Okaloosa County BOCC — August 6, 2013 — Emerald Coast CAC Final Payment — reading text

First Judicial Circuit Court Administration Robin M. Wright, Trial Court Administrator Catherine A. White, Drug Court Manager TOO West Maxwell Street, Pensacola, FL 30500 * TEL (850) 505-0005 * PAX (850) 305-5050 TO: Teresa Ward Clerk, Okaloosa County BCC FROM: Stacy Roberts Administrative Assistant Ill, Court Administration DATE: September 23, 2013 Re: Final Invoice for Approval by BCC Good afternoon Teresa. Attached are documents to be presented before the BCC for the October 15, 2013 meeting. After the meeting has concluded, please request Chairman Amends to sign off o the documents immediately following the meeting. | would appreciate the signed document being forwarded to clerk’s finance for payment for the 10/17/13 check run, if at all possible. We are at the end of this grant period (9/30/13), and will need to have all invoices and financial reports submitted to FDLE by 10/30/13. | apologize for the urgency in this matter and sincerely appreciate anything you can do to expedite payment of this invoice. Thank you! CONTRACT CLOSE-OUT CHECKLIST (To Be Prepared by the Purchasing Services Coordinator) DATE: September 9, 2013 TO: Contracts & Grants Manager, Finance Department Contracts & Grants Office SUBJECT: Contract No. C12-1998-CA MANAGING DEPARTMENT: Court Administration CONTRACTOR'S NAME: Emerald Coast Children’s Advocacy Center PROJECT TITLE: Mental Health Program for Crime Victims The attached has met the final payment contract requirement in subject contract. Yes 1, Final Invoice x] 2. Completed Contract/Lease Payment Approval Form x 3. Close-Out Documents Yes No a. Signed Release of Lien im i b. Proof of Completion Advertisement im im c. Certificate of Insurance im d. Consent of Surety to Final Payment Cl oO e. Proof of Performance/Payment Bond Oo oO Continuation 12 Months Following Final Payment Yes 4. Agenda Request X 5. Remarks <Liligle. walls No XML O & _- ParChasing Services Coordinator DATE —, ACCORD ee CERTIFICATE OF LIABILITY INSURANCE 9 OP ID: CH 09/10/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 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 Phone: 256-551-0060) sav." Catherine Walker Fountain, toe Ker, Harbarger Fax: 256-534-2042] PHONE 256-428-1025 FRE way, 256-428-1125 201 Washin fon, Street Ribuss. Cwalker@fphins.com David E. Harbarger/CAC Program PRODUCER Ing EMERA-1 INSURER(S) AFFORDING COVERAGE. NAIC # INSURED Gerald woast Cent insurer a: Philadelphia Insurance Company 23850 P.O. Box 1237 enter insurer 8: Hartford Insurance 19682 Niceville, FL 32588 INSURER ¢: 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 ADDL BUER| POLICY EFF | POLICY EXP. her TYPE OF INSURANCE, nse wyp POLICY NUMBER (MNUDDIYYYY)_|(MMUDDAYYYY) UMITS | GENERAL LIABILITY EACH OCCURRENCE 8 1,000,000 A [Xj COMMERCIAL GENERAL LIABILITY PHPK947582 1213112012 | 12/31/2013 | Brees (es oonirence) | § 100,000 ] CLAIMS. MADE MED EXP (Any one person) _| $ 5,000 |X | PROF LIAB $1M/$3M PERSONAL & ADVINJURY_[$ 1,000,000 | X |ABUSE $25K/$50K GENERAL AGGREGATE. $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG | $ 3,000,000 | leoucy! | 58S: Loc $ [ AUTOMOBILE LIABILITY Cue Oe UMIT lg “4,000,000} A |X | anvauto PHPKS47582 12/81/2012 | 12/31/2013 BODILY INJURY (Per person) | $ ALL OWNED AUTOS BODILY INJURY (Per accident}| $ | SCHEDULED AUTOS PROPERTY DAMAGE ; |} HIRED AUTOS (Per accident) | NON-OWNED AUTOS $ $ |] UMBRELLA Lia occur EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ F ' ec —_|__ XERSE LE B_ | Any PROPRIETOR/PARTNER/EXECUTIVE I21WECADi676 40/48/2042 | 10/18/2513 | Ei EACH ACCIDENT $ 1,080,066 OFFICER/MEMBER EXCLUDED? C] NIA 7 7,000,000) {Mandatory in NH} E.L DISEASE - EA EMPLOYEE] $ 2000, BREE RISHON OF SeERATIONS below ! E.L DISEASE - POLICY LIMIT | $ 1,000,000 A [Employee PHPK947582 12/31/2012 | 12/31/2013 |Limit 0,000 Dishonesty Ded 5,000; DESCRIPTION OF OPERATIONS / LOCA’ TIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION Okaloosa County BCC 602 