HomeMy WebLinkAbout2025-126AMaster Service Agreement 2.0
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CFRTI I BUTLER, CLERK
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This Master Service Agreement ("MSA") governs the provision of services to you (the "Employer") by Lively,
Inc. ("Lively") and is an integral part of the agreement between you and Lively. An "Affiliate" of a party is
defined as any business entity or enterprise, which controls, is controlled by, or is under common control with,
such party. This MSA must be read in conjunction with all other agreements that describe Services purchased
from Lively by Employer set forth in applicable Addenda (collectively, the "Agreement").
1 General.
1.1 Services. Employer engages Lively on the terms and conditions set forth in this Agreement to provide
certain services (the "Services") as set forth in the applicable Addendum or Addenda. The parties agree that
Lively may provide the Services using different technology platforms and may also modify or change
technology platforms in its discretion so long as the Services are provided, and Lively shall remain responsible
to provide the Services, in accordance with the applicable Addendum.
1.2 Addendum. "Addendum" (or Addenda, as applicable) refers to each of the agreements attached to the
MSA. Lively will provide a copy of any applicable Addendum upon reasonable request by Employer. Each
Addendum will describe the tasks to be performed by the parties in connection with the Services outlined in
that Addendum. Employer shall cooperate on a timely basis with Lively and perform the activities reasonably
required by Lively to enable Lively to fulfill its obligations and responsibilities under this Agreement. In the
event of any conflict between this MSA and any Addendum, the applicable Addendum shall control.
1.3 Employer Responsibility. Employer has the exclusive responsibility for providing Lively with timely and
accurate information and data as necessary for Lively to provide the Services.
1.4 Plan Administrator; Fiduciary. For Services subject to the Employee Retirement Income Security Act of
1974, as amended ("ERISA"), Employer is the Plan Sponsor and the named fiduciary for purposes of Employee
Retirement Income Security Act of 1974 ("ERISA") §402(a) (to the extent such law applies) of any and all
employee benefit plans or programs (each a "Plan" or, collectively, the "Plans"). Lively, or a designated third
party provider, is an independent contractor engaged to perform the agreed upon Services in a non -fiduciary
capacity. Written consent of Lively shall not be considered a representation that Lively has reviewed and/or
approved the content of such communication or document. Employer is responsible for paying all fees and/or
penalties arising from the Plans that are assessed by the Internal Revenue Service, the Department of Labor,
and/or other federal, state, or local governmental agencies.
1.5 Implementation. The parties will establish an implementation plan and work in good faith to implement
the Services and other arrangements contemplated by this Agreement in accordance with the terms hereof and
applicable laws and regulations. Each of the parties will designate an employee(s) to facilitate and manage the
implementation.
2 Term.
The Term of this Agreement shall be for a period of at least one year, but shall be extended in the case of any
applicable Addenda until ninety (90) days after the termination of all applicable Addenda.
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RYAN L. BUTLER, CLERK
3 Communications and Relationship Management.
3.1 Lively contact designation. Lively will designate a contact or team responsible for responding to inquiries
and requests made by Employer.
3.2 Employer communications. Employer is responsible for providing representatives ("Employer
Administrators") duly authorized to receive and furnish information or instructions ("Employer
Communication") within the Lively website as Employer Administrators. Lively may, without further review or
verification, honor or act upon any Employer Communication.
3.3 Notices. All notices to Lively with respect to this Agreement shall be sent via electronic mail to
employersupportlivelyme.com and/or to the Lively employee that has been assigned as Employer's dedicated
customer support individual. All Notices to Employer with respect to this Agreement shall be sent via
electronic mail to the Employer Administrator . Employer is responsible for maintaining an accurate list of
Employer Administrators within secure. livelyme. com. Lively will notify Employer in writing if its contact
information changes and shall provide Employer Lively's new contact information.
4 Representations and Warranties.
4.1 Applicable Laws. For purposes of this Agreement, "Applicable Law" means laws, regulations, rules or
orders of the applicable government agency or jurisdiction to the extent such laws, regulations, rules or orders
apply to the relevant party in the performance of its obligations under the Agreement. Additionally, "Data
Privacy Law" means all laws, rules, regulations, governmental requirements, codes as well as international,
federal, state, and provincial laws applicable to any information related to an identified or identifiable person
("Personal Information").
4.2 Full Power and Authority. Each party represents and warrants to the other party that (i) it has the full
right, power, and authority to enter into and perform its obligations under this Agreement, and (ii) no other
contractual obligation exists that would prevent Employer from entering into this Agreement or performing its
obligations under this Agreement.
4.3 Employer Warranties. Employer warrants that it complies with all applicable laws with respect to
confirming the identity and eligibility of its employees and other individuals whose information Employer
submits to Lively relative to this Agreement, and Employer has the necessary authorizations from such
employees and individuals to provide such information to Lively. Employer also warrants that all information
provided by Employer to Lively is accurate, complete, up-to-date, and it has, and will continue to have, the
right to transfer, or provide access to, the Personal Information to Lively and its subprocessors, for processing
consistent with the purposes contemplated in the Agreement and Addendum and such processing will not
breach applicable Data Privacy Law. Employer acknowledges that Lively's relationship with the individual
utilizing one or more of Lively Services ("Participant"), including employees of Employer, is governed by
separate documents, including Lively's End User Agreement, Privacy Policy, Custodial Agreement, E -
Signature Disclosure and any other document the Participant is required to sign.
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RYAN L. BUTLER, CLERK
4.4 Lively Warranties. Lively represents and warrants that (i) it will perform the Services in substantially the
manner and according to the specifications described herein and in the applicable Addenda; (ii) it can and shall
comply in all material respects with Applicable Law performing its obligations under this Agreement; and (iii)
it has right and authority to enter into this Agreement and to perform its obligations to the other party and the
users as set forth in this Agreement.
5. Effect of Termination
5.1 Termination. Either party may terminate this Agreement for cause in the event of a material breach by the
other party upon 90 days written notice, provided that the breaching party does not cure such breach on or
before the end of the notice period.
5.2. Suspension. Lively may suspend Employer's access to the Lively platform at any time without notice if
Services are discontinued, or if Lively reasonably believes that Employer has violated any term of this
Agreement, or as required to provide maintenance to, or investigate any security vulnerabilities in the Services.
In the event that the conditions of the suspension cannot be remedied within a reasonable period of time,
Lively may terminate the Agreement.
6. Confidentiality
6.1 In the general course of implementing this Agreement and providing the Services, each party may disclose
information that is considered confidential and proprietary to such party ("Confidential Information"). Unless
permitted in writing by the party whose Confidential Information is disclosed, all Confidential Information
disclosed by a party is to be considered strictly confidential and the receiving party shall use reasonable
commercial efforts to maintain the disclosing party's Confidential Information as strictly confidential and to
require their respective officers, directors, employees and agents to maintain the confidentiality of such
information. These obligations shall not apply, however, to any information which (i) is already in the public
domain at the time of disclosure or later becomes available to the public through no breach of this provision;
(ii) was, as between the recipient and the disclosing party, lawfully in the recipient's possession prior to receipt
from the disclosing party without obligation of confidentiality; (iii) is received by the recipient independently
from a third party free to lawfully disclose such information to the recipient; or (iv) is subsequently
independently developed by the recipient as evidenced by its business records.
