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HomeMy WebLinkAbout24778AGREEMENT INFORMATION AGREEMENT NUMBER 24778 NAME/TYPE OF AGREEMENT REVENUE OPTIMIZATION SOLUTIONS, LLC DESCRIPTION FINANCIAL SERVICES CONTRACTOR AGREEMENT/MEDICARE GROUND AMBULANCE DATA COLLECTION SYSTEM/MATTER ID: 23-3052 EFFECTIVE DATE ATTESTED BY TODD B. HANNON ATTESTED DATE 2/1/2024 DATE RECEIVED FROM ISSUING DEPT. 2/2/2024 NOTE DOCUSIGN AGREEMENT BY EMAIL CITY OF MIAMI DOCUMENT ROUTING FORM ORIGINATING DEPARTMENT: Fire -Rescue DEPT. CONTACT PERSON: Maria T. Martinez EXT. 1672 NAME OF OTHER CONTRACTUAL PARTY/ENTITY: "Revenue Optimization Solutions, LLC" IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? ❑ YES ® NO TOTAL CONTRACT AMOUNT: $7,000.00 FUNDING INVOLVED? ® YES ❑ NO TYPE OF AGREEMENT: ❑ MANAGEMENT AGREEMENT ® PROFESSIONAL SERVICES AGREEMENT ❑ GRANT AGREEMENT ❑ EXPERT CONSULTANT AGREEMENT ❑ LICENSE AGREEMENT ❑ PUBLIC WORKS AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ INTER -LOCAL AGREEMENT ❑ LEASE AGREEMENT ❑ PURCHASE OR SALE AGREEMENT OTHER: (PLEASE SPECIFY) PURPOSE OF ITEM (BRIEF SUMMARY): Vendor shall establish and maintain the information necessary for the City to comply with the Medicare Ground Ambulance Data Collection System, according to Medicare guidelines. COMMISSION APPROVAL DATE: FILE ID: ENACTMENT NO.: IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN: ROUTING INFORMATION Date PLEASE PRINT AND SIGN APPROVAL BY DEPARTMENTAL DIRECTOR January 30, 2024 PRINT:Tyron 07:29: SIGNATURE: r ldby: —4 °" ` M `"`�` � SUBMITTED TO RISK MANAGEMENT January 30, 2024 PRINT: ANN I 08:01: SIGNATURE: 097fiztr ... - Mls r d I4�9-�D549AARPE 1 EST FratAl a6144(17 SUBMITTED TO CITY ATTORNEY January 31, 2024 PRINT: VICT I 18:33: SIGNATURE: EZ 21ST� (--DS APPROVAL BY ASSISTANT CITY MANAGER EF9 AFGFE045-7... PRINT: SIGNATURE: RECEIVED BY CITY MANAGER February 1, 2024 PRINT: ART I 05:35:4415Ll SIGNATURE: NORIEGA -DocuSigned by: _ . ity `__849.Q €C37zo.a1,A.Iv011t-o.. PRINT: SIGNATURE: PRINT: SIGNATURE: PRINT: SIGNATURE: 1) ONE ORIGINAL TO CITY CLERK, 2) ONE COPY TO CITY ATTORNEY'S OFFICE, 3) REMAINING ORIGINAL(S) TO ORIGINATING DEPARTMENT PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE EXECUTION BY THE CITY MANAGER ATTEST: By: DocuSigned by: F Todd B. Hannon City Clerk APPROVED AS TO FORM AND CORRECTNESS DS DocuSigned by: L^ r� DocuSigned by: JCf FV'aln,� ��Owtti7 By: F1 EPA,4 �€€g4S7 .. By: 6g34g€14€7.. DocuSigned by: THE CITY OF MIAMI, a municipal Corporation of the State of Florida ,—DocuSigned by: alb Novi4a, By: `—asor.Fi;r,372nn42A Arthur Noriega City Manager APPROVED AS TO INSURANCE REQUIREMENTS Victoria Mendez Ann -Marie Sharpe, Director City Attorney Department of Risk Management Counterparts and Electronic Signatures. This Agreement may be executed in any number of counterparts, each of which so executed shall be deemed to be an original, and such counterparts shall together constitute but one and the same Agreement. The parties shall be entitled to sign and transmit an electronic signature of 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. Revenue Optimization Solutions, LLC Optimizing Revenue for Ambulance Services Providers MEDICARE GROUND AMBULANCE DATA COLLECTION SYSTEM (GADCS) FINANCIAL SERVICES CONTRACTOR AGREEMENT This Financial Services Contractor Agreement ("Agreement") is entered into by and between the City of Miami Fire -Rescue Department ("GADCS PROVIDER") and Revenue Optimization Solutions, LLC ("CONTRACTOR") as of the date signed by the GADCS Provider (the "Effective Date"). WHEREAS, CONTRACTOR represents to GADCS PROVIDER that CONTRACTOR has the skills and expertise necessary, on behalf of GADCS PROVIDER, to establish and maintain the information necessary to comply with the Medicare Ground Ambulance Data Collection System (GADCS) in accordance with federal Centers for Medicare and Medicaid Services (CMS) guidelines; WHEREAS, CONTRACTOR further represents to GADCS PROVIDER that CONTRACTOR has the skills and expertise necessary to manage, gather data from the GADCS PROVIDER, prepare and review, and submit the necessary information required for the GADCS report, on behalf of GADCS PROVIDER, in accordance with CMS guidance; WHEREAS, GADCS PROVIDER wishes to engage CONTRACTOR to perform the professional services necessary to establish and maintain the information necessary for GADCS PROVIDER to comply with the GADCS pursuant to the terms of this Agreement; and, WHEREAS, GADCS PROVIDER wishes to engage CONTRACTOR to perform the professional services necessary to manage, gather data from the GADCS PROVIDER, prepare and review, and submit the necessary information on behalf of GADCS PROVIDER as part of the GADCS pursuant to the terms of this Agreement. THEREFORE, for good and valuable consideration, the receipt and adequacy of which is acknowledged, GADCS PROVIDER and CONTRACTOR hereby agree as follows: 1. Description of Services CONTRACTOR will provide the professional project management, data gathering from the GADCS PROVIDER, report preparation and review, and report submittal services necessary for GADCS PROVIDER to comply with the GADCS guidelines as detailed by CMS, including the services described in Attachment A ("Contracted Services") of this Agreement. CONTRACTOR acknowledges and agrees that time is of the essence