C North Pearl Street Crestview, FL 32536 AUTHORIZED REPRESENTATIVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WiLL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. RIck L ACORD 25 (2009/03) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ai | ACCORD _ CERTIFICATE OF LIABILITY INSURANCE OP ID: CH DATE (MM/DDIYYYY) 09/10/2013 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 oe. Harbarer Phone: 256-551-0060| gxNe°" Catherine Walker BAssociates, LIC. Fax: 256-534-2042| PHONE 256-428-1025 TEAR op 256-428-1128 201 Washington Street Huntsville, AL 35801 David E. Harbarger/CAC Program EobRess: cwalker@fphins.com PRODUCER CUSTOMER Ip ¢. EMERA-1 INSURER(S) AFFORDING COVERAGE NAIC # INSURED emerald Coast insurer a : Philadelphia Insurance Company 23850 Children's Advocacy Center INSURER @ Hartford Insurance 19682 P.O. Box 1237 Niceville, FL 32588 INSURER C: INSURER D : INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S 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 DOL SUBR. POLICY EFF | POLICY EXP LTR TYPE OF INSURANCE Ivse [wyp POLICY NUMBER (MINUDDYYYY) | (MM/DDIYYYY) UMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A |X | ComMMERCIAL GENERAL LIABILITY PHPK947582 12681/2012 | 12/31/2013 | BARE Se mtence) | $ 100,000; ] cLaIMs-MADE MED EXP (Any one person) | $ 5,000; X |PROF LIAB $1M/$3M PERSONAL & ADVINJURY | $ 1,000,000 X _|ABUSE $25K/$50K GENERAL AGGREGATE $ 3,000,000) GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG | $ 3,000,000) POLICY Wd Loc $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT rx] 7582 12/31/2012 | 12/34/2013 2 2een) , 1,000,008 A |X| anyauto PHPK94 BODILY INJURY (Per person) | $ ALL OWNED AUTOS BODILY INJURY (Per accident)| $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ \ $ [| UMBRELLA LIAB OccUR { EACH OCCURRENCE $ iL EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS’ LIABILITY YIN cae, 4 x et LIMITS ER B | any PROPRIETOR/PARTNER/EXECUTIVE 24WECAD1670 40/18/2012 | 40/18/2013 | 2... ZACH ACCIDENT 3 1,000,000) OFFICER/MEMBER EXCLUDED? | NA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE] $ 1,000,000) DeSeReTON oF ‘OPERATIONS. below E.L DISEASE - POLICY LIMIT | $ 1,000,000 A |Employee IPHPK947582 12/31/2012 | 12/31/2013 |Limit 50,000 Dishonesty Ded 5,000) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION Okaloosa County BCC 602 C North Pearl Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Crestview, FL 32536 AUTHORIZED REPRESENTATIVE RIN h hy ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD OP ID: CW —_ ACORI® CERTIFICATE OF LIABILITY INSURANCE oars tnorn 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 endorsemeni(s). PRODUCER rker, Hari 286-651-0060| Sever“ Catherine Walker 8 Associates, LLG 256-534-2042 (2M cen, 256-428-1025 FAX 256-428-1125 201 Washington Street . fphi Huntsville, AL 35801 _ABbREss, cwalker@t phins.com David E, Harbarger/CAC Program CUSTOMER ip e: EMERA-1_ INSURER(S) s)A AFFORDING COVERAGE Nate # INSURED Emerald Coast INSURER A; Philadelphia Insurance Company ‘23850 Children's Advocacy Cente) iA Va / 999 INSURER B: Hartford Insurance 19682 P.O. Box 1237 Niceville, FL 32588 INSURER C :_ _ LINSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSRT ADDL|SUBR] POLICY EFF ; POLICY EXP aL 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. LIR TYPE OF INSURANCE INSR|WVD. POLICY NUMBER. {MMDDAYYYY) | (MM/DDIYYYY) LIMITS: "GENERAL LIABILITY | | BACH OCCURRENCE $ 4,000,000 A x]. CQMMERCAL GENERAL LIABILITY | |PHPK947582 | 12842 1213113 | | BREMISES (ea cxsrence) 8 100,009 Tl etaiisane [X! occur i | ; | MED EXP (Any one person) $ 5,000 x! | PROF LIAB $4 MEM : : ' PERSONAL &ADVINJURY 5S 1,000,000) x [x | Asse S25KISEOK | GENERAL AGGREGATE $ 3,000,000 | GEN AGGREGATE LIMIT APPLIES PER: | PRODUCTS - COMPIOP AGG | $. __3,000,009 “poucy! 1589 7] Loc | : 8 | AUTOMOBILE LIABILITY : : fone OE UMF os 1,000,000 Aj x ANY AUTO PHPK847562 : 1213112 | 1218113 coy INJURY (Per person) | § . 4 ALL OWNED AUTOS | | | BODILY INJURY (Per accident) $ | SCHEDULED AUTOS H