6.2 In the event Employer receives a request or demand to disclose all or any part of the Confidential
Information under the terms of a subpoena or order issued by a court of competent jurisdiction, an agency of
any State of the United States or of any other jurisdiction in which it conducts business, or otherwise,
Employer agrees to promptly notify Lively of the existence, terms and circumstances surrounding the request
so that Lively at its own cost may seek a protective order or other appropriate relief or remedy and/or waive
compliance with the terms of this Agreement. In the event that such protective order or other remedy is not
obtained, or Lively waives compliance with the provisions of this Agreement, Employer agrees to furnish only
that portion of the Confidential Information which in the reasonable judgment of its counsel is legally
required and to use its best efforts to ensure that confidential treatment will be accorded such Confidential
Information.
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RYAN L. BUTLER, CLERK
6.3 Parties agree that in the event either becomes aware of the occurrence of a breach of security with respect
to Confidential Information, they will immediately act to stop such breach and as soon as practicable
thereafter, notify the other in writing, of the breach, the extent of the breach, and possible consequences of the
breach. Each shall undertake all reasonable actions under the circumstances to respond to the breach and to
assure the other that it has made its best effort to mitigate any damages that may result from the breach. This
provision shall survive the termination or expiration of this Agreement.
7. Safeguard
7.1 The Gramm -Leach -Bliley Act requires financial institutions and their service providers to create
safeguards for customer records and information. The objectives of the safeguards are to (1) insure the security
and confidentiality of customer records and information; (2) protect against any anticipated threats or hazards
to the security or integrity of such records; (3) detect unauthorized access to or use of such records or
information and (4) protect against unauthorized access to or use of such records or information that would
result in substantial harm or inconvenience to any customer (the "Safeguarding Objectives"). In order to
implement these safeguarding requirements, both are required to have written contracts with their service
providers (any person or entity that maintains, processes, or otherwise is permitted access to customer
information) that requires the service provider implement appropriate measures designed to meet the
Safeguarding Objectives.
7.2 Lively may immediately suspend and/or terminate the applicable Addendum and/or the entire Agreement if
Employer does not complete or pass the due diligence screening performed by Lively. This due diligence may
include, but is not limited to, performing Know Your Customer screening on each beneficial owner and/or
controller of Employer, as required by FinCEN. Lively will also screen Employer against the OFAC watchlists.
Employer will undergo OFAC re-screen(s) at a cadence determined by Lively.
7.3 Employer represents and agrees that it has and will maintain in place commercially reasonable precautions
to safeguard the confidentiality, security and integrity of Confidential Information in a manner designed to
meet the Safeguarding Objectives.
8. Identify Theft Program
Employer acknowledges that Sections 114c and 315 of the The Fair and Accurate Credit Transactions Act of
2003, Pub.L. 108-159 ("FACTA") require financial institutions and their service providers to create an Identity
Theft Prevention Program designed to detect, prevent and mitigate identity theft. The program must include (1)
procedures to identify relevant patterns, practices or specific activity that indicates the possible existence of
identity theft ("Red Flags"); (2) detect Red Flags; (3) respond appropriately to detected Red Flags and (4)
periodic updates to the identity theft program. For the sake of this section, "identity theft" shall have the
meaning set forth in 16 CFR 603.2. Employer agrees to assist Lively in meeting its regulatory compliance with
FACTA by notifying Lively immediately upon discovery of any pattern, practice or specific activity that
indicates the possible existence of Identity Theft. This is in addition to any notification procedures required
under Section 10 of this Agreement (Safeguards).
9. Intellectual Proptrty Rights
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" YAN L. SUTLER, CLERK
9.1 Each party retains all respective intellectual property rights, including all patent, copyright and trademark
rights in any materials, software or processes belonging to it, its subsidiaries or Affiliates, including but not
limited to rights accruing by virtue of applicable federal, state, or common law protections for copyright,
patent, trade secret, and trademark and/or service mark rights. In the event either party discovers a violation of
such proprietary rights, that party, for itself and on behalf of its subsidiaries and Affiliates, expressly reserves
the right to seek or pursue in an appropriate state or federal court all available remedies for the infringement of
such rights. Except for any distribution rights granted to either party by the other under this Agreement, neither
party grants any other rights or licenses to the other. Employer may not alter or supplement documents
provided to Employer's employees in furtherance of opening a Lively account or any other document
containing Lively's, or any other entity which is the custodian of monies, name without Lively's prior written
consent.
9.2 Except as described herein and further in section 9.4 of this Agreement, parties shall not use any logo,
trademark, service mark, trade name, or image of the respective owner whether any of the foregoing are
registered or unregistered; or otherwise protected or protectable under state or federal law (each a "Logo") in
any manner other than as is expressly authorized in writing by an authorized representative of the owner. A
requesting party shall submit to the owner for prior written approval all proposed uses of the Logos, and shall
not use any Logo without such approval. The owner reserves the right to review any approved use of the
Logos and to require changes in such further use (such changes may include discontinuing the use, in the
owner's sole discretion), and requesting party agrees to comply with any such requirements. The requesting
party acknowledges and agrees that: (i) it shall not use any Logo in a manner likely to diminish their
commercial value; (ii) it shall not knowingly permit any third party to use the Logos unless authorized to do so
in writing by the owner; (iii) it shall not knowingly use or permit the use of any logo, trademark, service mark,
name, or image likely to cause confusion with a Logo; (iv) any and all goodwill associated with a requesting
party's use of any and all Logo(s) shall inure to the owner, its successors in interest, and assigns; (v) the Logos
are and shall remain the sole property of the owner; (vi) nothing in this Agreement or any written authorization
shall confer in the requesting party any right of ownership in any Logos, and the requesting party shall not
make any representation to the effect, or use the Logos in a manner that suggests that such rights are
conferred; and (vii) the requesting party shall not now or in the future contest the validity of any Logos.
Notwithstanding the foregoing, Lively may use Employer Logo in internal materials or for investor related
activity without prior written consent of Employer.
9.3 Lively and the Employer may provide links to each other's websites. Lively hereby grants to Employer,
during the term of this Agreement, a non-exclusive, non -transferable, limited license to copy, display, and to
use and transmit on and via the Internet the following Lively -owned Uniform Resource Locator ("URL"):
https://www.livelyme.cQm or similar URL designated by Lively ("Lively Link"). The license with respect to
Lively Link shall be limited to the placement of the link on the Employer website. The link will direct a user,
by clicking on the link, to automatically transfer the user's screen page directly to Lively's designated web
page, and to no other location. Employer hereby grants to Lively, during the term of this Agreement, a non-
exclusive, non -transferable, limited license to copy, display, and to use and transmit on and via the Internet to a
Employer owned Uniform Resource Locator ("URL") designated by Employer ("Employer Link"). The
license with respect to the Employer Link shall be limited to the placement of the link on Lively website. The
link will direct a user, by clicking on the link, to automatically transfer the user's screen page directly to the
Employer's designated web page, and to no other location.
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RYAN L. BUTLER, CLERK
9.4 Employer grants Lively the right to use its name and logo for marketing purposes. At any time, Employer
may revoke Lively's ability to do this through written notice. Lively will cease to use Employer's name and/or
logo after a reasonable period of time.