in the value of the Contracted Services, and shall render such Contracted Services in a prompt and diligent manner. CONTRACTOR agrees that it will use its own best expert and professional judgment Page 1 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers in complying with GADCS guidelines associated with the GADCS report, to submit the GADCS report by the deadlines established by CMS so as to maintain compliance on behalf of GADCS PROVIDER, per GADCS guidelines, as established by CMS. 2. Term a. The Term of this Agreement will begin on the Effective Date and end after the GADCS report is submitted, unless this Agreement is terminated earlier pursuant to Section 4 herein or extended by written agreement of the parties. i. Given the current GADCS guidelines for the GADCS report, GADCS PROVIDER shall provide to CONTRACTOR the documentation submitted to CMS or to the CMS Medicare Administrative Contractor (MAC), or similar organization or entity, that established the data reporting period for the GADCS, thus establishing the due date for the GADCS report and the end date for the Term of this Agreement. ii. Given the current GADCS guidelines for the GADCS report, the GADCS PROVIDER may be asked questions by CMS related to the GADCS report after the GADCS report is submitted. CONTRACTOR shall work with GADCS PROVIDER to address and answer questions from CMS, the MAC, or similar organization or entity as it pertains to the GADCS report, albeit after the GADCS report is submitted, as described in Attachment A of this Agreement. iii. Given the current GADCS guidelines for the GADCS report, CONTRACTOR shall submit a final invoice to GADCS PROVIDER for the Contracted Services after the GADCS report is submitted, as described in Section 3. and Attachment B of this Agreement. iv. In the event that GADCS PROVIDER is informed prior to the Term of the Agreement identified in 2.a that GADCS PROVIDER is no longer required to submit the GADCS report, CONTRACTOR shall invoice GADCS PROVIDER for the remaining balance of the Compensation identified in Section 3. and Attachment B of this Agreement, on the schedule as identified in Section 3. and Attachment B of this Agreement. b. The term of this Agreement may be changed and approved by both parties. Page 2 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers 3. Compensation a. GADCS PROVIDER will compensate CONTRACTOR pursuant to the provisions contained in this Section 3., and in Attachment B, and will not pay CONTRACTOR any other benefits, expenses, or compensation. b. GADCS PROVIDER will compensate CONTRACTOR within 45 days following receipt of an invoice statement from CONTRACTOR that comports with the terms of this Agreement. CONTRACTOR shall submit invoices directly to the GADCS PROVIDER Contact identified in Section 5. Payment by GADCS PROVIDER will be conditioned upon CONTRACTOR's performance of the Contracted Services to the reasonable satisfaction of GADCS PROVIDER. c. Upon termination of this Agreement, other than termination for cause under Section 4(b), or termination for convenience by CONTRACTOR under Section 4(c), CONTRACTOR will be entitled to receive compensation for Contracted Services satisfactorily provided prior to the effective date of termination, on a basis as set forth herein. Upon termination by GADCS PROVIDER for cause under Section 4(b), GADCS PROVIDER may deduct from such compensation to CONTRACTOR any costs, expenses, and damages reasonably attributable to the breach by CONTRACTOR; CONTRACTOR promptly shall return to GADCS PROVIDER any compensation that was paid in excess of this net amount due. d. The compensation arrangement may be changed by written agreement of both parties. 4. Termination a. General: The term of this Agreement is set forth in Section 2; provided, however, that the Agreement may be terminated before the end of the term pursuant to the following subsections of this Section 4. b. Termination for Cause: This Agreement may be terminated immediately by either party following a material breach of this Agreement by the other party; provided, however, that termination for breach shall not become effective unless and until the party in breach has been given written notice of such breach and such party shall have failed to have cured such breach to the reasonable satisfaction of the other within ten (10) days following said notice. Page 3 Revenue Optimization Solutions, LLC Optimizing Revenue for Ambulance Services Providers c. Termination for Convenience: Agreement may be terminated for convenience by either party following thirty (30) calendar days advance written notice to the other party. 5. Notices and Contact Persons All written notices required by this Agreement shall be sent to the following persons, who shall serve as Contact Persons unless replaced by a party by written notice to the other party: For GADCS PROVIDER — Contact Person: Robert M. Jorge Assistant Fire Chief Health & Emergency Medical Services Division City of Miami Dept. of Fire -Rescue 1151 NW 7 St. Miami, FL 33136 305-416-5404 rjorge@miamigov.com For CONTRACTOR: Kevin Coyle President Revenue Optimization Solutions, LLC 1000 Heritage Center Circle Round Rock, TX 78664 f512) 537-9588 kcoyle@revopsllc.com 6. Approval of Contracted Services CONTRACTOR shall periodically contact via email or phone, GADCS PROVIDER and the GADCS PROVIDER Contact Person as reasonably necessary, as determined by GADCS PROVIDER and CONTRACTOR, to provide status updates on the Contracted Services. The Contracted Services performed by CONTRACTOR are subject to acceptance by GADCS PROVIDER, which acceptance shall not be withheld unreasonably. Page 4 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers 7. CONTRACTOR Representations and Warranties CONTRACTOR hereby represents and warrants to GADCS PROVIDER as follows: a. CONTRACTOR is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in transactions by any federal, state, or local governmental authority. b. The execution of this Agreement and the performance of the obligations and duties hereunder does, and will at all times, comply with all applicable ordinances, laws, rules, and regulations of local, state, and federal governments, or any political subdivision or agency, authority or commission thereof, which may have jurisdiction to pass laws, ordinances, or make and enforce rules and regulations with respect to either party. c. CONTRACTOR shall immediately notify GADCS PROVIDER in writing if any of the representations contained in this Agreement become no longer accurate during the Term of this Agreement. 8. Standards of Conduct and Compliance with Laws a. CONTRACTOR shall comply with all applicable laws, rules, regulations, and standards of ethical conduct, including those relating specifically to the performance of the Contracted Services under this Agreement. All services furnished by the CONTRACTOR under this Agreement shall be rendered in full compliance with applicable federal, state and local laws, ordinances, rules and regulations. It shall be the CONTRACTOR's sole responsibility to determine which laws, rules, and regulations apply to the services rendered under this Agreement, and to maintain compliance with those applicable laws, rules, and regulations at all times. b. CONTRACTOR acknowledges that GADCS PROVIDER is a public entity and may be governed by applicable laws, rules, or regulations relating to public records (each a "Public Records Act"). CONTRACTOR understands that the public shall have access, at all reasonable times, to all documents and information pertaining to GADCS PROVIDER Agreements, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the GADCS PROVIDER and the public to all documents subject to disclosure under applicable laws. CONTRACTOR' S failure or refusal to comply with the provisions of this section shall result in the immediate cancellation of this Agreement by the GADCS PROVIDER. CONTRACTOR shall additionally Page 5 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers comply with Section 119.0701, Florida Statutes, including without limitation: (1) keep and maintain public records that ordinarily and necessarily would be required by GADCS PROVIDER to perform this service; (2) provide the public with access to public records on the same terms and conditions as the Customer 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 GADCS PROVIDER 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; and, (5) provide all electronically stored public records that must be provided to the GADCS PROVIDER in a format compatible with the GADCS PROVIDER' S information technology systems. Notwithstanding the foregoing, CONTRACTOR 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. If CONTRACTOR has questions regarding the application of chapter 119, Florida Statutes, to any duty to provide public records relating to this Agreement as a public contract, please contact GADCS PROVIDER'S custodian of public records at telephone number (305)416-1800; email: publicrecords@miamigov.com; or mailing address: Public Records c/o Office of the City Attorney, 9th floor, Miami Riverside Center, 444 S.W. 2nd Avenue, Miami, Florida 33130; or the Contact for GADCS PROVIDER. CONTRACTOR' S obligations under this Section shall survive the termination/expiration of this Agreement. 9. Relationship of the Parties a. The parties agree that CONTRACTOR is an independent contractor, and that neither it nor any of its employees is an employee of GADCS PROVIDER. b. CONTRACTOR shall, at its cost, secure and maintain all insurance, licenses, and permits necessary to perform the Contracted Services. CONTRACTOR shall pay all applicable state and federal taxes including unemployment insurance, social security taxes, and state and federal withholding taxes. CONTRACTOR understands that neither it nor its employees will be eligible for benefits or privileges provided by GADCS PROVIDER to its employees. GADCS PROVIDER will deliver to CONTRACTOR statements of income at the end of each tax year consistent with its independent contractor status. Page 6 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers c. CONTRACTOR has no authority to and shall not purport to bind, represent, or speak for GADCS PROVIDER or otherwise incur any obligation on behalf of GADCS PROVIDER for any purpose unless expressly authorized by GADCS PROVIDER. 10. Record Maintenance, Audit Support, and Protected/Patient Health Information a. With respect to all records of any kind that CONTRACTOR acquires or creates for purposes of performing the Contracted Services, CONTRACTOR shall comply with all applicable record retention requirements, shall not knowingly destroy records that are required to be preserved, and shall maintain project records in an orderly manner. b. CONTRACTOR shall make available to GADCS PROVIDER upon request all records relating to the Contracted Services, including records relating to its invoices. c. CONTRACTOR shall cooperate with GADCS PROVIDER in the event of any CMS questions relating to the Contracted Services, even if the contracted Term is expired. CONTRACTOR will provide the subject matter expertise to lead the CMS questions response for GADCS PROVIDER for the GADCS report period in which CONTRACTOR provided services. d. At the termination of this Agreement, if requested by GADCS PROVIDER, CONTRACTOR shall provide to GADCS PROVIDER all records relating to the Contracted Services. e. While receipt of information conforming to this section is not necessary to conduct the Contracted Services, CONTRACTOR will comply and take all steps necessary to comply with the Health Insurance Portability and Accountability Act ("HIPAA"), including the execution of a mutually agreed to Business Associate Agreement, in the event that such information conforming to this section is received by CONTRACTOR. GADCS PROVIDER's obligations are those of a "Covered Entity" and CONTRACTOR's obligations are those of a "Business Associate," both as defined by HIPAA. CONTRACTOR will return, destroy, or retain (in each instance subject to HIPAA safeguards) all individually identifiable health information obtained from GADCS PROVIDER. Page 7 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers 11. Indemnification and Insurance a. CONTRACTOR shall indemnify, defend and hold harmless the GADCS PROVIDER and its officers, directors, employees, agents, representatives, affiliates, successors and permitted assigns (collectively, "GADCS PROVIDER INDEMNIFIED PARTIES") against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorneys' fees, and attorneys' fees and the costs of enforcing any right to indemnification under this Agreement, and the attorneys' fees and cost of pursuing any insurance providers, incurred by GADCS PROVIDER INDEMNIFIED PARTIES or awarded against GADCS PROVIDER INDEMNIFIED PARTIES relating to, arising out of, or resulting from: (1) any claim of a third party arising out of or occurring in connection with CONTRACTOR'S gross negligence, willful misconduct, violation of any applicable law or regulation, or breach of this Agreement; (2) the ownership, licensing, selection, possession, leasing, renting, operation, control, use, maintenance, delivery, return, or other disposition of the operation or services that results in any personal injury, wrongful death, or property damage resulting in relation to the scope of Contract Services, and/or (3) any claim by any third party unaffiliated with the GADCS PROVIDER relating to, arising out of, or concerning any infringement or misappropriation of the Intellectual Property rights of a third party to the extent any such third party claim of infringement or other violation of any Intellectual Property right of any such third party. The indemnities provided in this paragraph shall survive the termination or expiration of this Agreement. b. CONTRACTOR shall maintain during the term of this Agreement appropriate insurance pursuant to Exhibit C. . c. Upon request, CONTRACTOR shall provide GADCS PROVIDER with a certificate of insurance and shall have GADCS PROVIDER included as an additional insured under CONTRACTOR's applicable insurance policies. 12. Assignments and Subcontracts CONTRACTOR may neither assign nor further subcontract its obligations under this Agreement to any other entity without the prior written consent of GADCS PROVIDER. Page 8 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers 13. Ownership of Work Product and Intellectual Property a. CONTRACTOR expressly assigns to GADCS PROVIDER any and all rights and interests that CONTRACTOR owns, or will own, in any work product and intellectual property that CONTRACTOR conceives, devises, or develops, or to which CONTRACTOR contributed, in connection with the performance of the Contracted Services under this Agreement including, but not limited to, any and all ownership rights and interests relating to the services in this Agreement. The parties acknowledge and agree that GADCS PROVIDER is, and will be, the sole owner of all rights and interests in the services in this Agreement at all times, both during and after the term of this Agreement. CONTRACTOR will retain ownership of all pre-existing software and other intellectual property that CONTRACTOR has acquired or developed prior to the commencement of this Agreement. b. CONTRACTOR represents that its use or creation of any intellectual property under this Agreement does not infringe upon the intellectual property rights of any third party. 14. Conflicts; No Raiding Agreement During the term of this Agreement and for one year thereafter, CONTRACTOR shall not, without the prior written consent of GADCS PROVIDER, knowingly solicit or offer employment to any GADCS PROVIDER employee. The parties understand that CONTRACTOR is not required to perform the Contracted Services on a full-time basis for GADCS PROVIDER and may perform services for other individuals and organizations consistent with the limitations in this Agreement. 15. Media Communications Except as specifically authorized by GADCS PROVIDER, CONTRACTOR shall not communicate with the news media concerning GADCS PROVIDER or the Contracted Servi ces. 16. Waiver The failure of a party to enforce a provision of this Agreement shall not constitute a waiver with respect to that provision or any other provision of this Agreement. Page 9 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers 17. Entire Agreement This Agreement (including the attachments) constitutes the entire agreement between the parties with respect to the subject matter of this Agreement, and supersedes all prior agreements and understandings, both written and oral. 18. Amendment This Agreement may be amended only by written agreement of the parties, signed by authorized representatives and referencing this Agreement. 19. Severability If any provision in this Agreement is found by a court of competent jurisdiction to be invalid or unenforceable, the remaining provisions in this Agreement shall continue in full force and effect. 20. Applicable Law The parties agree that this Agreement is governed by the laws of the State of Florida. The parties also consent to jurisdiction in the courts of the State of Florida and agree that such courts shall have exclusive jurisdiction over the enforcement of this Agreement. Further, the parties acknowledge that Miami Dade County, Florida is a place where performance of certain terms of this Agreement shall occur. Therefore, the parties agree that venue for any court action or proceeding arising out or relating to this Agreement shall be in the states courts located in in the Eleventh Judicial Circuit, in and for Miami Dade County, Florida. 21. Accounting Upon Termination Upon the termination of this Agreement, CONTRACTOR shall deliver to GADCS PROVIDER upon request, all records, notes, data, memoranda, work product, and equipment in its possession that are the property of GADCS PROVIDER, as well as all necessary documentation related to the submittals of all projects for which CONTRACTOR has provided services. Page 10 Revenue Optimization Solutions, Tic Optimizing Revenue for Ambulance Services Providers 22. Authority to Sign Each party represents that: (a) it has the authority to enter into this Agreement; and (b) that the individual signing this Agreement on its behalf is authorized to do so. CKe."4-e'ADocuSigned by: 6C7B201FC8E5416... January 29, 2024 1 18:58:36 PST Kevin Coyle, President Date Revenue Optimization Solutions, LLC DocuSigned by: art141/iLla. �a500EF;C172DD42A Arthur Noriega, City Manager City of Miami February 1, 2024 1 05:35:44 EST Date Page 11 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers ATTACHMENT A CONTRACTED SERVICES CONTRACTOR will provide to GADCS PROVIDER: I. Medicare Ground Ambulance Data Collection System (GADCS) Services include the project management, data gathering from the GADCS PROVIDER, report preparation and review, information submittal into the GADCS portal, and follow up required by the Centers for Medicare and Medicaid Services (CMS) as part of the Medicare Ground Ambulance Data Collection System (GADCS). CONTRACTOR shall work closely with GADCS PROVIDER throughout the Term of the Agreement to make sure all parties understand what information is being reported. The focus and purpose of this Agreement will be compliance with GADCS report guidelines to prevent the ten percent GADCS Medicare payment penalty, as defined by CMS. CONTRACTOR's services shall include: A. Project Management CONTRACTOR shall provide a project timeline, as identified in Section II A. of this Attachment, that shall comply with the reporting requirements for the GADCS report, as defined by CMS, and the report deadline, as defined by the GADCS PROVIDER per Section 2 of this Agreement. This phase of the work shall include a virtual meeting (project kickoff) to begin the GADCS Services, a review of the data that is needed from GADCS PROVIDER, agreeing upon data transfer to CONTRACTOR, and determining draft report and final report timelines. CONTRACTOR and GADCS PROVIDER shall establish necessary account(s) that comport with GADCS guidelines for the GADCS report submittal, including creating an account(s) on the GADCS web -based portal and linking the account(s) to the GADCS PROVIDER National Provider Identifier (NPI) number. B. Roles CONTRACTOR shall act in the capacity of the CMS defined, GADCS Submitter. Per GADCS guidelines, the GADCS Submitter [CONTRACTOR] is responsible for entering information into the GADCS portal (i.e., questions organized by section). GADCS PROVIDER shall act in the capacity of the CMS defined, GADCS Certifier. Per GADCS guidelines, the GADCS Certifier [GADCS PROVIDER] reviews the information Page 12 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers submitted by the GADCS Submitter, requests corrections, if necessary, and certifies the responses as accurate. C. Data Gathering from GADCS PROVIDER CONTRACTOR shall work with GADCS PROVIDER to obtain the necessary information for the GADCS report. CONTRACTOR shall review the financial, statistical, billing, and utilization information provided by GADCS PROVIDER and compare the information to the data guidance provided by CMS pertaining to the GADCS. In the event the data does not meet the GADCS guidelines for the GADCS report, CONTRACTOR shall work with GADCS PROVIDER to obtain information that will meet the data requirements for the GADCS report. In the event the GADCS PROVIDER cannot produce information that meets the GADCS report requirements, or in the event that information provided by the GADCS PROVIDER cannot be analyzed, organized, presented, summarized, or otherwise manipulated by the CONTRACTOR, in a timely and reasonable period, to conform to GADCS guidelines for the GADCS report, CONTRACTOR shall develop a reasonable estimate, as allowed by GADCS guidelines, and present that to GADCS PROVIDER. CONTRACTOR shall analyze, organize, present, summarize, or otherwise manipulate the GADCS PROVIDER data that meets GADCS report guidelines, and develop necessary calculations and provide data outputs that meet the prescribed GADCS report requirements, as necessary. Any analysis of data or the development of outputs and reports that are not germane to the GADCS report shall not be provided. D. Report Preparation and Review CONTRACTOR shall prepare a Microsoft Excel -based support file that details how the information for all GADCS sections was derived. The supporting documentation may be used for answering CMS, or its associated organizations and entities, questions related to the data in the GADCS report. While CMS is currently stating that GADCS reports will not be audited, CMS reserves the right to question any information included in the GADCS report and may request supporting documentation. CONTRACTOR shall prepare GADCS report supporting documentation for input into the GADCS portal and conduct a draft GADCS report review meeting virtually with GADCS PROVIDER to review the information going into the GADCS report. CONTRACTOR shall review all sections of the GADCS report with GADCS PROVIDER and adjust analyses, outputs, or answers, as necessary. Page 13 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers This phase of the work shall include phone, email, and virtual ad -hoc meeting(s), as necessary, before and after the draft GADCS report review meeting to address follow-up questions related to data needs from GADCS PROVIDER, and make sure the final GADCS report submittal will meet agreed upon timelines and GADCS guidelines pertaining to the GADCS report. E. Medicare Data Collection System Submittal Management CONTRACTOR shall manage the submittal of the information into the GADCS portal. CONTRACTOR shall act as GADCS Submitter, as defined by CMS in the GADCS report guidelines, and enter the GADCS report information into the GADCS portal. CONTRACTOR shall inform GADCS PROVIDER when data entry into the GADCS portal is complete, and will review with GADCS PROVIDER any questions or concerns related to the entry of information into the GADCS portal. Upon notification from the CONTRACTOR that the data has been entered into the GADCS portal, it becomes the responsibility of the GADCS PROVIDER to act as the GADCS Certifier, as defined by CMS in the GADCS guidelines, to review the entered information submitted by CONTRACTOR, request corrections, if necessary, and certify the responses as accurate. If corrections are necessary, GADCS PROVIDER shall notify CONTRACTOR prior to the GADCS report due date by email and phone that changes are necessary. CONTRACTOR and GADCS PROVIDER shall work together to make the necessary changes to comply with GADCS guidelines pertaining to the GADCS report. CONTRACTOR shall then re-enter the information into the GADCS portal in the capacity of the GADCS Submitter, and inform the GADCS PROVIDER when the information is ready for review by the GADCS PROVIDER in the capacity of the GADCS Certifier. GADCS PROVIDER, when acting in the capacity of the GADCS Certifier, bears the ultimate responsibility of submitting the GADCS report on or before the GADCS report due date. The GADCS guidelines and GADCS portal are structured in a manner that the GADCS report can only be formally submitted by a GADCS Certifier. F. GADCS Report Follow -Up CONTRACTOR shall manage the GADCS report follow-up question and answer process on behalf of the GADCS PROVIDER. Given the current GADCS guidelines for the GADCS report, the GADCS PROVIDER may be asked questions by CMS related to the GADCS report after the GADCS report is Page 14 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers submitted. CONTRACTOR shall work with GADCS PROVIDER to address and answer questions from CMS, the MAC, or similar organization or entity as it pertains to the GADCS report. II. GADCS Submittal Date Based on current GADCS guidelines as defined in 42 CFR 414.610, et al, the GADCS report must be submitted no later than February 29, 2024 , which is five months after the end of the data collection period. A. Timeline CONTRACTOR shall work with the GADCS PROVIDER to establish a timeline for CONTRACTOR, acting as GACS Submitter, to enter information into the GADCS portal so as to provide sufficient time for GADCS PROVIDER, acting as GADCS Certifier, to review GADCS report information, make necessary changes, and submit GADCS report by the deadline identified in this section. Page 15 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers ATTACHMENT B COMPENSATION I. GADCS PROVIDER shall compensate CONTRACTOR based on the following schedule: A. Medicare Ground Ambulance Data Collection System (GADCS) Services Pricing 1) GADCS PROVIDER shall compensate CONTRACTOR $7,000 for the Medicare Ground Ambulance Data Collection System (GADCS) Services associated with this Agreement, as detailed herein. B. Invoicing 1) The timing of the invoices from CONTRACTOR to GADCS PROVIDER shall be as follows: a) $3,500 will be invoiced by CONTRACTOR to GADCS PROVIDER upon contract signing. b) $3,500 will be invoiced by CONTRACTOR to GADCS PROVIDER after the GADCS report is submitted by GADCS PROVIDER, acting as the GADCS Certifier. C. Requirement to Submit Report 1) In the event GADCS PROVIDER is no longer required by CMS to submit the Medicare Ground Ambulance Data Collection System (GADCS) report prior to the Term of the Agreement identified in Section 2.a. of this Agreement, CONTRACTOR shall invoice GADCS PROVIDER for the remaining balance of the Compensation identified in Attachment B(I)(B)(1)(b) of this Agreement, on a pro rata basis as follows: a) GADCS PROVIDER is notified by CMS or associated organization or entity that GADCS PROVIDER no longer needs to submit a GADCS report, two hundred seventy-five days or more prior to the date the GADCS report is due, CONTRACTOR shall not invoice GADCS PROVIDER for the amount in Attachment B(I)(B)(1)(b) of this Agreement. Page 16 Revenue Optimization Solutions, LLc Optimizing Revenue for Ambulance Services Providers b) If GADCS PROVIDER is notified by CMS or associated organization or entity that GADCS PROVIDER no longer needs to submit a GADCS report, during the period less than two hundred seventy-five days prior to the date the GADCS report is due, CONTRACTOR shall invoice GADCS PROVIDER for the amount in Attachment B(I)(B)(1)(b) of this Agreement on the following schedule: Number of Days Notified Prior to GADCS Report Due Date Percentage of Attachment B(I)(6)(1)(b) to be Invoiced by CONTRACTOR 275+ Days 0% 92-274 Days 50% 0-91 Days 100% Page 17 EXHIBIT C INSURANCE REQUIREMENTS REVENUE OPTIMIZATION SOLUTIONS, LLC- MEDICARE GROUND AMBULANCE DATA COLLECTION SYSTEM GADCS 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 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 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/E&O Liability Combined Single Limit Each Claim $1,000,000 General Aggregate Limit $1,000,000 Retroactive date included VI. Crime (if applicable) Theft, Forgery and Alteration included $100,000 City listed as loss payee 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. ► CERTIFICATE OF LIABILITY INSURANCE DATE 01/22/24YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Ross Gray Insurance Agency, Inc 2404 South IH 35 Austin, TX 78704 CONTACTJORDAN KING NAME: PHONE 512-444-3366 I(A/C No)FAx 512-447-6226 ExtY E-MAINo ADDRESS: JORDAN . RGRAY@ FARMERSAGENCY . COM INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: INSURED REVENUE OPTIMIZATION SOLUTIONS LLC 1000 HERITAGE CENTER CIR ROUND ROCK, TX 78664 INSURER B: TEXAS MUTUAL INS. CO. INSURERC: INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADUL INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY lCLAIMS -MADE OCCUR EACH OCCURRENCE $ PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L R AGGREGATE LIMIT APPLIES PER: POLICY J OTHER: JECT PRO - OTHER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OPAGG $ $ AUTOMOBILE _ -' - LIABILITY ANYAUTO ALL OWNED AUTOS HIRED AUTOS - - SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED U RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE (Mandatory inNH)EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N N/A y 0001258074 09/16/2023 09/16/2029 X I PER STATUTE I I OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attachedif more space is required) CERTIFICATE HOLDER CANCELLATION City 444 S. Miami, of W. FL Miami 2nd Ave. 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ye ,' /1 e�i�L�1Y 9.6' ACORD 25 (2013/04) © 1988-2013 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 01 /25/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hiscox Inc. 5 Concourse Parkway Suite 2150 Atlanta GA, 30328 CONTACT P PHONE: (888) 202_3007 FAX (A/C No Ext): (A/C, No): E-MAIL contact@hiscox.com ADDRESS: INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA: Hiscox Insurance Company Inc 10200 INSURED REVENUE OPTIMIZATION SOLUTIONS, LLC 1000 HERITAGE CENTER CIRCLE ROUND ROCK, TX 78664 INSURER B INSURERC: INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y P100.701.484.11 11/01/2023 11/01/2024 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR DAMAGE RENTED PREMISESO(Ea occurrence) $ 1 00,000 MED EXP (Any one person) $ 5,000 PERSONAL&ADVINJURY $ 2,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ S/T Gen. Agg. $ A AUTOMOBILE X LIABILITY X SCHEDULED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ nDAMAGE PWNED PROPERTYer P accident) $ CGL HNOA Limit (per occurrence) $ 1 000 000 UMBRELLA LIAB EXCESS LIAB O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/M EMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N/A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liability Y P100.697.949.11 11/01/2023 11/01/2024 Each Claim: $ 2,000,000 Aggregate: $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Miami is listed as additional insured CERTIFICATE HOLDER CANCELLATION City of Miami 444 S.W. 2nd Ave. Miami, FL 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HISCOX encourage courage' Declarations Page HISCOX encourage courage HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois 60603 Commercial General Liability Declarations In return for the payment of the premium, and subject to all the terms of this Policy, we agree with you to provide the insurance as stated in this Policy. Declaration effective from: Policy No.: Named Insured: Address: Email Address: Policy period: Form of Business: January 25, 2024 P 100.701.484.11 REVENUE OPTIMIZATION SOLUTIONS, LLC 1000 HERITAGE CENTER CIRCLE ROUND ROCK, TX 78664 KCOYLE@REVOPSLLC.COM From: November 1, 2023 To: At 12:01 A.M. (Standard Time) at the address shown above. Each Occurrence Limit: Damage to Premises Rented to You Limit: Medical Expense Limit: Personal & Advertising Injury Limit: General Aggregate Limit: Products/Completed Operations Aggregate Limit: Supplemental Business Personal Property Floater Coverage Limit: Supplemental Business Personal Property Floater Coverage Deductible: All Premises You Own, Rent or Occupy Premises Number: Address: Total Premium: Attachments: November 1, 2024 Limited Liability Company $2,000,000 $100,000 Any one premises $5,000 Any one person $2,000,000 Any one person or organization $2,000,000 Products -completed operations are subject to the General Aggregate Limit $0 Not Applicable 1 1000 HERITAGE CENTER CIRCLE ROUND ROCK, TX 78664 550.00 See attached Forms and Endorsements Schedule. CGL D001 10 18 Includes copyrighted material of Insurance Services Office, Inc., with Page 1 its permission. © ISO Properties, Inc., 2000 etb HISCOX encourage courage® HISCOX INSURANCE COMPANY INC. (A Stock Company) 104 South Michigan Avenue, Suite 600, Chicago, Illinois 60603 IN VVITNESS WHEREOF, the Insurer indicated above has caused this Policy to be signed by its President and Secretary, but this Policy shall not be effective unless also signed by the Insurer's duly authorized representative. President Secretary Authorized Representative CGL D001 10 18 Includes copyrighted material of Insurance Services Office, Inc., with Page 2 its permission. © ISO Properties, Inc., 2000 H I SCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) encourage courage' Forms and Endorsements Schedule 104 South Michigan Avenue, Suite 600, Chicago, Illinois 60603 Forms and Endorsements made part of this policy at time of issue: CGL D001 10 18 - Commercial General Liability Declarations INT D001 01 10 - Forms and Endorsements Schedule CGL E5581 CW (03/16) - Primary and Noncontributory - Other Insurance Condition CGL E5410 CW (03/10) - Policy Changes INT D001 01 10 Page 1 of 1 HISCOX encourage courage' Endorsements HISCOX Policy Number: P100.701.484.11 Named Insured: REVENUE OPTIMIZATION SOLUTIONS, LLC Endorsement Number: 28 Endorsement Effective: 01/25/2024 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy, pro- vided: 1. you have agreed in a written contract or agreement to add such additional insured to a policy providing the type of coverage af- forded by this policy; and 2. you have agreed in a written contract or agreement with such additional insured that this insurance would be primary and would not seek contribution from any other insur- ance available to the additional insured. CGL E5581 CW (03/16) Includes copyrighted material of Page 1 of 1 Insurance Services Office, Inc., with its permission HISCOX Policy Number: P100.701.484.11 Named Insured: REVENUE OPTIMIZATION SOLUTIONS, LLC Endorsement Number: 29 Endorsement Effective: 01/25/2024 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES This endorsement will not be used to decrease coverage, increase rates or deductibles or alter any terms or con- ditions of coverage unless at the sole request of the insured. The following item(s): ❑ Insured's Name ❑ Insured's Mailing Address ❑ Policy Number ❑ Company ❑ Effective/Expiration Date ❑ Insured's Legal Status/Business of Insured ❑ Payment Plan ❑ Premium Determination ❑ Additional Interested Parties ® Coverage Forms and Endorsements ❑ Limits/Exposures ❑ Deductibles ❑ Covered Property/Located Description ❑ Classification/Class Codes ❑ Rates ❑ Underlying Insurance is (are) changed to read {See Additional Page(s)}: The above amendments result in a change in the premium as follows: ❑ NO CHANGES ❑ TO BE ADJUSTED ADDITIONAL PREMIUM RETURN PREMIUM AT AUDIT $ 27 $ CGL E5410 CW (03/10) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 ❑ POLICY CHANGES ENDORSEMENT DESCRIPTION It is understood and agreed that effective 01/25/2024, Endorsement # 28 entitled Primary and Noncontributory - Other Insurance Condition is added. All other terms and conditions remain unchanged. CGL E5410 CW (03/10) Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 with its permission. Olivera, Rosemary From: Martinez, Maria Sent: Friday, February 2, 2024 7:14 AM To: Olivera, Rosemary; Hannon, Todd; Lee, Denise Cc: McGann, Tyrone; Guerra, Jose Subject: Matter Id. 23 - 3052 - GADCS Contract Miami Attachments: Matter ID 23-3052 - GADCS Contract Miami.pdf Good morning Rosemary, Please find attached a fully executed agreement that is to be retained as an original for the City. Regards, Maria T. !Martinez Administrative Assistant I Department of Fire -fescue Technical -Services Division 305.416.1672 (Office) 305.400.5316 (Fax) mmartinez@miamigov.com i