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HomeMy Public PortalAbout003-2015 - Fire - Key Pointe Medical - PhysicalsAGREEMENT THIS AGREEMENT made and entered into this u — day of �Ql�G7�j'` Uj, 201.6- and referred to as Contract No. 3-2015 by and between the City of Richmond, In-iana, a municipal corporation acting by and through its Board of Public Works and Safety (hereinafter referred to as the "City") and Key Pointe Medical LLC d/b/a Public Safety Health & Wellness LLC, 235 Industrial Drive, Franklin, Ohio, 45005 (hereinafter referred to as the "Contractor"). SECTION I. STATEMENT AND SUBJECT OF WORK City hereby retains Contractor to provide physical examinations to the City of Richmond Firefighters, including but not limited to general physical examinations, pulmonary function tests, vision and hearing tests, and other standard medical testing. Requests for Quotes were made on December 3, 2014, and have been made available for inspection and are on file in the offices of the Fire Department for the City of Richmond, and are hereby incorporated by reference and made a part of this Agreement. Contractor agrees to abide by the same. Contractor's response to said Request for Quotes, received December 9, 2014, consisting of two (2) pages, is attached hereto as Exhibit A and is hereby incorporated by reference and made a part of this Agreement. Contractor agrees to abide by the same. Should any provisions, terms, or conditions contained in any of the documents attached hereto as Exhibits, or in any of the documents incorporated by reference herein, conflict with any of the provisions, terms, or conditions of this Agreement, this Agreement shall be controlling. Contractor shall perform all work herein in a timely manner, conforming to all applicable professional standards. The Contractor shall furnish all labor, material, equipment, and services necessary for the proper completion of all services. No work or performance of services shall commence until the following has been met: 1. The City is in receipt of any required certificates of insurance; 2. The City is in receipt of any required affidavit signed by Contractor in accordance with Indiana Code 22-5-1.7-11(a)(2); and 3. A purchase order has been issued by the Purchasing Department. SECTION II. STATUS OF CONTRACTOR Contractor shall be deemed to be an independent Contractor and is not an employee or agent of the City of Richmond. The Contractor shall provide, at its own expense, competent supervision of its services. Contract No. 3-2015 Page 1 of 6 SECTION III. COMPENSATION City shall pay Contractor an amount estimated not to exceed Twenty-eight Thousand Three Hundred Ninety Dollars and Zero Cents ($28,390.00), for the complete and satisfactory performance of the work required hereunder for the 2015 calendar year. SECTION IV. TERM OF AGREEMENT This Agreement shall become effective when signed by all parties and shall continue in effect until December 31, 2015. The City shall retain two annual options to renew for the 2016 and 2017 calendar years. Notwithstanding the term of this Agreement, City may terminate this Agreement in whole or in part, for cause, at any time by giving at least five (5) working days written notice specifying the effective date and the reasons for termination which shall include but not be limited to the following: a. failure, for any reason of the Contractor to fulfill in a timely and proper manner its obligations under this Agreement; b. submission by the Contractor to the City of reports that are incorrect or incomplete in any material respect; c. ineffective or improper use of funds provided under this Agreement; d. suspension or termination of the grant funding to the City under which this Agreement is made; or e. unavailability of sufficient funds to make payment on this Agreement. In the event of such termination, the City shall be required to make payment for all work performed prior to the effective date by Contractor, but shall be relieved of any other responsibility herein. This Agreement may also be terminated, in whole or in part, by mutual Agreement of the parties by setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. SECTION V. INDEMNIFICATION AND INSURANCE Contractor agrees to obtain insurance and to indemnify the City for any damage or injury to person or property or any other claims which may arise from the Contractor's conduct or performance of this Agreement, either intentionally or negligently; provided, however, that nothing contained in this Agreement shall be construed as rendering the Contractor liable for acts of the City, its officers, agents, or employees. Contractor shall as a prerequisite to this Agreement, purchase and thereafter maintain such insurance as will protect it from the claims set forth below which may arise out of or result from the Contractor's operations under this Page 2 of 6 Agreement, whether such operations by the Contractor or by any sub -contractors or by anyone directly or indirectly employed by any of them, or by anyone for whose acts the Contractor may be held responsible. Coverage A. Worker's Compensation & Disability Requirements B. Employer's Liability C. Comprehensive General Liability Section 1. Bodily Injury Section 2. Property Damage D. Comprehensive Auto Liability Section 1. Bodily Injury Section 2. Property Damage E. Comprehensive Umbrella