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HomeMy WebLinkAbout2019-490-E DSS - Premier Home Health Care contract amendment DocuSign Envelope ID: 147BE359-9EE3-4364-92AB-6619CE690DOB Contract#68-2035 Premier Home Heath Care Services,Inc. Contract Amendment Orange County Department of Social Services Fiscal Year Begins July 1, 2018 Ends June 30, 2019 Contract#68-2035 Amendment#1 SECTION I Agency: Orange County Department of Social Services Program: In-Home Aide Services Effective Period of the Contract: July 1, 2018-June 30, 2019 This Contract Amendment amends the contract between the Orange County Department of Social Services(the"County")and Premier Home Health Care Services, Ino. (the"Contractor").As provided for under the terms of the contract,The County and Contractor agree to amend the provision(s) indicated in Section 11 below. SECTION II Justification/Change to Contract: 3. Effective Period: This Agreement shall be effective July 1, 2018 through September 30, 2019. 5. County's Duties_ The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. (a) The total amount paid by the County to the Contractor under this Agreement for the provision of services to the Department of Social Services shall not exceed$610,647. This amount consists of$610,647 in Federal, State, and County funds (CFDA#_), $0 (source of other funds if applicable). SECTION III All other terms and conditions set forth in the original contract shall remain in effect for the duration of the contract. The contract specified above is amended by this Contract Amendment effective May 20, 2019. Contractor County Pre Doc u Sig ned by, rr Services, Inc. Oral[�Docu5igned by: By' D5COD146NFMC8.- gy' 6379949755E477.. Title: President Title: County Manager Date: 7/24/2019 Date: 7/25/2019 This agreement has been preaudited in the manner required by the Local Government Budget and Fiscal Control Act. Attest: Docusignea by: Orange County NC ` .&I County: Signature: 7o4E51s1ACC1409. Title: Finance Director Date: 7/25/2019 Contract-Amendment(07/08) Page 1 of 1 DocuSign Envelope ID: 147BE359-9EE3-4364-92AB-6619CE690DOB ® DATE IM MID DIYYYY) ACCDOR V CERTIFICATE OF LIABILITY INSURANCE 612112019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements). PRODUCER CONTACT NAME: Ma re La axon Miller&Miller Insurance Agency Inc PHONE FAX 720 Commerce Street , 914-741-6400 A1C Ne:914-741-6407 TFlornwood NY 10594 EOARIL$ : Mar leL Miller-Ins,com INSURER S AFFORDING COVERAGE NAIC H INSURER A:ACE AMERICAN INSURANCE COMPANY 22667 _ INSURED PREM14 INSURER a:National Continental Ins _ 10243 _ Premier Home Health Care Services Inc INSURERC:COVERYS SPECIALTY INSURANCE COMPANY 15686 1 North Lexington Ave,S#200 White Plains NY 10601 INSURERD:CHARTER OAK FIRE INS CO 25615 INSURERS:TRAVELERS IND CO 25658 INSURER F: Hiscox Insurance Company Inc 10200 COVERAGES CERTIFICATE NUMBER:1314738887 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'ro 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 IN L BR POLICY NUMBER MMIDOPOLICY LTR IYYYY MMIDDNYYY LIMITS A GENERAL LIABILITY MLPG28210551003 21212019 2/212020 EACH OCCURRENCE $1,000,U00 x COMMERCIAL GENERAL LIABILITY P EMGES(Ea Otto e a t 50,000 CLAIMS-MADE Fx-]OCCUR i MED EXP(Any one person) $5.000 X PROF-CLAIMS MADE PERSONAL&AD11INJURY $1,DDD,000 X SEXUAL ABUSE GENERAL AGGREGATE $3,000.000 GEN%AGGREGATELIMITAPPLIESPER: PRODUCTS-COMPICPAGG $1,000,600 _ POLICY F PRD- LCC Prof Aggregate Limit $3,000,OD0 B AUTOMOBILE LIABIUTY CNY00070629938 212120t9 2/212020 COMBINED SINGLE LIMIT Ea accident$ 5 1.0m,000 ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED 800ILY INJURY(per ocalden!) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS ere iden! C X UMBRELLA LIAB OCCUR OOSNY000026117 212/2019 212=20 EACH OCCURRENCE $25,W0,000 EXCESS LIAO x CLAIMS- 00 MADE AGGREGATE $25,0 ,00D RDE❑ i X RETENTION$10 000 SEXUAL ABUSE $10 000 000 I WORKERS COMPENSATION N U80N253D781951K GI30120 6130I2020 x WC STATU- OTH- E AND EMPLOYERS'LIABILITY YIN U89M8461691951R 6/30/269 6130/2020 ANY PROPRIETORIPARTNERIEXECUTIVE N 1 A E.L,EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? FN] (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 F Employee Theft UC2118450519 2/812019 V612020 Limit $50,00D DESCRIPTION OF OPERATIC NSI LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedute,II more space Is required) "Policies shown are subject to terms,conditions,exclusions,sublimits and deductibles not listed on this certificate. We recommend that requests for policy copies be directed to the Named Insured shown above.* Work Camp Policy #UBON2530781951 K-Covers the fallowing States-CT,GA, ,IL,MA, NJ,NY,NC,OK Work Comp Policy# UB9M8461691951 R -Covers the following States-FL,MA 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. Orange County Department of Social Services 113 Mayo Street AUTHORIZED RE ESENTATiVE Hillsborough NC 27278 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD