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HomeMy WebLinkAboutBack-Up DocumentsCity of Miami, FL RFQ 1733386 PROFESSIONAL SERVICES AGREEMENT Continental American Insurance Company By and Between The City of Miami, Florida And PROVIDER This Professional Services Agreement ("Agreement") is entered into this day of , 2024 by and between the City of Miami ("City"), a municipal corporation of the State of Florida, whose address is 444 S.W. 2nd Avenue, Miami, Florida 33130 ("City"), and Continental American Insurance Company, a foreign corporation qualified to do business in the State of Florida whose principal address is 1600 Williams Street, Columbia, SC 29201, hereinafter referred to as the ("Provider"). RECITALS: WHEREAS, the City issued a Request for Qualifications (RFQ) No. 1733386 on March 7, 2024 (the "RFQ" attached hereto, incorporated hereby, and made a part of as Exhibit A), for the provision of Employee Voluntary Supplemental Insurance Benefits, ("Services" as more fully set forth in the scope of work "Scope", attached hereto as Exhibit B) for the Risk Management Department, and Provider's proposal ("Proposal", attached hereto, incorporated hereby, and made part of hereof as Exhibit C), in response thereto, has been selected as a qualified proposal for the provision of the Services. WHEREAS, the Provider has offered to participate in the City's Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool for the purposes of providing Employee 1 City of Miami, FL RFQ 1733386 Voluntary Supplemental Insurance Benefits to the City that shall conform to the Scope of Services; City's Request for Qualifications (RFQ No. 1733386), and all associated addenda and attachments, incorporated herein by reference, any Work Orders issued as a result of this Agreement, and the requirements of applicable laws, regulations and of this Agreement; and WHEREAS, the Evaluation Committee appointed by the City Manager determined that the Proposal submitted by the Provider was responsive to the RFQ requirements and recommended that the City Manager approve the inclusion of the Provider in the Pool, and negotiate price with the Provider at the Work Order stage; and WHEREAS, the City and the Provider desire to enter into this Agreement under the terms and conditions set forth herein. NOW, THEREFORE, in consideration of the mutual covenants and promises herein contained, Provider and the City agree as follows: TERMS: 1. RECITALS AND INCORPORATIONS; DEFINITIONS: A. The recitals are true and correct and are hereby incorporated into and made a part of this Agreement. The City's RFQ is hereby incorporated into and made a part of this Agreement and attached hereto as Exhibit "A". The Services and Scope of Work are hereby incorporated into and made a part of this Agreement and attached as Exhibit "B". The Provider's Response dated, June 10, 2024, in response to RFQ 1733386, is hereby incorporated into and made a part of this Agreement as attached Exhibit "C". The Provider's Insurance Certificate is hereby incorporated into and made a part of this Agreement as attached Exhibit "D". The order of precedence 2 City of Miami, FL RFQ 1733386 whenever there is conflicting or inconsistent language between documents is as follows in descending order of priority: (1) Professional Services Agreement ("PSA") (2) Addenda/Addendum to the RFQ; (3) RFQ; and (4) Provider's response dated June 10, 2024, acknowledging scope of services, any addenda, and pricing component of services and, response to the Request for Qualifications. 2. CONTRACT TERM: The Agreement shall become effective on the date on the first page, and shall be for a duration of six (6) years: Initial term of three (3) years with one (1), three (3) year option to renew. The City, acting by and through its City Manager, shall have the option to extend or terminate the Agreement for convenience, that is, for any or no cause. 3. WORK ORDER TERM: Work Orders shall expire as stated on each individual Work Order issued under this Agreement and may extend past the expiration of this Agreement. The provisions of any specific Work order which commences prior to the termination date of this Agreement, and which will extend beyond said termination date shall survive the expiration or termination thereof. 4. SCOPE OF SERVICES: A. Provider agrees to provide the Services as specifically described, and under the special terms and conditions set forth in Exhibits "A" and "B" hereto, in addition to any Work Order as a result of this Agreement, which by this reference is incorporated into and made a part of this Agreement. B. Provider represents to the City that: (i) it possesses all qualifications, licenses, certificates, 3 City of Miami, FL RFQ 1733386 authorizations, and expertise required for the performance of the Services, including but not limited to full qualification to do business in Florida; (ii) it is not delinquent in the payment of any sums due the City, including payment of permits, fees, occupational licenses, contract or bond claims etc., nor in the performance of any obligations or payment of any monies to the City; (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified and trained to perform the tasks assigned to each; (iv) the Services will be performed in the manner described in Exhibit "A"; and (v) each person executing this Agreement on behalf of Provider has been duly authorized to so execute the same and fully bind Provider as a party to this Agreement. C. Provider shall at all times provide fully qualified, competent and physically capable employees to perform the Services under this Agreement. City may require Provider to remove any employee the City deems careless, incompetent, insubordinate, or otherwise objectionable and whose continued services under this Agreement is not in the best interest of the City. 5. COMPENSATION: A. The amount of compensation payable by the City to the Provider for all Work and Services performed under this Agreement, includes all costs associated with such Work and Services, and shall be as stated in each individual Work Order to this Agreement. The City shall have no obligation to pay the Provider any additional sum in excess of this amount set forth in each Work Order, except for a change and/or modification to the Agreement, which is approved and executed in writing by the City and the Provider. All Services undertaken by the Provider before City's approval of this Agreement and any subsequent Work Order shall be at the Provider's risk and 4 City of Miami, FL RFQ 1733386 expense. B. Payment shall be made in arrears based upon work performed to the satisfaction of the City within forty-five (45) days after receipt of Provider's invoice for Services performed, which shall be accompanied by sufficient supporting documentation and contain sufficient detail, to allow a proper audit of expenditures, should the City require one to be performed. Invoices shall be sufficiently detailed so as to comply with the "Florida Prompt Payment Act", §218.70. -218.79, Florida Statutes, and other applicable laws. No advance payments shall be made at any time. C. Provider agrees and understands that (i) any and all subcontractors providing Services related to this Agreement shall be paid through Provider and not paid directly by the City, and (ii) any and all liabilities regarding payment to or use of subcontractors for any of the Services related to this Agreement shall be borne solely by Provider and not be a debt or default of the City. The City only has privity of contract with the named Provider. 6. OWNERSHIP OF DOCUMENTS: Provider understands and agrees that any information, document, report, or any other material whatsoever which is given by the City to Provider, its employees, or any subcontractor, or which is otherwise obtained or prepared by Provider solely and exclusively for the City pursuant to or under the terms of this Agreement, is and shall at all times remain the property of the City. Provider agrees not to use any such information, document, report or material for any other purpose whatsoever without the written consent of the City Manager, which may be withheld or conditioned by the City Manager in his/her sole discretion. Provider is permitted to make and to maintain duplicate copies of the files, records, documents, etc. if Provider determines copies of such 5 City of Miami, FL RFQ 1733386 records are necessary subsequent to the termination of this Agreement; however, in no way shall the confidentiality as permitted by applicable law be breached. The City shall maintain and retain ownership of any and all documents which result upon the completion of the work and Services under this Agreement as per the terms of this Section 5. 7. AUDIT AND INSPECTION RIGHTS AND RECORDS RETENTION: A. Provider agrees to provide access to the City or to any of its duly authorized representatives, to any books, documents, papers, and records of Provider which are directly pertinent to this Agreement, for the purpose of audit, examination, excerpts, and transcripts. The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to Provider under this Agreement, audit and inspect, or cause to be audited and inspected, those books, documents, papers, and records of Provider which are related to Provider's performance under this Agreement. Provider agrees to maintain any and all such books, documents, papers, and records at its principal place of business for a period of three (3) years after final payment is made under this Agreement and all other pending matters are closed. Provider's failure to adhere to, or refusal to comply with, this condition shall result in the immediate cancellation of this Agreement by the City. B. The City may, at reasonable times during the term hereof, inspect the Provider's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods or services required to be provided by Provider under this Agreement conform to the terms hereof. Provider shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests, inspections and audits shall 6 City of Miami, FL RFQ 1733386 be subject to, and made in accordance with, the provisions of Section 18-101 and 18-102 of the Code of the City of Miami, Florida as same may be amended or supplemented, from time to time, which are deemed as being incorporated by reference herein. 8. AWARD OF AGREEMENT: Provider represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. 9. PUBLIC RECORDS: A. Provider understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City Agreements, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable laws. Provider's failure or refusal to comply with the provisions of this section shall result in the immediate cancellation of this Agreement by the City. B. Provider shall additionally comply with Section 119.0701, Florida Statutes, including without limitation: (1) keep and maintain public records that ordinarily and necessarily would be required by the City to perform this service; (2) provide the public with access to public records on the same terms and conditions as the City would at the cost provided by Chapter 119, Florida Statutes, or as otherwise provided by law; (3) ensure that public records that are exempt or confidential and exempt from disclosure are not disclosed except as authorized by law; (4) meet all requirements for retaining public records and transfer, at no cost, to the City all public records 7 City of Miami, FL RFQ 1733386 in its possession upon termination of this Agreement and destroy any duplicate public records that are exempt or confidential and exempt from disclosure requirements; and, (5) provide all electronically stored public records that must be provided to the City in a format compatible with the City's information technology systems. Notwithstanding the foregoing, Provider shall be permitted to retain any public records that make up part of its work product solely as required for archival purposes, as required by law, or to evidence compliance with the terms of the Agreement. C. Should Provider determine to dispute any public access provision required by Florida Statutes, and then Provider shall do so at its own expense and at no cost to the City. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT (305) 416-1830, Via email at PublicRecords@miamigov.com, or regular email at City of Miami Office of the City Attorney, 444 SW 2nd Avenue, 9th FL, Miami, FL 33130. 10. COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS: Provider understands that agreements with local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, record keeping, etc. City and Provider agree to comply with and observe all such applicable federal, state and local laws, rules, regulations, codes and ordinances, as they may be amended from time to time. 8 City of Miami, FL RFQ 1733386 Provider further agrees to include in all of Provider's agreements with subcontractors for any Services related to this Agreement this provision requiring subcontractors to comply with and observe all applicable federal, state, and local laws rules, regulations, codes and ordinances, as they may be amended from time to time. 11. INDEMNIFICATION: Provider shall indemnify, hold/save harmless and defend at its own cost and expense the City, its officials and employees, for claims (collectively referred to as "Indemnitees") and each of them from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's fees) or liabilities (collectively referred to as "Liabilities") by reason of any injury to or death of any person or damage to or destruction or loss of any property arising out of, resulting from, or in connection with (i) the negligent performance or non-performance of the Services contemplated by this Agreement (whether active or passive) of Provider or its employees or subcontractors (collectively referred to as "Provider") which is directly caused, in whole or in part, by any act, omission, default or negligence (whether active or passive or in strict liability) of the Indemnitees, or any of them, or (ii) the failure of the Provider to comply materially with any of the requirements herein, or the failure of the Provider to conform to statutes, ordinances, or other regulations or requirements of any governmental authority, local, federal or state, in connection with the performance of this Agreement even if it is alleged that the City, its officials and/or employees were negligent. Provider expressly agrees to indemnify, defend and hold harmless the Indemnitees, or any of them, from and against all liabilities which may be asserted by an employee or former employee of Provider, or any of its subcontractors, as provided above, for which the 9 City of Miami, FL RFQ 1733386 Provider's liability to such employee or former employee would otherwise be limited to payments under state Workers' Compensation or similar laws. Provider further agrees to indemnify, defend and hold harmless the Indemnitees from and against (i) any and all Liabilities imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or requirement, related directly to Provider's negligent performance under this Agreement, compliance with which is left by this Agreement to Provider, and (ii) any and all claims, and/or suits for labor, supplies, goods, services, equipment, and materials furnished by Provider or utilized in the performance of this Agreement or otherwise ( excluding only payment of fees due the Provider under the terms of this Agreement).. Provider's obligations to indemnify defend and hold harmless shall survive the termination or expiration of this Agreement. Provider understands and agrees that any and all liabilities regarding the use of any subcontractor for Services related to this Agreement shall be borne solely by Provider throughout the duration of this Agreement and that this provision shall survive the termination or expiration of this Agreement, as applicable. 12. DEFAULT: If Provider fails to comply materially with any term or condition of this Agreement or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from the City, then Provider shall be in default. Provider understands and agrees that termination of this Agreement under this section shall not release Provider from any obligation accruing prior to the effective date of termination. Should Provider be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, then, in addition to the foregoing, Provider shall be liable to the City for all expenses incurred by 10 City of Miami, FL RFQ 1733386 the City in preparation and negotiation of this Agreement, as well as all costs and expenses incurred by the City in the re -procurement of the Services, including consequential and incidental damages. 13. RESOLUTION OF AGREEMENT DISPUTES: Provider understands and agrees that all disputes between Provider and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Provider being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds Twenty - Five Thousand Dollars and No/Cents ($25,000), the City Manager's decision shall be approved or disapproved by the City Commission. Provider shall not be entitled to seek judicial relief unless: (i) it has first received City Manager's written decision, approved by the City Commission if the amount of compensation hereunder exceeds Twenty -Five Thousand Dollars and No/Cents ($25,000), or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation or ninety (90) days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by written instruments, signed by the City Manager. In no event may the amount of compensation under this Section exceed the total compensation set forth in Section 4 (A) of this Agreement. 14. TERMINATION; OBLIGATIONS UPON TERMINATION: A. The City, acting by and through its City Manager, shall have the right to terminate this 11 City of Miami, FL RFQ 1733386 Agreement, in its sole discretion, for convenience, and without penalty, at any time, by giving written notice to Provider at least thirty (30) calendar days prior to the effective date of such termination. In such event, the City shall pay to Provider compensation for Services rendered and approved expenses incurred prior to the effective date of termination. In no event shall the City be liable to Provider for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any consequential or incidental damages. The Provider shall have no recourse or remedy against the City for a termination under this subsection except for payment of fees due prior to the effective date of termination. B. The City, by and acting through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, upon the occurrence of an event of a material breach hereunder, and failure to cure the same within thirty (30) days after written notice of default. . In such event, the City shall not be obligated to pay any amounts to Provider for Services rendered by Provider after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of the effective date of termination. In no event shall the City be liable to Provider for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any direct, indirect, consequential or incidental damages. 15. INSURANCE: A. Provider shall, at all times during the term hereof, maintain such insurance coverage(s) as may be required by the City. The insurance coverage(s) required as of the Effective Date of this Agreement are attached hereto as Exhibit "D" and incorporated herein by this reference. The City 12 City of Miami, FL RFQ 1733386 RFQ number and title of the RFQ must appear on each certificate of insurance. The Provider shall add the City of Miami as an additional insured to its commercial general liability, and auto liability policies, and as a named certificate holder on all policies. Provider shall correct any insurance certificates as requested by the City's Risk Management Administrator. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection and evidence of such coverage(s) and shall be furnished to the City Risk Management Administrator on Certificates of Insurance indicating such insurance to be in force and effect and any cancelled or non -renewed policy will be replaced with no coverage gap and a current Certificate of Insurance will be provided. Completed Certificates of Insurance shall be filed with the City prior to the performance of Services hereunder, provided, however, that Provider shall at any time upon request file duplicate copies of the Certificate of Insurance with the City. B. Provider understands and agrees that any and all liabilities regarding the use of any of Provider's employees or any of Provider's subcontractors for Services related to this Agreement shall be borne solely by Provider throughout the term of this Agreement and that this provision shall survive the termination of this Agreement. Provider further understands and agrees that insurance for each employee of Provider and each subcontractor providing Services related to this Agreement shall be maintained in good standing and approved by the City Risk Management Administrator throughout the duration of this Agreement. C. Provider shall be responsible for assuring that the insurance certificates required under this Agreement remain in full force and effect for the duration of this Agreement, including any 13 City of Miami, FL RFQ 1733386 extensions hereof. If insurance certificates are scheduled to expire during the term of this Agreement and any extension hereof, Provider shall be responsible for submitting new or renewed insurance certificates to the City's Risk Management Administrator as soon as coverages are bound with the insurers. In the event that expired certificates are not replaced, with new or renewed certificates which cover the term of this Agreement and any extension thereof: (i) the City shall suspend this Agreement until such time as the new or renewed certificate(s) are received in acceptable form by the City's Risk Management Administrator; or (ii) the City may, at its sole discretion, terminate the Agreement for cause and seek re -procurement damages from Provider in conjunction with the violation of the terms and conditions of this Agreement. D. Compliance with the foregoing requirements shall not relieve Provider of its liabilities and obligations under this Agreement. 16. NONDISCRIMINATION: Provider represents to the City that Provider does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Provider's performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status or national origin. Provider further covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex, sexual orientation , religion, age, handicap, marital status or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. 17. ASSIGNMENT: This Agreement shall not be assigned, transferred, sold, conveyed or pledged by Provider, in 14 City of Miami, FL RFQ 1733386 whole or in part, and Provider shall not assign any part of its operations, without the prior written consent of the City Manager, which may be withheld or conditioned, in the City's sole discretion through the City Manager. 18. NOTICES: All notices or other communications required under this Agreement shall be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return receipt requested, addressed to the other party at the address indicated herein or to such other address as a party may designate by notice given as herein provided. Notice shall be deemed given on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. TO PROVIDER: John Finklea Continental Accident Insurance Company 1600 Williams Street Columbia, SC 29201 jfinklea©aflac.com 15 TO THE CITY: Arthur Noriega V City Manager 444 SW 2nd Avenue, 10th Floor Miami, FL 33130-1910 Ann -Marie Sharpe Director, Risk Management 444 SW 2nd Avenue, 9th Floor Miami, FL 33130 Annie Perez, CPPO Procurement Director 444 SW 2nd Avenue, 6th Floor Miami, FL 33130-1910 Victoria Mendez City Attorney 444 SW 2nd Avenue, 9th Floor Miami, FL 33130-1910 City of Miami, FL RFQ 1733386 19. MISCELLANEOUS PROVISIONS: A. This Agreement shall be construed and enforced according to the laws of the State of Florida. Venue in any proceedings between the parties shall be in Miami -Dade County, Florida. Each party shall bear its own attorney's fees. Each party waives any defense, whether asserted by motion or pleading, that the aforementioned courts are an improper or inconvenient venue. Moreover, the parties consent to the personal jurisdiction of the aforementioned courts and irrevocably waive any objections to said jurisdiction. The parties irrevocably waive any rights to a jury trial. B. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing. C. Should any provision, paragraph, sentence, word or phrase contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise unenforceable under the laws of the State of Florida or the City of Miami, such provision, paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable, then the same shall be deemed severable, and in event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect or limitation of its use. D. Provider shall comply with all applicable laws, rules and regulations in the performance of this Agreement, including but not limited to licensure, and certifications required by law for professional service Providers. E. This Agreement constitutes the sole and entire agreement between the parties hereto. No 16 City of Miami, FL RFQ 1733386 modification or amendment hereto shall be valid unless in writing and executed by properly authorized representatives of the parties hereto. Except as otherwise set forth in Section 2 above, the City Manager shall have the sole authority to extend, amend, or modify this Agreement on behalf of the City. 20. SUCCESSORS AND ASSIGNS: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns. 21. INDEPENDENT CONTRACTORS: Provider has been procured and is being engaged to provide Services to the City as an independent contractor, and not as an agent or employee of the City. Accordingly, neither Provider, nor its employees, nor any subcontractor hired by Provider to provide any Services under this Agreement shall attain, nor be entitled to, any rights or benefits under the Civil Service or Pension Ordinances of the City, nor any rights generally afforded classified or unclassified employees. Provider further understands that Florida Workers' Compensation benefits available to employees of the City are not available to Provider, its employees, or any subcontractor hired by Provider to provide any Services hereunder, and Provider agrees to provide or to require subcontractor(s) to provide, as applicable, workers' compensation insurance for any employee or agent of Provider rendering Services to the City under this Agreement. Provider further understands and agrees that Providers or subcontractors' use or entry upon City properties shall not in any way change its or their status as an independent contractor. 17 City of Miami, FL RFQ 1733386 22. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination due to lack of funds, reduction of funds, failure to allocate or appropriate funds, and/or change in applicable laws or regulations, upon thirty (30) days written notice. 23. FORCE MAJEURE: A "Force Majeure Event" shall mean an act of God, act of governmental body or military authority, fire, explosion, power failure, flood, storm, hurricane, sink hole, other natural disasters, epidemic, riot or civil disturbance, war or terrorism, sabotage, insurrection, blockade, or embargo. In the event that either party is delayed in the performance of any act or obligation pursuant to or required by the Agreement by reason of a Force Majeure Event, the time for required completion of such act or obligation shall be extended by the number of days equal to the total number of days, if any, that such party is actually delayed by such Force Majeure Event. The party seeking delay in performance shall give notice to the other party specifying the anticipated duration of the delay, and if such delay shall extend beyond the duration specified in such notice, additional notice shall be repeated no less than monthly so long as such delay due to a Force Majeure Event continues. Any party seeking delay in performance due to a Force Majeure Event shall use its best efforts to rectify any condition causing such delay and shall cooperate with the other party to overcome any delay that has resulted. 18 City of Miami, FL RFQ 1733386 24. CITY NOT LIABLE FOR DELAYS: Provider hereby understands and agrees that in no event shall the City be liable for, or responsible to Provider or any subcontractor, or to any other person, firm, or entity for or on account of, any stoppages or delay(s) in work herein provided for, or any damages whatsoever related thereto, because of any injunction or other legal or equitable proceedings or on account of any delay(s) for any cause over which the City has no control. 25. USE OF NAME: Provider understands and agrees that the City is not engaged in research for advertising, sales promotion, or other publicity purposes. Provider is allowed, within the limited scope of normal and customary marketing and promotion of its work, to use the general results of this project and the name of the City. The Provider agrees to protect any confidential information provided by the City and will not release information of a specific nature without prior written consent of the City Manager or the City Commission. Provider may not use or reproduce the official logo of the City. 26. NO CONFLICT OF INTEREST: Pursuant to City of Miami Code Section 2611, as amended ("City Code"), regarding conflicts of interest, Provider hereby certifies to the City that no individual member of Provider, no employee, and no subcontractor under this Agreement nor any immediate family member of any of the same is also a member of any board, commission, or agency of the City. Provider hereby represents and warrants to the City that throughout the term of this Agreement, Provider, its employees, and its subcontractors will abide by this prohibition of the City Code. 19 City of Miami, FL RFQ 1733386 27. NO THIRD -PARTY BENEFICIARY: No persons other than the Provider and the City (and their successors and assigns) shall have any rights whatsoever under this Agreement. 28. SURVIVAL: All obligations (including but not limited to indemnity and obligations to defend and hold harmless) and rights of any party arising during or attributable to the period prior to expiration or earlier termination of this Agreement shall survive such expiration or earlier termination. 29. TRUTH -IN -NEGOTIATION CERTIFICATION, REPRESENTATION AND WARRANTY: Provider hereby certifies, represents and warrants to the City that on the date of Provider's execution of this Agreement, and so long as this Agreement shall remain in full force and effect, the wage rates and other factual unit costs supporting the compensation to Provider under this Agreement are and will continue to be accurate, complete, and current. Provider understands, agrees and acknowledges that the City shall adjust the amount of the compensation and any additions thereto to exclude any significant sums by which the City determines the contract price of compensation hereunder was increased due to inaccurate, incomplete, or non -current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year of the end of this Agreement, whether naturally expiring or earlier terminated pursuant to the provisions hereof. 20 City of Miami, FL RFQ 1733386 30. COUNTERPARTS: ELECTRONIC SIGNATURES: This Agreement and any amendments hereto may be executed in counterparts and all such counterparts taken together shall be deemed to constitute one and the same instrument, each of which shall be an original as against either party whose signature appears thereon, but all of which taken together shall constitute but one and the same instrument. An executed facsimile or electronic scanned copy of this Agreement shall have the same force and effect as an original. The parties shall be entitled to sign and transmit an electronic signature on this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Any party providing an electronic signature agrees to promptly execute and deliver to the other parties an original signed Agreement upon request. 31. E-VERIFY EMPLOYMENT REQUIREMENTS: Provider(s) shall E-Verify the employment status of all employees and subcontractors to the extent required by federal, state, and local laws, rules, and regulations. The City shall consider the employment by Provider(s) of unauthorized aliens a violation of Section 274A(e) of the Immigration and Nationality Act. If the Provider(s) knowingly employs unauthorized aliens, such violation shall be cause for termination of the Contract. Furthermore, the Provider(s) agrees to utilize the U.S. Agency of Homeland Security's E-Verify System, https://e-verify.uscis.gov/emp, to verify the employment eligibility of all employees during the term of this Contract. Provider(s) shall also include a requirement in subcontracts that the subcontractor shall also utilize the E- Verify System to verify the employment eligibility of all employees of the subcontractor during the term of this Contract. 21 City of Miami, FL RFQ 1733386 32. Antitrust Violator Vendors: Pursuant to Section 287.137, Florida Statutes, a person or an affiliate who has been placed on the Antitrust Violator Vendors List following a conviction or being held civilly liable for an antitrust violation may not submit a bid, proposal, or reply on any agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on any agreement with a public entity for the construction or repair of a public building or public work; may not submit a bid, proposal, or reply on leases of real property to a public entity; may not be awarded or perform work as a grantee, supplier, subcontractor, or Provider under an agreement with a public entity; and may not transact new business with a public entity. 33. Anti -Human Trafficking: The Advisor confirms and certifies that it is not in violation of Section 787.06, Florida Statutes, and that it does not and shall not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes. The Advisor shall execute and submit to the City an Affidavit, of even date herewith, in compliance with Section 787.06(13), Florida Statutes, attached an incorporated herein as Exhibit "F." If the Advisor fails to comply with the terms of this Section, the City may suspend or terminate this Agreement immediately, without prior notice, and in no event shall the City be liable to Advisor for any additional compensation or for any consequential or incidental damages. 22 City of Miami, FL RFQ 1733386 34. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and only agreement of the parties relating to the subject matter hereof and correctly set forth the rights, duties, and obligations of each to the other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 23 City of Miami, FL RFQ 1733386 IN WITNESS WHEREOF, the Parties have executed this Agreement, or have caused the same to be executed, as of the date and year first above written. for "Provider" Continental Accident Insurance Company, a foreign profit corporation ATTEST: By: By: Mon !/ Yj /eK 4_, Print Name: Deborah Vandeventer Name: J. Matthew Loudermilk Title: VP, UW and Onboardinq Title: Corporate Secretary "CITY" CITY OF MIAMI, a Florida municipal corporation ATTEST: By: By: Todd B. Hannon Arthur Noriega V City Clerk City Manager APPROVED AS TO LEGAL FORM AND APPROVED AS TO INSURANCE CORRECTNESS: REQUIREMENTS: By: By: George K. Wysong, III Ann -Marie Sharpe, Director City Attorney Department of Risk Management 24 c City of Miami, FL RFQ 1733386 EXHIBIT A RFQ No. 1733386 Continental American Insurance Company 25 City of Miami, FL RFQ 1733386 EXHIBIT B SCOPE OF WORK Provide Employee Voluntary Supplemental Insurance Benefits, as provided in the individual Work Assignments, pursuant to Section 3.0, Specifications/Scope of Work, of the Solicitation. 26 City of Miami, FL RFQ 1733386 EXHIBIT C PROVIDER'S RESPONSE AND PRICE PROPOSAL 27 City of Miami, FL RFQ 1733386 EXHIBIT D INSURANCE REQUIREMENTS The Provider shall furnish to City of Miami, c/o Procurement Department, 444 SW 2nd Avenue, 6th Floor, Miami, Florida 33130, Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets the requirements as outlined below: I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $ 2,000,000 Personal and Adv. Injury $ 1,000,000 Products/Completed Operations $ 1,000,000 B. Endorsements Required City of Miami listed as additional insured Contingent & Contractual Liability Premises and Operations Liability Primary Insurance Clause Endorsement II. Business Automobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami listed as an additional insured 28 City of Miami, FL RFQ 1733386 III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation Employer's Liability A. Limits of Liability $100,000 for bodily injury caused by an accident, each accident $100,000 for bodily injury caused by disease, each employee $500,000 for bodily injury caused by disease, policy limit IV. Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim $1,000,000 General Aggregate Limit $1,000,000 Retro Date Included V. Network Security and Privacy Injury (Cyber Liability) Each Claim $1,000,000 Policy Aggregate $1,000,000 Retro Date Included Provider agrees to maintain professional liability/Errors & Omissions coverage, along with Network Security and Privacy Injury (Cyber) coverage, if applicable, for a minimum of 1 year after termination of the contract period subject to continued availability of commercially reasonable terms and conditions of such coverage. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer in accordance to policy provisions. 29 City of Miami, FL RFQ 1733386 Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A-" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. Certificates will indicate no modification or change in insurance shall be made without thirty (30) days written advance notice to the certificate holder. NOTE: CITY RFQ NUMBER AND/OR TITLE OF RFQ MUST APPEAR ON EACH CERTIFICATE. Compliance with the foregoing requirements shall not relieve the Provider of his liability and obligation under this section or under any other section of this Agreement. --If insurance certificates are scheduled to expire during the contractual period, the Provider shall be responsible for submitting new or renewed insurance certificates to the City at a minimum of ten (10) calendar days in advance of such expiration. --In the event that expired certificates are not replaced with new or renewed certificates which cover the contractual period, the City shall: (1) Suspend the contract until such time as the new or renewed certificates are received by the City in the manner prescribed in the Request for Qualifications. (2) The City may, at its sole discretion, terminate this contract for cause and seek re -procurement damages from the Provider in conjunction with the General and Special Terms and Conditions of the RFQ. The Provider shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in force for the duration of the contractual period; including any and all option terms that may be granted to the Provider. 30 City of Miami, FL RFQ 1733386 EXHIBIT E CORPORATE RESOLUTIONS AND EVIDENCE OF QUALIFICATION TO DO BUSINESS IN FLORIDA (To be provided upon document execution) 31 City of Miami, FL RFQ 1733386 CORPORATE RESOLUTION WHEREAS, Continental American Insurance Company a foreign corporation, desires to enter into an agreement with the City of Miami for the purpose of performing the work described in the contract to which this resolution is attached; and WHEREAS, the Board of Directors at a duly held corporate meeting has considered the matter in accordance with the bylaws of the corporation; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS that this Corporation is authorized to enter into the Agreement with the City, and the President and the Secretary are hereby authorized and directed to execute the Agreement in the name of this Company and execute any other document and perform any acts in connection therewith as may be requested to accomplish its purpose. IN WITNESS WHEREOF, this Continental American Insurance Company day of , 2024 ("Provider") A Florida Corporation By: (sign) Print Name: Title: Corporate Secretary (sign) Print Name: 32 City of Miami, FL RFQ 1733386 EXHIBIT F ANTI --HUMAN TRAFFICKING AFFIDAVIT 33 EXHIBIT F ANTI -HUMAN TRAFFICKING AFFIDAVIT 1. The undersigned affirms, certifies, attests, and stipulates as follows: a. The entity is a non -governmental entity authorized to transact business in the State of Florida and in good standing with the Florida Department of State, Division of Corporations. b. The nongovernmental entity is either executing, renewing, or extending a contract (including, but not limited to, any amendments, as applicable) with the City of Miami ("City") or one of its agencies, authorities, boards, trusts, or other City entity which constitutes a governmental entity as defined in Section 287.138(1), Florida Statutes (2024). c. The nongovernmental entity is not in violation of Section 787.06, Florida Statutes (2024), titled "Human Trafficking." d. The nongovernmental entity does not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes (2024), attached and incorporated herein as Exhibit Affidavit-1. 2. Under penalties of perjury, I declare the following: a. I have read and understand the foregoing Anti -Human Trafficking Affidavit and that the facts, statements and representations provided in Section 1 are true and correct. b. I am an officer or a representative of the nongovernmental entity authorized to execute this Anti - Human Trafficking Affidavit. Nongovernmental Entity: _Continental American Insurance Company Name: _Deborah Vandeventer JJ Officer Title: _VP,iU'v , arid' Onboarding Signature of Officer: I/ 61 Q..p(, 1441.61e-t/C�u Office Address: 1600 Williams Street, Columbia, SC 29201 Email Address: _dandeventer@aflac.com Main Phone Number: 803-995-9570 FEIN No. 5/7 -0 /5 /1 /4 /1 /3 /0 STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing instrument was sworn to and subscribed before me by means of Q physical presence or O online notarization, this _13th day of _January by Deborah Vandeventer , as the authorized officer or representative for the nongovernmental entity.. He/she is personally known to me or has produced N/A as identification. (NOTARY PUBLIC SEAL) My Commission Expires:_ December 17, 2034 Signature of Person Taking Oath Starla Stidham (Printed, Typed, or Stamped Name of Notary Public) , ) •!• EXHIBIT AFFIDAVIT-1 SECTION 787.06, FLORIDA STATUTES (2024) Select Year: 2024 v The 2024 Florida Statutes Go Title Chapter 787 View Entire XLVI KIDNAPPING; CUSTODY OFFENSES; HUMAN TRAFFICKING; AND RELATED Chapter CRIMES OFFENSES 787.06 Human trafficking.— (1)(a) The Legislature finds that human trafficking is a form of modern-day slavery. Victims of human trafficking are young children, teenagers, and adults. Thousands of victims are trafficked annually across international borders worldwide. Many of these victims are trafficked into this state. Victims of human trafficking also include citizens of the United States and those persons trafficked domestically within the borders of the United States. The Legislature finds that victims of human trafficking are subjected to force, fraud, or coercion for the purpose of sexual exploitation or forced labor. (b) The Legislature finds that while many victims of human trafficking are forced to work in prostitution or the sexual entertainment industry, trafficking also occurs in forms of labor exploitation, such as domestic servitude, restaurant work, janitorial work, sweatshop factory work, and migrant agricultural work. (c) The Legislature finds that traffickers use various techniques to instill fear in victims and to keep them enslaved. Some traffickers keep their victims under lock and key. However, the most frequently used practices are less obvious techniques that include isolating victims from the public and family members; confiscating passports, visas, or other identification documents; using or threatening to use violence toward victims or their families; telling victims that they will be imprisoned or deported for immigration violations if they contact authorities; and controlling the victims' funds by holding the money ostensibly for safekeeping. (d) It is the intent of the Legislature that the perpetrators of human trafficking be penalized for their illegal conduct and that the victims of trafficking be protected and assisted by this state and its agencies. In furtherance of this policy, it is the intent of the Legislature that the state Supreme Court, The Florida Bar, and relevant state agencies prepare and implement training programs in order that judges, attorneys, law enforcement personnel, investigators, and others are able to identify traffickers and victims of human trafficking and direct victims to appropriate agencies for assistance. It is the intent of the Legislature that the Department of Children and Families and other state agencies cooperate with other state and federal agencies to ensure that victims of human trafficking can access social services and benefits to alleviate their plight. (2) As used in this section, the term: (a) "Coercion" means: 1. Using or threatening to use physical force against any person; 2. Restraining, isolating, or confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his will; 3. Using lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined; 4. Destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person; 5. Causing or threatening to cause financial harm to any person; 6. Enticing or luring any person by fraud or deceit; or 7. Providing a controlled substance as outlined in Schedule I or Schedule II of s. 893.03 to any person for the purpose of exploitation of that person. (b) "Commercial sexual activity" means any violation of chapter 796 or an attempt to commit any such offense, and includes sexually explicit performances and the production of pornography. (c) "Financial harm" includes extortionate extension of credit, loan sharking as defined in s. 687.071, or employment contracts that violate the statute of frauds as provided in s. 725.01. (d) "Human trafficking" means transporting, soliciting, recruiting, harboring, providing, enticing, maintaining, purchasing, patronizing, procatih6r1306MiriWilietftreptrtligillt4r the purpose of exploitation of that person. (e) "Labor" means work of economic or financial value. (f) "Maintain" means, in relation to labor or services, to secure or make possible continued performance thereof, regardless of any initial agreement on the part of the victim to perform such type service. (g) "Obtain" means, in relation to labor, commercial sexual activity, or services, to receive, take possession of, or take custody of another person or secure performance thereof. (h) "Services" means any act committed at the behest of, under the supervision of, or for the benefit of another. The term includes, but is not limited to, forced marriage, servitude, or the removal of organs. (i) "Sexually explicit performance" means an act or show, whether public or private, that is live, photographed, recorded, or videotaped and intended to arouse or satisfy the sexual desires or appeal to the prurient interest. (j) "Unauthorized alien" means an alien who is not authorized under federal law to be employed in the United States, as provided in 8 U.S.C. s. 1324a(h)(3). The term shall be interpreted consistently with that section and any applicable federal rules or regulations. (k) "Venture" means any group of two or more individuals associated in fact, whether or not a legal entity. (3) Any person who knowingly, or in reckless disregard of the facts, engages in human trafficking, or attempts to engage in human trafficking, or benefits financially by receiving anything of value from participation in a venture that has subjected a person to human trafficking: (a)1. For labor or services of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services of an adult commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (b) Using coercion for commercial sexual activity of an adult commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (c)1. For labor or services of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services of an adult who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (d) Using coercion for commercial sexual activity of an adult who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (e)1. For labor or services who does so by the transfer or transport of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services who does so by the transfer or transport of an adult from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (f)1. For commercial sexual activity who does so by the transfer or transport of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age from outside this state to within this state commits a felony of the first degree, punishable by imprisonment for a term of years not exceeding life, or as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for commercial sexual activity who does so by the transfer or transport of an adult from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (g) For commercial sexual activity in which any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age, or in which any person who is mentally defective or mentally incapacitated as those terms are defined in s. 794.011(1), is involved commits a life felony, punishable as provided in s. 775.082(3)(a)6., s. 775.083, or s. 775.084. For each instance of human trafficking of any individual under this subsection, a separate crime is committed and a separate punishment is authorized. (4)(a) Any parent, legal guardian, or other person having custody or control of a minor who sells or otherwise transfers custody or control of such minor, or offers to sell or otherwise transfer custody of such minor, with knowledge or in reckless disregard of the fact that, as a consequence of the sale or transfer, the minor will be subject to human trafficking commits a life felony, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (b) Any person who, for the purpose of committing or facilitating an offense under this section, permanently brands, or directs to be branded, a victim of an offense under this section commits a second degree felony, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. For purposes of this subsection, the term "permanently branded" means a mark on the individual's body that, if it can be removed or repaired at all, can only be removed or repaired by surgical means, laser treatment, or other medical procedure. (5) The Criminal Justice Standards and Training Commission shall establish standards for basic and advanced training programs for law enforcement officers in the subjects of investigating and preventing human trafficking crimes. Every basic skills course required for law enforcement officers to obtain initial certification must include training on human trafficking crime prevention and investigation. (6) Each state attorney shall develop standards of instruction for prosecutors to receive training on the investigation and prosecution of human trafficking crimes and shall provide for periodic and timely instruction. (7) Any real property or personal property that was used, attempted to be used, or intended to be used in violation of this section may be seized and shall be forfeited as provided by the Florida Contraband Forfeiture Act. After satisfying any liens on the property, the remaining proceeds from the sale of any property seized under this section and owned by a defendant convicted of a violation of this section must first be allocated to pay any order of restitution of a human trafficking victim in the criminal case for which the owner was convicted. If there are multiple human trafficking victims in the criminal case, the remaining proceeds must be allocated equally among the victims to pay restitution. If the proceeds are sufficient to pay any such order of restitution, any remaining proceeds must be disbursed as required by s. 932.7055(5)-(9). (8) The degree of an offense shall be reclassified as follows if a person causes great bodily harm, permanent disability, or permanent disfigurement to another person during the commission of an offense under this section: (a) A felony of the second degree shall be reclassified as a felony of the first degree. (b) A felony of the first degree shall be reclassified as a life felony. (9) In a prosecution under this section, the defendant's ignorance of the victim's age, the victim's misrepresentation of his or her age, or the defendant's bona fide belief of the victim's age cannot be raised as a defense. (10)(a) Information about the location of a residential facility offering services for adult victims of human trafficking involving commercial sexual activity, which is held by an agency, as defined in s. 119.011, is confidential and exempt from s. 119.07(1) and s. 24(a), Art. I of the State Constitution. This exemption applies to such confidential and exempt information held by an agency before, on, or after the effective date of the exemption. (b) Information about the location of a residential facility offering services for adult victims of human trafficking involving commercial sexual activity may be provided to an agency, as defined in s. 119.011, as necessary to maintain health and safety standards and to address emergency situations in the residential facility. (c) The exemptions from s. 119.07(1) and s. 24(a), Art. I of the State Constitution provided in this subsection do not apply to facilities licensed by the Agency for Health Care Administration. r (11) A victim's lack of chastity or the willingness or consent of a victim is not a defense to prosecution under this section if the victim was under 18 years of age at the time of the offense. (12) The Legislature encourages each state attorney to adopt a pro -prosecution policy for human trafficking offenses, as provided in this section. After consulting the victim, or making a good faith attempt to consult the victim, the state attorney shall determine the filing, nonfiling, or diversion of criminal charges even in circumstances when there is no cooperation from a victim or over the objection of the victim, if necessary. (13) When a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services as defined in this section. For purposes of this subsection, the term "governmental entity" has the same meaning as in s. 287.138(1). History.—s. 2, ch. 2004-391; s. 1, ch. 2006-168; s. 5, ch. 2012-97; s. 300, ch. 2014-19; s. 7, ch. 2014-160; s. 96, ch. 2015-2; s. 2, ch. 2015-147; s. 3, ch. 2016-24; s. 25, ch. 2016-105; s. 4, ch. 2016-199; s. 2, ch. 2020-49; s. 2, ch. 2021-189; s. 3, ch. 2023-86; s. 7, ch. 2024- 184. Copyright © 1995-2024 The Florida Legislature • Privacy Statement • Contact Us CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO: Arthur Noriega V City Manager ,—oo<usi9ned by ‘--895,0Ee73CA.68 DATE: September 19, 2024 FILE: SUBJECT: Award Recommendation for Multiple Contracts to Establish the Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool FROM: Annie Perez, CPPO REFERENCES: Request for Qualifications Director/Chief Procurement Officer ("RFQ") 1733386 ENCLOSURES: Qualification Review/Score Sheets Recommendation: Based on the findings below, the Department of Procurement ("Procurement") hereby recommends approval for the award of Professional Services Agreements ("PSA")'s to Continental American Insurance Company, Colonial Life & Accident Insurance Company, Madison National Life Insurance Company, and Standard Insurance Company, collectively, the ("Providers"), for inclusion in a pre - qualified pool for the provision of Employee Voluntary Supplemental Insurance Benefits ("Pool"), pursuant to RFQ No. 1733386. Background: On March 7, 2024, Procurement, on behalf of the Risk Management Department ("Risk"), issued RFQ No. 1733386, under full and open competition, to obtain proposals from experienced and qualified firms for the provision of Employee Voluntary Supplemental Insurance Benefits. Proposers were required to meet all the minimum qualifications and other requirements established in the RFQ, in order to be considered for inclusion within the Pool. On June 10, 2024, five (5) proposals were received in response to the Solicitation. Subsequently, the Proposals were reviewed by Procurement for responsiveness, and one (1) was deemed non -responsive because it did not adhere to the requirements of the RFQ. The Evaluation Committee met on September 4, 2024 and reviewed and evaluated the proposals following the guidelines published in the RFQ. The Committee decided not to hold oral presentations, as the Proposals did not require further clarification. The Committee voted not to set a threshold for inclusion within the Pool. The final scores are listed below in order of ranking: Awardee Composite Score 1 Continental American Insurance Company 484 2 Colonial Life & Accident Insurance Company 463 3 Standard Insurance Company 442 4 Madison National Life Insurance Company, Inc. of Wisconsin 400 Due diligence was conducted to determine the Proposer(s) responsibility, including verifying corporate status, that there were no performance or compliance issues and no adverse findings related to the Porposer(s) responsibility were found. Notwithstanding the foregoing, the City does not guarantee the number of employee usage or premiums. The City retains the right to add or remove Providers from the Pool at its sole discretion. Fiscal Impact: There will be no fiscal impact on the City resultant of this solicitation as premiums shall be paid entirely by the employees that voluntarily purchase supplemental insurance products from the Pool providers. Consequently, approval of this recommendation to award is requested. Your signature below will indicate approval of this recommendation. oocussned by Approved: a.146r 14t,, Date: a �Fs�,zo� Arthur Joriega V City Manager September 24, 2024 1 10:25:17 EDT Cc: Larry M. Spring, CPA, Assistant City Manager/Chief Financial Officer Ann -Marie Sharpe, Director, Risk Management Department Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director, Procurement 2 EVALUATION OF PROPOSALS RFQ 1733386 Employee Voluntary Insurance Supplemental Insurance Benefits Pre -Qualification Pool SELECTION PROPOSERS CRITERIA Maximum Points Maximum Total Points (4 members) Continental American Insurance Company (Aflac) Colonial Life & Accident Insurance Company Madison National Life Insurance Company Standard Insurance Company Proposer's organization, qualifications, capabilities and financial ability 30 150 145 137 120 129 Proposed Benefit Offerings 25 125 122 121 89 107 Customer services and plan administration 25 125 120 109 97 110 Financial reporting and records 20 100 97 96 94 96 Total Technical score 100 500 484 463 400 442 Local Office Preference (5% of Technical Score) 5.0 25 0 0 0 0 TOTAL INCLUDING LOCALOCOFFICE POINTS 105 525 484.0 463.0 400.0 442.0 Rank > /) / IVH I UIjC:' CPfairperson PRINT NAME: Charles Johnson James Justin Griffin EVALUATION OF PROPOSALS RFQ 1733386 Employee Voluntary Insurance Supplemental Insurance Benefits Pre -Qualification Pool Jair Espinoza, City of Miami SELECTION PROPOSERS CRITERIA Proposer's organization, qualifications, capabilities and financial ability Proposed Benefit Offerings Customer services and plan administration Financial reporting and records Total Technical score Local Office Preference (5% of Technical Score) Maximum Points 30 25 25 20 100 5 Continental American Insurance Company (Aflac) Colonial Life & Accident Insurance Company a-& Z -5 z3 Madison National Life Insurance Company Z Z Z3 lY Standard Insurance Company v� TOTAL INCLUDING LOCAL OFFICE POINTS 105 EVALUATION OF PROPOSALS RFQ 1733386 Employee Voluntary Insurance Supplemental Insurance Benefits Pre -Qualification Pool Donald Ritts, City of North Miami SELECTION PROPOSERS CRITERIA v Maximum Points Continental American Insurance Company (Aflac) Colonial Life & Accident Insurance Company Madison National Life Insurance Company Standard Insurance Company Proposer's organization, qualifications, capabilities and financial ability 30 So 30 O Proposed Benefit Offerings 25 ,22 5- /5 v<0 Customer services and plan administration 25 5 5 ,2 0 „5 Financial reporting and records 20 0 d 0 2 0 2 0 Total Technical score Local Office Preference (5% of Technical Score) 100 5 /r D 0 / 0 0 U PO 00 9 TOTAL INCLUDING LOCAL OFFICE POINTS 105 / D 0 4,9 0 ? 0 -0- ,5- po,-, Ok 7/4/2 02 EVALUATION OF PROPOSALS RFQ 1733386 Employee Voluntary Insurance Supplemental Insurance Benefits Pre -Qualification Pool Darren McCray, City of Miami SELECTION PROPOSERS CRITERIA Maximum Points Continental American Insurance Company (Aflac) Colonial Life & Accident Insurance Company Madison National Life Insurance Company Standard Insurance Company Proposer's organization, qualifications, capabilities and financial ability 30 .c2K a P1 e25 Proposed Benefit Offerings 25 c25 a5 I ) 5' Customer services and plan administration 25 . 3 1 g 13 a 0 Financial reporting and records 20 .9 0 0 a a Total Technical score Local Office Preference (5% of Technical Score) 0 10 5 0 © 6 TOTAL INCLUDING LOCAL OFFICE POINTS 105 ite CI 0 to7 3 VE-f /az/ EVALUATION OF PROPOSALS RFQ 1733386 Employee Voluntary Insurance Supplemental Insurance Benefits Pre -Qualification Pool Marc Chevalier, City of Miami Beach SELECTION PROPOSERS CRITERIA Maximum Points Continental American Insurance Company (Aflac) Colonial Life & Accident Insurance Company Madison National Life Insurance Company Standard Insurance Company Proposer's organization, qualifications, capabilities and financial ability 30 Q\ a,'' 2 to Proposed Benefit Offerings 25 0-`1 '5 A& a� Customer services and plan administration 25 9--3 .k R.-1- Financial reporting and records 20 t 0 i 441 Total Technical score Local Office Preference (5% of Technical Score) 100 5 :—_- _ 43 - g TOTAL INCLUDING LOCAL OFFICE POINTS 105 ek- f teft- EVALUATION OF PROPOSALS RFQ 1733386 Employee Voluntary Insurance Supplemental Insurance Benefits Pre -Qualification Pool Juan Gutierrez, Village of Key Biscayne SELECTION PROPOSERS CRITERIA Proposer's organization, qualifications, capabilities and financial ability Proposed Benefit Offerings Customer services and plan administration Financial reporting and records Total Technical score Local Office Preference (5% of Technical Score) TOTAL INCLUDING LOCAL OFFICE POINTS Maximum Points 30 25 25 20 100 5 105 Continental American Insurance Company (Aflac) 2c- 0 Colonial Life & Accident Insurance Company Z6) 20 0 Madison National Life Insurance Company 0U 0 Standard Insurance Company D dS IYi Tag of 41Ftiami ANNIE PEREZ, CPPO Director/Chief Procurement Officer September 24, 2024 ARTHUR NORIEGA V City Manager All Responding Proposers (See Distribution List) SUBJECT: RFQ 1733386, Employee Voluntary Supplemental Insurance Pre -Qualification Pool Dear Proposers: The Evaluation of the proposals tendered in response to the above cited solicitation has been completed. The City Manager has recommended award as shown within the enclosed document. This notice is provided in accordance with Section 1.20 of the solicitation, and Sections 18-74 of the City of Miami Code. Our provision of this notice also serves to confirm the lifting of the Cone of Silence from this procurement action as dictated by Section 18-74 (d) (2) of the City of Miami Code. We appreciate the participation of all proposers which responded to the subject action. If you have any questions, please contact me at 305-416-1924 or cjohnson©miamigov.com. Sincerely, Charles Johnson, III, NIGP-CPP Senior Procurement Contracting Manager Distribution List: Continental American Insurance Company Colonial Life & Accident Insurance Company Standard Insurance Company Madison National Life Insurance Company, Inc. of Wisconsin United Healthcare Insurance Company Enclosure: City Manager's Award Recommendation Memo c: City Clerk Larry M. Spring, CPA, Assistant City Manager/Chief Financial Officer Ann -Marie Sharpe, Director, Risk Management Department Thomas M. Fossler, Assistant City Attorney Annie Perez, CPPO, Director/Chief Procurement Officer Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director, Department of Procurement CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO: Honorable Mayor and Commissioners DATE: February 11, 2025 of the City of Miami DoyuSigned by L arfLr Nulty. FROM Ilti =i briega V SUBJECT: Report of Evaluation Committee City Manager for Request for Proposals ("RFQ") No. 1733386, Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool ENCLOSURES: Evaluation Committee Report Honorable Mayor and Members of the City Commission: Pursuant to Section 18-542, Financial Integrity Principle No. 12.a.(ii) of the Code of the City of Miami, as amended, which states, "the recommendation(s) of the evaluation committee shall be provided to the Mayor and City Commission on all such solicitations prior to presentation to the City Commission for official action," attached please find for your review, a memo regarding the ranking order of proposing firms, for RFQ 1733386, "Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool," on behalf of the Risk Management Department. AP: cj CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO: Honorable Mayor and Commissioners DATE: November 9, 2023 of the City of Miami a Novice FROM: Arthur Noriega V City Manager SUBJECT: Report of Evaluation Committee for Request for Proposals ("RFQ") No. 1414387, Economic Impact and Feasibility Analysis Consultant Pool ENCLOSURES: Evaluation Committee Report Honorable Mayor and Members of the City Commission: Pursuant to Section 18-542, Financial Integrity Principle No. 12.a.(ii) of the Code of the City of Miami, as amended, which states, "the recommendation(s) of the evaluation committee shall be provided to the Mayor and City Commission on all such solicitations prior to presentation to the City Commission for official action," attached please find for your review, a memo from the City Manager regarding the ranking order of proposing firms, for RFQ No. 1414387, Economic Impact and Feasibility Analysis Consultant Pool, on behalf of the Planning Department. AP: cj c. Pablo J. Velez, Senior Assistant City Attorney Lakisha Hull, AICP, LEED AP BD+C, Director, Planning Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director, Department of Procurement PR24008 2/10/25, 5:52 PM Detail by Entity Name DIVISION OF CORPORATIONS an official State of Florida websire Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Foreign Profit Corporation CONTINENTALAMERICAN INSURANCE COMPANY Filing Information Document Number P15533 FEI/EIN Number 57-0514130 Date Filed 08/10/1987 State NE Status ACTIVE Last Event REINSTATEMENT Event Date Filed 11/18/2024 Principal Address 1600 WILLIAMS STREET COLUMBIA, SC 29201 Changed: 03/07/2016 Mailing Address P.O. BOX 427 COLUMBIA, SC 29202 Changed: 04/16/2009 Registered Agent Name & Address CHIEF FINANCIAL OFFICER 200 E. GAINES ST TALLAHASSEE, FL 32399-0000 Name Changed: 10/28/2022 Address Changed: 03/21/2014 Officer/Director Detail Name & Address Title Chairman AMOS, DANIEL P 1932 WYNNTON ROAD COLUMBUS, GA 31999 https://search.sunbiz.org/I nquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=CONTINE... 1/3 2/10/25, 5:52 PM Detail by Entity Name Title Secretary LOUDERMILK, J. MATTHEW 1932 WYNNTON ROAD COLUMBUS, GA 31999 Title President, Director Miller, Virgil R 1932 WYNNTON ROAD COLUMBUS, GA 31999 Annual Reports Report Year Filed Date 2023 05/12/2023 2024 11/18/2024 2025 01/31/2025 Document Images 01/31/2025 --ANNUAL REPORT 11/18/2024 -- REINSTATEMENT 05/12/2023 -- ANNUAL REPORT 10/28/2022 -- REINSTATEMENT 05/10/2021 --Amendment 04/08/2021 -- ANNUAL REPORT 03/24/2020 -- ANNUAL REPORT 06/14/2019 --ANNUAL REPORT 06/26/2018 -- ANNUAL REPORT 03/28/2017 -- ANNUAL REPORT 03/07/2016 --ANNUAL REPORT 02/17/2015 -- ANNUAL REPORT 03/21/2014 --ANNUAL REPORT 05/10/2013 --ANNUAL REPORT 04/26/2012 -- ANNUAL REPORT 04/20/2011 --ANNUAL REPORT 05/03/2010 --ANNUAL REPORT 04/16/2009 -- ANNUAL REPORT 04/23/2008 -- ANNUAL REPORT 04/30/2007 -- ANNUAL REPORT 03/30/2006 -- ANNUAL REPORT 04/28/2005 -- ANNUAL REPORT 02/10/2004 --ANNUAL REPORT 03/03/2003 -- ANNUAL REPORT 03/06/2002 -- ANNUAL REPORT 03/05/2001 -- ANNUAL REPORT 05/02/2000 -- ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=CONTINE... 2/3 2/10/25, 5:52 PM 03/20/2000 -- Name Change 05/03/1999 --ANNUAL REPORT 03/03/1998 -- ANNUAL REPORT 02/27/1997 -- ANNUAL REPORT 03/11 /1996 -- ANNUAL REPORT 07/11 /1995 -- ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Detail by Entity Name Florida Department of State, Division of Corporations https://search.sunbiz.org/Inquiry/CorporationSearch/Search Resu ItDetail?inquirytype=EntityName&directionType=1 nitial&search NameOrder=CONTI N E... 3/3 City of Miami Request for Qualifications NeolibiYai 1 Certification Statement tiU Q 1733386 Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (I) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: *Due to the space limitations in this section, we have provided our exceptions on the following page(s). We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a submission for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terms and conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME: Colonial Life & Accident Insurance Company ADDRESS: 1200 Colonial Life Boulevard, Columbia, SC 29210 PHONE: (803) 678-5976 FAX: (803) 678-5908 EMAIL:pLoposalcenter@coloniallife.com CELL(Optional): N/A SIGNED BY: TITLE: Vice President DATE: 3/25/24 FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY THIS RESPONSE. 3/7/2024 7:11 PM 1 P. 5 City of Miami Request for Qualifications N8olibi7 as WQ 1733386 Certifications Legal Name of Firm: Colonial Life & Accident Insurance Company Firm's Federal Employer Identification Number ("FEIN"): 57-0144607 Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Corporation Year Established: 1939 Office Location: City of Miami, Miami -Dade County, or Other Other - Home Office located in Columbia, SC; local office located very close to the City of Miami boundaries (5201 Blue I agoon Dr , Ste 981, Miami, FI 33126) hut actually in Miami -Dade County. Business Tax Receipt/Occupational License Number: City of Miami Business Tax Receipt provided following this form. The account number is 5897. The receipt number is 37. It's my understanding this was formerly known as an Occupational License. Business Tax Receipt/Occupational License Issuing Aency: The City of Miami Business Tax Receipt was issued by the City of Miami. It's my understanding this was formerly known as an Occupational I icense Business Tax Receipt/Occupational License Expiration Date: City of Miami Business Tax Receipt provided following this form. The expiration date is September 30, 2024. It's my understanding this was formerly known as an Occupational License. Will Subcontractor(s) be used? (Yes or No) Yes. Due to space limitations here, please see attached page. If subcontractor(s) will be utilized, provide their name, address and the portion of the work they will be responsible for under this contract (a copy of their license(s) must be submitted with your bid response). If no subcontractor(s) will be utilized, please insert N/A.: Due to space limitations here, please see attached page. Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1, 1/1/24). If no addendum/addenda was/were issued, please insert N/A. Addendum No. 1, 3/29/24; Addendum No. 2, 4/18/24; Addendum No. 3 4/24/24; Addendum No. 4, 5/3/24; Addendum No. 5, 5/14/24; Addendum No. 6, 5/22/24; Addendum No. 7, 5/29/24 Has Proposer reviewed the attached Sample Professional Services Agreement? Yes / No Yes Acknowledge that if awarded, Proposer will be required to execute the Professional Services 3/7/2024 7:11 PM p. 6 2 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Agreement in substantially the attached form. In addition, Proposer must acknowledge that certain clauses (including #2 Term, #6 Audit and Inspection Rights and Records Retention, #8 Public Records, #9 Compliance with Federal, State and Local Laws, #10 Indemnification/Hold Harmless/Duty to Defend, #13 Termination; Obligation Upon Termination, #15 Nondiscrimination, and # 23 City Not Liable for Delays) are non-negotiable. Understood. 3/7/2024 7:11 PM 3 p. 7 Tau of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 1 RFQ 1733386 March 29, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURNACE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Friday, April 19, 2024, at 5:OOPM. ALL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Gad 4. �� for �/ Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Department of Risk Management Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement 4 This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: Colonial Life & Accident Ins. Co. DATE: 4/5/24 SIGNATURE: 5 ANNIE PEREZ, CPPO Procurement Director Tau of 4Thami 0:0 If ARTHUR NORIEGA V City Manager ADDENDUM NO. 2 RFQ 1733386 April 18, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Friday, April 26, 2024, at 5:OOPM. B. The City of Miami's Full Time Employee Census is hereby attached as Exhibit A. C. The City of Miami's - Standard Insurance Company Certificate Group Short Term Disability Insurance Policy is hereby attached as Exhibit B. D. The City of Miami's - Standard Insurance Company Certificate Group Long Term Disability Insurance Policy is hereby attached as Exhibit C. E. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1: Describe any supplementary benefits currently in force with City Employees. Al: The voluntary benefits listed below were not procured by the City, nor are they managed by the City. They were either procured by the American Federation of State, County and Municipal Employees ("AFSCME") Local 1907 and AFSCME Local 871 or were "legacy" products. These benefits are not part of the City's open enrollment suite of benefits. Voluntary benefits include Accident, Critical Illness, Specified Disease, Group Hospital Confinement indemnity, Short Term Disability, Long term Disability, Legal, and Life as listed in the table below: 6 Non -City Managed Benefit Contact Info on hand Colonial Accident Policy Erin Wiggins Account Acquisition Executive D: 803-665-4399 / F: 866-316-9891 Email: ewiggins@e3benefit.com Colonial Critical Illness Colonial Group Specified Disease Colonial Grp Hosp Conf Indemnity www.e3benefit.com Colonial Short -Term Disability www.nationalenrollmentpartners.com FOP Colonial Accident Policy Please see contact above FOP Colonial Critical Illness FFB Conseco Anthony Muina District Manager Optavise/Washington National Insurance Co. / FFB Conseco / RELIANCE STANDARD LIFE (RSL) RSL is the Basic Life AD&D Carrier for AFSCME 1907 & SEA 871 P: 732-644-4550 Anthony.Muina@optavise.com RSL LTD RSL STD Southern Legal No contact info Southern Provident No contact info Transamerica Employee Benefit Mary Early Registered Representative Investment Advisor Representative Transamerica Agency Network, Inc. Office 786 615 7866 I Cell 786 663- 3959 I Fax 305 503 9695 Mary. Roberts@transamericanetwork.c om Q2: Will the above benefits and payroll access be terminated upon naming a new vendor(s)? A2: No. Q3: If benefits are different across departments/bargaining units (police/fire/etc.), please describe any differences in existing benefits/eligibility? A3: Sworn personnel groups, (Police, Fire Rescue, etc.), each have their own Health Trusts. Civilian full-time employees are eligible to participate in the City's Cafeteria Suite of benefits, which include Medical, Dental HMO & PPO, Comprehensive Vision, FSA HC and FSA DC, Legal Shield and ID Theft Protection. AFSCME Local 1907 and AFSCME Local 871 Members have post -tax voluntary benefits listed above in the response to Q1. Q4: How many employees will be eligible for the new offerings resulting from this RFQ? A4: All 4,238 full-time employees will be eligible. Refer to Exhibit A — March 2024 CMIA Full -Time Employee Census. Q5: How will employees be educated/enrolled in the new offerings? A5: The education and enrollment of employees with relation to these offerings will be facilitated by the Successful Proposer(s). Pursuant to Section 3.1, Specifications/Scope of Work, paragraph 2, "Successful Proposer(s) will provide appropriate resources to coordinate, monitor, market and place programs..." Appropriate resources should include the ability to conduct in -person and virtual sessions and conduct a voluntary mid -year enrollment period. Note that Proposer's team should have multilingual (English, Spanish, Creole) personnel for the marketing and enrollment sessions. Q6: Will a technology or enrollment firm be used? A6: No. Q7: Is there a broker or consultant partnering with the City on the new offerings? A7: No. Q8: Will a complete employee census be provided including date of birth, gender, job classification and annual compensation? A8: Refer to Exhibit A, March 2024 City of Miami Employee Census. 8 Q9: Will current plan designs be provided including summaries, certificates of coverage and any amendments to the plans? A9: Refer to Exhibit B, City of Miami — Standard Insurance Certificate Group Short Term Disability Insurance; and Exhibit C, City of Miami — Standard Insurance Certificate Group Long Term Disability Insurance. Q10. Is there a consultant or broker partnering with the City? If so, should Successful Proposer(s) build any Commission or fee for this partnership? A10. Refer to the response to Q7 above. Q11. Is there an enrollment firm involved in this process? If so, should Successful Proposer(s) build and Commission or fee for this partnership? A11. Refer to the response to Q6 above. Q12. Does the City have documentation detailing the last thirty-six (36) months of claims experience and open claims? Al2. No. These records have been requested from the City's current STD and LTD vendor, the Standard Insurance Company. Q13. How do employees currently enroll in coverage? A13. Currently, employee enrollment occurs during a three (3)-week annual open enrollment period during which employees can enroll in person or virtually. Q14. What platform is used for virtual enrollment? A14. The Employee Benefits module of the City's Oracle Enterprise Resource Planning ("ERP") system. Q15. Is there a current billing and/or eligibility file feed in place for voluntary supplemental lines? A15. The vendor and the City's Payroll Division file feeds and bills. Q16. Is a payment bond or performance bond required in relation to this RFQ? A16. No. 9 Q17. Describe the City's past enrollment strategy? A17. Refer to the response to Q13 above. Q18. Are Spanish and Creole enrollment materials needed? A18. Yes. Q19. Is the City open to working with an enrollment firm to help educate employees on all benefits offered by the City at no additional cost? A19. Yes. Q20. Does the City host an annual Benefits Fair?? A20. Yes. Q21. Who is the City's current benefits consultant/broker? A21. USI Insurance Services, LLC. Q22. Will the Successful Proposer(s) be required to be HIPPA compliant? A22. Yes. Refer to Section 1.41, Health Insurance Portability and Accountability Act (HIPPA). ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department 10 AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: Colonial Life & Accident Ins. Co. DATE: 4/22/24 SIGNATURE: 11 ANNIE PEREZ, CPPO Procurement Director Tau of 4Thami 0,0 . r, 1� ARTHUR NORIEGA V City Manager ADDENDUM NO. 3 RFQ 1733386 April 24, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Friday, May 3, 2024, at 5:OOPM. ALL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. y_ /� �ia.4. �� for Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney 12 This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: Colonial Life & Accident Ins. Co. DATE: 4/29/24 SIGNATURE: 13 Tau of 4Thami ANNIE PEREZ, CPPO ARTHUR NORIEGA V Procurement Director City Manager Cis, 4q ;ft if - ADDENDUM NO. 4 RFQ 1733386 May 3, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Wednesday, May 15, 2024, at 5:OOPM. ALL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. 4. /7i for Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney 14 This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: Colonial Life & Accident Ins. Co. DATE: 5/3/24 SIGNATURE: 15 Tau of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 5 RFQ 1733386 May 14, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Thursday, May 23, 2024, at 5:OOPM. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. �11i for ✓' Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney 16 This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: Colonial Life & Accident Ins. Co. DATE: 5/15/24 SIGNATURE: 17 ( itu of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 6 RFQ 1733386 May 22, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Thursday, May 30, 2024, at 5:OOPM ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney 18 This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: Colonial Life & Accident Ins. Co. DATE: 5/23/24 SIGNATURE: 19 Tau of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 7 RFQ 1733386 May 29, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Thursday, June 6, 2024 at 5:OOPM B. Attachment B, Reference Submittal Form has been deleted in its entirety and replaced with Revised Attachment B, Reference Submittal Form. C. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1: Please confirm whether Proposers are required to submit three (3) or five (5) references with their Proposals. Al: Pursuant to Section 2.8, References and Section 4.1.4.10, Proposers are required to submit three (3) references using Revised Attachment B, Reference Submittal Form attached herein. Q2: Will the City accept a minimum participation of ten (10) lives per line of coverage? A2: No. Refer to Section 3.1, Specifications/Scope of Work, subsection A.4. Q3: Does the RFQ contain any online questionnaires? A3: No. 20 Q4: Are electronic signatures acceptable? A4: Yes. Q5: Is the Performance/Payment Bond mentioned under item 1.61 on page 24 required? A5: No. Q6: Pursuant to Section 1.25 on page 18 of the RFQ Packet, please confirm whether Proposers will be disqualified if they identify items in the General or Special Conditions of the RFQ that they are unable to commit to and/or request revised wording. A6: Section 1.25 is titled "Debarment and Suspensions (Sec 18-107)" and does not address the issues listed in the question. Q7: Attachment B, Reference Submittal Form, shows "Federal Lobbying Services" as the category on the required form. Is this correct although federal lobbying services are not being sought? A7: Refer to Item B above. Q8. In order to qualify for the additional five (5) points for having a Local Office, does Attachment C, Local Office Certification, need to be completed by the Proposing entity or by any member of a joint venture with the Proposing entity if said member is utilized for the response to the RFQ? A8. Attachment C, Local Office Certification must be completed by the Proposing firm. Q9. Is the Corporate Resolution form provided on page 98 of the RFQ Packet, required to be completed and submitted with Proposers' responses to the RFQ? A9. No. The Corporate Resolution is part of the Sample Professional Services Agreement ("PSA") and is simply a sample of the document Successful Proposers will be required to submit with their signed PSA's prior to formal approval of award by the Miami City Commission. Q10. If Proposers are required to submit the Corporate Resolution with their Proposals, must Proposers complete the section where it states "A Florida Corporation", even if Proposer is headquartered outside the state of Florida? 21 A10. Refer to the response to Question 9 above. Q11. What is the expected effective date of coverage(s) upon award? A11. Immediately upon contract award, given a reasonable period (approximately four (4) to six (6) weeks) for the execution of PSA's, design, implementation, testing and live deployment. Q12. What are the expected enrollment dates? Al2. Refer to the response to item 11 above. Q13. What is the expected date for a decision to be made regarding the Pre - Qualification of Proposers? A13. The final decision regarding the award of contracts will be made by the Miami City Commission after the completion of the procurement process. At this time, the City anticipates that the item to award contracts resulting from this RFQ will be placed on a Miami City Commission meeting agenda in July 2024. Q14. Will an actual RFP be issued requesting product/rate information after the pre -qualified Pool of providers has been established? A14. No. Q15. What happens after the pre -qualified Pool has been established? A15. Successful Proposers awarded from this RFQ will allow for all City employees to freely choose which, if any, products they wish to enroll in, from any pre -qualified provider, on an entirely voluntary basis. Q16. With regard to the required Proposed Benefits Offerings section, confirm whether Proposers are required to provide product/plan descriptions and rates for the products/plans that we are including in their responses? A16. Proposers are required to provide product/plan descriptions with their responses, but not rates. Rates will not be evaluated as part of this RFQ process. Q17. Confirm whether the group participates in Social Security and if so, which if any occupations are exempt? A17. Sworn Police Officers and Firefighters are Social Security Exempt, whereas civilian (non -sworn) employees are fully subject to FICA contributions. 22 Q18. Will premium contributions be paid with pre-tax or post -tax dollars? A18. Premium contributions will be paid with Post -tax dollars. Q19. Does the group prepare W-2's for Short Term Disability ("STD") recipients, or is the STD carrier required to do so? A19. The STD carrier prepares the W-2's. Q20. Does the group require the carrier to pay for the FICA match for STD claimants or will the group pay the FICA match? A20. As these are post -tax benefits, the group will not pay the FICA match. Q21. Does the group currently have telephonic STD claims service? A21. No. STD claims are filed using forms provided by the current carrier. Q22. a) Does the group offer other STD plans to employees, or are there any other STD plans that use payroll deductions? b) If so, will the group eliminate these additional policies if a new STD carrier is selected? A22. a) American Federation of State County and Municipal Employees ("AFSCME") Local 1907 and AFSCME Local 871 have STD plans through their Basic Life Accidental Death and Dismemberment carrier, Reliance Standard Life; b) No. Q23. Please confirm what, if any, state retirement plans the group participates in. A23. City of Miami employees do not participate in any state retirement plan. Q24. Pursuant to Section 4, Submission Requirements, subsection B.6., Claims Administration and Customer Service: a) are the performance guarantees with premium at risk (monetary penalties) required?; b) Will Proposers be disqualified if they do not provide premium at/risk/monetary penalties with their responses?; and c) Please provide specific performance requirement expectations for Proposers to review and consider as part of their responses. A24. No, performance guarantees with premium at risk (monetary penalties) are not required and Proposers will not be disqualified if they do not include them in their responses. 23 Q25. a) Are Proposers required to respond to and provide all insurance products/plans that are mentioned in the RFQ?; b) Will proposers be disqualified if one of the products offered if their response to the RFQ is provided by Proposer's parent company? A25. a) No; and b) No. Q26. "Sub Item A", lists instructions for the preparation and submission of Proposals that are unclear. Please provide clarification of these instructions. A26. Refer to Section 4, Submission Requirements for instructions on the preparation, suggested format, and submission of Proposals. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: Colonial Life & Accident Ins. Co. DATE: 5/30/24 SIGNATURE: 24 CITY OF MIAMI BUSINESS TAX RECEIPT FY 23- 24 ISSUED: Mar 25, 2024 Robert Santos-Alborna Director, Code Compliance BUSINESS NAME: COLONIAL LIFE & ACC INS DBA: COLONIAL LIFE & ACC INS BTR HOLDER NAME: COLONIAL LIFE & ACCIDENT INS. BUSINESS ADDRESS: EXPIRES: Effective Year Oct. 1 2023 Thru Sep. 30 2024 ACCOUNT NUMBER: 5897 RECEIPT NUMBER: 37 COMMENTS: RESTRICTIONS: INSURANCE COMPANY OR ASSOCIATION This issuance of a business tax receipt does not permit the holder to violate any zoning laws of the City nor does it exempt the holder from any licenseor permits that may be required by law. This document does not constitute a certification that the holder is qualified to engage in the business, profession or occupation specified herein. The document indicates payment of the business tax receipt only. • PLEASE DISPLAY THIS CERTIFICATE IN A CONSPICUOUS LOCATION AT OCCUPANCY ADDRESS. • FAVOR DE MOSTRAR ESTE CERTIFICADO EN UN SITIO VISIBLE EN LA DIRECCION DEL COMERCIO. • TANPRI AFICHE SETIFIKA SA A NAN YON KOTE KONSIDEB NAN ADRES OKIPANS. www.miamigov.com 25 ••,,• Colonial Life Subcontractor Information As a global company with a strong international workforce, we have partnerships both within the U.S. and beyond it that reflect that diversity and global scale. Some of the companies we work with, including EXL, are U.S.-based companies with workforces overseas. CLA's external partners are global companies with a strong US presence and a workforce in the US, India, and the Philippines. These partnerships give us more flexibility in staffing levels and schedules, help us gain access to broader skillsets, and help us grow and strengthen our company. These partners are treated as an extension of CLA and have the same or higher expectations as our employees, and our promise to be liable for them remains. For additional information, please see https://www.unum.com/privacy. Colonial Life uses suppliers for a variety of purposes and manages those relationships on an ongoing basis. We hold our suppliers to very high standards that must either meet or exceed the same requirements Colonial Life follows such as ISO, NIST and other industry standards as applicable. Our corporate third -party risk management program addresses all such relationships and audits are conducted as deemed necessary and/or required by law or regulations. Four of our primary external partners include: Company Name: EXL Service Holdings Address: 320 Park Avenue, 29th Floor, New York, NY 10022 Phone: +1212-277-7100 Year Founded: 1999 Description: EXL Service Holdings, Inc. is an operations management, global analytics and digital solutions company that helps clients optimize workflows through advanced technological solutions. As a strategic partner, EXL enables Colonial Life to more effectively serve our customers. EXL currently provides functions like setting up of a claim shell in our system, assignment of images to claim files, contact centersupport, and staff augmentation. Company Name: Sutherland Global Services Address: 1160 Pittsford -Victor Rd., Pittsford, NY 14534 Phone: +1585 586-5757 Year Founded: 1986 Description: Sutherland Global Services is a digital transformation company that will provide contact center support for our Voluntary Benefits products. They are a partner who maximizes value for Colonial Life while minimizing risk in doing so. Sutherlands mission is to rethink and rebuild processes for the digital age by combining the speed and insight of design thinking with the scale and accuracy of data analytics. Company Name: Broadridge Financial Solutions Address: 5 Dakota Drive, Suite 300, Lake Success, NY 11042 Phone: +1800-353-0103 Year Founded: 2007 Description: Broadridge is a major print provider in the USA and works with Colonial life to provide transactional printing and related services. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 26 ••,,• Colonial Life Company Name: ReleasePoint Address: 405 W. Foothill Blvd., Suite 204, Claremont, CA 91711 Phone: +1800-999-9589 Year Founded: 1970 Description: ReleasePoint is a leading provider of medical record retrieval services, offering solutions in insurance, legal, disability, SSDI, and research markets. ReleasePoint's technology and proprietary processes are robust and proven including a comprehensive database of providers and notes and established processes on how best to connect with them, which enables Colonial Life to deliver a better customer experience through more timely retrieval of medical records during the claims process. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 27 ••1,I• Colonial Life Detailed Evidence For a Proposer(s) to be deemed responsive, the following minimum qualification requirements cited below shall be satisfied. In determining said responsiveness, each such minimum qualification requirement shall be addressed in detail in the Proposal submittal. Failure to meet each minimum qualification requirement and/or failure to provide sufficient detailed documentation concerning the same, shall result in the Proposal being deemed non -responsive. Proposer(s) Shall: A. Be licensed by the State of Florida, Office of Insurance Regulations to provide the plan services at the time of proposal due date, and throughout the term of the contract, any renewals and extensions thereof; We confirm. We have provided our Florida Certificate of Authority following this page. B. Be an insurance carrier, hold a minimum "A" insurance rating from A.M. Best ora comparable financial rating organization (i.e., Moody's, Standard & Poor's or Weiss) and a Financial Classification or "VII" or higher, at the time of proposal submission; We confirm. Our ratings are provided below. We have also provided a complete Financial Stability document following this page. A.M. Best: A Excellent Moody's: A3 Good Standard & Poor's: A Strong Fitch: A Strong C. Have a record of performance of no less than five (5) consecutive years, operating under the same name and Federal Employee Identification Number ("FEIN"), and providing group disability insurance programs for government clients or similar size private entities, similar in nature and scope, as described in the specifications herein; We confirm. Colonial Life was founded in 1939 and specializes in payroll -marketed, voluntary employee benefits. Colonial Life is a stand-alone subsidiary of Unum Group, a Fortune 500 company. UNUM Group is a holding company for multiple wholly owned insurance companies. Colonial Life currently operates in 49 states and the District of Columbia. In New York, similar products, if approved, are underwritten by a Colonial Life affiliate, The Paul Revere Life Insurance Company. Colonial Life has more than 4.5 million policies in force and serves approximately 100,000 businesses and organizations. Our FEIN is 57-0144607. We offer a full portfolio of both individual and group voluntary insurance products to include disability, life, dental, accident, special risk (critical illness and cancer), and hospital indemnity. We are quoting our group products only in response to this RFP because it is our understanding that the City utilizes the Oracle platform. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 28 ••1,I• Colonial Life Currently, we work with nearly 100,000 businesses and almost4.5 million policyholders nationwide. Including 5,000 local governments, 41 state governments, and 3,000 educational agencies, all providing valuable financial protection with our voluntary benefit solutions and services. D. Be an active, currently registered corporation, limited liability company or limited partnership with the State of Florida Division of Corporations, and be in good standing with the same; and We have provided our most current FL Certificate of Corporation Status following this document. E. Have never filed for bankruptcy, be in sound financial condition, have no record of civil litigation or pending lawsuits involving criminal activities of a moral turpitude, and shall not have conflicts of interest with the City. We confirm. F. Not have a member, principal, officer, or stockholder who is in arrears or in default of any debt or contract involving the City, is a defaulter or surety upon any obligation to the City, and/or has failed to perform faithfully any contract with the City. We confirm. Note: Submittals that do not address each of the above stipulated requirements within their proposal submission, shall be considered non -responsive and eliminated from the process. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 29 Florida Certificate of Authority t • + N • ♦." • W •••••11 40. •.• • W • ••• ••• • 4'••• ! H or fry • +y • ly i ••• 4 •N 4. • 1 1 • • 4044•*ma •• tate of F1orjjd OFFICE OF INSURANCE REGULATION Tallahassee, Florida AUGUST 5, 2003 1, the undersigned, Director of the Office of insurance Regulation of the State of Florida, do hereby certify that COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY COL UMBIA, SC Is authorized to transact the following lines of insurance in the State of Florida: LIFE, GROUP LIFE AND ANNUITIES, ACCIDENT AND HEALTH Until such time as its Certificate of Authority is amended, suspended, revoked or non -renewed. IN TESTIMONY WHEREOF, I hereto subscribe my name, and affix the Seal of my Office, at Tallahassee, the day and year first above written. Director, Office of Insurance Regulation 1 1 1 1 1 t Z I .1 1 1 1 1 2 { i t 2 1 ��;�;i.�.�:f+�!.M. �.M;�:W:i �N:�'W'i ��i'�.N l:Mi.� M:•:1+�:�:�! �:M.+1� a M N1'�:�M.i W.i W! W �"i • 30 Stable, Diverse, and Loyal Colonial Life & Accident Insurance Company provides financial protection benefits through the workplace, including disability, life, accident, cancer, critical illness, hospital confinement indemnity and dental insurance. Since the day we were founded in 1939, we have been committed to providing affordable insurance products to meet the needs of our customers. Today, we support more than 100,000 businesses and organizations, representing over 4.5 million working Americans and their families, through our benefits education, innovative enrollment and personalized support services. Throughout our history, we've met our financial commitments while maintaining profitable growth with a stable, diverse investment portfolio. As a stand-alone business of Unum, a Fortune 500 company and market leader in voluntary benefits, the customer call centers, underwriting, claims processing, product development and marketing activities are managed independently at the Colonial Life headquarters in Columbia, SC. Colonial Life operates in 49 states, the District of Columbia and Puerto Rico. In New York, similar products and services, if approved, are underwritten by our affiliate, The Paul Revere Life Insurance Company. •,ICI• Colonial Life We consistently earn strong financial ratings from the four major rating agencies. A Excellent A3 Good A.M. BEST COMPANY Measures financial strength and ability to meet ongoing insurance policy and contract obligations. MOODY'S INVESTORS SERVICE Ability to punctually pay senior policyholder claims and obligations. A STANDARD & POOR'S Ability to pay insurance Strong policy and contract obligations according to terms. A FITCH Ability to meet insurance policy and Strong contract obligations on a timely basis. ®2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a ColonialLife.com registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 31 State of Florida Department of State I certify from the records of this office that COLONIAL LIFE & ACCIDENT INSURANCE COMPANY is a South Carolina corporation authorized to transact business in the State of Florida, qualified on September 17, 1948. The document number of this corporation is 807701. I further certify that said corporation has paid all fees due this office through December 31, 2023, that its most recent annual report/uniform business report was filed on January 12, 2023, and that its status is active. I further certify that said corporation has not filed a Certificate of Withdrawal. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Twenty-eighth day of March, 2024 Secretut' of ,.Stute Tracking Number: 4737605493CU To authenticate this certificate,visit the following site,enter this number, and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateOfstatus/CertificateAuthentication 32 COVER PAGE/PROPOSAL PREPARED FOR: City of Miami (RFQ 1733386) Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool PROPOSER: JOSE R. CASTILLO BROKER: MARY ROBERTS EARLY DISTRICT GENERAL MANAGER LOCAL BUSINESS OFFICE: 5200 BLUE LAGOON DR., SUITE 850 PRIMARY OFFICE LOCATION: COLUMBIA, SC MIAMI, FL 33126 CONTACT PERSON FOR RFQ: LOI PARSONS/SR. CONSULTANT EMAIL: JOSE.CASTILLO@COLONIALLIFE.COM LPARSONS@COLONIALLIFE.COM BUSINESS PHONE: (786) 925-7058 (803) 678-5976 FEDERAL EMPLOYER'S IDENTIFICATION NUMBER: 57-0144607 FIRM'S LIASON FOR CONTRACT: JOSECASTILLO/L01 PARSONS DUE DATE: JUNE3,2024 THIS PROPOSAL IS VALID FOR 180 DAYS FROM THE DUE DATE 33 TABLE OF CONTENTS SECTION 1 Executive Summary SECTION 2 Proposer's, Relevant Experience, Qualifications & Past Performance SECTION 3 Proposed Benefit Offerings SECTION 4 Claims Administration & Customer Service SECTION r Financial Reporting & Records PAGE 35 40 57 251 316 34 .••1•. Colonial Life Executive Summary .•'1'. Colonial Life 35 .•.ie. Colonial Life. Name of Organization: Colonial Life & Accident Insurance Company Contact Person/Phone Numbers: Jose Castillo/District General Mgr. (786) 925-7058 Loi Parsons/Sr. Consultant, RFP Mgmt. (803) 678-5976 For more than 80 years, we've helped America's workers - employees just like yours - protect what they've worked so hard to build. Currently, we work with nearly 100,000 businesses and almost 4.5 million policyholders nationwide. Including 5,000 local governments, 41 state governments, and 3,000 educational agencies, all providing valuable financial protection with our voluntary benefit solutions and services. We're here to help you overcome your employee benefit challenges with our proven cost -saving solutions, end -to -end enrollment and communication tools, and benefits administration services. FINANCIAL PROTECTION By packaging core benefit offerings with our personal insurance products, you can enhance your benefits program and help employees fill the gaps in their individual coverage with the following products: 0 o ACCIDENT INSURANCE helps offset unexpected medical expenses that can result from a covered accidental injury. CRITICAL ILLNESS INSURANCE helps supplement major medical coverage by providing a lump -sum benefit that can be used to pay the direct and indirect costs related to a covered critical illness or cancer. DISABILITY INSURANCE replaces a portion of an employee's income to help make ends meet if he or she becomes disabled from a covered accident or sickness. HOSPITAL INDEMNITY INSURANCE provides a lump -sum benefit for a covered hospital confinement or outpatient surgery to help with co -payments and deductibles. COMPREHENSIVE BENEFITS EDUCATION Preparing your employees for enrollment can make a sizeable impact on your resources, so we take care of it all for you. With a personal approach to helping your employees understand their own benefits situation and the options available to them, we can help them make informed decisions on how best to protect their families. CUSTOMIZED COMMUNICATIONS From pre -enrollment announcements to product brochures and online educational tools, our benefits communication materials help ensure your employees understand all the benefit options available to them. We can completely digitize the engagement experience at no direct cost with your choice of communication methods to help boost understanding, engagement, and participation. PERSONALIZED DIGITAL DIGITAL BENEFITS PRODUCT WEBSITE POSTCARDS BOOKLETS VIDEOS EMAILS 36 .•.ie. Colonial Life. FLEXIBLE ENROLLMENT SERVICES When it's time for the enrollment, no challenge is too great. Multi -state, multi-lingual, multi -shift, we're flexible and adaptable to ensure it's your enrollment, your way. We can enroll both core and voluntary benefits directly through our proprietary software or by interfacing with a wide range of enrollment systems. This makes your enrollment as convenient as possible for your employees and less intrusive to their workday. Our benefits counselors will meet 1-to-1 with your employees to discuss their unique needs and help them select the benefits that are right for them. While we're always proponents of in -person, ongoing communication and guidance, we offer a variety of options to enroll your employees where they're at. VIRTUAL FACE -TO- TELEPHONIC FACE ONLINE ADMINISTRATIVE SERVICE AND SUPPORT We realize that an enrollment is only as good as the service that follows. The most important stance we can take is to ensure we deliver on our commitments through quality billing, claims processing and individual customer service. As your needs change, we make sure we change and adapt, too. BILLING AND REPORTING We have people and systems that can handle the most complicated billing situations. Through our online administration service, we can provide a quicker, simpler billing process - all available at no charge. CLAIMS PROCESSING Although account service is a high priority, we know that the bottom line for all our customers is claims processing and payment. We can process claims of all sizes quickly and efficiently to ensure your employees get the money they're entitled to when they need it most. UNDERWRITING We strive to keep the process simple for everyone by making fast, often automatic, underwriting decisions with little information compared to the typical individual insurance market. HISTORY OF FINANCIAL STABILITY Colonial Life operates as a standalone entity of Unum Group, a Fortune 500 company. Our entire operation - customer call centers, underwriting, claims processing, product development and marketing - is managed independently at our headquarters in Columbia, South Carolina. As a member of the Unum family of companies, Colonial Life is a strong industry leader with a secure future. Our financial position remains solid and well positioned to serve our customers' needs by delivering on our promises now and in the future. Date: 3/25/24 Signature: 37 Stable, Diverse, and Loyal Colonial Life & Accident Insurance Company provides financial protection benefits through the workplace, including disability, life, accident, cancer, critical illness, hospital confinement indemnity and dental insurance. Since the day we were founded in 1939, we have been committed to providing affordable insurance products to meet the needs of our customers. Today, we support more than 100,000 businesses and organizations, representing over 4.5 million working Americans and their families, through our benefits education, innovative enrollment and personalized support services. Throughout our history, we've met our financial commitments while maintaining profitable growth with a stable, diverse investment portfolio. As a stand-alone business of Unum, a Fortune 500 company and market leader in voluntary benefits, the customer call centers, underwriting, claims processing, product development and marketing activities are managed independently at the Colonial Life headquarters in Columbia, SC. Colonial Life operates in 49 states, the District of Columbia and Puerto Rico. In New York, similar products and services, if approved, are underwritten by our affiliate, The Paul Revere Life Insurance Company. •,ICI• Colonial Life We consistently earn strong financial ratings from the four major rating agencies. A Excellent A3 Good A.M. BEST COMPANY Measures financial strength and ability to meet ongoing insurance policy and contract obligations. MOODY'S INVESTORS SERVICE Ability to punctually pay senior policyholder claims and obligations. A STANDARD & POOR'S Ability to pay insurance Strong policy and contract obligations according to terms. A FITCH Ability to meet insurance policy and Strong contract obligations on a timely basis. ®2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a ColonialLife.com registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 38 Though the public sector has gone through some hardships due to the COVID-19 pandemic, many government organizations may scale back due to tax revenue loss, but they can't close their doors completely since they're mandated to protect citizens and provide services to enhance daily life. With more than 65 years of market expertise, we understand the hurdles you face working in the public sector. Our first payroll deduction account was a state highway patrol unit in 1955 - and they're still a customer today. Currently, we work with 41 state governments, 5,000 local governments, and 3,000 educational agencies to help manage the rising cost of employee benefits while providing the financial protection their employees need. We're earnest about helping you meet the ever - changing challenges of balancing budgets with the employee benefits needs of a public agency. Colonial Life.. ColonialLife.com WE PROUDLY WORK WITH 41 ii State governments 5,000 Bpi Local governments 3,000 Educational entities ®2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 39 Proposer's Relevant Experience, Qualifications,& Past Performance Colonial � lLife. ••1,I• Colonial Life Proposers, Relevant Experience, Qualifications, & Past Performance Our responses to the requirements for this section per the RFQ document are provided below and on the subsequent pages, if necessary. • Provide a list of five (5) comparable contracts (similar in scope of services to those requested herein), which Proposer has either ongoing, or has completed within the past ten (10) years. The description should identify for each project: i. Client ii. Description of work iii. Total dollar value of the contract iv. Dates covering the term of the contract v. Client contact person and phone number vi. Statement of whether Proposer is/was the prime contractor or subcontractor; if Proposer was the subcontractor, name the Prime vii. Detail Proposer's responsibilities and the results of the project City of Opa Locka (FL) Voluntary insurance product education and enrollment services. $190,942 Annual Sales Premium 2/17/1988-Present Diana Levers, (305) 953-2815 Prime contractor Managed all stages of the project to include enrollment implementation planning, enrollment communication, actual enrollment sessions with employees, and post enrollment activities. City of Hialeah (FL) Voluntary insurance product education and enrollment services. $414,585 Annual Sales Premium 1/10/2014-Present Frank Duharte, (305) 883-8059 Prime contractor Managed all stages of the project to include enrollment implementation planning, enrollment communication, actual enrollment sessions with employees, and post enrollment activities. State of Arkansas** Voluntary insurance product education and enrollment services. $4,356,821 Annual Sales Premium 9/16/65-Present Grant J. Wallace, (501) 682-5502 Prime contractor Managed all stages of the project to include enrollment implementation planning, enrollment communication, actual enrollment sessions with employees, and post enrollment activities. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 41 ••1,I• Colonial Life North Carolina Department of Revenue** Voluntary insurance product education and enrollment services. $247,376 Annual Sales Premium 10/28/1985-Present Judy A. Fields, (919) 814-1212 Prime contractor Managed all stages of the project to include enrollment implementation planning, enrollment communication, actual enrollment sessions with employees, and post enrollment activities. El Dorado Furniture Voluntary insurance product education and enrollment services. $369,903 Annual Sales Premium 2/1/20-Present Glenis Gomez, (772) 286-9400, ext. 256 Prime contractor Managed all stages of the project to include enrollment implementation planning, enrollment communication, actual enrollment sessions with employees, and post enrollment activities. Neighbors and Neighbors Assoc. Voluntary insurance product education and enrollment services. $31,766 Annual Sales Premium 3/1/2017-Present Leroy Jones, (305) 756-0605 Prime contractor Managed all stages of the project to include enrollment implementation planning, enrollment communication, actual enrollment sessions with employees, and post enrollment activities. Larkin University Voluntary insurance product education and enrollment services. $35,361 Annual Sales Premium 1/11/2019-Present Frida Musila, (305) 760-7470 Prime contractor Managed all stages of the project to include enrollment implementation planning, enrollment communication, actual enrollment sessions with employees, and post enrollment activities. • Where possible, list and describe those projects performed for government clients or similar size private entities (excluding and work performed for the City of Miami). In the event that Proposer has not performed five (5) comparable contracts within the past ten (10) years, Proposer should provide information that demonstrates its ability to perform the required services, as detailed within Section 3, Scope of Services. For more than 80 years, we've helped America's workers - employees just like yours - protect what they've worked so hard to build. Currently, we work with nearly 100,000 businesses and almost 4.5 million policyholders nationwide. Including5,000 local governments, 41 state governments, and 3,000 educational agencies, all providing valuable financial protection with our voluntary benefit solutions and services. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 42 ••1,I• Colonial Life We're hereto help you overcome your employee benefit challenges with our proven cost -saving solutions, end -to -end enrollment and communication tools, and benefits administration services. Total Number of Local Government Accounts in the state of FL: 505 Total Public Sector Accounts in the state of FL: 804 • List Proposer's subcontractors or sub consultants which will work on the City's employee voluntary supplemental insurance benefits and include a brief history of their background and experience. As a global company with a strong international workforce, we have partnerships both within the U.S. and beyond it that reflect that diversity and global scale. Some of the companies we work with, including EXL, are U.S.-based companies with workforces overseas. CLA's external partners are global companies with a strong US presence and a workforce in the US, India, and the Philippines. These partnerships give us more flexibility in staffing levels and schedules, help us gain access to broader skillsets, and help us grow and strengthen our company. These partners are treated as an extension of CLA and have the same or higher expectations as our employees, and our promise to be liable for them remains. For additional information, please see https://www.unum.com/privacy. Colonial Life uses suppliers for a variety of purposes and manages those relationships on an ongoing basis. We hold our suppliers to very high standards that must either meet or exceed the same requirements Colonial Life follows such as ISO, N IST and other industry standards as applicable. Our corporate third -party risk management program addresses all such relationships and audits are conducted as deemed necessary and/or required by law or regulations. Four of our primary external partners include: Company Name: EXL Service Holdings Address: 320 Park Avenue, 29th Floor, New York, NY 10022 Phone: +1212-277-7100 Year Founded: 1999 Description: EXL Service Holdings, Inc. is an operations management, global analytics and digital solutions company that helps clients optimize workflows through advanced technological solutions. As a strategic partner, EXL enables Colonial Life to more effectively serve our customers. EXL currently provides functions like setting up of a claim shell in our system, assignment of images to claim files, contact center support, and staff augmentation. Company Name: Sutherland Global Services Address: 1160 Pittsford -Victor Rd., Pittsford, NY 14534 Phone: +1585 586-5757 Year Founded: 1986 Description: Sutherland Global Services is a digital transformation company that will provide contact center support for our Voluntary Benefits products. They are a partner who maximizes value for Colonial Life while minimizing risk in doing so. Sutherlands mission is to rethink and rebuild processes for the digital age by combining the speed and insight of design thinking with the scale and accuracy of data analytics. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 43 ••1,I• Colonial Life Company Name: Broadridge Financial Solutions Address: 5 Dakota Drive, Suite 300, Lake Success, NY 11042 Phone: +1800-353-0103 Year Founded: 2007 Description: Broadridge is a major print provider in the USA and works with Colonial life to provide transactional printing and related services. Company Name: ReleasePoint Address: 405 W. Foothill Blvd., Suite 204, Claremont, CA 91711 Phone: +1800-999-9589 Year Founded: 1970 Description: ReleasePoint is a leading provider of medical record retrieval services, offering solutions in insurance, legal, disability, SSDI, and research markets. ReleasePoint's technology and proprietary processes are robust and proven including a comprehensive database of providers and notes and established processes on how best to connect with them, which enables Colonial Life to deliver a better customer experience through more timely retrieval of medical records during the claims process. • Provide any other information which the Proposer deems relevant to its organization and its ability to provide quality employee voluntary supplemental insurance benefits to the City. The world has undoubtedly changed. As many of us are adjusting our business practices due to the COVID-19 pandemic, our core business model hasn't changed. We remain dedicated to preserving and protecting the vitally important things America's workers have worked so hard to build, even if unexpected events and challenging times get in their way. Though the times have changed, our enrollment promise hasn't. We continue to educate and enroll employees in all their benefits, all year round, wherever they are. And, as all business Is migrating to a more digital response, we remain focused on offering solutions that are flexible, adaptable, and scalable to ensure uninterrupted support for voluntary as well as core benefits enrollment. With all the questions that generally occur when employees are trying to understand their benefits options, it takes some explanation — especially now. While we're always proponents of face-to-face, ongoing communication and guidance, we've expanded our telephonic enrollment team to be more responsive to the current environment. Additional relevant details about Colonial Life: • In business for more than 80 years • Pioneered worksite marketing in 1955 • Consistently strong industry ratings and long-term profitable growth • More than $1 billion in in -force premium This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 44 ••1,I• Colonial Life • Serving nearly 100,000 businesses and organizations • Provide coverage for more than 4.5 million policyholders • A broad portfolio of personal insurance coverage • Customized benefits education and counseling • Advanced yet simple -to -use enrollment technology • Individual attention and commitment to service • Lasting partnerships with customers, producers, employees, and the community • Provide Proposer's implementation plan that will be utilized in implementing the employee voluntary supplemental insurance benefits, anticipated to become effective immediately. This shall include, but not be limited to: a) training offered to City staff, b) sample of communication materials and administration manual, and c) all anticipated City assigned action items. Kickoff • Assigned Implementation Manager • Implementation Call • Establish enrollment goals and strategy • Create implementation agenda Implementation (4-8 weeks pre -enrollment) • Logistics discussions • Create communication plan • Start to establish enrollment database • Review billing preferences Pre -Enrollment (2-3 weeks pre -enrollment) • Deploy communication campaign • Schedule employee appointments • Complete enrollment database • Train benefits counselors Enrollment • Benefits counselors enroll employees • Measure and monitor enrollment metrics • Submit applications Post Enrollment (2-4 weeks post -enrollment) • Review enrollment evaluation reports • Team debriefing • Implement new hire strategy • First bill confirmation and review • Ongoing case management Client Responsibilities • Provide census data and logo; provide core plan and rate details if we will be enrollment core and voluntary benefits • Review and approve all communications This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 45 ••1,I• Colonial Life • Notify locations of set-up process • Attend all implementation calls Colonial Life Team Responsibilities • Ensure project flows smoothly and timelines are met • Manage enrollment logistics • Host implementation calls • Create enrollment schedule • Coordinate benefits counselor training • Create communication campaign Customized Communications From pre -enrollment announcements to product brochures and online educational tools, our benefits communication materials help ensure your employees understand all the benefit options available to them. We can completely digitize the engagement experience at no direct cost with your choice of communication methods to help boost understanding, engagement, and participation. PERSONALIZED DIGITAL DIGITAL BENEFITS PRODUCT WEBSITE POSTCARDS BOOKLETS VIDEOS EMAILS • Provide information concerning any prior or pending litigation or proceedings, either civil or criminal, involving Proposer, its partners, managers, other key staff members, and its professional activities or performance, that Proposer has been involved in which may affect the performance of the services to be rendered herein, if applicable. State the nature of the litigation, a brief description of each case, the outcome or projected outcome, and the monetary amounts involved. Discuss any bankruptcies involving Proposer, its partners, manager(s), or other key staff members, if applicable. In the normal course of business, any Unum subsidiary insurance company may, from time to time, be involved in litigation with claimants, beneficiaries or others, and a number of lawsuits are currently pending. In the opinion of management, the ultimate liability, if any, arising from all litigation is not expected to have material adverse effect on the financial position or the operating results of Unum Group. An overview of litigation can be found in our most recent 10-Q filing with the SEC atwww.investors.unum.com. • Provide a minimum of three (3) references using Attachment B, Reference Submittal Form, for projects performed for government clients or similar size private entities. The City reserves the right to contact any reference as part of the qualification process. We have provided our references on Attachment B, Reference Submittal Form following this document. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 46 ••1,I• Colonial Life • Provide information or documentation about the Proposer's qualifications and experience from which the City can benefit under this contract. Large employers have a full plate - especially when it comes to benefits. In addition to dealing with rising health care costs, the complexities of health care reform and other government regulations, your employees count on you to offer a competitive benefits package. Having more than 50 years of experience working with large employers, we understand your challenges because big business has always been a big part of our business. Currently, with over 3,700 of our customers having 500+ employees, we understand the specialized services you need to compete for top talent. As employee benefits packages are transitioning from standard to highly customized, we can help you offer the financial protection your employees - and their families - need the most. Our cost-effective and innovative solutions can help solve some of your biggest enrollment challenges with multi -site, multi-lingual and even multi -state needs. A national network of independent offices and local enrollment specialists can quickly scale and adapt to your insurance delivery needs. With our accounts having an average tenure of 20 years, you can see why we're the preferred choice for large employers. For decades, we've been working hand -in -hand with some of the largest organizations in the nation. This success is built on trusted relationships: • 180,000 employees (30-year client) • 170,000 employees (41-year client) • 70,000 employees (23-year client) • 62,000 employees (34-year client) • 55,000 employees (26-year client) • 45,000 employees (7-year client) • Describe any relevant industry/subject matter expertise, including any experience in the requested services listed herein, and any unique or proprietary project methodologies relevant to the requested services. In addition to the information that we have provided above regarding our expertise in both the public sector and large case space as it relates to voluntary insurance products and services, we also offer specialized account management support for our premier clients which is how we would categorize the City of Miami if we are awarded the bid. We realize that our premier large accounts require specialized services. That is why these clients are assigned a dedicated home office team that will provide the extra dedicated time and attention This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 47 ••1,I• Colonial Life needed to make the initial planning, enrollment and ongoing service runs as smoothly and be as successful as possible. This team consists of the following roles. Strategic Account Manager Primary home office point of contact responsible for the successful partnership between the client, broker, and internal team. Implementation Manager Drives the development and implementation of the enrollment strategy which includes managing key deliverables, identifying and securing required resources, monitoring expenses, and ensuring that plans are on track with enrollment objectives. Regional Enrollment Consultant Simplifies and customizes the enrollment with our experienced National Enrollment Team (NET) of certified enrollment specialists. Enrollment Solutions Consultant Benefits technology expert responsible for managing the exchange of electronic information between the client and Colonial Life. Regional Programs Manager Responsible for developing and implementing a programs strategy to enhance program awareness and utilization by Increasing employee participation and attendance in the region they support. Drive the tactical implementation of strategic program initiatives for our enrollments. Client Specialist Supports the Plan Administrator to ensure an exceptional customer experience and timely resolution to any account service question while directing the client to the tools and systems that allow for greater ease of doing business with us. Billing Coordinator Assists clients with maintaining accurate payroll deductions and helps navigate the billing process. Additionally, the local sales and service team also plays a significant role in the process. They provide the local level customer contact and support. They are the primary point of contact for daily account servicing issues. They develop strategies to address the core and voluntary benefits delivery challenges of the account through a customized combination of voluntary benefits products, benefits communication and education, as well as enrollment fulfillment and support. • List Proposer's subcontractors or sub consultants which will work on the employee voluntary supplemental insurance benefits and include a brief history of their background and experience. This is a duplicate question. Please refer to our answer above due to the length of our response. • Provide any other information which the Proposer deems relevant to its organization and its ability to provide quality employee voluntary supplemental insurance benefits. This is a duplicate question. Please refer to our answer above due to the length of our response. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 48 ••1,I• Colonial Life • Identify if Proposer has taken any exception(s) to the terms of this Solicitation. If so, indicate the alternative being offered and the cost implications of the exception(s). We confirm that we do not have any exceptions to the items in the RFQ marked as non-negotiable. Per the RFQ instructions and requirements, we have provided our exceptions on the Certification Statement. We have also provided them below. Terms and Conditions/General Terms and Conditions • Item 1.6/Assignment o We do have subcontractors that perform services as part of our normal course of business. We generally cannot agree not to allow any subcontractor to work on an account without the prior written consent of the client because these services are performed as part of our normal course of business. We can definitely agree not to subcontract the contract itself, and could not do so anyhow as the employee benefits under this contract must be provided by an insurance company licensed in the State of FL. Professional Services Agreement • Item 1/Recitals and Incorporations Definitions o As a highly regulated carrier, Colonial is legally restricted in its ability to vary the terms of its filed and approved insurance policies. As such, the filed insurance policies must govern in the event of a conflict between the policy and this agreement. • Item 2/Contract Term o Colonial can agree to this language but wanted to note two points: (1) termination of the Professional Services Agreement would not necessarily terminate insurance coverage as that coverage is governed by the insurance policy itself which, as a state -filed and approved document, cannot be modified by external contract; and (2) any renewal of insurance coverage would require review and approval by Colonial's underwriting department. • Item 4/Scope of Services/C o Colonial cannot agree to provide a customer with a unilateral right to require replacement of personnel; however, if the City has any concerns on any employees assigned to its account, Colonial will certainly meet and work to find a mutually agreeable resolution which may include replacement of personnel. • Item 10/Compliance with Federal, State and Local Laws o Colonial will not be engaging any subcontractors specifically to provide services to the City and is unable to modify its longstanding agreements with subcontractors to reflect customer -specific requests. With that said, Colonial does standardly include representations and warranties or other language requiring its subcontractors to comply with applicable law and remains responsible and liable for the actions of our subcontractors. • Item 12/Default o We have struck through the following wording: commence to perform thc Services within thc time provided or contemplated herein, then, in addition to thc foregoing, Consultant shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 49 ••1,I• Colonial Life expenses incurrcd by the City in the rc procurement of the Services, including consequential and incidental damages. Item 14/Termination; Obligations Upon Termination o As noted above, termination of the Professional Services Agreement will not necessarily terminate insurance coverage as those policies contain their own termination provisions and are state -flied and approved documents which cannot be modified by external contract. • Item 15/Insurance o Colonial can agree to include City of Miami as an additional insured, but it will be through a blanket endorsement. o Colonial is happy to submit a current certificate of insurance at any point but would ask that it be upon request of the City. o Please see revised wording below: ■ Item A/Consultant shall, at all times during the term hereof, maintain such insurance coverage(s) as may be required by the City. The insurance coverage(s) required as of the Effective Date of this Agreement are attached hereto as Exhibit "D" and incorporated herein by this reference. The City RFQ number and title of the RFQ must appear on each certificate of insurance. The Consultant shall add include the City of Miami as an additional insured via blanket endorsement to its commercial general liability, and auto liability policies, and listed as a named certificate holder on all policies. ■ Item C/ Consultant shall be responsible for assuring that the insurance certificates required under this Agreement remain in full force and effect for the duration of this Agreement, including any extensions hereof. If insurance certificates are scheduled to expire during the term of this Agreement and any extension hereof, Consultant shall be responsible for submitting new or renewed insurance certificates to the City's Risk Management Administrator as soon as coverages are bound with the insurers. In the event that expired certificates are not replaced, with new or renewed certificates which cover the term of this Agreement and any extension thereof: (i) the City shall suspend this Agreement until such time as the new or renewed certificate(s) are received in acceptable form by the City's Risk Management Administrator; or (ii) the City may, at its sole discretion, terminate the Agreement for cause and seek re -procurement damages from, but not before reaching out to the Contractor to request a copy of the updated certificate of insurance. • Item 31/E-Verify Employment Requirements o See comment above regarding Colonial's agreements with subcontractors. Insurance Requirements • We have struck through the wording noted below: o Certificates will indicate no modification or change in insurance shall be made without thirty (30) days written advance notice to the certificate holder. • Please note revised wording below: o If insurance certificates are scheduled to expire during the contractual period, the Consultant, shall be responsible for submitting new or renewed insurance certificate to the City at within a minimum often (10) calendar days of policy renewal. in advance of such expiration. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 50 ••1,I• Colonial Life o In the event that expired certificates are not replaced with new or renewed certificates which cover the contractual period, the City sha II, but not before reaching out to the contractor for an updated copy. • Confirm Proposer's organization has complied with all State of Florida, Office of insurance Regulation filing requirements for plan/product being offered to the employees of the City. We confirm. We have provided our Certificate of Authority for the State of Florida following this document which allows us to offer our proposed products and services per this RFQ response. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 51 RFQ NO.: 1733386 Revised Attachment B Reference Submittal Form CATEGORY: Employee Voluntary Supplemental Insurance Benefits FIRM NAME: Colonial Life & Accident Insurance Company Summarized Requirements: Refer to the details in Section 2.9, References, to verify that the information provided will suffice as proof of meeting the requirements of this solicitation. Past Performance Reference Check #1 Company/Organization Name: State of Arkansas Address: Little Rock, AR 72201 *This reference cannot be contacted directly. Please contact us at Contact Person: Grant J. Wallace * proposalcenter@coloniallife.com if you need to very this reference. Contact Phone Number: (501) 682-5502* Contact E-mail (if applicable): grant.wallace@arkansas.gov* Date of Contract or Sale: 9/16/1965 Past Performance Reference Check #2 Company/Organization Name: North Carolina Department of Revenue Address: Raleigh, NC Contact Person: Judy A. Fields* *This reference cannot be contacted directly. Please contact us at Contact Phone Number: (919) 814-1212* proposalcenter@coloniallife.com if you need to verify this reference. Contact E-mail (if applicable): Judy.Fields@ncdor.gov* Date of Contract or Sale: 10/28/1985 Past Performance Reference Check #3 Company/Organization Name: City of Hialeah Address:501 Palm Avenue, Hialeah,FL 33010 Contact Person: Frank Duharte Contact Phone Number: (305) 883-8059 Contact E-mail (if applicable): fduharte@hialeahfl.gov Date of Contract or Sale: 1/10/2014 1 52 Florida Certificate of Authority t • + N • ♦." • W •••••11 40. •.• • W • ••• ••• • 4'••• ! H or fry • +y • ly i ••• 4 •N 4. • 1 1 • • 4044•*ma •• tate of F1orjjd OFFICE OF INSURANCE REGULATION Tallahassee, Florida AUGUST 5, 2003 1, the undersigned, Director of the Office of insurance Regulation of the State of Florida, do hereby certify that COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY COL UMBIA, SC Is authorized to transact the following lines of insurance in the State of Florida: LIFE, GROUP LIFE AND ANNUITIES, ACCIDENT AND HEALTH Until such time as its Certificate of Authority is amended, suspended, revoked or non -renewed. IN TESTIMONY WHEREOF, I hereto subscribe my name, and affix the Seal of my Office, at Tallahassee, the day and year first above written. Director, Office of Insurance Regulation 1 1 1 1 1 t Z I .1 1 1 1 1 2 { i t 2 1 ��;�;i.�.�:f+�!.M. �.M;�:W:i �N:�'W'i ��i'�.N l:Mi.� M:•:1+�:�:�! �:M.+1� a M N1'�:�M.i W.i W! W �"i • 53 Impact of employee engagement Enrollment is about more than just checking a box. With a solid engagement strategy, your employees can understand how their benefits are an asset. At no cost, we can offer an array of communication methods that can help boost understanding while sharing important enrollment information. Our support can expand beyond pre -enrollment communication to include an ongoing effort that keeps employees engaged in their benefit options throughout the year. The result is a full -service, end -to -end enrollment communication plan that includes existing employees as well as new hires. In turn, employees are better informed about their benefits. Our research shows that, when employees understand their benefits, they're typically more appreciative and more loyal to their place of work. Colonial Life, Digitize the engagement experience with customized options such as: PERSONALIZED WEBSITE DIGITAL POSTCARDS DIGITAL BENEFITS BOOKLETS EMAILS PRODUCT VIDEOS ©2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a ColonialLife.com registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 54 4. Colonial1Life. Enrollment technology that works for you We understand the daunting task of navigating the ever-expanding list of benefits administration and human resource technology flooding the marketplace. Whether you are looking for a platform to support your growing business or you come across a client with an existing platform, Colonial Life provides the guidance you need to make technology work for you. POWERFUL PARTNERSHIPS - We partner with a wide range of industry -leading benefits administration and human capital management platforms that provide opportunities to expand your business. - Our strategic partnerships offer a user-friendly enrollment experience, virtual employee assistance, and discounted pricing in addition to many other benefits. POWERFUL RESULTS - Streamlined setup and simple user experience - Seamless enrollment of core and voluntary benefits - Access to our comprehensive individual and group voluntary benefits portfolio - Supported enrollment methods include in -person and virtual benefits counseling, call center, and self -enroll. ..Ole. Colonial Life ColonialLife.com View a full list of our existing partnerships Enrollment Technology Partner Portal FOR BROKER INFORMATION ONLY. Insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. ®2021 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 4-21 I NS-616751 55 Open enrollment may need to be managed differently than in years prior considering many companies are extending their work -from -home orders and seeking ways to limit contact in the workplace. As all business quickly pivots toward a digital response, we remain focused on offering solutions that are flexible, adaptable and scalable to ensure uninterrupted support for voluntary as well as core benefits enrollment. With all the questions that generally occur when employees are trying to select their benefits options, it takes some explanation - especially now. While we're always proponents of in -person, ongoing communication and guidance, we've expanded our telephonic enrollment team and offer video calls, chat and co -browse support to be more responsive to the needs for social distancing. These virtual solutions can still offer the individual counseling sessions between an employee and a benefits counselor, just via video chat or phone call. This flexible and adaptable approach can help engage employees and allow them to feel more confident in their benefits choices - even at a distance. Colonial Life, Enroll employees where they are: VIRTUAL FACE-TO-FACE TELEPHONIC ONLINE ©2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a ColonialLife.com registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 56 Proposed Benefit Offerings .•. Colonial Life 57 ••1,I• Colonial Life Proposed Benefits Offerings Our responses to the requirements for this section per the RFQ document are provided below and on the subsequent pages. • Provide in detail Proposer's Proposed employee voluntary supplemental insurance benefits offerings, and how this meets and exceeds the requirements listed in Section 3, Specifications. By packaging core benefit offerings with our personal insurance products, you can enhance your benefits program and help employees fill the gaps in their individual coverage. We are proposing the following voluntary supplemental insurance products. A broad range of financial protection options are available to your employees by offering our products and plans. We are offering our group Colonial Life products. It is our understanding that the City utilizes the Oracle platform; therefore, only our group products can be supported on a third -party hosted platform. • Accident insurance to help offset unexpected medical expenses that can result from a covered accidental injury. We have been offering this line of coverage since 1939. • Critical illness insurance to help supplement major medical coverage by providing a lump -sum benefit that can be used to pay the direct and indirect costs related to a covered critical illness or cancer. We have been offering this line of coverage since 1998. • Disability insurance to replace a portion of an employee's income to help make ends meet if he or she becomes disabled from a covered accident or sickness. We have been offering this line of coverage since the 1970's. • Hospital indemnity insurance to provide a lump -sum benefit for a covered hospital confinement or outpatient surgery to help with co -payments and deductibles. We have been offering this line of coverage since the 1970's. Colonial Life's coverages share important features: • With most products, coverage is available to spouses and eligible dependent children. • Benefits are paid directly to the insured, unless specified otherwise. • With most products, employees can continue coverage with no increase in premiums if they retire or change jobs. Please note that premiums for certain group policies may change if/when they are ported. Please also note that our Group Medical Bridge 7000 plan is not portable. • With most products, employees may receive benefits regardless of any other insurance. • Premiums are payroll deducted for easy administration. • Confirm that Proposer will not include minimum participation requirements. We confirm. Our detailed underwriting offer is provided following this document. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 58 ••1,I• Colonial Life • Confirm that insurance is offered on a "Guaranteed Issue" basis as required by the Scope of Services. Describe the underwriting requirements. We confirm. Our detailed underwriting offer is provided following this document. • Identify if an eligibility feed is required to manage the employee voluntary supplemental insurance benefits. Addendum 2 indicated that the City uses the Oracle platform for enrollment purposes. Because this would be considered a product hosting enrollment, Oracle becomes the system of record for all elections to include core (major medical, etc.) and voluntary (Colonial Life) insurance products. A data file containing enrollment information for our Colonial Life products will be sent back to us and uploaded on a specific date of every month for policy issue, claims payment, etc. The elections stay in the Oracle system and are available for transmission to the payroll vendor at a moment's notice. Any data that changes outside of the Oracle system (EE termination via portal, EE phone call cancellation, etc.) is uploaded automatically on a weekly basis from our system to Oracle and subsequently to the payroll vendor. This allows for the most current data to be available for payroll deductions and bill reconciliation. • Provide as an attachment, a description of Proposer's eligibility file record layout specifications. Addendum 2 indicated that the City uses the Oracle platform for enrollment purposes. Because this would be considered a product hosting enrollment, Oracle becomes the system of record for all elections to include core (major medical, etc.) and voluntary (Colonial Life) insurance products. A data file containing enrollment information for our Colonial Life products will be sent back to us and uploaded on a specific date of every month for policy issue, claims payment, etc. The elections stay in the Oracle system and are available for transmission to the payroll vendor at a moment's notice. Any data that changes outside of the Oracle system (EE termination via portal, EE phone call cancellation, etc.) is uploaded automatically on a weekly basis from our system to Oracle and subsequently to the payroll vendor. This allows for the most current data to be available for payroll deductions and bill reconciliation. • Provide a sample of the Proposer's policies for each benefits offering. We have provided our sample policy certificates following this document as well as our product descriptions for the products and plans that we are proposing. • Describe Proposer's available resources to assist Members in staying at work prior to becoming a disability claim. This is not applicable to the short-term disability product that we are offering. We don't manage disability claims in the sense that is being described in this item. We simply receive and process a disability claim filed under the policies sold by us. We don't assist the customer in any way as far as managing their disability, trying to remain at work, trying to return to work, etc. This is typically more applicable to a true group STD/LTD plan. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 59 ••1,I• Colonial Life • Provide any other information which the Proposer deems relevant to its organization and its ability to provide quality managed disability claims administration services to the City. This is not applicable to the short-term disability product that we are offering. We don't manage disability claims in the sense that is being described in this item. We simply receive and process a disability claim filed under the policies sold by us. We don't assist the customer in any way as far as managing their disability, trying to remain at work, trying to return to work, etc. This is typically more applicable to a true group STD/LTD plan. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 60 ol Colonial Colonial Life & Accident Insurance Company 1200 Colonial Life Blvd. Columbia, SC 29210 803.798.7000 ColonialLife.com April 18, 2024 Re: Underwriting Offer for the City of Miami Colonial Life is pleased to offer the following product and underwriting guidelines to the actively working, eligible employees of the City of Miami. Group Accident • On/off-job coverage available as Guaranteed Issue (GI)for all base accident plans and riders. • Gunshot Wound Benefit ($1000 or $5000)and $50 Wellbeing Assistance Benefit available. Group Critical Illness with Cancer • Guaranteed issue (GI) is available up to a $35,000 face amount. • Progressive Disease Rider and $50 Health Screening Benefit available as Gl. • All plans are HSA-compliant. • The spouse and dependent child(ren) benefit is always 50% of the employee benefit. • Pre-existing condition limitation is waived for all eligible employees during the initial open enrollment and for new hires going forward. Group Medical Bridge • Guaranteed Issue (GI) is available on all employee and family coverage. • Hospital Confinement Benefit of $1000 or $2000. • Includes Waiver of Premium, Daily Hospital Confinement Benefit, Observation Room Benefit, Rehabilitation Unit Benefit, Medical Treatment Package, Outpatient Surgical Procedures, Diagnostic Procedures, and $50 Wellbeing Assistance Benefit. • Pre-existing condition limitation is waived for all eligible employees during the initial open enrollment and for new hires going forward. Group Disability • On/off-job or off -job only coverage available with a "AAA" risk rating. • Guaranteed Issue (GI) available up to 60% of income to a maximum benefit of $4000. • Waiver of the pre-existing condition limitation is available for all eligible employees during the initial open enrollment and for new hires going forward. For all of the product guidelines outlined above: • Each of the group products above is available with a 5-year rate guarantee. • For each product, coverage can be issued with 1 application received during the initial enrollment - there will be no minimum participation requirements. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. NS-12502 61 • Waiver of the pre-existing condition limitation on group products is guaranteed for 2 years. Risk Manager review and approval is required beyond the second year. • These offers are extended with the expectation Colonial Life will be the sole provider of these benefits and the only carrier supported by payroll deduction for the selected products. If payroll deduction is not available, then the guarantees included in this offer letter will not apply. • All Colonial Life coverage must be enrolled under an active enrollment event not to exceed 30 days. Extension of the initial enrollment period must be approved by Risk Management. • A Master Application will be required for group products and must be provided at least three days prior to the enrollment start date. • Retirees are not eligible for coverage. • Products and plan variations may vary by state. • These product guidelines will be reviewed for performance and suitability on an annual basis. • This offer must be accepted within 90 days. Colonial Life appreciates the opportunity to partner with you to provide voluntary benefits to your employees. Thank you for your interest in our company. Sincerely, Eve Morris, Client Underwriter Growth & Risk Operations Cc: Matt Northam and Melisha Harley, Directors Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. NS-12502 62 Colonial Life Group Product Descriptions & Sample Policy Certificates .•'1'. Colonial Life Colonial Life. Group Disability Colonial Life's voluntary short-term disability insurance policy is a group plan that is sold via payroll deduction at the workplace. It insures your employee's paycheck by replacing a portion of your employee's income if he becomes disabled because of a covered accidental injury or covered sickness. Product Features • Situs State - In multi -state enrollments, benefit options and rates for multi -state companies are based on the state where the master application is signed. • Optional Employer -Selected Benefits are available. • Renewability - This policy is optionally renewable. • No integration - There is no coordination of benefits at claim with other coverages. Benefits are paid regardless of benefits received from other sources. • Level premiums - Rates are based on issue age and are level, not step -rated. • Geographical Limitations (Worldwide Coverage) — Geographical Limitations provision allows coverage for disabilities that occur outside the regularly covered geographical areas for up to 60 days. • Waiver of Premium - available after 90 consecutive days of a covered disability. • Benefits are paid directly to the insured unless they specify otherwise. • Right of Conversion - An employee may continue this coverage if he changes jobs or leaves your company while the master policy is in force, with no evidence of insurability required. Available Plans This policy offers two base Group Disability plan choices: • Off -Job Accident / Off -Job Sickness Disability benefits • On/Off-Job Accident and On/Off-Job Sickness Disability benefits Applicable to FL PS01640 11/13. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 64 Colonial Life. Disability Benefits As the employer, you can make several choices to tailor the plan design for your employees. Plan Structure • Off -Job Accident / Off -Job Sickness • On/Off-Job Accident and On/Off-Job Sickness Please note that the on -job benefit is 50% of the off job benefit. The employer may choose to offer the Off -Job plan, the On/Off-Job plan or both plans in the account. Monthly Benefit Amount $400 to $7,500 (offered in $100 increments) • Up to 60% of income for coverage amounts from $400 to $4,000 The employer may choose a lower maximum benefit amount and/or lower maximum income replacement. Benefit Periods • 3 months The employer chooses the benefit periods. Elimination Periods 7/7 Elimination periods based on benefit periods selected. The employer may consider limiting the number of elimination period choices to best fit needs and for ease of enrollment. Elimination period means a period of total disability during which no benefits are payable. The first number represents accident elimination period /the second number represents sickness elimination period. Eligibility Requirements • Offered to all permanent, benefit -eligible employees age 17-74 who work at least 20 hours per week on a regular basis. Employer may select a different minimum number of hours worked requirement (requires underwriting approval). • The employee must be actively at work at the time of application. • Seasonal and temporary employees are not eligible. Spouses and children are not eligible. Premium Information • Issue age -banded, one risk class and unisex. Age bands of 17-49, 50-64 and 65-74. • Premiums are based on the account's industry risk classification and optional employer benefits. • Premiums rates are based on issue age and are level, not step -rated. Applicable to FL PS01640 11/13. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 65 Colonial Life. Definitions Total Disability: If the benefit period shown on the Certificate Schedule is 12 months or less, Totally Disabled or Total Disability means you are: • unable to perform the material and substantial duties of your regular occupation ; and • under the regular and appropriate care of a doctor. If the benefit period shown on the Certificate Schedule is greater than 12 months of disability, the definition of Totally Disabled is the same as that shown above. After the first 12 months of disability, Totally Disabled means you are: • unable to perform the material and substantial duties of your regular occupation • not, in fact, working at any job; and • under the regular and appropriate care of a doctor Total Disability, if working for pay or benefits: We will pay 50% of the monthly benefit amount shown on the Certificate Schedule if you are working for pay or benefits during the first 12 months of your being Totally Disabled, or during the benefit period shown on the Certificate Schedule, if less. Waiver of Premium Benefit: After you have been totally disabled as the result of a covered accident or covered sickness for more than 90 consecutive days (while the certificate is in force), or after the elimination period shown in your certificate schedule (whichever is greater), we will waive the premium for as long as you remain disabled. The premium will be waived up to the maximum benefit period shown in your certificate schedule. You must pay all premiums to keep the certificate and any attached riders in force until you have been totally disabled for 90 consecutive days while the certificate is in force, or for the elimination period shown on the certificate schedule, whichever is greater. There is no limit to the number of times you can receive the Waiver of Premium benefit. This Waiver of Premium benefit does not apply to any period that you are totally disabled due to an accident or sickness which is excluded by name or specific description in the certificate. Geographical Limitations (Worldwide Coverage): If you become totally disabled as the result of a covered accident or a covered sickness while outside the covered geographical areas, the Geographical Limitations provision may allow us to provide benefits. You must be totally disabled longer than the elimination period, and the maximum benefit period for total disability while outside the covered geographical areas will be limited to 60 days. Covered geographical areas are the territorial limits of the United States, Canada, Mexico, Puerto Rico, the Bahama Islands, the Virgin Islands, Bermuda, or Jamaica. After the 60 day period, benefits will not be paid until you return to the covered geographical areas. Applicable to FL PS01640 11/13. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 66 Colonial Life. What is Not Covered General Exclusions and Limitations: • Alcoholism or Drug Addiction • Felonies or Illegal Occupations • Flying • Hazardous Avocations • Intoxicants and Narcotics • Psychiatric or Psychological Conditions • Racing • Semi-professional or Professional Sports • Suicide or Injuries Which You Intentionally Do to Yourself • War or Armed Conflict The above list does not include a complete description of each limitation and exclusion. To obtain a complete description of benefits, [imitations and exclusions, please refer to a sample policy, certificate or see your Colonial Life benefit counselor. This information is only intended for proposal use with employers. Applicable to FL PS01640 11/13. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 67 COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 1200 Colonial Life Boulevard, P. O. Box 1365, Columbia, South Carolina 29202 1.800.325.4368 coloniallife.com A Stock Company GROUP SHORT TERM DISABILITY INSURANCE CERTIFICATE THIS CERTIFICATE EXPLAINS THE BENEFITS PROVIDED UNDER THE GROUP SHORT TERM DISABILITY INSURANCE POLICY. Please Read This Certificate Carefully This is your certificate of coverage as long as you are insured under the policy. You will want to read it carefully and keep it in a safe place. Throughout this certificate, the words you, your or insured refers to the person named on the Certificate Schedule who is a member of an eligible class as described on the Policy Rate Schedule, who holds a certificate of coverage and for whom premiums are remitted. We, us, our or company refer to Colonial Life & Accident Insurance Company. Policyholder refers to the organization shown on the Policy Rate Schedule. It includes any division, subsidiary or affiliated company named on the Policy Rate Schedule. Policy means the group contract owned by the policyholder and available for review by you. The male pronoun includes the female whenever used. If the terms of your certificate of coverage and the policy differ, the policy wjIvern. The policy and this certificate may be chang be taken without the consent of or notice to you. approval must be in writing and evidenced by end hole or in part or cancelled as stated in the policy. Such an action may y an executive officer at our home office can approve a change. The nt on the policy or certificate or an amendment signed by the policyholder and one of our executive officers at our "'. office. No other person, including an agent, may change the policy or certificate or waive any of its provisions. PremTts subject to periodic changes. This certificate replaces any and all certificates previously issued for the eligible classe un er the Policy. For purposes of effective dates and ending dates under the grouul6licy, all days begin at 12:01 a.m. and end at 12:00 midnight at the policyholder's address. /15• Right to Return This Certificate If, for any reason, you are not satisfied with this certificate, you can return you receive it. At that time, you should ask us in writing to cancel it. We will Any premium paid will be refunded. s at our home office within 30 days after .der this certificate as if it never existed. You may call Colonial Life & Accident Insurance Company at 1.800.325.4368 for information, inquiries or complaints. Signed for Colonial Life & Accident Insurance Company: Ali-�rrz G � Secretary President and Chief Executive Officer PLEASE READ THIS CERTIFICATE CAREFULLY. GDIS-C-FL 1 68 SECTION 2 - CERTIFICATE GUIDE SECTION 1 FACE PAGE SECTION 2 CERTIFICATE GUIDE SECTION 3 CERTIFICATE SCHEDULE SECTION 4 GENERAL DEFINITIONS SECTION 5 ELIGIBILITY AND EFFECTIVE DATE SECTION 6 BENEFITS SECTION 7 GENERAL EXCLUSIONS AND LIMITATIONS SECTION 8 TERMINATION OF INSURANCE SECTION 9 CONVERSION SECTION 10 GENERAL PROVISIONS SECTION 11 CLAIMS PROVISIONS C10/- GDIS-C-FL 2 69 SECTION 4 — GENERAL DEFINITIONS Additional definitions may be contained in other certificate benefit provisions or any endorsement, amendment or rider. Activities of Daily Living means the following: • Dressing means putting on and taking off all items of clothing and any necessary braces, fasteners or artificial limbs. • Toileting means getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene. • Transferring means the ability to move in or out of a chair, bed or wheelchair. • Eating means feeding oneself by getting food into the body from a receptacle (such as a plate, cup or table). • Preparing meals. • Continence means the ability to maintain control of bowel and bladder function, or the ability to perform associated personal hygiene, including caring for catheter or colostomy bag. Benefit Period means the longest period of time we will make payments to you for any one period of disability. Certificate Anniversary Date occurs once a year on the same day and month as the Premium Effective Date. Complications of Pregnancy means that part of your pregnancy during which abnormal conditions or concurrent disease significantly affect the pregnancy's usual medical management. A complication may exist during the pregnancy, during the delivery, or after the delivery. Concurrent Disability means you are disabled due to more than one condition during the same period of time, whether the conditions are related or unrelated. Confinement means you are admitted to aTi i al and confined as a resident inpatient (including intensive care) on the advice of a doctor.22 Coverage Effective Date means the date covera� s as shown on the Certificate Schedule. The coverage effective date of this certificate is not the date you signed the ap at�for coverage. Covered Accident means an accident which: • occurs on or after the coverage effective date shown on th fcate Schedule; • occurs while this certificate is in force; • • is of the coverage type listed on the Certificate Schedule; and /jN • is not excluded by name or specific description in this certificate. l•c Covered Sickness means an illness, infection, disease or any other abnorhysical condition, not caused by an injury, which: • occurs on or after the coverage effective date shown on the Certificate Schedule; • occurs while this certificate is in force; • is of the coverage type listed on the Certificate Schedule; and • is not excluded by name or specific description in this certificate. Doctor or Physician means a person who: • is licensed by the state to practice a healing art; and • performs services for you which are allowed by his license. For purposes of this definition, Doctor or Physician does not include you, or anyone related to you by blood or marriage, a business or professional partner of yours, or any person who has a financial affiliation or a business interest with you. Elimination Period means a period of total disability during which no benefits are payable, as shown on your Certificate Schedule. Enrollment Period means a period of time determined by us and the policyholder during which you are eligible to enroll for or change your coverage. This period of time may be limited. Evidence of Insurability means a statement of medical history which we will use to determine if you are approved for coverage. GDIS-C-FL 3 70 Hospital means a place that: • is an institution licensed as a hospital and operated pursuant to law on a full-time basis; • provides overnight care of injured and sick people; • is supervised by a doctor; • has full-time nurses supervised by a registered nurse; and • has at its locations or uses on a pre -arranged basis: X-ray equipment, a laboratory and an operating room where surgical operations take place. Notwithstanding the above, a hospital is not: • a nursing home; • an extended care facility; • a skilled nursing facility; • a rest home or home for the aged; • a place for alcoholics or drug addicts; or • an assisted living facility. Injury means a condition sustained by you which is a direct result of an accident, independent of disease or bodily infirmity or any other cause and occurs while this certificate is in force. Leave of Absence means you are temporarily absent from active employment for a period of time that has been agreed to in advance in writing by your employer. Normal vacation time or any period of disability is not considered a leave of absence. Material and Substantial Duties of YourJjneans duties that are normally required to perform your regular job. Performing your job at a particular worksite or ir(rticular building is not a material and substantial duty of your job, provided that your employer will allow you to perf )f,r job at a different worksite or in a different building. Off -Job Accident means an accident that occurs whileOu a not working at any job for pay or benefits. Off -Job Sickness means a sickness that was not caused b Contributed to by your working at any job for pay or benefits. /"' . On -Job Accident means an accident that occurs while you are wore4oilt any job for pay or benefits. On -Job Sickness means a sickness that was caused by or contributed our working at any job for pay or benefits. Pre -Existing Condition means a sickness or physical condition, whether diagnosed or not, that during the 12 months preceding the effective date of this certificate had manifested itself in such a manner as would cause an ordinarily prudent person to seek medical advice, diagnosis, care, or treatment or for which medical advice, diagnosis, care or treatment was recommended or received. Genetic information is not a pre-existing condition in the absence of a diagnosis of the condition related to such information. Premium Effective Date is the first premium due date for which premium is received. Psychiatric or Psychological Conditions mean conditions including but not limited to affective disorders, neuroses, anxiety, stress and adjustment reactions. Alzheimer's Disease and other organic senile dementias are not considered psychiatric or psychological conditions. Recurrent Disability means your becoming disabled, ceasing to be disabled, then becoming disabled again for the same or related condition. The latter disability will be considered a recurrent disability. Sickness means an illness, infection, disease or any other abnormal physical condition not caused by an accident. Sickness includes complications of pregnancy. Subsequent Disability means a separate period of disability resulting from a condition unrelated to the previous period of disability. GDIS-C-FL 4 71 If the benefit period shown on the Certificate Schedule is 12 months or less, Totally Disabled or Total Disability means you are: • unable to perform the material and substantial duties of your regular occupation; and • under the regular and appropriate care of a doctor. If the benefit period shown on the Certificate Schedule is greater than 12 months of disability, the definition of Totally Disabled is the same as that shown above. After the first 12 months of disability, Totally Disabled means you are: • unable to perform the material and substantial duties of your regular occupation; • not, in fact, working at any job; and • under the regular and appropriate care of a doctor. Under the Regular and Appropriate Care of a Doctor means you are being cared for on a regular basis by a doctor and the care you are receiving is appropriate for the condition(s) which disable(s) you. SECTION 5 — ELIGIBILITY AND EFFECTIVE DATE Coverage Effective Date Your coverage under the policy will start at 12:01 a.m. Standard Time in the time zone where you live on the coverage effective date shown on your Certificate Schedule. Enrollment An individual who is a member of an eligible class may enroll in coverage during the eligibility period, as shown on the Policy Rate Schedule, that follows the later • the policy effective date as shown on olicy Rate Schedule; • the date the individual first becomes a mr of an eligible class; • the date the individual completes the policyr waiting period shown on the application of the policyholder, if applicable; • the date the individual meets evidence of insu ,equirements, if any. An individual who fails to enroll during the eligibility period insurability may be required. The policyholder and the comp ends. After the coverage effective date, you cannot period. Delayed Coverage Effective Date make nroll only during an enrollment period. Evidence of ill determine when an enrollment period begins and any changes to verage under this certificate until an enrollment The effective date of your coverage will be delayed if you are not a member of an eligible class on the coverage effective date shown on the Certificate Schedule. The coverage will be effective on the date that you return to status as a member of an eligible class. SECTION 6 — BENEFITS Totally Disabled or Total Disability We will pay the amount shown on the Certificate Schedule if you become totally disabled by a covered accident or by a covered sickness. If you are totally disabled longer than the elimination period shown on the Certificate Schedule, we will pay the total disability benefit for as long as this coverage is in force and you remain totally disabled up to the benefit period and in the amount shown on the Certificate Schedule, except for the Geographical Limitations provision in this certificate. We will pay 50% of the monthly benefit amount shown on the Certificate Schedule if you are working for pay or benefits during the first 12 months of your being Totally Disabled, or during the benefit period shown on the Certificate Schedule, if less. If benefits are payable for less than a full month, we will pay benefits in a daily amount. The daily amount is 1/30th of the monthly amount shown on the Certificate Schedule. GDIS-C-FL 5 72 If the elimination period for total disability due to the covered accident or covered sickness is 30 days or less, the monthly benefit for disability will begin the earlier of: • the first day of hospital confinement; or • the first day after the elimination period. If you do not have a job when you become totally disabled, we will pay the total disability benefit only as long as you are kept at home and cannot perform two of six Activities of Daily Living and are under the regular and appropriate care of a doctor. At home means in your house or yard. However, you can follow your doctor's orders even if it means leaving home. If you become disabled because of a pre-existing condition, we will not pay for any disability if it begins during the pre- existing condition limitation period shown on the Certificate Schedule. The disability benefit provided by this certificate terminates on the certificate anniversary date on or after you reach age 75. Recurrent Disability A recurrent disability will be treated as: • a continuation of the previous disability, not a new disability, if you have returned to work for less than 6 months. • a new disability, if you have returned to work for 6 months or more, working at least the same number of hours you were working before the previous disability began. • a continuation of the previous disability, not a new disability, if you do not have a job and you have ceased to be disabled for less than 6 months. • a new disability, if you do not have a joked you have ceased to be disabled for 6 months or more. • a continuation of the previous disabilit ny circumstances not specifically listed above. A new disability is subject to a new elimination . •, and a new benefit period applies. A disability that is considered a continuation of a previous disability is not subject • V = elimination period, and a new benefit period does not apply. Any recurrent disability caused by a pre-existing conwill not be covered if it is treated as a continuation of the previous disability. Concurrent Disability During any period in which you are disabled due to more than • ► • •edition, whether the conditions are related or unrelated, benefits will be paid as if you are disabled due to only • Akidition. In no event will your being disabled due to more than one condition extend the benefit period beyond the bene t jod shown on the Certificate Schedule. Subsequent Disability Separate periods of disability resulting from unrelated conditions are consid a continuation of the previous disability, not a new disability, unless the following requirements are met: • If you were employed when the previous period of disability ended: • The disability periods are separated by a minimum 10 calendar days; • During such time, you returned to work performing the material and substantial duties of your regular occupation; and • During such time, you were no longer qualified to receive total disability benefits. • If you were not employed, or did not return to work, when the previous period of disability ended: • The disability periods are separated by a minimum of 6 months; • During such time, you were released from the care of a doctor with no medical restrictions or limitations; and • During such time, you were no longer qualified to receive total disability benefits. Geographical Limitations If you become totally disabled as the result of a covered accident or a covered sickness while you are outside the covered geographical areas and you are totally disabled longer than the elimination period shown on the Certificate Schedule, your maximum benefit period for total disability while outside the covered geographical areas will be limited to 60 days. Covered geographical areas are the territorial limits of the United States, Canada, Mexico, Puerto Rico, the Bahama Islands, the Virgin Islands, Bermuda, or Jamaica. After the 60 day period, benefits will not be paid until you return to the covered geographical areas. GDIS-C-FL 6 73 If you are still totally disabled as defined in this certificate when you return from outside the covered geographical areas, we will determine your remaining applicable benefit period by subtracting the time period for which we have already paid you benefits from the benefit period shown on the Certificate Schedule. We will pay the monthly benefit amount shown on the Certificate Schedule for up to the remaining applicable benefit period. Waiver of Premium After you have been totally disabled as the result of a covered accident or a covered sickness for more than 90 consecutive days while this certificate is in force, or after the elimination period shown on the Certificate Schedule, whichever is greater, we will waive the premium for this certificate and any attached riders(s) for as long as you remain disabled, up to the benefit period shown on the Certificate Schedule. You must pay all premiums to keep this certificate and any attached rider(s) in force until you have been totally disabled for 90 consecutive days while this certificate is in force, or for the elimination period shown on the Certificate Schedule, whichever is greater. You must send us written notice as soon as you are no longer disabled. We will assume that you are no longer disabled if: • you do not send us satisfactory proof of loss when we request it; or • you notify us that you are no longer disabled. You must pay all premiums to keep this certificate and any attached rider(s) in force beginning with the first premium due after you are no longer disabled. The Waiver of Premium Benefit does not apply to any period that you are totally disabled due to an accident or sickness which is excluded by specific name or specific description in this certificate. There is no limit to the number of times you an receive the Waiver of Premium benefit. r,,ail SECTION 7 — GENERAL EXCLUSIO ID LIMITATIONS Exclusions Y,22 We will not pay benefits for losses that are causedjr/6ntributed to by or occur as a result of your: Alcoholism or Drug Addiction Addiction to alcohol or drugs, except for drugs taken as presci Felonies or Illegal Occupations Committing or attempting to commit a felony or engaging in an illegal ation. Flying Operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft or hot air balloon, including those which are not motor -driven. This does not include flying as a fare paying passenger. your doctor. Hazardous Avocations Engaging in hang-gliding, bungee jumping, parachuting, sailgliding, parasailing, or parakiting. Intoxicants and Narcotics Being legally intoxicated under state limits or under the influence of any narcotics unless administered on the advice of your doctor. Racing Riding in or driving any motor -driven vehicle in a race, stunt show or speed test. Semi-professional or Professional Sports Practicing for or participating in any semi-professional or professional competitive athletic contest for which any type of compensation or remuneration is received. Suicide or Injuries Which You Intentionally Do to Yourself Committing or trying to commit suicide or your injuring yourself intentionally, whether you are sane or not. GDIS-C-FL 7 74 War or Armed Conflict Any act of war, declared or undeclared, or serving in the armed forces of any country or authority. Limitations Giving Birth Limitation We will not pay benefits for losses due to you giving birth within the first 9 months after the coverage effective date of this certificate as a result of a normal pregnancy, including Cesarean. Complications of pregnancy will be covered to the same extent as any other covered sickness. Pre-existing Condition Limitation We will not pay for loss when the disability is a pre-existing condition as defined in this certificate, unless you have satisfied the pre-existing condition limitation period shown on the Certificate Schedule on the date you suffer a loss due to a covered accident or covered sickness. Credit toward the satisfaction of the pre-existing condition limitation period will be given for any continuous time you were covered under the pre-existing condition clause of previous coverage through another carrier if: • you were insured under the previous coverage at the time of enrollment in the coverage provided by this certificate; and • you were insured under the coverage provided by this certificate on the Policy Effective Date shown on the Policy Rate Schedule. You are responsible for furnishing proof of your previous coverage, to include type of coverage, length the previous coverage was in force and the date the previous coverage terminated. SECTION 8 — TERMINATION OF IN Termination Your insurance under the policy will terminate on'tarliest of the following dates: • the date the policy is terminated by either the /holder or us; or • the end of the grace period following the premium date we fail to receive the required premium for you; or • the date you are no longer in an eligible class; or • the date your class is no longer included for insurance; • the certificate anniversary date on or after your 75th birthdWA • the date the next premium is due after you ask us to end your NCE /age. 3 Termination of insurance for any reason described above will not affec%..'. rights to benefits, if any, for a disability that begins while your insurance is in force under the group policy. You are c• &ed to be continuously disabled if you aredisabled from one condition and, while still disabled from that condition, incuother condition that causes disability. Leave of Absence Under the Family and Medical Leave Act You may continue your coverage during absences for family or medical leave. If you are on a family or medical leave of absence, coverage will continue under this certificate as if you were in active employment, if the following conditions are met: • the premiums are paid in accordance with the policy's provisions; and • the policyholder has approved your leave in writing. Coverage will be continued for up to the greater of: • the leave period required by the federal Family and Medical Leave Act of 1993, and any amendments; or • the leave period required by applicable state law. If coverage is not continued during a family or medical leave of absence, upon your return to active employment, no new pre-existing condition limitation will be applied, and no new evidence of insurability will be required to reinstate the coverage which was in effect before the leave began. In order for these conditions to apply, the policyholder must notify us and commence paying premiums for your coverage within 31 days following your return to active employment following a leave of absence for family or medical leave. GDIS-C-FL 8 75 Extension of Benefits Termination of coverage will not affect any claim that began while the coverage was in force, subject to our right to withhold premium from claim payments as described in the Unpaid Premium provision. If you are receiving disability benefits on the date coverage terminates, we will continue to pay any applicable benefits until the earlier of: • the date the benefit period ends; or • the date you are no longer disabled. SECTION 9 — CONVERSION Right of Conversion If you cease to be eligible for coverage due to any of the following: • you are no longer in an eligible class; • your class is no longer included for insurance; • any other condition other than your failure to pay the required premium, then you have the right to convert to coverage similar to that contained in this certificate. No evidence of insurability will be required and coverage must be applied for and the first premium paid within 30 days following the date of notification. SECTION 10 — GENERAL PROVISIONS Misstatement of Age If your age has been misstated, we will ma payment over the amount due based on y your correct age. If you are not eligible beca Contestability No statement made by you relating to your insura • i i■ . II be used to contest the validity of the insurance after the insurance has been in force prior to the contest for a pd of two years during your lifetime unless the statement is contained in a written instrument signed by you, and the st er ent was fraudulent. ny equitable adjustment of premiums. We will refund any excess premium orrect age. We will request payment for any overdue premium based on age we will refund all premiums paid. Contest means that we question the validity of coverage und olicy through a letter to the policyholder or you. This contest is effective on the date we mail the letter and refund prem.R!►, All statements made by the policyholder or you shall be deemed repre made by the policyholder or you shall be used in any contest unless a c policyholder or you. tions and not warranties. No written statement efthe statement is furnished to the Changes in Coverage Changes in coverage may require evidence of insurability. You may choose to: • increase your coverage up to the maximum monthly benefit available; • decrease your coverage provided it is not less than the minimum amount shown on the Certificate Schedule; or • not participate. Effective Date for Changes in Coverage A change in coverage that is made during an enrollment period will begin at 12:01 a.m. Standard Time in the time zone where you live on the next premium due date after an enrollment period. If you are not in active employment on the date your change in coverage would be effective, any increased or additional coverage will begin on the date you return to active employment. SECTION 11 — CLAIM PROVISIONS Notice of Claim If you have a covered sickness or covered accident that may result in a claim for benefits under the policy, written notice must be given to us at our home office. This must be done within 90 days after a covered loss begins. If notice cannot be given within that time, it must be given as soon as is reasonably possible. The notice must contain enough information to identify you. GDIS-C-FL 9 76 Claim Forms When we receive written or verbal notice of a claim, claim forms will be sent with which to file Proof of Loss. If these forms are not given to you within 15 days, you will be excused from filing the forms as long as you send us Proof of Loss as described below. Proof of Loss You must give us written proof of loss within 90 days after the covered loss begins. Written proof of loss, provided at your expense, and in English or Spanish, means a completed claim form or other documentation that includes: • the date and description of an accident, if applicable; • your employer's statement verifying your last day of work, job title, job duties, your normal work schedule, and the return to work date, if any; and • your attending doctor's statement verifying dates of treatment, diagnosis, dates you were restricted from performing your job, and the applicable restrictions and limitations. If you are not able to give us written proof of loss within 90 days, it will not have a bearing on your claim, if proof is given as soon as it is reasonably possible. In any event, proof must be given no later than one year from the time stated unless you are legally unable to do so. Any additional proof that we require, such as medical records, will be at our expense. If you are self-employed when you become totally disabled, we will require that you provide a valid business license and filed federal tax returns as proof you are self-employed. We also reserve the right to require verification of any such information that you provide. ..Si We also reserve the right to have you examiir0n authorized company representative. 4 Evidence of Continuing Disability Once we approve your claim, you will be asked to pro( evidence of continuing disability at reasonable intervals based on your condition. Evidence of continuing disability mea`rtss mentation of your condition that is sufficient to allow us to determine if you are still disabled. If you do not submit evid nc _of continuing disability when requested, your payments will end. O A. .es. You must give us proof of continuing disability no later than 90 da er the end of a period for which we may owe you benefits. Upon receipt of evidence of continuing disability, benefit payments will res ubject to the terms of this certificate. If this certificate provides benefits for up to 24 months, we will be responsible . for the 6-month period for which you give us written proof of loss. We will send you a payment for any period for which we are liable. Payment of Claim Benefits will be paid to you unless we receive your written authorization to pay them elsewhere, such as to a hospital or a doctors office. This is called assignment. If we still owe benefits at your death, benefits due will be paid in this order to your: • spouse; or • children; or • parents; or • brothers and sisters; or • estate. If benefits are payable to your estate, we can pay benefits up to $1,000 to someone related to you by blood or marriage who we feel is fairly entitled to them. If we do this, we will have no responsibility for this payment because we made it in good faith. Time of Payment of Claim After we receive written proof of loss and process your claim, we will pay any benefits due. GDIS-C-FL 10 77 Unpaid Premium When a claim is paid under the policy, any premium then due and unpaid may be deducted by us from the claim payment. Overpaid Claim We have the right to recover any overpayments due to: • fraud; and • any error made in processing a claim. You must reimburse us in full. We will work with you to develop a reasonable method of repayment if you are financially unable to repay us in a lump sum. We will not recover more money than the amount we overpaid. Questions Concerning Your Claim If you have questions concerning your claim, you can call us at our home office. We are open Monday through Friday from 8:30 a.m. until 5:00 p.m. Eastern Time. Physical Exam and Autopsy We can require that you be examined by a doctor of our choice as often as it is reasonably necessary while your claim is pending. We can also require an autopsy in the event of your death in those states where this is allowed. Either or both of these will be done at our expense. Legal Action We cannot be sued for benefits under the policy: • until 60 days after we are sent written • after the expiration of the applicable st required to be provided to us. Claim Review f of loss; or 84.f limitations following the time period in which written proof of loss is /224 If a claim is denied, we will give written notice of: • the reason for denial; • the policy provision that relates to the denial; CAN • the right to ask for a review of the claims; and • the right to submit any additional information that might allow •cpange our decision. You may, upon written request, read any reports that are not confidentt1aJ_ r a small fee, we will make copies of those reports. Appeals Procedure Prior to filing any lawsuit and within 180 days after denial of a claim, you or your estate must appeal any denial of benefits under the policy by making a written request for review of the denial. 0 Workers' Compensation Not Affected The policy does not replace or change any requirement for coverage under Workers' Compensation insurance. TO OBTAIN INFORMATION OR MAKE A COMPLAINT, YOU MAY CALL OUR TOLL FREE NUMBER: 1.800.325.4368 GDIS-C-FL 11 78 Colonial Life Group Accident (GAC4100) Our Group Accident (GAC4100) insurance is designed to help covered employees meet the out-of-pocket expenses and extra bills that can follow an accidental injury, whether minor or catastrophic. Indemnity lump sum benefits are payable directly to the employee based on the amount of coverage listed in the schedule of benefits, regardless of any other insurance the employee may have. Product Features o Situs state: In multi -state enrollments, employees will receive the same benefit options and rates. o Composite rates: All eligible employees in an account have the same rate, regardless of risk class or age. o Guaranteed issue means no medical underwriting to qualify for coverage. o Family coverage options: Employees can choose whether they want individual or family coverage. o Coverage options: employee; employee and spouse; employee and dependent child(ren); or employee, spouse and dependent children) o Benefit amounts are the same for employee, spouse and dependent children, with the exception of accidental death benefits for children. o Portability: Included; an employee can take this coverage with them if they change jobs or leave the company while the master policy is in force. o Health Savings Account (HSA) compliant o Worldwide coverage: Included; coverage is available if a covered person is injured while traveling globally. Available Plans This policy offers the following base Group Accident plan choices: o Basic o Preferred The employer can choose a maximum of two plans to offer their employees. On/Off Job accident coverage is available for the account based on employer choice. Applicable to FL 01-2024 I PS02817 This information is only intended for proposal use with employers. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 79 Colonial Life Accident Coverage Benefits Benefits are payable once per covered person for each covered accident unless otherwise noted. Injury Benefits Basic Preferred 2' Degree Burns - At least 5%, but less than 20% of skin surface $375 $500 2' Degree Burns - 20 % or greater of skin surface $750 $1,000 3rd Degree Burns - Less than 5% of skin surface $1,500 $2,000 3rd Degree Burns - At least 5%, but less than 20% of skin surface $6,000 $7,000 3rd Degree Burns - 20% or greater of skin surface $12,000 $15,000 Concussion $275 $375 Connective Tissue Damage - One connective tissue $100 $100 Connective Tissue Damage - Two or more connective tissues $200 $200 Eye Injury $200 $300 Hearing Loss Injuries Once per lifetime per ear per Insured $120 $120 Injury Due to Auto Accident $250 $250 Internal Injuries $200 $200 Knee Cartilage (Meniscus) Injury $100 $150 Lacerations - No repair $50 $50 Lacerations - Repair less than 2 inches $75 $150 Lacerations - Repair at least 2 inches, but less than 6 inches $300 $300 Lacerations - Repair 6 inches or greater $600 $600 Loss of a Digit - Partial dismemberment of one finger or toe $200 $300 Loss of a Digit - Partial dismemberment of two or more fingers or toes $400 $600 Loss of a Digit - One digit (except a thumb or big toe) $500 $750 Loss of a Digit - One digit (a thumb or big toe) $750 $1,000 Loss of a Digit - Two or more digits $1,500 $2,000 Ruptured or Herniated Disc - One disc $125 $150 Ruptured or Herniated Disc - Two or more discs $250 $300 Fracture and Dislocation Benefits Maximum of two times the combined total amount for the bone with the highest benefit amount across Fractures and Dislocation and corresponding Surgical Repair benefits. Basic Preferred Fractures - Ankle (including malleus and lowertibia or fibula) $1,020 $1,200 Fractures - Bones of the face or nose (except mandible or maxilla) $700 $910 Fractures - Coccyx, sacrum $240 $320 Fractures - Collarbone (clavicle, sternum) $810 $1,200 Fractures - Finger $200 $200 Fractures - Foot or heel (except toes) $1,020 $1,200 Fractures - Forearm (radius or ulna) $1,020 $1,200 Fractures - Hand (except fingers) $1,020 $1,200 Fractures - Hip $2,100 $3,150 Fractures - Kneecap (patella) $1,020 $1,200 Fractures - Leg (mid to upper tibia and/or fibula) $1,200 $1,800 Fractures - Lower jaw, mandible (except alveolar process) $720 $1,200 Fractures - Pelvis (includes ilium, ischium, pubic, acetabulum except coccyx) $1,650 $2,400 Fractures - Rib $225 $375 Applicable to FL This information is only intended for proposal use with employers. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 80 01-2024 I PS02817 Colonial Life.. Fractures - Shoulder blade (scapula) $810 $1,200 Fractures - Skull, depressed skull fracture (except bones of face or nose) $2,250 $3,750 Fractures - Skull, non -depressed skull fracture (except bones of face or nose) $1,200 $1,800 Fractures - Thigh (femur) $2,100 $3,150 Fractu res - Toe $200 $200 Fractures - Upper arm between elbow and shoulder (humerus) $700 $1,050 Fractures - Upper jaw, maxilla (except alveolar process) $700 $1,050 Fractures -Vertebrae, body of (except vertebral processes) $1,800 $2,700 Fractures - Vertebral processes $450 $630 Fractures - Wrist (except fingers) $1,020 $1,200 Fractu res - Chip fracture Payable as a % of the applicable Fractures benefit 25% 25% Dislocations - Ankle $960 $1,200 Dislocations - Bone or bones of the foot (except toes) $960 $1,200 Dislocations - Bone or bones of the hand (except fingers) $540 $810 Dislocations - Collarbone (acromioclavicular and separation) $140 $200 Dislocations - Collarbone (sternoclavicular) $500 $800 Dislocations - Elbow $330 $450 Dislocations - Finger $140 $200 Dislocations - Hip $2,000 $3,000 Dislocations - Knee (except patella) $1,000 $1,500 Dislocations - Lower jaw $450 $720 Dislocations - Shoulder (glenohumeral) $750 $1,200 Dislocations - Toe $140 $200 Dislocations - Wrist $390 $600 Dislocations - Incomplete dislocation Payable as a % of the applicable Dislocations benefit 25% 25% Treatment Benefits Preferred Air Ambulance $1,000 $1,500 Ambulance (Ground or Water) $200 $300 Durable Medical Equipment - Tier 1 $35 $50 Durable Medical Equipment-Tier2 $75 $100 Durable Medical Equipment-Tier3 $150 $200 Emergency Dental Repair - Dental crown, denture, or implant $150 $300 Emergency Dental Repair - Dental extraction, filling, or chip repair $50 $100 Emergency Department (Calendar Year Maximum) $150 4 $200 4 Family Care One benefit per day for all Insureds combined, regardless of the number of children, up to a maximum of three days per Covered Accident $25 $50 Injections to Prevent or Limit Infection $50 $50 Lodging 30 days per Covered Accident $150 $200 Medical Imaging $150 $200 Pain Management Injections $50 $100 Pet Boarding One benefit per day for all Insureds combined, regardless of the number of pets, up to a maximum of three days per Covered Accident $20 $20 Applicable to FL This information is only intended for proposal use with employers. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 81 01-2024 I PS02817 Colonial Life.. Prosthetic Device or Artificial Limb - One device or limb $750 $1,250 Prosthetic Device or Artificial Limb - Two or more devices or limbs $1,500 $2,500 Skin Grafts Due to Burns Payable as a % of applicable Burn benefit 50% 50% Skin Grafts Not Due to Burns - Less than 20% of skin surface $125 $250 Skin Grafts Not Due to Burns - 20% or greater of skin surface $250 $500 Transfusions $300 $400 Transportation $100 $150 Treatment in a Physician's Office or Urgent Care Facility (Calendar Year Maximum) $75 4 $100 4 X-Ray or Ultrasound $50 $60 Surgery Benefits � Preferred Anesthesia - Epidural or regional anesthesia $50 $150 Anesthesia - General anesthesia $150 $250 Connective Tissue Surgery - Exploratory without repair $100 $125 Connective Tissue Surgery - Repair for one connective tissue $500 $800 Connective Tissue Surgery - Repair for two or more connective tissues $1,000 $1,600 Eye Surgery $200 $300 Surgical Repair- Dislocations Payable as a % of the applicable Injury benefit 100% 100% Surgical Repair- Fractures Payable as a % of the applicable Injury benefit 100% 100% General Surgery -Abdominal, thoracic, or cranial $1,000 $1,500 General Surgery- Exploratory $150 $225 Hernia Surgery $250 $300 Knee Cartilage (Meniscus) Surgery - Exploratory without repair $75 $100 Knee Cartilage (Meniscus) Surgery - Knee cartilage (meniscus) with repair $400 $600 Outpatient Surgical Facility $200 $300 Ruptured or Herniated Disc Surgery - Exploratory without repair $100 $125 Ruptured or Herniated Disc Surgery - Repair for one disc $475 $750 Ruptured or Herniated Disc Surgery - Repair for two or more discs $900 $1,500 Recovery Care Benefits Basic Preferred At -Home Care Five days per Covered Accident $75 $100 Physician Follow -Up Visit (Max Per Covered Accident) (Max Per Calendar Year) $50 3 12 $50 4 16 Rehabilitation or Sub -Acute Rehabilitation Unit Confinement 15 days per Covered Accident $100 $150 Therapy Services (Speech, Physical Therapy, Occupational, Respiratory and Vestibular Therapy) 15 days per Covered Accident $35 $45 Additional Benefits Basic Preferred Benefit Booster $5,000 in Payable Claims $500 $500 Applicable to FL This information is only intended for proposal use with employers. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 82 01-2024 l PS02817 Colonial Life Optional Employer -Selected Benefits Accidental Death and Dismemberment (AD&D) Benefits IfAD&D Benefits are included, the On/Off-Job selection will be the same as the base plan. Benefits Basic Preferred _ Accidental Death - Named Insured $25,000 $50,000 Accidental Death - Spouse $25,000 $50,000 Accidental Death - Dependent Children $5,000 $10,000 Accidental Death - Common Carrier - Named Insured $100,000 $200,000 Accidental Death - Common Carrier - Spouse $100,000 $200,000 Accidental Death - Common Carrier - Dependent Children $20,000 $40,000 Accidental Dismemberment - Both feet $50,000 $75,000 Accidental Dismemberment - Both hands $50,000 $75,000 Accidental Dismemberment - One foot $7,500 $9,000 Accidental Dismemberment - One hand $7,500 $9,000 Accidental Dismemberment - Thumb and index finger of the same hand $3,750 $4,500 Coma (7 or more consecutive days) $7,500 $10,000 Home Alterations and Automobile Modifications $1,000 $1,500 Loss of Use - Hearing (one ear) $7,500 $9,000 Loss of Use - Hearing (both ears) $50,000 $75,000 Loss of Use - Sight of one eye $7,500 $9,000 Loss of Use - Sight of both eyes $50,000 $75,000 Loss of Use - Speech $50,000 $75,000 Paralysis - U n i plegia $7,500 $9,000 Paralysis - Hem i plegia $50,000 $75,000 Paralysis - Paraplegia $50,000 $75,000 Paralysis - Tri plegia $50,000 $75,000 Paralysis - Quadriplegia $50,000 $75,000 Accident Hospital Benefits If Accident Hospital Benefits are included, the On/Off-Job selection will be the same as the base plan. i Benefits Basic _ Preferred Hospital Admission $750 $1,000 Hospital Admission - ICU $1,500 $1,750 Hospital Confinement - Daily Stay 365 days per Covered Accident $200 $250 Hospital ICU Confinement - Daily Stay 15 days per Covered Accident $250 $350 Hospital Sub -Acute ICU Confinement - Daily Stay 30 days per Covered Accident $300 $400 Short Stay 8 to less than 20 hours $200 $200 Applicable to FL This information is only intended for proposal use with employers. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 83 01-2024 l PS02817 Colonial Life Gunshot Wound If Gunshot Wound is included, this benefit is payable if an employee receives a gunshot wound that is the result of a covered accident. o Available amounts: $1,000 or $5,000 o Payable once per covered accident, and no more than once in a 24-hour period. o This benefit provides on/off-job coverage, regardless of the coverage type of the rest of the plan. This benefit is only available for the employee; it is not available for a spouse or dependent children. Wellbeing Assistance Benefit o Available amount: $50 o Payable once per calendar year per covered person O 30-day waiting period Covered tests: o Blood test for triglycerides o Bone marrow testing o BRCA1 or BRCA2 testing o Breast ultrasound o CA 15-3 (blood test for breast cancer) o CA125 (blood test for ovarian cancer) o Carotid doppler o CEA(bloodtestforcolon cancer) o Chest x-ray o Colonoscopy Eligibility Requirements o Echocardiogram (ECHO) o Electrocardiogram (EKG, ECG) o Fasting blood glucose test o Flexible sigmoidoscopy o Hemoccultstool analysis o Immunizations (included with Max level) o Mammography o Pap smear o PSA (blood test for prostate cancer) o Serum cholesterol test to determine level of HDL and LDL o Serum protein electrophoresis (blood test for myeloma) o Skin cancer biopsy o Stress testona bicycle or treadmill o Thermography o ThinPreppaptest o Virtual colonoscopy o Issue ages are 17+ for both employee and spouse o Dependent children (as defined in the certificate) o Full-time, permanent employees actively working at least 15 hours per week o The employee must be actively at work at the time of enrollment. What is Not Covered Accident plans will not provide benefits for a claim that is caused by, contributed to by, or resulting from any of the following: • Elective procedures • Felonies or illegal occupations • Hazardous avocations • Impaired driving • Incarceration The definition of hospital does not include certain facilities. Applicable to FL This information is only intended for proposal use with employers. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. • Racing • Semi-professional or professional sports • Sickness • Suicide or self-inflicted injuries • War or armed conflict 84 01-2024 I PS02817 Colonial Life Additional Plan Information End of Employee Coverage Coverage under this certificate ends on the earliest of: the date the policy is cancelled by us or the Policyholder; the date the employee is no longer in an eligible group; the date the employee's eligible group is no longer covered; the date of the employee's death; or the last day of the period any required premium contributions are made. If we receive premium for coverage extending beyond the dates specified for coverage ending, such premium will be refunded, with the exclusion of any premium required to continue coverage in accordance with the Continuation of your Coverage During Extended Absences provision under Portability. Premium Premium will vary based on the coverage selected. THIS INSURANCE PROVIDES LIMITED BENEFITS. This information is not intended to be a complete description of the insurance coverage available. The insurance or its provisions may vary or be unavailable in some states. The insurance has exclusions and limitations which may affect any benefits payable. Applicable to policy forms GAC4100-P-FL and GAC4100-P- FL-SM and certificate forms GAC4100-C-FL and GAC4100-C-FL-SM. For cost and complete details of coverage, call or write your Colonial Life benefits representative or the company. Applicable to FL 01-2024 I PS02817 This information is only intended for proposal use with employers. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 85 Colonial Life & Accident Insurance Company 1200 Colonial Life Blvd., P.O. Box 1365, Columbia, SC 29202 (800) 325-4368 coloniallife.com A Stock Company Group Accident Insurance Certificate of Coverage We welcome you as a customer and are committed to providing quality service. This is your Accident Certificate of Coverage. Accident coverage can ease the potential financial impact of unforeseen accidents by providing benefits. This certificate describes your Accident benefits in detail. Policyholder: ABC Company Policy Number: 123456-000 Policy Effective Date: January 1, 2024 Policy Anniversary: January 1 Governing Jurisdiction: Florida This certificate is issued to you under the Policy which is a contract between us and the Policyholder. If the terms and provisions of this certificate are different from the Policy, the Policy will govern. A copy of the Policy may be made available to you upon request. The Policy is delivered in and is governed by the laws of the governing jurisdiction and to the extent applicable, the Employee Retirement Income Security Act of 1974 (ERISA) and any amendments. All references to provisions, sections, and defined terms found within this certificate have been capitalized. If you have any questions about the terms and provisions of this certificate, please contact the Policyholder or us at (800) 325-4368 Monday through Friday 8 a.m. to 8 p.m. Eastern Standard Time. This Certificate of Coverage provides limited benefits under the non -participating Policy. The limited benefits provided under this Certificate of Coverage are a supplement to major medical coverage and are not a substitute for major medical coverage or other minimal essential coverage as required by federal law. This certificate contains certain proof of loss requirements, limitations, exclusions, and other provisions that may reduce benefits or prevent an Insured from receiving benefits under this certificate. Please read your certificate carefully and keep it in a safe place. Premiums are subject to periodic changes. This certificate replaces any and all certificates previously issued for the eligible classes under the Policy. Your certificate may include notices as required by your state of residence that may impact your benefits. If you have any questions or concerns regarding your state regulations, you may contact the Florida Office of Insurance Regulation at (850) 413-5914. Right to Return this Certificate If, for any reason, you are not satisfied with this certificate, you can return it to us within 30 days after you receive it. At that time, you should ask us in Writing to cancel it. We will consider this certificate as if it never existed and any premium paid will be refunded. You may contact us at (800) 325-4368 for assistance with any questions or complaints. Signed for Colonial Life & Accident Insurance Company: !:, /.0,/ President and Chief Executive Officer Secretary GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 86 1 TABLE OF CONTENTS ACCIDENT HIGHLIGHTS 3 ACCIDENT DETAILS 8 INJURY BENEFITS 8 <6t FRACTURES AND DISLOCATIONS 12 TREATMENT BENEFITS SURGERY BENEFITS 19 HOSPITAL BENEFITS 22 VC)1 RECOVERY CARE BENEFITS 24 ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS 27 ADDITIONAL BENEFITS 29 EXCLUSIONS AND LIMITATIONS 33 OTHER FEATURES 35 START OF COVERAGE 37 CONTINUATION AND END OF COVERAGE 37 CLAIM PROVISIONS 39 6</ GENERAL PROVISIONS 41 GLOSSARY 43 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 87 ACCIDENT HIGHLIGHTS Accident Insurance provides financial protection for an Insured by paying benefits if an Insured is involved in a Covered Accident that results in a Covered Loss payable under this certificate. This section includes highlights of an Insured's coverage. Please refer to the Accident Details for further information on the benefits available. Eligible Group(s) Group 1 All full-time Employees in Active Employment in the United States working a required minimum of 15 hours per week. Schedule of Benefits Policyholder: ABC Company Policy Number: 123456-000 Named Insured: John A. Doe Certificate Number: 123456-000 Coverage Type: Two Parent Family Governing Jurisdiction: Florida Coverage Effective Date: January 1, 2024 Billing Control Number: E123456 Accident Type: On & Off Job The benefits an Insured may receive for a Payable Claim are listed in the Schedule of Benefits, subject to all other terms and provisions of this certificate. Amounts are the same for all Insureds, unless noted otherwise. Multiple benefits may be payable for a single Covered Accident. Group 1 Benefit Categories Benefit Amount Injury Benefits /. 1110 Burns r 2nd Degree Bums At least 5%, but less than 20% of skin surface $375 20% or greater of skin surface $750 3rd Degree Burns Less than 5% of skin surface $1,500 At least 5%, but less than 20% of skin surface $6,000 20% or greater of skin surface $12,000 Concussion $275 Connective Tissue Damage One Connective Tissue $100 Two or more Connective Tissues $200 Eye Injury $200 Hearing Loss Injuries $120 Injury due to Auto Accident $250 Injury due to Felonious Act of Violence or Sexual Assault $250 Internal Injuries $200 Knee Cartilage (Meniscus) Injury $100 Lacerations No Repair $50 Repair Less than 2 inches $75 At least 2 inches but less than 6 inches $300 6 inches or greater $600 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 88 3 Loss of a Digit — Partial Partial Dismemberment of one finger or toe $200 Partial Dismemberment of two or more fingers or toes $400 Loss of a Digit One Digit (except a Thumb or Big Toe) $500 One Digit (a Thumb or Big Toe) $750 Two or more Digits $1,500 Ruptured or Herniated Disc One Disc $125 Two or more Discs $250 Fractures and Dislocations Fractures Ankle (including malleus and lower tibia or fibula) $1,020 Bones of the Face or Nose (except mandible or maxilla) $700 Coccyx, Sacrum $240 Collarbone (clavicle, stemum) $810 Finger $200 Foot or Heel (except toes) $1,020 Forearm (radius or ulna) $1,020 Hand (except fingers) $1,020 Hip $2,100 Kneecap (patella) $1,020 Leg (mid to upper tibia and/or fibula) $1,200 Lower Jaw, mandible (except alveolar process) $720 Pelvis (includes ilium, ischium, pubis, acetabulum except coccyx) $1,650 Rib $225 Shoulder Blade (scapula) $810 Skull, Depressed Skull fracture (except bones of face or nose) $2,250 Skull, Non -depressed Skull fracture (except bones of face or nose) $1,200 Thigh (femur) $2,100 Toe $200 Upper Arm between Elbow and Shoulder (humerus) $700 Upper Jaw, maxilla (except alveolar process) $700 Vertebrae, body of (except vertebral processes) $1,800 Vertebral Processes $450 Wrist (except fingers) $1,020 Chip Fracture Payable as a % of the applicable Fractures benefit 25% Dislocations Ankle $960 Bone or Bones of the Foot (except toes) $960 Bone or Bones of the Hand (except fingers) $540 Collarbone (acromioclavicular and separation) $140 Collarbone (stemoclavicular) $500 Elbow $330 Finger $140 Hip $2,000 Knee (except patella) $1,000 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 89 4 Lower Jaw $450 Shoulder (glenohumeral) $750 Toe $140 Wrist $390 Incomplete Dislocation Payable as a % of the applicable Dislocations benefit 25% Treatment Benefits Air Ambulance $1,000 Ambulance (Ground or Water) $200 Durable Medical Equipment Tier 1 $35 Tier 2 $75 Tier 3 $150 Emergency Dental Repair Dental Crown, Denture or Implant $150 Dental Extraction, Filling or Chip Repair $50 Emergency Department $150 Family Care $25 Injections to Prevent or Limit Infection $50 Lodging $150 Medical Imaging $150 Pain Management Injections $50 Pet Boarding $20 Prosthetic Device or Artificial Limb One Device or Limb $750 Two or more Devices or Limbs $1,500 Skin Grafts / Due to Burns Payable as a % of t applicable Burn benefit 50% Not due to Burns Less than 20% of skin surface $125 20% or greater of skin surface $250 Transfusions $300 Transportation $100 Treatment in a Physician's Office or Urgent Care Facility $75 X-ray or Ultrasound $50 Surgery Benefits l( coExploratory Anesthesia Epidural or Regional Anesthesia $50 General Anesthesia $150 Connective Tissue Surgery without Repair $100 Repair for One Connective Tissue $500 Repair for Two or more Connective Tissues $1,000 Dislocations — Surgical Repair Payable as a % of the applicable Injury Benefit 100% Eye Surgery $200 Fractures — Surgical Repair Payable as a % of the applicable Injury Benefit 100% General Surgery Abdominal, Thoracic, or Cranial $1,000 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 90 5 Exploratory $150 Hernia Surgery $250 Knee Cartilage (Meniscus) Surgery Exploratory without Repair $75 Knee Cartilage (Meniscus) with Repair $400 Outpatient Surgical Facility $200 Ruptured or Herniated Disc Surgery Exploratory without Repair $100 Repair for One Disc $475 Repair for Two or more Discs $900 Hospital Benefits Admission $750 Admission — Hospital ICU $1,500 Hospital Confinement - Daily Stay $200 Hospital ICU Confinement - Daily Stay , $300 Hospital Sub -Acute ICU Confinement - Daily Stay $250 Short Stay $200 Recovery Care Benefits At -Home Care $75 Behavioral Health Therapy $35 Physician Follow -Up Visits ♦ $50 Post -Traumatic Stress Disorder (PTSD) $200 Prescription Drug $25 Rehabilitation or Sub -Acute Rehabilitation Unit Confinement $100 Therapy Services $35 Accidental Death and Dismemberment Benefits JOHome Accidental Death Named Insured $25,000 Spouse\u, $25,000 Children $5,000 Accidental Death — Common Carrier Named Insured 0 $100,000 Spouse $100,000 Children $20,000 Accidental Dismemberment Both Feet $50,000 Both Hands $50,000 One Foot $7,500 One Hand $7,500 Thumb and Index Finger of the same Hand $3,750 Coma $7,500 Alterations and Automobile Modifications $1,000 Loss of Use Hearing (one ear) $7,500 Hearing (both ears) $50,000 Sight of one Eye $7,500 Sight of both Eyes $50,000 Speech $50,000 Paralysis Uniplegia $7,500 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 91 6 Hemiplegia $50,000 Paraplegia $50,000 Triplegia $50,000 Quadriplegia $50,000 Additional Benefits Active Lifestyles Payable as an additional % of the applicable benefits 20% Benefit Booster $5,000 in Payable Claims $500 Building Benefit Payable as an additional % of the applicable benefits v N 13 months through 36 months 5% 37 months through 60 monthsV%-10% 61 months 15% Gunshot Wound $5,000 Healthcare Employee Benefit Payable as an additional % of the applicable benefits 50% Sickness Hospital Benefits Admission for Covered Sicknesses $400 Admission - Hospital ICU for Covered Sicknesses $800 Hospital Confinement — Daily Stay for Covered Sicknesses ‘ $100 Short Stay for Covered Sicknesses $100 Wellbeing Assistance Benefit $50 GAC4100-C-FL Group Accident Certificate 7 Colonial Life & Accident Insurance Company 92 ACCIDENT DETAILS The information in this section provides details about the benefits that may be payable to you, any applicable Exclusions and Limitations, and Other Features included in your coverage. Benefits will only be payable for Covered Accidents that occur on or after the Insured's Coverage Effective Date. Benefits will not be paid for any Injury, treatment or care due to causes other than Covered Accidents. Benefits paid under this certificate may be taxable if the total benefits received are greater than unreimbursed out-of-pocket medical expenses. As with all tax matters, a tax advisor should be consulted to assess the impact of any benefits received. r Accident Type This certificate provides coverage for accidents that happen at any time, including while an Insured is working. INJURY BENEFITS Burns Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a 2nd or 3rd degree Burn in a Covered Accident and expenses are incurred. )‘ Burns are damage to the skin or deeper tissues caused by sun, hot liquids, fire, electricity, or chemicals. Burns are characterized by severe skin damage that causes the affected skin cells to die. A Physician must diagnose the Burn within 90 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains more than one type of Burn in a single Covered Accident, we will pay for the Burn with the highest benefit amount. Concussion Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Concussion in a Covered Accident and expenses are incurred. A Concussion is a mild traumatic brain injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance, and coordination. A Physician must diagnose the Concussion within 14 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Connective Tissue Damage Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains one or more torn, ruptured, or severed Connective Tissues in a Covered Accident and expenses are incurred. A Physician must diagnose the Connective Tissue Damage within 90 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 93 8 For purposes of this benefit, the following are considered Connective Tissues: - tendons; - ligaments; - rotator cuffs; and - muscles. For purposes of this benefit, the following do not meet the Benefit Description of Connective Tissue Damage: - sprains; and - pulled muscles. Benefit Duration This benefit is payable once per Insured per Covered Accident. Eye Injury Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Eye Injury in a Covered Accident and expenses are incurred. The Eye Injury must require the removal of a foreign object with or without anesthesia. A Physician must remove the object within 90 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Hearing Loss Injuries Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an ear injury resulting in at least 50% hearing loss as the result of a Covered Accident and expenses are incurred. Treatment must be received by a Physician within 90 days of the Covered Accident. For purposes of this benefit, hearing loss means 50% deafness in one or both ears, such that it cannot be corrected to any functional degree by any procedure, aid or device. This benefit is not payable for hearing loss injuries due to a Sickness. Benefit Duration This benefit is payable once per lifetime per ear for each Insured injured in a Covered Accident. Injury due to Auto Accident Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Injury or dies due to a Covered Accident while traveling in an Automobile and was transported by a licensed professional Air Ambulance or Ambulance (Ground or Water) company to a Hospital or medical facility and expenses are incurred. Treatment must: - be due to Injuries received as the result of a covered Automobile accident; - be provided by a Physician in a Hospital Emergency Department; and - occur within three days after the Covered Accident. Benefit Duration GAC4100-C-FL Group Accident Certificate 9 Colonial Life & Accident Insurance Company 94 This benefit is payable once per Insured per Covered Accident. Injury due to Felonious Act of Violence or Sexual Assault Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a qualifying treatment due to an Injury sustained as a victim of a Felonious Act of Violence or Sexual Assault in a Covered Accident and expenses are incurred. Any Payable Claim under this benefit must include a police report. AV Treatment must: - be due to injuries received as the result of a Felonious Act of Violence or Sexual Assault; - be payable under this certificate's Emergency Department or Treatment in a Physician's Office or Urgent Care Facility provisions; - occur within three days after the assault. Benefit Duration This benefit is payable a maximum of once per Insured per Calendar Year Internal Injuries Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Internal Injury in a Covered Accident and expenses are incurred. A Physician must diagnose the Internal Injury within 90 days of the Covered Accident. For purposes of this benefit, Internal Injuries include but are not limited to: - a collapsed or punctured lung; - a ruptured or torn spleen, kidney, or liver; or - a ruptured eardrum. For purposes of this benefit, the following do not meet the Benefit Description of Internal Injuries: - bruised organs or muscles; - internal bleeding; - swollen glands or organs; injuries to teeth, bones, joints or other connective tissues; and - injuries for which another Injury Benefit is payable. Benefit Duration This benefit is payable once per Insured per Covered Accident. Knee Cartilage (Meniscus) Injury Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a partially torn or fully torn Knee Cartilage in a Covered Accident and expenses are incurred. Knee Cartilage is the area of tissue which acts like a shock absorber in the joint called the meniscus. The meniscus may be partially torn or fully torn by a forceful knee movement while weight bearing on the same leg. A Physician must confirm the Knee Cartilage (Meniscus) Injury within 90 days of the Covered Accident by an MRI, other medical imaging study, or Surgical Procedure. Benefit Duration GAC4100-C-FL Group Accident Certificate 10 Colonial Life & Accident Insurance Company 95 This benefit is payable once per Insured per Covered Accident. Lacerations Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Laceration in a Covered Accident and expenses are incurred. A Laceration is an open wound or cut on the outside of the body. A Physician must treat the Laceration within three days of the Covered Accident. For purposes of this benefit, the following are considered repair techniques used by a Physician: - stitches; - staples; and - tissue adhesive. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains multiple Lacerations in a Covered Accident, the amount payable will be based on the total length of all Lacerations sustained requiring repair. Loss of a Digit — Partial Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains permanent, partial loss of one or more fingers, thumbs, or toes in a Covered Accident and expenses are incurred. A Physician must treat the Loss of a Digit — Partial within 90 days of the Covered Accident. For purposes of this benefit, the following losses meet the Benefit Description of Loss of a Digit — Partial: - Partial loss of a finger means the finger is cut off at the joint other than the first interphalangeal joint where it is attached to the hand; - Partial loss of a toe means the toe is cut off at the joint other than the first interphalangeal joint where it is attached to the foot. Benefit Duration This benefit is payable once per Insured per Covered Accident. Loss of a Digit Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains permanent and total loss of one or more fingers, thumbs, or toes in a Covered Accident and expenses are incurred. A Physician must treat the Loss of a Digit within 90 days of the Covered Accident. For purposes of this benefit, the following losses meet the Benefit Description of Loss of a Digit: - for fingers and thumbs, the digit must be cut off at the joint proximate to the first interphalangeal joint where it is attached to the hand.; and - for toes, the digit must be cut off at the joint where it is attached to the foot. Benefit Duration This benefit is payable once per Insured per Covered Accident. GAC4100-C-FL Group Accident Certificate 11 Colonial Life & Accident Insurance Company 96 Ruptured or Herniated Disc Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Ruptured or Herniated Disc in a Covered Accident and expenses are incurred. A Ruptured or Herniated Disc, also known as a slipped disc, occurs when one of the intervertebral discs in the spine develops a crack in its outer wall, allowing the inner core to leak out into the spinal canal, causing pain or numbness. A Physician must diagnose the Ruptured or Herniated Disc within 90 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. FRACTURES AND DISLOCATIONS r+ Fractures , Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a fracture as the result of a Covered Accident and expenses are incurred. If an Insured has a Chip Fracture, we will pay the percentage amount shown in the Schedule of Benefits for the bone involved. A Fracture is a break of a bone. A Chip Fracture is a Fracture in which a piece of the bone is broken off near a joint at a place where a ligament is usually attached. A Physician must confirm the bone fracture within 90 days of the Covered Accident. For purposes of this benefit, a bone injury diagnosed as a stress fracture does not meet the definition of Fractures. If the fracture requires a Surgical Procedure, an Insured may also be eligible for the Fractures — Surgical Repair benefit. Benefit Duration This benefit is payable once per Insured per bone per Covered Accident. If an Insured sustains multiple Fractures of the same bone in a Covered Accident, we will only pay one Fractures benefit for that bone. If an Insured sustains Fractures of multiple bones in a Covered Accident, we will pay for each bone, but will pay no more than two times the combined total amount of the Fractures benefit and the Fractures — Surgical Repair benefits for the bone involved with the highest benefit amount. If an Insured sustains a Dislocation and a Fracture in the same Covered Accident, we will pay for both. However, we will pay no more than two times the combined total amount of the Dislocations benefit and the Fractures benefit and the corresponding Surgical Repair benefit for the bone or joint involved which has the highest benefit amount. Dislocations Benefit Description GAC4100-C-FL Group Accident Certificate 12 Colonial Life & Accident Insurance Company 97 We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a dislocated joint in a Covered Accident and expenses are incurred. The Dislocation must require correction with anesthesia by a Physician. If the Dislocation requires reduction without anesthesia by a Physician, we will pay the percentage amount shown in the Schedule of Benefits for a dislocation of the joint involved. If an Insured has an Incomplete Dislocation, we will pay the percentage amount shown in the Schedule of Benefits for the joint involved. A Dislocation is an Injury to a joint where the ends of the bones are forced from their normal positions. An Incomplete Dislocation is a Dislocation in which the joint is not completely separated. A Physician must set the dislocated joint within 90 days of the Covered Accident. If the Dislocation requires a Surgical Procedure, an Insured may also be eligible for the Dislocations - Surgical Repair benefit. Benefit Duration If an Insured sustains multiple dislocated joints in a Covered Accident, we will pay for each joint, but will pay no more than two times the combined total amount of the Dislocations benefit and the Dislocations — Surgical Repair benefit for the joint involved with the highest benefit amount. If an Insured sustains a Dislocation and a Fracture in the same Covered Accident, we will pay for both. However, we will pay no more than two times the combined total amount of the Dislocations benefit and the Fractures benefit and the corresponding Surgical Repair benefit for the bone or joint involved which has the highest benefit amount. We will pay this benefit only for the first Dislocation of a joint after the Coverage Effective Date shown in the Schedule of Benefits. Subsequent Dislocations of the same joint after the Coverage Effective Date shown in the Schedule of Benefits will not be covered under this benefit. TREATMENT BENEFITS Air Ambulance 10‘\ Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if a licensed professional air ambulance company transports an Insured by air to or from a Hospital or between medical facilities where treatment is received due to Injuries sustained in a Covered Accident and expenses are incurred. If an Insured is treated by Air Ambulance staff, but is not transported for a Covered Accident, we will pay the corresponding amount shown for Ambulance (Ground or Water). The Air Ambulance transportation must be within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Ambulance (Ground or Water) Benefit Description GAC4100-C-FL Group Accident Certificate 13 Colonial Life & Accident Insurance Company 98 We will pay the corresponding amount shown in the Schedule of Benefits if a licensed professional ambulance company transports an Insured by ground or water to or from a Hospital or between medical facilities where treatment is received due to Injuries sustained in a Covered Accident and expenses are incurred. If an Insured is treated by Ambulance staff, but is not transported for a Covered Accident, we will pay the corresponding amount shown for Ambulance (Ground or Water). The Ambulance (Ground or Water) transportation must be within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident for Ambulance (Ground or Water) transportation. Durable Medical Equipment Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is prescribed Durable Medical Equipment by a Physician or Therapist as an aid in treatment, recovery, or mobility due to Injuries sustained in a Covered Accident and expenses are incurred. The Durable Medical Equipment must be prescribed to the Insured within 90 days of the Covered Accident. Durable Medical Equipment Tier 1 - Arm Sling - Cane - Medical Ring Cushion - Neck Brace - Wrist or Ankle Splint <(t Tier 2 - Bedside Commode - Cold Therapy System (Cryothpy) - Crutches - Leg Brace - Shower Chair - Walker or Walking Boot that extends above the ankle Tier 3 - Back Brace - Body Jacket - Continuous Passive Movement (CPM) - Electric Scooter - Halo - Hospital Bed - Knee Scooter - Stair Lift Chair - Wheelchair We will use the current relative value to determine the appropriate Tier amount for any medical equipment not listed above. For purposes of this benefit, the Durable Medical Equipment must: - be designed for and able to withstand repeated use by more than one person; GAC4100-C-FL Group Accident Certificate 14 Colonial Life & Accident Insurance Company 99 - customarily serve a medical purpose; and - be generally not useful in the absence of an Injury. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured is prescribed multiple pieces of Durable Medical Equipment as a result of a single Covered Accident, we will pay the amount for the highest Tier. Emergency Dental Repair Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured has an Emergency Dental Repair for a partially broken or broken tooth sustained in a Covered Accident and expenses are incurred. The partially broken or broken tooth must require repair by a Dental Crown, Denture or Implantor Dental Extraction, Filling or Chip Repair. The Emergency Dental Repair must be within 180 days of the Covered Accident. Benefit Duration Each Emergency Dental Repair benefit shown on the Schedule of Benefits is payable once per Insured per Covered Accident regardless of the number of teeth involved. Emergency Department Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured requires examination or treatment by a Physician in the Emergency Department due to Injuries sustained in a Covered Accident and expenses are incurred. Emergency Department treatment must be within three days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident, up to a maximum of four times per Insured per Calendar Year. Family Care Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for Family Care that takes place when an Insured has a Child attending a Child Care Center during an Insured's period of Confinement or when an Insured undergoes a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. Benefit Duration This benefit is payable a maximum of one benefit per day for all Insureds combined, up to a maximum of three days per Covered Accident, regardless of the number of Children. Injections to Prevent or Limit Infection Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives an injection after exposure to bacteria, viruses, or venom in a Covered Accident and expenses are incurred. A Physician must administer the injection within 180 days of the Covered Accident. For purposes of this benefit, Injections to Prevent or Limit Infection include, but are not limited to: GAC4100-C-FL Group Accident Certificate 15 Colonial Life & Accident Insurance Company 100 - tetanus boosters; - rabies shots; - antivenom; and - immune globulin. For the purposes of this benefit, the following do not meet the Benefit Description of Injections to Prevent or Limit Infection: - immunizations; - tetanus boosters as part of routine medical care; and - EpiPen injections intended to limit an allergic reaction. Benefit Duration This benefit is payable once per Insured per Covered Accident. Lodging Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day of a hotel stay for a companion accompanying an Insured to a Surgical Procedure or during a period of Confinement due to Injuries sustained in a Covered Accident and expenses are incurred. The Lodging must be within 180 days of the Covered Accident. The Surgical Procedure or Confinement must be at a Hospital or other medical facility more than 50 miles from the companion's residence. Benefit Duration This benefit is payable up to a maximum of 30 days per Covered Accident. Medical Imaging Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Medical Imaging Test ordered by a Physician due to Injuries sustained in a Covered Accident and expenses are incurred. The Medical Imaging must be within 180 days of the Covered Accident. Medical Imaging Tests\ - Bone Scan; - Computed Axial Tomography (CAT); - Computed Tomography Scan (CT); Electroencephalogram (EEG); - Magnetic Resonance (MR); - Magnetic Resonance Angiogram (MRA); and Magnetic Resonance Imaging (MRI). Benefit Duration This benefit is payable once per Insured per Medical Imaging Test per Covered Accident, regardless of the number of Medical Imaging Test ordered. Pain Management Injections Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives an injection for the purposes of blocking pain in a particular region of the body due to Injuries sustained in a Covered Accident and expenses are incurred. GAC4100-C-FL Group Accident Certificate 16 Colonial Life & Accident Insurance Company 101 A Physician must administer the injection within 180 days of the Covered Accident. For purposes of this benefit, the following are considered Pain Management Injections: - cortisone shots; - steroid shots; and - epidural steroids. For the purposes of this benefit, the following do not meet the Benefit Description of Pain Management Injections: - oral prescriptions for pain relief; - over the counter pain medications;‘\t - topical pain management; - general, regional, or local anesthesia; and sop - pain management injections for chronic pain or causes other than a Covered Accident. nefit Duration Be This benefit is payable once per Insured per Covered Accident. Pet Boarding Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for Pet Boarding that takes place during an Insured's period of Confinement or when an Insured undergoes a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. The Pet or Pets must be boarded overnight at a Pet Boarding Facility. Benefit Duration This benefit is payable a maximum of one benefit per day for all Insureds combined, up to a maximum of three days per Covered Accident, regardless of the number of Pets that are boarded. Prosthetic Device or Artificial Limb Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a Prosthetic Device or Artificial Limb for a permanently missing hand, arm, foot, leg, or eye due to Injuries sustained in a Covered Accident and expenses are incurred. The Prosthetic Device or Artificial Limb can be a newly required device or a replacement of an existing device, which was irreparably damaged in the Covered Accident. The Prosthetic Device or Artificial Limb must be received within 365 days of the Covered Accident. For purposes of this benefit, the following do not meet the Benefit Description of Prosthetic Device or Artificial Limb: - hearing aids; - dental aids (including false teeth); - eyeglasses; - cosmetic prostheses such as wigs; and - artificial hips, knees, or other joint replacements. Benefit Duration This benefit is payable once per Insured per Covered Accident. Skin Grafts Benefit Description GAC4100-C-FL Group Accident Certificate 17 Colonial Life & Accident Insurance Company 102 We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a Skin Graft due to Injuries sustained in a Covered Accident and expenses are incurred. A Skin Graft is the transplantation of a piece of skin to replace a lost portion of skin due to burns or other accidental traumatic loss of skin. The Insured must receive the Skin Graft within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per type of Skin Graft per Covered Accident. ."(/ Transfusions Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a Transfusion due to Injuries sustained in a Covered Accident and expenses are incurred. A Transfusion is the receipt of blood, plasma, or platelets intravenously. The Transfusion must be within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Transportation Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for any mode of Transportation, including a personal car, for an Insured if the Insured requires diagnosis, treatment, or a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. The Transportation must be within 180 days of the Covered Accident. The diagnosis, treatment, or Surgical Procedure must be at a Hospital or other medical facility more than 50 miles from the Insured's residence. For purposes of this benefit, any mode of Air Ambulance or Ambulance (Ground or Water) transportation does not meet the Benefit Description of Transportation. Benefit Duration This benefit is payable up to a maximum of six one-way trips per Insured per Covered Accident. A trip must either start or end at the Insured's residence. Treatment in a Physician's Office or Urgent Care Facility Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives initial examination or treatment by a Physician due to Injuries sustained in a Covered Accident and expenses are incurred. The Treatment in a Physician's Office or Urgent Care Facility must be within 14 days of the Covered Accident. For purposes of this benefit a routine physical or annual wellness exam and treatment that meets the Benefit Description of Therapy Services do not meet the Benefit Description of Treatment in a Physician's Office or Urgent Care Facility. Benefit Duration GAC4100-C-FL Group Accident Certificate 18 Colonial Life & Accident Insurance Company 103 This benefit is payable once per Insured per Covered Accident, up to a maximum of four times per Insured per Calendar Year. X-ray or Ultrasound Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes an X-ray or Ultrasound test ordered by a Physician due to Injuries sustained in a Covered Accident and expenses are incurred. The X-ray or Ultrasound must be within 180 days of the Covered Accident. For purposes of this benefit, X-rays are considered a single test, regardless of the number of images produced. Benefit Duration This benefit is payable once per Insured per Covered Accident. SURGERY BENEFITS Anesthesia Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if general, epidural, or regional Anesthesia is administered to an Insured during a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. General Anesthesia is the induction of a balanced state of unconsciousness, accompanied by the absence of pain sensation and the paralysis of skeletal muscle over the entire body. Epidural Anesthesia is an injection of anesthetic into the space between the spinal column and outer membrane of the spinal cord. Regional Anesthesia is the use of anesthetics to block sensations of pain from a large area of the body such as an arm, leg, or the abdomen. A Physician must administer the Anesthesia within 365 days of the Covered Accident. For purposes of this benefit, the following do not meet the Benefit Description of Anesthesia: - epidural anesthesia administered for Childbirth; - peripheral nerve blocks; and - local anesthesia used to temporarily numb a small area of the body. Benefit Duration This benefit is payable once per Insured per Covered Accident. Connective Tissue Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to treat one or more torn, ruptured, or severed Connective Tissues sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For purposes of this benefit, the following are considered Connective Tissues: - tendons; GAC4100-C-FL Group Accident Certificate 19 Colonial Life & Accident Insurance Company 104 - ligaments; - rotator cuffs; and - muscles. For the Connective Tissue Surgery benefit to be paid, a Connective Tissue Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Dislocations — Surgical Repair Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to repair a dislocated joint sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Dislocations — Surgical Repair benefit to be paid, a Dislocations Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per joint per Covered Accident. If an Insured sustains multiple dislocated joints in a Covered Accident and they are repaired with a Surgical Procedure, we will pay the Dislocations — Surgical Repair benefit for each joint but will pay no more than two times the amount for the joint involved with the highest benefit amount. Eye Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure with anesthesia due to an Eye Injury sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Fractures — Surgical Repair Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for a Surgical Procedure to repair a fractured bone sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Fractures — Surgical Repair benefit to be paid, a Fractures Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per bone per Covered Accident. If an Insured sustains multiple Fractures of the same bone in a Covered Accident and they are repaired with a Surgical Procedure, we will only pay one Fractures — Surgical Repair benefit for that bone. GAC4100-C-FL Group Accident Certificate 20 Colonial Life & Accident Insurance Company 105 If an Insured sustains Fractures of multiple bones in a Covered Accident and they are repaired with a Surgical Procedure, we will pay the Fractures — Surgical Repair benefit for each bone but will pay no more than two times the amount for the bone involved with the highest benefit amount. General Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. If an exploratory abdominal, thoracic, or cranial Surgical Procedure is performed, we will pay the corresponding amount for General Surgery — Exploratory. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For purposes of this benefit, the following are considered a General Surgery: - abdominal surgery; - thoracic surgery; - cranial surgery; and - exploratory. Benefits for General Surgery will not be paid for a Covered Accident for which any other Surgery Benefits are paid. Benefit Duration This benefit is payable once per Insured per Covered Accident. Hernia Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to repair a Hernia sustained in a Covered Accident and expenses are incurred. A hernia occurs when an organ is displaced and protrudes through the wall of the cavity containing it. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Knee Cartilage (Meniscus) Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to treat a Knee Cartilage (Meniscus) Injury sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Knee Cartilage (Meniscus) Surgery benefit to be paid, a Knee Cartilage (Meniscus) Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Outpatient Surgical Facility GAC4100-C-FL Group Accident Certificate 21 Colonial Life & Accident Insurance Company 106 Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure on an Outpatient Basis in a Hospital, Ambulatory Surgical Center, or other medical facility due to Injuries sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For purposes of this benefit, the following do not meet the Benefit Description of Outpatient Surgical Facility: - Surgical Procedures performed in the Emergency Department; and - Surgical Procedures performed while Confined in a Hospital or other medical facility. Benefit Duration This benefit is payable once per Insured per Covered Accident. Ruptured or Herniated Disc Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to treat a Ruptured or Herniated Disc sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Ruptured or Herniated Disc Surgery benefit to be paid, a Ruptured or Herniated Disc Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. HOSPITAL BENEFITS Admission Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital due to Injuries sustained in a Covered Accident and expenses are incurred. fl4f The Admission and Confinement must be within 180 days of the Covered Accident. We will not pay the Admission benefit and the Admission - Hospital ICU benefit for the same Covered Accident concurrently. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. Benefit Duration This benefit is payable up to a maximum of one days per Insured per Covered Accident. Admission — Hospital ICU Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital ICU due to Injuries sustained in a Covered Accident and expenses are incurred. The Admission - Hospital ICU and Confinement must be within 180 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate 22 Colonial Life & Accident Insurance Company 107 We will not pay the Admission - Hospital ICU benefit and the Admission benefit for the same Covered Accident concurrently. Benefit Duration This benefit is payable up to a maximum of one days per Insured per Covered Accident. Hospital Confinement - Daily Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital due to Injuries sustained in a Covered Accident and expenses are incurred. The Confinement must begin within 180 days of the Covered Accident. We will not pay the Hospital Confinement — Daily Stay benefit and the Hospital ICU Confinement — Daily Stay benefit and the Hospital Sub -Acute ICU Confinement - Daily Stay benefit for the same Covered Accident concurrently. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. Benefit Duration This benefit is payable up to a maximum of 365 days per Insured per Covered Accident. Hospital ICU Confinement - Daily Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital ICU due to Injuries sustained in a Covered Accident and expenses are incurred. The Confinement must begin within 180 days of the Covered Accident. If the Hospital ICU Confinement extends beyond the maximum benefit shown in the Schedule of Benefits under the Hospital ICU Confinement - Daily Stay benefit, we will pay benefits under the Hospital Sub -Acute ICU Confinement - Daily Stay benefit: - until the Insured is released from Confinement for the Covered Accident; or - the maximum benefits payable under the Hospital Sub -Acute ICU Confinement - Daily Stay benefit have been reached. We will not pay the Hospital Confinement — Daily Stay benefit, the Hospital Sub -Acute ICU Confinement - Daily Stay benefit, and the Hospital ICU Confinement — Daily Stay benefit concurrently. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. Hospital Sub -Acute ICU Confinement — Daily Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital Sub -Acute ICU due to Injuries sustained in a Covered Accident and expenses are incurred. The Confinement must begin within 180 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate 23 Colonial Life & Accident Insurance Company 108 If the Hospital Sub -Acute ICU Confinement extends beyond the maximum benefit shown in the Schedule of Benefits under the Hospital Sub -Acute ICU Confinement - Daily Stay benefit, we will pay benefits under the Hospital Confinement - Daily Stay benefit: - until the Insured is released from Confinement for the Covered Accident; or - the maximum benefits payable under the Hospital Confinement - Daily Stay benefit have been reached. We will not pay the Hospital Confinement — Daily Stay benefit, the Hospital Sub -Acute ICU Confinement — Daily Stay benefit and the Hospital ICU Confinement — Daily Stay benefit concurrently. Benefit Duration This benefit is payable up to a maximum of 30 days per Insured per Covered Accident. Short Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is treated on an Outpatient Basis due to a Covered Accident for minimum of eight consecutive hours in any of the following facilities and expenses are incurred: - Ambulatory Surgical Center; - Emergency Department; - Hospital; or - Observation Unit. The Short Stay must be within 180 days of the Covered Accident. Benefits for Short Stay will not be paid for any day that benefits are paid for Admission, Admission — Hospital ICU, Hospital Confinement - Daily Stay, Hospital ICU Confinement — Daily Stay, and Hospital Sub -Acute ICU Confinement — Daily Stay. Benefit Duration This benefit is payable up to a maximum of one day per Insured per Covered Accident. RECOVERY CARE BENEFITS At -Home Care Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured receives At - Home Care from a Nurse at the direction of a Physician and expenses are incurred. At -Home Care must be prescribed to begin within 14 days of release from the Hospital after a Surgical Procedure or period of Confinement due to Injuries sustained in a Covered Accident. For purposes of this benefit, the following services do not meet the Benefit Description of At -Home Care: - hospice care; and - any care provided by you, a Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you. Benefits for At -Home Care will not be paid for any day that benefits are paid for Hospital Admission, or Hospital ICU Admission, or Hospital Confinement — Daily Stay, or Hospital ICU Confinement — Daily Stay, or Hospital Sub -Acute ICU Confinement — Daily Stay, or Rehabilitation or Sub -Acute Rehabilitation Unit Confinement. Benefit Duration This benefit is payable up to a maximum of five days per Insured per Covered Accident. Behavioral Health Therapy GAC4100-C-FL Group Accident Certificate 24 Colonial Life & Accident Insurance Company 109 Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured receives Behavioral Health Therapy due to Injuries sustained in a Covered Accident and expenses are incurred. A licensed Mental Health Professional must provide the Behavioral Health Therapy to the Insured. The therapy must begin within 90 days after the Covered Accident and must be received within 365 days of the Covered Accident. We will pay either the Accident follow-up Physician Visit benefit or the Behavioral Health Therapy benefit for the same Covered Accident if the treatment occurs on the same date by the same Physician. When both treatments occur on the same date by the same Physician, we will pay the benefit with the highest benefit amount. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. Physician Follow -Up Visits Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives any of the following and expenses are incurred: - initial examination or treatment by a Physician due to Injuries sustained in a Covered Accident more than 14 days after the Covered Accident; or - follow-up care by a Physician prescribed to occur after the initial examination or treatment due to Injuries sustained in a Covered Accident. The Physician Follow -Up Visit must be within 365 days from the Covered Accident. For purposes of this benefit, care received in a Physician's office, Hospital, or through Telemedicine meets the Benefit Description of Physician Follow -Up Visit. For purposes of this benefit, routine physical or wellness exams do not meet the Benefit Description of Physician Follow -Up Visit. Benefit Duration This benefit is payable up to a maximum of three visit[s] per Insured per Covered Accident, up to a maximum of twelve times per Insured per Calendar Year. Post -Traumatic Stress Disorder (PTSD) Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if a Physician diagnoses the Insured with PTSD due to a Covered Accident and expenses are incurred. Benefit Duration This benefit is payable once per Insured per Covered Accident. Prescription Drug Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if a Physician prescribes medication to an Insured due to Injuries sustained in a Covered Accident and expenses are incurred. Prescriptions must be filled at a pharmacy within 90 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate 25 Colonial Life & Accident Insurance Company 110 For purposes of this benefit, the following do not meet the Benefit Description of Prescription Drug: - medication administered while Confined or during a Surgical Procedure; - medication administered on an Outpatient Basis; - medication recommended by a Physician that is available without a prescription (over-the-counter); - refills of a Prescription Drug for which a benefit has previously been paid under this certificate; and - therapeutic devices or Durable Medical Equipment. Benefit Duration This benefit is payable once per Insured per Covered Accident. Rehabilitation or Sub -Acute Rehabilitation Unit Confinement Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Rehabilitation or Sub -Acute Rehabilitation Unit and expenses are incurred. The Insured must be transferred to the Rehabilitation or Sub -Acute Rehabilitation Unit for inpatient care immediately after a period of Confinement in a Hospital due to Injuries sustained in a Covered Accident. Benefits for Rehabilitation or Sub -Acute Rehabilitation Unit Confinement will not be paid for any day that benefits are paid for Hospital Admission, or Hospital ICU Admission, or Hospital Confinement — Daily Stay, or Hospital ICU Confinement — Daily Stay, or Hospital Sub -Acute ICU Confinement — Daily Stay, or At -Home Care. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. Therapy Services Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured receives Therapy Services due to Injuries sustained in a Covered Accident and expenses are incurred. A Physician must prescribe the Therapy Services to the Insured on an Outpatient Basis with a Physician or Therapist. The therapy must begin within 90 days after the Covered Accident and must be received within 365 days of the Covered Accident. For purposes of this benefit, the following are considered Therapy Services: - Acupuncture Therapy; Alternative Therapy; - Chiropractic Therapy; Occupational Therapy; - Physical Therapy; Respiratory Therapy; - Speech Therapy; and - Vestibular Therapy. For purposes of this benefit, therapy received in a Rehabilitation or Sub -Acute Rehabilitation Unit is considered inpatient and does not meet the Benefit Description of Therapy Services. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. If more than one type of Therapy Service is received on the same day by the same Physician, we will pay only one day of Therapy Services. GAC4100-C-FL Group Accident Certificate 26 Colonial Life & Accident Insurance Company 111 ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS Accidental Death Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured dies due to Injuries sustained in a Covered Accident. The Accidental Death must be within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured. If we pay this benefit, we will not pay the Accidental Death — Common Carrier benefit. Jsx, Accidental Death — Common Carrier Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured dies while traveling as a fare -paying passenger on a Common Carrier due to Injuries sustained in a Covered Accident. A Common Carrier is commercial transportation including airplanes, trains, buses, trolleys, subways, ferries and boats that operate on a regularly scheduled basis between predetermined points or cities. Taxis and privately chartered vehicles are not common carriers. The Accidental Death must be within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured. If we pay this benefit, we will not pay the Accidental Death benefit. Accidental Dismemberment Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Dismemberment in a Covered Accident and expenses are incurred. The Accidental Dismemberment must be within 365 days of the Covered Accident. For purposes of this benefit, the following losses meet the Benefit Description of Accidental Dismemberment: - for the loss of a foot, all of the foot is cut off at or above the ankle joint; - for the loss of a hand, all four fingers are cut off at or below the knuckles joining each to the hand; and - for the loss of a thumb and index finger, all of the thumb and index finger are cut off at or below the joint closest to the wrist. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains multiple Dismemberments in a single Covered Accident, we will pay for each Dismemberment, but will pay no more than the Insured's Accidental Death benefit amount. Coma Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is in a Coma for a period of seven or more consecutive days due to Injuries sustained in a Covered Accident and expenses are incurred. GAC4100-C-FL Group Accident Certificate 27 Colonial Life & Accident Insurance Company 112 A Coma is a continuous state of profound unconsciousness requiring intubation for respiratory assistance characterized by the absence of: - eye opening; - verbal response; and - motor response. A Physician must confirm the Coma within 365 days of the Covered Accident. <<t For purposes of this benefit, the term Coma does not include any medically induced coma. Benefit Duration This benefit is payable once per Insured per Covered Accident. Home Alterations and Automobile Modifications Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Injury due to a Covered Accident, which requires; - permanent structural alterations that were made to the Insured's primary residence to make it accessible and livable; or - modifications that were made to a primary Automobile to make it accessible to drive. The Home Alterations and Automobile Modifications must take place and expenses must be incurred within 365 days of the Covered Accident. This benefit will not be paid unless: - home alterations are recommended by a Physician; or - modifications to an Automobile are recommended by a Physician, are made by a person or persons with experience in these types of modifications, and modifications are approved by the federal or state vehicle licensing authorities if required. For the Home Alterations and Automobile Modifications benefit to be paid, an Accidental Dismemberment, Loss of Use, or Paralysis Benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Loss of Use Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured loses the ability to hear, see, or speak due to Injuries sustained in a Covered Accident and expenses are incurred. A Physician must confirm the Loss of Use within 365 days of the Covered Accident. For the purposes of this benefit, the following losses meet the Benefit Description of Loss of Use: for the loss of hearing, total deafness in one or both ears; - for the loss of sight in one eye, the eye must be totally blind and no sight can be restored in that eye; - for the loss of sight in both eyes, the: - sight in the better eye reduced to a best corrected visual acuity of 20/200 or less (Snellen or E-Chart Acuity); - visual field remaining is less than 20° in the better eye; and - the Insured was not previously legally blind; and - for the loss of speech, the ability to speak is a total and irrecoverable loss. GAC4100-C-FL Group Accident Certificate 28 Colonial Life & Accident Insurance Company 113 For purposes of this benefit, any loss that can be corrected to any functional degree by any procedure, aid, or device does not meet the Benefit Description of Loss of Use. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains multiple losses in a single Covered Accident, we will pay for each Loss of Use, but will pay no more than the Insured's Accidental Death benefit amount. Paralysis S‹, Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains Paralysis of one or more limbs in a Covered Accident and expenses are incurred. A Physician must confirm the Paralysis within 365 days of the Covered Accident. For the purposes of this benefit, the following types of Paralysis meet the Benefit Description of Paralysis: - for Uniplegia, the total and irreversible paralysis of any one limb; - for Hemiplegia, the total and irreversible paralysis of both limbs on either side of the body, for example the right arm and right leg, or the left arm and left leg; - for Paraplegia, the total and irreversible paralysis of any two limbs; - for Triplegia, the total and irreversible paralysis of any three limbs; and - for Quadriplegia, the total and irreversible paralysis of all four limbs. Benefit Duration This benefit is payable once per Insured per Covered Accident. ADDITIONAL BENEFITS Active Lifestyles k Benefit Description We will pay the corresponding additional amount shown in the Schedule of Benefits if an Insured sustains any of the benefits listed below as the result of Injuries sustained in a Covered Accident. Concussion; Connective Tissue Damage, Dislocations; Emergency Dental Repair; Eye Injury; - Fracture; - Knee Cartilage (Meniscus) Injury; - Lacerations; Medical Imaging; Ruptured or Herniated Disc; Surgery: - Connective Tissue Surgery - Exploratory without Repair, Repair for One Connective Tissue, Repair for Two or more Connective Tissues; - Dislocations - Surgical Repair; - Eye Surgery; - Fractures - Surgical Repair; - General Surgery -Abdominal, Thoracic, Cranial, Exploratory; - Knee Cartilage (Meniscus) Surgery - Exploratory without Repair, Knee Cartilage (Meniscus) with Repair; GAC4100-C-FL Group Accident Certificate 29 Colonial Life & Accident Insurance Company 114 - Ruptured or Herniated Disc Surgery — Exploratory without Repair, Repair for One Disc, Repair for Two or more Discs; and - X-Ray or Ultrasound. Benefit Duration This benefit is payable once per Insured per Covered Accident for applicable benefits. Benefit Booster Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits, if the total amount of Payable Claims for a Covered Accident equals or exceeds the amount shown in the Schedule of Benefits. For the purpose of this benefit, the Building Benefit does not apply to the total amount of Payable Claims. This benefit is payable for Payable Claims that occur within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Building Benefit Benefit Description We will pay the corresponding additional amount shown in the Schedule of Benefits if an Insured sustains any of the benefits listed below as the result of a Covered Accident and expenses are incurred. This benefit is based on the number of months an Insured is continuously covered under this certificate. The applicable percentage amount will be calculated from your Coverage Effective Date to the date of the Covered Accident. This benefit will be payable for the following Benefit Categories as the result of Injuries sustained in a Covered Accident: - Injury Benefits; - Fractures and Dislocations;c)f - Treatment Benefits; - Surgery Benefits;e, - Hospital Benefits; - Recovery Care Benefits; - Accidental Death and Dismemberment Benefits; and - The following Additional Benefits: - Active Lifestyles; - Gunshot Wound; - Healthcare Employee Benefit; For the Building Benefit to be paid, an applicable benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Gunshot Wound Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Gunshot Wound as the result of a Covered Accident and expenses are incurred and which does not cause the Insured to die. Treatment must be received by a Physician, including Confinement in a Hospital, within 24 hours of the Covered Accident. GAC4100-C-FL Group Accident Certificate 30 Colonial Life & Accident Insurance Company 115 A Gunshot Wound is caused when a bullet or other projectile is shot into or through the body. The Gunshot Wound must be caused by a weapon which fires a shot (bullet or pellet) by gun powder or compressed gas. This benefit covers Gunshot Wounds received both on and off -job. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured is shot more than once in a 24-hour period, we will pay benefits only for the first wound. The Gunshot Wound benefit is not available for your Spouse or your Children. Healthcare Employee Benefit Benefit Description We will pay the corresponding additional amount shown in the Schedule of Benefits if an Insured is admitted, Confined, or receives services in a Hospital owned, operated, or controlled by the Policyholder. This benefit will be payable for the following Benefit Categories as the result of Injuries sustained in a Covered Accident: - Hospital Benefits. Benefit Duration This benefit is payable once per Insured per Covered Accident for applicable benefits. Sickness Hospital Benefits Admission for Covered Sicknesses Benefit Description - We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital due to a Covered Sickness and expenses are incurred. We will not pay the Admission for Covered Sicknesses benefit and the Admission - Hospital ICU for Covered Sicknesses benefit for the same Covered Sickness concurrently. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. Benefit Duration This benefit is payable up to a maximum of one day per Insured per Covered Sickness, up to a maximum of one time per Insured per Calendar Year. Admission - Hospital ICU for Covered Sicknesses Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital ICU due to a Covered Sickness and expenses are incurred. We will not pay the Admission - Hospital ICU for Covered Sicknesses benefit and the Admission for Covered Sicknesses benefit for the same Covered Sickness concurrently. GAC4100-C-FL Group Accident Certificate 31 Colonial Life & Accident Insurance Company 116 Benefit Duration This benefit is payable up to a maximum of one day per Insured per Covered Sickness, up to a maximum of one time per Insured per Calendar Year. Hospital Confinement — Daily Stay for Covered Sicknesses Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital due to a Covered Sickness and expenses are incurred. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. Benefit Duration r w This benefit is payable up to a maximum of 30 days per Insured per Covered Sickness. Short Stay for Covered Sicknesses Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is treated on an Outpatient Basis due to a Covered Sickness for minimum of eight consecutive hours in any of the following facilities and expenses are incurred: - Ambulatory Surgical Center; - Emergency Department; - Hospital; or - Observation Unit. Benefits for Short Stay for Covered Sicknesses will not be paid for any day that benefits are paid for Admission for Covered Sicknesses, and Admission - Hospital ICU for Covered Sicknesses, and Hospital Confinement — Daily Stay for Covered Sicknesses. Benefit Duration This benefit is payable up to a maximum of one day per Insured per Calendar Year. Wellbeing Assistance Benefit Benefit Description We will pay the corresponding amount shown on the Schedule of Benefits as a result of having one of the routine, preventative tests covered by this certificate. The test must be performed after the 30 day Benefit Waiting Period has been satisfied. The Benefit Waiting Period is the period of time during which Insureds must have continuous coverage before benefits for Wellbeing Assistance become payable. The covered tests include: - Annual Physical; - examples include: - Annual exams; - Sports Physicals; - Well -child visits; - Blood test for triglycerides; - Bone marrow testing; - BRCA1 or BRCA2 testing; - Breast ultrasound; - Carotid Doppler; GAC4100-C-FL Group Accident Certificate 32 Colonial Life & Accident Insurance Company 117 - CA 15-3; - CA 125; - CEA; - Chest X-ray; - Colonoscopy; - Electrocardiogram (EKG, ECG); - Echocardiogram (ECHO); - Fasting blood glucose; - Flexible sigmoidoscopy; - Hemoccult stool analysis; - Immunizations; - Mammography; - Pap smear; - PSA; - Serum protein electrophoresis; - Serum cholesterol test for HDL and LDL; - Skin cancer biopsy; - Stress test on a bicycle or treadmill; - Thermography; - ThinPrep pap test; or - Virtual colonoscopy. Benefit Duration This benefit is payable a maximum of once per Insured per Calendar Year. EXCLUSIONS AND LIMITATIONS •<</ Exclusions We will not pay benefits for a claim that is caused by, contributed to by, or resulting from any of the following: Elective Procedures - elective procedures, cosmetic surgery, or reconstructive surgery unless it is a result of organ donation, trauma, infection, or other diseases. Felonies or Illegal Occupations - committing or attempting to commit a felony; - being engaged in an illegal occupation or activity. Hazardous Avocations operating, learning to operate, serving as a crew member of any aircraft or hot air balloon, including those which are not motor -driven, unless flying as a fare paying passenger; - jumping, parachuting, or falling from any aircraft or hot air balloon, including those which are not motor - driven; - travel or flight in any aircraft or hot air balloon, including those which are not motor -driven, if it is being used for testing or experimental purposes, used by or for any military authority, or used for travel beyond the earth's atmosphere; - engaging in hang-gliding, bungee jumping, sail gliding, parasailing, parakiting, or BASE jumping. Impaired Driving - Operating any motorized vehicle while under the influence of intoxicants or narcotics. Incarceration GAC4100-C-FL Group Accident Certificate 33 Colonial Life & Accident Insurance Company 118 - a Covered Loss that occurs while an Insured is legally incarcerated in a penal or correctional institution. Racing - Riding or driving an air, land or water vehicle in a race, speed or endurance contest. Semi-professional or Professional Sports - practicing for or participating in any semi-professional or professional competitive athletic contests for which any type of compensation or remuneration is received. Sickness - any Sickness, bodily infirmity, or other abnormal physical condition or Mental or Nervous Disorders, including diagnosis, treatment, or surgery for it. The Mental or Nervous Disorders exclusion does not apply to the Behavioral Health Therapy benefit when the condition is due directly to a Covered Accident; - Infection. This exclusion does not apply when the infection is due directly to an Injury sustained in a Covered Accident. Suicide or Self -Inflicted Injuries - injuring oneself intentionally or attempting or committing suicide, whether sane or not. War or Armed Conflict active participation in a riot, insurrection, or terrorist activity. This does not include civil commotion or disorder, Injury as an innocent bystander, or Injury for self-defense. Losses as a result of terrorist activity committed by individuals or groups will not be excluded from coverage unless the Insured who suffered the loss committed the terrorist activity; - participating in war or any act of war, whether declared or undeclared; - combat or training for combat while serving in the armed forces of any nation or authority, including the National Guard, or similar government organizations. Additionally, no benefits will be paid for a Covered Loss that occurs prior to the Coverage Effective Date. Exclusions and Limitations for Sickness Hospital Benefits All of the Exclusions listed in the certificate apply to the Sickness Hospital Benefits except: Sickness - any Sickness, bodily infirmity, or other abnormal physical condition or Mental or Nervous Disorders, including diagnosis, treatment, or surgery for it; - Infection. This exclusion does not apply when the infection is due directly to a cut or wound sustained in a Covered Accident. In addition, we will not pay benefits for a claim that is caused by, contributed to by, or resulting from any of the following: Dental Care - treatment for dental care or dental care procedures. Mental or Nervous Disorders - Having a psychiatric or psychological condition including, but not limited to, affective disorders, neuroses, anxiety, stress and adjustment reactions. However this exclusion does not include dementia if it is a result of: - stroke, Alzheimer's disease, trauma, viral infection; or - other conditions which are not usually treated by a Mental Health Professional or other qualified provider using psychotherapy, psychotropic drugs, or other similar methods of treatment. GAC4100-C-FL Group Accident Certificate 34 Colonial Life & Accident Insurance Company 119 Well Baby Care - any Confinement of a newborn following Childbirth unless the newborn has an Injury or Sickness. Limitations Childbirth Limitation We will not pay benefits for Sickness Hospital Benefits due to any Insured giving birth within the first nine months after the Coverage Effective Date of this certificate as a result of a normal pregnancy, including Cesarean. Complications of Pregnancy will be covered to the same extent as any other Covered Sickness. Pre-existing Condition Limitation We will not pay benefits for Sickness Hospital Benefits in the first 6 months following the Insured's Coverage Effective Date if the Covered Sickness is caused by, contributed to by, or resulting from a Pre- existing Condition. A Pre-existing Condition is a Sickness or physical condition for which an Insured was treated, had medical testing, received medical advice or had taken medication within the 6 months before the Coverage Effective Date. OTHER FEATURES Newborn Coverage Feature Your newborn or newly adopted Children will automatically be covered for 60 days from their Coverage Eligibility Date if you are insured. If you wish to continue Child coverage, you must notify us on or before the end of the 60 day period and pay any additional premium. If you already have coverage for your Children, then all eligible Children will be covered and you do not need to notify us or pay any additional premium for the newly eligible Child. Portability Portability allows you, and your Spouse, and Children to continue coverage when coverage under the Policy would otherwise end due to an Eligible Portability Event. The certificate in force at the time of an Insured's Eligible Portability Event will reflect the terms and condition of the coverage that can be continued. Any future changes made in the Policyholder's group Policy will not apply to coverage an Insured has ported, unless required by law. Eligible Portability Events You are eligible to port coverage on the date: - the Policyholder cancels the Policy; or - you are no longer in an Eligible Group. However, you will not be considered eligible to port coverage if: - the Policyholder's Policy is closed to new enrollments; or - the Policyholder's Policy is cancelled by us. Applying for Portable Coverage If you choose to apply for portable coverage for yourself, you may also port coverage for your Spouse and or Children who were covered under the Policy. GAC4100-C-FL Group Accident Certificate 35 Colonial Life & Accident Insurance Company 120 You must apply for portable coverage and pay the first premium within 31 days from the date of an Eligible Portability Event. Ported Coverage Effective Date Once premiums and all forms have been received within the specified time period, ported coverage is effective on the day after coverage would have otherwise ended under the Policy. End of Ported Coverage For you Ported coverage will automatically end on the earliest of: - the last day for which premiums have been paid; - the date you return to an Eligible Group and are covered under the Policy; - the date coverage provided under Portability is cancelled by us for any reason upon 31 days notice; or - the date you die. For your Spouse Your Spouse's coverage will end on the earliest of: the last day for which premiums have been paid; - the date your Spouse no longer meets the definition of a Spouse; - the date of your divorce or annulment; the date coverage provided under Portability is cancelled by us for any reason upon 31 days notice; - the date the Named Insured dies; or - the date of your Spouse's death. For your Children Your Children's coverage will end on the earliest of: - the last day for which premiums have been paid; - the date your Children no longer meet the definition of Children; - the date coverage provided under Portability is cancelled by us for any reason upon 31 days notice; - the date the Named Insured dies; or - the date of your Children's death. Once ported coverage ends, it cannot be reinstated. Paying for Ported Coverage You must make all premium contributions for ported coverage. We will bill you directly for any premium due. Rates for Ported Coverage Premium will be based on the rates for Portability in effect on the date you apply to your port coverage. Portability rates may be changed by us at any time. We will provide Written notice at least 45 days before any change is to take effect. Portability In The Event Of Your Death, Divorce Or Annulment Portability allows your covered Spouse to continue coverage when coverage under the Policy would otherwise end in the case of your death, divorce or annulment. Such coverage will provide the same rights and conditions as portable coverage available to a Named Insured. Your Spouse is not eligible to continue coverage under this provision if your Spouse was not covered under this certificate on the date of your death, divorce or annulment. GAC4100-C-FL Group Accident Certificate 36 Colonial Life & Accident Insurance Company 121 START OF COVERAGE Coverage Eligibility Date For you If you are in an Eligible Group, you are eligible for coverage on the later of: - the Policy Effective Date; or - the day after any applicable Eligibility Waiting Period has been satisfied. For your Spouse and your Children If you elect coverage for yourself, and your Spouse, and your Children are eligible for coverage on the later of: - the date you are eligible for coverage; or - the date you first acquire a Spouse or Child. Enrolling for Coverage Initial Enrollment You may apply for any coverage available for you, and your Spouse, and your Children within 31 days of your, your Spouse's, or your Children's Coverage Eligibility Date. You may also apply for any coverage available for you, and your Spouse, and your Children during any scheduled annual Enrollment Period or within 31 days of a Qualifying Life Event. Late Enrollment If you did not apply for coverage during your, or your Spouse's, or your Children's Initial Enrollment or you voluntarily cancelled coverage for you, or your Spouse, or your Children and are re -applying, you may apply for coverage during any scheduled annual Enrollment Period or within 31 days of a Qualifying Life Event. Coverage Effective Date Coverage under this certificate will start at 12:01 a.m. Standard Time in the time zone where you live on the Coverage Effective Date shown on your Certificate Schedule for purposes of all dates under this Certificate of Coverage. Coverage Effective Date if you are not in Active Employment You must be in Active Employment in order for coverage to become effective for any Insured in accordance with the Coverage Effective Date provision. If you are not in Active Employment due to a temporary Layoff, Furlough, or Leave of Absence on the date coverage would become effective, your, and your Spouse's, and your Children's Coverage Effective Date will be the date you return to Active Employment. Coverage Effective Date for Initial Enrollment and Late Enrollment are subject to this provision. A delay of Coverage Effective Date for a change in coverage will not affect coverage that is currently in force. CONTINUATION AND END OF COVERAGE Continuation of your Coverage During Extended Absences Family and Medical Leave of Absence We will continue coverage during absences for family and medical leave if premium payments continue and the Policyholder approved your leave in Writing. You will be covered up to the end of the latest of: - the leave period required by the Federal Family and Medical Leave Act of 1993, and any amendments; - the leave period required by applicable state law; or - the leave period provided to you for an Injury or Sickness, provided premium is paid and the Policyholder has approved your leave in Writing. GAC4100-C-FL Group Accident Certificate 37 Colonial Life & Accident Insurance Company 122 If coverage is not continued during a Family and Medical Leave of Absence, upon the Named Insured's return to Active Employment: - no new Pre-existing Condition Limitation will be applied; - and - we will not apply a new Eligibility Waiting Period. In order for these conditions to apply, the Policyholder must notify us and commence paying premiums for the Named Insured's coverage within 31 days following a Named Insured's return to Active Employment following a Leave of Absence for Family and Medical Leave. The time period in the Pre-existing Condition Limitation period will continue to run through a Named Insured's Family and Medical Leave of Absence. Leave of Absence, other than a Family and Medical Leave of Absence If the Named Insured is on a Layoff, Furlough, or Leave of Absence other than for Family and Medical Leave, you will be covered through the premium due date immediately following the date your Layoff, Furlough, or Leave of Absence begins, provided premium is paid. If premium is remitted beyond the premium due date referenced above, our only liability will be to return the premium. Extension of Benefits Termination of coverage will not affect any claim that began while the coverage was in force, and may be continued for at least 90 days, subject to any benefit limits provided in the certificate. End of Coverage For You Your coverage under this certificate ends on the earliest of: - the date the Policy is cancelled by us or the Policyholder; - the date you are no longer in an Eligible Group; - the date your Eligible Group is no longer covered; - the date of your death; or - the last day of the period any required premium contributions are made. If we receive premium for coverage extending beyond the dates specified for coverage ending, such premium will be refunded, with the exclusion of any premium required to continue coverage: - in accordance with the Continuation of your Coverage During Absences provision; or - under Portability for you, and your Spouse, and your Children under Portability. We will provide coverage for a Payable Claim that occurs while you are covered under this certificate. For your Spouse Your Spouse's coverage will end on the earliest of: - the date your coverage under this certificate ends; - the date your Spouse is no longer eligible for coverage; - the date your Spouse no longer meets the definition of a Spouse; - the date of your Spouse's death; or - the date of your divorce or annulment. If your Spouse's coverage ends as a result of your death, divorce or annulment, your Spouse may elect to continue Spouse and Children coverage in accordance with the Portability In The Event Of Your Death, Divorce, or Annulment provision. GAC4100-C-FL Group Accident Certificate 38 Colonial Life & Accident Insurance Company 123 If we receive premium for coverage extending beyond the dates specified for coverage ending, such premium will be refunded, with the exclusion of any premium required to continue coverage under Portability. We will provide coverage for a Payable Claim that occurs while your Spouse is covered under this certificate. For your Children Your Children's coverage will end on the earliest of: - the date your coverage under this certificate ends; - the date your Children are no longer eligible for coverage; - the date of your Children's death; or - the date your Children no longer meet the definition of Children. x</- If we receive premium for coverage extending beyond the dates specified for coverage ending, such premium will be refunded, with the exclusion of any premium required to continue coverage under Portability. We will provide coverage for a Payable Claim that occurs while your Children are covered under this certificate. CLAIM PROVISIONS Notice of a Claim A claim for benefits under this certificate must be submitted in Writing within 90 days from the date of the Covered Loss, or as soon as reasonably possible. Claim Forms After receiving the Notice of a Claim, we will send a claim form, if required, to you or your authorized representative within 20 days from the date we receive the Notice of a Claim. If you or your authorized representative do not receive a claim form from us within 20 days after we receive the Notice of a Claim, a Written statement from you or your authorized representative as to the nature and extent of the Covered Loss will be deemed Proof of Loss, if sent to us within the time limit stated in the Proof of Loss section below. Proof of Loss Proof of Loss must be sent to us no later than 90 days after the date of Covered Loss. If it is not reasonably possible to provide Proof of Loss within this time period, it will not affect a Payable Claim if it is provided within one year, unless the Insured lacks the legal capacity to do so. In no event can Proof of Loss be submitted after the expiration of the time limit for commencing Legal Action as stated in this certificate, even if the failure to provide Proof of Loss is due to a lack of legal capacity. Proof of Loss, provided at your or your authorized representative's expense, must establish the nature and extent of the Covered Loss and should include but not be limited to the following: - the cause of death or Covered Loss; - the extent of the Covered Loss; - the date of Covered Loss; - the name and address of any Hospital or institution where treatment was received, including all attending Physicians; - a Physician's bill, a Hospital bill, or other proof of expenses incurred; and - in case of death, a certified copy of the death certificate or other lawful evidence providing equivalent information. GAC4100-C-FL Group Accident Certificate 39 Colonial Life & Accident Insurance Company 124 If the Proof of Loss is not complete, we will request additional information. Authorization for Release of Information We may request Written authorization from an Insured. This authorization may be required in order for us to obtain the necessary medical and non -medical information needed for Proof of Loss. This information may include any appropriate financial records such as income tax returns. Failure to provide us with Written authorization may result in the denial of a claim if the Insured does not send proof to us and we are not able to obtain the proof that is required to make a claim decision. Right to Exam, Test, or Interview We may ask the Insured to be examined or tested by one or more Physicians, other medical practitioners, or vocational experts of our choice. We may also require the Insured to be interviewed by an authorized representative of ours. We have the right to request exams or tests as often as it is reasonably necessary during the pendency of an Insured's claim. Any exam, test, or interview that we require will be paid at our expense. If the Insured fails to attend or fully participate, we will not pay the benefits or we will stop sending benefits under this certificate. Autopsy We will have the right to request an Autopsy necessary during the pendency of an Insured's claim where it is allowed by law. Claim Procedures After the Insured has satisfied the requirements above, we will process and evaluate the information to determine if a claim is payable. We will notify the Insured of a claim decision and issue payment for a Payable Claim in accordance with the Payment of Benefits provision. If a claim for benefits under this certificate is wholly or partially denied, we will provide notice of our decision in Writing within 45 days after receipt of the claim. V Payment of Benefits 1 Benefits for which we are liable will be paid within 45 days after we complete the Claim Procedures. All benefits will be paid to you, unless we receive Written authorization to pay them elsewhere. This is an assignment of benefits. Payment shall be treated as being made on the date a draft or other valid instrument which is equivalent to payment was placed in the United States mail in a properly addressed, postpaid envelope or, if not so posted, on the date of delivery. In the event of your death, any unpaid benefits will be paid to your beneficiary in accordance with the Beneficiary Designation and Change provision. In the event of your Spouse's death, should your Spouse have survived you and continued coverage, any unpaid benefits for your Spouse, will be paid to your surviving Spouse's beneficiary in accordance with the Beneficiary Designation and Change provision. Payment of Interest Any benefit payment issued after 45 days from the date we receive satisfactory proof will accrue simple interest on the net benefit amount paid in accordance with the state requirements of the state where the Insured resides. Interest will accrue beginning on the day after the Payment of Benefits was due and ending on the date we make the payment. Beneficiary Designation and Change GAC4100-C-FL Group Accident Certificate 40 Colonial Life & Accident Insurance Company 125 When a person becomes insured under this certificate, the Insured is responsible for designating a beneficiary in Writing for any benefits due in the event of the Insured's death. It is important to list the full name of each beneficiary and that all beneficiary designations are kept current and provided to us. You are the beneficiary for any Insured under this certificate while you are still living unless there is a valid change in beneficiary designation by an Insured. If an Insured wishes to change their beneficiary designation, they may do so by sending us a completed, dated, and signed beneficiary designation change form. Changes in beneficiary designations will take effect on the date notice of the beneficiary designation is signed by the Insured. Unless you make an irrevocable designation of beneficiary, the right to change a beneficiary is reserved to you and the consent of the beneficiary or beneficiaries shall not be requisite to assignment of the Policy or to change of beneficiary or beneficiaries, or to any changes in the Policy. A change of beneficiary will not have a bearing on any payment we make before we receive it. If a beneficiary is not named, or if all named beneficiaries do not survive the Insured, or the named beneficiary is legally unable to receive benefits, any benefits due will be paid to the Insured's estate. Overpayment of Claims We have the right to recover any overpayments due to: - Fraud (including any misrepresentations, omissions, concealment of facts or incorrect statements); or - any error we make in processing a claim. We must be reimbursed in full. If it is not possible for you to reimburse us in a lump sum payment, we will develop a reasonable method of repayment. This may include reducing or withholding future payments. We will not recover more money than the amount we paid you. Underpayment of Claims We have the responsibility to make additional payments if any underpayments have been made. Any underpayments will be paid in accordance with the Payment of Benefits provision. Unpaid Premium Any Unpaid Premium due for an Insured's coverage at the time of payment for a claim may be deducted from the Insured's claim payment. Legal Actions If you or your authorized representative disagree with our decision, you or your authorized representative can start Legal Action regarding your claim 60 days after Proof of Loss has been given to us and up to five years from the latest of when: - original Proof of Loss was first required to have been given to us; - your claim was denied; or - your benefits were terminated, unless otherwise provided under federal law. GENERAL PROVISIONS When Days Begin and End For the purpose of all dates under this Certificate of Coverage, all days begin at 12:01 a.m. and end at 12:00 midnight in the time zone where you live. Certificate of Coverage Contents Coverage for an Insured is provided under this Certificate of Coverage which is a part of the Policy issued to the Policyholder. The Policy consists of: GAC4100-C-FL Group Accident Certificate 41 Colonial Life & Accident Insurance Company 126 - all Policy provisions, and any riders, amendments and endorsements, and other attachments approved for use with the Policy; - this Certificate of Coverage, and any riders, amendments and endorsements, and other attachments approve for use with this Certificate of Coverage; - the Policyholder's application for group insurance; and - Named Insured's enrollment form and Evidence of Insurability, if applicable. Certificate of Coverage We will provide a Certificate of Coverage for each Named Insured. Your certificate describes: - the Policy Number of your Group Accident Insurance Certificate of Coverage; - the coverage to which an Insured may be entitled;\<<t - to whom we will make a payment; and - the limitations, exclusions, and requirements that apply to an Insured's coverage. If any of the terms and provisions of this certificate are different than in the Policy, the Policy will govern. Cancellation or Modification to the Policy and this Certificate of Coverage The Policy and this Certificate of Coverage may be cancelled or modified by the Policyholder at any time without the Insured's consent. Any cancellation or modification to the Policy or certificate requested by the Policyholder will take effect on the date agreed upon by us and the Policyholder. In the event of cancellation of the Policy and certificate, the Policyholder will notify the Insured in Writing at least 45 days in advance of the date of cancellation. Representation in Applications In the absence of Fraud or intentional misrepresentation of material fact, any statements made by you will be considered a representation and not a warranty. We will not use such statements to avoid insurance, reduce benefits, or deny a claim unless such statements are included in an application signed by you, and a copy of the signed application has been provided to you or your beneficiary. Assignment An Assignment transfers all or part of your legal title and rights under the Policy and this certificate to someone else, known as an "assignee." We will recognize your assignee(s) as owners of the rights you transferred under the Policy and this certificate if the Assignment is in Writing, is certified or signed by you and the assignee, is filed with us, and is in a form acceptable to us. An Assignment will take effect on the date notice of the Assignment is signed by you. If we have taken any action or made any payment before we receive notice of the Assignment, that Assignment will not go into effect for those actions taken or payments made. Once legal titles and rights under the Policy and this certificate are assigned, the assignee has authority to make changes to an Insured's coverage and beneficiary designation. We are not responsible for the validity of any Assignment. We advise you to verify your Assignment is legal in your state and that it accomplishes the goals you intend. An Assignment will remain in place until we receive Written notice of termination of the Assignment or Written notice by or on behalf of some other person claiming some interest in the Policy in conflict with the Assignment. Contestability We can take legal or other action using statements made in signed applications for coverage only when a Covered Loss occurs during the first two years after an Insured's Coverage Effective Date. However, in the event of Fraud or intentional misrepresentation of material fact, we can take Legal Action at any time as permitted by applicable law. Misstatement of Information GAC4100-C-FL Group Accident Certificate 42 Colonial Life & Accident Insurance Company 127 If you or the Policyholder provides us information about an Insured that is incorrect, we will: - use the facts to decide whether the Insured has coverage under this certificate and the Policy and in what amounts; and - if necessary, make the applicable premium adjustments.We will not charge additional premiums for past coverage that was based on misstated information. Fraud We want to make sure you and the Policyholder do not incur additional insurance costs as a result of the undermining effects of insurance fraud. We promise to focus on all means necessary to support fraud detection, investigation, and prosecution. It is a crime if anyone knowingly, and with intent to injure, defrauds, or deceives us. This includes filing a claim or providing information that contains any false, incomplete, or misleading information. These actions will result in denial of a claim, and are subject to prosecution and punishment to the full extent under state and federal law. We will pursue all appropriate legal remedies in the event of insurance fraud. Agency For purposes of the Policy, the Policyholder acts on their own behalf or as your agent. Under no circumstances will the Policyholder be deemed our agent. Workers' Compensation or State Disability Insurance This certificate does not replace or affect the requirements for coverage by any workers' compensation or state disability insurance. Communicating With you or the Policyholder We may provide notices, information, and other communications to you or the Policyholder in Written form. To protect our customers, we will abide by all applicable privacy laws and regulations. GLOSSARY Active Employment You are working for the Policyholder for eamings that are paid regularly, and you are performing the Material and Substantial Duties of your Regular Occupation. You must be regularly scheduled to work at least the minimum number of hours as determined by the Policyholder. Your work site must be: - the Policyholder's usual place of business in the United States; - an alternative work site in the United States at the direction of the Policyholder; or - a location in the United States to which your job requires you to travel. Normal vacation, holidays, or temporary business closures are considered Active Employment provided you are in Active Employment on the last scheduled work day preceding such time off. For purposes of this certificate, temporary business closures that meet the Glossary definition of Active Employment include, but are not limited to: - inclement weather; - power outage; and - public health agency orders. Temporary and seasonal workers are excluded from coverage. GAC4100-C-FL Group Accident Certificate 43 Colonial Life & Accident Insurance Company 128 Acupuncture Therapy The practice of penetrating the skin with thin, solid, metallic needles, which are then activated through gentle and specific movements of the practitioner's hands or with electrical stimulation. Alternative Therapy Treatment that includes: - biofeedback; or - electrical stimulation. Ambulatory Surgical Center A facility, separate from a Hospital, equipped for Physicians to perform Surgical Procedures on an Outpatient Basis and must: - provide anesthesia administered by a licensed anesthesiologist or licensed nurse anesthetist; and - have agreements with local Hospitals to immediately accept patients who develop complications. Automobile A private passenger motor vehicle, also refered to as "auto," which is licensed for use on public roads and highways, and is subject to motor vehicle registration. The term Automobile does not include an All -Terrain Vehicle (ATV), motorcycle, scooter, or golf cart. Behavioral Health Therapy The treatment of an Insured by a Mental Health Professional. Calendar Year The period beginning on the Insured's Coverage Effective Date and ending on December 31 of the same year. For each following year, it is the period beginning on January 1 and ending on December 31. Certificate of Coverage The document issued to the Named Insured, also referred to as the "certificate," describing an Insured's benefits and rights under the Policy, including any riders, amendments and endorsements, and other attachments approved for use with this certificate and the Policy. Child Care Center Any facility or private care that: - is licensed as a child care center by the state; - provides non -medical care and supervision for Children; and - is not operated by you or a Family Member. Childbirth Birth of a Child by routine vaginal delivery or non -emergency Cesarean section. Children Any Child from live birth to age 26 who is: - your own natural offspring; - your Spouse's Child; - your lawfully adopted Child as of the earliest of the date: - the Child is placed in your home or in a medical facility; - a petition is filed for you to adopt the Child; or - an adoption agreement, signed by you that includes your binding obligation to assume financial responsibility for the Child; - a foster Child placed with you by an authorized placement agency or by judgment, decree, or other order of any court of competent jurisdiction; or - grandchildren, nieces, and nephews living with you in a regular parent -child relationship that are dependent on you for primary financial support; or GAC4100-C-FL Group Accident Certificate 44 Colonial Life & Accident Insurance Company 129 - any other Child residing with you through legal mandate that is dependent on you for financial support. Children may continue coverage up to age 30 if: - they are unmarried and do not have a dependent of their own; - are a resident of this state or a student; and - they are not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan, or is not entitled to benefits under Title XVIII of the Social Security Act. Your Child may be eligible for coverage past age 26 if your Child is incapable of self-sustaining employment due to permanent intellectual or physical incapacity prior to reaching age 26 and is dependent upon you for support and maintenance. You must submit proof of the Child's incapacity and dependency to us within 31 days of the Child's 26th birthday or we will accept proof within 31 days of the Child's Coverage Eligibility Date. Ongoing proof of incapacity and dependency must be provided when requested by us, but not more frequently than once a year. Your Children may not be insured as both a Child and an Employee. Your Children may not be insured by more than one Employee. Chiropractic Therapy Spinal manipulation services conducted by a licensed chiropractor to correct a structural imbalance. For purposes of this certificate, the following services do not meet the Glossary definition of Chiropractic Therapy: - massage therapy; - treatment of chronic conditions; and - other Injuries not related to structural imbalance. Complications of Pregnancy Abnormal conditions or concurrent diseases that significantly affect the pregnancy's usual medical management. A complication may exist during the pregnancy, during the birth, or after the birth. Childbirth or Complications of Pregnancy will be treated as any other Sickness. Colonial Life & Accident Insurance Company Referred to as "Colonial" and "we," "us," and "our." Confined or Confinement Assignment to a bed as a resident inpatient in a medical or treatment facility, including an Observation Unit, for a minimum of 20 continuous hours on the advice of a Physician. Covered Accident An unintended or unforeseen bodily Injury sustained by an Insured, wholly independent of disease, bodily infirmity, illness, infection, or any other abnormal physical condition and which: - occurs on or after the Coverage Effective Date; - occurs while coverage is in force; and - is not excluded by name or specific description in this certificate. Covered Loss An accidental death, dismemberment, loss, or other Injury for which benefits are payable under this certificate. Covered Sickness GAC4100-C-FL Group Accident Certificate 45 Colonial Life & Accident Insurance Company 130 An illness, infection, disease, or any other abnormal physical condition that is not the result of an Injury, which: - occurs on or after the Coverage Effective Date; - occurs while coverage is in force; and - is not excluded by name or specific description in this certificate. Eligibility Waiting Period The continuous period of time an individual must be in an Eligible Group before they may enroll in coverage. Emergency Department A specified area within a Hospital, or standalone facility that is affiliated with a Hospital, designated for the emergency care of accidental Injuries or Sicknesses. This area must: - be staffed and equipped to handle trauma; - be supervised and have treatment provided by Physicians; and - provide care seven days per week, 24 hours per day. Employee A person, also referred to as "you," who is in Active Employment in the United States with the Policyholder. Enrollment Period A period of time determined by the Policyholder and us during which you are eligible to enroll for or change your coverage. This period of time may be limited. Family Member A Child, stepchild, Spouse, parent, stepparent, sibling, stepsibling, parent -in-law, Child -in-law, sibling -in-law, grandparent, grandparent's Spouse, grandchild, or grandchild's Spouse. Felonious Act of Violence An act of violence that is considered a felony where the act occurred. Felonious Acts of Violence include, but are not limited to: - assault and battery; civil disturbance; - hijacking; )‘f - murder; 1. - robbery; sniping; and - theft. Furlough Temporary absence from Active Employment for a period of time that has determined in advance by the Policyholder. Hospital A licensed institution supervised by Physicians and operated pursuant to law on a full-time basis. The Hospital must: - provide overnight care to people with Injuries or Sicknesses; - have full-time Nurses on duty or on call who are supervised by a registered Nurse; and - have X-ray equipment, a laboratory, and a surgical operating room at its locations or available to use on a pre -arranged basis. For purposes of this certificate, the following hospital units meet the Glossary definition of Hospital: - Progressive Care Unit; - Intermediate Care Unit; and - Step -Down Unit. GAC4100-C-FL Group Accident Certificate 46 Colonial Life & Accident Insurance Company 131 For purposes of this certificate, the following do not meet the Glossary definition of Hospital: - a nursing home, a rest home, home for the aged, or an assisted living facility; - a hospice care facility; - a Rehabilitation or Sub -Acute Rehabilitation Unit; - a psychiatric unit or facility for the treatment of Mental or Nervous Disorders; and - a facility for the treatment of Substance Abuse. Hospital ICU A specifically designated area of the Hospital that is restricted to patients who are critically ill or injured and who require intensive, comprehensive observation and care. The Hospital ICU must: - be separate and apart from the surgical recovery room and from rooms, beds, and wards customarily used for patient Confinement; - be permanently equipped with special lifesaving equipment for the care of the critically ill or injured; - be under close observation by a specially trained nursing staff assigned exclusively to the ICU on a 24 hour basis; and 1r have a Physician assigned to the ICU on a full-time basis. For purposes of this certificate, the following Hospital units meet the Glossary definition of Hospital ICU: - Intensive Care Unit (ICU); - Coronary Care Unit; - Neonatal ICU; - Pulmonary Care Unit; - Burn Unit; and - Transplant Unit. Hospital Sub -Acute ICU A specifically designated area of the Hospital that provides a level of medical care below intensive care, but above a regular private or semi -private room or ward with or without monitoring equipment. The Hospital Sub - Acute ICU must: - be separate and apart from the surgical recovery room and from rooms, beds, and wards customarily used for patient Confinement; and - be permanently equipped with special lifesaving equipment for the care of the critically ill or injured; - be under close observation by a specially trained nursing staff assigned exclusively to the Hospital Sub - Acute ICU on a 24 hour basis. A Hospital Sub -Acute ICU may be referred to by other names such as progressive care, intermediate care, or a step-down unit. Injury Any damage or harm to the body that is the direct result of a Covered Accident and not related to any other cause. Insured Any person who has coverage under this certificate. Layoff Temporary suspension or permanent termination of Active Employment. Normal vacation time, holidays, or temporary business closures are not considered a temporary Layoff. Leave of Absence Temporary absence from Active Employment for a period of time under a leave granted in Writing by the Policyholder that is in accordance with the Policyholder's formal leave policies. GAC4100-C-FL Group Accident Certificate 47 Colonial Life & Accident Insurance Company 132 Normal vacation time, holidays, or temporary business closures are not considered a Leave of Absence. Material And Substantial Duties Duties that: - are routinely required for the performance of your Regular Occupation; and - cannot be reasonably omitted or modified. Mental Health Professional A healthcare professional licensed by the state to practice and provide Behavioral Health Therapy. Any Mental Health Professional must be acting within the scope of their license. A Mental Health Professional does not include an Insured or a Family Member. Mental or Nervous Disorders A psychiatric or psychological condition classified in the most recent Diagnostic and Statistical Manual of Mental Health Disorders (DSM) published by the American Psychiatric Association (APA), as of the date of Covered Loss. If the DSM is discontinued or replaced, these disorders will be those classified in the diagnostic manual then used by the APA as of the date of Covered Loss. If the APA no longer publishes a diagnostic manual or the APA ceases to exist, we will use a comparable diagnostic manual. Nurse A healthcare professional trained to care for people with Injuries or Sicknesses. A Nurse may include a graduate Registered Nurse (R.N.), Licensed Practical Nurse (L.P.N.), or Licensed Vocational Nurse (L.V.N.). We will not recognize you, your Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you, as a Nurse for a claim that you send to us. Observation Unit A specified area within a Hospital, separate from the Emergency Department, where a patient can be monitored following a Surgical Procedure performed on an Outpatient Basis or treatment in the Emergency Department. The Observation Unit must: - be under the direct supervision of a Physician or registered Nurse; - be staffed by Nurses assigned specifically to that unit; and - provide care seven days per week, 24 hours a day. Occupational Therapy The treatment of an Insured by means of constructive activities designed and adapted to promote the restoration of the person's ability to satisfactorily accomplish the ordinary tasks of daily living and those tasks required by the person's particular occupational role. For purposes of this certificate, the following do not meet the Glossary definition of Occupational Therapy: - diversional therapy; - recreational therapy; and - any vocational therapies (e.g. hobbies, arts, and crafts). Off -Job Accident A Covered Accident that occurs while an Insured is not working at any job for pay or benefits. On -Job Accident A Covered Accident that occurs while an Insured is working at any job for pay or benefits. Outpatient Basis Medical care and treatment received without being admitted to a Hospital or other facility. GAC4100-C-FL Group Accident Certificate 48 Colonial Life & Accident Insurance Company 133 Payable Claim A claim for which we are liable for under the terms of this certificate. Pet A domestic animal that lives with an Insured and is dependent on the Insured for primary care and maintenance. Pet Boarding Facility An appropriately licensed independent animal care provider or facility specializing in the care and overnight or long-term boarding of animals that is not owned or operated by an Insured or a Family Member. Physical Therapy Treatment by physical means, hydrotherapy, heat or similar modalities, physical agents, bio-mechanical, and neuro-physiological principles and devices. Such therapy is given to relieve pain, restore function, and to prevent additional Injury following Injury or loss of a body part. Physician A person performing tasks that are within the limits of their medical license and is also: - a legally qualified medical practitioner according to the laws and regulations of the governing jurisdiction; - licensed to practice medicine, prescribe and administer drugs, or to perform surgery; or - a person with a doctoral degree in Psychology (Ph.D. or Psy.D.) whose primary practice is treating patients. We will not recognize you, a Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you, as a Physician for a claim that you send to us. Policy The Group Accident Insurance Policy issued to the Policyholder, including this Certificate of Coverage and any riders, amendments and endorsements, and other attachments approved for use with this certificate and the Policy. Policyholder The entity to which the Policy is issued. It includes any division, subsidiary or affiliated company named in the Policy Rate Schedule. Qualifying Life Event For coverage determination purposes, a Qualifying Life Event means an event including, but not limited to: - birth, adoption, or addition of a Child; - a change in legal marital status; - a change in employment status; or - death of an Insured. Qualifying Life Event coverage changes made in accordance with the Start of Coverage provisions must be consistent with the Qualifying Life Event. Regular Occupation The occupation you are routinely performing. We will look at your occupation as it is normally performed in the national economy, instead of how the work tasks are performed for a specific employer at a specific location. Rehabilitation Unit An appropriately licensed facility that provides rehabilitation care services on an inpatient basis. The care services provided by the Rehabilitation Unit must: - consist of the combined use of medical, social, educational, and vocational services to enable patients disabled by accidental Injury or Sickness to achieve the highest possible functional ability; and - be provided by or under the supervision of an organized staff of Physicians. GAC4100-C-FL Group Accident Certificate 49 Colonial Life & Accident Insurance Company 134 The Rehabilitation Unit may be part of a Hospital or a standalone facility. For purposes of this certificate, the following do not meet the Glossary definition of Rehabilitation Unit: - a nursing home, a rest home, home for the aged, or an assisted living facility; - a hospice care facility; - a Sub -Acute Rehabilitation Unit; - a psychiatric unit or facility for the treatment of Mental or Nervous Disorders; and Respiratory Therapy X (‹t - a facility for the treatment of Substance Abuse. Treatment and assistance used to recover lung function. Sexual Assault Any nonconsensual sexual act proscribed by Federal, tribal, or State law, including when the victim Tacks capacity to consent. Sickness An illness or disease. — e Speech Therapy Treatment and assistance for disorders related to speech, language, cognitive -communication, voice, swallowing, and fluency. Spouse The person who is your partner through lawful marriage, civil union, domestic partnership (established by a declaration acceptable to us), or your legally separated Spouse. Your Spouse may not be insured as both a Spouse and an Employee. Sub -Acute Rehabilitation Unit A licensed facility or distinct part of a facility supervised at all times by a Physician or Nurse. The facility must provide care to people with Injuries or Sicknesses on an inpatient basis. The Sub -Acute Rehabilitation Unit must have a Physician available at all times and have a transfer agreement in effect with one or more participating Hospitals. For purposes of this certificate, the following do not meet the Glossary definition of Sub -Acute Rehabilitation Unit: - a nursing home, a rest home, home for the aged, or an assisted living facility; - a hospice care facility; a Rehabilitation Unit; - a psychiatric unit or facility for the treatment of Mental or Nervous Disorders; and a facility for the treatment of Substance Abuse. Substance Abuse Abuse of or addiction to drugs or alcohol. Surgical Procedure The cutting into the skin or other organ to accomplish any of the following goals: - further explore the condition for the purpose of diagnosis; - take a biopsy of a suspicious lump; - remove diseased tissues or organs; - remove an obstruction; - reposition structures to their normal position; - redirect channels; GAC4100-C-FL Group Accident Certificate 50 Colonial Life & Accident Insurance Company 135 - transplant tissue or whole organs; - implant mechanical or electronic devices; - repair an area that has been injured or affected by trauma, overuse, or Sickness; or - restore proper function. For purposes of this certificate, the following do not meet the Glossary definition of Surgical Procedure: - venipuncture (drawing blood); - lumbar puncture; - epidural steroid injections; - removal of skin tags; and - foreign body removal from the eye. Telemedicine A medical inquiry with a Physician via the use of telecommunication and information technologies (including, but not limited to, audio or video communications) for the Insured's evaluation, diagnosis, or treatment as would be practiced in person. This does not include requests for prescription refills or medical records. Therapist A health care professional appropriately licensed by the state to perform Therapy Services with the exception of you, your Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you. Urgent Care Facility A health care facility that is organizationally separate from a Hospital with the primary purpose of offering and providing urgent and immediate, short-term medical care, without an appointment. Vestibular Therapy Treatment and assistance for balance and dizziness problems, and vestibular disorders. Writing or Written A record on or transmitted by paper, electronic, or telephonic means consistent with applicable law. GAC4100-C-FL Group Accident Certificate 51 Colonial Life & Accident Insurance Company 136 Colonial Life & Accident Insurance Company 1200 Colonial Life Blvd., P.O. Box 1365, Columbia, SC 29202 (800) 325-4368 coloniallife.com A Stock Company Group Accident Insurance Certificate of Coverage We welcome you as a customer and are committed to providing quality service. This is your Accident Certificate of Coverage. Accident coverage can ease the potential financial impact of unforeseen accidents by providing benefits. This certificate describes your Accident benefits in detail. Policyholder: ABC Company Policy Number: 123456-000 Policy Effective Date: January 1, 2024 Policy Anniversary: January 1 Governing Jurisdiction: Florida This certificate is issued to you under the Policy which is a contract between us and the Policyholder. If the terms and provisions of this certificate are different from the Policy, the Policy will govern. A copy of the Policy may be made available to you upon request. The Policy is delivered in and is governed by the laws of the governing jurisdiction and to the extent applicable, the Employee Retirement Income Security Act of 1974 (ERISA) and any amendments. All references to provisions, sections, and defined terms found within this certificate have been capitalized. If you have any questions about the terms and provisions of this certificate, please contact the Policyholder or us at (800) 325-4368 Monday through Friday 8 a.m. to 8 p.m. Eastern Standard Time. This Certificate of Coverage provides limited benefits under the non -participating Policy. The limited benefits provided under this Certificate of Coverage are a supplement to major medical coverage and are not a substitute for major medical coverage or other minimal essential coverage as required by federal law. This certificate contains certain proof of loss requirements, limitations, exclusions, and other provisions that may reduce benefits or prevent an Insured from receiving benefits under this certificate. Please read your certificate carefully and keep it in a safe place. Premiums are subject to periodic changes. This certificate replaces any and all certificates previously issued for the eligible classes under the Policy. Your certificate may include notices as required by your state of residence that may impact your benefits. If you have any questions or concerns regarding your state regulations, you may contact the Florida Office of Insurance Regulation at (850) 413-5914. Right to Return this Certificate If, for any reason, you are not satisfied with this certificate, you can return it to us within 30 days after you receive it. At that time, you should ask us in Writing to cancel it. We will consider this certificate as if it never existed and any premium paid will be refunded. You may contact us at (800) 325-4368 for assistance with any questions or complaints Signed for Colonial Life & Accident Insurance Company: President and Chief Executive Officer Secretary GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 137 1 TABLE OF CONTENTS ACCIDENT HIGHLIGHTS 3 ACCIDENT DETAILS 8 INJURY BENEFITS 8 FRACTURES AND DISLOCATIONS 12 TREATMENT BENEFITS %, 13 SURGERY BENEFITS 19 HOSPITAL BENEFITS 22 RECOVERY CARE BENEFITS 24 ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITSc) 27 ADDITIONAL BENEFITS V 29 EXCLUSIONS AND LIMITATIONS 33 OTHER FEATURES � 35 START OF COVERAGE 37 CONTINUATION AND END OF COVERAGE 37 CLAIM PROVISIONS 39 C)</ GENERAL PROVISIONS 41 GLOSSARY 43 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 138 ACCIDENT HIGHLIGHTS Accident Insurance provides financial protection for an Insured by paying benefits if an Insured is involved in a Covered Accident that results in a Covered Loss payable under this certificate. This section includes highlights of an Insured's coverage. Please refer to the Accident Details for further information on the benefits available. Eligible Group(s) Group 1 All full-time Employees in Active Employment in the United States working a required minimum of 15 hours per week. Schedule of Benefits Policyholder: ABC Company Policy Number: 123456-000 Named Insured: John A. Doe Certificate Number: 123456-000 Coverage Type: Two Parent Family Governing Jurisdiction: Florida Coverage Effective Date: January 1, 2024 Billing Control Number: E123456 Accident Type: On & Off Job The benefits an Insured may receive for a Payable Claim are listed in the Schedule of Benefits, subject to all other terms and provisions of this certificate. Amounts are the same for all Insureds, unless noted otherwise. Multiple benefits may be payable for a single Covered Accident. Group 1 Benefit Categories Benefit Amount Injury Benefits Burns 2nd Degree Burns At least 5%, but less than 20% of skin surface $500 20% or greater of skin surface $1,000 3rd Degree Burns Less than 5% of skin surface $2,000 At least 5%, but less than 20% of skin surface $7,000 20% or greater of skin surface $15,000 Concussion $375 Connective Tissue Damage One Connective Tissue $100 Two or more Connective Tissues $200 Eye Injury $300 Hearing Loss Injuries $120 Injury due to Auto Accident $250 Injury due to Felonious Act of Violence or Sexual Assault $250 Internal Injuries $200 Knee Cartilage (Meniscus) Injury $150 Lacerations No Repair $50 Repair Less than 2 inches $150 At least 2 inches but less than 6 inches $300 6 inches or greater $600 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 139 3 Loss of a Digit — Partial Partial Dismemberment of one finger or toe $300 Partial Dismemberment of two or more fingers or toes $600 Loss of a Digit One Digit (except a Thumb or Big Toe) $750 One Digit (a Thumb or Big Toe) $1,000 Two or more Digits $2,000 Ruptured or Herniated Disc One Disc $150 Two or more Discs $300 Fractures and Dislocations eft 0 Fractures Ankle (including malleus and lower tibia or fibula) $1,200 Bones of the Face or Nose (except mandible or maxilla) $910 Coccyx, Sacrum $320 Collarbone (clavicle, sternum) $1,200 Finger $200 Foot or Heel (except toes) $1,200 Forearm (radius or ulna) $1,200 Hand (except fingers) $1,200 Hip $3,150 Kneecap (patella) $1,200 Leg (mid to upper tibia and/or fibula) $1,800 Lower Jaw, mandible (except alveolar process) $1,200 Pelvis (includes ilium, ischium, pubis, acetabulum except coccyx) $2,400 Rib $375 Shoulder Blade (scapula) $1,200 Skull, Depressed Skull fracture (except bones of face or nose) $3,750 Skull, Non -depressed Skull fracture (except bones of face or nose) $1,800 Thigh (femur) $3,150 Toe $200 Upper Arm between Elbow and Shoulder (humerus) $1,050 Upper Jaw, maxilla (except alveolar process) $1,050 Vertebrae, body of (except vertebral processes) $2,700 Vertebral Processes $630 Wrist (except fingers) $1,200 Chip Fracturel(r Payable as a % of the applicable Fractures benefit 25% Dislocations Ankle $1,200 Bone or Bones of the Foot (except toes) $1,200 Bone or Bones of the Hand (except fingers) $810 Collarbone (acromioclavicular and separation) $200 Collarbone (sternoclavicular) $800 Elbow $450 Finger $200 Hip $3,000 Knee (except patella) $1,500 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 140 4 Lower Jaw $720 Shoulder (glenohumeral) $1,200 Toe $200 Wrist $600 Incomplete Dislocation Payable as a % of the applicable Dislocations benefit 25% Treatment Benefits Air Ambulance $1,500 Ambulance (Ground or Water) $300 Durable Medical Equipment Tier 1 $50 Tier 2 $100 Tier 3 $200 Emergency Dental Repair Dental Crown, Denture or Implant $300 Dental Extraction, Filling or Chip Repair $100 Emergency Department $200 Family Care $50 Injections to Prevent or Limit Infection $50 Lodging $200 Medical Imaging $200 Pain Management Injections $100 Pet Boarding $20 Prosthetic Device or Artificial Limb One Device or Limb $1,250 Two or more Devices or Limbs N $2,500 Skin Grafts Due to Burns le Payable as a % of tkapplicable Burn benefit 50% Not due to Burns Less than 20% of skin surface $250 20% or greater of skin surface $500 Transfusions $400 Transportation $150 Treatment in a Physician's Office or Urgent Care Facility $100 X-ray or Ultrasound $60 Surgery Benefits o► 0 Anesthesia Epidural or Regional Anesthesia $150 General Anesthesia $250 Connective Tissue Surgery Exploratory without Repair $125 Repair for One Connective Tissue $800 Repair for Two or more Connective Tissues $1,600 Dislocations — Surgical Repair Payable as a % of the applicable Injury Benefit 100% Eye Surgery $300 Fractures — Surgical Repair Payable as a % of the applicable Injury Benefit 100% General Surgery Abdominal, Thoracic, or Cranial $1,500 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 141 5 Exploratory $225 Hernia Surgery $300 Knee Cartilage (Meniscus) Surgery Exploratory without Repair $100 Knee Cartilage (Meniscus) with Repair $600 Outpatient Surgical Facility $300 Ruptured or Herniated Disc Surgery Exploratory without Repair $125 Repair for One Disc $750 Repair for Two or more Discs $1,500 Hospital Benefits Admission $1,000 Admission — Hospital ICU $1,750 Hospital Confinement - Daily Stay $250 Hospital ICU Confinement - Daily Stay $400 Hospital Sub -Acute ICU Confinement - Daily Stay $350 Short Stay $200 Recovery Care Benefits At -Home Care $100 Behavioral Health Therapy $45 Physician Follow -Up Visits $50 Post -Traumatic Stress Disorder (PTSD) $200 Prescription Drug $25 Rehabilitation or Sub -Acute Rehabilitation Unit Confinement $150 Therapy Services $45 Accidental Death and Dismemberment Benefits ' Aft ,..) Accidental Death Named Insured $50,000 Spouse $50,000 Children $10,000 Accidental Death — Common Carrier Named Insured $200,000 Spouse $200,000 Children $40,000 Accidental Dismemberment Both Feet $75,000 Both Hands $75,000 One Foot $9,000 One Hand $9,000 Thumb and Index Finger of the same Hand $4,500 Coma $10,000 Home Alterations and Automobile Modifications $1,500 Loss of Use Hearing (one ear) $9,000 Hearing (both ears) $75,000 Sight of one Eye $9,000 Sight of both Eyes $75,000 Speech $75,000 Paralysis Uniplegia $9,000 GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 142 6 Hemiplegia $75,000 Paraplegia $75,000 Triplegia $75,000 Quadriplegia $75,000 Additional Benefits Active Lifestyles Payable as an additional % of the applicable benefits 20% Benefit Booster $5,000 in Payable Claims $500 Building Benefit Payable as an additional % of the applicable benefits 13 months through 36 months 5% 37 months through 60 months 10% 61 months 15% Gunshot Wound $5,000 Healthcare Employee Benefit Payable as an additional % of the applicable benefits 50% Sickness Hospital Benefits Admission for Covered Sicknesses $400 Admission - Hospital ICU for Covered Sicknesses $800 Hospital Confinement — Daily Stay for Covered Sicknesses $100 Short Stay for Covered Sicknesses $100 Wellbeing Assistance Benefit $50 G GAC4100-C-FL Group Accident Certificate 7 Colonial Life & Accident Insurance Company 143 ACCIDENT DETAILS The information in this section provides details about the benefits that may be payable to you, any applicable Exclusions and Limitations, and Other Features included in your coverage. Benefits will only be payable for Covered Accidents that occur on or after the Insured's Coverage Effective Date. Benefits will not be paid for any Injury, treatment or care due to causes other than Covered Accidents. Benefits paid under this certificate may be taxable if the total benefits received are greater than unreimbursed out-of-pocket medical expenses. As with all tax matters, a tax advisor should be consulted to assess the impact of any benefits received. Iir Accident Type This certificate provides coverage for accidents that happen at any time, including while an Insured is working. INJURY BENEFITS Burns Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a 2nd or 3rd degree Burn in a Covered Accident and expenses are incurred. )‘ Burns are damage to the skin or deeper tissues caused by sun, hot liquids, fire, electricity, or chemicals. Burns are characterized by severe skin damage that causes the affected skin cells to die. A Physician must diagnose the Burn within 90 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains more than one type of Burn in a single Covered Accident, we will pay for the Burn with the highest benefit amount. Concussion Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Concussion in a Covered Accident and expenses are incurred. A Concussion is a mild traumatic brain injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance, and coordination. A Physician must diagnose the Concussion within 14 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Connective Tissue Damage Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains one or more torn, ruptured, or severed Connective Tissues in a Covered Accident and expenses are incurred. A Physician must diagnose the Connective Tissue Damage within 90 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate Colonial Life & Accident Insurance Company 144 8 For purposes of this benefit, the following are considered Connective Tissues: - tendons; - ligaments; - rotator cuffs; and - muscles. For purposes of this benefit, the following do not meet the Benefit Description of Connective Tissue Damage: - sprains; and - pulled muscles. Benefit Duration This benefit is payable once per Insured per Covered Accident. Eye Injury Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Eye Injury in a Covered Accident and expenses are incurred. The Eye Injury must require the removal of a foreign object with or without anesthesia. A Physician must remove the object within 90 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Hearing Loss Injuries Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an ear injury resulting in at least 50% hearing loss as the result of a Covered Accident and expenses are incurred. Treatment must be received by a Physician within 90 days of the Covered Accident. For purposes of this benefit, hearing loss means 50% deafness in one or both ears, such that it cannot be corrected to any functional degree by any procedure, aid or device. This benefit is not payable for hearing loss injuries due to a Sickness. Benefit Duration This benefit is payable once per lifetime per ear for each Insured injured in a Covered Accident. Injury due to Auto Accident Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Injury or dies due to a Covered Accident while traveling in an Automobile and was transported by a licensed professional Air Ambulance or Ambulance (Ground or Water) company to a Hospital or medical facility and expenses are incurred. Treatment must: - be due to Injuries received as the result of a covered Automobile accident; - be provided by a Physician in a Hospital Emergency Department; and - occur within three days after the Covered Accident. Benefit Duration GAC4100-C-FL Group Accident Certificate 9 Colonial Life & Accident Insurance Company 145 This benefit is payable once per Insured per Covered Accident. Injury due to Felonious Act of Violence or Sexual Assault Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a qualifying treatment due to an Injury sustained as a victim of a Felonious Act of Violence or Sexual Assault in a Covered Accident and expenses are incurred. Any Payable Claim under this benefit must include a police report. Treatment must: - be due to injuries received as the result of a Felonious Act of Violence or Sexual Assault; - be payable under this certificate's Emergency Department or Treatment in a Physician's Office or Urgent Care Facility provisions; occur within three days after the assault. Benefit Duration This benefit is payable a maximum of once per Insured per Calendar Year Internal Injuries Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Internal Injury in a Covered Accident and expenses are incurred. A Physician must diagnose the Internal Injury within 90 days of the Covered Accident. For purposes of this benefit, Internal Injuries include but are not limited to: - a collapsed or punctured lung; - a ruptured or torn spleen, kidney, or liver; or - a ruptured eardrum. For purposes of this benefit, the following do not meet the Benefit Description of Internal Injuries: bruised organs or muscles; - internal bleeding; - swollen glands or organs; - injuries to teeth, bones, joints or other connective tissues; and - injuries for which another Injury Benefit is payable. Benefit Duration This benefit is payable once per Insured per Covered Accident. Knee Cartilage (Meniscus) Injury Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a partially torn or fully torn Knee Cartilage in a Covered Accident and expenses are incurred. Knee Cartilage is the area of tissue which acts like a shock absorber in the joint called the meniscus. The meniscus may be partially torn or fully torn by a forceful knee movement while weight bearing on the same leg. A Physician must confirm the Knee Cartilage (Meniscus) Injury within 90 days of the Covered Accident by an MRI, other medical imaging study, or Surgical Procedure. Benefit Duration GAC4100-C-FL Group Accident Certificate 10 Colonial Life & Accident Insurance Company 146 This benefit is payable once per Insured per Covered Accident. Lacerations Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Laceration in a Covered Accident and expenses are incurred. A Laceration is an open wound or cut on the outside of the body. A Physician must treat the Laceration within three days of the Covered Accident. For purposes of this benefit, the following are considered repair techniques used by a Physician: - stitches; - staples; and ii)Sfr - tissue adhesive. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains multiple Lacerations in a Covered Accident, the amount payable will be based on the total length of all Lacerations sustained requiring repair. Loss of a Digit — Partial Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains permanent, partial loss of one or more fingers, thumbs, or toes in a Covered Accident and expenses are incurred. A Physician must treat the Loss of a Digit — Partial within 90 days of the Covered Accident. For purposes of this benefit, the following losses meet the Benefit Description of Loss of a Digit — Partial: - Partial loss of a finger means the finger is cut off at the joint other than the first interphalangeal joint where it is attached to the hand; - Partial loss of a toe means the toe is cut off at the joint other than the first interphalangeal joint where it is attached to the foot. Benefit Duration This benefit is payable once per Insured per Covered Accident. Loss of a Digit Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains permanent and total loss of one or more fingers, thumbs, or toes in a Covered Accident and expenses are incurred. A Physician must treat the Loss of a Digit within 90 days of the Covered Accident. For purposes of this benefit, the following losses meet the Benefit Description of Loss of a Digit: - for fingers and thumbs, the digit must be cut off at the joint proximate to the first interphalangeal joint where it is attached to the hand.; and - for toes, the digit must be cut off at the joint where it is attached to the foot. Benefit Duration This benefit is payable once per Insured per Covered Accident. GAC4100-C-FL Group Accident Certificate 11 Colonial Life & Accident Insurance Company 147 Ruptured or Herniated Disc Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Ruptured or Herniated Disc in a Covered Accident and expenses are incurred. A Ruptured or Herniated Disc, also known as a slipped disc, occurs when one of the intervertebral discs in the spine develops a crack in its outer wall, allowing the inner core to leak out into the spinal canal, causing pain or numbness. A Physician must diagnose the Ruptured or Herniated Disc within 90 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. FRACTURES AND DISLOCATIONS t+ Fractures r Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a fracture as the result of a Covered Accident and expenses are incurred. If an Insured has a Chip Fracture, we will pay the percentage amount shown in the Schedule of Benefits for the bone involved. A Fracture is a break of a bone. A Chip Fracture is a Fracture in which a piece of the bone is broken off near a joint at a place where a ligament is usually attached. A Physician must confirm the bone fracture within 90 days of the Covered Accident. For purposes of this benefit, a bone injury diagnosed as a stress fracture does not meet the definition of Fractures. If the fracture requires a Surgical Procedure, an Insured may also be eligible for the Fractures — Surgical Repair benefit. Benefit Duration This benefit is payable once per Insured per bone per Covered Accident. If an Insured sustains multiple Fractures of the same bone in a Covered Accident, we will only pay one Fractures benefit for that bone. If an Insured sustains Fractures of multiple bones in a Covered Accident, we will pay for each bone, but will pay no more than two times the combined total amount of the Fractures benefit and the Fractures — Surgical Repair benefits for the bone involved with the highest benefit amount. If an Insured sustains a Dislocation and a Fracture in the same Covered Accident, we will pay for both. However, we will pay no more than two times the combined total amount of the Dislocations benefit and the Fractures benefit and the corresponding Surgical Repair benefit for the bone or joint involved which has the highest benefit amount. Dislocations Benefit Description GAC4100-C-FL Group Accident Certificate 12 Colonial Life & Accident Insurance Company 148 We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a dislocated joint in a Covered Accident and expenses are incurred. The Dislocation must require correction with anesthesia by a Physician. If the Dislocation requires reduction without anesthesia by a Physician, we will pay the percentage amount shown in the Schedule of Benefits for a dislocation of the joint involved. If an Insured has an Incomplete Dislocation, we will pay the percentage amount shown in the Schedule of Benefits for the joint involved. A Dislocation is an Injury to a joint where the ends of the bones are forced from their normal positions. An Incomplete Dislocation is a Dislocation in which the joint is not completely separated. A Physician must set the dislocated joint within 90 days of the Covered Accident. If the Dislocation requires a Surgical Procedure, an Insured may also be eligible for the Dislocations - Surgical Repair benefit. Benefit Duration If an Insured sustains multiple dislocated joints in a Covered Accident, we will pay for each joint, but will pay no more than two times the combined total amount of the Dislocations benefit and the Dislocations — Surgical Repair benefit for the joint involved with the highest benefit amount. If an Insured sustains a Dislocation and a Fracture in the same Covered Accident, we will pay for both. However, we will pay no more than two times the combined total amount of the Dislocations benefit and the Fractures benefit and the corresponding Surgical Repair benefit for the bone or joint involved which has the highest benefit amount. We will pay this benefit only for the first Dislocation of a joint after the Coverage Effective Date shown in the Schedule of Benefits. Subsequent Dislocations of the same joint after the Coverage Effective Date shown in the Schedule of Benefits will not be covered under this benefit. TREATMENT BENEFITS Air Ambulance AP& Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if a licensed professional air ambulance company transports an Insured by air to or from a Hospital or between medical facilities where treatment is received due to Injuries sustained in a Covered Accident and expenses are incurred. If an Insured is treated by Air Ambulance staff, but is not transported for a Covered Accident, we will pay the corresponding amount shown for Ambulance (Ground or Water). The Air Ambulance transportation must be within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Ambulance (Ground or Water) Benefit Description GAC4100-C-FL Group Accident Certificate 13 Colonial Life & Accident Insurance Company 149 We will pay the corresponding amount shown in the Schedule of Benefits if a licensed professional ambulance company transports an Insured by ground or water to or from a Hospital or between medical facilities where treatment is received due to Injuries sustained in a Covered Accident and expenses are incurred. If an Insured is treated by Ambulance staff, but is not transported for a Covered Accident, we will pay the corresponding amount shown for Ambulance (Ground or Water). The Ambulance (Ground or Water) transportation must be within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident for Ambulance (Ground or Water) transportation. Durable Medical Equipment Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is prescribed Durable Medical Equipment by a Physician or Therapist as an aid in treatment, recovery, or mobility due to Injuries sustained in a Covered Accident and expenses are incurred. The Durable Medical Equipment must be prescribed to the Insured within 90 days of the Covered Accident. Durable Medical Equipment Tier 1 - Arm Sling - Cane - Medical Ring Cushion - Neck Brace - Wrist or Ankle Splint <(t Tier 2 - Bedside Commode - Cold Therapy System (Cryothepy) - Crutches - Leg Brace - Shower Chair - Walker or Walking Boot that extends above the ankle Tier 3 - Back Brace - Body Jacket - Continuous Passive Movement (CPM) - Electric Scooter - Halo - Hospital Bed - Knee Scooter - Stair Lift Chair - Wheelchair We will use the current relative value to determine the appropriate Tier amount for any medical equipment not listed above. For purposes of this benefit, the Durable Medical Equipment must: - be designed for and able to withstand repeated use by more than one person; GAC4100-C-FL Group Accident Certificate 14 Colonial Life & Accident Insurance Company 150 - customarily serve a medical purpose; and - be generally not useful in the absence of an Injury. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured is prescribed multiple pieces of Durable Medical Equipment as a result of a single Covered Accident, we will pay the amount for the highest Tier. Emergency Dental Repair Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured has an Emergency Dental Repair for a partially broken or broken tooth sustained in a Covered Accident and expenses are incurred. The partially broken or broken tooth must require repair by a Dental Crown, Denture or Implantor Dental Extraction, Filling or Chip Repair. The Emergency Dental Repair must be within 180 days of the Covered Accident. Benefit Duration Each Emergency Dental Repair benefit shown on the Schedule of Benefits is payable once per Insured per Covered Accident regardless of the number of teeth involved. Emergency Department Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured requires examination or treatment by a Physician in the Emergency Department due to Injuries sustained in a Covered Accident and expenses are incurred. Emergency Department treatment must be within three days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident, up to a maximum of four times per Insured per Calendar Year. Family Care Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for Family Care that takes place when an Insured has a Child attending a Child Care Center during an Insured's period of Confinement or when an Insured undergoes a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. Benefit Duration This benefit is payable a maximum of one benefit per day for all Insureds combined, up to a maximum of three days per Covered Accident, regardless of the number of Children. Injections to Prevent or Limit Infection Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives an injection after exposure to bacteria, viruses, or venom in a Covered Accident and expenses are incurred. A Physician must administer the injection within 180 days of the Covered Accident. For purposes of this benefit, Injections to Prevent or Limit Infection include, but are not limited to: GAC4100-C-FL Group Accident Certificate 15 Colonial Life & Accident Insurance Company 151 - tetanus boosters; - rabies shots; - antivenom; and - immune globulin. For the purposes of this benefit, the following do not meet the Benefit Description of Injections to Prevent or Limit Infection: - immunizations; - tetanus boosters as part of routine medical care; and - EpiPen injections intended to limit an allergic reaction. Benefit Duration This benefit is payable once per Insured per Covered Accident. Lodging Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day of a hotel stay for a companion accompanying an Insured to a Surgical Procedure or during a period of Confinement due to Injuries sustained in a Covered Accident and expenses are incurred. The Lodging must be within 180 days of the Covered Accident. The Surgical Procedure or Confinement must be at a Hospital or other medical facility more than 50 miles from the companion's residence. Benefit Duration This benefit is payable up to a maximum of 30 days per Covered Accident. Medical Imaging Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Medical Imaging Test ordered by a Physician due to Injuries sustained in a Covered Accident and expenses are incurred. The Medical Imaging must be within 180 days of the Covered Accident. Medical Imaging Tests - Bone Scan; - Computed Axial Tomography (CAT); - Computed Tomography Scan (CT); - Electroencephalogram (EEG); - Magnetic Resonance (MR); - Magnetic Resonance Angiogram (MRA); and - Magnetic Resonance Imaging (MRI). Benefit Duration This benefit is payable once per Insured per Medical Imaging Test per Covered Accident, regardless of the number of Medical Imaging Test ordered. Pain Management Injections Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives an injection for the purposes of blocking pain in a particular region of the body due to Injuries sustained in a Covered Accident and expenses are incurred. GAC4100-C-FL Group Accident Certificate 16 Colonial Life & Accident Insurance Company 152 Benefit Duration This benefit is payable once per Insured per Covered Accident. A Physician must administer the injection within 180 days of the Covered Accident. For purposes of this benefit, the following are considered Pain Management Injections: - cortisone shots; - steroid shots; and - epidural steroids. For the purposes of this benefit, the following do not meet the Benefit Description of Pain Management Injections: - oral prescriptions for pain relief; \t - over the counter pain medications; - topical pain management; - general, regional, or local anesthesia; and pain management injections for chronic pain or causes other than a Covered Accident. sop Pet Boarding Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for Pet Boarding that takes place during an Insured's period of Confinement or when an Insured undergoes a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. The Pet or Pets must be boarded overnight at a Pet Boarding Facility. Benefit Duration This benefit is payable a maximum of one benefit per day for all Insureds combined, up to a maximum of three days per Covered Accident, regardless of the number of Pets that are boarded. Prosthetic Device or Artificial Limb Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a Prosthetic Device or Artificial Limb for a permanently missing hand, arm, foot, leg, or eye due to Injuries sustained in a Covered Accident and expenses are incurred. The Prosthetic Device or Artificial Limb can be a newly required device or a replacement of an existing device, which was irreparably damaged in the Covered Accident. The Prosthetic Device or Artificial Limb must be received within 365 days of the Covered Accident. For purposes of this benefit, the following do not meet the Benefit Description of Prosthetic Device or Artificial Limb: - hearing aids; - dental aids (including false teeth); - eyeglasses; - cosmetic prostheses such as wigs; and - artificial hips, knees, or other joint replacements. Benefit Duration This benefit is payable once per Insured per Covered Accident. Skin Grafts Benefit Description GAC4100-C-FL Group Accident Certificate 17 Colonial Life & Accident Insurance Company 153 We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a Skin Graft due to Injuries sustained in a Covered Accident and expenses are incurred. A Skin Graft is the transplantation of a piece of skin to replace a lost portion of skin due to burns or other accidental traumatic loss of skin. The Insured must receive the Skin Graft within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per type of Skin Graft per Covered Accident. Transfusions Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives a Transfusion due to Injuries sustained in a Covered Accident and expenses are incurred. A Transfusion is the receipt of blood, plasma, or platelets intravenously. 'kL'‘j‘ The Transfusion must be within 180 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Transportation Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for any mode of Transportation, including a personal car, for an Insured if the Insured requires diagnosis, treatment, or a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. The Transportation must be within 180 days of the Covered Accident. The diagnosis, treatment, or Surgical Procedure must be at a Hospital or other medical facility more than 50 miles from the Insured's residence. For purposes of this benefit, any mode of Air Ambulance or Ambulance (Ground or Water) transportation does not meet the Benefit Description of Transportation. Benefit Duration This benefit is payable up to a maximum of six one-way trips per Insured per Covered Accident. A trip must either start or end at the Insured's residence. Treatment in a Physician's Office or Urgent Care Facility Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives initial examination or treatment by a Physician due to Injuries sustained in a Covered Accident and expenses are incurred. The Treatment in a Physician's Office or Urgent Care Facility must be within 14 days of the Covered Accident. For purposes of this benefit a routine physical or annual wellness exam and treatment that meets the Benefit Description of Therapy Services do not meet the Benefit Description of Treatment in a Physician's Office or Urgent Care Facility. Benefit Duration GAC4100-C-FL Group Accident Certificate 18 Colonial Life & Accident Insurance Company 154 This benefit is payable once per Insured per Covered Accident, up to a maximum of four times per Insured per Calendar Year. X-ray or Ultrasound Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes an X-ray or Ultrasound test ordered by a Physician due to Injuries sustained in a Covered Accident and expenses are incurred. The X-ray or Ultrasound must be within 180 days of the Covered Accident. For purposes of this benefit, X-rays are considered a single test, regardless of the number of images produced. Benefit Duration This benefit is payable once per Insured per Covered Accident. SURGERY BENEFITS Anesthesia Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if general, epidural, or regional Anesthesia is administered to an Insured during a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. General Anesthesia is the induction of a balanced state of unconsciousness, accompanied by the absence of pain sensation and the paralysis of skeletal muscle over the entire body. Epidural Anesthesia is an injection of anesthetic into the space between the spinal column and outer membrane of the spinal cord. _ Regional Anesthesia is the use of anesthetics to block sensations of pain from a large area of the body such as an arm, leg, or the abdomen. A Physician must administer the Anesthesia within 365 days of the Covered Accident. For purposes of this benefit, the following do not meet the Benefit Description of Anesthesia: - epidural anesthesia administered for Childbirth; - peripheral nerve blocks; and - local anesthesia used to temporarily numb a small area of the body. Benefit Duration This benefit is payable once per Insured per Covered Accident. Connective Tissue Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to treat one or more torn, ruptured, or severed Connective Tissues sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For purposes of this benefit, the following are considered Connective Tissues: - tendons; GAC4100-C-FL Group Accident Certificate 19 Colonial Life & Accident Insurance Company 155 - ligaments; - rotator cuffs; and - muscles. For the Connective Tissue Surgery benefit to be paid, a Connective Tissue Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Dislocations — Surgical Repair Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to repair a dislocated joint sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Dislocations — Surgical Repair benefit to be paid, a Dislocations Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per joint per Covered Accident. If an Insured sustains multiple dislocated joints in a Covered Accident and they are repaired with a Surgical Procedure, we will pay the Dislocations — Surgical Repair benefit for each joint but will pay no more than two times the amount for the joint involved with the highest benefit amount. Eye Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure with anesthesia due to an Eye Injury sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Fractures — Surgical Repair Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for a Surgical Procedure to repair a fractured bone sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Fractures — Surgical Repair benefit to be paid, a Fractures Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per bone per Covered Accident. If an Insured sustains multiple Fractures of the same bone in a Covered Accident and they are repaired with a Surgical Procedure, we will only pay one Fractures — Surgical Repair benefit for that bone. GAC4100-C-FL Group Accident Certificate 20 Colonial Life & Accident Insurance Company 156 If an Insured sustains Fractures of multiple bones in a Covered Accident and they are repaired with a Surgical Procedure, we will pay the Fractures — Surgical Repair benefit for each bone but will pay no more than two times the amount for the bone involved with the highest benefit amount. General Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure due to Injuries sustained in a Covered Accident and expenses are incurred. If an exploratory abdominal, thoracic, or cranial Surgical Procedure is performed, we will pay the corresponding amount for General Surgery — Exploratory. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For purposes of this benefit, the following are considered a General Surgery: - abdominal surgery; - thoracic surgery; - cranial surgery; and - exploratory. Benefits for General Surgery will not be paid for a Covered Accident for which any other Surgery Benefits are paid. Benefit Duration This benefit is payable once per Insured per Covered Accident. Hernia Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to repair a Hernia sustained in a Covered Accident and expenses are incurred. A hernia occurs when an organ is displaced and protrudes through the wall of the cavity containing it. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Knee Cartilage (Meniscus) Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to treat a Knee Cartilage (Meniscus) Injury sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Knee Cartilage (Meniscus) Surgery benefit to be paid, a Knee Cartilage (Meniscus) Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Outpatient Surgical Facility GAC4100-C-FL Group Accident Certificate 21 Colonial Life & Accident Insurance Company 157 Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure on an Outpatient Basis in a Hospital, Ambulatory Surgical Center, or other medical facility due to Injuries sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For purposes of this benefit, the following do not meet the Benefit Description of Outpatient Surgical Facility: - Surgical Procedures performed in the Emergency Department; and - Surgical Procedures performed while Confined in a Hospital or other medical facility. Benefit Duration This benefit is payable once per Insured per Covered Accident. Ruptured or Herniated Disc Surgery Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured undergoes a Surgical Procedure to treat a Ruptured or Herniated Disc sustained in a Covered Accident and expenses are incurred. A Physician must perform the Surgical Procedure within 365 days of the Covered Accident. For the Ruptured or Herniated Disc Surgery benefit to be paid, a Ruptured or Herniated Disc Injury benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. HOSPITAL BENEFITS Admission Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital due to Injuries sustained in a Covered Accident and expenses are incurred. ry The Admission and Confinement must be within 180 days of the Covered Accident. We will not pay the Admission benefit and the Admission - Hospital ICU benefit for the same Covered Accident concurrently. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. Benefit Duration This benefit is payable up to a maximum of one days per Insured per Covered Accident. Admission — Hospital ICU Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital ICU due to Injuries sustained in a Covered Accident and expenses are incurred. The Admission - Hospital ICU and Confinement must be within 180 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate 22 Colonial Life & Accident Insurance Company 158 We will not pay the Admission - Hospital ICU benefit and the Admission benefit for the same Covered Accident concurrently. Benefit Duration This benefit is payable up to a maximum of one days per Insured per Covered Accident. Hospital Confinement - Daily Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital due to Injuries sustained in a Covered Accident and expenses are incurred. The Confinement must begin within 180 days of the Covered Accident. We will not pay the Hospital Confinement — Daily Stay benefit and the Hospital ICU Confinement — Daily Stay benefit and the Hospital Sub -Acute ICU Confinement - Daily Stay benefit for the same Covered Accident concurrently. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. Benefit Duration This benefit is payable up to a maximum of 365 days per Insured per Covered Accident. Hospital ICU Confinement - Daily Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital ICU due to Injuries sustained in a Covered Accident and expenses are incurred. The Confinement must begin within 180 days of the Covered Accident. If the Hospital ICU Confinement extends beyond the maximum benefit shown in the Schedule of Benefits under the Hospital ICU Confinement - Daily Stay benefit, we will pay benefits under the Hospital Sub -Acute ICU Confinement - Daily Stay benefit: - until the Insured is released from Confinement for the Covered Accident; or - the maximum benefits payable under the Hospital Sub -Acute ICU Confinement - Daily Stay benefit have been reached. We will not pay the Hospital Confinement — Daily Stay benefit, the Hospital Sub -Acute ICU Confinement - Daily Stay benefit, and the Hospital ICU Confinement — Daily Stay benefit concurrently. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. Hospital Sub -Acute ICU Confinement — Daily Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital Sub -Acute ICU due to Injuries sustained in a Covered Accident and expenses are incurred. The Confinement must begin within 180 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate 23 Colonial Life & Accident Insurance Company 159 If the Hospital Sub -Acute ICU Confinement extends beyond the maximum benefit shown in the Schedule of Benefits under the Hospital Sub -Acute ICU Confinement - Daily Stay benefit, we will pay benefits under the Hospital Confinement - Daily Stay benefit: - until the Insured is released from Confinement for the Covered Accident; or - the maximum benefits payable under the Hospital Confinement - Daily Stay benefit have been reached. We will not pay the Hospital Confinement — Daily Stay benefit, the Hospital Sub -Acute ICU Confinement — Daily Stay benefit and the Hospital ICU Confinement — Daily Stay benefit concurrently. Benefit Duration This benefit is payable up to a maximum of 30 days per Insured per Covered Accident. Short Stay Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is treated on an Outpatient Basis due to a Covered Accident for minimum of eight consecutive hours in any of the following facilities and expenses are incurred: - Ambulatory Surgical Center; - Emergency Department; - Hospital; or - Observation Unit. The Short Stay must be within 180 days of the Covered Accident. Benefits for Short Stay will not be paid for any day that benefits are paid for Admission, Admission — Hospital ICU, Hospital Confinement - Daily Stay, Hospital ICU Confinement — Daily Stay, and Hospital Sub -Acute ICU Confinement — Daily Stay. Benefit Duration This benefit is payable up to a maximum of one day per Insured per Covered Accident. RECOVERY CARE BENEFITS At -Home Care Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured receives At - Home Care from a Nurse at the direction of a Physician and expenses are incurred. At -Home Care must be prescribed to begin within 14 days of release from the Hospital after a Surgical Procedure or period of Confinement due to Injuries sustained in a Covered Accident. For purposes of this benefit, the following services do not meet the Benefit Description of At -Home Care: - hospice care; and - any care provided by you, a Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you. Benefits for At -Home Care will not be paid for any day that benefits are paid for Hospital Admission, or Hospital ICU Admission, or Hospital Confinement — Daily Stay, or Hospital ICU Confinement — Daily Stay, or Hospital Sub -Acute ICU Confinement — Daily Stay, or Rehabilitation or Sub -Acute Rehabilitation Unit Confinement. Benefit Duration This benefit is payable up to a maximum of five days per Insured per Covered Accident. Behavioral Health Therapy GAC4100-C-FL Group Accident Certificate 24 Colonial Life & Accident Insurance Company 160 Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured receives Behavioral Health Therapy due to Injuries sustained in a Covered Accident and expenses are incurred. A licensed Mental Health Professional must provide the Behavioral Health Therapy to the Insured. The therapy must begin within 90 days after the Covered Accident and must be received within 365 days of the Covered Accident. We will pay either the Accident follow-up Physician Visit benefit or the Behavioral Health Therapy benefit for the same Covered Accident if the treatment occurs on the same date by the same Physician. When both treatments occur on the same date by the same Physician, we will pay the benefit with the highest benefit amount. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. Physician Follow -Up Visits Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured receives any of the following and expenses are incurred: - initial examination or treatment by a Physician due to Injuries sustained in a Covered Accident more than 14 days after the Covered Accident; or - follow-up care by a Physician prescribed to occur after the initial examination or treatment due to Injuries sustained in a Covered Accident. The Physician Follow -Up Visit must be within 365 days from the Covered Accident. For purposes of this benefit, care received in a Physician's office, Hospital, or through Telemedicine meets the Benefit Description of Physician Follow -Up Visit. For purposes of this benefit, routine physical or wellness exams do not meet the Benefit Description of Physician Follow -Up Visit. Benefit Duration This benefit is payable up to a maximum of four visit[s] per Insured per Covered Accident, up to a maximum of sixteen times per Insured per Calendar Year. Post -Traumatic Stress Disorder (PTSD) Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if a Physician diagnoses the Insured with PTSD due to a Covered Accident and expenses are incurred. Benefit Duration This benefit is payable once per Insured per Covered Accident. Prescription Drug Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if a Physician prescribes medication to an Insured due to Injuries sustained in a Covered Accident and expenses are incurred. Prescriptions must be filled at a pharmacy within 90 days of the Covered Accident. GAC4100-C-FL Group Accident Certificate 25 Colonial Life & Accident Insurance Company 161 For purposes of this benefit, the following do not meet the Benefit Description of Prescription Drug: - medication administered while Confined or during a Surgical Procedure; - medication administered on an Outpatient Basis; - medication recommended by a Physician that is available without a prescription (over-the-counter); - refills of a Prescription Drug for which a benefit has previously been paid under this certificate; and - therapeutic devices or Durable Medical Equipment. Benefit Duration This benefit is payable once per Insured per Covered Accident. Ae \<da. Rehabilitation or Sub -Acute Rehabilitation Unit Confinement Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Rehabilitation or Sub -Acute Rehabilitation Unit and expenses are incurred. The Insured must be transferred to the Rehabilitation or Sub -Acute Rehabilitation Unit for inpatient care immediately after a period of Confinement in a Hospital due to Injuries sustained in a Covered Accident. Benefits for Rehabilitation or Sub -Acute Rehabilitation Unit Confinement will not be paid for any day that benefits are paid for Hospital Admission, or Hospital ICU Admission, or Hospital Confinement — Daily Stay, or Hospital ICU Confinement — Daily Stay, or Hospital Sub -Acute ICU Confinement — Daily Stay, or At -Home Care. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. Therapy Services Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured receives Therapy Services due to Injuries sustained in a Covered Accident and expenses are incurred. A Physician must prescribe the Therapy Services to the Insured on an Outpatient Basis with a Physician or Therapist. The therapy must begin within 90 days after the Covered Accident and must be received within 365 days of the Covered Accident. For purposes of this benefit, the following are considered Therapy Services: Acupuncture Therapy; - Alternative Therapy; - Chiropractic Therapy; - Occupational Therapy; - Physical Therapy; - Respiratory Therapy; - Speech Therapy; and - Vestibular Therapy. For purposes of this benefit, therapy received in a Rehabilitation or Sub -Acute Rehabilitation Unit is considered inpatient and does not meet the Benefit Description of Therapy Services. Benefit Duration This benefit is payable up to a maximum of 15 days per Insured per Covered Accident. If more than one type of Therapy Service is received on the same day by the same Physician, we will pay only one day of Therapy Services. GAC4100-C-FL Group Accident Certificate 26 Colonial Life & Accident Insurance Company 162 ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS Accidental Death Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured dies due to Injuries sustained in a Covered Accident. The Accidental Death must be within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured. If we pay this benefit, we will not pay the Accidental Death — Common Carrier benefit. Accidental Death — Common Carrier Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured dies while traveling as a fare -paying passenger on a Common Carrier due to Injuries sustained in a Covered Accident. A Common Carrier is commercial transportation including airplanes, trains, buses, trolleys, subways, ferries and boats that operate on a regularly scheduled basis between predetermined points or cities. Taxis and privately chartered vehicles are not common carriers. The Accidental Death must be within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured. If we pay this benefit, we will not pay the Accidental Death benefit. Accidental Dismemberment Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Dismemberment in a Covered Accident and expenses are incurred. The Accidental Dismemberment must be within 365 days of the Covered Accident. For purposes of this benefit, the following losses meet the Benefit Description of Accidental Dismemberment: - for the loss of a foot, all of the foot is cut off at or above the ankle joint; - for the loss of a hand, all four fingers are cut off at or below the knuckles joining each to the hand; and - for the loss of a thumb and index finger, all of the thumb and index finger are cut off at or below the joint closest to the wrist. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains multiple Dismemberments in a single Covered Accident, we will pay for each Dismemberment, but will pay no more than the Insured's Accidental Death benefit amount. Coma Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is in a Coma for a period of seven or more consecutive days due to Injuries sustained in a Covered Accident and expenses are incurred. GAC4100-C-FL Group Accident Certificate 27 Colonial Life & Accident Insurance Company 163 A Coma is a continuous state of profound unconsciousness requiring intubation for respiratory assistance characterized by the absence of: - eye opening; - verbal response; and - motor response. Home Alterations and Automobile Modifications Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains an Injury due to a Covered Accident, which requires; - permanent structural alterations that were made to the Insured's primary residence to make it accessible and livable; or - modifications that were made to a primary Automobile to make it accessible to drive. A Physician must confirm the Coma within 365 days of the Covered Accident. For purposes of this benefit, the term Coma does not include any medically induced coma. 0<<t Benefit Duration This benefit is payable once per Insured per Covered Accident. The Home Alterations and Automobile Modifications must take place and expenses must be incurred within 365 days of the Covered Accident. This benefit will not be paid unless: - home alterations are recommended by a Physician; or modifications to an Automobile are recommended by a Physician, are made by a person or persons with experience in these types of modifications, and modifications are approved by the federal or state vehicle licensing authorities if required. For the Home Alterations and Automobile Modifications benefit to be paid, an Accidental Dismemberment, Loss of Use, or Paralysis Benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Loss of Use Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured loses the ability to hear, see, or speak due to Injuries sustained in a Covered Accident and expenses are incurred. A Physician must confirm the Loss of Use within 365 days of the Covered Accident. For the purposes of this benefit, the following losses meet the Benefit Description of Loss of Use: - for the loss of hearing, total deafness in one or both ears; - for the Toss of sight in one eye, the eye must be totally blind and no sight can be restored in that eye; - for the loss of sight in both eyes, the: - sight in the better eye reduced to a best corrected visual acuity of 20/200 or less (Snellen or E-Chart Acuity); - visual field remaining is less than 20° in the better eye; and - the Insured was not previously legally blind; and - for the loss of speech, the ability to speak is a total and irrecoverable loss. GAC4100-C-FL Group Accident Certificate 28 Colonial Life & Accident Insurance Company 164 For purposes of this benefit, any loss that can be corrected to any functional degree by any procedure, aid, or device does not meet the Benefit Description of Loss of Use. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured sustains multiple losses in a single Covered Accident, we will pay for each Loss of Use, but will pay no more than the Insured's Accidental Death benefit amount. Paralysis .1(dildw Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains Paralysis of one or more limbs in a Covered Accident and expenses are incurred. A Physician must confirm the Paralysis within 365 days of the Covered Accident. vr For the purposes of this benefit, the following types of Paralysis meet the Benefit Description of Paralysis: - for Uniplegia, the total and irreversible paralysis of any one limb; - for Hemiplegia, the total and irreversible paralysis of both limbs on either side of the body, for example the right arm and right leg, or the left arm and left leg; - for Paraplegia, the total and irreversible paralysis of any two limbs; - for Triplegia, the total and irreversible paralysis of any three limbs; and - for Quadriplegia, the total and irreversible paralysis of all four limbs. Benefit Duration This benefit is payable once per Insured per Covered Accident. ADDITIONAL BENEFITS Active Lifestyles Benefit Description We will pay the corresponding additional amount shown in the Schedule of Benefits if an Insured sustains any of the benefits listed below as the result of Injuries sustained in a Covered Accident. Concussion; Connective Tissue Damage; - Dislocations; - Emergency Dental Repair; Eye Injury; - Fracture; - Knee Cartilage (Meniscus) Injury; Lacerations; Medical Imaging; Ruptured or Herniated Disc; Surgery: - Connective Tissue Surgery - Exploratory without Repair, Repair for One Connective Tissue, Repair for Two or more Connective Tissues; - Dislocations - Surgical Repair; - Eye Surgery; - Fractures - Surgical Repair; - General Surgery - Abdominal, Thoracic, Cranial, Exploratory; - Knee Cartilage (Meniscus) Surgery - Exploratory without Repair, Knee Cartilage (Meniscus) with Repair; GAC4100-C-FL Group Accident Certificate 29 Colonial Life & Accident Insurance Company 165 - Ruptured or Herniated Disc Surgery — Exploratory without Repair, Repair for One Disc, Repair for Two or more Discs; and - X-Ray or Ultrasound. Benefit Duration This benefit is payable once per Insured per Covered Accident for applicable benefits. Benefit Booster Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits, if the total amount of Payable Claims for a Covered Accident equals or exceeds the amount shown in the Schedule of Benefits. For the purpose of this benefit, the Building Benefit does not apply to the total amount of Payable Claims. This benefit is payable for Payable Claims that occur within 365 days of the Covered Accident. Benefit Duration This benefit is payable once per Insured per Covered Accident. Building Benefit Benefit Description We will pay the corresponding additional amount shown in the Schedule of Benefits if an Insured sustains any of the benefits listed below as the result of a Covered Accident and expenses are incurred. This benefit is based on the number of months an Insured is continuously covered under this certificate. The applicable percentage amount will be calculated from your Coverage Effective Date to the date of the Covered Accident. This benefit will be payable for the following Benefit Categories as the result of Injuries sustained in a Covered Accident: - Injury Benefits; - Fractures and Dislocations;c)f - Treatment Benefits; Surgery Benefits; Hospital Benefits; - Recovery Care Benefits; Accidental Death and Dismemberment Benefits; and - The following Additional Benefits: - Active Lifestyles; - Gunshot Wound; - Healthcare Employee Benefit; For the Building Benefit to be paid, an applicable benefit must be paid first. Benefit Duration This benefit is payable once per Insured per Covered Accident. Gunshot Wound Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured sustains a Gunshot Wound as the result of a Covered Accident and expenses are incurred and which does not cause the Insured to die. Treatment must be received by a Physician, including Confinement in a Hospital, within 24 hours of the Covered Accident. GAC4100-C-FL Group Accident Certificate 30 Colonial Life & Accident Insurance Company 166 A Gunshot Wound is caused when a bullet or other projectile is shot into or through the body. The Gunshot Wound must be caused by a weapon which fires a shot (bullet or pellet) by gun powder or compressed gas. This benefit covers Gunshot Wounds received both on and off -job. Benefit Duration This benefit is payable once per Insured per Covered Accident. If an Insured is shot more than once in a 24-hour period, we will pay benefits only for the first wound. The Gunshot Wound benefit is not available for your Spouse or your Children. f Healthcare Employee Benefit Benefit Description We will pay the corresponding additional amount shown in the Schedule of Benefits if an Insured is admitted, Confined, or receives services in a Hospital owned, operated, or controlled by the Policyholder. This benefit will be payable for the following Benefit Categories as the result of Injuries sustained in a Covered Accident: - Hospital Benefits. Benefit Duration This benefit is payable once per Insured per Covered Accident for applicable benefits. Sickness Hospital Benefits Admission for Covered Sicknesses Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital due to a Covered Sickness and expenses are incurred. We will not pay the Admission for Covered Sicknesses benefit and the Admission - Hospital ICU for Covered Sicknesses benefit for the same Covered Sickness concurrently. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. Benefit Duration This benefit is payable up to a maximum of one day per Insured per Covered Sickness. Admission - Hospital ICU for Covered Sicknesses Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is admitted and Confined to a Hospital ICU due to a Covered Sickness and expenses are incurred. We will not pay the Admission - Hospital ICU for Covered Sicknesses benefit and the Admission for Covered Sicknesses benefit for the same Covered Sickness concurrently. GAC4100-C-FL Group Accident Certificate 31 Colonial Life & Accident Insurance Company 167 Benefit Duration This benefit is payable up to a maximum of one day per Insured per Covered Sickness. Hospital Confinement — Daily Stay for Covered Sicknesses Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits for each day an Insured is Confined in a Hospital due to a Covered Sickness and expenses are incurred. We will not pay the Hospital Confinement — Daily Stay for Covered Sicknesses benefit and the Hospital ICU Confinement — Daily Stay for Covered Sicknesses benefit for the same Covered Sickness concurrently. For purposes of this benefit, the following Hospital services are not eligible: - treatment in the Emergency Department; - treatment on an Outpatient Basis; and - any Confinement of less than 20 hours. rN Benefit Duration This benefit is payable up to a maximum of 365 days per Insured per Covered Sickness. Short Stay for Covered Sicknesses Benefit Description We will pay the corresponding amount shown in the Schedule of Benefits if an Insured is treated on an Outpatient Basis due to a Covered Sickness for minimum of eight consecutive hours in any of the following facilities and expenses are incurred: - Ambulatory Surgical Center; - Emergency Department; - Hospital; or - Observation Unit. Benefits for Short Stay for Covered Sicknesses will not be paid for any day that benefits are paid for Admission for Covered Sicknesses, and Admission - Hospital ICU for Covered Sicknesses, and Hospital Confinement — Daily Stay for Covered Sicknesses. Benefit Duration This benefit is payable up to a maximum of one day per Insured per Calendar Year. Wellbeing Assistance Benefit Benefit Description We will pay the corresponding amount shown on the Schedule of Benefits as a result of having one of the routine, preventative tests covered by this certificate. The test must be performed after the 30 day Benefit Waiting Period has been satisfied. The Benefit Waiting Period is the period of time during which Insureds must have continuous coverage before benefits for Wellbeing Assistance become payable. The covered tests include: - Annual Physical; - examples include: - Annual exams; - Sports Physicals; - Well -child visits; - Blood test for triglycerides; - Bone marrow testing; - BRCA1 or BRCA2 testing; - Breast ultrasound; GAC4100-C-FL Group Accident Certificate 32 Colonial Life & Accident Insurance Company 168 - Carotid Doppler; - CA 15-3; CA 125; CEA; - Chest X-ray; Colonoscopy; - Electrocardiogram (EKG, ECG); - Echocardiogram (ECHO); Fasting blood glucose; - Flexible sigmoidoscopy; Hemoccult stool analysis; Immunizations; - Mammography; - Pap smear; - PSA; - Serum protein electrophoresis; Serum cholesterol test for HDL and LDL; Skin cancer biopsy; - Stress test on a bicycle or treadmill; Thermography; - ThinPrep pap test; or - Virtual colonoscopy. Benefit Duration This benefit is payable a maximum of once per Insured per Calendar Year. EXCLUSIONS AND LIMITATIONS •<</ Exclusions We will not pay benefits for a claim that is caused by, contributed to by, or resulting from any of the following: Elective Procedures - elective procedures, cosmetic surgery, or reconstructive surgery unless it is a result of organ donation, trauma, infection, or other diseases. Felonies or Illegal Occupations - committing or attempting to commit a felony; - being engaged in an illegal occupation or activity. Hazardous Avocations - operating, learning to operate, serving as a crew member of any aircraft or hot air balloon, including those which are not motor -driven, unless flying as a fare paying passenger; jumping, parachuting, or falling from any aircraft or hot air balloon, including those which are not motor - driven; - travel or flight in any aircraft or hot air balloon, including those which are not motor -driven, if it is being used for testing or experimental purposes, used by or for any military authority, or used for travel beyond the earth's atmosphere; - engaging in hang-gliding, bungee jumping, sail gliding, parasailing, parakiting, or BASE jumping. Impaired Driving - Operating any motorized vehicle while under the influence of intoxicants or narcotics. GAC4100-C-FL Group Accident Certificate 33 Colonial Life & Accident Insurance Company 169 Incarceration - a Covered Loss that occurs while an Insured is legally incarcerated in a penal or correctional institution. Racing - Riding or driving an air, land or water vehicle in a race, speed or endurance contest. Semi-professional or Professional Sports - practicing for or participating in any semi-professional or professional competitive athletic contests for which any type of compensation or remuneration is received. Sickness - any Sickness, bodily infirmity, or other abnormal physical condition or Mental or Nervous Disorders, including diagnosis, treatment, or surgery for it. The Mental or Nervous Disorders exclusion does not apply to the Behavioral Health Therapy benefit when the condition is due directly to a Covered Accident; - Infection. This exclusion does not apply when the infection is due directly to an Injury sustained in a Covered Accident. Suicide or Self -Inflicted Injuries - injuring oneself intentionally or attempting or committing suicide, whether sane or not. War or Armed Conflict - active participation in a riot, insurrection, or terrorist activity. This does not include civil commotion or disorder, Injury as an innocent bystander, or Injury for self-defense. Losses as a result of terrorist activity committed by individuals or groups will not be excluded from coverage unless the Insured who suffered the loss committed the terrorist activity; - participating in war or any act of war, whether declared or undeclared; - combat or training for combat while serving in the armed forces of any nation or authority, including the National Guard, or similar government organizations. Additionally, no benefits will be paid for a Covered Loss that occurs prior to the Coverage Effective Date. Exclusions and Limitations for Sickness Hospital Benefits All of the Exclusions listed in the certificate apply to the Sickness Hospital Benefits except: Sickness - any Sickness, bodily infirmity, or other abnormal physical condition or Mental or Nervous Disorders, including diagnosis, treatment, or surgery for it; - Infection. This exclusion does not apply when the infection is due directly to a cut or wound sustained in a Covered Accident. In addition, we will not pay benefits for a claim that is caused by, contributed to by, or resulting from any of the following: Dental Care - treatment for dental care or dental care procedures. Mental or Nervous Disorders - Having a psychiatric or psychological condition including, but not limited to, affective disorders, neuroses, anxiety, stress and adjustment reactions. However this exclusion does not include dementia if it is a result of: - stroke, Alzheimer's disease, trauma, viral infection; or - other conditions which are not usually treated by a Mental Health Professional or other qualified provider using psychotherapy, psychotropic drugs, or other similar methods of treatment. GAC4100-C-FL Group Accident Certificate 34 Colonial Life & Accident Insurance Company 170 Well Baby Care - any Confinement of a newborn following Childbirth unless the newborn has an Injury or Sickness. Limitations Childbirth Limitation We will not pay benefits for Sickness Hospital Benefits due to any Insured giving birth within the first nine months after the Coverage Effective Date of this certificate as a result of a normal pregnancy, including Cesarean. Complications of Pregnancy will be covered to the same extent as any other Covered Sickness. Pre-existing Condition Limitation We will not pay benefits for Sickness Hospital Benefits in the first 6 months following the Insured's Coverage Effective Date if the Covered Sickness is caused by, contributed to by, or resulting from a Pre- existing Condition. A Pre-existing Condition is a Sickness or physical condition for which an Insured was treated, had medical testing, received medical advice or had taken medication within the 6 months before the Coverage Effective Date. OTHER FEATURES Newborn Coverage Feature Your newborn or newly adopted Children will automatically be covered for 60 days from their Coverage Eligibility Date if you are insured. If you wish to continue Child coverage, you must notify us on or before the end of the 60 day period and pay any additional premium. If you already have coverage for your Children, then all eligible Children will be covered and you do not need to notify us or pay any additional premium for the newly eligible Child. Portability Portability allows you, and your Spouse, and Children to continue coverage when coverage under the Policy would otherwise end due to an Eligible Portability Event. The certificate in force at the time of an Insured's Eligible Portability Event will reflect the terms and condition of the coverage that can be continued. Any future changes made in the Policyholder's group Policy will not apply to coverage an Insured has ported, unless required by law. Eligible Portability Events You are eligible to port coverage on the date: - the Policyholder cancels the Policy; or - you are no longer in an Eligible Group. However, you will not be considered eligible to port coverage if: - the Policyholder's Policy is closed to new enrollments; or - the Policyholder's Policy is cancelled by us. Applying for Portable Coverage If you choose to apply for portable coverage for yourself, you may also port coverage for your Spouse and or Children who were covered under the Policy. GAC4100-C-FL Group Accident Certificate 35 Colonial Life & Accident Insurance Company 171 You must apply for portable coverage and pay the first premium within 31 days from the date of an Eligible Portability Event. Ported Coverage Effective Date Once premiums and all forms have been received within the specified time period, ported coverage is effective on the day after coverage would have otherwise ended under the Policy. End of Ported Coverage For you Ported coverage will automatically end on the earliest of: - the last day for which premiums have been paid; ONet‘op - the date you return to an Eligible Group and are covered under the Policy; - the date coverage provided under Portability is cancelled by us for any reason upon 31 days notice; or - the date you die. For your Spouse Your Spouse's coverage will end on the earliest of: - the last day for which premiums have been paid; - the date your Spouse no longer meets the definition of a Spouse; - the date of your divorce or annulment; - the date coverage provided under Portability is cancelled by us for any reason upon 31 days notice; - the date the Named Insured dies; or - the date of your Spouse's death. For your Children Your Children's coverage will end on the earliest of: - the last day for which premiums have been paid; - the date your Children no longer meet the definition of Children; - the date coverage provided under Portability is cancelled by us for any reason upon 31 days notice; - the date the Named Insured dies; or - the date of your Children's death. Once ported coverage ends, it cannot be reinstated. Paying for Ported Coverage You must make all premium contributions for ported coverage. We will bill you directly for any premium due. Rates for Ported Coverage Premium will be based on the rates for Portability in effect on the date you apply to your port coverage. Portability rates may be changed by us at any time. We will provide Written notice at least 45 days before any change is to take effect. Portability In The Event Of Your Death, Divorce Or Annulment Portability allows your covered Spouse to continue coverage when coverage under the Policy would otherwise end in the case of your death, divorce or annulment. Such coverage will provide the same rights and conditions as portable coverage available to a Named Insured. Your Spouse is not eligible to continue coverage under this provision if your Spouse was not covered under this certificate on the date of your death, divorce or annulment. GAC4100-C-FL Group Accident Certificate 36 Colonial Life & Accident Insurance Company 172 START OF COVERAGE Coverage Eligibility Date For you If you are in an Eligible Group, you are eligible for coverage on the later of: - the Policy Effective Date; or - the day after any applicable Eligibility Waiting Period has been satisfied. For your Spouse and your Children If you elect coverage for yourself, and your Spouse, and your Children are eligible for coverage on the later of: - the date you are eligible for coverage; or - the date you first acquire a Spouse or Child. Enrolling for Coverage Initial Enrollment You may apply for any coverage available for you, and your Spouse, and your Children within 31 days of your, your Spouse's, or your Children's Coverage Eligibility Date. You may also apply for any coverage available for you, and your Spouse, and your Children during any scheduled annual Enrollment Period or within 31 days of a Qualifying Life Event. Late Enrollment If you did not apply for coverage during your, or your Spouse's, or your Children's Initial Enrollment or you voluntarily cancelled coverage for you, or your Spouse, or your Children and are re -applying, you may apply for coverage during any scheduled annual Enrollment Period or within 31 days of a Qualifying Life Event. Coverage Effective Date Coverage under this certificate will start at 12:01 a.m. Standard Time in the time zone where you live on the Coverage Effective Date shown on your Certificate Schedule for purposes of all dates under this Certificate of Coverage. Coverage Effective Date if you are not in Active Employment You must be in Active Employment in order for coverage to become effective for any Insured in accordance with the Coverage Effective Date provision. If you are not in Active Employment due to a temporary Layoff, Furlough, or Leave of Absence on the date coverage would become effective, your, and your Spouse's, and your Children's Coverage Effective Date will be the date you return to Active Employment. Coverage Effective Date for Initial Enrollment and Late Enrollment are subject to this provision. A delay of Coverage Effective Date for a change in coverage will not affect coverage that is currently in force. CONTINUATION AND END OF COVERAGE Continuation of your Coverage During Extended Absences Family and Medical Leave of Absence We will continue coverage during absences for family and medical leave if premium payments continue and the Policyholder approved your leave in Writing. You will be covered up to the end of the latest of: - the leave period required by the Federal Family and Medical Leave Act of 1993, and any amendments; - the leave period required by applicable state law; or - the leave period provided to you for an Injury or Sickness, provided premium is paid and the Policyholder has approved your leave in Writing. GAC4100-C-FL Group Accident Certificate 37 Colonial Life & Accident Insurance Company 173 If coverage is not continued during a Family and Medical Leave of Absence, upon the Named Insured's return to Active Employment: - no new Pre-existing Condition Limitation will be applied; - and - we will not apply a new Eligibility Waiting Period. In order for these conditions to apply, the Policyholder must notify us and commence paying premiums for the Named Insured's coverage within 31 days following a Named Insured's return to Active Employment following a Leave of Absence for Family and Medical Leave. The time period in the Pre-existing Condition Limitation period will continue to run through a Named Insured's Family and Medical Leave of Absence. Leave of Absence, other than a Family and Medical Leave of Absence If the Named Insured is on a Layoff, Furlough, or Leave of Absence other than for Family and Medical Leave, you will be covered through the premium due date immediately following the date your Layoff, Furlough, or Leave of Absence begins, provided premium is paid. If premium is remitted beyond the premium due date referenced above, our only liability will be to return the premium. Extension of Benefits Termination of coverage will not affect any claim that began while the coverage was in force, and may be continued for at least 90 days, subject to any benefit limits provided in the certificate. End of Coverage For You Your coverage under this certificate ends on the earliest of: - the date the Policy is cancelled by us or the Policyholder; - the date you are no longer in an Eligible Group; - the date your Eligible Group is no longer covered; - the date of your death; or - the last day of the period any required premium contributions are made. If we receive premium for coverage extending beyond the dates specified for coverage ending, such premium will be refunded, with the exclusion of any premium required to continue coverage: - in accordance with the Continuation of your Coverage During Absences provision; or - under Portability for you, and your Spouse, and your Children under Portability. We will provide coverage for a Payable Claim that occurs while you are covered under this certificate. For your Spouse Your Spouse's coverage will end on the earliest of: - the date your coverage under this certificate ends; - the date your Spouse is no longer eligible for coverage; - the date your Spouse no longer meets the definition of a Spouse; - the date of your Spouse's death; or - the date of your divorce or annulment. If your Spouse's coverage ends as a result of your death, divorce or annulment, your Spouse may elect to continue Spouse and Children coverage in accordance with the Portability In The Event Of Your Death, Divorce, or Annulment provision. GAC4100-C-FL Group Accident Certificate 38 Colonial Life & Accident Insurance Company 174 If we receive premium for coverage extending beyond the dates specified for coverage ending, such premium will be refunded, with the exclusion of any premium required to continue coverage under Portability. We will provide coverage for a Payable Claim that occurs while your Spouse is covered under this certificate. For your Children Your Children's coverage will end on the earliest of: - the date your coverage under this certificate ends; - the date your Children are no longer eligible for coverage; - the date of your Children's death; or - the date your Children no longer meet the definition of Children. x</ If we receive premium for coverage extending beyond the dates specified for coverage ending, such premium will be refunded, with the exclusion of any premium required to continue coverage under Portability. We will provide coverage for a Payable Claim that occurs while your Children are covered under this certificate. CLAIM PROVISIONS Notice of a Claim A claim for benefits under this certificate must be submitted in Writing within 90 days from the date of the Covered Loss, or as soon as reasonably possible. Claim Forms After receiving the Notice of a Claim, we will send a claim form, if required, to you or your authorized representative within 20 days from the date we receive the Notice of a Claim. If you or your authorized representative do not receive a claim form from us within 20 days after we receive the Notice of a Claim, a Written statement from you or your authorized representative as to the nature and extent of the Covered Loss will be deemed Proof of Loss, if sent to us within the time limit stated in the Proof of Loss section below. Proof of Loss Proof of Loss must be sent to us no later than 90 days after the date of Covered Loss. If it is not reasonably possible to provide Proof of Loss within this time period, it will not affect a Payable Claim if it is provided within one year, unless the Insured lacks the legal capacity to do so. In no event can Proof of Loss be submitted after the expiration of the time limit for commencing Legal Action as stated in this certificate, even if the failure to provide Proof of Loss is due to a lack of legal capacity. Proof of Loss, provided at your or your authorized representative's expense, must establish the nature and extent of the Covered Loss and should include but not be limited to the following: - the cause of death or Covered Loss; - the extent of the Covered Loss; - the date of Covered Loss; - the name and address of any Hospital or institution where treatment was received, including all attending Physicians; - a Physician's bill, a Hospital bill, or other proof of expenses incurred; and - in case of death, a certified copy of the death certificate or other lawful evidence providing equivalent information. GAC4100-C-FL Group Accident Certificate 39 Colonial Life & Accident Insurance Company 175 If the Proof of Loss is not complete, we will request additional information. Authorization for Release of Information We may request Written authorization from an Insured. This authorization may be required in order for us to obtain the necessary medical and non -medical information needed for Proof of Loss. This information may include any appropriate financial records such as income tax returns. Failure to provide us with Written authorization may result in the denial of a claim if the Insured does not send proof to us and we are not able to obtain the proof that is required to make a claim decision. Right to Exam, Test, or Interview We may ask the Insured to be examined or tested by one or more Physicians, other medical practitioners, or vocational experts of our choice. We may also require the Insured to be interviewed by an authorized representative of ours. We have the right to request exams or tests as often as it is reasonably necessary during the pendency of an Insured's claim. Any exam, test, or interview that we require will be paid at our expense. If the Insured fails to attend or fully participate, we will not pay the benefits or we will stop sending benefits under this certificate. Autopsy We will have the right to request an Autopsy necessary during the pendency of an Insured's claim where it is allowed by law. Claim Procedures After the Insured has satisfied the requirements above, we will process and evaluate the information to determine if a claim is payable. We will notify the Insured of a claim decision and issue payment for a Payable Claim in accordance with the Payment of Benefits provision. If a claim for benefits under this certificate is wholly or partially denied, we will provide notice of our decision in Writing within 45 days after receipt of the claim. Payment of Benefits Benefits for which we are liable will be paid within 45 days after we complete the Claim Procedures. All benefits will be paid to you, unless we receive Written authorization to pay them elsewhere. This is an assignment of benefits. Payment shall be treated as being made on the date a draft or other valid instrument which is equivalent to payment was placed in the United States mail in a properly addressed, postpaid envelope or, if not so posted, on the date of delivery. In the event of your death, any unpaid benefits will be paid to your beneficiary in accordance with the Beneficiary Designation and Change provision. In the event of your Spouse's death, should your Spouse have survived you and continued coverage, any unpaid benefits for your Spouse, will be paid to your surviving Spouse's beneficiary in accordance with the Beneficiary Designation and Change provision. Payment of Interest Any benefit payment issued after 45 days from the date we receive satisfactory proof will accrue simple interest on the net benefit amount paid in accordance with the state requirements of the state where the Insured resides. Interest will accrue beginning on the day after the Payment of Benefits was due and ending on the date we make the payment. Beneficiary Designation and Change GAC4100-C-FL Group Accident Certificate 40 Colonial Life & Accident Insurance Company 176 When a person becomes insured under this certificate, the Insured is responsible for designating a beneficiary in Writing for any benefits due in the event of the Insured's death. It is important to list the full name of each beneficiary and that all beneficiary designations are kept current and provided to us. You are the beneficiary for any Insured under this certificate while you are still living unless there is a valid change in beneficiary designation by an Insured. If an Insured wishes to change their beneficiary designation, they may do so by sending us a completed, dated, and signed beneficiary designation change form. Changes in beneficiary designations will take effect on the date notice of the beneficiary designation is signed by the Insured. Unless you make an irrevocable designation of beneficiary, the right to change a beneficiary is reserved to you and the consent of the beneficiary or beneficiaries shall not be requisite to assignment of the Policy or to change of beneficiary or beneficiaries, or to any changes in the Policy. A change of beneficiary will not have a bearing on any payment we make before we receive it. If a beneficiary is not named, or if all named beneficiaries do not survive the Insured, or the named beneficiary is legally unable to receive benefits, any benefits due will be paid to the Insured's estate. Overpayment of Claims We have the right to recover any overpayments due to: - Fraud (including any misrepresentations, omissions, concealment of facts or incorrect statements); or - any error we make in processing a claim. We must be reimbursed in full. If it is not possible for you to reimburse us in a lump sum payment, we will develop a reasonable method of repayment. This may include reducing or withholding future payments. We will not recover more money than the amount we paid you. Underpayment of Claims We have the responsibility to make additional payments if any underpayments have been made. Any underpayments will be paid in accordance with the Payment of Benefits provision. Unpaid Premium Any Unpaid Premium due for an Insured's coverage at the time of payment for a claim may be deducted from the Insured's claim payment. Legal Actions If you or your authorized representative disagree with our decision, you or your authorized representative can start Legal Action regarding your claim 60 days after Proof of Loss has been given to us and up to five years from the latest of when: - original Proof of Loss was first required to have been given to us; - your claim was denied; or - your benefits were terminated, unless otherwise provided under federal law. GENERAL PROVISIONS When Days Begin and End For the purpose of all dates under this Certificate of Coverage, all days begin at 12:01 a.m. and end at 12:00 midnight in the time zone where you live. Certificate of Coverage Contents Coverage for an Insured is provided under this Certificate of Coverage which is a part of the Policy issued to the Policyholder. The Policy consists of: GAC4100-C-FL Group Accident Certificate 41 Colonial Life & Accident Insurance Company 177 - all Policy provisions, and any riders, amendments and endorsements, and other attachments approved for use with the Policy; - this Certificate of Coverage, and any riders, amendments and endorsements, and other attachments approve for use with this Certificate of Coverage; - the Policyholder's application for group insurance; and - Named Insured's enrollment form and Evidence of Insurability, if applicable. Certificate of Coverage We will provide a Certificate of Coverage for each Named Insured. Your certificate describes: - the Policy Number of your Group Accident Insurance Certificate of Coverage; - the coverage to which an Insured may be entitled; - to whom we will make a payment; and - the limitations, exclusions, and requirements that apply to an Insured's coverage. s</ If any of the terms and provisions of this certificate are different than in the Policy, the Policy will govern. Cancellation or Modification to the Policy and this Certificate of Coverage The Policy and this Certificate of Coverage may be cancelled or modified by the Policyholder at any time without the Insured's consent. Any cancellation or modification to the Policy or certificate requested by the Policyholder will take effect on the date agreed upon by us and the Policyholder. In the event of cancellation of the Policy and certificate, the Policyholder will notify the Insured in Writing at least 45 days in advance of the date of cancellation. Representation in Applications In the absence of Fraud or intentional misrepresentation of material fact, any statements made by you will be considered a representation and not a warranty. We will not use such statements to avoid insurance, reduce benefits, or deny a claim unless such statements are included in an application signed by you, and a copy of the signed application has been provided to you or your beneficiary. Assignment An Assignment transfers all or part of your legal title and rights under the Policy and this certificate to someone else, known as an "assignee." We will recognize your assignee(s) as owners of the rights you transferred under the Policy and this certificate if the Assignment is in Writing, is certified or signed by you and the assignee, is filed with us, and is in a form acceptable to us. An Assignment will take effect on the date notice of the Assignment is signed by you. If we have taken any action or made any payment before we receive notice of the Assignment, that Assignment will not go into effect for those actions taken or payments made. Once legal titles and rights under the Policy and this certificate are assigned, the assignee has authority to make changes to an Insured's coverage and beneficiary designation. We are not responsible for the validity of any Assignment. We advise you to verify your Assignment is legal in your state and that it accomplishes the goals you intend. An Assignment will remain in place until we receive Written notice of termination of the Assignment or Written notice by or on behalf of some other person claiming some interest in the Policy in conflict with the Assignment. Contestability We can take legal or other action using statements made in signed applications for coverage only when a Covered Loss occurs during the first two years after an Insured's Coverage Effective Date. However, in the event of Fraud or intentional misrepresentation of material fact, we can take Legal Action at any time as permitted by applicable law. Misstatement of Information GAC4100-C-FL Group Accident Certificate 42 Colonial Life & Accident Insurance Company 178 If you or the Policyholder provides us information about an Insured that is incorrect, we will: - use the facts to decide whether the Insured has coverage under this certificate and the Policy and in what amounts; and - if necessary, make the applicable premium adjustments.We will not charge additional premiums for past coverage that was based on misstated information. Fraud We want to make sure you and the Policyholder do not incur additional insurance costs as a result of the undermining effects of insurance fraud. We promise to focus on all means necessary to support fraud detection, investigation, and prosecution. It is a crime if anyone knowingly, and with intent to injure, defrauds, or deceives us. This includes filing a claim or providing information that contains any false, incomplete, or misleading information. These actions will result in denial of a claim, and are subject to prosecution and punishment to the full extent under state and federal law. We will pursue all appropriate legal remedies in the event of insurance fraud. Agency For purposes of the Policy, the Policyholder acts on their own behalf or as your agent. Under no circumstances will the Policyholder be deemed our agent. Workers' Compensation or State Disability Insurance This certificate does not replace or affect the requirements for coverage by any workers' compensation or state disability insurance. Communicating With you or the Policyholder We may provide notices, information, and other communications to you or the Policyholder in Written form. To protect our customers, we will abide by all applicable privacy laws and regulations. GLOSSARY Active Employment You are working for the Policyholder for earnings that are paid regularly, and you are performing the Material and Substantial Duties of your Regular Occupation. You must be regularly scheduled to work at least the minimum number of hours as determined by the Policyholder. Your work site must be: the Policyholder's usual place of business in the United States; - an alternative work site in the United States at the direction of the Policyholder; or - a location in the United States to which your job requires you to travel. Normal vacation, holidays, or temporary business closures are considered Active Employment provided you are in Active Employment on the last scheduled work day preceding such time off. For purposes of this certificate, temporary business closures that meet the Glossary definition of Active Employment include, but are not limited to: - inclement weather; - power outage; and - public health agency orders. Temporary and seasonal workers are excluded from coverage. GAC4100-C-FL Group Accident Certificate 43 Colonial Life & Accident Insurance Company 179 Acupuncture Therapy The practice of penetrating the skin with thin, solid, metallic needles, which are then activated through gentle and specific movements of the practitioner's hands or with electrical stimulation. Alternative Therapy Treatment that includes: - biofeedback; or - electrical stimulation. Ambulatory Surgical Center A facility, separate from a Hospital, equipped for Physicians to perform Surgical Procedures on an Outpatient Basis and must: - provide anesthesia administered by a licensed anesthesiologist or licensed nurse anesthetist; and - have agreements with local Hospitals to immediately accept patients who develop complications. Automobile A private passenger motor vehicle, also refered to as "auto," which is licensed for use on public roads and highways, and is subject to motor vehicle registration. The term Automobile does not include an All -Terrain Vehicle (ATV), motorcycle, scooter, or golf cart. Behavioral Health Therapy The treatment of an Insured by a Mental Health Professional. Calendar Year The period beginning on the Insured's Coverage Effective Date and ending on December 31 of the same year. For each following year, it is the period beginning on January 1 and ending on December 31. Certificate of Coverage The document issued to the Named Insured, also referred to as the "certificate," describing an Insured's benefits and rights under the Policy, including any riders, amendments and endorsements, and other attachments approved for use with this certificate and the Policy. Child Care Center Any facility or private care that: - is licensed as a child care center by the state; - provides non -medical care and supervision for Children; and - is not operated by you or a Family Member. Childbirth Birth of a Child by routine vaginal delivery or non -emergency Cesarean section. Children Any Child from live birth to age 26 who is: - your own natural offspring; - your Spouse's Child; - your lawfully adopted Child as of the earliest of the date: - the Child is placed in your home or in a medical facility; - a petition is filed for you to adopt the Child; or - an adoption agreement, signed by you that includes your binding obligation to assume financial responsibility for the Child; - a foster Child placed with you by an authorized placement agency or by judgment, decree, or other order of any court of competent jurisdiction; or grandchildren, nieces, and nephews living with you in a regular parent -child relationship that are dependent on you for primary financial support; or GAC4100-C-FL Group Accident Certificate 44 Colonial Life & Accident Insurance Company 180 - any other Child residing with you through legal mandate that is dependent on you for financial support. Children may continue coverage up to age 30 if: - they are unmarried and do not have a dependent of their own; - are a resident of this state or a student; and - they are not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan, or is not entitled to benefits under Title XVIII of the Social Security Act. Your Child may be eligible for coverage past age 26 if your Child is incapable of self-sustaining employment due to permanent intellectual or physical incapacity prior to reaching age 26 and is dependent upon you for support and maintenance. You must submit proof of the Child's incapacity and dependency to us within 31 days of the Child's 26th birthday or we will accept proof within 31 days of the Child's Coverage Eligibility Date. Ongoing proof of incapacity and dependency must be provided when requested by us, but not more frequently than once a year. Your Children may not be insured as both a Child and an Employee. Your Children may not be insured by more than one Employee. Chiropractic Therapy Spinal manipulation services conducted by a licensed chiropractor to correct a structural imbalance. For purposes of this certificate, the following services do not meet the Glossary definition of Chiropractic Therapy: - massage therapy; - treatment of chronic conditions; and - other Injuries not related to structural imbalance. Complications of Pregnancy Abnormal conditions or concurrent diseases that significantly affect the pregnancy's usual medical management. A complication may exist during the pregnancy, during the birth, or after the birth. Childbirth or Complications of Pregnancy will be treated as any other Sickness. Colonial Life & Accident Insurance Company Referred to as "Colonial" and "we," "us," and "our." Confined or Confinement Assignment to a bed as a resident inpatient in a medical or treatment facility, including an Observation Unit, for a minimum of 20 continuous hours on the advice of a Physician. Covered Accident An unintended or unforeseen bodily Injury sustained by an Insured, wholly independent of disease, bodily infirmity, illness, infection, or any other abnormal physical condition and which: - occurs on or after the Coverage Effective Date; - occurs while coverage is in force; and - is not excluded by name or specific description in this certificate. Covered Loss An accidental death, dismemberment, loss, or other Injury for which benefits are payable under this certificate. Covered Sickness GAC4100-C-FL Group Accident Certificate 45 Colonial Life & Accident Insurance Company 181 An illness, infection, disease, or any other abnormal physical condition that is not the result of an Injury, which: - occurs on or after the Coverage Effective Date; - occurs while coverage is in force; and - is not excluded by name or specific description in this certificate. Eligibility Waiting Period The continuous period of time an individual must be in an Eligible Group before they may enroll in coverage. Emergency Department A specified area within a Hospital, or standalone facility that is affiliated with a Hospital, designated for the emergency care of accidental Injuries or Sicknesses. This area must: - be staffed and equipped to handle trauma; - be supervised and have treatment provided by Physicians; and - provide care seven days per week, 24 hours per day. Employee A person, also referred to as "you," who is in Active Employment in the United States with the Policyholder. Enrollment Period A period of time determined by the Policyholder and us during which you are eligible to enroll for or change your coverage. This period of time may be limited. Family Member A Child, stepchild, Spouse, parent, stepparent, sibling, stepsibling, parent -in-law, Child -in-law, sibling -in-law, grandparent, grandparent's Spouse, grandchild, or grandchild's Spouse. Felonious Act of Violence An act of violence that is considered a felony where the act occurred. Felonious Acts of Violence include, but are not limited to: - assault and battery; - civil disturbance; - hijacking; murder;. - robbery; - sniping; and - theft. Furlough Temporary absence Policyholder. Hospital A licensed institution supervised by Physicians and operated pursuant to law on a full-time basis. The Hospital must: - provide overnight care to people with Injuries or Sicknesses; - have full-time Nurses on duty or on call who are supervised by a registered Nurse; and - have X-ray equipment, a laboratory, and a surgical operating room at its locations or available to use on a pre -arranged basis. from Active Employment for a period of time that has determined in advance by the For purposes of this certificate, the following hospital units meet the Glossary definition of Hospital: - Progressive Care Unit; - Intermediate Care Unit; and - Step -Down Unit. GAC4100-C-FL Group Accident Certificate 46 Colonial Life & Accident Insurance Company 182 For purposes of this certificate, the following do not meet the Glossary definition of Hospital: - a nursing home, a rest home, home for the aged, or an assisted living facility; - a hospice care facility; - a Rehabilitation or Sub -Acute Rehabilitation Unit; - a psychiatric unit or facility for the treatment of Mental or Nervous Disorders; and - a facility for the treatment of Substance Abuse. Hospital ICU A specifically designated area of the Hospital that is restricted to patients who are critically ill or injured and who require intensive, comprehensive observation and care. The Hospital ICU must: - be separate and apart from the surgical recovery room and from rooms, beds, and wards customarily used for patient Confinement; - be permanently equipped with special lifesaving equipment for the care of the critically ill or injured; - be under close observation by a specially trained nursing staff assigned exclusively to the ICU on a 24 hour basis; and - have a Physician assigned to the ICU on a full-time basis. For purposes of this certificate, the following Hospital units meet the Glossary definition of Hospital ICU: - Intensive Care Unit (ICU); - Coronary Care Unit; - Neonatal ICU; - Pulmonary Care Unit; - Burn Unit; and - Transplant Unit. Hospital Sub -Acute ICU A specifically designated area of the Hospital that provides a level of medical care below intensive care, but above a regular private or semi -private room or ward with or without monitoring equipment. The Hospital Sub - Acute ICU must: be separate and apart from the surgical recovery room and from rooms, beds, and wards customarily used for patient Confinement; and - be permanently equipped with special lifesaving equipment for the care of the critically ill or injured; - be under close observation by a specially trained nursing staff assigned exclusively to the Hospital Sub - Acute ICU on a 24 hour basis. A Hospital Sub -Acute ICU may be referred to by other names such as progressive care, intermediate care, or a step-down unit. Injury U Any damage or harm to the body that is the direct result of a Covered Accident and not related to any other cause. Insured Any person who has coverage under this certificate. Layoff Temporary suspension or permanent termination of Active Employment. Normal vacation time, holidays, or temporary business closures are not considered a temporary Layoff. Leave of Absence Temporary absence from Active Employment for a period of time under a leave granted in Writing by the Policyholder that is in accordance with the Policyholder's formal leave policies. GAC4100-C-FL Group Accident Certificate 47 Colonial Life & Accident Insurance Company 183 Normal vacation time, holidays, or temporary business closures are not considered a Leave of Absence. Material And Substantial Duties Duties that: - are routinely required for the performance of your Regular Occupation; and - cannot be reasonably omitted or modified. Mental Health Professional A healthcare professional licensed by the state to practice and provide Behavioral Health Therapy. Any Mental Health Professional must be acting within the scope of their license. A Mental Health Professional does not include an Insured or a Family Member. Mental or Nervous Disorders A psychiatric or psychological condition classified in the most recent Diagnostic and Statistical Manual of Mental Health Disorders (DSM) published by the American Psychiatric Association (APA), as of the date of Covered Loss. If the DSM is discontinued or replaced, these disorders will be those classified in the diagnostic manual then used by the APA as of the date of Covered Loss. If the APA no longer publishes a diagnostic manual or the APA ceases to exist, we will use a comparable diagnostic manual. Nurse A healthcare professional trained to care for people with Injuries or Sicknesses. A Nurse may include a graduate Registered Nurse (R.N.), Licensed Practical Nurse (L.P.N.), or Licensed Vocational Nurse (L.V.N.). We will not recognize you, your Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you, as a Nurse for a claim that you send to us. Observation Unit A specified area within a Hospital, separate from the Emergency Department, where a patient can be monitored following a Surgical Procedure performed on an Outpatient Basis or treatment in the Emergency Department. The Observation Unit must: - be under the direct supervision of a Physician or registered Nurse; - be staffed by Nurses assigned specifically to that unit; and - provide care seven days per week, 24 hours a day. Occupational Therapy The treatment of an Insured by means of constructive activities designed and adapted to promote the restoration of the person's ability to satisfactorily accomplish the ordinary tasks of daily living and those tasks required by the person's particular occupational role. For purposes of this certificate, the following do not meet the Glossary definition of Occupational Therapy: - diversional therapy; - recreational therapy; and - any vocational therapies (e.g. hobbies, arts, and crafts). Off -Job Accident A Covered Accident that occurs while an Insured is not working at any job for pay or benefits. On -Job Accident A Covered Accident that occurs while an Insured is working at any job for pay or benefits. Outpatient Basis Medical care and treatment received without being admitted to a Hospital or other facility. GAC4100-C-FL Group Accident Certificate 48 Colonial Life & Accident Insurance Company 184 Payable Claim A claim for which we are liable for under the terms of this certificate. Pet A domestic animal that lives with an Insured and is dependent on the Insured for primary care and maintenance. Pet Boarding Facility An appropriately licensed independent animal care provider or facility specializing in the care and overnight or long-term boarding of animals that is not owned or operated by an Insured or a Family Member. Physical Therapy Treatment by physical means, hydrotherapy, heat or similar modalities, physical agents, bio-mechanical, and neuro-physiological principles and devices. Such therapy is given to relieve pain, restore function, and to prevent additional Injury following Injury or loss of a body part. Physician A person performing tasks that are within the limits of their medical license and is also: - a legally qualified medical practitioner according to the laws and regulations of the governing jurisdiction; licensed to practice medicine, prescribe and administer drugs, or to perform surgery; or a person with a doctoral degree in Psychology (Ph.D. or Psy.D.) whose primary practice is treating patients. We will not recognize you, a Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you, as a Physician for a claim that you send to us. Policy The Group Accident Insurance Policy issued to the Policyholder, including this Certificate of Coverage and any riders, amendments and endorsements, and other attachments approved for use with this certificate and the Policy. Policyholder The entity to which the Policy is issued. It includes any division, subsidiary or affiliated company named in the Policy Rate Schedule. Qualifying Life Event For coverage determination purposes, a Qualifying Life Event means an event including, but not limited to: - birth, adoption, or addition of a Child; - a change in legal marital status; - a change in employment status; or - death of an Insured. Qualifying Life Event coverage changes made in accordance with the Start of Coverage provisions must be consistent with the Qualifying Life Event. Regular Occupation The occupation you are routinely performing. We will look at your occupation as it is normally performed in the national economy, instead of how the work tasks are performed for a specific employer at a specific location. Rehabilitation Unit An appropriately licensed facility that provides rehabilitation care services on an inpatient basis. The care services provided by the Rehabilitation Unit must: - consist of the combined use of medical, social, educational, and vocational services to enable patients disabled by accidental Injury or Sickness to achieve the highest possible functional ability; and - be provided by or under the supervision of an organized staff of Physicians. GAC4100-C-FL Group Accident Certificate 49 Colonial Life & Accident Insurance Company 185 The Rehabilitation Unit may be part of a Hospital or a standalone facility. For purposes of this certificate, the following do not meet the Glossary definition of Rehabilitation Unit: a nursing home, a rest home, home for the aged, or an assisted living facility; - a hospice care facility; - a Sub -Acute Rehabilitation Unit; - a psychiatric unit or facility for the treatment of Mental or Nervous Disorders; and - a facility for the treatment of Substance Abuse. Respiratory Therapy A<<t Treatment and assistance used to recover lung function. Sexual Assault Any nonconsensual sexual act proscribed by Federal, tribal, or State law, including when the victim lacks capacity to consent. Sickness An illness or disease. Speech Therapy Treatment and assistance for disorders related to speech, language, cognitive -communication, voice, swallowing, and fluency. Spouse The person who is your partner through lawful marriage, civil union, domestic partnership (established by a declaration acceptable to us), or your legally separated Spouse. Your Spouse may not be insured as both a Spouse and an Employee. Sub -Acute Rehabilitation Unit A licensed facility or distinct part of a facility supervised at all times by a Physician or Nurse. The facility must provide care to people with Injuries or Sicknesses on an inpatient basis. The Sub -Acute Rehabilitation Unit must have a Physician available at all times and have a transfer agreement in effect with one or more participating Hospitals. For purposes of this certificate, the following do not meet the Glossary definition of Sub -Acute Rehabilitation Unit: a nursing home, a rest home, home for the aged, or an assisted living facility; a hospice care facility; - a Rehabilitation Unit; - a psychiatric unit or facility for the treatment of Mental or Nervous Disorders; and - a facility for the treatment of Substance Abuse. Substance Abuse Abuse of or addiction to drugs or alcohol. Surgical Procedure The cutting into the skin or other organ to accomplish any of the following goals: - further explore the condition for the purpose of diagnosis; - take a biopsy of a suspicious lump; - remove diseased tissues or organs; - remove an obstruction; - reposition structures to their normal position; - redirect channels; GAC4100-C-FL Group Accident Certificate 50 Colonial Life & Accident Insurance Company 186 - transplant tissue or whole organs; - implant mechanical or electronic devices; - repair an area that has been injured or affected by trauma, overuse, or Sickness; or - restore proper function. For purposes of this certificate, the following do not meet the Glossary definition of Surgical Procedure: - venipuncture (drawing blood); - lumbar puncture; - epidural steroid injections; - removal of skin tags; and - foreign body removal from the eye. Telemedicine A medical inquiry with a Physician via the use of telecommunication and information technologies (including, but not limited to, audio or video communications) for the Insured's evaluation, diagnosis, or treatment as would be practiced in person. This does not include requests for prescription refills or medical records. Therapist A health care professional appropriately licensed by the state to perform Therapy Services with the exception of you, your Family Member, a business or professional partner, or any person who has a financial affiliation or business interest with you. Urgent Care Facility A health care facility that is organizationally separate from a Hospital with the primary purpose of offering and providing urgent and immediate, short-term medical care, without an appointment. Vestibular Therapy Treatment and assistance for balance and dizziness problems, and vestibular disorders. Writing or Written A record on or transmitted by paper, electronic, or telephonic means consistent with applicable law. GAC4100-C-FL Group Accident Certificate 51 Colonial Life & Accident Insurance Company 187 01'Colonial Life® Group Critical Illness Colonial Life's Group Critical Illness insurance helps your employees and their families maintain financial security during the lengthy, expensive recovery period after an illness has been diagnosed. It provides a lump -sum benefit to help with out-of-pocket medical costs or everyday expenses. There are also options to include coverage for progressive diseases, such as Alzheimer's disease. Coverage is available to: Named Insured (Employee); Named Insured and Spouse; Name Insured and Dependent Children (One -Parent Family); and Named Insured, Spouse and Dependent Children (Two - Parent Family). Features • Option to combine cancer and critical illness coverage into a single policy • Benefits are payable in addition to other insurance your employees may have with other insurance companies • Benefits are payable directly to the employee unless they specify otherwise • Benefits are payable multiple times for the same or different covered conditions • Benefits may be used however the covered person chooses. Typical uses include: • Out-of-pocket medical costs • Home health care • Recovery and rehabilitation • Daily living expenses • Travel expenses to and from treatment centers • All plans are Health Savings Account (HSA)-compliant • Coverage is portable. Employees can continue their coverage if they change jobs or retire. Benefits As the employer, you will make several choices to tailor the plan design for your employees. Plan Design You may choose to offer the following plan to your employees. • Plan 2 - Plan 2 Critical Illness with Benefit Payable Upon Subsequent Diagnosis of a Critical Illness • Cancer with Reoccurrence of Invasive Cancer (Including all Breast Cancer) • Rate Structure We are offering attained age, uni-tobacco rates. Proposal applicable to FL This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 11/2022 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 PS02672 188 01'Colonial Life Critical Illness Benefit (Included in Plan 2) Critical Illness Percentage of Applicable Face Amount • Benign Brain Tumor • Coma • End Stage Renal (Kidney) Failure • Heart Attack (Myocardial Infarction) • Loss of Hearing • Loss of Sight • Loss of Speech • Major Organ Failure Requiring Transplant • Occupational Infectious HIV or Occupational Infectious Hepatitis B, C, or D • Permanent Paralysis due to a Covered Accident • Stroke • Sudden Cardiac Arrest 100% Plant Coronary Artery Disease 25% Plan 2 — One -Parent or Two -Parent Family Coverage Additional Covered Conditions for Dependent Children: • Cerebral Palsy • Cleft Lip or Palate • Cystic Fibrosis • Down Syndrome • Spina Bifida 100o/0 Benefit Payable Upon Subsequent Diagnosis of a Critical Illness - Allows the covered person to use the coverage more than once. The plan includes coverage for subsequent diagnosis of a different critical illness. • If the covered person receives a benefit for a critical illness, and is later diagnosed with a different critical illness, we may pay 100% of the applicable face amount for the critical illness diagnosed. The plan includes coverage for subsequent diagnosis of the same critical illness. • If the covered person receives a benefit for a critical illness and is later diagnosed with the same critical illness (except those listed below), we may pay 25% of the applicable face amount. Critical illnesses that do not qualify include: • Coronary Artery Disease; • Loss of Hearing; • Loss of Sight; • Loss of Speech; and • Occupational Infectious HIV or Occupational Infectious Hepatitis B, C or D. Dates of diagnoses of covered critical illnesses must be separated by more than 180 days. There is no maximum benefit amount under the Benefit Payable Upon Subsequent Diagnosis of a Critical Illness. Proposal applicable to FL This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 11/2022 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 PS02672 189 01'•Colonial Life. Diagnosis of Cancer Benefits (Included in Plan 2) Diagnosis We may pay: Invasive Cancer (Including all Breast Cancer) 100%offace amount Non -Invasive Cancer 25% of face amount Skin Cancer Initial Diagnosis $400 per lifetime The plan includes Reoccurrence of Invasive Cancer (Including all Breast Cancer) • If a covered person has been diagnosed with and received a benefit for Invasive Cancer (Including all Breast Cancer) and is diagnosed with a reoccurrence of invasive cancer, we may pay an amount equal to 25% of the initial benefit amount for the invasive cancer diagnosed if the covered person is treatment free for at least 12 months and in complete remission prior to the date of reoccurrence. The Benefit Payable Upon Reoccurrence of Invasive Cancer (Including all Breast Cancer) is not payable for non-invasive or skin cancer. Wellbeing Assistance Benefit You may choose to include this benefit with any plans. If included, the benefit amount is $50. The covered tests include: • Blood test for triglycerides • Bone marrow testing • BRCA1 or BRCA2 testing • Breast ultrasound • Carotid Doppler • CA 15-3 • CA 125 • CEA • Chest x-ray • Colonoscopy • Electrocardiogram (EKG, ECG) • Echocardiogram (ECHO) • Fasting blood glucose • Flexible sigmoidoscopy • Hemoccult stool analysis • Mammography • Pap smear • PSA • Serum protein electrophoresis • Serum cholesterol test for HDL and LDL • Skin cancer biopsy • Stress test on a bicycle or treadmill • Thermography • Thin Prep pap test • Virtual colonoscopy This benefit is payable once per covered person per calendar year. There is a 30-day waiting period before the benefit is payable. The test must be performed after the waiting period. Proposal applicable to FL This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 11/2022 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 PS02672 190 01'Colonial Lfe® Additional Coverage Options You may choose to offer the following rider to your employees: Progressive Diseases Rider: • The benefit is payable at 25% of the face amount for any of the covered progressive diseases if the covered person is unable to perform two or more activities of daily living and the 90-day elimination period has been met. • The benefit is payable for each progressive disease once per covered person per lifetime. A covered progressive disease means one of the following: Amyotrophic Lateral Sclerosis (ALS) Muscular Dystrophy Dementia (Including Alzheimer's Disease) Myasthenia Gravis Huntington's Disease Parkinson's Disease Lupus Systemic Sclerosis (Scleroderma) Multiple Sclerosis (MS) Once you have selected the plan options, your employee will make the following selections: Choice Options Face Amount Employees choose their face amount based on plan design offered: • Plan 2: $5,000-$50,000 Coverage Type Employees choose coverage for: • Named Insured (Employee) • Named Insured and Spouse • Named Insured and Dependent Children (One -Parent Family) • Named Insured, Spouse and Dependent Children (Two -Parent Family) If coverage is chosen for spouse and/or eligible dependent children, the face amount will be 50% of the employee's face amount for Plan 2. Additional Coverage Options • Employees choose whether to purchase riders you selected Proposal applicable to FL This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 11/2022 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 PS02672 191 01'•Colonial Life. Eligibility Requirements • Account: ■ Payroll deduction only • Employee: Actively at work and not disabled at the time of application Full time, permanent employee working at least 20 hours per week Employed for 90 days No seasonal or temporary employees will be covered Issue ages: 17 — 74 • Spouse: • Must be the spouse of an eligible employee ■ Employee must purchase coverage for spouse to be eligible • Issueages:17-74 • Dependent Children: • Under age 26 • Dependent on employee or spouse for financial support • Employee must purchase coverage for dependent children to be eligible ■ May not be insured as both a child and a named insured • May not be insured by more than one named insured Premium Information Premiums are based on plan type chosen, rate structure, age, and tobacco status. Exclusions and Limitations Exclusions and Limitations for Critical Illness - We will not pay benefits for a critical illness that occurs as a result of a covered person's: alcoholism or drug addiction; felonies or illegal occupations; intoxicants and narcotics; suicide; war or armed conflict. Exclusions and Limitations for Cancer - We will not pay the Invasive Cancer (Including all Breast Cancer) Benefit, Non -Invasive Cancer Benefit, Benefit Payable Upon Reoccurrence of Invasive Cancer (Including all Breast Cancer) or Skin Cancer Initial Diagnosis Benefit for a covered person's invasive cancer or non- invasive cancer that: is diagnosed or treated outside the territorial limits of the United States, its possessions or the countries of Canada and Mexico. Exclusions and Limitations Progressive Diseases Rider - We will not pay benefits that occur as a result of a covered person's: alcoholism or drug addiction; felonies or illegal occupations; intoxicants and narcotics; suicide; war or armed conflict. Proposal applicable to FL This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 11/2022 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 PS02672 192 COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 1200 Colonial Life Boulevard, P. O. Box 1365, Columbia, South Carolina 29202 1.800.325.4368 coloniallife.com A Stock Company GROUP CRITICAL ILLNESS AND CANCER LIMITED BENEFIT INSURANCE CERTIFICATE THIS CERTIFICATE EXPLAINS THE BENEFITS PROVIDED UNDER THE GROUP CRITICAL ILLNESS AND CANCER LIMITED BENEFIT INSURANCE POLICY. THIS IS A NON -PARTICIPATING CERTIFICATE THAT PROVIDES LIMITED BENEFITS. THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT 1 AN ADDITIONAL PAYMENT WITH YOUR TAXES. Please Read This Certificate Carefully This is your certificate of coverage as long as you are insured under the policy. You in a safe place. This certificate describes your benefits in detail. This certificate c limitations, exclusions, and other provisions that may reduce benefits or pr this certificate. Throughout this certificate, the word you or your refers to the named member of an eligible class as described on the Policy Rate Schedul premiums are remitted. Covered person refers to any person cove Schedule. We, us, our or company refers to Colonial Life & Ac organization shown on the Policy Rate Schedule. It inclu Policy Rate Schedule. Policy means the group contract terms of your certificate of coverage and the policy differ, The policy and this certificate may be changed in be notified at least 45 days in advance prior t the consent of or notice to any covered person. approval must be in writing and evidenced policyholder and one of our executive offic policy or certificate or waive any of its p and all certificates previously issued You may call Colonial ill?> Right to Return This C If, for any reason, you are n receive it. At that time, you s premium paid will be refunded. Signed for Colonial Life & Accident Insurance Company: n' read it carefully and keep it ain proof of loss requirements, d from receiving benefits under n on the Certificate Schedule, who is a s a certificate of coverage and for whom uflr►r the policy as described on the Certificate urance Company. Policyholder refers to the subsidiary or affiliated company named in the policyholder and available for review by you. If the y will govern. or in .art or cancelled as stated in the policy. The policyholder will lations or nonrenewal by us. Such an action may be taken without xecutive officer at our home office can approve a change. The ement on the policy or certificate or an amendment signed by the ome office. No other person, including an agent, may change the remiums are subject to periodic changes. This certificate replaces any classes under the policy. ent Insurance Company at (800) 325-4368 for information, inquiries or complaints. sfied with this certificate, you can retum it to us at our home office within 30 days after you uld ask us in writing to cancel it. We will consider this certificate as if it never existed. Any Secretary President and Chief Executive Officer Please read this certificate carefully. THIS IS NOT MEDICARE SUPPLEMENT COVERAGE. If you are eligible for Medicare, review the Guide To Health Insurance for People with Medicare available from the company. GCI6000-C-FL 193 SECTION 2 CERTIFICATE GUIDE SECTION 1 FACE PAGE SECTION 2 CERTIFICATE GUIDE SECTION 3 CERTIFICATE SCHEDULE SECTION 4 GENERAL DEFINITIONS SECTION 5 DEFINITIONS FOR CRITICAL ILLNESS BENEFIT SECTION 6 DEFINITIONS FOR ADDITIONAL CRITICAL ILLNESS BENEFIT FOR DEPENDENT CHILDREN SECTION 7 DEFINITIONS FOR CANCER BENEFITS SECTION 8 ELIGIBILITY AND EFFECTIVE DATE SECTION 9 CRITICAL ILLNESS BENEFIT SECTION 10 ADDITIONAL CRITICAL ILLNESS BENEFIT FORE D CHILDREN SECTION 11 CANCER BENEFITS + ` SECTION 12 WELLBEING ASSISTANCE BENEFIT SECTION 13 EXCLUSIONS AND LIMITATIONS FOR? AL ILLNESS SECTION 14 EXCLUSIONS AND LIMITATIONS FOR CANCER SECTION 15 TERMINATION OF INSURANCE SECTION 16 GENERAL PROVISION SECTION 17 CLAIM PROVISIO S II\SECTION 18 PORTABILI q> GCI6000-C-FL 2 194 SECTION 4 — GENERAL DEFINITIONS Additional definitions may be contained in other certificate benefit provisions or any endorsement, amendment or rider. Calendar Year means the period beginning on the coverage effective date shown on the Certificate Schedule and ending on December 31 of the same year. Thereafter, it is the period beginning on January 1 and ending on December 31 of each following year. Child or Dependent Child(ren) means any child from live birth who is under age 26 who is: • your own natural offspring; • your spouse's child; • your lawfully adopted child as of the earliest of (i) the date the child is placed in your home or in a medical facility, (ii) the date a petition is filed for you to adopt the child, or (iii) the date an adoption agreement signed by you includes your binding obligation to assume financial responsibility for the child; • a foster child placed with you by an authorized placement agency or by judgment, decree or other order of any court of competent jurisdiction; or • any other child residing with you through legal mandate that is dependent on you fupport. Coverage for your child may be continued past age 26 if your child is incapable of s- -s tig employment due to permanent intellectual or physical incapacity prior to reaching age 26 and is depe• - - i • you for support and maintenance. You must submit proof of the child's incapacity and depende y t31 days of the child's 26th birthday. Ongoing proof of incapacity and dependency must be provided - e. a -d by us, but not more frequently than once a year after the two-year period following the termination data i ontinue to charge any appropriate premium for that child as long as they meet the definition of a depend .. is your responsibility to notify us if an y dependent child no longer qualifies as an eligible dependent. If this i - -nt family or two -parent family coverage and all of your dependent children no longer qualify as eligible dependen n u do not notify us, the extent of our liability will be to refund premium paid for the time period for which they did ,�► y Your dependent children may not be insured as both a ed insured. Your dependent children may not be insured by more thanafamed insured. Dependent children may continue coverage resident of the state of Florida or are enrolle of higher learning; and are not provided c other group or individual health benefit Complications of Pregnancy me significantly affect the pregnanc delivery, or after the deliv, 0 if they are unmarried; have no dependents of their own; are a e or part-time student at an accredited public or private institution a named subscriber, insured, enrollee or covered person under any health plan or, church plan or entitled to benefits under Social Security. art o your pregnancy during which abnormal conditions or concurrent disease medical management. A complication may exist during the pregnancy, during the Coverage Effective Dathe date coverage begins as shown in the Certificate Schedule. The coverage effective date of this certificate is not ate you signed the application for coverage. Covered Condition means any sickness, diagnosis, or loss shown on the Certificate Schedule which: • occurs on or after the coverage effective date; • occurs while coverage is in force; and • is not excluded by name or specific description in this certificate. Covered Person means any person covered under this certificate as described on the Certificate Schedule. Date of Diagnosis means the date a physician confirms or a test proves that a covered condition exists. Date of diagnosis requirements vary by covered conditions. Doctor or Physician means a person who: • is licensed by the state to practice a healing art; and • performs services for a covered person which are allowed by the physician's license. GCI6000-C-FL 3 195 For purposes of this definition, doctor or physician does not include any covered person or anyone related to any covered person by blood or marriage, a business or professional partner of any covered person or any person who has a financial affiliation or a business interest with any covered person. Evidence of Insurability means a statement of your medical history which we will use to determine if you are approved for coverage. Policy Anniversary Date means the date that occurs annually on the same day and in the same month as the First Policy Anniversary shown on the Policy Rate Schedule. Pre-existing Condition means a sickness or physical condition for which a covered person was treated, had medical testing, received medical advice or had taken medication within six months before the coverage effective date shown on the Certificate Schedule. Genetic information is not a pre-existing condition in the absence of a diagnosis of the condition related to such information. Spouse means the person who is your partner through lawful marriage, civil union, domestic nership or your legally separated spouse. Temporary Layoff or Leave of Absence means the named insured is temporarily a active employment for a period of time that has been agreed to in advance in writing by the employer. Norma time or any period of disability is not considered a temporary layoff or leave of absence. ♦ SECTION 5 - DEFINITIONS FOR CRITICAL ILLNESS BE4I 4111 Additional definitions may be contained in other certificate benefit pro s ny endorsement, amendment or rider. Benign Brain Tumor means a non -cancerous brain tumor resuinurological deficits including but not limited to loss of sight, loss of hearing, or balance disruption. For purposes of this certificate, the following do not meee definition of benign brain tumor: • tumors of the skull; • pituitary adenomas; and • germinomas. Benign Brain Tumor Date of Diagnosis i of the examination of tissue (biopsy or surgical excision) or specific neuroradiological examination. Cardiologist means a doctor who i ce ed to •ractice medicine and who is also licensed to practice by the American Board of Internal Medicine in thcity of cardiovascular disease. Coma means a continutsi s tat ofound unconsciousness requiring intubation for respiratory assistance as the result of a severe traumatic brainihjury la ting for a period of 7 or more consecutive days, characterized by the absence of: • eye opening; • verbal response; and • motor response. For purposes of this certificate, the following do not meet the definition of coma: • coma due to stroke; and • any medically induced coma. Coma Date of Diagnosis is the date a doctor confirms a coma. Coronary Artery Disease means a narrowing or blockage of one or more coronary arteries resulting from plaque buildup. Coronary Artery Disease Date of Diagnosis is the date a cardiologist recommends a covered person undergo a surgical procedure of either a coronary artery bypass graft or valve replacement within 60 days following the date of recommendation. GCI6000-C-FL 4 196 Covered Accident means an unintended or unforeseen bodily injury sustained by a covered person, wholly independent of disease, bodily infirmity, illness, infection, or any other abnormal physical condition and which: • occurs on or after the coverage effective date; • occurs while coverage is in force; and • is not excluded by name or specific description in this certificate. Covered Sickness means an illness, infection, disease, or any other abnormal physical condition that is not the result of an injury, which: • occurs on or after the coverage effective date; • occurs while coverage is in force; and • is not excluded by name or specific description in this certificate. Complications of pregnancy or childbirth will be treated as any other covered sickness. Critical Illness means one of the covered conditions listed in the Benefit for Critical Illness section of the Certificate Schedule. End Stage Renal (Kidney) Failure means chronic irreversible failure of the function of*Illio person must undergo at least weekly hemodialysis or peritoneal dialysis. s such that the covered End Stage Renal (Kidney) Failure Date of Diagnosis means the date th •e p sicitllTfrcommends regular hemodialysis or peritoneal dialysis to sustain life; the covered person has a kidney triped; or the covered person is placed on the UNOS (United Network for Organ Sharing) list for a kidney tra plat. Heart Attack (Myocardial Infarction) means the ischemic death ofk of heart muscle (myocardium) as a result of obstruction of one or more of the coronary arteries. A positive dipf myocardial infarction must occur and must be supported by three or more of the following: • chest pain; • electrocardiographic (EKG) changes indicative of m ardia •nfarction; in the case of myocardial infarction associated with percutaneous coronary intervention (b angioplasty, stent implantation, and related procedures to increase the flow of blood through the coro rteries), evolving ST elevations or new Q wave changes must • be documented and included as one of th riilestablishing a diagnosis; elevation of biochemical markers of myoc confirmatory imaging studies. sis; and In the event of death, an autopsy, me er's confirmation or death certificate identifying heart attack (myocardial infarction) as the cause of death wil e e e The following are not to bspa heart attack (myocardial infarction) for purposes of this certificate: • an established (old) • angina; • atherosclerotic heart di • cardiac arrest (including arrhythmias); • congestive heart failure; • coronary artery disease; and • any other disease, injury, or dysfunction of the cardiovascular system. Heart Attack (Myocardial Infarction) Date of Diagnosis is the date the ischemic death of a portion of the heart muscle (myocardium) occurred based on the criteria listed under the heart attack (myocardial infarction) definition . Injury means any damage or harm to the body that is the direct result of a covered accident and not related to any other cause. Loss of Hearing means total and irrecoverable loss of hearing in both ears that follows a period where the covered person had the ability to hear. GCI6000-C-FL 5 197 The following are not to be construed as loss of hearing for purposes of this certificate: • congenital birth defects; • developmental delays; and • any loss of hearing that can be corrected by any procedure, aid or device. Loss of Hearing Date of Diagnosis means the date a physician confirms loss of hearing in both ears. Loss of Sight means permanent reduction in sight certified by a physician that follows a period where the covered person was not legally blind such that: • sight in the better eye reduced to a best corrected visual acuity of 20/200 or less (Snellen or E-Chart Acuity); or • visual field remaining is less than 20° in the better eye. The following are not to be construed as loss of sight for purposes of this certificate: • congenital birth defects; • developmental delays; and • any loss of sight that can be corrected by any procedure, aid or device. Loss of Sight Date of Diagnosis is the date a physician confirms the irreversible redu ejt. Loss of Speech means total and irrecoverable loss of speech that follows a peri ability to speak. • The following are not to be construed as loss of speech for purposes ott1j rtt te: • congenital birth defects; • developmental delays; and cvi • any loss of speech that can be corrected by any procedure, Loss of Speech Date of Diagnosis is the date a physic Fi'on 'i .ss of speech. e covered person had the Major Organ Failure Requiring Transplant means failu heart, kidney, liver, both lungs, or pancreas resulting in the covered person being placed on the UNOS (Unit d Netwo for Organ Sharing) list for a transplant. Major Organ Failure Requiring Transplant D e4nosis is the date that the covered person is placed on the UNOS list for transplantation. .ram Occupational Infectious HIV or Oc at infectious Hepatitis B, C or D means diagnosis of Human Immunodeficiency Virus (HIV) infection or Hepatitis B, C or D resulting from exposure to HIV -contaminated or Hepatitis B, C or D contaminated fluids as the t s�a covered accident during the normal course of performing an occupation for which remuneration is eamed. r A We will pay this benefit i • within five days of thaccident, it is reported and recorded by the appropriate person according to the legislation, regulations, ards or guidelines that apply to the covered person's occupation or profession; • the covered accident is investigated and a written investigation report is provided to us by the covered person's employer; • a confirmatory antibody HIV or Hepatitis B, C or D test is taken within five days of the covered accident and HIV or Hepatitis B, C or D is not present; • all HIV or Hepatitis B, C or D tests are performed by a state certified and licensed laboratory; and • a follow-up confirmatory antibody HIV or Hepatitis B, C or D test is taken between 90 days and 180 days after the covered accident, and the result is positive. Occupational Infectious HIV or Occupational Infectious Hepatitis B, C or D excludes: • HIV or Hepatitis B, C or D infection as the result of IV drug use; • HIV or Hepatitis B, C or D infection as the result of sexual transmission; and • HIV or Hepatitis B, C or D infection determined not to have been the result of a covered accident. GCI6000-C-FL 6 198 Occupational Infectious HIV or Occupational Infectious Hepatitis B, C or D Date of Diagnosis is the date of a positive antibody test for HIV or Hepatitis B, C or D subsequent to a prior negative test for the same condition with a lapse of between 90 and 180 days between the two tests. Permanent Paralysis Due to a Covered Accident means the complete and permanent loss of the use of two or more limbs due to a new paralysis as the result of a covered accident as defined in this certificate. For purposes of this certificate losing the use of two or more limbs as the result of a stroke will not be construed as permanent paralysis due to a covered accident. Permanent Paralysis Due to a Covered Accident Date of Diagnosis The date a physician diagnoses the paralysis or severed spinal cord. Stroke means the sudden death of brain cells due to lack of oxygen, caused by blockage of blood flow or rupture of an artery to the brain. The following are not to be construed as a stroke for purposes of this c • transient ischemic attack; • brain injury related to trauma or infection; • brain injury associated with hypoxia/anoxia or hypotension; • vascular disease affecting the eye or optic nerve; and • ischemic disorders of the vestibular system. If a stroke results in death, an autopsy confirmation verifying stroke a Stroke Date of Diagnosis is the date a stroke occurs, and the dia • evidence of persistent neurological deficits confirmed by a limited to impaired motor function, altered sensation, �n • confirmatory neuroimaging studies consistent with t diag s S§;(" death will be accepted. ertificate: t be supported by: at least 30 days after the stroke including but not culty swallowing, or cognitive impairment; and of a new stroke. Sudden Cardiac Arrest means the sudden, unexp- ed los • heart function in which the heart, abruptly and without warning, stops working as a result of an inter el ( . system heart malfunction due to Coronary Artery Disease, Cardiomyopathy, or Hypertension. Sudden Car - .t does not mean a Heart Attack (Myocardial Infarction). Sudden Cardiac Arrest Date of Diagng j date the pumping action of the heart fails based on the sudden cardiac arrest definition. SECTION 6 — DEFINITIODDITIONAL CRITICAL ILLNESS BENEFIT FOR DEPENDENT CHILDREN Cerebral Palsy means anon-progressive disorders of movement and posture attributed to abnormal development of, or damage to motor con nters of the brain while a child's brain is still developing before, during, and immediately after birth. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, cognition, communication, perception, and behavior, as well as seizures and secondary musculoskeletal problems. Cerebral Palsy Date of Diagnosis is the date a physician makes or confirms an initial diagnosis of cerebral palsy after live birth. Cleft Lip means a narrow opening or gap in the skin of the upper lip that extends all the way to the base of the nose, including unilateral clefting and bilateral clefting. Cleft Lip Date of Diagnosis is the date a physician makes or confirms an initial diagnosis of a cleft lip after live birth. Cleft Palate means an opening between the roof of the mouth and the nasal cavity. Cleft Palate Date of Diagnosis is the date a physician makes or confirms an initial diagnosis of a cleft palate after live birth. GCI6000-C-FL 7 199 Cystic Fibrosis means a hereditary disorder affecting the exocrine glands. It causes the production of abnormally thick mucus, leading to the blockage of the pancreatic ducts, intestines, and bronchi and often resulting in respiratory infection. Cystic Fibrosis Date of Diagnosis is the date the condition is first diagnosed by a physician and supported by a sweat test with sweat chloride concentrations greater than 60 mmol/L. Down Syndrome means a congenital disorder arising from a chromosome defect involving chromosome 21, causing intellectual impairment, physical abnormalities and developmental delays. Down Syndrome includes: • Trisomy 21- an individual has three instead of two chromosome 21's. • Translocation - an extra part of chromosome 21 is attached to another chromosome. • Mosaicism - the individual has an extra chromosome 21 in only some of the cells but not all of them. The other cells have the usual pair of chromosome 21's. Down Syndrome Date of Diagnosis is the date a physician makes or confirms an initi i di sit through the study of the 21 st chromosome after live birth. of Down syndrome Spina Bifida means a congenital defect of the spine in which part of the spinal cord n ninges are exposed through a gap in the backbone. Spina bifida includes meningocele or myelomenin • (0\ For purposes of this certificate, spina bifida occulta does not meet the VIa bifida. Spina Bifida Date of Diagnosis means the date a h sician makes an initial diag nosis physician gn osis of spina bifida, meningocele or myelomeningocele after live birth. SECTION 7 — DEFINITIONS FOR CANCER BENfFa Additional definitions may be contained in other certificat enef provisions or any endorsement, amendment or rider. 1:Complete Remission means having no symptom no signs that can be identified to indicate the presence of invasive or non-invasive cancer. Hospital means a place that: • is an institution licensed as a hospi • provides overnight care of injure • is supervised by a doctor; • has full-time nurses supervLP y'registered nurse; and d operating pursuant to law on a full-time basis; k people; • has at its locations or uses on pre -arranged basis: X-ray equipment, a laboratory and an operating room where surgical operations talace.lw Notwithstanding the above, o pital is not: • a nursing home; • an extended care facility; • a skilled nursing facility; • a rest home or home for the aged; • a place for alcoholics or drug addicts; or • an assisted living facility. Initial Benefit Amount refers to the amount a covered person receives for the initial diagnosis of cancer as shown on the Certificate Schedule. Invasive Cancer (Including all Breast Cancer) means a disease that is identified by the presence of malignant cells or a malignant tumor characterized by the uncontrolled and abnormal growth and spread of invasive malignant cells. Any cancer of the breast is considered invasive cancer including breast cancer which is classified as stage 0 or in situ . GCI6000-C-FL 8 200 The following are not to be construed as invasive cancer for purposes of this certificate: • pre -malignant conditions or conditions with malignant potential; • cancer that has not become invasive, typically classified as stage 0 or in situ; • cancer on the surface of the body (skin) that may be: melanomas that are in situ or stage 1, which require only local treatment and affect only the melanoma and area close to it; • basal cell carcinoma; or • squamous cell carcinoma of the skin. Invasive Cancer (Including all Breast Cancer) Date of Diagnosis means the date the tissue specimen, blood samples or titer(s) are taken upon which the diagnosis of invasive or non-invasive cancer is based. Maintenance Drug Therapy means a course of systemic medication given to a patient after a cancer goes into complete remission because of primary treatment. Maintenance drug therapy includes ongoing hormonal therapy, immunotherapy, or chemo-prevention therapy. Maintenance drug therapy is meant to decrease the risk of cancer recurrence; it is not meant to treat a cancer that is still present. Non -Invasive Cancer means a malignant tumor which is typically classified as stage r that has not yet become invasive but is confined to the site of origin without having invaded neighboring tissue. For purposes of this certificate, the following do not meet the definition of non-invasi • pre -malignant conditions or conditions with malignant potential; • • any stage 0 or in situ cancer of the breast; and • cancer on the surface of the body (skin) that may be: • melanomas that are in situ or stage 1, which require only local treat 4S4EICSifect only the melanoma and area close to it; • basal cell carcinoma; or • squamous cell carcinoma of the skin. Non -Invasive Cancer Date of Diagnosis means the d - - the ti which the diagnosis of invasive or non-invasive cancer i eased. Pathologist means a doctor who is licensed to pra by the American Board of Pathology. A pathois Osteopathic Board of Pathology. Skin Cancer means cancer on the surface • melanomas that are in situ or stage • basal cell carcinoma; or • squamous cell carcinoma of t pecimen, blood samples ortiter(s) are taken upon medicine and who is also licensed to practice pathologic anatomy eans an Osteopathic Pathologist who is certified by the ody (skin) that may be: uire only local treatment and affect only the melanoma and area close to it; Skin Cancer Date of Di- , •L is rLf`the date the tissue specimen is taken on which the diagnosis of skin cancer is based. Signs and/or Symptoms a e - evidence of disease or physical disturbance observed by a physician or other medical professional. The p ician must observe these signs while acting within the scope of their license. Treatment -Free from Cancer refers to the period of time without the consultation, care, or services provided by a physician. This includes receiving diagnostic measures and taking prescribed drugs and medicines including maintenance drug therapy. SECTION 8- ELIGIBILITY AND EFFECTIVE DATE Coverage Effective Date Your coverage under the policy will start at 12:01 a.m. Standard Time in the time zone where you live on the coverage effective date shown on your Certificate Schedule for purposes of all dates under this certificate of coverage. GCI6000-C-FL 9 201 Enrollment An individual who is a member of an eligible class may enroll in coverage during the eligibility period, as shown on the Policy Rate Schedule, that follows the later of: • the policy effective date as shown on the Policy Rate Schedule; • the date the individual first becomes a member of an eligible class; • the date the individual completes the policyholder probationary period, if applicable; or • the date the individual meets evidence of insurability requirements, if any. A late entrant is an individual who fails to enroll during the initial product offering, the new hire eligibility period or has voluntarily cancelled previous coverage and is reapplying. A late entrant may only apply during an open enrollment period with evidence of insurability. The policyholder and the company will determine when an open enrollment period begins and ends. After the coverage effective date, the named insured cannot make any changes to the coverage type under this certificate until an open enrollment period, unless the named insured has a qualifying event. A qualifying event, for the purposes of this provision, means: • birth or adoption of a child; • placement of a child for adoption and/or foster care; • issuance of a court order requiring coverage of a child; • marriage; • divorce; or • death of a covered person. q)'(*# The named insured will have 31 days from the date of occurrence of fq'Jf g event in which to: • notify us they wish to make a change; • complete any required enrollment form; and • pay any additional premium, if applicable. Delayed Coverage Effective Date The effective date of your coverage will be delayed date shown on the Certificate Schedule. The an eligible class. If this is named insured and sp on the spouse and/or dependent children wi class. Who is Covered by This Certifica If this is named insured coverag If this is named insured If this is one -parent family u are not a member of an eligible class on the coverage effective II be effective on the date that you return to status as a member of rage, one -parent family or two -parent family coverage, coverage ive on the date that you retum to status as a member of an eligible on the Certificate Schedule, we insure you, the named insured. erage as shown on the Certificate Schedule, we insure you and your spouse. e as shown on the Certificate Schedule, we insure you and your dependent children. If this is two -parent family coverage as shown on the Certificate Schedule, we insure you, your spouse and your dependent children. You may not apply for coverage for your spouse if your spouse is covered as a named insured under other coverage. Coverage on newborn children begins from the moment of live birth. Coverage for adopted children begins with the date of placement into your custody for adoption or, in the case of a newbom child, at the moment of birth if a written agreement to adopt such child has been entered into by you prior to the birth of the child, whether or not the agreement is enforceable. Coverage will not be provided for an adopted child who is not ultimately placed in your residence. Coverage for a foster child begins with the date of placement in your home. Coverage for a custodial child will be covered from the date of placement in a custodial home. If the coverage is named insured coverage or named insured and spouse coverage, a notice of birth or placement must be submitted to us. This must be done within 31 days after the date of such birth or placement in order to continue coverage beyond the 31 day period. If timely notice is given, premium will not be charged for the notice period. If timely notice is not GCI6000-C-FL 10 202 given, premium will be charged from the date of birth or placement. If notice is given within 60 days of the date of birth or placement, we will not deny coverage for a child due to your failure to timely notify us of the birth or placement of the child. SECTION 9 — BENEFIT FOR CRITICAL ILLNESS Critical Illness Benefit We will pay this benefit if a covered person is diagnosed with a critical illness, as defined in this certificate, and: • the date of diagnosis is while this certificate is in force; • the critical illness is diagnosed during the 12 months following the coverage effective date and is not a pre-existing condition; and • the critical illness is not excluded by name or specific description in this certificate. We will not pay the Critical Illness Benefit for any critical illness diagnosed during the 12 months following the coverage effective date if the critical illness is a pre-existing condition. We will pay the percentage of the covered person's face amount shown on the Certificate Sile for the critical illness diagnosed. ) We will not pay the benefit for Benign Brain Tumor if any covered person is diagnoselF . rtWthe coverage effective date with any of the following conditions: ` • neurofibromatosis I; • neurofibromatosis II; • von Hippel-Lindau; • tuberous sclerosis; • Li-Fraumani syndrome; • cowden disease; and • turcot syndrome. • •` We will not pay the benefit for Sudden Cardiac Arrest if t sud n cardiac arrest is caused by or contributed to by a Heart Attack (Myocardial Infarction). If a covered person is on the UNOS list for a c organ failure requiring transplant, a single benefi We will pay the benefit for Coronary Arte Infectious HIV or Occupational Infectio If the date of diagnosis of two or illness benefit. We will pay the I bind transplant (example: heart and lung) as listed in the definition of major tj�aid . oss of Hearing, Loss of Sight, Loss of Speech or Occupational B, C or D only once per covered person per lifetime. I illness covered conditions is on the same day, we will pay only one critical e two critical illness benefits. The Critical Illness Beayable for conditions other than the critical illness covered conditions defined in this certificate. Benefit Payable Upon Subsequent Diagnosis of a Critical Illness If a covered person has been diagnosed with and received a benefit for a critical illness and is subsequently diagnosed with a different critical illness, we will pay the percentage of the covered person's face amount shown on the Certificate Schedule for the critical illness diagnosed, if: • the date of diagnosis of the subsequent critical illness is more than 180 days after any previous date of diagnosis for a critical illness; • the subsequent date of diagnosis is while coverage under this certificate is in force; and • the critical illness is not excluded by name or specific description in this certificate. GCI6000-C-FL 11 203 If a covered person has been diagnosed with and received a benefit for a critical illness and is subsequently diagnosed with the same critical illness (other than Coronary Artery Disease and Occupational Infectious HIV or Occupational Infectious Hepatitis B, C or D), we will pay an amount equal to 25% of the face amount shown for the covered person as shown on the Certificate Schedule, if: • the date of diagnosis of the subsequent critical illness is more than 180 days after any previous date of diagnosis for the same critical illness; • the covered person has not received treatment during the 180 days between the dates of diagnosis for the same critical illness. For purposes of the preceding sentence, treatment does not include medications and follow-up visits to the covered person's physician; • the subsequent date of diagnosis is while coverage under this certificate is in force; and • the critical illness is not excluded by name or specific description in this certificate. SECTION 10 - ADDITIONAL CRITICAL ILLNESS BENEFIT FOR DEPENDENT CHILDREN Additional Critical Illness Benefit for Dependent Children We will pay this benefit if a covered dependent child is initially diagnosed with a critical ' ne and: • the additional critical illness for dependent children is diagnosed during the 12 ming date and is not a pre-existing condition; • the date of diagnosis is while this certificate is in force; and • • the critical illness is not excluded by name or specific description in. efined in this certificate, the coverage effective We will not pay the Additional Critical Illness Benefit for Dependent C el o' ny critical illness diagnosed during the 12 months following the coverage effective date if the critical illness is re- i g condition. We will pay up to the maximum benefit amount shown on e`5chedule per covered dependent child. I n is The Additional Critical Illness Benefit for Dependent Chi t payable for conditions other than the critical illness covered conditions defined in this certificate. A Benefit Payable Upon Subsequent Diagnosi fI Illness Benefit for Dependent Children. SECTION 11 - CANCER BENE Invasive Cancer (Including all We will pay this benefit when y • the date of diagnosi • the invasive cancer condition; and cer) Benefit nosed as having invasive cancer if: rtificate is in force; during the 12 months following the coverage effective date and is not a pre-existing al Illness does not apply to the diagnosis of an Additional Critical • the invasive cancer is noirxcluded by name or specific description in this certificate. We will pay the percentage of the covered person's face amount shown on the Certificate Schedule for the diagnosed cancer. We will not pay the Invasive Cancer (Including all Breast Cancer) Benefit for any invasive cancer diagnosed during the 12 months following the coverage effective date if the invasive cancer is a pre-existing condition. Invasive Cancer (Including all Breast Cancer) must be diagnosed in one of two ways: 1. Pathological Diagnosis A pathological diagnosis of invasive cancer made by a pathologist is based on a microscopic study of fixed tissue or preparations from the hemic (blood) system. This type of malignancy diagnosis must be in accordance with the standards established by the American Board of Pathology. A pathological diagnosis of invasive cancer can be made before or after death. GCI6000-C-FL 12 204 2. Clinical Diagnosis A clinical diagnosis of invasive cancer is based on the study of symptoms. We will pay benefits for a clinical diagnosis only if: • a pathological diagnosis cannot be made because it is medically inappropriate or life -threatening; • there is medical evidence to support the diagnosis; and • a doctor is treating the covered person for invasive cancer. In addition to the pathological or clinical diagnosis required, we may require additional information from the doctor and hospital. If a covered person has been diagnosed with and received a benefit for non-invasive cancer and is subsequently diagnosed with invasive cancer, we will pay the Invasive Cancer (Including all Breast Cancer) Benefit for the covered person as shown on the Certificate Schedule, up to the Maximum Benefit Amount for the Invasive Cancer (Including all Breast Cancer) Benefit and subject to the provisions of this certificate, if the date of diagnosis of the invasive cancer is more than 180 days after the date of diagnosis for the non-invasive cancer. If the diagnosis of two or more invasive or non-invasive cancers is on the same day, w esio will We will pay the larger of the two cancer benefits. • the date of diagnosis is while this certificate is in force; • the non-invasive cancer is diagnosed during the 12 months following tlxcl!! effective date and is not a pre- existing condition; and • the non-invasive cancer is not excluded by name or specific des c Qn'tP is certificate. ly one cancer benefit. Non -Invasive Cancer Benefit We will pay this benefit when you are diagnosed as having non-invasive ca�er,( We will pay the percentage of the covered person's face amoun h =n the Certificate Schedule for the diagnosed non- invasive cancer. We will not pay the Non -Invasive Cancer Benefit for any coverage effective date if the non-invasive cancer is a pre - Non -Invasive Cancer must be diagnosed in o 1. Pathological Diagnosis A pathological diagnosis of non-invasive a preparations from the hemic (blood) s established by the American Board ' . of after death. 2. Clinical Diagnosis A clinical diagnosis of n only if: ive cancer diagnosed during the 12 months following the condition. de by a pathologist is based on a microscopic study of fixed tissue or type of malignancy diagnosis must be in accordance with the standards pathological diagnosis of non-invasive cancer can be made before or e ancer is based on the study of symptoms. We will pay benefits for a clinical diagnosis • a pathological diagnosis cannot be made because it is medically inappropriate or life -threatening; • there is medical evidence to support the diagnosis; and • a doctor is treating the covered person for non-invasive cancer. In addition to the pathological or clinical diagnosis required, we may require additional information from the doctor and hospital. If a covered person has been diagnosed with and received a benefit for invasive cancer and is subsequently diagnosed with non-invasive cancer, we will pay the Non -Invasive Cancer Benefit for the covered person as shown on the Certificate Schedule, up to the Maximum Benefit Amount for the Non -Invasive Cancer Benefit and subject to the provisions of this certificate, if the date of diagnosis of the non-invasive cancer is more than 180 days after the date of diagnosis for the invasive cancer. If the diagnosis of two or more invasive or non-invasive cancers is on the same day, we will pay only one cancer benefit. We will pay the larger of the two cancer benefits. GCI6000-C-FL 13 205 Benefit Payable Upon Reoccurrence of Invasive Cancer (Including all Breast Cancer) If a covered person has been diagnosed with and received a benefit for Invasive Cancer (Including all Breast Cancer) and is diagnosed with a reoccurrence of invasive cancer, we will pay an amount equal to 25 percent of the initial benefit amount for the invasive cancer diagnosed if: • the invasive cancer is not caused or contributed to by a critical illness for which benefits have been paid; • the covered person is treatment -free from invasive cancer for at least 12 months before the date of reoccurrence diagnosis; • the covered person is in complete remission prior to the date of a reoccurrence diagnosis as evidenced by the absence of all clinical, radiological, biological, and biochemical proof of the presence of invasive cancer; • the date of diagnosis is while coverage under this certificate is in force; and • the invasive cancer is not excluded by name or specific description in this certificate. The Benefit Payable Upon Reoccurrence of Invasive Cancer (Including all Breast Cancer) is not payable for non-invasive or skin cancer. Skin Cancer Initial Diagnosis Benefit We will pay the amount shown on the Certificate Schedule if any covered person is dia nos • the date of diagnosis is while this certificate is in force; • the skin cancer is diagnosed during the 12 months following the coverage effecti condition; and • the skin cancer is not excludedby name or specific description in this c rtlfl We will accept a clinical diagnosis if a pathological diagnosis cannot bed ` This benefit is limited to one payment per covered person per lifetime SECTION 12 - WELLBEING ASSISTANCE BENEF We will pay the amount shown on the Certificate Sched missed work, and other incidentals, as a result of having The test must be performed after the waiting period while following each covered person's coverage effectiv The covered tests include: • Blood test for triglycerides • Bone marrow testing • BRCA1 or BRCA2 testing • Breast ultrasound • Carotid Doppler • CA 15-3 • CA 125 • CEA • Chest x-ray • Colonoscopy • Electrocardiogram (EKG, ECG) • Echocardiogram (ECHO) • Fasting blood glucose • Flexible sigmoidoscopy • Hemoccult stool analysis • Mammography • Pap smear • PSA • Serum protein electrophoresis • Serum cholesterol test for HDL and LDL • Skin cancer biopsy • Stress test on a bicycle or treadmill • Thermography skin cancer if: is not a pre-existing monetary expenditures such as transportation, e routine, preventative tests covered by this certificate. ificate is in force. Waiting Period means the first 30 days during which benefits are not payable. GCI6000-C-FL 14 206 • ThinPrep pap test • Virtual colonoscopy We will pay a maximum of one day per covered person per calendar year. SECTION 13 —EXCLUSIONS AND LIMITATIONS FOR CRITICAL ILLNESS We will not pay benefits for a critical illness that occurs as a result of a covered person's: Alcoholism or Drug Addiction Addiction to alcohol or drugs, except for drugs taken as prescribed by a doctor. Felonies or Illegal Occupations Committing or attempting to commit a felony or engaging in an illegal occupation. Intoxicants and Narcotics Being intoxicated or under the influence of any narcotic or voluntary use of or treatment for or non-prescription drug, alcohol, poison, fume, or other chemical substance unless tak covered person's physician. Suicide Committing or trying to commit suicide or injuring oneself intentionally, w War or Armed Conflict Involvement in any act of war, declared or undeclared, or serving in th a result of acts of terrorism committed by individuals or groups will person who suffered the loss committed or contributed to the actrism. Pre -Existing Condition Limitation We will not pay the Critical Illness Benefit, Benefits Pay le Up Subsequent Diagnosis of a Critical Illness or Additional Critical Illness Benefit for Dependent Children for any cov d on when the critical illness is a pre-existing condition as defined in this certificate, unless the covered perso • .s satis ied the pre-existing condition limitation period shown on the Certificate Schedule on the date the covered rsi J' • . gnosed with a critical illness. Credit toward the satisfaction of the pre-existing condition limitation period will be gi > continuous time the covered person was covered under the pre- existing condition clause of previous covera• another carrier if: • The previous coverage was similar to • d d the coverage provided under this certificate; • The covered person was insured ur h. _ evious coverage at the time of enrollment in the coverage provided by this certificate; and • The covered person was insychid�the coverage provided by this certificate on the policy effective date shown on the Policy Rate Schedule. ��� ry use of any prescription ribed or directed by the ces of any country or authority. Losses as ded from coverage unless the covered The covered person is r e1'6r furnishing proof of previous coverage, to include type of coverage, length the previous coverage was in force d the date the previous coverage terminated. SECTION 14 —EXCLUSIONS AND LIMITATIONS FOR CANCER We will not pay the Invasive Cancer (Including all Breast Cancer) Benefit, Non -Invasive Cancer Benefit, Benefit Payable Upon Reoccurrence of Invasive Cancer (Including all Breast Cancer) or Skin Cancer Initial Diagnosis Benefit for a covered person's invasive cancer or non-invasive cancer that: Pre -Existing Condition Limitation Is a pre-existing condition, unless the covered person has satisfied the pre-existing condition limitation period shown on the Certificate Schedule on the date the covered person is initially diagnosed as having invasive or non-invasive cancer. No Pre-existing Condition Limitation will be applied for dependent children who are bom or adopted while you are covered under this policy, and who are continuously covered from the date of birth or adoption. Credit toward the satisfaction of the pre-existing condition limitation period will be given for any continuous time the covered person was covered under the pre- existing condition clause of previous coverage through another carrier if: • The previous coverage was similar to or exceeded the coverage provided under this certificate; • The covered person was insured under the previous coverage at the time of enrollment in the coverage provided by this certificate; and GCI6000-C-FL 15 207 • The covered person was insured under the coverage provided by this certificate on the policy effective date shown on the Policy Rate Schedule. The covered person is responsible for fumishing proof of previous coverage, to include type of coverage, length the previous coverage was in force and the date the previous coverage terminated. Geographical Limitation Is diagnosed or treated outside the territorial limits of the United States, its possessions, or the countries of Canada and Mexico. SECTION 15 -TERMINATION OF INSURANCE Termination of The Named Insured's Coverage The coverage on a named insured under the policy will terminate on the earliest of the following dates: • the date the policy terminates; • your policyholder cancels the policy and does not offer replacement coverage; • the end of the grace period following the premium due date and we do not receive t er insured; • the date the named insured is no longer in an eligible class; • the date the named insured's class is no longer included for insurance; or • the date the named insured asks us to end coverage. • We will provide coverage for a claim for which we are liable under the AP are covered. Cancellation of coverage is without prejudice to any priohi c refunded based on the date of cancellation. Extension of Benefits Termination of coverage will not affect any claim that be provided in the certificate. Za hi overage was in force, subject to any benefit limits Ncertificate if the loss occurs while you I itionally, any unearned premium will be premium for the named When Coverage Ends on Your Spouse and Dependentren If this is a named insured and spouse coverage orarent family coverage, coverage on your spouse will end on the earliest of the following dates: • the date your coverage under the policy • the end of the grace period following t spouse; • the date you ask us to end your Jesse' • -rage; • the date you die; or • the date you divorce y r sour marriage is annulled. If this is a named insured and spouse coverage or two - parent family cover nd y vorce your spouse, or your marriage is annulled and you do not notify us, the extent of our liability will be emium paid for the time period for which they did not qualify. due date and we do not receive the required premium for your If this is a one -parent family oo wo-parent family coverage, coverage on your dependent children will end on the earliest of the following dates: • the date your coverage under the policy terminates; • the end of the grace period following the premium due date and we do not receive the required premium for your dependent children; • the date you ask us to end your dependent children's coverage; • the date you die; or • the date they no longer meet the definition of dependent children shown in the General Definitions section of this certificate. We will provide coverage for a claim for which we are liable under the terms of this certificate if the loss occurs while you r spouse and/or dependent child is covered. GCI6000-C-FL 16 208 Leave of Absence Under the Family and Medical Leave Act A named insured may continue coverage during absences for family or medical leave. If a named insured is on a family or medical leave of absence, coverage will continue under this certificate as if the named insured were in active employment, if the following conditions are met: • the premiums are paid in accordance with the policy's provisions; and • the policyholder has approved the named insured's leave in writing. Coverage will be continued for up to the greater of: • the leave period required by the federal Family and Medical Leave Act of 1993, and any amendments; or • the leave period required by applicable state law. If coverage is not continued during a family or medical leave of absence, upon the named insured's retum to active employment • no new pre-existing condition limitation will be applied; and • no new evidence of insurability will be required to reinstate the coverage which was in effect before the leave began. In order for these conditions to apply, the policyholder must notify us and commence p ing .� insured's coverage within 31 days following a named insured's return to active employ t family or medical leave. ms for the named g a leave of absence for The time period in the pre-existing condition limitation period will continue to run u amed insured's family or medical leave of absence. • Leave of Absence — Other If the named insured is on a temporary layoff or leave of absence oth paid in accordance with the policy's provisions, you will be covered ou date the temporary layoff or leave of absence begins. Ni'Tamily or medical leave and premium is premium due date immediately following the If premium is remitted beyond the premium due date ref enced , our only liability will be to retum the premium. SECTION 16 — GENERAL PROVISIONS Coverage Provided by the Policy We insure a covered person for loss accordivisions of the policy. Misstatement of Age If the age of the named insured has any excess premium payment over premium based on your correct or increase the benefit anent insured is not eligible b d, we will make any equitable adjustment of premiums. We will refund e based on your correct age. We will request payment for any overdue e isstatement is discovered after a payment is due and payable, we will reduce y the amount of excess or overdue premium due to the misstatement. If a named we will refund all premiums paid. Misstatement of Tobacco his If there is a misstatement in the application of the named insured's tobacco status, we will adjust the benefits payable to the amounts which would have been purchased at the correct tobacco status in consideration of the most recent premium. We will not make such an adjustment after this policy has been in force for two years from the coverage effective date. Contestability No statement made by any named insured relating to any covered person's insurability shall be used to contest the validity of the insurance after the insurance has been in force prior to the contest for a period of two years during the lifetime of the person about whom the statement was made and unless the statement is contained in a written instrument signed by the named insured making the statement, unless the statement was fraudulent. Contest means that we question the validity of coverage under this policy through a letter to the policyholder or the named insured. This contest is effective on the date we mail the letter and refund premiums. All statements made by the policyholder or any named insured shall be deemed representations and not warranties. No written statement made by the policyholder or any named insured shall be used in any contest unless a copy of the statement is furnished to the policyholder or the named insured. GCI6000-C-FL 17 209 Policyholder as Agent For purposes of the policy and this certificate, the policyholder acts on its own behalf or as your agent. Under no circumstances will the policyholder be deemed our agent. SECTION 17 — CLAIM PROVISIONS Notice of Claim If a covered person has an injury or sickness that may result in a claim for benefits under the policy, written notice must be given to us at our home office. This must be done within 90 days after a covered loss begins. If notice cannot be given within that time, it must be given as soon as is reasonably possible. The notice must contain enough information to identify the covered person. If a loss occurs before receiving notification of our decision on any coverage amount subject to evidence of insurability requirements, the coverage amount applicable to the claim will be the coverage amount previously approved and on file with us and your policyholder. _ Claim Forms When we receive written or verbal notice of a claim, claim forms will be sent with whic of of Loss. If these forms are not given to you within 15 days, you will be excused from filing the forms as Iona s nd us Proof of Loss as described below. Proof of Loss We must receive a written proof of loss within 90 days after the cover: d4r� s ci) g . If you are not able to give us written proof of loss within 90 days, it will not have a bearing on this claim if p �f i •i to us as soon as it is reasonably possible. In any event, proof must be given no later than one year frstated unless you are legally unable to do so. Written proof of loss must include one or more of the follo g: • documentation of diagnosis or treatment provided by . •hysic n or medical facility and supported by clinical, radiological, histological, pathological, or laboratory evidence; • a physician's bill, a hospital bill or other proof o . rges; and • in the case of death, a certified copy of the Authorization for Release of Information We may request written authorization from . ' -d person. This authorization may be required in order for us to obtain the necessary medical and non -medical in • . 'r-eded for proof of loss and continuing proof of loss. Failure to provide us with written authorization may result in the el. •f •roc-ssing your claim. If the covered person does not send proof to us and we are not able to obtain proof of loss thr- . fired, we will be unable to make a claim decision. ate, or other lawful evidence providing equivalent information. Time of Payment of CI After we receive writtenCfof)ss and process your claim, we will pay any benefits due within 45 days. If all or any portion of a claim is contested by us, you or your assignees, if any, will be notified in writing that the claim is contested or denied within 45 days after receipt of the claim by us. The notice that a claim is contested will identify the contested portion of the claim and the reasons for contesting the claim. Upon receipt of the additional information requested from you or your assignees, if any, we will pay or deny the contested claim or portion of the contested claim, within 60 days. We will pay or deny any claim no later than 120 days after receiving the claim. Payment will be treated as being made on the date a draft or other valid instrument which is equivalent to payment, was placed in the U.S. mail in a properly addressed, postpaid envelope, or if not so posted, on the date of delivery. All overdue payments will bear simple interest at the rate of 10% per year. GCI6000-C-FL 18 210 Payment of Claim Benefits will be paid directly to you unless we receive your valid written authorization to pay benefits elsewhere, such as to a hospital or a physician's office. This is called assignment of benefits. We reserve the right to determine if an assignment of benefits is valid and consistent with applicable laws. You have the right to name a beneficiary. It is important to list the full name of each beneficiary and that all beneficiary designations are kept current and provided to us or the policyholder. If you wish to change the beneficiary designation, you may do so by sending us or the policyholder a completed, dated, and signed beneficiary designation change form. Changes in beneficiary designations will take effect on the date notice of the beneficiary designation is signed by the named insured. If one is not named, and we still owe you benefits at your death, benefits due will be paid in this order to your: • spouse; • children; • parents; • brothers and sisters; or • estate. If benefits are payable to your estate, we can pay benefits up to $3,000 to someone rela tt by blood or marriage who we feel is fairly entitled to them. If we do this, we will have no responsibility for tl - t because we made it in good faith. Unpaid Premium• When a claim is paid under the policy, any premium then due and unpajdfificate may be deducted by us from the claim payment. ` 2)C° Overpaid Claim We have the right to recover any overpayments due to: • fraud; or r • any error made during the processing of a claim. You must reimburse us in full. We will work with you to dev/i reasonable method of repayment if you are financially unable to repay us in a lump sum. This may includ ucing or withholding future payments. We will not recover more money than the am rpaid. Questions Concerning the Named In im If you have questions concerning yo� can call us at our home office. We are open Monday through Friday from 8:30 a.m. until 5:00 p.m. Eastem Ti Physical Exam and Auto We can require that any vocational experts of ou autopsy in the event of the done at our expense. n be examined or tested by one or more physicians, other medical practitioners, or s often as it is reasonably necessary while this claim is pending. We can also require an of any covered person in those states where this is allowed. Either or both of these will be Legal Action We cannot be sued for benefits under the policy: • until 60 days after we are sent written proof of loss; or • after the expiration of the applicable statute of limitations following the time period in which written proof of loss is required to be provided to us. Claim Review If a claim is denied, we will give written notice of: • the reason for denial; • the policy provision that relates to the denial; • the right to ask for a review of the claims; and • the right to submit any additional information that might allow us to change our decision. GCI6000-C-FL 19 211 You may, upon written request, read any reports that are not confidential. For a small fee, we will make copies of those reports. Appeals Procedure Within 60 days after denial of a claim, you or your estate must appeal any denial of benefits under the policy by making a written request for review of the denial. Workers' Compensation Not Affected The policy does not replace or change any requirement for coverage under Workers' Compensation insurance. SECTION 18 — PORTABILITY Portability allows you to continue coverage when coverage under the policyholder's group policy would otherwise end due to an eligible portability event. Portability is made a part of this certificate and is subject to all of the provisions, limitations and exclusions of this certificate. Any future changes made in the policyholder's group policy will not apply to coverage a1V d} rson has ported, unless required by law.io Eligible Portability Events We will provide specified disease insurance portability coverage, subject t *t s ro 'ns. Such coverage will not be available for a named insured, unless: • the named insured's specified disease insurance terminates and t is Termination of the Named Insured's Coverage for one of the following reasons: o the named insured is no longer in an eligible class; or o the named insured's class is no longer included for insur • we receive a written request by the named insured a ► --yI premiums due for the portability coverage not later than 63 days after such termination; • such termination is while the policy is in force; and • the request is made on a form we furnish or approve • • •urpose. However, you will not be considered eligible tor(c�e�age at the time of an eligible portability event if: • the policyholder's policy is closed to new en • the policyholder's policy is cancelled b • the policyholder cancels the policy • -rs eplacement coverage; or • the policyholder's policy is chan o •'e the class of covered persons to which you belong. Coverage The benefits, terms and c► - • iti portability coverage will be the same as those provided under the policy for specified disease insur. e • - !� named insured's insurance terminated. We will allow you to decrease the face amount at the time porta. is quested; provided that the face amount cannot be decreased below a Face Amount for Named Insured of $5,000. • •ility coverage may include any eligible family members who were covered under the policy. Any change made to the policy after a named insured is insured under the portability privilege will not apply to that named insured unless it is required by law. Once premiums and all forms have been received, portability coverage will be effective on the day after coverage under the policy terminates. Premiums You must make all premium contributions for ported coverage. Premiums are due and payable in advance to us at our home office. Premium due dates are the first day of each calendar month. The premium rates are based on the portability rates in effect on the date you apply to port coverage. We have the right to change the portability premium we charge on any premium due date. Written notice will be given at least 45 days before the change is to take effect. GCI6000-C-FL 20 212 Grace Period (If Premiums Are Not Paid When Due) After the first premium, if the premium is not paid when it is due, it can be paid during the next 31 days. These 31 days are called the grace period. During the grace period this coverage will stay in force. If the premium is not paid before the grace period ends, the coverage provided by this certificate will terminate at the end of the grace period. Termination of Insurance Insurance under this portability privilege will automatically end on the earliest of the following dates: • the date the named insured again becomes eligible for specified disease insurance under the policy; • the last day for which premiums have been paid, if the named insured fails to pay premiums when due, subject to the Grace Period provision; • the date the named insured dies; or • the date insurance under this Portability provision is cancelled by us for any reason upon 31 days notice. With respect to insurance for your spouse and dependent children, insurance under this portability privilege will automatically end on the earliest of the following dates: • the date the named insured's insurance terminates; • as to your dependent children, the date the dependent child ceases to qualify as a hild as defined in this certificate; or • as to your spouse, the date the next premium is due after you divorce your spouarriage is annulled or the date of your spouse's death. In the event your policyholder's policy is terminated, any covered person who has or nued their coverage under the Portability provision prior to the policyholder's policy termination date w4 nbe affected. Once insurance under this portability provision is cancelled, it cannot Termination of the Policy Portability coverage may continue beyond the termination date of the policy, subject to the timely payment of premiums. Benefits, terms and conditions for portability coverage w(I be deterrfIhred as if the policy had remained in force and effect. ted. GCI6000-C-FL 21 213 COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 1200 Colonial Life Boulevard, P. O. Box 1365, Columbia, South Carolina 29202 1.800.325.4368 coloniallife.com A Stock Company CANCER BENEFITS RIDER THIS IS A LIMITED RIDER - READ IT CAREFULLY. THIS RIDER IS NOT ATTACHED TO A MEDICARE SUPPLEMENT POLICY. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare available from the company. All terms, definitions of terms, conditions, exclusions and limitations stated in the certificate for cancer will also apply to this rider unless we state otherwise in this rider. Coverage Provided by This Rider We will provide the benefit stated in this rider as a part of the certificate to which it the Rider Schedule, subject to any limitations in this rider or the certificate. the person(s) shown on � r p() You may call Colonial Life & Accident Insurance Company at (800) 325-4368 for information, inquiries or complaints. Definitions Bone Marrow or Peripheral Stem Cell Donation means receivi donor, other than yourself, for a transplant procedure. ceiarrow or peripheral stem cells from a matched Bone Marrow or Peripheral Stem Cell Transplant meaniNa s 9 , storage, reinfusion or subsequent reinfusion of bone marrow or peripheral stem cells taken from a matched donor or yourself, performed under general anesthesia or intravenous (IV) sedation. Calendar Month means any of the twelve parts into which the calendar year is divided. Calendar Year means the period beginning on the rider coverage effective date shown on the Rider Schedule and ending on December 31 of the same year. Thereafter, it is the period beginning on January 1 and ending on December 31 of each following year. Chemotherapy means treatme it 'INical substances that have a cancericidal effect for the purpose of the destruction of malignant cells ‘ -in he treatment of invasive cancer. Commercial Transportatians a vehicle licensed to carry passengers for a fee (i.e., plane, train or bus). v Confined or Con& me means the assignment to a bed as a resident inpatient in a hospital on the advice of a doctor or, for the purposes of the hospital confinement benefit only, confinement in an observation unit within a hospital for a period of no less than 20 continuous hours on the advice of a doctor. Disabled means you are: • unable to perform the material and substantial duties of your job; • not, in fact, working at any job for pay or benefits; and • under the regular and appropriate care of a doctor for the treatment of invasive cancer. R-GCI6000-CB-FL 1 214 Experimental Treatment means: • drugs or chemical substances that are pending approval by the United States Food and Drug Administration (FDA) for use in the treatment of invasive cancer; and • surgery or therapy endorsed by either the National Cancer Institute or the American Cancer Society for experimental studies. Family Member means your spouse, sister or brother (includes step -sister and step -brother), children (includes step- children), parents (includes step-parents), grandchildren, father or mother-in-law, brothers or sisters-in-law and spouses, as applicable, to any of these. Home Health Agency means an agency that is certified by your state government. Its main purpose is to arrange and provide nursing services, home health aide services, and other related services. Hospice means an organization that provides care for the terminally ill that: • is licensed by a governmental agency; • is accredited by the Joint Commission on Accreditation of Hospitals; or • is qualified to receive benefit payments from Medicare or Medicaid. The organization must have on its staff at least one doctor and one registered nu records for each patient. Hospice does not include: • food services, meals, and dietary counseling; or • services related to well -baby care; or • services provided by volunteers; or • support for the family after the death of the covered Hospital means a place that: • is an institution licensed as a hospital and operati • provides overnight care of injured and sick people; • is supervised by a doctor; • has full-time nurses supervised by a registered nise; and person. excli\ Von a full-time basis; eep complete medical • has at its locations or uses on a pre -arranged b is: x-ray equipment, a laboratory and an operating room where surgical operations take place. Notwithstanding the above, a hospital • a nursing home; • an extended care facility; • a skilled nursing facility; • a rest home or home for • a place for alcoholics • an assisted living faci ddicts; or Immunotherapy nl ns t atments intended to improve the immune system by providing antibodies, colony stimulating factors, or immunogl s for the purpose of treating invasive cancer. Injected Chemotherapy means medications taken intravenously, including but not limited to continuous infusion that has a cancericidal effect for the purpose of the destruction of malignant cells during the treatment of invasive cancer. Invasive Cancer (Including all Breast Cancer) means a disease that is identified by the presence of malignant cells or a malignant tumor characterized by the uncontrolled and abnormal growth and spread of invasive malignant cells. Any cancer of the breast is considered invasive cancer including breast cancer which is classified as stage 0 or in situ. The following are not to be construed as invasive cancer for purposes of this rider: • pre -malignant conditions or conditions with malignant potential; • cancer that has not become invasive, typically classified as stage 0 or in situ; • cancer on the surface of the body (skin) that may be: melanomas that are in situ or stage 1 which require only local treatment and affect only the melanoma and area close to it; R-GC16000-CB-FL 2 215 • basal cell carcinoma; and • squamous cell carcinoma of the skin. Material and Substantial Duties of Your Job means duties that: • are normally required to perform your regular job; and • cannot be reasonably omitted or modified. Performing your job at a particular worksite or in a particular building is not a material and substantial duty of your job, provided that your employer will allow you to perform your job at a different worksite or in a different building. Observation Unit means a specified area within a hospital, apart from the emergency room, where a patient can be monitored following outpatient surgery or treatment in the emergency room by a doctor and which: • is under the direct supervision of a doctor or registered nurse; • is staffed by nurses assigned specifically to that unit; and • provides care seven days per week, 24 hours per day. t Oral Hormonal Chemotherapy means medications taken by mouth to prevent or control the ea recurrence of malignant cells by: • altering the production or level of hormones; or R\ • blocking hormones. Oral Non -Hormonal Chemotherapy means medications taken by mouth, er than ormonal therapy medications, that have a cancericidal effect for the purpose of the destruction of malignant during the treatment of invasive cancer. Outpatient Surgical Center means a place that: • is equipped for outpatient surgical procedures administered by . : i • physicians; • provides anesthesia (other than local) by a licensed anesthe or ertified Registered Nurse Anesthetist; and • has written agreements with local hospitals to accept paten i • -tely who develop complications. Private Full-time Nursing means providing services red person for at least eight consecutive hours during any 24-hour period while confined to a hospital. Radiation means the following treatments for the purse o the destruction of malignant cells during the treatment of invasive cancer: • • tele radiotherapy, using either natural or ially propagated radiation; or • interstitial or intracavitary applicatioj for radioisotopes in sealed or non -sealed sources. Office visits, laboratory tests, diagno treatment planning, simulation, treatment devices, dosimetry, radiation physics, teletherapy, laser surge r_• , - procedures related to these treatments will not be considered radiation. Reconstructive Surgery mr the purpose of reconstruction of anatomic defects that result from treatment of invasive cancer. Skilled Nursing eans a place where a covered person goes to recover from an illness and: • is licensed an• _.-ra' d as a skilled nursing care facility according to the law of the jurisdiction in which it is located; • is a legally opera - :cility that can be a wing or part of a hospital; • operates 24 hours a day and will accept inpatients on an overnight basis; • is supervised by a doctor; • has a 24-hour nursing staff which is supervised by a registered nurse (RN); and • keeps written daily records for each patient. Notwithstanding the above, a skilled nursing care facility is not: • a rest home or a home for the aged; • a place that provides mostly custodial care; or • a place for alcoholics or drug addicts. R-GCI6000-CB-FL 3 216 Skin Cancer means cancer on the surface of the body (skin) that may be: • melanomas that are in situ or stage 1, which require only local treatment and affect only the melanoma and area close to it; • basal cell carcinoma; or • squamous cell carcinoma of the skin. Supportive or Protective Care Drugs and Colony Stimulating Factors means: • bone marrow growth factors; • radiation and chemotherapy protectants; and • medications that promote bone growth. Supportive or Protective Care Drugs must be approved for the treatment of invasive cancer by the United States Food and Drug Administration and must be prescribed by a physician. Surgery means the cutting into the skin or other organ to accomplish any of the following go• • take a biopsy of a suspicious lump that results in a diagnosis of invasive cancer; • remove diseased tissues or organs; • remove an obstruction; • reposition structures to their normal position; • redirect channels; • transplant tissue or whole organs; • implant mechanical or electronic devices; • reconstruct anatomic defects that result from treatment of invasive cance r • restore proper function. The following will not be considered a surgical procedure for theeZ s of this rider: • venipuncture (drawing blood); ♦♦` • lumbar puncture; • epidural steroid injections; • removal of skin tags; • catherization; or • scopes not requiring biopsy or removal of tissue/ Topical Chemotherapy means a the purpose of the destruction of malignant Under the Regular and Appropr the care you are receiving is ap reached your maximum point g placed directly onto the skin that has a cancericidal effect for the the treatment of invasive cancer. f a Doctor means you are being cared for on a regular basis by a doctor and the treatment of invasive cancer which disable(s) you, unless you have d the doctor states that continued treatment would be of no benefit to you. U. S. Government saa a hospital that is funded by the U. S. Government primarily for military enlisted personnel and th a ilie military veterans. Eligibility For Bene We will pay cancer bennee its if any covered person incurs a charge and receives treatment by a physician for the benefits shown on the Rider Schedule for invasive cancer, including skin cancer where applicable, if: • the treatment is recommended by a physician; • the covered person receives treatment for invasive cancer or skin cancer while this rider is in force; and • the invasive cancer or treatment is not excluded by name or specific description in this rider. If invasive cancer is not pathologically or clinically diagnosed until after you die, we will only pay benefits for invasive cancer treatment performed during the 45-day period before your death. R-GCI6000-CB-FL 4 217 Invasive Cancer (Including all Breast Cancer) must be diagnosed in one of two ways: 1. Pathological Diagnosis A pathological diagnosis of invasive cancer made by a pathologist is based on a microscopic study of fixed tissue or preparations from the hemic (blood) system. This type of malignancy diagnosis must be in accordance with the standards established by the American Board of Pathology. A pathological diagnosis of invasive cancer can be made before or after death. 2. Clinical Diagnosis A clinical diagnosis of invasive cancer is based on the study of symptoms. We will pay benefits for a clinical diagnosis only if: • a pathological diagnosis cannot be made because it is medically inappropriate or life -threatening; • there is medical evidence to support the diagnosis; and • a doctor is treating the covered person for invasive cancer. In addition to the required pathological or clinical diagnosis, we may require additional informa the attending We will only pay benefits for skin cancer where specifically stated. tC\ If treatment for invasive cancer or skin cancer is received in a U. S. Govem ent Ho e will not require a covered person to incur charges for services for benefits to be payable. Cancer Benefits doctor and hospital. Air Ambulance We will pay the amount shown on the Rider Schedule for Air A professional air ambulance company transports by air any c facilities while the covered person is confined as an in than two trips each time the covered person is confine la charge is incurred and a licensed n to or from a hospital or between medical atment of invasive cancer. We will pay for no more lent for the treatment of invasive cancer. There is no limit to the total number of trips for which a cov_ -d person receives benefits, other than two trips each time the covered person is confined as an inpatient for the�reatment of invasive cancer. Benefits for ambulance transportation, other than air ambulance, will be paid under the Amb lance benefit. Ambulance We will pay the amount shown on the professional ambulance company tr between medical facilities, while will pay for no more than two trj cancer. There is no limit to time a covered p paid under the Air ule for Ambulance if a charge is incurred and a licensed medical y covered person by ground transportation to or from a hospital or person is confined as an inpatient for the treatment of invasive cancer. We a covered person is confined as an inpatient for the treatment of invasive r of trips for which a covered person can receive benefits, other than two trips each d as an inpatient for the treatment of invasive cancer. Benefits for air ambulance will be ce benefit. Anesthesia We will pay the amount shown on the Rider Schedule if any covered person incurs a charge and receives general anesthesia administered by an anesthesiologist or a Certified Registered Nurse Anesthetist during a surgical procedure that is performed for the treatment of invasive cancer and for which a benefit is payable. If a covered person incurs a charge and receives local anesthesia during a surgical procedure performed for the treatment of invasive cancer for which a benefit is payable, we will pay the amount shown on the Rider Schedule. If a covered person has more than one surgical procedure performed at the same time, we will pay only one Anesthesia benefit. We will pay the Anesthesia benefit for the surgical procedure performed that has the highest dollar value. Any anesthesia administered for reconstructive surgery will be paid only under the Reconstructive Surgery benefit provision. This benefit is payable for skin cancer. R-GCI6000-CB-FL 5 218 There is no limit to the number of times a covered person can receive benefits for anesthesia during the treatment of invasive or skin cancer. Anti -Nausea Medication We will pay the amount shown on the Rider Schedule if a covered person incurs a charge for medication for nausea as a result of radiation or chemotherapy treatments prescribed by a doctor during the treatment of invasive cancer. This benefit is payable each day a covered person receives anti -nausea medication administered in a physician's office, clinic, hospital or prescriptions filled for anti -nausea medication, subject to the Maximum Benefit Amount shown on the Rider Schedule. We will only pay one Anti -Nausea Medication benefit per day regardless of the number of anti -nausea medications a covered person receives on the same day. If a covered person receives a prescription for anti -nausea that is for more than one month, t� t is limited to the calendar month in which the charge is incurred. Refills of the same prescription within the she le r month are not considered a different anti -nausea medicine. Benefits for radiation and/or chemotherapy prescribed by your physician are only Radiation/Chemotherapy or Immunotherapy benefit. Benefits for supportive or prot stimulating factors are only available under the Supportive or Protective Carrugs benefit. Blood/Plasma/Platelets/Immunoglobulins We will pay the amount shown on the Rider Schedule if any covered blood/plasma/platelets/immunoglobulins during the treatment of i Bone Marrow Donor Screening We will pay the amount shown on the Rider Schedule oerson provides documentation of participation in a screening test as a potential bone marrow donor. This benefit is limited to one payment per covered person r lifetime. Bone Marrow or Peripheral Stem Cell Donation We will pay the amount shown on the Rider •edule if any covered person incurs a charge for receiving bone marrow or stem cells in connection with a coveredrocedure during the treatment of invasive cancer. erthe re drugs and colony olony Stimulating Factors n incurs a charge and receives a transfusion of cer, subject to the Maximum Benefit Amount. This benefit is limited to one payments red person per lifetime. Bone Marrow or Peripheral Ste nsplant We will pay the amount shown e Schedule if any covered person incurs a charge for and receives a bone marrow or peripheral stem - n ant for the treatment of invasive cancer. This benefit is limii,lb t - • ,¢ . plant payments per covered person per lifetime. Cancer Vaccine We will pay the amouliown on the Rider Schedule if any covered person incurs a charge and receives any invasive cancer vaccine that is United States Food and Drug Administration (FDA) approved for the prevention of invasive cancer and while this rider is in force. The vaccine must be administered by licensed medical personnel while this rider is in force. This benefit is limited to one payment per covered person per lifetime. Companion Transportation We will pay the amount shown on the Rider Schedule if a charge is incurred for one companion to provide care and accompany a covered person, while incapacitated, to another city where the covered person is receiving treatment for invasive cancer at a hospital or medical facility if: • the doctor advises treatment or diagnosis of your invasive cancer in another city; • charges are incurred for commercial travel (i.e., plane, train or bus); • the destination is more than 50 miles one way from the city where the covered person lives; and • treatment is for invasive cancer. R-GCI6000-CB-FL 6 219 We will measure the mileage for the most direct route from the residential address where the covered person lives to the city in which treatment is received. This benefit is not payable for personal vehicle transportation. Benefits for air ambulance and ambulance are only available under the Air Ambulance and Ambulance benefits. There is no limit to the number of times a covered person receives benefits for Companion Transportation, subject to the Maximum Benefit Amount shown on the Rider Schedule per covered person per round trip. Egg(s) Extraction or Harvesting/Sperm Collection and Storage (Cryopreservation) We will pay the amount shown on the Rider Schedule if a covered person incurs a charge to have eggs extracted and harvested or sperm collected. We will pay an additional benefit as shown on the Rider Schedule for the storage of a covere eggs or sperm when a charge is incurred to store it with a licensed reproductive tissue bank or a similar lic e for e facility. The extraction, harvesting, collection and storage must occur prior to the chemothera. , is i unotherapy treatment that has been prescribed by a doctor for the covered person's treatment . i cancer. We will pay these benefits only once per covered person per lifetime. Experimental Treatment We will pay the amount shown on the Rider Schedule each day any covered incurs a charge and receives hospital, medical or surgical care in connection with experimental trea nt o invasive cancer. These treatments must be prescribed by a physician and must be received in an experimental as cancer treatment program. Payment of this benefit is in place of payment of any other a f�P�j�`�ame covered treatments. There is no limit to the number of treatments a covere ,•� shown on the Rider Schedule. Hair/External Breast/Voice Box Prosthesis We will pay the amount shown on the Rider Schedullef any covered person incurs a charge and receives a hair prosthesis, extemal breast prosthesis or voiprosthesis needed as a direct result of invasive cancer. receive, subject to the Maximum Benefit Amount There is no limit to the number of years aerson can receive benefits for a hair prosthesis, external breast prosthesis or voice prosthesis. Home Health Care Services We will pay the amount show the following home health in a hospital: Schedule each day any covered person incurs a charge and receives any of s prescribed by a doctor for the treatment of invasive cancer instead of confinement • professional sin r&d by a registered nurse; • home health a es provided under the supervision of a registered nurse or qualified therapist; • physical therapy; • occupational therapy; • speech therapy and audiology; • respiratory and inhalation therapy; • nutrition counseling by a nutritionist or dietitian; • medical social services; • medical supplies; • prosthesis and orthopedic appliances; • rental or purchase of durable medical equipment; or • administration of drugs or medicine. Prior confinement in a hospital is not required. The service must be rendered by a home health agency as part of a plan of care established by the doctor and the home health agency. R-GCI6000-CB-FL 7 220 We will pay this benefit for up to the greater of: • 30 days per calendar year; or • twice the number of days the covered person was confined to a hospital during a calendar year for the treatment of invasive cancer. We will not pay the Home Health Care Services benefit for: • services or supplies for personal comfort or convenience, including housekeeping services; • services performed by family members or provided by the hospital; • child care; or • food services or meals other than dietary counseling. This benefit will not be paid for days that the Hospice benefit is payable. There is no limit to the number of years a covered person can receive benefits for Home Health Ca Services subject to the calendar year maximum. Hospice We will pay the amount shown on the Rider Schedule each day any covered persoe and receives hospice care, as the result of invasive cancer, consisting of one or more of the following setvices received by a covered person for whom a doctor determines that invasive cancer treatments are no longer of beneffif d that the covered person is expected to live for only six months or less: �/ • a visit from a representative of a hospice care team at home; • the services of a hospital on an outpatient basis under the direction of a Ike, • a visit to a hospice on an outpatient basis for treatment or services. nd • confinement to a hospice care facility. We will pay the amount shown on the Rider Schedule for initial hospi re on the first day a covered person receives hospice care. Initial hospice care is payable once per co rson er lifetime regardless of the number of times a covered person receives hospice care. We will not pay this benefit while a covered person is con d to a hospital, or to a skilled nursing care facility. This benefit will not be paid for days that the Home Health are rvices benefit is payable. There is no limit to the number of days a cov person can receive benefits for hospice, subject to the Maximum Benefit Amount shown on the Rider Schedule. Hospital Confinement We will pay the amount shown on th hospital (including intensive care hedule each day any covered person incurs a charge for confinement to a atment of invasive cancer. If we pay benefits for a perio• h• •ital confinement and a covered person is confined to a hospital again within 30 days for the treatment of invasjn. ' , we will treat this confinement as a continuation of the prior confinement. • r If more than 30 dshare passed between the periods of hospital confinement (including intensive care), we will treat this confinement as a ricorlfinement. There is no limit to the number of days any covered person can receive benefits for being confined to a hospital for the treatment of invasive cancer. Lodging We will pay the amount shown on the Rider Schedule each day any covered person or any one adult companion or family member incurs a charge for lodging required to render care while the covered person is incapacitated and being treated for invasive cancer at a hospital or medical facility more than 50 miles from the covered person's residence. We will pay up to 90 days per calendar year. R-GCI6000-CB-FL 8 221 Medical Imaging Studies We will pay the amount shown on the Rider Schedule if any covered person incurs a charge for a covered medical imaging study. It must be prescribed by a doctor for the treatment of invasive cancer and after the initial diagnosis or follow-up evaluation of invasive cancer. Covered imaging studies are: • Computed Tomography (CT) imaging or Computed Axial Tomography (CAT Scan); • Magnetic Resonance (MR) or Magnetic Resonance Imaging (MRI); • Positron Emission Tomography (PET or Bone Scan); and • Ultrasound (US) Imaging. There is no limit to the number of times a covered person can receive this benefit, subject to the calendar year maximum shown on the Rider Schedule. Outpatient Surgical Center We will pay the amount shown on the Rider Schedule each day any covered person incurs a the a d has surgery at an outpatient surgical center for the treatment of invasive cancer. This does not include sur y re+ i in the emergency room or while confined to the hospital. We will only pay benefits for one outpatient surgery per day, even if a covered pe o than one surgical procedure performed. This benefit is not payable on the same day as the Hospital Confinement be Benefits for the surgical procedure and anesthesia are payable under the su ry enefits and the Anesthesia benefit. There is no limit to the number of days a covered person can receiv shown on the Rider Schedule. Private Full-time Nursing Services We will pay the amount shown on the Rider Scheduleach day al►j covered person incurs a charge for private full-time nursing services (other than those regularly fumished by thihospital) required and authorized by a doctor while confined to a hospital for the treatment of invasive cancer. efit, subject to the calendar year maximum Private full-time nursing must be performed by a regi tered nurse (RN), a licensed practical or a licensed vocational nurse. Nursing services performed by family . - -f provided by the hospital are not covered. There is no limit to the number of c ' • • ered person can receive benefits for the use of services of a private full-time nurse. Prosthetic Device/Artificial Li We will pay the amount shown cethe Rider Schedule if any covered person incurs a charge and receives a surgically implanted prosthde e`orartificial limb which is prescribed by a doctor needed as a direct result of invasive cancer surgery. We will pay any appropriate surgery or reconstructive surgery benefit as described in those benefit provision(s) for the surgical procedure required for the implant. This benefit does not include coverage for tissue expanders or a Breast Transverse Rectus Abdominis Myocutaneous (TRAM) Flap. We will pay for no more than one of the same type of prosthetic device or artificial limb per site. Radiation/Chemotherapy or Immunotherapy We will pay the amount shown on the Rider Schedule if any covered person incurs a charge and receives one or more of the covered treatments listed below during the treatment of invasive cancer. R-GCI6000-CB-FL 9 222 Covered Treatments consist of the following: • Chemotherapy, consisting of one or more of the following: o chemotherapy treatments injected by medical personnel in a doctors office, clinic or hospital; o chemotherapy treatments injected by yourself or anyone other than personnel in a doctor's office, clinic or hospital; o a pump for chemotherapy initially filled or refilled; o a prescription for topical chemotherapy; o a prescription for oral hormonal chemotherapy; or o a prescription for oral non -hormonal chemotherapy. • Radiation, consisting of radioactive treatments delivered by medical personnel in a doctor's office, clinic, or hospital. • Immunotherapy, consisting of treatments intended to improve the immune system by providing antibodies, colony stimulating factors, or immunoglobulins for the purpose of treating invasive cancer. Covered Treatments injected or delivered by medical personnel in a doctor's office, clinic or calendar month, subject to the calendar year amount shown on the Rider Schedule and in which the covered person incurs a charge for the treatment of invasive cancer. payable each calendar month Covered Treatments delivered by any other method, as listed above, are payable : 'ch cal ndar month, subject to the calendar year amount shown on the Rider Schedule and are limited to the c[endar - in which the covered person incurs a charge for the treatment of invasive cancer. Payment of this benefit is not based on the number, duration or frequency of d ered treatment. If a covered person receives a prescription for chemotherapy that is calendar month in which the charge is incurred. Refills of the sa considered a different chemotherapy medicine. than one month, this benefit is limited to the ption within the same calendar month are not Radiation and chemotherapy treatments must be app . -r th'treatment of invasive cancer by the United States Food and Drug Administration (FDA). Radioactive treatments delivered by medical persona are not payable each month a radium implant or radioisotope remains in the body. This benefit is not payable for the samea Experimental Treatment benefit is paid. Benefits for supportive or protective under the Supportive or Protectiv prescribed by your doctor are and colony stimulating factors prescribed by your doctor are only available d Colony Stimulating Factors benefit. Benefits for anti -nausea medication under the Anti -nausea Medication benefit. We will not pay this benef e'iisits, laboratory tests, diagnostic x-rays, treatment planning, simulation, treatment devices, dosimetry ia� cs, teletherapy or other procedures related to these treatments. Reconstructive We will pay the amou6wn on the Rider Schedule if any covered person incurs a charge for a reconstructive surgery that: • requires an incision; • is performed by a doctor for treatment of invasive cancer; and • is due to invasive cancer. We will pay for no more than two surgeries per site. We will use the most current published Physicians' Relative Value table and the Current Procedural Terminology (CPT) Code, provided by the doctor who performed your surgery, to determine the surgical unit value assigned to each surgery. How to calculate this benefit: Dollar amount per unit X Surgical Unit Value = Surgery Benefit Amount (up to the maximum per procedure) R-GCI6000-CB-FL 10 223 If the Reconstructive Surgery benefit calculated above is less than the Maximum Benefit Amount allowed for this benefit, then we will also pay up to 25% of the reconstructive surgery benefit amount if a covered person incurs charges for and has general anesthesia administered during surgery. In no event, will the amount paid for this benefit exceed the lesser of: • the surgical unit value multiplied by the dollar amount per unit shown above plus 25% for general anesthesia administered during reconstructive surgery; or • the maximum amount per procedure shown above. If a covered person has more than one reconstructive surgery performed at the same time and through the same incision, we will pay only one Reconstructive Surgery benefit. We will pay the benefit that has the highest dollar value. If a covered person has more than one reconstructive surgery performed at the same time but thro h different incisions, we will pay for each one. Second Medical Opinion We will pay the amount shown on the Rider Schedule if any covered person incurs medical opinion from another doctor on recommended surgery or treatment follow cancer. A covered person is not required to obtain a second medical opinion in or benefits under this rider. This benefit is limited to one payment per covered person per lifetime. Skilled Nursing Care Facility We will pay the amount shown on the Rider Schedule each day a skilled nursing care facility during the treatment of invasive nc btains a second s e diagnosis of invasive ive the surgical or other cperson incurs a charge and is confined to a Confinement must begin within 14 days after a coveresed from a hospital. We will pay this benefit for no more than the number of days we paid the Hospital Co - ent nefit for your most recent confinement. There is no limit to the number of times a covered person c. receive benefits for being confined to a skilled nursing care facility during the treatment of any invasive cancer *mg as each confinement begins within 14 days after a covered person is released from a hospital. Supportive or Protective Care Drugs Stimulating Factors We will pay the amount shown on the - - c dule each day any covered person incurs a charge and receives supportive or protective care drugs - • , •I y stimulating factors for the treatment of invasive cancer. Benefits for supportive or prot- - c. - . gs and/or colony stimulating factors will only be payable for the day a covered person has the prescription fi We will only pay o n i .i •.y regardless of the number of supportive or protective care drugs and/or colony stimulating facto co— • rson receives on the same day. If a covered person r s a prescription for supportive or protective care drugs and/or colony stimulating factors that is for more than one mont , this benefit is limited to the calendar month in which the charge is incurred. Refills of the same prescription within the same calendar month are not considered a different supportive or protective care drug and/or colony stimulating factor medicine. Benefits for radiation/chemotherapy or immunotherapy will only be available under the Radiation/Chemotherapy or Immunotherapy benefit. Benefits for anti -nausea medication prescribed by a doctor solely to prevent nausea will only be available under the Anti -Nausea Medication benefit. Medications prescribed for experimental treatment will only be available under the Experimental Treatment benefit. There is no limit to the number of times a covered person can receive this benefit, subject to the calendar year maximum shown on the Rider Schedule. R-GCI6000-CB-FL 11 224 Surgical Procedures We will pay the amount shown on the Rider Schedule if any covered person incurs a charge for a surgical procedure performed by a doctor for the treatment of invasive cancer, subject to the Maximum Benefit Amount. The Maximum Benefit Amount is the lesser of: • the surgical unit value multiplied by the dollar amount per unit; or • the maximum amount per procedure. We will use the most current published Physicians' Relative Value table and the Current Procedural Terminology (CPT) Code, provided by the doctor who performed your surgery, to determine the surgical unit value assigned to each surgery. How to calculate this benefit: Dollar amount per unit X Surgical Unit Value = Benefit Amount (up to the maximum per procedure) If a covered person has more than one surgical procedure performed at the same time and will pay only one Surgical Procedures benefit. We will pay the benefit that has the highest d�o alal has more than one surgical procedure performed at the same time but through different i one. same incision, we f a covered person I pay for each Surgery performed laparoscopically with more than one incision will be considere. Tji"j ical procedure regardless of the number of incisions. We will pay the benefit that has the highest dollar vue. Benefits for reconstructive surgical procedures for invasive cancer will only b%)( under the Reconstructive Surgery benefit. This benefit is payable for skin cancer. There is no limit to the number of times a covered person c r- . invasive or skin cancer. Transportation We will pay the amount shown on the Rider Schedule if anovered person receiving treatment incurs a charge and must travel from their residence more than 50 miles one wwfrom the city in which the covered person lives to receive a diagnosis or treatment for invasive cancer. Treatmen for invasive cancer must be: nefits for surgical procedures for the treatment of • prescribed by a doctor; and • not available locally. We will pay this benefit when charge • commercial travel (Le., plane • non-commercial travel (1. red for travel to and from your destination for either: s); or sonal car or ride -sharing services). We will measure the mile • - "e most direct route from the residential address where the covered person lives to the city in which treat We will pay this beach round trip, subject to the Maximum Benefit Amount shown on the Rider Schedule per covered person. Benefits for air ambulance and ambulance are only available under the Air Ambulance and Ambulance benefits. There is no limit to the number of times a covered person can receive benefits for transportation. Waiver of Premium You, the named insured, will not be required to continue to pay premiums to keep this rider in force if you have been disabled as the result of invasive cancer if: • the treatment is recommended by a physician; • you receive treatment for invasive cancer while this rider is in force; and • you are disabled for more than 90 consecutive days while this rider is in force. R-GCI6000-CB-FL 12 225 If you do not have a job, we will not require you to pay premiums as long as you are kept at home because of your invasive cancer and are under the regular and appropriate care of a doctor. At home means in your house or yard. However, you can follow your doctor's orders even if it means leaving home. If you do have a job, we will require an employer's statement of your inability to perform the material and substantial duties of your job. We may also each month thereafter require a doctor's statement that you continue to be disabled as defined in this rider. After it has been determined that you have been disabled for more than 90 consecutive days, we will not require you to pay premiums for the length of time you continue to be disabled because of your invasive cancer. We can require that you be examined by a doctor, chosen by us, to verify that you are disabled. This will be done at our expense. Before we waive your premiums, you must send us a written notice prepared by your doctor ja g: • the date you were diagnosed as having invasive cancer; • that you are disabled due to invasive cancer; and • the date you became continuously disabled because of invasive cancer. We will waive the premium beginning on the next premium due date for the certific e and ny attached riders up to a lifetime maximum of 24 months from the first day you are disabled due to in If we do not require you to pay premiums during a period of disability, and yo ome disabled again within 30 days because of invasive cancer, we will treat this disability as the same disability. . e than 30 days have passed between the periods of disability, we will treat this disability as a new disability ou must be disabled again for more than 90 consecutive days before we will waive your premiums. You must send us written notice as soon as you are no to • you do not send us satisfactory proof of loss when • you do not agree to have physical examination by • you notify us that you are no longer disabled. i - 4 We will assume you are no longer disabled if: u t •rch sen by us; or You must pay all premiums to keep this rider in forcq�eginning with the first premium due after you are no longer disabled. This benefit does not apply to your spous disabled due to invasive cancer. How all family members insured by this r children. We will waive premiums only if you, the named insured, are s is a one -parent or a two -parent family rider, we will waive premiums on EXCLUSIONS AND LIMITAT NCER Pre-existing Condition We will not pay C existing condition, Certificate Schedule on applicable. or treatment of invasive cancer, including skin cancer where applicable, that is a pre- overed person has satisfied the pre-existing condition limitation period shown on the date the covered person receives treatment for invasive cancer, including skin cancer where Geographical Limitation We will not pay Cancer Benefits for treatment of invasive cancer, including skin cancer where applicable, that is diagnosed or treated outside the territorial limits of the United States, its possessions, or the countries of Canada and Mexico. TERMINATION OF THE NAMED INSURED'S COVERAGE The coverage on a named insured under this rider will terminate on the earliest of the following dates: • the date coverage terminates under the certificate to which this rider is attached; • the end of the grace period following the premium due date and we do not receive the required premium for the named insured; • the date the named insured is no longer in an eligible class; R-GCI6000-CB-FL 13 226 • the date the named insured's class is no longer included for insurance; or • the date the next premium is due after the named insured asks us to end coverage. We will provide coverage for a claim for which we are liable under the terms of this rider if the loss occurs while you are covered. WHEN COVERAGE ENDS ON YOUR SPOUSE AND DEPENDENT CHILDREN If this is a named insured and spouse coverage or two -parent family coverage, coverage on your spouse will end on the earliest of the following dates: • the date the coverage terminates under the certificate to which this rider is attached; • the end of the grace period following the premium due date and we do not receive the required premium for your spouse; • the date you ask us to end your spouse's coverage; • the date you die; or • the date you divorce your spouse or your marriage is annulled. If this is a named insured and spouse coverage or two -parent family coverage and you divorce your spouse, or yarriage is annulled and you do not notify us, the extent of our liability will be to refund premium paid for the time period for which the covered person did not qualify. If this is a one -parent family or two -parent family coverage, coverage on your depe Idren will end on the earliest of the following dates: • the date your coverage terminates under the certificate to which this rid tached; • the end of the grace period following the premium due date and we do n ive the required premium for your dependent children; • the date you ask us to end your dependent children's coverage; • the date you die; or • the date they no longer meet the definition of dependen hi rJ vn in the General Definitions section of the certificate. We will provide coverage for a claim for which we are Iifinder the terms of this rider if the loss occurs while your spouse and/or dependent child is covered. Coverage for your child may be continued past age Atif your child is incapable of self-sustaining employment due to permanent intellectual or physical incapacity, prior to reaching age 26 and is dependent upon you for support and maintenance. You must submit proof ofiwe child's incapacity and dependency to us within 31 days of the child's 26th birthday. Ongoing proof of incapacity and dependency must be provided when requested by us, but not more frequently than once a year after the two-year period following the termination date. We will continue to charge any appropriate premium for that child as long as ey meetrthe definition of a dependent child. It is your responsibility to notify us if any dependent child no longer qual' ' as an eligible dependent. If this is one -parent family or two -parent family coverage and all of your dependent childrenrno longer qualify as eligible dependents and you do not notify us, the extent of our liability will be to refund premium fche time period for which they did not qualify. CO 7f/tw> Secretary R-GCI6000-CB-FL 14 227 Group Medical Bridge 7000 — Plan 2 • Colonial Life Colonial Life's group hospital indemnity insurance plan, Group Medical Bridge, offers a customizable and flexible plan design that will help supplement your major medical plan offering. This coverage provides benefits that your employees can use to offset deductibles, co -pays, and out-of-pocket medical and non -medical expenses related to covered events that cause financial exposure, such as hospital confinement, outpatient surgical procedures, diagnostic procedures, etc. Product Features • Coverage is guaranteed issue for all covered insureds; there are no health questions or medical underwriting. • Premiums can be employer or employee paid. Premium discounts may be available for 100% employer paid accounts. • In multi -state enrollments, situs state rules apply to Group Medical Bridge. • Benefits are paid regardless of any other insurance the insured may have with another company. • Benefits are indemnity based and are paid as a lump -sum. • Benefits are paid directly to the named insured unless an assignment of benefits is received. • Product is marketed, underwritten, and administered by Colonial Life. Plan Design at -a -Glance Plan 2 Hospital Confinement Waiver of Premium ✓ Daily Hospital Confinement Employer Option Diagnostic Procedure Employer Option Medical Treatment Package (Accident and Sickness) Employer Option Observation Room Employer Option Outpatient Surgical Procedure Employer Option Rehabilitation Unit Confinement Employer Option Wellbeing Assistance -Standard Employer Option Several plan design and benefit options are available forthe employer to customize the employee's plan offering. • The employer will select the plan design(s) and optional benefits to be offered. Two different plan design options allow for the needs of each account to be met. Both plan designs may be offered in an account. • The employer will select a maximum of two hospital confinement levels per plan design. • The employer will choose whether to include the employer optional benefits. • Employer optional benefits with benefit amounts selections will be chosen by the employer. Plan 2 Benefits Hospital Confinement: The Hospital Confinement benefit level(s) selected below by the employer is payable once per day with a maximum of one day per covered person per calendar year. ❑ Level 2: $1,000 ❑ Level4: $2,000 Waiver of Premium: After 30 continuous days of a covered confinement of the named insured, the Waiver of Premium benefit is available. This benefit waives the premium forthe entire certificate as the named insured is continuously confined, or up to 12 months, whichever occurs first. Applicable to GMB7000 in the following states: FL This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 06/16 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 PS02509 228 ••���• Colonial Life Employer Optional Benefits The following optional benefits are available for the employer to include in the plan design. These benefits are not optional for the employee. ❑ Daily Hospital Confinement: $100 per day with a maximum of 365 days per covered person per confinement ❑ Diagnostic Procedure: The employer selects the Diagnostic Procedure option to offer to the employees. The Diagnostic Procedure benefit is payable once per day with a maximum of one day per covered person per calendar year for the specified diagnostic proceduresl. ❑ Option 1 $250 Covered Diagnostic Procedures1Breast Digestive Barium Enema/Lower GI series Barium Lymphatic Biopsy Miscellaneous Biopsy (incisional, needle, stereotactic) Swallow/Upper GI series Bone marrow aspiration/biopsy Cardiac Angiogram Esophagogastroduodenscopy Renal Biopsy Arteriogram (EGD) Respiratory Tha [Hum Stress Test Transesophageal Ear/Nose/Throat/Mouth Biopsy Echocardiogram La ryngoscopy Gynecological Bronchoscopy Pulmonary (TEE) Amniocentesis Function Test Diagnostic Radiology Cervical biopsy Cone (PFT) Computerized TomographyScan (CT biopsy Endometrial Skin Scan) biopsy Hysteroscopy Biopsy Electroencephalogram (EEG) Loop Electrosurgical Excisional Excision of lesion Magnetic Resonance Imaging (MRI) Procedure (LEEP) Thyroid Biopsy Myelogram Liver Urologic Nuclear medicine test Biopsy Cystoscopy Positron Emission Tomography Scan (PET Scan) ❑ Medical Treatment Package (Accident and Sickness): • AirAmbulance: $1,000 per day with a maximum of one day per covered person per calendar year • Ambulance: $100 per day with a maximum of one day per covered person per calendar year • Appliance: $100 per day with a maximum of one day per covered person per calendar year • Doctor's Office Visit/Telemedicine: $25 per day with a maximum of three days per calendar year for named insured only coverage; maximum of five days per calendar year for all covered persons combined for family coverage • Emergency Room Visit: $100 per day with a maximum of two days per covered person per calendar year • X-Ray: $25 per day with a maximum of two days per covered person per calendar year ❑ Observation Room: $100 per day with a maximum of two days per covered person per calendar year. This benefit is payable for treatment in an observation room in a hospital for less than 20 hours. O Outpatient Surgical Procedure: The employer selects the Outpatient Surgical Procedure option to offer to the employees. The option contains two tiers of benefits. Both tiers are payable per day with a calendar year maximum per covered person per calendar year and a maximum of one day per outpatient surgical procedure. Below is a sample list of covered surgical procedures. We will also pay the Outpatient Surgical Procedure benefit for a procedure that is not listed if the procedure meets the definition of a covered surgical procedure as outlined in the certificate. Applicable to GMB7000 in the following states: FL PS02509 This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 06/16 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 229 ••���• Colonial Life Tier 1 Surgery) Sample procedures shown below Tier 2 Surgery3 Sample procedures shown below Calendar Year Max ❑ Option 2 $750 $1,500 $2,500 Tier 1 Sample Surgical Procedures2 Breast Ear/Nose/Throat/Mouth Liver Axillarynodedissection Breast Adenoidectomy Removal Paracentesis Musculoskeletal capsulotomy Lumpectomy of oral lesions System Carpal/cubital repair or Cardiac Myringotomy release Foot surgery Pacemaker insertion Tonsillectomy (bunionectomy, Digestive Colonoscopy Tracheostomy exostectomy, arthroplasty, Fistulotomy Tympanotomy hammertoe repair) Hemorrhoidectomy Gynecological Removal of orthopedic hardware Lysis of adhesions Dilation &Curettage (D&C) Endometrial Removal of tendon lesion ablation Skin Lysis of adhesions Laparoscopic hernia repair Skin grafting Tier 2Sample Surgical Procedures' Breast Breast reconstruction Ear/Nose/Throat/Mouth continued Musculoskeletal System Arthroscopic knee surgery with Breast reduction Septoplasty menisectomy (knee cartilage Cardiac Stapedectomy repair) Angioplasty Tympanoplasty Eye Arthroscopic shoulder surgery Cardiac catheterization Cataract surgery Clavicle resection Dislocations Digestive Corneal surgery (penetrating (ORIF - open Exploratory la pa roscopy keratoplasty) reduction Laparoscopic appendectomy Glaucoma surgery with internal fixation) La paroscopic cholecystectomy (trabeculectomy) Fracture (ORIF-open reduction with internal fixation) Ear/Nose/Throat/Mouth Vitrectomy Removal or implantation of cartilage Ethmoidectomy Mastoidectomy Tendon/ligament repair Gynecological Thyroid Hysterectomy Excision of a mass Myomectomy Urologic Lithotripsy ❑ Rehabilitation Unit Confinement: $100 per day with a maximum of 15 days per confinement with a 30 day maximum per covered person per calendar year. This benefit is payable for inpatient rehabilitation immediately following confinement either in a unit that is part of a hospital or in a free-standing facility. ❑ Wellbeing Assistance -Standard: The employer decides whether to offer the Standard Wellbeing Assistance benefit. The benefit amount is $50. The benefit is payable per day with a maximum of one day per covered per calendar year. Wellbeing Assistance - Standard applies to 24 tests. Benefit is subject to a 30-day waiting period. Applicable to GMB7000 in the following states: FL This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 06/16 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 PS02509 230 • Colonial Life Employee Eligibility Requirements • Minimum issue age is 17 for both the named insured and spouse. No maximum age. • The named insured must be actively at work at the time of application and working 15 or more hours per week. • Children younger than the age of26 are considered eligible dependent children. • This coverage is available only at the initial product enrollment, to new hires enrolling within their new hire enrollment period, or to current employees during the annual open enrollment period (if participation was met at the initial enrollment). Premium Information • Composite, and discounted composite rates are available. • There is a four -tier rate structure: Named Insured Only; Named Insured and Spouse; Named Insured and Dependent Children; and Named Insured, Spouse and Dependent Children Coverage. General Exclusions and Limitations We will not pay any benefits for injuries received in accidents or for sicknesses which are caused by, contributed to by or occurs as the result of the covered person's: • Alcoholism or Drug Addiction • War • Dental Procedures • Well Baby Care Limitation • Dependent child's pregnancy, including services rendered to her child after birth. Complications of pregnancy will be covered to the same extent as any other covered sickness. • Elective Procedures and Cosmetic Surgery • Felonies or Illegal Occupations • Mental or Nervous Disorders • Pregnancy of Dependent Child • Suicide or Injuries Which Any Covered Person Intentionally Does to Himself The above list does not include a complete description of each limitation and exclusion. To obtain a complete description, please see your Colonial Life representative. Applicable to GMB7000 in the following states: FL PS02509 This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 06/16 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 231 COLONIAL LIFE & ACCIDENT INSURANCE COMPANY 1200 Colonial Life Boulevard, P. O. Box 1365, Columbia, South Carolina 29202 1.800.325.4368 coloniallife.com A Stock Company GROUP HOSPITAL INDEMNITY INSURANCE CERTIFICATE THIS CERTIFICATE EXPLAINS THE BENEFITS PROVIDED UNDER THE GROUP HOSPITAL INDEMNITY INSURANCE POLICY. THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES. Please Read This Certificate Carefully This is your certificate of coverage as long as you it in a safe place. Throughout this certificate, the word yo member of an eligible class as describe premiums are remitted. Covered perso Schedule. We, us, our or company refers organization shown on the Po to Sched Policy Rate Schedule. Poli ea he group male pronoun includes th male w never used policy will govern. The policy and this certificate may be notified at least 45 days in adv without the consent of or notice to change. The approval must be in writin signed by the policyholder and one of our ex change the policy or certificate or waive an replaces any and all Certificates previously iss Right to Return This Certificate If, for any reason, you are not satisfied with this certifica you receive it. At that time, you should ask us in writing Any premium paid will be refunded. . If are insured under the policy. You will want to read it carefully and keep fers to the named insured shown on the Certificate Schedule who is a licy Rate Schedule, who holds a certificate of coverage and for whom person covered under the policy as described on the Certificate ife & Accident Insurance Company. Policyholder refers to the dgs any division, subsidiary or affiliated company named in the d by the policyholder and available for review by you. The f your certificate of coverage and the policy differ, the ged in whole or i any cancellat o an. Onl cal by endorsem fficsrs at our h Premiums d f/the,�ligible classes celled as stated in the policy. The policyholder will I by us. Such an action may be taken ficer at our home office can approve a policy or certificate or an amendment e o other person, including an agent, may ect to periodic changes. This Certificate r the Policy. an return it to us at our home office within 30 days after e will consider this certificate as if it never existed. You may call Colonial Life & Accident Insurance Company _4368 for information, inquiries or complaints. Signed for Colonial Life & Accident Insurance Company: Secretary President and Chief Executive Officer THE GROUP POLICY IS A LIMITED POLICY. Please read this certificate carefully. THIS IS NOT MEDICARE SUPPLEMENT COVERAGE. If you are eligible for Medicare, review the Guide To Health Insurance for People with Medicare available from the company. GMB7000-C-FL 1 232 SECTION 2 - CERTIFICATE GUIDE SECTION 1 - FACE PAGE SECTION 2 - CERTIFICATE GUIDE SECTION 4 - GENERAL DEFINITIONS SECTION 5 - ELIGIBILITY AND EFFECTIVE DATE SECTION 6 - BENEFITS SECTION 7 - GENERAL EXCLUSIONS AND LIMITATIONS SECTION 8 - TERMINATION OF INSURANCE SECTION 9 - GENERAL PROVI 1O S• SECTION 10 - CLAIM PROVISIONS 4:: GMB7000-C-FL 2 233 SECTION 4 - GENERAL DEFINITIONS Additional definitions may be contained in other certificate benefit provisions or any endorsement, amendment or rider. Accident means an unintended or unforeseen bodily injury sustained by a covered person, wholly independent of disease, bodily infirmity, illness, infection, or any other abnormal physical condition. Calendar Year means the period beginning on the coverage effective date shown on the Certificate Schedule and ending on December 31 of the same year. Thereafter, it is the period beginning on January 1 and ending on December 31 of each following year. Cerebral Palsy means a group of disorders of the development of movement and posture causing activity limitation that are attributed to progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of Cerebral Palsy are often accompanied by disturbances of sensation, cognition, communication, perception, and/or behavior and/or by a seizure disorder. Certificate means a document that provides a description of the insurance provided by the policy and states: • the benefits provided under the policy; • to whom benefits are payable; • the limitations, exclusions and requi • how to file a claim against the cove Cleft Lip means a narrow opening or gap in Cleft Palate means an op on one side of the mouth Complications of Pregnan disease significantly affect the preusual medical during the delivery, or after the de en the roo t apply to coverage under the policy; and he upper lip that extends all the way to the base of the nose. and the nasal cavity. This certificate covers clefts occurring fting) or on bside he mouth (bilateral clefting). part of your pTegn y ' ing which abnormal conditions or concurrent A cgmplication may exist during the pregnancy, Confined or Confinement means the sign t *bed as a resi t . nt in a hospital on the advice of a physician or, for the purposes of the Hospit o ' nd Daily o ��� nfinement benefit(s) only, confinement in an observation unit within a hospital for a pe n► : s than 20 conti 'G ours on the advice of a physician. Coverage Effective Date means the date covera•e i shown in the Certificate Schedule. The coverage effective date of this certificate is not the date you signed the p atio or coverage. Covered Accident means an accident which: • occurs on or after the coverage effective date shown on • occurs while this certificate is in force; and • is not excluded by name or specific description in this certificat chedule; Covered Sickness means a sickness which: • occurs on or after the coverage effective date shown on the Certificate chedule; • occurs while this certificate is in force; and • is not excluded by name or specific description in this certificate. Cystic Fibrosis means a hereditary disorder affecting the exocrine glands. It causes the production of abnormally thick mucus, leading to the blockage of the pancreatic ducts, intestines, and bronchi and often resulting in respiratory infection. Date of Diagnosis • for Heart Attack (Myocardial Infarction), the date that the ischemic death of a portion of the heart muscle (myocardium) occurred based on the applicable criteria listed under the heart attack (myocardial infarction) definition; • for Stroke, the date a stroke occurred based on neuroimaging or other neurodiagnostic study consistent with an acute or subacute infarction, hemorrhage, embolism, thrombosis and presence of neurological deficits persisting for a period of 30 days or greater; • for End Stage Renal (Kidney) Failure, the date that regular hemodialysis or peritoneal dialysis begins; • for Cerebral Palsy, the date a physician makes or confirms a diagnosis of Cerebral Palsy after live birth; • for Cleft Lip or Cleft Palate, the date a physician makes or confirms a diagnosis of Cleft Lip or Cleft Palate after live birth; GMB7000-C-FL 3 234 • for Cystic Fibrosis, the date the condition is confirmed by a physician and supported by a sweat test with sweat chloride concentrations greater than 60 mmol/L; • for Down Syndrome, the date a physician makes or confirms a diagnosis of Down Syndrome through the study of the 21st chromosome after live birth; • for Spina Bifida, the date a physician makes or confirms a diagnosis of Spina Bifida after live birth. Dependent Children means any: • natural children; or • step -children; or • foster children; or • legally adopted children; or • children placed into your custody for adoption; or • children for whom you legally provide coverage; and • children who are under 26 years of age. However, dependent children may continue coverage up to age 30 if they are unmarried; have no dependents of their own; are a resident of the state of Florida or are enrolled as a full-time or part-time student at a public or private institution of higher learning; and are not provided covw as a named subscriber, insured, enrollee or covered person under any other group or individual health benefit planirgrMp health plan or, church plan or entitled to benefits under Social Security. Down Syndrome means a congenital disorder arising from a chromosome defect involving chromosome 21, causing intellectual impairment, physical abnormalities and developmental delays. Down Syndrome includes: • Trisomy 21 — An individual has three instead of NOT nu 1 chromosomes; • Translocation — An extra part of the 21 st chromoso att ed to another chromosome; and • Mosaicism — The individual has an extra 21 St chromoso ome of the cells but not all of them. The other cells have the usual pair of 21St chromosome ` Emergency Room means a specified Oa wit] h pitaljivhi d for the emergency care of accidental injuries or sicknesses. This area must: • be staffed and equipped to handle trau • be supervised and provide treatment by p • provide care seven days per week, 24 hours r day. As used in this certificate, the term emergency room jionot clude urgent care facilities. End Stage Renal (Kidney) Failure means chronic irreve le • of the function of both kidneys such that the covered person must undergo at least weekly hemodialysis lysis. Enrollment Period means a period of time determined by us an• th ioIii i Ider during which you are eligible to enroll for or change your coverage. This period of time may be limited. Heart Attack (Myocardial Infarction) means the ischemic death of a pof heart muscle (myocardium) as a result of obstruction of one or more of the coronary arteries. A positive diagnosis of myocardial infarction must occur and must be supported by three or more of the following: • chest pain; • electrocardiographic (EKG) changes indicative of myocardial infarction; in the case of myocardial infarction associated with percutaneous coronary intervention (balloon angioplasty, stent implantation, and related procedures to increase the flow of blood through the coronary arteries), evolving ST elevations or new Q wave changes must be documented and included as one of the criteria in establishing a diagnosis; • elevation of biochemical markers of myocardial necrosis; and • confirmatory imaging studies. In the event of death, an autopsy, medical examiner's confirmation or death certificate identifying heart attack (myocardial infarction) as the cause of death will be accepted. A heart attack (myocardial infarction) is not congestive heart failure, atherosclerotic heart disease, angina, coronary artery disease, cardiac arrest (including arrhythmias), or any other disease, injury or dysfunction of the cardiovascular system. GMB7000-C-FL 4 235 Hospital means a place that: • is an institution licensed as a hospital and operating pursuant to law on a full-time basis; • provides overnight care of injured and sick people; • is supervised by a physician; • has full-time nurses supervised by a registered nurse; and • has at its locations or uses on a pre -arranged basis: X-ray equipment, a laboratory and an operating room where surgical operations take place. Notwithstanding the above, a hospital is not: • a nursing home; • an extended care facility; • a skilled nursing facility; • a rest home or home for the aged; • a hospice care facility; • a facility for alcoholics or drug addicts; or • an assisted living facility. Immunization means receiving an injection illed or weakened organism that produces immunity in the body to protect from a disease. Immunizations do n inc e influenza (flu) vaccinations and allergy shots. Mental Health Facility means a licens faci primarily engaged in providing, by or under the supervision of a physician, services for the diagnosis and r enliental and nervous disorders. Mental or Nervous Disord disorders i luding but not limited to affective disorders, neurosis, anxiety, stress and adjustment reactions. heime Disease an other organic senile dementias are not considered mental or nervous disorders. Observation Room means a3'�T• - -a within a hospit monitored by a physician; and wh • is under the direct supervision . : p yAn or register • is staffed by nurses assigned specifically to that unit; an • provides care seven days per week, 24 hours gN d Physician or Doctor means a person who: • is licensed by the state to practice a healing «' a • performs services for a covered person which ar /ved)I his license. m the emergency room, where a patient can be For purposes of this definition, Physician or Doctor does't include any covered person or anyone related to any covered person by blood or marriage, a business or professional part r • co ed person, or any person who has a financial affiliation or a business interest with any covered person. Policy Anniversary Date occurs once a year on the same day and e premium effective date. Pre-existing Condition means a sickness or physical condition for whi - .vered person was treated, had medical testing, received medical advice or had taken medication within six months before the coverage effective date. Genetic information is not a pre-existing condition in the absence of a diagnosis of the condition related to such information. Rehabilitation Unit means an appropriately licensed facility that provides rehabilitation care services on an inpatient basis. Rehabilitation care services consist of the combined use of medical, social, educational, and vocational services to enable patients disabled by sickness or accidental injury to achieve the highest possible functional ability. Services are provided by or under the supervision of an organized staff of physicians. The rehabilitation unit may be part of a hospital or a freestanding facility. A rehabilitation unit is not: • a nursing home; • an extended care facility; • a skilled nursing facility; • a rest home or home for the aged; • a hospice care facility; • a facility for alcoholics or drug addicts; or • an assisted living facility. GMB7000-C-FL 5 236 Sickness means an illness, infection, disease or any other abnormal physical condition not caused by an accident. Sickness includes complications of pregnancy. Spina Bifida means a congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. Spina Bifida includes Meningocele and Myelomeningocele and excludes Occulta. Specified Critical Illness means one of the Specified Critical Illnesses shown on the Certificate Schedule. Spouse means a person who is married to you on the day we issue your certificate. Stroke means an acute or sub -acute cerebrovascular incident, including infarction of brain tissue, cerebral and subarachnoid hemorrhage, cerebral embolism and cerebral thrombosis. The diagnosis must be supported by: • evidence of persistent neurological deficits confirmed by a neurologist at least 30 days after the event; and • confirmatory neuroimaging studies consistent with the diagnosis of a new stroke. The following are not to be construed as a stroke for purposes of this certificate: • transient ischemic attack; Ir • brain injury related to trauma or infection; • brain injury associated with hypoxia/anoxia or hypotension; • vascular disease affecting the eye or optic nerve; and • ischemic disorders of the vestibular system. In the event of death, an a .psy co firmation identifying stroke as the cause of death will be accepted. Telemedicine means a medical inquiry with a physician4ia the e of telecommunication and information technologies (including, but not limited to, audio or video communications ff tr .vered person's evaluation, diagnosis and/or treatment as would be practiced i person. This does not insn• ' equ:.ts fcyprescription refills or medical records. Temporary Layoff or Leave of Absen ea a fume• ins _ , iFn.orarily absent from active employment for a period of time that has been agreed to i adv a v7Fiting by the ermal vacation time or any period of disability is not considered a temporary layo or 1es: nce. Waiting Period means the first 30 days following ch ered person's coverage effective date during which no benefits are payable. SECTION 5 — ELIGIBILITY AND EFFECTIVE�Q�E Coverage Effective Date Your coverage under the policy will start at 12:01 a.m. Standard m�i g p y t effective date shown on your Certificate Schedule. Enrollment An individual who is a member of an eligible class may enroll in coverage during the eligibility period, as shown on the Policy Rate Schedule, that follows the later of: • the policy effective date as shown on the Policy Rate Schedule; • the date the individual first becomes a member of an eligible class; • the date the individual completes the policyholder probationary period, if applicable. e zone where you live on the coverage A late entrant is an individual who fails to enroll during the eligibility period and may enroll only during an open enrollment period. The policyholder and the company will determine when an open enrollment period begins and ends. After the coverage effective date, the named insured cannot make any changes to the coverage type under this certificate until an open enrollment period, unless the named insured has a qualifying event. A qualifying event, for the purposes of this provision, means: • birth or adoption of a child; • placement of a child for adoption and/or foster care; • issuance of a court order requiring coverage of a child; • marriage; • divorce; or GMB7000-C-FL 6 237 • death of a covered person. The named insured will have 31 days from the date of occurrence of a qualifying event in which to: • notify us he wishes to make a change; • complete any required enrollment form; and • pay any additional premium, if applicable. Delayed Coverage Effective Date The effective date of your coverage will be delayed if you are not a member of an eligible class on the coverage effective date shown on the Certificate Schedule. The coverage will be effective on the date that you return to status as a member of an eligible class. If this is named insured and spouse coverage, one -parent family or two -parent family coverage, coverage on the spouse and/or dependent children will be effective on the date that you return to status as a member of an eligible class. Who is Covered by This Certificate If this is named insured coverage as shown on the Certificate Schedule, we insure you, the named insured. If this is named insured and spouse coverage as shown on the Certificate Schedule, we insure you and your spouse. If this is one -parent family coverage as e Certificate Schedule, we insure you and your dependent children. If this is two -parent family coverage as sly tl ertificate Schedule, we insure you, your spouse and your dependent children. You may not apply for cov Coverage on newborn chil ur spouseiur n begins from the moment of placement into your Gusto. . �•n or, in the ca - of agreement to adopt such child ha enforceable. Coverage will not be for a foster child begins with the dat date of placement in a custodial home. If the coverage is named insured coverage be submitted to us. This must be done within 3Td coverage beyond the 31 day period. If timely noti notice is not given, premium will be charged from tha date of birth or placement, we will not deny coverage fo placement of the child. tered into by yo an adopted ch your h SECTION 6 - BENEFITS Hospital Confinement We will pay this benefit if any covered person incurs charges for and is covered sickness. The confinement to a hospital must begin while the cov- age is in force. e is covered as a named insured under other coverage. h. Coverage for adopted children begins with the date rn child, at the moment of birth if a written birth of the child, whether or not the agreement is otlmately placed in your residence. Coverage for a custodial child will be covered from the re. and spousge, a notice of birth or placement must the date of such or placement in order to continue emium will not be charged for the notice period. If timely h or placement. If notice is given within 60 days of the to your failure to timely notify us of the birth or We will pay the amount shown on the Certificate Schedule. to a hospital due to a covered accident or We will pay this benefit a maximum of one day per covered person per calendar year. We will pay this benefit a maximum of one day per covered person per confinement. If a covered person is confined and is discharged and confined again for the same or related condition within 90 days of discharge, we will treat this later confinement as a continuation of the previous confinement. If more than 90 days have passed between the periods of hospital confinement, we will treat this later confinement as a new and separate confinement. We will not pay this benefit for emergency room treatment, outpatient treatment, or confinement of less than 20 hours in an observation room. We will not pay the Hospital Confinement benefit and any of the following benefit(s) for the same dates of service: • Observation Room • Inpatient Mental and Nervous • Rehabilitation Unit Confinement GMB7000-C-FL 7 238 Waiver of Premium After you have been confined to a hospital, or rehabilitation unit or mental health facility due to a covered accident or covered sickness for more than 30 continuous days while the policy and certificate are in force, and you received the Hospital Confinement benefit and any of the following benefits: • Daily Hospital Confinement • Rehabilitation Unit Confinement • Inpatient Mental and Nervous, we will waive the premium for this certificate and any attached riders for as long as you are continuously confined, or up to 12 months, whichever occurs first. This benefit does not apply to your spouse or your dependent children. We will waive premiums only if you, the named insured, are confined for more than 30 continuous days. However, if this is named insured and spouse coverage, one - parent family coverage, or two -parent family coverage, we will waive premiums on all family members insured by the certificate. You must pay all premiums to keep this certificate and any attached rider(s) in force until you have been confined for more than 30 continuous days and the waiver of premium becomes effective. Before we waive your premiums, you must s • the dates you were confined; and • that you were confined due to a cov us a written notice prepared by your physician stating: nt or covered sickness. After we verify that you were confined, as d i} S certificate, for more than 30 continuous days, we will not require ngth you to pay premiums for the leof time you to be confined due to a covered accident or covered sickness. You must send us written ice as on as you ai"n• .ng: confined. We will assume you are no longer confined if: • you do not send us s isfactory roof of loss w w- .. t it; or • you notify us that you lob confined. You must pay all premiums to ke after you are no longer confined. If we waive premiums during a confinement, accident or covered sickness, we will treat t another 30-day waiting period to qualify for wa ate and any a force beginning with the first premium due If more than 90 days have passed between the peri confinement. You must be confined for another 30 conti • or Daily Hospital Confinement • or Rehabilitation Unit Confinement • or Inpatient Mental and Nervous benefit before waiver of p me confin' is as the s in 90 days because of the same covered nement. You will not be required to meet ement, we will treat the second confinement as a new ys and receive a Hospital Confinement: plicable for a new confinement. The Waiver of Premium benefit does not apply to any period that yod due to an accident, sickness or condition which is excluded by name or specific description. Air Ambulance We will pay this benefit if any covered person incurs charges for and a licensed professional air ambulance company transports any covered person by air transportation to or from a hospital or between medical facilities, while he is confined as an inpatient, due to a covered accident or covered sickness. The air ambulance transportation must be within 48 hours after the covered accident while this certificate is in force. We will pay the amount shown on the Certificate Schedule. We will pay this benefit a maximum of one day per covered person per calendar year. Ambulance We will pay this benefit if any covered person incurs charges for and a licensed professional ambulance company transports any covered person by ground transportation to or from a hospital or between medical facilities, while he is confined as an inpatient, due to a covered accident or covered sickness. The ground ambulance transportation must be within 90 days after the covered accident while this certificate is in force. We will pay the amount shown on the Certificate Schedule. We will pay this benefit a maximum of one day per covered person per calendar year. Appliance We will pay this benefit if any covered person incurs charges for and a physician prescribes the use of a medical appliance as an aid in personal locomotion or mobility due to a covered accident or a covered sickness. Crutches and GMB7000-C-FL 8 239 wheelchairs are examples of medical appliances. The use of an appliance must begin within 90 days after the covered accident while this certificate is in force. We will pay the amount shown on the Certificate Schedule. We will pay this benefit a maximum of one day per covered person per calendar year. Doctor's Office Visit/Telemedicine We will pay this benefit if any covered person incurs charges for and has a doctor's office visit or the use of telemedicine while this certificate is in force. We will pay the amount shown up to the maximum number of days shown on the Certificate Schedule. This benefit is not payable for services rendered by a physician while a covered person is confined to a hospital. Emergency Room Visit We will pay this benefit if any covered person incurs charges for and requires examination and treatment by a physician in an emergency room due to a covered accident or covered sickness. Treatment due to a covered accident must be received within 72 hours following the accident and while this certificate is in force. We will pay the amount shown up to the maximum number of days shown on the Certificate Schedule. X-Ray We will pay this benefit if any covered pers incurs charges for and receives an X-Ray as the result of a covered accident or covered sickness. The test must be prescribed by a physician and performed in a physician's office or in a hospital on an inpatient or outpatient basis and performed within 90 days of the covered accident while this certificate is in force. We will not pay both the Diagnostic Procedurnd the X-Ray benefit for the same covered service. The following will not be considered an X-Ray • Computed Tomography (CT) imaging or Co • Positron Emission Tomography Scan (PET Sc • Electroencephalogram'VEG); or • Magnetic Resonance () or Ma'tic Resonance We will pay the amount shown up'to the m Daily Hospital Confinement We will pay this benefit if any covered pers covered sickness. The confinement to a hos rpses of this certificate: Tomography (CAT Scan); um number o n/f'the Certificate Schedule. We will pay the Daily Hospital Confinement bene in covered person is confined to a hospital, up to the maxi pay this benefit for emergency room treatment, outpatie an observation unit within a hospital. for and is i+vhile this c o a hospital due to a covered accident or is in force. nt shown on the Certificate Schedule for each day the efit period shown on the Certificate Schedule. We will not or confinement of less than 20 continuous hours in Ad If a covered person is confined and is discharged and confinen for the same or related condition within 90 days of discharge, we will treat this later confinement as a continuation o the previous confinement. If more than 90 days have passed between the periods of hospital confinement, we will treat thits later co nement as a new and separate ‘„„. confinement. We will not pay the Daily Hospital Confinement benefit and any of the following benefit(s) for the same dates of service: • Observation Room • Inpatient Mental and Nervous • Rehabilitation Unit Confinement Diagnostic Procedure We will pay this benefit when any covered person incurs charges for and has one of the following specified diagnostic procedures while this certificate is in force. The procedure must be required due to a covered accident or covered sickness. GMB7000-C-FL 9 240 Diagnostic Procedures Breast Biopsy (incisional, needle, stereotactic) Cardiac Angiogram Arteriogram Thallium Stress Test Transesophageal Echocardiogram (TEE) Diagnostic Radiology Computerized Tomography Scan (CT Scan) Electroencephalogram (EEG) Magnetic Resonance Imaging (MRI) Myelogram Nuclear medicine test Positron Emission Tomography Scan (PET Scan) Digestive Barium Enema/Lower GI series Barium Swallow/Upper GI series Esophagogastroduodenoscopy (EGD) Ear/Nose/Throat/Mouth Laryngoscopy Gynecological Amniocentesis Cervical biopsy Cone biopsy Endometrial biopsy Hysteroscopy Loop Electrosurgical Excisional Procedure (LEEP) Liver Biopsy tic We will pay the amount shown on the Certi If any covered person has Surgical Procedure benefi paid the maximum Diagno benefit, up to the calendar y Inpatient Mental and Nervous We will pay this benefit if any cover mental health facility as the result of a ntal facility must begin while coverage is in force overed D y pay the Di ure benefit forte c per covered p Miscellaneous Bone marrow aspiration/biopsy Renal Biopsy Respiratory Biopsy Bronchoscopy Pulmonary Function Test (PFT) Skin Biopsy Excision of lesion Thyroid Biopsy Urologic Cystoscopy edures which would be payable under the Outpatient edure benefit. However, if the covered person has been ear, we will pay the Outpatient Surgical Procedure son omra on the Certificate Schedule. • �d We will not pay this benefit for emergency room tre e , ou tient treatment, or confinement of less than 20 hours in an observation room. ined, on an inpatient basis, to a hospital or inement to a hospital or mental health We will pay the amount shown on the Certifica Observation Room We will pay this benefit if any covered person incurs charges hospital due to a covered accident or covered sickness, for a per We will pay the amount shown up to the maximum number of days d e res treatment in an Observation Room in a e - n 20 hours while this certificate is in force. e Certificate Schedule. We will not pay the Observation Room benefit and any of the following • Hospital Confinement • Inpatient Mental and Nervous • Daily Hospital Confinement t b t(s) for the same dates of service: This benefit is not payable for treatment received in an emergency room or confinement to an observation room following an outpatient surgical procedure. Outpatient Surgical Procedure We will pay this benefit if any covered person incurs charges for and requires an outpatient surgical procedure due to a covered accident or covered sickness, and he is not confined in a hospital at the time of the procedure. The procedure must be performed by a physician in a hospital or ambulatory surgical center. Ambulatory Surgical Center means a place which: • is equipped for surgical procedures performed by qualified physicians; • provides anesthesia administered by a licensed anesthesiologist or licensed nurse anesthetist; and • has written agreements with local hospitals to immediately accept patients who develop complications. GMB7000-C-FL 10 241 Surgical Procedure means the cutting into the skin or other organ to accomplish any of the following goals: • further explore the condition for the purpose of diagnosis; • take a biopsy of a suspicious lump; • remove diseased tissues or organs; • remove an obstruction; • reposition structures to their normal position; • redirect channels; • transplant tissue or whole organs; • implant mechanical or electronic devices; • repair an area that has been injured or affected by trauma, overuse, or disease; or • restore proper function. If a covered person requires a procedure that does not meet the definition of Surgical Procedure, but the procedure is listed as a Tier 1 or Tier 2 Outpatient Surgical Procedure, we will pay this benefit. We will not pay this benefit for a procedure that is not listed as a Tier 1 or Tier 2 Outpatient Surgical Procedure unless it meets the definition of Surgical Procedure. The following will not be considered a surgical rocedure for the purposes of this certificate: • Venipuncture (drawing blood); • Lumbar puncture; • Epidural injections; • Removal of skin tags; or • Foreign body removal from the eye. We will pay the amount sh on t Certificate re• e will pay this benefit for only one outpatient surgical procedure performed at th same time even if cause' m. - than one accident or sickness. In that event, we will pay the higher of the two bene amounts. The surgical proce- e must occur while this certificate is in force. To determine the amount payable ftr a surgical procedure, at: - ocedure in one of the tiers shown in the Outpatient Surgical Procedures below and refer to the benefit procedure appears. .0"%le If the specific procedure is not listed in the O tpatientt Terminology (CPT) Code provided by the cc ered per tier of the procedure. ertificate Schedule for the tier in which the ical Proc ures, we will use the Current Procedural 8hysician arld a current relative value scale to determine the We will pay for only one surgical procedure for the s colfted accident or covered sickness in a 90-day time period. If any covered person receives a subsequent surgical pro edure for the same covered accident or same covered sickness, we will pay an additional benefit only if the subsequent urperformed more than 90 days after the last covered procedure was performed. We will pay no more than the Calendar Year Maximum for theurgical Procedure benefit shown on the Certificate Schedule. If any covered person has an outpatient surgical procedure and is confined as a result of complications from the procedure within 90 days following the procedure, we will not pay both the Outpatient Surgical Procedure benefit and the Hospital Confinement benefit. In that event, we will pay the higher of the two benefit amounts. If we have already paid the Outpatient Surgical Procedure benefit, and the Hospital Confinement benefit provides a higher benefit, we will deduct the Outpatient Surgical Procedure benefit amount paid and pay the difference under the Hospital Confinement benefit. If any covered person has one of the covered Diagnostic Procedures which would be payable under the Outpatient Surgical Procedure benefit, we will only pay the Diagnostic Procedure benefit. However, if the covered person has been paid the maximum Diagnostic Procedure benefit for the calendar year, we will pay the Outpatient Surgical Procedure benefit, up to the calendar year maximum per covered person shown on the Certificate Schedule. GMB7000-C-FL 11 242 Tier 1 Outpatient Surgical Procedures Breast Axillary node dissection Breast capsulotomy Lumpectomy Cardiac Pacemaker insertion Digestive Colonoscopy* Fistulotomy Hemorrhoidectomy Lysis of adhesions Ear/Nose/Throat/Mouth Adenoidectomy Removal of oral lesions Myringotomy Tonsillectomy Tracheostomy Tympanotomy Gynecological Dilation & Curettage (D&C) Endometrial ablation Lysis of adhesions Liver Paracentesis Musculoskeletal System Carpal/cubital repair or release Foot surgery (bunionectomy, exostectomy, arthroplasty, hammertoe repair) Removal of orthopedic hardware Removal of tendon lesion Skin Laparoscopic hernia repair Skin grafting *Colonoscopy must result in polyp removal or be recommended by a physician for the purposes of treating or diagnosing a sickness. Tier 2 Outpatient Surgical Procedures Breast Breast reconstruction Breast reduction Cardiac Angioplasty Cardiac catheterization Digestive Exploratory laparosc Laparoscopic appe Laparoscopic chole Ear/Nose/Throat/Mouth Ethmoidectomy Mastoidectomy Septoplasty Stapedectomy Tympanoplasty Prescription Drug We will pay the amount specified in the Certificat prescription for drugs after the 30-day waiting perio by a physician and dispensed by a licensed pharmacist! prescriptions shown on the Certificate Schedule. Eye act surgery or al surgery (penetrating k atoplasty) u - a surgery (trabeculectomy) Gyn : .1 H Myo Musculoskelet Arthrosco meniscect repair) scopic icl*esection ery with rtilaae Musculoskeletal System (Cont'd) Dislocations (ORIF - open reduction with internal fixation) Fracture (ORIF - open reduction with internal fixation) Removal or implantation of cartilage Tendon/ligament repair Thyroid Excision of a mass Urologic Lithotripsy en any covered person incurs charges for filling a s certificate is in force. Such drugs must be prescribed t will be limited to the maximum number of Medication recommended by a physician that is available withtion (over-the-counter) will not be covered. This benefit is not payable for therapeutic devices or appliances. The Prescription Drug benefit is not subject to the limitations and exclu tion of this certificate. Rehabilitation Unit Confinement We will pay this benefit if any covered person incurs charges for and is transferred to a rehabilitation unit immediately after a period of confinement due to a covered accident or covered sickness. We will pay the amount shown on the Certificate Schedule for each day of confinement in a rehabilitation unit, up to the maximum number of days shown on the Certificate Schedule. We will not pay the Rehabilitation Unit Confinement benefit and any of the following benefit(s) for the same dates of service: • Hospital Confinement • Daily Hospital Confinement Specified Critical Illness (for any covered person) We will pay this benefit if a covered person incurs charges for and is diagnosed with one of the Specified Critical Illness conditions shown on the Certificate Schedule if: • the date of diagnosis is while this certificate is in force; and • it is not excluded by name or specific description in this certificate. GMB7000-C-FL 12 243 No benefits are payable for conditions other than the Specified Critical Illness conditions defined in this certificate. We will pay a maximum of one day per covered person per diagnosis. Additional Specified Critical Illnesses (for covered dependent children only) We will pay this benefit if a covered dependent child incurs charges for and is diagnosed with one of the Additional Specified Critical Illnesses shown on the Certificate Schedule if: • the date of diagnosis is while this certificate is in force; and • it is not excluded by name or specific description in this certificate. No benefits are payable for conditions other than the Specified Critical Illness conditions defined in this certificate. We will pay a maximum of one per day per covered dependent child with a lifetime maximum of one day. Benefit Payable Upon Subsequent Diagnosis of a Specified Critical Illness If a covered person has been diagnosed with and received a benefit for a specified critical illness and is subsequently diagnosed with a different specified critical illness, we will pay the amount shown on the Certificate Schedule for the critical illness diagnosed, if: • the date of diagnosis of the subsequent . - 'ed critical illness is more than 180 days after any previous date of diagnosis for a specified critical illne ; • the subsequent date of diagnosis is hile .v- rage under this certificate is in force; and • the specified critical illness is not ex • - ► .y - - e or specific description in this certificate. If a covered person has been sed with - e a benefit for a specified critical illness and is subsequently diagnosed with the same specified ical illness, w n amount equal to 25% of the amount shown on the Certificate Schedule if: • the date of diagnosis df the subsequent specified critis is more than 180 days after any previous date of diagnosis for the same specified critical illness; and • the covered person has not received treatment during t1V1 % • - bet een the dates of diagnosis for the same specified critical illness. for purposes of the preceding se , - -tr t does not include medications and follow-up visits to the covered person's phr • the subsequent date of diagnosis is hile • the specified critical illness is not exclud under this certificate'in force; and pecific description in this certificate. A subsequent diagnosis of a Specified Critical flln�5` d not apply to the Additional Specified Critical Illnesses (for covered dependent children only). Benefit Reduction The benefit amount will reduce by 50% on the first policy date after the named insured attains age 75. All specified critical illness benefits payable after that date will b as d onhhlfreduced benefit amount. Wellbeing Assistance - Standard We will pay the amount shown on the Certificate Schedule to help with onetary expenditures such as transportation, missed work, and other incidentals, as a result of having one of the rou e, preventative tests covered by this certificate. The test must be performed after the waiting period while this ertificate is in force. The covered tests include: • Blood test for triglycerides • Bone marrow testing • Breast ultrasound • Carotid Doppler • CA 15-3 (blood test for breast cancer) • CA 125 (blood test for ovarian cancer) • CEA (blood test for colon cancer) • Chest x-ray • Colonoscopy • Electrocardiogram (EKG, ECG) • Echocardiogram (ECHO) • Fasting blood glucose • Flexible sigmoidoscopy • Hemoccult stool analysis GMB7000-C-FL 13 244 • Mammography • Pap smear • PSA (blood test for prostate cancer) • Serum protein electrophoresis (blood test for myeloma) • Serum cholesterol test for HDL and LDL • Skin cancer biopsy • Stress test on a bicycle or treadmill • Thermography • ThinPrep pap test • Virtual colonoscopy We will pay the maximum of one day(s) per covered person per calendar year. Wellbeing Assistance - Basic We will pay the amount shown on the Certificate Schedule to help with monetary expenditures such as transportation, missed work, and other incidentals, as a result of having one of the routine, preventative tests or services covered by this certificate. The test or service must be performed after the waiting period while this certificate is in force. The covered tests or services include: • Annual Physical • Blood test for triglycerides • Bone marrow testing • Breast ultrasound • Carotid Doppler • CA 15-3 (blood test f. •reaut cer) • CA 125 (blood test fo ovarian c- ncer) • CEA (blood test for co olidOnc 4/0 • Chest x-ray • Colonoscopy • Electrocardiogram (EKG, ECG • Echocardiogram (ECHO) • Fasting blood glucose • Flexible sigmoidoscopy • Hemoccult stool analysis • Immunizations • Mammography • Pap smear • PSA (blood test for prostate cancer) • Serum protein electrophoresis (blood test for myeloma) • Serum cholesterol test for HDL and LDL • Skin cancer biopsy • Stress test on a bicycle or treadmill • Thermography • ThinPrep pap test • Virtual colonoscopy We will pay the maximum of one day(s) per calendar year for all covered persons combined. SECTION 7 — GENERAL EXCLUSIONS AND LIMITATIONS We will not pay any benefits for injuries received in accidents or for sicknesses which are caused by, contributed to by or occurs as a result of the covered person's: Alcoholism or Drug Addiction - Addiction to alcohol or drugs, except for drugs taken as prescribed by his physician. Dental Procedures - Treatment for dental care or dental procedures, unless treatment is the result of a covered accident. Elective Procedures and Cosmetic Surgery - Undergoing elective procedures or cosmetic surgery. This includes procedures or hospital confinement for complications arising from elective or cosmetic surgery. This does not include GMB7000-C-FL 14 245 congenital birth defects or anomalies of a child; or reconstructive surgery related to a covered sickness or injuries received in a covered accident. Felonies or Illegal Occupations - Committing or attempting to commit a felony or engaging in an illegal occupation. Mental or Nervous Disorders - Having a disorder including but not limited to affective disorders, neurosis, anxiety, stress and adjustment reactions. Alzheimer's Disease and other organic senile dementias are not considered mental or nervous disorders. This exclusion does not apply to Inpatient Mental and Nervous benefit. Pregnancy of a Dependent Child - Dependent child's pregnancy, including services rendered to her child after birth. Complications of pregnancy will be covered to the same extent as any other covered sickness. Suicide or Injuries Which Any Covered Person Intentionally Does to Himself - Committing or trying to commit suicide or his injuring himself intentionally, whether he is sane or not. War - Involvement in any act of war, declared or undeclared, or serving in the armed forces of any country or authority. Losses as a result of acts of terrorism committed by individuals or groups will not be excluded from coverage unless the covered person who suffered the loss committed or contributed to the act of terrorism. Birth Limitation - We will not pay benefj person giving birth within the first nine ( normal pregnancy, including Cesarean. covered sickness. Pre-existing Condition Li for any covered person w covered person has satisfi • Rehabilitation Unit Con • Daily Hospital Confinement • Inpatient Mental and Nervous • Specified Critical Illness • Outpatient Surgical Procedure • Diagnostic Procedure We will n such Is results fro the pre-existing conditi• I ital Confinement or Daily Hospital Confinement due to any covered fter the coverage effective date of this certificate as a result of a s of pregnancy will be covered to the same extent as any other Credit toward the satisfaction of the pre-existing covered person was covered under the pre-existing • The previous coverage was similar to or exceeded • The covered person was insured under the previous this certificate; and • The covered person was insured under the coverage prov on the Policy Rate Schedule. for Hospital Confinement or any of the following benefit(s) ting condition as defined in this certificate, unless the eriod shown on the Certificate Schedule: ation period will be given for any continuous time the use of previous coverage through another carrier if: provided under this certificate; he time of enrollment in the coverage provided by ertificate on the Policy Effective Date shown The covered person is responsible for furnishing proof of his previous c, to include type of coverage, length the previous coverage was in force and the date the previous coverage term Well Baby Care Limitation - We will not pay benefits for Hospital Confinement or Daily Hospital Confinement of a newborn child following his birth unless he is injured or sick. SECTION 8 - TERMINATION OF INSURANCE Termination of the Named Insured's Coverage The coverage on a named insured under the policy will terminate on the earliest of the following dates: • the date the policy terminates; or • the end of the grace period following the premium due date we fail to receive the required premium for the named insured; or • the date the named insured is no longer in an eligible class; or • the date the named insured's class is no longer included for insurance; or • the date the next premium is due after the named insured asks us to end his coverage. GMB7000-C-FL 15 246 We will provide coverage for a claim for which we are liable under the terms of this certificate if the loss occurs while you are covered. Cancellation of coverage is without prejudice to any prior claims. Additionally, any unearned premium will be refunded based on the date of cancellation. Extension of Benefits Termination of coverage will not affect any claim that began while the coverage was in force, subject to any benefit limits provided in the certificate. When Coverage Ends on Your Spouse and Dependent Children If this is a named insured and spouse coverage or two -parent family coverage, coverage on your spouse will end on the earliest of the following dates: • the date your coverage under the policy terminates; or • the end of the grace period following the premium due date we fail to receive the required premium for your spouse; or • the date you ask us to end your spouse's coverage; or • the date you die; or • the date you divorce your spouse or your marriage is annulled. If this is a named insured and spouse coverage, one - parent family coverage or two -parent fami coverage and you divorce your spouse or your marriage is annulled and you do not notify us, the extent of our liill be to refund premium paid for the time period for which he did not qualify. If this is a one -parent family or two -pared c► - age, coverage on your dependent children will end on the earliest of the following dates: • the date your coverage ue policy to • the end of the grace po .d folio, •ng the pre a we fail to receive the required premium for your dependent children; o • the date you ask us to ur dependent children' verJe; or • the date you die; or • the date they no longer meet ire definition of dependenthe General Definitions section of this certificate. r1 We will provide coverage for a claim for�hic table under th o his certificate if the loss occurs while your spouse and/or dependent child is covered .^ A dependent child who reaches age 26 may rem covered if that child is and continues to be intellectually or physically disabled and is dependent on you for support and maintenande. You must submit satisfactory proof of incapacity and dependency to us within 31 days of the termination date and subsequently as we may require, but not more frequently than annually after the two-year period following the termination -. We will continue to charge any appropriate premium for that child as long as he meets the definition of a dependent childis your responsibility to notify us if any dependent child no longer qualifies as an eligible dependent. If this is on .ar= f or two -parent family coverage and all of your dependent children no longer qualify as eligible dependents an. .0 notify us, the extent of our liability will be to refund premium paid for the time period for which they did not quaff Leave of Absence Under the Family and Medical Leave Act A named insured may continue his coverage during absences for family or1 edical leave. If a named insured is on a family or medical leave of absence, coverage will continue under this certificate as if the named insured were in active employment, if the following conditions are met: • the premiums are paid in accordance with the policy's provisions; and • the policyholder has approved the named insured's leave in writing. Coverage will be continued for up to the greater of: • the leave period required by the federal Family and Medical Leave Act of 1993, and any amendments; or • the leave period required by applicable state law. If coverage is not continued during a family or medical leave of absence, upon the named insured's return to active employment: • no new waiting periods will be applied; and • no new pre-existing condition limitation will be applied. GMB7000-C-FL 16 247 In order for these conditions to apply, the policyholder must notify us and commence paying premiums for the named insured's coverage within 31 days following a named insured's return to active employment following a leave of absence for family or medical leave. The time period in the pre-existing condition limitation period will continue to run through a named insured's family or medical leave of absence. Leave of Absence — Other If the named insured is on a temporary layoff or leave of absence other than for family or medical leave and premium is paid in accordance with the policy's provisions, he will be covered through the premium due date immediately following the date the temporary layoff or leave of absence begins. If premium is remitted beyond the premium due date referenced above, our only liability will be to return the premium. SECTION 9 — GENERAL PROVISIONS Coverage Provided by the Policy We insure a covered person for loss accordir the provisions of the policy. Misstatement of Age If the age of the named insured has beted, we will make any equitable adjustment of premiums. We will refund any excess premium payment over the amount due based on your correct age. We will request payment for any overdue premium based on your correct age. If the mis tement is discovered after a payment is due and payable, we will reduce or increase the benefit amo le by the ount of excess or overdue premium due to the misstatement. If a named insured is not eligible beca a of ag we will refu'nrrj all premiums paid. Contestability No statement made by any nmed insured relating to his ins il' • the insurability of his dependents shall be used to contest the validity of the insurance after the insurance has e- fo - pri to the contest for a period of two years during the lifetime of the person aut who s atement - ad- : n less the statement is contained in a written instrument signed by the named insure kin stem t, - s statement was fraudulent. Contest means that we question the validit c rape under the polla letter to the policyholder or the named insured. This contest is effective on the date aitte'r and refun. ums. All statements made by the policyholder or any nam hall be deemed representations and not warranties. No written statement made by the policyholder or any n m insu d shall be used in any contest unless a copy of the statement is furnished to the policyholder or the named u ed. Policyholder as Agent For purposes of the policy and this certificate, the policyholder circumstances will the policyholder be deemed our agent. SECTION 10 — CLAIM PROVISIONS eown behalf or as your agent. Under no Notice of Claim If a covered person has an injury or sickness that may result in a claim for benefits under the policy, written notice must be given to us at our home office. This must be done within 90 days after a covered loss begins. If notice cannot be given within that time, it must be given as soon as is reasonably possible. The notice must contain enough information to identify the covered person. Claim Forms When we receive written or verbal notice of a claim, claim forms will be sent with which to file Proof of Loss. If these forms are not given to you within 15 days, you will be excused from filing the forms as long as you send us Proof of Loss as described below. Proof of Loss We must receive a written proof of loss within 90 days after the covered loss begins. If you are not able to give us written proof of loss within 90 days, it will not have a bearing on this claim if proof is given to us as soon as it is reasonably possible. In any event, proof must be given no later than one year from the time stated unless you are legally unable to do SO. GMB7000-C-FL 17 248 Written proof of loss must include one or more of the following: a physician's bill, a hospital bill or other proof of charges. Written proof of loss for Prescription Drug(s) should include a pharmacy detailed receipt or mail order pharmaceutical statement showing the covered person's name, the name of the prescription drug(s) and the prescription(s) fill date. Time of Payment of Claim After we receive written proof of loss and process your claim, we will pay any benefits due within 45 days. If all or any portion of a claim is contested by us, you or your assignees, if any, will be notified in writing that the claim is contested or denied within 45 days after receipt of the claim by us. The notice that a claim is contested will identify the contested portion of the claim and the reasons for contesting the claim. Upon receipt of the additional information requested from you or your assignees, if any, we will pay or deny the contested claim or portion of the contested claim, within 60 days. We will pay or deny any claim no later than 120 days after receiving the claim. Payment will be treated as being made on the date a draft or other valid instrument which is equivalent to payment, was placed in the U.S. mail in a properly addressed, postpaid envelope, or if not so posted, on the date of delivery. All overdue payments will bear simple interest at the rate of 10% per year. Payment of Claim Benefits will be paid directly to you unless we receive your valid written authorization to pay benefits elsewhere, such as to a hospital or a physician's office. This is called assignment of benefits. We reserve the right to determine if an assignment of benefits is valid - • • consistent with applicable laws. . (1 You have the right to nam : benefi. :ry. If one isoand we still owe you benefits at your death, benefits due will be paid in this order to • spouse; or , • children; or • parents; or • brothers and sisters; or • estate. If benefits are payable to your estate, w/11e ca a u.to $3,000 orl one related to you by blood or marriage who we feel is fairly entitled to them. If we do t s, wi ave no respons y for this payment because we made it in good faith. Unpaid Premium When a claim is paid under the policy, any premium then the claim payment. Overpaid Claim We have the right to recover any overpayments due to: • fraud; and • any error made during the processing of a claim. aid for your certificate may be deducted by us from You must reimburse us in full. We will work with you to develop a reasonable method of repayment if you are financially unable to repay us in a lump sum. We will not recover more money than the amount we overpaid. Questions Concerning the Named Insured's Claim If you have questions concerning your claim, you can call us at our home office. We are open Monday through Friday from 8:30 a.m. until 5:00 p.m. Eastern Time. Physical Exam and Autopsy We can require that any covered person be examined by a physician of our choice as often as it is reasonably necessary while his claim is pending. We can also require an autopsy in the event of the death of any covered person in those states where this is allowed. Either or both of these will be done at our expense. GMB7000-C-FL 18 249 Legal Action We cannot be sued for benefits under the policy: • until 60 days after we are sent written proof of loss; or • after the expiration of the applicable statute of limitations following the time period in which written proof of loss is required to be provided to us. Claim Review If a claim is denied, we will give written notice of: • the reason for denial; and • the policy provision that relates to the denial; and • the right to ask for a review of the claims; and • the right to submit any additional information that might allow us to change our decision. You may, upon written request, read any reports that are not confidential. For a small fee, we will make copies of those reports. Appeals Procedure Within 60 days after denial of a claim, you or written request for review of the denial. Workers' Compensation Not Affecte The policy does not replace or change ai�ire t for coverage under Workers' Compensation insurance. ur estate must appeal any denial of benefits under the policy by making a 0V/2,2, 0, . 4)/0 ceco, GMB7000-C-FL 19 250 Claims Administration & Customer Service .•'f'. Colonial Life 251 ••1,I• Colonial Life Claims Administration & Customer Service Describe Claims Office Operations to include intake adjudication, clinical support, capacity for phone/email inquiries and any services outsourced or offshored. We have provided our information in response to the items listed below. Our third parties perform administrative functions that augment our claims' area. That said, data resides in Unum's owned and managed data center in Columbia, SC. and is replicated to our disaster recovery data center in Alpharetta, GA. However, as a global company with a strong international workforce, we have partnerships both within the U.S. and beyond it that reflect that diversity and global scale. Some of the companies we work with, including EXL, are U.S.-based companies with workforces overseas. Unum's external partners are global companies with a strong US presence and a workforce in the US, India, and the Philippines. These partnerships give us more flexibility in staffing levels and schedules, help us gain access to broader ski llsets, and help us grow and strengthen our company. These partners are treated as an extension of Unum and have the same or higher expectations as our employees. We do offshore some calls and chat function responses that come from our Contact Center. • Identify where the claims office that will handle claims for the benefits offered is located. Claims for Colonial Life products will be handled by our home office located in Columbia, SC. • Indicate whether the same claims office that handles STD claims will also handle LTD claims. Colonial Life does not offer an LTD product. • Provide the hours of operation for the claims office. Questions regarding claims for Colonial Life products are handled by our Contact Center team. Customer Service Specialists, including Spanish-speaking bilingual specialists, are available Monday through Friday, 8:00 a.m. - 8:00 p.m. (EST). Our toll free, automated customer service center is available 24 hours a day, 365 days a year. • Describe the training provided to Proposer's Claims Representatives. New claims examiners receive classroom training on products and processing guidelines for 2-3 months. They continue to work directly with a trainer for approximately 6 months until they reach certain proficiency levels. Once released from the training department, all examiners have access to a senior claims specialist who can assist with ongoing questions and training needs. • Describe Proposer's expected team's current case load, each (number of clients). Caseload can vary by state, product, and medical condition. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 252 ••1,I• Colonial Life • Describe Proposer's database utilized for the management of each claimant. Our claims system (proposer database) supports processing across all product lines and can calculate benefits based on selections made by the examiners. Our specialists use multiple software applications supporting risk management and benefit payments. We also use MD Guidelines, an online tool that provides detailed information about conditions and reasonable recovery periods associated with both diagnosis and occupation type. • Describe maximum number of open and new claims handled, per Proposer's examiners or clinicians. This can vary by state, product, and medical condition. • Identify at what point in the proposed claims process, that Proposer begin to transition a claim from STD to LTD. Not applicable. Colonial Life does not offer an LTD product. • Provide as an attachment, Proposer's processed claims process, if no eligibility file is in place. We do not utilize an eligibility file to process claims for our voluntary products. Please see our claims process below. • The policyholder submits claim to us for processing either via our online submission process or via regular U.S. mail. • The policyholder will be notified by telephone (or email) when information is received regarding the claim. • Ifthe electronic messaging option was selected, the policyholder will receive a call once the claim is processed. • Ifthe claim is for a sickness or health condition occurring within the first year, we may need to determine whether the policyholder has a pre-existing condition. If we must contact the doctor and/or request copies of the medical records, it may lengthen our processing time. • We will notify the policyholder by letter if any additional information is needed from the doctor or any other source(s). We welcome the policyholder's assistance in encouraging the doctor to provide the needed information as quickly as possible. • Identify how Proposer's claims representatives will "warm transfer" claimant Members to other vendors (i.e., EAP, Disease Management, etc.), if necessary. This is not applicable to the products being offered by Colonial Life. Describe Proposer's Customer Service Center Operations: Our primary goal is to give you an excellent customer experience. Our Contact Center uses a combination of sophisticated technology and customer focused training to provide prompt, professional, and reliable service to all customers. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 253 ••1,I• Colonial Life • Provide the hours of operation for the customer service center. Colonial Life's service organization is structured around our primary customer groups. For our policyholders, Colonial Life's toll free, automated customer service center is available 24 hours a day, 365 days a year. The policyholder service center is accessible by calling 1.800.325.4368. Customer Service Specialists, including Spanish-speaking bilingual specialists, are available Monday through Friday, 8:00 a.m. - 8:00 p.m. (EST). We also have two different chat options available. • Portal Chat Policyholder accesses the chat option through the Customer Portal and interacts with us within the portal. Hours of operation are 8a-6pm. There is an automated chat that will field some questions and then pass the chat to a live representative if needed. • IVR to Text Chat Policyholder accesses the chat through the phone IVR and chats with us via text functionality on their phone. Hours of operation are 8a-6pm. There is an automated chat that will field some questions and then pass the chat to a live representative if needed. • Indicate whether there will be dedicated Customer Service Representatives specifically for City employees. If so, how many? Yes. The local service office in Miami will have a dedicated customer service line specifically dedicated to City of Miami employees. This dedicated line will be staffed with representatives located in Miami -Dade county who are proficient in English, Spanish, and Creole which will ensure smooth and effective communication for City employees. The line will operate from 8 AM to 7 PM EST, Monday through Friday, providing extended support to accommodate the employees' needs throughout the week. Our commitment to serving the diverse city employee population is reflected in this initiative which is aimed at providing immediate, accessible, and culturally competent assistance to every employee of the City. Additionally, the Colonial Life home office has a dedicated Customer Service team. However, specific personnel will not be assigned for the City exclusively. Our Customer Service calls are automatically routed to the first available representative. This provides a much quicker response time and first call resolution rather than an employee having to leave a message and wait for a return call later. Our system also prevents callers from receiving busy signals. We use industry wide staffing models that consider service level expectations, historical trends, and projected call volumes to determine ongoing staffing needs. We constantly review these trends and adjust staffing as necessary to meet our high service standards. • Indicate how many members each Customer Service Representative will be servicing on average. This can vary by state, product, and medical condition. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 254 ••1,I• Colonial Life • Describe the training provided to Proposer's Customer Service Representatives. To guarantee professional service, new representatives go through one week on on boarding, four weeks of classroom training, and two weeks of on-the-job training under the close direction of support staff that includes Trainers, Senior Contact Center Representatives, and designated coaches. These representatives then transition to our GRO (Getting Ready for Operations) Team for eight weeks of post training under the direction of our Senior Contact Center Representatives. During this time, our representatives are trained to provide each customer with quality, personal service. Our goal is to resolve all customer issues during their first contact by understanding and meeting their needs. To ensure reliable service, new representatives also receive detailed training on our customer service desktop applications, which include Client View, our primary graphical user interface desktop application that contains all client data including history, and Imaging, our paperless imaging system used to view all customer correspondence online. Representatives track every call, so a detailed history of each customer interaction is available for future reference. Indicate whether Proposer maintains separate toll -free numbers for customer service and claims. Explain how members' questions regarding the status of their claim are addressed. Will the Proposer's customer service center address inquiry or will Member be directed to contact claims examiner directly? Our Contact Center handles all calls related to customer service and claims. Yes. Our service team will address the inquiry directly. Based on the nature of the service issue, all representatives have the option to; escalate issues to Escalation Trained Representatives, Supervisors, or Managers, send electronic memos to the specific business area - i.e., Claims, Account Services for prompt attention or connecting the customer directly to a Claims Specialist through our CEG (9 AM - 4M) when the customer requires more information or further explanation due to the complexity of the claim. In addition, if a situation warrants, we will work directly with the appropriate area via telephone or face- to-face to resolve issues as quickly as possible. Indicate whether there is an internet site available for Member use. Describe the capabilities. Yes. There is an internet site available for both employee and Plan Administrator use. The online services available to both groups are provided below. Policyholder • File a claim, review claim details, and check the status of a claim. • File a wellness claim. • View active policies and understand benefit coverage. • Update personal information and account information including E-Consent and Direct Deposit. • Make online payments. Plan Administrator • Simplify account administration with a suite of online services such as deduction file submission, online bill, bill payment and employee administration. • Email questions or requests directly to the Plan Administrator Service Center, 24 hours a day, 7 days a week. • Download claim forms and request for service forms This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 255 ••1,I• Colonial Life • Access CCH HRAnswersNow®, a specialized website that contains information on human resources policies and guidelines, tools, and checklists, as well as the most up-to-date state and federal laws and regulations. Describe Proposer's telephonic intake of claims. Claims must be filed electronically online, via fax, or via U.S. mail. We are unable to intake claims over the phone. • Identify if members are able to provide voice authorization in order to release medical records. No. A H IPAA compliant authorization is required when we need to obtain records. • Identify whether Proposer utilizes robo-calls in any part of their disability claims processing. If so, please specify the purpose of usage (e.g., reminders of outstanding recommendations, approval notifications, etc.). No. There are no ro-bo calls utilized in the claims process. We will email a customer when there is an update to their claim instructing them to go online to obtain the details. • Indicate whether Proposer offers on-line intake of claims. If so, describe the process. Policyholders can submit claims online via our policyholder website. The electronic filing claims submission process is the preferred method for submitting claims as it represents the fastest and easiest way for our customers to notify Colonial Life. • Policyholders can initiate the claims process by logging into www.ColonialLife.com through their computer or mobile device and selecting File an Online Claim. • Customers will be asked a few questions specific to the types of policies they own. • A list of required supporting documents will be referenced and the policyownerwill have the ability to upload this information along with their completed claim. • Once submitted, information will be transmitted directly over to Colonial Life for review. • Customers will receive confirmation that information was sent. Describe Proposer's written claims appeal process utilized for recommendation of benefit denial. For denied or disputed claims, Colonial Life will always review any new information furnished by policy owner. An appeal should be submitted in writing, and the policy owner should include any information that may clarify the issue. The claim will be reviewed by an independent and different specialist and a response sent in writing explaining our decision. Describe the role(s) that the Proposer's staff types (claim analysts, nurses, physicians, claim supervisors) have in benefits determination (both acceptance and denial). The Colonial Life Claims Department is staffed with Claims Examiners, Senior Claims Examiners, and various levels of supervisors and managers. We also utilize nurses and physicians on staff as consultant resources for claim review when needed. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 256 ••1,I• Colonial Life Identify Proposer's proposed commitment to implementing the following performance guarantees and the premium at risk associated with each: o Speed of answering calls; o Length of time on hold; o Responding to after-hours callers; o Abandonment rate of calls; o Claim turnaround time; o Percent of claims audited; o Claims payment accuracy; and o Social Security award success for Long Term Disability claimants. In the normal course of business, Colonial Life does not provide performance guarantees to our employer clients. Each of our home office service departments have aggressive standards and expectations that are constantly being reviewed and measured. If Colonial Life is named a finalist in this RFP process, and we are provided your particular areas of concern, we will be happy to discuss specific performance guarantees. *Please note that the last bullet regarding Long Term Disability (LTD) is not applicable to our RFQ response since we do not offer an LTD product. Describe Proposer's approach to client services as it relates to resolving complaints from the City and/or resolution of errors. The Contact Center uses a combination of sophisticated technology and customer focused training to provide prompt, professional, and reliable service to all customers. Most issues received by our Contact Center are resolved on first contact with one telephone call. Our Contact Center staff includes Customer Service Representatives, Spanish-speaking Bilingual Representatives, and Senior Contact Center Representatives. These individuals are highly trained to help policyholders with any questions they may have. We use industry wide staffing models that consider service level expectations, historical trends, and projected call volumes to determine ongoing staffing needs. We constantly review these trends and adjust staffing as necessary to meet our high service standards. We set high service standards for all customer interactions and measure them frequently to provide excellent service. Our representatives are monitored and scored for quality and accurate performance. Accuracy is the most critical component of the score, and quality audits are conducted by an independent third -party entity to ensure non -biased reviews. Describe Proposer's internal audit program. We have a team of Claims Quality Assurance Coordinators. We audit all business lines on a routine basis proportional to the volume of claims processed. Our Accuracy program includes random and target audits by the Quality Assurance team. Audits from all sources (random and target) would account for .5%of all resolved claims. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 257 ••1,I• Colonial Life All claims decision makers are held to a minimum overall accuracy level. A fully trained specialist is authorized to make claim payments up to a defined dollar amount based on skill sets, experience, and individual performance. If the payment amount exceeds the approved authorization level, a lead specialist or manager must review the claim before releasing the payment. This practice provides another level of quality assurance in our Claims Department. Provide examples of Proposer's standard notifications, forms, letters, and reimbursement agreements. We have providing examples following this document. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 258 PO Box 100195 Columbia SC 29202 03/04/2024 We are writing in reference to: Colonial Life. Do more online! File Claims, check claims status and upload documents. Visit ColonialLife.com/claims Claimant: Claim Number: Date of Claim Event: 12/13/2023 You are a valued customer. To help us promptly process your claim, please upload the information requested below by visiting ColonialLife.com/claims. Please have your employer submit all dates you worked between 12/01/2023 to 12/14/2023. The enclosed claim form, with the "Employer's Section" of the claim form completed by the employer. Complete and return the enclosed authorization so we can update our files. The 2023 calendar year maximum hospital confinement benefit was previously paid. Therefore, we are unable to provide hospital confinement benefits for 12/13/23-12/17/23 confinement. Until we receive the requested information, we will be unable to process your claim. Your claim is closed and no further action will be taken on it until such time as we receive the needed information. Please be sure that any information from the doctor's office, medical facility or employer includes the correct name, address and phone number, so we can contact them if necessary. You can quickly and easily add this document to your claim at ColonialLife.com/claims. Electronic access allows you to: • Go Paperless and choose online correspondence • View the status of your claim and provide us with updated claim information • Keep us up to date on any changes to your current address and telephone number You may also fax additional information to 1-800-880-9325 or mail to Colonial Life & Accident Insurance Company Claims Department, PO Box 100195, Columbia, SC 29202. We look forward to receiving this information and will review it promptly. Para obtener ayuda en espanol, puede Ilamar gratis al 1-800-325-4368 al Centro de Servicio de Colonial Life & Accident Insurance Company y hablar con un representante bilingoe. Colonial Life esta a su disposicion para informarle en su idioma. Colonial Life 1200 Colonial Life Boulevard Columbia, SC 29210 ColonialLife.com FAX 800.880.9325 Phone 800.845.7330 Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 259 DUPLICATE Thank you for your assistance. As soon as we receive this information, we will promptly review the claim. Sincerely, Claims Department Colonial Life & Accident Insurance Company Reference: oniiiiimmomimmims Al DLH Enclosure(s): Privacy Notice Form Disability Claim Form Authorization Form Disability Claim Form You can file new claims, manage existing claims, locate forms and find answers to common questions any time by visiting ColonialLife.com. For additional assistance or automated phone services, contact our Customer Service Center at 1-800-325-4368. Service specialists are available Monday - Friday, 8 a.m. - 8 p.m., ET. Colonial Life & Accident Insurance Company Claims Department PO Box 100195 Columbia, SC 29202 Fax: 1-800-880-9325 260 DUPLICATE • • • unum Privacy Notice This Privacy Notice applies to Unum Group's United States insurance operations and is being provided on behalf of its affiliates listed below ("Unum" "we"), as required by the Gramm -Leach Bliley Act and state insurance laws. This Notice describes how we collect, share, and protect nonpublic personal information (NPI). COLLECTING INFORMATION We collect NPI about our customers to provide them with insurance products and services, perform underwriting, provide stop loss coverage, and administer claims. The types of NPI we collect for these purposes may include telephone number, address, Social Security number, date of birth, occupation, income, and medical history, including treatment. We may receive NPI from your applications and forms, medical providers, other insurers, employers, insurance support organizations and service providers. SHARING INFORMATION We share the types of NPI described above primarily with people who perform insurance, business and professional services for us, such as helping us perform underwriting, provide stop loss coverage, pay claims, detect fraud, and to provide reinsurance or auditing. We may share NPI with medical providers for insurance and treatment purposes and with insurance support organizations. The organizations may retain the NPI and disclose it to others for whom it performs services. In certain cases, we may share NPI with group policyholders for reporting and auditing purposes, with parties for a proposed or final sale of insurance business or for study purposes. We may also share NPI when otherwise required or permitted by law, such as sharing with governmental or other legal authorities. When legally necessary, we ask your permission before sharing NPI about you. Our practices apply to our former, current and future customers. We do not share your health NPI to market any product or service. We also do not share any NPI to market non -financial products and services. The law allows us to share NPI as described above (except health information) with affiliates to market financial products and services. The law does not allow you to restrict these disclosures. We may also share with companies that help us market our insurance products and services, such as vendors that provide mailing services to us. We may share with other financial institutions to jointly market financial products and services. When required by law, we ask your permission before we share NPI for marketing purposes. When other companies help us conduct business, we expect them to follow applicable privacy laws. We do not authorize them to use or share NPI except when necessary to conduct the work they are performing for us or to meet regulatory or other governmental requirements. Unum companies, including insurers and insurance service providers, may share NPI about you with each other. The NPI might not be directly related to our transaction or experience with you. It may include financial or other personal information such as employment history. Consistent with the Fair Credit Reporting Act, we ask your permission before sharing NPI that is not directly related to our transaction or experience with you. 261 DUPLICATE SAFEGUARDING INFORMATION We have physical, electronic and procedural safeguards that protect the confidentiality and security of NPI. We give access only to employees who need to know the NPI to provide insurance products or services to you. ACCESS TO INFORMATION You may request access to certain NPI we collect to provide you with insurance products and services. You must make your request in writing, providing your full name, address, telephone number and policy number, to the address below. We will reply within 30 business days of receipt. If you request, we will send copies of the NPI to you or make available to you at our office. If the NPI includes health information, we may provide the health information to you through a health care provider you designate. We will also send you information related to disclosures. We may charge a reasonable fee to cover our copying costs. This section applies to NPI we collect to provide you with coverage. It does not apply to NPI we collect in anticipation of a claim or civil or criminal proceeding. CORRECTION OF INFORMATION If you believe the NPI we have about you is incorrect, please write to us and include your full name, address, telephone number and policy number if we have issued a policy, and the reason you believe the NPI is inaccurate. We will reply within 30 business days of receipt. If we agree with you, we will correct the NPI and notify you and insurance support organizations that may have received NPI from us in the preceding 7 years. We will also, if you ask, notify any person who may have received the incorrect NPI from us in the past 2 years. If we disagree with you, we will tell you we are not going to make the correction and the reason(s) for our refusal. We will also tell you that you may submit a statement to us. Your statement should include the NPI you believe is correct and the reason(s) why you disagree with our decision not to correct the NPI in our files. We will file your statement with the disputed NPI to be accessible. We will include your statement any time the disputed NPI is reviewed or disclosed. We will also give the statement to insurance support organizations that gave us NPI and to any person designated by you, if we disclosed the disputed NPI to that person in the past two years. COVERAGE DECISIONS If we decide not to issue coverage to you, we will provide you with the specific reason(s) for our decision. We will also tell you how to access and correct certain NPI. You may submit a written request for the reason(s) for our decision within 90 business days of our decision. We will reply within 21 business days of receipt with the specific reasons, if not initially furnished, and specific items of information that supported our decision. CONTACTING US For additional information about Unum's commitment to privacy and to view a copy of our HIPAA Privacy Notice, please visit: unum.com/privacy or coloniallife.com. You may also write to: Privacy Officer, Unum, 2211 Congress Street, B267, Portland, Maine 04122 or at Privacy@unum.com. We reserve the right to modify this notice. We will provide you with a new notice if we make material changes to our privacy practices. Unum is providing this notice to you on behalf of the following insuring companies: Unum Life Insurance Company of America, Unum Insurance Company, First Unum Life Insurance Company, Provident Life and Accident Insurance Company, Provident Life and Casualty Insurance Company, Colonial Life & Accident Insurance Company, The Paul Revere Life Insurance Company and Starmount Life Insurance Company. © 2020 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. unum.com MK-1883 (06-2020) 2 262 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 4 FAX this direction FAX this form: 1-800-880-9325 Or mail: P.O. Box 100195, Columbia, SC 29202 Number of pages: File Your Claim Online Simply log into your account at Coloniallife.com and click on "File an Online Claim". As an added convenience, you may also select Direct Deposit when filing online. Not a member? Log onto Coloniallife.com and click on "Register" then "Join the Policyholder Website" to set up your account. Optional Service Release Agreement Please indicate below for optional services you desire. Any marks used (check mark, X, initials, etc.) will be considered as your authorization and will be processed as if they were selected. I authorize Colonial Life to facilitate processing this claim by releasing its details to the following individual inquiring on my behalf. Note: Leave blank if you do not want anyone accessing your claim information. Sales representative Employer Spouse, family member or significant other Name: I want Colonial Life to update me on the status of my claim through prerecorded messages at my contact number indicated on this form. I understand that messages will be left with anyone who answers the phone or on my answering machine. Note: To avoid blocked calls, you should program the number 1-800-325-4368 into your phone. Yes, I want ALL payment(s) for this claim sent by overnight delivery. I understand payment(s) under $100.00 cannot be sent overnight. I also understand that if I want my claim to be sent by overnight delivery, a $22.00 fee will be deducted from my claim payment. This fee is subject to rate increases by carrier, includes delivery only on business days and does not include weekend or holiday delivery. I understand that Colonial Life is unable to send overnight mail to a P.O. Box. Yes, I want to Direct Deposit all payments into my bank account. I have enclosed a voided check for a checking account or a deposit slip for a savings account with my initial claim submission. Please note: Allow up to three business days after claim payment for deposit into your account. I also understand that I must notify Colonial Life to discontinue any of these services. Complete each section before submitting your claim. If you were not employed when the disability began, the employer's statement in section 2 is not needed. Incomplete claim form submission may result in a delay in the processing of your claim. Please make sure that all written responses are legible. ■ If your name has changed, attach a copy of legal documentation of the change. ■ Dates should be written in month/day/year format (i.e. 12/14/ 1980). ■ Social Security number is indicated by SSN. ■ Benefits are payable to you unless we receive written authorization to pay benefits elsewhere. This is called an assignment. ■ If this claim is for an individual covered by Medicaid, most non -disability benefits are automatically assigned according to state regulations. This means we must pay the benefits to Medicaid or to the medical provider to reduce the charges billed to Medicaid. Section 1 - Claimant statement (completed by policy owner) Claimant name: ❑ Male ❑ Female DOB: / / SSN: Relationship to policy owner: ❑ Self ❑ Spouse ❑ Domestic partner ❑ Dependent Policy owner information (ifotherthan claimant) Name: DOB: // SSN: Address: Apt. # City: State: ZIP: Email: Telephone/Contact Number: Claim is for: Accident CI Sickness Date the accident occurred (not when it was treated): / / Condition that keeps you from working: Is your condition work related? Have you been treated forsame or similar condition prior to this occurrence? ❑ Yes ❑ No If yes, date: / / Description of where and how the accident occurred (if auto accident, please attach a copy of the police report, if available.) Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 1 I ColonialLife.com 19-23 164387-24 263 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claim Fraud Statements Before signing this claim form, please read the warning for the state where you reside and for the state where the insurance policy under which you are claiming a benefit is issued. For your protection, state laws, including Alaska, Arizona, Arkansas, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming require the following statementto appear on this form. Fraud Warning: Any person who knowingly, and with intent to injure, defraud, or deceive an insurance company, files a statement of claim containing any false, incomplete, or misleading information is guilty of insurance fraud, which is a felony. For your protection: Alabama law requires the following statement to appear on this form: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly present false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison, or any combination thereof. California law requires the following statement to appear on this form: Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. Colorado law requires the following statement to appear on this form: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies. District of Columbia law requires the following statement to appear on this form: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/ or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant. Florida law requires the following statement to appear on this form: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. Kentucky law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other person files a statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime. Minnesota law requires the following statement to appear on this form: A person who files a claim with intentto defraud or helps commit a fraud against an insurer is guilty of a crime. New Hampshire law requires the following statement to appear on this form: Any person who, with a purpose to injure, defraud, or deceive any insurance company, files a statement of claim containing any false, incomplete, or misleading information is subject to prosecution and punishment for insurance fraud, as provided in RSA 638.20. New Jersey law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other persons, files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact, material thereto, commits a fraudulent insurance act, subject to criminal prosecution and civil penalties. New York law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. Pennsylvania law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. Puerto Rico law requires the following statement to appear on this form: Any person who knowingly and with the intention of defrauding presents false information in an insurance application, or presents, helps, or causes the presentation of a fraudulent claim for the payment of a Toss or any other benefit, or presents more than one claim for the same damage or loss, shall incur a felony and, upon conviction, shall be sanctioned for each violation with the penalty of a fine of not less than five thousand (5,000) dollars and not more than ten thousand (10,000) dollars, ora fixed term of imprisonment for three (3) years, or both penalties. If aggravating circumstances are present, the penalty thus established may be increased to a maximum of five (5) years; if extenuating circumstances are present; it may be reduced to a minimum of two (2) years. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 2 I ColonialLife.com 19-23 I 64387-24 264 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: Claimant SSN: Section 1 - Claimant statement — continued (completed by policy owner) Were you at work at the time of your accident or sickness? ❑Yes ID No Is your condition work related? ID Yes ID No Have you filed for workers' compensation benefits? ❑ Yes ❑ No (If on -job injury, attach copy of Report of Injury document) Have you been unable to work: ❑ Yes ❑ No If yes, list the dates unable to work. From: / / To: / / What is your job title/occupation? What specific job duties are you unable to perform? What are the physical requirements of yourjob? 0n average, how many hours a day are spent walking or standing at yourjob? 0n average, how many pounds do you lift, carry, push or pull at yourjob? Does yourjob require you to bend, twist, squat, kneel or climb on a daily basis? ❑ Yes ❑ No Were you employed at time of loss? ❑ Yes ❑ No If not employed at the time of loss, what was the last date that you worked at the previous occupation? If not employed, have you been unable to perform activities of daily living? ❑ Yes D No If yes, list dates: From: / / To: / / Check activities of daily living that you are unable to perform: ❑Dressing ❑Eating Meal preparation ❑Toileting ❑Continence ❑Bathing ❑Transferring If not employed, list dates of house confinement: From: / / To: / / House confinement means that you are kept at home (in house oryard) by the condition. However, you may follow the physician's orders, even if it means leaving home. Date returned to work: Full-time: / / Part-time: / / If part-time, hours worked per week: Please submit itemized billing if confined to a hospital, as well as an operative report, if surgery was performed. Hospital confinement: ❑ Yes ❑ No Admission date: / / Time: ❑ AM ❑ PM Date released: / / Time: ❑ AM ❑ PM Hospital: Telephone: Address: City: State: ZIP: List all physicians who have treated you for this condition. Primary physician: Telephone: Fax: Address: City: State: ZIP: Physician: Telephone: Fax: Address: City: State: ZIP: Physician: Telephone: Fax: Address: City: State: ZIP: Physician: Telephone: Fax: Address: City: State: ZIP: Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 3 I ColonialLife.com 19-23 I 64387-24 265 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: Claimant SSN: Certification Policy owner's name: SSN: I have checked the answers on this claim form, and they are correct. I certify under penalty of perjury that my correct Social Security number is shown on this form. I acknowledge that I received the Claim Fraud Statements on page two of this form and that I read the statement required by the State Department of Insurance for my state, if my state was listed on the form. Fraud Warning: For your protection, Arizona law requires the following to appear on this claim form: Any person who knowingly and with the intent to injure, defraud or deceive an insurance company presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Fraud Warning: For your protection, New York law requires the following to appear on this claim form: Any person who knowingly and with the intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. Fraud Notice: Any person who knowingly files a statement of claim containing false or misleading information is subject to criminal and civil penalities. This includes the Physician Statement portion of the claim form. Print claimant's name Print policy owner's name Claimant's signature Policy owner's signature Date(MM/DD/YYYY) Date(MM/DD/YYYY) Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 4 I ColonialLife.com 19-23 1 64387-24 266 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: I Claimant SSN: Section 2 — Employer statement (completed by employer) Employee name: SSN: Employee title: Hire date: / / Average number of scheduled hours per week: Date last worked: / / Date employment terminated: / / Employee unable to work (Full-time): From: To: Sick leave was exhausted on: / / _/ _/ _/_/ Approved for FMLA (if eligible): From: / / To: _/_/ Was employee at work when accident or sickness occurred? CIYes ❑ No Workers' compensation claim filed? ❑ Yes E No Workers' compensation carrier Name: Telephone: Hourly employee rate: Hours worked per week: Annual salary: If paid on commission basis, attach commission breakdown for prior 12 months from date last worked. Do you permit light duty for employee? ❑Yes ❑ No Do you permit partia duty for employee? ❑ Yes ❑ No Expected return to work: / / Actual return to work: Full-time: / / Actual return to work: Part-time:// Hours per week: Employee's duties include: Reaching/pulling/pushing: ❑ Sitting per hr. ❑ Walking per hr. ❑Climbing stairs/ladders per hr. ❑ Standing per hr. ❑ Driving hrs. per day Lifting: ❑ Less than 15 Ibs. E 15 to 44 Ibs. ❑ More than 45 Ibs. Stooping/bending: ❑ none E seldom E frequent E none ❑ seldom E frequent Crawling/kneeling: ❑ none ❑ seldom ❑ frequent Repetitive motion: ❑ none ❑ seldom ❑ frequent Contact for updates on return to work status: Telephone: Email: files a statement of claim containing civil penalties. This includes employer's portions Fax: Fraud warning: Any person who knowingly criminal and false or misleading information is subject to of the claim form. Signature of authorized person Date (MM/DD/YYYY) Title of authorized person: Employer/company name: Telephone: Fax: Email: Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 5 I ColonialLife.com 19-23 164387-24 267 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: Claimant SSN: Section 3 - Physician statement (completed by physician) Patient name: DOB: / / Is condition due to an accidental injury? ❑ Yes ❑ No If yes, date and description of accidental injury: Is the condition the result of their employment? E Yes ❑No El Unknown What primary diagnosis prevents the patient from working? (If pregnancy, list complications. If routine pregnancy, complete information below.) Date first treated for this condition: / / Are there any secondary diagnoses preventing the patient from working? ❑Yes ❑No Secondary diagnoses: When did symptoms first appear? / / Date of new patient consultation: / / Symptoms: Current treatment plan: List all dates patient received: medical advice, diagnosis or treatment for this condition (or a related condition) for the 18 months prior to this disability to the present. (list dates: MM/DD/YYYY) List any test performed (submit copy of test results) Date: / / CPT code: List any surgeries performed (submit copy of operative report) Date: / / CPT code: Date: / / CPT code: Date: / / CPT code: Date of patient's last visit: / / Date of next scheduled visit: / / How soon do you expect significant improvement in the patient's medical condition? 0 1- 2 months ❑ 3 - 4 months 0 5 - 6 months 0 more than 6 months Does patient have permanent restrictions and/or limitations? ❑ Yes 0 No If yes, which ones are permanent: Limitations (patient CANNOT DO): Restrictions (patient SHOULD NOT DO): Dates unable to work (full-time): From: / / To: / / Expected return to work: / / Dates able to work (part-time): From: / / To: / / Number of hours: Actual return to work: / / Did this condition require house confinement: ❑ Yes ❑ No If yes, From: / / To: / / House confinement means the patient is kept at home (in house or yard) by the condition. However, the patient may follow your orders, even if it means leaving home. Check activities of daily living that the patient is unable to perform: ❑ Dressing ❑ Eating ❑ Meal preparation ❑ Bathing ❑ Transferring ❑ Toileting ❑ Continence Dates unable to perform activities of daily living: From: _// To: // Date(s) of hospitalization (last 6 months): Date(s) of office visit (last 6 months): How often do you see the patient? Have you referred patientto a specialist? ❑ Yes ❑ No Hospital: Specialist: Address: Address: City: State: ZIP: City: State: ZIP: Telephone: Fax: Telephone: Fax: _ii PREGNAN Estimated date of delivery: / / Type of delivery: ❑ vaginal ❑ C-section Date first treated: / / Date of delivery: / / Procedure code: Fraud warning: Any person who knowingly files a statement of claim containing false or misleading information is subject to criminal and civil penalties. This includes attending physician portions of the claim form. Physician signature Date (MM/DD/YYYY) Physician/group name: Patient account number: Physician's specialty: Telephone: FAX: Address: City: State: ZIP: Tax ID orSSN: Do you accept medical record requests by fax? 0 Yes 0 No Do you require a special authorization for release of information? ❑ Yes ❑ No Patient Portal ❑ Yes ❑ No Will you accept the standard HIPAA release? ❑ Yes ❑ No Was patient referred to you by another physician? ❑ Yes ❑ No Authorization on file to release information to Colonial Life: ❑ Yes ❑ No Referring physician: Telephone: Fax: Address: City: State: ZIP: Tax ID orSSN: Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 6 I ColonialLife.com 19-23 I 64387-24 268 DUPLICATE This page intentionally left blank. 269 DUPLICATE Colonial Life & Accident Insurance Company, P.O. Box 100195, Columbia, SC 29202 I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Authorization for Colonial Life & Accident Insurance Company Sign and return this authorization to Claims Department at the address listed above. This authorization is designed to comply with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. I hereby authorize the disclosure of the following information about me and, if applicable, my dependents, from the sources listed below to Colonial Life & Accident Insurance Company and its duly authorized representatives (Colonial Life). Health information may be disclosed by any medical or medically related provider or institution, rehabilitation professionals, vocational evaluators, health plan or health care clearinghouse that has any records or knowledge about me, including prescription drug database or pharmacy benefit manager, ambulance or other medical transport service, any insurance company, Medicare or Medicaid agencies orthe Medical Information Bureau (MIB). Non -health information may be disclosed by any entity, person or organization that has any records about me, including but not limited to my employer, employer representative and compensation sources, insurance company, financial institution, consumer reporting agencies including credit bureaus, professional licensing bodies, attorneys or governmental entities. Health information includes my entire medical record, prescription drug history and insurance claim history, including HIV, AIDS or other disorders of the immune system, information on the diagnosis, treatment, and testing results related to sexually transmitted diseases, unless further restricted by state law, use of drugs or alcohol, mental or physical history, condition, advice or treatment, but does not include psychotherapy notes. Non -health information, includes earnings, financial or credit history, professional licenses, employment history or any other facts deemed necessary by Colonial Life to evaluate my application or claim forms. Any information Colonial Life obtains pursuant to this authorization will be used for the purpose of evaluating and administering my claim for benefits or for evaluating my eligibility for insurance, including checking for and resolving any issues that may arise regarding incomplete or incorrect information on my application or claim forms. Some information, once obtained, may not be protected by certain federal regulations governing the privacy of health information, but the information is protected by state privacy laws and other applicable laws. Colonial Life will not re -disclose the information unless permitted or required by those laws or as authorized by me. I also authorize Colonial Life to disclose my information to the following persons (for the purpose of reporting claim status, or experience, or so that the recipient may carry out health care operations, claims payment, administrative or audit functions related to any benefit, plan or claim): any employee benefit plan sponsored by my employer; any person providing services or insurance benefits to (or on behalf of) my employer, any such plan or claim, or any benefit offered by Colonial Life; or, the Social Security Administration. Colonial Life will not condition the payment of insurance benefits on whether I authorize Colonial Life to re -disclose my information. For the purposes of these disclosures by Colonial Life, this authorization is valid for one year or for the length of time otherwise permitted by law. This authorization is valid for two (2) years from its execution orthe duration of my claim (to include any subsequent financial management and/or benefit recovery review), whichever is earlier, and a copy is as valid as the original. I know that I, or my authorized representative, may request a copy of this authorization. This authorization may be revoked by me or my authorized representative at any time except to the extent Colonial Life has relied on the authorization prior to notice of revocation or has a legal right to contest coverage under the contract or the contract itself. If I do not sign this authorization or if I alter or revoke it, except as specified above, Colonial Life may not be able to evaluate my claim or eligibility for insurance. I may revoke this authorization by sending written notice to the Claims Department at the address listed above. Signature Date signed (MM/DD/YYYY) Printed name of individual subject to this disclosure XXX-XX- Last Date of birth(MM/DD/YYYY) If applicable, I signed on behalf of the insured as (indicate relationship). If legal guardian, power of attorney designee, conservator, beneficiary or personal representative, please attach a copy of the document granting authority. Printed name of legal representative Signature of legal representative Date signed (MM/DD/YYYY) Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. i page 8 I ColonialLife.com I 9-23 I 64387-24 270 DUPLICATE Colonial Life & Accident Insurance Company, P.O. Box 100195, Columbia, SC 29202 I CLAIMSAUTHORIZATION I Fax: 1-800-880-9325 I Telephone: 1-800-325-4368 Authorization for Colonial Life & Accident Insurance Company Sign and return this authorization to Claims Department at the address listed above. This authorization is designed to comply with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. I hereby authorize the disclosure of the following information about me and, if applicable, my dependents, from the sources listed below to Colonial Life & Accident Insurance Company and its duly authorized representatives (Colonial Life). Health information may be disclosed by any medical or medically related provider or institution, rehabilitation professionals, vocational evaluators, health plan or health care clearinghouse that has any records or knowledge about me, including prescription drug database or pharmacy benefit manager, ambulance or other medical transport service, any insurance company, Medicare or Medicaid agencies or the Medical Information Bureau (MIB). Non -health information may be disclosed by any entity, person or organization that has any records about me, including but not limited to my employer, employer representative and compensation sources, insurance company, financial institution, consumer reporting agencies including credit bureaus, professional licensing bodies, attorneys or governmental entities. Health information includes my entire medical record, prescription drug history and insurance claim history, including HIV, AIDS or other disorders of the immune system, information on the diagnosis, treatment, and testing results related to sexually transmitted diseases, unless further restricted by state law, use of drugs or alcohol, mental or physical history, condition, advice or treatment, but does not include psychotherapy notes. Non -health information, includes earnings, financial or credit history, professional licenses, employment history or any other facts deemed necessary by Colonial Life to evaluate my application or claim forms. Any information Colonial Life obtains pursuant to this authorization will be used forthe purpose of evaluating and administering my claim for benefits or for evaluating my eligibility for insurance, including checking for and resolving any issues that may arise regarding incomplete or incorrect information on my application or claim forms. Some information, once obtained, may not be protected by certain federal regulations governing the privacy of health information, but the information is protected by state privacy laws and other applicable laws. Colonial Life will not re -disclose the information unless permitted or required by those laws or as authorized by me. I also authorize Colonial Life to disclose my information to the following persons (forthe purpose of reporting claim status, or experience, or so that the recipient may carry out health care operations, claims payment, administrative or audit functions related to any benefit, plan or claim): any employee benefit plan sponsored by my employer; any person providing services or insurance benefits to (or on behalf of) my employer, any such plan or claim, or any benefit offered by Colonial Life; or, the Social Security Administration. Colonial Life will not condition the payment of insurance benefits on whether I authorize Colonial Life to re -disclose my information. For the purposes of these disclosures by Colonial Life, this authorization is valid for one year or for the length of time otherwise permitted by law. This authorization is valid for two (2) years from its execution or the duration of my claim (to include any subsequent financial management and/or benefit recovery review), whichever is earlier, and a copy is as valid as the original. I know that I, or my authorized representative, may request a copy of this authorization. This authorization may be revoked by me or my authorized representative at any time except to the extent Colonial Life has relied on the authorization prior to notice of revocation or has a legal right to contest coverage under the contract or the contract itself. If I do not sign this authorization or if I alter or revoke it, except as specified above, Colonial Life may not be able to evaluate my claim or eligibility for insurance. I may revoke this authorization by sending written notice to the Claims Department at the address listed above. Signature Date signed (MM/DD/YYYY) Printed name of individual subjectto this disclosure xxx-xx- Lastfour digits ofSSN Date of birth (MM/DD/YYYY) If applicable, I signed on behalf of the insured as (indicate relationship). If legal guardian, power of attorney designee, conservator, beneficiary or personal representative, please attach a copy of the document granting authority. Printed name of legal representative Signature of legal representative Date signed (MM/DD/YYYY) Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. ColonialLife.com I 3-21 I 57644-8 271 DUPLICATE 272 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 4 FAX this direction FAX this form: 1-800-880-9325 Or mail: P.O. Box 100195, Columbia, SC 29202 Number of pages: File Your Claim Online Simply log into your account at Coloniallife.com and click on "File an Online Claim". As an added convenience, you may also select Direct Deposit when filing online. Not a member? Log onto Coloniallife.com and click on "Register" then "Join the Policyholder Website" to set up your account. Optional Service Release Agreement Please indicate below for optional services you desire. Any marks used (check mark, X, initials, etc.) will be considered as your authorization and will be processed as if they were selected. I authorize Colonial Life to facilitate processing this claim by releasing its details to the following individual inquiring on my behalf. Note: Leave blank if you do not want anyone accessing your claim information. Sales representative Employer Spouse, family member or significant other Name: I want Colonial Life to update me on the status of my claim through prerecorded messages at my contact number indicated on this form. I understand that messages will be left with anyone who answers the phone or on my answering machine. Note: To avoid blocked calls, you should program the number 1-800-325-4368 into your phone. Yes, I want ALL payment(s) for this claim sent by overnight delivery. I understand payment(s) under $100.00 cannot be sent overnight. I also understand that if I want my claim to be sent by overnight delivery, a $22.00 fee will be deducted from my claim payment. This fee is subject to rate increases by carrier, includes delivery only on business days and does not include weekend or holiday delivery. I understand that Colonial Life is unable to send overnight mail to a P.O. Box. Yes, I want to Direct Deposit all payments into my bank account. I have enclosed a voided check for a checking account or a deposit slip for a savings account with my initial claim submission. Please note: Allow up to three business days after claim payment for deposit into your account. I also understand that I must notify Colonial Life to discontinue any of these services. Complete each section before submitting your claim. If you were not employed when the disability began, the employer's statement in section 2 is not needed. Incomplete claim form submission may result in a delay in the processing of your claim. Please make sure that all written responses are legible. ■ If your name has changed, attach a copy of legal documentation of the change. ■ Dates should be written in month/day/year format (i.e. 12/14/ 1980). ■ Social Security number is indicated by SSN. ■ Benefits are payable to you unless we receive written authorization to pay benefits elsewhere. This is called an assignment. ■ If this claim is for an individual covered by Medicaid, most non -disability benefits are automatically assigned according to state regulations. This means we must pay the benefits to Medicaid or to the medical provider to reduce the charges billed to Medicaid. Section 1 - Claimant statement (completed by policy owner) Claimant name: ❑ Male ❑ Female DOB: / / SSN: Relationship to policy owner: ❑ Self ❑ Spouse ❑ Domestic partner ❑ Dependent Policy owner information (ifotherthan claimant) Name: DOB: // SSN: Address: Apt. # City: State: ZIP: Email: Telephone/Contact Number: Claim is for: Accident CI Sickness Date the accident occurred (not when it was treated): / / Condition that keeps you from working: Is your condition work related? Have you been treated forsame or similar condition prior to this occurrence? III Yes III No If yes, date: / / Description of where and how the accident occurred (if auto accident, please attach a copy of the police report, if available.) Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 1 I ColonialLife.com 19-23 164387-24 273 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claim Fraud Statements Before signing this claim form, please read the warning for the state where you reside and for the state where the insurance policy under which you are claiming a benefit is issued. For your protection, state laws, including Alaska, Arizona, Arkansas, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming require the following statementto appear on this form. Fraud Warning: Any person who knowingly, and with intent to injure, defraud, or deceive an insurance company, files a statement of claim containing any false, incomplete, or misleading information is guilty of insurance fraud, which is a felony. For your protection: Alabama law requires the following statement to appear on this form: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly present false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison, or any combination thereof. California law requires the following statement to appear on this form: Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. Colorado law requires the following statement to appear on this form: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies. District of Columbia law requires the following statement to appear on this form: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/ or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant. Florida law requires the following statement to appear on this form: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. Kentucky law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other person files a statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime. Minnesota law requires the following statement to appear on this form: A person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime. New Hampshire law requires the following statement to appear on this form: Any person who, with a purpose to injure, defraud, or deceive any insurance company, files a statement of claim containing any false, incomplete, or misleading information is subject to prosecution and punishment for insurance fraud, as provided in RSA 638.20. New Jersey law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other persons, files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact, material thereto, commits a fraudulent insurance act, subject to criminal prosecution and civil penalties. New York law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. Pennsylvania law requires the following statement to appear on this form: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. Puerto Rico law requires the following statement to appear on this form: Any person who knowingly and with the intention of defrauding presents false information in an insurance application, or presents, helps, or causes the presentation of a fraudulent claim for the payment of a Toss or any other benefit, or presents more than one claim for the same damage or loss, shall incur a felony and, upon conviction, shall be sanctioned for each violation with the penalty of a fine of not less than five thousand (5,000) dollars and not more than ten thousand (10,000) dollars, ora fixed term of imprisonment for three (3) years, or both penalties. If aggravating circumstances are present, the penalty thus established may be increased to a maximum of five (5) years; if extenuating circumstances are present; it may be reduced to a minimum of two (2) years. Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 2 I ColonialLife.com 19-23 I 64387-24 274 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: Claimant SSN: Section 1 - Claimant statement — continued (completed by policy owner) Were you at work at the time of your accident or sickness? ❑Yes ID No Is your condition work related? ID Yes ID No Have you filed for workers' compensation benefits? ❑ Yes ❑ No (If on -job injury, attach copy of Report of Injury document) Have you been unable to work: ❑ Yes ❑ No If yes, list the dates unable to work. From: / / To: / / What is your job title/occupation? What specific job duties are you unable to perform? What are the physical requirements of yourjob? 0n average, how many hours a day are spent walking or standing at yourjob? 0n average, how many pounds do you lift, carry, push or pull at yourjob? Does yourjob require you to bend, twist, squat, kneel or climb on a daily basis? ❑ Yes ❑ No Were you employed at time of loss? ❑ Yes ❑ No If not employed at the time of loss, what was the last date that you worked at the previous occupation? If not employed, have you been unable to perform activities of daily living? ❑ Yes ❑ No If yes, list dates: From: / / To: / / Check activities of daily living that you are unable to perform: ❑Dressing ❑Eating Meal preparation ❑Toileting ❑Continence ❑Bathing ❑Transferring If not employed, list dates of house confinement: From: / / To: / / House confinement means that you are kept at home (in house or yard) by the condition. However, you may follow the physician's orders, even if it means leaving home. Date returned to work: Full-time: / / Part-time: / / If part-time, hours worked per week: Please submit itemized billing if confined to a hospital, as well as an operative report, if surgery was performed. Hospital confinement: ❑ Yes ❑ No Admission date: / / Time: ❑ AM ❑ PM Date released: / / Time: ❑ AM ❑ PM Hospital: Telephone: Address: City: State: ZIP: List all physicians who have treated you for this condition. Primary physician: Telephone: Fax: Address: City: State: ZIP: Physician: Telephone: Fax: Address: City: State: ZIP: Physician: Telephone: Fax: Address: City: State: ZIP: Physician: Telephone: Fax: Address: City: State: ZIP: Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 1 page 3 1 ColonialLife.com 19-23 1 64387-24 275 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: Claimant SSN: Certification Policy owner's name: SSN: I have checked the answers on this claim form, and they are correct. I certify under penalty of perjury that my correct Social Security number is shown on this form. I acknowledge that I received the Claim Fraud Statements on page two of this form and that I read the statement required by the State Department of Insurance for my state, if my state was listed on the form. Fraud Warning: For your protection, Arizona law requires the following to appear on this claim form: Any person who knowingly and with the intent to injure, defraud or deceive an insurance company presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Fraud Warning: For your protection, New York law requires the following to appear on this claim form: Any person who knowingly and with the intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. Fraud Notice: Any person who knowingly files a statement of claim containing false or misleading information is subject to criminal and civil penalities. This includes the Physician Statement portion of the claim form. Print claimant's name Print policy owner's name Claimant's signature Policy owner's signature Date(MM/DD/YYYY) Date(MM/DD/YYYY) Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 4 I ColonialLife.com 19-23 1 64387-24 276 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: I Claimant SSN: Section 2 — Employer statement (completed by employer) Employee name: SSN: Employee title: Hire date: / / Average number of scheduled hours per week: Date last worked: / / Date employment terminated: / / Employee unable to work (Full-time): From: To: Sick leave was exhausted on: / / _/ _/ _/_/ Approved for FMLA (if eligible): From: / / To: _/ _/ Was employee at work when accident or sickness occurred? ❑Yes ❑ No Workers' compensation claim filed? ❑ Yes ❑ No Workers' compensation carrier Name: Telephone: Hourly employee rate: Hours worked per week: Annual salary: If paid on commission basis, attach commission breakdown for prior 12 months from date last worked. Do you permit light duty for employee? ❑ Yes ❑ No Do you permit partia duty for employee? ❑Yes ❑ No Expected return to work: / / Actual return to work: Full-time: / / Actual return to work: Part-time:// Hours per week: Employee's duties include: Reaching/pulling/pushing: ❑ Sitting per hr. ❑ Walking per hr. ❑Climbing stairs/ladders per hr. ❑ Standing per hr. ❑ Driving hrs. per day Lifting: ❑ Less than 15 Ibs. E 15 to 44 Ibs. ❑ More than 45 Ibs. Stooping/bending: ❑ none E seldom E frequent E none ❑ seldom E frequent Crawling/kneeling: ❑ none ❑ seldom ❑ frequent Repetitive motion: E none ❑ seldom E frequent Contact for updates on return to work status: Telephone: Email: files a statement of claim containing civil penalties. This includes employer's portions Fax: information is subject to form. Fraud warning: Any person who knowingly criminal and false or misleading of the claim Signature of authorized person Date (MM/DD/YYYY) Title of authorized person: Employer/company name: Telephone: Fax: Email: Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 1 page 5 1 ColonialLife.com 19-23 1 64387-24 277 DUPLICATE Colonial Life & Accident Insurance Company, Columbia, SC I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Claimant name: Claimant SSN: Section 3 - Physician statement (completed by physician) Patient name: DOB: / / Is condition due to an accidental injury? ❑ Yes ❑ No If yes, date and description of accidental injury: Is the condition the result of their employment? E Yes ❑No El Unknown What primary diagnosis prevents the patient from working? (If pregnancy, list complications. If routine pregnancy, complete information below.) Date first treated for this condition: / / Are there any secondary diagnoses preventing the patient from working? ❑Yes ❑No Secondary diagnoses: When did symptoms first appear? / / Date of new patient consultation: / / Symptoms: Current treatment plan: List all dates patient received: medical advice, diagnosis or treatment for this condition (or a related condition) for the 18 months prior to this disability to the present. (list dates: MM/DD/YYYY) List any test performed (submit copy of test results) Date: / / CPT code: List any surgeries performed (submit copy of operative report) Date: / / CPT code: Date: / / CPT code: Date: / / CPT code: Date of patient's last visit: / / Date of next scheduled visit: / / How soon do you expect significant improvement in the patient's medical condition? ❑ 1- 2 months ❑ 3 - 4 months ❑ 5 - 6 months ❑ more than 6 months Does patient have permanent restrictions and/or limitations? ❑ Yes ❑ No If yes, which ones are permanent: Limitations (patient CANNOT DO): Restrictions (patient SHOULD NOT DO): Dates unable to work (full-time): From: / / To: / / Expected return to work: / / Dates able to work (part-time): From: / / To: / / Number of hours: Actual return to work: / / Did this condition require house confinement: ❑ Yes D No If yes, From: / / To: / / House confinement means the patient is kept at home (in house or yard) by the condition. However, the patient may follow your orders, even if it means leaving home. Check activities of daily living that the patient is unable to perform: ❑ Dressing ❑ Eating D Meal preparation ❑ Bathing ❑ Transferring D Toileting ❑ Continence Dates unable to perform activities of daily living: From: _// To: // Date(s) of hospitalization (last 6 months): Date(s) of office visit (last 6 months): How often do you see the patient? Have you referred patientto a specialist? ❑ Yes ❑ No Hospital: Specialist: Address: Address: City: State: ZIP: City: State: ZIP: Telephone: Fax: Telephone: Fax: _ii PREGNAN Estimated date of delivery: / / Type of delivery: ❑ vaginal ❑ C-section Date first treated: / / Date of delivery: / / Procedure code: Fraud warning: Any person who knowingly files a statement of claim containing false or misleading information is subject to criminal and civil penalties. This includes attending physician portions of the claim form. Physician signature Date (MM/DD/YYYY) Physician/group name: Patient account number: Physician's specialty: Telephone: FAX: Address: City: State: ZIP: Tax ID orSSN: Do you accept medical record requests by fax? 0 Yes 0 No Do you require a special authorization for release of information? ❑ Yes 0 No Patient Portal ❑ Yes 0 No Will you accept the standard HIPAA release? ❑ Yes ❑ No Was patient referred to you by another physician? ❑ Yes ❑ No Authorization on file to release information to Colonial Life: ❑ Yes ❑ No Referring physician: Telephone: Fax: Address: City: State: ZIP: Tax ID orSSN: Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. I page 6 I ColonialLife.com 19-23 I 64387-24 278 DUPLICATE This page intentionally left blank. 279 DUPLICATE Colonial Life & Accident Insurance Company, P.O. Box 100195, Columbia, SC 29202 I DISABILITY I FAX: 1-800-880-9325 I Telephone: 1-800-325-4368 Authorization for Colonial Life & Accident Insurance Company Sign and return this authorization to Claims Department at the address listed above. This authorization is designed to comply with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. I hereby authorize the disclosure of the following information about me and, if applicable, my dependents, from the sources listed below to Colonial Life & Accident Insurance Company and its duly authorized representatives (Colonial Life). Health information may be disclosed by any medical or medically related provider or institution, rehabilitation professionals, vocational evaluators, health plan or health care clearinghouse that has any records or knowledge about me, including prescription drug database or pharmacy benefit manager, ambulance or other medical transport service, any insurance company, Medicare or Medicaid agencies orthe Medical Information Bureau (MIB). Non -health information may be disclosed by any entity, person or organization that has any records about me, including but not limited to my employer, employer representative and compensation sources, insurance company, financial institution, consumer reporting agencies including credit bureaus, professional licensing bodies, attorneys or governmental entities. Health information includes my entire medical record, prescription drug history and insurance claim history, including HIV, AIDS or other disorders of the immune system, information on the diagnosis, treatment, and testing results related to sexually transmitted diseases, unless further restricted by state law, use of drugs or alcohol, mental or physical history, condition, advice or treatment, but does not include psychotherapy notes. Non -health information, includes earnings, financial or credit history, professional licenses, employment history or any other facts deemed necessary by Colonial Life to evaluate my application or claim forms. Any information Colonial Life obtains pursuant to this authorization will be used for the purpose of evaluating and administering my claim for benefits or for evaluating my eligibility for insurance, including checking for and resolving any issues that may arise regarding incomplete or incorrect information on my application or claim forms. Some information, once obtained, may not be protected by certain federal regulations governing the privacy of health information, but the information is protected by state privacy laws and other applicable laws. Colonial Life will not re -disclose the information unless permitted or required by those laws or as authorized by me. I also authorize Colonial Life to disclose my information to the following persons (for the purpose of reporting claim status, or experience, or so that the recipient may carry out health care operations, claims payment, administrative or audit functions related to any benefit, plan or claim): any employee benefit plan sponsored by my employer; any person providing services or insurance benefits to (or on behalf of) my employer, any such plan or claim, or any benefit offered by Colonial Life; or, the Social Security Administration. Colonial Life will not condition the payment of insurance benefits on whether I authorize Colonial Life to re -disclose my information. For the purposes of these disclosures by Colonial Life, this authorization is valid for one year or for the length of time otherwise permitted by law. This authorization is valid for two (2) years from its execution orthe duration of my claim (to include any subsequent financial management and/or benefit recovery review), whichever is earlier, and a copy is as valid as the original. I know that I, or my authorized representative, may request a copy of this authorization. This authorization may be revoked by me or my authorized representative at any time except to the extent Colonial Life has relied on the authorization prior to notice of revocation or has a legal right to contest coverage under the contract or the contract itself. If I do not sign this authorization or if I alter or revoke it, except as specified above, Colonial Life may not be able to evaluate my claim or eligibility for insurance. I may revoke this authorization by sending written notice to the Claims Department at the address listed above. Signature Date signed (MM/DD/YYYY) Printed name of individual subject to this disclosure XXX-XX- Last four digits of SSN Date of birth (MM/DD/YYYY) If applicable, I signed on behalf of the insured as (indicate relationship). If legal guardian, power of attorney designee, conservator, beneficiary or personal representative, please attach a copy of the document granting authority. Printed name of legal representative Signature of legal representative Date signed (MM/DD/YYYY) Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. i page 8 I ColonialLife.com I 9-23 I 64387-24 280 DUPLICATE PO Box 100195 Columbia SC 29202 03/04/2024 We are writing in reference to: Colonial Life. Do more online! File Claims, check claims status and upload documents. Visit ColonialLife.com/claims Claimant: Claim Number: Date of Claim Event: 11/12/2023 During the processing of this claim, the following coverage was considered for possible benefits: After completing our evaluation of this claim, no benefits are payable at this time for the reason(s) outlined in this letter. The disability rider coverage has an elimination period of 7 days. This means total disability benefits would begin on the 8th day of disability. The information we received does not indicate the period of disability was more than 7 days. In reaching our decision on this claim, we relied on the policy. "Elimination Period means the period of time during which no benefits are payable, as shown on the Rider Schedule." During the claim evaluation we considered and/or obtained the information listed below: • Information provided on the claim form • Medical records from treating doctor(s) Per the medical information received, you were totally disabled from 11/12/2023-11/16/2023. Since this is Tess than 8 days, total disability benefits are not payable. At Colonial Life & Accident Insurance Company , we review every claim in a thorough and timely manner. We want to ensure that our policyholders understand their coverage and receive all the benefits it may provide. Para obtener ayuda en espanol, puede Ilamar gratis al 1-800-325-4368 al Centro de Servicio de Colonial Life & Accident Insurance Company y hablar con un representante biling0e. Colonial Life esta a su disposicion para informarle en su idioma. Colonial Life 1200 Colonial Life Boulevard Columbia, SC 29210 ColonialLife.com FAX 800.880.9325 Phone 800.845.7330 Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 281 DUPLICATE We hope this letter explains our evaluation of this claim. If you believe our understanding of the facts is incorrect, or if you have additional information that could impact the decision, you may go online and ask us to reconsider the claim. Reconsideration will require you to upload new information. The Claims Specialist will review it and notify you whether the claim decision has changed. If you have new information you want us to consider, please upload it as soon as possible by visiting our online claims portal: ColonialLife.com/claims. You can also find the most up-to-date information on your existing claims as well as quickly file new claims on the portal. Regardless of whether you request reconsideration, you have the right to appeal the decision within 180 days from the date of this letter. Please note any reconsideration is considered part of the same 180-day appeal period. An appeal is your written disagreement with our claim decision and a request for review of that decision by an Appeals Specialist. You will need to submit a written letter of appeal outlining the basis of your disagreement and include any additional information you want us to consider. This information may include written comments, documents, or other information in support of your appeal. You must submit the appeal request to the address below within 180 days from the date of this letter. You can do so by visiting our online claims portal: ColonialLife.com/claims Electronic access allows you to: • Go paperless and choose online correspondence • View the status of your claim and provide us with updated claim information • Keep us up to date on any changes to your current address and telephone number You may also fax additional information to 1-800-880-9325 or mail to Colonial Life & Accident Insurance Company Claims Department, PO Box 100195, Columbia, SC 29202. An Appeals Specialist will review the entire claim, including any new information you submitted, and may also consult medical experts or other resources. The Appeals Specialist will make an independent decision on the claim. If we do not receive your written appeal within 180 days from the date you receive this letter, our claim determination will be final. Sincerely, Claims Department Colonial Life & Accident Insurance Company Reference: R1 HRC Enclosure(s): Privacy Notice Form Translation Options Form 282 DUPLICATE You can file new claims, manage existing claims, locate forms and find answers to common questions any time by visiting ColonialLife.com. For additional assistance or automated phone services, contact our Customer Service Center at 1-800-325-4368. Service specialists are available Monday - Friday, 8 a.m. - 8 p.m., ET. For Claims Reconsideration Colonial Life & Accident Insurance Company Claims Department PO Box 100195 Columbia, SC 29202 For Claims Appeals Colonial Life & Accident Insurance Company Appeals Unit PO Box 100284 Columbia, SC 29202-3195 283 DUPLICATE 284 DUPLICATE • • • unum Privacy Notice This Privacy Notice applies to Unum Group's United States insurance operations and is being provided on behalf of its affiliates listed below ("Unum" "we"), as required by the Gramm -Leach Bliley Act and state insurance laws. This Notice describes how we collect, share, and protect nonpublic personal information (NPI). COLLECTING INFORMATION We collect NPI about our customers to provide them with insurance products and services, perform underwriting, provide stop loss coverage, and administer claims. The types of NPI we collect for these purposes may include telephone number, address, Social Security number, date of birth, occupation, income, and medical history, including treatment. We may receive NPI from your applications and forms, medical providers, other insurers, employers, insurance support organizations and service providers. SHARING INFORMATION We share the types of NPI described above primarily with people who perform insurance, business and professional services for us, such as helping us perform underwriting, provide stop loss coverage, pay claims, detect fraud, and to provide reinsurance or auditing. We may share NPI with medical providers for insurance and treatment purposes and with insurance support organizations. The organizations may retain the NPI and disclose it to others for whom it performs services. In certain cases, we may share NPI with group policyholders for reporting and auditing purposes, with parties for a proposed or final sale of insurance business or for study purposes. We may also share NPI when otherwise required or permitted by law, such as sharing with governmental or other legal authorities. When legally necessary, we ask your permission before sharing NPI about you. Our practices apply to our former, current and future customers. We do not share your health NPI to market any product or service. We also do not share any NPI to market non -financial products and services. The law allows us to share NPI as described above (except health information) with affiliates to market financial products and services. The law does not allow you to restrict these disclosures. We may also share with companies that help us market our insurance products and services, such as vendors that provide mailing services to us. We may share with other financial institutions to jointly market financial products and services. When required by law, we ask your permission before we share NPI for marketing purposes. When other companies help us conduct business, we expect them to follow applicable privacy laws. We do not authorize them to use or share NPI except when necessary to conduct the work they are performing for us or to meet regulatory or other governmental requirements. Unum companies, including insurers and insurance service providers, may share NPI about you with each other. The NPI might not be directly related to our transaction or experience with you. It may include financial or other personal information such as employment history. Consistent with the Fair Credit Reporting Act, we ask your permission before sharing NPI that is not directly related to our transaction or experience with you. 285 DUPLICATE SAFEGUARDING INFORMATION We have physical, electronic and procedural safeguards that protect the confidentiality and security of NPI. We give access only to employees who need to know the NPI to provide insurance products or services to you. ACCESS TO INFORMATION You may request access to certain NPI we collect to provide you with insurance products and services. You must make your request in writing, providing your full name, address, telephone number and policy number, to the address below. We will reply within 30 business days of receipt. If you request, we will send copies of the NPI to you or make available to you at our office. If the NPI includes health information, we may provide the health information to you through a health care provider you designate. We will also send you information related to disclosures. We may charge a reasonable fee to cover our copying costs. This section applies to NPI we collect to provide you with coverage. It does not apply to NPI we collect in anticipation of a claim or civil or criminal proceeding. CORRECTION OF INFORMATION If you believe the NPI we have about you is incorrect, please write to us and include your full name, address, telephone number and policy number if we have issued a policy, and the reason you believe the NPI is inaccurate. We will reply within 30 business days of receipt. If we agree with you, we will correct the NPI and notify you and insurance support organizations that may have received NPI from us in the preceding 7 years. We will also, if you ask, notify any person who may have received the incorrect NPI from us in the past 2 years. If we disagree with you, we will tell you we are not going to make the correction and the reason(s) for our refusal. We will also tell you that you may submit a statement to us. Your statement should include the NPI you believe is correct and the reason(s) why you disagree with our decision not to correct the NPI in our files. We will file your statement with the disputed NPI to be accessible. We will include your statement any time the disputed NPI is reviewed or disclosed. We will also give the statement to insurance support organizations that gave us NPI and to any person designated by you, if we disclosed the disputed NPI to that person in the past two years. COVERAGE DECISIONS If we decide not to issue coverage to you, we will provide you with the specific reason(s) for our decision. We will also tell you how to access and correct certain NPI. You may submit a written request for the reason(s) for our decision within 90 business days of our decision. We will reply within 21 business days of receipt with the specific reasons, if not initially furnished, and specific items of information that supported our decision. CONTACTING US For additional information about Unum's commitment to privacy and to view a copy of our HIPAA Privacy Notice, please visit: unum.com/privacy or coloniallife.com. You may also write to: Privacy Officer, Unum, 2211 Congress Street, B267, Portland, Maine 04122 or at Privacy@unum.com. We reserve the right to modify this notice. We will provide you with a new notice if we make material changes to our privacy practices. Unum is providing this notice to you on behalf of the following insuring companies: Unum Life Insurance Company of America, Unum Insurance Company, First Unum Life Insurance Company, Provident Life and Accident Insurance Company, Provident Life and Casualty Insurance Company, Colonial Life & Accident Insurance Company, The Paul Revere Life Insurance Company and Starmount Life Insurance Company. © 2020 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. unum.com MK-1883 (06-2020) 2 286 DUPLICATE Translation Options Spanish: To obtain assistance in Spanish, call 1-800-325-4368. Para obtener asistencia en Espanol, Ilame al 1-800-325-4368. Chinese: To obtain assistance in Chinese, call 1-800-325-4368. (Et) : ttuWAROD PA, ili 1-800-325-4368. l ^ s3 Tagalog: To obtain assistance in Tagalog, call 1-800-325-4368. Kung kailangan ninyo ngtulongsa Tagalog, tumawag sa 1-800-325-4368. Navajo: To obtain assistance in Dine, call 1-800-325-4368. Dinek' ehgo shika at' ohwol ninisingo, kwiijigo holne' 1-800-325-4368. 287 3-18 1101878 DUPLICATE 288 DUPLICATE PO Box 100195 Columbia SC 29202 Bot lacc 123 Test Street Test SC 29072 Please see the attached letter for an explanation of these benefits. Please fold and tear along this perforated line 12/07/2020 T007029-3007029 51-44/119 PAY Eight Hundred Ninety -Eight Dollars And No/100 $898.00 To The Order Of Bot lacc Ref: Bot lacc 123 Test Street 03796104620010 Test SC 29072 Void After 1 Year Bank of America Hartford, CT <3007029< : 011900445: 9A0000068225< DUPLICATE 290 DUPLICATE PO Box 100195 Columbia SC 29202 Payee Name: Bot lacc Claim Submitted For: Bot lacc Date of Claim Event: 06/01/2019 Claim Number: 03796104620010 980855712 Payment Date: 12/07/2020 Below is an explanation of this Benefit Paid Laceration Acc Injury/Auto Acciden Acc Emergency Treatment Medical Imaging Study X-Ray Acc F/U Trmt/Telemed claim's status and the benefits this payment provides. Payment Rate Flat 250.00 /trtmt Flat 300.00 /trtmt Date(s) 06/01/19 06/01/19 06/01/19 06/15/19 06/01/19 06/07/19 Total Amount of Payment During the processing of this claim, the following policies were considered for possible benefits: 3796104620 The accident policy provides the Accident Follow -Up Treatment/Telemedicine benefit when a covered person: • Requires transportation (bus, car, or taxi) for follow-up treatment (other than occupational, speech, or physical therapy); or • Uses telemedicine after a covered accident. Treatment must be provided by a physician for injuries received as the result of a covered accident in an emergency room, urgent care, or doctor's office. Telemedicine service is also covered. Treatment must be completed within 365 days after the covered accident. The maximum number of visits is 6 per covered accident and 12 per calendar year. This payment represents 1 of the 6 visits for this accident. The accident policy provides a Coma benefit when certain requirements are met. The coma must be the result of a severe traumatic brain injury due to a covered accident, and it must require intubation for respiratory assistance. Coma means a continuous state of profound unconsciousness lasting for a period of 7 or more consecutive days and characterized by the absence of: • Eye opening, • Motor response, and Para obtener ayuda en esparto!, puede Ilamar gratis al 1-800-325-4368 al Centro de Servicio de Colonial Life & Accident Insurance Company y hablar con un representante bilingue. Colonial Life esta a su disposicion para informarle en su idioma. Amount 120.00 250.00 125.00 300.00 48.00 55.00 $898.00 Colonial Life 1200 Colonial Life Boulevard Columbia, SC 29210 ColonialLife.com FAX 800.880.9325 Phone 800.845.7330 Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 291 DUPLICATE • Verbal response The term "coma" does not include any medically induced coma. To help us promptly process your claim, please submit all of the information requested below so that we may review for any additional benefits that may apply. Copies of the physical therapy bills related to this accident. If you disagree with our decision, you have the right to request that we reconsider the decision. If you have new information you want us to consider, you need to send it to us as soon as possible. The Claim Specialist who made the initial decision will review the claim again taking the new information into consideration. You should fax your new information to: Colonial Life & Accident Insurance Company PO Box 100195 Columbia SC 29202 Fax Number: 1-800-880-9325 Sincerely, Claims Department Colonial Life & Accident Insurance Company Reference: E91692100000 E2 SLV Cheryl Test Grp Prod Dev Policies paid for with post -tax dollars (dollars already taxed) result in benefit payments that are not reported to the IRS as potential income. Policies paid for with pre-tax dollars (dollars not yet taxed) or employer paid dollars may result in benefit payments that are reportable to the IRS; however, generally, Colonial Life is not required to report: • Death benefit payments; • Payments or reimbursements of medical expenses that were not covered by your health insurance program; • Payments for specific permanent injuries (such as the loss of the use of an arm or leg). While Colonial Life may not be required to report the amount paid to you, you may be required to report this amount on your federal income tax return. Please consult your own tax or legal advisor. For more information, please see Page 5 of IRS Publication 15-B (2017) at https://www.irs.gov/pub/irs-pdf/p15b.pdf . If you need further assistance, please call our Customer Service Center 1-800-325-4368. We offer web services at ColonialLife.com so you can: • File a claim • Request direct deposit of a claim • Receive the current status of a claim • Change your mailing address • Get forms 292 DUPLICATE These features are available 24 hours, every day of the year, and do not require that you speak to a service specialist. If you need to speak with a service representative, we recommend you call early in the day or later in the afternoon on Tuesdays, Wednesdays or Thursdays to avoid wait times associated with our peak calling periods. Service representatives are available Monday through Friday, 8:00 a.m. - 8:00 p.m., EDT. Enclosure(s): Privacy Notice Form 293 DUPLICATE 294 DUPLICATE 295 DUPLICATE 296 DUPLICATE PO Box 100195 Columbia SC 29202 New Ci Case 1234 Colonial Life Way Columbia SC 29212 Please see the attached letter for an explanation of these benefits. Please fold and tear along this perforated line 12/11/2020 T007043-3007043 51-44/119 PAY Seven Thousand, Five Hundred Dollars And No/100 $7,500.00 To The Order Of New Ci Case Ref: New Ci Case 1234 Colonial Life Way 03796001900010 Columbia SC 29212 Void After 1 Year Bank of America Hartford, CT <3007043< : 011900445: p0000068225< DUPLICATE 298 DUPLICATE PO Box 100195 Columbia SC 29202 Payee Name: New Ci Case Claim Submitted For: New Ci Case Date of Claim Event: 06/18/2017 Claim Number: 03796001900010 980843505 Payment Date: 12/11/2020 Below is an explanation of this claim's status and the benefits this payment provides. Benefit Paid Payment Rate Date(s) Amount Coronary By -Pass Main I 06/18/17 7500.00 Total Amount of Payment $7,500.00 During the processing of this claim, the following policies were considered for possible benefits: 3796001900 Your policy provides the Coronory Artery Bypass Graft Benefit once per covered individual. This payment represents the maximum amount payable for the Coronory Artery Bypass Graft Benefit. If you disagree with our decision, you have the right to request that we reconsider the decision. If you have new information you want us to consider, you need to send it to us as soon as possible. The Claim Specialist who made the initial decision will review the claim again taking the new information into consideration. You should fax your new information to: Colonial Life & Accident Insurance Company PO Box 100195 Columbia SC 29202 Fax Number: 1-800-880-9325 Sincerely, Claims Department Colonial Life & Accident Insurance Company Reference: E99831230000 Gmb Er 35PCT Gi Goal Met E2 MCF If you need further assistance, please call our Customer Service Center 1-800-325-4368. We offer web services at ColonialLife.com so you can: • File a claim Para obtener ayuda en esparto!, puede Ilamar gratis al 1-800-325-4368 al Centro de Servicio de Colonial Life & Accident Insurance Company y hablar con un representante bilingue. Colonial Life esta a su disposicion para informarle en su idioma. Colonial Life 1200 Colonial Life Boulevard Columbia, SC 29210 ColonialLife.com FAX 800.880.9325 Phone 800.845.7330 Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 299 DUPLICATE • Request direct deposit of a claim • Receive the current status of a claim • Change your mailing address • Get forms These features are available 24 hours, every day of the year, and do not require that you speak to a service specialist. If you need to speak with a service representative, we recommend you call early in the day or later in the afternoon on Tuesdays, Wednesdays or Thursdays to avoid wait times associated with our peak calling periods. Service representatives are available Monday through Friday, 8:00 a.m. - 8:00 p.m., EDT. Enclosure(s): Privacy Notice Form We have provided benefits based on our understanding of the circumstances of your claim event, the medical information received and the policy provisions. If you have any questions or concerns about how these benefits were determined, please call us or send us written clarification. 300 DUPLICATE 301 DUPLICATE 302 DUPLICATE PO Box 100195 Columbia SC 29202 Do more online! File Claims, check claims status and upload documents. Visit ColonialLife.com/claims Para obtener ayuda en esparto!, puede Ilamar gratis al 1-800-325-4368 al Centro de Servicio de Colonial Life & Accident Insurance Company y hablar con un representante bilingiie. Colonial Life esta a su disposicion para informarle en su idioma. Colonial Life 1200 Colonial Life Boulevard Columbia, SC 29210 ColonialLife.com FAX 800.880.9325 Phone 800.845.7330 Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. Colonial Life & Accident Insurance Company PO Box 100195 Columbia SC 29202 Sincerely, Claims Department Colonial Life & Accident Insurance Company Reference: E2 JRH Enclosure(s): Privacy Notice Form You can file new claims, manage existing claims, locate forms and find answers to common questions any time by visiting ColonialLife.com. For additional assistance or automated phone services, contact our Customer Service Center at 1-800-325-4368. Service specialists are available Monday - Friday, 8 a.m. - 8 p.m., ET. Colonial Life & Accident Insurance Company Claims Department PO Box 100195 Columbia, SC 29202 Fax: 1-800-880-9325 304 PO Box 100195 Columbia SC 29202 Oregon Accfourthousand PO Box 1365 Columbia SC 29202 Please see the attached letter for an explanation of these benefits. Please fold and tear along this perforated line 12/09/2020 T007038-3007038 51-44/119 PAY One Hundred Dollars And No/100 $100.00 To The Order Of Oregon Accfourthousand Ref: Oregon Accfourthousand PO Box 1365 03796282740010 Columbia SC 29202 Void After 1 Year Bank of America Hartford, CT <3007038< : 011900445: QA0000068225< DUPLICATE 306 DUPLICATE PO Box 100195 Columbia SC 29202 Payee Name: Oregon Accfourthousand Claim Submitted For: Oregon Accfourthousand Date of Claim Event: 05/10/2017 Claim Number: 03796282740010 980854456 Payment Date: 12/09/2020 Below is an explanation of this claim's status and the benefits this payment provides. Benefit Paid Payment Rate Date(s) Amount Wellbeing Assist Standa Flat 100.00 /trtmt 05/10/17 100.00 Total Amount of Payment During the processing of this claim, the following policies were considered for possible benefits: 3796282740 $100.00 The accident policy provides a Wellbeing Assistance benefit that covers the specific preventative tests listed in the policy. The maximum benefit is one day per covered person per calendar year. This payment represents the maximum yearly benefit for calendar year 2017. As the maximum benefit has now been paid, it is not necessary to submit charges for any additional tests. Policies paid for with post -tax dollars (dollars already taxed) result in benefit payments that are not reported to the IRS as potential income. Policies paid for with pre-tax dollars (dollars not yet taxed) or employer paid dollars may result in benefit payments that are reportable to the IRS; however, generally, Colonial Life is not required to report: • Death benefit payments; • Payments or reimbursements of medical expenses that were not covered by your health insurance program; • Payments for specific permanent injuries (such as the loss of the use of an arm or leg). While Colonial Life may not be required to report the amount paid to you, you may be required to report this amount on your federal income tax return. Please consult your own tax or legal advisor. For more information, please see Page 5 of IRS Publication 15-B (2017) at https://www.irs.gov/pub/irs-pdf/p15b.pdf . If you need further assistance, please call our Customer Service Center 1-800-325-4368. We offer web services at ColonialLife.com so you can: • File a claim Para obtener ayuda en esparto!, puede Ilamar gratis al 1-800-325-4368 al Centro de Servicio de Colonial Life & Accident Insurance Company y hablar con un representante bilingue. Colonial Life esta a su disposicion para informarle en su idioma. Colonial Life 1200 Colonial Life Boulevard Columbia, SC 29210 ColonialLife.com FAX 800.880.9325 Phone 800.845.7330 Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 307 DUPLICATE • Request direct deposit of a claim • Receive the current status of a claim • Change your mailing address • Get forms These features are available 24 hours, every day of the year, and do not require that you speak to a service specialist. If you need to speak with a service representative, we recommend you call early in the day or later in the afternoon on Tuesdays, Wednesdays or Thursdays to avoid wait times associated with our peak calling periods. Service representatives are available Monday through Friday, 8:00 a.m. - 8:00 p.m., EDT. Sincerely, Claims Department Colonial Life & Accident Insurance Company Reference: E32884200000 Gmb7000 Or Integrated El MCF 308 DUPLICATE 309 DUPLICATE 310 DUPLICATE We understand what that claim represents - a request for help and the expectation of a promise kept. We are here when our policyholder needs us most. Our claims professionals work diligently to ensure that every policyholder receives all the benefits to which they are entitled, not just those submitted, when filing a claim. And they do so quickly. With advancements to our online claims process coupled with direct deposit capabilities, our processing time is consolidated to days and not weeks. Approximately 800,000 claims are filed every year, paying out more than $35 million in benefits during a given month. Staffed with 200 employees, or Claims Department is the heart of our business. These highly trained employees are dedicated to knowing and understanding our customers' needs so they can go the extra mile to exceed expectations. Colonial Life MOST CLAIMS ARE PROCESSED THE DAY WE RECEIVE THEM While some carriers start measuring turnaround time once "all required claim documentation is received," we start our clocks as soon as the initial claim is received. We resolve nine out of 10 claims within 10 working days. • 90% of claims filed electronically are processed in 5 business days or less o 80% in 2 days o Over 60% in 1 day • 95% of wellness claims in 2 days or less, which is better than our key competitor Colonial Life, Internal Data, 2020 02020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a ColonialLife.com registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 311 We aim to deliver an excellent customer experience that is simple, modern and personal. There are two quick and easy ways to connect with us: POLICYHOLDER • File a claim, review claim details and check the current status of a claim. • File a wellness claim. • View active policies and understand benefit coverage. • Update personal Information and account Information Including E-Consent and Direct Deposit. • Make online payments. PLAN ADMINISTRATOR • Simplify account administration with a suite of online services such as deduction file submission, online bill, bill payment and employee administration. • Email questions or requests directly to the Plan Administrator Service Center, 24 hours a day, 7 days a week. • Download claim forms and request for service forms. • Access CCH HRAnswersNow®, a specialized website that contains information on human resources policies and guidelines, tools and checklists, as well as the most up-to-date state and federal laws and regulations. Colonial Life.. ColonialLife.com ONLINE CLAIMS With our eClaims feature, spend less time on paperwork and process your claim faster. • From ColonialLife.com, file claims from any device. It's fast, easy and available 24/7. • Select direct deposit to receive your benefit payment faster. • Easily submit additional documents. ©2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 312 Offering voluntary benefits to your employees shouldn't add to your workload. That's why we make doing business with us as quick, simple and easy as possible - saving you valuable time and energy with fewer clicks and more control. Our online billing and administration services are designed with plan administrators in mind. DEDUCTION FILE SUBMISSION This quick and easy service enables us to reconcile your bill electronically. ONLINE BILL RECONCILIATION + BILL PAYMENT View, print and download your due, past due, scheduled or paid bills. Pay your invoice online. Reconcile your invoice online, in real-time. EMPLOYEE ADMINISTRATION Easily search at the employee level and view information such as policy status, coverage effective dates and policy/coverage type. You can review and update employee details, view and change employee coverage or enter upcoming employee leave of absence information. HRAnswersNow° As a member of our website, you receive access to HRAnswersNow, an online resource designed by HR professionals and managed by Wolters Kluwer, a market -leading global information provider. Here you will find industry knowledge, sample policies and expert advice. Colonial Life bin• Our commitment to simplifying account management continually earns us top honors for customer service, as well as consistent praise from our customers. ©2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a ColonialLife.com registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 313 Flexible billing options Monthly, semi-monthly, bi-weekly, weekly, or eight-, nine- or ten-month billing options, we will work with you to determine the payment frequency that best aligns with your deduction/payroll schedule. Through our flexible billing system, you can pay all your Colonial Life premiums through one payroll slot, if you choose. Electronic data transmission provides simple, thorough electronic transfer of benefit enrollment elections from our enrollment system to your payroll system. This provides quicker confirmation of elections and deductions, and a more accurate first bill. Quickly and easily view and pay your premium bill online through the My Account Administration website. Electronically reconcile your deductions with the file submission, self -billing service. After we reconcile your bill, a Deduction Change Report is sent electronically to communicate any deduction changes that need to be made. To safeguard fraud or billing irregularities, we audit first bills and conduct independent and random ongoing billing reconciliation and discrepancy resolution audits. Colonial Life, ColonialLife.com INDIVIDUAL PAY OPTIONS Most of Colonial Life's products are convertible to an individual pay basis. When employees leave your employment or decide to discontinue paying premiums through payroll deduction, they may continue certain coverage with no increase in premium by paying Colonial Life directly. When we're notified of an employee leaving employment, we will offer the employee the opportunity to continue coverage on an individual basis. We will provide the employee various payment options such as online payment, monthly bank draft or a quarterly, semi-annually or annually direct bill. Employees can contact their Colonial Life Benefits Counselor or call the Colonial Life Service Center at (800) 325-4368 to discuss continuing coverage. ©2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 314 Electronic deduction services Our Electronic Deduction Load (EDL) service is available at no cost to help make doing business with us easier. • Eliminate administration time by sending the electronic payroll file and your Colonial Life premium -- we handle the rest! • Improve accuracy and reduce billing errors associated with a manual payment process. • Quicker bill reconciliation equals quicker claims payment. During the four weeks between the end of an enrollment period and the plan effective date, we send the electronic deduction file. A file can be sent once a month if there are significant new hires. We compile the deduction data and then transmit it to you via the Secure File Transfer tool on our My Account Administration website. Easily add and update employee deductions with this electronic file that can be uploaded to your payroll system. Reduce clean-up after the enrollment by quickly matching the deductions in the billing system. Note any discrepancies that exist between the file and our system for more accurate administration. Our free bill payment service allows you to electronically remit your premiums to Colonial Life. Once the payment and file are received, we can process the bill payment. Colonial Life PAYROLL DEDUCTIONS We're extremely flexible regarding the deduction files we can accept and there are no file submission fees. The only fields we require are: • Employee name • Social Security number or unique employee ID number • Deduction amount Though not required, we encourage the inclusion of data for termination information, deduction date and pretax/post-tax indicators. We accept a variety of file formats, but PRN files or .TXT files work best. Unfortunately, we cannot accept read-onlv files. such as a PDF. ©2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a ColonialLife.com registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 315 Financial Reporting & Records Colonial Life 316 ••1,I• Colonial Life Financial Reporting & Records Recent Improvements/Successful Application of Proposed Approach At Colonial Life we offer more than just insurance that is of value to our customers. Valuable services such as enrollment and employee education services, benefits enrollment technology, and non-traditional benefits that we call Programs. Below are examples of some of these valuable services and what our customers had to say about them. Enrollment Services Private Company: "Our employees really valued being able to sit down with a Colonial Life benefits counselor to help them understand and enroll in the benefits program. Colonial Life has positively enhanced our employee's experience in moving medical carriers. We appreciate your partnership and support." City: "A holistic employee benefits offering — one that protects and enhances an employee's life, beyond traditional health insurance — can positively impact employee engagement." School: By combining voluntary benefits with our trusted partner network, we helped create a more robust benefits offering. Employees attending a 1-to-1 benefits counseling session received access to the Candidly student loan repayment program with Public Service Loan Forgiveness support. Additionally, our Funded Flex program was used to manage the administration of the Flexible Spending Account (FSA). Any employee transitioning from the prior carrier was given credit for time insured, allowing for a seamless continuation of coverage. Employee engagement improved, warranting an extension of the enrollment period to accommodate increased interest in our voluntary benefits and value-added program. Dependable Highway Express: We achieved 100% employee participation. Rather than treating enrollment technology as an add -on service, we paired it with our 1-to-1 benefits counseling services. This personal, consultative approach helped boost participation levels and educated employees on any gaps in knowledge or coverage. Regardless of the delivery method, we remain focused on helping employees make the best decisions to protect themselves and their families. Utilities company: We drastically improved employee financial protection. We enrolled $4.5 million of core coverage, and nearly 60% of employees added voluntary benefits. We enhanced employee experience, and 96% of employees were satisfied with their benefits counseling. Nearly 90% said it improved their understanding of benefits. Non -Traditional Benefits We can typically offer one of the programs listed below without impacting your budget in addition to our voluntary insurance products for one year as a new Colonial Life account. Since no particular programs were requested in the RFQ, we will be happy to work with City to determine which option would bring the most value to the City and its employees. Some programs listed below require Underwriting approval. • Pet Insurance • ID Theft • Legal Services This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 317 ••1,I• Colonial Life • Financial Wellness • Discount Programs • Student Loan Management HIPAA Compliance Colonial Life remains committed to strict compliance with both federal and state laws governing privacy and information security, and in particular, any and all laws related to the Health insurance Portability and Accountability (HIPAA) Act. This further includes the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and any associated privacy provisions applicable to our business. However, please note that the majority of Colonial Life's products are exempt from HIPAA mandates. For example, Short Term Disability, Life, Supplemental Disability, Accident and Critical Illness coverages are excluded from the H IPAA privacy regulations. Privacy and Confidentiality Affirmation Colonial Life affirms that we will develop, adopt, and implement standards to safeguard the privacy and confidentiality of all personal information about eligible employees and members of the Program as required by applicable law. We have provided our corporate privacy and security information following this document. Please note that our corporate privacy and security policies and procedures have been implemented and apply to the references listed in Attachment B, Reference Submittal Form and all of our clients and customers as applicable by law. Federal Income Tax Withholdings If the insureds' premiums are paid under a flexible benefits plan with pre-tax dollars, or if the employer pays part or all of the premiums, some of these benefits may be taxable. If the benefits are taxable, the insured may receive a 1099 from Colonial Life and/or a W-2 form from the employer that will indicate the amount the insured should report as taxable income to the IRS. If the insured has any questions about the taxability of benefits, the insured should discuss with the employer or their tax representative. This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 2016 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 318 • • • unum® Information Security Program Unum Group (unum.com) is a leading provider of financial protection benefits in the United States and our portfolio includes disability, life, accident, critical illness, cancer, dental and vision coverage, which help protect millions of working people and their families in the event of an illness or injury. OUR COMMITMENT Unum understands that the confidentiality, integrity, and availability of our customers' information are keys to its overall business success. Unum's Information Security Risk Management team partners with Unum's Privacy Office to ensure that customer information is protected from unauthorized access, disruption, modification, or destruction, and that Unum is compliant with all applicable privacy laws and regulations pertaining to the collection, use and disclosure of customer information both in UK and US. Unum's Information Security Program as outlined below is based on international regulatory requirements and industry best practices such as NIST and ISO 27001/27002. Oversight for Unum's Information Security Program is provided by the Global Chief Information Security Officer. © 2021 Unum Group. All rights reserved. Unum is a registered trademark Information Security Program I 1 and marketing brand of Unum Group and its insuring subsidiaries. (10/21) 319 POLICIES AND RISK MANAGEMENT Unum has comprehensive Information Security Policies which are prominently placed on the Company intranet. Mandatory privacy and information security training is provided to new hires as part of the onboarding program and existing employees on an annual basis as well as through various types of targeted training based on business and compliance need. Employees are required to manage personal data responsibly and in compliance with applicable privacy laws and existing company policies. Unum's Information Security Risk Management team implements, maintains and monitors a comprehensive suite of controls spanning governance, policies, standards, procedures and multiple layers of technical defenses. INFORMATION & DATA PROTECTION As part of enterprise risk management framework for data protection, Unum employs a Chief Privacy Officer who has the responsibility for Data Privacy. All business data provided to Unum by our customers is treated as confidential. Our email system leverages secure protocol exchange wherever possible and has additional capability to encrypt confidential or secret data as required by information security and privacy policies. Data Loss Prevention and monitoring tools help secure possible exfiltration points. Unum operates using clean desk principles and has secure print release in place. SECURE DATA CENTER Unum's primary and recovery data centers are located in Columbia, South Carolina and Alpharetta, Georgia, respectively. Unum's data center controls include: • 24-hour manned security, including foot patrols and perimeter inspections • Two-part access authentication - Biometric scanning and access card • Video surveillance throughout facility and perimeter • Building engineered for local seismic, storm, and flood risks • Tracking of asset removal . Humidity and temperature control Underground utility power feed Redundant CPS/UPS systems Redundant power distribution units (PDUs) Redundant diesel generators with on -site diesel fuel storage Redundant internal networks High bandwidth capacity Fire detection and suppressions systems 320 Information Security Program 12 NETWORK SECURITY Unum takes a multi -layered approach to data security throughout our computing environment. This strategy limits access to sensitive systems and data, while simultaneously containing any failures or vulnerabilities that may be exploited. • Unum employs dual firewalls at each ingress\ egress point to the Internet. Each of these points has a DMZ (demilitarized zone) which acts to buffer production data and resources from external threats. • Unum has also implemented Network Intrusion Detection and Prevention systems which are monitored 24x7 by a Managed Security Service's Network Operations Center. • Unum has implemented Host -Based Intrusion Sensors on critical host servers within the DMZ and on the internal network. These sensors are monitored by Unum's Enterprise Information Security Risk Management team. • State-of-the-art tools filter malicious email and web traffic and block unauthorized access to servers and workstations • Anti -virus and other information security hygiene tools are deployed at multiple layers • Patching processes and tools ensure the environment is updated in a proactive and timely manner Threat intelligence is monitored and acted upon by our Network Security and Vulnerability Management team within Enterprise Information Security Risk Management, supported by the expertise of an industry - leading managed security monitoring service. Unum partners with our security vendors, other businesses and industry recognized specialist organizations to share information about cyber threats. Unum routinely engages independent specialists to test and assess our capabilities to continue to strengthen our information security program, stay current, and respond effectively to emerging threats. See examples below. • Configuration standards for servers and systems are defined in formal procedures with default system accounts disabled • Secure, remote access for authorized individuals, via VPN, requires two -factor authentication • Industry -leading network access controls prevent unauthorized devices from connecting to our network • Our System Development Life Cycle is supported by an established project methodology, formal and robust change/release/incident management processes and static/dynamic code scanning • Third -party tools routinely scan the internal network and external perimeter to detect vulnerabilities and identify any malicious activity • Independent penetration testing and additional security assessments make sure our infrastructure/applications are highly resilient to attacks ACCESS MANAGEMENT All assets and user access are authorized through a centralized process granting minimum access necessary to perform the job function (least privilege). New hires, role changes and terminations are managed through processes linking our HR system with the IT service desk. Access is allocated based on job requirements and removed upon termination. Unum's access policies demonstrate strong password standards including minimum length, complexity, enforced changes, no password re -use, and account locking. Administrative access is tightly controlled and monitored with privileged accounts using a privileged account management and vaulting solution. All access is reviewed according to existing access policies with dormant accounts flagged for investigation. SECURE TRANSMISSIONS Industry standard encryption is required for all connections to Unum's environment and for all customer data transmitted over public networks. Information Security Program 13 321 CHANGE MANAGEMENT Unum uses automated processes to help ensure changes are authorized, tested and approved before implementation into the production environment. Unum uses a change management application to track and record the movement of changes into the production environment. Unum also maintains development and acceptance environments to enhance control including segregation of duties. Authorized personnel are required to electronically sign off on a change prior to moving to production. An audit trail and historical record of production changes is available within the change management application; timing of migrations consistent with business and systems needs are automatically checked against approved windows. The change management application tool verifies all necessary approvals are obtained for all changes prior to setting the change to an approved state. Also, other various enterprise standards and audit requirements are enforced. THIRD -PARTY RISK MANAGEMENT Unum continually looks at ways to work smarter, deliver value, and elevate the customer experience. As a result, Unum leverages external partners to help us work more efficiently, deliver new capabilities and access new technologies - all with a focus on delivering a truly exceptional customer experience. These partners are treated as an extension of Unum and have the same or higher expectations as our employees. Prior to entering these relationships, Unum performs risk -based assessments commensurate with the level of inherent risk. These assessments evaluate areas such as Privacy, Enterprise Risk Management, Information Security, Financial, and others as needed specifically focusing on controls, policies and practices. Ongoing due diligence is also risk -based and driven by the nature of the relationship and service characteristics. Also, our partners which may have access to Unum's sensitive personal information are required to sign contracts that include non -disclosure language and agreements and relevant security requirements. The standard for assurance during the assessments is confidential/sensitive information is protected as well in the third-party's environment as it would be inside Unum's environment. ONGOING EFFECTIVENESS To ensure that our Information Security Program and specifically Unum's IT General Controls are effective and meet current industry standards, Unum continues to perform evaluations internally or by contracting with Global Leading Consulting firms for the following: • Ongoing testing of Unum's business processes, applications and technical controls; • Ongoing testing of SOX related controls across all financial processes, application and systems; • Quarterly, annual Independent testing of Unum's financial and technical controls; • Annual completion of SOC 1 and SOC 2, Type II reports; • Additional Targeted Assessments completed historically: • Network Security Tests (Ext/Int) • Depth in Defense Maturity Analysis • Phishing & Social Engineering Tests • Wireless Security Assessment • Information Security Assessment • Threat Vulnerability Testing • Cyber Security Readiness • Global Info Sec Program Assessment • Privacy & Info Risk Assessment Information Security Program 14 322 BUSINESS RESILIENCY Unum takes many precautions to minimize the potential for a computer system outage and to ensure that critical business systems are available to support its customers. While prudent steps have been taken to minimize or mitigate the risks, disasters can happen, and Unum maintains a recovery data center and documented plans which will be activated when necessary. Our comprehensive framework covers loss of facilities, people, and technology. Our incident management processes follow best practices, including the handling of security breaches according to clearly defined protocols using external specialists if needed. The framework and plans are regularly reviewed and tested for ongoing effectiveness and alignment with industry best practice providing assurances of our commitment to both protecting information and maintaining our high quality of service. Unum leverages a co -location facility to augment its existing infrastructure capabilities with a focus on cloud connectivity, diverse redundant circuits with burstable bandwidth, isolation of internet from data center traffic, and next generation firewalls. Unum continues to invest in foundational capabilities which increase our capacity to meet customer needs and provide stability. REGULATORY INFORMATION As a licensed insurance company, Unum is heavily regulated by a variety of state, federal and international entities, and subject by law to periodic examinations by federal and state regulators in which business is conducted. Extensive and comprehensive supervision and regulation applies to areas such as: • Claims handling • Policyholder service • Underwriting • Privacy • Information security • Producer licensing • Marketing practices • Policy and rate filing • Consumer complaint handling • Financial reporting and financial condition Laws and regulations are complex, subject to change and continually evolve. Unum has a robust internal system designed to aid us with compliance with applicable laws and regulations including accurate representation of our product and service offerings to customers and shareholders. Our philosophy is always to put customers first, and we make sure our products, and the customer information and service that go with them, are designed, written, and protected to meet customer needs. You can find read more at unum.com/privacy. Information Security Program 15 323 • • • unum® Global Information Security (GIS) Policies PURPOSE Global Information Security policies define the objectives and constraints for Unum's Information Security program. Each security policy describes information security objectives and strategies of an organization. The basic purpose of a security policy is to protect people and information, set the rules for expected behaviors by users, define, and authorize the consequences of violation. SCOPE These policies seek to address criteria required to meet Unum's Security Requirements satisfactorily. Deviations from these Policies require policy exceptions to be submitted, approved, and documented in the Unum system of record. © 2021 Unum Group. All rights reserved. Unum is a registered trademark and Global Information Security (GIS) I 1 marketing brand of Unum Group and its insuring subsidiaries. (10/21) 324 POLICIES ANTI -VIRUS The purpose of this policy is to reduce the risk of infection to Unum computers and computer systems by computer virus and other malicious code. The policy is intended to prevent major and widespread damage to applications, data, and hardware. APPLICATION ACCESS REVIEWS The purpose of this policy is to establish rules governing the ongoing review of application access. Periodic and regular access reviews are a security best practice and are required elements of certain regulatory acts. This policy coupled with appropriate standards and procedures provides a consistent and effective approach for the application access review process. APPLICATION ID ENTERPRISE The purpose of this Application ID Policy is to establish rules governing the use of application IDs (also known as "service accounts") at Unum. This Policy, coupled with appropriate standards and procedures, provides a consistent and effective approach for the use of application IDs. APPROPRIATE USE OF COMPANY ASSETS The purpose of this policy is to establish rules governing the use of Unum company assets including but not limited to various network systems, computing resources, telephones, and fax machines owned or leased by Unum that are provided to authorized Unum information users for business use. Computing resources include but are not limited to mainframe, midrange, desktop, e-mail systems, and Internet access. APPROPRIATE USE OF SOFTWARE ASSETS The purpose of this policy is to establish rules governing the appropriate use of Unum's software assets. Software, through its recognition as intellectual property, is automatically protected by federal copyright law from the moment of its inception. The license rules and regulations of vendors can vary greatly from vendor to vendor and it is necessary that Unum ensure compliance with those regulations. ASSET HARDENING The purpose of this policy is to demonstrate that Unum (the "Company") has committed to implementing and documenting asset configuration baselines according to industry standards. This Policy (the "Policy") describes appropriate requirements to ensure the confidentiality, integrity, audit logs, authenticity, and availability of systems and information provided by Unum. BRING YOUR OWN DEVICE (BYOD) ACCEPTABLE USE The purpose of this policy is to define standards, procedures, and restrictions for Approved Users who wish to connect a Personal Device to the Company's network for business purposes. Global Information Security (GIS) 12 325 CLOUD SERVICES The purpose of this policy is to establish governance of cloud storage services, that aligns with Unum's overall governance and policy framework and provides a basis to assure the privacy, confidentiality, integrity and availability of cloud systems and the data contained in these systems. Outline controls and safeguards that meet or exceed the regulatory and statutory requirements for controlled data (primarily PII, PHI) maintained by Unum. Ensure that the enforceable contractual requirements of Unum customers, business partners and stakeholders are being met or exceeded. Define responsibilities for administrators, users and suppliers of cloud storage services. COMMUNICATIONS The purpose of this Electronic Communications Policy (the "Policy") is to establish rules governing the acceptable use of email systems provided by Unum (the "Company"). All email messages and attachments delivered, received and stored in Company email systems are property of the Company. DATA CLASSIFICATION AND SECURITY The purpose of this policy is to appropriately and consistently protect information at all classifications and no matter what form it takes, what technology is used to process it, who handles it, where the information may be located, and what stage in its lifecycle (creation, production usage, archival storage, destruction, etc.) DIGITAL FORENSICS The purpose of this policy is to establish rules governing the appropriate handling of data and hardware for forensic use. DISPOSITION OF TERMINATED USER IDS The purpose of this policy is to establish rules governing the appropriate handling of terminated user IDs. This policy addresses issues related to system overhead, unauthorized reactivation of user IDs, and consistent documented policy and procedures for deletion of IDs. DORMANT MAINFRAME IDS The purpose of this policy is to establish rules governing the disposition of dormant mainframe user IDs at Unum. User IDs for Unum mainframe systems are assigned to all employees and contractors. When these IDs are left on the system in a dormant, or unused, state various problems can occur. Furthermore, dormant IDs may present security risks such as unauthorized access by another user, fraud, and sabotage. ELECTRONIC STORAGE MEDIA DISPOSAL AND SANITIZATION The purpose of this Policy is to assist with decision making when it is determined that electronic storage media requires disposal, will be reused, or will be leaving Unum Group's (the Company) effective control. These decisions should be never be made without the careful consideration and compliance with the policies and procedures established by Information and Records Management, including Information Protection Orders (IPOs), as well as other policy and procedures established by Global Information Security (GIS). Global Information Security (GIS) 13 326 EMERGENCY LOGON ID (EMER ID) USE The purpose of this policy is to establish rules governing the acceptable use of emergency logon IDs (EMER IDs) at Unum. EMER IDs are IDs whose passwords remain in revoked status and may be temporarily activated to address various situations, including emergency access to data to resolve problems impacting day to day business. They have a high level of authority to data, usually including the ability to delete data. ENCRYPTION The purpose of this encryption policy is to define the circumstances under which encryption must be used. It also provides guidance that limits the use of encryption to those algorithms that have received substantial public review and have been proven to work effectively. GENERIC USER IDS The purpose of this policy is to establish rules governing the acceptable use of generic user IDs. With the growing need to support testing and training needs and areas that experience a high turnover rate with temporary personnel, Unum will support the use of generic user accounts and training user accounts when all other access alternatives have been explored. Unum must ensure that employees understand the responsibilities associated with generic/training user accounts. INCIDENT RESPONSE AND REPORTING The purpose of this policy is to establish a protocol to guide a response to a computer incident or event impacting Unum's technical infrastructure or data. This Computer Incident Response and Reporting Policy (the "Policy") establishes rules governing the following incident response and reporting capabilities: • Responding to security incidents systematically so that the appropriate steps are taken; • Helping Unum personnel to recover quickly and efficiently from security incidents, minimizing loss or theft of information and disruption of services; • Document security incidents and their outcomes; • Using information gained during security incident handling to better prepare for handling future security incidents and to provide stronger protection for systems and data; and • Dealing properly with business and\or legal issues that may arise during security incidents. INTERNET USE AND SECURITY The purpose of this policy is to establish rules governing the acceptable use of Internet access provided by Unum. The company's Internet access is provided as a business tool and is to be used solely for business purposes. Limited, incidental personal use is allowed but is a privilege, and must be consistent with Company policy. Users of these tools are required to employ this resource in an efficient, ethical and lawful manner. INTRUSION DETECTION The purpose of this policy is to demonstrate that Unum has committed to the establishment of an intrusion detection and response program. The system itself will be maintained and monitored on a regular basis. This will provide Unum with one component of a layered defense approach for protecting the network and its associated infrastructure. Incident handling procedures have been established and will be followed to provide a means for proper handling of an electronic ticket. Global Information Security (GIS) 14 327 MANAGEMENT AND USE OF TRAINING COMPUTERS The purpose of this policy is to establish requirements for the management and use of training room PCs to ensure that information and technologies are not compromised, and that production services are protected from lab activities. MOBILE DEVICE SECURITY The purpose of this policy is to establish rules governing the acceptable use and security of all Unum mobile devices. Any individual assigned a Unum Mobile Device is responsible for the data stored, processed and/ or transmitted via that computer or device, and for following the Company's security requirements for information stored on these devices. NON -EMPLOYEE SYSTEMS ACCESS The purpose of this policy is to establish rules for governing how to determine access levels, request access, and revalidate access for non -employees. Strict security policies and procedures must be put in place to govern access for this class of user. The policy will also outline the role of the Sponsor. PATCH MANAGEMENT The purpose of this policy is to demonstrate that Unum has committed to the establishment of a patch management program. The system itself will be maintained and monitored on a regular basis. This will provide Unum with one component of a layered defense approach for protecting the network and its associated infrastructure. POLICY EXCEPTIONS The purpose of this document is to establish rules governing policy deviations and exceptions. This Policy, coupled with appropriate standards and procedures, provides a consistent and effective approach for risk associated with policy deviations and exceptions. PRIVACY The purpose of this policy is to outline how we handle and protect the personal information that we collect about individuals who obtain our products and services. It is every employee's obligation to read, understand and follow the Privacy Policy. Additional privacy requirements may apply to certain products and in certain states. However, this Privacy Policy applies generally to all products in all states unless otherwise modified or prohibited by a specific state or federal law or regulation. PRIVILEGED ACCESS The purpose of this policy is to establish rules governing the acceptable use of distributed privileged access user credentials. This is a fundamental policy that underlies many privileged access control policies and procedures. Inappropriate use of privileged access can be a major contributory factor to the failure or breach of systems. PUBLIC ACCESS The purpose of this policy is to establish rules governing the acceptable use of Public Access designations to Unum information in conjunction with the Data Classification Policy as well as regulatory authorities. Global Information Security (GIS) 15 328 REMOTE ACCESS The purpose of this policy is to establish rules governing the acceptable use of remote access provided by Unum. Remote Access allows users of the Unum network to access company systems, including email and data, while traveling or working from outside of the office. The company's remote access solutions are provided as business tools and are to be used solely for business purposes. REUSE OF USER IDS The purpose of this policy is to establish common, cross -platform guidelines for the consistent handling of deleted user IDs. ROBOTIC (BOT) IDS The purpose of this policy is to establish rules around the use of BOT IDs at Unum. SECURE SOFTWARE ASSURANCE The goal of this policy is to establish mandatory rules for software solutions so that Unum achieves the level of risk that is deemed effective to operate according to the strategic directives of the board and executive leadership. SHAREPOINT SECURITY GOVERNANCE Unum's SharePoint Governance Policy outlines the administration, maintenance, and support of Unum's SharePoint environments. It identifies lines of ownership for both business and technical teams, defining who is responsible for what areas of the system. Furthermore, it establishes rules for appropriate usage of the SharePoint environments. USER IDENTIFICATION AND AUTHENTICATION The purpose of this policy is to establish rules governing user identification and authentication. All users of Unum's information computing environment will be held accountable for any and all uses of a user account established for them. WEB PROXIES ROUTERS AND FIREWALLS The purpose of this Policy is to establish rules governing the requirements regarding web proxies, routers, and firewalls provided by Unum. WIRELESS LAN TECHNOLOGY The purpose of this policy is to establish rules governing the deployment and acceptable use of wireless communications/technologies provided by Unum. It intends to protect Unum resources and data from security threats. This policy prohibits access to Unum networks via unsecured wireless communication mechanisms that do not meet the security criteria as set forth in this policy. WORKSTATION AND LAPTOP SECURITY The purpose of this policy is to establish rules governing the use and protection of information stored and processed on workstations and laptops provided by Unum. Global Information Security (GIS) 16 329 unum' Program Overview: Physical Security Environmental Controls Safety Perimeter and interior access control play a major role in safeguarding Unum's workforce, assets, and information. The primary controls include security officers, electronic access control on exterior entry and interior sensitive areas, employee/visitor identification program, CCTV/recording systems, and anti -tailgating revolving doors and speedlanes. Controls are regularly maintained and tested to ensure performance meets physical security requirements. SECURITY SERVICES Security Services are provided by a contract security company operating under site procedures specifically written to ensure the correct level of concern and response in the event of an emergency, or during routine operations. Security Services consists of site managers and shift supervisors responsible for ensuring their teams are trained and operate under parameters of the site procedures. All components of the Security Services program, including quality control and review, are the responsibility of Unum's Corporate Security Department. GLOBAL SECURITY OPERATIONS CENTER Our 24-hour Global Security Operations Center (GSOC) is staffed with highly trained contract security analyst with support from on -call management personnel. The GSOC provides support for our workforce and locations worldwide to include centralized reporting, situational monitoring, and alarm and video monitoring. GSOC analysts operate and execute site procedures ensuring the correct level of concern and response. All components of the GSOC, including quality control and review, are the responsibility of Unum's Corporate Security Department. © 2022 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. (6/22) 330 PHYSICAL SECURITY IDENTITY & TECHNOLOGY MANAGEMENT TEAM The Physical Security Identity & Technology Management team is comprised of four embedded contract security professionals dedicated to the management and support of our global access management system, camera systems, and other security technology equipment. This team is solely responsible for the centralized administration and programming of the global physical access control system, to include access credential issuance and changes. The team works closely with our Corporate Real Estate department to provide physical security design specifications and installation oversight for new locations and moves, adds, or changes to ensure compliance with Corporate Security standards. Additionally, the maintenance of security related hardware is overseen by this team. The Physical Security Identity & Technology Management team performs regular hardware firmware and software patching of equipment and systems. The team provides 24-hour support to the Security Services and GSOC team. Unum's Corporate Security Department provides oversight of the Physical Identity & Technology Management team, including quality control and review. PHYSICAL ACCESS POLICY The corporate Physical Access Policy was implemented to safeguard Unum's workforce, assets, and information. Visitors and contractors, without access credentials, are required to show a government issued identification at sign -in and be escorted while on premise. Everyone is required to display an identification badge while on premise. Managers may request a physical access credential for employees and contractors through an online submission. Similar to employees, contractors undergo criminal background screenings in order to be eligible for an access credential. Access credentials are not transferable, and all credentials are immediately disabled upon notification of separation. Additionally, contractor credentials automatically disable after a predefined timeframe of inactivity. Our global physical access control system is updated nightly with an automated feed from our HRIS application to ensure accuracy of data. Physical Security I Environmental Controls I Safety Programs 12 331 PHYSICAL ACCESS POLICY CONTINUED Sensitive access areas are defined as computer rooms, LAN rooms, file information storage areas, and any other area that requires a secondary level of protection; computer rooms are secured using two-part authentication, access credential + biometric. Each sensitive access area has designated approvers who are responsible for authorizing access requests based on business requirements and notifying Physical Security Identity and Technology Management when access is no longer required. The Physical Security Identity and Technology Management team provides the designated sensitive access area approver a listing of individuals that have access to the area(s) they are accountable for on at least a quarterly basis. It is the responsibility of the sensitive access area approver to review the listing and notify Physical Security Identity and Technology Management of any changes. PHYSICAL SECURITY TECHNOLOGY Unum utilizes an enterprise physical access control system (PACS) to secure and monitor locations globally. The PACS provides us the ability to remotely monitor activity and alarms, both in real time and using historical data. The PACS is fully supported on Unum servers within our primary data center, with failover capabilities to the secondary data center. Unum's largest facilities utilize security revolving doors that prevent unauthorized access from individuals tailgating. Additionally, speedlanes are installed in the main lobbies to aid security personnel with access control. Building entries and some sensitive spaces contain cameras designed to identify activity and individuals. Cameras are recorded on centralized network recording devices that are managed through a video management system (VMS) providing remote monitoring in real time and through historical review. Unum maintains a minimum of 30 days of recorded video in US locations and complies with international regulatory requirements related to video retention. Physical Security I Environmental Controls I Safety Programs 13 332 ENVIRONMENTAL CONTROLS Unum's main campuses and data center locations are equipped with fire detection, sprinklers, and notification systems in addition to on -site security services personnel. On -site facility technicians monitor and support equipment and operations, supported by building automation systems that control and monitor environmental conditions. Some of Unum's main campuses are fully supported by generator back-up systems in the event of power loss, with critical infrastructure on main campuses supported by UPS and generator back-up systems. Data centers and computer rooms are fully supported by UPS systems and generators with on - site fuel capabilities of three plus days, with agreements in place for refueling. Data Centers are designed with a dual power configuration, A and B side, providing redundancy and ability for preventative maintenance with maximum uptime. Data centers are equipped with temperature monitoring, leak trace sensors, heat and smoke sensors, dry sprinkler systems, and fire suppression such as FM200 or Ecaro. Computer rooms are constructed with floor to deck walls, with no exterior windows or access. Environmental, power, and protection systems are monitored and on regular preventative maintenance cycles. SAFETY Unum, through the Corporate Safety and Health & Wellbeing Departments, ensure employees have the knowledge, skills, and work environment to prevent work -related injuries and illnesses. This program promotes employee productivity and optimizes services to our customers. Due to the prevalent risk of upper extremity soft tissue injuries in a computerized work environment, we have incorporated sit/stand workstations, ergonomic aids, and training for our employees. We are committed to educating employees about safe work practices and the impact of personal health choices. Finally, Unum recognizes the importance of early recognition and intervention when a repetitive use injury occurs. New employees complete a custom eLearning on Ergonomics, including proper workstation setup and behaviors. On -going education is provided through internal social media platforms and safety education programs. Our Leave and Disability team works with employees to ensure maximum productivity through reasonable accommodations such as workstation assessments and modifications, assistive technology, job process modifications, and compliance with medication restrictions and limitations. Physical Security I Environmental Controls I Safety Programs 14 333 A PARTNERSHIP YOU CAN TRUST At the end of the day, we want the same thing you do: a better benefits experience for you and your employees. Through our competitive benefits, administrative solutions and dedicated service, we'll be there to help you every step of the way. COMPENSATION DISCLOSURE: Colonial Life compensates producers to facilitate the sale and delivery of our voluntary benefits. This compensation might include commissions as well as various incentives and awards. We support disclosure of our compensation programs. Colonial Life representative can provide you with complete details about these programs. You may also contact our Plan Administrator Service Center at 1-800-256-7004. 1 � Colonual Underwritten by Colonial Life &Accident Insurance Company, Columbia, SC. Dental plans are underwritten by Colonial Life &Accident Insurance Company, Columbia, SC. Some dental plans are administered by Starmount Life Insurance Company. ©2020 Colonial Life &Accident Insurance Com pany. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 334 City of Miami Solicitation RFQ 1733386 Solicitation RFQ 1733386 Employee Voluntary Supplemental Insurance Benefits Pre - Qualification Pool Solicitation Designation: Public 3/7/2024 7:11 PM p. 1 City of Miami Solicitation RFQ 1733386 City of Miami 3/7/2024 7:11 PM p. 2 City of Miami Solicitation RFQ 1733386 Solicitation RFQ 1733386 Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool Solicitation Number RFQ 1733386 Solicitation Title Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool Solicitation Start Date Mar 7, 2024 9:08:57 PM EST Solicitation End Date Apr 1, 2024 5:00:00 PM EDT Question & Answer End Mar 22, 2024 5:00:00 PM EDT Date Solicitation Contact Charles Johnson 305-416-1924 cjohnson@miamigov.com Contract Duration See Specifications Contract Renewal 1 annual renewal Prices Good for 30 days Pre -Solicitation Conference Mar 18, 202411:00:00 AM EDT Attendance is optional Location: Click here to join the meeting Conference ID 285 815 306 773# Passcode - muGcHH or via phone at (786) 598-2961 Phone Conference ID AfAfA, AfAfA, A, AAfA, A, A" 424 929 21# Item Response Form Item RFQ 1733386--01-01 - Please disregard this line item. See RFQ Document Quantity 1 each Unit Price Delivery Location City of Miami City of Miami Department of Procurement 111'1 SW 2nd Ave 6th Floor Miami FL 33130 Qty 1 Description Please disregard this line item. See RFQ Document 3/7/2024 7:11 PM p. 3 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1733386 City of Miami Request for Qualifications (RFQ) Procurement Department Miami Riverside Center 444 SW 2^d Avenue, 6th Floor Miami, Florida 33130 Web Site Address: www.miamigov.com/procurement RFQ Number: 1733386 Title: Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool Issue Date/Time: Thursday, March 7, 2024 at 7:00 PM RFQ Closing Date/Time: Monday, April 1, 2024 at 3:00 PM Pre-Bid/Pre-Proposal Conference: Voluntary Pre-Bid/Pre-Proposal Date/Time: Monday, March 18, 2024 at 11:00 AM Pre-Bid/Pre-Proposal Location: Click here to join the meeting Conference ID 285 815 306 773# Passcode - muGcHH or via phone at (786) 598-2961 Phone Conference ID — 424 929 21# Deadline for Request for Clarification: Wednesday, February —, 2024 at 5:00 PM Contracting Officer: Johnson, Charles Contracting Officer E-Mail Address: cjohnson@miamigov.com 3/7/2024 7:11 PM p. 4 City of Miami Request for Qualifications NeolibiYai 1 Certification Statement tiU Q 1733386 Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (I) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a submission for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terms and conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME: ADDRESS: PHONE: FAX: EMAIL: CELL(Optional): SIGNED BY: TITLE: DATE: FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY THIS RESPONSE. 3/7/2024 7:11 PM P. 5 City of Miami Request for Qualifications NeolitiWB tiU Q 1733386 Certifications Legal Name of Firm: Firm's Federal Employer Identification Number ("FEIN"): Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Year Established: Office Location: City of Miami, Miami -Dade County, or Other Business Tax Receipt/Occupational License Number: Business Tax Receipt/Occupational License Issuing Agency: Business Tax Receipt/Occupational License Expiration Date: Will Subcontractor(s) be used? (Yes or No) If subcontractor(s) will be utilized, provide their name, address and the portion of the work they will be responsible for under this contract (a copy of their license(s) must be submitted with your bid response). If no subcontractor(s) will be utilized, please insert N/A.: Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1, 1/1/24). If no addendum/addenda was/were issued, please insert N/A. Has Proposer reviewed the attached Sample Professional Services Agreement? Yes / No Acknowledge that if awarded, Proposer will be required to execute the Professional Services 3/7/2024 7:11 PM p. 6 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Agreement in substantially the attached form. In addition, Proposer must acknowledge that certain clauses (including #2 Term, #6 Audit and Inspection Rights and Records Retention, #8 Public Records, #9 Compliance with Federal, State and Local Laws, #10 Indemnification/Hold Harmless/Duty to Defend, #13 Termination; Obligation Upon Termination, #15 Nondiscrimination, and # 23 City Not Liable for Delays) are non-negotiable. 3/7/2024 7:11 PM p. 7 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 IMPORTANT NOTICE TO PROPOSERS • FAILURE TO COMPLETE, SIGN, AND UPLOAD THE FOLLOWING WILL RENDER YOUR PROPOSAL NON -RESPONSIVE: o THE CERTIFICATION STATEMENT; AND o CERTIFICATIONS SECTION. • ATTACHMENT FILES SHALL BE NO MORE THAN 250MB IN SIZE EACH, SHOULD THERE BE A NEED FOR A LARGER SIZE FILE TO BE UPLOADED SPLIT IN MULTIPLE FILES. • CONTACT BIDSYNC VENDOR SUPPORT TOLL -FREE NUMBER 800-990-9339, EMAIL SUPPORT( a�BIDSYNC.COM, OR SUPPORT.BIDSYNC.COM FOR BIDSYNC TECHNICAL DIFFICULTIES AND/OR ISSUES. 3/7/2024 7:11 PM p. 8 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Table of Contents Terms and Conditions 1. General Terms and Conditions 1.1. GENERAL TERMS AND CONDITIONS 2. Special Conditions 2.1. PURPOSE 2.2. VOLUNTARY PRE -PROPOSAL CONFERENCE 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL INFORMATION/CLARIFICATION 2.4. TERM OF CONTRACT 2.5. CONDITIONS FOR RENEWAL 2.6. LIVING WAGE ORDINANCE 2.7. PROPOSERS MINIMUM QUALIFICATIONS 2.8. REFERENCES 2.9. LOCAL PREFERENCE 2.10. EXECUTION OF AN AGREEMENT 2.11. INSURANCE REQUIREMENTS 2.12. PROJECT MANAGER 2.13. METHOD OF AWARD 2.14. SUBCONTRACTOR(S) OR SUBCONSULTANT(S) 2.15. REMOVAL OF EMPLOYEES/SUBCONTRACTORS 2.16. UNAUTHORIZED WORK 2.17. CHANGES/ALTERATIONS 2.18. METHOD OF PAYMENT 2.19. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD 2.20. RECORDS 2.21. ADDITIONAL SERVICES 2.22. TRUTH IN NEGOTIATION CERTIFICATE 2.23. NON -APPROPRIATION OF FUNDS 2.24. FAILURE TO PERFORM 2.25. TERMINATION 2.26. ADDITIONAL TERMS AND CONDITIONS 2.27. E-VERIFY EMPLOYMENT REQUIREMENTS 3. Specifications 3.1. SPECIFICATIONS/SCOPE OF WORK 4. Submission Requirements 4.1. SUBMISSION REQUIREMENTS 5. Evaluation Criteria 5.1. EVALUATION CRITERIA 3/7/2024 7:11 PM P. 9 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Terms and Conditions 1. General Terms and Conditions GENERAL TERMS AND CONDITIONS Intent: The General Terms and Conditions described herein apply to the acquisition of goods/equipment/services with an estimated aggregate cost of $25,000.00 or more. Definition: A formal solicitation is defined as issuance of an Invitation for Bids, Request for Proposals, Request for Qualifications, or Request for Letters of Interest pursuant to the City of Miami Procurement Code and/or Florida Law, as amended. Formal Solicitation and Solicitation shall be defined in the same manner herein. 1.1 ACCEPTANCE OF GOODS, EQUIPMENT OR SERVICES - Any good(s), equipment or services delivered under this formal solicitation, if applicable, shall remain the property of the seller until a physical inspection and actual usage of the good is made, and thereafter is accepted as satisfactory to the City. It must comply with the terms herein and be fully in accordance with specifications and of the highest quality. In the event the goods/equipment supplied to the City are found to be defective or does not conform to specifications, the City reserves the right to cancel the order upon written notice to the Contractor and return the product to the Contractor at the Contractor's expense. In terms of this Solicitation the use of the word "services" includes without limitation professional and personal services as that term professional and personal services is defined by the City of Miami Procurement Ordinance and as set forth in the Definitions Section 18-73 of the City Code. 1.2 ACCEPTANCE OF OFFER - Subject to prior occurrence of all condition's precedent set forth in Section 1.88, The signed or electronic submission of your solicitation response shall be considered an offer on the part of the Proposer; such offer shall be deemed accepted upon the occurrence of all conditions precedent and issuance by the City of a purchase order or notice to proceed, as applicable. In summation, execution of a Professional Services Agreement and/or Agreement, approval by a referendum as stated in this RFQ, and issuance by the City of a purchase order, and/or notice to proceed, as applicable. 1.3 ACCEPTANCE/REJECTION - The City reserves the right to accept or reject any or all responses or parts of after opening/closing date and request re -issuance on the goods/services described in the formal solicitation. In the event of such rejection, the Director of Procurement shall notify all affected Proposers and make available a written explanation for the rejection. The City also reserves the right to reject the response of any Proposer: 1) Who has previously failed to properly perform under the terms and conditions of a Professional Services Agreement ("PSA") and/or Agreement, 2) Who failed to deliver on time, contracts of a similar nature, 3) Who is not in a position to perform the requirements defined in this formal solicitation 4) Who has been debarred, 5) Who is on the convicted vendors list, 6) Who is indebted to the City, or 3/7/2024 7:11 PM p. 10 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 7) Who is otherwise determined to be non- responsive or non -responsible. The City further reserves the right to waive any irregularities, minor informalities, or technicalities in any or all responses and may, at its discretion, re -issue this formal solicitation. 1.4 ADDENDA - It is the Proposer's responsibility to ensure receipt of all Addenda. Addenda are available on the BidSync Procurement Solutions Platform ("BidSync") only. 1.5 ALTERNATE RESPONSES WILL NOT BE CONSIDERED. 1.6 ASSIGNMENT - Contractor agrees not to subcontract, assign, transfer, convey, sublet, or otherwise dispose of the resulting Contract, or any or all its rights, title or interest herein, without the City Manager's prior written consent. 1.7 ATTORNEY'S FEES - In connection with any litigation, mediation and arbitration arising out of this Contract, each party shall bear their own attorney's fees through and including appellate litigation and any post judgment proceedings. 1.8 AUDIT RIGHTS AND RECORDS RETENTION - The Successful Proposer(s) agrees to provide access at all reasonable times to the City, or to any of its duly authorized representatives, to any books, documents, papers, and records of Contractor which are directly pertinent to this formal solicitation, for the purpose of audit, examination, excerpts, and transcriptions. The Successful Proposer(s) shall maintain and retain any and all of the books, documents, papers and records pertinent to the Contract for three (3) years after the City makes final payment and all other pending matters are closed. Contractor's failure to or refusal to comply with this condition shall result in the immediate cancellation of this contract by the City. The audit and inspection provisions set forth in Sections 18-100 to 18-102, City Code, are deemed as being incorporated by reference herein as set forth in full. 1.9 AVAILABILITY OF CONTRACT STATE-WIDE - Any governmental, not -for -profit, or quasi - governmental entity in the State of Florida, may avail itself of this Contract and purchase any, and all goods/services, specified herein from the Successful Proposer(s) at the Contract price(s) established herein, when permissible by Federal, State, and local laws, rules, and regulations. Additionally, any governmental entity outside of the State of Florida but, within the Continental United States of America, may avail itself to this Contract and purchase any and all goods/services, specified herein from the Successful Proposer(s) at the Contract price(s) established herein, when permissible by Federal, State, and local laws, rules, and regulations. Each governmental, not -for -profit or quasi -governmental entity which uses this Formal Solicitation and resulting Contract will establish its own Contract, place its own orders, issue its own purchase orders, be invoiced there from and make its own payments, determine shipping terms and issue its own exemption certificates as required by the Successful Proposer(s). 1.10 AWARD OF CONTRACT: A. The PSA and/or Agreement, the Formal Solicitation, the Proposer's response, any addenda issued, and the 3/7/2024 7:11 PM p. 11 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 blanket purchase order shall constitute the entire contract, unless modified in accordance with any ensuing amendment or addenda. B. The award of this contract may be preconditioned on the subsequent submission of other documents as specified in the Special Conditions or Technical Specifications. Proposer shall be in default of its contractual obligation if such documents are not submitted in a timely manner and in the form required by the City. Where Proposer is in default of these contractual requirements, the City, through action taken by the Department of Procurement, will void its acceptance of the Proposer's Response and may accept the Response from the next lowest responsive, responsible Proposal most advantageous to the City or re -solicit the City's requirements. The City, at its sole discretion, may seek monetary restitution from Proposer and its proposal bond or guaranty, if applicable, as a result of damages or increased costs sustained as a result of the Proposer's default. C. The term of the contract shall be specified in one of three documents which shall be issued to the Successful Proposer(s). These documents may either be a blanket purchase order, notice of award and/or contract award sheet. D. The City reserves the right to automatically extend this contract for up to one hundred twenty (120) calendar days beyond the stated contract term in order to provide City departments with continual service and supplies while a new contract is being solicited, evaluated, and awarded. If the right is exercised, the City shall notify the Proposer, in writing, of its intent to extend the contract at the same price, terms and conditions for a specific number of days. Additional extensions over the first one hundred twenty (120) day extension may occur, if, the City and the Successful Proposer(s) are in mutual agreement of such extensions. E. Where the contract involves a single shipment of goods to the City, the contract term shall conclude upon completion of the expressed or implied warranty periods. F. An PSA and/or Agreement shall be awarded to the Proposer by the City Commission based upon the minimum qualification requirements reflected herein. As a result of a RFP, RFQ, or RFLI, the City reserves the right to execute or not execute, as applicable, an PSA and/or Agreement with the Proposer, whichever is determined to be in the City's best interests. Such PSA and/or Agreement which will be furnished by the City, will contain certain terms as are in the City's best interests, and will be subject to approval as to legal form by the City Attorney. All conditions precedent identified in Section 1.88 before any Agreement is binding. 1.11 BID BOND/ BID SECURITY - A cashier's or certified check, or a Bid Bond signed by a recognized surety company that is licensed to do business in the State of Florida, payable to the City of Miami, for the amount bid is required from all Proposers, if so indicated under the Special Conditions. This check or bond guarantees that the Proposer will accept the order or contract/agreement, as proposed, if it is awarded to the Proposer. Proposer shall forfeit proposal deposit to the City should the City award the contract/agreement to the Proposer and if Proposer fails to accept the award. The City reserves the right to reject any and all surety tendered to the City. Proposal deposits are returned to uns within ten (10) days after the award and Successful Proposer(s)'s acceptance of award. If sixty (60) days have passed after the date of the formal solicitation closing date, and no contract has been awarded, all deposits will be returned on demand. 1.12 RESPONSE FORM - All forms should be completed, signed and submitted accordingly. 3/7/2024 7:11 PM p. 12 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 1.13 BID SECURITY FORFEITED LIQUIDATED DAMAGES - Failure to execute a PSA and/or Agreement and/or file an acceptable Performance Bond, when required, as provided herein, shall be just cause for the annulment of the award and the forfeiture of the Bid Security to the City, which forfeiture shall be considered, not as a penalty, but in mitigation of damages sustained. Award may then be negotiated with the next highest ranked responsive and responsible Proposal most advantageous to the City or all responses may be rejected. 1.14 BRAND NAMES - If and wherever in the specifications brand names, makes, models, names of any manufacturers, trade names, or Proposer catalog numbers are specified, it is for the purpose of establishing the type, function, minimum standard of design, efficiency, grade or quality of goods only. When the City does not wish to rule out other competitors' brands or makes, the phrase "OR EQUAL" is added. When bidding/proposing an approved equal, Proposers will submit, with their response, complete sets of necessary data (factory information sheets, specifications, brochures, etc.) in order for the City to evaluate and determine the equality of the item(s) bid/proposed. The City shall be the sole judge of equality and its decision shall be final. Unless otherwise specified, evidence in the form of samples may be requested if the proposed brand is other than specified by the City. Such samples are to be furnished after formal solicitation opening/closing only upon request of the City. If samples should be requested, such samples must be received by the City no later than seven (7) calendar days after a formal request is made. 1.15 CANCELLATION - The City reserves the right to cancel all formal solicitations before its opening/closing. In the event of proposal cancellation, the Director of Procurement shall notify all prospective Proposers and make available a written explanation for the cancellation. 1.16 CAPITAL EXPENDITURES - Proposer understands that any capital expenditures that the firm makes, or prepares to make, in order to deliver/perform the goods/services required by the City, is a business risk which the Contractor must assume. The City will not be obligated to reimburse amortized or unamortized capital expenditures, or to maintain the approved status of any Contractor. If Contractor has been unable to recoup its capital expenditures during the time it is rendering such goods/services, it shall not have any claim upon the City. 1.17 CITY NOT LIABLE FOR DELAYS - It is further expressly agreed that in no event shall the City be liable for, or responsible to, the Proposer/Consultant, any sub-contractor/sub-consultant, or to any other person for, or on account of, any stoppages or delay in the work herein provided for by injunction or other legal or equitable proceedings or on account of any delay for any cause over which the City has no control. 1.18 COLLUSION - Proposer, by submitting a response, certifies that its response is made without previous understanding, agreement or connection either with any person, firm or corporation submitting a response for the same items/services or with the City of Miami's Procurement Depai liuent or initiating depai linent. The Proposer certifies that its response is fair, without control, collusion, fraud or other illegal action. Proposer certifies that it is in compliance with the Conflict of Interest and Code of Ethics Laws. The City will investigate all potential situations where collusion may have occurred, and the City reserves the right to reject any and all responses where collusion may have occurred. 1.19 COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS - Contractor understands that contracts between private entities and local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, records keeping, competitive solicitations etc., et. al., as 3/7/2024 7:11 PM p. 13 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 applicable. City and Contractor agree to comply with and observe all applicable laws, codes and ordinances as that may in any way affect the goods or equipment offered, including but not limited to: A. Executive Order 11246, which prohibits discrimination against any employee, applicant, or client because of race, creed, color, national origin, sex, or age with regard to, but not limited to, the following: employment practices, rate of pay or other compensation methods, and training selection. B. Occupational, Safety and Health Act (OSHA), as applicable to this Formal Solicitation. C. The State of Florida Statutes, Section 287.133(3)(A) on Public Entity Crimes. D. Environment Protection Agency (EPA), as applicable to this Formal Solicitation. E. Uniform Commercial Code (Florida Statutes, Chapter 672). F. Americans with Disabilities Act of 1990, as amended. G. National Institute of Occupational Safety Hazards (NIOSH), as applicable to this Formal Solicitation. H. National Forest Products Association (NFPA), as applicable to this Formal Solicitation. I. City Procurement Ordinance City Code Section 18, Article III. J. Conflict of Interest, City Code Section 2-611;61. K. Cone of Silence, City Code Section 18-74. L. The Florida Statutes Sections 218.73 and 218.74 on Prompt Payment. M. City Financial Policies, City Code Chapter 18, Article IX. N. City of Miami Charter Sections 3(f) (iii) and 29-B. O. City of Miami Sale or Lease of Real Property, City Code Chapter 18, Article V. P. City of Miami Living Wage Ordinance, Chapter 18, Article X, City Code. Q. Alcoholic beverage, food and beverage laws, approvals and permits as required by state and local laws. R. Miami -Dade County Shoreline Review Ordinance Chapter 33D, Article III, Miami -Dade County Code. Lack of knowledge or notice by the Proposer will in no way be a cause for relief from responsibility. Non- compliance with all local, state, and federal directives, orders, regulations, and laws may be considered grounds for termination of contract(s). 3/7/2024 7:11 PM p. 14 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Copies of the City Ordinances may be obtained from the City Clerk's Office. 1.20 CONE OF SILENCE - Pursuant to Section 18-74 of the City of Miami Code, a "Cone of Silence" is imposed upon each RFP, RFQ, or RFLI after advertisement and terminates at the time the City Manager issues a written recommendation to the Miami City Commission. The Cone of Silence shall be applicable only to Contracts for the provision of goods and services and public works or improvements for amounts greater than $200,000. The Cone of Silence prohibits any communication regarding RFPs, RFQs, or RFLIs between potential vendors, service providers, Proposers, lobbyists or consultants (among others) and the City's professional staff including, but not limited to, the City Manager and the City Manager's staff; the Mayor, City Commissioners, or their respective staffs and any member of the respective selection/evaluation committee. The provision does not apply to, among other communications, oral communications with the City's Procurement staff, provided the communication is limited strictly to matters of process or procedure already contained in the formal solicitation document. The provisions of the Cone of Silence do not apply to oral communications at duly noticed site visits/inspections, pre -proposal conferences, oral presentations before selection/evaluation committees, contract negotiations during any duly noticed public meeting, or public presentations made to the Miami City Commission during a duly noticed public meeting; or communications in writing or by email at any time with any City employee, official or member of the City Commission unless specifically prohibited by the applicable RFP, RFQ, or RFLI documents; or communications in connection with the collection of industry comments or the performance of market research regarding a particular RFP, RFQ, or RFLI, by City Procurement staff. Proposers must file a copy of any written communications with the Office of the City Clerk, which shall be made available to any person upon request. The City shall respond in writing and file a copy with the Office of the City Clerk (clerks@miamigov.com), which shall be made available to any person upon request. Written communications may be in the form of e-mail, with a copy to the Office of the City Clerk. In addition to any other penalties provided by law, violation of the Cone of Silence by any Proposer shall render any award voidable. A violation by a particular Proposer, Offeror, Respondent, lobbyist or consultant shall subject same to potential penalties pursuant to the City Code. Any person having personal knowledge of a violation of these provisions shall report such violation to the State Attorney and/or may file a complaint with the Miami -Dade County Ethics Commission. Proposers should reference Section 18-74 of the City of Miami Code for further clarification. This language is only a summary of the key provisions of the Cone of Silence. Please review City of Miami Code Section 18-74 for a complete and thorough description of the Cone of Silence. You may contact the City Clerk at 305-250-5360, to obtain a copy of same. 1.21 CONFIDENTIALITY - As a political subdivision and Florida municipality, the City of Miami is subject to the Florida Sunshine Act and Public Records Law. If this Contract/Agreement contains a confidentiality provision, it shall have no application when disclosure is required by Florida law or upon court order. 1.22 CONFLICT OF INTEREST - Proposers, by responding to this Formal Solicitation, certify that to the best of their knowledge or belief, no elected/appointed official or employee of the City of Miami is financially interested, directly or indirectly, in the purchase of goods/services specified in this Formal Solicitation. Any 3/7/2024 7:11 PM p. 15 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 such interests on the part of the Proposer or its employees must be disclosed in writing to the City. Further, you must disclose the name of any City employee (or former employee of the City who left City service within the past two (2) years) who owns, directly or indirectly, an interest of five percent (5%) or more of the total assets of capital stock in the Proposer's firm. A. Proposer further agrees not to use or attempt to use any knowledge, property or resource which may be within their trust, or perform their duties, to secure a special privilege, benefit, or exemption for itself, or others. Proposer may not disclose or use information not available to members of the general public and gained by reason of their position, except for information relating exclusively to governmental practices, for their personal gain or benefit or for the personal gain or benefit of any other person or business entity. B. Proposer who is a person (every officer, official and employee of the city, including every member of any board, commission or agency of the city) as defined in Section 2-611 of the City Code, hereby acknowledges that it has not contracted or transacted any business with the City or any person or agency acting for the City and has not appeared in representation of any third party before any board, commission or agency of the City within the past two years. Proposer further warrants that they are not related, specifically the spouse, son, daughter, parent, brother or sister, to: (i) any member of the commission; (ii) the mayor; (iii) any city employee; or (iv) any member of any board or agency of the City. C. A violation of this section may subject the Proposer to immediate termination of any Professional Services Agreement with the City, imposition of the maximum fine and/or any penalties allowed by law. Additionally, violations may be considered by and subject to action by the Miami -Dade County Commission on Ethics. 1.23 COPYRIGHT OR PATENT RIGHTS - Proposers warrant that there has been no violation of any intellectual property, copyright or patent rights in manufacturing, producing, or selling the goods or equipment shipped or ordered and/or services provided as a result of this formal solicitation, and Proposers agree to hold the City harmless from any and all liability, loss, or expense occasioned by any such violation. 1.24 COST INCURRED BY PROPOSER - All expenses involved with the preparation and submission of Responses to the City, or any work performed in connection therewith shall be borne by the Proposer(s). 1.25 DEBARMENT AND SUSPENSIONS (Sec 18-107) (a) Authority and requirement to debar and suspend. After reasonable notice to an actual or prospective Contractual Party, and after reasonable opportunity for such party to be heard, the City Manager, after consultation with the Chief Procurement Officer and the city attorney, shall have the authority to debar a Contractual Party, for the causes listed below, from consideration for award of city Contracts. The debarment shall be for a period of not fewer than three years. The City Manager shall also have the authority to suspend 3/7/2024 7:11 PM p. 16 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 a Contractual Party from consideration for award of city Contracts if there is probable cause for debarment, pending the debarment determination. The authority to debar and suspend contractors shall be exercised in accordance with regulations which shall be issued by the Chief Procurement Officer after approval by the City Manager, the city attorney, and the City Commission. (b) Causes for debarment or suspension. Causes for debarment or suspension include the following: (i) Conviction for commission of a criminal offense incident to obtaining or attempting to obtain a public or private Contract or subcontract, or incident to the performance of such Contract or subcontract. (ii) Conviction under state or federal statutes of embezzlement, theft, forgery, bribery, falsification or destruction of records, receiving stolen property, or any other offense indicating a lack of business integrity or business honesty. (iii) Conviction under state or federal antitrust statutes arising out of the submission of Bids or Proposals. (iv) Violation of Contract provisions, which is regarded by the Chief Procurement Officer to be indicative of non -responsibility. Such violation may include failure without good cause to perform in accordance with the terms and conditions of a Contract or to perform within the time limits provided in a Contract, provided that failure to perform caused by acts beyond the control of a party shall not be considered a basis for debarment or suspension. (v) Debarment or suspension of the Contractual Party by any federal, state, local, or other governmental (public) agency or entity. (vi) False certification pursuant to paragraph (c) below. (vii) Found in violation of a zoning ordinance for which the violation remains noncompliant. (viii) Found in violation any city ordinance or regulation and for which a civil penalty or fine is due and owing to the city. (ix) Any other cause judged by the City Manager to be so serious and compelling as to affect the responsibility of the Contractual Party performing city Contracts. (c) Certification. All Contracts for goods and services, sales, and leases by the city shall contain a certification that neither the Contractual Party nor any of its principal owners or personnel have been convicted of any of the violations set forth above or debarred or suspended as set forth in paragraph (b)(v). (d) Debarment and suspension decisions. Subject to the provisions of paragraph (a), the City Manager shall render a written decision stating the reasons for the debarment or suspension. A copy of the decision shall be provided promptly to the Contractual Party, along with a notice of said parry's right to seek judicial relief. 1.26 DEBARRED/SUSPENDED VENDORS - An entity or affiliate who has been placed on the State of 3/7/2024 7:11 PM p. 17 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Florida debarred or suspended vendor list may not: 1) submit a response fora contract to provide goods or services to a public entity; 2) Submit a response on a contract with a public entity for the construction or repair of a public building or public work; 3) Submit response on leases of real property to a public entity; 4) award or perform work as a contractor, supplier, subcontractor, or consultant under contract with any public entity; and 5) transact business with any public entity. 1.27 DEFAULT/FAILURE TO PERFORM - The City shall be the sole judge of nonperformance, which shall include any failure on the part of the Successful Proposer(s) to accept the award, to furnish required documents, and/or to fulfill any portion of this contract within the time stipulated. Upon default by the Successful Proposer(s) to meet any terms of this agreement, the City will notify the Proposer of the default and will provide the contractor three (3) days (weekends and holidays excluded) to remedy the default. Failure on the contractor's part to correct the default within the required three (3) days shall result in the Contract being terminated and upon the City notifying in writing the contractor of its intentions and the effective date of the termination. The following shall constitute default: A. Failure to perform the work or deliver the goods/services required under the Contract and/or within the time required or failing to use the subcontractors, entities and personnel as identified and set forth, and to the degree specified in the Contract. B. Failure to begin the work under this Contract within the time specified. C. Failure to perform the work with sufficient workers and equipment or with sufficient materials to ensure timely completion. D. Neglecting or refusing to remove materials or perform new work where prior work has been rejected as nonconforming with the terms of the Contract. E. Becoming insolvent, being declared bankrupt, or committing any act of bankruptcy or insolvency, or making an assignment for the benefit of creditors, if the insolvency, bankruptcy, or assignment renders the Successful Proposer(s) incapable of performing the work in accordance with and as required by the Contract. F. Failure to comply with any of the terms of the Contract in any material respect. All costs and charges incurred by the City as a result of a default or a default incurred beyond the time limits stated, together with the cost of completing the work, shall be deducted from any monies due or which may become due on this Contract. 1.28 DETERMINATION OF RESPONSIVENESS AND RESPONSIBILITY - Each proposal will be reviewed to determine if it is responsive to the submission requirements outlined in the Formal Solicitation. A. Responsive Proposal is one which follows the requirements of the Formal Solicitation, includes all documentation, is submitted in the format outlined in the Formal Solicitation, is of timely submission, and has appropriate signatures as required on each document. Failure to comply with these requirements may deem a Proposal non -responsive. 3/7/2024 7:11 PM p. 18 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 B. Determination of Responsibility. A Responsible Proposer shall mean a Proposer who has submitted a proposal and who has the capability, as determined under Section 18-95 of the City Code, in all respects to fully perform the Contract requirements, and the integrity and reliability of which give reasonable assurance of good faith and performance. 1. Proposals will only be considered from any person or firm who are regularly engaged in the business of providing the good(s)/service(s) required by the Formal Solicitation. Proposer must be able to demonstrate a satisfactory record of performance and integrity, and have sufficient financial, material, equipment, facility, personnel resources, and expertise to meet all contractual requirements. 2. The City may consider any information available regarding the financial, technical, and other qualifications and abilities of a Proposer, including past performance (experience) with the City or any other governmental entity, in making the award. 3. The City may require the Proposer(s) to provide documentation that they have been designated as an authorized representative of a manufacturer or supplier which is the actual source of supply, if required by the Formal Solicitation. 1.29 DISCOUNTS OFFERED DURING TERM OF CONTRACT - Discount Prices offered in the response shall be fixed after the award by the Commission, unless otherwise specified in the Special Terms and Conditions. Price discounts off the original prices quoted in the response will be accepted from Successful Proposer(s) during the term of the contract. Such discounts shall remain in effect for a minimum of 180 days from approval by the City Commission. Any discounts offered by a manufacturer to Proposer will be passed on to the City. 1.30 DISCREPANCIES, ERRORS, AND OMISSIONS - Any discrepancies, errors, or ambiguities in the Formal Solicitation or addenda (if any) should be reported in writing to the City's Purchasing Department. Should it be found necessary, a written addendum will be incorporated in the Formal Solicitation and will become part of the purchase agreement (contract documents). The City will not be responsible for any oral instructions, clarifications, or other communications. A. Order of Precedence -Any inconsistency in this formal solicitation shall be resolved by giving precedence to the following documents, the first of such list being the governing documents. 1) PSA and/or Agreement and/or any Amendments to the PSA and/or Agreement 2) Specifications 3) Special Conditions 4) General Terms and Conditions 1.31 EMERGENCY / DISASTER PERFORMANCE - In the event of a hurricane or other emergency or disaster situation, the successful vendor shall provide the City with the commodities/services defined within the scope of this formal solicitation at the price contained within vendor's response. Further, successful vendor shall deliver/perform for the city on a priority basis during such times of emergency. 3/7/2024 7:11 PM p. 19 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 1.32 ENTIRE BID CONTRACT OR AGREEMENT - The Bid Contract or Agreement consists of this City of Miami Formal Solicitation and specifically this General Conditions Section, Contractor's Response and any written agreement entered into by the City of Miami and Contractor in cases involving RFPs, RFQs, and RFLIs, and represents the entire understanding and agreement between the parties with respect to the subject matter hereof and supersedes all other negotiations, understanding and representations, if any, made by and between the parties. To the extent that the agreement conflicts with, modifies, alters or changes any of the terms and conditions contained in the Formal Solicitation and/or Response, the Formal Solicitation and then the Response shall control. This Contract may be modified only by a written agreement signed by the City of Miami and Contractor. 1.33 ESTIMATED QUANTITIES - Estimated quantities or estimated dollars are provided for your guidance only. No guarantee is expressed or implied as to quantities that will be purchased during the contract period. The City is not obligated to place an order for any given amount subsequent to the award of this contract. Said estimates may be used by the City for purposes of determining the most advantageous Proposer meeting specifications. The City reserves the right to acquire additional quantities at the prices bid/proposed or at lower prices in this Formal Solicitation. 1.34 EVALUATION OF RESPONSES A. Rejection of Responses The City may reject a Response for any of the following reasons: 1) Proposer fails to acknowledge receipt of addenda; 2) Proposer misstates or conceals any material fact in the Response; 3) Response does not conform to the requirements of the Formal Solicitation; 4) Response requires a conditional award that conflicts with the method of award; 5) Response does not include required samples, certificates, licenses as required; and 6) Response was not executed by the Proposer's authorized agent. The foregoing is not an all-inclusive list of reasons for which a Response may be rejected. The City may reject and re -advertise for all or any part of the Formal Solicitation whenever it is deemed in the best interest of the City. B. Elimination from Consideration 1) A contract shall not be awarded to any person or firm which is in arrears to the City upon any debt or contract, or which is in default on a bid, payment/ performance, bond they have submitted or as the surety bond or certificate furnished has not performed despite demand they do so or otherwise upon any obligation to the City. 2) A contract may not be awarded to any person or firm which has failed to perform under the terms and 3/7/2024 7:11 PM p. 20 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 conditions of any previous contract with the City or deliver on time contracts of a similar nature. 3) A contract may not be awarded to any person or firm which has been debarred by the City in accordance with the City's Debarment and Suspension Ordinance. C. Determination of Responsibility 1) Responses will only be considered from entities who are regularly engaged in the business of providing the goods/equipment/services required by the Formal Solicitation. Proposer must be able to demonstrate a satisfactory record of performance and integrity; and, have sufficient financial, material, equipment, facility, personnel resources, and expertise to meet all contractual requirements. The terms "equipment and organization" as used herein shall be construed to mean a fully equipped and well -established entity in line with the best industry practices in the industry as determined by the City. 2) The City may consider any evidence available regarding the financial, technical and other qualifications and abilities of a Proposer, including past performance (experience) with the City or any other governmental entity in making the award. 3) The City may require the Proposer(s) to show proof that they have been designated as an authorized representative of a manufacturer or supplier which is the actual source of supply, if required by the Formal Solicitation. 1.35 EXCEPTIONS TO GENERAL AND/OR SPECIAL CONDITIONS OR SPECIFICATIONS - Exceptions to the specifications shall be listed on the Response and shall reference the section. Any exceptions to the General or Special Conditions shall be cause for the bid (IFB) to be considered non -responsive. It also may be cause for a RFP, RFQ, or RFLI to be considered non -responsive; and, if exceptions are taken to the terms and conditions of the resulting agreement it may lead to terminating negotiations. 1.36 F.O.B. DESTINATION - Unless otherwise specified in the Formal Solicitation, all prices quoted/proposed by the Proposer must be F.O.B. DESTINATION, inside delivery, with all delivery costs and charges included in the bid/proposal price, unless otherwise specified in this Formal Solicitation. Failure to do so may be cause for rejection of bid/proposal. 1.37 FIRM PRICES - The Proposer warrants that prices, terms, and conditions quoted in its response will be firm throughout the duration of the contract unless otherwise specified in the Formal Solicitation. Such prices will remain firm for the period of performance or resulting purchase orders or contracts, which are to be performed or supplied over a period of time. 1.38 FLORIDA MINIMUM WAGE AND CITY OF MIAMI LIVING WAGE ORDINANCE - A. Florida Minimum Wage. In accordance with the Constitution of the State of Florida, Article X, Section 24, employers shall pay employee wages no less than the minimum wage for all hours worked in Florida. 3/7/2024 7:11 PM p. 21 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Accordingly, it is the Successful Proposer(s)'s/Contractor's and their subcontractor's responsibility to understand and comply with this Florida minimum wage requirement and pay its employees the current established hourly minimum wage rate. This minimum wage rate is subject to change or adjusted by the rate of inflation using the consumer price index ("CPI") for urban wage earners and clerical workers, CPI-W, or a successor index as calculated by the United States Department of Labor. Each adjusted minimum wage rate calculated, shall be determined and published by the Agency Workforce Innovation on September 30th of each year and take effect on the following January 1st. It is the Proposer's and their subcontractor's (if applicable), full responsibility to determine whether any of their employees may be impacted by this Florida Minimum Wage Law, at any given point in time during the term of the Bid Contract. If impacted, Proposer must provide, with its bid, employee name(s), job title(s), job description(s), and current pay rate(s). Failure to submit this information at the time of bid submittal constitute Successful Proposer(s)'s/Contractor's acknowledgement and understanding that the Florida Minimum Wage Law will not impact its prices throughout the term of the Bid Contract, and a waiver of any contractual price increase request(s). The City reserves the right to request and the Successful Proposer(s)/Contractor must provide for any, and all information to make a wage and contractual price increase(s) determination. B. City of Miami Living Wage Ordinance. The City of Miami adopted a Living Wage Ordinance for City Service Contracts with a total contract value exceeding $100,000 annually, and that have been competitively solicited and awarded on, or after January 1, 2017 by the City. "Service Contract" means a contract to provide services to the City, excluding, however, professional services as defined by the "Consultants Competitive Negotiation Act" set forth in F.S. § 287.055, and Section 18-87 of the City Code, and/or the other exclusions provided by Section 18-557 of the City Code. If a solicitation requires services, effective on January 1, 2017, Contractors must pay to all its employees, who provide services, a living wage of no less than $15.00 per hour without health benefits; or a wage of no less than $13.19 an hour, with health benefits. This language is only a summary of the key provisions of the City of Miami Living Wage Ordinance. Please review Section 18-557 of the City Code for a complete and thorough description of the City of Miami Living Wage Ordinance. 1.39 GOVERNING LAW AND VENUE - The validity and effect of this Contract shall be governed by the laws of the State of Florida. The parties agree that any action, mediation or arbitration arising out of this Contract shall take place in Miami -Dade County, Florida. In any action or proceeding each party shall bear their own respective attorney's fees. 1.40 HEADINGS AND TERMS - The headings to the various paragraphs of this Contract have been inserted for convenient reference only and shall not in any manner be construed as modifying, amending or affecting in any way the expressed terms and provisions hereof. 1.41 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) - Any person or entity that performs or assists the City of Miami with a function or activity involving the use or disclosure of "individually identifiable health information (IIHI) and/or Protected Health Information (PHI) shall comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the City of Miami Privacy 3/7/2024 7:11 PM p. 22 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Standards. HIPAA mandates for privacy, security and electronic transfer standards, which include but are not limited to: A. Use of information only for performing services required by the contract or as required by law; B. Use of appropriate safeguards to prevent non -permitted disclosures; C. Reporting to the City of Miami of any non -permitted use or disclosure; D. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Proposer and reasonable assurances that IIHI/PHI will be held confidential; E. Making Protected Health Information (PHI) available to the customer; F Making PHI available to the customer for review and amendment; and incorporating any amendments requested by the customer; G Making PHI available to the City of Miami for an accounting of disclosures; and H. Making internal practices, books and records related to PHI available to the City of Miami for compliance audits. PHI shall maintain its protected status regardless of the form and method of transmission (paper records, and/or electronic transfer of data). The Proposer must give its customers written notice of its privacy information practices including specifically, a description of the types of uses and disclosures that would be made with protected health information. 1.42 INDEMNIFICATION - Contractor shall indemnify, hold/save harmless and defend at its own costs and expense the City, its officials, officers, agents, directors, and employees, from liabilities, damages, losses, and costs, including, but not limited to reasonable attorney's fees, to the extent caused by the negligence, recklessness or intentional wrongful misconduct of Contractor and persons employed or utilized by Contractor in the performance of this Contract and will indemnify, hold harmless and defend the City, its officials, officers, agents, directors and employees against, any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted work, even if it is alleged that the City, its officials and/or employees were negligent. These indemnifications shall survive the term of this Contract. In the event that any action or proceeding is brought against City by reason of any such claim or demand, Contractor shall, upon written notice from City, resist and defend such action or proceeding by counsel satisfactory to City. The Contractor expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by Contractor shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate Contractor to defend at its own expense to and through appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against City whether performed by Contractor, or persons employed or utilized by Contractor. 3/7/2024 7:11 PM p. 23 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 This indemnity will survive the cancellation or expiration of the Contract. This indemnity will be interpreted under the laws of the State of Florida, including without limitation and which conforms to the limitations of §725.06 and/or §725.08, Fla. Statues, as amended from time to time as applicable. Contractor shall require all Sub -Contractor agreements to include a provision that they will indemnify the City. The Contractor agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Contractor in which the City participated either through review or concurrence of the Contractor's actions. In reviewing, approving or rejecting any submissions by the Contractor or other acts of the Contractor, the City in no way assumes or shares any responsibility or liability of the Contractor or Sub -Contractor, under this Agreement. 1.43 FORMATION AND DESCRIPTIVE LITERATURE - Proposer must furnish all information requested in the spaces provided in the Formal Solicitation. Further, as may be specified elsewhere, each Proposer must submit for evaluation, cuts, sketches, descriptive literature, technical specifications, and Material Safety Data Sheets (MSDS)as required, covering the products offered. Reference to literature submitted with a previous response or on file with the Buyer will not satisfy this provision. 1.44 INSPECTIONS - The City may, at reasonable times during the term hereof, inspect Contractor's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods and/or services required to be provided by the Contractor under this Contract conform to the terms and conditions of the Formal Solicitation. Contractor shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests and inspections shall be subject to, and made in accordance with, the provisions of the City of Miami Ordinance No. 12271 (Section 18-79), as same may be amended or supplemented from time to time. 1.45 INSPECTION OF RESPONSE - Responses received by the City pursuant to a Formal Solicitation will not be made available until such time as the City provides notice of a decision or intended decision or within 30 days after bid closing, whichever is earlier. Bid/Proposal results will be tabulated and may be furnished upon request via fax or e-mail to the Sr. Procurement Specialist issuing the Solicitation. Tabulations also are available on the City's Web Site following recommendation for award. 1.46 INSURANCE - Within ten (10) days after receipt of Notice of Award, the successful Contractor, shall furnish Evidence of Insurance to the Purchasing Department, if applicable. Submitted evidence of coverage shall demonstrate strict compliance to all requirements listed on the Special Conditions entitled "Insurance Requirements". The City shall be listed as an "Additional Insured." Issuance of a Purchase Order is contingent upon the receipt of proper insurance documents. If the insurance certificate is received within the specified time frame but not in the manner prescribed in this Solicitation the Contractor shall be verbally notified of such deficiency and shall have an additional five (5) calendar days to submit a corrected certificate to the City. If the Contractor fails to submit the required insurance documents in the manner prescribed in this Solicitation within fifteen (15) calendar days after receipt Notice of Award, the contractor shall be in default of the contractual terms and conditions and shall not be awarded the contract. Under such circumstances, the Proposer may be prohibited from submitting future responses to the City. Information regarding any insurance requirements shall be directed to the Risk Administrator, Depal lruent of 3/7/2024 7:11 PM p. 24 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Risk Management, at 444 SW 2nd Avenue, 9th Floor, Miami, Florida 33130, 305-416-1604. The Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in effect for the duration of the contractual period; including any and all option terms that may be granted to the Proposer. 1.47 INVOICES - Invoices shall contain purchase order number and details of goods and/or services delivered (i.e. quantity, unit price, extended price, etc.); and in compliance with Chapter 218 of the Florida Statutes (Prompt Payment Act). 1.48 LOCAL PREFERENCE A. City Code Section 18-85, states, "when a responsive, responsible non -local bidder submits the lowest bid price, and the bid submitted by one or more responsive, responsible local bidders who maintain a local office, as defined in Section 18-73, is within fifteen percent (15%) of the price submitted by the non -local bidder, then that non -local bidder and each of the aforementioned responsive, responsible local bidders shall have the opportunity to submit a best and final bid equal to or lower than the amount of the low bid previously submitted by the non -local bidder. Contract award shall be made to the lowest responsive, responsible bidder submitting the lowest best and final bid. In the case of a tie in the best and final bid between a local bidder and a non - local bidder, contract award shall be made to the local bidder." B. City Code Section 18-86, states, "the RFP, RFLI or RFQ, as applicable, may, in the exercise of the reasonable professional discretion of the City Manager, director of the using agency, and the Chief Procurement Officer, include a five (5%) percent evaluation criterion in favor of proposers who maintain a local office, as defined in Section 18-73. In such cases, this five (5%) percent evaluation criterion in favor of proposers who maintain a local office will be specifically defined in the RFP, RFLI or RFQ, as applicable; otherwise, it will not apply. 1.49 MANUFACTURER'S CERTIFICATION - The City reserves the right to request from Proposers a separate Manufacturer's Certification of all statements made in the bid/proposal. Failure to provide such certification may result in the rejection of bid/proposal or termination of contract/agreement, for which the Proposer must bear full liability. 1.50 MODIFICATIONS OR CHANGES IN PURCHASE ORDERS AND CONTRACTS - No contract or understanding to modify this Formal Solicitation and resultant purchase orders or contracts, if applicable, shall be binding upon the City unless made in writing by the Director of Procurement of the City of Miami, Florida through the issuance of a change order, addendum, amendment, or supplement to the contract, purchase order or award sheet as appropriate. 1.51 MOST FAVORED NATIONS - Successful Proposer(s) shall not treat the City of Miami ("City") worse than any other similarly -situated local government and, in this regard, grants the City a "most favored nations clause" meaning the City will be entitled to receive and be governed by the most favorable terms and conditions that Successful Proposer(s) grants now or in the future to a similarly situated local government. 1.52 NO PARTNERSHIP OR JOINT VENTURE - Nothing contained in this Contract will be deemed or construed to create a partnership or joint venture between the City of Miami and Contractor, or to create any 3/7/2024 7:11 PM p. 25 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 other similar relationship between the parties. 1.53 NONCONFORMANCE TO CONTRACT CONDITIONS - Items may be tested for compliance with specifications under the direction of the Florida Depai tiiient of Agriculture and Consumer Services or by other appropriate testing Laboratories as determined by the City. The data derived from any test for compliance with specifications is public record and open to examination thereto in accordance with Chapter 119, Florida Statutes. Items delivered not conforming to specifications may be rejected and returned at Proposer's expense. These non -conforming items not delivered as per delivery date in the response and/or Purchase Order may result in Proposer being found in default in which event any and all re -procurement costs may be charged against the defaulted contractor. Any violation of these stipulations may also result in the supplier's name being removed from the City of Miami's Supplier's list. 1.54 DISABILITIES ACT - Successful Proposer(s) shall not unlawfully discriminate against any person in its operations and activities or in its use or expenditure of funds in fulfilling its obligations under this Agreement. Successful Proposer(s) shall affirmatively comply with all applicable provisions of the Americans with Disabilities Act (ADA) in the course of providing any services funded by City, including Titles I and II of the ADA (regarding nondiscrimination on the basis of disability), and all applicable regulations, guidelines, and standards. In addition, Successful Proposer(s) shall take affirmative steps to ensure nondiscrimination in employment against disabled persons. Successful Proposer(s) affirms that it shall not discriminate as to race, age, religion, color, gender, gender identity, sexual orientation, national origin, marital status, physical or mental disability, political affiliation, or any other factor which cannot be lawfully used in connection with its performance under the Formal Solicitation. Furthermore, Successful Proposer(s) affirms that no otherwise qualified individual shall solely by reason of their race, age, religion, color, gender, gender identity, sexual orientation, national origin, marital status, physical or mental disability, political affiliation, or any other factor which cannot be lawfully used, be excluded from the participation in, be denied benefits of, or be subjected to, discrimination under any program or activity. In connection with the conduct of its business, including performance of services and employment of personnel, Successful Proposer(s) shall not discriminate against any person on the basis of race, age, religion, color, gender, gender identity, sexual orientation, national origin, marital status, physical or mental disability, political affiliation, or any other factor which cannot be lawfully used. All persons having appropriate qualifications shall be afforded equal opportunity for employment. 1.55 NON-EXCLUSIVE CONTRACT/ PIGGYBACK PROVISION - At such times as may serve its best interest, the City of Miami reserves the right to advertise for, receive, and award additional contracts for these herein goods and/or services, and to make use of other competitively bid (governmental) contracts, agreements, or other similar sources for the purchase of these goods and/or services as may be available. It is hereby agreed and understood that this formal solicitation does not constitute the exclusive rights of the Successful Proposer(s) to receive all orders that may be generated by the City in conjunction with this Formal Solicitation. In addition, any and all commodities, equipment, and services required by the City in conjunction with construction projects are solicited under a distinctly different solicitation process and shall not be purchased 3/7/2024 7:11 PM p. 26 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 under the terms, conditions and awards rendered under this solicitation, unless such purchases are determined to be in the best interest of the City. 1.56 NOTICE REGARDING "CURES" - Proposals submitted with irregularities, deficiencies, and/or technicalities that deviate from the minimum qualifications and submission requirements of Request for Qualifications (RFQ), Request for Proposals (RFP), Invitation to Bid (ITB), Invitation for Bids (IFB), Invitation to Quote (ITQ), Requests for Letters of Interest (RFLI) and Request for Sponsorships (RFS) shall result in a non -responsive determination. any solicitation issued after May 6, 2019, shall comply with APM 2-19. APM 2-19 is attached hereto. only minor irregularities, deficiencies, and technicalities may be allowed to be timely cured by the proposer at the sole discretion of the city. material irregularities, deficiencies, and technicalities cannot be cured by the proposer, and are not waivable by the city. PROPOSALS SUBMITTED WITH IRREGULARITIES, DEFICIENCIES, AND/OR TECHNICALITIES THAT DEVIATE FROM THE MINIMUM QUALIFICATIONS AND SUBMISSION REQUIREMENTS OF THIS RFP/Q SHALL RESULT IN A NON -RESPONSIVE DETERMINATION. The City will not give consideration to the curing of any Proposals that fail to meet the minimum qualifications and submission requirements of this RFP/Q. Proposer understands that non -responsive Proposals will not be evaluated and, therefore, will be eliminated from the Evaluation/Selection Process. 1.57 OCCUPATIONAL LICENSE - Any person, firm, corporation or joint venture, with a business location in the City of Miami and is submitting a Response under this Formal Solicitation shall meet the City's Occupational License Tax requirements in accordance with Chapter 31.1, Article I of the City of Miami Charter. Others with a location outside the City of Miami shall meet their local Occupational License Tax requirements. A copy of the license must be submitted with the response; however, the City may at its sole option and in its best interest allow the Proposer to supply the license to the City during the evaluation period, but prior to award. 1.58 ONE PROPOSAL - Only one (1) Response from an individual, firm, partnership, corporation or joint venture will be considered in response to this Formal Solicitation. 1.59 OWNERSHIP OF DOCUMENTS - It is understood by and between the parties that any documents, records, files, or any other matter whatsoever which is given by the City to the Successful Proposer(s) pursuant to this formal solicitation shall at all times remain the property of the City and shall not be used by the Proposer for any other purposes whatsoever without the written consent of the City. 1.60 PARTIAL INVALIDITY - If any provision of this Contract or the application thereof to any person or circumstance shall to any extent be held invalid, then the remainder of this Contract or the application of such provision to persons or circumstances other than those as to which it is held invalid shall not be affected thereby, and each provision of this Contract shall be valid and enforced to the fullest extent permitted by law. 1.61 PERFORMANCE/PAYMENT BOND - A Contractor may be required to furnish a Performance/Payment Bond as part of the requirements of this Contract, in an amount equal to one hundred percent (100%) of the contract price. 1.62 PREPARATION OF RESPONSES - Proposers are expected to examine the specifications, required delivery, drawings, and all special and general conditions. All bid/proposed amounts, if required, shall be 3/7/2024 7:11 PM p. 27 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 either typewritten or entered into the space provided with ink. Failure to do so will be at the Proposer's risk. A. Each Proposer shall furnish the information required in the Formal Solicitation. The Proposer shall sign the Response and print in ink or type the name of the Proposer, address, and telephone number on the face page and on each continuation sheet thereof on which he/she makes an entry, where required. B. If so required, the unit price for each unit offered shall be shown, and such price shall include packaging, handling and shipping, and F.O.B. Miami delivery inside City premises unless otherwise specified. Proposer shall include in the response all taxes, insurance, social security, workmen's compensation, and any other benefits normally paid by the Proposer to its employees. If applicable, a unit price shall be entered in the "Unit Price" column for each item. Based upon estimated quantity, an extended price shall be entered in the "Extended Price" column for each item offered. In case of a discrepancy between the unit price and extended price, the unit price will be presumed correct. C. The Proposer must state a definite time, if required, in calendar days for delivery of goods and/or services. D. The Proposer should retain a copy of all response documents for future reference. E. All responses, as described, must be fully completed and typed or printed in ink and must be signed in ink with the firm's name and by an officer or employee having authority to bind the company or firm by his/her signature. Bids/Proposals having any erasures or corrections must be initialed in ink by person signing the response or the response may be rejected. F. Responses are to remain valid for at least 180 days. Upon award of a contract, the content of the Successful Proposer(s)'s response may be included as part of the contract, at the City's discretion. G. The City of Miami's Response Forms shall be used at all times. Use of any other forms will result in the rejection of the response. ANY REQUIRED ATTACHMENTS PROVIDED BY THE CITY MUST BE RETURNED TO THE CITY OR YOUR RESPONSE SHALL BE DEEMED NON -RESPONSIVE. 1.63 PRICE ADJUSTMENTS - Any price decrease effectuated during the contract period either by reason of market change or on the part of the contractor to other customers shall be passed on to the City of Miami. 1.64 PRODUCT SUBSTITUTES - In the event a particular good (that has been awarded and approved) becomes unavailable during the term of the Contract, the Contractor awarded that item may arrange with the City's authorized representative(s) to supply a substitute product at the awarded price or lower, provided that a sample is approved in advance of delivery and that the new product meets or exceeds all quality requirements. 1.65 CONFLICT OF INTEREST, AND UNETHICAL BUSINESS PRACTICE PROHIBITIONS - Contractor represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Contract and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Contract. 1.66 PROMPT PAYMENT - Proposers may offer a cash discount for prompt payment; however, discounts 3/7/2024 7:11 PM p. 28 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 shall not be considered in determining the lowest net cost for response evaluation purposes. Proposers are required to provide their prompt payment terms in the space provided on the Formal Solicitation. If no prompt payment discount is being offered, the Proposer must enter zero (0) for the percentage discount to indicate no discount. If the Proposer fails to enter a percentage, it is understood and agreed that the terms shall be 2% 20 days, effective after receipt of invoice or final acceptance by the City, whichever is later. When the City is entitled to a cash discount, the period of computation will commence on the date of delivery, or receipt of a correctly completed invoice, whichever is later. If an adjustment in payment is necessary due to damage, the cash discount period shall commence on the date final approval for payment is authorized. If a discount is part of the contract, but the invoice does not reflect the existence of a cash discount, the City is entitled to a cash discount with the period commencing on the date it is determined by the City that a cash discount applies. Price discounts off the original prices quoted on the Price Sheet will be accepted from Successful Proposer(s)s during the term of the contract. 1.67 PROPERTY - Property owned by the City of Miami is the responsibility of the City of Miami. Such property furnished to a Contractor for repair, modification, study, etc., shall remain the property of the City of Miami. Damages to such property occurring while in the possession of the Contractor shall be the responsibility of the Contractor. Damages occurring to such property while in route to the City of Miami shall be the responsibility of the Contractor. In the event that such property is destroyed or declared a total loss, the Contractor shall be responsible for replacement value of the property at the current market value, less depreciation of the property, if any. 1.68 PROVISIONS BINDING - Except as otherwise expressly provided in the resulting Contract, all covenants, conditions and provisions of the resulting Contract shall be binding upon and shall inure to the benefit of the parties hereto and their respective heirs, legal representatives, successors and assigns. 1.69 PUBLIC ENTITY CRIMES - A person or affiliate who has been placed on the convicted vendor list, following a conviction for a public entity crime may not: A. Submit a Bid to provide any goods or services to a public entity. B. Submit a Bid on a contract with a public entity for the construction or repair of a public building or public work. C. Submit responses on leases of real property to a public entity. D. Be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity. E. Transact business with any public entity in excess of the threshold amount provided in Section 287.017, CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 1.70 PUBLIC RECORDS - Proposer understands that the public shall have access, at all reasonable times, 3/7/2024 7:11 PM p. 29 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 to all documents and information pertaining to City contracts, subject to the provisions of Chapter 119, Florida Statutes, and City Code, Section 18, Article III, and agrees to allow access by the City and the public, to all documents subject to disclosure under applicable law. Successful Proposer(s) shall additionally comply with the provisions of Section 119.0701, Florida Statutes, titled "Contracts; public records". Proposer shall additionally comply with Section 119.0701, Florida Statutes, including without limitation: A. Keep and maintain public records that ordinarily and necessarily would be required by the City to perform this service. B. Provide the public with access to public records on the same terms and conditions as the City would at the cost provided by Chapter 119, Florida Statutes, or as otherwise provided by law. C. Ensure that public records that are exempt or confidential and exempt from disclosure are not disclosed except as authorized by law. D. Meet all requirements for retaining public records and transfer, at no cost, to the City all public records in its possession upon termination of this Agreement and destroy any duplicate public records that are exempt or confidential and exempt from disclosure requirements. E. All electronically stored public records must be provided to the City in a format compatible with the City's information technology systems. IF THE CONSULTANT HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONSULTANT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT THE DIVISION OF PUBLIC RECORDS AT (305) 416-1800, VIA EMAIL AT PUBLICRECORDS@,MIAMIGOV.COM, OR REGULAR MAIL AT CITY OF MIAMI OFFICE OF THE CITY ATTORNEY, 444 SW 2ND AVENUE, 9TH FL, MIAMI, FL 33130. THE CONSULTANT MAY ALSO CONTACT THE RECORDS CUSTODIAN AT THE CITY OF MIAMI DEPARTMENT WHO IS ADMINISTERING THIS CONTRACT. 1.71 QUALITY OF GOODS, MATERIALS, SUPPLIES, PRODUCTS, AND EQUIPMENT - All materials used in the manufacturing or construction of supplies, materials, or equipment covered by this solicitation shall be new. The items bid/proposed must be of the latest make or model, of the best quality, and of the highest grade of workmanship, unless as otherwise specified in this Solicitation. 1.72 QUALITY OF WORK/SERVICES - The work/services performed must be of the highest quality and workmanship. Materials furnished to complete the service shall be new and of the highest quality except as otherwise specified in this Solicitation. 1.73 REMEDIES PRIOR TO AWARD (Sec. 18-106) - If prior to Contract award it is determined that a formal solicitation or proposed award is in violation of law, then the solicitation or proposed award shall be cancelled by the City Commission, the City Manager or the Chief Procurement Officer, as may be applicable, or revised to comply with the law. 1.74 RESOLUTION OF CONTRACT DISPUTES (Sec. 18-105) A. Authority to resolve Contract disputes. The City Manager, after obtaining the approval of the City Attorney, 3/7/2024 7:11 PM p. 30 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 shall have the authority to resolve disputes between the Proposer and the City which arise under, or by virtue of, a Contract between them; provided that, in cases involving an amount greater than $25,000, the City Commission must approve the City Manager's decision. Such authority extends, without limitation, to disputes based upon breach of Contract, mistake, misrepresentation, or lack of complete performance, and shall be invoked by a Contractual Party by submission of a protest to the City Manager. B. Contract dispute decisions. If a dispute is not resolved by mutual consent, the City Manager shall promptly render a written report stating the reasons for the action taken by the City Commission, or the City Manager, which shall be final and conclusive. A copy of the decision shall be immediately provided to the protesting party, along with a notice of such parry's right to seek judicial relief, provided that the protesting party shall not be entitled to such judicial relief without first having followed the procedure set forth in this Section. 1.75 RESOLUTION OF PROTESTED SOLICITATIONS AND AWARDS (SECTION 18-104): Right to protest. The following procedures shall be used for resolution of protested solicitations and awards except for purchases of goods, supplies, equipment, and services, the estimated cost of which does not exceed $25,000.00. Protests thereon shall be governed by the administrative policies and procedures of purchasing. Protest of solicitation. a. Any prospective proposer who perceives itself aggrieved in connection with the solicitation of a contract may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within three days after the request for proposals, request for qualifications or request for letters of interest is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the chief procurement officer; or b. Any prospective bidder who intends to contest bid specifications or a bid solicitation may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within three days after the bid solicitation is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the chief procurement officer. Protest of award. a. Any actual proposer who perceives itself aggrieved in connection with the recommended award of contract may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within two days after receipt by the proposer of the notice of the city manager's recommendation for award of contract. The receipt by proposer of such notice shall be confirmed by the city by facsimile or electronic mail or U.S. mail, return receipt requested. A notice of intent to file a protest is considered filed when received by the chief procurement officer; or b. Any actual responsive and responsible bidder whose bid is lower than that of the recommended bidder may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within two days after receipt by the bidder of the notice of the city's determination of non -responsiveness or non -responsibility. The receipt by bidder of such notice shall be confirmed by the city 3/7/2024 7:11 PM p. 31 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 by facsimile or electronic mail or U.S. mail, return receipt requested. A notice of intent to file a protest is considered filed when received by the chief procurement officer. c. A written protest based on any of the foregoing must be submitted to the chief procurement officer within five days after the date the notice of protest was filed. A written protest is considered filed when received by the chief procurement officer. The written protest may not challenge the relative weight of the evaluation criteria or the formula for assigning points in making an award determination. The written protest shall state with particularity the specific facts and law upon which the protest of the solicitation or the award is based and shall include all pertinent documents and evidence and shall be accompanied by the required filing fee as provided in subsection (f). This shall form the basis for review of the written protest and no facts, grounds, documentation or evidence not contained in the protester's submission to the chief procurement officer at the time of filing the protest shall be permitted in the consideration of the written protest. No time will be added to the above limits for service by mail. In computing any period of time prescribed or allowed by this section, the day of the act, event or default from which the designated period of time begins to run shall not be included. The last day of the period so computed shall be included unless it is a Saturday, Sunday or legal holiday in which event the period shall run until the end of the next day which is neither a Saturday, Sunday or legal holiday. Intermediate Saturdays, Sundays and legal holidays shall be excluded in the computation of the time for filing. Authority to resolve protests; hearing officer(s). Hearing officers appointed by the city shall have authority to resolve protests filed under this chapter of the City Code. The city manager shall appoint a hearing officer, from a separate list of potential hearing officers pre -approved by the city commission, to resolve protests filed in accordance with this section, no later than five working days following the filing of a bid protest. The hearing officer shall have the authority to settle and resolve any written protest. The hearing officer shall submit said decision to the protesting party and to the other persons specified within ten days after he/she holds a hearing under the protest. (1) Hearing officer. The hearing officer may be a special master as defined in chapter 2, article X, section 2- 811 of the City Code, or a lawyer in good standing with the Florida Bar for a minimum of ten years with a preference given to a lawyer who has served as an appellate or trial court judge. The hearing officer may be appointed from alternative sources (e.g. expert consulting agreements, piggyback contracts, etc.) where the city commission adopts a recommendation of the city attorney that such action is necessary to achieve fairness in the proceedings. The engagement of hearing officers is excluded from the procurement ordinance as legal services. The hearing officers appointed in the pre -qualified group should be scheduled to hear protests on a rotational basis. (2) Right of protest. Any actual bidder or proposer who has standing under Florida law dissatisfied and aggrieved with the decision of the city regarding the protest of a solicitation or the protest of an award as set forth above in this section may request a protest hearing. Such a written request for a protest hearing must be initiated with a notice of intent to protest followed by an actual protest as provided in subsection 18-104(a). 3/7/2024 7:11 PM p. 32 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 The notice of intent to protest and the actual protest must each be timely received by the chief procurement officer and must comply with all requirements set forth in subsection 18-104(a). Failure to submit the required notice of intent to protest and the actual protest within the specified timeframes will result in an administrative dismissal of the protest. (3) Hearing date. Within 30 days of receipt of the notice of protest, the chief procurement officer shall schedule a hearing before a hearing officer, at which time the person protesting shall be given the opportunity to demonstrate why the decision of the city relative to the solicitation or the award, which may include a recommendation for award by the city manager to the city commission, as applicable, should be overturned. The party recommended for award, if it is a protest of award, shall have a right to intervene and be heard. (4) Hearing procedure. The procedure for any such hearing conducted under this article shall be as follows: a. The city shall cause to be served by certified mail a notice of hearing stating the time, date, and place of the hearing. The notice of hearing shall be sent by certified mail, return receipt requested, to the mailing address of the protester. b. The party, any intervenor, and the city shall each have the right to be represented by counsel, to call and examine witnesses, to introduce evidence, to examine opposing or rebuttal witnesses on any relevant matter related to the protest even though the matter was not covered in the direct examination, and to impeach any witness regardless of which party first called him/her to testify. The hearing officer may extend the deadline for completion of the protest hearing for good cause shown, but such an extension shall not exceed an additional five business days. The hearing officer shall consider the written protest and supporting documents and evidence appended thereto, supporting documents or evidence from any intervenor, and the decision or recommendation as to the solicitation or award being protested, as applicable. The protesting party, and any intervenor, must file all pertinent documents supporting his/her protest or motion to intervene at least five business days before the hearing, as applicable. The hearing officer shall allow a maximum of two hours for the protest presentation and a maximum of two hours for the city response. When there is an intervenor, a maximum of two hours will be added for the intervenor. In the event of multiple protests for the same project, the hearing officer shall allocate time as necessary to ensure that the hearing shall not exceed a total of one day. c. The hearing officer shall consider the evidence presented at the hearing. In any hearing before the hearing officer, irrelevant, immaterial, repetitious, scandalous, or frivolous evidence shall be excluded. All other evidence of a type commonly relied upon by reasonably prudent persons in the conduct of their affairs shall be admissible whether or not such evidence would be admissible in trial in the courts of Florida. The hearing officer may also require written summaries, proffers, affidavits, and other documents the hearing officer determines to be necessary to conclude the hearing and issue a final order within the time limits set forth by this section. d. The hearing officer shall determine whether procedural due process has been afforded, whether the essential requirements of law have been observed, and whether the decision was arbitrary, capricious, an abuse of discretion, or unsupported by substantial evidence as a whole. Substantial evidence means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. e. Within ten days from the date of the hearing, the hearing officer shall complete and submit to the 3/7/2024 7:11 PM p. 33 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 City Manager, the City Attorney, any intervenor, the Chief Procurement Officer, and the person requesting said hearing a final order consisting of his/her findings of fact and conclusions of law as to the denial or granting of the protest, as applicable. f. The decisions of the hearing officer are final in terms of city decisions relative to the protest. Any appeal from the decision of the hearing officer shall be in accordance with the Florida Rules of Appellate Procedure. Compliance with filing requirements. Failure of a party to timely file either the notice of intent to file a protest or the written protest, together with the required filing fee as provided in subsection (f), with the chief procurement officer within the time provided in subsection (a), above, shall constitute a forfeiture of such party's right to file a protest pursuant to this section. The protesting party shall not be entitled to seek judicial relief without first having followed the procedure set forth in this section. Stay of procurements during protests. Upon receipt of a written protest filed pursuant to the requirements of this section, the city shall not proceed further with the solicitation or with the award of the contract until the protest is resolved by the chief procurement officer or the city commission as provided in subsection (b) above, unless the city manager makes a written determination that the solicitation process or the contract award must be continued without delay in order to avoid an immediate and serious danger to the public health, safety or welfare. Costs. All costs accruing from a protest shall be assumed by the protestor. Filing fee. The written protest must be accompanied by a filing fee in the form of a money order or cashier's check payable to the city in an amount equal to one percent of the amount of the bid or proposed contract, or $5,000.00, whichever is less, which filing fee shall guarantee the payment of all costs which may be adjudged against the protestor in any administrative or court proceeding. If a protest is upheld by the chief procurement officer and/or the city commission, as applicable, the filing fee shall be refunded to the protestor less any costs assessed under subsection above. If the protest is denied, the filing fee shall be forfeited to the city in lieu of payment of costs for the administrative proceedings as prescribed by subsection (e) above. (Ord. No. 12271, § 2, 8-22-02; Ord. No. 13629, § 2, 9-8-16). 1.76 SAMPLES - Samples of items, when required, must be submitted within the time specified at no expense to the City. If not destroyed by testing, Proposer(s) will be notified to remove samples, at their expense, within 30 days after notification. Failure to remove the samples will result in the samples becoming the property of the City. 1.77 SELLING, TRANSFERRING OR ASSIGNING RESPONSIBILITIES - Proposer shall not sell, 3/7/2024 7:11 PM p. 34 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 assign, transfer or subcontract at any time during the term of the Contract, or any part of its operations, or assign any portion of the performance required by this contract, except under and by virtue of written permission granted by the City through the proper officials, which may be withheld or conditioned, in the City's sole discretion. 1.78 SERVICE AND WARRANTY - When specified, the Proposer shall define all warranty, service and replacements that will be provided. Proposer must explain on the Response to what extent warranty and service facilities are available. A copy of the manufacturer's warranty, if applicable, should be submitted with your response. 1.79 SILENCE OF SPECIFICATIONS - The apparent silence of these specifications and any supplemental specification as to any detail or the omission from it of detailed description concerning any point shall be regarded as meaning that only the best commercial practices are to prevail and that only materials of first quality and correct type, size and design are to be used. All workmanship and services are to be first quality. All interpretations of these specifications shall be made upon the basis of this statement. If your firm has a current contract with the State of Florida, Department of General Services, to supply the items on this solicitation, the Proposer shall quote not more than the contract price; failure to comply with this request will result in disqualification of proposal. 1.80 SUBMISSION AND RECEIPT OF RESPONSES - Electronic Proposal submittals to this RFP are to be submitted through BidSync Electronic Bidding System ("BidSync") until the date and time as indicated in the Solicitation. The responsibility for submitting a Proposal on/or before the stated closing time and date is solely and strictly the responsibility of the Proposer. The City will in no way be responsible for delays caused by technical difficulties or caused by any other occurrence. Electronic Proposal submissions may require the uploading of electronic attachments. The submission of attachments containing embedded documents or proprietary file extensions is prohibited. All documents should be attached as individual files and labeled. Any Proposals received and time stamped through BidSync, prior to the Proposal submittal deadline shall be accepted as a timely submittal; anything thereafter will be rejected. Additionally, BidSync will not allow for the electronic Proposal submittal after the closing date and time has lapsed. Proposals will be opened promptly at the time and date specified. 1. Must register, free of charge, with BidSync Electronic Bidding System ("BidSync") to establish an account in order to have access to view and/or respond to any solicitations issued by the City of Miami's Procurement Depai truent ("City"). 2. Shall submit all Proposals electronically. Hard copy Bid submittals will not be accepted. NO EXCEPTIONS. 3. Must submit the Certification Statement and associated solicitation documents which define requirements of items and/or services to be purchased and must be completed and submitted as outlined within the solicitation via BidSync. The use of any other forms and/or the modification of City forms will result in the rejection of the Proposer's Proposal submittal. 4. Shall ensure that the Certification Statement is fully completed and provided with your Proposal. Failure to comply with these requirements may cause the Proposal to be rejected. 5. Must ensure that an authorized agent of the Proposer's firm signs the Certification Statement and submits it electronically. FAILURE TO SIGN THE CERTIFICATION STATEMENT SHALL DEEM THE PROPOSAL NON -RESPONSIVE. 3/7/2024 7:11 PM p. 35 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 6. May be considered non -responsive if Proposals do not conform to the terms and conditions of this solicitation. 1.81 TAXES - The City of Miami is exempt from any taxes imposed by the State and/or Federal Government. Exemption certificates will be provided upon request. Notwithstanding, Proposers should be aware of the fact that all materials and supplies which are purchased by the Proposer for the completion of the contract is subject to the Florida State Sales Tax in accordance with Section 212.08, Florida Statutes, as amended and all amendments thereto and shall be paid solely by the Proposer. 1.82 TERMINATION -The City Manager on behalf of the City of Miami reserves the right to terminate this contract by written notice to the contractor effective the date specified in the notice should any of the following apply: A. The contractor is determined by the City to be in breach of any of the terms and conditions of the contract. B. The City has determined that such termination will be in the best interest of the City to terminate the contract for its own convenience; C. Funds are not available to cover the cost of the goods and/or services. The City's obligation is contingent upon the availability of appropriate funds. 1.83 TERMS OF PAYMENT - Payment will be made by the City after the goods and/or services awarded to a Proposer have been received, inspected, and found to comply with award specifications, free of damage or defect, and properly invoiced. No advance payments of any kind will be made by the City of Miami. Payment shall be made after delivery, within 45 days of receipt of an invoice and authorized inspection and acceptance of the goods/services and pursuant to Section 218.74, Florida Statutes and other applicable law. 1.84 TIMELY DELIVERY - Time will be of the essence for any orders placed as a result of this solicitation. The City reserves the right to cancel such orders, or any part thereof, without obligation, if delivery is not made within the time(s) specified on their Response. Deliveries are to be made during regular City business hours unless otherwise specified in the Special Conditions. 1.85 TITLE - Title to the goods or equipment shall not pass to the City until after the City has accepted the goods/equipment or used the goods, whichever comes first. 1.86 TRADE SECRETS EXECUTION TO PUBLIC RECORDS DISCLOSURE - All Responses submitted to the City are subject to public disclosure pursuant to Chapter 119, Florida Statutes. An exception may be made for "trade secrets." If the Response contains information that constitutes a "trade secret", all material that qualifies for exemption from Chapter 119 must be submitted in a separate envelope, clearly identified as "TRADE SECRETS EXCEPTION," with your firm's name and the Solicitation number and title marked on the outside. Please be aware that the designation of an item as a trade secret by you may be challenged in court by any person. 3/7/2024 7:11 PM p. 36 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 By your designation of material in your Response as a "trade secret" you agree to indemnify and hold harmless the City for any award to a plaintiff for damages, costs or attorney's fees and for costs and attorney's fees incurred by the City by reason of any legal action challenging your claim. 1.87 UNAUTHORIZED WORK OR DELIVERY OF GOODS - Neither the qualified Proposer(s) nor any of his/her employees shall perform any work or deliver any goods unless a change order or purchase order is issued and received by the Contractor. The qualified Proposer(s) shall not be paid for any work performed or goods delivered outside the scope of the contract or any work performed by an employee not otherwise previously authorized. 1.88 USE OF NAME - The City is not engaged in research for advertising, sales promotion, or other publicity purposes. No advertising, sales promotion or other publicity materials containing information obtained from this Solicitation are to be mentioned, or imply the name of the City, without prior express written permission of the City Manager or the City Commission. 1.89 VARIATIONS OF SPECIFICATIONS - For purposes of solicitation evaluation, Proposers must indicate any variances from the solicitation specifications and/or conditions, no matter how slight. If variations are not stated on their Response, it will be assumed that the product fully complies with the City's specifications. 3/7/2024 7:11 PM p. 37 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 2. Special Conditions 2.1. PURPOSE The purpose of this Solicitation is to establish a contract, for a pre -qualified pool of firms to provide Employee Voluntary Supplemental Insurance Benefits, including but not limited to: Disability, Group Hospital Indemnity, and Group Accident Insurance products as specified herein, from a source(s), that will provide prompt and efficient service, fully compliant with the terms, conditions and stipulations of the Solicitation. 2.2. VOLUNTARY PRE -PROPOSAL CONFERENCE A Virtual Voluntary pre -proposal conference will be held Monday, March 18, 2024 at 11:00 AM, via Teams Click here to join the meeting , Meeting ID: 285 815 306 773; Passcode: muGcHH, or via phone (786) 598-2961,Phone Conference ID: 424 929 21#. A discussion of the requirements of the Solicitation will occur at that time. Each potential Proposer is required, prior to submitting a Proposal, to acquaint itself thoroughly with any and all conditions and/or requirements that may in any manner affect the work to be performed. All questions and answers affecting the scope of work/specifications of the RFQ will be included in an addendum, that will be distributed through BidSync, following the Pre -Proposal Conference to all the attendees. Because the City considers the Pre -Proposal Conference to be critical to understanding the Solicitation requirements, attendance is highly recommended. 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL INFORMATION / CLARIFICATION Any questions or clarifications concerning this solicitation shall be submitted electronically via the Bidsync Portal. All questions must be received no later than Friday, March 22, 2024 @ 5:00 PM. All responses to questions will be sent to all prospective bidders/proposers in the form of an addendum. NO QUESTIONS WILL BE RECEIVED VERBALLY OR AFTER SAID DEADLINE. 2.4. TERM OF CONTRACT The Proposer(s) qualified to provide the services requested herein (the "Successful Proposer(s)") shall be required to execute a Professional Service Agreement ("Contract") with the City, which shall include, but not be limited to, the following terms: (1) The term of the Contract shall be for three (3) years with an option to renew for one (1) additional three (3) year period. (2) The City shall have the option to extend or terminate the Contract. Continuation of the contract beyond the initial period is a City prerogative; not a right of the Proposer. This prerogative will be exercised only when such continuation is clearly in the best interest of the City. 2.5. CONDITIONS FOR RENEWAL Each renewal of this contract is subject to the following: (1) Continued satisfactory performance compliance with the specifications, terms and conditions 3/7/2024 7:11 PM p. 38 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 established herein. (2) Availability of funds 2.6. LIVING WAGE ORDINANCE The City of Miami adopted a Living Wage Ordinance for City Service Contracts with a total contract value exceeding $100,000 annually, and that have been competitively solicited and awarded on, or after January 1, 2017 by the City. "Service Contract" means a contract to provide services to the City, excluding, however, professional services as defined by the "Consultants Competitive Negotiation Act" set forth in FL. Stat. § 287.055, and Section 18-87 of the City Code, and/or the other exclusions provided by Section 18-557 of the City Code. Section 18-557 is attached as Attachment A and is located in the Documents Section of BidSync. Please refer to Attachment A, Section 18-557 in the Solicitation. If a solicitation requires services, effective on January 1, 2017, contractors must pay to all its employees, who provide services, a living wage of no less than $15.00 per hour without health benefits; or a wage of no less than $13.19 an hour, with health benefits. This language is only a summary of the key provisions of the City of Miami Living Wage Ordinance. Please review Attachment A, attached hereto, for a complete and thorough description of the City of Miami Living Wage Ordinance. 2.7. PROPOSERS' MINIMUM QUALIFICATIONS For a Proposer(s) to be deemed responsive, the following minimum qualification requirements cited below shall be satisfied. In determining said responsiveness, each such minimum qualification requirement shall be addressed in detail in the Proposal submittal. Failure to meet each minimum qualification requirement and/or failure to provide sufficient detailed documentation concerning the same, shall result in the Proposal being deemed non -responsive. Proposer(s) Shall: A. Be licensed by the State of Florida, Office of Insurance Regulations to provide the plan services at the time of proposal due date, and throughout the term of the contract, any renewals and extensions thereof; B. Bean insurance carrier, hold a minimum "A" insurance rating from A.M. Best or a comparable financial rating organization (i.e., Moody's, Standard & Poor's or Weiss) and a Financial Classification or "VII" or higher, at the time of proposal submission; C. Have a record of performance of no less than five (5) consecutive years, operating under the same name and Federal Employee Identification Number ("FEIN"), and providing group disability insurance programs for government clients or similar size private entities, similar in nature and scope, as described in the specifications herein; D. Be an active, currently registered corporation, limited liability company or limited partnership with the State of Florida Division of Corporations, and be in good standing with the same; and E. Have never filed for bankruptcy, be in sound financial condition, have no record of civil litigation or pending lawsuits involving criminal activities of a moral turpitude, and shall not have conflicts of interest with the City. 3/7/2024 7:11 PM p. 39 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 F. Not have a member, principal, officer, or stockholder who is in arrears or in default of any debt or contract involving the City, is a defaulter or surety upon any obligation to the City, and/or has failed to perform faithfully any contract with the City. Note: Submittals that do not address each of the above stipulated requirements within their proposal submission, shall be considered non -responsive and eliminated from the process. 2.8. REFERENCES Each proposal MUST be accompanied by a list of three (3) references, submitted on Attachment B, Reference Submittal Form, for projects performed for government clients or similar size privateentities which shall include for each project, the name of the organization, dates covering the term of the contract; description of the scope of work; client contact person and phone number, and statement of whether Proposer was the prime contractor or subcontractor. 2.9. LOCAL PREFERENCE Proposers wishing to apply for the local office preference shall comply with the General Terms and Conditions, Section 1.48 Local Preference of this solicitation and with Section 18-73 of the City of Miami Procurement Code, titled "Definitions", and shall submit with the Proposal at the time of the Proposal due date the following: • Completion and submission of the attached City of Miami Local Office Certification Form provided as Attachment C, located in the Documents Section in BidSync; • Submission of a copy of the Proposer's lease documents at the location being deemed a City of Miami Local Office; • Submission of a City of Miami Business Tax Receipt; • Submission of a Miami Dade County Business Tax Receipt; and • Submission of a copy of the license, certificate of competency, and certificate of use that authorizes the performance of the Proposer. 2.10 EXECUTION OF AN AGREEMENT The Successful Proposer(s), evaluated and ranked in accordance with the requirements of this Solicitation, shall be awarded an opportunity to negotiate a Professional Services Agreement ("PSA") with the City. The City reserves the right to execute or not execute, as applicable a PSA with the Successful Proposer(s) in substantially the same form as the sample PSA included as part of this solicitation. Such PSA will be furnished by the City, will contain certain terms as are in the City's best interest, and will be subject to approval as to legal by the City Attorney. 2.11. INSURANCE REQUIREMENTS INDEMNIFICATION Successful Proposer(s) shall indemnify, hold and save harmless, and defend (at its own cost and expense), the City, its officers, agents, directors, and/or employees, from all liabilities, damages, losses, 3/7/2024 7:11 PM p. 40 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 judgments, and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, negligent act or omission, or intentional wrongful misconduct of Successful Proposer(s) and persons employed or utilized by Successful Proposer(s) in the performance of this Contract. Successful Proposer(s) shall further, hold the City, its officials and employees, indemnify, save and hold harmless for, and defend (at its own cost), the City its officials and/or employees against any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted Work, even if it is alleged that the City, its officials, and/or employees were negligent. In the event that any action or proceeding is brought against the City by reason of any such claim or demand, the Successful Proposer(s) shall, upon written notice from the City, resist and defend such action or proceeding by counsel satisfactory to the City. The Successful Proposer(s) expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by the Successful Proposer(s) shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate the Successful Proposer(s) to defend, at its own expense, to and through trial, administrative, appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at the City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against the City, whether performed by the Successful Proposer(s), or persons employed or utilized by Successful Proposer(s). These duties will survive the cancellation or expiration of the Contract. This Section will be interpreted under the laws of the State of Florida, including without limitation and interpretation, which conforms to the limitations of Sections 725.06 and/or 725.08, Florida Statutes, as applicable and as amended. Successful Proposer(s) shall require all subcontractors(s) agreements to include a provision that each subcontractor(s) will indemnify the City in substantially the same language as this Section. The Successful Proposer(s) agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Successful Proposer(s) in which the City participated either through review or concurrence of the Successful Proposer(s)'s actions. In reviewing, approving or rejecting any submissions by the Successful Proposer(s) or other acts of the Successful Proposer(s), the City, in no way, assumes or shares any responsibility or liability of the Successful Proposer(s) or subcontractor(s) under this Contract. Ten dollars ($10) of the payments made by the City constitute separate, distinct, and independent consideration for the granting of this Indemnification, the receipt and sufficiency of which is voluntarily and knowingly acknowledged by the Successful Proposer(s). Note: Insurance Definitions, Conditions and Additional Requirements are provided as Attachment D to this solicitation which is located in the Documents Section of BidSync. The Successful Proposer(s) shall furnish to City of Miami, c/o Procurement Depai linent, 444 SW 2nd Avenue, 6th Floor, Miami, Florida 33130, Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets the requirements as outlined below: I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence General Aggregate Limit $ 1,000,000 $ 2,000,000 3/7/2024 7:11 PM p. 41 City of Miami Solicitation RFQ 1733386 B. Personal and Adv. Injury Products/Completed Operations Endorsements Required City of Miami listed as additional insured Contingent & Contractual Liability Premises and Operations Liability Primary Insurance Clause Endorsement II. Business Automobile Liability Request for Qualifications No. 1773386 $ 1,000,000 $ 1,000,000 A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami listed as an additional insured III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation Employer's Liability A. Limits of Liability $500,000 for bodily injury caused by an accident, each accident $500,000 for bodily injury caused by disease, each employee $500,000 for bodily injury caused by disease, policy limit, IV. Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim $ 5,000,000 General Aggregate Limit $ 5,000,000 Retro Date Included V. Network Security and Piracy Injury (Cyber Liability) Each Claim Policy Aggregate Retro Date Included $3,000,000 $3,000,000 3/7/2024 7:11 PM p. 42 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Consultant agrees to maintain professional liability/Errors & Omissions coverage, along with Network Security and Privacy Injury (Cyber) coverage for a minimum of 1 year after termination of the contract period subject to continued availability of commercially reasonable terms and conditions of such coverage. VI. Umbrella Liability A Each Occurrence $ 3,000,000 Policy Aggregate $ 3,000,000 B. Endorsements Required City of Miami listed as additional insured Coverage is excess over all applicable liability policies. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer in accordance with policy provisions. Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A-" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. 2.12. PROJECT MANAGER Upon award, Successful Proposer(s) shall report and work directly with Ann -Marie Sharpe, Director, Risk Management Department, or designee, who shall be designated as the Project Manager for the City. 2.13. SUBCONTRACTOR(S) OR SUBCONSULTANT(S) A Sub -Consultant, herein known as Sub-Contractor(s) is an individual or firm contracted by the Proposer or Proposer's firm to assist in the performance of services required under this Solicitation. Sub -Contractors shall be paid through Proposer or Proposer's firm and not paid directly by the City. Sub -Contractors are allowed by the City in the performance of the services delineated within this Solicitation. Proposer must clearly reflect in its Proposal the major Sub-Contractor(s) to be utilized in the performance of required services. The City retains the right to accept or reject any Sub -Contractors proposed in the response of Successful Proposer(s) or prior to contract execution. Any and all liabilities regarding the use of a Sub-Contractor(s) shall be borne solely by the Successful Proposer(s) and insurance for each Sub-Contractor(s) must be maintained in good standing and approved by the City throughout the duration of the Contract. Neither Successful Proposer(s) nor any of its Sub -Contractors are considered to be employees or agents of the City. Failure to list all Sub -Contractors and provide the required information may disqualify any proposed Sub -Contractors from performing work under this 3/7/2024 7:11 PM p. 43 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Solicitation. Proposers shall include in their Responses the requested Sub -Contractor information and include all relevant information required of the Proposer. In addition, within five (5) working days after the identification of the award to the Successful Proposer(s), the Successful Proposer(s) shall provide a list confirming the Sub -Contractors that the Successful Proposer(s) intends to utilize in the Contract, if applicable. The list shall include, at a minimum, the name, location of the place of business for each Sub -Contractor, the services Sub -Contractor will provide relative to any contract that may result from this Solicitation, any applicable licenses, references, ownership, and other information required of Proposer. 2.14. REMOVAL OF EMPLOYEES / SUBCONTRACTORS All employees of the Successful Proposer(s) and Subcontractor(s)'s, if applicable, shall be considered to be, at all times, employees of the Successful Proposer(s) and Subcontractor(s) under its sole direction and not employees or agents of the City. The Successful Proposer(s) and Subcontractor(s) shall supply competent and capable employees. The City may require the Successful Proposer(s) or Subcontractor(s) to remove an employee(s) the City deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment under this contract is not in the best interest of the City. 2.15. UNAUTHORIZED WORK The Successful Proposer(s) shall not begin work until a Purchase Order and/or a Notice to Proceed are received. 2.16. CHANGES/ALTERATIONS Proposer may change or withdraw a Proposal at any time prior to Proposal submission deadline; however, no oral modifications will be allowed. Written modifications shall not be allowed following the proposal deadline. 2.17. METHOD OF PAYMENT Payment will be made upon receipt and acceptance of invoices. No partial down payments will be made. 2.18. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD The procedure for response evaluation, selection and award is as follows: (1) Solicitation issued; (2) Receipt of responses; (3) Opening and listing of all responses received; (4) Procurement staff will review each submission for compliance with the submission requirements of the solicitation, including verifying that each submission includes all documents required; (5) An Evaluation Committee ("Committee"), appointed by the City Manager, comprised of appropriate City Staff and members of the community, as deemed necessary, with the appropriate technical expertise and/or knowledge, shall meet to evaluate the proposals in accordance with the requirements 3/7/2024 7:11 PM p. 44 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 of this solicitation and based upon the evaluation criteria as specified within Section 5, Evaluation Criteria; (6) The Committee reserves the right, in its sole discretion, to request Proposers to make oral presentations before the Committee as part of the evaluation process. The presentation may be scheduled at the convenience of the Committee and shall be recorded. The recommendations of the Committee shall be submitted to the City Manager; (7) The City Manager reserves the right to reject the Committee's recommendations and instruct the Committee to re-evaluate and make another recommendation or reject all proposals. No Proposer(s) shall have any rights against the City arising from such termination thereof; (8) If the City Manager accepts the Committee's recommendations the City Manager shall then submit his or her award recommendation and contract(s) to the City Commission for approval. Written notice shall be provided to all proposers. If the City Manager accepts the award recommendation(s), the City Manager's recommendation for award of contract(s) will be posted on the City of Miami Procurement Department website, in the Supplier Corner, Current Solicitations and Notice of Recommendation of Award Section. The notice of the City Manager's recommendation can be found by selecting the details of the solicitation and is listed as Recommendation of Award Posting Date and Recommendation of "Award To" fields. If "various" is indicated in the Recommendation of "Award To" field, the Proposer must contact the Contracting Officer for that solicitation to obtain the suppliers names. (9) After reviewing the City Manager's recommendation, the City Commission may: 1. Approve the City Manager's award recommendation and contract(s); 2. Reject all proposals; 3. Reject all proposals and instruct the City Manager to reissue a solicitation; or 4. Reject all proposals and instruct the City Manager to enter into competitive negotiations with at least three individuals possessing the ability to perform such services and obtain information from said individuals relating to experience, qualifications and the proposed cost or fee for said services, and make a recommendation to the City Commission. The decision of the City Commission shall be final. Written notice of the award shall be given to the Successful Proposer(s). 2.19. RECORDS During the contract period, and for a least five (5) subsequent years thereafter, Successful Proposer(s) shall provide City access to all files and records maintained on the City's behalf. 2.20. ADDITIONAL SERVICES Services not specifically identified in this Solicitation may be added to any resultant contract upon successful negotiation and mutual consent of the contracting parties. 2.21. TRUTH IN NEGOTIATION CERTIFICATE Execution of the resulting agreement by the Successful Proposer(s) shall act as the execution of truth - in -negotiation certificate stating that wage rates and other factual unit costs supporting the compensation of the resulting Agreement are accurate, complete, and current at the time of contracting. The original contract price and any additions thereto shall be adjusted to exclude any significant sums by which City 3/7/2024 7:11 PM p. 45 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 determines the contract price was increased due to inaccurate, incomplete, or non -current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year following the end of the Agreement. 2.22. NON -APPROPRIATION OF FUNDS In the event no funds or insufficient funds are appropriated and budgeted or are otherwise unavailable in any fiscal period for payments due under this contract, then the City, upon written notice to the Successful Proposer(s) or his/her assignee of such occurrence, shall have the unqualified right to terminate the contract without any penalty or expense to the City. No guarantee, warranty or representation is made that any project(s) will be awarded to any firm(s). 2.23. FAILURE TO PERFORM Should it not be possible to reach the Successful Proposer(s) and/or should remedial action not be taken within forty-eight (48) hours of any failure to perform according to specifications, the City reserves the right to declare Successful Proposer(s) in default of the contract or make appropriate reductions in the contract payment. 2.24. TERMINATION A. FOR DEFAULT If Successful Proposer(s) defaults in its performance under this Contract and does not cure the default within thirty (30) days after written notice of default, the City Manager may terminate this Contract, in whole or in part, upon written notice without penalty to the City of Miami. In such event the Successful Proposer(s) shall be liable for damages including the excess cost of procuring similar supplies or services: provided that if, (1) it is determined for any reason that the Successful Proposer(s) was not in default or (2) the Successful Proposer(s)'s failure to perform is without his or his Subcontractor's control, fault or negligence, the termination will be deemed to be a termination for the convenience of the City of Miami. B. FOR CONVENIENCE The City Manager may terminate this Contract, in whole or in part, upon thirty (30) days prior written notice when it is in the best interest of the City of Miami. If this Contract is for supplies, products, equipment, or software, and so terminated for the convenience by the City of Miami the Successful Proposer(s) will be compensated in accordance with an agreed upon adjustment of cost. To the extent that this Contract is for services and so terminated, the City of Miami shall be liable only for payment in accordance with the payment provisions of the Contract for those services rendered prior to termination. 2.25. ADDITIONAL TERMS AND CONDITIONS No additional terms and conditions included as part of your solicitation response shall be evaluated or considered, and any and all such additional terms and conditions shall have no force or effect and are inapplicable to this solicitation. If submitted either purposely, through intent or design, or inadvertently, appearing separately in transmittal letters, specifications, literature, price lists or warranties, it is understood and agreed that the General Conditions and Special Conditions in this solicitation are the only conditions applicable to this solicitation and that the Proposer's authorized signature affixed to the 3/7/2024 7:11 PM p. 46 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 Proposer's acknowledgment form attests to this. If a Professional Services Agreement ("PSA") or other Agreement is provided by the City and is expressly included as part of this solicitation, no additional terms or conditions which materially or substantially vary, modify or alter the terms or conditions of the PSA or Agreement, in the sole opinion and reasonable discretion of the City will be considered. Any and all such additional terms and conditions shall have no force or effect and are inapplicable to this PSA or Agreement. 2.26. E-VERIFY EMPLOYMENT REQUIREMENTS Successful Proposer(s) shall E-Verify the employment status of all employees and subcontractors to the extent required by federal, state, and local laws, rules, and regulations. The City shall consider the employment by Successful Proposer(s) of unauthorized aliens a violation of Section 274A(e) of the Immigration and Nationality Act. If the Successful Proposer(s) knowingly employs unauthorized aliens, such violation shall be cause for termination of the Contract. Furthermore, the Successful Proposer(s) agrees to utilize the U.S. Agency of Homeland Security's E-Verify System, https://e- verify.uscis.gov/emp, to verify the employment eligibility of all employees during the term of this Contract. Successful Proposer(s) shall also include a requirement in subcontracts that the subcontractor shall also utilize the E-Verify System to verify the employment eligibility of all employees of the subcontractor during the term of this Contract. 3/7/2024 7:11 PM p. 47 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 3. Specifications 3.1. SPECIFICATIONS/SCOPE OF WORK The City of Miami, hereinafter referred to as the "City," as represented by the City's Risk Management Department ("Risk"), is soliciting proposals from experienced and qualified firms to provide Employee Voluntary Supplemental Insurance Benefits, including but not limited to: Disability, Group Hospital Indemnity, and Group Accident Insurance products. Successful Proposer(s) will provide appropriate resources to coordinate, monitor, market and place the programs. Employee enrollment in these programs will be 100% voluntary. A. SPECIFICATIONS FOR ALL PLANS 1. All plans will be fully insured. 2. The effective dates of all benefits shall be effective immediately. 3. Employees are eligible for coverage on the first day of full-time employment. 4. The City will not allow minimum participation requirements. 5. Annual premiums will be deducted from employee payrolls on a bi-weekly basis and pro -rated over twenty-six (26) pay periods. 6. Employee participation is optional. 7. Variations in enrollment levels shall not impact premiums. 8. Benefits will not be reduced on the basis of participant age. 9. Guaranteed issue with guaranteed issue strategy for future re -enrollments should be incorporated. 10. If multiple benefit offerings are proposed, they should differ only in the amount of benefits paid. B. INDIVIDUAL PLAN SPECIFICATIONS: Successful Proposer(s) shall propose plan(s)/products(s) that include, at a minimum, the following: 1. Short Term Disability: 1. Return to Work Incentive 2. Long Term Disability: 1. Return to Work Incentive 2. Rehabilitation Incentive Benefit 3. HOSPITAL INDEMNITY: 1. Admission and confinement benefits 2. Successor Insured Benefit 3/7/2024 7:11 PM p. 48 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 4. ACCIDENT INSURANCE: 1. Wellness Benefit 2. Emergency Room Benefit 3. Hospital/ICU Admission Benefit 3/7/2024 7:11 PM p. 49 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 4. Submission Requirements 4.1. SUBMISSION REQUIREMENTS Proposers shall carefully follow the format and instruction outlined below, observing format requirements as indicated. Proposals should contain the information itemized below and in the order indicated. This information should be provided for the Proposer and any sub -consultants to be utilized for the work contemplated by this Solicitation. Proposals submitted which do not include the following items may be deemed non -responsive and may not be considered for contract award. The Proposal shall be written in sufficient detail to permit the City to conduct a meaningful evaluation of the proposed services. However, overly elaborate responses are neither requested nor desired. Proposals must be submitted through BidSync Electronic Bidding System ("BidSync") no later than the date and time indicated within the RFQ, in order to be considered. Faxed documents are not acceptable. Emailed submissions are not acceptable. Hardcopy submissions are not acceptable. Proposals must be timely submitted through BidSync, or the Proposal will be disqualified. Untimely or misdelivered submittals will not be considered. NO EXCEPTIONS. The responses to this solicitation shall be presented in the following format. Failure to do so may deem your Proposal non -responsive. A. Include the signed RFQ Certification Statement and completed Certification Questions. B. Include in detail, evidence that clearly demonstrates Proposer meets or exceeds the minimum qualification requirements, pursuant to Section 2.7, Proposer's Minimum Qualifications 1. Cover Page The Cover Page should include the Proposer's name; Contact Person for the RFQ; Firm's Liaison for the Contract; Primary Office Location; Local Business Address, if applicable; Business Phone and Fax Numbers, if applicable Email addresses; Title of RFQ; RFQ Number; and Federal Employer Identification Number. 2. Table of Contents The table of contents should outline, in sequential order, the major sections of the Proposal as listed below, including all other relevant documents requested for submission. All pages of the Proposal, including the enclosures, should be clearly and consecutively numbered and correspond to the table of contents. 3. Executive Summary A signed and dated summary of not more than two (2) pages containing Proposer's overall Qualifications and Experience and Technical Qualifications, as contained in the submittal. Proposer shall include the name of the organization, business phone and contact person and a summary of the work to be performed. 4. Proposer's, Relevant Experience, Qualifications. and Past Performance 1. Describe the Proposer's organizational history and structure, past performance and state the number of years the Proposer has been in business, using the same FEIN, providing a similar service(s). Provide Page48 3/7/2024 7:11 PM p. 50 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 the number of employees and the primary markets served, 2. Provide a list of all principals, partners, officers, owners and/or directors of Proposer, including joint ventures and/or sub-consultant(s), if applicable. 3. Provide: i. The number of years in existence of Proposer, both nationally and in the Florida market; ii. The current number of members enrolled in the Proposer's plan, both nationally and in Florida, and the primary markets served; and iii. Proposer's involvement in providing disability benefits, particularly in the South Florida market. 4. Indicate whether the City has previously awarded any contracts to the Proposer. If so, discuss the nature of the contract, types of services performed, and the term of the contract. 5. Provide a list of five (5) comparable contracts (similar in scope of services to those requested herein), which Proposer has either ongoing, or has completed within the past ten (10) years. The description should identify for each project: i. Client ii. Description of work iii. Total dollar value of the contract iv. Dates covering the term of the contract v. Client contact person and phone number vi. Statement of whether Proposer is/was the prime contractor or subcontractor; if Proposer was the subcontractor, name the Prime vii. Detail Proposer's responsibilities and the results of the project Where possible, list and describe those projects performed for government clients or similar size private entities (excluding and work performed for the City of Miami). In the event that Proposer has not performed five (5) comparable contracts within the past ten (10) years, Proposer should provide information that demonstrates its ability to perform the required services, as detailed within Section 3, Scope of Services. 6. List Proposer's subcontractors or sub consultants which will work on the City 's employee voluntary supplemental insurance benefits and include a brief history of their background and experience. 7. Provide any other information which the Proposer deems relevant to its organization and its ability to provide quality employee voluntary supplemental insurance benefits to the City. 8. Provide Proposer's implementation plan that will be utilized in implementing the employee voluntary Page49 3/7/2024 7:11 PM p. 51 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 supplemental insurance benefits, anticipated to become effective immediately. This shall include, but not be limited to: a) training offered to City staff, b) sample of communication materials and administration manual, and c) all anticipated City assigned action items. 9. Provide information concerning any prior or pending litigation or proceedings, either civil or criminal, involving Proposer, its partners, managers, other key staff members, and its professional activities or performance, that Proposer has been involved in which may affect the performance of the services to be rendered herein, if applicable. State the nature of the litigation, a brief description of each case, the outcome or projected outcome, and the monetary amounts involved. Discuss any bankruptcies involving Proposer, its partners, manager(s), or other key staff members, if applicable. 10. Provide a minimum of three (3) references using Attachment B, Reference Submittal Form, for projects performed for government clients or similar size private entities. The City reserves the right to contact any reference as part of the qualification process. 11. Provide information or documentation about the Proposer's qualifications and experience from which the City can benefit under this contract. 12. Describe any relevant industry/subject matter expertise, including any experience in the requested services listed herein, and any unique or proprietary project methodologies relevant to the requested services. 13. List Proposer's subcontractors or sub consultants which will work on the employee voluntary supplemental insurance benefits and include a brief history of their background and experience. 14. Provide any other information which the Proposer deems relevant to its organization and its ability to provide quality employee voluntary supplemental insurance benefits. 15. Identify if Proposer has taken any exception(s) to the terms of this Solicitation. If so, indicate the alternative being offered and the cost implications of the exception(s). 16. Confirm Proposer's organization has complied with all State of Florida, Office of insurance Regulation filing requirements for plan/product being offered to the employees of the City. 5. Proposed Benefits Offerings: 1. Provide in detail Proposer's Proposed employee voluntary supplemental insurance benefits offerings, and how this meets and exceeds the requirements listed in Section 3, Specifications. 2. Confirm that Proposer will not include minimum participation requirements. 3. Confirm that insurance is offered on a "Guaranteed Issue" basis as required by the Scope of Services. Describe the underwriting requirements. Page50 3/7/2024 7:11 PM p. 52 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 4. Identify if an eligibility feed is required to manage the employee voluntary supplemental insurance benefits. 5. Provide as an attachment, a description of Proposer's eligibility file record layout specifications. 6. Provide a sample of the Proposer's policies for each benefits offering. 7. Describe Proposer's available resources to assist Members in staying at work prior to becoming a disability claim. 8. Provide any other information which the Proposer deems relevant to its organization and its ability to provide quality managed disability claims administration services to the City. 6. Claims Administration and Customer Service 1. Describe Claims Office Operations to include intake adjudication, clinical support, capacity for phone/email inquiries and any services outsourced or offshored. a. Identify where the claims office that will handle claims for the benefits offered is located. b. Indicate whether the same claims office that handles STD claims will also handle LTD claims. c. Provide the hours of operation for the claims office. d. Describe the training provided to Proposer's Claims Representatives. e. Describe Proposer's expected team's current case load, each (number of clients). f. Describe Proposer's database utilized for the management of each claimant. g. Describe maximum number of open and new claims handled, per Proposer's examiners or clinicians. h. Identify at what point in the proposed claims process, that Proposer begin to transition a claim from STD to LTD. i. Provide as an attachment, Proposer's processed claims process, if no eligibility file is in place. j. Identify how Proposer's claims representatives will "warm transfer" claimant Members to other vendors (i.e., EAP, Disease Management, etc.), if necessary. 2. Describe Proposer's Customer Service Center Operations: a. Provide the hours of operation for the customer service center. b. Indicate whether there will be dedicated Customer Service Representatives specifically for City employees. If so, how many? c. Indicate how many members each Customer Service Representative will be servicing on average. d. d. Describe the training provided to Proposer's Customer Service Representatives. Page51 3/7/2024 7:11 PM p. 53 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 3. Indicate whether Proposer maintains separate toll -free numbers for customer service and claims. Explain how members' questions regarding the status of their claim are addressed. Will the Proposer's customer service center address inquiry or will Member be directed to contact claims examiner directly? 4. Indicate whether there is an internet site available for Member use. Describe the capabilities. 5. Describe Proposer's telephonic intake of claims. a. Identify if members are able to provide voice authorization in order to release medical records. b. Identify whether Proposer utilizes robo-calls in any part of their disability claims processing. If so, please specify the purpose of usage (e.g., reminders of outstanding recommendations, approval notifications, etc.). 6. Indicate whether Proposer offers on-line intake of claims. If so, describe the process. 7. Describe Proposer's written claims appeal process utilized for recommendation of benefit denial. 8. Describe the role(s) that the Proposer's staff types (claim analysts, nurses, physicians, claim supervisors) have in benefits determination (both acceptance and denial). 9. Identify Proposer's proposed commitment to implementing the following performance guarantees and the premium at risk associated with each: a. Speed of answering calls; b. Length of time on hold; c. Responding to after-hours callers; d. Abandonment rate of calls; e. Claim turnaround time; f. Percent of claims audited; g. Claims payment accuracy; and h. Social Security award success for Long Term Disability claimants. 10. Describe Proposer's approach to client services as it relates to resolving complaints from the City and/or resolution of errors. 11. Describe Proposer's internal audit program. 12. Provide examples of Proposer's standard notifications, forms, letters and reimbursement agreements. 7. Financial Reporting and Records 1. Provide a list of recent improvements to similar Proposer programs and their respective outcomes. Specifically, describe how Proposer has successfully applied the proposed approach in comparable contracts to make recommendations to improving benefits, and describe the net effect outcome of these Page52 3/7/2024 7:11 PM p. 54 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 recommendations. 2. Describe Proposer's compliance with HIPAA regulations. 3. Proposer shall provide a statement affirming that Proposer will develop, adopt, and implement standards to safeguard the privacy and confidentiality of all personal information about eligible employees and members of the Program. Provide description of some of the safeguards that Proposer has implemented for any of the three (3) references listed in Attachment B, Reference Submittal Form. 4. Describe how Proposer assures accurate and timely remittance of federal income tax withholdings to the IRS. Additionally, describe how accurate calculation of federal income tax withholding is assured. Page53 3/7/2024 7:11 PM p. 55 City of Miami Solicitation RFQ 1733386 Request for Qualifications No. 1773386 5. Evaluation Criteria 5.1. EVALUATION CRITERIA Each proposal will be reviewed to determine of the proposal is responsive to the submission requirements outlined in this solicitation. A responsive proposal is one which follows the requirements of the solicitation, includes all required documentation, is submitted in the format outlined in this solicitation, is of timely submission, and has appropriate signatures as applicable. failure to comply with these requirements may result in the proposals being deemed non -responsive. Proposals will be evaluated by an Evaluation Committee ("Committee") which shall evaluate and rank proposals on criteria listed below. The Committee will be comprised of appropriate City personnel and members of the community, as deemed necessary, with the appropriate experience and/or knowledge. The criteria are itemized with their respective weights for a maximum of one hundred (105) points per Committee member. Below are the criteria and weight: CRITERIA AND POINTS Proposer's organization, qualifications, capabilities and (30 Points) financial stability: Proposed benefit offerings: (25 Points) Customer services and plan administration: (25 Points) Financial reporting and records: (20 points) Five percent evaluation criterion in favor of Proposers who Maintain a local office as defined in Section 18-73," Definitions" of the City's Procurement Code will be applied to those (5 Points) who meet the criteria pursuant to Section 2.9, Local Preference Maximum Points Available: 105 Points Page54 3/7/2024 7:11 PM p. 56 City of Miami Solicitation RFQ 1733386 ATTACHMENT A CITY OF MIAMI LIVING WAGE ORDINANCE ARTICLE X. - LIVING WAGE REQUIREMENTS FOR SERVICE CONTRACTS AND CITY EMPLOYEESI Footnotes: --- (9) --- Note— Section 5 of Ord. No. 12787 states that this article shall be effective October 1, 2006. Editor's note— Prior to the adoption of Ord. No. 12787, Ord. No. 12623, § 2, adopted December 9, 2004, repealed article X, divisions 1-4, in its entirety, which pertained to the economic development financing authority and derived from Ord. No. 12062, § 3, adopted May 10, 2001. Sec. 18-556. - Definitions. City means the government of the City of Miami or any authorized agents, any board, agency, commission, department, or other entity thereof, or any successor thereto. Contract means any contract to provide services to the city in which the total value of the contract exceeds $100,000.00 per year. Contractor means any "for profit" individual, business entity, corporation, partnership, limited liability company, joint venture, or similar business entity which meets the following criteria: (1) The contractor is paid in whole or part from one or more of the city's general funds, capital project funds, special revenue funds, or any other funds, including, but not limited to, grants, donations, and the like, whether by competitive bid process, requests for proposals, or some other form of competitive solicitation, negotiation, or agreement, or any other decision to enter into a contract; and (2) The contractor is engaged in the business of or part of a contract to provide services for the benefit of the city. This section shall apply to employees of the contractor who spend the majority of their time on covered City of Miami service contracts. If the contract is for both goods and services it shall only apply to the services portion of such contract. This section shall not apply to contracts which are primarily for the sale or leasing of goods. Goods are defined in section 18-73 of the City Code. Covered employee means anyone employed by the city working more than 35 hours per week or any service contractor employee, working full or part-time, with or without benefits, that is involved in providing services under the service contractor's contract with the city. Covered employer means the city and any and all service contractors and subcontractors of a service contractor. Living wage means a wage that is as defined in section 18-557 of this Code. The living wage may be adjusted once annually by an amount equivalent to the cost of living adjustment for Miami -Dade County as published by the United States Department of Labor, Bureau of Labor Statistics. Language so stating will be included in all request for proposals, or other competitive solicitation documents, issued by the city for the procurement of services (unless the living wage provisions are excluded as provided in section 18-557 herein). New service contracts means those having contracts competitively solicited and awarded on or after January 1, 2017. Page 1 3/7/2024 7:11 PM p. 57 City of Miami Solicitation RFQ 1733386 Service contract means a contract to provide services to the city excluding, however, professional services as defined by the "Consultants Competitive Negotiation Act" set forth in F.S. § 287.055, and section 18-87 of the City Code and/or the other exclusions provided by section 18-557 of the City Code. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13648, § 2, 11-17-16) Sec. 18-557. - Living wage. (a) Living wage paid. (1) New service contractors. All new service contracts shall pay to all its employees who provide covered services a living wage of no less than $15.00 per hour without health benefits; or a wage of no less than $13.19 an hour with health benefits as defined in this section unless otherwise excluded pursuant to this article. (2) Existing service contracts. Service contracts awarded and effective or competitively solicited prior to January 1, 2017, shall not be subject to the payment of the living wage set forth in this section and shall continue to be governed by the terms and conditions of the respective solicitation and resulting contractual documents, when applicable. The living wage provisions shall apply to all contracts covered by this section unless specifically excluded by one or more subsections below: a. The living wage provision is disallowed by a federal or state law or regulation, grant requirements, or by a contract the city is accessing by "piggybacking", and which contract does not include a living wage provision; b. Funding sources for the contract disallow the living wage provision or provide contradictory funding requirements, or are contained in a contract awarded or solicited prior to the effective date of January 1, 2017, and which contract includes renewals or extensions; c. Professional service contracts awarded under the "Consultants Competitive Negotiation Act", F.S. § 287.055, for the professional services within the scope of the practice of architecture, professional engineering, landscape architecture, registered surveying, and/or mapping; d. The living wage provision is waived by the city commission by resolution, prior to issuance of the competitive solicitation document, upon written recommendation of the city manager or authorized designee, when the city commission finds it is in the best interest(s) of the city to approve such waiver, in which case the living wage provision shall not apply in the competitive solicitation document; or e. All responsible wage construction contracts covered by section 18-120 of this Code. (4) City employees. For covered employees of the city, the city will begin to pay the living wage on a phase - in basis over a nine-year period beginning with the 2006-2007 city budget year to be implemented in the 2014-2015 fiscal year. The city manager, in his sole discretion, without further city commission approval, shall have the option to consider whether it is in the city's best interest to complete the phase -in payment of living wage to city employees on a four-year period. Thereafter, the living wage to be paid by the city shall be subject to negotiations within the collective bargaining structure. (b) Health benefits; eligibility period. For a covered employer to comply with this article by choosing to pay the lower wage scale available when a covered employer also provides a standard health benefit plan, such health benefit plan shall consist of a payment of at least $1.81 per hour toward the provision of health benefits for covered employees and their dependents and shall be approved by the city. If the health benefit plan of the covered employer requires an initial period of employment for a new employee to be eligible for health benefits (the "eligibility period"), a covered employer may qualify to pay the $13.19 per hour wage scale for a term not to exceed the new employee's eligibility period, provided the new employee will be paid health benefits upon completion of the eligibility period, which period shall not exceed 90 days. (c) Certification required before payment. Any and all service contracts subject to this article shall be void, and no funds may be released, unless prior to entering any such contract with the city, the service contractor certifies to the city that it will pay each of its covered employees no less than the living wage. A copy of this Page 2 (3) 3/7/2024 7:11 PM p. 58 City of Miami Solicitation RFQ 1733386 certificate must be made available to the public upon request. The certificate, at a minimum, must include the following: (1) The name, address, and phone number of the employer, a contact person, and the specific project for which the service contract is sought; (2) The amount of the service contract and the city department the contract will serve. (3) A brief description of the project or service provided; (4) A statement of the wage levels for all covered employees; and (5) A commitment to pay all covered employees the living wage. (d) Observation of other laws. Every covered employee shall be paid without subsequent deduction or rebate on any account (except as such payroll deductions as are directed or permitted by law or by a collective bargaining agreement). The service contractor shall pay covered employees wage rates in accordance with federal and all other applicable laws such as overtime and similar wage laws. (e) Posting. A copy of the living wage rate shall be kept posted by the service contractor subject to this article, at the site of the work in a prominent place where it can easily be seen and read by the covered employees and shall be supplied to such employees within a reasonable time after a request to do so. Additionally, service contractors subject to this article, shall furnish a copy of the requirements of this article to any entity submitting a bid for a subcontract on any service contract subject to this article. Posting requirements will not be required where the service contractor subject to this article, prints the following statements on the front of the covered employee's first paycheck and every six months thereafter. "You are required by the City of Miami Living Wage Ordinance to be paid a living wage. If you do not believe you are being paid at the living wage rate, contact your employer, an attorney, or the City of Miami." All notices will be printed in English, Spanish and Creole. (f) Collective bargaining. Nothing in this article shall be read to require or authorize any service contractor subject to this article, to reduce wages set by a collective bargaining agreement or as required under any prevailing wage law. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13110, § 2, 10-22-09; Ord. No. 13405, § 2, 9-26-13; Ord. No. 13648, § 2, 11-17-16) Sec. 18-558. - Implementation. (a) Maintenance of payroll records. Each service contractor to which living wage requirements apply, as described in this article, shall maintain payroll record for all covered employees and basic records relating thereto and shall preserve them for a period of three years from the date of termination or expiration of the service contract. The records shall contain: (1) The name and address of each covered employee; (2) The job title and classification; (3) The number of hours worked each day; (4) The gross wages earned and deductions made; (5) Annual wages paid; (6) A copy of the social security returns and evidence of payment thereof; (7) A record of fringe benefit payments including contributions to approved plans; and (8) Any other data or information the city shall require from time to time. (b) Reporting payroll. Every six months, the service contractor to which living wage requirements apply, as described in this article, shall file with the city's procurement director a listing of all covered employees together with a certification of compliance with this article. Upon request from the city, the service contractor shall produce for inspection and copying its payroll records for any or all of its covered employees for any Page 3 3/7/2024 7:11 PM p. 59 City of Miami Solicitation RFQ 1733386 period covered by the service contract. The city may examine payroll records as needed to ensure compliance. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13110, § 2, 10-22-09) Sec. 18-559. - Compliance and enforcement. (a) Service contractor to cooperate. The service contractor shall permit city employees, agents, or representatives to observe work being performed at, in or on the project or matter for which the service contractor has a contract. The city representatives may examine the books and records of the service contractor relating to the employment and payroll of covered employees and may survey covered employees to determine if the service contractor is in compliance with the provisions of this article. (b) Complaint procedures and sanctions. An employee who believes that he/she is a covered employee of a service contractor and that the service contractor is or was not complying with the requirements of this article has a right to file a complaint with the procurement director of the city. Such complaints may be made at any time and shall be investigated within a reasonable period of time by the city. Written and oral statements by any such employee shall be treated as confidential and shall not be disclosed without the written consent of the employee to the extent allowed by the Florida Statutes. (c) Private right of action against service contractor. Any covered employee or former covered employee of a service contractor may, instead of utilizing the city administrative procedure set forth in this article, but not in addition to such procedure, bring an action by filing suit against the service contractor in any court of competent jurisdiction to enforce the provisions of this article and may be awarded back pay, benefits, attorneys fees, and costs. The applicable statute of limitations for such a claim will be two years as provided in F.S. § 95.11(4)(c) as may be amended from time to time for an action for payment of wages. The court may also impose sanctions on the service contractor, including those persons or entities aiding or abetting the service contractor, to include wage restitution to the affected covered employee and damages payable to the covered employee in the sum of up to $500.00 for each week the service contractor is found to have violated this article. (d) Sanctions against service contractors. For violations of this article, the city shall sanction a service contractor by requiring the service contractor to pay wage restitution at its expense for each affected employee. The city may also sanction the service contractor in at least one of the following additional ways: (1) The city may impose damages in the sum of $500.00 for each week for each covered employee found to have not been paid in accordance with this article; (2) The city may suspend or terminate payment under the service contract or terminate the contract with the service contractor; and The city may declare the service contractor ineligible for future service contracts for three years or until all penalties and restitution have been paid in full, whichever is longer. In addition, any employer shall be ineligible for a service contract where principal officers of such employer were principal officers of a service contractor who has been declared ineligible under this article. (4) If the contract has been awarded under the city procurement ordinance, the city may debar or suspend the contractor as provided therein. (e) Public record of sanctions. All such sanctions recommended or imposed shall be a matter of public record. (f) Sanctions for aiding and abetting. The sanctions contained in this article shall also apply to any party or parties aiding and abetting in any violation of this article. Retaliation and discrimination barred. A service contractor shall not discharge, reduce the compensation, or otherwise discriminate against any covered employee for making a complaint to the city, or otherwise asserting his or her rights under this article, participating in any of its proceedings or using any civil remedies to enforce his or her rights under this article. Allegations of retaliation or discrimination, if found true in a city administrative proceeding or by a court of competent jurisdiction, shall result in an order of restitution and reinstatement of a discharged covered employee with back pay to the date of the violation or such other relief as deemed appropriate. (3) (g) Page 4 3/7/2024 7:11 PM p. 60 City of Miami Solicitation RFQ 1733386 (h) Remedies herein non-exclusive. No remedy set forth in this article is intended to be exclusive or a prerequisite for asserting a claim for relief to enforce the rights under this article or in a court of law. This article shall not be construed to limit an employee's right to bring a common law cause of action for wrongful termination. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13648, § 2, 11-17-16) Sec. 18-560. - Employers receiving direct tax abatement or subsidy. The city reserves the right to impose the living wage requirements of this article on or after January 1, 2017 on any employer as a condition of that employer receiving a direct tax abatement or subsidy from the city. (Ord. No. 13648, § 2, 11-17-16) Secs. 18-561-18-599. - Reserved. Page 5 3/7/2024 7:11 PM p. 61 City of Miami Solicitation RFQ 1733386 RFQ NO.: 1790386 Attachment B Reference Submittal Form CATEGORY: Federal Lobbying Services FIRM NAME: Reference Section Summarized Requirements: Refer to the details in Section 2.9, References, to verify that the information provided will suffice as proof of meeting the requirements of this solicitation. Section 3.6 Past Performance Reference Check #1 Company/Organization Name: Address: Contact Person: Contact Phone Number: Contact E-mail (if applicable): Date of Contract or Sale: Section 3.6 Past Performance Reference Check #2 Company/Organization Name: Address: Contact Person: Contact Phone Number: Contact E-mail (if applicable): Date of Contract or Sale: Section 3.6 Past Performance Reference Check #3 Company/Organization Name: Address: Contact Person: Contact Phone Number: Contact E-mail (if applicable): Date of Contract or Sale: 1 3/7/2024 7:11 PM p. 62 Attachment C City of Miami Solicitation RFQ 1733386 CITY OF MIAMI LOCAL OFFICE CERTIFICATION (City Code, Chapter 18, Article III, Section 18-73) Solicitation Type and Number: Solicitation Title: (i.e. IFQ/IFB/RFP/RFQ/RFLI No. 123456) (Bidder/Proposer) hereby certifies compliance with the Local Office requirements stated under Chapter 18/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Local office means a business within the city which meets all of the following criteria: (1) Has had a staffed and fixed office or distribution point, operating within a permanent structure with a verifiable street address that is located within the corporate limits of the city, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue; for purposes of this section, "staffed" shall mean verifiable, full-time, on -site employment at the local office for a minimum of forty (40) hours per calendar week, whether as a duly authorized employee, officer, principal or owner of the local business; a post office box shall not be sufficient to constitute a local office within the city; (2) If the business is located in the permanent structure pursuant to a lease, such lease must be in writing, for a term of no less than twelve (12) months, been in effect for no less than the twelve (12) months immediately preceding the date bids or proposals were received, and be available for review and approval by the chief procurement officer or its designee; for recently -executed leases that have been in effect for any period less than the twelve (12) months immediately preceding the date bids or proposals were received, a prior fully -executed lease within the corporate limits of the city that documents, in writing, continuous business residence within the corporate limits of the city for a term of no less than the twelve (12) months immediately preceding the date bids or proposals were received shall be acceptable to satisfy the requirements of this section, and shall be available for review and approval by the chief procurement officer or its designee; further requiring that historical, cleared rent checks or other rent payment documentation in writing that documents local office tenancy shall be available for review and approval by the chief procurement officer or its designee; (3) Has had, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, a current business tax receipt issued by both the city and Miami - Dade County, if applicable; and (4) Has had, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, any license or certificate of competency and certificate of use required by either the city or Miami -Dade County that authorizes the performance of said business operations; and (5) Has certified in writing its compliance with the foregoing at the time of submitting its bid or proposal to be eligible for consideration under this section; provided, however, that the burden of proof to provide all supporting documentation in support of this local office certification is borne by the business applicant submitting a bid or proposal. 1 FORM -City of Miami Local Office Certification 3/7f la,4231131 PM p. 63 City of Miami Solicitation RFQ 1733386 PLEASE PROVIDE THE FOLLOWING INFORMATION: Bidder/Proposer Local Office Address: Does Bidder/Proposer conduct verifiable, full- time, on -site employment at the local office for a minimum of forty (40) hours per calendar week? YES NO ❑ ❑ If Bidder/Proposer's Local Office tenancy is pursuant to a lease, has Bidder/Proposer enclosed a copy of the lease? N/A ❑ YES ❑ NO ❑ Has Bidder/Proposer enclosed a copy of the Business Tax Receipt (BTR) issued by the City of Miami and Miami -Dade County? City of Miami: Cite Exemption: NO Exempt ❑ YES Miami -Dade County: Cite Exemption: ❑ YES ❑ NO ❑ Exempt Has Bidder/Proposer enclosed a copy of the license, certificate of competency and certificate of use that authorizes the performance of Bidder/Proposer's business operations? YES NO ❑ ❑ Bidder/Proposer's signature below certifies compliance with the Local Office requirements stated under Chapter 18/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Print Name (Bidder/Proposer Authorized Representative) Signature Date 2 FORM -City of Miami Local Office Certification 3/7/,92aA1 PM p. 64 City of Miami Solicitation RFQ 1733386 STATE OF FLORIDA COUNTY OF Certified to and subscribed before me this day of , 20 , by (NOTARY SEAL) (Signature of Notary Public -State of Florida) (Name of Notary Typed, Printed, or Stamped) Personally Known OR Produced Identification Type of Identification Produced 3 FORM -City of Miami Local Office Certification 3/7/,92aA1 PM p. 65 City of Miami Solicitation RFQ 1733386 ATTACHMENT D INSURANCE DEFINITIONS, CONDITIONS, AND ADDITIONAL REQUIREMENTS The Successful Proposer agrees to provide and maintain throughout the life of this contract and at Successful Proposer's expense insurance coverage outlined herewith as applicable insuring all operations related to the contract and any extensions thereof. Workers Compensation and Employers Liability Statutory requirements per Chapter 440, Florida Statutes, as amended, are applicable, and this coverage is subject to the Laws of the State of Florida. This coverage protects against lawsuits stemming from workplace accidents. It provides for medical care to injured employees, along with compensation for lost income. Commercial General Liability It protects against accidents and injuries that occur on company property or the property of a customer. It compensates an injured person or owner of property for injuries and property damages, and the cost of defending lawsuits, including legal settlements or investigations. This policy also covers claims resulting from products exposures, libel, slander, copyright infringement, and other personal and advertisement injuries. Commercial Automobile Liability It protects against liability, no fault, medical payments, uninsured and underinsured motorists claims, collision and other than collision physical damage. In addition, this policy affords coverage on autos that are hired or borrowed or non -owned for use in the business. The non -owned can be autos owned by employees or members of their households. Non -Owned Auto exposures can be endorsed or added under the Commercial General Liability Policy. Professional/Errors and Omissions Liability Used by many professionals such as engineers, lawyers, accountants, stock brokers, financial advisers, insurance agents, court reports, dentists, nurses and teachers. It 3/7/2024 7:11 PM p. 66 City of Miami Solicitation RFQ 1733386 protects against the financial effects of liability lawsuits filed by clients. It basically protects professionals who cause harm to a client due to incompetence, errors , or negligence. Umbrella Liability It protects against liability and losses after primary insurance benefits have been exhausted. This supplemental coverage kicks in only after the underlined liability policies have paid their maximum benefits. Environmental Liability It protects against the financial costs of claims of injury or damage due to pollution, and other costs of cleaning up pollutants. These policies are designed to cover both property and liability risks. Directors and Officers Liability This coverage protects against claims from stockholders, employees and clients that are also aimed individually at directors and officers. These claims typically stem from errors in judgement, breaches of duty and wrongful acts in connection with company business. Cyber Liability It protects against costs of the theft, destruction or unauthorized use of electronic data through computer viruses or network intrusions. It also adds protection to a business against such costs if a business fails to safeguard another party's electronic data. Companies sharing data outside their internal network benefit from this coverage Commercial Property It protects against claims or damages to the insured's buildings, business personal property and personal property of others. It can also provide for loss of business income coverage or extra expenses incurred because of physical loss by a covered peril to the insured's property. Commercial Crime It protects against loss of money, securities and other property because of a variety of criminal acts such as employee theft or embezzlement, burglary, robbery, forgery, 3/7/2024 7:11 PM p. 67 City of Miami Solicitation RFQ 1733386 computer fraud, kidnapping and extortion. Crime insurance also covers money and securities against damage or destruction by almost any cause of loss, not just crime. Builders Risk It protects against damage to or destruction of buildings or other structures during their construction. Any party with a financial interest in a construction, remodeling, or repair project benefits from this coverage. Surety Bonds Surety bonds are three party contracts. The principal, the party that undertakes the obligation, pays for the issuance of a bond by a surety company. The bond provides capital to guarantee the obligation will be performed. The obligee is the party that receives the benefit of the bond If the obligation is improperly performed. If payment and performance bonds are required such bonds must be substantially in the form prescribed by Florida Statutes 255.05, as amended, and will be subject to the approval of the City of Miami Director of the Department of Risk Management. Valuable Papers It pays for the cost to reconstruct damaged or destroyed valuable papers and records. Typically is defined to include almost all forms of printed documents or records with the exception of money or securities, and data and media which is usually excluded. Additional Requirements The Successful Proposer must furnish the City of Miami, Department of Procurement, and Risk Management located at 444 S.W. 2nd Avenue Miami, Florida 33130, original Certificates of insurance to be in force on the date of this Contract, and Renewal Certificates of insurance thereafter. All policies indicated on the certificate must be in compliance with all Contract requirements. The failure of the City to obtain the applicable or corresponding certificates from Contractor is not a waiver by the City of any requirements for the Successful Proposer. The Successful Proposer must furnish Certificates insurance listing the City of Miami as an additional insured. All insurance certificates must be signed, dated and reference the City contract number. The insurance must provide for sixty (30) days prior written notice to be given to the City in the event coverage is substantially changed, canceled, or non -renewed. 3/7/2024 7:11 PM p. 68 City of Miami Solicitation RFQ 1733386 Any deductibles or self -insured retentions on referenced insurance coverages must be borne by Successful Proposer. The Successful Proposer further agrees to have insurers waive their rights of subrogation against the City of Miami, its employees, elected officials, agents, or representatives. The coverages and limits furnished by Successful Proposer in no way limit the Successful Proposer's liabilities and responsibilities specified within the Contract or law. Any insurance or self-insurance programs maintained by the City of Miami shall not contribute with insurance provided by the Successful Proposer under the Contract. The required insurance to be carried is not limited by any limitations expressed in the indemnification language in this Contract or any limitation placed on the indemnity in this Contract given as a matter of law. If the Successful Proposer is a joint venture or limited liability company, the insurance policies must name the joint venture or Limited Liability Company and each of its separate constituent entities as named insureds. The Successful Proposer must require all subcontractors to provide the insurance required herein. All subcontractors are subject to the same insurance requirements of the Successful Proposer unless otherwise specified in this Contract. If the Successful Proposer or subcontractor desire additional coverages, the party desiring the additional coverages is responsible for the acquisition and cost. Notwithstanding any provision in the Contract to the contrary, the City of Miami Risk Management Department maintains and reserves the right to modify, delete, alter or change these requirements. Note: The duty to carry and maintain insurance during the life of the contract will survive the cancellation or expiration, as applicable, under the Contract. 3/7/2024 7:11 PM p. 69 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 PROFESSIONAL SERVICES AGREEMENT By and Between The City of Miami, Florida And CONSULTANT This Professional Services Agreement ("Agreement") is entered into this day of , 2024 by and between the City of Miami ("City"), a municipal corporation of the State of Florida, whose address is 444 S.W. 2nd Avenue, Miami, Florida 33130 ("City"), and , company, qualified to do business in the State of Florida whose principal address is , hereinafter referred to as the ("Consultant"). RECITALS: WHEREAS, the City issued a Request for Qualifications (RFQ) No. 1733386 on , 2024 (the "RFQ" attached hereto, incorporated hereby, and made a part of as Exhibit A), for the provision of Employee Voluntary Supplemental Insurance Benefits, ("Services" as more fully set forth in the scope of work "Scope", attached hereto as Exhibit B) for the Risk Management Department, and Consultant's proposal ("Proposal", attached hereto, incorporated hereby, and made part of hereof as Exhibit C), in response thereto, has been selected as a qualified proposal for the provision of the Services. WHEREAS, the Consultant has offered to participate in the City's Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool for the purposes of providing Employee 1 3/7/2024 7:11 PM p. 70 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 Voluntary Supplemental Insurance Benefits to the City that shall conform to the Scope of Services; City's Request for Qualifications (RFQ No. 1733386), and all associated addenda and attachments, incorporated herein by reference, any Work Orders issued as a result of this Agreement, and the requirements of applicable laws, regulations and of this Agreement; and WHEREAS, the Evaluation Committee appointed by the City Manager determined that the Proposal submitted by the Consultant was responsive to the RFQ requirements and recommended that the City Manager approve the inclusion of the Consultant in the Pool, and negotiate price with the Consultant at the Work Order stage; and WHEREAS, the City and the Consultant desire to enter into this Agreement under the terms and conditions set forth herein. NOW, THEREFORE, in consideration of the mutual covenants and promises herein contained, Consultant and the City agree as follows: TERMS: 1. RECITALS AND INCORPORATIONS; DEFINITIONS: A. The recitals are true and correct and are hereby incorporated into and made a part of this Agreement. The City's RFQ is hereby incorporated into and made a part of this Agreement and attached hereto as Exhibit "A". The Services and Scope of Work are hereby incorporated into and made a part of this Agreement and attached as Exhibit "B". The Consultant's Response dated, , 2024, in response to RFQ 1733386, is hereby incorporated into and made a part of this Agreement as attached Exhibit "C". The Consultant's Insurance Certificate is hereby incorporated into and made a part of this Agreement as attached Exhibit "D". The order of 2 3/7/2024 7:11 PM p. 71 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 precedence whenever there is conflicting or inconsistent language between documents is as follows in descending order of priority: (1) Professional Services Agreement ("PSA") (2) Addenda/Addendum to the RFQ; (3) RFQ; and (4) Consultant's response dated 2024, acknowledging scope of services, any addenda, and pricing component of services and, response to the Request for Qualifications. 2. CONTRACT TERM: The Agreement shall become effective on the date on the first page, and shall be for a duration of six (6) years: Initial term of three (3) years with one (1), three (3) year option to renew. The City, acting by and through its City Manager, shall have the option to extend or terminate the Agreement for convenience, that is, for any or no cause. 3. WORK ORDER TERM: Work Orders shall expire as stated on each individual Work Order issued under this Agreement and may extend past the expiration of this Agreement. The provisions of any specific Work order which commences prior to the termination date of this Agreement, and which will extend beyond said termination date shall survive the expiration or termination thereof. 4. SCOPE OF SERVICES: A. Consultant agrees to provide the Services as specifically described, and under the special terms and conditions set forth in Exhibits "A" and "B" hereto, in addition to any Work Order as a result of this Agreement, which by this reference is incorporated into and made a part of this Agreement. B. Consultant represents to the City that: (i) it possesses all qualifications, licenses, certificates, 3 3/7/2024 7:11 PM p. 72 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 authorizations, and expertise required for the performance of the Services, including but not limited to full qualification to do business in Florida; (ii) it is not delinquent in the payment of any sums due the City, including payment of permits, fees, occupational licenses, contract or bond claims etc., nor in the performance of any obligations or payment of any monies to the City; (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified and trained to perform the tasks assigned to each; (iv) the Services will be performed in the manner described in Exhibit "A"; and (v) each person executing this Agreement on behalf of Consultant has been duly authorized to so execute the same and fully bind Consultant as a party to this Agreement. C. Consultant shall at all times provide fully qualified, competent and physically capable employees to perform the Services under this Agreement. City may require Consultant to remove any employee the City deems careless, incompetent, insubordinate, or otherwise objectionable and whose continued services under this Agreement is not in the best interest of the City. 5. COMPENSATION: A. The amount of compensation payable by the City to the Consultant for all Work and Services performed under this Agreement, includes all costs associated with such Work and Services, and shall be as stated in each individual Work Order to this Agreement. The City shall have no obligation to pay the Consultant any additional sum in excess of this amount set forth in each Work Order, except for a change and/or modification to the Agreement, which is approved and executed in writing by the City and the Consultant. All Services undertaken by the Consultant before City's approval of this Agreement and any subsequent Work Order shall be at the 4 3/7/2024 7:11 PM p. 73 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 Consultant's risk and expense. B. Payment shall be made in arrears based upon work performed to the satisfaction of the City within forty-five (45) days after receipt of Consultant's invoice for Services performed, which shall be accompanied by sufficient supporting documentation and contain sufficient detail, to allow a proper audit of expenditures, should the City require one to be performed. Invoices shall be sufficiently detailed so as to comply with the "Florida Prompt Payment Act", §218.70. -218.79, Florida Statutes, and other applicable laws. No advance payments shall be made at any time. C. Consultant agrees and understands that (i) any and all subcontractors providing Services related to this Agreement shall be paid through Consultant and not paid directly by the City, and (ii) any and all liabilities regarding payment to or use of subcontractors for any of the Services related to this Agreement shall be borne solely by Consultant and not be a debt or default of the City. The City only has privity of contract with the named Consultant. 6. OWNERSHIP OF DOCUMENTS: Consultant understands and agrees that any information, document, report, or any other material whatsoever which is given by the City to Consultant, its employees, or any subcontractor, or which is otherwise obtained or prepared by Consultant solely and exclusively for the City pursuant to or under the terms of this Agreement, is and shall at all times remain the property of the City. Consultant agrees not to use any such information, document, report or material for any other purpose whatsoever without the written consent of the City Manager, which may be withheld or conditioned by the City Manager in his/her sole discretion. Consultant is permitted to make and to maintain duplicate copies of the files, records, documents, etc. if Consultant determines copies 5 3/7/2024 7:11 PM p. 74 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 of such records are necessary subsequent to the termination of this Agreement; however, in no way shall the confidentiality as permitted by applicable law be breached. The City shall maintain and retain ownership of any and all documents which result upon the completion of the work and Services under this Agreement as per the terms of this Section 5. 7. AUDIT AND INSPECTION RIGHTS AND RECORDS RETENTION: A. Consultant agrees to provide access to the City or to any of its duly authorized representatives, to any books, documents, papers, and records of Consultant which are directly pertinent to this Agreement, for the purpose of audit, examination, excerpts, and transcripts. The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to Consultant under this Agreement, audit and inspect, or cause to be audited and inspected, those books, documents, papers, and records of Consultant which are related to Consultant's performance under this Agreement. Consultant agrees to maintain any and all such books, documents, papers, and records at its principal place of business for a period of three (3) years after final payment is made under this Agreement and all other pending matters are closed. Consultant's failure to adhere to, or refusal to comply with, this condition shall result in the immediate cancellation of this Agreement by the City. B. The City may, at reasonable times during the term hereof, inspect the Consultant's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods or services required to be provided by Consultant under this Agreement conform to the terms hereof. Consultant shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests, inspections and 6 3/7/2024 7:11 PM p. 75 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 audits shall be subject to, and made in accordance with, the provisions of Section 18-101 and 18- 102 of the Code of the City of Miami, Florida as same may be amended or supplemented, from time to time, which are deemed as being incorporated by reference herein. 8. AWARD OF AGREEMENT: Consultant represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. 9. PUBLIC RECORDS: A. Consultant understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City Agreements, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable laws. Consultant's failure or refusal to comply with the provisions of this section shall result in the immediate cancellation of this Agreement by the City. B. Consultant shall additionally comply with Section 119.0701, Florida Statutes, including without limitation: (1) keep and maintain public records that ordinarily and necessarily would be required by the City to perform this service; (2) provide the public with access to public records on the same terms and conditions as the City would at the cost provided by Chapter 119, Florida Statutes, or as otherwise provided by law; (3) ensure that public records that are exempt or confidential and exempt from disclosure are not disclosed except as authorized by law; (4) meet all requirements for retaining public records and transfer, at no cost, to the City all public records 7 3/7/2024 7:11 PM p. 76 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 in its possession upon termination of this Agreement and destroy any duplicate public records that are exempt or confidential and exempt from disclosure requirements; and, (5) provide all electronically stored public records that must be provided to the City in a format compatible with the City's information technology systems. Notwithstanding the foregoing, Consultant shall be permitted to retain any public records that make up part of its work product solely as required for archival purposes, as required by law, or to evidence compliance with the terms of the Agreement. C. Should Consultant determine to dispute any public access provision required by Florida Statutes, and then Consultant shall do so at its own expense and at no cost to the City. . IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT (305) 416-1830, Via email at PublicRecords@miamigov.com, or regular email at City of Miami Office of the City Attorney, 444 SW 2nd Avenue, 9th FL, Miami, FL 33130. 10. COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS: Consultant understands that agreements with local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, record keeping, etc. City and Consultant agree to comply with and observe all such applicable federal, state and local laws, rules, regulations, codes and ordinances, as they may be amended from time to time. 8 3/7/2024 7:11 PM p. 77 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 Consultant further agrees to include in all of Consultant's agreements with subcontractors for any Services related to this Agreement this provision requiring subcontractors to comply with and observe all applicable federal, state, and local laws rules, regulations, codes and ordinances, as they may be amended from time to time. 11. INDEMNIFICATION: Consultant shall indemnify, hold/save harmless and defend at its own cost and expense the City, its officials and employees, for claims (collectively referred to as "Indemnitees") and each of them from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's fees) or liabilities (collectively referred to as "Liabilities") by reason of any injury to or death of any person or damage to or destruction or loss of any property arising out of, resulting from, or in connection with (i) the negligent performance or non-performance of the Services contemplated by this Agreement (whether active or passive) of Consultant or its employees or subcontractors (collectively referred to as "Consultant") which is directly caused, in whole or in part, by any act, omission, default or negligence (whether active or passive or in strict liability) of the Indemnitees, or any of them, or (ii) the failure of the Consultant to comply materially with any of the requirements herein, or the failure of the Consultant to conform to statutes, ordinances, or other regulations or requirements of any governmental authority, local, federal or state, in connection with the performance of this Agreement even if it is alleged that the City, its officials and/or employees were negligent. Consultant expressly agrees to indemnify, defend and hold harmless the Indemnitees, or any of them, from and against all liabilities which may be asserted by an employee or former employee of Consultant, or any of its subcontractors, as provided 9 3/7/2024 7:11 PM p. 78 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 above, for which the Consultant's liability to such employee or former employee would otherwise be limited to payments under state Workers' Compensation or similar laws. Consultant further agrees to indemnify, defend and hold harmless the Indemnitees from and against (i) any and all Liabilities imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or requirement, related directly to Consultant's negligent performance under this Agreement, compliance with which is left by this Agreement to Consultant, and (ii) any and all claims, and/or suits for labor, supplies, goods, services, equipment, and materials furnished by Consultant or utilized in the performance of this Agreement or otherwise ( excluding only payment of fees due the Consultant under the terms of this Agreement). . Consultant's obligations to indemnify defend and hold harmless shall survive the termination or expiration of this Agreement. Consultant understands and agrees that any and all liabilities regarding the use of any subcontractor for Services related to this Agreement shall be borne solely by Consultant throughout the duration of this Agreement and that this provision shall survive the termination or expiration of this Agreement, as applicable. 12. DEFAULT: If Consultant fails to comply materially with any term or condition of this Agreement, or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from the City, then Consultant shall be in default. Consultant understands and agrees that termination of this Agreement under this section shall not release Consultant from any obligation accruing prior to the effective date of termination. Should Consultant be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, 10 3/7/2024 7:11 PM p. 79 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 then, in addition to the foregoing, Consultant shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and expenses incurred by the City in the re -procurement of the Services, including consequential and incidental damages. 13. RESOLUTION OF AGREEMENT DISPUTES: Consultant understands and agrees that all disputes between Consultant and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Consultant being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds Twenty - Five Thousand Dollars and No/Cents ($25,000), the City Manager's decision shall be approved or disapproved by the City Commission. Consultant shall not be entitled to seek judicial relief unless: (i) it has first received City Manager's written decision, approved by the City Commission if the amount of compensation hereunder exceeds Twenty -Five Thousand Dollars and No/Cents ($25,000), or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation or ninety (90) days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by written instruments, signed by the City Manager. In no event may the amount of compensation under this Section exceed the total compensation set forth in Section 4 (A) of this Agreement. 14. TERMINATION; OBLIGATIONS UPON TERMINATION: 11 3/7/2024 7:11 PM p. 80 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 A. The City, acting by and through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, for convenience, and without penalty, at any time, by giving written notice to Consultant at least thirty (30) calendar days prior to the effective date of such termination. In such event, the City shall pay to Consultant compensation for Services rendered and approved expenses incurred prior to the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any consequential or incidental damages. The Consultant shall have no recourse or remedy against the City for a termination under this subsection except for payment of fees due prior to the effective date of termination. B. The City, by and acting through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, upon the occurrence of an event of a material breach hereunder, and failure to cure the same within thirty (30) days after written notice of default. . In such event, the City shall not be obligated to pay any amounts to Consultant for Services rendered by Consultant after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any direct, indirect, consequential or incidental damages. 15. INSURANCE: A. Consultant shall, at all times during the term hereof, maintain such insurance coverage(s) as may be required by the City. The insurance coverage(s) required as of the Effective Date of 12 3/7/2024 7:11 PM p. 81 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 this Agreement are attached hereto as Exhibit "D" and incorporated herein by this reference. The City RFQ number and title of the RFQ must appear on each certificate of insurance. The Consultant shall add the City of Miami as an additional insured to its commercial general liability, and auto liability policies, and as a named certificate holder on all policies. Consultant shall correct any insurance certificates as requested by the City's Risk Management Administrator. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection and evidence of such coverage(s) and shall be furnished to the City Risk Management Administrator on Certificates of Insurance indicating such insurance to be in force and effect and any cancelled or non -renewed policy will be replaced with no coverage gap and a current Certificate of Insurance will be provided. Completed Certificates of Insurance shall be filed with the City prior to the performance of Services hereunder, provided, however, that Consultant shall at any time upon request file duplicate copies of the Certificate of Insurance with the City. B. Consultant understands and agrees that any and all liabilities regarding the use of any of Consultant's employees or any of Consultant's subcontractors for Services related to this Agreement shall be borne solely by Consultant throughout the term of this Agreement and that this provision shall survive the termination of this Agreement. Consultant further understands and agrees that insurance for each employee of Consultant and each subcontractor providing Services related to this Agreement shall be maintained in good standing and approved by the City Risk Management Administrator throughout the duration of this Agreement. C. Consultant shall be responsible for assuring that the insurance certificates required under 13 3/7/2024 7:11 PM p. 82 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 this Agreement remain in full force and effect for the duration of this Agreement, including any extensions hereof. If insurance certificates are scheduled to expire during the term of this Agreement and any extension hereof, Consultant shall be responsible for submitting new or renewed insurance certificates to the City's Risk Management Administrator as soon as coverages are bound with the insurers. In the event that expired certificates are not replaced, with new or renewed certificates which cover the term of this Agreement and any extension thereof: (i) the City shall suspend this Agreement until such time as the new or renewed certificate(s) are received in acceptable form by the City's Risk Management Administrator; or (ii) the City may, at its sole discretion, terminate the Agreement for cause and seek re -procurement damages from Consultant in conjunction with the violation of the terms and conditions of this Agreement. D. Compliance with the foregoing requirements shall not relieve Consultant of its liabilities and obligations under this Agreement. 16. NONDISCRIMINATION: Consultant represents to the City that Consultant does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Consultant's performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status or national origin. Consultant further covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex, sexual orientation , religion, age, handicap, marital status or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. 17. ASSIGNMENT: 14 3/7/2024 7:11 PM p. 83 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 This Agreement shall not be assigned, transferred, sold, conveyed or pledged by Consultant, in whole or in part, and Consultant shall not assign any part of its operations, without the prior written consent of the City Manager, which may be withheld or conditioned, in the City's sole discretion through the City Manager. 18. NOTICES: All notices or other communications required under this Agreement shall be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return receipt requested, addressed to the other party at the address indicated herein or to such other address as a party may designate by notice given as herein provided. Notice shall be deemed given on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. TO CONSULTANT: TO THE CITY: Arthur Noriega V City Manager 444 SW 2nd Avenue, 10th Floor Miami, FL 33130-1910 Ann -Marie Sharpe Director, Risk Management 444 SW 2nd Avenue, 9th Floor Miami, FL 33130 Annie Perez, CPPO Procurement Director 444 SW 2nd Avenue, 6th Floor Miami, FL 33130-1910 Victoria Mendez City Attorney 15 3/7/2024 7:11 PM p. 84 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 444 SW 2nd Avenue, 9th Floor Miami, FL 33130-1910 19. MISCELLANEOUS PROVISIONS: A. This Agreement shall be construed and enforced according to the laws of the State of Florida. Venue in any proceedings between the parties shall be in Miami -Dade County, Florida. Each party shall bear its own attorney's fees. Each party waives any defense, whether asserted by motion or pleading, that the aforementioned courts are an improper or inconvenient venue. Moreover, the parties consent to the personal jurisdiction of the aforementioned courts and irrevocably waive any objections to said jurisdiction. The parties irrevocably waive any rights to a jury trial. B. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing. C. Should any provision, paragraph, sentence, word or phrase contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise unenforceable under the laws of the State of Florida or the City of Miami, such provision, paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable, then the same shall be deemed severable, and in event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect or limitation of its use. D. Consultant shall comply with all applicable laws, rules and regulations in the performance of this Agreement, including but not limited to licensure, and certifications required by law for professional service Consultants. 16 3/7/2024 7:11 PM p. 85 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 E. This Agreement constitutes the sole and entire agreement between the parties hereto. No modification or amendment hereto shall be valid unless in writing and executed by properly authorized representatives of the parties hereto. Except as otherwise set forth in Section 2 above, the City Manager shall have the sole authority to extend, amend, or modify this Agreement on behalf of the City. 20. SUCCESSORS AND ASSIGNS: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns. 21. INDEPENDENT CONTRACTORS: Consultant has been procured and is being engaged to provide Services to the City as an independent contractor, and not as an agent or employee of the City. Accordingly, neither Consultant, nor its employees, nor any subcontractor hired by Consultant to provide any Services under this Agreement shall attain, nor be entitled to, any rights or benefits under the Civil Service or Pension Ordinances of the City, nor any rights generally afforded classified or unclassified employees. Consultant further understands that Florida Workers' Compensation benefits available to employees of the City are not available to Consultant, its employees, or any subcontractor hired by Consultant to provide any Services hereunder, and Consultant agrees to provide or to require subcontractor(s) to provide, as applicable, workers' compensation insurance for any employee or agent of Consultant rendering Services to the City under this Agreement. Consultant further understands and agrees that Consultants or subcontractors' use or entry upon City properties shall not in any way change its or their status as an independent contractor. 17 3/7/2024 7:11 PM p. 86 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 22. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination due to lack of funds, reduction of funds, failure to allocate or appropriate funds, and/or change in applicable laws or regulations, upon thirty (30) days written notice. 23. FORCE MAJEURE: A "Force Majeure Event" shall mean an act of God, act of governmental body or military authority, fire, explosion, power failure, flood, storm, hurricane, sink hole, other natural disasters, epidemic, riot or civil disturbance, war or terrorism, sabotage, insurrection, blockade, or embargo. In the event that either party is delayed in the performance of any act or obligation pursuant to or required by the Agreement by reason of a Force Majeure Event, the time for required completion of such act or obligation shall be extended by the number of days equal to the total number of days, if any, that such party is actually delayed by such Force Majeure Event. The party seeking delay in performance shall give notice to the other party specifying the anticipated duration of the delay, and if such delay shall extend beyond the duration specified in such notice, additional notice shall be repeated no less than monthly so long as such delay due to a Force Majeure Event continues. Any party seeking delay in performance due to a Force Majeure Event shall use its best efforts to rectify any condition causing such delay and shall cooperate with the other party to overcome any delay that has resulted. 24. CITY NOT LIABLE FOR DELAYS: 18 3/7/2024 7:11 PM p. 87 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 Consultant hereby understands and agrees that in no event shall the City be liable for, or responsible to Consultant or any subcontractor, or to any other person, firm, or entity for or on account of, any stoppages or delay(s) in work herein provided for, or any damages whatsoever related thereto, because of any injunction or other legal or equitable proceedings or on account of any delay(s) for any cause over which the City has no control. 25. USE OF NAME: Consultant understands and agrees that the City is not engaged in research for advertising, sales promotion, or other publicity purposes. Consultant is allowed, within the limited scope of normal and customary marketing and promotion of its work, to use the general results of this project and the name of the City. The Consultant agrees to protect any confidential information provided by the City and will not release information of a specific nature without prior written consent of the City Manager or the City Commission. Consultant may not use or reproduce the official logo of the City. 26. NO CONFLICT OF INTEREST: Pursuant to City of Miami Code Section 2611, as amended ("City Code"), regarding conflicts of interest, Consultant hereby certifies to the City that no individual member of Consultant, no employee, and no subcontractor under this Agreement nor any immediate family member of any of the same is also a member of any board, commission, or agency of the City. Consultant hereby represents and warrants to the City that throughout the term of this Agreement, Consultant, its employees, and its subcontractors will abide by this prohibition of the City Code. 19 3/7/2024 7:11 PM p. 88 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 27. NO THIRD -PARTY BENEFICIARY: No persons other than the Consultant and the City (and their successors and assigns) shall have any rights whatsoever under this Agreement. 28. SURVIVAL: All obligations (including but not limited to indemnity and obligations to defend and hold harmless) and rights of any party arising during or attributable to the period prior to expiration or earlier termination of this Agreement shall survive such expiration or earlier termination. 29. TRUTH -IN -NEGOTIATION CERTIFICATION, REPRESENTATION AND WARRANTY: Consultant hereby certifies, represents and warrants to the City that on the date of Consultant's execution of this Agreement, and so long as this Agreement shall remain in full force and effect, the wage rates and other factual unit costs supporting the compensation to Consultant under this Agreement are and will continue to be accurate, complete, and current. Consultant understands, agrees and acknowledges that the City shall adjust the amount of the compensation and any additions thereto to exclude any significant sums by which the City determines the contract price of compensation hereunder was increased due to inaccurate, incomplete, or non -current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year of the end of this Agreement, whether naturally expiring or earlier terminated pursuant to the provisions hereof. 20 3/7/2024 7:11 PM p. 89 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 30. COUNTERPARTS: ELECTRONIC SIGNATURES: This Agreement and any amendments hereto may be executed in counterparts and all such counterparts taken together shall be deemed to constitute one and the same instrument, each of which shall be an original as against either party whose signature appears thereon, but all of which taken together shall constitute but one and the same instrument. An executed facsimile or electronic scanned copy of this Agreement shall have the same force and effect as an original. The parties shall be entitled to sign and transmit an electronic signature on this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Any party providing an electronic signature agrees to promptly execute and deliver to the other parties an original signed Agreement upon request. 31. E-VERIFY EMPLOYMENT REQUIREMENTS: Consultant(s) shall E-Verify the employment status of all employees and subcontractors to the extent required by federal, state, and local laws, rules, and regulations. The City shall consider the employment by Consultant(s) of unauthorized aliens a violation of Section 274A(e) of the Immigration and Nationality Act. If the Consultant(s) knowingly employs unauthorized aliens, such violation shall be cause for termination of the Contract. Furthermore, the Consultant(s) agrees to utilize the U.S. Agency of Homeland Security's E-Verify System, https://e- verify.uscis.gov/emp, to verify the employment eligibility of all employees during the term of this Contract. Consultant(s) shall also include a requirement in subcontracts that the subcontractor shall also utilize the E-Verify System to verify the employment eligibility of all employees of the subcontractor during the term of this Contract. 21 3/7/2024 7:11 PM p. 90 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 32. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and only agreement of the parties relating to the subject matter hereof and correctly set forth the rights, duties, and obligations of each to the other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 22 3/7/2024 7:11 PM p. 91 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 IN WITNESS WHEREOF, the Parties have executed this Agreement, or have caused the same to be executed, as of the date and year first above written. "Consultant" a Florida profit corporation ATTEST: By: By: Print Name: Name: Title: Title: ATTEST: "CITY" CITY OF MIAMI, a Florida municipal corporation By: By: Todd B. Hannon Arthur Noriega V City Clerk City Manager APPROVED AS TO LEGAL FORM AND APPROVED AS TO INSURANCE CORRECTNESS: REQUIREMENTS: By: By: Victoria Mendez Ann -Marie Sharpe, Director City Attorney Department of Risk Management 23 3/7/2024 7:11 PM p. 92 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 EXHIBIT A RFQ No. 1733386 24 3/7/2024 7:11 PM p. 93 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 EXHIBIT B SCOPE OF WORK Provide Employee Voluntary Supplemental Insurance Benefits, as provided in the individual Work Assignments, pursuant to Section 3.0, Specifications/Scope of Work, of the Solicitation. 25 3/7/2024 7:11 PM p. 94 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 EXHIBIT C INSURANCE REQUIREMENTS The Consultant shall furnish to City of Miami, c/o Procurement Department, 444 SW 2nd Avenue, 6th Floor, Miami, Florida 33130, Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets the requirements as outlined below: I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $ 2,000,000 Personal and Adv. Injury $ 1,000,000 Products/Completed Operations $ 1,000,000 B. Endorsements Required City of Miami listed as additional insured Contingent & Contractual Liability Premises and Operations Liability Primary Insurance Clause Endorsement II. Business Automobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami listed as an additional insured 26 3/7/2024 7:11 PM p. 95 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation Employer's Liability A. Limits of Liability $100,000 for bodily injury caused by an accident, each accident $100,000 for bodily injury caused by disease, each employee $500,000 for bodily injury caused by disease, policy limit IV. Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim $1,000,000 General Aggregate Limit $1,000,000 Retro Date Included V. Network Security and Privacy Injury (Cyber Liability) Each Claim $1,000,000 Policy Aggregate $1,000,000 Retro Date Included Consultant agrees to maintain professional liability/Errors & Omissions coverage, along with Network Security and Privacy Injury (Cyber) coverage, if applicable, for a minimum of 1 year after termination of the contract period subject to continued availability of commercially reasonable terms and conditions of such coverage. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer in accordance to policy provisions. 27 3/7/2024 7:11 PM p. 96 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A-" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. Certificates will indicate no modification or change in insurance shall be made without thirty (30) days written advance notice to the certificate holder. NOTE: CITY RFQ NUMBER AND/OR TITLE OF RFQ MUST APPEAR ON EACH CERTIFICATE. Compliance with the foregoing requirements shall not relieve the Consultant of his liability and obligation under this section or under any other section of this Agreement. --If insurance certificates are scheduled to expire during the contractual period, the Consultant shall be responsible for submitting new or renewed insurance certificates to the City at a minimum of ten (10) calendar days in advance of such expiration. --In the event that expired certificates are not replaced with new or renewed certificates which cover the contractual period, the City shall: (1) Suspend the contract until such time as the new or renewed certificates are received by the City in the manner prescribed in the Request for Qualifications. (2) The City may, at its sole discretion, terminate this contract for cause and seek re -procurement damages from the Consultant in conjunction with the General and Special Terms and Conditions of the RFQ. The Consultant shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in force for the duration of the contractual period; including any and all option terms that may be granted to the Consultant. 28 3/7/2024 7:11 PM p. 97 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 EXHIBIT D CORPORATE RESOLUTIONS AND EVIDENCE OF QUALIFICATION TO DO BUSINESS IN FLORIDA (To be provided upon document execution) 29 3/7/2024 7:11 PM p. 98 City of Miami Solicitation RFQ 1733386 City of Miami, FL RFQ 1733386 WHEREAS, CORPORATE RESOLUTION ., a corporation, desires to enter into an agreement with the City of Miami for the purpose of performing the work described in the contract to which this resolution is attached; and WHEREAS, the Board of Directors at a duly held corporate meeting has considered the matter in accordance with the bylaws of the corporation; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS that this Corporation is authorized to enter into the Agreement with the City, and the President and the Secretary are hereby authorized and directed to execute the Agreement in the name of this Company and execute any other document and perform any acts in connection therewith as may be requested to accomplish its purpose. IN WITNESS WHEREOF, this day of , 2024 ("Consultant") A Florida Corporation By: (sign) Print Name: Title: (sign) Print Name: 30 3/7/2024 7:11 PM p. 99 City of Miami Solicitation RFQ 1733386 Question and Answers for Solicitation #RFQ 1733386 - Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool Overall Solicitation Questions There are no questions associated with this Solicitation. Question Deadline: Mar 22, 2024 5:00:00 PM EDT 3/7/2024 7:11 PM p. 100 Tau of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 1 RFQ 1733386 March 29, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURNACE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Friday, April 19, 2024, at 5:OOPM. ALL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Ga.c 4. C- c?A� for �/ Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Department of Risk Management Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: ANNIE PEREZ, CPPO Procurement Director Tau of 4Thami If ,rIM`C. ARTHUR NORIEGA V City Manager ADDENDUM NO. 2 RFQ 1733386 April 18, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Friday, April 26, 2024, at 5:OOPM. B. The City of Miami's Full Time Employee Census is hereby attached as Exhibit A. C. The City of Miami's - Standard Insurance Company Certificate Group Short Term Disability Insurance Policy is hereby attached as Exhibit B. D. The City of Miami's - Standard Insurance Company Certificate Group Long Term Disability Insurance Policy is hereby attached as Exhibit C. E. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1: Describe any supplementary benefits currently in force with City Employees. Al: The voluntary benefits listed below were not procured by the City, nor are they managed by the City. They were either procured by the American Federation of State, County and Municipal Employees ("AFSCME") Local 1907 and AFSCME Local 871 or were "legacy" products. These benefits are not part of the City's open enrollment suite of benefits. Voluntary benefits include Accident, Critical Illness, Specified Disease, Group Hospital Confinement indemnity, Short Term Disability, Long term Disability, Legal, and Life as listed in the table below: Non -City Managed Benefit Contact Info on hand Erin Wiggins Account Acquisition Executive D: 803-665-4399 / F: 866-316-9891 Email: ewiggins@e3benefit.com Colonial Accident Policy Colonial Critical Illness Colonial Group Specified Disease Colonial Grp Hosp Conf Indemnity www.e3benefit.com Colonial Short -Term Disability www.nationalenrollmentpartners.com FOP Colonial Accident Policy Please see contact above FOP Colonial Critical Illness FFB Conseco Anthony Muina District Manager Optavise/Washington National Insurance Co. / FFB Conseco / RELIANCE STANDARD LIFE (RSL) RSL is the Basic Life AD&D Carrier for AFSCME 1907 & SEA 871 P: 732-644-4550 Anthony.Muina@optavise.com RSL LTD RSL STD Southern Legal No contact info Southern Provident No contact info Transamerica Employee Benefit Mary Early Registered Representative Investment Advisor Representative Transamerica Agency Network, Inc. Office 786 615 7866 I Cell 786 663- 3959 I Fax 305 503 9695 Mary. Roberts@transamericanetwork.c om Q2: Will the above benefits and payroll access be terminated upon naming a new vendor(s)? A2: No. Q3: If benefits are different across departments/bargaining units (police/fire/etc.), please describe any differences in existing benefits/eligibility? A3: Sworn personnel groups, (Police, Fire Rescue, etc.), each have their own Health Trusts. Civilian full-time employees are eligible to participate in the City's Cafeteria Suite of benefits, which include Medical, Dental HMO & PPO, Comprehensive Vision, FSA HC and FSA DC, Legal Shield and ID Theft Protection. AFSCME Local 1907 and AFSCME Local 871 Members have post -tax voluntary benefits listed above in the response to Q1. Q4: How many employees will be eligible for the new offerings resulting from this RFQ? A4: All 4,238 full-time employees will be eligible. Refer to Exhibit A — March 2024 CMIA Full -Time Employee Census. Q5: How will employees be educated/enrolled in the new offerings? A5: The education and enrollment of employees with relation to these offerings will be facilitated by the Successful Proposer(s). Pursuant to Section 3.1, Specifications/Scope of Work, paragraph 2, "Successful Proposer(s) will provide appropriate resources to coordinate, monitor, market and place programs..." Appropriate resources should include the ability to conduct in -person and virtual sessions and conduct a voluntary mid -year enrollment period. Note that Proposer's team should have multilingual (English, Spanish, Creole) personnel for the marketing and enrollment sessions. Q6: Will a technology or enrollment firm be used? A6: No. Q7: Is there a broker or consultant partnering with the City on the new offerings? A7: No. Q8: Will a complete employee census be provided including date of birth, gender, job classification and annual compensation? A8: Refer to Exhibit A, March 2024 City of Miami Employee Census. Q9: Will current plan designs be provided including summaries, certificates of coverage and any amendments to the plans? A9: Refer to Exhibit B, City of Miami — Standard Insurance Certificate Group Short Term Disability Insurance; and Exhibit C, City of Miami — Standard Insurance Certificate Group Long Term Disability Insurance. Q10. Is there a consultant or broker partnering with the City? If so, should Successful Proposer(s) build any Commission or fee for this partnership? A10. Refer to the response to Q7 above. Q11. Is there an enrollment firm involved in this process? If so, should Successful Proposer(s) build and Commission or fee for this partnership? Al 1. Refer to the response to Q6 above. Q12. Does the City have documentation detailing the last thirty-six (36) months of claims experience and open claims? Al2. No. These records have been requested from the City's current STD and LTD vendor, the Standard Insurance Company. Q13. How do employees currently enroll in coverage? A13. Currently, employee enrollment occurs during a three (3)-week annual open enrollment period during which employees can enroll in person or virtually. Q14. What platform is used for virtual enrollment? A14. The Employee Benefits module of the City's Oracle Enterprise Resource Planning ("ERP") system. Q15. Is there a current billing and/or eligibility file feed in place for voluntary supplemental lines? A15. The vendor and the City's Payroll Division file feeds and bills. Q16. Is a payment bond or performance bond required in relation to this RFQ? A16. No. Q17. Describe the City's past enrollment strategy? A17. Refer to the response to Q13 above. Q18. Are Spanish and Creole enrollment materials needed? A18. Yes. Q19. Is the City open to working with an enrollment firm to help educate employees on all benefits offered by the City at no additional cost? A19. Yes. Q20. Does the City host an annual Benefits Fair?? A20. Yes. Q21. Who is the City's current benefits consultant/broker? A21. USI Insurance Services, LLC. Q22. Will the Successful Proposer(s) be required to be HIPPA compliant? A22. Yes. Refer to Section 1.41, Health Insurance Portability and Accountability Act (HIPPA). ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: EXHIBIT A City of Miami Full Time Employee Census Row Labels Count of EMPLOYEE NUMBER AFSCME 1632 Board Members 11 City Attorney 1 Commissioners 5 Detention Officer 7 Executives 100 Fire Executives 16 Fire Union 761 Managerial/Confidential 71 Police Executives 42 Police Trainees 21 Sanitation Union 164 Sworn Police Officers 1225 Temporary Fulltime 56 Unclassified 126 Grand Total 4238 Total # of W2 EEs 4852 Regular Parttime 231 Seasonal 376 Temporary Parttime 7 Excluded - Not benefit Eli 614 Total Benefit Eligible Ees 4238 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 43405 12-Apr-90 M 41708 29-Sep-92 M 28008 8-Dec-76 M 156 10-May-78 M 71 22-Jan-72 M 27168 29-Sep-58 F 28435 22-Aug-78 M 43806 31-Jul-97 M 25491 7-Nov-77 M 45813 12-Dec-76 M 40803 26-Nov-72 M 2794215-Feb-85 M 67 7-Apr-80 M 28207 30-Mar-79 M 44906 6-Jul-81 F 40620 30-May-91 M 4634018-Nov-83 F 41962 18-Dec-68 F 40663 12-Dec-72 M 45486 4-Mar-57 M 24488 19-Nov-71 M 42677 20-Jul-93 F 45292 22-Dec-91 M 46848 2-Apr-98 M 45560 18-Feb-90 M 42785 20-Nov-94 M 26605 5-Apr-65 F 41480 9-Aug-87 M 4053610-Jan-92 M 41746 12-Jun-73 M 25 22-Dec-77 M 43587 13-Feb-95 M 40471 11-Nov-86 M 46872 29-Jan-02 F 25531 31-Dec-75 M 65 3-Apr-74 F 45414 2-Oct-93 F 43579 5-Jul-89 F 28549 6-Mar-83 M 26988 4-Jan-80 M 27384 3-Mar-67 F 40274 27-Jan-87 M 4604618-Dec-01 M 40333 7-May-94 F 44379 5-Dec-92 M 44754 25-Jan-89 M 41824 18-Feb-88 M 56 5-Jan-80 M 4006610-Mar-84 M 17399 25-Aug-62 M 4689213-Oct-98 F 40802 21-Dec-79 M 44394 12-May-93 F 45522 4-Aug-68 M 42986 18-Jan-94 M 40275 14-Apr-77 M 4458617-Jan-00 M 28704 28-Aug-76 F 45955 15-Sep-91 F 28561 15-Apr-85 F 40967 19-Jun-86 M 42573 9-Oct-87 F 45569 4-Jan-89 F 69 3-Dec-71 F 42143 13-Apr-87 M 46859 30-Sep-73 F 1366 30-Sep-79 F 41438 17-Nov-61 M 2753611-Apr-69 F 25850 7-Sep-66 M 45314 9-Apr-87 M 41115 14-Oct-88 M 26636 24-Feb-77 M 43670 10-Feb-97 M 62 27-Dec-70 M 45906 5-Sep-77 F 43712 16-Sep-87 F 28377 28-Aug-81 F 29107 7-Sep-85 F 45291 1-Jul-86 M 42211 18-Oct-87 M 4027616-Nov-86 M 46921 12-Nov-97 F 42678 29-Jul-48 M 2867716-Jul-70 M 45266 8-Jun-72 M 40801 22-Dec-85 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 64,537.32 Fire Union Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 165,878.97 Police Executives Fulltime-Regular 01/01/18 #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 71,452.78 Sanitation Union Fulltime-Regular #N/A #NIA $ 78,492.21 Fire Union Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 122,715.09 Fire Union Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 80,935.85 Fire Union Fulltime-Regular #N/A #NIA $ 90,866.67 Fire Union Fulltime-Regular #N/A #NIA $ 196,470.54 Police Executives Fulltime-Regular 11/01/21 #NIA $ 92,017.12 AFSCME Fulltime-Regular #N/A #NIA $ 83,462.50 AFSCME Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #NIA $ 40,146.91 AFSCME Probationary #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 51,238.51 AFSCME Fulltime-Regular #N/A #NIA $ 81,612.33 AFSCME Fulltime-Regular #N/A #NIA $ 82,527.74 Sanitation Union Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 55,749.65 Fire Union Fulltime-Regular #N/A #NIA $ 55,857.56 Police Trainees Probationary #N/A #NIA $ 50,566.46 Fire Union Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 103,184.31 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 112,293.99 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 111,521.07 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,000.00 Unclassified Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 81,120.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 93,136.49 Fire Union Fulltime-Regular #N/A #NIA $ 119,448.59 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 70,381.55 AFSCME Fulltime-Regular #N/A #NIA $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 226,923.46 Police Executives Fulltime-Regular 01/01/18 06/01/18 $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #NIA $ 55,000.00 Unclassified Fulltime-Regular #N/A #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Fulltime-Regular #N/A #NIA $ 77,726.27 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,486.40 Fire Union Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Probationary #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 94,384.50 Executives Fulltime-Regular 03/28/22 03/28/22 $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Probationary #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 134,495.11 Executives Fulltime-Regular 01/01/18 #NIA $ 120,000.00 AFSCME Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 87,635.30 Unclassified Fulltime-Regular #N/A #NIA $ 75,597.84 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 65,395.22 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 99,200.81 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 44,261.56 AFSCME Probationary #N/A #NIA $ 83,273.13 Unclassified Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 55,749.65 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 86,486.40 Fire Union Fulltime-Regular #N/A #N/A $ 60,000.00 Unclassified Fulltime-Regular #N/A #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #N/A #N/A $ 58,918.08 Sanitation Union Fulltime-Regular #N/A #NIA $ 158,283.32 Executives Fulltime-Regular 07/15/19 #N/A $ 86,486.40 Fire Union Fulltime-Regular #N/A #NIA JOB TITLE Fire Fighter 96 Hrs Police Officer Sergeant -At -Arms Police Officer Police Sergeant Waste Col Op II Fire Fighter 96 Hrs Police Officer Fire Captain 52/104 Hrs Auto Mechanic Fire Fighter 52/104hrs Fire Lieut 80 Hrs Police Commander Program Coord, Asst Victims Advocate Rec Specialist Early Childhood Educator Admin Aide II Tree Trimmer Mechanical Inspector Waste Eqpt Op Police Officer Fire Fighter 96 Hrs Pol Officer-Prob Fire Fighter 96 Hrs Police Officer Engineer I Fire Fighter 96 Hrs Laborer I Senior Electrical Inspector Police Officer Police Officer Police Sergeant Receptionist (Elected Official) Grounds Tender Police Officer Urban Design Planner, T Police Officer Police Officer Fire Lieut 96 Hrs Planner II Fire Fighter 96 Hrs Police Officer Assistant Agenda Coordinator Building Services Assistant I Police Officer Fire Fighter 96 Hrs Asst Chief Police Fire Lieut 96 Hrs Fire Fighter 96 Hrs District Aide (Elected Official) Fire Fighter 96 Hrs Crime Scene Investigator I Building Inspector Police Officer Fire Lieut 96 Hrs Graphic Designer Building Services Assistant III Asst City Attorny Police Sergeant Program Assistant Public Service Aide Public Art Manager Police Officer Assistant City Attorney, Supervisor Structural Plans Examiner (Residential) Police Officer Waste Collector-Garbg Asst to the Dir - Grants & Sustainable Initiatives Painter Police Officer Budget Analyst Electrical Inspector Police Officer Police Officer Admin Aide I Asst To Dir-Pks &Rec Public Service Aide Police Lt Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Lieut 96 Hrs Constituent Liaison (Elected Official) Waste Collector-Garbg Waste Col Op I Assistant Director, Development & Transportation Fire Lieut 96 Hrs 1 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 41495 24-Sep-90 M 25769 30-Apr-81 M 2477213-Mar-78 M 40729 9-Aug-91 M 133 1-May-76 F 40884 6-Nov-92 F 22656 20-May-65 M 26020 21-Apr-76 M 27070 22-Oct-77 M 41866 23-Feb-71 M 41373 23-Oct-80 F 43881 10-Jan-67 F 43574 21-Jan-96 M 45513 17-May-87 M 43140 5-Dec-70 M 25661 24-Nov-69 F 42618 23-May-82 F 63 21-Mar-75 M 28656 29-Jun-83 F 29287 4-Jun-82 M 45230 14-Dec-85 M 24182 1-Mar-74 M 46045 1-Nov-96 F 46330 4-Jan-72 M 40730 9-Mar-85 M 46850 9-Aug-01 M 28436 23-Nov-86 M 29414 10-Oct-73 M 4202616-Jul-69 M 26030 13-Jun-60 F 41323 4-Nov-91 M 25975 25-Oct-65 M 2938312-Oct-80 M 149 8-Dec-75 F 43847 3-Dec-00 F 46768 3-Feb-86 M 46926 13-Mar-81 M 45369 1-Mar-88 M 42510 14-Jul-87 M 41425 14-Sep-81 M 28101 12-Nov-87 M 40756 21-Aug-85 F 27943 27-Sep-79 M 40910 20-Jul-82 M 45796 11-Nov-91 F 2805317-Jan-66 M 40277 30-Nov-77 M 120 8-Feb-73 M 42141 5-Apr-56 M 29379 22-Sep-70 M 46762 22-Nov-97 F 43743 3-Oct-90 M 41869 18-Apr-63 F 41823 24-Jan-92 M 46931 30-Jul-97 M 42813 30-Jun-93 M 42612 29-Jul-75 M 41478 23-Apr-87 M 45803 26-Mar-72 M 41264 26-Apr-85 M 46516 15-Nov-99 M 46864 28-Feb-97 M 43053 28-Dec-90 M 43611 10-Apr-67 M 25413 29-Apr-48 M 42926 12-Jan-95 M 24362 6-Aug-62 M 43882 20-Feb-82 M 144 29-Nov-71 M 45441 11-Oct-95 F 27150 12-Mar-61 M 41189 1-Oct-78 M 40732 20-May-87 M 40731 15-Sep-87 M 18393 22-Jul-72 F 4286713-Dec-83 M 152 8-Jul-77 F 26989 4-Jan-69 M 46675 26-Jun-83 M 29119 30-Sep-71 F 42039 24-Feb-68 M 40099 21-Oct-79 M 43113 25-Feb-79 F 43583 30-Mar-90 F 46812 6-Jul-72 M 29283 2-Oct-88 M 42532 12-Jul-95 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 84,529.32 Fire Union Fulltime-Regular #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 109,334.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 103,420.42 Fire Union Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 165,386.30 Executives Fulltime-Regular 11/01/18 01/01/19 $ 39,968.65 Sanitation Union Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 50,895.52 Sanitation Union Fulltime-Regular #NIA #NIA $ 96,148.27 AFSCME Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 79,487.82 AFSCME Probationary #NIA #NIA $ 97,853.39 Fire Union Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Probationary #NIA #NIA $ 85,033.22 Fire Union Fulltime-Regular #NIA #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #N/A $ 93,379.20 AFSCME Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 75,025.39 Sanitation Union Fulltime-Regular #NIA #NIA $ 111,847.63 AFSCME Fulltime-Regular #NIA #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Probationary #NIA #N/A $ 40,560.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 79,487.82 AFSCME Fulltime-Regular #NIA #NIA $ 85,033.22 Fire Union Fulltime-Regular #NIA #N/A $ 74,710.02 Fire Union _ _ Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 74,711.72 Fire Union Fulltime-Regular #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 55,650.00 Unclassified Fulltime-Regular #NIA #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #NIA $ 53,800.45 AFSCME Probationary #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 62,282.39 Unclassified Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 71,688.86 AFSCME Probationary #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 108,184.90 Unclassified Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 80,935.85 Fire Union Fulltime-Regular #NIA #N/A $ 58,650.59 Sworn Police Officers Probationary #NIA #NIA $ 62,281.23 AFSCME Probationary #NIA #N/A $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #N/A $ 65,303.99 AFSCME Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Probationary #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #N/A $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,997.74 AFSCME Fulltime-Regular #NIA #NIA $ 92,017.12 AFSCME Probationary #NIA #NIA $ 103,184.18 AFSCME Fulltime-Regular #NIA #NIA $ 116,801.98 Fire Union Fulltime-Regular #NIA #NIA $ 68,275.17 AFSCME Probationary #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 102,775.02 AFSCME Fulltime-Regular #NIA #N/A $ 40,004.45 AFSCME Fulltime-Regular #NIA #NIA $ 92,017.12 AFSCME Fulltime-Regular #NIA #N/A $ 90,000.00 AFSCME Probationary #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA JOB TITLE Fire Fighter 96 Hrs Ocean Rescue Lifeguard Fire Fighter 80 Hrs Police Officer Police Officer Police Sergeant Fire Lieut 52/104 Hrs Fire Lieut 52/104 Hrs Police Officer Heavy Eqp Mech Assistant Director, Zoning Waste Collector-Garbg Police Officer Emergency Dispatcher Waste Col Op I GF Budget and Financial Support Advisor Public Service Aide Police Officer Police Sergeant Police Officer Business Systems Administrator Fire Lieut 80 Hrs Police Officer Eng Tech III Police Officer Eng Tech I Fire Fighter 52/104hrs Waste Col Op II Admin Aide I Police/Fire Payroll Coordinator Police Officer Waste Col Op II Project Manager - Cip Typist Clerk III Rec Specialist Water Safety Instructor, T Staff Services Assistant, T Police Officer Police Officer Auto Mechanic Police Lt Legislative Coordinator Fire Fighter 52/104hrs Fire Fighter 96 Hrs Emergency Dispatcher Welder Fire Fighter 80 Hrs Police Officer Special Aide (Elected Official) Auto Mechanic Digital Communications Specialist Police Officer Admin Aide I Fire Fighter 96 Hrs Programmer Police Officer Admin Asst 11 Fire Fighter 96 Hrs Planning Tech Fire Fighter 52/104hrs Police Officer Planner 1 Fire Fighter 96 Hrs Maint Mechanic Marinas Faclt Att Auto Mech Helper Custodian 11 Park Ranger Supervisor Police Officer 911 Operator (Emergency Call -Taker) Facility Attend Fire Fighter 96 Hrs Police Officer Police Officer Typist Clerk III Zoning Plans Examiner Code Compliance Inspector Fire Captain 52/104 Hrs Geographic Information Systems Data Spec Police Officer Mason Information Technology Tech. III Geographic Information Systems Data Spec Planner 11 Project Cost Estimator Police Sergeant Police Officer 2 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 40800 22-Jul-86 M 27181 25-Aug-60 M 43087 31-Oct-83 F 23339 24-Feb-72 M 25688 27-Nov-68 F 41346 19-Mar-66 F 41287 2-Nov-89 M 22970 30-Nov-63 F 41947 25-Jan-93 F 4377519-Sep-77 M 25493 11-Dec-68 M 44904 1-Mar-95 F 2787616-Jan-77 M 42210 7-Jan-93 M 24999 11-Apr-70 M 23757 2-Apr-66 M 24046 25-Dec-70 M 46536 11-Jul-00 M 44612 29-Oct-95 F 44573 3-Jan-80 M 41263 21-Aug-90 M 42850 29-Jan-68 F 42061 18-Sep-84 M 40733 22-May-89 M 42550 27-Dec-84 M 29246 1-Jan-82 M 25448 6-Apr-66 F 29193 7-Sep-87 M 27403 16-May-74 F 43160 12-Jun-86 M 44166 24-May-84 M 26990 2-Oct-80 M 4206710-Aug-87 M 26022 20-Jan-74 M 4006817-Sep-81 F 45313 25-Jun-85 M 42703 22-Jul-87 M 43068 20-Dec-88 M 21701 26-May-75 M 183 7-May-72 M 46117 6-Jun-73 F 40069 30-Jul-81 M 40278 31-Dec-86 M 43735 26-Feb-99 M 19718-Sep-72 M 24118 2-Oct-68 M 44420 14-Sep-92 M 28675 23-Dec-84 M 42469 14-Jul-90 M 29112 4-Jun-75 F 46880 4-Dec-00 M 3890 29-Jul-84 F 4003416-Dec-81 M 2670517-May-67 F 44220 15-May-66 M 28437 16-Jul-81 M 40912 2-Mar-87 F 40070 23-Jan-74 M 28686 4-Nov-81 F 46331 14-Nov-83 F 42794 26-Nov-86 F 46784 3-Sep-93 M 28614 14-Jul-82 F 25479 6-Mar-75 M 41518 25-Mar-70 F 44193 8-Jun-77 M 4073417-Nov-88 M 222 27-Apr-73 M 41444 18-Feb-68 M 45648 24-Apr-62 M 41769 14-Nov-82 F 46891 30-Jan-03 F 4302210-Mar-89 M 43801 16-Jun-92 F 25595 15-May-63 F 4090717-Mar-90 F 41692 15-Nov-83 F 27228 20-Sep-78 M 26032 12-Jan-83 M 25520 11-Sep-70 M 41683 26-Jul-76 M 4079918-Dec-85 M 236 16-Mar-78 M 27590 17-Jan-81 M 2224816-Dec-66 M 10641 3-May-74 F 45428 27-Aug-92 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 86,486.40 Fire Union Fulltime-Regular #N/A #NIA $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 83,462.50 AFSCME Fulltime-Regular #N/A #NIA $ 82,527.74 Sanitation Union Fulltime-Regular #NIA #NIA $ 64,957.15 Sanitation Union Fulltime-Regular #N/A #NIA $ 150,935.24 AFSCME Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 89,134.71 AFSCME Fulltime-Regular #NIA #NIA $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 103,924.50 AFSCME Probationary #NIA #NIA $ 202,285.01 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 59,314.94 AFSCME Probationary #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 84,529.32 Fire Union Fulltime-Regular #NIA #NIA $ 74,711.72 Fire Union Fulltime-Regular #NIA #NIA $ 113,278.67 Fire Union Fulltime-Regular #NIA #NIA $ 45,865.24 Fire Union Probationary #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 53,440.40 Sanitation Union Fulltime-Regular #NIA #NIA $ 73,411.16 Fire Union Fulltime-Regular #NIA #NIA $ 109,334.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 79,487.82 AFSCME Fulltime-Regular #NIA #NIA $ 91,889.56 AFSCME Fulltime-Regular #NIA #N/A $ 88,648.68 Fire Union Fulltime-Regular #NIA #NIA $ 134,086.63 AFSCME Fulltime-Regular #NIA #N/A $ 113,566.98 AFSCME Fulltime-Regular #NIA #NIA $ 61,464.00 Fire Union Fulltime-Regular #NIA #N/A $ 87,159.11 Fire Union Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #N/A $ 82,467.63 Fire Union Fulltime-Regular #NIA #NIA $ 88,648.68 Fire Union Fulltime-Regular #NIA #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 80,709.93 AFSCME Fulltime-Regular #NIA #N/A $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 75,597.84 AFSCME Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 137,865.00 Executives Fulltime-Regular 06/15/22 07/01/22 $ 76,579.56 Fire Union Fulltime-Regular #NIA #NIA $ 86,488.27 Fire Union Fulltime-Regular #NIA #N/A $ 44,261.56 AFSCME Probationary #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 119,448.63 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 91,889.66 AFSCME Fulltime-Regular #N/A #NIA $ 58,650.59 Sworn Police Officers Probationary #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 98,627.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 113,760.59 AFSCME Fulltime-Regular #N/A #NIA $ 125,207.36 AFSCME Fulltime-Regular #NIA #NIA $ 105,190.59 Fire Union Fulltime-Regular #N/A #NIA $ 86,486.40 Fire Union Fulltime-Regular #NIA #NIA $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 42,154.32 AFSCME Probationary #NIA #N/A $ 95,318.49 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Probationary #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 72,097.79 AFSCME Probationary #NIA #N/A $ 109,334.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,200.60 Unclassified Fulltime-Regular #NIA #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 40,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 87,436.61 Unclassified Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 165,878.97 Police Executives Fulltime-Regular 01/30/22 #NIA $ 61,863.98 Sanitation Union Fulltime-Regular #NIA #NIA $ 121,620.51 AFSCME Fulltime-Regular #NIA #N/A $ 72,097.79 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 78,492.21 Fire Union Fulltime-Regular #NIA #N/A $ 171,000.00 Executives Fulltime-Regular 01/01/18 #NIA $ 121,955.07 Unclassified Fulltime-Regular #N/A #N/A $ 62,280.79 Managerial/Confidential Fulltime-Regular #NIA #NIA Fire Lieut 96 Hrs Laborer I Parks Naturalist Sr. Waste Eqpt Op Waste Col Op I Information Technology Customer Service Manager Police Officer Code Compliance Inspector Police/Fire Payroll Coordinator Senior Building Inspector Asst Chief Fire Emergency Dispatcher Police Officer Fire Fighter 96 Hrs Fire Fighter 80 Hrs Fire Fighter 80 Hrs Fire Captain 80 Hours Fire Fighter 96 Hrs Police Officer Police Officer Fire Fighter 96 Hrs Waste Collector II Fire Fighter 52/104hrs Police Sergeant Police Officer Building Services Assistant IV Engineer I Fire Lieut 96 Hrs Program Coord. Programmer Sr Fire Fighter 96 Hrs Fire Fighter 52/104hrs Fire Fighter 96 Hrs Fire Fighter 80 Hrs Fire Lieut 96 Hrs Police Officer Information Technology Technician II Fire Fighter 96 Hrs Irrigation Specialist Police Officer Asst City Attorny Fire Fighter 80 Hrs Fire Lieut 80 Hrs Admin Aide I Police Sergeant Comm Tech Supv Police Officer Building Services Assistant III Police Officer Day Care Ctr Supv Police Officer Police Officer Police Officer Contract Compliance Analyst Software Quality Assurance Analyst Fire Captain 80 Hours Fire Lieut 96 Hrs Fire Lieut 96 Hrs Public Service Aide Building Services Assistant II Police Sergeant Video Retrieval Specialist Police Officer Fire Lieut 52/104 Hrs Events Agent Heavy Eqp Mech Supv Police Sergeant Police Sergeant Police Officer Commissioner's Aide Police Officer District Assistant (Elected Official) Police Officer Police Officer Custodian I Assistant to Director - Risk Management Laborer I Sergeant -At -Arms Waste Col Op I Supt.- Garage Or Motor Pool Auto Mechanic Fire Fighter 96 Hrs Police Sergeant Fire Fighter 96 Hrs Director, Capital Improvement Program Asst To Dir -Solid Waste Human Resources Generalist 3 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 4280617-Aug-91 M 44532 22-Nov-93 F 42776 28-Jun-94 M 23735 14-Oct-72 F 26253 27-Sep-59 F 41608 2-Jun-87 F 45818 29-Jul-76 F 4337510-Oct-84 F 46325 29-Jun-62 F 44388 29-Apr-94 F 28416 28-Apr-70 M 2557416-Sep-62 M 232 4-Oct-67 F 26294 20-Sep-69 M 45239 7-Aug-83 F 28047 20-Jan-71 F 26991 1-Apr-69 M 45771 1-Jul-67 M 26880 25-Sep-87 M 29260 26-Jan-85 M 45561 5-Jun-84 M 27224 4-Apr-80 F 41822 2-Mar-92 M 44171 9-Sep-85 M 27431 23-Jul-75 M 42916 10-Apr-84 M 18874 2-May-68 M 260 21-Oct-68 M 45344 27-Feb-86 F 42527 24-Jun-94 M 46749 21-Oct-96 M 43404 20-Oct-90 M 40886 26-Aug-88 M 43063 23-Aug-84 M 40281 15-Dec-86 M 44438 12-Dec-87 M 46932 5-Jan-73 M 23987 22-Mar-79 F 4350610-Aug-84 M 28517 5-Dec-73 F 42993 6-Apr-74 F 41747 7-Aug-69 M 44938 22-Jun-85 M 41734 9-Aug-74 F 43065 25-Sep-88 M 2843817-Nov-84 M 40906 1-Sep-86 F 18704 3-Jun-77 M 46521 19-Oct-93 F 27586 22-Feb-81 M 41322 26-Apr-91 M 4380713-Aug-74 M 28399 25-Feb-64 F 41820 28-Jul-94 M 41819 27-Sep-84 M 45345 21-Oct-93 F 43164 24-Oct-93 M 2843918-Oct-83 M 42717 13-Aug-91 F 23880 5-Sep-76 M 40965 27-Nov-89 F 1723315-Dec-67 M 29278 3-Oct-88 F 41199 30-Jul-71 F 28440 25-Feb-83 M 27945 3-Oct-82 M 40343 23-Jan-77 F 332 5-Mar-69 M 28041 15-Oct-67 M 43553 14-Aug-85 F 26449 21-Aug-68 F 45457 27-Jul-83 M 46913 6-Apr-95 F 43130 12-Nov-96 M 40825 26-Apr-50 M 46282 20-Jul-94 M 335 26-Jun-73 M 43634 28-Apr-94 M 24461 16-Nov-74 M 44182 15-Sep-79 F 41456 15-Dec-87 M 382 31-Mar-69 M 41818 19-May-89 M 2379216-Oct-74 M 43685 30-Jan-70 F 27576 30-Jan-64 F 46622 28-Feb-61 F YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 100,084.60 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 108,097.57 AFSCME Fulltime-Regular #N/A #N/A $ 81,727.25 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 56,112.36 Sanitation Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Probationary #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 89,134.03 AFSCME Fulltime-Regular #N/A #N/A $ 196,470.54 Police Executives Fulltime-Regular 01/01/24 #N/A $ 176,179.43 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 61,863.98 Sanitation Union Fulltime-Regular #N/A #N/A $ 87,159.11 Fire Union Fulltime-Regular #N/A #N/A $ 109,120.34 AFSCME Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Probationary #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 92,071.94 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 61,464.00 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 150,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 109,334.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 86,488.27 Fire Union Fulltime-Regular #N/A #N/A $ 131,557.65 Executives Fulltime-Regular 11/01/18 #N/A $ 132,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Probationary #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 106,946.94 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 127,581.74 AFSCME Fulltime-Regular #N/A #N/A $ 64,538.86 Fire Union Fulltime-Regular #N/A #N/A $ 105,187.43 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A $ 113,953.04 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 96,483.85 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 119,177.91 AFSCME Fulltime-Regular #N/A #N/A $ 56,524.33 AFSCME Fulltime-Regular #N/A #N/A $ 78,776.67 Sanitation Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 130,330.77 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 105,190.59 Fire Union Fulltime-Regular #N/A #N/A $ 113,953.04 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 70,998.11 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 89,977.88 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,368.00 Fire Union Fulltime-Regular #N/A #N/A $ 142,058.69 Fire Union Fulltime-Regular #N/A #N/A $ 111,847.40 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 83,346.47 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Probationary #N/A #N/A JOB TITLE Police Officer Police Officer Police Sergeant Comm Center Supervisor,Medical/Fire Senior Legal Assistant Waste Col Op I Code Compliance Inspector Police Officer Early Childhood Educator Crime Scene Investigator I Police Officer Human Resources Technician II Police Commander Applications Support Supervisor Laborer I Waste Col Op I Fire Fighter 52/104hrs Senior Building Inspector Admin Asst II Senior Park Ranger Fire Fighter 96 Hrs Education Initiatives Coordinator Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer Chief of Staff (Elected Official) Fire Fighter 80 Hrs Police Officer Police Officer Police Officer Pol Officer-Prob Fire Fighter 96 Hrs Police Sergeant Fire Fighter 96 Hrs Fire Lieut 80 Hrs Asst Dir Gsa Senior Advisor (Elected Official) Fire Fighter 96 Hrs Police Officer Pol Prop Spec I Police Staffing Specialist Electrical Inspector Police Officer Finance Manager Fire Fighter 80 Hrs Fire Captain 96 Hrs Police Officer Fire Fighter 52/104hrs Fire Fighter 96 Hrs Fire Captain 52/104 Hrs Police Officer Police Officer Financial Analyst II Fire Fighter 96 Hrs Fire Fighter 96 Hrs Crime Scene Investigator I Police Officer Fire Lieut 96 Hrs Police Officer Supt. of Recreation Facilities & Programming Administrative Clerk Waste Col Op II Laborer I Grant Funded Project Manager Fire Captain 80 Hours Fire Captain 52/104 Hrs Building Services Assistant IV Police Sergeant Facility Maintenance Technician Admin Aide II Senior Park Ranger Roofing Inspector Pol Prop Spec I Police Officer Laborer I Fire Fighter 96 Hrs Police Officer Police Officer Fire Fighter 52/104hrs Program Assistant Police Officer Police Officer Fire Lieut 96 Hrs Chief Fire Officer 52/104 Hrs Occupational Health Nurse Payroll Specialist Customer Service Representative 4 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 27844 24-Jan-64 M 44310 2-Jun-88 F 28510 13-Jul-55 M 27613 4-Jan-77 M 29398 31-Aug-81 F 41262 18-Dec-80 M 43301 11-Aug-80 F 27944 22-Oct-82 M 4088818-Dec-88 M 41754 29-Nov-60 M 46537 9-Oct-91 M 27294 7-Oct-76 F 29194 22-Mar-74 M 40696 22-Jun-89 F 4281910-Jul-88 M 44819 8-Mar-83 M 41409 13-Dec-84 M 26204 2-Feb-68 F 40897 22-Apr-91 M 41426 12-Feb-50 M 42092 12-May-55 M 46782 14-Jul-00 M 2928817-Feb-84 M 44975 28-Oct-69 F 45311 15-Oct-97 F 46211 29-Sep-95 M 42151 29-Nov-83 M 377 3-Jul-67 M 45900 21-Jul-73 F 28542 21-Nov-56 M 42846 8-Sep-92 M 27597 5-Nov-79 M 46831 23-Mar-73 F 43731 21-Sep-94 M 27344 7-May-52 M 40418 30-Sep-75 F 46533 20-Oct-99 M 42985 14-Apr-83 F 29077 14-Apr-81 M 23601 21-Jan-73 M 44939 5-Nov-93 M 408 4-Apr-76 M 45562 28-Aug-00 M 412 7-Aug-76 F 28518 4-Dec-76 F 2587018-Nov-59 M 24714 18-Dec-75 M 40913 8-Apr-86 M 4347316-Jul-68 M 40064 27-Oct-57 F 413 11-Jul-69 M 41816 10-Apr-87 M 41788 4-Feb-91 M 43602 29-Apr-83 M 43829 29-Nov-88 F 2269315-Nov-78 M 46752 1-Apr-89 F 2858415-Sep-67 F 26710 11-Oct-64 F 43732 20-Dec-58 M 26637 30-May-70 F 43054 21-May-92 M 45853 4-Jan-62 F 469 25-Aug-73 M 41441 18-Apr-70 F 40611 12-Jul-88 M 42676 1-May-88 M 42702 12-Feb-76 F 4547616-Dec-69 F 44610 29-Apr-93 M 26261 18-May-78 F 41489 3-May-94 M 44879 1-Nov-74 F 29168 18-May-52 M 23779 3-Nov-75 M 42513 21-Feb-79 M 43008 26-Sep-90 M 44759 25-Aug-95 M 43691 10-Oct-57 M 41787 18-Oct-91 M 504 26-Dec-74 M 42842 26-Apr-85 M 41777 27-Sep-86 M 41261 22-Sep-82 M 42791 9-Dec-90 M 41793 27-Jan-87 M 4310910-Jul-88 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 101,308.15 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Probationary #N/A #NIA $ 90,866.67 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 58,918.08 Sanitation Union Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #NIA $ 113,760.59 AFSCME Fulltime-Regular #N/A #N/A $ 88,650.43 Fire Union Fulltime-Regular #N/A #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 87,118.24 AFSCME Fulltime-Regular #N/A #N/A $ 109,334.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 168,525.00 Unclassified Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 131,915.72 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,597.80 AFSCME Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 50,567.71 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 159,800.12 AFSCME Fulltime-Regular #N/A #N/A $ 171,356.62 Executives Fulltime-Regular 02/10/20 #N/A $ 86,486.40 Fire Union Fulltime-Regular #N/A #N/A $ 133,333.78 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,368.00 Fire Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 59,051.61 Sanitation Union Fulltime-Regular #N/A #N/A $ 98,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 175,774.06 Executives Fulltime-Regular 01/01/18 01/01/19 $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 91,681.11 Unclassified Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 93,591.38 AFSCME Fulltime-Regular #N/A #NIA $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 97,659.02 AFSCME Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 108,343.51 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 68,731.93 AFSCME Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 106,521.38 AFSCME Fulltime-Regular #N/A #N/A $ 111,847.63 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A Grounds Tender Laborer I Laborer I Fire Fighter 96 Hrs Parks & Recreation Sery Coord Fire Fighter 96 Hrs Aquatic Specialist Fire Lieut 80 Hrs Police Officer Waste Col Op I Fire Fighter 96 Hrs Public Rel Splst Fire Lieut 80 Hrs Business Tax Receipts Aide Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Building Services Assistant IV Police Sergeant Eng Tech III Waste Collector-Garbg Video Retrieval Specialist Police Sergeant Clerk I Police Officer Video Retrieval Specialist Grounds Tender Police Lt Chief of Staff (Elected Official) Laborer I Police Officer Chief Fire Officer 52/104 Hrs Agenda Office Aide Police Officer Laborer I Info & Referral Specialist (Homeless Program) Fire Fighter 96 Hrs Police Officer Emergency Dispatcher Fire Fighter 52/104hrs Police Officer Police Sergeant Fire Fighter 80 Hrs Police Officer Police Officer Database Specialist(Sgl Server) Treasurer (Assistant Director, Finance) Fire Lieut 96 Hrs Police Budget And Finance Manager Admin Aide 11 Police Lt Fire Lieut 96 Hrs Police Officer Police Officer Emergency Dispatcher Waste Collector-Garbg Director of Special Projects (Elected Official) Police Sergeant Director, Grants And Sustainable Initiat Police Officer Asst to Dir, Real Estate and Asset Management Police Officer Opportunity Center Employer Consultant Emergency Dispatcher Financial Analyst 1 Auto Eqp Op 1 Police Officer Business Systems Administrator Loan Specialist Police Officer Admin Asst II Police Officer Project Manager - CIP (Vertical) Grant Funded Administrative Aide 11 Fire Fighter 52/104hrs Police Officer Police Officer Police Officer Professional Engineer II Finance Manager Police Officer Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Police Officer Mason 5 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 46905 5-Apr-00 M 46819 14-Sep-64 M 44450 30-Sep-95 M 40889 25-Jan-86 M 45869 11-Jan-74 M 23909 27-Apr-66 F 27572 28-Feb-76 F 42007 4-Feb-85 M 24214 23-Oct-73 M 26888 29-Aug-88 F 41321 13-Apr-91 M 46821 5-Nov-90 F 22771 8-May-68 M 27702 10-Jun-79 F 15196 22-Feb-67 M 40071 20-Aug-86 M 41938 16-Jul-86 M 43155 26-Nov-78 F 46255 22-Apr-94 M 603 20-Jul-73 F 46844 2-May-97 F 29274 22-Oct-80 F 43751 6-Aug-93 M 24342 20-Jul-69 F 40579 20-Dec-68 F 65512-Sep-58 F 42589 23-Nov-91 F 29390 20-Jan-66 F 27063 2-Oct-67 M 2563512-Oct-69 F 40725 19-May-71 M 41655 22-Feb-95 F 1997 2-Nov-71 F 45317 9-Feb-74 M 45896 11-Feb-79 M 26796 26-Jun-83 M 24268 1-Mar-65 M 46391 9-Nov-97 M 5172 12-Aug-70 F 46387 14-Nov-98 F 40915 30-Aug-83 M 44871 14-Mar-65 F 46247 26-Jun-82 F 4266618-Mar-92 M 45448 1-Jan-80 F 28539 3-Feb-78 M 41259 6-Jul-83 M 695 9-Mar-72 F 27946 12-Jun-84 M 27614 29-Dec-81 M 4592215-Oct-88 M 45871 11-Aug-76 F 715 9-Dec-79 F 24130 28-Aug-74 M 43632 3-Apr-91 M 27297 18-Jun-64 M 744 28-Nov-76 F 44189 19-Nov-60 M 16342 15-May-65 M 2635513-May-64 M 41363 15-May-87 M 4220615-Apr-83 M 28441 22-Feb-84 M 2593016-Oct-78 F 700 27-Mar-66 M 26082 14-Mar-80 M 41821 28-Sep-90 M 42681 15-Aug-93 M 42218 21-Dec-88 M 27347 20-Aug-85 M 757 14-Aug-72 M 27229 12-Jun-82 M 762 26-Sep-79 M 4277417-Jan-80 F 29273 14-Oct-71 M 29118 5-Feb-84 M 24203 21-Jun-62 M 45327 5-Aug-95 M 40282 7-Feb-84 M 46716 14-Jun-78 F 41437 28-Jun-83 M 46280 11-Apr-98 F 45370 9-May-94 M 4298310-Aug-95 M 28519 11-Apr-84 M 27513 28-Dec-66 M 41519 20-Apr-91 F YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 152,500.00 Executives Fulltime-Regular 10/03/23 10/03/23 $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 120,267.78 Sworn Police Officers Probationary #N/A #N/A $ 65,357.76 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 149,886.46 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 37,835.20 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 61,723.79 Sanitation Union Fulltime-Regular #N/A #N/A $ 97,853.39 Fire Union Fulltime-Regular #N/A #N/A $ 88,650.43 Fire Union Fulltime-Regular #N/A #N/A $ 106,279.80 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,997.74 AFSCME Fulltime-Regular #N/A #N/A $ 49,999.99 Unclassified Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 111,913.83 Unclassified Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,392.48 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 98,270.79 AFSCME Fulltime-Regular #N/A #N/A $ 64,809.88 Sanitation Union Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,065.42 Sanitation Union Fulltime-Regular #N/A #N/A $ 39,968.65 Sanitation Union Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 131,095.48 AFSCME Probationary #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 98,270.79 AFSCME Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 169,680.00 Executives Fulltime-Regular 08/01/22 08/01/22 $ 83,462.28 Unclassified Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 121,768.35 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 65,357.76 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,239.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 64,397.00 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 152,734.67 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 56,490.47 AFSCME Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 98,436.95 Fire Union Fulltime-Regular #N/A #N/A $ 79,197.85 AFSCME Fulltime-Regular #N/A #N/A $ 134,086.47 AFSCME Fulltime-Regular #N/A #N/A $ 48,582.14 Sanitation Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,711.72 Fire Union Fulltime-Regular #N/A #N/A $ 104,895.00 Unclassified Fulltime-Regular #N/A #N/A $ 106,038.92 AFSCME Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 109,334.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 124,923.76 AFSCME Probationary #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A JOB TITLE Pol Officer-Prob Asst City Attorny Police Officer Police Lt Paralegal Claims Manager Police Sergeant Police Officer Fire Lieut 52/104 Hrs Emergency Dispatcher Police Officer Early Childhood Educator, T Fire Fighter 96 Hrs Waste Col Op II Fire Lieut 80 Hrs Fire Lieut 80 Hrs Capital Improvement Program Budget Coordinator Police Officer Police Officer Public Service Aide Commissioner's Aide Information Clerk Laborer I Clerk I Labor Reins Splt Pol Prop Spec II Police Officer Senior Financial Analyst Police Sergeant Cust Service Rep Sr Waste Col Op II Building Services Assistant I Police Officer Waste Collector-Garbg Waste Collector-Garbg Parks & Recreation Mgr 11 Zoning Permitting Supervisor Planner 1 Admin Asst I Pol Prop Spec 1 Fire Fighter 96 Hrs Housing Quality Inspector Chief Resilience Officer Assistant to the Director- Procurement Day Care Ctr Supv Police Officer Fire Fighter 96 Hrs Police Officer Fire Fighter 96 Hrs Chief Fire Ofcr.-96 H Customer Service Representative Paralegal Police Lt Fire Fighter 52/104hrs Police Officer Waste Collector-Garbg Community Service Provider Parks & Recreation Mgr I Fire Fighter 80 Hrs Real Estate Manager Marinas Aide Fire Fighter 96 Hrs Fire Lieut 52/104 Hrs Procurement Card/Surplus Administrator Latent Print Examiner Supervisor Waste Collector-Garbg Fire Fighter 96 Hrs Police Officer Fire Fighter 96 Hrs Waste Col Op II Police Officer Police Officer Police Officer Typist Clerk II Park Ranger Laborer I Arborist Police Officer Fire Fighter 80 Hrs Director of Communications (Elected Official) Senior Electrical Inspector Fire Fighter 96 Hrs Police Officer Police Officer Police Sergeant IT Customer Service Supervisor Admin Aide 1 6 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 42840 28-Sep-88 F 4356513-Mar-90 M 40485 27-Aug-87 M 44418 14-Nov-90 M 44892 21-Dec-85 F 44186 30-Apr-97 M 45406 26-Mar-99 M 41738 5-Feb-81 M 40948 1 0-Jul-67 M 4302515-Dec-86 F 43612 26-Feb-78 M 26026 30-Oct-80 F 25626 23-Mar-77 M 22108 5-Jun-68 F 41551 4-Dec-70 F 44839 24-Mar-84 M 29337 4-Jan-84 M 41873 20-Apr-90 F 45289 1-Aug-93 M 2827319-Nov-89 F 28400 4-Dec-79 M 28943 21-May-66 M 41610 27-Jul-97 M 2758413-Jul-83 M 40310 31-Aug-67 F 43290 7-Apr-74 M 45315 29-Dec-88 F 25999 17-Jun-60 M 41051 26-Aug-87 M 41969 14-Oct-96 M 4437519-Apr-64 M 41730 20-Sep-86 M 29423 9-Apr-55 M 28702 26-Jan-62 M 45950 23-Aug-82 F 2922716-Mar-87 M 27321 13-Dec-83 M 29159 4-May-79 M 28075 7-Sep-79 F 44200 28-Dec-88 M 46515 15-Sep-00 M 42902 30-Jan-86 M 41795 5-Mar-77 M 42587 24-Sep-85 M 794 28-May-74 M 797 23-Oct-74 M 795 11-Jun-56 F 21211 1-Oct-64 F 46534 3-Jul-80 M 805 30-Aug-80 M 24533 24-Jun-77 M 44851 18-Dec-95 F 44214 2-Feb-87 M 27666 28-Mar-89 M 46113 23-Oct-93 F 4007213-Jan-87 M 28794 2-Dec-81 M 26243 31-Aug-57 F 25446 20-Feb-72 M 27592 4-Mar-78 M 28100 15-Feb-81 M 41375 15-May-83 M 46099 31-Jul-94 M 23919 12-Sep-68 M 46351 2-Aug-90 F 44301 12-Sep-97 F 46907 9-Aug-93 F 42531 21-Feb-88 M 41399 10-Aug-83 M 841 7-Jun-73 M 42659 8-Aug-95 M 41670 8-Aug-89 M 40478 6-Feb-79 F 45961 5-May-87 M 22345 20-Mar-71 F 42615 3-Feb-74 M 4475810-Jan-59 M 45981 9-Nov-97 M 28124 8-Aug-83 F 45407 12-Jun-87 M 44277 6-Aug-78 F 25929 6-Jan-54 M 2860317-Oct-73 M 23721 29-Jun-73 M 42528 9-Jun-93 M 25963 14-Jun-69 M 29195 2-Dec-82 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 44,731.60 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,554.84 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 144,614.77 AFSCME Probationary #NIA #NIA $ 84,890.00 AFSCME Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #NIA #NIA $ 73,158.11 Managerial/Confidential Fulltime-Regular #NIA #NIA $ - Board Members Elected Official #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,618.00 Unclassified Fulltime-Regular #NIA #NIA $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Probationary #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 83,462.50 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,467.63 Fire Union Fulltime-Regular #NIA #NIA $ 107,190.51 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Probationary #NIA #NIA $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 133,830.89 AFSCME Fulltime-Regular #N/A #N/A $ 143,845.18 AFSCME Fulltime-Regular #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 93,136.49 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 160,552.97 Executives Fulltime-Regular 06/25/18 01/01/19 $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 169,196.55 Police Executives Fulltime-Regular 01/01/18 #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 127,701.56 AFSCME Fulltime-Regular #N/A #NIA $ 45,865.24 Fire Union Probationary #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 122,715.09 Fire Union Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 113,566.98 AFSCME Fulltime-Regular #NIA #NIA $ 87,635.60 AFSCME Fulltime-Regular #N/A #NIA $ 94,384.50 Executives Fulltime-Regular 06/13/22 #NIA #NIA $ 111,173.60 Fire Union Fulltime-Regular #N/A $ 90,613.07 AFSCME Fulltime-Regular #NIA #NIA $ 79,197.74 AFSCME Fulltime-Regular #N/A #N/A $ 141,981.59 AFSCME Fulltime-Regular #NIA #NIA $ 78,492.21 Fire Union Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 117,909.58 Sworn Police Officers Probationary #NIA #N/A $ 33,087.60 AFSCME Fulltime-Regular #NIA #NIA $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 55,857.56 Police Trainees Probationary #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 96,554.84 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 114,534.00 Executives Fulltime-Regular 04/02/22 04/02/22 $ 115,790.48 AFSCME Fulltime-Regular #NIA #NIA $ 103,008.59 AFSCME Fulltime-Regular #NIA #NIA $ 64,466.48 AFSCME Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 103,008.47 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 75,597.84 AFSCME Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #NIA #NIA JOB TITLE Info & Referral Specialist (Homeless Program) Police Officer Police Officer Police Officer Emergency Dispatcher Supervisor, Police Police Officer Police Officer Police Officer Guard Police Officer Heavy Eqp Mech Business Systems Administrator Auto Mechanic Fire Fighter 80 Hrs Legal Assistant Civil Sery Brd Memb Police Officer Assistant to the Director - Public Works Fire Fighter 96 Hrs Admin Aide II Police Officer Police Officer Office Equipment Analyst Police Officer Claims Adjustor II Police Officer Police Officer Fire Fighter 80 Hrs Police Sergeant Parks & Recreation Mgr I Senior Construction Coordinator Police Officer Project Manager - Cip Chief Elevator Inspector Staff Services Assistant, T Police Officer Fire Lieut 96 Hrs Police Officer Assistant Director of Procurement Police Officer Police Officer Police Officer Police Officer Police Officer Sergeant -At -Arms Police Officer Typist Clerk II Planner I Fire Fighter 96 Hrs Police Sergeant Fire Captain 52/104 Hrs 911 Operator (Emergency Call -Taker) Programmer Sr Prop Maint Supt Asst City Attorny Fire Captain 52/104 Hrs Crime Scene Investigator II Admin Aide II Senior Electrical Inspector Fire Fighter 96 Hrs Police Officer Police Lt Info & Referral Aide Park Tender II Staff Services Assistant, T Police Officer Pol Officer-Prob Police Officer Fire Fighter 96 Hrs Police Sergeant Police Officer Police Officer Police Officer Asst City Attorny Code Compliance Inspector Information Technology Tech III Information Technology Technician II Engineer I Police Officer Police Officer Procurement Asst Waste Collector-Garbg Police Officer Information Technology Technician II Police Officer Painter Fire Lieut 96 Hrs 7 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 2755810-Aug-79 M 43763 21-Dec-94 M 2608919-Nov-79 F 46309 20-Nov-97 M 42140 21-May-94 M 28548 23-Aug-84 M 46911 24-Aug-95 F 45288 3-Nov-86 M 21866 12-Mar-55 M 867 25-Sep-75 M 29196 31-Oct-81 M 42018 3-Feb-76 F 44187 29-Mar-95 M 46882 3-Jan-00 M 43297 25-Oct-87 F 2580419-Mar-80 F 28299 21-Mar-88 M 41494 20-Aug-86 M 2466313-Oct-75 M 25173 15-Nov-76 M 45309 26-Jan-99 M 44146 27-Sep-87 F 4258519-Apr-88 M 41360 13-Dec-84 M 4632218-Apr-01 M 23488 6-Sep-68 M 23489 9-Sep-74 M 856 2-Jun-77 M 26239 6-Sep-67 M 27650 2-Nov-69 M 4330010-Dec-87 M 4439318-Jul-82 F 26083 20-Feb-63 M 41765 28-Jun-93 M 28564 30-Apr-74 F 26155 1-May-86 F 2844215-Feb-72 M 46385 29-Feb-84 M 43914 14-May-76 F 26210 17-Nov-80 M 42604 1-Mar-86 F 40125 29-Aug-86 F 45823 1-Aug-78 F 45595 1-Jun-89 F 41146 27-Aug-68 M 15634 9-Sep-51 M 42860 5-Oct-87 M 29197 2-Feb-81 M 43416 15-Jul-89 M 43709 4-Jan-95 M 45793 26-May-87 M 42049 9-Aug-93 F 44226 24-Aug-94 F 938 13-Jan-75 M 4375816-Jul-84 M 27507 29-Jun-77 M 43285 17-Jun-91 M 29528 8-Feb-89 M 2767216-Oct-81 F 43779 26-Aug-89 F 25871 21-Jul-80 M 4007313-Dec-82 M 42032 11-Mar-88 M 2877318-Aug-68 F 22912 4-Aug-75 M 29419 24-Nov-71 F 28210 25-May-83 M 46218 9-Oct-94 F 29064 3-Nov-77 M 41706 17-Nov-90 M 46360 8-Nov-91 M 4007413-Apr-84 M 41258 24-Jul-89 M 2447813-Oct-77 M 41315 8-Nov-84 F 43058 5-Mar-93 M 21304 16-Nov-63 M 27885 25-Sep-69 M 43800 6-Dec-92 M 42730 30-Jul-90 M 40035 12-Feb-75 F 1533310-Sep-77 M 28259 28-Aug-84 M 44447 22-Jan-86 F 2548519-Aug-79 M 45545 30-Apr-79 M 42844 24-Apr-91 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 55,749.65 Fire Union Fulltime-Regular #N/A #N/A $ 58,200.00 Commissioners Elected Official 01/01/18 #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 76,579.56 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 42,698.30 AFSCME Fulltime-Regular #N/A #N/A $ 77,081.84 Fire Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 93,591.38 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 167,248.62 Fire Executives Fulltime-Regular 11/01/18 #N/A $ 113,275.46 Fire Union Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 121,620.50 AFSCME Fulltime-Regular #N/A #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 192,150.00 Executives Fulltime-Regular 11/01/18 #N/A $ 105,088.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 96,618.14 AFSCME Fulltime-Regular #N/A #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,471.94 Unclassified Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 135,119.92 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 130,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,959.26 Fire Union Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 62,317.42 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 83,511.96 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 87,513.96 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 130,368.40 Sworn Police Officers Probationary #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 165,878.97 Police Executives Fulltime-Regular 06/27/21 #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 113,914.52 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A Police Sergeant Comm Tech Public Service Aide Fire Fighter 96 Hrs Police Officer Police Officer Admin Aide I Fire Fighter 96 Hrs Board Of Comm Police Lt Fire Fighter 80 Hrs Admin Aide I Police Officer Pol Officer-Prob Crime Scene Investigator I Info & Referral Aide Fire Fighter 52/104hrs Fire Fighter 96 Hrs Fire Fighter 96 Hrs Emergency Dispatcher Police Officer Police Officer Police Officer Zoning Plans Examiner Building Services Assistant I Executive Officer to the Fire Chief Fire Captain 96 Hrs Police Lt Parks Recreation Coordinator Waste Col Op II Fire Fighter 96 Hrs Crime Scene Investigator I Sr Adv to CM for Economic Development (VM) Police Sergeant Police Officer Police Officer Fire Lieut 96 Hrs Public Service Aide Safety Officer Waste Col Op II Police Officer Commissioner's Aide Zoning Plans Examiner Senior Fire Protection Engineer Construction Procurement Assistant Chief of Staff (Elected Official) Police Officer Fire Fighter 52/104hrs Fire Fighter 96 Hrs Police Officer Housing Development Coordinator Admin Aide I Admin Aide 11 Police Lt Police Officer Police Officer Police Officer Senior Park Ranger Police Officer Code Compliance Inspector Code Compliance Inspector Fire Fighter 96 Hrs Communications Technical Operator Disabilities Program Leader Pools Supervisor Legislative Services Rep. 11 Police Lt Police Officer Police Sergeant Police Officer Transcriber Fire Lieut 96 Hrs Fire Fighter 96 Hrs Fire Fighter 80 Hrs Police Officer Fire Fighter 96 Hrs Labor Crew Ldr I Sergeant -At -Arms Police Officer Public Service Aide Police Sergeant Fire Fighter 52/104hrs Parks & Recreation Mgr 11 Police Officer Fire Captain 52/104 Hrs Fire Fighter 96 Hrs Police Officer 8 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 41989 30-Jan-86 M 947 2-Jul-64 M 45371 15-Apr-97 M 2844315-Oct-80 M 28444 20-May-84 M 26071 19-Feb-79 F 11484 10-Nov-76 M 42714 14-Jan-63 M 45352 8-Jul-87 F 43552 6-Aug-82 M 41800 28-Aug-87 F 23234 1-Jul-69 M 44293 29-Feb-88 M 44178 29-Jun-80 M 41282 23-Dec-73 F 29084 21-Jul-75 M 43736 5-Feb-54 F 27543 8-Feb-82 M 42974 21-Apr-95 M 2524615-Jan-67 F 29198 3-Feb-81 M 25967 2-Jul-68 F 45287 26-Jan-90 M 41477 15-Feb-91 M 41475 5-Oct-91 M 29199 7-Feb-85 M 43757 6-Jul-90 M 19555 18-Jul-61 M 45873 24-Sep-85 F 43802 28-Nov-84 M 4434718-Aug-93 F 42784 8-Jul-86 M 26756 1-Nov-85 M 43209 9-Jan-75 M 29315 25-Jan-85 F 42221 19-Dec-93 M 45346 20-Sep-95 F 43012 13-Jan-94 F 45917 22-Jun-99 M 41729 30-Sep-93 M 24152 28-Apr-75 M 42885 18-Feb-68 M 25675 3-Dec-60 M 40916 16-Jul-87 M 2794815-Dec-68 M 46514 30-Nov-94 F 29169 5-Jul-55 M 44371 18-Mar-91 M 43857 8-Mar-89 M 42547 27-Jun-93 M 46613 26-Oct-96 F 2932210-Jul-83 M 28683 28-Jul-73 M 4688417-Dec-81 F 43831 20-Mar-79 F 40917 11-Jul-85 M 1049 4-Jan-73 M 28490 26-Oct-82 M 41640 5-Mar-98 M 15957 2-May-62 F 42515 30-Jun-65 M 24377 21-Apr-68 F 40309 8-Dec-86 M 46098 28-Feb-59 M 18681 25-Sep-62 M 40474 14-Feb-86 M 19164 15-Mar-56 F 45347 28-Jul-89 M 28162 11-Apr-74 M 26363 13-Jun-76 M 45290 2-Jan-95 M 14803 27-Aug-60 M 41073 31-Dec-93 F 13179 6-Mar-58 F 1068 7-Sep-58 M 41538 1-May-91 M 43919 19-Jul-93 F 17622 21-Jan-67 M 1070 20-Jun-74 F 41213 7-Mar-72 M 44454 23-Sep-73 M 44177 2-Dec-95 M 40797 25-May-88 M 1103 24-Jan-76 M 43174 31-Aug-87 F 28516 4-Sep-75 F 29481 26-Apr-87 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 105,187.43 Fire Union Fulltime-Regular #N/A #N/A $ 105,187.43 Fire Union Fulltime-Regular #N/A #N/A $ 135,000.00 Executives Fulltime-Regular 01/01/18 #N/A $ 113,275.46 Fire Union Fulltime-Regular #N/A #NIA $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #NIA $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 87,488.60 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 106,521.37 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 61,464.00 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 106,521.38 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 68,569.48 AFSCME Fulltime-Regular #N/A #N/A $ 96,036.07 Fire Union Fulltime-Regular #N/A #N/A $ 68,569.48 AFSCME Fulltime-Regular #N/A #N/A $ 55,749.65 Fire Union Fulltime-Regular #N/A #N/A $ 82,368.00 Fire Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 88,650.43 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 98,270.82 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 125,306.06 Sworn Police Officers Probationary #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 105,088.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,889.89 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 127,701.45 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Probationary #N/A #N/A $ 59,315.04 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 192,618.18 Police Executives Fulltime-Regular 06/16/22 06/16/22 $ 129,080.87 AFSCME Fulltime-Regular #N/A #NIA $ 53,800.45 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 96,398.70 AFSCME Fulltime-Regular #N/A #N/A $ 127,701.56 AFSCME Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 190,890.00 Executives Fulltime-Regular 06/06/22 06/06/22 $ 113,275.46 Fire Union Fulltime-Regular #N/A #N/A $ 96,554.84 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 95,465.01 Fire Union Fulltime-Regular #N/A #N/A $ 55,751.07 Fire Union Fulltime-Regular #N/A #N/A $ 91,194.06 Sanitation Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #N/A $ 79,377.48 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 83,273.19 AFSCME Fulltime-Regular #N/A #N/A $ 61,464.00 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 74,711.72 Fire Union Fulltime-Regular #N/A #N/A JOB TITLE Sanitation Inspector II Police Officer Police Officer Fire Captain 96 Hrs Fire Captain 96 Hrs Asst Director, Building - Enterprise Permitting Fire Captain 96 Hrs Auto Mech Supv Police Officer Senior Code Compliance Inspector Senior Human Resources Generalist Code Compliance Inspector Police Officer Fire Fighter 96 Hrs Police Officer Police Sergeant Project Manager Police Officer Building Services Assistant II Group Insurance Aide Fire Lieut 52/104 Hrs Duplicating Equip Op II Fire Fighter 96 Hrs Fire Lieut 96 Hrs Fire Fighter 96 Hrs Fire Lieut 80 Hrs Police Officer Auto Mechanic Social Broadcasting Specialist Police Officer Police Officer Police Officer Code Compliance Inspector Engineer I Police Lt Fire Fighter 96 Hrs Police Officer Police Officer Eng Tech III Police Sergeant Auto Eqp Op III Eng Tech III Business Tax Receipts Supervisor Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer Auto Mech Helper Police Officer Senior Park Ranger Police Officer Crime Scene Investigator I Police Officer Police Officer Historic Preservation Planner Account Clerk Fire Fighter 96 Hrs Police Commander Finance Manager Parks & Recreation Mgr I Recreation Aide Application Support Staff Analyst Prncpl Auto Mechanic Chief Information Officer/Director of IT Fire Captain 96 Hrs Police Officer Aquatic Specialist Public Service Aide Police Officer Fire Lieut 96 Hrs Fire Fighter 80 Hrs Waste Col Op II Fiscal Assistant Finance Accounting Aide Police Officer Police Officer Public Service Aide Fire Fighter 96 Hrs Police Lt Heavy Eqp Mech Building Inspector Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer 911 Operator (Emergency Call -Taker) Public Service Aide Fire Fighter 80 Hrs 9 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 42824 28-Jan-91 M 45308 9-Nov-95 M 45878 23-Jul-77 M 28378 11-Aug-85 M 27409 2-Jun-78 F 26634 10-Mar-61 M 42954 1-Sep-64 F 43659 9-Nov-89 M 46874 2-Oct-73 M 27993 12-Jan-83 M 4206417-Nov-87 M 2494 30-May-82 F 1133 9-Aug-79 F 43027 3-Nov-87 M 40250 29-Nov-83 F 42684 31-May-77 F 45830 3-Oct-88 M 40543 11-Jan-88 M 41231 30-Jul-72 M 26993 25-Nov-76 M 44233 5-Feb-98 M 1171 14-Sep-79 F 23862 25-Mar-73 M 44818 29-Oct-90 M 41124 16-Sep-64 M 44531 5-Sep-94 F 41900 17-Sep-70 M 41445 4-Mar-72 M 46317 28-May-02 M 28011 9-Jul-73 M 40417 27-Apr-95 M 25212 13-Jul-70 M 4084516-Feb-65 M 2759417-Sep-79 M 42898 9-Jun-92 F 45702 8-Oct-00 M 4535517-Mar-92 F 40076 24-Jun-83 M 28316 30-Dec-79 F 27230 31-JuI-85 M 42065 12-Nov-83 M 1187 5-Dec-69 F 45860 21-Feb-66 M 27280 21-Sep-59 M 16284 1-Jun-64 M 45965 13-Feb-70 F 42751 9-Oct-85 F 27105 12-Dec-74 M 40510 12-Oct-45 M 2736410-Dec-73 F 41037 22-Jan-85 M 44962 14-Feb-84 F 41814 5-Jun-83 M 46658 7-Oct-96 F 29431 21-Oct-62 M 40283 18-Jun-81 F 27949 24-Jan-85 M 43035 22-Mar-94 M 26373 21-Nov-72 M 42125 21-Oct-93 M 45967 22-May-94 M 24115 28-Dec-71 M 27598 30-Aug-78 M 45596 20-Apr-68 M 4302912-Sep-80 M 41094 4-Apr-93 M 1228 6-Jun-58 M 40738 4-Dec-89 F 40739 29-Apr-87 M 4500215-Sep-94 F 2749418-Sep-76 F 41140 27-Aug-91 M 28446 9-May-86 M 41320 20-Dec-76 M 4342513-Sep-86 F 2874515-Jul-68 F 41345 3-Dec-79 M 44817 19-Dec-90 M 46797 9-Dec-99 F 28981 25-Jan-62 M 42943 5-Nov-89 F 45924 9-Feb-72 M 1246 28-Mar-71 M 28401 30-Jun-73 F 42865 15-Feb-93 F 10878 22-Aug-52 F 1263 12-Jan-77 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 85,850.00 Unclassified Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 223,013.45 Executives Fulltime-Regular 01/04/21 #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 101,448.88 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,300.80 Temporary Fulltime Fulltime-Temporary #N/A #NIA $ 78,494.00 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,377.48 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,511.86 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 78,418.66 AFSCME Fulltime-Regular #N/A #N/A $ 80,454.56 Fire Union Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 106,102.09 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 50,900.09 AFSCME Fulltime-Regular #N/A #N/A $ 127,701.53 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 192,618.18 Police Executives Fulltime-Regular 01/06/22 #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 64,396.98 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.45 AFSCME Probationary #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 56,174.99 Unclassified Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 93,590.95 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 113,914.52 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 105,187.43 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 82,465.84 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 44,010.72 AFSCME Fulltime-Regular #N/A #N/A $ 97,853.39 Fire Union Fulltime-Regular #N/A #NIA $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.66 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ - Board Members Elected Official #N/A #N/A $ 109,334.36 Sworn Police Officers Probationary #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,065.42 Sanitation Union Fulltime-Regular #N/A #N/A $ 91,680.99 AFSCME Probationary #N/A #N/A $ 123,804.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 85,033.22 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 92,980.30 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A Police Officer Police Officer Asst To Dir -Solid Waste Police Officer Assistant City Manager Laborer I Customer Service Supervisor Police Officer Financial Analyst, T Fire Fighter 80 Hrs Fire Fighter 96 Hrs Police Officer 911 Operator (Emergency Call -Taker) Police Officer Human Resources Generalist Police Officer Police Officer Auto Eqp Op I Sanitation Supervisor Fire Fighter 96 Hrs Police Officer Senior Code Compliance Inspector Fire Lieut 96 Hrs Fire Fighter 96 Hrs Human Resources Medical Supervisor Police Officer Building Services Assistant 11 Sanitation Supervisor Staff Services Assistant, T Grounds Tender Laborer 1 Senior Financial Analyst Building Services Assistant 1 Fire Fighter 96 Hrs Payroll Assistant Police Officer Emergency Dispatcher Fire Fighter 96 Hrs 911 Operator (Emergency Call -Taker) Police Commander Fire Fighter 96 Hrs Police Teletype Operator Cust Service Rep Sr Program Assistant Fire Lieut 52/104 Hrs Commissioner's Aide Police Teletype Operator Microwave Technician Grounds Tender Police Officer Fire Fighter 96 Hrs Day Care Admin Fire Fighter 96 Hrs Public Service Aide Police Sergeant Fire Fighter 96 Hrs Fire Captain 96 Hrs 911 Operator (Emergency Call -Taker) Fire Fighter 96 Hrs Building Services Assistant III Information Technology Technician 1 Fire Lieut 80 Hrs Fire Lieut 96 Hrs Senior Mechanical Inspector Police Officer Fire Fighter 96 Hrs Pension Board Member Police Sergeant Police Officer Waste Collector-Garbg Special Projects Coordinator Police Lt Fire Fighter 52/104hrs Police Officer Clerk I Crime Scene Investigator 1 Laborer I Fire Fighter 96 Hrs 911 Operator (Emergency Call -Taker) Grounds Tender Emergency Dispatcher Supervisor, Police Code Compliance Inspector Police Officer Police Officer Admin Asst I Composting Facility Supervisor Police Officer 10 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 42570 7-Jun-85 M 40740 14-Jul-88 M 21414 20-Dec-63 F 46256 4-Sep-00 M 43009 21-Nov-88 M 45286 9-Apr-98 M 28164 15-Aug-84 F 27546 23-Jun-86 M 4486313-Nov-88 M 4277519-Oct-61 M 1259 26-Mar-77 M 40796 29-Dec-86 M 40741 3-Apr-82 M 26310 10-Jan-78 F 4279315-Dec-90 F 44401 9-Jul-91 M 41418 29-Sep-81 M 41735 3-Nov-88 M 46108 25-Nov-96 M 28010 8-Nov-82 M 4586519-Sep-56 M 25018 18-Apr-66 M 41815 28-Dec-87 M 1269 23-Jul-73 M 24518 3-Aug-60 F 45285 20-Jun-86 M 12952 2-May-68 M 1260 28-Sep-73 M 25015 24-Aug-71 M 27322 1-Sep-78 M 41812 1-Jun-80 M 42158 19-Jul-71 M 40684 29-Aug-73 F 42825 4-Oct-90 F 40795 11-Mar-82 M 29244 22-Sep-88 F 27868 18-May-69 M 43693 30-Jan-55 F 41416 9-Oct-89 M 41756 10-Dec-58 F 46570 30-Jan-66 F 45898 24-May-98 F 4543019-Dec-99 F 44058 14-Aug-85 M 4308615-Nov-46 M 45459 25-Aug-87 M 42872 8-May-88 F 29120 18-Feb-78 M 28753 8-Oct-80 F 27995 4-Sep-83 F 1346 17-Dec-61 F 4304610-Aug-76 F 29397 28-Jun-72 F 26011 30-Sep-75 M 1340 26-Jul-72 F 25510 14-Jan-75 F 27980 22-May-78 F 1341 1-Jan-71 F 41446 26-Dec-84 M 41045 10-Sep-88 M 1342 18-Jan-83 M 16707 1-Apr-58 M 1337 24-Feb-81 M 45668 21-Dec-67 M 21279 13-Mar-73 M 21278 20-Sep-63 M 43465 24-Oct-70 M 1345 7-Sep-64 M 29410 8-Dec-77 M 1357 17-Oct-72 F 26208 14-Sep-67 F 42127 30-Apr-90 M 26986 6-Sep-79 M 45318 14-Dec-66 F 46212 30-Apr-97 M 41786 5-Aug-94 F 28531 29-Dec-80 M 40819 4-Mar-67 F 1468 24-Apr-77 M 43123 14-Nov-91 M 19858 10-Jan-64 M 28058 2-Nov-53 M 40858 25-Mar-83 M 25041 15-Nov-73 F 1471 7-Dec-78 M 1466 11-Sep-74 M 41537 10-Jul-80 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 109,334.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 98,270.64 AFSCME Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 55,749.65 Fire Union Fulltime-Regular #N/A #NIA $ 73,710.00 Unclassified Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #NIA $ 161,266.14 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,486.40 Fire Union Fulltime-Regular #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 98,047.75 AFSCME Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 54,927.60 Unclassified Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Probationary #N/A #NIA $ 98,270.77 AFSCME Fulltime-Regular #N/A #NIA $ 82,368.00 Fire Union Fulltime-Regular #N/A #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 45,000.00 Unclassified Fulltime-Regular #N/A #NIA $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 93,136.49 Fire Union Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 58,918.08 Sanitation Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 82,189.05 AFSCME Fulltime-Regular #N/A #N/A $ 81,031.46 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 59,314.94 Managerial/Confidential Probationary #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 109,120.34 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 157,869.19 Executives Fulltime-Regular 01/01/18 06/01/18 $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 91,808.43 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 129,374.79 AFSCME Fulltime-Regular #NIA #NIA $ 95,466.80 Fire Union Fulltime-Regular #N/A #NIA $ 79,197.87 AFSCME Probationary #NIA #NIA $ 75,025.39 Sanitation Union Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 116,506.28 AFSCME Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 75,598.05 AFSCME Fulltime-Regular #N/A #NIA $ 140,791.01 AFSCME Fulltime-Regular #N/A #N/A $ 79,197.87 AFSCME Fulltime-Regular #N/A #NIA $ 36,545.60 Temporary Fulltime Fulltime-Temporary #N/A #NIA $ 97,851.68 Fire Union Fulltime-Regular #N/A #NIA $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 49,906.58 AFSCME Fulltime-Regular #N/A #NIA $ 83,346.47 AFSCME Fulltime-Regular #N/A #N/A $ 64,809.88 Sanitation Union Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,597.84 AFSCME Fulltime-Regular #NIA #NIA $ 113,865.42 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 107,817.21 Fire Union Fulltime-Regular #NIA #NIA $ 114,549.93 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 40,146.91 AFSCME Probationary #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #N/A #NIA $ 82,188.93 AFSCME Fulltime-Regular #NIA #NIA $ 79,354.64 Unclassified Fulltime-Regular #N/A #NIA $ 139,624.57 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 58,918.08 Sanitation Union Fulltime-Regular #NIA #NIA $ 106,373.56 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA JOB TITLE Police Officer Police Sergeant Claims Account Specialist Police Officer Police Officer Fire Fighter 96 Hrs Senior Constituent Affairs Aide (Elected Official) Police Officer Police Officer Eng Tech III Police Captain Fire Lieut 96 Hrs Police Officer Contract Compliance Analyst Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Commissioner's Aide Sanitation Inspector I Heavy Eqp Mech Parks & Recreation Mgr II Fire Lieut 96 Hrs Police Sergeant District Aide (Elected Official) Fire Fighter 96 Hrs Fire Captain 52/104 Hrs Police Officer Fire Fighter 52/104hrs Fire Lieut 96 Hrs Fire Fighter 96 Hrs Grounds Tender Waste Col Op I Police Officer Fire Fighter 96 Hrs Public Service Aide Admin Asst I Paralegal Fire Fighter 96 Hrs Information Clerk Human Resources Generalist Human Resources Technician I 911 Operator (Emergency Call -Taker) Auto Mechanic Senior Mechanical Inspector Laborer I Police Officer Police Sergeant Police Officer Ast Dir Of Finance Police Officer Eo/Diversity Specialist, Sr Construction Contract Compliance Manager Fire Lieut 80 Hrs Admin Aide II Waste Col Op II Pol Prop Spec I Criminal Intelligence Analyst II Laborer I Heavy Eqp Mech Helper 911 Operator (Emergency Call -Taker) Supt.- Garage Or Motor Pool Police Comm. Records Custodian Maintenance Mechanic, T Fire Lieut 96 Hrs Fire Lieut 96 Hrs Laborer I Crime Scene Investigator I Waste CoI Op II Police Officer Auto Eqp Op III Budget Coordinator Fire Captain 96 Hrs Building/Zoning Quality Control Manager Police Teletype Operator Info & Referral Specialist (Homeless Program) Code Compliance Inspector Assistant to the Director - Communications Police Lt Police Officer Police Officer Eng Tech III Waste CoI Op I Budget And Financial Support Advisor, Sr Police Sergeant Police Lt Police Officer 11 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 41098 21-Mar-85 F 4248817-Dec-90 M 46345 26-Aug-80 M 41355 15-Apr-89 M 13975 25-Mar-67 F 41257 1-Nov-87 M 19869 8-Apr-77 M 25394 16-May-71 F 28447 14-Sep-72 M 42744 24-Jun-96 M 44144 16-Apr-89 M 41780 2-Mar-88 M 16258 5-Dec-71 M 18685 26-Mar-67 M 28691 7-Jan-70 M 29316 15-Aug-82 M 44417 14-Apr-88 M 42795 14-Sep-84 F 4682513-Oct-81 F 4495716-Sep-82 F 27112 6-Jun-66 F 28582 7-Oct-78 M 45821 8-Nov-61 M 40879 29-Jan-73 F 25552 9-Sep-81 M 46902 5-Feb-71 F 41791 4-Apr-83 M 27559 8-Aug-85 M 40279 27-Mar-85 M 42584 21-Apr-92 M 41424 19-Dec-93 F 41897 15-Jun-87 M 41214 29-May-76 M 44816 17-Feb-94 M 28576 8-Jun-65 M 46513 19-Aug-01 M 45372 1-Mar-93 F 29303 11-Nov-66 M 1367 28-Oct-82 M 2703913-Mar-68 F 23190 26-Jun-66 M 1482 9-Jun-65 M 1465 22-Aug-69 M 42720 2-Aug-95 F 19617 21-Oct-61 M 23316 19-Sep-75 F 45930 19-May-89 F 44356 11-Jan-83 M 41775 15-Jan-85 M 46273 26-May-57 M 27363 4-Dec-68 M 43916 12-Oct-91 F 28616 2-Nov-81 M 1478 5-Apr-82 M 45493 8-Sep-83 F 44908 26-Apr-85 F 43589 25-Apr-60 M 46074 29-Aug-01 M 1472 28-Apr-76 F 4306413-Dec-84 M 41326 7-Jun-90 F 46807 8-Jun-88 M 28697 20-Oct-80 F 43728 5-Dec-61 M 43600 21-Jul-56 F 1475 13-Mar-70 M 46509 11-Nov-01 M 43434 30-Sep-77 M 41859 19-Jul-63 M 27264 27-Jul-79 F 23728 12-Jan-76 F 28448 5-Sep-74 M 23183 16-Aug-67 M 28945 13-May-87 F 46086 12-Apr-96 M 1441 9-May-70 M 17347 25-Oct-65 M 28449 27-May-86 M 28450 30-May-86 M 4664719-Mar-76 F 44546 26-Dec-91 F 41764 4-Mar-83 M 43080 24-Aug-84 M 25839 28-May-71 F 41512 13-May-83 M 28102 6-Oct-79 M 41679 4-Dec-48 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Probationary #N/A #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 164,526.72 Unclassified Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 202,285.01 Fire Executives Fulltime-Regular 01/01/18 #NIA $ 51,238.51 AFSCME Probationary #N/A #NIA $ 90,864.88 Fire Union Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Probationary #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 122,715.09 Fire Union Fulltime-Regular #N/A #NIA $ 98,270.61 AFSCME Fulltime-Regular #N/A #NIA $ 83,462.50 AFSCME Fulltime-Regular #N/A #NIA $ 98,627.36 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 82,036.71 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 45,988.80 Temporary Fulltime Fulltime-Temporary #N/A #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 175,572.15 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 85,693.08 AFSCME Fulltime-Regular #N/A #NIA $ 91,964.57 Unclassified Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 62,281.23 Managerial/Confidential Probationary #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 192,618.18 Police Executives Fulltime-Regular 07/21/23 #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 107,190.51 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 123,385.25 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 63,415.28 Fire Union Fulltime-Regular #N/A #NIA $ 113,760.73 AFSCME Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 65,104.41 Sanitation Union Fulltime-Regular #N/A #N/A $ 138,276.90 AFSCME Fulltime-Regular #N/A #NIA $ 110,250.00 Unclassified Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 52,312.00 Unclassified Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 73,710.00 Unclassified Fulltime-Regular #N/A #NIA $ 66,240.30 Detention Officer Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 83,511.86 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 140,000.00 AFSCME Probationary #N/A #N/A $ 87,513.96 AFSCME Fulltime-Regular #N/A #NIA $ 99,781.61 AFSCME Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Probationary #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #NIA $ 109,375.73 Unclassified Fulltime-Regular #N/A #N/A $ 103,184.33 AFSCME Fulltime-Regular #N/A #NIA $ 78,494.00 Fire Union Fulltime-Regular #N/A #NIA $ 84,529.32 Fire Union Fulltime-Regular #N/A #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Probationary #N/A #NIA $ 216,117.57 Police Executives Fulltime-Regular 01/01/18 #NIA $ 84,529.32 Fire Union Fulltime-Regular #N/A #NIA $ 90,864.88 Fire Union Fulltime-Regular #N/A #NIA $ 179,003.39 Fire Executives Fulltime-Regular 11/01/18 #NIA $ 62,281.23 AFSCME Probationary #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 64,538.86 Fire Union Fulltime-Regular #N/A #NIA $ 94,338.42 Unclassified Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 192,618.18 Police Executives Fulltime-Regular 01/01/18 #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA Police Officer Police Officer Fiscal Assistant Police Officer Law Office Manager Fire Fighter 96 Hrs Asst Chief Fire Auto Eqp Op II Fire Lieut 96 Hrs Police Officer Police Officer Police Officer Fire Captain 52/104 Hrs Heavy Eqp Mech Financial Analyst I Police Officer Police Officer Senior Legal Assistant Client Support Services Specialist, T Fiscal Assistant Geographic Information Systems (GIS) Supervisor Police Officer Building Inspector Assistant to the Director- Code Compliance Police Officer Paralegal Police Officer Police Commander Fire Fighter 96 Hrs Police Officer Police Sergeant Compensation Supervisor Maint Mechanic Fire Fighter 52/104hrs Elec Supervisor Police Officer Police Officer Waste Collector-Garbg Police Sergeant Payroll Clerk Fire Lieut 52/104 Hrs Police Officer Police Sergeant Police Officer Waste Collector-Garbg Senior Capital Assets Analyst Assistant to the Director - Venture Miami Police Officer Police Officer Commissioner's Aide Police Officer Police Officer Police Officer Police Officer Senior Aide Detention Officer Eng Tech III Police Officer Admin Aide I Fire Fighter 96 Hrs Human Resources Generalist Professional Engineer III Admin Asst I Network Analyst Cadd Operator Police Officer Eng Tech I Laborer I Waste Collector-Garbg Assistant to the Director - Finance Parks & Recreation Mgr II Fire Fighter 80 Hrs Fire Fighter 80 Hrs Police Sergeant Police Officer Police Major Fire Fighter 80 Hrs Fire Lieut 96 Hrs Asst Chief Fire Planner I Police Officer Fire Fighter 96 Hrs Fire Fighter 80 Hrs Admin Asst I Police Officer Police Commander Eng Tech III 12 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 29336 6-Mar-69 M 1444 17-Jul-72 M 4422819-Feb-84 F 41531 14-Apr-84 M 21354 29-Nov-66 M 4453417-Aug-89 M 4689815-Jul-97 M 27648 20-Aug-80 F 42093 11-Sep-75 M 42876 11-Apr-89 F 40742 5-Nov-88 M 43266 22-Mar-64 M 29226 14-Aug-66 F 41536 26-Feb-88 M 11582 20-Jul-63 M 42873 24-Mar-93 M 41349 24-Feb-65 M 42066 21-Feb-89 M 42727 8-Nov-91 M 23305 18-JuI-79 M 146917-Sep-67 M 24808 8-Nov-77 F 27865 11-Jan-85 F 26021 31-JuI-76 M 45866 14-Oct-98 M 28664 2-Sep-86 M 41681 26-Jul-82 F 44262 22-Sep-95 M 44340 6-Mar-68 M 41879 29-Mar-60 F 41813 14-Apr-85 M 46532 24-Jun-02 M 27560 27-Apr-62 M 28685 14-Mar-50 F 43594 12-Apr-84 M 1512 1-Oct-62 M 2485610-Aug-76 M 27487 25-Oct-66 F 45260 25-Jan-98 F 42661 24-May-91 F 27599 3-Nov-81 M 25806 29-Sep-75 F 44899 21-Jan-94 F 26000 1-Feb-74 M 41256 26-Aug-86 M 41987 12-JuI-68 F 4276910-Nov-90 F 29413 25-Apr-76 F 43176 13-Mar-72 M 43286 29-Dec-91 M 18599 30-Apr-63 F 1532 10-Apr-79 M 20168 13-Sep-56 M 26291 9-Apr-58 F 4497813-Nov-94 F 27455 25-Apr-79 F 45893 29-Oct-54 M 41187 18-Jun-89 F 27553 5-Jun-84 M 28021 25-Jan-64 F 42044 1-Nov-87 M 43378 2-Dec-87 M 4537319-Oct-90 F 28927 21-Aug-53 F 17384 25-Jun-72 M 42810 11-Dec-91 M 45669 27-Mar-73 F 4069916-Aug-93 M 4068515-Mar-96 F 41753 20-Aug-84 F 4268919-Sep-88 F 28598 23-Mar-73 F 41309 15-Jan-84 M 40918 19-Dec-85 M 40744 12-Nov-71 M 41255 22-Oct-86 M 40172 26-Oct-67 M 41951 12-Apr-87 F 25278 7-May-71 M 45419 26-Aug-98 M 45009 23-Dec-83 F 25968 7-Sep-79 F 28114 29-Mar-69 M 26038 4-Aug-65 M 16153 24-Jun-59 M 28505 4-Apr-73 M 40976 22-Jun-88 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 121,620.50 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #NIA $ 86,298.40 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 168,897.66 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 202,285.01 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 142,058.69 Fire Union Fulltime-Regular #N/A #N/A $ 92,717.63 AFSCME Fulltime-Regular #N/A #N/A $ 89,337.99 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 64,919.71 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,487.90 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,139.05 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,834.46 AFSCME Fulltime-Regular #N/A #N/A $ 113,278.67 Fire Union Fulltime-Regular #N/A #N/A $ 68,569.48 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 AFSCME Probationary #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 95,465.01 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 182,034.77 Executives Fulltime-Regular 01/01/18 #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 111,847.63 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,986.68 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,561.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 64,259.97 Unclassified Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,377.70 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #NIA $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 121,492.05 AFSCME Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,488.27 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 74,547.78 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 203,949.78 AFSCME Fulltime-Regular #N/A #N/A $ 173,128.70 Executives Fulltime-Regular 01/01/18 #N/A $ 139,596.60 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A Marinas Faclt Att Police Sergeant Police Officer Police Officer Gen Recreation Prog Planner Police Officer Crime Scene Investigator I Admin Asst I Police Officer Police Officer Police Officer Laborer I Waste Collector-Garbg Police Officer Senior Chief of Unsafe Structures Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Asst Chief Fire, Fire Marshall Police Sergeant Chief Fire Officer 52/104 Hrs Staff Anlst Sr Fire Fighter 52/104hrs Building Services Assistant 11 Laborer I Admin Aide 1 Police Officer Administrative Services Manager Clerk I Police Officer Fire Fighter 96 Hrs Police Officer Grant Funded Administrative Aide II Police Officer Stable Attndnt Supvr. Fire Captain 80 Hours Finance Accounting Aide Clerk 1 Public Service Aide Fire Fighter 96 Hrs Rec Specialist Emergency Dispatcher Fire Lieut 96 Hrs Fire Fighter 96 Hrs Assistant City Attorney, Supervisor Police Officer Human Resources Technician 11 Clerk 1 Police Officer Admin Asst 1 Police Officer Waste Eqpt Op Waste Collector-Garbg Accountant 911 Operator (Emergency Call -Taker) Commissioner's Aide Police Teletype Operator Police Lt Emergency Dispatcher Police Officer Pol Prop Spec 11 Police Officer Human Resources Technician 11 Fire Captain 52/104 Hrs Police Officer Construction Manager (Horizontal) Police Officer Special Projects Coordinator Admin Aide 11 Building Services Assistant I Senior Project Manager - OCI Police Officer Fire Fighter 96 Hrs Police Officer Fire Lieut 80 Hrs Events Agent Admin Aide 1 Auto Eqp Op III Laborer 1 Sanitation Inspector I Auto Eqp Op 11 Ocean Rescue Lifeguard Applications Support & Integration Manager Asst. Director, Community Development Fire -Rescue Budget and Finance Manager Marinas Faclt Att 13 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 25492 28-Feb-80 M 7472 1-Oct-74 F 26001 30-Jun-74 F 46856 20-Feb-83 F 43679 22-Nov-60 M 41794 18-Dec-61 M 27132 9-Feb-81 F 46900 8-Mar-82 F 27998 11-Apr-79 M 46301 15-Jul-97 M 27411 21-Feb-61 M 41307 23-Sep-63 M 40562 3-Feb-85 M 46070 4-Feb-94 M 28451 3-Sep-83 M 41565 24-May-95 M 40437 28-May-92 M 28423 9-Apr-64 F 41999 7-Nov-88 M 784 31-Dec-59 F 544116-Oct-70 F 43595 1-Oct-90 F 41884 5-Apr-77 F 23892 23-Feb-62 F 41618 12-Jan-72 F 40987 6-May-65 F 43694 12-Nov-60 M 25332 8-Feb-84 M 45417 20-Oct-74 M 23258 11-Sep-70 M 1745 10-May-71 M 42332 26-Sep-96 M 16116 20-Sep-69 M 2790717-Aug-73 M 44064 4-Jul-64 M 41774 15-May-84 M 41044 29-Jun-71 F 41492 7-Feb-85 M 40794 4-Sep-87 M 1765 1-Sep-56 F 28723 29-Sep-64 F 26023 22-Mar-77 M 46303 28-Sep-99 M 4528415-Jul-92 M 26361 5-Apr-65 M 42068 21-Feb-90 M 27616 4-Aug-83 M 4206910-Jan-92 M 45874 20-Nov-90 M 43289 22-Jan-92 M 2928410-Mar-86 M 44224 18-Jun-84 F 46209 21-May-85 M 4428818-Dec-94 F 40307 12-Dec-63 M 27499 5-Jan-68 M 4264018-Dec-91 F 4492419-Nov-97 M 4363310-Oct-76 M 22391 19-Aug-69 F 1615 9-Nov-74 M 2622310-Feb-74 M 2957213-Sep-73 M 26201 10-Aug-59 M 23929 29-Oct-60 M 43631 15-Jul-89 M 25935 6-Dec-71 M 27983 5-Aug-87 M 45078 1-Mar-85 M 41052 9-Aug-75 F 27314 14-Aug-64 M 40896 26-Apr-81 M 44873 23-Jan-85 M 27905 8-Mar-61 M 2842918-Sep-78 F 24037 5-Dec-57 M 26464 31-Jul-82 M 4549413-Apr-61 F 46128 3-Jan-72 M 29270 24-Aug-79 F 25542 1-Mar-74 F 28318 7-Sep-76 M 41147 27-Apr-87 F 42121 8-Jan-72 M 40919 6-Nov-87 M 83 13-Jul-71 F 1833 31-Jan-65 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 142,058.69 Fire Union Fulltime-Regular #N/A #NIA $ 139,624.57 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 89,337.99 Fire Union Fulltime-Regular #N/A #NIA $ 130,000.00 Executives Fulltime-Regular 11/21/23 #NIA $ 50,895.52 Sanitation Union Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 53,788.80 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #NIA #NIA $ 108,343.66 AFSCME Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #NIA #NIA $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #NIA #NIA $ 76,577.77 Fire Union Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 153,226.69 Executives Fulltime-Regular 01/01/18 #NIA $ 64,661.79 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 216,117.57 Police Executives Fulltime-Regular 11/01/18 #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,180.24 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 96,618.08 AFSCME Fulltime-Regular #NIA #NIA $ 111,847.63 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #N/A $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #N/A $ 122,715.09 Fire Union Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 58,537.19 Fire Union Fulltime-Regular #NIA #NIA $ 113,278.67 Fire Union Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,618.08 AFSCME Fulltime-Regular #NIA #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #N/A $ 71,154.09 Fire Union Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #N/A $ 87,565.91 AFSCME Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #N/A $ 89,337.99 Fire Union Fulltime-Regular #NIA #NIA $ 48,158.57 Fire Union Fulltime-Regular #NIA #N/A $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 89,337.99 Fire Union Fulltime-Regular #NIA #N/A $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 98,436.95 Fire Union Fulltime-Regular #NIA #N/A $ 67,765.77 Fire Union Fulltime-Regular #N/A #NIA $ 75,702.85 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,861.65 AFSCME Fulltime-Regular #N/A #NIA $ 45,760.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 135,723.75 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 83,346.47 AFSCME Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 155,222.10 AFSCME Fulltime-Regular #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 75,024.56 Sanitation Union Fulltime-Regular #NIA #N/A $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 87,513.98 AFSCME Fulltime-Regular #N/A #N/A $ 133,782.48 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 59,051.61 Sanitation Union Fulltime-Regular #NIA #NIA $ 107,190.51 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 160,000.00 Executives Fulltime-Regular 06/10/19 #NIA $ 42,058.59 AFSCME Fulltime-Regular #NIA #N/A $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 139,190.63 Executives Fulltime-Regular 11/01/18 #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #N/A $ 144,616.26 Executives Fulltime-Regular 01/01/18 06/01/18 $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 56,700.00 Unclassified Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #N/A $ 65,104.41 Sanitation Union Fulltime-Regular #NIA #NIA $ 123,140.77 AFSCME Fulltime-Regular #NIA #N/A $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #N/A $ 80,935.85 Fire Union Fulltime-Regular #NIA #NIA $ 157,500.09 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA Chief Fire Officer 52/104 Hrs Police Lt Fire Fighter 52/104hrs AD, Parks & Recreation (Operations) Waste Col Op I Auto Eqp Op I Parks & Recreation Mgr II Opportunity Center Employer Consultant, T Police Sergeant Fire Fighter 96 Hrs Electrician II Heavy Eqp Mech Waterfront Park Manager Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Fighter 96 Hrs Asst. Director, Community Development Police Officer Admin Aide I Police Major Police Officer Senior Budget Analyst Fiscal Assistant Planner II Building Services Assistant III Admin Aide II Fire Fighter 96 Hrs Code Compliance Inspector Fire Captain 52/104 Hrs Police Officer Fire Fighter 96 Hrs Fire Captain 80 Hours Police Sergeant Latent Print Examiner Police Officer Admin Aide I Fire Fighter 80 Hrs Fire Fighter 96 Hrs Admin Asst I Admin Aide I Fire Fighter 52/104hrs Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Fighter 52/104hrs Fire Fighter 96 Hrs Fire Lieut 52/104 Hrs Fire Fighter 80 Hrs Historic Preservation Planner Police Officer Police Lt Grant Funded Homeless Housing Specialist Lifeguard II, T Police Officer Group Benefits Manager Admin Aide II Police Officer Police Officer Police Officer Professional Engineer III Police Officer Waste Eqpt Op Heavy Eqp Mech Heavy Eqp Mech Comm Tech Supt Police Officer Waste Collector-Garbg Police Sergeant Dir., Parks & Rec Info & Referral Aide Auto Eqp Op III Police Officer Asst City Attorny Laborer I Assistant City Clerk Facility Attend Laborer I Administrative Assistant (Elected Official) Auto Eqp Op I Environmental Resources Specialist I Waste Collector-Garbg Procurement Contracting Manager 911 Operator (Emergency Call -Taker) Code Compliance Inspector Fire Fighter 52/104hrs Police Officer Police Officer 14 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 42732 23-Mar-95 M 44491 8-Jan-86 M 25976 12-Mar-77 M 44217 5-Dec-92 F 4440415-May-83 M 41790 16-Apr-91 F 40920 4-Nov-87 M 21825 26-Mar-77 F 26010 23-Sep-70 M 14232 17-Feb-69 F 4453313-Aug-98 M 42754 11-Mar-68 M 1873 22-Dec-77 F 1891 9-Apr-67 M 4527216-Nov-98 M 40047 23-Jul-83 F 25214 3-Jan-65 F 4279617-Aug-83 F 4344916-Aug-90 M 46849 2-Jun-87 M 41468 30-Sep-78 F 1879 25-Jul-81 M 44918 11-Apr-94 M 40059 3-May-62 F 28394 21-Aug-68 M 11233 16-Mar-53 F 40077 4-Nov-68 M 27951 21-Dec-84 M 41417 4-Sep-89 M 26706 20-Apr-59 F 41772 4-Mar-90 M 46588 8-Jul-00 F 28115 30-Mar-75 M 4307512-Sep-90 M 27398 3-May-66 M 27414 4-Jun-78 M 28452 27-May-69 M 46394 2-Sep-81 F 41868 23-Oct-51 M 2607313-Oct-83 M 25895 29-Jul-61 F 29309 5-Jul-81 M 44229 1-May-91 F 4275710-Jan-90 F 42649 26-Jul-91 F 2583410-Dec-80 F 26600 25-Apr-81 F 41809 2-Mar-84 M 46791 17-Mar-71 M 20775 3-May-69 M 44212 29-Mar-91 M 25919 21-Aug-76 M 46254 9-May-96 M 41347 2-Mar-81 F 44856 28-Jul-81 M 4577219-Apr-77 M 45357 27-Mar-74 F 45548 26-Mar-94 M 40878 2-Sep-86 M 28453 5-Jul-84 M 4660519-Aug-95 M 24338 22-Dec-67 M 27982 2-May-63 M 28547 12-Jul-85 F 43031 14-Nov-90 M 18533 29-Oct-62 F 26304 5-Dec-55 M 45876 6-May-77 F 41752 25-Oct-88 M 43814 3-Mar-61 F 40311 8-Jan-56 M 17095 5-Oct-63 M 43092 14-Oct-87 F 45686 28-May-02 M 16210 20-Apr-77 M 40877 10-Nov-91 M 44767 21-Sep-96 F 45408 4-Dec-87 M 4303719-Sep-72 M 27452 12-Feb-84 M 43601 15-Dec-87 F 43010 7-Sep-86 M 21865 3-Jan-61 F 42753 21-Dec-78 F 40613 26-Mar-75 M 41745 9-Oct-76 M 4088210-Apr-87 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 87,635.60 AFSCME Fulltime-Regular #NIA #NIA $ 71,452.78 Sanitation Union Fulltime-Regular #N/A #NIA $ 106,050.00 Executives Fulltime-Regular 02/14/22 #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 103,183.95 AFSCME Fulltime-Regular #NIA #NIA $ 89,337.99 Fire Union Fulltime-Regular #N/A #N/A $ 97,238.78 AFSCME Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,440.40 Sanitation Union Fulltime-Regular #NIA #NIA $ 75,597.84 AFSCME Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 79,377.91 AFSCME Fulltime-Regular #NIA #NIA $ 119,245.12 AFSCME Fulltime-Regular #NIA #NIA $ 55,749.65 Fire Union Probationary #NIA #NIA $ 87,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 151,439.40 Executives Fulltime-Regular 10/05/20 10/05/20 $ 118,638.01 AFSCME Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 73,710.00 Unclassified Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 94,374.00 Unclassified Fulltime-Regular #NIA #NIA $ 76,577.77 Fire Union Fulltime-Regular #NIA #N/A $ 105,187.43 Fire Union Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #N/A $ 79,377.58 AFSCME Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 52,500.00 Unclassified Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #N/A $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 83,346.47 AFSCME Fulltime-Regular #NIA #N/A $ 211,879.97 Police Executives Fulltime-Regular 01/01/18 #NIA $ 90,866.67 Fire Union Fulltime-Regular #NIA #N/A $ 51,238.51 AFSCME Probationary #NIA #NIA $ - Board Members Elected Official #NIA #N/A $ 96,617.98 AFSCME Fulltime-Regular #NIA #NIA $ - Board Members Elected Official #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 66,664.85 Managerial/Confidential Fulltime-Regular #NIA #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 108,343.47 AFSCME Fulltime-Regular #NIA #NIA $ 98,041.42 AFSCME Fulltime-Regular #NIA #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 44,261.56 AFSCME Probationary #NIA #NIA $ 97,853.39 Fire Union Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 163,275.00 Unclassified Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Probationary #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 105,008.80 AFSCME Fulltime-Regular #NIA #NIA $ 109,120.34 AFSCME Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 72,098.23 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 98,436.95 Fire Union Fulltime-Regular #NIA #N/A $ 36,414.56 AFSCME Probationary #NIA #NIA $ 91,571.50 Fire Union Fulltime-Regular #NIA #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 95,318.49 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 87,472.74 AFSCME Fulltime-Regular #NIA #N/A $ 64,957.15 Sanitation Union Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #N/A $ 67,034.65 AFSCME Fulltime-Regular #NIA #NIA $ 96,618.08 AFSCME Fulltime-Regular #NIA #N/A $ 83,462.50 AFSCME Fulltime-Regular #NIA #NIA $ 65,104.41 Sanitation Union Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Fulltime-Regular #NIA #NIA $ 91,681.29 AFSCME Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 113,502.53 AFSCME Fulltime-Regular #NIA #NIA $ 185,000.00 Executives Fulltime-Regular 10/30/23 #N/A $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #N/A $ 39,085.28 Sworn Police Officers Fulltime-Regular #NIA #NIA Police Officer Project Manager - CIP (Vertical) Waste Col Op II Assistant Chief Resilience Officer Crime Analyst II Police Officer Fire Fighter 96 Hrs Emergency Dispatcher Supervisor, M/F Fire Fighter 52/104hrs Grant Funded Special Projects Coord Police Officer Waste Col Op I 911 Operator (Emergency Call -Taker) Police Sergeant Fire Fighter 96 Hrs Police Officer Crime Prevention Specialist Programmer Sr Fire Fighter 96 Hrs Senior Multimedia Specialist (Elected Official) Chief Of Staff Senior Application Support Police Officer Asst to the Mayor - Community Prog & Intl Affairs Police Officer District Director (Elected Official) Fire Fighter 96 Hrs Fire Captain 96 Hrs Fire Fighter 96 Hrs Admin Aide II Police Officer Legislative Aide (Elected Official) Ocean Rescue Operations Supervisor Fire Fighter 96 Hrs Auto Mechanic Police Major Fire Lieut 80 Hrs Emergency Dispatcher Pension Board Member Special Projects Coordinator Pension Board Member Police Officer Legal Assistant Crime Scene Investigator I Police Officer Budget And Financial Support Advisor, Sr Special Projects Coordinator Fire Fighter 96 Hrs Maint Mechanic Fire Lieut 80 Hrs Police Officer Chief of Staff (Elected Official) Eng Tech III Police Officer IT Security Analyst Senior Electrical Inspector Building Services Assistant II Fire Fighter 96 Hrs Budget Analyst Fire Lieut 52/104 Hrs Marinas Aide Fire Fighter 52/104hrs Auto Eqp Op III Police Officer Police Sergeant Admin Asst I Waste Col Op I Hearing Board Specialist II Acquisitions Specialist Supervisor Project Representative, Senior Claims Adjustor II Waste Collector-Garbg Police Officer Public Service Aide Parks & Recreation Mgr II Police Officer Police Officer Police Officer Laborer I 911 Operator (Emergency Call -Taker) Police Officer Police Officer Spec Projects Coord Chief Data Officer/Concierge Services Laborer I Marinas Aide Police Officer 15 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 42773 4-Nov-82 M 41281 11-Jun-77 M 2762713-Apr-81 M 44886 23-Jun-98 M 4673016-Aug-90 M 45889 15-Mar-66 F 4587719-Oct-88 F 41467 29-Mar-94 M 27075 6-Mar-82 M 40542 24-Mar-87 M 45477 11-Jan-94 F 29181 19-Jun-72 F 46836 21-Nov-89 M 41878 8-Nov-85 F 45554 1-Mar-00 M 28621 12-Aug-76 F 45581 5-Jun-90 M 46285 24-Dec-85 F 45238 11-Aug-77 F 25888 4-Feb-78 M 2030 13-Jan-68 M 44196 15-Mar-93 F 4207015-Oct-88 M 27894 21-Apr-71 M 42888 6-Sep-71 M 27323 5-Oct-74 M 46811 1-Dec-91 M 42749 20-Oct-93 F 26996 25-Sep-78 F 28830 1-May-86 M 46447 4-Jan-89 M 2078 29-Jul-63 M 44378 23-Aug-83 M 41405 25-Oct-82 M 25698 23-Dec-83 M 209819-Oct-68 M 2930016-Jul-88 M 44424 31-Oct-78 M 29066 28-Oct-85 F 2101 1-Sep-74 M 28550 7-Aug-83 M 41810 15-Sep-87 M 1993818-Sep-63 M 46373 26-Mar-79 M 19815 26-Jul-67 F 27888 4-Sep-81 M 42222 7-Dec-92 M 40590 26-Sep-91 M 43084 26-Apr-93 M 23248 27-Jan-71 M 2328813-Dec-74 M 43066 7-Oct-90 M 4650215-Mar-95 M 45360 29-Sep-81 M 44309 4-Nov-86 M 45610 6-Aug-98 F 2865419-Dec-65 M 42838 27-Mar-88 F 46865 19-Feb-64 M 29099 14-Mar-89 M 2140 21-Oct-76 M 10150 14-Apr-61 M 13108 27-Dec-58 F 24167 17-Jul-77 M 28604 27-Mar-78 F 28323 28-Sep-80 F 4678317-Aug-93 F 41352 22-May-70 M 27561 3-Jul-78 M 42071 30-Jul-90 F 46908 11-Nov-96 M 42072 28-Aug-84 M 46287 12-Aug-00 M 41318 4-Apr-83 M 506 11-May-72 F 41280 15-Jul-88 F 28644 17-Jul-71 M 44185 16-Nov-89 M 4207318-Aug-82 M 40793 10-Jun-86 M 45368 22-Nov-89 M 41253 31-Jan-90 M 19826 8-Sep-73 F 27952 19-Jul-71 M 41336 22-Jul-86 F 44247 11-Jun-73 M 43543 11-Jul-64 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 48,798.67 AFSCME Fulltime-Regular #N/A #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,866.67 Fire Union Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 55,857.56 Police Trainees Probationary #N/A #NIA $ 58,200.00 Commissioners Elected Official 11/10/21 #NIA $ 80,220.00 Unclassified Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #N/A #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #NIA $ 125,900.57 Unclassified Fulltime-Regular #NIA #NIA $ 110,000.00 Executives Fulltime-Regular 11/14/23 #NIA $ 65,395.20 AFSCME Probationary #NIA #NIA $ 50,566.46 Fire Union Fulltime-Regular #NIA #NIA $ 98,627.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 110,000.00 Executives Fulltime-Regular 04/05/21 #NIA $ 48,158.57 Fire Union Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 108,158.85 AFSCME Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 107,913.76 AFSCME Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 103,184.39 AFSCME Fulltime-Regular #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #NIA #NIA $ 93,136.49 Fire Union Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 93,136.49 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 39,968.65 Sanitation Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 100,849.28 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Probationary #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 196,470.54 Police Executives Fulltime-Regular 07/07/21 #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 175,000.00 Executives Fulltime-Regular 01/17/23 #NIA $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 113,275.46 Fire Union Fulltime-Regular #N/A #NIA $ 113,275.46 Fire Union Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #N/A #NIA $ 33,028.73 AFSCME Probationary #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #N/A #NIA $ 36,414.56 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 58,200.00 Commissioners Elected Official 12/02/23 #NIA $ 111,173.60 Fire Union Fulltime-Regular #NIA #N/A $ 211,879.97 Police Executives Fulltime-Regular 11/01/18 #NIA $ - Board Members Elected Official #NIA #N/A $ 59,051.61 Sanitation Union Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 87,635.60 AFSCME Fulltime-Regular #NIA #N/A $ 40,146.91 AFSCME Probationary #NIA #NIA $ 92,017.12 AFSCME Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #N/A $ 55,857.56 Police Trainees Probationary #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 48,158.57 Fire Union Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 83,157.75 AFSCME Fulltime-Regular #NIA #NIA $ 107,190.51 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 74,711.72 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 87,513.54 AFSCME Fulltime-Regular #NIA #NIA $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #NIA #NIA Typist Clerk II Police Officer Fire Lieut 80 Hrs Emergency Dispatcher Pol Officer-Prob Board Of Comm Senior Administrative Assistant (Elected Official) Police Officer Grounds Tender Auto Eqp Op II 911 Operator (Emergency Call -Taker) Elections Coordinator Asst City Attorny Building Services Assistant IV Fire Fighter 96 Hrs Police Officer Asst City Attorny Fire Fighter 96 Hrs Fiscal Assistant Information Technology Technician II Police Sergeant Systems Analyst Sr Fire Fighter 96 Hrs Plumber Waste Collector-Garbg Fire Lieut 96 Hrs Environmental Resources Specialist II Police Officer Fire Lieut 96 Hrs Laborer I Code Compliance Inspector Police Officer Waste Collector-Garbg Fire Fighter 96 Hrs Code Compliance Field Supervisor Police Officer Waste Collector-Garbg Auto Eqp Op II Police Sergeant Police Commander Police Sergeant Fire Fighter 96 Hrs Fire Fighter 80 Hrs Dir Public Facilities Recreation Aide Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Captain 96 Hrs Fire Captain 96 Hrs Fire Fighter 96 Hrs Fire Supplies Clerk I 911 Operator (Emergency Call -Taker) Laborer I Emergency Dispatcher Police Officer Building Services Assistant III Board Of Comm Fire Captain 52/104 Hrs Police Major Pension Board Member Waste Collector-Garbg Laborer I Police Officer Zoning Information Specialist Police Teletype Operator Air Cond Mech Police Officer Fire Fighter 96 Hrs Pol Officer-Prob Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer Admin Aide II Police Sergeant Police Officer Police Officer Fire Fighter 96 Hrs Fire Fighter 80 Hrs Code Compliance Inspector Fire Fighter 96 Hrs Procurement Assistant II Fire Lieut 96 Hrs Emergency Dispatcher Supervisor, Police Police Officer Parks & Recreation Mgr II 16 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 46920 5-Aug-84 F 45647 28-Sep-75 M 42710 21-Aug-88 M 42688 5-Nov-92 F 42120 21-Jul-54 M 26698 12-Mar-70 F 2185 19-Jan-70 M 2649715-Oct-75 M 41411 29-Jun-92 M 43675 11-Oct-91 M 42929 31-Oct-66 M 41401 18-Feb-86 M 43293 30-Jul-86 M 40284 19-May-76 M 24931 28-Jul-68 M 42733 20-Nov-90 F 41392 7-Oct-87 M 44278 19-May-91 M 44304 2-Apr-62 M 26590 3-Sep-87 M 21299 11-Feb-62 M 46397 10-Feb-78 F 4492512-Sep-87 F 42558 1-Nov-71 M 21018 27-Jan-65 F 24307 9-Apr-70 M 43504 14-Jan-93 M 2845417-Sep-77 M 4424613-Oct-97 F 27600 6-Oct-82 M 4550016-Oct-67 M 4357816-Apr-61 M 27542 4-Nov-85 M 44175 30-Dec-94 F 27108 3-Nov-86 M 40612 10-Dec-88 M 44392 26-Mar-91 M 28455 21-Dec-81 M 26012 25-Aug-74 M 41781 26-Mar-91 M 41289 2-Feb-69 M 4307619-Jul-82 M 29280 21-Feb-88 M 42374 29-Aug-65 F 43650 27-Jan-88 M 27377 24-Apr-60 F 26963 1-Jul-80 M 41862 26-Jan-70 F 29080 12-Nov-86 F 26768 5-Jan-73 M 18190 18-Nov-59 M 43011 4-Jun-92 F 4483017-Apr-97 M 45556 4-Jun-97 M 46044 2-Aug-85 M 43094 25-Aug-88 F 28541 15-Jun-73 M 40545 7-Jan-81 F 2219 23-Apr-77 M 4578918-Oct-96 M 43573 27-Dec-88 M 2478716-Apr-76 M 46339 27-Oct-86 M 26850 12-Dec-59 M 2231 18-Sep-70 F 45918 6-Apr-92 M 2233 14-Jun-66 F 27985 29-Jun-87 M 46764 9-Nov-91 F 45704 27-Apr-98 M 4537418-Jan-95 M 43623 7-Apr-83 F 46115 4-Nov-78 F 45592 12-May-98 M 42667 18-Aug-86 F 42851 16-Jun-84 M 41860 10-Jan-76 F 41596 17-Nov-78 F 41114 4-May-79 M 2563913-Feb-84 M 44545 30-Jan-82 F 27464 4-Mar-84 F 45847 24-Jan-66 M 26471 1-Jan-84 M 44535 9-Jun-94 F 27069 3-Jan-80 M 41325 5-Dec-88 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 31,110.04 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 46,200.58 Unclassified Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 77,309.23 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 169,196.55 Police Executives Fulltime-Regular 01/01/18 #NIA $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 80,935.85 Fire Union Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 114,576.38 AFSCME Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 113,275.46 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 73,641.30 Unclassified Fulltime-Regular #N/A #N/A $ 74,711.72 Fire Union Fulltime-Regular #N/A #N/A $ 213,392.45 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 85,033.22 Fire Union Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 105,190.59 Fire Union Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 80,710.01 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,464.00 Fire Union Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 90,866.67 Fire Union Fulltime-Regular #N/A #N/A $ 103,420.42 Fire Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,561.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 95,318.49 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 127,808.85 AFSCME Fulltime-Regular #N/A #N/A $ 91,547.83 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 216,117.57 Police Executives Fulltime-Regular 01/01/18 #N/A $ 33,028.73 AFSCME Probationary #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #NIA $ 50,000.08 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 71,998.16 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 154,350.00 Executives Fulltime-Regular 01/10/22 #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Probationary #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 62,281.23 AFSCME Probationary #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 120,750.00 Executives Fulltime-Regular 01/01/18 06/01/18 $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 149,000.00 Executives Fulltime-Regular 03/03/23 #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 81,457.76 Unclassified Fulltime-Regular #N/A #N/A $ 39,968.65 Sanitation Union Fulltime-Regular #N/A #N/A $ 83,157.67 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A Administrative Aide II, T Commissioner's Aide Police Officer Typist Clerk II Auto Eqp Op III Legal Assistant Sergeant -At -Arms Finance Accounting Specialist Fire Fighter 52/104hrs Police Officer Senior Electrical Inspector Fire Fighter 96 Hrs Police Officer Fire Fighter 96 Hrs Fire Captain 96 Hrs Police Officer Police Officer Police Officer Community Liaison (Elected Official) Fire Fighter 80 Hrs Deputy Fire Chief Administrative Clerk Police Officer Waste Collector-Garbg Rec Specialist Fire Fighter 80 Hrs Police Officer Fire Fighter 52/104hrs Police Officer Fire Captain 80 Hours Air Cond Mech Information Technology Technician II Police Sergeant Fire Fighter 96 Hrs Supt. of Park Operations & Maintenance Laborer I Crime Scene Investigator I Fire Lieut 80 Hrs Fire Lieut 52/104 Hrs Police Officer Waste Collector-Garbg Fire Fighter 96 Hrs Fire Lieut 96 Hrs Waste Collector-Garbg Police Officer Waste Collector-Garbg Heavy Eqp Mech Helper Waste Collector-Garbg Police Sergeant Housing Spcl Prncpl Sanitation Inspector II Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Police Officer Financial Analyst I Legislative Services Rep. I Police Major Fire Supplies Clerk I Police Officer Fire Fighter 52/104hrs Special Projects Specialist, T Painter Police Officer Executive Director of Venture Miami Police Officer Police Sergeant Payroll Specialist Police Officer Police Officer Code Compliance Inspector Code Compliance Inspector Emergency Dispatcher Asst City Attorny Special Projects Assistant Contract Compliance Analyst Sanitation Inspector I Director of Human Services Parks & Recreation Mgr I Police Officer Executive Assistant City Manager's Office (CMO) Waste Collector-Garbg Client Support Services Specialist Public Service Aide Police Sergeant Police Officer 17 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 42083 5-Mar-74 M 2596217-Nov-66 F 4362710-Apr-68 M 29202 7-Sep-66 M 45557 27-Sep-93 M 2307 3-Oct-72 F 27415 5-Oct-83 M 27889 14-Sep-83 M 40167 15-Jun-84 F 28646 30-Aug-70 M 27387 21-Aug-62 F 11246 14-May-63 M 23216 7-Oct-76 M 28095 22-Oct-87 M 24437 2-Feb-72 M 25523 14-Feb-65 M 46316 23-May-90 M 27056 22-Jun-76 F 4059415-May-69 M 45872 3-May-69 M 4286618-Oct-61 M 2372 14-Mar-69 M 40546 18-May-86 M 27820 1-Jun-80 F 40289 29-Oct-78 M 2668819-Dec-67 F 23160 26-Jun-68 M 45946 1-Feb-94 F 42115 25-Mar-93 M 45375 6-Dec-96 M 24602 22-Oct-68 M 42723 26-Aug-91 M 41252 7-Mar-90 M 4260810-Aug-87 F 2603 12-Jul-76 M 25207 1-Aug-62 M 28688 5-Jan-88 M 2369 5-Jun-74 M 43417 28-Jun-90 M 43713 16-Mar-57 M 4202216-Aug-60 F 26013 1-Jan-77 M 19208 9-Mar-56 M 43635 16-Jun-94 M 11456 24-Oct-75 M 42637 21-Mar-87 M 25287 25-Sep-60 F 25406 9-Jul-82 F 27074 22-Dec-66 F 19997 3-Feb-67 F 26620 2-Jun-65 M 46813 22-Jul-93 F 26174 13-Sep-61 F 41963 16-Jan-69 M 4632717-Nov-75 M 41188 22-Jan-92 M 46049 24-Jul-96 M 29313 11-Oct-70 M 46221 7-Feb-02 M 45518 18-Nov-94 F 46512 10-Mar-96 M 45553 5-Jun-97 M 45427 24-Oct-89 M 41672 6-Apr-93 M 41413 11-Dec-84 M 28711 25-Feb-82 M 42816 21-Jan-90 F 45975 14-Nov-66 F 2622418-Dec-39 M 4444913-Apr-88 M 44861 4-Jul-98 M 27396 4-Jul-64 M 45468 11-Nov-94 F 41251 11-Dec-89 M 43730 28-May-92 F 41229 1-Jul-79 F 40836 21-Jan-66 M 20022 11-May-68 M 45921 22-Mar-85 F 46794 22-Jan-01 M 27953 27-May-82 M 4086013-Jan-89 M 43510 17-Mar-98 F 2368 24-Aug-79 M 45903 26-Nov-95 M 43798 31-Jul-88 M 41285 12-Sep-79 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 88,358.30 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 82,959.26 Fire Union Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 93,378.48 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 129,351.66 AFSCME Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 113,275.46 Fire Union Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 75,025.39 Sanitation Union Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 101,078.43 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 181,504.58 Executives Fulltime-Regular 11/01/21 #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 178,164.00 Executives Fulltime-Regular 09/17/18 #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 162,327.04 Unclassified Fulltime-Regular #N/A #N/A $ 121,620.50 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 51,238.59 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 202,285.01 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,486.40 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 125,495.84 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 153,000.00 Executives Fulltime-Regular 01/01/18 06/01/18 $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 110,512.64 Fire Union Fulltime-Regular #N/A #N/A $ 103,183.95 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,404.60 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 103,184.33 AFSCME Fulltime-Regular #N/A #N/A $ 106,373.56 AFSCME Fulltime-Regular #N/A #N/A $ 119,245.13 AFSCME Fulltime-Regular #N/A #N/A $ 97,853.39 Fire Union Fulltime-Regular #N/A #N/A $ 89,131.22 AFSCME Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 40,331.66 Unclassified Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 89,773.42 AFSCME Fulltime-Regular #N/A #N/A $ 60,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,760.83 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 86,488.27 Fire Union Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 99,200.81 AFSCME Fulltime-Regular #N/A #N/A $ 97,853.39 Fire Union Fulltime-Regular #N/A #N/A $ 67,409.99 Unclassified Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 85,033.22 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 216,117.57 Police Executives Fulltime-Regular 01/01/18 #N/A $ 50,947.94 AFSCME Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A Fire Fighter 96 Hrs Paralegal Safety Specialist Fire Fighter 52/104hrs Fire Fighter 96 Hrs Emergency Dispatcher Supervisor, Police Police Sergeant Police Officer Procurement Contracting Officer Fleet Management Representative Fiscal Administrator Fire Lieut 96 Hrs Fire Captain 96 Hrs Fire Lieut 96 Hrs Fire Fighter 96 Hrs Waste Col Op II Planner II Parks & Recreation Sery Coord Mason Asst City Attorny Laborer I Police Officer Director of Zoning/Zoning Administrator Police Officer Fire Fighter 96 Hrs Assistant to the City Attorney Utility Analyst Building Services Assistant II Stock Clerk II Police Officer Asst Chief Fire Police Officer Fire Lieut 96 Hrs Police Officer Police Sergeant Property & Casualty Manager Public Service Aide Police Lt Fire Fighter 96 Hrs Assistant Director - Roadway Infrastructure Waste Collector-Garbg Fire Captain 96 Hrs Heavy Eqp Mech Police Officer Code Compliance Field Supervisor Police Officer Loan Specialist Budget And Financial Support Advisor, Sr Computer Training Specialist Fire Lieut 80 Hrs Emergency Dispatcher Pol Officer-Prob Admin Aide I Admin Aide I Engineer I Laborer I Police Officer Laborer I Fire Supplies Clerk II. Special Aide (Elected Official) Police Officer Fire Fighter 96 Hrs Emergency Dispatcher Police Officer Fire Fighter 96 Hrs Info & Referral Specialist (Homeless Program) 911 Operator (Emergency Call -Taker) Senior Floodplain Inspector District Director (Elected Official) Police Officer Police Officer Electrician II Building Services Assistant I Fire Lieut 80 Hrs Police Officer Police Officer Mechanical Inspector Fire Lieut 80 Hrs Commissioner's Aide Staff Services Assistant, T Fire Fighter 52/104hrs Police Officer Admin Aide I Police Major Information Technology Technician II Police Officer Police Officer 18 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 2454 28-Apr-70 M 46894 30-Dec-61 M 41986 28-Apr-63 M 2442 18-Nov-67 M 41223 30-Aug-70 M 43364 28-Apr-89 M 4307817-Jan-89 M 24011 1-Mar-67 M 2795418-Oct-84 M 24623 29-Sep-67 M 45558 2-Jan-99 M 43287 4-Jan-91 M 44487 27-Oct-64 F 19928 5-Aug-73 M 46185 21-Mar-87 F 40268 3-Nov-58 F 29296 2-Dec-60 F 40609 24-Jul-49 M 28486 31-Dec-79 M 46068 20-Nov-01 F 43616 27-Feb-72 F 42905 30-Sep-82 F 4340213-Mar-86 M 44860 1-Oct-97 F 26288 23-Aug-68 F 40353 17-Jun-51 M 28052 29-Jan-61 M 44184 13-Sep-73 M 46232 3-Jan-02 F 46375 23-Sep-85 M 25014 9-May-71 M 2451 9-Apr-72 M 40584 25-Jun-81 M 2397917-Mar-70 M 42393 1-Nov-89 M 24630 22-Oct-63 M 4533019-Sep-88 M 42805 17-May-86 M 43016 4-Jul-87 F 19449 15-Jan-59 F 27402 22-Jun-67 F 44859 13-May-98 F 42874 29-Mar-83 F 43127 17-Jul-83 M 27043 11-Jan-85 M 43556 27-Jun-93 M 43105 19-Jan-90 M 43678 27-Mar-91 M 45815 16-Apr-79 F 28633 23-Nov-69 F 43121 14-Feb-72 M 4602510-Sep-56 M 45843 18-Nov-64 F 27232 27-May-81 M 29175 12-Sep-79 F 41465 29-Apr-86 F 42718 13-Jul-94 F 27851 19-Sep-38 M 41883 15-Aug-90 M 43126 12-Dec-88 M 42117 8-Aug-88 F 45294 21-May-73 F 28648 24-Aug-81 M 13321 11-Dec-58 M 40221 6-Jan-86 M 44902 31-May-92 F 41388 12-Aug-81 F 41452 6-Dec-59 M 29082 21-Aug-66 M 29427 4-Nov-62 M 42229 5-Aug-88 M 40037 6-Apr-76 F 43408 31-May-90 M 17708 25-May-62 F 2506 24-Jul-68 F 43021 13-Apr-85 M 1375 29-Sep-70 F 45264 3-Jul-76 M 44842 7-Oct-93 M 46545 21-May-96 F 41358 10-Apr-84 M 44000 4-Nov-85 F 41579 30-Mar-96 M 25101 25-May-82 M 40586 14-Jan-53 M 29083 12-Jul-86 M 40726 7-Dec-63 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 57,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #NIA $ 130,000.00 Executives Fulltime-Regular 01/18/22 #NIA $ 152,190.50 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 69,915.43 Fire Union Fulltime-Regular #N/A #NIA $ 84,527.53 Fire Union Fulltime-Regular #NIA #NIA $ 90,866.67 Fire Union Fulltime-Regular #N/A #NIA $ 115,828.87 AFSCME Fulltime-Regular #NIA #NIA $ 50,566.46 Fire Union Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #NIA $ 91,571.50 Fire Union Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Probationary #NIA #NIA $ 53,360.36 AFSCME Fulltime-Regular #NIA #NIA $ 89,579.23 AFSCME Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 135,951.09 Unclassified Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #N/A $ 99,200.81 AFSCME Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #NIA #N/A $ 61,582.76 Sworn Police Officers Probationary #NIA #NIA $ 119,448.61 AFSCME Fulltime-Regular #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 72,097.79 AFSCME Fulltime-Regular #NIA #N/A $ 134,086.64 AFSCME Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #N/A $ 84,890.09 AFSCME Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #NIA #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 87,635.60 AFSCME Fulltime-Regular #NIA #N/A $ 103,184.18 AFSCME Fulltime-Regular #NIA #NIA $ 87,565.83 Managerial/Confidential Fulltime-Regular #NIA #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Probationary #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #N/A $ 114,534.00 AFSCME Fulltime-Regular #N/A #NIA $ 176,048.30 Executives Fulltime-Regular 09/29/21 09/29/21 $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 83,511.86 AFSCME Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 105,000.00 Executives Fulltime-Regular 07/27/23 #NIA $ 58,472.96 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ - Board Members Elected Official #N/A #NIA $ 71,290.54 Sanitation Union Fulltime-Regular #NIA #NIA $ 75,702.85 AFSCME Probationary #NIA #NIA $ 101,448.88 AFSCME Fulltime-Regular #NIA #NIA $ 117,908.68 AFSCME Fulltime-Regular #NIA #NIA $ 291,488.60 Executives Fulltime-Regular 01/01/18 06/01/18 $ 61,723.79 Sanitation Union Fulltime-Regular #NIA #N/A $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 113,914.52 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 108,343.51 AFSCME Fulltime-Regular #NIA #NIA $ 71,997.74 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Probationary #NIA #NIA $ 83,462.50 AFSCME Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 58,650.59 Sworn Police Officers Probationary #NIA #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 126,000.00 Executives Fulltime-Regular 01/01/18 #N/A $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 144,861.28 Managerial/Confidential Fulltime-Regular #NIA #N/A $ 273,501.65 Executives Fulltime-Regular 01/01/18 #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA JOB TITLE Police Officer Community Liaison (Elected Official) Crime Scene Investigator I Senior Advisor to the City Manager Senior Oracle ERP Application Developer Police Officer Fire Fighter 52/104hrs Fire Fighter 96 Hrs Fire Lieut 80 Hrs Air Cond Mech Fire Fighter 96 Hrs Police Officer Building Services Assistant 11 Fire Fighter 52/104hrs Admin Asst 1 Legal Services Aide Admin Asst 1 Marinas Aide Police Officer Police Officer Police Officer Police Officer Fire Fighter 96 Hrs Building Services Assistant II Executive Secretary To City Manager Laborer I Grounds Tender Plumbing Inspector Police Officer Police Officer Parks Operations Coordinator Police Officer Auto Mechanic Parks Recreation Coordinator Business Tax Receipts Aide Parks & Recreation Mgr I Police Officer Police Officer Grants Financial Analyst Building Services Assistant IV Human Resources Generalist Police Officer Police Officer Police Officer Police Lt Police Officer Police Officer Police Officer Building Services Assistant III Waste Collector-Garbg Senior Park Ranger Senior Building Inspector Director, Office of Management and Budget Police Officer Criminal Intelligence Analyst 1 Admin Aide II Police Officer Marinas Faclt Att Laborer 1 Police Officer Assistant Director, Solid Waste - Operations Information Technology Technician 11 Police Officer Pension Board Member Waste Eqpt Op Special Projects Coordinator Procurement Analyst Senior Plumbing Inspector Chf Depty City Atty Waste Col Op 11 Fire Fighter 96 Hrs Police Sergeant Fire Fighter 96 Hrs Fire And Life Safety Education Coordinat Pol Prop Spec I Police Officer Pol Prop Spec II Senior Procurement Contracting Officer Police Officer Police Officer Police Officer Senior Assistant City Attorney Parks & Recreation Mgr I Grant Funded Project Manager Auditor General Police Officer Carpenter 19 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 28425 29-Jul-77 M 2602 30-Dec-72 M 43157 20-Jun-96 M 27570 21-Feb-72 F 26343 29-Sep-71 F 27324 24-Aug-83 M 40865 26-Sep-69 M 40269 25-May-92 M 41300 13-Oct-88 M 42150 26-Apr-84 M 29342 22-Oct-77 M 4293013-Dec-64 M 44257 3-Nov-91 F 2610 22-Dec-78 F 4300410-May-89 M 28022 30-Mar-71 F 28563 21-Jun-73 M 2608 8-Sep-79 F 26213 20-Mar-75 M 228915-Sep-72 M 43638 8-Jun-95 M 45825 29-Mar-98 M 46085 6-Jan-92 M 263315-Aug-66 F 24367 7-Dec-68 M 2646816-Jul-85 M 28317 29-Nov-74 F 28402 24-Jan-81 M 28457 1-Nov-84 F 28495 7-Jan-53 M 27878 25-Nov-82 M 40844 21-Nov-90 F 40791 15-Oct-86 M 42005 8-Nov-72 M 45307 1-May-77 M 44245 14-May-82 M 42084 22-Dec-85 M 41954 2-Jun-92 F 45348 30-May-92 F 27799 11-Oct-72 F 24346 8-May-69 M 46220 22-Aug-97 M 28577 27-Aug-83 M 2664 27-Mar-82 M 43023 5-Jan-72 M 42004 8-Sep-91 F 42843 7-Apr-87 M 4527312-Sep-96 M 2856515-Mar-85 M 44926 24-May-81 M 28280 3-Nov-79 F 41103 27-Dec-96 F 2692 2-May-74 M 46643 26-Apr-95 F 27566 4-Feb-79 F 26459 14-May-65 M 4049013-Aug-75 M 41299 9-Jul-85 F 43112 26-Dec-95 F 26081 31-Jul-72 M 45654 13-May-97 M 41886 11-Nov-65 M 27541 23-Sep-71 M 4086313-Dec-82 M 18828 8-Jul-75 M 43674 24-Jul-94 F 29160 29-Jan-80 M 2797 5-Oct-71 M 22326 11-Oct-70 M 42654 26-Jul-84 F 2819 31-Aug-81 F 4204710-Aug-86 M 43980 1-Feb-80 F 45563 1-Aug-95 F 2597418-Jan-82 M 46332 27-Feb-65 M 43665 22-Feb-89 M 46909 29-Jan-97 F 42781 11-Dec-68 M 23313 4-Dec-77 M 2823 18-May-68 M 27601 10-Mar-83 M 27802 6-Sep-71 F 28458 8-Dec-82 M 28062 11-Oct-79 F 25462 12-Jan-58 M 4346919-Jan-90 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 216,117.57 Police Executives Fulltime-Regular 01/01/18 #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 108,097.80 AFSCME Fulltime-Regular #N/A #N/A $ 107,820.33 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,597.84 AFSCME Fulltime-Regular #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,462.49 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 101,368.53 AFSCME Fulltime-Regular #N/A #N/A $ 47,250.00 Unclassified Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,494.00 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 130,368.40 Sworn Police Officers Probationary #N/A #N/A $ 92,017.38 AFSCME Probationary #N/A #N/A $ 93,693.60 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 108,343.53 AFSCME Fulltime-Regular #N/A #N/A $ 202,285.01 Fire Executives Fulltime-Regular 11/01/18 #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 55,749.65 Fire Union Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 87,315.55 AFSCME Fulltime-Regular #N/A #NIA $ 44,261.56 AFSCME Probationary #N/A #N/A $ 58,918.08 Sanitation Union Fulltime-Regular #N/A #NIA $ 192,988.59 Executives Fulltime-Regular 01/01/18 #N/A $ 101,219.01 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 113,275.46 Fire Union Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 129,374.79 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 202,285.01 Fire Executives Fulltime-Regular 11/01/18 #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 71,452.78 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,866.67 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 105,190.59 Fire Union Fulltime-Regular #N/A #N/A $ 79,377.70 AFSCME Fulltime-Regular #N/A #N/A $ 129,073.75 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A Police Officer Police Major Police Officer Marinas Aide Contracts Manager Fire Captain 80 Hours Police Officer Public Service Aide Police Officer Police Officer Crime Prevention Specialist Heavy Eqp Mech Police Officer Police Officer Police Officer Zoning Information Specialist Police Officer Criminal Intelligence Analyst II Special Projects Coordinator (Elected Official) Police Lt Police Officer Crime Scene Investigator I Police Officer Police Teletype Operator Sanitation Supervisor Laborer I 911 Operator (Emergency Call -Taker) Police Sergeant Fire Fighter 80 Hrs Laborer I Police Lt Admin Asst II Fire Lieut 52/104 Hrs Maint Mechanic Police Officer Police Officer Fire Fighter 96 Hrs Clerk I Public Service Aide Engineer II Asst Chief Fire Building Services Assistant I Police Lt Police Officer Police Officer Police Officer Police Officer Fire Fighter 96 Hrs Police Lt Police Officer Code Compliance Field Supervisor Code Compliance Inspector Police Officer Emergency Dispatcher Police Officer Parks & Recreation Mgr I Fire Fighter 96 Hrs Public Service Aide Police Officer Parks & Recreation Mgr II Ocean Rescue Lifeguard Waste Col Op I City Clerk Senior Procurement Contracting Manager Fire Captain 96 Hrs Police Officer Senior Construction Manager Police Officer Asst Chief Fire Police Officer Payroll Clerk Sanitation Inspector I Payroll Specialist 911 Operator (Emergency Call -Taker) Waste Col Op II Auto Mechanic Police Officer Pol Officer-Prob Police Officer Fire Lieut 52/104 Hrs Police Lt Fire Lieut 80 Hrs Pol Prop Spec I Fire Captain 80 Hours Emergency Dispatcher Fire Plans Examiner Building Services Assistant III 20 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 46112 9-Mar-93 F 40923 26-Feb-75 M 43647 5-Dec-69 M 25996 27-Jan-81 M 40566 7-Aug-87 M 26014 18-Jan-74 M 25922 14-Nov-66 F 43400 9-Jan-90 M 27836 18-Feb-67 F 42243 25-Dec-92 M 40290 1-Jul-83 M 42670 6-Aug-65 M 28741 13-Dec-78 F 27738 4-Jan-87 F 41961 17-Jun-85 F 42935 17-Jun-88 F 2971 24-Mar-80 F 4208519-Mar-84 M 40285 29-Jun-84 F 2396519-Oct-78 M 25921 4-May-65 M 46845 6-Jul-00 M 40748 27-Mar-90 M 40749 24-Aug-87 M 41294 9-Mar-76 M 46288 7-Feb-91 M 25500 12-May-69 M 29358 7-Nov-59 M 46778 11-Oct-98 F 42693 24-Apr-79 M 45649 18-May-76 M 41720 25-Sep-90 F 46883 6-Mar-83 M 42481 24-Sep-72 M 40108 10-Feb-68 M 42847 11-Oct-93 M 4095419-Aug-67 M 25932 23-Dec-62 F 42768 29-Jan-92 M 41851 16-Nov-92 M 45306 26-Nov-95 M 46938 23-Feb-04 F 23589 20-Sep-80 F 3022 10-Jun-60 M 41302 18-Jan-91 M 43045 23-Mar-93 M 4529519-Jul-86 M 44849 24-Aug-96 M 46290 16-May-01 M 41607 9-Aug-75 M 4594018-Oct-58 F 44829 14-Apr-93 M 46257 16-Mar-01 M 27469 4-Oct-56 F 42578 10-May-70 M 41850 17-Jan-86 M 22708 22-Sep-66 M 44211 27-Jul-90 M 4084813-Nov-89 M 26035 9-Nov-76 M 26006 28-May-76 M 41902 3-Apr-86 F 21292 17-Nov-63 M 46291 31-Jul-97 M 28382 21-Jul-88 F 43158 5-Sep-93 F 44172 19-Nov-93 M 26362 7-Sep-78 M 4624318-Nov-85 M 44841 6-Oct-79 M 26413 5-Jul-57 F 44160 5-Dec-74 F 46233 26-Feb-00 M 45512 3-Jan-85 M 40256 12-Mar-58 F 43817 30-Dec-84 M 4078817-Dec-87 M 28116 27-Feb-67 M 44519 10-Dec-81 M 29067 19-Feb-73 M 29535 20-Oct-89 M 46048 1-Sep-99 M 4265313-Nov-83 M 43706 28-Jun-85 M 40787 5-Jan-90 M 46562 11-Jan-96 F 4553013-Jan-70 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 53,440.40 Sanitation Union Fulltime-Regular #N/A #N/A $ 56,239.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Probationary #N/A #N/A $ 82,465.84 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 64,957.15 Sanitation Union Fulltime-Regular #N/A #NIA $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Probationary #N/A #N/A $ 159,800.12 AFSCME Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #N/A $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 84,745.43 AFSCME Fulltime-Regular #N/A #N/A $ 42,910.40 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 72,097.79 AFSCME Probationary #N/A #N/A $ 46,200.58 Unclassified Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 111,407.18 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 98,270.79 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 76,960.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 212,100.00 Executives Fulltime-Regular 02/28/22 #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 73,040.25 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 95,465.01 Fire Union Fulltime-Regular #N/A #NIA $ 110,512.64 Fire Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 127,701.55 AFSCME Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 61,464.00 Fire Union Fulltime-Regular #N/A #N/A $ 110,512.64 Fire Union Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 93,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 100,084.60 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,486.40 Fire Union Fulltime-Regular #N/A #N/A $ 45,052.80 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A Public Service Aide Fire Fighter 96 Hrs Waste Col Op I Waste Collector-Garbg Auto Eqp Op I Fire Fighter 96 Hrs Auto Eqp Op 11 Fire Fighter 96 Hrs Waste Col Op 1 Fire Fighter 96 Hrs Fire Fighter 96 Hrs Sanitation Inspector 1 Public Service Aide Admin Asst 1 Admin Aide 11 Clerk III Police Sergeant Fire Fighter 96 Hrs Fire Fighter 96 Hrs Environmental Resources Specialist II Systems Analyst Sr Pol Officer-Prob Police Officer Police Officer Police Officer Fire Fighter 96 Hrs Fire Lieut 52/104 Hrs Information Technology Technician II Administrative Aide 11, T Environmental Resources Specialist II Commissioner's Aide Budget And Financial Support Advisor Pol Officer-Prob Staff Anlst Sr Budget Coordinator Police Officer Heavy Eqp Mech Waste Collector-Garbg Police Officer Fire Fighter 96 Hrs Police Officer Staff Services Assistant, T Payroll Clerk Admin Asst I Police Officer Police Officer Special Projects Coordinator T Police Officer Fire Fighter 96 Hrs Heavy Eqp Mech Assistant City Attorney, Supervisor Police Officer Police Officer Info & Referral Specialist (Homeless Program) Information Technology Technician 11 Fire Fighter 96 Hrs Fire Fighter 52/104hrs Police Officer Police Officer Fire Lieut 96 Hrs Fire Captain 96 Hrs Police Officer Beach Operations Supv Fire Fighter 96 Hrs Human Resources Technician 11 Police Officer Fire Fighter 96 Hrs Fire Captain 96 Hrs Police Officer Police Officer Program Assistant Finance Accounting Specialist Police Officer Director of Constituent Affairs (Elected Official) Information Clerk Police Officer Fire Fighter 96 Hrs Ocean Rescue Lifeguard Grants Financial Analyst Police Officer Senior Code Compliance Inspector Police Officer Police Sergeant Police Officer Fire Lieut 96 Hrs Assistant Waterfront Park Manager, T. Staff Services Assistant, T 21 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 40924 12-Mar-81 M 40374 9-Mar-88 F 42782 25-Oct-92 M 44891 23-Apr-94 M 303815-Sep-76 M 25498 25-Dec-76 M 45829 9-Apr-90 M 27890 23-Oct-70 M 2745918-Mar-68 M 27577 27-Sep-73 F 28459 12-Feb-83 M 42875 22-Mar-90 M 44180 12-Aug-97 M 18385 21-Nov-72 M 41724 8-Aug-88 M 44848 25-Jun-91 M 43688 24-Oct-69 F 40925 31-Mar-82 M 46383 25-Jul-97 F 3045 3-Aug-78 F 4266919-May-89 M 13527 17-Jan-74 M 28829 14-Oct-87 F 25719 30-Jul-81 F 6558 4-Nov-68 F 29374 23-Mar-80 M 4047313-Dec-80 F 24116 16-Sep-74 M 25505 25-Jul-69 M 43013 7-Sep-91 F 40472 20-Nov-72 M 42989 8-Nov-84 M 26323 14-Jan-69 M 44971 7-Nov-86 F 17610 13-Feb-64 M 42086 24-Nov-87 F 45738 31-Jan-89 M 43799 4-Feb-80 M 2926719-Sep-58 M 4372919-Sep-88 F 43307 22-Apr-77 F 12550 31-May-64 M 3192 16-Jan-77 F 41728 25-Jul-76 M 2869819-Oct-64 M 46881 3-Oct-61 F 4058519-Aug-77 F 4340615-Apr-91 F 42228 27-May-87 F 40504 26-Nov-63 M 43161 21-Aug-87 M 29203 22-Nov-82 M 4057513-Aug-82 F 27955 8-Dec-68 F 46378 25-Aug-90 F 44343 7-Nov-77 M 1136419-Oct-70 M 4083410-May-86 M 27932 7-Oct-53 M 43167 28-Dec-90 F 3287 11-Sep-77 F 41459 23-Sep-90 F 41200 13-Sep-80 M 40786 20-May-88 M 41460 12-Apr-47 M 11402 18-Jul-76 M 42512 15-Jul-82 M 23062 11-JuI-72 F 3319 4-Dec-75 M 41130 9-Nov-83 F 4679511-JuI-70 F 41975 5-Apr-47 M 42231 24-May-94 M 40122 5-Dec-61 M 40080 9-Apr-71 M 41957 2-Apr-93 F 28880 12-Apr-91 M 27575 25-Nov-79 M 2708413-Feb-83 M 4534918-Feb-97 M 3350 8-Jan-68 M 46871 24-Dec-81 M 4004616-Jan-82 F 42922 3-Sep-85 M 26016 7-May-75 M 44867 6-Apr-81 M 40081 30-Apr-70 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,464.00 Fire Union Fulltime-Regular #N/A #NIA $ 213,392.45 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 98,627.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 111,521.07 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 142,058.69 Fire Union Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 111,521.07 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #N/A #N/A $ 72,056.68 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 119,448.72 AFSCME Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Probationary #N/A #N/A $ 51,238.51 AFSCME Probationary #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 90,986.68 Sanitation Union Fulltime-Regular #N/A #N/A $ 82,189.05 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 66,400.25 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 67,765.77 Fire Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 75,765.78 AFSCME Fulltime-Regular #N/A #N/A $ 61,863.98 Sanitation Union Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 86,486.40 Fire Union Fulltime-Regular #N/A #NIA $ 157,869.19 Executives Fulltime-Regular 01/08/18 #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #NIA $ 100,084.60 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 144,285.85 Executives Fulltime-Regular 01/01/18 06/01/18 $ 216,117.57 Police Executives Fulltime-Regular 01/01/18 #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 123,032.22 AFSCME Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 286,617.99 Executives Fulltime-Regular 01/01/18 #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Probationary #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,362.38 AFSCME Probationary #N/A #N/A $ 110,515.80 Fire Union Fulltime-Regular #N/A #N/A $ 120,123.55 Unclassified Fulltime-Regular #N/A #N/A $ 76,579.56 Fire Union Fulltime-Regular #N/A #N/A JOB TITLE Fire Fighter 96 Hrs Waterfront Park Manager Police Officer Emergency Dispatcher Police Officer Fire Fighter 52/104hrs Police Officer Police Officer Police Officer Typist Clerk III Fire Fighter 96 Hrs Police Officer Fire Fighter 96 Hrs Deputy Fire Chief Police Officer Police Officer Admin Aide I Fire Fighter 96 Hrs Public Service Aide Police Officer Police Officer Fire Lieut 96 Hrs Laborer I Public Service Aide Police Officer Police Officer Police Sergeant Chief Fire Officer 52/104 Hrs Fire Lieut 96 Hrs Admin Aide II Police Sergeant Police Officer Waste Col Op II Paralegal Parks Operations Coordinator Fire Fighter 96 Hrs Laborer I Auto Eqp Op II Senior Park Ranger Public Rel Agnt Pol Prop Spec I Waste Eqpt Op Admin Asst I Auto Eqp Op II Information Technology Technician I Staff Services Assistant, T 911 Operator (Emergency Call -Taker) Fire Fighter 96 Hrs Fire Fighter 80 Hrs Grounds Tender Police Officer Fire Lieut 96 Hrs Opportunity Center Employer Consultant Waste Col Op I Police Officer Laborer I Fire Captain 52/104 Hrs Waste Collector-Garbg Auto Eqp Op I Financial Analyst I Police Officer Police Officer Comm Repair Wrkr Fire Lieut 96 Hrs Assistant Director, Building Services Fire Fighter 52/104hrs Police Sergeant Eo/Diversity Prg, Admin Police Major Auto Eqp Op II Staff Services Assistant, T Senior Building Inspector Fire Fighter 96 Hrs Deputy City Manager Fire Fighter 96 Hrs Admin Aide I Aquatic Specialist Police Sergeant Grounds Tender Public Service Aide Police Officer Senior Park Ranger Police Officer Information Technology Technician II Fire Captain 80 Hours Audit Supervisor Fire Fighter 80 Hrs 22 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 46887 24-Feb-95 F 46016 19-Dec-72 M 27032 24-Apr-81 F 41733 18-Jul-84 F 29241 25-Jun-84 M 45039 5-Jan-00 F 27796 20-Dec-89 M 27062 8-Dec-73 M 26719 18-Jun-73 F 28703 27-Feb-65 F 4688612-Oct-95 M 45420 6-Jun-95 M 28679 4-Feb-88 M 41464 20-Jan-93 M 2750310-Sep-61 F 28591 13-Jul-54 M 42591 2-Dec-85 M 40118 18-Feb-62 F 43796 14-Aug-87 F 27416 31-Dec-79 M 43445 30-Mar-58 F 29204 22-Jan-84 M 41283 9-Apr-82 M 28813 11-May-63 M 46401 5-Sep-02 F 27986 1-Jul-86 M 13998 4-Feb-79 F 16339 9-Dec-63 M 43765 8-Dec-89 M 44958 23-Dec-83 F 4269416-Sep-87 M 45461 21-Jul-84 F 28002 23-Jul-69 M 27629 9-Sep-77 M 41333 21-Mar-69 M 4686717-Apr-96 M 27617 15-Nov-76 M 4290415-Feb-64 F 28339 26-Mar-74 F 41106 29-Mar-62 M 3330 26-Dec-64 M 41751 2-Aug-66 M 4494515-Oct-95 M 27526 9-Feb-84 F 28166 10-Jan-58 M 43106 2-May-75 M 25050 29-Apr-66 M 44521 2-Jan-90 M 41428 6-Jul-89 F 23769 3-Jul-67 F 4278716-Aug-83 M 42695 5-May-84 F 41887 14-Feb-82 F 28611 16-Jul-80 F 40701 31-Mar-89 M 4642313-Apr-92 F 4544915-Mar-86 F 14847 3-May-67 F 27915 25-Mar-58 M 44244 8-Apr-91 F 43388 29-Aug-92 M 10164 13-May-56 M 10949 26-Jul-60 F 46408 5-Nov-89 F 44914 15-Jul-78 M 11721 19-Oct-72 M 45274 9-Jun-96 M 26614 3-Apr-76 M 42941 2-May-89 M 43403 14-Mar-96 M 4340912-Oct-94 M 28556 1-Nov-78 M 46552 6-Aug-00 M 3495 21-Jun-68 F 26229 5-Nov-62 M 348818-Feb-73 F 40038 20-Nov-86 M 40466 27-Dec-76 M 3493 7-Nov-64 F 3459 4-Sep-70 F 28729 31-Jan-86 M 27938 17-May-73 M 12224 4-Jun-70 M 46119 29-Jul-99 F 25979 27-Jan-62 M 41397 28-Jul-83 M 28796 20-Sep-88 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 36,414.56 AFSCME Probationary #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 108,097.80 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 128,196.12 AFSCME Fulltime-Regular #N/A #NIA $ 131,393.49 AFSCME Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Probationary #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 61,863.98 Sanitation Union Fulltime-Regular #NIA #NIA $ 84,745.43 AFSCME Fulltime-Regular #NIA #NIA $ 40,665.43 AFSCME Fulltime-Regular #NIA #NIA $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 87,635.60 AFSCME Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #NIA #NIA $ 88,648.68 Fire Union Fulltime-Regular #NIA #NIA $ 82,125.68 Detention Officer Fulltime-Regular #NIA #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,930.45 Unclassified Fulltime-Regular #NIA #N/A $ 97,853.39 Fire Union Fulltime-Regular #NIA #NIA $ 157,500.00 Executives Fulltime-Regular 01/01/18 #N/A $ 72,056.68 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 61,863.98 Sanitation Union Fulltime-Regular #NIA #N/A $ 98,270.58 AFSCME Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Probationary #NIA #N/A $ 125,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 78,492.21 Fire Union Fulltime-Regular #NIA #N/A $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 96,541.46 AFSCME Fulltime-Regular #NIA #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 131,467.76 AFSCME Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 101,448.88 AFSCME Fulltime-Regular #NIA #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 89,134.24 AFSCME Fulltime-Regular #N/A #NIA $ 47,064.11 AFSCME Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 106,521.38 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Probationary #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 98,270.79 AFSCME Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,538.86 Fire Union Fulltime-Regular #NIA #NIA $ 83,346.68 AFSCME Fulltime-Regular #NIA #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #NIA #NIA $ 72,097.79 AFSCME Probationary #N/A #NIA $ - Board Members Elected Official #NIA #NIA $ 113,760.42 AFSCME Fulltime-Regular #NIA #NIA $ 60,395.46 Fire Union Fulltime-Regular #NIA #NIA $ 119,519.71 AFSCME Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #N/A $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Probationary #NIA #NIA $ 79,377.48 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 113,914.52 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,554.84 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 87,315.09 AFSCME Fulltime-Regular #NIA #NIA $ 93,591.16 AFSCME Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,950.46 Managerial/Confidential Fulltime-Regular #NIA #N/A $ 84,529.32 Fire Union Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Probationary #NIA #N/A $ 75,025.39 Sanitation Union Fulltime-Regular #NIA #NIA $ 56,112.36 Sanitation Union Fulltime-Regular #NIA #N/A $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA Senior Park Ranger Heavy Eqp Mech Budget And Financial Support Advisor, Sr Police Officer Police Officer Parks & Recreation Mgr I Fire Fighter 96 Hrs Police Sergeant Program Coordinator - Capital Improvements Program Finance Manager Historic Preservation Planner Pol Prop Spec I Public Service Aide Police Officer Waste Col Op I Information Technology Technician II Info & Referral Aide Payroll Specialist Victims Advocate Police Sergeant Waste Collector-Garbg Fire Lieut 96 Hrs Detention Officer Waste Collector-Garbg Staff Services Assistant, T Police Lt Assist to the Exec Secretary - Civil Service Board Fire Lieut 80 Hrs Executive Director, Civilian Investigative Panel Paralegal Police Officer Staff Services Assistant, T Waste Col Op I Environmental Compliance Coord. Auto Eqp Op 11 Chief of Staff (Elected Official) Fire Fighter 96 Hrs Information Clerk Admin Asst 11 Automotive Service Writer Police Officer Database Specialist (Oracle) Police Staffing Supervisor Police Officer Parks Supv 1 Police Officer Auto Mechanic Code Compliance Inspector Public Service Aide Code Compliance Inspector Laborer 1 Laborer I Hazard Mitigation/Disaster Recovery Spec Police Officer Senior Park Ranger Public Relations Aide Early Childhood Educator Parks & Recreation Mgr 1 Laborer 1 Police Officer Fire Fighter 80 Hrs Maint Mechanic Waste Collector-Garbg Senior Financial Analyst Pension Board Member Electrician Fire Fighter 52/104hrs Telecommunications Technician (RJ) Code Compliance Inspector Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer 911 Operator (Emergency Call -Taker) Admin Aide 1 Grounds Tender Police Officer Police Sergeant Police Officer Police Property Mgr Admin Asst 1 Police Officer Senior Procurement Contracting Manager Fire Fighter 80 Hrs Human Resources Technician 1 Waste Col Op 11 Waste Col Op 1 Public Service Aide 23 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 6185 17-Nov-72 F 43642 20-Jun-93 M 27634 4-Sep-77 F 24292 23-Oct-65 F 3489 11-Nov-70 M 42087 11-Oct-89 M 3458 12-Nov-74 F 42641 21-Feb-83 M 3492 23-May-74 M 40321 26-Oct-70 F 27190 4-Oct-76 F 21101 20-Aug-73 F 28939 24-Apr-92 F 3470 16-Mar-72 F 18156 24-Feb-65 M 1395818-Dec-63 M 46910 29-Jan-00 M 45810 29-May-77 M 3472 29-Mar-71 F 28103 2-Jun-80 M 42897 9-Sep-89 F 23571 22-Apr-77 F 27519 1-Sep-71 F 27805 30-Dec-71 M 40713 28-Dec-83 F 29205 9-Feb-87 M 660515-Aug-75 F 45276 5-Jun-86 M 45934 2-Jan-86 M 44421 27-Jan-62 M 46342 1-Apr-74 M 6254 13-Jun-73 F 28731 19-Oct-58 M 42548 2-Mar-88 M 25916 3-Nov-74 M 21362 14-Oct-67 M 45574 12-Jul-95 M 42166 13-Aug-81 F 3491 8-Nov-71 M 27233 9-Sep-83 F 29154 21-Dec-76 M 41680 14-Mar-84 M 41906 7-Jul-88 M 4530410-Sep-93 M 25983 22-Nov-66 F 29294 28-Oct-82 M 3490 9-Jan-66 M 22811 29-Jan-64 M 41927 24-Nov-65 M 7122 4-Nov-77 F 45572 2-Jun-93 M 29289 21-Feb-84 M 41852 22-Nov-83 M 42797 25-Oct-79 M 29323 29-Aug-81 M 46399 14-Jun-79 M 4583810-Nov-68 M 27608 25-Dec-79 M 46539 24-May-91 M 43478 11-Aug-86 F 2157 26-Sep-73 F 27418 14-Nov-71 M 23196 27-Apr-69 M 2754910-Apr-60 M 42901 26-May-85 M 24325 30-Dec-69 F 42756 11-Aug-89 F 29206 7-Nov-84 M 40082 26-Nov-79 M 20954 29-Jul-64 M 28405 20-May-85 F 26124 19-Apr-70 M 41771 20-Jan-88 M 3593 16-Apr-71 M 46111 1-Jun-96 M 13750 29-Nov-74 F 362710-Sep-76 M 25773 12-Mar-82 M 42482 6-Apr-63 F 40304 9-Jul-59 F 26235 26-Nov-58 F 40956 12-Aug-59 M 25243 20-Dec-78 M 4369210-Oct-88 M 45565 20-Aug-95 F 46914 24-Feb-93 F 23304 27-Dec-74 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 73,029.84 Detention Officer Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 65,303.99 AFSCME Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 91,889.61 AFSCME Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 61,863.98 Sanitation Union Fulltime-Regular #N/A #NIA $ 149,886.46 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 71,997.74 AFSCME Fulltime-Regular #N/A #N/A $ 75,025.39 Sanitation Union Fulltime-Regular #N/A #N/A $ 82,715.56 Sanitation Union Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 101,446.37 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 115,594.50 Executives Fulltime-Regular 03/25/22 03/25/22 $ 107,853.11 AFSCME Fulltime-Regular #N/A #N/A $ 87,893.12 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 249,843.56 Executives Fulltime-Regular 01/01/18 #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 55,749.65 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 44,065.42 Sanitation Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 108,343.52 AFSCME Fulltime-Regular #N/A #N/A $ 202,285.01 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 68,569.52 AFSCME Fulltime-Regular #N/A #N/A $ 211,879.97 Police Executives Fulltime-Regular 11/01/18 #N/A $ 98,627.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,462.40 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,502.57 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 119,245.12 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ - Board Members Elected Official #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #NIA $ 45,865.24 Fire Union Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 106,005.99 Fire Union Fulltime-Regular #N/A #N/A $ 125,207.38 AFSCME Fulltime-Regular #N/A #NIA $ 106,521.38 AFSCME Fulltime-Regular #N/A #N/A $ 89,134.28 AFSCME Fulltime-Regular #N/A #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #NIA $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 90,986.68 Sanitation Union Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 101,078.44 AFSCME Fulltime-Regular #N/A #N/A $ 196,470.54 Police Executives Fulltime-Regular 01/01/18 #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 125,207.47 AFSCME Fulltime-Regular #N/A #N/A $ 125,582.94 Unclassified Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 71,614.81 Sanitation Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A JOB TITLE 911 Operator (Emergency Call -Taker) Detention Officer Public Service Aide Program Assistant Police Sergeant Fire Fighter 96 Hrs Emergency Dispatcher Supervisor, Police Police Officer Police Officer Admin Asst I Waste Col Op I Human Resources Records Supervisor Police Staffing Specialist Typist Clerk III Waste Col Op II Waste Col Op II Pol Officer-Prob Chief of Urban Design Police Officer Police Officer Asst City Attorny Zoning Information Specialist Senior Legal Assistant Deputy City Attorney Laborer I Fire Fighter 96 Hrs Police Sergeant Fire Fighter 96 Hrs Engineer I Waste Collector-Garbg Auto Eqp Op I Police Officer Info & Referral Specialist (Homeless Program) Pol Prop Spec I Information Analyst Asst Chief Fire Police Officer Admin Aide I Public Service Aide Police Major Police Officer Budget Analyst Police Officer Police Officer 911 Operator (Emergency Call -Taker) Police Officer Police Officer Parks & Recreation Facility Maintenance Manager Marinas Faclt Att Public Service Aide Police Officer Police Sergeant Fire Fighter 96 Hrs Programmer Sr Police Officer Pension Board Member Preservation Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer Police Officer Police Officer Fire Lieut 52/104 Hrs Geographic Information Systems Developer Zoning Manager Disabilities Program Leader Waste Collector-Garbg Fire Lieut 96 Hrs Fire Fighter 96 Hrs Waste Eqpt Op Police Sergeant Senior Park Ranger Police Officer Police Officer Public Service Aide Admin Asst II Police Commander Auto Mechanic Database Specialist(Sgl Server) Audit Supervisor Typist Clerk III Heavy Eqp Mech Waste Col Op II Sanitation Supervisor 911 Operator (Emergency Call -Taker) Pol Prop Spec I Fire Fighter 52/104hrs 24 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 3679 8-Apr-73 F 40287 14-Mar-86 M 46267 27-Jun-88 M 43122 8-Apr-69 F 27457 29-Apr-78 F 29098 25-Sep-80 F 4586210-Sep-82 M 26364 19-Jul-81 M 41455 28-Feb-80 F 44232 24-Dec-87 M 42763 1-Jan-85 M 41449 22-Jun-61 M 28612 8-Feb-80 M 3777 1-Nov-76 M 25663 1-Jul-71 M 46827 5-Nov-69 F 45277 8-Jun-93 M 43658 4-Jun-94 M 28155 17-Sep-90 F 43677 4-Apr-91 M 41739 15-Oct-93 M 44145 9-Feb-90 M 26965 22-Nov-55 M 2695615-Oct-60 M 4204318-Nov-83 M 27931 22-Sep-70 M 42088 24-Apr-85 M 41277 6-Apr-91 M 25463 27-Apr-70 M 44527 4-Sep-79 F 26942 1-Jun-85 M 41348 24-Jan-86 F 41225 8-Oct-85 M 45958 24-Aug-77 M 2530715-Mar-60 F 40317 24-Oct-77 F 28460 3-Mar-76 M 3865 24-Sep-72 M 40312 12-Sep-69 F 46266 12-Mar-91 M 42089 17-Jun-88 M 3872 23-May-70 M 46379 14-May-88 F 44282 4-Oct-92 M 28889 28-May-73 M 45326 19-Feb-96 M 23772 29-Mar-81 F 42627 11-May-88 M 46511 7-Jan-00 M 41266 9-Oct-67 F 46775 8-Nov-70 M 42715 25-Mar-90 M 28417 22-Nov-72 M 4622215-Jan-92 F 28428 24-Oct-68 F 43605 27-Sep-85 M 27733 11-Oct-76 F 3898 21-Dec-74 M 44408 3-Jul-60 M 46114 28-May-99 M 46371 28-May-99 M 41295 7-Jan-91 F 45577 8-Nov-00 M 10012 2-Feb-51 M 28403 6-Mar-84 M 43901 28-Sep-79 F 29393 30-Sep-84 F 42818 28-Nov-89 F 46754 8-Aug-97 M 3982 28-Nov-71 M 23580 25-Oct-71 F 16421 17-Sep-73 M 45515 30-Jun-67 M 28735 12-Jun-53 M 43968 20-Feb-78 F 2723419-Aug-76 M 5939 21-Mar-71 F 26132 18-Dec-83 F 44336 2-Sep-82 F 3940 29-Mar-80 M 42164 12-Aug-50 F 41074 10-Nov-66 F 2037618-Nov-61 F 4447710-Oct-88 F 28692 23-May-77 M 27517 12-Aug-73 M 43636 9-Jan-97 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 119,722.03 Fire Union Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 165,249.97 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 120,000.00 Executives Fulltime-Regular 10/04/23 #N/A $ 55,749.65 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 119,245.12 AFSCME Fulltime-Regular #N/A #N/A $ 125,360.66 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 53,800.44 AFSCME Probationary #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 155,222.10 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,290.54 Sanitation Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 107,190.51 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #N/A $ 64,396.98 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 85,033.22 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,270.76 AFSCME Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME _ Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 194,576.04 Police Executives Fulltime-Regular 01/01/18 #N/A $ 87,635.60 Managerial/Confidential Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 56,490.51 AFSCME Probationary #N/A #N/A $ 114,000.00 AFSCME Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,760.69 AFSCME Fulltime-Regular #N/A #N/A $ 196,470.54 Police Executives Fulltime-Regular 10/20/22 #N/A $ 103,241.45 Unclassified Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,889.58 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 34,741.99 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 80,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,776.67 Sanitation Union Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 38,604.80 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 91,808.75 Unclassified Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 108,343.87 AFSCME Fulltime-Regular #N/A #N/A $ 68,580.87 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A Police Officer Fire Fighter 96 Hrs Resilience Programs Manager Crime Scene Investigator I Police Sergeant Police Officer Engineer I Fire Captain 52/104 Hrs Fiscal Assistant Police Officer Police Officer GIS Technician Police Sergeant Police Sergeant Testing And Validation Supervisor Assistant Director, Human Services Fire Fighter 96 Hrs Police Officer Crime Analyst I Sanitation Inspector I Police Officer Police Officer Information Technology Tech. III Budget Coordinator Eng Tech III Code Compliance Inspector Fire Fighter 96 Hrs Police Officer Professional Engineer III Police Officer Waste Eqpt Op Police Officer Police Sergeant Zoning Information Technician Typist Clerk III Public Service Aide Fire Fighter 52/104hrs Police Officer Admin Asst I Park Planner II Fire Fighter 96 Hrs Senior Sergeant at Arms Chief Accountant Police Officer Police Lt Police Officer Parks & Recreation Mgr I Police Officer Police Officer Building Services Assistant III Senior Building Inspector Police Officer Police Officer Planning Tech Police Officer Police Officer Financial Analyst II Police Commander Staff Auditor, Senior Code Compliance Inspector Code Compliance Inspector Public Service Aide Police Officer Labor Crew Ldr II Police Sergeant Info & Referral Aide Police Officer Police Officer Legislative Aide (Elected Official) Police Sergeant Waste Col Op II Fire Fighter 52/104hrs Waste Collector Operator II, T Info & Referral Specialist (Homeless Program) Opportunity Center Client Support Specialist Spvsr Police Officer Police Officer Legislative Services Rep. I Asst To Director -Planning Police Sergeant STEAM Education Coordinator Waterfront Park Manager Asst Accts Receivable Supervisor Human Resources Generalist Heavy Eqp Mech Air Cond Mech Police Officer 25 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 43559 14-Oct-58 M 44256 14-Mar-65 F 46244 25-May-95 M 40894 25-Nov-83 M 43107 3-Dec-94 M 24981 3-Oct-57 M 4426419-Aug-93 M 4544217-Nov-62 M 40083 22-Jan-83 M 46736 5-Jul-94 M 41521 20-May-85 F 27551 5-Jan-84 F 28521 15-Oct-60 M 42501 5-Jan-95 M 40439 28-Sep-63 M 26181 19-Jul-84 M 40753 3-Nov-67 M 28728 28-Aug-84 F 28559 2-Aug-82 M 46543 14-Mar-95 M 2622712-Oct-62 M 41202 20-Apr-67 M 42014 11-Feb-84 M 25955 19-Jul-81 M 44494 26-Nov-87 F 41396 28-Jan-75 F 46362 1-Aug-02 M 27705 22-Aug-74 F 21088 8-Mar-72 M 4008415-Mar-73 M 28680 12-Aug-81 M 2866710-Dec-66 F 46226 6-Apr-90 M 41249 27-Mar-85 M 41329 19-Jul-81 F 42789 29-Apr-82 M 2345010-Mar-68 M 44858 4-Nov-81 F 4592319-Aug-72 F 10699 16-Feb-69 M 4009218-Oct-82 F 18878 1-Sep-77 F 40513 14-Nov-59 M 43072 6-Nov-90 M 28307 7-Jan-78 M 46335 1-Apr-04 F 41759 14-Nov-89 M 41490 20-Jul-80 F 46234 1-Jan-01 F 26726 8-Sep-79 F 45948 12-Jun-88 F 2609418-Apr-83 M 4070315-Aug-61 M 43165 8-Feb-83 M 4062 21-Sep-65 M 41853 17-Mar-88 M 29187 9-Jan-74 M 46357 20-Aug-97 M 44815 22-Dec-84 M 43672 20-Sep-96 M 2806012-Oct-86 M 40085 20-Feb-80 M 26618 7-Jul-62 F 26228 7-Aug-68 F 29343 1-May-63 F 2876619-Oct-89 F 4063 16-Mar-77 M 46245 8-Sep-90 M 4112 2-Feb-74 M 44915 23-Aug-89 M 40903 27-Feb-59 M 28595 12-Dec-80 F 4266013-Dec-79 F 2795919-Sep-82 M 4285617-Aug-88 M 46192 15-Feb-96 F 44445 6-Jul-94 M 40503 18-Jan-48 M 2777417-Nov-74 M 26602 4-Aug-73 M 41893 19-May-74 M 25762 27-Oct-84 M 27028 28-Mar-52 M 42829 20-Aug-91 M 2752317-Dec-79 M 40086 25-Dec-82 M 40627 18-Jun-49 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 103,924.50 AFSCME Probationary #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 141,981.59 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 31,456.25 AFSCME Probationary #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 64,809.88 Sanitation Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,809.88 Sanitation Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 64,809.88 Sanitation Union Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Probationary #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 79,487.82 AFSCME Probationary #N/A #N/A $ 98,047.22 AFSCME Probationary #N/A #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 106,373.64 AFSCME Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 97,853.39 Fire Union Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 203,949.81 AFSCME Fulltime-Regular #N/A #N/A $ 102,621.79 Fire Union Fulltime-Regular #N/A #N/A $ 131,131.10 Fire Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 84,745.43 AFSCME Fulltime-Regular #N/A #N/A $ 75,000.00 Unclassified _ Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 78,275.39 AFSCME Fulltime-Regular #N/A #N/A $ 31,512.00 AFSCME Probationary #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,368.00 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Probationary #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 108,097.78 AFSCME Fulltime-Regular #N/A #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 79,195.26 AFSCME Fulltime-Regular #N/A #N/A $ 104,466.52 AFSCME Fulltime-Regular #N/A #N/A $ 103,184.27 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 127,362.94 Unclassified Fulltime-Regular #N/A #N/A $ 96,675.64 AFSCME Fulltime-Regular #N/A #N/A $ 98,436.95 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,331.66 Unclassified Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 152,190.55 AFSCME Fulltime-Regular #N/A #N/A $ 118,907.64 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 88,650.43 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A JOB TITLE Senior Building Inspector Transportation Planning Aide Police Officer Emergency Dispatcher Police Officer Senior Building Inspector Police Officer Electrician Fire Fighter 96 Hrs Marinas Faclt Att Emergency Dispatcher Supervisor, M/F Police Lt Public Service Aide Laborer I Waste Col Op 11 Police Officer Waste Col Op 11 Police Officer Police Sergeant Police Officer Code Compliance Inspector Budget And Financial Support Advisor Financial Analyst 11 Waste Col Op II Lease Manager Senior Procurement Contracting Officer Human Resources Technician 1 Finance Accounting Specialist Emergency Dispatcher Supervisor, M/F Fire Fighter 96 Hrs Police Officer Financial Analyst II Planner 11 Fire Fighter 96 Hrs Engineer 11 Police Officer Fire Lieut 80 Hrs Police Officer Engineer 1 Information Systems Manager, Fire/Police Fire Captain 96 Hrs Chief Fire Ofcr.-96 H Info & Referral Specialist (Homeless Program) Fire Fighter 96 Hrs Information Technology Technician 11 Senior Communications Aide (Elected Official) Police Officer Crime Scene Investigator 1 Police Officer Code Compliance Inspector Info & Referral Aide Parks & Recreation Mgr I Laborer 1 Police Officer Police Officer Fire Lieut 96 Hrs Parks Supv 1 Planning Tech Fire Fighter 96 Hrs Police Officer Superintendent of Aquatics & Ocean Rescue Fire Fighter 96 Hrs Client Support Services Specialist Claims Adjustor III Financial Analyst 11 Crime Scene Investigator 1 Police Sergeant Police Officer Police Officer Police Officer Laborer I Asst To Dir Gsa Legislative Services Supervisor Fire Lieut 52/104 Hrs Police Officer Special Aide (Elected Official) Police Officer Laborer 1 Geographic Information System Technical Analyst Senior Construction Manager Building Services Assistant I Police Lt Grounds Tender Police Officer Laborer I Fire Lieut 80 Hrs Laborer I 26 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 44353 12-Feb-81 F 27563 30-Jun-78 M 4028816-Sep-83 M 4684012-Sep-80 M 27609 2-Oct-78 M 40049 8-Nov-77 M 853 14-Mar-81 F 43389 6-Apr-78 M 25653 8-Jul-63 M 29185 23-Jun-85 M 41806 1-Jan-71 F 4689310-Apr-82 F 28617 20-Jan-67 M 25915 12-Jun-81 F 45836 23-Feb-92 M 4256517-Mar-80 M 4182 9-JuI-84 M 43827 29-Oct-63 F 43128 13-Dec-90 M 45479 7-Apr-94 F 41892 31-Oct-63 M 41384 5-Jan-78 M 42742 1-Aug-93 F 25973 24-Dec-82 M 4186 18-Jan-80 M 43172 26-Dec-62 M 2332718-Mar-80 M 25007 23-Oct-65 F 46412 28-JuI-94 M 45376 11-Feb-90 M 4307418-Oct-91 M 42245 23-Mar-56 F 28609 31-Oct-69 M 43873 30-Sep-86 F 40207 20-Feb-93 M 46861 29-May-93 M 4369018-Jan-73 M 40572 3-Aug-85 M 44916 4-Apr-97 M 45575 30-Nov-93 M 41803 15-Aug-69 M 42663 24-Nov-65 M 46292 30-Aug-99 M 4252 10-Mar-64 M 25410 8-JuI-72 M 24583 6-Nov-62 M 26949 11-Jun-65 F 44355 25-Nov-96 M 40926 8-Oct-82 M 27397 28-May-73 M 41248 24-Aug-83 M 13241 2-Dec-65 F 46047 25-Sep-95 M 43102 13-Mar-93 F 41292 23-Jun-79 M 40242 7-Oct-92 M 24201 19-Mar-72 F 24081 22-Jun-69 M 46250 29-Oct-98 F 27510 21-Oct-70 M 40660 1-Apr-94 M 25094 26-Apr-58 M 25535 14-Apr-64 M 41497 30-Aug-85 M 42980 23-Mar-95 M 2920710-May-86 M 40927 7-Apr-89 M 14845 15-Nov-66 M 28574 14-JuI-80 M 4222713-Apr-81 M 42041 14-Sep-71 M 43114 26-May-93 F 4453916-Dec-92 M 4349 27-Dec-69 M 46246 29-JuI-92 F 40087 7-Mar-86 M 46026 30-Sep-97 M 44896 14-JuI-82 F 4346 21-Nov-69 M 41247 13-Dec-88 M 44365 3-Jan-92 F 43664 31-Oct-87 M 11782 22-Jan-72 M 46337 17-May-80 M 2930716-Dec-85 M 26972 31-Oct-62 M 40039 20-Sep-75 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 37,999.99 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 131,915.72 Fire Union Fulltime-Regular #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 93,378.89 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 113,760.59 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 111,847.63 AFSCME Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Probationary #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,346.47 AFSCME Fulltime-Regular #NIA #NIA $ 64,661.79 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 92,017.12 AFSCME Fulltime-Regular #NIA #NIA $ 192,618.18 Police Executives Fulltime-Regular 04/06/22 #NIA $ 87,635.60 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 83,511.87 AFSCME Fulltime-Regular #NIA #NIA $ 101,448.88 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,452.78 Sanitation Union Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 83,346.24 AFSCME Fulltime-Regular #NIA #N/A $ 142,748.74 AFSCME Fulltime-Regular #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 153,336.81 AFSCME Fulltime-Regular #NIA #N/A $ 42,154.32 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 55,857.56 Police Trainees Probationary #NIA #NIA $ 79,487.82 AFSCME Fulltime-Regular #NIA #N/A $ 59,314.94 AFSCME Probationary #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,618.08 AFSCME Fulltime-Regular #NIA #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 45,865.24 Fire Union Probationary #NIA #N/A $ 106,521.37 AFSCME Fulltime-Regular #NIA #NIA $ 68,569.28 AFSCME Fulltime-Regular #NIA #N/A $ 117,439.71 AFSCME Fulltime-Regular #NIA #NIA $ 59,174.96 Sanitation Union Fulltime-Regular #NIA #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 83,346.24 AFSCME Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Probationary #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 149,635.42 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 75,531.01 AFSCME Fulltime-Regular #N/A #NIA $ 98,047.76 AFSCME Probationary #NIA #NIA $ 110,512.64 Fire Union Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #NIA #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 42,154.32 AFSCME Probationary #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #N/A $ 91,571.50 Fire Union Fulltime-Regular #NIA #NIA $ 77,081.84 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 76,577.77 Fire Union Fulltime-Regular #NIA #N/A $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 90,986.68 Sanitation Union Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #N/A $ 40,146.91 AFSCME Probationary #NIA #NIA $ 96,618.08 AFSCME Probationary #NIA #NIA $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 58,650.59 Sworn Police Officers Probationary #NIA #NIA $ 88,648.68 Fire Union Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #N/A $ 96,618.08 AFSCME Probationary #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 167,790.04 AFSCME Fulltime-Regular #NIA #NIA $ 38,235.18 AFSCME Probationary #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 144,943.38 AFSCME Fulltime-Regular #NIA #N/A $ 98,627.36 Sworn Police Officers Fulltime-Regular #NIA #NIA Police Officer Police Officer Fire Fighter 96 Hrs Events Worker, T Chief Fire Officer 52/104 Hrs Police Officer Emergency Dispatcher Supervisor, Police Financial Analyst I Contract Compliance Analyst Laborer I Finance Manager Construction Manager Police Officer Labor Crew Ldr 11 Police Officer Property Mgmt Specialist Police Commander Budget And Financial Support Advisor, Sr Police Officer Code Compliance Inspector Civilian Investigative Panel Analyst Senior Financial Analyst Police Officer Waste Col Op II Police Sergeant Maint Mechanic Eng Tech III Impact Fee Coordinator Staff Services Assistant, T Police Officer Fire Fighter 96 Hrs Planning Tech Marinas Manager Account Clerk Police Officer Pol Officer-Prob Code Compliance Field Supervisor Building Services Assistant II Police Officer Police Officer Engineer 11 Maint Mechanic Fire Fighter 96 Hrs Helicopter Pilot Parks Supv 1 Heavy Eqp Mech Supv Waste Collector-Garbg Police Officer Fire Fighter 96 Hrs Auto Mechanic Fire Fighter 96 Hrs Recreation Aide Police Officer Police Officer Real Estate Manager Training and Development Specialist Claims Account Coordinator Fire Captain 96 Hrs Planner 11 Police Lt Grounds Tender Laborer 1 Fire Fighter 52/104hrs Fire Fighter 52/104hrs Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Waste Eqpt Op Police Sergeant Fire Fighter 96 Hrs Grounds Tender Business Systems Administrator Heavy Eqp Mech Supv Police Sergeant Police Officer Fire Lieut 96 Hrs Police Officer 911 Operator (Emergency Call -Taker) Police Officer Fire Fighter 96 Hrs Planning Project Manager Police Officer Oracle Systems Administrator Cashier 11 Police Sergeant Systems Analyst Sr Police Officer 27 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 4379 19-Mar-79 M 23463 22-Apr-71 M 4679218-Oct-98 M 4373310-Aug-87 F 41422 28-Feb-70 M 46774 31-Oct-00 M 42602 21-Mar-95 M 41319 9-Jul-82 M 44526 9-Jun-95 M 46215 6-Dec-97 F 46732 20-Sep-01 F 44320 15-Apr-74 M 42090 9-Jan-88 M 42514 15-Jun-95 M 40823 26-Sep-70 M 20718 24-Feb-66 M 22301 31-Jan-68 M 45377 5-Nov-92 M 42133 23-Aug-88 M 46396 29-Sep-97 M 41474 23-Apr-91 M 29290 29-Mar-85 M 44197 24-Jan-87 M 27842 3-Jan-58 M 44837 11-Jan-85 F 44203 24-Jul-86 M 4638213-Jan-60 M 45378 3-Jul-90 M 43727 24-Aug-84 F 41269 2-Sep-90 M 10765 12-Aug-61 F 16300 7-Nov-66 M 45514 3-Aug-71 M 42308 20-Jun-98 F 40568 17-May-54 M 27235 2-Nov-75 M 41211 2-Nov-85 M 43083 21-Nov-91 M 4447619-Jul-89 F 41354 22-Sep-93 M 19993 19-Jul-65 M 40088 3-Aug-82 M 41871 12-Dec-92 M 42739 3-Dec-88 F 4352716-Jan-93 M 28434 2-Jan-79 M 42855 9-Aug-88 M 43637 11-Feb-82 M 41410 25-Feb-87 M 45452 17-Jan-84 M 40893 3-Jun-81 M 20797 28-Sep-61 F 25587 20-Aug-74 F 43915 9-Aug-64 F 41925 9-Dec-91 F 42474 29-May-91 M 40815 8-Jun-51 M 28566 29-Dec-84 F 46582 7-Dec-93 F 2503810-Apr-55 M 46939 20-Nov-60 M 4289515-May-92 M 27048 11-Sep-80 M 23584 26-Oct-74 M 27525 26-Feb-69 M 25504 27-Jul-77 M 41010 27-Mar-63 M 13612 12-Aug-63 M 41412 15-Aug-86 M 2583816-Sep-83 M 27015 14-Apr-78 F 4429 11-Jun-77 F 2834615-Jan-76 F 46510 28-Aug-95 F 4264219-Sep-80 M 27492 30-Jun-71 F 40785 11-Feb-85 M 4359619-Sep-84 M 46275 7-Oct-88 M 4092810-Jan-89 M 45576 28-Sep-95 F 4460517-Jul-76 M 45952 12-Mar-00 M 2649617-Apr-80 M 40595 9-Oct-73 M 21673 16-Apr-59 F 27593 30-Jun-72 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,278.67 Fire Union Fulltime-Regular #N/A #N/A $ 42,910.40 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 156,131.50 AFSCME Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 204,211.84 Executives Fulltime-Regular 01/01/18 #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 39,968.65 Sanitation Union Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,535.20 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 106,521.38 AFSCME Probationary #N/A #N/A $ 113,566.98 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 101,448.88 AFSCME Fulltime-Regular #N/A #N/A $ 143,738.08 Police Executives Fulltime-Regular 01/01/24 #N/A $ 66,252.24 AFSCME Probationary #N/A #N/A $ 113,278.67 Fire Union Fulltime-Regular #N/A #N/A $ 46,059.10 Sanitation Union Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,278.67 Fire Union Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 46,268.76 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 93,591.16 AFSCME Fulltime-Regular #N/A #N/A $ 91,889.66 AFSCME Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Probationary #N/A #N/A $ 71,997.53 AFSCME Fulltime-Regular #N/A #N/A $ 49,999.99 Unclassified Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 193,878.44 Executives Fulltime-Regular 01/01/18 #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 122,224.76 AFSCME Fulltime-Regular #N/A #N/A $ 103,184.18 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 103,184.27 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 135,843.56 Unclassified Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,488.27 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 142,509.77 AFSCME Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 90,866.67 Fire Union Fulltime-Regular #N/A #N/A Police Sergeant Fire Captain 80 Hours Administrative Aide II, T Code Compliance Field Supervisor Chief Project Manager Pol Officer-Prob Police Officer Police Officer Police Officer Police Teletype Operator Pol Officer-Prob Director of Building Fire Fighter 96 Hrs Police Officer Plumber Waste Collector-Garbg Fire Fighter 80 Hrs Police Officer Communications Technical Operator Staff Services Assistant, T Fire Fighter 96 Hrs Police Sergeant Police Officer Laborer I Professional Engineer II Programmer Sr General Laborer, T. Police Officer Project Manager - CIP (Vertical) Sergeant -At -Arms Admin Aide II Fire Captain 80 Hours Waste Col Op II Police Officer Information Clerk Police Sergeant Police Officer Marinas Aide Emergency Dispatcher Police Officer Fire Captain 80 Hours Fire Lieut 96 Hrs Waste Collector-Garbg Public Service Aide Police Officer Fire Fighter 96 Hrs Police Officer Police Officer Fire Fighter 96 Hrs Financial Analyst I Emergency Dispatcher Admin Asst I Records Systems Specialist Contract Compliance Analyst Crime Scene Investigator I Police Officer Parks Supv I Police Sergeant Therapeutic Recreation Spec Greenskeeper District Aide (Elected Official) Police Officer Police Officer Ast Dir Human Resources Welder Fire Fighter 52/104hrs Mech Insp Chief Code Compliance Inspector Fire Fighter 96 Hrs Mason Parks & Recreation Mgr II Pol Prop Spec I Labor Reins Splt, Sr Police Officer Laborer I Police Officer Fire Lieut 80 Hrs Police Officer Maint Mech Supv Fire Fighter 96 Hrs Police Officer Mason Laborer I Fire Lieut 96 Hrs Professional Engineer III-Floodplain Administrator Engineer II Fire Lieut 80 Hrs 28 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 41301 7-Nov-91 F 23300 19-May-76 M 40804 6-May-67 M 25314 1-Jul-82 F 23430 9-Oct-72 F 4454 7-Jan-77 F 29091 23-Oct-91 M 40814 17-Feb-62 F 42525 8-Dec-82 M 46544 28-Apr-92 M 43870 25-Sep-80 F 44405 4-Oct-89 F 28265 9-Jan-90 F 42244 1-May-92 M 44361 5-Mar-92 M 40873 21-Sep-84 M 29101 2-Dec-79 M 4212 7-Mar-76 F 42599 2-Feb-71 F 45458 2-Jul-95 M 42963 20-Dec-85 M 2529418-Oct-68 F 26024 12-Aug-73 M 15071 23-Jun-72 F 41635 14-Sep-85 F 4452318-Apr-67 M 29352 8-Sep-73 M 45879 27-Mar-01 F 42600 10-May-82 M 46435 21-Sep-72 F 42034 19-Jul-91 M 4602 25-Nov-68 M 40929 9-Aug-83 M 26303 9-Sep-59 M 43460 3-Dec-89 F 25437 27-Aug-56 F 26375 19-May-66 F 44140 19-Apr-87 M 28395 25-Sep-61 M 41959 22-Jun-91 M 22339 12-Aug-68 M 29291 3-Nov-70 M 28489 26-Apr-83 F 43661 19-Jul-83 F 1749 26-Mar-63 F 41414 1-Jan-79 M 4282817-Sep-88 M 4358615-Sep-58 M 26349 12-May-81 M 26351 2-Oct-64 F 46912 22-Feb-70 M 28368 9-Jul-79 M 41731 2-Aug-50 M 42656 21-Oct-75 M 41498 23-Nov-83 M 2923818-Dec-75 M 43166 7-Aug-87 M 26392 3-Mar-81 M 25704 20-Mar-78 F 27827 8-Mar-52 F 44544 29-Aug-96 M 13286 17-Feb-72 F 42792 9-Oct-84 F 29209 3-Oct-85 M 46484 29-Feb-84 M 42568 27-Sep-84 M 45379 21-Dec-91 M 45908 11-Feb-89 M 46223 29-Sep-88 M 2447716-Nov-72 M 26987 12-Apr-79 M 41849 23-Aug-91 M 45451 9-Mar-90 M 42458 3-Feb-97 F 40240 14-Mar-57 F 27887 25-Jul-83 F 42962 20-Oct-70 M 2852218-Aug-88 F 43052 25-Mar-88 M 43776 12-Apr-95 M 4691 27-Feb-78 M 4285318-Apr-91 M 43187 24-May-89 F 4686 5-Nov-68 F 42123 30-Apr-70 M 46434 2-Aug-82 F 40849 30-May-90 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 102,950.14 AFSCME Fulltime-Regular #N/A #N/A $ 58,918.08 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 123,311.76 Unclassified Fulltime-Regular #N/A #N/A $ 96,265.10 AFSCME Probationary #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 144,614.62 AFSCME Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 71,893.26 Managerial/Confidential Probationary #N/A #N/A $ 92,017.12 AFSCME Probationary #N/A #N/A $ 100,084.60 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 82,276.69 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 129,477.62 Unclassified Fulltime-Regular #N/A #N/A $ 82,465.84 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 53,561.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 59,051.61 Sanitation Union Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 61,330.25 AFSCME Fulltime-Regular #N/A #N/A $ 82,465.84 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 67,680.28 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 202,285.01 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 123,385.21 Unclassified Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 91,889.61 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 46,268.76 Sanitation Union Fulltime-Regular #N/A #N/A $ 140,063.61 Unclassified Fulltime-Regular #N/A #N/A $ 130,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 96,618.08 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,809.47 Sanitation Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 151,385.32 Unclassified Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 77,726.27 AFSCME Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 87,159.11 Fire Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Probationary #N/A #N/A $ 119,245.18 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 Managerial/Confidential Probationary #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A Public Service Aide Parks Recreation Coordinator Waste Col Op I Rec Specialist Admin Asst 11 Risk Management Specialist Rec Specialist Waste Collector-Garbg IT Security Supervisor Police Officer Building Services Assistant 11 Senior Legal Assistant Zoning Plans Examiner Police Sergeant Police Officer Emergency Dispatcher Police Sergeant Police Officer Accountant IT Security Analyst Building Services Assistant III Assistant to the Assistant City Manager Fire Fighter 96 Hrs Sanitation Inspector I 911 Operator (Emergency Call -Taker) Safety Officer Waste Collector-Garbg Emergency Dispatcher Police Officer Information & Referral Aide, T Group Insurance Aide Police Officer Fire Fighter 96 Hrs Waste Collector-Garbg Fire Supplies Clerk 11. Pol Prop Spec I Fire Fighter 96 Hrs Parks Supv I Painter Police Officer Asst Chief Fire Police Officer Capital Improvmt Prog Budget/Financ Admi Special Projects Assistant Interrogat Steno Fire Fighter 96 Hrs Building Services Assistant 11 OCI Program Coordinator - External Waste Collector-Garbg Admin Asst III Deputy Chief of Staff (Elected Official) Laborer 1 Senior Procurement Contracting Officer Police Officer Fire Fighter 96 Hrs Police Officer Police Officer Waste Eqpt Op Code Compliance Inspector Typist Clerk 11 Police Officer Asst to Director, Building Special Projects Coordinator Fire Lieut 96 Hrs Plumbing Inspector Police Officer Police Officer Code Compliance Inspector Police Officer Fire Fighter 80 Hrs Fire Fighter 52/104hrs Fire Fighter 96 Hrs Heavy Eqp Mech Emergency Dispatcher Programmer Sr Police Sergeant Code Compliance Inspector Public Service Aide Fire Fighter 96 Hrs Police Officer Police Officer Police Officer Public Service Aide Pol Prop Spec 1 Heavy Eqp Mech Human Resources Generalist Police Officer 29 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 43306 25-Aug-71 F 4607615-Oct-91 M 40555 24-Oct-89 F 41712 26-Jul-85 F 28049 11-Jan-72 M 2699717-Dec-82 M 41374 6-Jan-90 M 45521 10-Aug-68 M 40026 25-Feb-92 M 23317 19-Mar-72 M 42033 21-Jul-89 M 25211 10-Feb-62 F 26713 12-Apr-74 F 23552 22-Feb-73 F 44300 12-Jul-90 F 42013 6-Jun-92 F 42719 12-Dec-90 F 41505 13-Mar-86 M 2348717-May-67 F 41588 11-Aug-96 F 41844 3-Oct-89 M 25998 8-Jan-78 M 4256915-Jul-73 M 42008 6-Apr-52 M 28873 24-Feb-65 M 42560 18-Feb-77 M 28179 24-Sep-83 M 43614 30-Aug-93 F 29375 1-May-64 M 4725 27-Sep-69 M 2303716-Feb-74 F 23883 28-Jan-79 M 28098 21-Aug-60 F 45409 30-Sep-93 M 4733 22-Apr-81 M 27547 5-Aug-83 M 42556 22-Aug-95 M 28615 6-Jun-87 M 42800 24-Dec-89 M 24685 13-May-72 M 24727 14-Nov-69 F 2549418-Sep-70 M 41568 14-Jul-97 M 43124 21-Aug-92 M 27960 4-Nov-78 M 43644 31-Jan-83 F 43002 24-Mar-77 M 43394 25-Jul-81 M 44402 26-Apr-80 M 42622 1-Sep-79 M 23998 5-JuI-61 M 42994 14-Jan-87 M 41535 18-Dec-93 M 28109 23-Dec-66 F 44923 22-Nov-80 M 40806 9-Jun-73 F 29376 22-Dec-64 M 24257 4-Feb-71 M 46307 23-Jan-93 F 29400 14-Jan-81 M 4304810-Aug-89 M 4760 10-JuI-68 M 2869410-JuI-68 M 45478 4-Mar-70 F 26218 6-Jan-60 M 28523 28-Mar-78 F 41001 14-Sep-94 M 28404 21-Jan-84 F 25503 12-Aug-75 M 4787 30-Oct-83 F 4259313-Aug-82 F 19652 11-JuI-71 M 46879 14-Nov-00 M 18197 19-Aug-71 F 46641 18-Mar-86 F 44354 4-Mar-88 M 29344 29-May-74 M 46667 24-Jun-01 M 13703 8-Oct-66 F 29409 26-Aug-65 M 46922 9-Oct-90 M 46901 3-Sep-92 F 2607716-Aug-84 F 40908 30-Oct-85 M 4093010-Nov-87 M 13733 20-Jan-76 M 4549619-Nov-56 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 40,146.91 AFSCME Probationary #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 92,017.40 AFSCME Fulltime-Regular #N/A #N/A $ 74,855.04 Sanitation Union Fulltime-Regular #N/A #N/A $ 107,817.21 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 98,975.34 AFSCME Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,025.39 Sanitation Union Fulltime-Regular #N/A #N/A $ 343,155.05 City Attorney Fulltime-Regular 01/01/18 #N/A $ 119,531.32 Unclassified Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 111,847.63 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 103,420.42 Fire Union Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 34,680.46 AFSCME Probationary #N/A #N/A $ 48,471.90 Sanitation Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 103,184.18 AFSCME Fulltime-Regular #N/A #N/A $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 61,863.98 Sanitation Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 97,853.39 Fire Union Fulltime-Regular #N/A #N/A $ 98,443.42 AFSCME Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 55,749.65 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,866.67 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 195,067.27 Executives Fulltime-Regular 01/01/18 #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 81,053.48 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 56,239.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Probationary #N/A #N/A $ 113,760.59 AFSCME Fulltime-Regular #N/A #N/A $ 57,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 110,000.00 Executives Fulltime-Regular 06/21/23 #N/A $ 90,710.46 AFSCME Fulltime-Regular #N/A #N/A $ 96,483.85 AFSCME Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 175,134.00 Executives Fulltime-Regular 01/01/18 #N/A $ 53,561.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 37,500.00 Unclassified Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Probationary #N/A #N/A $ 86,488.27 Fire Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 142,058.69 Fire Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A Aquatic Specialist Police Officer 911 Operator (Emergency Call -Taker) Special Projects Coordinator Waste Eqpt Op Fire Captain 96 Hrs Police Officer Senior Plumbing Inspector Fire Fighter 96 Hrs Fire Fighter 80 Hrs Police Officer Waste Col Op II City Attorney Admin Asst II Police Officer Police Officer Police Officer Code Compliance Inspector Sanitation Supervisor Rec Specialist Fire Fighter 96 Hrs Fire Lieut 52/104 Hrs Waste Collector-Garbg Laborer I Laborer I Waste Col Op I Police Officer Police Officer Police Officer Police Officer Code Compliance Inspector Code Compliance Inspector Waste Col Op I Laborer I Police Sergeant Police Officer Police Officer Police Sergeant Police Officer Fire Lieut 80 Hrs Admin Asst I Fire Lieut 96 Hrs Fire Fighter 96 Hrs Police Officer Fire Lieut 80 Hrs Fleet Management Representative Heavy Eqp Mech Police Officer Police Officer Police Officer Assistant Director, Management and Budget Police Officer Police Officer Legal Assistant Code Compliance Inspector Payroll Clerk Police Officer Fire Captain 52/104 Hrs Pol Prop Spec I Crime Scene Investigator 11 Fire Fighter 96 Hrs Police Officer Police Officer 911 Operator (Emergency Call -Taker) Waste Collector-Garbg Crime Scene Investigator 1 Parks Supv 1 Police Officer Fire Fighter 52/104hrs Police Officer Pol Prop Spec II Parks & Recreation Mgr 11 Community Liaison (Elected Official) Sanitation Inspector 1 Asst City Attorny IT Security Analyst Public Wks Supv Public Service Aide Executive Secretary-Csb Waste Collector-Garbg District Service Worker (Elected Official) Resilience Programs Manager Fire Lieut 80 Hrs Police Officer Fire Fighter 96 Hrs Chief Fire Officer 52/104 Hrs Eng Tech III 30 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 19397 28-Sep-56 F 46868 12-Mar-76 M 44326 4-Dec-84 M 42611 22-Nov-78 M 2882315-Feb-52 M 44243 6-Apr-53 F 23626 2-Apr-76 M 4808 14-Jul-75 F 28573 29-Jun-80 M 41732 9-Mar-88 M 28583 5-Jul-80 M 46370 27-Oct-75 M 42052 2-Oct-66 M 40821 26-May-89 M 2549515-Apr-72 M 27660 2-Jul-63 M 40475 4-Aug-66 M 4352612-Sep-85 M 40931 6-Jun-81 M 45943 27-Dec-85 F 41485 8-Aug-89 M 42609 8-Sep-80 M 42845 30-Jun-94 M 41664 11-Aug-88 M 43555 24-Mar-90 M 41221 7-Dec-82 F 42959 6-Dec-57 F 40784 27-May-87 M 46358 27-Nov-73 F 40901 15-Mar-81 M 43639 2-Jul-92 M 2446310-Nov-64 M 41929 11-Jul-81 M 23466 7-Dec-67 M 4860 14-Jul-76 F 25358 5-Mar-77 F 4592518-Oct-89 F 25943 11-Jan-83 F 45585 14-Nov-01 F 4234918-Nov-96 M 45775 14-Feb-95 M 42603 29-Sep-88 M 43005 10-May-95 M 41529 8-Feb-92 M 6933 28-Feb-70 F 45351 12-Mar-87 F 19421 27-May-59 M 27518 22-Sep-60 M 29113 13-Jan-65 M 2864918-Mar-76 M 25453 7-Feb-67 M 44981 12-Sep-63 M 46834 22-Apr-77 M 45827 28-Jul-76 M 40783 5-Mar-88 M 41131 23-Feb-75 F 45380 25-Oct-96 F 41246 31-Jul-87 M 28461 28-Feb-83 M 45366 27-Jan-89 M 40456 23-Feb-73 M 40105 19-Dec-69 F 41985 26-May-94 F 4886 23-Oct-70 M 44889 12-Mar-91 M 28819 1-Mar-85 F 41403 18-Dec-82 F 44331 23-Jul-96 M 28593 3-Jul-85 M 46504 19-Jan-74 F 45670 20-Mar-64 M 44250 14-Aug-89 M 4692910-Oct-97 F 28545 26-Mar-63 M 28091 13-Oct-70 F 44813 8-Apr-94 M 45365 23-Aug-88 M 46029 27-Sep-96 M 42633 18-Jul-91 M 46338 9-Sep-69 M 27908 1-Feb-81 M 28795 8-Jun-86 M 44351 6-Jan-97 M 44357 11-Jan-92 M 4285813-Jan-92 F 42564 27-Aug-87 F 28352 20-Apr-84 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 84,889.89 AFSCME Fulltime-Regular #N/A #NIA $ 50,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 60,000.00 Unclassified Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 119,519.85 AFSCME Fulltime-Regular #N/A #NIA $ 37,835.20 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 113,275.46 Fire Union Fulltime-Regular #N/A #NIA $ 93,591.38 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 42,154.32 AFSCME Fulltime-Regular #NIA #NIA $ 87,635.60 AFSCME Fulltime-Regular #N/A #NIA $ 109,334.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 84,527.53 Fire Union Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 96,554.84 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #N/A $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Probationary #NIA #N/A $ 83,768.25 Detention Officer Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 142,748.74 AFSCME Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 103,184.33 AFSCME Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #N/A $ 87,513.87 AFSCME Fulltime-Regular #NIA #NIA $ 143,325.00 Executives Fulltime-Regular 01/31/22 #N/A $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Fulltime-Regular #NIA #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 57,512.00 Temporary Fulltime Fulltime-Temporary #NIA #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 167,248.62 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #N/A #NIA $ 89,134.61 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 137,000.00 Executives Fulltime-Regular 05/13/19 #NIA $ 56,472.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 39,968.65 Sanitation Union Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 105,187.43 Fire Union Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Probationary #NIA #NIA $ 40,664.99 AFSCME Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 262,395.00 Police Executives Fulltime-Regular 01/01/18 #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 91,681.40 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 91,889.66 AFSCME Fulltime-Regular #NIA #NIA $ 58,650.59 Sworn Police Officers Probationary #NIA #N/A $ 36,545.60 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Probationary #NIA #NIA $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA $ 152,190.57 AFSCME Fulltime-Regular #NIA #NIA $ 58,537.19 Fire Union Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 85,693.08 AFSCME Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA Fiscal Assistant District Coordinator (Elected Official) Special Advisor (Elected Official) Carpenter Project Manager - Cip Early Childhood Educator, T Fire Captain 96 Hrs Emergency Dispatcher Police Officer Police Officer Police Officer Heavy Eqp Mech Helper Electrician Police Sergeant Fire Fighter 96 Hrs Info & Referral Specialist (Homeless Program) Police Officer Auto Eqp Op II Fire Fighter 96 Hrs Customer Service Representative Fire Fighter 96 Hrs Police Officer Police Officer Police Officer Police Officer Police Officer Specialized Fitness Instructor Fire Fighter 96 Hrs Senior Digital Communications Specialist Detention Officer Police Officer Zoning Information Supervisor Police Officer Engineer I Business Tax Receipts Aide Parks & Recreation Mgr II Sr Exec Asst to CM for Strategic Engagement (VM) Code Compliance Inspector Emergency Dispatcher Police Officer Automotive Service Writer Police Officer Clerk I Police Officer Victims Advocate (Witness Coordinator), T Police Officer Executive Officer to the Fire Chief Waste Col Op II Parks & Recreation Mgr II Police Officer Auto Eqp Op II Asst Director, Parks & Recreation (Construction) Special Projects Assistant, T Waste Collector-Garbg Fire Fighter 96 Hrs Cashier I Police Officer Fire Fighter 96 Hrs Fire Captain 96 Hrs Code Compliance Inspector Building Services Assistant III Info & Referral Aide Police Officer Chief Of Police Emergency Dispatcher Admin Asst I Fire Fighter 96 Hrs Police Officer Parks & Recreation Mgr II Police Officer Maintenance Mechanic, T Police Officer Emergency Dispatcher Laborer I Data Base Manager Fire Fighter 96 Hrs Senior Code Compliance Inspector Staff Services Assistant, T Police Officer Plumbing Inspector Police Sergeant Police Officer Police Officer Police Officer Police Officer Investigator, Civilian Investig Panel Police Officer 31 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 27365 18-Jan-84 F 28820 29-May-80 F 25289 4-May-77 F 25006 26-Jun-75 M 28732 7-Oct-67 M 43570 22-Feb-74 M 41526 22-Dec-77 M 46763 22-Nov-97 F 44376 3-Jan-82 F 28678 26-Dec-86 F 42235 14-Sep-82 M 27325 20-May-77 M 44985 23-Nov-93 F 41245 19-Mar-87 M 44756 5-Oct-86 M 42236 12-Jul-90 M 23476 17-May-80 F 23477 22-Feb-77 M 4954 23-Aug-68 M 4952 21-Jul-64 M 41776 7-Feb-85 M 45886 30-Apr-83 M 46100 3-Feb-90 F 2787518-Dec-76 M 4625818-Nov-95 F 40631 1-Nov-90 F 46530 7-Jan-91 M 4453818-Dec-91 M 41244 26-Aug-86 F 24480 27-Nov-82 M 24168 3-Nov-81 F 45381 1-Dec-97 F 2339312-Oct-80 F 41471 2-May-92 M 41842 25-Aug-90 M 44377 11-Nov-71 M 45489 6-May-84 F 27473 11-May-80 M 45954 4-Aug-82 F 43861 31-Aug-91 F 4207519-Mar-78 M 26358 24-Mar-68 M 2449515-Dec-80 M 29115 20-Dec-79 F 41911 25-Oct-90 F 46419 14-Nov-88 M 44864 6-Sep-82 M 26034 7-Nov-76 M 40040 3-Oct-82 M 41840 25-Mar-86 M 40045 23-Jul-81 M 46278 14-May-75 M 44398 22-Nov-90 F 41875 15-Aug-92 M 45422 11-Apr-81 M 43006 3-Feb-82 M 43477 29-Sep-82 M 45631 5-Mar-76 M 41440 27-Dec-66 M 26998 22-Dec-80 M 42827 25-Jan-87 F 2705310-Dec-77 F 46295 20-May-97 M 40772 3-Jul-76 F 41242 8-Jul-87 M 45701 30-Nov-91 M 46734 23-Nov-95 F 44940 21-Dec-94 M 40870 2-Apr-71 M 43015 15-Aug-82 F 27821 6-Feb-80 F 45431 8-Jun-60 M 45901 13-Apr-82 F 27399 12-Mar-84 M 1888 28-Sep-67 F 45508 8-Jun-73 M 46359 15-Feb-90 F 28571 9-Feb-82 M 44302 22-Oct-72 M 41381 30-Jan-78 F 41240 9-Aug-91 M 12109 24-Dec-71 M 27511 13-Jul-80 M 23874 14-Feb-72 M 28555 23-Jun-63 M 41511 30-Mar-93 M 525312-Oct-67 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 65,395.20 AFSCME Fulltime-Regular #N/A #NIA $ 75,702.84 AFSCME Probationary #NIA #NIA $ 139,714.67 Executives Fulltime-Regular 01/10/23 #NIA $ 91,571.50 Fire Union Fulltime-Regular #NIA #NIA $ 68,705.39 AFSCME Fulltime-Regular #N/A #NIA $ 75,702.84 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 40,146.91 AFSCME Probationary #N/A #NIA $ 36,414.56 AFSCME Probationary #N/A #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 90,866.67 Fire Union Fulltime-Regular #N/A #NIA $ 87,635.60 AFSCME Fulltime-Regular #N/A #NIA $ 86,486.40 Fire Union Fulltime-Regular #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 147,870.81 Executives Fulltime-Regular 01/01/18 06/01/18 $ 117,574.95 AFSCME Fulltime-Regular #N/A #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 100,747.48 AFSCME Fulltime-Regular #N/A #NIA $ 96,483.85 AFSCME Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Probationary #N/A #NIA $ 51,238.51 AFSCME Probationary #N/A #NIA $ 45,865.24 Fire Union Probationary #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 71,128.51 Sanitation Union Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #NIA $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Probationary #N/A #N/A $ 65,395.20 AFSCME _ Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 64,809.47 Sanitation Union Fulltime-Regular #N/A #NIA $ 167,248.62 Fire Executives Fulltime-Regular 09/14/22 09/14/22 $ 92,072.06 AFSCME Fulltime-Regular #NIA #NIA $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Probationary #NIA #NIA $ 50,895.52 Sanitation Union Fulltime-Regular #N/A #N/A $ 108,098.22 AFSCME Probationary #N/A #NIA $ 113,914.52 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 77,081.84 Fire Union Fulltime-Regular #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 56,170.19 AFSCME Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,200.58 Unclassified Fulltime-Regular #N/A #NIA $ 109,120.34 AFSCME Fulltime-Regular #N/A #NIA $ 80,456.27 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #NIA $ 57,642.54 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Probationary #N/A #NIA $ 53,800.44 AFSCME Fulltime-Regular #N/A #NIA $ 61,863.98 Sanitation Union Fulltime-Regular #N/A #NIA $ 83,346.47 AFSCME Fulltime-Regular #N/A #NIA $ 120,394.32 Executives Fulltime-Regular 01/25/21 #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Probationary #N/A #NIA $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 127,701.45 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 128,890.87 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA 911 Operator (Emergency Call -Taker) Building Services Assistant IV Assistant Director, Parks & Rec (Administration) Fire Fighter 52/104hrs Case Management Assistant Auto Mech Supv Police Officer Eng Tech I Senior Park Ranger Auto Eqp Op 11 Fire Fighter 96 Hrs Fire Lieut 80 Hrs Latent Print Examiner Fire Lieut 96 Hrs Police Officer Fire Fighter 96 Hrs Asst Dir Solid Waste Chief of Code Compliance Police Officer Police Sergeant Police Officer Facility Maintenance Manager Building Inspector Public Wks Supv Police Officer Public Service Aide Fire Fighter 96 Hrs Police Officer Fire Fighter 96 Hrs Waste Eqpt Op Rec Specialist Crime Scene Investigator I Parks & Recreation Mgr 1 Fire Fighter 96 Hrs Fire Fighter 96 Hrs Planner II Hearing Board Specialist 11 Police Sergeant Building Services Assistant 11 Emergency Dispatcher Fire Fighter 96 Hrs Waste Eqpt Op Executive Officer to the Fire Chief GF Budget and Financial Support Advisor Crime Scene Investigator 11 Planner II Waste Col Op 1 GF Budget and Financial Support Advisor Police Sergeant Fire Fighter 52/104hrs Police Officer Information Technology Technician II Police Officer Police Officer Emergency Dispatcher Police Officer Police Officer Commissioner's Aide Senior Elevator Inspector Fire Fighter 80 Hrs Police Officer Clerk 1 Fire Fighter 96 Hrs Crime Prevention Specialist Fire Fighter 96 Hrs Police Officer Pol Officer-Prob Police Officer Laborer I Sanitation Inspector 1 Police Sergeant Eng Tech III Emergency Dispatcher Waste Col Op 1 911 Operator (Emergency Call -Taker) Assistant Director, Code Compliance Customer Service Representative Police Officer Marinas Manager, Asst. Admin Aide 1 Fire Fighter 96 Hrs Staff Analyst Prncpl Police Officer Fire Captain 52/104 Hrs Senior Project Manager - OCI Police Officer Police Officer 32 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 27490 20-Jan-82 M 29520 7-Jul-63 M 45594 22-May-66 F 2927517-Jul-56 M 2549610-Nov-73 M 40291 1-Aug-84 M 28254 22-Mar-63 F 5267 25-Jun-76 M 41458 5-Dec-91 M 46346 31-Oct-79 F 46028 8-Oct-90 M 43564 14-Apr-81 F 41265 12-Feb-87 M 41334 25-Aug-90 M 46075 9-Nov-01 M 44537 26-Dec-79 M 2597710-Oct-81 M 44312 23-Mar-64 M 45455 5-Nov-67 M 45570 26-Jun-97 M 2934015-Jul-76 F 45968 1-Feb-66 F 2620217-Nov-73 F 44955 12-Jul-64 M 43482 5-Oct-92 M 26628 8-Nov-70 M 25502 20-Oct-76 M 29349 28-Sep-67 M 41617 5-Jul-77 M 41684 21-Dec-83 M 41958 22-Jan-85 F 15028 4-Nov-60 M 45552 11-Feb-00 M 41271 15-Dec-86 M 45798 27-Apr-94 M 27619 7-Aug-74 M 40352 7-Jan-51 M 27356 20-Sep-58 M 27080 9-Mar-70 M 2932418-Feb-82 M 19568 17-Mar-61 F 29245 1-Apr-70 M 24515 17-Sep-78 F 2792815-Sep-63 F 18866 23-Sep-73 M 25397 20-Oct-73 F 4252618-Sep-87 M 2744218-Aug-66 M 23264 11-Apr-73 F 45353 2-Jun-96 F 42770 5-Sep-92 F 25279 22-Sep-64 M 2938917-Sep-66 F 29424 6-Feb-60 M 27295 28-May-69 F 27461 28-Feb-85 M 46789 26-Mar-93 F 43803 14-Jul-81 F 4082610-Nov-81 M 45944 22-Mar-93 F 40090 28-Sep-83 M 45341 17-Apr-00 M 41847 2-Feb-89 M 40292 25-Mar-86 M 41516 31-Oct-74 F 2799417-Jan-83 M 23881 19-Feb-80 M 41770 31-Aug-90 M 40202 6-May-69 M 40850 5-Jul-87 M 26007 30-Aug-77 M 5418 26-Jun-79 M 46189 7-Jul-82 F 41662 10-Oct-90 M 42076 27-Mar-74 M 5422 15-May-66 M 41825 6-Apr-91 F 42077 23-Jan-82 M 26153 28-Jul-78 M 40561 7-Jan-54 F 42931 18-Aug-85 F 41239 29-Dec-89 M 4207817-Aug-89 M 40966 24-Sep-54 M 43617 16-Jun-72 F 44237 24-Mar-90 M 4538217-Sep-98 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 45,760.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 194,576.04 Police Executives Fulltime-Regular 10/17/22 #N/A $ 105,088.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 56,174.99 Unclassified Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,239.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 144,943.37 AFSCME Fulltime-Regular #N/A #N/A $ 399,832.11 Executives Fulltime-Regular 02/24/20 02/24/20 $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 75,597.84 AFSCME Fulltime-Regular #N/A #N/A $ 59,999.99 Unclassified Fulltime-Regular #N/A #N/A $ 123,311.76 Unclassified Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 103,184.30 AFSCME Fulltime-Regular #N/A #N/A $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 123,311.76 AFSCME Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 78,776.67 Sanitation Union Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 98,436.95 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 131,467.97 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 98,627.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 142,628.93 AFSCME Fulltime-Regular #N/A #N/A $ 62,317.84 AFSCME Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 176,179.43 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 119,448.59 AFSCME Fulltime-Regular #N/A #N/A $ 114,162.23 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,141.85 AFSCME Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 141,903.33 AFSCME Fulltime-Regular #N/A #N/A $ 111,504.63 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 76,577.77 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 82,368.00 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 53,832.68 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 115,919.61 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 95,465.01 Fire Union Fulltime-Regular #N/A #N/A $ 158,104.12 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 121,275.00 Unclassified Fulltime-Regular #N/A #N/A $ 96,675.54 AFSCME Fulltime-Regular #N/A #N/A $ 101,448.88 AFSCME Probationary #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A Police Sergeant Lifeguard II, T Staff Services Assistant, T Laborer I Fire Lieut 96 Hrs Fire Fighter 96 Hrs Admin Aide I Executive Officer to the Police Chief Police Sergeant Code Compliance Inspector Commissioner's Aide Building Services Assistant II Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer Police Officer Waste Collector-Garbg IT Project Manager City Manager Fire Fighter 96 Hrs Emergency Dispatcher Commissioner's Aide Asst to the Equal Opportunity/Diversity Prog Admin Senior Staff Analyst Police Officer Videographer/Editor Fire Captain 52/104 Hrs Laborer I Senior Planning Project Manager Parks & Recreation Mgr II Admin Aide I Waste Col Op II Fire Fighter 96 Hrs Police Officer Cashier II Fire Lieut 52/104 Hrs Laborer I Programmer Sr Police Officer Police Officer Recreation Aide Police Officer Chief of Environmental Resources Admin Aide I Fire Fighter 80 Hrs Applications Support Supervisor Police Officer Hvacr Supervisor Records System Coordinator Public Service Aide Police Officer Admin Aide II Engineer I Senior Construction Manager Spec Projects Coord Marinas Supervisor Creative Content Videographer/Editor Police Officer Laborer I Building Services Assistant II Fire Fighter 96 Hrs Building Services Assistant II Fire Lieut 96 Hrs Fire Fighter 96 Hrs Administrative Clerk Videographer /Editor Code Compliance Coordinator Police Officer Marinas Faclt Att Police Officer Fire Lieut 96 Hrs Police Captain Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Chief of Staff (Elected Official) Admin Asst II Parks Capital Program Administrator Fire Fighter 96 Hrs Fire Fighter 96 Hrs Building Services Assistant IV Police Officer Police Officer Police Officer 33 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 25841 27-Sep-72 M 40339 12-Jun-61 M 44241 28-Feb-65 F 40782 7-Jul-87 M 41197 16-Aug-70 M 41220 28-Feb-90 M 4433415-Mar-90 F 26999 29-Aug-71 M 25091 12-Feb-74 M 28567 27-Aug-78 M 40236 8-Nov-67 F 44847 23-Feb-97 M 46765 28-Mar-77 F 45831 6-Mar-94 M 28462 6-Nov-84 M 40932 7-Jul-86 M 41087 17-Nov-84 M 41470 7-Feb-89 M 5451 12-Aug-82 M 27012 17-Aug-73 M 27326 12-Dec-78 M 41874 21-Aug-86 F 45491 1-Mar-68 F 43476 20-Apr-89 M 4367313-Dec-91 M 46311 24-Mar-49 M 29239 22-Feb-75 M 2387215-Jan-57 M 11641 3-Nov-77 F 4022715-Oct-55 M 26211 11-Sep-68 F 2524413-Dec-65 M 4085418-Apr-82 M 41454 2-Oct-67 M 5469 3-Jun-66 M 2408412-Oct-69 F 41881 7-Aug-84 F 1473 14-Nov-77 F 5475 8-Jun-70 M 46866 12-Jun-63 M 27077 28-Oct-79 M 2600518-Aug-66 M 44543 3-Oct-98 M 4629615-Mar-95 M 4683813-Apr-99 M 42685 28-Dec-93 M 46852 5-May-91 F 41238 25-Nov-86 M 45549 22-Mar-90 F 46097 1-Dec-93 F 27456 5-Feb-83 M 2762015-Feb-83 M 44284 8-Dec-73 F 42833 21-JuI-56 F 2838410-Jan-70 M 24786 25-Jun-76 F 28645 9-Oct-70 M 28581 19-Sep-82 M 5533 15-Oct-71 M 44287 4-Jun-85 M 25002 26-May-69 M 43014 8-Jul-80 M 44222 20-Jun-60 F 5519 25-Aug-62 F 11474 10-Dec-67 M 5471 29-Jul-69 M 40488 23-Jun-89 M 24738 28-May-51 M 2752713-Nov-74 M 6711 28-Mar-75 F 43833 4-Aug-71 M 4262518-Feb-91 F 43707 28-Apr-88 F 23207 9-Jan-75 M 44261 29-Apr-75 M 45573 7-Jun-89 M 44024 20-Nov-00 F 28418 17-Jan-79 M 44912 19-Feb-87 M 45506 31-Dec-81 F 18593 5-Dec-62 M 44812 2-Apr-80 M 42079 27-Aug-89 M 27237 30-Jun-68 M 44258 26-Apr-96 F 27587 30-Sep-83 M 29165 4-Aug-78 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 152,190.49 AFSCME Fulltime-Regular #N/A #N/A $ 96,675.54 AFSCME Fulltime-Regular #N/A #N/A $ 37,600.57 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 111,847.63 AFSCME Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 87,159.11 Fire Union Fulltime-Regular #N/A #N/A $ 142,058.69 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 101,308.97 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,995.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 105,187.43 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 123,804.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,369.87 Fire Union Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 80,454.56 Fire Union Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 85,693.08 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,303.99 AFSCME Fulltime-Regular #N/A #N/A $ 113,502.73 AFSCME Fulltime-Regular #N/A #N/A $ 42,601.52 AFSCME Fulltime-Regular #N/A #N/A $ 91,889.57 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 82,527.74 Sanitation Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 127,701.45 AFSCME Fulltime-Regular #N/A #N/A $ 137,337.64 Executives Fulltime-Regular 01/01/18 #N/A $ 158,104.12 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 161,266.14 Sworn Police Officers Fulltime-Regular #N/A #N/A $ - Commissioners Elected Official #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 89,337.99 Fire Union Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,158.57 Fire Union Fulltime-Regular #N/A #N/A $ 49,999.99 Unclassified Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Probationary #N/A #N/A $ 80,935.85 Fire Union Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 101,078.52 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 103,184.26 AFSCME Fulltime-Regular #N/A #N/A $ 197,960.69 Executives Fulltime-Regular 01/01/18 06/01/18 $ 116,536.38 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 152,190.49 AFSCME Fulltime-Regular #N/A #N/A $ 40,664.99 AFSCME Fulltime-Regular #N/A #N/A $ 71,997.74 AFSCME Fulltime-Regular #N/A #N/A $ 125,421.00 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 151,014.83 Police Executives Fulltime-Regular 07/13/22 #N/A $ 89,134.03 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,147.16 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 103,184.26 AFSCME Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Probationary #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 115,771.88 AFSCME Fulltime-Regular #N/A #N/A $ 40,331.66 Unclassified Fulltime-Regular #N/A #N/A $ 98,270.72 AFSCME Fulltime-Regular #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A JOB TITLE Web Administrator Facility Maint. Manager Clerical Aide Fire Fighter 96 Hrs Project Manager - CIP (Vertical) Police Officer Police Officer Fire Fighter 52/104hrs Chief Fire Officer 52/104 Hrs Police Officer Special Projects Assistant Police Officer Events Worker, T Police Officer Fire Captain 96 Hrs Fire Fighter 96 Hrs Police Lt Fire Lieut 80 Hrs Police Sergeant Tree Trimmer Fire Fighter 96 Hrs Admin Asst I Staff Services Assistant, T Police Officer Police Officer Building Inspector Police Officer Marinas Aide Staff Anlst Sr Info & Referral Specialist (Homeless Program) Senior Human Resources Generalist Waste Eqpt Op Police Officer Marinas Faclt Att Police Sergeant Senior Financial Analyst Assistant City Attorney, Supervisor Police Captain Police Captain Board Of Comm Police Sergeant Fire Fighter 52/104hrs Police Officer Fire Fighter 96 Hrs Commissioner's Aide Police Officer Planner I Fire Fighter 52/104hrs Fire Fighter 96 Hrs Human Resources Technician I Communications Center Administrator - Police Fire Fighter 96 Hrs Cadd Operator Typist Clerk II Financial Analyst II Dir Finance Senior Building Inspector Police Sergeant Police Officer Police Officer Fire Fighter 80 Hrs Oracle ERP Application Developer Info & Referral Aide Police Teletype Operator Supt.- Garage Or Motor Pool Police Officer Sergeant -At -Arms Heavy Eqp Mech Police Sergeant Police Officer Laborer I Police Officer Police Officer Parks Operations Coordinator Laborer I Police Officer Special Projects Assistant Police Sergeant Network Analyst Special Aide (Elected Official) Parks & Recreation Mgr II Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer Police Officer Fire Fighter 96 Hrs Offset Press Opr 34 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 2788619-Dec-83 M 41421 14-Dec-88 M 42790 5-Jan-87 F 45858 19-Jun-88 F 29212 19-Mar-75 M 40500 25-Nov-81 F 42596 29-Jun-83 M 41758 12-Aug-61 M 43681 ID-Jul-78 M 46216 6-Feb-01 F 46503 24-Jan-72 M 26599 28-Mar-81 F 42045 28-May-84 M 46677 12-JuI-91 M 44928 7-Oct-98 M 41990 8-Mar-80 M 44192 17-Nov-82 M 46458 31-May-75 M 41761 4-Dec-59 M 4685410-Feb-67 M 45303 28-Mar-99 M 44483 25-Dec-85 F 45883 2-Feb-88 F 46839 31-Jan-76 F 40057 8-Feb-74 F 41520 11-Oct-84 F 45532 3-Jun-96 F 5675 8-JuI-65 F 4606616-Apr-89 F 28383 6-Mar-86 F 44210 10-Dec-85 M 45331 5-Dec-91 M 40862 22-Aug-89 M 5646 6-Apr-71 M 42554 17-Jun-96 M 29213 4-Jan-88 M 27000 24-Nov-78 M 41928 4-Jul-73 M 41748 12-Apr-70 F 5580 12-Dec-77 M 44238 14-Dec-62 M 27987 6-Dec-82 M 44435 28-Jan-72 F 29214 27-Mar-82 M 42777 30-Nov-94 M 5607 6-Jan-74 M 40781 16-JuI-84 M 27041 31-Aug-72 M 28562 10-JuI-81 F 29255 27-May-81 F 41217 15-Mar-89 M 45392 1-Nov-89 F 44319 29-May-78 F 45535 25-Mar-86 M 28464 21-Sep-85 M 45302 20-Oct-88 M 42771 11-Apr-92 M 41341 30-Apr-77 M 27710 15-Sep-89 M 45646 29-Nov-60 F 27822 1-Nov-68 M 5629 8-Feb-72 F 45619 25-Feb-91 F 46073 24-Apr-02 F 41501 6-Aug-81 M 28409 28-Oct-82 M 4539315-Oct-64 M 40933 7-May-87 M 41846 21-Jun-84 M 5685 2-Apr-76 M 41843 9-Nov-85 M 5630 14-May-73 M 41343 23-Jun-93 M 5620 5-Jun-70 M 43420 30-Mar-90 M 40477 3-Apr-82 M 45525 25-Jan-68 M 43329 4-May-99 F 2846510-Feb-85 M 46592 18-May-67 M 42475 1-Jun-92 M 2732713-Oct-73 F 24662 7-Jan-74 M 45437 28-Jun-71 M 25896 24-Mar-64 F 45972 14-Sep-67 M 40750 27-Mar-69 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 96,617.98 Unclassified Fulltime-Regular #N/A #NIA $ 59,315.04 AFSCME Fulltime-Regular #NIA #NIA $ 88,648.68 Fire Union Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 124,909.17 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #NIA $ 89,134.05 AFSCME Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 89,500.00 Executives Fulltime-Regular 08/08/23 08/08/23 $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 107,913.76 AFSCME Fulltime-Regular #NIA #NIA $ 65,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Probationary #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 65,394.83 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Probationary #NIA #NIA $ 50,566.46 Fire Union Fulltime-Regular #NIA #N/A $ 71,998.16 AFSCME Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #N/A $ 102,621.79 Fire Union Fulltime-Regular #NIA #NIA $ 124,812.48 Fire Union Fulltime-Regular #NIA #N/A $ 120,122.84 AFSCME Fulltime-Regular #N/A #NIA $ 202,189.00 Executives Fulltime-Regular 01/01/18 #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 144,943.41 AFSCME Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 75,702.85 AFSCME Fulltime-Regular #NIA #N/A $ 82,959.26 Fire Union Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,486.40 Fire Union Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Probationary #N/A #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 76,650.00 Unclassified Fulltime-Regular #NIA #NIA $ 50,566.46 Fire Union Fulltime-Regular #N/A #NIA $ 90,864.88 Fire Union Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 163,218.16 Executives Fulltime-Regular 01/01/18 #NIA $ 72,097.79 AFSCME Fulltime-Regular #NIA #NIA $ 54,135.41 Unclassified Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 98,270.79 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 82,368.00 Fire Union Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 226,923.46 Police Executives Fulltime-Regular 01/01/18 #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 96,554.84 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 94,262.27 AFSCME Fulltime-Regular #NIA #NIA $ 56,472.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 105,187.43 Fire Union Fulltime-Regular #NIA #NIA $ 95,000.00 AFSCME Probationary #NIA #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 80,454.56 Fire Union Fulltime-Regular #NIA #N/A $ 128,700.72 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Probationary #NIA #N/A $ 101,308.05 Unclassified Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Probationary #NIA #N/A $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA Police Officer Police Officer Assistant to the Director of Human Services Risk Management Specialist Fire Lieut 96 Hrs Admin Aide I Police Officer Information Systems Manager, Fire/Police Police Officer 911 Operator (Emergency Call -Taker) Information & Referral Aide, T Emergency Dispatcher Police Officer Asst City Attorny Police Officer Police Officer Programmer Sr Multimedia Manager (Elected Official) Auto Eqp Op I Plumber Police Officer Building Services Assistant III Human Resources Generalist Events Worker, T Human Resources Technician II Eng Tech I Fire Fighter 96 Hrs Admin Aide I Police Officer Video Retrieval Specialist Police Officer Video Retrieval Specialist Police Officer Police Sergeant Fire Fighter 96 Hrs Fire Captain 96 Hrs Chief Fire Ofcr.-96 H Senior Building Inspector Dir, Purchasing Police Lt IT Project Manager Police Sergeant Financial Analyst I Fire Fighter 52/104hrs Police Officer Police Sergeant Fire Lieut 96 Hrs Police Officer Police Sergeant Admin Aide II Marinas Aide Crime Scene Investigator I Deputy Chief of Staff (Elected Official) Fire Fighter 96 Hrs Fire Lieut 96 Hrs Police Officer Police Officer Senior Assistant City Attorney Code Compliance Inspector Commissioner's Aide Police Officer Admin Asst I Emergency Dispatcher Police Officer Fire Fighter 96 Hrs Police Officer Facility Maintenance Technician Fire Fighter 96 Hrs Fire Lieut 96 Hrs Police Officer Fire Fighter 96 Hrs Asst Chief Police Police Officer Police Sergeant Fire Fighter 96 Hrs Police Officer Senior Building Inspector Special Projects Assistant, T Fire Captain 96 Hrs Mechanical Inspector Police Officer Fire Fighter 96 Hrs Senior Budget Analyst Sanitation Inspector I Assistant to Director -Human Resources Ocean Rescue Lifeguard 911 Operator (Emergency Call -Taker) 35 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 4252913-May-85 M 40934 4-Jun-86 M 40258 7-Jun-65 M 29180 10-Aug-71 F 28618 14-Jul-76 F 40487 6-Sep-86 M 4685818-Mar-88 M 1600 11-Dec-72 F 45301 16-Dec-91 M 27328 28-Jul-72 M 4004218-Feb-84 M 42011 4-Aug-85 M 41377 9-Jul-62 F 4004319-Jan-86 F 25995 7-Sep-64 M 46820 26-Feb-79 M 2323810-Nov-73 M 42859 28-May-92 M 4394716-Jan-99 M 5652 30-Jun-74 F 5681 22-Dec-79 F 42577 21-Dec-80 M 2742517-Aug-73 M 5689 23-Mar-71 M 4498312-Sep-93 M 42743 22-Jul-68 F 25008 20-Dec-70 F 5690 9-Aug-71 F 41885 1-Jan-67 F 43081 27-Mar-89 M 23222 26-Jan-65 M 25439 3-Oct-57 M 27437 16-May-70 F 44198 17-Feb-94 M 5674 4-Oct-68 M 26690 4-Jan-61 F 4554017-Sep-98 M 40467 21-Jun-86 M 44286 20-Oct-88 M 4694317-Oct-51 M 26955 16-Jul-71 F 41606 14-Jan-94 M 4585918-Apr-74 M 27859 7-Nov-65 M 26002 3-Sep-77 M 46410 27-Oct-81 M 27808 14-Oct-83 F 40780 22-Jan-85 M 26238 19-May-71 F 5677 1 1 -Jan-73 M 46897 2-Apr-84 M 11025 25-Mar-64 M 27033 25-Dec-63 M 43032 1-Dec-81 M 4426319-Sep-83 F 29215 2-Jun-69 M 42621 11-May-90 M 24444 9-Mar-78 M 4302813-Dec-95 F 42234 14-Nov-88 F 44882 20-May-63 F 25671 2-Feb-75 M 26366 3-Oct-77 M 41532 18-May-91 F 4046810-Dec-81 M 4357518-Aug-81 M 43119 22-Mar-77 M 44307 16-Aug-63 M 29216 16-Aug-84 M 1242 20-Oct-81 F 19633 6-Jan-68 M 16417 15-Oct-64 M 28467 6-Apr-79 M 19804 29-Dec-60 M 26744 21-Jun-67 M 13901 21-Nov-73 M 29501 29-Nov-55 M 42647 24-Feb-76 M 41743 5-Jun-55 M 23543 6-Aug-71 M 23564 23-Jan-72 M 45814 7-Jan-68 M 40559 4-Feb-73 M 40253 1 0-Jul-64 M 27635 30-Sep-70 F 29243 22-Jan-86 F 23021 5-Sep-65 F JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 67,895.77 Sanitation Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 96,554.84 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 97,000.00 Executives Fulltime-Regular 11/28/23 #N/A $ 101,308.16 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 100,897.86 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 62,281.23 Managerial/Confidential Probationary #N/A #N/A $ 167,790.02 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 83,346.47 AFSCME Fulltime-Regular #N/A #N/A $ 93,379.10 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Probationary #N/A #N/A $ 83,462.50 AFSCME Probationary #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 108,343.52 AFSCME Fulltime-Regular #N/A #N/A $ 79,377.48 AFSCME Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 98,272.13 AFSCME Fulltime-Regular #N/A #N/A $ 75,597.84 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,424.73 AFSCME Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 96,554.84 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,999.98 Unclassified Fulltime-Regular #N/A #N/A $ 131,770.60 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 119,890.29 AFSCME Fulltime-Regular #N/A #N/A $ 89,337.99 Fire Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Fulltime-Regular #N/A #N/A $ 83,346.64 AFSCME Fulltime-Regular #N/A #N/A $ 80,935.85 Fire Union Fulltime-Regular #N/A #N/A $ 67,518.25 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 150,000.00 Executives Fulltime-Regular 01/08/24 #N/A $ 155,222.01 AFSCME Fulltime-Regular #N/A #N/A $ 75,597.84 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 76,579.56 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 202,285.01 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 106,219.33 AFSCME Fulltime-Regular #N/A #N/A $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 119,722.03 Fire Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 111,521.07 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 73,029.84 Detention Officer Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 156,944.07 Executives Fulltime-Regular 01/01/18 #N/A $ 102,624.91 Fire Union Fulltime-Regular #N/A #N/A $ 108,098.02 AFSCME Fulltime-Regular #N/A #N/A $ 97,853.39 Fire Union Fulltime-Regular #N/A #N/A $ 148,149.69 AFSCME Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 159,800.01 AFSCME Fulltime-Regular #N/A #N/A $ 113,278.67 Fire Union Fulltime-Regular #N/A #N/A $ 127,777.55 AFSCME Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 156,888.74 AFSCME Probationary #N/A #N/A $ 113,275.46 Fire Union Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 96,618.08 AFSCME Fulltime-Regular #N/A #N/A $ 129,477.30 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 97,369.42 AFSCME Fulltime-Regular #N/A #N/A Police Officer Fire Fighter 96 Hrs Waste Eqpt Op Laborer I Police Sergeant Police Officer Senior Advisor to the City Manager Police Records Supr Police Officer Fire Lieut 52/104 Hrs Police Officer Police Officer Community Service Provider Police Officer Waste Collector -Trash Paralegal IT Infrastructure Mgr. Police Officer Laborer I Admin Aide I Emergency Dispatcher Supervisor, Police Zoning Information Specialist Code Compliance Field Supervisor Police Officer Identification Aide Finance Accounting Specialist Accountant Sr Pol Prop Spec II Waste Collector-Garbg Fire Fighter 96 Hrs Heavy Eqp Mech Finance Accounting Aide Police Sergeant Police Officer Police Officer Grant Funded Assessment/Referral Spec Fire Fighter 96 Hrs Police Officer Police Officer District Assistant (Elected Official) Property Manager Police Officer Heavy Eqp Mech Senior Roofing Inspector Fire Fighter 52/104hrs Marinas Aide Code Compliance Inspector Fire Fighter 52/104hrs Sanitation Inspector I Police Officer Asst Director, Real Estate & Asset Management Superintendent Of Maintenance, Assistant Information Services Liaison Police Officer Police Officer Fire Fighter 80 Hrs Police Officer Asst Chief Fire Police Officer Fire Fighter 96 Hrs Capital Impry Community Outreach & Engmt Coord Code Compliance Inspector Fire Captain 52/104 Hrs Police Officer Police Sergeant Detention Officer Parks Supv I Assistant Director of Procurement Fire Captain 80 Hours Communications Center Administrator - Police Fire Lieut 80 Hrs Chief Of Inspection Services Fire Lieut 96 Hrs Fire Fighter 96 Hrs Information Systems Manager, Fire/Police Fire Captain 80 Hours Project Manager - Cip Grant Funded Special Projects Asst Chief of Quality Control Fire Captain 96 Hrs Fire Fighter 52/104hrs Gen Maint Rep-Pnt/Mec Electrician II Senior Professional Surveyor & Mapper Public Service Aide Public Service Aide Special Projects Coordinator 36 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 4086610-Apr-73 M 4625915-Oct-96 M 46191 23-May-94 M 44974 28-Mar-87 M 43212 20-Aug-78 F 5759 1-Aug-66 M 42772 6-Aug-85 F 2779413-Dec-79 M 24388 14-Nov-73 M 27573 14-Mar-82 M 41275 28-Aug-86 M 45432 13-Nov-81 F 3072 11-Apr-72 F 5761 28-Feb-71 M 41487 23-Nov-85 M 44396 15-Jun-85 M 42520 12-Apr-75 M 44444 9-Mar-87 M 5803 25-Mar-67 M 25501 3-Apr-74 M 4534015-Dec-71 M 28061 18-Dec-72 F 42010 18-Oct-89 M 2736713-Dec-70 M 28650 23-Dec-66 F 44929 16-May-97 M 12557 24-Jun-49 M 2479918-Feb-68 M 44265 25-Nov-91 M 43137 23-Mar-95 M 5822 15-Jan-62 F 29363 30-May-68 F 21023 31-Dec-64 F 25208 1-Oct-59 F 41827 30-Mar-84 M 5819 21-Jun-67 M 40828 2-Jul-71 M 44335 10-Jun-98 M 21015 12-Feb-70 M 42449 5-Aug-76 M 40892 25-Feb-82 F 28028 23-Mar-80 F 41406 24-Jul-87 M 44852 5-Jan-68 M 5838 28-Nov-70 M 41327 1-Jan-59 F 45539 30-Oct-90 M 45832 26-Jan-98 F 46801 21-Aug-94 M 40946 25-Oct-70 M 46924 23-Oct-87 M 41841 21-Jul-84 M 40861 13-Sep-89 M 27358 5-Apr-82 F 46352 1-Nov-54 F 27564 6-Jul-82 M 25958 9-Jun-77 F 29048 22-Aug-83 M 44280 23-Feb-97 M 29326 24-Dec-69 M 40231 15-Oct-57 M 28767 19-Mar-91 M 43797 1-Aug-85 M 44199 17-Oct-87 M 29334 11-J uI-76 M 42601 18-Jul-92 M 25223 8-Jul-58 F 46084 3-Mar-97 M 42483 27-May-70 M 40757 3-May-86 F 26067 14-Nov-76 F 26003 28-Oct-78 M 43700 20-Jan-86 M 46213 29-Apr-98 M 46549 20-Nov-90 F 28419 7-Nov-81 M 2569210-Sep-68 M 28716 20-Sep-62 M 45867 4-Jul-85 F 43077 31-Jul-92 M 43442 7-Nov-74 F 46770 24-Aug-98 F 40867 23-May-72 M 43125 3-Jul-82 F 2744318-Oct-83 M 44949 4-Apr-84 M 42894 7-JuI-80 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 59,999.99 Unclassified Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Probationary #N/A #N/A $ 119,178.18 AFSCME Probationary #N/A #N/A $ 100,084.60 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 137,728.22 AFSCME Fulltime-Regular #N/A #N/A $ 117,440.13 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 126,109.62 Executives Fulltime-Regular 06/06/20 #N/A $ 169,196.55 Police Executives Fulltime-Regular 11/01/18 #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 83,462.21 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 75,597.80 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,112.36 Sanitation Union Fulltime-Regular #N/A #N/A $ 68,205.07 Sanitation Union Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 110,313.38 AFSCME Fulltime-Regular #N/A #N/A $ 93,591.16 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 108,343.52 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 87,635.26 Unclassified Fulltime-Regular #N/A #N/A $ 96,483.85 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 83,462.49 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,649.95 AFSCME Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 37,500.00 Unclassified Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 108,159.03 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 163,781.71 Executives Fulltime-Regular 01/01/18 #N/A $ 83,462.49 AFSCME Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 114,756.65 AFSCME Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 105,008.80 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,433.47 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 96,484.04 AFSCME Fulltime-Regular #N/A #N/A $ 110,512.64 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,056.79 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #N/A $ 69,915.43 Fire Union Fulltime-Regular #N/A #N/A $ 44,999.96 Unclassified Fulltime-Regular #N/A #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 62,139.56 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,855.04 Sanitation Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 140,954.63 Executives Fulltime-Regular 11/01/18 #N/A Police Officer Police Officer Police Officer Commissioner's Aide Grant Funded Administrative Aide II Crime Scene Investigations Supervisor Police Sergeant Cyber Security Analyst Admin Asst II Police Sergeant Police Officer Asst City Attorny Sergeant -At -Arms Police Officer Fire Fighter 96 Hrs Heavy Eqp Mech Helper Human Resources Generalist Police Officer Police Sergeant Fire Fighter 96 Hrs Heavy Eqp Mech Fleet Management Representative Police Officer Police Sergeant School Crossing Guard Supervisor Police Officer Waste Col Op I Waste Col Op I Police Officer Police Officer Code Compliance Inspector Crime Analyst I Claims Adjustor II Admin Asst I Fire Fighter 96 Hrs Police Officer Marinas Manager, Asst. Stable Attendant Parks & Recreation Mgr II Police Officer Assistant to the Director - Management & Budget Financial Analyst II Fire Fighter 96 Hrs Electrician II Police Officer Opportunity Center Client Support Specialist Fire Fighter 96 Hrs Police Officer District Service Worker (Elected Official) Info & Referral Specialist (Homeless Program) Staff Services Assistant, T Fire Fighter 96 Hrs Police Officer Information Technology Tech. III Human Resources Technician I Police Lt Dir General Serv. Admin Zoning Information Specialist Police Officer Police Sergeant Project Manager - Cip Fire Fighter 96 Hrs Cyber Security Analyst Police Officer Police Officer Police Officer Marinas Aide Police Officer Comm Tech Admin Aide II Admin Asst I Fire Captain 96 Hrs Police Officer Police Officer Police Officer Police Officer Parks Supv I Info & Referral Specialist (Homeless Program) Building Services Assistant III Fire Fighter 52/104hrs District Assistant (Elected Official) Staff Services Assistant, T Irrigation Specialist Police Officer Waste Eqpt Op Police Staffing Specialist Controller (Assistant Director, Finance) 37 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 44942 30-Sep-91 M 44311 16-Jul-78 M 27979 1-Sep-84 M 5893 3-Feb-82 M 4684613-Feb-02 M 28501 7-Feb-72 M 29434 5-Sep-82 M 41484 17-Jul-91 M 17206 27-Jan-62 F 24319 8-Apr-68 M 22834 21-May-71 F 44231 24-Sep-92 M 41966 23-Oct-56 M 43412 22-Mar-86 M 29261 14-Jun-57 M 41279 23-Nov-88 M 25790 11-Oct-60 M 46043 3-Dec-63 M 27512 3-Feb-84 M 4550315-Mar-59 M 16305 2-Dec-63 F 4282017-Jan-55 F 41032 10-Aug-93 F 15970 29-Sep-60 M 26820 9-Feb-86 F 285751-Ju1-77 M 25745 19-Apr-85 M 46063 21-Jun-96 F 45601 16-Feb-80 M 44933 28-Dec-93 M 46878 25-Sep-71 F 42933 4-Jul-76 F 45332 6-Jun-66 F 27439 29-Apr-77 M 23838 11-Jun-70 M 28468 6-Jun-84 M 40718 23-Sep-87 M 24343 11-Jun-68 M 46072 8-Oct-98 F 44536 6-Feb-94 M 28552 21-Oct-72 F 23287 22-Jul-73 F 46219 26-Jul-92 F 46507 30-Jun-99 M 27082 19-May-67 M 28738 5-Sep-74 F 44930 24-Aug-85 M 29320 21-Mar-67 M 43090 5-May-86 F 15103 12-May-44 M 19106 6-Sep-50 F 28568 14-Sep-87 M 5978 26-Sep-72 M 46526 1-Feb-93 M 27893 2-Jul-85 M 45533 7-Jan-95 M 46780 6-Oct-92 F 41968 12-Aug-91 F 4366016-Nov-89 M 45915 22-Jun-79 F 46366 17-Mar-71 F 43050 11-Jul-81 M 42239 25-Jun-77 M 28507 5-Dec-83 M 24110 27-Apr-77 M 27734 1-Mar-78 F 2637616-Apr-81 M 11534 10-Jun-77 F 23117 1-Jul-73 M 45571 31-Jan-74 M 42648 22-Jan-94 M 23978 21-Dec-66 M 5987 20-Aug-72 M 40708 27-Apr-62 M 41661 16-Feb-88 M 2667417-Nov-74 M 4427619-Jul-82 M 42095 25-Mar-88 M 27930 26-Jul-63 M 44836 1-Jul-95 M 4580012-Sep-87 F 46386 7-Sep-96 M 13437 11-May-59 M 44894 4-Aug-99 M 28208 20-Jul-78 M 26217 25-Mar-80 M 41831 13-Jul-91 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 112,694.74 AFSCME Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 211,879.97 Police Executives Fulltime-Regular 01/01/18 #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 113,914.52 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 82,368.00 Fire Union Fulltime-Regular #N/A #N/A $ 229,832.73 Executives Fulltime-Regular 01/01/18 #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 116,815.16 Unclassified Fulltime-Regular #N/A #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Probationary #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 141,400.00 AFSCME Probationary #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.90 AFSCME Probationary #N/A #N/A $ 113,566.95 AFSCME Fulltime-Regular #N/A #N/A $ 68,508.87 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 83,346.68 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 160,038.13 Executives Fulltime-Regular 11/01/18 #N/A $ 36,414.56 AFSCME Probationary #N/A #N/A $ 94,262.27 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 Managerial/Confidential Probationary #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,275.46 Fire Union Fulltime-Regular #N/A #N/A $ 93,693.60 Fire Union Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 147,988.45 Unclassified Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 58,650.59 Sworn Police Officers Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 58,200.00 Commissioners Elected Official 01/01/18 #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Probationary #N/A #N/A $ 100,084.60 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 37,835.20 Temporary Fulltime Fulltime-Temporary #N/A #NIA $ 54,927.60 Unclassified Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #NIA $ 73,411.16 Fire Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #NIA $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 68,378.85 AFSCME Fulltime-Regular #N/A #NIA $ 95,466.80 Fire Union Fulltime-Regular #N/A #N/A $ 87,513.54 AFSCME Fulltime-Regular #N/A #NIA $ 119,448.72 AFSCME Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Probationary #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,760.42 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 119,448.59 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 87,513.54 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Probationary #N/A #N/A $ 40,331.66 Unclassified Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Probationary #N/A #N/A $ 71,615.23 Sanitation Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,452.78 Sanitation Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A Police Officer Chief of Inspection Services Fire Lieut 96 Hrs Police Major Pol Officer-Prob Laborer I Police Sergeant Fire Lieut 96 Hrs Senior Assistant City Attorney Waste Collector-Garbg Assistant to the Zoning Director Police Officer Typist Clerk III Fire Fighter 96 Hrs Senior Park Ranger Police Officer Facility Attend Structural Engineer(plans Exam) Police Lt Police Staffing Specialist Fitness Center Specialist Business Analyst Human Resources Generalist Facilities Oper Worker,Senior Code Compliance Inspector Police Officer Assistant Director of Building - Administration Senior Park Ranger Senior Building Inspector Police Officer Legal Assistant Grant Writer Early Childhood Educator Police Officer Fire Captain 96 Hrs Fire Lieut 52/104 Hrs Police Officer Fire Fighter 96 Hrs Police Officer Police Officer Police Sergeant Asst to the Dir - Resilience & Public Works/CRO Police Officer Police Officer Police Officer Public Service Aide Police Officer Police Sergeant Admin Aide I Board Of Comm Staff Services Assistant, T Police Lt Police Sergeant Fire Fighter 96 Hrs Police Sergeant Fire Fighter 96 Hrs 911 Operator (Emergency Call -Taker) Police Sergeant Auto Mechanic Early Childhood Educator, T Commissioner's Aide Fire Fighter 96 Hrs Fire Fighter 52/104hrs Park Tender I Fire Fighter 52/104hrs 911 Operator (Emergency Call -Taker) Fire Lieut 80 Hrs Code Compliance Inspector Parks Operations Coordinator Building Services Assistant II Police Officer Heavy Eqp Mech Supv Police Officer Laborer I Police Officer Print Shop Supt Fiscal Assistant Fire Fighter 96 Hrs Heavy Eqp Mech Building Services Assistant II Special Assistant (Elected Official) Eng Tech II Waste Col Op I Emergency Dispatcher Police Officer Waste Col Op II Fire Fighter 96 Hrs 38 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 42096 20-May-88 M 41090 4-Jun-88 M 46195 23-Jun-96 F 46334 22-Dec-83 M 41784 6-Oct-60 F 29292 27-Apr-76 M 40935 30-Aug-86 M 19390 18-Jun-53 F 27961 2-Jun-79 M 41945 20-Sep-87 M 44188 18-Aug-93 M 26185 23-May-72 M 24706 23-Feb-70 F 41834 30-Jan-74 M 44905 21-Aug-96 F 28538 31-Mar-77 M 21377 14-May-66 M 41837 20-May-87 M 26418 15-Nov-83 M 25213 14-Dec-62 M 21752 7-May-69 F 46263 2-Jan-80 F 26411 31-May-79 F 41636 11-Jun-96 F 2889018-Jul-78 F 43051 26-Oct-89 M 2765417-Aug-86 F 25991 4-Dec-81 M 28535 15-Feb-77 F 2387613-Jan-72 M 27430 1-Mar-82 M 45606 27-Dec-98 F 40707 4-Sep-74 F 45278 7-May-98 M 46547 22-Oct-91 M 46321 26-Feb-77 F 41430 7-Apr-63 M 43576 3-Apr-85 M 42530 11-Jun-85 M 27420 6-Apr-85 M 4682919-Apr-65 M 44205 3-Sep-81 M 46347 23-Aug-01 F 46873 3-Nov-00 M 45931 1-Apr-83 M 42861 8-Nov-82 M 46895 20-Jun-44 M 44249 2-Oct-95 M 597518-Dec-68 F 2732915-Sep-76 M 42857 25-Mar-94 M 42630 22-May-91 M 24150 19-Feb-76 M 2862715-Nov-79 M 40462 6-Aug-70 F 23486 3-Oct-66 F 4090219-Oct-88 F 26980 29-May-78 M 43292 11-Nov-92 F 45084 18-Jun-85 M 43702 23-Sep-92 M 2595016-Sep-69 M 27621 12-Apr-78 M 44281 21-Dec-92 M 44834 29-Jul-98 F 44542 29-Aug-90 M 28946 5-Aug-87 M 40853 12-Nov-84 M 44910 6-Apr-68 F 5964 14-May-67 M 45534 30-Jul-96 M 42060 30-Dec-88 F 26981 11-Aug-76 M 41369 25-Jun-91 M 6073 1-Feb-72 M 26004 28-Aug-78 M 43007 11-Jul-93 M 29308 26-Nov-83 M 46242 25-Aug-83 M 41524 19-Jul-86 M 42594 1-Jul-89 M 28546 29-Nov-57 M 44272 2-Jul-95 F 28470 29-Aug-81 M 28471 13-May-86 M 43792 8-Aug-85 F 4542317-Aug-70 F YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #N/A #NIA $ 53,800.44 AFSCME Probationary #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 64,396.80 AFSCME Fulltime-Regular #NIA #NIA $ 78,492.21 Fire Union Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 59,314.94 Managerial/Confidential Probationary #NIA #NIA $ 91,889.66 AFSCME Fulltime-Regular #N/A #NIA $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 122,715.09 Fire Union Fulltime-Regular #NIA #NIA $ 149,000.00 Fire Union Fulltime-Regular #NIA #NIA $ 87,635.60 AFSCME Fulltime-Regular #NIA #NIA $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 196,065.60 Executives Fulltime-Regular 01/01/18 #NIA $ 56,490.47 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 64,661.79 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,051.61 Sanitation Union Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 93,378.23 AFSCME Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 40,146.91 AFSCME Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Fulltime-Regular #N/A #N/A $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 89,440.00 AFSCME Probationary #N/A #N/A $ 153,772.50 Executives Fulltime-Regular 11/18/22 11/18/22 $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 36,414.56 AFSCME Probationary #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 41,914.91 AFSCME Probationary #NIA #NIA $ 98,975.34 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 87,635.60 AFSCME Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 93,591.38 AFSCME Fulltime-Regular #NIA #NIA $ 80,454.56 Fire Union Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 84,529.32 Fire Union Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 57,512.