10. Limitation of Liability
10.1 LIVELY WILL NOT BE LIABLE TO EMPLOYER, REGARDLESS OF THE FORM OF THE ACTION
AND WHETHER IN CONTRACT OR IN TORT (INCLUDING WITHOUT LIMITATION NEGLIGENCE,
STRICT LIABILITY OR ANY OTHER LEGAL OR EQUITABLE CLAIM), FOR ANY PUNITIVE,
SPECIAL, INCIDENTAL, CONSEQUENTIAL OR OTHER INDIRECT DAMAGES, INCLUDING
WITHOUT LIMITATION DAMAGES FOR LOST PROFITS, BUSINESS INTERRUPTION OR DELAY,
LOSS OF DATA OR COST OF PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES, EVEN IF IT
HAS BEEN INFORMED OF THE POSSIBILITY OF SUCH DAMAGES. LIVELY WILL NOT BE LIABLE
TO EMPLOYER FOR DAMAGES ARISING FROM, OR RESULTING FROM, ANY ACH FUNDS
TRANSFER (WHETHER INITIATED MANUALLY IN THE APPLICATION, AS A RESULT OF
AUTOMATIC FUNDS TRANSFER SETTINGS IN THE APPLICATION, OR THROUGH ANOTHER
MECHANISM) RELATED TO: (a) EMPLOYER ERROR IN SETTING THE AUTOMATIC FUNDS
TRANSFER FUNCTION OR FAILING TO ANTICIPATE ITS CONSEQUENCES; (b) ANY ADVERSE
FINANCIAL, TAX OR OTHER CONSEQUENCES OF THE TRANSFER; (c) ANY FEES RELATED TO
THE TRANSFER (INCLUDING WITHOUT LIMITATION OUTGOING AND INCOMING TRANSFER
FEES AND INSUFFICIENT FUNDS FEES); (d) ANY CONSEQUENCES OF INCORRECT OR
OUTDATED ACCOUNT OR BALANCE INFORMATION, WHETHER THAT INFORMATION WAS
PROVIDED TO LIVELY THROUGH THE APPLICATION OR ANOTHER MECHANISM.
ADDITIONALLY, THE AGGREGATE LIABILITY OF LIVELY TO EMPLOYER FOR ANY AND ALL
LOSSES, DAMAGES, COSTS OR EXPENSES ARISING UNDER THIS AGREEMENT, REGARDLESS
OF THE FORM OF THE ACTION AND WHETHER IN CONTRACT OR IN TORT (INCLUDING
WITHOUT LIMITATION NEGLIGENCE, STRICT LIABILITY OR ANY OTHER LEGAL OR
EQUITABLE CLAIM), WILL BE LIMITED TO DIRECT DAMAGES IN AN AMOUNT NOT TO EXCEED
THE TOTAL FEES ACTUALLY PAID BY EMPLOYER TO LIVELY UNDER THIS AGREEMENT
DURING THE THREE (3) MONTH PERIOD IMMEDIATELY PRECEDING THE EVENT WHICH GAVE
RISE TO THE CLAIM.
10.2 NOTWITHSTANDING SECTION 10.1 ABOVE, IN NO EVENT WILL LIVELY BE LIABLE TO
EMPLOYER FOR ANY DAMAGES WHATSOEVER, WHETHER DIRECT, INDIRECT, SPECIAL,
CONSEQUENTIAL OR OTHERWISE, ARISING OR RESULTING FROM MISTAKE, THEFT, FRAUD OR
OTHER MISCONDUCT BY EMPLOYER IN CONNECTION WITH THE APPLICATION.
10.3 THE LIMITATIONS SET FORTH IN THIS SECTION 10 DO NOT APPLY TO ANY claim, damage,
liability, loss, government procedure OR cost, including WITHOUT LIMITATION reasonable attorneys' fees,
incurred or suffered by Employer to the extent arising from or attributable to the unauthorized access of
Personal Information by any third party that is caused by the gross negligence or willful misconduct of Lively.
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RYAN L. BUTLER, CLERK
10.4 The parties expressly acknowledge and agree that Lively and Employer have entered into this Agreement
in reliance upon the limitations of liability specified herein.
10.5 Some jurisdictions may not allow the exclusion or limitation of incidental, special, consequential, or
other damages, so the above limitations or exclusions may not apply to any individual who establishes and
maintains an account at Lively while employed by Employer. In such event, the liability of Lively for such
damages with respect to the Services will be limited to the greatest extent permitted by applicable law in such
jurisdiction.
11. Force Majeure Event
11.1 "Force Majeure Event" means any act or event, whether foreseen or unforeseen, that: (i) prevents a party
(the "Nonperforming Party"), in whole or in part, from: performing its obligations under this Agreement; (ii) is
beyond the commercially reasonable control of and not the fault of the Nonperforming Party, and (iii) the
Nonperforming Party has been unable to avoid or overcome the act or event by the exercise of due diligence. A
Force Majeure Event does not include economic hardship, changes in market conditions, insufficiency of
funds, unavailability of equipment or supplies or strikes, work -to -rule actions, go-slows or similar labor
difficulties.
11.2 If a Force Majeure Event occurs, the Nonperforming Party is excused from whatever performance is
prevented by the Force Majeure Event to the extent so prevented. Despite the previous sentence, no obligation
by either the Performing Party or the Nonperforming Party to make any payment required under this
Agreement is excused as a result of a Force Majeure Event.
11.3 During the continuation of the Force Majeure Event, the Nonperforming Party shall exercise
commercially reasonable efforts to mitigate or limit damages to the Performing Party, continue to perform its
obligations under this Agreement to the extent it is able; and exercise commercially reasonable due diligence
to cause the Suspension of Performance to be of no greater scope and no longer duration than the Force
Majeure Event requires.
12. Miscellaneous
12.1 Either party may assign this Agreement to any subsidiary or Affiliate under its control, or as part of the
sale of any substantial portion of its assets, or pursuant to any merger, consolidation or other reorganization,
without the other party's prior written consent. Except as so provided, Employer may not assign its rights and
responsibilities under this Agreement without the prior written consent of Lively, which consent shall not be
unreasonably withheld. Lively may assign this Agreement for any reason with prior written notice to Employer.
An assignee of either party, if authorized hereunder, shall have all of the rights and obligations of the assigning
party set forth in this Agreement.
12.2 This Agreement will be governed, controlled and interpreted by the laws of the state of Florida without
regard to the provisions thereof related to choice of laws or conflicts of laws.
12.3 If any term, condition or provision of this Agreement is held invalid or otherwise unenforceable, such
invalidity or unenforceability shall not affect the validity and enforceability of the remaining terms, conditions
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RYAN L. BUTLER, CLERK
or provisions and the remaining terms, conditions and provisions shall remain in full force and effect.
12.4 The forbearance from or failure by any party to exercise any right provided for herein shall not be deemed
to be a waiver of any right hereunder. All rights and remedies of a non -defaulting party are cumulative and not
exclusive of any remedies provided by law or equity.
12.5 This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an
original and shall be binding on the parties. Electronic signatures and copies of the executed Agreement shall
have full force and effect.
12.6 Employer acknowledges and agrees that this Agreement shall not preclude Lively from entering into
similar agreements with other parties with respect to the marketing and administration of Lively account.
12.7 This Agreement, including all attachments hereto, sets forth the entire understanding of the parties, its
subject matter and may not be modified or amended except in writing executed by both parties. If a separate
agreement is executed in writing and executed by both parties, such agreement shall supersede this Agreement.
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RYAN L. BUTLER, CLERK
BUSINESS ASSOCIATE AGREEMENT - Exhibit B
This agreement ("Agreement") is effective as of 06/26/2025
Associate") and Indian River County- ("Covered Entity").
("Effective Date") by and between Lively, Inc. ("Business
WHEREAS, Business Associate will provide certain services to Covered Entity to assist with the administration of employee benefits
programs, accounts, and/or services; and
WHEREAS, Covered Entity and Business Associate mutually agree that the terms of this Agreement will comply with the requirements
of the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and its regulations promulgated thereunder (45 C.F.R.
Parts 160-164).
