No preview available
HomeMy WebLinkAboutC17-210 Trio Therapy PartnersAGREEMENT FOR PROFESSIONAL SERVICES BETWEEN EAGLE COUNTY, COLORADO AND TRIO THERAPY PARTNERS, LLC THIS AGREEMENT ("Agreement") is effective as of the Vh day of May, 2017 by and between Trio Therapy Partners, a Colorado limited liability company (hereinafter "Consultant" or "Contractor") and Eagle County, Colorado, a body corporate and politic (hereinafter "County"). RECITALS WHEREAS, the County, through its Department of Health and Human Services ("HHS") works to promote the health, safety and welfare of County residents of all ages; and WHEREAS, the County uses outside providers and professionals to enhance the ability of County to promote such health, safety and welfare; and WHEREAS, County desires to hire the Consultant to perform the Services defined below in paragraph 1; and WHEREAS, Consultant is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the Services; and WHEREAS, this Agreement shall govern the relationship between Consultant and County in connection with the Services. AGREEMENT NOW, THEREFORE, in consideration of the foregoing and the following promises Consultant and County agree as follows: 1. Services. Consultant agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the services described in Exhibit A ("Services") which is attached hereto and incorporated herein by reference. The Services shall be performed in accordance with the provisions and conditions of this Agreement. The Services shall be delivered at designated offices, clients' homes and other locations approved by the County's Representative. a. Subject to the provisions of paragraph 11 hereof, Consultant agrees to furnish the Services through May 31, 2019 and in accordance with the schedule established in Exhibit A. If no completion date is specified in Exhibit A, then Consultant agrees to furnish the Services in a timely and expeditious manner consistent with the applicable standard of care. By signing below Consultant represents that it has the expertise and personnel necessary to properly and timely perform the Services. C17-210 b. In the event of any conflict or inconsistency between the terms and conditions set forth in Exhibit A and the terms and conditions set forth in this Agreement, the terms and conditions set forth in this Agreement shall prevail. C. Consultant agrees that it will not enter into any consulting or other arrangements with third parties that will conflict in any manner with the Services. d. Consultant shall protect the confidentiality of all records and other materials containing personally identifying information that are maintained in accordance with this Agreement pursuant to applicable state and federal law and regulations. Except as provided by law, no information about any individual in the possession of the Consultant shall be disclosed in any form. Client specific reports are subject to the confidentiality provisions of Section 19-1-101, et seq. and 26-1-101, et seq., C.R.S. , as amended; the federal Health Insurance Portability and Accountability Act of 1996; 42 U.S.C. Section 290 dd-2 regarding the confidentiality of alcohol and drug abuse patient records; and other applicable federal and state law and regulation. 2. County's Representative. The Human Service Department's designee shall be Consultant's contact with respect to this Agreement and performance of the Services. 3. Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to the provisions of paragraph 11 hereof, shall continue in full force and effect through the 31st day of May, 2019. 4. Extension or Modification. This Agreement may not be amended or supplemented, nor may any obligations hereunder be waived, except by agreement signed by both parties. No additional services or work performed by Consultant shall be the basis for additional compensation unless and until Consultant has obtained written authorization and acknowledgement by County for such additional services in accordance with County's internal policies. Accordingly, no course of conduct or dealings between the parties, nor verbal change orders, express or implied acceptance of alterations or additions to the Services, and no claim that County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written authorization and acknowledgment by County for such additional services is not timely executed and issued in strict accordance with this Agreement, Consultant's rights with respect to such additional services shall be deemed waived and such failure shall result in non-payment for such additional services or work performed. 5. Compensation. For the satisfactory performance of the Services, the Consultant shall be paid on a fee-for-service basis in accordance with Exhibit A. The performance of the Services under this Agreement shall not exceed $10,000 annually. Contractor shall not be entitled to bill at overtime and/or double time rates for work done outside of normal business hours unless specifically authorized in writing by County. Contractor shall not charge or collect fees from clients for the Services provided hereunder. a. Method of Compensation. Contractor shall be compensated for Services satisfactorily performed in accordance with the statewide "Trails Users Fiscal Calendar" and by means of the Trails Revisod 512017 provider payroll system. Consultant shall submit an invoice to the County by the tenth (10) day of the month for Services performed in the preceding month. Upon receipt of the invoice, the County will input the Consultant's invoice into the Trails system Payment will be made by the State of Colorado through the Trails provider payroll system. Invoices shall include a description of Services