. The Grantee hereby agrees that it will comply with City of Miami Beach Human Rights Ordinance as codified in Chapter 62 of the City Code, as may be amended from time to time, prohibiting discrimination in employment, housing and public accommodations on account of actual or perceived race, color, national origin, religion, sex, intersexuality, gender identity, sexual orientation, marital and familial status, age, disability, ancestry, height, weight, domestic partner status, labor organization membership, familial situation, or political affiliation. The City endorses, and Grantee shall comply with, the clear mandate of the Americans with Disabilities Act of 1990 (ADA) to remove barriers, which prevents qualified individuals with disabilities from enjoying the same employment opportunities that are available to persons without disabilities. The City also endorses the mandate of the Rehabilitation Act of 1973 and Section 504 and prohibits discrimination on the basis of disability and requires that Grant recipients provide equal access Page 9 and equal opportunity and services without discrimination on the basis of any disability. 25. GOVERNING LAW AND EXCLUSIVE VENUE: This Agreement shall be governed by, and construed in accordance with, the laws of the State of Florida, both substantive and remedial,without regard to principles of conflict of laws. The exclusive venue for any litigation arising out of this Agreement shall be Miami-Dade County, Florida, if in State court, and the U.S. District Court, Southern District of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT, GRANTOR AND GRANTEE EXPRESSLY WAIVE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL BY JURY OF ANY CIVIL LITIGATION RELATED TO, OR ARISING OUT OF, THIS AGREEMENT. THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Page 10 EXHIBIT 1 PROJECT DESCRIPTION BACKGROUND/DESCRIPTION OF NEED According to the 2016 Unites States Census Bureau American Community Survey, 22.7% of Miami Beach Residents do not have health insurance. The breakdown by zip codes of uninsured residents is as follows: 33139 (21.7%), 33140 (13.7%), and 33141 (28.8%). KEY INTENDED OUTCOME (KIO): Maximize the Miami Beach brand as a world class destination. PROGRAM DESCRIPTION Miami Beach Community Health Center's (MBCHC) goal is to enroll eligible City of Miami Beach residents into affordable health insurance coverage. Miami Beach Community Health Center utilizes Public Benefits Coordinators and Outreach and Enrollment Coordinators to provide information and enroll Miami Beach residents into Medicaid, Children's Health Insurance Program (CHIP) or the Health Insurance Marketplace. LOCATION Miami Beach Community Health Center Stanley C. Myers location: 710 Alton Road, Miami Beach, Florida 33139 GRANT ACTIVITIES Activity Name Activity Description Description of Service Number of Service Recipients Recipients Medicaid and MBCHC Public Benefits The service recipients 1,000 Insurance Enrollment Coordinator educates and are uninsured enrolls eligible residents into children, young adults Medicaid, Children's Health and seniors with a gap Insurance Program or in coverage Health Insurance Marketplace GOALS/OUTCOMES Outcome Measure Target Reporting Timeline Submitted applications Number of approved applications 1,000 10/1118-9/30/19 for enrollment Page 11 STAFFING Position Title Description/Responsibilities to Grant Program Public Benefit Coordinator Public Benefit Coordinator provides education and enrolls uninsured eligible residents into affordable health insurance THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Page 12 EXHIBIT 2 PROJECT BUDGET Budget Line Item Description Project Budget Staff Salary and Wages: The annual salary budgeted for the 1.0 $18,780.95 Public Benefit Coordinator FTE Public Benefit Coordinator is $31,304. This Agreement funds 60% of the salary which equals$18,780.95. Fringe Benefits: Fica/Mica & Fringe Benefits are budgeted at 17.14% $3,219.05 Health Insurance of the total salary of the Public Benefit Coordinator which equals $5,365.51. This Agreement funds 60% of fringe benefits which equals $3,219.05 Total $22,000 Page 13 EXHIBIT 3 CITY OF MIAMI BEACH GRANT QUARTERLY STATUS REPORT FORM CMB GRANT AGREEMENT No.: 2019-CMB-02 GRANTEE NAME: Miami Beach Community Health Center GRANTEE ADDRESS: 710 Alton Road, Miami Beach, FL 33139 GRANTEE CONTRACT ADMINISTRATOR: Sorangely Menjivar GRANTEE CONTRACT ADMINISTRATOR'S Sorangelym@mbchc.com E-MAIL ADDRESS: REPORT PERIOD: ❑ Oct. 1 - Dec. 31 ❑ Jan. 1 —Mar. 31 ❑ Apr. 1 —Jun. 30 ❑ Jul. 1 - Sept.30 Due Jan, 15 Due Ap. 15 Due Jul. 15 Due Oct. 15 WORK ACCOMPLISHED: PROBLEM ENCOUNTERED: PERCENTAGE COMPLETION: OTHER NOTABLE ITEMS: Grantee: Name Signature/Date City of Miami Beach Name Name Page 14 Signature/Date Signature/Date EXHIBIT 4 CITY OF MIAMI BEACH GRANT REIMBURSEMENT REQUEST FORM Part 1 of 2 CMB AGREEMENT No.: 2019-CMB-02 GRANTEE NAME: Miami Beach Community Health Center GRANTEE ADDRESS: 710 Alton Road, Miami Beach, FL 33139 GRANTEE CONTRACT ADMINISTRATOR: Sorangely Menjivar GRANTEE CONTRACT ADMINISTRATOR'S Sorangelym@mbchc.com E-MAIL ADDRESS: REQUEST No. Amount of Assistance: [ $22,000 Less Previous Total Disbursements: $ Balance Available: 1 $22,000 Funds Requested This $ Disbursement: Certification of Payment: I certify that the above expenses were necessary and reasonable for the maintenance and operation of our premises and in accordance with this agreement. Grantee: Name Signature/Date City of Miami Beach Name Name Page 15 Signature/Date Signature/Date Page 16 Client#:22143 MIAMIBEA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE OAMMINl%YYI 11/08/2018 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 cm this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). ONTACT PRODUCER NAME. Bouchard Insurance(CLW) PHONE 727447-6481 IWC No), 727 449-1267 101 N Starcrest Dr. INC.E. Nn,AIL ADDRESS:E lcerts@bouchardinsurance.com AD .cicerts@bouchardinsurance.com Clearwater,FL 33765 INSURERS AFFORDING COVERAGE NAM* 727 417-64 81 INSURER A'.Markel Global Reinsurance Company . 10829 INSURED INSURER R:Associated Industries Ins Co 23140 Miami Beach Community Health ' INSURER C: 11645 Biscayne Blvd#207 INSURER 0: Miami, FL 33181-3138 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 CONTRACTOR 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. CY EXP I LTR TYPE OF INSURANCE NSP WVD POLICY NUMBER (MSUBR MIDrfVYY) (MMNDIYrcv) LIMITS A xl COMMERCIAL GENERAL LIABILITY y ' y 1 FITGL388472018 • 06/01/2018 06/01/2019 EACH OCCURRENCE $1,000,000 I CLAIMS-MADE XI OCCUR PRRECIMISES{EaEocEnence) 51,000,000 MED ESP(Any one person) $10,000 PERSONAL BADV INJURY $1,000,000 • GENT.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICYI I JECCT LOC PRODUCTS-COMP(OP AGO x3,000,000 OTHER:ICOMRwED SINGLE LIMIT S A AUTOMOBILE LIABILITY FITAU388472018 06/01/201806/01/2015(Eeawaenp 41,000,000 X ANY AUTO 1 BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S OS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOG ONLY AUTOS ONLLYY Per accident) ■ $ A UMBRELLALIAB OCCUR FITXS388472018 06/01/2018 06/01/201 EACH OCCURRENCE $10,000,000 I X EXCESSLMB © CLAIMS-MADE I AGGREGATE 510,_000,000 DED I X': RETENTION S0 ,y 5 B WORKERS COMPENSATION AWC1093443 12(21/2017 12/21/201q X ETATI RH F ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVEE L.EACH ACCIDENT $1,000,000 OFFIn NH)MEMBE) EXCLUDED(' Y N(A EL DISEASE-EA EMPLOYEE 81,000,000 Mandatory If yes.descnbunder DESCRIPTIONN OE OPERATIONS below EL.DISEASE-Priv LIMIT 51,000,000 A Professional Liab FITGL388472018 06/01/2018 06/01/2019 31,000,000/53,000,000 A Abuse/Molestation FITGL388472018 06/01/2018 06/01/2019 $1,000,000/$3,000,000 DESCRIPTION OF OPERADONS r LOCATIONS VEHICLES(ACORo 101,AddIlonal Remarks Schedule.may ha attached If mon space Is required) Certificate Holder is an Additional Insured with respect to General Liability including ongoing and completed operations,where required by written contract and subject to the terms,conditions and exclusions of the policy. A waiver of subrogation applies in favor of City of Miami Beach C/O:HR Department/Risk Management Division (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Miami Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN • C/O:HR Department/Risk ACCORDANCE WITH THE POLICY PROVISIONS. Management Division 1700 Convention Center Drive AUTHORIZED REPRESENTATIVE Miami,FL 33139I -qA YTS-- ©1980-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S947931/M867551 KEVCO DESCRIPTIONS (Continued from Page 1) respect to General Liability where required by written contract and subject to the terms,conditions and limits of the policies. SAGITTA 25.3(2015/03) 2 of 2 #5947931/M867551