NOW, THEREFORE, in consideration of the premises and the mutual covenants contained herein, Parties hereto agree as follows:
A. Privacy of Protected Health Information.
1. Permitted Uses and Disclosures. Business Associate is permitted to use and disclose Protected Health Information, including
electronic Protected Health Information (collectively "PHI"), that it creates or receives on Covered Entity's behalf or received from
Covered Entity (or another business associate of Covered Entity) and to request Protected Health Information on Covered Entity's behalf
(collectively, "Covered Entity's Protected Health Information") only as follows:
a) Functions and Activities on Covered Entity's Behalf. Except as otherwise limited in this Agreement, Business Associate is
permitted to request Covered Entity's Protected Health Information on Covered Entity's behalf and to use and to disclose Covered
Entity's Protected Health Information for the following purposes:
b) Business Associate's Operations. For Business Associate's proper management and administration or to carry out Business
Associate's legal responsibilities, provided that, with respect to disclosure of Covered Entity's Protected Health Information, either:
(i) The disclosure is Required by Law; or
(ii) Business Associate obtains reasonable assurance, evidenced by written contract, from any person or entity to which Business
Associate will disclose Covered Entity's Protected Health Information that the person or entity will:
a. Hold Covered Entity's Protected Health Information in confidence and use or further disclose Covered Entity's Protected
Health Information only for the purpose for which Business Associate disclosed Covered Entity's Protected Health
Information to the person or entity or as Required by Law; and
b. Promptly notify Business Associate (who will in turn notify Covered Entity in accordance with Section D (1) of this
Agreement of any instance of which the person or entity becomes aware in which the confidentiality of Covered Entity's
Protected Health Information was breached.
c) Valid Authorization. Business Associate may use and disclose Protected Health Information to the extent allowable under a valid
authorization from the individual who is the subject of the Protected Health Information.
d) Minimum Necessary. Business Associate will, in its performance of the functions, activities, services, and operations specified in
Section A(1) above, make reasonable efforts to use, to disclose, and to request of a Covered Entity only the minimum amount of
Protected Health Information reasonably necessary to accomplish the intended purpose of the use, disclosure or request, except that
Business Associate will not be obligated to comply with this minimum necessary limitation with respect to:
(i) Disclosure to or request by a health care provider for Treatment;
(ii) Use with or disclosure to an individual who is the subject of Covered Entity's Protected Health Information, or that
individual's personal representative;
(iii) Use or disclosure made pursuant to an authorization compliant with 45 C.F.R. § 164.508 that is signed by an individual who
is the subject of Covered Entity's Protected Health Information to be used or disclosed, or by that individual's personal
representative;
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(iv) Disclosure to the United States Department of MM, ler &1W1 nWi SPv0rC'DHHS") in accordance with Section E(1) of this
Agreement (Such disclosure by Business Associate is not intended to waive any attorney-client privilege claimed by Business
Associate.);
(v) Use or disclosure that is Required by Law; or
(vi) Any other use or disclosure that is excepted from the minimum necessary limitation as specified in 45 C.F.R. § 164.502(b)
(2)•
e) Exception to PHI. Parties acknowledge that Business Associate that processes consumer -conducted financial transactions by debit,
credit, or other payment card, clears checks, initiates or processes electronic funds transfers, and conducts other activities that directly
facilitate or effect the transfer of funds for payment for health care or health plan premiums. In doing so Business Associate is
providing its normal financial transaction services to its own customers; it is not performing a function or activity for, or on behalf of,
the Covered Entity. Any information disclosed to Business Associate by Covered Entity for the purposes described in this paragraph
is not subject to the requirements of HIPAA and any accompanying regulations.
2. Prohibition on Unauthorized Use or Disclosure. Business Associate will neither use nor disclose Covered Entity's Protected Health
Information except as permitted or required by this Agreement or in writing by Covered Entity or as Required by Law.
3. Security of Organization's Electronic Protected Health Information. Business Associate will develop, implement, maintain, and
use administrative, technical, and physical safeguards that reasonably and appropriately protect the confidentiality, integrity, and
availability of Electronic Protected Health Information (as defined in 45 CFR 160.103) that Business Associate creates, receives,
maintains, or transmits on Covered Entity's behalf as required by the Security Rule, 45 CFR Part 164, Subpart C.
4. Security Incidents. Business Associate will promptly report to Covered Entity any successful (A) unauthorized access, use,
disclosure, modification, or destruction of Electronic Protected Health Information or (B) interference with Business Associate's system
operations in Business Associate's information systems, of which Business Associate becomes aware. Business Associate will promptly
report to Covered Entity any use or disclosure of the PHI not provided for in this Agreement upon becoming aware of it and will
indemnify and hold Covered Entity harmless from all liabilities, costs and damages arising out of or in any manner connected with the
disclosure by Business Associate of any PHI. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this Agreement.
5. Information Safeguards. Business Associate will develop, implement, maintain and use appropriate administrative, technical and
physical safeguards, in compliance with 45 C.F.R. § 164.530(c) and any other implementing regulation issued by DHHS that is applicable
to Business Associate's obligations with respect to Covered Entity's Protected Health Information. The safeguards will be designed to
preserve the integrity and confidentiality of, and to prevent intentional or unintentional non -permitted use or disclosure of Covered
Entity's Protected Health Information.
6. Subcontractors. For purposes of this Business Associate Agreement, "Subcontractor" is defined as an agent or
Subcontractor who is providing the services that the Covered Entity contracted with the Business Associate to perform. Business
Associate will require any of its Subcontractors, to which Business Associate is permitted by this Agreement or in writing by Covered
Entity to disclose Covered Entity's Protected Health Information to provide reasonable assurances, that such Subcontractor will comply
with the same privacy and security obligations with respect to Covered Entity's Protected Health Information that are applicable to
Business Associate under this Agreement.
B. Compliance with Transaction Standards. If Business Associate conducts in whole or part electronic Transactions on behalf of
Covered Entity for which DHHS has established Standards, Business Associate will comply, and will require any Subcontractor it
involves with the conduct of such Transactions to comply, with each applicable requirement of 45 C.F.R. Part 162. Business Associate
will not enter into, or permit its Subcontractors or agents to enter into, any trading partner agreement in connection with the conduct of
Standard Transactions on behalf of Covered Entity that:
1. Changes the definition, data condition, or use of a data element or segment in a Standard Transaction; 2. Adds any data element or
segment to the maximum defined data set;
3. Uses any code or data element that is marked "not used" in the Standard Transaction's implementation specification or is not in the
Standard Transaction's implementation specification; or
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''4N L. BUTLER, CLERK
C. Individual Rights.
1. Access. Business Associate will, within 20 days following Covered Entity's request, make available to Covered Entity or, at Covered
Entity's direction, to an individual (or the individual's personal representative) for inspection and obtaining copies Covered Entity's
Protected Health Information about the individual that is in Business Associate's custody or control, so that Covered Entity may meet its
access obligations under 45 C.F.R. § 164.524.
2. Amendment. Business Associate will, upon receipt of notice from Covered Entity, promptly amend or permit Covered Entity access to
amend any portion of Covered Entity's Protected Health Information, so that Covered Entity may meet its amendment obligations under
45 C.F.R. §164.526.
3. Disclosure Accounting. So that Covered Entity may meet its disclosure accounting obligations under 45 C.F.R. § 164.528:
a) Disclosures Subject to Accounting. Business Associate will record the information specified in Section C(3)(c) below ("Disclosure
Information") for each disclosure of Covered Entity's Protected Health Information, not excepted from disclosure accounting as specified
in Section C(3)(b) below, that Business Associate makes to Covered Entity or to a third party.
b) Disclosures Not Subject to Accounting. Business Associate will not be obligated to record Disclosure Information or otherwise
account for disclosures of Covered Entity's Protected Health Information:
(i) That occurred before April 14, 2003;
(ii) For Treatment, Payment or Health Care Operations activities;
(iii) To an individual who is the subject of Covered Entity's Protected Health Information disclosed, or to that individual's personal
representative;
(iv) Pursuant to an authorization compliant with 45 C.F.R. § 164.508 that is signed by an individual who is the subject of Covered
Entity's Protected Health Information disclosed, or by that individual's personal representative;
(v) For notification of and to persons involved in the health care or payment related to the health care of an individual who is the
subject of Covered Entity's Protected Health Information disclosed and for disaster relief,
(vi) To law enforcement officials or correctional institutions in accordance with 45 C.F.R. § 164.512(k)(5);
(vii) For national security or intelligence purposes in accordance with 45 C.F.R. § 164.512(k)(2); (viii) In a Limited Data Set;
(ix) Incident to a use or disclosure that Business Associate is otherwise permitted to make by this Agreement; and (x) Otherwise
excepted from disclosure accounting as specified in 45 C.F.R. § 164.528.
(xi) Processing of any consumer -conducted financial transactions by debit, credit, or other payment card, clearing checks, initiating
or processing electronic funds transfers, or conducting any other activity that directly facilitates or effects the transfer of funds for
payment for health care or health plan premiums, or any other normal banking or other financial transaction services provided by
Business Associate to its own customers.
c) Disclosure Information. With respect to any disclosure by Business Associate of Covered Entity's Protected Health Information that
is not excepted from disclosure accounting by Section 3(b)(ii) above, Business Associate will record the following Disclosure
Information as applicable to the type of accountable disclosure made:
(i) Disclosure Information Generally
Except for repetitive disclosures of Covered Entity's Protected Health Information as specified in Section C(3)(c)(ii) below , the
Disclosure Information that Business Associate must record for each accountable disclosure is (i) the disclosure date, (ii) the name
and (if known) address of the entity to which Business Associate made the disclosure, (iii) a brief description of Covered Entity's
Protected Health Information disclosed, and (iv) a brief statement of the purpose of the disclosure.
(ii) Disclosure Information for Repetitive Disclosures
For repetitive disclosures of Covered Entity's Protected Health Information that Business Associate makes for a single purpose to the
same person or entity (including Covered Entity), the Disclosure Information that Business Associate must record is either the
Disclosure Information specified in Section C(3)(c)(i) above for each accountable disclosure, or (i) the Disclosure Information
specified in Section C(3)(c)(i) above for the first of the repetitive accountable disclosures, (ii) the frequency, periodicity, or number
of the repetitive accountable disclosures, and (iii) the date of the last of the repetitive accountable disclosures.
d) Availability of Disclosure Information. Business Associate will maintain the Disclosure Information for at least 6 years following
the date of the accountable disclosure to which the Disclosure Information relates.
Business Associate will report the Disclosure Information to Covered Entity upon 30 days' written notice.
4. Restriction Requests: Confidential Communications. Business Associate will comply with any agreement that Covered Entity
makes that either (i) restricts use or disclosure of Covered Entity's Protected Health Information pursuant to 45 C.F.R. § 164.522(a), or
(ii) requires confidential communication about Covered Entity's Protected Health Information pursuant to 45 C.F.R. § 164.522(b),
provided that Covered Entity notifies Business Associate in writing of the restriction or confidential communication obligations that
Business Associate must follow and furnishes Business Associate a copy of such agreement. Covered Entity will promptly notify
Business Associate in writing of the termination of any such restriction agreement or confidential communication requirement and, with
respect to termination of any such restriction agreement, instruct Business Associate whether any of Covered Entity's Protected Health
Information will remain subject to the terms of the restriction agreement.
D. Breach of Privacy Obligations.
1. Reporting. Business Associate will report to Covered Entity any use or disclosure of Covered Entity's Protected Health Information
not permitted by this Agreement of which it becomes aware. Business Associate will make the report to Covered Entity's Legal
Department not more than 10 days after Business Associate learns of such non -permitted use or disclosure. Business Associate's report
will at least:
a) Identify the nature of the non -permitted use or disclosure;
b) Identify Covered Entity's Protected Health Information used or disclosed;
c) Identify who made the non -permitted use or disclosure and who received the non -permitted disclosure;
d) Identify what corrective action Business Associate took or will take to prevent further non -permitted uses or disclosures;
e) Identify what Business Associate did or will do to mitigate any deleterious effect of the non -permitted use or disclosure; and
f) Provide such other information, including a written report, as Covered Entity may reasonably request.
2. Termination of Agreement.
a) Right to Terminate for Breach. Covered Entity may terminate Agreement if it determines, in its sole discretion, that Business Associate
has breached any material provision of this Agreement and upon written notice to Business Associate of the breach, Business Associate
fails to cure the breach within 30 days after receipt of the notice. Covered Entity may exercise this right to terminate Agreement by
providing Business Associate written notice of termination, stating the failure to cure the breach of the Agreement that provides the basis
for the termination. Any such termination will be effective immediately or at such later date specified in Covered Entity's notice of
termination. No disclosure made at the request of Covered Entity, whether or not in violation of this Agreement or 45 C.F.R. Part 164,
shall be considered a material breach of this Agreement.
b) Right to Terminate on Regulation Change. Either Covered Entity or Business Associate may terminate Agreement if amendment or
addition to 45 C.F.R. Parts 160-64 affects the obligations under this Agreement or the party.
c) Obligations upon Termination.
(i) Procedure When Return or Destruction Is Not Feasible. Business Associate is a Financial Institution; return or destruction of
Protected Health Information is not feasible. Business Associate will limit its further use or disclosure of such information to those
purposes that make return or destruction of such information infeasible. Business Associate will, with any Subcontractor to which
Business Associate discloses Covered Entity's Protected Health Information as permitted by Section A (6) of this Agreement,
reasonably require such Subcontractor to limit its further use or disclosure of Covered Entity's Protected Health Information to the
extent such Subcontractor cannot feasibly return or destroy to those purposes that make the return or destruction of such information
infeasible.
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CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
(ii) Continuing Privacy Obligation. Business Associate's obligation to protect the privacy of Covered Entity's Protected Health
Information as specified in this Agreement will be continuous and survive termination, cancellation, expiration or other conclusion of
this Agreement.
3. Indemnification. Business Associate will indemnify and hold harmless Covered Entity and any Covered Entity affiliate, officer,
director, employee or agent from and against any claim, cause of action, liability, damage, cost or expense, including, without limitation,
reasonable attorneys' fees and court costs, arising out of or in connection with any non -permitted or violating use or disclosure of
Protected Health Information or other breach of this Agreement by Business Associate or any Subcontractor, of Business Associate or
other person or entity under Business Associate's control.
Covered Entity will indemnify and hold harmless Business Associate and any Business Associate affiliate, officer, director, employee or
agent from and against any claim, cause of action, liability, damage, cost or expense, including, without limitation, reasonable attorneys'
fees and court costs, arising out of or in connection with Covered Entity's release of non -permitted Protected Health Information to
Business Associate and/or Covered Entity's failure to notify Business Associate of any changes in, or revocation of, permission by an
individual to use or disclose the individual's Protected Health Information, which changes affect Business Associate's permitted or
required uses or disclosures.
E. General Provisions.
1. Inspection of Internal Practices, Books, and Records. Business Associate will make its internal practices, books, and records,
relating to its use and disclosure of Covered Entity's Protected Health Information available to Covered Entity and to DHHS to
determine Covered Entity's compliance with 45 C.F.R. Parts 164, Subpart E "Privacy of Individually Identifiable Health Information."