performed. If County is not satisfied with the completeness of a submitted invoice, County may request Consultant to either revise the invoice or provide additional information. All invoices shall include detail regarding the hours spent, tasks performed, who performed each task and such other detail as County may request. All invoices must be emailed to the following address to ensure proper payment: dh s acetpay able @ eaglec ou my . u s b. Billing Cut-off Date. Consultant shall not be reimbursed for billing received by the County two (2) months or more after the date of Service. Any out-of-pocket expenses to be incurred by Consultant and reimbursed by County shall be identified on Exhibit A. Out-of-pocket expenses will be reimbursed without any additional mark-up thereon and are included in the not to exceed contract amount set forth above. Out-of-pocket expenses shall not include any payment of salaries, bonuses or other compensation to personnel of Consultant. Consultant shall not be reimbursed for expenses that are not set forth on Exhibit A unless specifically approved in writing by County. d. If, prior to payment of compensation or reimbursement for Services but after submission to County of a request therefore by Contractor, County reasonably determines that payment as requested would be improper because the Services were not performed as prescribed by the provisions of this Agreement, the County shall have no obligation request payment through the Trails provider payroll system. If, at any time after or during the term or after termination or expiration of this Agreement, County reasonably determines that any payment theretofore paid to Contractor was improper because the Services for which payment was made were not performed as set forth in this Agreement, then upon written notice of such determination and request for reimbursement from County, Consultant shall forthwith return such payment(s) to County for payment to the State of Colorado. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be returned to County. d. All funds received by Contractor under this Agreement shall be or have been expended solely for the purpose for which granted, and any funds not so expended, including funds lost or diverted for other purposes, shall be returned to the State of Colorado. e. Contractor shall provide the County with progress reports as more specifically set forth in the attached Exhibit A. County will not withhold any taxes from monies paid to the Consultant hereunder and Consultant agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. Rcvisod 512017 g. Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations under this Agreement after, nor shall any payments be made to Consultant in respect of any period after December 31 of any year, without an appropriation therefor by County in accordance with a budget adopted by the Board of County Commissioners in compliance with Article 25, title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). b. Sub -consultants. Consultant acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Consultant. Consultant shall not enter into any sub -consultant agreements for the performance of any of the Services or additional services without County's prior written consent, which may be withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the subject project during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the project. Consultant shall require each sub -consultant, as approved by County and to the extent of the Services to be performed by the sub -consultant, to be bound to Consultant by the terms of this Agreement, and to assume toward Consultant all the obligations and responsibilities which Consultant, by this Agreement, assumes toward County. County shall have the right (but not the obligation) to enforce the provisions of this Agreement against any sub -consultant hired by Consultant and Consultant shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its agents, employees and sub -consultants or sub -contractors. 7. Insurance. Consultant agrees to provide and maintain at Consultant's sole cost and expense, the following insurance coverage with limits of liability not less than those stated below: a. Types of Insurance. i. Workers' Compensation insurance as required by law. ii. Auto coverage with limits of liability not less than $1,000,000 each accident combined bodily injury and property damage liability insurance, including coverage for owned, hired, and non -owned vehicles. iii. Commercial General Liability coverage to include premises and operations, personal/advertising injury, productslcompleted operations, broad form property damage with limits of liability not less than $1,000,000 per occurrence and $2,000,000 aggregate limits. This policy shall be endorsed to include coverage for physical/sexual abuse and molestation. iv. Professional liability insurance with prior acts coverage for all Services required hereunder, in a form and with an insurer or insurers satisfactory to County, with limits of liability of not less than $1,000,000 per claim and $2,000,000 in the aggregate. In the event the professional liability insurance is on a claims -made basis, Consultant warrants that any retroactive date under the policy shall precede the effective date of this Agreement. Continuous coverage will be maintained during any applicable statute of limitations for the Services. Rovisod 512017 V. Third party fidelity/crime coverage including coverage for theft and mysterious disappearance. The policy shall include coverage for all directors, officers, agents and employees of the Consultant. The policy shall name Eagle County and Eagle County's clients as loss payee as their interests may appear. The policy shall not contain a condition requiring an arrest or conviction. Policies shall be endorsed to provide coverage for computer crime/fraud. b. Other Requirements. L The automobile and commercial general liability coverage and such other coverage as indicated above shall be endorsed to include Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers as additional insureds. ii. Consultant's certificates of insurance shall include sub -consultants as additional insureds under its policies or Consultant shall furnish to County separate certificates and endorsements for each sub -consultant. All coverage(s) for sub -consultants shall be subject to the same minimum requirements identified above. Consultant and sub -consultants, if any, shall maintain the foregoing coverage in effect until the Services are completed. In addition, all such policies shall be kept in force by Consultant and its sub -consultants until the applicable statute of limitations for the Services has expired. iii. Insurance shall be placed with insurers duly licensed or authorized to do business in the State of Colorado and with an "A.M. Best" rating of not less than A -VII. iv. Consultant's insurance coverage shall be primary and non-contributory with respect to all other available sources. Consultant's policy shall contain a waiver of subrogation against Eagle County. V. All policies must contain an endorsement affording an unqualified thirty (30) days' notice of cancellation to County in the event of cancellation of coverage. vi. All insurers must be licensed or approved to do business within the State of Colorado and all policies must be written on a per occurrence basis unless otherwise provided herein. vii. Consultant's certificate of insurance evidencing all required coverage(s) is attached hereto as Exhibit B. Upon request, Consultant shall provide a copy of the actual insurance policy and/or required endorsements required under this Agreement within five (5) business days of a written request from County, and hereby authorizes Consultant's broker, without further notice and authorization by Consultant, to immediately comply with any written request of County for a complete copy of the policy. viii. Consultant shall advise County in the event the general aggregate or other aggregate limits are reduced below the required per occurrence limit. Consultant, at its own expense, will reinstate the aggregate limits to comply with the minimum limits and shall furnish County a new certificate of insurance showing such coverage. Rovisod 512017 ix. If Consultant fails to secure and maintain the insurance required by this Agreement and provide satisfactory evidence thereof to County, County shall be entitled to immediately terminate this Agreement. X. The insurance provisions of this Agreement shall survive expiration or termination hereof. xi. The parties hereto understand and agree that the County is relying on, and does not waive or intend to waive by any provision of this Agreement, the monetary limitations or rights, immunities and protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and volunteers. xii. Consultant is not entitled to workers' compensation benefits except as provided by the Consultant, nor to unemployment insurance benefits unless unemployment compensation coverage is provided by Consultant or some other entity. The Consultant is obligated to pay all federal and state income tax on any moneys paid pursuant to this Agreement. S. Indemnification. The Consultant shall indemnify and hold harmless County, and any of its officers, agents and employees against any losses, claims, damages or liabilities for which County may become subject to insofar as any such losses, claims, damages or liabilities arise out of, directly or indirectly, this Agreement, or are based upon any performance or nonperformance by Consultant or any of its sub -consultants hereunder including claims for bodily injury or personal injury including death, or loss or damage to tangible or intangible property; and Consultant shall reimburse County for reasonable attorney fees and costs, legal and other expenses incurred by County in connection with investigating or defending any such loss, claim, damage, liability or action. This indemnification shall not apply to claims by third parties against the County to the extent that County is liable to such third party for such claims without regard to the involvement of the Consultant. This paragraph shall survive expiration or termination hereof. 9. Ownership of Documents. All documents prepared by Consultant in connection with the Services shall become property of County. Consultant shall execute written assignments to County of all rights (including common law, statutory, and other rights, including copyrights) to the same as County shall from time to time request. For purposes of this paragraph, the term "documents" shall mean and include all reports, plans, studies, tape or other electronic recordings, drawings, sketches, estimates, data sheets, maps and work sheets produced, or prepared by or for Consultant (including any employee or subcontractor in connection with the performance of the Services and additional services under this Agreement). 10. Notice. Any notice required by this Agreement shall be deemed properly delivered when (i) personally delivered, or (ii) when mailed in the United States mail, first class postage prepaid, or (iii) when delivered by FedEx or other comparable courier service, charges prepaid, to the parties at their respective addresses listed below, or (iv) when sent via facsimile so long as the sending party can provide Revisod 512017 facsimile machine or other confirmation showing the date, time and receiving facsimile number for the transmission, or (v) when transmitted via e-mail with confirmation of receipt. Either party may change its address for purposes of this paragraph by giving five (5) days prior written notice of such change to the other party. COUNTY: Eagle County, Colorado Attention: Kendra Kleinschmidt 551 Broadway Post Office Box 660 Eagle, CO 81631 Telephone: 970-328-8827 Facsimile: 855-848-8826 E -Mail: Kendra.kleinschmidt@eaglecounty.us With a copy to: Eagle County Attorney 500 Broadway Post Office Box 850 Eagle, Co 81631 Telephone: 970-328-8685 Facsimile: 970-328-8699 E -Mail: atty@eaglecounty.us CONSULTANT: Trio Therapy Partners, LLC Lauren Shaeffer, Owner PO Box 4002, Eagle CO 81631 Telephone: 970-306- 7505 E -Mail: trioeaat@gmail.com 11. Termination. County may terminate this Agreement, in whole or in part, at any time and for any reason, with or without cause, and without penalty therefor with seven (7) calendar days' prior written notice to the Consultant. County may also terminate this Agreement as set forth in paragraph 14 below. Upon termination of this Agreement, Consultant shall immediately provide County with all documents as defined in paragraph 9 hereof, in such format as County shall direct and shall return all County owned materials and documents. County shall pay Consultant for Services satisfactorily performed to the date of termination. 12. Venue, Jurisdiction and Applicable Law. Any and all claims, disputes or controversies related to this Agreement, or breach thereof, shall be litigated in the District Court for Eagle County, Colorado, which shall be the sole and exclusive forum for such litigation. This Agreement shall be construed and interpreted under and shall be governed by the laws of the State of Colorado. Rcvisod 512017 13. Execution by Counterparts; Electronic Signatures. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same instrument. The parties approve the use of electronic signatures for execution of this Agreement. Only the following two forms of electronic signatures shall be permitted to bind the parties to this Agreement: (i) Electronic or facsimile delivery of a fully executed copy of the signature page; (ii) the image of the signature of an authorized signer inserted onto PDF format documents. All documents must be properly notarized, if applicable. All use of electronic signatures shall be governed by the Uniform Electronic Transactions Act, C.R.S. 24-71.3-101 to 121. 14. Other Contract Requirements. a. In rendering the Services hereunder, Contractor shall comply with the highest standards of customer service to the public. Contractor shall provide appropriate supervision of its employees to ensure the maintenance of these high standards of customer service and professionalism are maintained. The performance of such obligation shall be determined at the sole discretion of County. In the event County finds these standards of customer service are not being met by Consultant, County may terminate this Agreement, in whole or in part, upon seven (7) days' notice to Consultant. b. Consultant shall be responsible for the completeness and accuracy of the Services, including all supporting data or other documents prepared or compiled in performance of the Services, and shall correct, at its sole expense, all significant errors and omissions therein. The fact that the County has accepted or approved the Services shall not relieve Consultant of any of its responsibilities. Consultant shall perform the Services in a skillful, professional and competent manner and in accordance with the standard of care, skill and diligence applicable to Consultants performing similar services. This paragraph shall survive termination of this Agreement. C. Consultant represents and warrants that it has the expertise and personnel necessary to properly perform the Services and covenants that its professional personnel are duly licensed to perform the Services within Colorado. Specifically, during the period of this Agreement, Consultant and its professional personnel shall each be licensed as a professional counselor through the Colorado Department of Regulatory Agencies ("DORA"), shall maintain such license in good standing and shall adhere to all rules, standards, policies and laws applicable to such license, including, but not limited to, any requirements for criminal background checks. Consultant shall immediately notify the County if any state or local agency makes a substantiated finding of abuse, neglect or injurious environment against it or any of its professional personnel during the period of this Agreement. In the event of a substantiated finding as set forth herein, the County in its sole discretion may terminate this Agreement, in whole or in part, upon seven (7) days' notice to Consultant. d. Consultant agrees to work in an expeditious manner, within the sound exercise of its judgment and professional standards, in the performance of this Agreement. Time is of the essence with respect to this Agreement. e. This Agreement constitutes an agreement for performance of the Services by Consultant as an independent contractor and not as an employee of County. Nothing contained in this Agreement Rovisod 512017 shall be deemed to create a relationship of employer-employee, master -servant, partnership, joint venture or any other relationship between County and Consultant except that of independent contractor. Consultant shall have no authority to bind County. f. Consultant represents and warrants that at all times in the performance of the Services, Consultant shall comply with any and all applicable federal and state laws, codes, rules and regulations. g. Contractor shall comply with the Civil Rights Act of 1964 and Section 504, Rehabilitation Act of 1973, concerning discrimination on the basis of race, color, sex, age, religion, political beliefs, national origin or handicap. h. This Agreement contains the entire agreement between the parties with respect to the subject matter hereof and supersedes all other agreements or understanding between the parties with respect thereto. i. Consultant shall not assign any portion of this Agreement without the prior written consent of the County. Any attempt to assign this Agreement without such consent shall be void. j. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted assigns and successors in interest. Enforcement of this Agreement and all rights and obligations hereunder are reserved solely for the parties, and not to any third party. k. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding breach. 1. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision hereof. M. Consultant shall maintain for a minimum of three years, adequate financial and other records for reporting to County. Consultant shall be subject to financial audit by federal, state or county auditors or their designees. Consultant authorizes such audits and inspections of records during normal business hours, upon 48 hours' notice to Consultant. Consultant shall fully cooperate during such audit or inspections. n. The signatories to this Agreement aver to their knowledge, no employee of the County has any personal or beneficial interest whatsoever in the Services or Property described in this Agreement. The Consultant has no beneficial interest, direct or indirect, that would conflict in any manner or degree with the performance of the Services and Consultant shall not employ any person having such known interests. o. The Consultant, if a natural person eighteen (1$) years of age or older, hereby swears and affirms under penalty of perjury that he or she (i) is a citizen or otherwise lawfully present in the United Revisod 512017 States pursuant to federal law, (ii) to the extent applicable shall comply with C.R.S. 24-76.5-103 prior to the effective date of this Agreement. 15. Prohibitions on Government Contracts. As used in this Section 15, the term undocumented individual will refer to those individuals from foreign countries not legally within the United States as set forth in C.R.S. 8-17.5-101, et. seq. If Consultant has any employees or subcontractors, Consultant shall comply with C.R.S. 8-17.5-101, et. seq., and this Agreement. By execution of this Agreement, Consultant certifies that it does not knowingly employ or contract with an undocumented individual who will perform under this Agreement and that Consultant will participate in the E -verify Program or other Department of Labor and Employment program ("Department Program") in order to confirm the eligibility of all employees who are newly hired for employment to perform Services under this Agreement. a. Consultant shall not: i. Knowingly employ or contract with an undocumented individual to perform Services under this Agreement; or H. Enter into a subcontract that fails to certify to Consultant that the subcontractor shall not knowingly employ or contract with an undocumented individual to perform work under the public contract for services. b. Consultant has confirmed the employment eligibility of all employees who are newly hired for employment to perform Services under this Agreement through participation in the E -Verify Program or Department Program, as administered by the United States Department of Homeland Security. Information on applying for the E -verify program can be found at- htlp://www.dhs. ovlxprevprot/programslgc _1185221678150.shtm C. Consultant shall not use either the E -verify program or other Department Program procedures to undertake pre-employment screening of job applicants while the public contract for services is being performed. d. If Consultant obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an undocumented individual, Consultant shall be required to: i. Notify the subcontractor and County within three (3) days that Consultant has actual knowledge that the subcontractor is employing or contracting with an undocumented individual; and H. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to subparagraph (i) of the paragraph (d) the subcontractor does not stop employing or contracting with the undocumented individual; except that Consultant shall not terminate the contract with the subcontractor if during such three (3) days the subcontractor provides information to la Rcvks 512017 establish that the subcontractor has not knowingly employed or contracted with an undocumented individual. e. Consultant shall comply with any reasonable request by the Department of Labor and Employment made in the course of an investigation that the department is undertaking pursuant to its authority established in C.R.S. 8-17.5-102(5). f. If Consultant violates these prohibitions, County may terminate the Agreement for breach of contract. If the Agreement is so terminated specifically for breach of this provision of this Agreement, Consultant shall be liable for actual and consequential damages to County as required by law. g. County will notify the Colorado Secretary of State if Consultant violates this provision of this Agreement and County terminates the Agreement for such breach. IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set forth above. COUNTY OF EAGLE, STATE OF COLORADO, By and Throu Its .COUNTY MANAGER - By: .v Bryan Treu, Interim County Manager CONSULTANT: E— By: Print Name: Lauren Shaeffer Title: Rcvks 512017 Principle and Physical EXIMIT