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 113,858.57 Managerial/Confidential Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 116,801.98 Fire Union Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 83,346.43 AFSCME Fulltime-Regular #NIA #N/A $ 105,187.43 Fire Union Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 53,549.99 Unclassified Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 50,566.46 Fire Union Fulltime-Regular #NIA #NIA $ 111,847.63 AFSCME Probationary #NIA #NIA $ 100,897.86 Fire Union Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,465.84 Fire Union Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 85,693.08 AFSCME Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 116,891.57 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 113,953.04 Fire Union Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #NIA #NIA JOB TITLE Fire Fighter 96 Hrs Police Officer Police Officer Code Compliance Inspector Admin Aide I Police Officer Fire Fighter 96 Hrs Early Childhood Educator Fire Fighter 96 Hrs Maint Mechanic Police Officer Human Resources Generalist Parks & Recreation Mgr 11 Fire Fighter 96 Hrs Emergency Dispatcher Police Officer Fire Captain 52/104 Hrs Fire Lieut 96 Hrs Engineer 1 Arborist Dir Human Resources Legal Assistant Events Specialist Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Waste Collector-Garbg Public Service Aide Video Retrieval Specialist Police Sergeant Pol Prop Spec I Parks Naturalist Technician Fire Fighter 96 Hrs Electrical Inspector Assistant Director, Maintenance Operations Information Clerk Police Officer Police Officer Police Officer Senior Park Ranger Laborer I 911 Operator (Emergency Call -Taker) Information Technology Technician I Senior Mechanical Inspector Police Officer Construction Manager Police Officer Crime Prevention Specialist Fire Fighter 96 Hrs Police Officer Emergency Dispatcher Fire Fighter 80 Hrs Police Sergeant Victims Advocate (Witness Coordinator), T Net Administrator Police Officer Fire Captain 52/104 Hrs Police Officer Maint Mechanic Police Officer Auto Mechanic Fire Captain 96 Hrs Police Officer Police Officer Police Officer Police Sergeant Police Officer Commissioner's Aide Police Officer Fire Fighter 96 Hrs Business Systems Administrator Fire Lieut 52/104 Hrs Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Police Sergeant Electrical Inspector Police Officer Police Officer Senior Building Inspector Police Officer Fire Fighter 96 Hrs Fire Captain 52/104 Hrs Police Officer ROW Permitting Supervisor 39 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 41218 24-Nov-70 F 4209813-Aug-83 M 46355 9-Mar-01 M 29234 3-Jun-85 M 27498 29-Nov-76 M 41707 7-Jul-80 M 5969 8-Oct-71 M 5971 23-Apr-74 M 6180 19-Mar-74 M 2796218-Dec-82 M 43139 23-Sep-86 M 27963 6-Dec-84 M 41926 20-Sep-89 F 28209 12-Feb-68 M 41977 6-Dec-91 F 46906 21-Jan-97 M 27791 13-May-79 M 5895 17-Jul-80 F 4553619-Mar-85 M 41224 15-Nov-83 M 27964 27-Apr-69 M 46527 11-Jun-99 M 44173 16-Mar-93 M 41965 20-May-72 F 43475 21-Aug-89 M 41502 19-Oct-92 M 4087518-Jan-75 M 26098 21-Dec-84 F 42081 20-Mar-75 F 2873610-Nov-60 M 28067 9-Oct-79 M 41585 6-Dec-83 M 5966 7-Jan-80 M 41058 17-Feb-92 M 40936 31-Oct-87 M 45443 9-Jun-62 M 27330 25-Mar-72 M 42099 22-Mar-93 M 25942 6-Oct-69 M 43030 26-Jun-85 M 42511 1-Mar-90 M 43671 11-Apr-89 F 43159 14-Feb-91 M 41137 22-Sep-89 M 29417 12-Sep-76 F 41863 18-Sep-91 F 16345 15-May-65 M 26887 8-Apr-87 F 28472 6-Oct-74 M 43071 26-Dec-93 M 46308 3-Jul-98 F 25576 8-Dec-66 M 41802 10-Oct-76 M 28558 12-Mar-78 F 6092 10-Mar-53 M 25512 11-Sep-71 M 43835 11-Jul-81 M 42051 9-Dec-88 M 40959 28-Jun-93 M 27017 29-Jun-77 M 25990 7-Dec-57 M 41889 28-May-91 M 5972 21-JuI-73 M 45293 28-Jan-72 M 26982 23-Dec-77 M 45300 20-Jul-97 M 40751 18-Nov-83 M 44364 21-Aug-86 F 25952 21-Oct-71 F 44901 5-Nov-89 F 46106 22-Aug-66 M 26306 2-Aug-76 M 44209 7-Feb-94 F 13928 7-Apr-77 M 1185 27-Oct-73 F 2762613-Oct-61 F 44380 27-Apr-87 F 42880 5-May-81 M 27495 1-Jul-58 F 4493413-Dec-93 F 46528 8-Aug-00 M 45299 2-Sep-94 M 40724 31-May-81 M 28326 6-Apr-73 M 42629 26-May-90 M 43393 22-Jan-88 M 44922 2-Jan-97 F YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 117,509.77 AFSCME Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 196,470.54 Police Executives Fulltime-Regular 07/21/23 09/01/23 $ 216,117.57 Police Executives Fulltime-Regular 01/01/18 #NIA $ 93,693.60 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 87,315.90 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 107,190.51 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A $ 61,464.00 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 87,635.60 AFSCME Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 101,308.17 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Probationary #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 93,138.24 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 87,513.75 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 96,180.21 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 107,190.51 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 113,278.67 Fire Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 113,278.67 Fire Union Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ - Board Members Elected Official #N/A #N/A $ 87,635.60 AFSCME Probationary #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 108,343.55 AFSCME Fulltime-Regular #N/A #NIA $ 75,025.39 Sanitation Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #NIA $ 107,817.21 Fire Union Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #NIA $ 113,760.59 AFSCME Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Probationary #N/A #N/A $ 100,747.50 AFSCME Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,598.01 AFSCME Fulltime-Regular #N/A #N/A $ 90,087.73 AFSCME Fulltime-Regular #N/A #N/A $ 117,346.55 Unclassified Fulltime-Regular #N/A #N/A $ 68,250.00 Unclassified Fulltime-Regular #N/A #N/A $ 110,400.37 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 74,547.57 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #N/A $ 117,010.95 AFSCME Fulltime-Regular #N/A #N/A $ 52,557.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A JOB TITLE Project Manager - Cip Fire Fighter 96 Hrs Welder Police Sergeant Police Sergeant Police Officer Police Officer Police Commander Police Major Fire Lieut 52/104 Hrs Police Officer Fire Lieut 96 Hrs Police Officer Police Officer Police Officer Pol Officer-Prob Public Wks Supv Police Sergeant Fire Fighter 96 Hrs Police Sergeant Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Fighter 96 Hrs Receptionist/Typist Police Officer Fire Fighter 96 Hrs Public Rel Agnt Secretary of the Unsafe Structures Panel Admin Aide II Info & Referral Specialist (Homeless Program) Planner I Heavy Eqp Mech Police Officer Resilience Programs Manager Fire Fighter 96 Hrs Construction Coordinator Fire Lieut 80 Hrs Fire Fighter 96 Hrs Gen Maint Rep-Electr/Air Cond. Police Officer Police Officer Training & Development Supervisor Police Officer Police Sergeant Fiscal Assistant Police Officer Fire Captain 80 Hours Admin Aide I Fire Fighter 96 Hrs Fire Fighter 96 Hrs Admin Aide I Fire Captain 80 Hours Heavy Eqp Mech Police Sergeant Pension Board Member Superintendent Of Solid Waste Laborer I Police Officer Laborer I Parks Recreation Coordinator Waste Col Op II Police Officer Police Lt Engineer I Fire Captain 96 Hrs Police Officer Police Officer Zoning Plans Examiner Budget And Financial Support Advisor, Sr Admin Asst I Senior Electrical Inspector Grounds Tender Police Officer Auto Eqp Op III Admin Asst I Asst To Dir-Com.Dev District Manager (Elected Official) Community Partnership Manager Admin Aide I Police Officer Fire Fighter 96 Hrs Police Officer Auto Mechanic Project Manager - CIP (Horizontal) Police Officer Fire Fighter 96 Hrs Crime Scene Investigator I 40 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 2862015-Sep-66 M 45588 30-Jul-99 M 2743518-Sep-85 M 42100 4-Jan-85 M 25185 26-Jan-68 M 25119 6-Jan-65 M 43419 4-Aug-84 M 6183 24-Oct-70 M 26681 8-Jul-54 M 29420 22-Sep-67 F 28821 30-Dec-68 F 45945 6-Mar-84 F 46799 21-Aug-63 M 40341 27-Sep-90 F 28474 23-Jun-83 M 45109 20-May-02 F 44221 18-Dec-80 M 4264319-Feb-92 M 44248 1-Jul-97 F 28666 20-Jul-78 F 40822 7-Jan-90 M 46129 28-Jun-74 F 19532 3-Aug-71 M 41138 7-Sep-87 F 43294 6-Oct-74 M 27052 3-Mar-79 F 5985 16-May-76 M 41496 6-Jun-87 M 6065 22-Feb-61 F 40185 28-Jan-70 M 46196 19-Jun-95 M 42899 24-Feb-84 M 44811 21-Jul-89 M 28475 14-Apr-84 M 46857 2-Apr-60 M 28476 4-Feb-77 M 45834 9-Aug-96 M 43281 23-Oct-87 M 46843 9-Jan-67 M 43067 6-Oct-89 M 46862 10-Jun-01 F 27291 8-Nov-72 M 43718 30-Nov-92 M 24018 22-Nov-72 M 41507 8-Sep-59 M 43715 25-Dec-74 M 41407 30-Nov-83 M 45607 25-Nov-01 M 29217 11-Jul-86 M 42230 22-Aug-87 M 26263 8-Aug-66 F 24213 28-Jan-76 M 40313 2-Feb-73 M 26368 2-Feb-82 M 40324 8-Jun-80 F 40937 26-Oct-85 M 25259 8-Nov-74 F 41089 23-Feb-89 F 28422 24-Jan-83 M 46320 21-Feb-81 F 28536 3-Mar-74 M 20511 6-Jun-56 M 28147 21-Jul-90 M 6189 2-May-56 F 41839 15-Jun-88 M 42892 7-Sep-85 M 44267 22-Oct-73 M 42241 28-Aug-84 M 43705 9-Jan-66 F 23406 5-Jan-77 M 41907 8-Nov-76 M 44810 7-Nov-84 M 45268 24-Dec-90 M 4263516-Nov-84 M 40813 18-May-63 M 27591 8-Apr-75 F 40233 28-Feb-74 F 43320 26-Apr-00 F 2925910-Sep-80 M 46353 6-Oct-81 M 27485 22-Dec-81 F 6263 4-Sep-67 M 45537 23-Mar-91 M 42725 27-Sep-92 M 25662 5-Oct-62 F 25556 20-Feb-74 F 4493519-Nov-84 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 78,775.63 Sanitation Union Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 124,322.01 Unclassified Fulltime-Regular #N/A #NIA $ 75,702.85 AFSCME Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #NIA $ 59,314.94 AFSCME Probationary #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #N/A $ 98,436.95 Fire Union Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 83,157.68 AFSCME Fulltime-Regular #N/A #N/A $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 33,028.73 AFSCME Probationary #N/A #N/A $ 122,715.09 Fire Union Fulltime-Regular #N/A #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 79,377.58 AFSCME Probationary #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 123,311.76 Unclassified Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 119,500.00 Executives Fulltime-Regular 11/27/23 11/27/23 $ 105,187.43 Fire Union Fulltime-Regular #N/A #N/A $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Probationary #N/A #N/A $ 68,275.17 AFSCME Probationary #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 55,857.56 Police Trainees Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME _ Fulltime-Regular #N/A _#N/A $ 53,561.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A _#N/A $ 74,711.72 Fire Union Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A $ 102,621.79 Fire Union Fulltime-Regular #N/A #N/A $ 67,765.77 Fire Union Fulltime-Regular #N/A #N/A $ 89,134.28 AFSCME Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 77,322.27 AFSCME Fulltime-Regular #N/A #N/A $ 127,936.43 Fire Union Fulltime-Regular #N/A #N/A $ 142,179.42 Unclassified Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 119,448.71 AFSCME Fulltime-Regular #N/A #N/A $ 123,804.92 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 46,474.89 AFSCME Probationary #N/A #NIA $ 91,681.14 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 87,513.54 AFSCME Fulltime-Regular #N/A #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Probationary #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 142,058.69 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Probationary #N/A #N/A $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 68,705.37 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 96,618.08 AFSCME Probationary #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 98,270.82 AFSCME Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #N/A Police Officer Emergency Dispatcher Police Sergeant Fire Fighter 96 Hrs Waste Eqpt Op Fire Fighter 52/104hrs Fire Fighter 96 Hrs Police Sergeant Assistant to the Director of Human Services Fire & Life Safety Ed.Spec. Engineer I Client Support Services Supervisor Investigator 11, Civilian Investigative Panel Staff Services Assistant, T Fire Lieut 52/104 Hrs Building Services Assistant I Admin Asst 1 Laborer I Police Officer Admin Asst I Police Officer Information Clerk Fire Captain 52/104 Hrs Police Officer Audiovisual Technician Admin Aide II Police Lt Fire Fighter 96 Hrs Admin Asst 11 Auto Eqp Op III Police Officer Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Assistant Director, Risk Management Fire Captain 96 Hrs Police Officer Fire Fighter 96 Hrs Information Technology Tech. III Fire Fighter 96 Hrs Pol Officer-Prob Police Officer Police Officer Grounds Tender Waste Collector-Garbg Financial Analyst I Fire Fighter 80 Hrs Fire Fighter 96 Hrs Fire Captain 96 Hrs Fire Fighter 80 Hrs Admin Aide 11 Fire Fighter 80 Hrs Acquisitions Specialist Supervisor Chief Fire Ofcr.-80 H Information Systems Audit Supervisor Fire Fighter 96 Hrs Program Coord, Asst Police Lt Police Officer Eng Tech 11 Senior Procurement Contracting Officer Rec Specialist Fire Fighter 96 Hrs Admin Aide 1 Fire Fighter 96 Hrs Police Officer Auto Eqp Op III Fire Fighter 96 Hrs Admin Aide I Chief Fire Officer 52/104 Hrs Heavy Eqp Mech Fire Fighter 96 Hrs Crime Scene Investigator I Police Officer Laborer I Fire Lieut 96 Hrs Grant Funded Administrative Aide II Building Services Assistant III Zoning Plans Examiner Project Representative, Senior Building Services Assistant I Police Sergeant Fire Fighter 96 Hrs Police Officer Typist Clerk II Emergency Dispatcher Supervisor, M/F Police Officer 41 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 45062 6-Dec-57 M 41237 13-Jan-90 M 4687616-Apr-61 M 45538 10-Jan-94 M 4060716-Apr-94 M 25784 22-May-83 M 41766 21-Aug-89 F 27596 1-Sep-84 M 41830 23-Apr-90 M 45385 26-Feb-98 M 42671 4-Oct-88 M 43296 8-Nov-95 M 18798 10-Jan-63 M 41534 16-May-88 M 2698319-Mar-80 M 6266 9-Jan-78 M 6275 10-Oct-71 M 6281 21-Jun-77 M 42101 15-Nov-91 M 27914 16-Aug-71 M 2724819-Sep-81 M 2798816-Oct-81 M 22378 20-Nov-77 F 41855 11-Feb-92 M 40295 28-Dec-77 M 40779 6-Sep-82 M 45426 11-Aug-92 F 41236 9-Mar-88 M 43618 23-Jun-82 F 13668 16-Jun-61 F 2689015-Sep-77 F 40093 11-Dec-84 M 45620 30-Apr-90 F 2874210-Dec-84 F 43248 22-Feb-79 M 42190 23-Feb-57 M 26984 27-May-73 M 41027 4-Oct-58 M 45938 25-Apr-89 F 45386 27-Oct-96 M 27166 15-Apr-77 F 41703 24-Feb-82 F 42553 29-May-83 M 46832 27-Jan-01 M 44313 15-Mar-95 M 41904 18-Mar-91 F 41833 27-Sep-90 M 42102 3-Oct-87 M 41499 8-Jan-88 M 40230 16-Nov-76 M 23422 1-Feb-77 F 40573 9-Dec-59 M 25988 26-Sep-39 M 41123 15-Nov-75 M 27516 28-May-82 M 2847816-Dec-80 M 29201 13-Nov-85 F 28663 5-Jun-66 M 41235 28-Feb-86 M 4141910-Jul-86 M 29457 7-Dec-89 M 45781 4-Jan-59 M 41389 29-Nov-72 M 28560 22-Feb-79 M 44809 11-Sep-87 M 42103 3-Feb-84 M 40752 22-Jul-86 M 29302 27-Apr-62 F 42104 11-Mar-79 M 46446 23-Sep-56 M 44416 3-May-92 M 4639815-Nov-83 M 46810 8-May-86 M 45850 8-Oct-85 M 28479 29-Jul-82 M 28131 30-Aug-89 M 45387 6-Mar-00 M 46062 1-May-91 F 29377 2-Nov-73 M 44766 8-Feb-83 M 6259 12-Feb-72 M 29167 31-Jan-81 M 42783 14-Feb-83 M 44170 4-Feb-91 M 6272 26-Nov-62 F 43754 9-Jan-92 M 4652912-Sep-97 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 89,773.42 AFSCME Fulltime-Regular #N/A #N/A $ 86,486.40 Fire Union Fulltime-Regular #N/A #N/A $ 130,000.00 Unclassified Fulltime-Regular #N/A #N/A $ 50,567.71 Fire Union Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Probationary #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 131,915.72 Fire Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 122,715.09 Fire Union Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 107,820.33 Fire Union Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 87,513.54 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 86,488.27 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 89,134.28 AFSCME Fulltime-Regular #N/A #N/A $ 119,519.84 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 83,462.50 AFSCME Fulltime-Regular #N/A #N/A $ 61,723.79 Sanitation Union Fulltime-Regular #N/A #N/A $ 181,329.75 Executives Fulltime-Regular 01/01/18 #N/A $ 80,454.56 Fire Union Fulltime-Regular #N/A #N/A $ 83,462.49 AFSCME Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Probationary #N/A _#N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 82,368.00 Fire Union Fulltime-Regular #N/A #N/A $ 231,863.04 Executives Fulltime-Regular 01/01/18 #N/A $ 120,524.30 Executives Fulltime-Regular 06/22/20 #N/A $ 96,675.54 AFSCME Fulltime-Regular #N/A #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #N/A $ 106,521.38 AFSCME Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 88,648.68 Fire Union Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 73,411.16 Fire Union Fulltime-Regular #N/A #N/A $ 159,075.00 Executives Fulltime-Regular 07/12/21 #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 58,537.19 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #NIA $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 74,024.70 AFSCME Probationary #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 120,000.00 Executives Fulltime-Regular 09/07/23 #N/A $ 34,680.46 AFSCME Probationary #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #N/A #N/A $ 139,624.57 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 91,681.41 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 61,464.00 Fire Union Fulltime-Regular #N/A #N/A $ 93,591.33 AFSCME Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 45,865.24 Fire Union Probationary #N/A #N/A Senior Electrical Inspector Fire Lieut 96 Hrs Legal & Policy Advisor (Elected Official) Fire Fighter 80 Hrs Admin Asst II Parks & Recreation Mgr I Police Officer Chief Fire Officer 52/104 Hrs Fire Fighter 96 Hrs Police Officer Police Officer Police Officer Fire Captain 52/104 Hrs Police Officer Fire Captain 80 Hours Police Sergeant Police Officer Police Officer Fire Fighter 96 Hrs Heavy Eqp Mech Police Officer Police Officer Fire Fighter 80 Hrs Fire Fighter 96 Hrs Fire Lieut 80 Hrs Fire Fighter 96 Hrs Emergency Dispatcher Fire Fighter 96 Hrs Police Officer Admin Aide I Police Personnel Manager Fire Lieut 96 Hrs Police Teletype Operator Hearing Boards Coordinator Waste CoI Op II Dir. Solid Waste Fire Fighter 96 Hrs Heavy Eqp Mech Supv Planner II Police Officer Waste CoI Op II Police Officer Police Officer Marinas Aide Police Officer Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Lieut 96 Hrs Dir Public Works Agenda Coordinator Admin Asst II Marinas Faclt Att Venues Manager Police Lt Fire Fighter 96 Hrs Fire Lieut 96 Hrs Admin Aide II Fire Fighter 96 Hrs Fire Fighter 96 Hrs Fire Fighter 52/104hrs Director, Code Compliance Waste Collector-Garbg Police Officer Fire Fighter 96 Hrs Fire Fighter 96 Hrs Police Officer Waste Collector-Garbg Fire Fighter 96 Hrs Plumbing Inspector Police Officer Auto Mechanic Asst Dir. Civilian Investigative Panel Laborer I Fire Lieut 96 Hrs Grounds Tender Police Officer Police Officer Police Sergeant Customer Service Representative Police Lt Graphic Designer,Senior Police Officer Fire Fighter 96 Hrs Admin Asst I Police Officer Fire Fighter 96 Hrs 42 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 46896 11-Jun-61 M 43613 11-Nov-79 F 29038 7-Jul-86 F 42747 23-Mar-90 F 20036 30-Sep-65 F 43295 9-Oct-89 F 45578 9-Oct-94 M 25352 22-Dec-75 M 29388 16-Feb-90 M 4536210-Jan-77 F 42812 19-May-86 M 43585 23-Jul-64 M 45516 31-Jul-60 F 46422 3-Dec-94 M 45524 4-Apr-60 M 23906 11-Jun-76 M 41342 31-Dec-79 M 44808 3-Oct-78 M 4538815-Aug-93 M 46761 27-Jun-71 F 46851 8-Apr-93 F 41525 12-Dec-83 F 41666 25-Jun-80 M 41835 7-Jan-84 M 41983 27-Apr-85 M 29405 23-Jan-86 M 4449010-Oct-87 F 41998 11-Oct-88 M 44338 9-Jan-63 M 26711 2-Mar-69 F 41177 26-Oct-62 F 41933 29-May-89 M 21272 7-Dec-65 F 2340013-Jan-67 F 45848 21-Jan-72 M 41243 13-Jul-88 M 46031 19-Oct-70 F 43719 19-Feb-81 M 25579 10-Jun-80 M 42233 19-Jun-90 M 6500 29-Sep-75 M 29133 15-Oct-83 M 43371 14-Apr-87 M 43163 18-May-94 F 26254 3-Oct-72 M 40972 7-Nov-45 M 45808 26-May-75 F 45783 3-Jul-87 M 27610 28-Jul-85 M 27646 26-Feb-82 F 42546 23-Nov-86 M 28194 6-Jun-88 M 27823 20-Sep-75 M 43401 9-Aug-73 M 24023 13-Mar-71 M 6515 26-Mar-80 F 15481 26-Mar-77 M 27824 28-Jul-80 M 29406 26-Sep-83 M 41304 15-Nov-85 F 26916 17-Apr-85 M 6540 14-Apr-73 M 43070 8-Mar-86 M 46837 4-Apr-95 F 25527 8-Jan-64 F 26424 21-Jun-74 M 29264 4-Mar-80 M 41395 24-Jul-78 F 2742415-Nov-82 M 43508 27-Oct-75 F 24988 25-Oct-72 M 4652018-Jan-88 F 25275 8-Jun-70 F 41293 23-Oct-87 F 26879 4-Jun-81 F 4584616-Aug-68 M 29032 28-Sep-90 F 28000 30-Aug-83 M 41917 12-Aug-80 M 28071 13-Jan-82 M 46333 16-JuI-82 F 46824 25-Nov-89 F 25422 17-JuI-41 M 41391 1-Feb-83 F 43708 29-Jan-93 F 46899 25-Jul-85 F 28557 6-Oct-84 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 90,000.00 Unclassified Fulltime-Regular #N/A #NIA $ 77,172.82 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Probationary #N/A #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #NIA #NIA $ 108,343.51 AFSCME Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,661.79 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 91,889.66 AFSCME Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 44,065.42 Sanitation Union Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 105,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 95,000.00 Unclassified Fulltime-Regular #N/A #NIA $ 105,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 89,977.88 AFSCME Fulltime-Regular #NIA #NIA $ 125,207.60 AFSCME Fulltime-Regular #NIA #NIA $ 81,281.31 AFSCME Fulltime-Regular #NIA #NIA $ 58,537.19 Fire Union Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 38,235.18 AFSCME Probationary #NIA #NIA $ 53,800.44 Managerial/Confidential Probationary #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 161,377.00 Unclassified Fulltime-Regular #NIA #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Fulltime-Regular #NIA #N/A $ 125,136.64 AFSCME Fulltime-Regular #NIA #NIA $ 195,715.98 Executives Fulltime-Regular 01/01/18 06/01/18 $ 117,440.01 AFSCME Fulltime-Regular #NIA #NIA $ 71,997.74 AFSCME Fulltime-Regular #NIA #N/A $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 39,968.65 Sanitation Union Fulltime-Regular #NIA #N/A $ 86,486.40 Fire Union Fulltime-Regular #NIA #NIA $ 153,772.50 Executives Fulltime-Regular 05/11/22 05/11/22 $ 120,032.43 AFSCME Fulltime-Regular #NIA #NIA $ 108,691.75 AFSCME Fulltime-Regular #NIA #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 216,117.57 Police Executives Fulltime-Regular 05/16/18 #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 95,318.49 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 91,680.88 AFSCME Fulltime-Regular #NIA #N/A $ 142,748.74 AFSCME Fulltime-Regular #NIA #NIA $ 76,678.89 Unclassified Fulltime-Regular #NIA #N/A $ 44,261.56 AFSCME Fulltime-Regular #N/A #NIA $ 78,492.21 Fire Union Fulltime-Regular #NIA #NIA $ 74,547.61 AFSCME Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,538.86 Fire Union Fulltime-Regular #N/A #NIA $ 90,986.68 Sanitation Union Fulltime-Regular #NIA #NIA $ 211,879.97 Police Executives Fulltime-Regular 01/01/18 #NIA $ 91,889.65 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 58,537.19 Fire Union Fulltime-Regular #NIA #NIA $ 48,798.67 AFSCME Probationary #N/A #NIA $ 104,344.91 Managerial/Confidential Fulltime-Regular #NIA #NIA $ 71,290.54 Sanitation Union Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Probationary #NIA #NIA $ 92,017.12 AFSCME Probationary #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Probationary #NIA #N/A $ 92,017.12 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Probationary #NIA #NIA $ 83,346.47 AFSCME Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Probationary #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 64,661.79 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #NIA #NIA $ 83,462.50 AFSCME Fulltime-Regular #NIA #NIA $ 165,734.28 Executives Fulltime-Regular 02/14/22 #N/A $ 131,250.00 Executives Fulltime-Regular 11/28/22 #NIA $ 36,244.00 Unclassified Fulltime-Regular #NIA #N/A $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 42,154.32 AFSCME Probationary #NIA #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #NIA Staff Auditor Paralegal Parks & Recreation Mgr I Waste Collector-Garbg Public Wks Supv Police Officer Police Officer Parks & Recreation Mgr II Police Officer Waste Collector-Garbg Police Officer Senior Communications Aide (Elected Official) Dep Dir of Constituent Affairs (Elected Official) Ex Asst to CM for Market Research & Analytics (VM) Building Inspector Web Developer I Opportunity Center Employer Consultant Supervisor Fire Fighter 96 Hrs Police Officer Pol Prop Spec I Legal Assistant Police Officer Police Officer Fire Fighter 96 Hrs Police Officer Police Sergeant Director of Communications, Office of the Mayor Police Officer Auto Mech Helper Senior Financial Analyst Director, Risk Management Principal Planner - Neighborhood Planning Pol Prop Spec I Laborer I Waste Collector-Garbg Fire Lieut 96 Hrs Assistant Director, Stormwater & Permitting Chief Building Inspector Code Compliance Field Supervisor Fire Fighter 96 Hrs Police Major Police Lt Police Officer Police Sergeant Senior Plumbing Inspector Structural Engineer(plans Exam) Communications Director (Elected Official) Building Services Assistant II Fire Fighter 96 Hrs Crime Scene Investigator I Police Officer Laborer I Police Officer Fire Fighter 80 Hrs Waste Eqpt Op Police Major Parks & Recreation Mgr II Police Officer Police Officer Police Officer Laborer I Police Sergeant Fire Fighter 96 Hrs Emergency Dispatcher Human Resources Generalist Waste Eqpt Op Senior Park Ranger Zoning Information Specialist Police Sergeant Construction Inspection Representative Auto Eqp Op III Code Compliance Inspector Admin Aide I Police Officer Senior Park Ranger Environmental Resources Specialist II Police Officer Waste Collector-Garbg Special Projects Coordinator Assistant Director of Planning Asst City Attorny Special Aide (Elected Official) Laborer I Police Officer Police Officer Finance Accounting Aide Police Lt 43 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 46567 26-Oct-84 F 43468 30-Sep-74 F 4270815-Sep-94 M 27334 22-Mar-83 M 43562 29-Aug-64 M 27806 8-Mar-63 M 41311 28-Jun-87 F 26226 24-Nov-78 M 40476 26-Jul-77 M 27991 6-Mar-68 M 27891 24-Dec-73 M 43549 27-Sep-68 F 27825 1-Jan-76 M 4489517-Oct-89 F 45833 2-Jan-94 M 42815 8-Jul-91 M 42841 14-May-90 F 46042 27-Dec-82 M 42579 2-Apr-74 M 46236 13-May-97 F 40502 21-Oct-65 M 41857 23-Jan-86 F 42631 24-Jun-89 F 23747 21-Sep-74 M 44541 25-Nov-94 F 667218-Feb-74 M 40296 1-Jul-85 M 41937 4-Oct-63 F 29218 5-Feb-80 M 44780 21-Oct-92 F 4304013-Oct-65 M 27331 26-Jun-81 F 41086 14-Dec-83 M 4592710-Mar-72 M 26280 1-Aug-72 M 44755 25-Aug-92 F 17461 11-Jul-78 M 27047 6-Apr-77 M 41288 22-Feb-60 M 44114 1-Nov-00 M 43767 2-May-92 M 40955 11-Oct-88 M 46304 8-Oct-81 F 27611 11-Jul-86 M 46760 8-Sep-84 F 46403 8-Aug-88 M 2756213-Aug-82 F 27239 21-Oct-81 M 26105 6-Dec-63 M 25966 10-Nov-81 M 25286 23-Sep-70 F 41483 19-Sep-88 M 4476519-Aug-87 F 46067 11-Aug-75 F 4265819-Aug-90 F 46779 9-Jun-93 F 42105 26-Nov-87 M 46061 12-Sep-96 M 28108 2-Apr-84 F 6814 8-Nov-72 F 41981 5-Apr-89 M 46297 26-Dec-92 M 42106 9-Nov-81 M 28481 16-Jan-84 M 43598 30-Jun-83 F 46823 22-Mar-82 M 4272417-Aug-89 M 40061 6-Oct-77 M 42541 6-Jul-66 F 6833 12-Jul-77 M 6823 3-May-74 M 25218 10-Mar-76 M 45282 29-Dec-88 F 27496 25-Dec-67 M 4269816-Mar-76 M 41625 12-Aug-92 M 2359215-Sep-77 M 46427 9-Oct-86 M 42706 4-Jan-92 M 43862 7-Oct-67 F 28606 20-Dec-83 M 6844 13-Apr-71 M 41804 25-Aug-81 F 44827 27-Sep-93 M 46348 22-Nov-99 F 44728 11-Sep-97 M 15937 27-Dec-67 M YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 102,000.00 Executives Fulltime-Regular 05/15/23 #NIA $ 44,731.39 AFSCME Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 107,817.21 Fire Union Fulltime-Regular #NIA #NIA $ 38,718.80 AFSCME Fulltime-Regular #N/A #NIA $ 75,597.80 AFSCME Fulltime-Regular #NIA #NIA $ 126,000.00 Executives Fulltime-Regular 03/11/19 #N/A $ 108,097.76 AFSCME Fulltime-Regular #NIA #NIA $ 96,554.84 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 79,377.79 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 151,500.00 AFSCME Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 64,661.79 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 100,747.50 AFSCME Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #NIA #NIA $ 64,809.88 Sanitation Union Fulltime-Regular #NIA #NIA $ 75,702.85 AFSCME Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 122,715.09 Fire Union Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 130,368.40 Sworn Police Officers Probationary #NIA #NIA $ 86,486.40 Fire Union Fulltime-Regular #NIA #N/A $ 79,487.82 AFSCME Fulltime-Regular #NIA #NIA $ 88,650.43 Fire Union Fulltime-Regular #NIA #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #N/A $ 78,492.21 Fire Union Fulltime-Regular #NIA #NIA $ 61,723.79 Sanitation Union Fulltime-Regular #NIA #N/A $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 247,450.00 Executives Fulltime-Regular 06/21/22 #N/A $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 90,864.88 Fire Union Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 53,561.66 Sanitation Union Fulltime-Regular #NIA #N/A $ 39,968.65 Sanitation Union Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #NIA #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #NIA $ 148,470.00 Executives Fulltime-Regular 10/05/22 10/05/22 $ 90,866.67 Fire Union Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Probationary #NIA #N/A $ 38,235.18 AFSCME Probationary #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #N/A #NIA $ 71,860.67 AFSCME Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #N/A #NIA $ 75,702.85 AFSCME Probationary #NIA #NIA $ 87,809.40 AFSCME Probationary #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Probationary #N/A #NIA $ 73,411.16 Fire Union Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #N/A #N/A $ 100,519.78 Unclassified Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 48,158.57 Fire Union Fulltime-Regular #NIA #N/A $ 73,411.16 Fire Union Fulltime-Regular #NIA #NIA $ 105,190.59 Fire Union Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 180,000.00 Executives Fulltime-Regular 10/02/23 #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 97,000.00 Executives Elected Official 01/01/18 #N/A $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #NIA #NIA $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 131,858.03 AFSCME Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 97,853.39 Fire Union Fulltime-Regular #NIA #NIA $ 70,499.72 AFSCME Probationary #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 109,120.34 AFSCME Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 98,808.82 AFSCME Fulltime-Regular #NIA #NIA $ 58,537.19 Fire Union Fulltime-Regular #NIA #N/A $ 51,238.51 AFSCME Probationary #NIA #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #N/A Board Members Elected Official #NIA #NIA JOB TITLE Asst City Attorny Building Services Assistant I Police Officer Fire Captain 96 Hrs Supervisor Of Payrolls, Assistant Auto Eqp Op III Senior Assistant City Attorney Senior Multimedia Production Manager Police Officer Auto Mechanic Police Officer Chief Structural Engineer Police Officer Emergency Dispatcher Police Officer Police Officer Police Officer Senior Plumbing Inspector Parks Supv I Police Officer Waste Col Op II Grant Program Lead Police Officer Fire Captain 52/104 Hrs Police Officer Police Lt Fire Lieut 96 Hrs Procurement Contracting Officer Fire Lieut 80 Hrs Police Staffing Specialist Laborer I Fire Fighter 96 Hrs Waste Col Op II Storekeeper Chief Fin Officer (CFO)/Assistant City Manager 911 Operator (Emergency Call -Taker) Fire Lieut 96 Hrs Police Officer Waste Collector-Garbg Waste Collector-Garbg Admin Aide I Zoning Plans Examiner Assistant Director Fire Lieut 80 Hrs Grants Financial Analyst Auto Eqp Op I Police Officer Police Sergeant Laborer I Marinas Supervisor Admin Aide I Fire Fighter 96 Hrs Supervisor of Payrolls Senior Application Support Emergency Dispatcher 911 Operator (Emergency Call -Taker) Fire Fighter 52/104hrs Police Officer Admin Asst II Police Officer Police Officer Fire Fighter 96 Hrs Fire Fighter 52/104hrs Fire Captain 80 Hours Police Officer Chief Of Staff -Mayor Police Officer Executive Mayor Laborer I Police Officer Police Officer Waste Collector-Garbg Fire Fighter 96 Hrs Plumbing Insp Chf Police Officer Police Officer Fire Lieut 80 Hrs Mechanical Inspector Police Officer Senior Building Inspector Police Officer Police Officer Admin Asst II Fire Fighter 96 Hrs Emergency Dispatcher Ocean Rescue Operations Supervisor Civil Sery Brd Memb 44 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 43566 23-Oct-87 M 41380 12-Aug-67 F 12357 29-Jun-73 M 45888 25-Mar-95 F 46826 3-Jul-67 M 28406 26-Aug-83 M 40393 12-Feb-86 M 4029717-Dec-76 M 44745 21-Apr-61 F 41482 22-Jan-84 F 42135 20-Sep-86 F 42619 29-Sep-77 F 41829 3-Aug-91 M 41952 13-Apr-87 M 28390 25-Oct-54 M 40778 29-Sep-86 M 42240 22-Jun-87 F 6918 13-Mar-84 M 41469 8-Oct-92 M 41633 18-Aug-88 M 41905 3-Apr-84 M 41184 1-Dec-91 M 4302617-Mar-95 M 41956 18-Jan-83 F 27622 3-Jan-81 M 27636 4-May-65 F 27604 26-Apr-80 M 27839 27-Nov-76 M 4049818-Dec-84 M 6941 28-Aug-68 M 45963 27-Sep-82 F 46350 22-May-84 F 24867 13-Jun-73 M 45227 6-Mar-02 F 29134 15-Jan-78 M 40777 29-Apr-87 M 46927 9-Nov-90 F 27565 26-Nov-77 M 6903 24-Jan-76 M 27013 24-Oct-77 F 28013 21-Aug-74 M 42031 15-Oct-86 M 4693016-Dec-93 M 41967 6-Oct-68 M 43666 3-Nov-76 F 45541 13-Jan-89 M 700713-Sep-73 M 7013 10-Sep-73 F 46376 26-Mar-93 M 26369 28-Feb-74 M 2282216-Apr-77 M 41785 20-Jan-64 F 26008 26-Jul-76 M 46069 2-Jan-02 M 46253 6-Oct-70 F 43546 20-Oct-90 M 25285 1-Feb-81 F 7019 12-Nov-76 F 45566 14-May-92 F 27694 9-May-73 F 26664 2-Jul-81 F 19813 25-Sep-63 F 13819 10-Aug-67 M 7024 24-Feb-71 M 29123 24-Mar-80 M 42944 2-Jun-82 F 23097 7-May-77 F 42961 12-Jan-72 M 17107 5-Aug-66 M 42881 4-Jul-91 M 44370 8-Aug-70 F 44479 2-Jan-89 M 16813 23-Apr-68 M 42675 11-Nov-61 M 4426019-Sep-90 M 41450 7-May-85 M 7797 6-May-78 F 2848215-Feb-80 M 40961 24-Sep-86 F 43918 22-May-81 F 43710 26-Jan-78 F 2783419-Jan-59 M 28590 21-Jul-84 M 45389 23-Dec-93 M 45364 14-Apr-80 F 43141 6-Nov-84 F 41828 14-Sep-88 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 49,999.99 Unclassified Fulltime-Regular #N/A #N/A $ 87,436.30 Managerial/Confidential Probationary #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #NIA $ 74,711.72 Fire Union Fulltime-Regular #N/A #N/A $ 79,487.82 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 83,511.85 AFSCME Fulltime-Regular #N/A #N/A $ 82,368.00 Fire Union Fulltime-Regular #N/A #NIA $ 48,167.39 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 86,486.40 Fire Union Fulltime-Regular #N/A #N/A $ 67,764.15 Fire Union Fulltime-Regular #N/A #N/A $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 89,232.00 Fire Union Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 107,190.51 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 105,190.59 Fire Union Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 78,492.21 Fire Union Fulltime-Regular #N/A #N/A $ 68,050.32 Sanitation Union Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,174.99 Unclassified Fulltime-Regular #N/A #N/A $ 42,154.32 AFSCME Fulltime-Regular #N/A #N/A $ 156,557.98 Executives Fulltime-Regular 01/01/18 #N/A $ 42,154.32 AFSCME Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #N/A #N/A $ 48,798.67 AFSCME Probationary #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 84,943.03 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 91,681.64 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 95,000.00 AFSCME Probationary #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #N/A #N/A $ 65,395.20 AFSCME Fulltime-Regular #N/A #N/A $ 50,566.46 Fire Union Fulltime-Regular #N/A #N/A $ 124,852.71 AFSCME Probationary #N/A #N/A $ 226,923.46 Police Executives Fulltime-Regular 01/01/18 #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 56,239.66 Sanitation Union Fulltime-Regular #N/A #N/A $ 97,851.68 Fire Union Fulltime-Regular #N/A #N/A $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #N/A $ 95,466.80 Fire Union Fulltime-Regular #N/A #N/A $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 47,010.60 Unclassified Fulltime-Regular #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Probationary #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #NIA $ 48,798.67 AFSCME Fulltime-Regular #N/A #N/A $ 67,616.43 AFSCME Fulltime-Regular #N/A #NIA $ 68,780.85 AFSCME Fulltime-Regular #N/A #N/A $ 84,529.32 Fire Union Fulltime-Regular #N/A #NIA $ 84,527.53 Fire Union Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.84 AFSCME Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 48,582.14 Sanitation Union Fulltime-Regular #N/A #NIA $ 113,566.99 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 44,065.42 Sanitation Union Fulltime-Regular #N/A #N/A $ 98,270.77 AFSCME Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 51,238.51 AFSCME Fulltime-Regular #N/A #N/A $ 111,847.63 AFSCME Fulltime-Regular #N/A #N/A $ 100,784.18 AFSCME Fulltime-Regular #N/A #N/A $ 125,207.34 AFSCME Fulltime-Regular #N/A #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 92,017.12 AFSCME Probationary #N/A #N/A $ 124,923.68 AFSCME Probationary #N/A #N/A $ 71,152.47 Fire Union Fulltime-Regular #N/A #N/A Police Officer Crime Prevention Specialist Fire Lieut 96 Hrs Commissioner's Aide Liability Claims Manager Police Sergeant Fire Fighter 96 Hrs Fire Fighter 80 Hrs Accountant Supervisor Police Officer Admin Aide I Criminal Intelligence Analyst I Fire Lieut 96 Hrs Police Officer Crime Scene Investigator I Fire Lieut 96 Hrs Fire Fighter 96 Hrs Police Lt Fire Lieut 52/104 Hrs Emergency Dispatcher Police Officer Police Sergeant Police Officer Admin Aide II Fire Captain 80 Hours Public Service Aide Fire Fighter 96 Hrs Waste Col Op II Auto Mechanic Police Sergeant Commissioner's Aide Police Teletype Operator Asst. Director, Community Development Building Services Assistant II Police Officer Fire Fighter 96 Hrs Emergency Dispatcher Police Officer Police Sergeant Paralegal Engineer I Police Officer Elevator Inspector Maint Mechanic Disabilities Program Leader Fire Fighter 96 Hrs Forensic Investigations Manager Asst Chief Police Police Officer Waste Collector-Garbg Fire Lieut 96 Hrs Waste Collector-Garbg Fire Lieut 80 Hrs Police Officer Administrative Assistant (Elected Official) Police Officer Building Services Assistant III Typist Clerk II 911 Operator (Emergency Call -Taker) 911 Operator (Emergency Call -Taker) Transcriber Fire Fighter 80 Hrs Fire Fighter 96 Hrs Police Officer Police Officer Emergency Dispatcher Supervisor, Police Building Services Assistant I Waste Collector-Garbg Information Technology Technician II Police Officer Admin Aide I Waste Collector-Garbg Sanitation Inspector Chief Police Officer Police Officer Auto Mechanic Police Officer Fire Lieut 96 Hrs Building Services Assistant III Public Service Aide Chief of Land Development Zoning Plans Examiner Computer Systems Supervisor Police Officer Zoning Project Manager Geographic Information System Technical Analyst Fire Fighter 96 Hrs 45 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 43430 22-Aug-88 M 40938 5-Jan-87 M 46569 29-Mar-79 M 44367 3-Dec-87 F 44273 2-Jan-90 M 4547218-Sep-73 F 4532415-Sep-65 M 45421 17-Aug-92 F 46118 16-Jan-66 M 45542 1-Sep-99 M 25936 19-Oct-73 M 41486 20-Jan-90 M 19883 31-Aug-63 F 2696916-Aug-67 M 43110 3-Aug-90 M 45363 20-May-98 M 46766 30-Nov-70 M 43656 10-Jun-93 F 26597 23-Oct-77 M 44274 27-Jul-90 F 25089 13-Jun-63 M 43391 22-Sep-93 M 43175 22-Jul-65 F 7166 7-Mar-80 M 46015 14-Dec-61 F 2796713-Sep-85 F 29258 28-Dec-87 M 26435 24-May-87 F 26285 9-Sep-65 F 4299812-Aug-87 F 11605 3-Apr-61 M 42801 4-Aug-86 M 25376 1-Jun-81 M 43921 2-Nov-85 M 41378 13-Jan-79 M 2565512-Oct-57 F 42955 30-Nov-58 F 23688 29-Oct-68 F 4009516-Feb-84 M 29240 14-Jan-82 M 45405 22-Mar-61 M 27493 21-May-82 M 4203716-Jan-90 M 28112 13-Feb-85 F 41838 12-Sep-89 F 27624 3-Sep-84 M 25514 26-Dec-71 M 43652 6-Oct-90 M 4286218-Aug-64 M 41139 16-May-91 M 40855 7-May-80 M 2950415-Sep-84 F 11606 6-Feb-60 F 46923 11-Jun-98 F 45951 28-Dec-01 F 27896 7-Nov-70 M 41779 7-Aug-92 M 28113 30-Mar-85 M 41876 16-Aug-92 M 43525 20-Aug-61 M 7330 19-Dec-76 M 42780 11-Feb-90 M 25604 11-May-51 M 45297 29-Oct-82 M 41949 28-Nov-62 M 27423 2-Jun-85 F 45280 9-Aug-90 M 44840 30-Aug-73 M 24747 22-Aug-71 F 42750 27-Jul-91 M 44484 27-May-91 M 27081 5-Aug-71 M 45974 27-Oct-94 F 7228 9-Nov-71 M 45396 28-May-87 M 7329 30-Mar-74 M 42632 5-Apr-87 M 46237 22-Feb-96 M 46238 30-Dec-97 M 4080 7-Aug-72 F 44807 21-Oct-93 M 7331 22-Feb-77 M 7334 3-Apr-76 M 7358 7-May-71 M 44168 17-Aug-89 M 42699 5-Aug-79 M 43871 28-May-99 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,486.40 Fire Union Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Probationary #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 111,988.86 AFSCME Probationary #N/A #NIA $ 50,566.46 Fire Union Fulltime-Regular #NIA #NIA $ 180,285.00 Executives Fulltime-Regular 06/22/22 #NIA $ 82,368.00 Fire Union Fulltime-Regular #NIA #NIA $ - Board Members Elected Official #N/A #NIA $ 135,332.93 AFSCME Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 35,999.99 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 68,664.96 AFSCME Probationary #NIA #NIA $ 93,378.89 AFSCME Fulltime-Regular #NIA #NIA $ 16,745.87 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 75,597.84 AFSCME Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 43,428.73 AFSCME Probationary #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 94,262.27 AFSCME Fulltime-Regular #NIA #NIA $ 92,017.12 AFSCME Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #N/A $ 83,462.50 AFSCME Fulltime-Regular #NIA #NIA $ 61,863.98 Sanitation Union Fulltime-Regular #NIA #N/A $ 40,146.91 AFSCME Fulltime-Regular #NIA #NIA $ 90,532.88 AFSCME Fulltime-Regular #NIA #N/A $ 119,245.12 AFSCME Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #N/A $ 56,490.51 AFSCME Probationary #NIA #NIA $ 58,918.08 Sanitation Union Fulltime-Regular #NIA #N/A $ 44,261.56 AFSCME Fulltime-Regular #NIA #NIA $ 75,702.85 AFSCME Fulltime-Regular #NIA #N/A $ 83,396.10 AFSCME Fulltime-Regular #NIA #NIA $ 88,648.68 Fire Union Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #N/A $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Probationary #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,154.09 Fire Union Fulltime-Regular #NIA #N/A $ 90,864.88 Fire Union Fulltime-Regular #NIA #NIA $ 124,923.52 AFSCME Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Probationary #N/A #NIA $ 109,334.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,711.72 Fire Union Fulltime-Regular #N/A #NIA $ 79,377.48 AFSCME Fulltime-Regular #NIA #NIA $ 31,200.00 Temporary Fulltime Fulltime-Temporary #N/A #NIA $ 44,261.56 AFSCME Probationary #NIA #NIA $ 117,011.02 AFSCME Fulltime-Regular #N/A #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 192,618.18 Police Executives Fulltime-Regular 10/01/22 #NIA $ 105,088.88 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 196,470.54 Police Executives Fulltime-Regular 07/21/23 #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 55,749.65 Fire Union Fulltime-Regular #NIA #NIA $ 109,120.34 AFSCME Fulltime-Regular #NIA #NIA $ 83,346.47 AFSCME Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 75,702.84 AFSCME Fulltime-Regular #NIA #NIA $ 139,624.57 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #NIA #NIA $ 61,582.76 Sworn Police Officers Probationary #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 58,537.19 Fire Union Fulltime-Regular #NIA #NIA $ 139,624.57 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 194,576.04 Police Executives Fulltime-Regular 01/06/22 01/06/22 $ 66,586.00 Fire Union Fulltime-Regular #NIA #NIA $ 92,017.12 AFSCME Fulltime-Regular #NIA #N/A $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA Police Officer Fire Lieut 96 Hrs Code Compliance Inspector Admin Aide II Police Officer Emergency Dispatcher Supervisor, Police Facility Maintenance Technician Strategic Planning & Performance Analyst Senior Elevator Inspector Fire Fighter 96 Hrs Assistant Director, Building/Building Official Fire Lieut 96 Hrs Pension Board Member Homeless Program Administrator Police Officer Fire Fighter 96 Hrs Events Worker, T Admin Asst I Emergency Dispatcher Supervisor, M/F Police Officer Auto Eqp Op II Fire Fighter 96 Hrs Building Services Assistant I Police Sergeant Senior Building Inspector Admin Asst II Park Ranger Senior Code Compliance Inspector Waste Col Op I Building Services Assistant I Grant Funded Special Projects Asst Programmer Sr Parks Supv I Pools Supervisor Waste Col Op I Early Childhood Educator Financial Analyst I Special Projects Assistant Fire Lieut 96 Hrs Police Officer Code Compliance Inspector Police Officer Arborist Police Officer Fire Fighter 80 Hrs Fire Lieut 96 Hrs Business Relationship Manager Police Officer Code Compliance Inspector Fire Fighter 96 Hrs Police Sergeant Fire Fighter 80 Hrs Sanitation Inspector I Staff Services Assistant, T Building Services Assistant 11 Project Manager - CIP (Horizontal) Police Officer Police Commander Police Sergeant Heavy Eqp Mech Police Commander Police Officer Park Tender 1 Police Officer Information Clerk Police Sergeant Fire Fighter 96 Hrs Senior Plumbing Inspector Finance Accounting Aide Police Officer Engineer I Police Sergeant Floodplain Coordinator Police Sergeant Electrician Police Lt Zoning Information Technician Police Officer Police Officer Police Sergeant Fire Fighter 96 Hrs Police Lt Police Sergeant Executive Officer to the Police Chief Fire Fighter 52/104hrs Parks Aquatic Coordinator Building Services Assistant III 46 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 27892 5-Sep-80 M 29321 16-Jan-87 M 2674618-Aug-53 M 24481 2-Nov-75 M 13961 17-Feb-64 M 45656 24-Jun-99 M 4546716-Mar-96 F 41408 17-Nov-83 M 27786 23-Nov-71 M 25534 2-Sep-76 M 45401 13-Oct-99 M 27429 8-Nov-81 F 42634 12-Jun-82 F 43390 17-Feb-78 M 41750 26-Apr-89 M 41481 12-Jul-88 M 7230 16-Jun-59 F 4425212-Oct-87 M 45208 27-Aug-02 M 28483 3-Dec-80 M 43648 20-Oct-88 M 7336 6-Dec-73 F 28407 26-Mar-70 M 23322 24-Dec-72 M 4639313-Dec-84 F 42779 8-Feb-81 M 2858813-Sep-83 M 42748 30-May-90 M 28398 7-Aug-76 M 40096 26-Aug-82 M 28408 2-Jul-69 M 4429019-Aug-89 F 2493415-Apr-76 M 25577 11-Apr-72 M 44835 29-May-95 M 29230 20-Jun-86 M 41186 30-Aug-82 M 40939 22-Dec-88 M 7305 13-Mar-67 M 26985 6-Feb-80 M 29350 31-Dec-56 M 42480 8-Jul-93 F 44333 23-Sep-96 M 4303617-Aug-60 F 28769 11-Nov-73 M 7314 21-May-73 M 23821 28-May-70 M 44363 6-Oct-87 F 42711 11-Sep-73 M 42242 30-Jan-92 M 44941 27-Feb-90 M 4202715-Sep-71 F 46310 11-Mar-02 F 43643 9-Dec-67 F 7317 20-Sep-69 M 27625 6-May-74 M 10370 9-Nov-72 M 40856 7-Feb-89 M 28682 25-Jun-72 M 41215 5-Jan-57 M 45969 11-Dec-75 F 27965 1-Mar-85 M 4580418-Jul-97 F 41204 4-Apr-79 M 40120 24-Jan-83 M 42107 19-Jul-83 M 44464 11-Nov-97 M 7361 22-Dec-83 M 7335 20-Sep-73 M 44786 16-Jun-90 F 40298 11-Dec-78 M 2798415-Feb-83 F 41832 10-Dec-91 M 44806 21-Feb-95 M 41651 30-Aug-75 M 42551 16-Apr-92 M 21333 21-Sep-78 F 45265 23-Jul-02 F 43724 14-Jul-87 M 27935 4-Oct-78 M 11137 26-Sep-63 F 44234 21-Jan-98 M 19140 3-Jul-56 M 25992 24-Jun-80 M 2742813-Dec-83 M 42108 14-May-83 M 4063913-Nov-65 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 136,886.88 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #N/A #NIA $ 83,346.47 AFSCME Fulltime-Regular #NIA #NIA $ 91,571.50 Fire Union Fulltime-Regular #N/A #NIA $ 45,865.24 Fire Union Probationary #NIA #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 74,710.02 Fire Union Fulltime-Regular #NIA #NIA $ 133,019.64 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 91,571.50 Fire Union Fulltime-Regular #NIA #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 110,466.10 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 64,537.32 Fire Union Fulltime-Regular #NIA #NIA $ 72,097.79 AFSCME Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 75,597.84 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Fulltime-Regular #NIA #NIA $ 78,492.21 Fire Union Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Probationary #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 91,571.50 Fire Union Fulltime-Regular #NIA #NIA $ 102,900.00 Unclassified Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 131,467.98 AFSCME Fulltime-Regular #NIA #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 88,650.43 Fire Union Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 87,635.60 AFSCME Fulltime-Regular #NIA #NIA $ 134,086.64 AFSCME Fulltime-Regular #NIA #N/A $ 122,715.09 Fire Union Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 80,935.85 Fire Union Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 80,454.56 Fire Union Fulltime-Regular #NIA #NIA $ 108,343.53 AFSCME Fulltime-Regular #NIA #N/A $ 100,084.60 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 97,851.68 Fire Union Fulltime-Regular #NIA #N/A $ 92,017.12 AFSCME Fulltime-Regular #N/A #NIA $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 67,765.77 Fire Union Fulltime-Regular #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #NIA $ 38,916.80 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 73,029.84 Detention Officer Fulltime-Regular #N/A #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,864.88 Fire Union Fulltime-Regular #N/A #NIA $ 84,527.53 Fire Union Fulltime-Regular #NIA #NIA $ 109,334.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 162,205.22 Executives Fulltime-Regular 01/01/18 #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #NIA #N/A $ 57,512.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 78,494.00 Fire Union Fulltime-Regular #NIA #N/A $ 70,000.00 Unclassified Fulltime-Regular #NIA #NIA $ 92,805.44 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 42,601.54 AFSCME Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #N/A $ 31,200.00 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 136,886.88 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #N/A $ 86,486.40 Fire Union Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 77,081.84 Fire Union Fulltime-Regular #NIA #NIA $ 58,537.19 Fire Union Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Probationary #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 133,479.10 AFSCME Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Probationary #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,189.16 AFSCME Fulltime-Regular #NIA #N/A $ 93,591.47 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 91,571.50 Fire Union Fulltime-Regular #NIA #NIA $ 71,614.81 Sanitation Union Fulltime-Regular #NIA #N/A $ 118,516.73 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #N/A $ 48,798.67 AFSCME Fulltime-Regular #NIA #NIA Police Lt Police Sergeant Waste Collector-Garbg Facility Maintenance Technician Fire Fighter 52/104hrs Fire Fighter 96 Hrs Engineer I Fire Fighter 96 Hrs Employment Supervisor Fire Fighter 52/104hrs Police Officer Police Sergeant Administrative Service Manager Fire Fighter 96 Hrs Auto Mechanic Fire Fighter 96 Hrs Police Teletype Operator Police Officer Building Services Assistant I Fire Fighter 96 Hrs Admin Asst I Police Officer Police Officer Fire Fighter 52/104hrs Staff Auditor, Senior Police Officer Web Developer 11 Police Officer Police Sergeant Fire Lieut 80 Hrs Police Officer Engineer II Plumber Supervisor Fire Captain 52/104 Hrs Police Officer Police Officer Police Officer Fire Fighter 52/104hrs Police Officer Fire Fighter 96 Hrs Budget And Financial Support Advisor, Sr Police Sergeant Police Officer Admin Aide I Parks & Recreation Mgr 1 Police Officer Fire Lieut 96 Hrs Zoning Plans Examiner Auto Eqp Op 1 Fire Fighter 80 Hrs Police Officer Account Clerk Administrative Aide 1, T Detention Officer Police Sergeant Fire Lieut 96 Hrs Fire Fighter 96 Hrs Police Sergeant Senior Assistant City Attorney Waste Collector-Garbg Victims Advocate (Witness Coordinator), T Fire Fighter 80 Hrs Special Aide (Elected Official) Police Officer Info & Referral Specialist (Homeless Program) Fire Fighter 96 Hrs Information & Referral Aide, T Police Lt Police Sergeant Building Services Assistant 11 Fire Lieut 96 Hrs Police Sergeant Fire Fighter 52/104hrs Fire Fighter 96 Hrs Maint Mechanic Police Officer Grant Funded Emergency Management Coordinator Rec Specialist Police Officer Heavy Eqp Specialist Admin Aide II Police Officer Fire Fighter 52/104hrs Waste Eqpt Op Police Sergeant Fire Fighter 96 Hrs Laborer I 47 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 735615-Oct-66 M 42745 24-Nov-93 M 43133 29-Mar-88 M 4298415-Mar-83 M 29135 14-Dec-74 M 45390 27-May-93 M 42764 24-Dec-91 M 42682 31-Mar-64 M 42130 31-May-69 M 28269 23-Apr-78 M 40131 22-Dec-89 M 41250 18-Sep-93 F 44389 21-JuI-92 F 46436 24-Mar-87 M 4682810-Nov-00 M 41159 8-May-70 M 40593 9-Aug-57 F 4432419-Aug-72 F 20271 31-Mar-51 M 45316 10-Aug-62 F 27333 9-Nov-82 M 26167 26-Apr-85 M 44900 20-Dec-79 F 7349 7-Dec-72 F 7320 20-Aug-64 F 43544 30-Aug-66 F 2870611-Apr-84 M 15233 25-Nov-63 M 14112 21-Jan-69 F 23706 11-Mar-82 F 4546616-Sep-91 M 25956 12-Jan-61 M 41530 5-Sep-85 M 46671 10-Jul-87 M 42616 7-Oct-93 M 42778 7-Oct-93 M 42266 22-Aug-76 F 26259 22-Jul-63 M 43777 8-Jun-89 M 44932 29-Apr-94 F 27631 10-Jan-86 F 25430 12-Mar-64 M 27612 29-Jun-69 M 24790 24-Feb-77 M 28104 25-Jan-84 M 28484 2-Aug-86 M 46377 9-Aug-88 M 40272 22-Apr-87 M 29018 11-Nov-51 F 40422 20-Jul-86 M 13449 14-Jun-57 F 28701 3-May-85 M 45966 12-Jan-84 F 2789517-Jan-73 F 41357 17-Feb-83 F 43913 6-Jun-85 F 43687 25-Jan-88 F 43073 17-Jun-92 M 46017 10-Jul-02 M 7543 11-Jun-78 F 29435 14-Jan-77 M 7627 29-May-72 F 4529619-Jan-92 F 41312 31-Jan-85 F 41234 3-Feb-72 M 4223719-Oct-85 M 27858 31-Jan-69 M 7644 6-Jan-68 M 4350713-Oct-91 M 19746 15-Jul-67 M 41148 13-Sep-86 M 43291 20-Apr-94 M 7647 6-Feb-73 M 2700217-Dec-63 F 45543 23-Sep-91 F 41836 20-Jul-88 M 44227 12-Dec-67 M 45001 13-May-77 M 44854 27-Dec-64 M 27426 28-May-74 M 46814 27-Jul-76 M 46384 26-Aug-88 F 4270018-Apr-91 M 41665 18-Aug-88 M 27606 8-Oct-81 M 26546 8-Jul-86 M 7679 28-Apr-67 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 120,887.10 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 144,943.41 AFSCME Fulltime-Regular #N/A #NIA $ 65,395.20 AFSCME Fulltime-Regular #NIA #NIA $ 61,464.00 Fire Union Fulltime-Regular #N/A #NIA $ 86,486.40 Fire Union Fulltime-Regular #NIA #NIA $ 65,395.20 AFSCME Fulltime-Regular #N/A #NIA $ 99,000.00 Executives Fulltime-Regular 04/10/23 #NIA $ 48,798.67 AFSCME Probationary #N/A #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #NIA #NIA $ 111,847.63 AFSCME Fulltime-Regular #NIA #NIA $ 105,468.90 Unclassified Fulltime-Regular #NIA #NIA $ 37,835.20 Temporary Fulltime Fulltime-Temporary #NIA #NIA $ 116,801.98 Fire Union Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Probationary #NIA #NIA $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 87,513.96 AFSCME Fulltime-Regular #NIA #NIA $ 93,591.26 AFSCME Fulltime-Regular #NIA #NIA $ 40,146.91 AFSCME Probationary #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 96,618.08 AFSCME Fulltime-Regular #NIA #NIA $ 101,448.88 AFSCME Fulltime-Regular #N/A #N/A $ 90,985.85 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 89,134.65 AFSCME Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 75,702.85 AFSCME Probationary #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 59,314.94 AFSCME Fulltime-Regular #NIA #NIA $ 78,597.16 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #N/A $ 156,551.47 AFSCME Fulltime-Regular #NIA #NIA $ 90,864.88 Fire Union Fulltime-Regular #N/A #N/A $ 86,646.14 AFSCME Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #NIA #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 86,488.27 Fire Union Fulltime-Regular #N/A #NIA $ 83,396.10 AFSCME Fulltime-Regular #NIA #NIA $ 74,710.02 Fire Union Fulltime-Regular #N/A #NIA $ 71,997.74 AFSCME Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 56,174.99 Unclassified Fulltime-Regular #NIA #NIA $ 53,800.44 AFSCME Probationary #N/A #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #N/A #NIA $ 61,582.76 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 71,998.16 AFSCME Fulltime-Regular #NIA #N/A $ 98,627.36 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 84,889.58 AFSCME Fulltime-Regular #NIA #N/A $ 71,289.92 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 63,034.46 AFSCME Fulltime-Regular #N/A #NIA $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #N/A $ 119,448.59 AFSCME Fulltime-Regular #NIA #NIA $ 196,470.54 Police Executives Fulltime-Regular 10/01/22 #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 87,277.42 Detention Officer Fulltime-Regular #NIA #N/A $ 100,084.60 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 51,238.51 AFSCME Fulltime-Regular #NIA #NIA $ 50,566.46 Fire Union Fulltime-Regular #NIA #NIA $ 71,152.47 Fire Union Fulltime-Regular #NIA #NIA $ 56,490.51 AFSCME Probationary #NIA #NIA $ 44,065.42 Sanitation Union Fulltime-Regular #NIA #NIA $ 50,895.52 Sanitation Union Fulltime-Regular #NIA #NIA $ 118,516.73 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 38,235.18 AFSCME Probationary #NIA #NIA $ 38,235.18 AFSCME Probationary #N/A #N/A $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,985.85 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 90,864.88 Fire Union Fulltime-Regular #NIA #NIA $ 46,474.89 AFSCME Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA Police Sergeant Police Officer Police Officer Police Officer Police Officer Police Officer Police Officer Stock Clerk I Senior Oracle ERP Application Developer Video Retrieval Specialist Fire Fighter 96 Hrs Fire Lieut 96 Hrs Crime Scene Investigator I Asst City Attorny Emergency Dispatcher Waste Collector-Garbg Account Clerk Transportation Manager District Administrator (Elected Official) Early Childhood Educator, T Fire Captain 52/104 Hrs Labor Crew Ldr II Emergency Dispatcher Admin Asst I Admin Aide I Early Childhood Educator Police Officer Welder Sanitation Inspector II Police Officer Eng Tech III Auto Mech Supv Police Officer Cultural Center Manager Police Officer Police Officer Early Childhood Educator Park Tender I Police Officer Police Officer Public Service Aide Elec Insp Chief Fire Lieut 96 Hrs Admin Asst I Police Sergeant Fire Lieut 96 Hrs Police Officer Fire Lieut 80 Hrs Admin Asst I Fire Fighter 96 Hrs Typist Clerk III Police Officer Commissioner's Aide Payroll Specialist Police Officer Police Officer Crime Scene Investigator I Fire Fighter 96 Hrs Police Officer 911 Operator (Emergency Call -Taker) Police Officer 911 Operator (Emergency Call -Taker) Police Officer Opportunity Center Client Support Specialist Comm Repair Wrkr Fire Fighter 96 Hrs Public Works Superintendent Police Commander Police Officer Detention Officer Police Sergeant Police Officer Police Officer Senior Park Ranger Fire Fighter 96 Hrs Fire Fighter 96 Hrs Auto Eqp Op III Waste Collector-Garbg Waste Col Op I Police Sergeant Auto Eqp Op I Public Service Aide Police Officer Police Officer Fire Lieut 96 Hrs Laborer I Police Officer 48 EXHIBITA- City of Miami FT Employee Census EMPLOYEE NUMBER DATE OF BIRTH GENDER 25886 21-Sep-73 F 4303417-Oct-79 F 7683 15-Apr-71 M 4359915-Apr-80 F 28717 21-Dec-56 M 44513 25-Aug-92 M 42891 18-Nov-90 F 44488 10-May-88 F 40642 21-Aug-77 F 7731 30-Apr-72 F 1434 24-Apr-70 F 40869 4-Feb-82 M 40904 8-Sep-81 M 7734 5-Feb-72 M 27241 19-Jan-83 F 2848517-Aug-87 M 25482 23-Sep-77 F 19441 20-Nov-71 M 15198 14-Dec-63 F 773818-Apr-75 M 40299 9-Oct-76 M 26009 20-Jul-79 M 27917 12-Jul-62 F 23312 27-Nov-79 M 2343619-Feb-74 M 40891 7-Jul-86 M 42118 16-Oct-77 M 43561 9-Feb-89 F 46354 26-May-89 F 27413 17-Oct-83 M 2632515-Jul-60 F 46390 17-Feb-78 F 2882416-Apr-80 M 28219 11-Feb-82 F 40217 31-Aug-91 M 17565 22-Jun-66 M 28024 1-Jun-79 M 5615 29-Aug-69 F 43421 20-Nov-85 M 45510 20-Jan-66 F 41713 21-Mar-80 M 44289 8-Apr-88 M 25023 3-Oct-71 M 42765 28-Apr-94 M _ 42707 17-May-88 M 46773 14-Jun-93 M 42939 5-Oct-84 M 7866 24-Jan-77 F 40680 31-Dec-91 F 40300 25-Jun-77 M 40097 30-Aug-88 M 46847 30-Jan-02 M 4200016-Apr-73 F 4584010-Dec-89 F 42110 20-May-88 M 41955 7-Nov-69 F 41993 4-Oct-90 F 26953 12-Feb-72 F 27966 29-Dec-76 M 4666016-Mar-99 M 29220 24-Jan-84 M JOB TITLE YRLY HR EMPLOYEE GROUP ASSIGNMENT CATEGORY Exec LTD Eff Exec STD Eff $ 91,808.70 Managerial/Confidential Probationary #N/A #NIA $ 74,854.20 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #N/A #NIA $ 82,526.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 59,314.94 AFSCME Fulltime-Regular #N/A #NIA $ 41,360.59 AFSCME Fulltime-Regular #NIA #NIA $ 68,664.96 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 79,307.46 Managerial/Confidential Fulltime-Regular #N/A #N/A $ 75,426.00 AFSCME Fulltime-Regular #NIA #NIA $ 72,097.79 AFSCME Fulltime-Regular #N/A #N/A $ 53,800.44 AFSCME Fulltime-Regular #NIA #NIA $ 109,334.36 Sworn Police Officers Fulltime-Regular #N/A #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 102,598.70 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 90,864.88 Fire Union Fulltime-Regular #NIA #NIA $ 84,527.53 Fire Union Fulltime-Regular #NIA #NIA $ 131,131.10 Fire Union Fulltime-Regular #NIA #NIA $ 42,154.32 AFSCME Fulltime-Regular #NIA #NIA $ 120,887.10 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,488.27 Fire Union Fulltime-Regular #NIA #NIA $ 119,722.03 Fire Union Fulltime-Regular #NIA #NIA $ 101,448.88 AFSCME Fulltime-Regular #NIA #NIA $ 106,005.99 Fire Union Fulltime-Regular #NIA #NIA $ 97,851.68 Fire Union Fulltime-Regular #NIA #NIA $ 94,661.63 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 79,487.82 AFSCME Fulltime-Regular #N/A #N/A $ 68,664.96 AFSCME Fulltime-Regular #NIA #NIA $ 54,927.60 Unclassified Fulltime-Regular #N/A #N/A $ 56,490.51 AFSCME Probationary #NIA #NIA $ 56,490.51 AFSCME Fulltime-Regular #N/A #N/A $ 36,414.56 AFSCME Probationary #NIA #NIA $ 116,815.18 AFSCME Fulltime-Regular #N/A #N/A $ 62,281.23 AFSCME Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #N/A #N/A $ 232,093.69 Executives Fulltime-Regular 01/01/18 #NIA $ 78,492.21 Fire Union Fulltime-Regular #NIA #N/A $ 104,650.62 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 64,537.32 Fire Union Fulltime-Regular #NIA #N/A $ 40,331.66 Unclassified Fulltime-Regular #NIA #NIA $ 51,011.16 Sanitation Union Fulltime-Regular #NIA #N/A $ 75,702.85 AFSCME Fulltime-Regular #N/A #NIA $ 237,605.40 Fire Executives Fulltime-Regular 01/01/18 #N/A $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #NIA $ 86,653.21 Sworn Police Officers Fulltime-Regular #NIA #N/A $ 55,857.56 Police Trainees Probationary #NIA #NIA $ 48,582.14 Sanitation Union Fulltime-Regular #NIA #N/A $ 142,896.29 AFSCME Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Fulltime-Regular #NIA #NIA $ 86,486.40 Fire Union Fulltime-Regular #N/A #NIA $ 76,579.56 Fire Union Fulltime-Regular #NIA #NIA $ 55,857.56 Police Trainees Probationary #N/A #NIA $ 56,490.51 AFSCME Fulltime-Regular #NIA #NIA $ 42,154.32 AFSCME Fulltime-Regular #N/A #NIA $ 67,764.15 Fire Union Fulltime-Regular #NIA #NIA $ 44,261.56 AFSCME Fulltime-Regular #N/A #NIA $ 72,097.79 AFSCME Probationary #NIA #NIA $ 79,377.79 AFSCME Fulltime-Regular #N/A #N/A $ 85,033.22 Fire Union Fulltime-Regular #NIA #NIA $ 38,235.18 AFSCME Probationary #NIA #N/A $ 88,648.68 Fire Union Fulltime-Regular #NIA #NIA Violent Crime Intervention Adm. Police Officer Police Officer Police Officer Grant Funded Homeless Housing Supervisor Building Services Assistant I Grant Funded Administrative Aide 11 Emergency Dispatcher Human Resources Generalist Community Service Provider Crime Scene Investigator 1 Grant Funded Homeless Housing Specialist Police Sergeant Police Officer Police Officer Fire Lieut 96 Hrs Fire Fighter 96 Hrs Chief Fire Ofcr.-96 H Pol Prop Spec I Police Sergeant Fire Lieut 80 Hrs Fire Captain 52/104 Hrs Senior Financial Analyst Fire Lieut 52/104 Hrs Fire Lieut 96 Hrs Police Officer Sanitation Supervisor Loan Specialist Commissioner's Aide Eng Tech 11 Auto Eqp Op 1 Marinas Aide Project Manager - OTM Fleet Liaison Fire Fighter 96 Hrs Deputy City Attorney Fire Fighter 96 Hrs Police Officer Fire Fighter 96 Hrs Special Aide (Elected Official) Waste Collector-Garbg Engineer I Chief Of Fire Police Officer Police Officer Pol Officer-Prob Waste Collector-Garbg Chief of Hearing Boards Parks & Recreation Mgr 11 Fire Lieut 96 Hrs Fire Fighter 80 Hrs Pol Officer-Prob Public Service Aide Stable Attendant Fire Fighter 96 Hrs Stock Clerk 1 Special Projects Coordinator Code Compliance Inspector Fire Fighter 52/104hrs Public Service Aide Fire Lieut 96 Hrs 49 EXHIBIT B STANDARD INSURANCE COMPANY A Stock Life Insurance Company 900 SW Fifth Avenue Portland, Oregon 97204-1282 (503) 321-7000 GROUP SHORT TERM DISABILITY INSURANCE POLICY Policyholder City of Miami Policy Number: 755831-A Effective Date: January 1, 2018 The consideration for this Group Policy is the application of the Policyholder and the payment by the Policyholder of premiums as provided herein. Subject to the Policyholder Provisions and the Incontestability Provisions, this Group Policy (a) is issued for the Initial Rate Guarantee Period shown in the Coverage Features, and (b) may be renewed for successive renewal periods by the payment of the premium set by us on each renewal date. The length of each renewal period will be set by us, but will not be less than 12 months. For purposes of effective dates and ending dates under this Group Policy, all days begin and end at 12:00 midnight Standard Time at the Policyholder's address. All provisions on this and the following pages are part of this Group Policy. "You" and "your" mean the Member. 'We", "us", and "our" mean Standard Insurance Company. Other defined terms appear with their initial letters capitalized. Section headings, and references to them, appear in boldface type. STANDARD INSURANCE COMPANY By 4...,- Chairman, President and CEO GP190—STD/S399 Corporate Secretary Table of Contents COVERAGE FEATURES 1 GENERAL POLICY INFORMATION 1 BECOMING INSURED 1 PREMIUM CONTRIBUTIONS 2 SCHEDULE OF INSURANCE 2 DISABILITY PROVISIONS 2 EXCLUSIONS AND LIMITATIONS 2 OTHER PROVISIONS 2 PREMIUM RATES AND RENEWALS 3 INSURING CLAUSE 4 DEFINITION OF DISABILITY 4 RETURN TO WORK INCENTIVE 4 TEMPORARY RECOVERY 4 WHEN STD BENEFITS END 5 PREDISABILITY EARNINGS 5 DEDUCTIBLE INCOME 6 RULES FOR DEDUCTIBLE INCOME 6 BENEFITS AFTER INSURANCE ENDS OR IS CHANGED 6 EFFECT OF NEW DISABILITY 7 EXCLUSIONS 7 LIMITATIONS 7 CLAIMS 7 ALLOCATION OF AUTHORITY 9 TIME LIMITS ON LEGAL ACTIONS 9 INCONTESTABILITY PROVISIONS 9 WHEN YOUR INSURANCE BECOMES EFFECTIVE 10 ACTIVE WORK PROVISIONS 11 WHEN YOUR INSURANCE ENDS 11 REINSTATEMENT OF INSURANCE 12 CLERICAL ERROR AND MISSTATEMENT 12 TERMINATION OR AMENDMENT OF THE GROUP POLICY 12 DEFINITIONS 13 POLICYHOLDER PROVISIONS 14 Index of Defined Terms Active Work, Actively At Work, 11 Benefit Waiting Period, 2, 13 Class Definition, 1 Contributory, 13 Deductible Income, 6 Disability, 4 Disabled, 4 Eligibility Waiting Period, 13 Employer(s), 1 Evidence Of Insurability, 13 Grace Period, 3 Group Policy, 13 Group Policy Effective Date, 1 Group Policy Number, 1 Initial Rate Guarantee Period, 3 Injury, 13 Leave Of Absence Period, 2 LLC Owner -Employee, 13 Material Duties, 4 Maximum Benefit Period, 2, 13 Maximum STD Benefit, 2 Member, 1 Minimum Participation Number, 3 Minimum STD Benefit, 2 Noncontributory, 13 Notice of Rate Change, 3 Partial Disability Income Percentage, 2 Partially Disabled, 4 PC Partner, 13 Physician, 13 Policyholder, 1 Predisability Earnings, 5 Pregnancy, 13 Premium Due Dates, 3 Premium Rate, 3 Prior Plan, 13 Proof Of Loss, 8 STD Benefit, 13 Temporary Recovery, 4 War, 7 COVERAGE FEATURES This section contains many of the features of your short term disability (STD) insurance. Other provisions, including exclusions, limitations, and Deductible Income, appear in other sections. Please refer to the text of each section for full details. The Table of Contents and the Index of Defined Terms help locate sections and definitions. GENERAL POLICY INFORMATION Group Policy Number: 755831-A Policyholder: City of Miami Employer(s): City of Miami Group Policy Effective Date: January 1, 2018 Policy Issued in: Florida BECOMING INSURED To become insured you must: (a) Be a Member; (b) Complete your Eligibility Waiting Period; and (c) Meet the requirements in Active Work Provisions and When Your Insurance Becomes Effective. Definition of Member: Class Definition: Eligibility Waiting Period: Evidence Of Insurability: You are a Member if you are: 1. A regular Executive employee of the Employer; and 2. Regularly working at least 30 hours each week. You are not a Member if you are: 1. A temporary or seasonal employee. 2. A leased employee. 3. An independent contractor. 4. A full time member of the armed forces of any country. None You are eligible on one of the following dates: If you are a Member on the Group Policy Effective Date, you are eligible on that date. If you become a Member after the Group Policy Effective Date, you are eligible on the date you become a Member. Required: a. For late application for Contributory insurance. b. For reinstatements if required. c. For Members eligible but not insured under the Prior Plan. 03/16/2018 - 1 - 755831-A PREMIUM CONTRIBUTIONS Insurance is: Contributory SCHEDULE OF INSURANCE STD Benefit: 60% of the first $3,333 of your Predisability Earnings, before reduction by Deductible Income. Maximum: $2,000 before reduction by Deductible Income. Minimum: $15 Benefit Waiting Period: For Disability caused by accidental Injury: For Disability caused by Physical Disease, Pregnancy or Mental Disorder: 30 days 30 days However, you will be credited for time served under the Prior Plan's benefit waiting period when your Disability is a recurrent disability under the Prior Plan's recurrent disability provisions. Maximum Benefit Period: 180 days. However, if you are eligible for benefits under a long term disability insurance plan sponsored by your Employer, your Maximum Benefit Period will be reduced by the Benefit Waiting Period. If you are Disabled for less than one full week, we will pay one -seventh of the STD Benefit for each day of Disability. DISABILITY PROVISIONS Partial Disability: Covered. The Partial Disability Income Percentage is 60% of your Predisability Earnings. See Definition Of Disability for more information. EXCLUSIONS AND LIMITATIONS Work Related Disability Exclusion: Yes See Exclusions and Limitations for these and other exclusions and limitations. OTHER PROVISIONS Daily Hospital Benefit: No First Day Hospital Benefit: No Leave Of Absence Period: 30 days or less. Predisability Earnings based on: Earnings in effect on your last full day of Active Work. 03/16/2018 - 2 - 755831-A PREMIUM RATES AND RENEWALS Premium Rate: Age of insured on last January 1 Monthly rate per $10.00 of STD Benefit before reduction by Deductible Income Under age 30 $ 0.382 30 through 34 0.423 35 through 39 0.328 40 through 44 0.302 45 through 49 0.363 50 through 54 0.423 55 through 59 0.580 60 or over 0.710 Premium Due Dates: January 1, 2018 and the first day of each calendar month thereafter. Grace Period: Initial Rate Guarantee Period: Notice of Rate Change: Minimum Participation Number: 31 days January 1, 2018 to January 1, 2021 60 days The greater of 20% of eligible Members or 10 insured Members 03/16/2018 3 755831-A INSURING CLAUSE If you become Disabled while insured under the Group Policy, we will pay STD Benefits according to the terms of the Group Policy after we receive satisfactory Proof Of Loss. DEFINITION OF DISABILITY You are Disabled if you meet either of the following definitions: A. Definition Of Disability; or B. Definition Of Partial Disability. A. Definition Of Disability You are Disabled if, as a result of Physical Disease, Injury, Pregnancy, or Mental Disorder you are unable to perform with reasonable continuity the Material Duties of your Own Occupation. B. Definition Of Partial Disability You are Partially Disabled when you work for your Employer but, as a result of Physical Disease, Injury, Pregnancy, or Mental Disorder are unable to earn more than the Partial Disability Income Percentage shown in the Coverage Features. One half of your Work Earnings will be Deductible Income. See Return To Work Incentive and Deductible Income. Own Occupation means any employment, business, trade, profession, calling or vocation that involves Material Duties of the same general character as your regular and ordinary employment with your Employer. Your Own Occupation is not limited to your job with your Employer. Material Duties means the essential tasks, functions and operations, and the skills, abilities, knowledge, training and experience, generally required by those engaged in a particular occupation. RETURN TO WORK INCENTIVE You may serve your Benefit Waiting Period while working if you meet the Own Occupation definition of Disability. You are eligible for the Return To Work Incentive on the first day you work after the Benefit Waiting Period if STD Benefits are payable on that date. Your Work Earnings will be Deductible Income as determined in 1., 2. and 3. 1. Determine the amount of your STD Benefit as if there were no Deductible Income, and add your Work Earnings to that amount. 2. Determine 100% of your Predisability Earnings. 3. If 1. is greater than 2., the difference will be Deductible Income. TEMPORARY RECOVERY You may temporarily recover from your Disability during the Maximum Benefit Period, and then become Disabled again from the same cause or causes, without having to serve a new Benefit Waiting Period. Temporary Recovery means you cease to be Disabled for no longer than the allowable period. A. Allowable Period The allowable period of recovery during the Maximum Benefit Period is a total of 90 days. 03/16/2018 - 4 - 755831-A B. Effect Of Temporary Recovery If your Temporary Recovery does not exceed the allowable period, 1 through 4 below will apply. 1. The Predisability Earnings used to determine your STD Benefit will not change. 2. The period of Temporary Recovery will not count toward your Maximum Benefit Period. 3. No STD Benefits will be payable for the period of Temporary Recovery. 4. Except as stated above, the provisions of the Group Policy will be applied as if there had been no interruption of your Disability. WHEN STD BENEFITS END Your STD Benefits end automatically on the earliest of 1 through 5 below. 1. The date you are no longer Disabled. 2. The date your Maximum Benefit Period ends. 3. The date you die. 4. The date you begin working for an employer other than your Employer, or become self-employed. 5. The date long term disability benefits become payable to you under a group long term disability policy issued by us. PREDISABILITY EARNINGS Your Predisability Earnings will be based on your earnings in effect on your last full day of Active Work unless a different date applies (see the Coverage Features). Any subsequent change in your earnings will not affect your Predisability Earnings. Predisability Earnings means your weekly rate of earnings from your Employer, including: 1. Contributions you make through a salary reduction agreement with your Employer to: a. An Internal Revenue Code (IRC) Section 401(k), 403(b), 408(k), or 457 deferred compensation arrangement; or b. An executive nonqualified deferred compensation arrangement. 2. Amounts contributed to your fringe benefits according to a salary reduction agreement under an IRC Section 125 plan. Predisability Earnings does not include: 1. Bonuses. 2. Commissions. 3. Overtime pay. 4. Shift differential pay. 5. Stock options or stock bonuses. 6. Your Employer's contributions on your behalf to any deferred compensation arrangement or pension plan. 7. Any other extra compensation. If you are paid on an annual contract basis, your weekly rate of earnings is one fifty-second (1 /52nd) of your annual contract salary 03/16/2018 - 5 - 755831-A If you are paid hourly, your weekly rate of earnings is based on your hourly pay rate multiplied by the number of hours you are regularly scheduled to work per week, but not more than 40 hours. If you do not have regular work hours, your weekly rate of earnings is based on the average number of hours you worked per week during the preceding 52 weeks (or during your period of employment if less than 52 weeks), but not more than 40 hours. DEDUCTIBLE INCOME Deductible Income means: 1. Your Work Earnings, as described in the Return To Work Incentive. 2. Any amount you receive or are eligible to receive because of your disability under a state disability income benefit law or similar law. 3. Any earnings or compensation included in Predisability Earnings which you receive or are eligible to receive while STD Benefits are payable. 4. Any amount you receive or are eligible to receive under any unemployment compensation law or similar act or law. 5. Any amount you receive by compromise, settlement, or other method as a result of a claim for any of the above, whether disputed or undisputed. RULES FOR DEDUCTIBLE INCOME A. Weekly Equivalents Each week we will determine your STD Benefit using the Deductible Income for the same weekly period, even if you actually receive the Deductible Income in another week. If you are paid Deductible Income in a lump sum or by a method other than weekly, we will determine your STD Benefit using a prorated amount. We will use the period of time to which the Deductible Income applies. If no period of time is stated, we will use a reasonable one. B. Your Duty To Pursue Deductible Income You must pursue Deductible Income for which you may be eligible. We may ask for written documentation of your pursuit of Deductible Income. You must provide it within 60 days after we mail you our request. Otherwise, we may reduce your STD Benefits by the amount we estimate you would be eligible to receive upon proper pursuit of the Deductible Income. C. Pending Deductible Income We will not deduct pending Deductible Income until it becomes payable. You must notify us of the amount of the Deductible Income when it is approved. You must repay us for the resulting overpayment of your claim. See Claims. BENEFITS AFTER INSURANCE ENDS OR IS CHANGED During each period of continuous Disability, we will pay STD Benefits according to the terms of the Group Policy in effect on the date you become Disabled. Your right to receive STD Benefits for a period of Disability which begins while you are insured will not be affected by: 1. Termination of the Group Policy after you become Disabled; 2. Termination of your insurance while the Group Policy remains in force; or 3. Any amendment to the Group Policy approved after the date you become Disabled. 03/16/2018 - 6 - 755831-A EFFECT OF NEW DISABILITY If a period of Disability is extended by a new cause while STD Benefits are payable, STD Benefits will continue while you remain Disabled. However, 1 and 2 below will apply. 1. STD Benefits will not continue beyond the end of the original Maximum Benefit Period. 2. All provisions of the Group Policy, including the Exclusions and Limitations sections will apply to the new cause of Disability. EXCLUSIONS A. War You are not covered for a Disability caused or contributed to by War or any act of War. War means declared or undeclared war, whether civil or international, and any substantial armed conflict between organized forces of a military nature. B. Intentionally Self -Inflicted Injury You are not covered for a Disability caused or contributed to by an intentionally self-inflicted Injury while sane or insane. C. Work Related You are not covered for a Disability arising out of or in the course of any employment for wage or profit, if you are receiving benefits for the disability under any workers' compensation or occupational disease law. LIMITATIONS A. Care Of A Physician You must be under the ongoing care of a Physician in the appropriate specialty as determined by us during the Benefit Waiting Period. No STD Benefits will be paid for any period of Disability when you are not under the ongoing care of a Physician in the appropriate specialty as determined by us. B. Occupational Benefits No STD Benefits will be paid for any period when you are receiving benefits under a workers' compensation law or similar law. If your claim for these benefits is accepted, compromised or settled (whether disputed or undisputed), you must repay us for the full amount of any payments we make to you while your claim for occupational benefits is pending. C. Working No STD Benefits will be paid for any period: (a) when you are working for wage or profit for any employer other than your Employer; or (b) when you are self-employed. This limitation applies whether you are working in your own or another occupation. CLAIMS A. Filing A Claim Claims should be filed on our forms. If you do not receive our forms within 15 days after you ask for them, you may submit your claim in a letter to us. The letter should include the date Disability began, and the cause and nature of the Disability. B. Time Limits On Filing Proof Of Loss 03/16/2018 - 7 - 755831-A You must give us Proof Of Loss within 90 days after the end of the Benefit Waiting Period. If you cannot do so, you must give it to us as soon as reasonably possible, but not later than one year after that 90-day period. If Proof Of Loss is filed outside these time limits, your claim will be denied. These limits will not apply while you lack legal capacity. C. Proof Of Loss Proof Of Loss means written proof that you are Disabled and entitled to STD Benefits. Proof Of Loss must be provided at your expense. D. Documentation Completed claims statements, a signed authorization for us to obtain information, and any other items we may reasonably require in support of a claim must be submitted at your expense. If the required documentation is not provided within 45 days after we mail our request, your claim may be denied. E. Investigation Of Claim We may investigate your claim at any time. At our expense, we may have you examined at reasonable intervals by specialists of our choice. We may deny or suspend STD Benefits if you fail to attend an examination or cooperate with the examiner. F. Time Of Payment We will pay STD Benefits within 60 days after you satisfy Proof Of Loss. STD Benefits will be paid to you at the end of each week you qualify for them. STD Benefits remaining unpaid at your death will be paid to your estate. G. Overpayment Of Claim We will notify you of the amount of any overpayment of your claim under any group disability insurance policy issued by us. You must immediately repay us. You will not receive any STD Benefits until we have been repaid in full. In the meantime, any STD Benefits paid, including the Minimum STD Benefit, will be applied to reduce the amount of the overpayment. We may charge you interest at the legal rate for any overpayment which is not repaid within 30 days after we first mail you notice of the amount of the overpayment. H. Notice Of Decision On Claim We will evaluate your claim promptly after you file it. Within 45 days after we receive your claim we will send you: (a) a written decision on your claim; or (b) a notice that we are extending the period to decide your claim for 30 days. Before the end of this extension period we will send you: (a) a written decision on your claim; or (b) a notice that we are extending the period to decide your claim for an additional 30 days. If an extension is due to your failure to provide information necessary to decide the claim, the extended time period for deciding your claim will not begin until you provide the information or otherwise respond. If we extend the period to decide your claim, we will notify you of the following: (a) the reasons for the extension; (b) when we expect to decide your claim; (c) an explanation of the standards on which entitlement to benefits is based; (d) the unresolved issues preventing a decision; and (e) any additional information we need to resolve those issues. If we request additional information, you will have 45 days to provide the information. If you do not provide the requested information within 45 days, we may decide your claim based on the information we have received. If we deny any part of your claim, you will receive a written notice of denial containing: a. The reasons for our decision. 03/16/2018 - 8 - 755831-A b. Reference to the parts of the Group Policy on which our decision is based. c. A description of any additional information needed to support your claim. d. Information concerning your right to a review of our decision. I. Review Procedure You must request in writing a review of a denial of all or part of your claim within 60 days after you receive notice of the denial. When you request a review, you may send us written comments or other items to support your claim. You may review any non -privileged information that relates to your request for review. We will review your claim promptly after we receive your request. We will send you a notice of our decision within 60 days after we receive your request, or within 120 days if special circumstances require an extension. We will state the reasons for our decision and refer you to the relevant parts of the Group Policy. J. Assignment The rights and benefits under the Group Policy are not assignable. ALLOCATION OF AUTHORITY Except for those functions which the Group Policy specifically reserves to the Policyholder, we have full and exclusive authority to control and manage the Group Policy, to administer claims, and to interpret the Group Policy and resolve all questions arising in its administration, interpretation, and application. Our authority includes, but is not limited to: 1. The right to resolve all matters when a review has been requested; 2. The right to establish and enforce rules and procedures for the administration of the Group Policy and any claim under it; 3. The right to determine: a. Eligibility for insurance; b. Entitlement to benefits; c. Amount of benefits payable; d. Sufficiency and the amount of information we may reasonably require to determine a., b., or c., above. Subject to the review procedures of the Group Policy, any decision we make in the exercise of our authority is conclusive and binding. TIME LIMITS ON LEGAL ACTIONS No action at law or in equity may be brought until 60 days after you have given us Proof Of Loss. No such action may be brought after expiration of the applicable statute of limitations from the earlier of: 1. The date we receive Proof Of Loss; and 2. The end of the period within which Proof Of Loss is required to be given. INCONTESTABILITY PROVISIONS A. Incontestability Of Member's Insurance 03/16/2018 - 9 - 755831-A Any statement you make to obtain insurance is a representation and not a warranty. No misrepresentation by you will be used to reduce or deny your claim unless: 1. Your insurance would not have been approved if we had known the truth; and 2. We have given you a copy of a written instrument signed by you which contains your misrepresentation. After your insurance has been in effect for two years, we will not use a misrepresentation by you to reduce or deny your claim, unless it was a fraudulent misrepresentation. B. Incontestability Of Group Policy Any statement made by the Policyholder or Employer to obtain the Group Policy is a representation and not a warranty. No misrepresentation by the Policyholder or Employer will be used to deny a claim or to deny the validity of the Group Policy unless: 1. The Group Policy would not have been issued if we had known the truth; and 2. We have given the Policyholder or Employer a copy of a written instrument signed by the Policyholder or Employer which contains the misrepresentation. The validity of the Group Policy will not be contested after it has been in force for two years, except for nonpayment of premiums or fraudulent misrepresentations. WHEN YOUR INSURANCE BECOMES EFFECTIVE The Coverage Features states whether your insurance is Contributory or Noncontributory. A. Noncontributory Insurance Subject to the Active Work Provisions, your Noncontributory insurance becomes effective on the date you become eligible. B. Contributory Insurance You must apply in writing for Contributory insurance and agree to pay premiums. Subject to the Active Work Provisions, your insurance becomes effective on: 1. The date you become eligible, if you apply on or before that date; 2. The date you apply, if you apply within 31 days after you become eligible; or 3. The date we approve your Evidence Of Insurability, if you apply more than 31 days after you become eligible (late application). C. Insurance Subject To Evidence Of Insurability Subject to the Active Work Provisions, insurance subject to Evidence Of Insurability becomes effective on the date we approve Evidence Of Insurability. D. Takeover Provisions 1. If you were insured under the Prior Plan on the day before the effective date of your Employer's coverage under the Group Policy, your Eligibility Waiting Period is waived on the effective date of your Employer's coverage under the Group Policy. 2. You must submit satisfactory Evidence Of Insurability to become insured for insurance if you were eligible for insurance under the Prior Plan for more than 31 days but were not insured. 03/16/2018 - 10 - 755831-A ACTIVE WORK PROVISIONS A. Active Work Requirement If you are incapable of Active Work because of Physical Disease, Injury, Pregnancy, or Mental Disorder on the day before the scheduled effective date of your insurance, your insurance will not become effective until the day after you complete one full day of Active Work as an eligible Member. Active Work and Actively At Work mean performing the Material Duties of your Own Occupation at your Employer's usual place of business. You will also meet the Active Work requirement if: 1. You were absent from Active Work because of a regularly scheduled day off, holiday, or vacation day; 2. You were Actively At Work on your last scheduled work day before the date of your absence; and 3. You were capable of Active Work on the day before the scheduled effective date of your insurance. B. Changes In Insurance This Active Work requirement also applies to any increase in your insurance. However, if you return to Active Work during a period of Disability or Temporary Recovery (see Temporary Recovery), you will not qualify for any change in insurance caused by a change in: 1. Your status as a member of a class; 2. The rate of earnings used to determine your Predisability Earnings; or 3. The terms of the Group Policy. WHEN YOUR INSURANCE ENDS Your insurance ends automatically on the earliest of: 1. The date the last period ends for which you made a premium contribution, if your insurance is Contributory. 2. The date the Group Policy terminates. 3. The date your employment terminates. 4. The date you cease to be a Member. However, if you cease to be a Member because you are not working the required minimum number of hours, your insurance will be continued during the following periods, unless it ends under 1 through 3 above. a. While your Employer is paying you at least the same Predisability Earnings paid to you immediately before you ceased to be a Member. b. During the Benefit Waiting Period and while STD Benefits are payable. c. During a leave of absence if continuation of your insurance under the Group Policy is required by a state -mandated family or medical leave act or law. d. During any other leave of absence approved by your Employer in advance and in writing and scheduled to last the Leave Of Absence Period shown in the Coverage Features. 03/16/2018 - 11 - 755831-A REINSTATEMENT OF INSURANCE If your insurance ends, you may become insured again as a new Member. However, the following will apply. 1. If your insurance ends because you cease to be a Member, and if you become a Member again within 90 days, the Eligibility Waiting Period will be waived. 2. If your insurance ends because you fail to make a required premium contribution, you must provide Evidence Of Insurability to become insured again. 3. If your insurance ends because you are on a federal or state mandated family or medical leave of absence, and you become a Member again immediately following the period allowed, your insurance will be reinstated pursuant to the federal or state mandated family or medical leave act or law. CLERICAL ERROR AND MISSTATEMENT A. Clerical Error Clerical error by the Policyholder, your Employer, or their respective employees or representatives will not: 1. Cause a person to become insured. 2. Invalidate insurance under the Group Policy otherwise validly in force. 3. Continue insurance under the Group Policy otherwise validly terminated. B. The Policyholder and your Employer act on their own behalf as your agent, and not as our agent. C. Misstatement Of Age If a person's age has been misstated, we will make an equitable adjustment of premiums, benefits or both. The adjustment will be based on: 1. The amount of insurance based on the correct age; and 2. The difference between the amount paid and the amount which would have been paid if the age had been correctly stated. TERMINATION OR AMENDMENT OF THE GROUP POLICY The Group Policy may be terminated by us or the Policyholder according to its terms. It will terminate automatically for nonpayment of premium. The Policyholder may terminate the Group Policy in whole, and may terminate insurance for any class or group of Members, at any time by giving us written notice. Benefits under the Group Policy are limited to its terms, including any valid amendment. No change or amendment will be valid unless it is approved in writing by one of our executive officers and given to the Policyholder for attachment to the Group Policy. The Policyholder, your Employer, and their respective employees or representatives have no right or authority to change or amend the Group Policy or to waive any of its terms or provisions without our signed written approval. We may change the Group Policy in whole or in part when any change or clarification in law or governmental regulation affects our obligations under the Group Policy, or with the Policyholder's consent. Any such change or amendment of the Group Policy may apply to current or future Members or to any separate classes or groups of Members. 03/16/2018 - 12 - 755831-A DEFINITIONS Benefit Waiting Period means the period you must be continuously Disabled before STD Benefits become payable. No STD Benefits are payable for the Benefit Waiting Period. See Coverage Features. Contributory means you pay all or part of the premium for your insurance. Eligibility Waiting Period means the period you must be a Member before you become eligible for insurance. See Coverage Features. Providing Evidence Of Insurability means you must: 1. Complete and sign our medical history statement; 2. Sign our form authorizing us to obtain information about your health; 3. Undergo a physical examination, if required by us, which may include blood testing; and 4. At your expense, provide any additional information about your insurability that we may reasonably require. Group Policy means the group short term disability insurance policy issued by us to the Policyholder and identified by the Group Policy Number. Injury means an injury to your body. L.L.C. Owner -Employee means an individual who owns an equity interest in an Employer and is actively employed in the conduct of the Employer's business. Maximum Benefit Period means the longest period for which STD Benefits are payable for any one period of continuous Disability, whether from one or more causes. It begins at the end of the Benefit Waiting Period. No STD Benefits are payable after the end of the Maximum Benefit Period, even if you are still Disabled. See Coverage Features. Mental Disorder means any mental, emotional, behavioral, psychological, personality, cognitive, mood or stress -related abnormality, disorder, disturbance, dysfunction or syndrome, regardless of the cause (including any biological or biochemical disorder or imbalance of the brain) or the presence of physical symptoms. Mental Disorder includes, but is not limited to, bipolar affective disorder, organic brain syndrome, schizophrenia, psychotic illness, manic depressive illness, depression and depressive disorders, anxiety and anxiety disorders. Noncontributory means the Policyholder or Employer pays the entire premium for your insurance. P.C. Partner means the sole active employee and majority shareholder of a professional corporation in partnership with the Policyholder. Physical Disease means a physical disease entity or process that produces structural or functional changes in your body as diagnosed by a Physician. Physician means a licensed M.D. or D.O., acting within the scope of the license. Physician does not include you or your spouse, or the brother, sister, parent, or child of either you or your spouse. Pregnancy means your pregnancy, childbirth, or related medical conditions, including complications caused by pregnancy. Prior Plan means your Employer's group short term disability insurance plan in effect on the day before the effective date of your Employer's coverage under the Group Policy and which is replaced by the Group Policy. STD Benefit means the weekly benefit payable to you under the terms of the Group Policy. 03/16/2018 - 13 - 755831-A POLICYHOLDER PROVISIONS A. Premiums The premium due on each Premium Due Date is the sum of the premiums for all persons then insured. Premium Rates are shown in the Coverage Features. B. Contributions From Members The Policyholder determines the amount, if any, of each Member's contribution toward the cost of insurance under the Group Policy. C. Changes In Premium Rates We may change Premium Rates when: 1. A change or clarification in law or governmental regulation affects the amount payable under the Group Policy. Any such change in Premium Rates will reflect only the change in our obligations; 2. Factors material to underwriting the risk we assumed under the Group Policy with respect to an Employer, including, but not limited to, number of persons insured, age, Predisability Earnings, gender, and occupational classification, change by 25% or more. 3. We and the Policyholder mutually agree to change Premium Rates. Except as provided above, Premium Rates will not be changed during the Initial Rate Guarantee Period shown in the Coverage Features. Thereafter, except as provided above, we may change Premium Rates upon advance written notice to the Policyholder. The minimum advance notice is shown in the Coverage Features as Notice of Rate Change. Any such change in Premium Rates may be made effective on any Premium Due Date, but no such change will be made more than once in any contract year. Contract years are successive 12 month periods computed from the end of the Initial Rate Guarantee Period. D. Payment Of Premiums All premiums are due on the Premium Due Dates shown in the Coverage Features. Each premium is payable on or before its Premium Due Date directly to us at our home office. The payment of each premium as it becomes due will maintain the Group Policy in force until the next Premium Due Date. E. Grace Period And Termination For Nonpayment If a premium is not paid on or before its Premium Due Date, it may be paid during the following Grace Period. The length of the Grace Period is shown in the Coverage Features. The Group Policy will remain in force during the Grace Period. If the premium is not paid during the Grace Period, the Group Policy will terminate automatically at the end of the Grace Period. The Policyholder is liable for premium for insurance under the Group Policy during the Grace Period. We may charge interest at the legal rate for any premium which is not paid during the Grace Period, beginning with the first day after the Grace Period. F. Termination For Other Reasons The Policyholder may terminate the Group Policy by giving us written notice. The effective date of termination will be the later of: 1. The date stated in the notice; and 2. The date we receive the notice. 03/16/2018 - 14 - 755831-A We may terminate the Group Policy as follows: 1. On any Premium Due Date if the number of persons insured is less than the Minimum Participation Number or less than the Minimum Participation Percentage shown in the Coverage Features. 2. On any Premium Due Date if we determine that the Policyholder has failed to promptly furnish any necessary information requested by us, or has failed to perform any other obligations relating to the Group Policy. The minimum advance notice of such termination by us is the same as the Notice of Rate Change stated in the Coverage Features. G. Premium Adjustments Premium adjustments involving a return of unearned premiums to the Policyholder will be limited to the 12 months just before the date we receive a request for premium adjustment. H. Certificates We will issue certificates to the Policyholder showing the coverage under the Group Policy. The Policyholder will distribute a certificate to each insured Member. If the terms of the certificate differ from the Group Policy, the terms stated in the Group Policy will govern. I. Records And Reports The Policyholder or Employer will furnish on our forms all information reasonably necessary to administer the Group Policy. We have the right at all reasonable times to inspect the payroll and other records of the Policyholder or Employer which relate to insurance under the Group Policy. J. Notice Of Suit The Policyholder and Employer shall promptly give us written notice of any lawsuit or other legal proceedings arising under the Group Policy. K. Entire Contract, Changes The Group Policy and the application of the Policyholder constitute the entire contract between the parties. A copy of the Policyholder's application is attached to the Group Policy when issued. The Group Policy may be changed in whole or in part. No change in the Group Policy will be valid unless it is approved in writing by one of our executive officers and given to the Policyholder for attachment to the Group Policy. No agent has authority to change the Group Policy or to waive any of its provisions. L. Effect On Workers' Compensation, State Disability Insurance The coverage provided under the Group Policy is not a substitute for coverage under a workers' compensation or state disability income benefit law and does not relieve the Employer of any obligation to provide such coverage. STDP97X 03/16/2018 - 15 - 755831-A EXHIBIT C STANDARD INSURANCE COMPANY A Stock Life Insurance Company 900 SW Fifth Avenue Portland, Oregon 97204-1282 (503) 321-7000 CERTIFICATE GROUP LONG TERM DISABILITY INSURANCE Policyholder: City of Miami Policy Number: 755831-B Effective Date: January 1, 2018 The Group Policy has been issued to the Policyholder. We certify that you will be insured as provided by the terms of your Employer's coverage under the Group Policy. If the terms of this Certificate differ from the terms of your Employer's coverage under the Group Policy, the latter will govern. If your coverage is changed by an amendment to the Group Policy, we will provide the Employer with a revised Certificate or other notice to be given to you. Possession of this Certificate does not necessarily mean you are insured. You are insured only if you meet the requirements set out in this Certificate. "You" and "your" mean the Member. "We", "us" and "our" mean Standard Insurance Company. Other defined terms appear with the initial letters capitalized. Section headings, and references to them, appear in boldface type. Chairman, President and CEO GC190-LTD/S399 Table of Contents COVERAGE FEATURES 1 GENERAL POLICY INFORMATION 1 SCHEDULE OF INSURANCE 1 PREMIUM CONTRIBUTIONS 2 INSURING CLAUSE 3 BECOMING INSURED 3 WHEN YOUR INSURANCE BECOMES EFFECTIVE 3 ACTIVE WORK PROVISIONS 4 CONTINUITY OF COVERAGE 4 WHEN YOUR INSURANCE ENDS 5 WAIVER OF PREMIUM 5 REINSTATEMENT OF INSURANCE 5 DEFINITION OF DISABILITY 6 RETURN TO WORK PROVISIONS 7 REASONABLE ACCOMMODATION EXPENSE BENEFIT 8 REHABILITATION PLAN PROVISION 8 TEMPORARY RECOVERY 9 WHEN LTD BENEFITS END 9 PREDISABILITY EARNINGS 10 DEDUCTIBLE INCOME 10 EXCEPTIONS TO DEDUCTIBLE INCOME 11 RULES FOR DEDUCTIBLE INCOME 12 SUBROGATION 13 SURVIVORS DEATH BENEFIT 13 BENEFITS AFTER INSURANCE ENDS OR IS CHANGED 13 EFFECT OF NEW DISABILITY 14 DISABILITIES EXCLUDED FROM COVERAGE 14 DISABILITIES SUBJECT TO LIMITED PAY PERIODS 15 LIMITATIONS 16 CLAIMS 16 ALLOCATION OF AUTHORITY 18 TIME LIMITS ON LEGAL ACTIONS 19 INCONTESTABILITY PROVISIONS 19 CLERICAL ERROR, AGENCY, AND MISSTATEMENT 19 TERMINATION OR AMENDMENT OF THE GROUP POLICY 20 DEFINITIONS 20 Index of Defined Terms Active Work, Actively At Work, 4 Allowable Periods, 9 Any Occupation, 7 Any Occupation Period, 1 Benefit Waiting Period, 2, 20 Class Definition, 1 Contributory, 20 CPI-W, 20 Deductible Income, 10 Disabled, 6 Eligibility Waiting Period, 1 Employer, 20 Employer(s), 1 Evidence Of Insurability, 4 Group Policy, 21 Group Policy Effective Date, 1 Group Policy Number, 1 Hospital, 15 Indexed Predisability Earnings, 21 Injury, 21 L.L.C. Owner -Employee, 21 LTD Benefit, 21 Material Duties, 7 Maximum Benefit Period, 2, 21 Maximum LTD Benefit, 1 Member, 1, 3 Mental Disorder, 15 Minimum LTD Benefit, 2 Noncontributory, 21 Other Limited Conditions, 15 Own Occupation, 6 Own Occupation Period, 1 P.C. Partner, 21 Physical Disease, 21 Physician, 21 Policyholder, 1 Predisability Earnings, 10 Preexisting Condition, 14 Pregnancy, 21 Prior Plan, 21 Reasonable Accommodation Expense Benefit, 8 Rehabilitation Plan, 8 Social Security Normal Retirement Age (SSNRA), 2 Substance Abuse, 15 Survivors Death Benefit, 13 Temporary Recovery, 9 War, 14 Work Earnings, 8 COVERAGE FEATURES This section contains many of the features of your long term disability (LTD) insurance. Other provisions, including exclusions, limitations, and Deductible Income, appear in other sections. Please refer to the text of each section for full details. The Table of Contents and the Index of Defined Terms help locate sections and definitions. GENERAL POLICY INFORMATION Group Policy Number: 755831-B Policyholder: City of Miami Employer(s): City of Miami Group Policy Effective Date: January 1, 2018 Policy Issued in: Florida Member means: 1. A regular Executive employee of the Employer; 2. Actively At Work at least 30 hours each week (for purposes of the Member definition, Actively At Work will include regularly scheduled days off, holidays, or vacation days, so long as the person is capable of Active Work on those days); and 3. A citizen or resident of the United States or Canada. Member does not include a temporary or seasonal employee, a full-time member of the armed forces of any country, a leased employee, or an independent contractor. Class Definition: None SCHEDULE OF INSURANCE Eligibility Waiting Period: You are eligible on one of the following dates: If you are a Member on the Group Policy Effective Date, you are eligible on that date. If you become a Member after the Group Policy Effective Date, you are eligible on the date you become a Member. Eligibility Waiting Period means the period you must be a Member before you become eligible for insurance. Own Occupation Period: Any Occupation Period: The first 12 months for which LTD Benefits are paid. From the end of the Own Occupation Period to the end of the Maximum Benefit Period. LTD Benefit: Maximum: 60% of the first $16,667 of your Predisability Earnings, reduced by Deductible Income. $10, 000 before reduction by Deductible Income. 02/21/2018 1 755831-B Minimum: $100 or 10% of your LTD Benefit before reduction by Deductible Income, whichever is greater. Benefit Waiting Period: 180 days. However, you will be credited for time served under the Prior Plan's benefit waiting period when your Disability is a recurrent disability under the Prior Plan's recurrent disability provisions. Maximum Benefit Period: Determined by your age when Disability begins, as follows: Age Maximum Benefit Period 61 or younger To age 65, or to SSNRA, or 3 years 6 months, whichever is longest. 62 To SSNRA, or 3 years 6 months, whichever is longer. 63 To SSNRA, or 3 years, whichever is longer. 64 To SSNRA, or 2 years 6 months, whichever is longer. 65 2 years 66 1 year 9 months 67 1 year 6 months 68 1 year 3 months 69 or older 1 year Social Security Normal Retirement Age (SSNRA) means your normal retirement age under the Federal Social Security Act, as amended. PREMIUM CONTRIBUTIONS Insurance is: Noncontributory 02/21/2018 2 755831-B INSURING CLAUSE If you become Disabled while insured under the Group Policy, we will pay LTD Benefits according to the terms of the Group Policy after we receive Proof Of Loss satisfactory to us. LT.IC.OT.1 BECOMING INSURED To become insured you must be a Member, complete your Eligibility Waiting Period, and meet the requirements in Active Work Provisions and When Your Insurance Becomes Effective. You are a Member if you are: 1. A regular Executive employee of the Employer; 2. Actively At Work at least 30 hours each week (for purposes of the Member definition, Actively At Work will include regularly scheduled days off, holidays, or vacation days, so long as you are capable of Active Work on those days); and 3. A citizen or resident of the United States or Canada. You are not a Member if you are a temporary or seasonal employee, a full-time member of the armed forces of any country, a leased employee, or an independent contractor. Eligibility Waiting Period means the period you must be a Member before you become eligible for insurance. Your Eligibility Waiting Period is shown in the Coverage Features. (VAR MBR DEF) LT.BI.OT.1 WHEN YOUR INSURANCE BECOMES EFFECTIVE A. When Insurance Becomes Effective Subject to the Active Work Provisions, your insurance becomes effective as follows: 1. Insurance Subject To Evidence Of Insurability Insurance subject to Evidence Of Insurability becomes effective on the date we approve your Evidence Of Insurability. 2. Insurance Not Subject To Evidence of Insurability The Coverage Features states whether insurance is Contributory or Noncontributory. a. Noncontributory Insurance Noncontributory insurance not subject to Evidence Of Insurability becomes effective on the date you become eligible. b. Contributory Insurance You must apply in writing for Contributory insurance and agree to pay premiums. Contributory insurance not subject to Evidence Of Insurability becomes effective on: i. The date you become eligible if you apply on or before that date; or ii. The date you apply if you apply within 31 days after you become eligible. Late application: Evidence Of Insurability is required if you apply more than 31 days after you become eligible. B. Takeover Provisions 02/21/2018 -3- 755831-B 1. If you were insured under the Prior Plan on the day before the effective date of your Employer's coverage under the Group Policy, your Eligibility Waiting Period is waived on the effective date of your Employer's coverage under the Group Policy. 2. You must submit satisfactory Evidence Of Insurability to become insured if you were eligible for insurance under the Prior Plan for more than 31 days but were not insured. C. Evidence Of Insurability Requirement Evidence Of Insurability satisfactory to us is required: a. For late application for Contributory insurance. b. For Members eligible but not insured under the Prior Plan. c. For reinstatements if required. Providing Evidence Of Insurability means you must: 1. Complete and sign our medical history statement; 2. Sign our form authorizing us to obtain information about your health; 3. Undergo a physical examination, if required by us, which may include blood testing; and 4. Provide any additional information about your insurability that we may reasonably require. (VAR EOI) LT.EF.OT.1 ACTIVE WORK PROVISIONS A. Active Work Requirement You must be capable of Active Work on the day before the scheduled effective date of your insurance or your insurance will not become effective as scheduled. If you are incapable of Active Work because of Physical Disease, Injury, Pregnancy or Mental Disorder on the day before the scheduled effective date of your insurance, your insurance will not become effective until the day after you complete one full day of Active Work as an eligible Member. Active Work and Actively At Work mean performing with reasonable continuity the Material Duties of your Own Occupation at your Employer's usual place of business. B. Changes In Insurance This Active Work requirement also applies to any increase in your insurance. LT.AW.OT.1 CONTINUITY OF COVERAGE If your Disability is subject to the Preexisting Condition Exclusion, LTD Benefits will be payable if: 1. You were insured under the Prior Plan on the day before the effective date of your Employer's coverage under the Group Policy; 2. You became insured under the Group Policy when your insurance under the Prior Plan ceased; 3. You were continuously insured under the Group Policy from the effective date of your insurance under the Group Policy through the date you became Disabled from the Preexisting Condition; and 4. Benefits would have been payable under the terms of the Prior Plan if it had remained in force, taking into account the preexisting condition exclusion, if any, of the Prior Plan. For such a Disability, the amount of your LTD Benefit will be the lesser of: 02/21/2018 -4- 755831-B a. The monthly benefit that would have been payable under the terms of the Prior Plan if it had remained in force; or b. The LTD Benefit payable under the terms of the Group Policy, but without application of the Preexisting Condition Exclusion. Your LTD Benefits for such a Disability will end on the earlier of the following dates: a. The date benefits would have ended under the terms of the Prior Plan if it had remained in force; or b. The date LTD Benefits end under the terms of the Group Policy. (PX) LT.CC.OT.1 WHEN YOUR INSURANCE ENDS Your insurance ends automatically on the earliest of: 1. The date the last period ends for which a premium contribution was made for your insurance. 2. The date the Group Policy terminates. 3. The date your employment terminates. 4. The date you cease to be a Member. However, your insurance will be continued during the following periods when you are absent from Active Work, unless it ends under any of the above. a. During the first 90 days of a temporary or indefinite administrative or involuntary leave of absence or sick leave, provided your Employer is paying you at least the same Predisability Earnings paid to you immediately before you ceased to be a Member. A period when you are absent from Active Work as part of a severance or other employment termination agreement is not a leave of absence, even if you are receiving the same Predisability Earnings. b. During a leave of absence if continuation of your insurance under the Group Policy is required by a state -mandated family or medical leave act or law. c. During any other temporary leave of absence approved by your Employer in advance and in writing and scheduled to last 30 days or less. A period of Disability is not a leave of absence. d. During the Benefit Waiting Period. LT.EN.OT.1 WAIVER OF PREMIUM We will waive payment of premium for your insurance while LTD Benefits are payable. LT.WP.OT. 1 REINSTATEMENT OF INSURANCE If your insurance ends, you may become insured again as a new Member. However, the following will apply: 1. If you cease to be a Member because of a covered Disability following the Benefit Waiting Period, your insurance will end; however, if you become a Member again immediately after LTD Benefits end, the Eligibility Waiting Period will be waived and, with respect to the condition(s) for which LTD Benefits were payable, the Preexisting Condition Exclusion will be applied as if your insurance had remained in effect during that period of Disability. 02/21/2018 -5- 755831-B 2. If your insurance ends because you cease to be a Member for any reason other than a covered Disability, and if you become a Member again within 90 days, the Eligibility Waiting Period will be waived. 3. If your insurance ends because you fail to make a required premium contribution, you must provide Evidence Of Insurability to become insured again. 4. If your insurance ends because you are on a federal or state -mandated family or medical leave of absence, and you become a Member again immediately following the period allowed, your insurance will be reinstated pursuant to the federal or state -mandated family or medical leave act or law. 5. The Preexisting Conditions Exclusion will be applied as if insurance had remained in effect in the following instances: a. If you become insured again within 90 days. b. If required by federal or state -mandated family or medical leave act or law and you become insured again immediately following the period allowed under the family or medical leave act or law. 6. In no event will insurance be retroactive. LT.RE.OT.2 DEFINITION OF DISABILITY You are Disabled if you meet the following definitions during the periods they apply: A. Own Occupation Definition Of Disability. B. Any Occupation Definition Of Disability. A. Own Occupation Definition Of Disability During the Benefit Waiting Period and the Own Occupation Period you are required to be Disabled only from your Own Occupation. You are Disabled from your Own Occupation if, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder: 1. You are unable to perform with reasonable continuity the Material Duties of your Own Occupation; and 2. You suffer a loss of at least 20% in your Indexed Predisability Earnings when working in your Own Occupation. Note: You are not Disabled merely because your right to perform your Own Occupation is restricted, including a restriction or loss of license. During the Own Occupation Period you may work in another occupation while you meet the Own Occupation Definition Of Disability. However, you will no longer be Disabled when your Work Earnings from another occupation meet or exceed 80% of your Indexed Predisability Earnings. Your Work Earnings may be Deductible Income. See Return To Work Provisions and Deductible Income. Own Occupation means any employment, business, trade, profession, calling or vocation that involves Material Duties of the same general character as the occupation you are regularly performing for your Employer when Disability begins. In determining your Own Occupation, we are not limited to looking at the way you perform your job for your Employer, but we may also look at the way the occupation is generally performed in the national economy. If your Own Occupation involves the rendering of professional services and you are required to have a professional or 02/21/2018 -6- 755831-B occupational license in order to work, your Own Occupation is as broad as the scope of your license. Material Duties means the essential tasks, functions and operations, and the skills, abilities, knowledge, training and experience, generally required by employers from those engaged in a particular occupation that cannot be reasonably modified or omitted. In no event will we consider working an average of more than 40 hours per week to be a Material Duty. B. Any Occupation Definition Of Disability During the Any Occupation Period you are required to be Disabled from all occupations. You are Disabled from all occupations if, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder, you are unable to perform with reasonable continuity the Material Duties of Any Occupation. Any Occupation means any occupation or employment which you are able to perform, whether due to education, training, or experience, which is available at one or more locations in the national economy and in which you can be expected to earn at least 60% of your Indexed Predisability Earnings within twelve months following your return to work, regardless of whether you are working in that or any other occupation. Material Duties means the essential tasks, functions and operations, and the skills, abilities, knowledge, training and experience, generally required by employers from those engaged in a particular occupation that cannot be reasonably modified or omitted. In no event will we consider working an average of more than 40 hours per week to be a Material Duty. Your Own Occupation Period and Any Occupation Period are shown in the Coverage Features. (OWNOCC_ANY_WITH 40) LT.DD.OT.1 RETURN TO WORK PROVISIONS A. Return To Work Responsibility During the Own Occupation Period no LTD Benefits will be paid for any period when you are able to work in your Own Occupation and able to earn at least 20% of your Indexed Predisability Earnings, but you elect not to work. During the Any Occupation Period no LTD Benefits will be paid for any period when you are able to work in Any Occupation and able to earn at least 20% of your Indexed Predisability Earnings, but you elect not to work. B. Return To Work Incentive You may serve your Benefit Waiting Period while working if you meet the Own Occupation Definition Of Disability. You are eligible for the Return To Work Incentive on the first day you work after the Benefit Waiting Period if LTD Benefits are payable on that date. The Return To Work Incentive changes 12 months after that date, as follows: 1. During the first 12 months, your Work Earnings will be Deductible Income as determined in a., b. and c: a. Determine the amount of your LTD Benefit as if there were no Deductible Income, and add your Work Earnings to that amount. b. Determine 100% of your Indexed Predisability Earnings. c. If a. is greater than b., the difference will be Deductible Income. 2. After those first 12 months, 50% of your Work Earnings will be Deductible Income. 02/21/2018 -7- 755831-B C. Work Earnings Definition Work Earnings means your gross monthly earnings from work you perform while Disabled, plus the earnings you could receive if you worked as much as you are able to, considering your Disability, in work that is reasonably available: a. In your Own Occupation during the Own Occupation Period; and b. In Any Occupation during the Any Occupation Period. Work Earnings includes earnings from your Employer, any other employer, or self-employment, and any sick pay, vacation pay, annual or personal leave pay or other salary continuation earned or accrued while working. Earnings from work you perform will be included in Work Earnings when you have the right to receive them. If you are paid in a lump sum or on a basis other than monthly, we will prorate your Work Earnings over the period of time to which they apply. If no period of time is stated, we will use a reasonable one. In determining your Work Earnings we: 1. Will use the financial accounting method you use for income tax purposes, if you use that method on a consistent basis. 2. Will not be limited to the taxable income you report to the Internal Revenue Service. 3. May ignore expenses under section 179 of the IRC as a deduction from your gross earnings. 4. May ignore depreciation as a deduction from your gross earnings. 5. May adjust the financial information you give us in order to clearly reflect your Work Earnings. If we determine that your earnings vary substantially from month to month, we may determine your Work Earnings by averaging your earnings over the most recent three-month period. During the Own Occupation Period you will no longer be Disabled when your average Work Earnings over the last three months exceed 80% of your Indexed Predisability Earnings. During the Any Occupation Period you will no longer be Disabled when your average Work Earnings over the last three months exceed 60% of your Indexed Predisability Earnings. LT.RW.OT. 1 REASONABLE ACCOMMODATION EXPENSE BENEFIT If you return to work in any occupation for any employer, not including self-employment, as a result of a reasonable accommodation made by such employer, we will pay that employer a Reasonable Accommodation Expense Benefit of up to $25,000, but not to exceed the expenses incurred. The Reasonable Accommodation Expense Benefit is payable only if the reasonable accommodation is approved by us in writing prior to its implementation. LT.RA.OT. 1 REHABILITATION PLAN PROVISION While you are Disabled you may qualify to participate in a Rehabilitation Plan. Rehabilitation Plan means a written plan, program or course of vocational training or education that is intended to prepare you to return to work. To participate in a Rehabilitation Plan you must apply on our forms or in a letter to us. The terms, conditions and objectives of the plan must be accepted by you and approved by us in advance. We have the sole discretion to approve your Rehabilitation Plan. 02/21/2018 -8- 755831-B While you are participating in an approved Rehabilitation Plan, your LTD Benefit will be increased by 10% of your Predisability Earnings. Your LTD Benefit may not exceed the Maximum LTD Benefit shown in the Coverage Features as a result of this increase. An approved Rehabilitation Plan may include our payment of some or all of the expenses you incur in connection with the plan, including: a. Training and education expenses. b. Family care expenses. c. Job -related expenses. d. Job search expenses. (WITH REHAB INC BFT) LT.RH.OT.1 TEMPORARY RECOVERY You may temporarily recover from your Disability and then become Disabled again from the same cause or causes without having to serve a new Benefit Waiting Period. Temporary Recovery means you cease to be Disabled for no longer than the applicable Allowable Period. See Definition Of Disability. A. Allowable Periods 1. During the Benefit Waiting Period: a total of 90 days of recovery. 2. During the Maximum Benefit Period: 180 days for each period of recovery. B. Effect Of Temporary Recovery If your Temporary Recovery does not exceed the Allowable Periods, the following will apply. 1. The Predisability Earnings used to determine your LTD Benefit will not change. 2. The period of Temporary Recovery will not count toward your Benefit Waiting Period, your Maximum Benefit Period or your Own Occupation Period. 3. No LTD Benefits will be payable for the period of Temporary Recovery. 4. No LTD Benefits will be payable after benefits become payable to you under any other disability insurance plan under which you become insured during your period of Temporary Recovery. 5. Except as stated above, the provisions of the Group Policy will be applied as if there had been no interruption of your Disability. (NEW TR PERIOD) LT.TR.OT.1 WHEN LTD BENEFITS END Your LTD Benefits end automatically on the earliest of: 1. The date you are no longer Disabled. 2. The date your Maximum Benefit Period ends. 3. The date you die. 4. The date benefits become payable under any other LTD plan under which you become insured through employment during a period of Temporary Recovery. 5. The date you fail to provide proof of continued Disability and entitlement to LTD Benefits. LT.BE.OT. 1 02/21/2018 -9- 755831-B PREDISABILITY EARNINGS Your Predisability Earnings will be based on your earnings in effect on your last full day of Active Work. Any subsequent change in your earnings after that last full day of Active Work will not affect your Predisability Earnings. Predisability Earnings means your monthly rate of earnings from your Employer, including: 1. Contributions you make through a salary reduction agreement with your Employer to: a. An Internal Revenue Code (IRC) Section 401(k), 403(b), 408(k), 408(p), or 457 deferred compensation arrangement; or b. An executive nonqualified deferred compensation arrangement. 2. Amounts contributed to your fringe benefits according to a salary reduction agreement under an IRC Section 125 plan. Predisability Earnings does not include: 1. Bonuses. 2. Commissions. 3. Overtime pay. 4. Shift differential pay. 5. Stock options or stock bonuses. 6. Your Employer's contributions on your behalf to any deferred compensation arrangement or pension plan. 7. Any other extra compensation. If you are paid on an annual contract basis, your monthly rate of earnings is one -twelfth (1/ 12th) of your annual contract salary. If you are paid hourly, your monthly rate of earnings is based on your hourly pay rate multiplied by the number of hours you are regularly scheduled to work per month, but not more than 173 hours. If you do not have regular work hours, your monthly rate of earnings is based on the average number of hours you worked per month during the preceding 12 calendar months (or during your period of employment if less than 12 months), but not more than 173 hours. (BASE NO STOCK) LT.PD.OT. 1 DEDUCTIBLE INCOME Subject to Exceptions To Deductible Income, Deductible Income means: 1. Sick pay, annual or personal leave pay, severance pay, or other salary continuation, including donated amounts, (but not vacation pay) payable to you by your Employer. 2. Your Work Earnings, as described in the Return To Work Provisions. 3. Any amount you receive or are eligible to receive because of your disability, including amounts for partial or total disability, whether permanent, temporary, or vocational, under any of the following: a. A workers' compensation law; b. The Jones Act; c. Maritime Doctrine of Maintenance, Wages, or Cure; d. Longshoremen's and Harbor Worker's Act; or 02/21/2018 - 10 - 755831-B e. Any similar act or law. 4. Any amount you, your spouse, or your child under age 18 receive or are eligible to receive because of your disability or retirement under: a. The Federal Social Security Act; b. The Canada Pension Plan; c. The Quebec Pension Plan; d. The Railroad Retirement Act; or e. Any similar plan or act. Full offset: Both the primary benefit (the benefit awarded to you) and dependents benefit are Deductible Income. Benefits your spouse or a child receives or are eligible to receive because of your disability are Deductible Income regardless of marital status, custody, or place of residence. The term "child" has the meaning given in the applicable plan or act. 5. Any amount you receive or are eligible to receive because of your disability under any state disability income benefit law or similar law. 6. Any amount you receive or are eligible to receive because of your disability under another group insurance coverage. 7. Any disability or retirement benefits you receive or are eligible to receive under your Employer's retirement plan, including a public employee retirement system, a state teacher retirement system, and a plan arranged and maintained by a union or employee association for the benefit of its members. You and your Employer's contributions will be considered as distributed simultaneously throughout your lifetime, regardless of how funds are distributed from the retirement plan. If any of these plans has two or more payment options, the option which comes closest to providing you a monthly income for life with no survivors benefit will be Deductible Income, even if you choose a different option. 8. Any earnings or compensation included in Predisability Earnings which you receive or are eligible to receive while LTD Benefits are payable. 9. Any amount you receive or are eligible to receive under any unemployment compensation law or similar act or law. 10. Any amount you receive or are eligible to receive from or on behalf of a third party because of your disability, whether by judgment, settlement or other method. If you notify us before filing suit or settling your claim against such third party, the amount used as Deductible Income will be reduced by a pro rata share of your costs of recovery, including reasonable attorney fees. 11. Any amount you receive by compromise, settlement, or other method as a result of a claim for any of the above, whether disputed or undisputed. (SL NO CHOICE_NO OTHR OFFST_PUB_WITH 3RD) LT.DI.OT.1 EXCEPTIONS TO DEDUCTIBLE INCOME Deductible Income does not include: 1. Any cost of living increase in any Deductible Income other than Work Earnings, if the increase becomes effective while you are Disabled and while you are eligible for the Deductible Income. 2. Reimbursement for hospital, medical, or surgical expense. 02/21/2018 - 11 - 755831-B 3. Reasonable attorneys fees incurred in connection with a claim for Deductible Income. 4. Benefits from any individual disability insurance policy. 5. Early retirement benefits under the Federal Social Security Act which are not actually received. 6. Group credit or mortgage disability insurance benefits. 7. Accelerated death benefits paid under a life insurance policy. 8. Benefits from the following: a. Profit sharing plan. b. Thrift or savings plan. c. Deferred compensation plan. d. Plan under IRC Section 401(k), 408(k), 408(p), or 457. e. Individual Retirement Account (IRA). f. Tax Sheltered Annuity (TSA) under IRC Section 403(b). g. Stock ownership plan. h. Keogh (HR-10) plan. (PUB_NO OTHR OFFST) LT.ED.OT. 1 RULES FOR DEDUCTIBLE INCOME A. Monthly Equivalents Each month we will determine your LTD Benefit using the Deductible Income for the same monthly period, even if you actually receive the Deductible Income in another month. If you are paid Deductible Income in a lump sum or by a method other than monthly, we will determine your LTD Benefit using a prorated amount. We will use the period of time to which the Deductible Income applies. If no period of time is stated, we will use a reasonable one. B. Your Duty To Pursue Deductible Income You must pursue Deductible Income for which you may be eligible. We may ask for written documentation of your pursuit of Deductible Income. You must provide it within 60 days after we mail you our request. Otherwise, we may reduce your LTD Benefits by the amount we estimate you would be eligible to receive upon proper pursuit of the Deductible Income. C. Pending Deductible Income We will not deduct pending Deductible Income until it becomes payable. You must notify us of the amount of the Deductible Income when it is approved. You must repay us for the resulting overpayment of your claim. D. Overpayment Of Claim We will notify you of the amount of any overpayment of your claim under any group disability insurance policy issued by us. You must immediately repay us. You will not receive any LTD Benefits until we have been repaid in full. In the meantime, any LTD Benefits paid, including the Minimum LTD Benefit, will be applied to reduce the amount of the overpayment. We may charge you interest at the legal rate for any overpayment which is not repaid within 30 days after we first mail you notice of the amount of the overpayment. LT. RU.OT.1 02/21/2018 - 12 - 755831-B SUBROGATION If LTD Benefits are paid or payable to you under the Group Policy as the result of any act or omission of a third party, we will be subrogated to all rights of recovery you may have in respect to such act or omission. You must execute and deliver to us such instruments and papers as may be required and do whatever else is needed to secure such rights. You must avoid doing anything that would prejudice our rights of subrogation. If you notify us before filing suit or settling your claim against such third party, the amount to which we are subrogated will be reduced by a pro rata share of your costs of recovery, including reasonable attorney fees. If suit or action is filed, we may record a notice of payments of LTD Benefits, and such notice shall constitute a lien on any judgment recovered. If you or your legal representative fail to bring suit or action promptly against such third party, we may institute such suit or action in our name or in your name. We are entitled to retain from any judgment recovered the amount of LTD Benefits paid or to be paid to you or on your behalf, together with our costs of recovery, including attorney fees. The remainder of such recovery, if any, shall be paid to you or as the court may direct. LT.SG.OT. 1 SURVIVORS DEATH BENEFIT If you die while LTD Benefits are payable, and on the date you die you have been continuously Disabled for at least 180 days, we will pay a Survivors Death Benefit according to 1 through 4 below. 1. The Survivors Death Benefit is a lump sum equal to 3 times your LTD Benefit without reduction by Deductible Income. 2. The Survivors Death Benefit will first be applied to reduce any overpayment of your claim. 3. The Survivors Death Benefit will be paid at our option to any one or more of the following: a. Your surviving spouse; b. Your surviving unmarried children, including adopted children, under age 25; c. Your surviving spouse's unmarried children, including adopted children, under age 25; or d. Any person providing the care and support of any person listed in a., b., or c. above. 4. No Survivors Death Benefit will be paid if you are not survived by any person listed in a., b., or c. above. (MULTPL) LT.SB.FL. 1 BENEFITS AFTER INSURANCE ENDS OR IS CHANGED During each period of continuous Disability, we will pay LTD Benefits according to the terms of the Group Policy in effect on the date you become Disabled. Your right to receive LTD Benefits will not be affected by: 1. Any amendment to the Group Policy that is effective after you become Disabled. 2. Termination of the Group Policy after you become Disabled. LT. BA.OT.1 02/21/2018 - 13 - 755831-B EFFECT OF NEW DISABILITY If a period of Disability is extended by a new cause while LTD Benefits are payable, LTD Benefits will continue while you remain Disabled. However, 1 and 2 apply. 1. LTD Benefits will not continue beyond the end of the original Maximum Benefit Period. 2. The Disabilities Excluded From Coverage, Disabilities Subject To Limited Pay Periods, and Limitations sections will apply to the new cause of Disability. LT. ND.OT.1 DISABILITIES EXCLUDED FROM COVERAGE A. War You are not covered for a Disability caused or contributed to by War or any act of War. War means declared or undeclared war, whether civil or international, and any substantial armed conflict between organized forces of a military nature. B. Intentionally Self -Inflicted Injury You are not covered for a Disability caused or contributed to by an intentionally self-inflicted Injury, while sane or insane. C. Preexisting Condition 1. Definition Preexisting Condition means a mental or physical condition whether or not diagnosed or misdiagnosed: a. For which you have done or for which a reasonably prudent person would have done any of the following: i. Consulted a physician or other licensed medical professional; ii. Received medical treatment, services or advice; iii. Undergone diagnostic procedures, including self-administered procedures; iv. Taken prescribed drugs or medications; b. Which, as a result of any medical examination, including routine examination, was discovered or suspected; at any time during the 90-day period just before your insurance becomes effective. 2. Exclusion You are not covered for a Disability caused or contributed to by a Preexisting Condition or medical or surgical treatment of a Preexisting Condition unless, on the date you become Disabled, you: a. Have been continuously insured under the Group Policy for 12 months; and b. Have been Actively At Work for at least one full day after the end of that 12 months. D. Loss Of License Or Certification You are not covered for a Disability caused or contributed to by the loss of your professional license, occupational license or certification. E. Violent Or Criminal Conduct 02/21/2018 - 14 - 755831-B You are not covered for a Disability caused or contributed to by your committing or attempting to commit an assault or felony, or actively participating in a violent disorder or riot. Actively participating does not include being at the scene of a violent disorder or riot while performing your official duties. (WITH PRUDNT) LT.XD.OT.1 DISABILITIES SUBJECT TO LIMITED PAY PERIODS A. Mental Disorders, Substance Abuse and Other Limited Conditions Payment of LTD Benefits is limited to 12 months during your entire lifetime for a Disability caused or contributed to by any one or more of the following, or medical or surgical treatment of one or more of the following: 1. Mental Disorders; 2. Substance Abuse; or 3. Other Limited Conditions. However, if you are confined in a Hospital solely because of a Mental Disorder at the end of the 12 months, this limitation will not apply while you are continuously confined. Mental Disorder means any mental, emotional, behavioral, psychological, personality, cognitive, mood or stress -related abnormality, disorder, disturbance, dysfunction or syndrome, regardless of cause (including any biological or biochemical disorder or imbalance of the brain) or the presence of physical symptoms. Mental Disorder includes, but is not limited to, bipolar affective disorder, organic brain syndrome, schizophrenia, psychotic illness, manic depressive illness, depression and depressive disorders, anxiety and anxiety disorders. Substance Abuse means use of alcohol, alcoholism, use of any drug, including hallucinogens, or drug addiction. Other Limited Conditions means chronic fatigue conditions (such as chronic fatigue syndrome, chronic fatigue immunodeficiency syndrome, post viral syndrome, limbic encephalopathy, Epstein - Barr virus infection, herpes virus type 6 infection, or myalgic encephalomyelitis), any allergy or sensitivity to chemicals or the environment (such as environmental allergies, sick building syndrome, multiple chemical sensitivity syndrome or chronic toxic encephalopathy), chronic pain conditions (such as fibromyalgia, reflex sympathetic dystrophy or myofascial pain), carpal tunnel or repetitive motion syndrome, temporomandibular joint disorder, craniomandibular joint disorder, arthritis, diseases or disorders of the cervical, thoracic, or lumbosacral back and its surrounding soft tissue, and sprains or strains of joints or muscles. However, Other Limited Conditions does not include neoplastic diseases, neurologic diseases, endocrine diseases, hematologic diseases, asthma, allergy -induced reactive lung disease, tumors, malignancies, or vascular malformations, demyelinating diseases, lupus, rheumatoid or psoriatic arthritis, herniated discs with neurological abnormalities that are documented by electromyogram and computerized tomography or magnetic resonance imaging, scoliosis, radiculopathies that are documented by electromyogram, spondylolisthesis, grade II or higher, myelopathies and myelitis, traumatic spinal cord necrosis, osteoporosis, discitis, Paget's disease. Hospital means a legally operated hospital providing full-time medical care and treatment under the direction of a full-time staff of licensed physicians. Rest homes, nursing homes, convalescent homes, homes for the aged, and facilities primarily affording custodial, educational, or rehabilitative care are not Hospitals. Hospital does not include any rehabilitative care facility unless the rehabilitative care is for treatment of physical disability and is provided in a licensed hospital which is accredited by the Joint Commission on the Accreditation of Hospitals, the American Osteopathic Association, or the Commission on the Accreditation of Rehabilitative Facilities. B. Rules For Disabilities Subject To Limited Pay Periods 02/21/2018 - 15 - 755831-B 1. If you are Disabled as a result of a Mental Disorder or any Physical Disease or Injury for which payment of LTD Benefits is subject to a limited pay period, and at the same time are Disabled as a result of a Physical Disease, Injury, or Pregnancy that is not subject to such limitation, LTD Benefits will be payable first for conditions that are subject to the limitation. 2. No LTD Benefits will be payable after the end of the limited pay period, unless on that date you continue to be Disabled as a result of a Physical Disease, Injury, or Pregnancy for which payment of LTD Benefits is not limited. (WITH MUSC) LT.LP.FL.1 LIMITATIONS A. Care Of A Physician You must be under the ongoing care of a Physician in the appropriate specialty as determined by us during the Benefit Waiting Period. No LTD Benefits will be paid for any period of Disability when you are not under the ongoing care of a Physician in the appropriate specialty as determined by us. B. Return To Work Responsibility During the Own Occupation Period no LTD Benefits will be paid for any period of Disability when you are able to work in your Own Occupation and able to earn at least 20% of your Indexed Predisability Earnings, but you elect not to work. During the Any Occupation Period, no LTD Benefits will be paid for any period of Disability when you are able to work in Any Occupation and able to earn at least 20% of your Indexed Predisability Earnings, but elect not to work. C. Rehabilitation Program No LTD Benefits will be paid for any period of Disability when you are not participating in good faith in a plan, program or course of medical treatment or vocational training or education approved by us unless your Disability prevents you from participating. D. Foreign Residency Payment of LTD Benefits is limited to 12 months for each period of continuous Disability while you reside outside of the United States or Canada. E. Imprisonment No LTD Benefits will be paid for any period of Disability when you are confined for any reason in a penal or correctional institution. LT. LM.OT.1 CLAIMS A. Filing A Claim Claims should be filed on our forms. If we do not provide our forms within 15 days after they are requested, you may submit your claim in a letter to us. The letter should include the date disability began, and the cause and nature of the disability. B. Time Limits On Filing Proof Of Loss You must give us Proof Of Loss within 90 days after the end of the Benefit Waiting Period. If you cannot do so, you must give it to us as soon as reasonably possible, but not later than one year after that 90-day period. If Proof Of Loss is filed outside these time limits, your claim will be denied. These limits will not apply while you lack legal capacity. 02/21/2018 - 16 - 755831-B C. Proof Of Loss Proof Of Loss means written proof that you are Disabled and entitled to LTD Benefits. Proof Of Loss must be provided at your expense. For claims of Disability due to conditions other than Mental Disorders, we may require proof of physical impairment that results from anatomical or physiological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques. D. Documentation Completed claims statements, a signed authorization for us to obtain information, and any other items we may reasonably require in support of a claim must be submitted at your expense. If the required documentation is not provided within 45 days after we mail our request, your claim may be denied. E. Investigation Of Claim We may investigate your claim at any time. At our expense, we may have you examined at reasonable intervals by specialists of our choice. We may deny or suspend LTD Benefits if you fail to attend an examination or cooperate with the examiner. F. Time Of Payment We will pay LTD Benefits within 60 days after you satisfy Proof Of Loss. LTD Benefits will be paid to you at the end of each month you qualify for them. LTD Benefits remaining unpaid at your death will be paid to the person(s) receiving the Survivors Death Benefit. If no Survivors Death Benefit is paid, the unpaid LTD Benefits will be paid to your estate. G. Notice Of Decision On Claim We will evaluate your claim promptly after you file it. Within 45 days after we receive your claim we will send you: (a) a written decision on your claim; or (b) a notice that we are extending the period to decide your claim for 30 days. Before the end of this extension period we will send you: (a) a written decision on your claim; or (b) a notice that we are extending the period to decide your claim for an additional 30 days. If an extension is due to your failure to provide information necessary to decide the claim, the extended time period for deciding your claim will not begin until you provide the information or otherwise respond. If we extend the period to decide your claim, we will notify you of the following: (a) the reasons for the extension; (b) when we expect to decide your claim; (c) an explanation of the standards on which entitlement to benefits is based; (d) the unresolved issues preventing a decision; and (e) any additional information we need to resolve those issues. If we request additional information, you will have 45 days to provide the information. If you do not provide the requested information within 45 days, we may decide your claim based on the information we have received. If we deny any part of your claim, you will receive a written notice of denial containing: a. The reasons for our decision. b. Reference to the parts of the Group Policy on which our decision is based. c. A description of any additional information needed to support your claim. d. Information concerning your right to a review of our decision. H. Review Procedure If all or part of a claim is denied, you may request a review. You must request a review in writing within 180 days after receiving notice of the denial. 02/21/2018 - 17 - 755831-B You may send us written comments or other items to support your claim. You may review and receive copies of any non -privileged information that is relevant to your request for review. There will be no charge for such copies. You may request the names of medical or vocational experts who provided advice to us about your claim. The person conducting the review will be someone other than the person who denied the claim and will not be subordinate to that person. The person conducting the review will not give deference to the initial denial decision. If the denial was based on a medical judgment, the person conducting the review will consult with a qualified health care professional. This health care professional will be someone other than the person who made the original medical judgment and will not be subordinate to that person. Our review will include any written comments or other items you submit to support your claim. We will review your claim promptly after we receive your request. Within 45 days after we receive your request for review we will send you: (a) a written decision on review; or (b) a notice that we are extending the review period for 45 days. If the extension is due to your failure to provide information necessary to decide the claim on review, the extended time period for review of your claim will not begin until you provide the information or otherwise respond. If we extend the review period, we will notify you of the following: (a) the reasons for the extension; (b) when we expect to decide your claim on review; and (c) any additional information we need to decide your claim. If we request additional information, you will have 45 days to provide the information. If you do not provide the requested information within 45 days, we may conclude our review of your claim based on the information we have received. If we deny any part of your claim on review, you will receive a written notice of denial containing: a. The reasons for our decision. b. Reference to the parts of the Group Policy on which our decision is based. c. Information concerning your right to receive, free of charge, copies of non -privileged documents and records relevant to your claim. I. Assignment The rights and benefits under the Group Policy are not assignable. (REV PUB WRDG) LT.CL.FL.2 ALLOCATION OF AUTHORITY Except for those functions which the Group Policy specifically reserves to the Policyholder or Employer, we have full and exclusive authority to control and manage the Group Policy, to administer claims, and to interpret the Group Policy and resolve all questions arising in the administration, interpretation, and application of the Group Policy. Our authority includes, but is not limited to: 1. The right to resolve all matters when a review has been requested; 2. The right to establish and enforce rules and procedures for the administration of the Group Policy and any claim under it; 3. The right to determine: a. Eligibility for insurance; b. Entitlement to benefits; c. The amount of benefits payable; and 02/21/2018 - 18 - 755831-B d. The sufficiency and the amount of information we may reasonably require to determine a., b., or c., above. Subject to the review procedures of the Group Policy, any decision we make in the exercise of our authority is conclusive and binding. LT.AL.OT. 1 TIME LIMITS ON LEGAL ACTIONS No action at law or in equity may be brought until 60 days after you have given us Proof Of Loss. No such action may be brought after expiration of the applicable statute of limitations from the earlier of: 1. The date we receive Proof Of Loss; and 2. The time within which Proof Of Loss is required to be given. LT.TL.FL.1 INCONTESTABILITY PROVISIONS A. Incontestability Of Insurance Any statement made to obtain insurance or to increase insurance is a representation and not a warranty. No misrepresentation will be used to reduce or deny a claim or contest the validity of insurance unless: 1. The insurance would not have been approved if we had known the truth; and 2. We have given you or any other person claiming benefits a copy of the signed written instrument which contains the misrepresentation. After insurance has been in effect for two years during the lifetime of the insured, we will not use a misrepresentation to reduce or deny the claim, unless it was a fraudulent misrepresentation. B. Incontestability Of The Group Policy Any statement made by the Policyholder or Employer to obtain the Group Policy is a representation and not a warranty. No misrepresentation by the Policyholder or your Employer will be used to deny a claim or to deny the validity of the Group Policy unless: 1. The Group Policy would not have been issued if we had known the truth; and 2. We have given the Policyholder or Employer a copy of a written instrument signed by the Policyholder or Employer which contains the misrepresentation. The validity of the Group Policy will not be contested after it has been in force for two years, except for nonpayment of premiums or fraudulent misrepresentations. CLERICAL ERROR, AGENCY, AND MISSTATEMENT A. Clerical Error LT.IN.OT.1 Clerical error by the Policyholder, your Employer, or their respective employees or representatives will not: 1. Cause a person to become insured. 02/21/2018 - 19 - 755831-B 2. Invalidate insurance under the Group Policy otherwise validly in force. 3. Continue insurance under the Group Policy otherwise validly terminated. B. Agency The Policyholder and your Employer act on their own behalf as your agent, and not as our agent. The Policyholder and your Employer have no authority to alter, expand or extend our liability or to waive, modify or compromise any defense or right we may have under the Group Policy. C. Misstatement Of Age If a person's age has been misstated, we will make an equitable adjustment of premiums, benefits, or both. The adjustment will be based on: 1. The amount of insurance based on the correct age; and 2. The difference between the premiums paid and the premiums which would have been paid if the age had been correctly stated. LT.CE.OT.1 TERMINATION OR AMENDMENT OF THE GROUP POLICY The Group Policy may be terminated by us or the Policyholder according to its terms. It will terminate automatically for nonpayment of premium. The Policyholder may terminate the Group Policy in whole, and may terminate insurance for any class or group of Members, at any time by giving us written notice. Benefits under the Group Policy are limited to its terms, including any valid amendment. No change or amendment will be valid unless it is approved in writing by one of our executive officers and given to the Policyholder for attachment to the Group Policy. If the terms of the certificate differ from the Group Policy, the terms stated in the Group Policy will govern. The Policyholder, your Employer, and their respective employees or representatives have no right or authority to change or amend the Group Policy or to waive any of its terms or provisions without our signed written approval. We may change the Group Policy in whole or in part when any change or clarification in law or governmental regulation affects our obligations under the Group Policy, or with the Policyholder's consent. Any such change or amendment of the Group Policy may apply to current or future Members or to any separate classes or groups of Members. LT.TA.OT.1 DEFINITIONS Benefit Waiting Period means the period you must be continuously Disabled before LTD Benefits become payable. No LTD Benefits are payable for the Benefit Waiting Period. See Coverage Features. Contributory means insurance is elective and Members pay all or part of the premium for insurance. CPI-W means the Consumer Price Index for Urban Wage Earners and Clerical Workers published by the United States Department of Labor. If the CPI-W is discontinued or changed, we may use a comparable index. Where required, we will obtain prior state approval of the new index. Employer means an employer (including approved affiliates and subsidiaries) for which coverage under the Group Policy is approved in writing by us. Group Policy means the group LTD insurance policy issued by us to the Policyholder and identified by the Group Policy Number. 02/21/2018 -20- 755831-B Indexed Predisability Earnings means your Predisability Earnings adjusted by the rate of increase in the CPI-W. During your first year of Disability, your Indexed Predisability Earnings are the same as your Predisability Earnings. Thereafter, your Indexed Predisability Earnings are determined on each anniversary of your Disability by increasing the previous year's Indexed Predisability Earnings by the rate of increase in the CPI-W for the prior calendar year. The maximum adjustment in any year is 10%. Your Indexed Predisability Earnings will not decrease, even if the CPI-W decreases. Injury means an injury to the body. L.L.C. Owner -Employee means an individual who owns an equity interest in an Employer and is actively employed in the conduct of the Employer's business. LTD Benefit means the monthly benefit payable to you under the terms of the Group Policy. Maximum Benefit Period means the longest period for which LTD Benefits are payable for any one period of continuous Disability, whether from one or more causes. It begins at the end of the Benefit Waiting Period. No LTD Benefits are payable after the end of the Maximum Benefit Period, even if you are still Disabled. See Coverage Features. Noncontributory means (a) insurance is nonelective and the Policyholder or Employer pay the entire premium for insurance; or (b) the Policyholder or Employer require all eligible Members to have insurance and to pay all or part of the premium for insurance. P.C. Partner means the sole active employee and majority shareholder of a professional corporation in partnership with the Policyholder. Physical Disease means a physical disease entity or process that produces structural or functional changes in the body as diagnosed by a Physician. Physician means a licensed M.D. or D.O., acting within the scope of the license. Physician does not include you or your spouse, or the brother, sister, parent, or child of either you or your spouse. Pregnancy means your pregnancy, childbirth, or related medical conditions, including complications caused by pregnancy. Prior Plan means your Employer's group long term disability insurance plan in effect on the day before the effective date of your Employer's participation under the Group Policy and which is replaced by coverage under the Group Policy. LT.DF.FL.1 FL/LTDC2000 02/21/2018 - 21 - 755831-B ANNIE PEREZ, CPPO Procurement Director Tau of 4Thami 0,0 . r, 1� ARTHUR NORIEGA V City Manager ADDENDUM NO. 3 RFQ 1733386 April 24, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Friday, May 3, 2024, at 5:OOPM. ALL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. y_ /� �ia.4. �� for Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: Tau of 4Thami ANNIE PEREZ, CPPO ARTHUR NORIEGA V Procurement Director City Manager Cis, 4q ;ft if - ADDENDUM NO. 4 RFQ 1733386 May 3, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Wednesday, May 15, 2024, at 5:OOPM. ALL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. 4. /7i for Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: Tau of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 5 RFQ 1733386 May 14, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Thursday, May 23, 2024, at 5:OOPM. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. �11i for ✓' Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: ( itu of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 6 RFQ 1733386 May 22, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Thursday, May 30, 2024, at 5:OOPM ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: Tau of 4Thami ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 7 RFQ 1733386 May 29, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Thursday, June 6, 2024 at 5:OOPM B. Attachment B, Reference Submittal Form has been deleted in its entirety and replaced with Revised Attachment B, Reference Submittal Form. C. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1: Please confirm whether Proposers are required to submit three (3) or five (5) references with their Proposals. Al: Pursuant to Section 2.8, References and Section 4.1.4.10, Proposers are required to submit three (3) references using Revised Attachment B, Reference Submittal Form attached herein. Q2: Will the City accept a minimum participation of ten (10) lives per line of coverage? A2: No. Refer to Section 3.1, Specifications/Scope of Work, subsection A.4. Q3: Does the RFQ contain any online questionnaires? A3: No. Q4: Are electronic signatures acceptable? A4: Yes. Q5: Is the Performance/Payment Bond mentioned under item 1.61 on page 24 required? A5: No. Q6: Pursuant to Section 1.25 on page 18 of the RFQ Packet, please confirm whether Proposers will be disqualified if they identify items in the General or Special Conditions of the RFQ that they are unable to commit to and/or request revised wording. A6: Section 1.25 is titled "Debarment and Suspensions (Sec 18-107)" and does not address the issues listed in the question. Q7: Attachment B, Reference Submittal Form, shows "Federal Lobbying Services" as the category on the required form. Is this correct although federal lobbying services are not being sought? A7: Refer to Item B above. Q8. In order to qualify for the additional five (5) points for having a Local Office, does Attachment C, Local Office Certification, need to be completed by the Proposing entity or by any member of a joint venture with the Proposing entity if said member is utilized for the response to the RFQ? A8. Attachment C, Local Office Certification must be completed by the Proposing firm. Q9. Is the Corporate Resolution form provided on page 98 of the RFQ Packet, required to be completed and submitted with Proposers' responses to the RFQ? A9. No. The Corporate Resolution is part of the Sample Professional Services Agreement ("PSA") and is simply a sample of the document Successful Proposers will be required to submit with their signed PSA's prior to formal approval of award by the Miami City Commission. Q10. If Proposers are required to submit the Corporate Resolution with their Proposals, must Proposers complete the section where it states "A Florida Corporation", even if Proposer is headquartered outside the state of Florida? A10. Refer to the response to Question 9 above. Q11. What is the expected effective date of coverage(s) upon award? A11. Immediately upon contract award, given a reasonable period (approximately four (4) to six (6) weeks) for the execution of PSA's, design, implementation, testing and live deployment. Q12. What are the expected enrollment dates? Al2. Refer to the response to item 11 above. Q13. What is the expected date for a decision to be made regarding the Pre - Qualification of Proposers? A13. The final decision regarding the award of contracts will be made by the Miami City Commission after the completion of the procurement process. At this time, the City anticipates that the item to award contracts resulting from this RFQ will be placed on a Miami City Commission meeting agenda in July 2024. Q14. Will an actual RFP be issued requesting product/rate information after the pre -qualified Pool of providers has been established? A14. No. Q15. What happens after the pre -qualified Pool has been established? A15. Successful Proposers awarded from this RFQ will allow for all City employees to freely choose which, if any, products they wish to enroll in, from any pre -qualified provider, on an entirely voluntary basis. Q16. With regard to the required Proposed Benefits Offerings section, confirm whether Proposers are required to provide product/plan descriptions and rates for the products/plans that we are including in their responses? A16. Proposers are required to provide product/plan descriptions with their responses, but not rates. Rates will not be evaluated as part of this RFQ process. Q17. Confirm whether the group participates in Social Security and if so, which if any occupations are exempt? A17. Sworn Police Officers and Firefighters are Social Security Exempt, whereas civilian (non -sworn) employees are fully subject to FICA contributions. Q18. Will premium contributions be paid with pre-tax or post -tax dollars? A18. Premium contributions will be paid with Post -tax dollars. Q19. Does the group prepare W-2's for Short Term Disability ("STD") recipients, or is the STD carrier required to do so? A19. The STD carrier prepares the W-2's. Q20. Does the group require the carrier to pay for the FICA match for STD claimants or will the group pay the FICA match? A20. As these are post -tax benefits, the group will not pay the FICA match. Q21. Does the group currently have telephonic STD claims service? A21. No. STD claims are filed using forms provided by the current carrier. Q22. a) Does the group offer other STD plans to employees, or are there any other STD plans that use payroll deductions? b) If so, will the group eliminate these additional policies if a new STD carrier is selected? A22. a) American Federation of State County and Municipal Employees ("AFSCME") Local 1907 and AFSCME Local 871 have STD plans through their Basic Life Accidental Death and Dismemberment carrier, Reliance Standard Life; b) No. Q23. Please confirm what, if any, state retirement plans the group participates in. A23. City of Miami employees do not participate in any state retirement plan. Q24. Pursuant to Section 4, Submission Requirements, subsection B.6., Claims Administration and Customer Service: a) are the performance guarantees with premium at risk (monetary penalties) required?; b) Will Proposers be disqualified if they do not provide premium at/risk/monetary penalties with their responses?; and c) Please provide specific performance requirement expectations for Proposers to review and consider as part of their responses. A24. No, performance guarantees with premium at risk (monetary penalties) are not required and Proposers will not be disqualified if they do not include them in their responses. Q25. a) Are Proposers required to respond to and provide all insurance products/plans that are mentioned in the RFQ?; b) Will proposers be disqualified if one of the products offered if their response to the RFQ is provided by Proposer's parent company? A25. a) No; and b) No. Q26. "Sub Item A", lists instructions for the preparation and submission of Proposals that are unclear. Please provide clarification of these instructions. A26. Refer to Section 4, Submission Requirements for instructions on the preparation, suggested format, and submission of Proposals. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement Pablo Velez, Senior Assistant City Attorney This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: Tau of 4Thami ANNIE PEREZ, CPPO ARTHUR NORIEGA V Procurement Director City Manager ADDENDUM NO. 8 RFQ 1733386 June 6, 2024 REQUEST FOR QUALIFICATIONS ("RFQ") FOR EMPLOYEE VOLUNTARY SUPPLEMENTAL INSURANCE BENEFITS PRE -QUALIFICATION POOL The following changes, additions, clarifications, and deletions amend the RFQ documents of the above captioned RFQ and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Monday, June 10, 2024 at 5:OOPM B. Exhibit A, BidSync Submission Instructions is hereby attached to this Addendum and is made available in the Documents Section of BidSync. C. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1: The instructions in the BidSync online portal under "How to place offer(s)", indicate that Proposers must list fill out their qualifications. When the link for qualifications is clicked, it only shows qualifications for General Building Engineering and Specialty Trade Services. This isn't applicable to this particular RFQ. Should Proposers ignore this section and click on the blue button labeled "Place Offer"? Al: Yes. Q2: Does "placing the offer" in BidSync consist of only uploading a single .pdf document of the complete RFQ response, inclusive of all required items? If so, what is the actual process for placing an offer? A2: Submitting a response or "placing the offer" in BidSync can be accomplished by uploading a single .pdf document or multiple .pdf documents inclusive of all required items. The process for doing so is as follows: 1. Click and view all documents; 2. Once all documents have been viewed, and have a green check next to them, scroll down to the blue "place offer" button; 3. Enter the number "0" in the field labeled "Unit Price" and click the "upload documents" link to upload document(s); 4. Click "Review Documents"; and 5. Review all documents, accept all addenda, then click the blue "Confirm & submit response" button. For a visual diagram of this process, refer to item B above. If further clarification is needed, Proposers can review the information and video contained in the below link and/or contact BidSync Support at (800) 990-9339 / supportbidsync.com: https://support. bidsync.com/hc/en-us/articles/222437508-How-do-I-respond-to-a- bid Q3: Please provide current rates and full policy with plan design, benefits, limitations, etc. for Accident and Hospital Indemnity. A3: These plans are offered through the employee unions and are not administered by the City. As such, this information is not available. Q4: What, if any, commissions should be included? A4: Proposers are not required to provide information related to commissions. Refer to Section 4.1, Submission Requirements for a complete list of the documents/information Proposers are required to submit with their Proposals. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFQ AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFQ REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Senior Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: EXHIBIT A - BIDSYNC SUBMISSION INSTRUCTIONS Download Solicitation Packet Add to My bids-1 Details Documents Line items Q8p Prebidconference I Vendorad5 Solicitation #RFO 1733386 - Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool FFu€1b0 You must viewiacoept all documents before you can place an offer on this bid. To accept or view a pending document, click on the name of the document, NOT on [download]. Click on download only if you want to save the document to your computer andjor print it out. When working with a document from this section, be sure to save your work at least every 30 minutes to avoid losing any data that you have entered. Select the documents you want to view: I I RFQ 1733388 - Employee Voluntary Supplemental Insurance Benefits Pre-Ci.ah°catior Pool.pc' aownbad] f Yk'red I_ I Attachment A - Living Wage Ordinance.pdf download] Viewed C I Revised Attachment B - Reference Submittal Form.pdf download] to Viewed [I Attachment C - City of Miami Local Office Certification.pdf download] 18 viewed O Attachment D - Insurance Definitions, Conditions and Additional Requirements.pdf do+rrlas " lei Mona O RFQ 1733388 Sample PSA.pdf fdownload] tilt Viewed O Addendum No 1 - 1733388.pdf download] t Viewed tWiAggprdum 2 - RFQ 1733388 - Employee Supplemental Insurance Program.pdf download] O Exhibit A - FT Employee Census.pdf download] r Vkwed O Exhibit B - STD Insurance Policy.pdf download] Viewed O Exhibit C - LTD Insurance Policy.pdf download] (Pi Viewed Ilampdendum 3 - RFQ 1733388 - Employee Supplemental Irsi.rance Program.pdf (download) 4idendum 4 - RFQ 1733388 - Employee Supplemental Insurance Program.pdf download] Q O Addendum 5 - RFQ 1733388.pdf download] raj viewed O Addendum 8 - RFQ 1733388.pdf download] Viewed I I Addendum 7 - RFQ 1733388.pdf download] l Select all Deselect all = Included in Bid Packet = Exchded from Bid =_ _• _. Generate zip fie pe-em e a z'7 "e sera! _''e ewe ti:K^ '+e "s sac a av ="=r neaJe z'a ^'e" Download Solicitation Packet b aa.ke2 's a a2,^.e a" ao:.re.^!s a-b lob Oehttul l+_VdVta ,ue%5 [ Send to Print Vendor Bid #RFQ 1733386 - Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool Time Left: ' -3y, 23 hrs Bid Ends Jun 6, 20243:00.00 FM MDT Offer RFQ 17333E16 01.01 DAauk lot Please disregard the F item See RFQ Document Product Code NoseFaayer Grad Total hire Bid Notes These notes appyto the bid as a whole Note This agency may choose to make all documents and notes open to the pubtr * Fee Waived Review Offer unit Mee 1 Attachment* 34 JMddnM1 % rit Tad Mae 1ream p 1.00 Altsrrteate offer Remowe Renew response Bid #RFQ 1733386 - Employee Voluntary Supplemental Insurance Benefits Pre -Qualification Pool Grad Total Pike S000 1,1330 .. Cr 01 Please disregard this line item See PFQ Doc neat Product Code Offer Not Coonfirntd Noeeaesaryer Grand Total Prkc Bid Notes: - —hese notes apply to the bid as a whole. ad Madrrvas: - Thee ateederere apply m ire Mesa whole " Fee Waived. Uriranee QgtAe19 TOM Anleto 0 s103 1reeer 6100 GraidTeelMee S100 Addendum N1 - Made On Mar 29, 2024125014 PM MDT Description/Bid Comments Iwvr:mation ...added New Documents Addendum No 1 - 1733386pdf Previous End Date Apr 1, 20243:0000 PM MDT Accept Addendum 0 P.ei. Eoc Date Apr 19. 2024 3:00:00 PM MDT Addendum 82 - Made On Apr 18, 20247:4421 AM MDT New Documents Addendum 2- RFQ 1733386- Employee Supplemental Insurance Program.pdf Exhibit A - FT Employee Census.pdf Exhibit B - STD Insurance Policy-pdf Exhibit C - LTD Insurance Policy.pdf Pox' . s End Cate Apr 19, 2024 3:00:00 PM MDT Accept AddeMum _ Vex Era Date Apr 26, 2024 30000 PM MDT