This agreement to disclosure by Business Associate is not intended to waive any attorney-client privilege claimed by Business Associate.
2. Definitions. The capitalized terms "Covered Entity," "Protected Health Information," "Standard," "Required by Law" and
"Transaction" have the meanings set out in 45 C.F.R. § 160.103. The terms "Health Care Operations," "Payment," "Research," and
"Treatment" have the meanings set out in 45 C.F.R. § 164.501. The terms "Limited Data Set" and "Standard Transaction" have the
meanings set out in, respectively 45 C.F.R. § 164.514(e) and 45 C.F.R. § 162.103. The term "use" means with respect to Protected Health
Information, utilization, employment, examination, analysis or application within Business Associate. The terms "disclose" and
"disclosure" mean, with respect to Protected Health Information, release, transfer, providing access to or divulging to a person or entity
not within Business Associate.
3. Amendment to Agreement. Upon the compliance date of any final regulation or amendment to final regulation promulgated by
DHHS that affects Business Associate's use or disclosure of Covered Entity's Protected Health Information or Standard Transactions,
this Agreement will be automatically amended such that the obligations imposed on Business Associate remain in compliance with the
final regulation, unless Covered Entity or Business Associate elects to terminate Agreement in accordance with Section D(2)(b) of this
Agreement. No other alteration or modification of the terms and conditions of this Agreement shall be valid or of any force or effect
unless it is expressly in a written memorandum executed for Parties by persons duly authorized to do so.
4. Assignment. Covered Entity may assign this Agreement or any of its rights or obligations hereunder to any successor through merger,
sale or consolidation with prior written notice to and approval of Business Associate. Business Associate may assign this Agreement or
any of its rights or obligations hereunder to any successor through merger, sale or consolidation with prior written notice to and approval
of Covered Entity.
5. Interpretation. This Agreement shall be interpreted as broadly as necessary to implement and comply with HIPAA, the regulations
promulgated thereunder (45 C.F.R. Parts 160-164) and applicable state laws. The parties agree that any ambiguity in this Agreement shall
be resolved in favor of a meaning that complies and is consistent with these laws and regulations.
6. Relationship of Parties. No relationship of employer and employee, or partners or joint ventures between Covered Entity and
Business Associate is created by this Agreement, and neither Party may therefore make any claim against the other Party for social
security benefits, workers' compensation benefits, unemployment insurance benefits, vacation pay, sick leave or any other employee
benefit of any kind. In addition, neither Party shall have any power or authority to act for or on behalf of, or to bind, the other except as
herein expressly granted, and no other or greater power or authority shall be implied by the grant or denial of power or authority
specifically mentioned herein.
7. Entire Agreement. This Agreement constitutes the entire contract between the Parties relative to Business Associate's performance of
duties described in the first page of this Agreement, and cancels, replaces and supersedes any and all previous agreements relating to
such service.
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CERTIFICATION ON LAST PAGE
RYAN L. 6UTLER, CLERK
8. Effective Date. This Agreement shall be effective as of the Effective Date and shall continue for a period of twenty-four (24) calendar
month periods ("Initial Term") unless terminated earlier in accordance with Section D(2).
9. Automatic Renewal. Unless terminated earlier in accordance with Section D(2), this Agreement shall be automatically renewed for
successive twelve (12) calendar month periods ("Succeeding Terms") at the expiration of the Initial Term or any Succeeding Term;
provided, that either party may terminate the Agreement on the last day of
the Initial Term or any Succeeding Term by giving at least 45 days prior written notice by registered mail to that effect to the other party.
10. Severability. In the event that any portion of this Agreement is found to be void or illegal, the validity or enforceability of any other
portion shall not be affected.
11. Governing Law. To the extent not superseded by Federal law, the rights and obligations of the Parties hereto under this Agreement
shall be governed by the laws of the State of California.
12. Jurisdiction. Except for actions over which the district courts of the United States have jurisdiction, the courts of the State of
California shall have exclusive jurisdiction over any and all matters or disputes arising from this Agreement.
13. Arbitration. Upon the written mutual agreement of the Parties, any claim or controversy arising out of or relating to this Agreement
or the breach of this Agreement shall be settled by arbitration in accordance with the Commercial Arbitration Rules of the American
Arbitration Association ("AAA") using one arbitrator selected by mutual agreement of the Parties. The Parties agree to divide equally the
AAA's administrative fee as well as the arbitrator's fee, if any, unless otherwise assessed by the arbitrator. The administrative fee shall be
advanced by the initiating party subject to final apportionment by the arbitrator in his/her award. The arbitrator's award may be enforced
in any court having jurisdiction thereof by the filing of a petition to enforce said award. The cost of filing may be recovered by the party,
which initiates such action to have an award enforced. Nothing contained in this Agreement shall require mandatory arbitration by the
parties and any arbitration must be agreed to in writing by both parties.
14. Notice. Notices under this Agreement shall be in writing and sent via postage -paid Certified Mail, Return Receipt Requested to the
following addresses, or to any other address specified in writing by a Party. Any notice under this Agreement shall be in writing and sent
via postage -paid Certified Mail, Return Receipt Requested to the following addresses, or to any other address specified in writing by a
Party. Notice shall be deemed given on the date it is hand delivered or duly deposited enclosed in a postpaid properly addressed envelope
in an official depository under the exclusive custody of the United States Post Office. If an email address is included below, an email
courtesy copy will be transmitted at the same time, which shall not alone satisfy the notice requirement of this section.
15.Contractor is registered with and will use the Department of Homeland Security's E -Verify system (www.e-verify.gov) to confirm the
employment eligibility of all newly hired employees for the duration of this agreement, as required by Section 448.095, F.S. Contractor is
also responsible for obtaining an affidavit from all subcontractors, as required in Section 448.095(5)(b), F.S., stating the subcontractor
does not employ, contract with, or subcontract with an unauthorized alien.
CONTRACTOR certifies that it and those related entities of CONTRACTOR as defined by Florida law are not on the Scrutinized
Companies that Boycott Israel List, created pursuant to s. 215.4725 of the Florida Statutes, and are not engaged in a boycott of Israel.
OWNER may terminate this Contract if CONTRACTOR, including all wholly owned subsidiaries, majority-owned subsidiaries, and
parent companies that exist for the purpose of making profit, is found to have been placed on the Scrutinized Companies that Boycott
Israel List or is engaged in a boycott of Israel as set forth in section 215.4725, Florida Statutes. In addition, if this agreement is for goods
or services of one million dollars or more, CONTRACTOR certifies that it and those related entities of CONTRACTOR as defined by
Florida law are not on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran
Petroleum Energy Sector List, created pursuant to Section 215.473 of the Florida Statutes and are not engaged in business operations in
Cuba or Syria. OWNER may terminate this Contract if CONTRACTOR is found to have submitted a false certification as provided
under section 287.135(5), Florida Statutes, been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized
Companies with Activities in the Iran Petroleum Energy Sector List, or been engaged in business operations in Cuba or Syria, as defined
by section 287.135, Florida Statutes.
If to Business Associate:
Business Associate: Lively, Inc.
Address: 301 Howard St, #550, San Francisco, CA 94105
Attention: Legal Department
Email: legal@livelyme.com
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CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
If to Covered Entity:
Covered Entity: Indian River County Board of County Commissioners
Address: 1800 27th Street, Building b
Attention: Suzanne M. Boyll, Director of Human Resources
Email: sboyll@indianriver.gov
SIGNATURE PAGE TO FOLLOW
A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
IN WITNESS WHEREOF, Covered Entity and Business Associate, by the signatures below of their duly authorized representatives,
execute this Agreement in multiple originals to be effective as of the Effective Date.