A SCOPE OF SERVICES, PAYMENT & FEE SCHEDULE Description of Services: Provide individual, family counseling and other therapeutic services, including equine assisted therapy for clients (children, youth and families) of the Department of Human Services to prevent unnecessary placement of children and youth in out -of -home care, support family preservation, and assist in family reunification. Additional Provisions: 1. Assessments and Planning. Contractor shall provide the County with an assessment and plan within thirty (30) days of enrollment or participation in services by a family or child. This plan shall include the treatment plan for the child's family, including specific goals, objectives and target dates for accomplishment. Such plan shall be subject to review and approval by County. Thereafter, at monthly intervals, Contractor shall submit reports that include progress and barriers in achieving the goals and provisions of the treatment plan via e-mail. Reimbursement for services relating to the plan is subject to the timely receipt of written assessment, plan, and reports. 2. Eli ig bility. County is responsible for determining the eligibility of each individual family for services under this agreement. County shall advise Contractor in writing of the authorized service plan within three (3) working days of receipt of the certification and service plan. There shall be no payment for services provided without prior authorization for such services by the County. Such authorization shall include the level of services to be provided, the nature and type of services provided and the time frames in which these services are to be provided. 3. Mandatory Reporting. Contractor shall notify the state-wide hotline of all reports of suspected child abuse or neglect involving Contractor, including, but not limited to, employees, volunteers and clients. DHS contractors are considered to be mandatory reporters for suspected child abuse and neglect and are to make those reports directly to the Hotline at 1 -844 -CO -4 -KIDS (844-264-5437). Payment and Fee Schedule: County will compensate Contractor for performance of services as follows: (1) Face to face contact for individual therapy with clients - $85 per hour for In Office Services and $95 per hour for In Home/ Off Site Services; (2) Group Therapy Services for clients -$45 per hour (3) Case management services (report writing) - $35 per hour; (4) Attendance at Family Engagement Meetings (also called Individual Service & Support Team meetings) - $45 per hour. The maximum contract amount is not to exceed $10,000. 12 Rcvks 512017 EXIIIBIT B INSURANCE CERTIFICATE 13 Rcvks 512017 DATE I MMIVIA' YY Y Y; AGORDTLS GLK I 11-16A I t OF LIAISILI I Y INSUMANUt 04-19-2 01 Y - -- THIS CERTIFICATE I5 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENDF 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 policyliesf must LE: endorsed. If SUBROGATION IS WAIVED, subject to the [arms and Conditions of the policy, certainlicies may require an endarsemant. A ssaterrlent on this certificia p dues not Conw rights to the Certificate holder in lieu 0 uLiah endnrsarrierit s]. PRanIDCER CONTACT DE%CRLPYKM OF OPERATIONS,EACATI ONSIIFEMCL ES IAtreds ACDRD 96 1, Addrtionai Rerparks SLhe"e, B www -nee 4% required? Certificate holder is included as additional insured fpr operations conducted by the named insured. CERTIFICATE HOLDER Eagle Cwrry P.O. H.A 6 60 Eagle, CO 61633 ACOR❑ 25 (201W05j CANCELLATION ^1 Smt)In ANY OF lrHE ABOVE DESCRIBED POLICIES BE CA NUE LtEO BE FOgC Thi J )r RATS ON DATE TI4EREOF, NOIKA 1AILL HE DaMETiED IN AC,CORQLiW.F WITH THE PODUY FROVISIONS, AUTHORIZED REPRESENTATIVE �SWO Bruce A.f�ay - ................... - .. _... _............ -- [cj 1988-2[311? A O RATION. iAElts reserved. The AGC3RD name and logo an registered marks of ACORD ❑bbd? I Debi Deiurk Pefoso PHONE - FAX 7765 West:. Highway 80 (AIC No, Ext): {AIC No)=. Greenville, FL 32331 F-m'mA ADDRESS:... INSUREWS) AFFORDING COVERAGE NAIL # INS€JRER A: MARECEL INSURANCE COMPANY 38970_. m�Irf�D Trio Therapy Partrsces, LI_C INSURER 6: _--..__ ...._...._. cjo Lauren Shaeffer INSURER C- PO Fox 4002 INSURER D: Eagle, CO 21631 INSURER E: ENSURER F: -- _.... . COVERAGES CERTIFICATE NUMBER: -- ---- REVISION NUMBER' — _. .......... ........_._._...._.._._ . - •........ -.... _._.... THIS IS TO CERTIFY THAT THF FGLICifS OF INSUM NCC LISTrD BELOW HAVE SEEN ISSU E -D TO IHL: INS L RED NAMED ABOVE FOR THE POLICY PFR 10r) IN] IIGATED . NOTWITH STAN DIN 3 ANY REOUIRFMENT, TE RM OR CONDITION OF ANY CONTRACT OR 0-1 HER TIM UWNT METH RES PCCT TO VVHiCH THIS CERTIFICATE MAY FIE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCHES DESCRIBED HFRCIN [S SUB. ECT TO ALL THE TERMS, EXGLUSONS AND CONoITION5 OF SUCti POLICIES. LIMFTS SHOWN MAY HAVE BEEN REDUCED DY PAID CLAIM - €RSR ... ADL SUER ......_ .. . POI ICY EFF PODGY FxP L#H TYPE DfWSURANCE Ni9R vWP PDLICYNUrABER (IJE{u1ADD,'YYYY) II1AfY176D1Y-YYYI...-.._......... unerrs . ......... EACH OCaCURREh10E. '. S 1,000,000 A 0H&RAL LIABILITY t:OMAERCIAL GENERAL LLAHfLITY ® ❑ ' RFMS F lE RENTEDD cicc�renca7 g 100,0()u ..P P.FRMSES IE .. ❑ CLAIMS - MADE � OCCUR . _ � MED E%P [My nor_ person? .......... 9 .. ----- � 6,OF]tY ❑ 3602AG414161-2 177-07-2016 (17-07-20,17 PFnsawu s AnUlulilRY s t,IX1DpuD ❑ _.._.__..._ _ . ........ .... ......._....... C,ENFRAL AGGREGATE s 3,0UopUU GLN'L AGGREGATE f iMIT APPLIES EER: PRMLICTS - COW OP AGG S I,UDo.00O ❑ POLICY ❑ .W ❑ IAC 5 .. ........._.._..._ ....—._.. ... .. .. ........ .. ....... ....... . ....... .. .. ................. ... ❑ ❑ .... .. .... .... Cc)MOINED f,'RVr'IF LWIT s AUTOMOBkE UABILITY . ❑ ANY AUTO iEa acci�rq ku DLY INJURY {E'er Prrsarnl 9 AH C?V.'NF❑ ❑ SCHEDULED ❑ HOOtLY INJURY (Paraccid M AUTOS AIJT`JS -.-8- . iRnPFR•IY DAMAGE $ NOWOVAJEC ❑ HIRE C1 AUTOS ❑ leer ac k6rlli ........... .. .., AUTOS................ ❑ ..---- ._....... . , S UMBRELLA UAB OCCUR ❑ 13. LAC:H Q=RFC-NCE ! "� EXCE33 UAa OIAIMS MADE ® ASGREGHTE 6 ❑ pr -r3 ❑ riETENTIphf 8 VIOLU(ERS COW T-MRATfON . ❑ WGbfAf U- OTI-i- . AND EMPLOYERS' LIABILITY Yew TORY um..tT&.ER ...---..... ..... .. A.NY'Ro-METC)P4PAN INER,TXLCUTIVr. - WA � . F.L. EACH ACCIDENT$ OFFiC:ER.'AAENISER EXCf.UOM? ..__...... .................... .. ..-----.--.. - ... _....._.. . MandsMry in NHI .. E- L-- DISEASE - E 4 EMPLOYEE s .. _._... ......... ..... ...... -.. .._..... _......: ff Yrs, dexrilre tender............ E f1:Y LIlAhT E.L. OiSFiA;R4f.F - CS OECRIPT�N L1F OPERATIONS below .. DE%CRLPYKM OF OPERATIONS,EACATI ONSIIFEMCL ES IAtreds ACDRD 96 1, Addrtionai Rerparks SLhe"e, B www -nee 4% required? Certificate holder is included as additional insured fpr operations conducted by the named insured. CERTIFICATE HOLDER Eagle Cwrry P.O. H.A 6 60 Eagle, CO 61633 ACOR❑ 25 (201W05j CANCELLATION ^1 Smt)In ANY OF lrHE ABOVE DESCRIBED POLICIES BE CA NUE LtEO BE FOgC Thi J )r RATS ON DATE TI4EREOF, NOIKA 1AILL HE DaMETiED IN AC,CORQLiW.F WITH THE PODUY FROVISIONS, AUTHORIZED REPRESENTATIVE �SWO Bruce A.f�ay - ................... - .. _... _............ -- [cj 1988-2[311? A O RATION. iAElts reserved. The AGC3RD name and logo an registered marks of ACORD IDA: IE (MWDDIYYYYI ACORD TM CERTIFICATE OF LIABILITY INSURANCE June 1, 2016 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 UR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollinyflas] must he endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions a[ 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 endorsament(s). PRODUCER 0000I i Debi DeTUrk Felnsn 7765 West Highvday 90 Greenville, FL 32331 INSURED -I rio 'I herapy Partners. LLC cia Lauren Shaeffer PO Box 4DO2 INSURER D: Eagle, CO 81531 INSURFR E: 1N5UREH F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICiLS OF INSU9ANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATFn. NO WITHSTANDING ANY REQUIREMENT. TERRA DR CDNDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To WHICH I -HIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, I HE INSURANCE AFFORD 10 BY THE POLICIES DESCRIBED HFRFIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDrTIONS CSF SUCH POLIGIE$. LIMITS SHOWN MAY NINE BEEN R'EUUCED BY FAIL) CLAINIS. NSR ALJUL SUBFi' POLICY EFF PDOCY EXP LTR TYPE or INSURANCE INSR 1NVD _POLICY NUMBER (MM;DDIYYYy) IMMlDD!YYYY} LIMITS FArH OCCURRENCE 8 1,000,000 A GENERAL LIABILITY PAfviERCIAI GENERAL LIAB;UTY DAMAGE TO RENTED E 100,000 ® CO ❑ PRFMI.SES ;Ery ucwrrulu:sl u ❑ CLAIMS-k+IADF ® OCCUR MED EXP (Any one person] $ -50000, ❑ 3602AG41,1161-2 07-07-2016 07-07-2017 PFRSONAL & ADV INJURY s 1,000,000 ❑ GFWFRAI AGGREGATE $ 3,000,000 GC N'L AGGR EfATF I IMIT AP LES PER: r1R0DLI CTS - C:O MPIOP AGG $ 1 ,UO0,000 ❑ POLICY ❑ PFO7 ❑ LOC $ CONTACT NAME: PHONE FAX {AIC No, Ext}: (A1C Na): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A: MARKEL INSURANCE COMPANY INSURER 3: INSURER C: NAIL # AUTOMOBILE LIABI-ITY ❑ ❑ ❑ ANY AUTn $ BODILY INJURY {Pur amidant] ❑ ALL OWNED ❑ SCHEDULE.) 5 AUTOS AUTOS HIRED AUTOS dNED AUTOS AUTOS UMBRELLA LIAR [_1 OCCUR ❑ ❑ EXCESS LIAB Ci :IMS -MP DE DED nETEN7IQN fi YVORKERS COMPENSATION AND EMPLUYEHS' LIABILITY Y,,N ANY PROIRIETOUtPARTNERIEXECUTIVFF-1Nry, F—]OFFICERIMEMBER ]CCI IIDF--7 IMdzidl Lary in NH It yea, describe umc. er DESCFIPTION OF OFFFIAT1ONS bcicw —11 ❑ DES CF1IPTION OF 0PFRATInNSrL0CATiONS)VEHIGLES (Aria ch AC ORD 1U1, Additional Remarks Schedule, If mnrP cparc is required) Certificate holder only. CERTIFICATE HOLDER Trio Therapy Paltller% LLC: CI0 Lauren Shaeffer PO Box 4002 Eagle, CO 81631 (2010145) CANCELLATION COMBINED SINGLL LIMIT {Ea accident] 6 DODILY INJURY (Per personl $ BODILY INJURY {Pur amidant] $ PROPERLY UAIJIAQE 5 (Per a:uide"Ll LAC! I OCCURRENCE AGGREGATE ❑ WC STATU- ❑ CTH- TORY LIMITS ER E, L. EACH ACCIDEN I 5 E.L. DISEASE - EA EMPI.OYF+ A E.E. DISEASE - POLICY LIMIT SHOULD ANY OF THE AROVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIIL BE DELIVERED IN ACCORDANCE WITH THE POLICY PR O V IS IONS. I AIJ-HOR17FD nFrw';FNTAnVE RME Bruce. A. Cay A L7 �f ff KSPO (c] 1988-2010 CQ i7RATION rights reserved. The ACORD name and logo are rc:?stered marks of ACORD I CeaM`` ra�°e �� Asp ,5 A►+'�4,� N 60 %��� EGrB . � G� e�on$�. pata••��' 1 ,•� 6yq�v Cion �6[''�• � o -0 400 top s � F ��C G'•�` c14�� C3 1u;Be� pQ,w�l • ate• 31�a ,1 1 IA Axe ' �9 1G�t��tti-'�����1 pro�r 1lY C��i 0111, Client # 1806881 ?VMMORANDUM OF INSURANCE ate Issued 07101/2016 Producer This memorandum is issued as a matter of informatio Mercer Consumer, a service of Mercer Health & Benefits Administration LLL P.O. Box 14576 only and confers no rights upon the holder. This ruemnra.nchim dries nol. amend. extend or alter th coverages afforded by the Certificate listed below. Des Maines. lA 50306 3576 1-890-503-9230Company Affording Coverage Liberty Insurance Underwriters Inc Insured Lauren Cremonese PO Box 4432 Eagle CO 8.1531 This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicated not withstanding any requirement, term or condition of any contract or other document with respect to which this memorandum may be issued or Tliay pertain, the insurance afforded by the Certificate described herein is subject to all the erms, exclusions and conditions of such Certificate. The limits shown Ina • have been redo ed by paid clahus. Type of Insurance Certificate Number Effective Date Expiration Date Limits Professional Liability AI-IY-829562001 07!01121116 47/01/2017 Per Incident/ $1,000,000 Occurrence PhysiWThp SE Physical Therapist Annual Aggregate $3,000,000 Memorandum -Holder: Should the above describe C:ertiticate be cancullc cfore 1he expiration date thereof, the issuing company "11 endeavor to inail 30 days written notice to (h crnorandum T-4older named to the left, but failure t all such notice shall impose no obligation or liabili f any kind upon the company, its agents o epresentatives. Authorized Representative Mark 13rostowita Mercer Consumer, a service. of Mercer Health & Benefits Adiahih nfto LLL. In CA WiNa Mercer Hea" & Benefits tnwraace Services I.I.C. Cil ins I..ic POG39709 Client # 1 A66RR 1 MEMORANDUM OF ENSURANCE Date Issued - - July 7, 2016 Producer This memorandum is issued as a matter of i6ormation only and Mercer C Pnsumcr, a scnrcc of confers no rights upon the hololcr. This memorandum does not Mercer Health & Benefits Administratinn I.LC arnend, extend or alter the coverages afforded by the Certificate listed P.0. Boa 14576 below. Des h4aines, TA 50306 3576 www.proliabilityxom Company Affording Coverage Insured Liberty insurance Llnderwziters, Inc. Lauren Cremonese PO Bax 4432 Eagle, CO 8 163 1 This is to ceHfy that the Certificate Iisted beluw has been issued to the insured named above for the policy period indicated, not withstanding any requirement, term or condition of any contract or other doLument with respect to which this memorandum maybe issued or may pertain, the insurance afforded by the Certificate described herein is subject to all the terms, exclusions and conditions of such Certificate. The limits shown may have been reduced by paid claims. Type of Tnsurance Certificate Effective Expiration Limits Number Date Date Professional Liability 07101!2016 07/01/2017 Pei 51,000,000 Physical Therapist Oecummce S3,000,000 Aggregate General Liability Pe Occurrance A ate Evidence of Insurance Memorandum Holder is added as an Additional Insured, but only as respects to claims arisin out of the sole Negligence of the named insured subject to the terms and provisions of the policy. Memorandum Halder: Should the above described Corti fi.cate be cancelled before the expiration dale thereof, the issuing company will endeavor to mail 34 Lauren Shaeffer Consulting LLC days written notice to the Memorandum Halder named to the left, but PO Box 4432. failure to mail such notice shall u npose no obligation or liability of an Eagle, CO 81631 kind -upon the company, its agents of representatives. Authorized Representative Mark Brostowitc Principal CA ins Lic. #Wj39709, In CA d�bia Mercer Health &- Benefits Lnsurance Services LLC OP INSURANCE Mercer Consumer, a service of /Mercer Health & Benefits Administrrtinu 1.1 -C P.D. Sox 19576 Des Moines, IA 50306-3576 1-800-503-9230 nsured Lauren Cremonese PO Box 4432 Eagle CO 81631 Client # 1806851 Issued 07/01/2016 Phis mcuwrandum is issued as a mutter of in Format )nly and confers no rights upon the holder. 'I memorandum does not amend, extend or altum :overages afforded by the Certificate listed below. ompany Affording Coverage Insurance Underwriters Inc is to certify that the Certificate listed below has been issoed to Ilse insured named above for the policy period indica withstanding any requirement, term or condition of any contract or other document with respect to which torandkim may be issued or may periain, the insurance afforded by the Certificate described herein is Subject to all s, exclusions and conditions of such Certificate. The limits shown inay have been reduced by paid claims. Type of Insurance Professional Liability PhysicalThp SE Physical Therapist Holder: Certificate Number I Effective Date AI Y-829562001 1 07/01/2016 Expiration Date I Limits 07/01/201710ccurrence Per Incident/ I $1,000,000 Aggregate 1 $3,000,000 could the above describe Certificate be cancellec -foie tate expiration date thereof, the issuing compan- ill endeavor to mail 30 days written notice to the [emorandum Holder named to the left_ but failure tc ail mich notice shall impose no obligation or liabilitJ any kind upon the company, its agents oa i zed Representative- Mark epresentativel9ark Brostowite O(K6b-t -C.. `11-�_- Mercer C"sumer, a service of Mercer Health L. Senefit_s AdminMratWu LLC. In CA dib/a Mercer IIeakh & P.eza its lriwi vice Services LLC. CA Ins Lic_ 40G39709 MEMORANDUM OF INT SCJR.&NCY, Prod ucer Meret:r Consumer, a service of Mercer Health & Benefits Adininistration LLC P,0Box 14575 Des Nfoi=,1A 511306-3376 1-840-503-9234 Insured Lauren Cremonese PO Box 4432 Eagle Co 81631 Client # 1806991 Issued 07/0112016 coverages afforded by the Certificate listed below. Company Affording Coverage Liberty lnsumce Underwriters Inc This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicat - not withstanding any requirement, term or condition of any co�atract or other -'- - --------.... �- terms, exclusions and conditions of such Certificate. The limits shown may have been reduced by paid claims, Type of IusuEralace Ce ificate Dumber Effective Date Exphstlou Date Limits Professional Liability AHY-829562001 47.0112016 07,10117-017 Per Incident/ $1,000,000 Occurrence P11ysiGalTltp 5E Physical Therapist Annual Aggregate $3,000,000 Memorandum Holden Should the above describe Certificate; be c--;nceiled bcf= the expiration dato lhorcof the issuing company will endeavor to mail 30 day-, written wtiee to Elle Memorandwrt Holder wined to lite left. but Failure tri cns.il such notice shall impose no obligatiort or liability of any kind upon tho company, its agents or representatives. Authorized Representative Marlr BmstowAz IAmzer Con -mer. a service of Aercer Health do 13 LL U. In CA Wa Metcer Health & Brne&ts lummnce Senwes LLC. CA Fns Lic. ;OM 9709