Emergency Power Plan for Rule 59AER17-1

1. Provide basic information concerning the facility to include: a. Name of Facility: RK3, LLC dba KR at College Harbor b. Facility Type: Skilled Nursing Facility c. Facility Address: 4600 54th Avenue South

· St Petersburg, FL 33711

2. Identify the area(s) in your facility that you plan to keep below 80 degrees:

Resident rooms

3. What is the square footage of the cooled area?

The total combined Resident room space for the SNF is 7,812 sf.

4. Identify what kind of equipment will be used to cool the areas identified (HVAC, Portable NC, Window A/C):

HVAC

5. Identify how many people (residents and staff) the area to be cooled will accommodate:

45 residents + 30 staff x 40sf = 3,000 sf

6. Please provide a statement for how you plan to move _residents to this location:

Will be cooling resident rooms so no one will be moved

7. Will beds be available in the cooled area? Residents beds in place a. If yes, how many: 52 b. Are the beds located on site? Yes

8. Describe how staff will ensure the area does not exceed 80 degrees and how often the temperature will be monitored:

There is a thermostat in each resident room that monitors temperature.

9. Describe where the generator is located at your facility:

Located behind Facility

10. Describe make, model and size of generator(s). Is the generator fixed or portable?

ONAN 75'i<J/v fixed generator model number 750DVB-15R

11. If your facility is planning on installing a fixed generator, describe the construction implementation time and attach the plans:

Current generator in place, will add secondary generator if necessary to support load needs.

12. Describe what emergency features the generator is capable of powering (lights, fridge, AJC, etc.) ·

Currently covers Emergency lighting, select emergency outlets next to each bed, select emergency outlets in common.,areas of building.

13. Provide a maintenance schedule for both the generator and HVAC system (include mechanism for load testing and documentation of test):

Generator is operated weekly for 30 minutes with log of oil level, battery level, water level, oil psi, volts and water temperature.

In addition, generator is on a schedule twice a year service contract with Paramount Power, out of Largo, FL.

14. Describe the fuel type you will need to operate the generator:

Diesel

15. Describe how you plan on storing 96 hours of fuel on-site:

Currently have 500 gallon tank on site. Will complete load analysis that includes HVAC to determine load and fuel requirements for 96 continuous run time. If necessary, second tank will be added.

16. State the procedure for how your facility will refuel before and after an emergency. If a fuel agreement is established, please provide the agreement:

Have attached a letter from Jet Age Fuel confirming we are placed on an emergency priority list for fuel supply. This process worked perfectly prior to Hurricane Irma as they topped off our tank as requested.

17. Provide a training procedure to ensure staff is aware of how to operate the emergency power to the facility:

Facility has an automatic transfer switch. Maintenance and Administrator have been trained on starting procedures and reading the fuel tank level to insure fuel level. At the time the tank reads 50% full, they will contact fuel supplier to fill tank back to full.

18. Describe how new staff will be informed of the emergency power plan:

Periodic training will be provided for all employees of the emergency plan clarifying what emergency power sources will be working for residents and staff and scheduling for shift coverage during the emergency period.

19. Please attach a certified HVAC letter with a quote approving the tonnage required to cool the space indicated.

Each resident room already has their own PTAC unit that maintains temperature and meets the required 80 degrees. Will provide letter to supporting thi;, .function.

20. Please attach a certified electrician letter with a quote specifying generator capacity is required to run HVAC system and fuel for 96 hours.

In process with Cuhaci to establish parameters for the size of generator that is required to run current emergency load and the additional HVAC for the Assisted Living Facility. Once the appropriate size is established and its fuel consumption, will provide documentation to County as requested.