Name: Jordan Mazur
Title: General Counsel
.+;GO. • ; • FSS' •,
ame: Joseph E. Flesch
Title: Chairman
Company: Lively, Inc. Company: Indian River County
APPROVED TO FORM
AND LEG FFICIENCY
BY
CHRI TOP E
RA.KS
ASSISTA T C
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroller
By:
�UtYCWk
Docusign Envelope ID: E007A1C1-9A8047F6-9FF8-83E57097B514
A TRUE COPY
'ERTIFICATION ON LAST PAGE
BUTLER, CLERK
Foreign Entity Ownership Affidavit
(required with every bid or offer, or contract which gives Entity access to an
individual's personal identifying information)
The undersigned, on behalf of the Entity listed below, hereby attests under penalty of perjury as
follows:
1. Entity is not owned by the government of a foreign country of concern as defined
in Section 287.138, Florida Statutes. (Source: § 287.138(2)(a), Florida Statutes)
2. The government of a foreign country of concern does not have a controlling
interest in Entity. (Source: § 287.138(2)(b), Florida Statutes)
3. Entity is not organized under the laws of, and does not have a principal place of
business in, a foreign country of concern. (Source: § 287.138(2)(c), Florida
Statutes)
4. Entity is not owned or controlled by the government of a foreign country of
concern, as defined in Section 692.201, Florida Statutes. (Source: § 288.007(2),
Florida Statutes)
5. Entity is not a partnership, association, corporation, organization, or other
combination of persons organized under the laws of or having its principal place
of business in a foreign country of concern, as defined in Section 692.201,
Florida Statutes, or a subsidiary of such entity. (Source: § 288.007(2), Florida
Statutes)
6. Entity is not a foreign principal, as defined in Section 692.2o1, Florida Statutes.
(Source: § 692.202(5)(a)(1), Florida Statutes)
7. Entity is in compliance with all applicable requirements of Sections 692.202,
692.203, and 692.204, Florida Statutes.
8. (Only applicable if purchasing real property) Entity is not a foreign principal
prohibited from purchasing the subject real property. Entity is either (a) not a
person or entity described in Section 692.204(1)(a), Florida Statutes, or (b)
authorized under Section 692.204(2), Florida Statutes, to purchase the subject
property. Entity is in compliance with the requirements of Section 692.204,
Florida Statutes. (Source: §§ 692.203(6)(a), 692.204(6)(a), Florida Statutes)
9. The undersigned is authorized to execute this affidavit on behalf of Entity.
DocuSigned by:
k., I ..n, &,&±)W
Jordan Mazur
Printed Name
General counsel
Title
Lively, Inc.
Entity
Date: 6/20/2025
Docusign Envelope ID: 211C91413-84404061-9FF8-F5E49F1027F6
A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
Anti -Human Trafficking Affidavit
every executed, renewed or extended contract)
The undersigned, on behalf of the entity listed below, in accordance with Florida Statute
787.o6(13) hereby attests under penalty of perjury that the entity does not use coercion for labor
or services.
As defined in F.S. 787.06(13):
"Coercion" means:
I. 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.
"Labor" means work of economic or financial value.
"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.
Doc[Signed by:
er ur
���3g0045A...
Jordan Mazur
Printed Name
General counsel
Title
Lively, Inc.
Entity Name
Date: 6/20/2025
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CERTIFICATION ON LAST PAGE
FLEXIBLE SPENDING ACCOUNT RYAN L. BUTLER, CLERK
PRICING EXHIBIT A
Version 2.0
The following Fee Schedule is pursuant to the FLEXIBLE SPENDING ACCOUNT ADDENDUM for
Employer: Indian River County for the Plan Year s): 10-01-2025 - 09-30-2026.
Capitalized terms used in this Exhibit and not defined have the meanings given in the FLEXIBLE
SPENDING ACCOUNT ADDENDUM, MASTER SERVICE AGREEMENT, and /or Lively's Website
which can be found at https://Iivelyme.com.
FSA EMPLOYER SERVICES FEE:
Description Amount Comment
Monthly Administration Fee:
General Purpose (Health) FSA
$2.95 PPPM
Monthly Administration Fee is the
standalone
greater of the Minimum Administration
Fee per Month listed below, or Per
Participant Per Month (PPPM) fees
calculated monthly based on actual plan
participation.
Dependent Care FSA
$2.95 PPPM
standalone
Rate Guarantee
3 years
The PPPM listed above is guaranteed to
be in effect for 3 from the start of the
Plan Year.
Minimum Administration Fee per
$200.00
If the total monthly billable fees across
Month.
all products are less than the minimum
monthly fee, an adjustment fee will be
applied, so that the total billable fees
equal the minimum monthly fee.
Implementation Fee:
For Lively products
$0.00
The Implementation fee includes the
creation of a draft Plan Document, a draft
Summary Plan Description, and
participant debit cards. The Account
Implementation Fee also covers the Plan
Year as defined on this Pricing Exhibit
and is due the first invoice month after
contracts are signed
r
Optional ,Pease'
10-t
3
Plan Amendment / Document
$250 per
Optional service provided upon written
Changes
occurrence
request from Employer. Fees are due
when service is rendered.
Customizations / custom work
$185/hr
Any custom work for Employer will
need to be agreed to with a separate
statement of work but such work shall be
charged at the rate listed on the left, if
applicable.
Printing & mailing
At cost
Reimbursement of all printing and
mailing of physical collateral not legally
or regulatorily required that Employer
asks from Lively.
In -Person travel
$500/day + cost of
In cases where Employer asks Lively to
actual expenses
join for in-person or on-site visits, Lively
to charge the fee on the left plus the cost
of actual expenses to be billed in the
month such expense is incurred.
Virtual meetings
Included
No charge for virtual meetings.
Transactional Fees:
Non -Sufficient Funds (NSF) Fees
$50 per occurrence
Each declined transaction due to
insufficient funds in employer funding
account will result in a $50 charge billed
to the employer
Data for Form 5500
Included
Lively will provide the data to populate
IRS Form 5500 at no extra cost, at least
90 days before Form 5500 filing deadline
date
Other Card Costs
At Cost
Pass-thru costs for Rush Order or pulling
cards once processed. Optional service
provided upon written request from
Employer.
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CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
Bulk Reprocessing Returned $5 per card Lively having to reprocess bulk debit
Cards card sends due to an error from the
Employer (e.g., faulty mailing addresses
for everyone) at the direction of the
Employer. For the avoidance of doubt,
the Employer will not be responsible for
a returned card due to error resulting
from an employee providing Lively
mailing information directly.
1. FSA ACCOUNT HOLDER FEES:
1. FSA RESERVE FUNDING
All applicable fees payable to Lively by Employer pursuant to this Agreement shall be automatically
debited from Employer's designated account upon being due, unless otherwise agreed to between
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CERTIFICATION ON LAST PAGE
P.YAN L. BUTLER, CLERK
Lively and Employer. All such fees will be reflected on a detailed invoice provided by Lively to
Employer.
1. All fees are due upon receipt of an invoice or notification from Lively. Fees shall be paid when
due. Fees are deemed late if not paid within thirty (30) days of the invoice or due date, whichever
comes first. Late fees may be subject to a 3% penalty. All services not set forth in this Pricing
Exhibit may be subject to additional fees.
ature
f
Joseph E. Flescher o,�,��'.fEGo����.��
Name .......