Liability Limits Statutory $100,000 $1,000,000 each occurrence $2,000,000 aggregate $1,000,000 each occurrence $1,000,000 each person $2,000,000 each occurrence $1,000,000 each occurrence $1,000,000 each occurrence $2,000,000 each aggregate F. Malpractice/Errors & Omissions Insurance $1,000,000 each occurrence $2,000,000 each aggregate SECTION VI. COMPLIANCE WITH WORKER'S COMPENSATION LAW Contractor shall comply with all provisions of the Indiana Worker's Compensation law, and shall, before commencing performance under this Agreement, provide the City a certificate of insurance, or a certificate from the industrial board showing that the Contractor has complied with Indiana Code Sections 22-3-2-5, 22-3-5-1 and 22-3-5-2. If Contractor is an out of state employer and therefore subject to another state's worker's compensation law, Contractor may choose to comply with all provisions of its home state's worker's compensation law and provide the City proof of such compliance in lieu of complying with the provisions of the Indiana Worker's Compensation Law. SECTION VII. PROHIBITION AGAINST DISCRIMINATION A. Pursuant to Indiana Code 22-9-1-10, Contractor, any sub -Contractor, or any person acting on behalf of Contractor or any sub -Contractor shall not discriminate against any employee or applicant for employment to be employed in the performance of this Agreement, with respect to hire, tenure, terms, conditions or privileges of employment or any matter directly or indirectly related to employment, because of race, religion, color, sex, disability, national origin, or ancestry. Page 3 of 6 B. Pursuant to Indiana Code 5-16-6-1, the Contractor agrees: That in the hiring of employees for the performance of work under this Agreement of any subcontract hereunder, Contractor, any subcontractor, or any person acting on behalf of Contractor or any sub -contractor, shall not discriminate by reason of race, religion, color, sex, national origin or ancestry against any citizen of the State of Indiana who is qualified and available to perform the work to which the employment relates; 2. That Contractor, any sub -contractor, or any person action on behalf of Contractor or any sub -contractor shall in no manner discriminate against or intimidate any employee hired for the performance of work under this Agreement on account of race, religion, color, sex, national origin or ancestry; 3. That there may be deducted from the amount payable to Contractor by the City under this Agreement, a penalty of five dollars ($5.00) for each person for each calendar day during which such person was discriminated against or intimidated in violation of the provisions of the Agreement; and 4. That this Agreement may be canceled or terminated by the City and all monies due or to become due hereunder may be forfeited, for a second or any subsequent violation of the terms or conditions of this section of the Agreement. C. Violation of the terms or conditions of this Agreement relating to discrimination or intimidation shall be considered a material breach of this Agreement. SECTION VIII. COMPLIANCE WITH INDIANA E-VERIFY PROGRAM REQUIREMENTS Pursuant to Indiana Code 22-5-1.7, Contractor is required to enroll in and verify the work eligibility status of all newly hired employees of the contractor through the Indiana E-Verify program. Contractor is not required to verify the work eligibility status of all newly hired employees of the contractor through the Indiana E-Verify program if the Indiana E-Verify program no longer exists. Prior to the performance of this Agreement, Contractor shall provide to the City its signed Affidavit affirming that Contractor does not knowingly employ an unauthorized alien in accordance with IC 22-5-1.7-11 (a) (2). In the event Contractor violates IC 22-5-1.7 the Contractor shall be required to remedy the violation not later than thirty (30) days after the City notifies the Contractor of the violation. If Contractor fails to remedy the violation within the thirty (30) day period provided above, the City shall consider the Contractor to be in breach of this Agreement and this Agreement will be terminated. If the City determines that terminating this Agreement would be detrimental to the public interest or public property, the City may allow this Agreement to remain in effect until the City procures a new contractor. If this Agreement is terminated under this section, then pursuant to IC 22-5-1.7-13 (c) the Contractor will remain liable to the City for actual damages. Page 4 of 6 SECTION IX. IRAN INVESTMENT ACTIVITIES Pursuant to Indiana Code (IC) 5-22-16.5, Contractor certifies that Contractor is not engaged in investment activities in Iran. In the event City determines during the course of this Agreement that this certification is no longer valid, City shall notify Contractor in writing of said determination and shall give contractor ninety (90) days within which to respond to the written notice. In the event Contractor fails to demonstrate to the City that the Contractor has ceased investment activities in Iran within ninety (90) days after the written notice is given to the Contractor, the City may proceed with any remedies it may have pursuant to IC 5-22-16.5. In the event the City determines during the course of this Agreement that this certification is no longer valid and said determination is not refuted by Contractor in the manner set forth in IC 5- 22-16.5, the City reserves the right to consider the Contractor to be in breach of this Agreement and terminate the agreement upon the expiration of the ninety (90) day period set forth above. SECTION X. RELEASE OF LIABILITY Contractor hereby agrees to release and hold harmless the City and all officers, employees, or agents of the same from all liability for negligence which may arise in the course of Contractor's performance of its obligations pursuant to this Agreement. SECTION XI. MISCELLANEOUS This Agreement is personal to the parties hereto and neither party may assign or delegate any of its rights or obligations hereunder without the prior written consent of the other party. It shall be controlled by Indiana law and shall be binding upon the parties, their successors and assigns. It constitutes the entire Agreement between the parties, although it may be altered or amended in whole or in part at any time by filing with the Agreement a written instrument setting forth such changes signed by both parties. This Agreement may be simultaneously executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. The parties hereto submit to jurisdiction of the courts of Wayne County, Indiana, and suit arising under this Contract, if any, must be filed in said courts. The parties specifically agree that no arbitration or mediation shall be required prior to the commencement of legal proceedings in said Courts. Any person executing this Contract in a representative capacity hereby warrants that he has been duly authorized by his or her principal to execute this Contract. In the event of any breach of this Agreement by Contractor, and in addition to any other damages or remedies, Contractor shall be liable for all costs incurred by City due to the enforcement of this Agreement, including but not limited to City's reasonable attorney's fees, whether or not suit is filed. In the event that an ambiguity or question of intent or a need for interpretation of this Agreement arises, this Agreement shall be construed as if drafted jointly by the parties, and no presumption Page 5 of 6 or burden of proof shall arise favoring or disfavoring any party by virtue of the authorship of any of the provisions of this Agreement. IN WITNESS WHEREOF, the parties have executed this Agreement at Richmond, Indiana, as of the day and year first written above, although signatures may be affixed on different dates. "CITY" THE CITY OF RICHMOND, INDIANA BY AND THROUGH ITS Board of Public Works and Safety By: � Vicki Robinson, President By: 4n-1— Ricffard Foore, Member Anthony I,/. Toster, Ir Member Date: APPROV Sarah L. Hutton, Mayor Date: "CONTRACTOR" KEY POINTE MEDICAL LLC, DBA PUBLIC SAFETY HEALTH & WELLNESS LLC 235 Industrial Drive Franklin, OH 45005 By: Printed: �„� /� fir-•► �- ��� Title: 9�fP1� Date: / //L 1, r Page 6 of 6 1EXHIB— IT F PAGE I OF�I ;-{ CITY OF RICHMOND PRICE REQUEST y of `0, MIRE DEPARTMENT y 101 SOUTH FIFFII STREET-RICIIMOND, INDIANA 47374 u I PHONE (765) 983-7266 -- FAX (765) 962-1808 THIS IS NOT AN ORDER E-mail: jparcell@richmondindiana.gov E-mail: tbrownnrichmondindiana.gov J" 01ANP VENDOR INSTRUCTIONS Corporate Health of Ohio, Inc., 235 Industrial Drive Franklin, OH 45005 Phone: 937.743.9474 Fax: 937.743.9475 DATE 12/03/14 This is a request for a price or quote for the services or materials described below. Any additional specifications may be attached hereto. This is not an order and the Richmond Fire Department reserves the right to accept all or part, or decline the entire proposal. Please complete your full name, address, and phone number below with signature. Please return in care of Richmond Fire Department at address above by the specified date and time to be considered unless otherwise specified. REPLY MUST BE IN 12/15/14 * The Richmond Fire Department reserves the right to reject any and all bids, parts of bids, or re -solicit bids for the same and to waive informalities or errors in bidding. PRICE REQUEST STANDARD FIREFIGHTER PHYSICAL EXAM TO INCLUDE: NAME: APPROX. # PRICE: PAYMENT TERMS Upon receipt of Invoice DEC -9 2014 ?I ilOrld Fire Dept,, Physical Exam 75 6,57.00 Pulmonary Function Test 75 Lj5-. 0 a Vision Test DOT Level) 75 . o 0 Hearin Test (NIOSH Certified Hearin Booth) 75 A ro , 00 CBC 75 — 0 CMP (Electrolytes and Hepatic Profile) 75 00 Lipid Profile 75 /S. © 0 Urinalysis 75 , . c EKG 75 c D TB Testing 65 Js`. c PSA 31 50.00 Stress Test (Bruce Protocol) Dive & Hazmat) 30 i90 _0 0 Chest X-ray 6 Off Site Fee Blood draws and physicals would need to be scheduled for the first and second week of January, 2015. All testing to be performed in an appropriate off site facility This bid, if awarded, could result in the option of renewing a contract for an additional 2nd and/or 3`d year. NOTE: THIS WILL BE AN OPTIONAL REQUEST: Please include with your bid an option to set up instruction on exercise and nutrition which would be seperate from physicals -1-2 times per year. EXHIBIT 7 PAGE OF o umd4 nwc Brenda Dingwerth Executive Secretary State Tax Exemption No. 003121909.001 NAME OF FIRM QUOTING: ,2 3 5 s �r,a_C' 6,- i ✓.e Address rYL-Ct� t< /, o, 0// '�5y� s" City, State, Zip ZI1-a'e# Authorized by: Title y -/ Date )y3 -7y7y Phone Number If you should have any questions, please feel free to contact: Jerry L. Purcell, Fire Chief 765.983.7264