29 September 2017

Mr. Paul Dengler KR Management, LLC 20001 Gulf Blvd., Suite 10 Indian Shores, FL 33785

ADDINGTON PLACE AT COLLEGE HARBOR EMERGENCY POWER RETROFIT 4600 54rn A VENUE SOUTH ST. PETERSBURG, FL 33711 ±TBD S.F., REMODEL, 5-STORY IL AND 3-STORY AL/SNF

Dear Paul:

CP: 2170795

In response to your recent request, we are pleased to submit this proposal for Engineering Services to evaluate, report and prepare Construction Documents to implement State of Florida Elder Affairs, Rule No: 58AER-17, Titled: Procedures regarding Emergency Environment Control for Assisted Living Facilities and/or Agency for Health Care Administration, Rule No: 59AER-17-1, Titled: Nursing Home Emergency Power Plan at the above referenced project.

The following proposal is submitted for your review and consideration. This document serves as a Professional Service Agreement, made on this date by and between KR Management, LLC (Client) and Cuhaci & Peterson Architects, Inc. (Architect). It is anticipated that the form of agreement will be an executed version of this document.

Understanding of the Project

The following represents our understanding of the project scope: State of Florida is requiring the facility to be air conditioned to ensure that the ambient temperature of the Assisted Living Facility and Nursing Home will be maintained at 80 degrees or less for a minimum of ninety-six (96) hours in the event of the loss of electrical power. Research is required to determine how to meet the State's emergency environmental control requirement, followed by preparation of Construction Documents to implement the design.

We will meet with the Client to determine the existing conditions, their needs and prepare a report of findings with recommendations. Upon review and approval of the recommendations by Client, we shall proceed with Construction Documents as required, to obtain Building Department and ACHA approvals, sub-bid and construct the improvements. The time parameters of the project are to be mutually developed between Client and Architect.

Scope of Work

We propose to perform our services in two (2) separate phases. Phase 1 to consist of site visit, to review existing conditions, prepare a report of findings and provide recommendations. Phase 2 is to prepare Construction Documents for proposed improvements to comply with State's requirements:

Breakdown of the tasks in each Phase is as follows:

1925 Prospect Avenue • Orlando, FL 32814 • PH: 407-661-9100 • FAX: 407-661-91 O 1 • www.c-p.com

Mr. Paul Dengler 29 September 2017 Pagel

PHASE 1:

A. Visit Site to Review: )- Main MOP normal service panel )- Main EMDP emergency I generator service panel )- Transfer switches & associated over-current protection devices )- Panels that are to be added to generator )- Nameplates of equipment that are to be added to the generator )- Location on site for new fuel tank (as applicable) )- Typical resident room for emergency duplex receptacle )- Misc. items: BAS system, generator annunciator, etc. )- Locate space for new EM panel & A TS (if required)

B. Report of Findings and Recommendations: )- Evaluate and compile data )- Prepare load calculations )- Prepare report which includes Schematic Design for recommendations (building systems

descriptions, riser diagram and equipment block diagrams).

C. Department of Elder Affairs Submittal: :)- Answer questions and furnish supplemental information to assist Client in reporting status I

plan to Department of Elder Affairs and I or ACHA.

PHASE 2:

A. Construction Documents: )- Develop site and floor plans base sheets from Client provided record drawings. )- Electrical Design

o Power plans o Site plan o Details o Power distribution diagram o Panel schedules o Specifications

)- Calculations )- Architectural Design

o Modifications to existing generator screen walls to accommodate required equipment clearance( s ).

)- Respond to all comments from Building Department and ACHA to obtain approval(s) for construction.

)- Review of Contractor's submittals for electrical gear and emergency generator.

Fee Basis

For the Architect's services as described in this proposal, the compensation shall be computed on a Lump Sum Basis of Forty Six Thousand, Six Hundred Forty Dollars ($46,640.00) plus reimbursable expenses (Phase I is: $17,820.00; Phase 2 is: $28,820.00). An initial payment of $0.00 shall be made upon execution of this agreement.

Mr. Paul Dengler 29 September 2017 Page3

Additional Services

If authorized in writing, the Architect shall furnish or obtain from others additional services that are not considered normal or customary basic services. The cost of additional services from others shall be billed at their direct cost plus 15%. Additional services will be by lump sum proposal or by hourly rates. When hourly additional services are authorized, the hourly rates indicated in the attached "Standard Terms and Conditions for Architectural Services" shall apply. Additional service include, but not limited to, the following:

);:> Interior Improvement Construction Documents );:> Security system planning or design );:> Design work or Construction Document preparation for items outside the demised parcel );:> ADA inspection/report of building's exterior or interior );:> Zoning research );:> Furniture selection/specification );:> Data/sound system/phone system/POS design beyond power and conduit requirements ~ Extensive/Exhaustive revisions required by the Client/Contractor/City );:> Exterior signage design, research, or permitting );:> Preparation of record drawings );:> Permit expediting );:> Interior design services and/or finish selection );:> 3D Presentation CAD Model );:> Fire alarm or fire protection design ), LEED Design or Documentation );:> Site/Civil Design or City zoning approvals related to proposed location of new generators or

supplemental fuel tanks

Reimbursable Expenses

Reimbursable expenses indicated in this proposal will be billed per the schedule indicated in the "Standard Terms and Conditions for Architectural Services" as attached or amended herein. All printing in support of permitting and construction, including contractor bidding, will be billed as a reimbursable expense.

Permit fees, impact fees, and other project related fees in support of the design and construction of the building are the responsibility of the client. Payments, which the Architect advances on behalf of the client, will be billed at direct cost plus an administration fee.

Client Related Submission Items

The Client will be responsible to coordinate all Owner related submission items, including legal documents, development agreements, bonds, lease documents, utility agreements, etc.

Permit Filing Requirements

The Client and/or his General Contractor shall be solely responsible for filing and coordination of documents required for the approval of governmental authorities having jurisdiction over the project. The Architect shall assist the Client by answering questions and providing supplemental information when required to obtain building permit. Phase One is for Concept Design Only and shall not include any permitting services except what is included in our scope.

Mr. Paul Dengler 29 September 2017 Page4

Permit filing services may be added by the Client to this proposal as an additional service. The additional service cost is a lump sum fee of $1,800.00.

Client's Approval of Services: DYes O No Client's Initials:

Special Terms and Conditions

1. Due to current wide variation in consulting engineers' work load and related fees, the Architect can maintain the validity of this unsigned proposal for only 30 days.

2. If at any time the project is cancelled or delay,~d, minimum payment due the Architect shall be reimbursement of all expenses accrued to date plus a percentage of Contract work completed to date.

3. If the project is suspended by the Client for more than 30 consecutive days, the Architect shall be compensated for services performed prior to notice of such suspension. When the project is resumed, the Architect's compensation shall be equitably adjusted to provide for expenses incurred in the interruptions and resumption of the Architect's services.

4. Any scope contained in this proposal where indicated as field visit is not intended to he an exhaustive analysis of dimensions or systems in the facility. It is intended solely to give the Architect an understanding of the space and develop from visual observation, constraints that may be encountered. The field visit or use of the word "documentation" does not imply the Architect will develop a record condition or that he will be accountable for the discovery of conditions or inconsistencies between the existing condition and other matedals provided in conjunction with the project.

5. Lf a required item or component of the project is omitted from the Architect's construction documents, the Architect shaJL not be responsible for paying the cost of such item or component to the extent that such item or component would have been otherwise necessary to the project. In no event will the Architect be responsible for any cost or expense that provides betterment, upgrades, or enhancement of the project.

6. Client Furnished Information - Architect shall consider all information supplied by Client as accurate and correct. Extra work or work done over because of inaccurate or incorrect information supplied by the Client shall be paid for as additional services.

Services requested in this agreement will not commence until an executed agreement is received from you by this office. This agreement is governed by provisions set forth in the Stan d Terms and Conditions for Architectural Services" as attached or amended herein. /I

Michael E. Lynch, NCARB, LEED AP, CDP, FL #10661 Executive Vice President MEL/jla

APPROVED: Signature

Raymond Paull, PMP, LEED AP Project Manager

Date

\2 I 70795prop0 I .doc

STANDARD TERMS AND CONDITIONS FOR ARCHITECTURAL SERVICES

Hourly Rate Schedule: Individual rates for hourly services are indicated below:

President DirectorNice President Architectural Studio Manager Project Manager Assistant Project Manager Project Architect Graduate Intern Sr. Project Coordinator Project Coordinator Construction Coordinator Manager of Government Relations Permitting Coordinator

$250.00 $200.00 $175.00 $150.00 $130.00 $125.00 $ 85.00 $115.00 $ 85.00 $110.00 $125.00 $ 85.00

Design Architect Designer Graphics Project Engineer Graduate Engineer Engineering Designer Engineer-in-Training Land Planner Landscape Architect Site Planner CADD Technician Admin./IT/Support Staff

$150.00 $125.00 $ 90.00 $150.00 $100.00 $ 95.00 $ 85.00 $150.00 $115.00 $ 90.00 $ 80.00 $ 65.00

6/16

Reimbursable Expenses: Reimbursable expenses are in addition to the basic construction document services indicated in this document and include expenditures made by this office in the interest of this project. All expenses such as consultants not typically associated with this project type, materials for renderings and models ovem.ight delivery and courier services, business travel, and reprographics (digital copies, bond copies, scanning, laminating, digital media, etc.) will be billed at a cost plus" rate. Please note an administrative fee of 15% will be added to all reimbursable expenditures for processing and handling. Individual reimbursable unit prices are indicated below:

Printing Color Plotting (bond paper) Color Copies Mileage

$ .35 per sq. ft. $6.00 per sq. ft. $1.75 per copy $ .50 per mi.

Digital Photography Compact Disks (CD) Lender Certifications:

$ .25 per image plus printing $ 15.00 ea. Original - $50.00 ea. Revision - $25.00 ea.

Payments for Services: Payments shall be made upon receipt of invoices following each month of work and are due and payable within 10 days following receipt. Payments due under this agreement shall bear interest at the legal rate (1.5% per month) commencing 30 days after invoice date. In the event that any portion or all of any account remains unpaid 90 days after billing, the Owner shall pay the cost of collecti.on, including reasonable attorney 's fees. Payment of fees to the Architect shall not be conditional or contingent upon the Owner's ability to secure construction and/or permanent finan.cing for this project

Attorney's Fees and Costs: With regard to attorney's fees and costs in connection with any litigation, including appellate or other proceedings arising out of this Contract, the prevailing party shall be entitled to recover reasonable attorney's fees and cost for both trial and appellate levels.

Limit of Liability: The Owner agrees to limit the liability of the Architect and its employees with regard to any claim Owner may have against the Architect arising out of the work performed by the Architect under this Contract, to a sum not to exceed the amount paid to the Architect under this Contract (exclusive of consultant ' s fees and expenses).

Waiver of Consequential Damages: The Architect and Owner waive consequential damages for claims, disputes, or other matters in question arising out of or relating to this Agreement. This mutual waiver is applicable, without limitation, to all consequential damages.

Ownership and Use of Documents: Drawings speciJications and other documents, including those in electronic Forni prepared by the Architect and Architect s consultants, are instruments of service for use solely on th.is project. The Owner shall be permitted to retain copies, including reproducible copies of the Architect's drawings, specifications and other documents and information and reference in connection with the project.

Cert'ifications - Guarantees and Warrantees: The Architect shall not be required to execute any document that would result in its certifying, guaranteeing or warranting the existence of conditions whose existence the Architect cannot ascertain.

Termination of Services: This agreement may be terminated upon 10 days written notice by either party should the other fail to perform his obligations hereunder. In the event of termination, the Owner shall pay the Architect for all services, rendered to the date of termination, plus all reimbursable expenses.

Applicable Law: This agreement shall be governed by the laws of Florida.

October 2 7, 2017

JET AGE FUEL, INC. 519 Pennsylvania Avenue Clearwater, florida 33755

727-441-1706

Jet Age Fuel will make every effort to provide College Harbor Skilled Nursing with fuel for the emergency generator. Jet Age Fuel, Inc. will have College Harbor Skilled Nursing one of the top priority accounts in the event of inclement weather such as a hurricane and/ or other type of emergency, but cannot guarantee deliveries.

<f.e.nulfl~~ Ka en Deluca

Jet Age Fuel, Inc.