Chairman
Title
Indian River Coun
Employer
:lune 3. 2025
Date
APPROVED AS TO FORM
AND LEGAL S FFICIENCY
BY
C S O HER A. HICKS
ASSISTA C UNTY ATTORNEY
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroller
By:
puty Clerk
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CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
A TRUE COPY
CERTIFICATION ON LAST PAGE
FYAN L. c-UTLFR, CLERK
COBRA & DIRECT BILL
ADMINISTRATION
PRICING EXHIBIT A
Version 2.0
The following Fee Schedule is pursuant to the Employer COBRA Addendum for Em_ loyer: Indian River
County for the Plan Year(s): 10-01-2025 - 09-30-2026.
Capitalized terms used in this Exhibit and not defined have the meanings given in the Employer COBRA
Addendum, Master Service Agreement, and /or Lively Website, which can be found at
https://Iivelyme.com.
COBRA & DIRECT BILL EMPLOYER SERVICES FEE:
Description i
Monthly COBRA Administration Fee Per Benefit Eligible Employee
Indian River
SO 52
Monthly Administration Fee is the greater
of: the Minimum Administration Fee per
Month listed below, or Per Benefit
Eligible Employee ("BEPM") Per Month
fees calculated monthly based on Benefit
Eligible Employee count reported by the
employer.
Rate Guarantee
3 Years
The BEPM listed above is guaranteed to
be in effect for 3 from the start of the Plan
Year.
Minimum Administration Fee per
$200.00
If the total monthly billable fees are less
Month for multiple products.
than the minimum monthly fee, an
adjustment fee will be applied, so that the
total billable fees equal the minimum
monthly fee
Takeover of Existing COBRA /
Included at no
Acquisition and integration of existing
Direct Bill Participants
additional charge
COBRA participant information,
including the production of new monthly
payment invoices, tracking the remainder
of the eligibility period, and providing
access to participant information, and
notification of takeover to participants
COBRA & DIRECT BILL Implementation Fee:
For Lively products
$0.00
The Implementation Fee covers the Plan
Year as defined on this Pricing Exhibit
and is due on the first day of the Plan
Year.
Annual COBRA & DIRECT BILL Open Enrollment Support Services
Annual OE Support Renewal
s0
Lively will implement new plan
Fees
information into the system, produce and
mail Participant Open Enrollment Notice
and Election Form packages and will
manage carrier and billing updates.
Additional printing and paper processing
fees may be passed to the client. The
Annual Renewal Fees are assessed on the
first day of subsequent Plan Years.
Optional Service Fees (COBRA and DIRECT BILL):
Blanket General Rights /Initial
$1.50 per notice
Automatically provided unless Employer
Notices to all covered employees
provides written confirmation that this
should not be handled. Fees are due when
service is rendered.
Open Enrollment Package
$1.50 per notice
Automatically provided unless Employer
Mailing per Qualified Beneficiary
that outlines online
provides written confirmation that this
open enrollment
should not be handled. Fees are due when
options (default)
service is rendered.
OR
Note: Online open enrollment is the
default. In the case that online open
$10.00 per packet
enrollment is unavailable for a specific
plan design or an employee requests a
paper packet, the $10 fee will apply.
Print Cost for Premium Notices
$1.50 per notice
Automatically provided unless Employer
mailed
provides written confirmation that this
should not be handled. Fees are due when
service is rendered.
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CERTIFICATION ON LAST PAGE
F:YAN L. BUTLER, CLERK
Print cost for standard letters
$1.50 per letter
Automatically provided unless Employer
(other than letters included in
mailed
provides written confirmation that this
Monthly Service Fee)
should not be handled. Fees are due when
service is rendered.
Non -Standard Fulfillment /
$2.50 per item
Optional service provided upon written
Mailing
request from Employer. Fees are due
when service is rendered.
Paper Enrollment form
$5.00 per form
Applied automatically when a paper
processing
package is received. Fees are due when
service is rendered.
Carrier Remittance — premium
$35/carrier/month
Optional service provided upon written
remittance to carrier(s)
or custom quote
request from Employer. Lively can remit
payment so long as all plans are end -of -
month and fully insured. Note: Lively is
unable to reconcile against carrier
billings, if applicable. Fees are due when
service is rendered.
Customizations / custom work
$185/hr
Any custom work for Employer will need
to be agreed to with a separate statement
of work but such work shall be charged at
the rate listed on the left, if applicable.
Additional portal setup
$75 per portal
IfEmployer needs multiple portals, a fee
of $75 will be charged per additional
portal. Implementation Fee includes
initial portal.
Divisional Setup
First 5 divisions
If Employer needs multiple divisions in
included
one portal, a one-time fee will be applied
per additional division that exceeds 5
$10 per additional
divisions.
division set up
Divisional Remittance
First 5 divisions
If Employer requires divisional
included
remittance for more than 5 bank accounts,
a monthly fee of $15 will be charged per
$15 per division per
additional bank account added. A
month
minimum fee of $150 per month will be
charged.
Minimum of
$150/month
Custom Report Creation
Quote
Custom work for Employer will require a
separate Statement of Work (SOW) which
will indicate the pricing.
Integrated Enrollment Platform
$0.06 per Pending
Added to monthly Administration Fee' for
Fee
or Enrolled
utilization of any integrated enrollment
Employee Per
platform, such as Employee Navigator.
Month
This fee does not apply if SFTP is used.
A TRUE COPY
-CERTtFtCATtON ON LAST PAGE
RYAN L. BUTLER, CLERK
In -Person travel
$500/day + cost of
In cases where Employer asks Lively to
actual expenses
join for in-person or on-site visits, Lively
to charge the fee on the left plus the cost
of actual expenses to be billed in the
month such expense is incurred.
Virtual meetings
No cost
No charge for virtual meetings
Transactional Fees:
Bank Return Fees
$10 per returned
Each declined transaction due to
item or credit card
insufficient funds in COBRA or Direct
chargeback
Bill participant account will result in a
$10 charge per returned item or
chargeback billed to the employer
Refund Checks
$5.00 per check
Each returned check, for any reason, will
result in $5.00 per check
1. The following administrative services are included in the Monthly COBRA Administration Fee
1. Qualified Event Notification
2. Election Processing
3. Eligibility reporting to client or health plan
4. COBRA Termination
5. Takeover Notices
6. Rate Change Letters
7. Premium billing and collection
8. HIPAA Certificates (Certificate of Coverage and HIPAA Portability Rights)
1. Lively, through its partner, WEX shall collect and retain from each COBRA Participant an
administration fee of two percent (2%) of premiums paid by the COBRA Participant.
1. All applicable fees payable to Lively by Employer pursuant to this Agreement shall be
automatically debited from Employer's designated account upon being due, unless otherwise
agreed to between Lively and Employer. All such fees will be reflected on a detailed invoice
provided by Lively to Employer.
A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
$TAT( OF FLUR10A
INOIAN RNER COUNTY
TMIS 15 TO CERTIFY THAT THIS ISA TRUE AND CORRECT
CUPY OF THE CKIGtNAL ON FILE IN THIS OFFICE.
RYAN L BUTLER, CLERK
by
SAT Q 6 3
All fees are due upon receipt of an invoice or notification from Lively. Fees shall be paid when
due. Fees are deemed late if not paid within thirty (30) days of the invoice or due date, whichever
comes first. Late fees may be subject to a 3% penalty. All services not set forth in this Pricing
Exhibit may be subject to additional fees.
Joseph E. Flescher
Name
Chairman
Title
Indian River County
Company
June 3, 2025
Date
''•9L•• GJ � 'O.�
•�''9:�FR COUTA-0
APPROVED AS TO FORM
AND LEGA SUFFICIENCY
BY
CHRIS OP ER A. HICKS
ASSISTANTCO NTY ATTORNEY
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroller