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HomeMy Public PortalAboutORD14896 BILL NO. 2011-114 SPONSORED BY COUNCILMAN Koon ORDINANCE N0. f 1 AN ORDINANCE OF THE CITY OF JEFFERSON, MISSOURI, AUTHORIZING THE MAYOR AND CITY CLERK TO EXECUTE AN AGREEMENT WITH ST. MARY'S HEALTH CENTER FOR PROFESSIONAL MEDICAL SERVICES. BE IT ENACTED BY THE COUNCIL OF THE CITY OF JEFFERSON, MISSOURI, AS FOLLOWS: Section 1. The Mayor and City Clerk are hereby authorized and directed to execute an agreement with St. Mary's Health Center for professional medical services. Section 2. The agreement shall be substantially the same in form and content as that agreement attached hereto as Exhibit A. Section 3. This Ordinance shall be in full force and effect from and after the date of its passage and approval. r Passed: � . ' y Approved: ` ,zc r Presiding Off Mayor ATTEST: APPROVED AS TO FORM: City Clerk Interim City Counselor z ST. Y'S OCCUPATIONAL MEDICINE PAYOR AGREEMENT This City Agreement ("Agreement") is entered into effective as of the 1 ti` of January, 2012, ("Effective Date") by and between the City of Jefferson, a Missouri corporation ("City") and St Mary's Occupations Medicine, a worker's compensation program ("St. Mary's Occupational Medicine"). WHEREAS, such benefits include coverage for certain medical expenses incurred by employees with work related illnesses and/or injuries; and WHEREAS,St.Mary's Occupational Medicine has established anetwork ofhospitals,physicians and other healthcare providers for the provision of healthcare services for work related illnesses and/or injuries; and WHEREAS,City has requested St.Mary's Occupational Medicindo furnish access to its network- of providers to provide certain administrative services in connection therewith; and !Y WHEREAS, St. Mary's Occupational Medicine submitted a proposal to the City which included additional services including Workers' Compensation Treatment and Medical Care, Case Management (24 hours a day, 7 days a week), Physical Examinations, Physical Fitness Testing, Corporate Fitness Programs,Work-Site Evaluation, Work Injury Rehabilitation,Drug and Alcohol ,. .3� Testing, Immunizations, Laboratory Services, x-ray procedures; and WHEREAS, it is the purpose of this Agreement to establish a contractual relationship whereby St. Mary's Occupational Medicine shall provide City with such access and administrative services as set forth herein. NOW, THEREFORE, in consideration of the premises and covenants set forth herein, the parties hereto mutually agree as follows: I. DEFINITIONS UACI„ur;,ct1`111 ',WL-1, ,,rs,t,c4asrtirty.ncre� 1 As used herein, the following terms shall have the following meaning: A. COVERED SERVICES" means those MEDICALLY NECESSARY services and supplies provided by a PARTICIPATING PROVIDER to an EMPLOYEE. B. "EMPLOYEE" means any person referred t6t.Mary's Occupational Medicine by City for the coordination of medical services relative to an actual or alleged work related illness and/or injury, C. "MEDICALLY NECESSARY" services and supplies means those services and supplies deemed by St. Mary's Occupational Medicine's CASE MANAGEMENT PROGRAM, to be medically appropriate services and supplies for the evaluation and/or treatment of the actual or alleged work related illness and/or injury. D. "PARTICIPATING PROVIDER" means those licensed physicians, hospitals, and other providers under written contract with St. Mary's Occupational Medicine to provide medical services for actual or alleged work related illness and/or injury in accordance with the terms of the Participating Provider Agreement as well as the policies and procedures referenced therein.A copy of St. Mary's Occupational Medicine's Participating Provider Agreement form as well as the policies referenced therein shall be provided to City upon request. E. "CASE MANAGEMENT PROGRAM" means the process of assessing, planning, coordinating,monitoring and evaluating the services required to respond to an individual's healthcare needs to attain the goals of quality and cost effective care. F. "PROPOSAL"means that proposal submitted by St. Mary's Occupational Medicine to City as supplemented. II. RELATIONSHIP BETWEENCITYAND ST.MARY'S OCCUPATIONAL MEDICINE A. Relationship between City and St. Mary's Occupational Medicine The relationship between City and St. Mary's Occupational Medicine is that of independent contracting parties and neither City nor St. Mary's Occupational Medicine nor the employees, servants, agents, or representatives or either shall be considered the employee, servant, agent, or UAConiho Senn Sl Al;vy'SAGRUMENr?III?.w�l t representative of the other.Nothing herein should be construed as creating any relationship between the contracting parties hereunder other than the relationship of independent entities contracting together to affect the arrangement which is the subject of this Agreement. B. Relationship between St. Mary's Occupational Medicine and PARTICIPATING PROVIDERS The relationship between St. Mary's Occupational Medicine and any PARTICIPATING PROVIDER is that of an independent contractor relationship. PARTICIPATING PROVIDERS are not agents or representatives of St.Mary's Occupational Medicine and do not have any expressed or implied right or authority to create or assume any obligation or responsibility on behalf of St. Mary's Occupational Medicine. In addition, PARTICIPATING PROVIDERS are solely responsible for any and all care and treatment provided to EMPLOYEES and at all times are free to exercise their independent medical judgment.Neither St.Mary's Occupational Medicine,nor its directors,employees and/or agents,shall be liable,or held responsible,for any damages arising from the act or failure to act of any PARTICIPATING PROVIDER. III. SERVICES OF St. Mary's Occupational Medicine St. Mary's Occupational Medicine shall provide the following services to City under this Agreement: A. Establish and maintain a network of PARTICIPATING PROVIDERS. St. Mary's Occupational Medicine will monitor PARTICIPATING PROVIDERS for their compliance with the Participating Provider Agreement as well as any all policies and procedures developed by St. Mary's Occupational Medicine and referenced therein. City acknowledges, however, that St. Mary's Occupational Medicine does not practice medicine nor does it exercise control over the methods or professional judgments by which a PARTICIPATING PROVIDER renders services to an EMPLOYEE. B. Upon referral, from City; or City's designee, St. Mary's Occupational Medicine shall coordinate provision of COVERED SERVICES to EMPLOYEES on behalf of the EMPLOYEE'S employer. Such coordination will include, but not be limited to, utilization and case management services and oversight from the initial date of the EMPLOYEE'S referral to St. Mary's Occupational Medicine with respect to the injury and/or illness. C. St. Mary's Occupational Medicine shall review and discount all billed services for work IhT Wreel marti',OURFFNIENT DII?.upd F 3 comp injuries from PARTICIPATING PROVIDERS by according to the attached schedule and forward the adjusted bill to City for payment directly to the PARTICIPATING PROVIDER. D. In addition to the services set out in paragraphs A, B, and C abofd,Mary's Occupational Medicine shall provide all services as set out in its PROPOSAL. The Fee Schedule as set out in the Proposal and by reference hereto made a part of this agreement shall be valid for the term of this contract. IV. COMPENSATION A. City shall compensate PARTICIPATING PROVIDERS for ALL COVERED services provided to EMPLOYEES under this Agreement within thirty(30)days of its receipt of the adjusted bill from St. Mary's Occupational Medicine. City shall return a copy of the adjusted bill to the PARTICIPATING PROVIDER with its payment.Provided that an EMPLOYEE was referred to St. Mary's Occupational Medicine for medical treatment pursuant to this Agreement, City shall be bound by St. Mary's Occupational Medicine's decision regarding what services constitute COVERED SERVICES pursuant to this Agreement.Notwithstanding the foregoing,nothing herein shall prevent City for compensating PARTICIPATING PROVIDERS for services which do not constitute COVERED SERVICES under this Agreement but nothing in this Agreement so requires. B. City shall pay such additional fees and charges as set out in St. Mary's Occupational Medicine's PROPOSAL and any fees and charges shall be limited to the amounts included in the PROPOSAL. V. INSURANCE St.Mary's Occupational Medicine,at its sole cost and expense,shall obtain or maintain coverage for general liability,professional liability and other exposures as may be necessary to insure itself, its directors, and employees against any liability, claims or damages arising by reason of acts or omissions of St.Mary's Occupational Medicine or its directors,or employees in the perfonnance of its responsibilities under this Agreement.Uponrequest,St.Mary's Occupational Medicine will provide evidence of such coverage and St. Mary's Occupational Medicine shall notify City promptly if it receives notice of the termination of such coverage in the event that it is not able to secure alternative coverage. Such coverage shall carry a miniinuin limit of$2,000,000. VI. TERM AND TERMINATION A. Tenn U:iUou1—t Yili�tI'rt�iue.inrrrt Scnicint51 jian':UIGREL�iiNT?OF?.urya! ......... .................. .............. ................ _.... __ __.. __._ _._ _.___. i This Agreement shall commence as of the Effective Date and shall continue in effect for initial term of two (2) years of such date. Thereafter, this Agreement may be renewed by agreement of the parties for three successive one (l ) year periods unless sooner terminated by the parties hereto in accordance with the provisions set forth in this Section Vl. B. Voluntary Termination Either St.Mary's Occupational Medicine or City may terminate this Agreement upon ninety(90) days prior written notice given at any time with or without cause. C. Involuntary Termination This Agreement may be involuntarily terminated by either party as follows: I. If City fails to pay St. Mary's Occupational Medicine, or any PARTICIPATING PROVIDER,amounts due under this Agreement in accordance with the tenns herewith and fails to snake entire payment within five (S) days of St. Mary's Occupational Medicine's written notice of such failure,theiSt. Mary's Occupational Medicinenayterminate this Agreement immediately without further notice. 2. If either party is in material default in the performance of the terms and conditions of this Agreement,then the non-defaulting party may tenninate this Agreement immediately upon written notice upon the expiration of a thirty(30) day written notice (specifying the nature of the default) and cure period. 3. Either party can terminate this Agreement immediately upon written notice in the event that the other party files for bankruptcy or is declared insolvent. D. In the event of the tennination of this AgreementCity shall remain obligated to pay for any services provided prior to the effective date of termination including, but not limited to, any COVERED SERVICES provided by PARTICIPATING PROVIDERS. VII. CONFIDENTIALITY AND PROPRIETARY RIGHTS During St. Mary's Occupational Medicine's perfonnance of service hereunder, City may obtain infonnation relating to the business affairs of St. Mary's Occupational Medicine which is highly U:u­1_1 F! i s«i­tisi%iny,.'AcrzecMeNr 20 i l»pi confidential and proprietary including,but not limited to,PARTICIPATING PROVIDER discount, claims data, and case management processes,programs, systems and software. City hereby agrees to treat such information as secret and confidential and to obligate its employees and agents to treat such information as secret and confidential and not to disclose or make available any such information to any firm, person or corporation or use it in any manner (except as contemplated in this Agreement) without the prior written consent of St. Mary's Occupational Medicine unless required by valid court order or subpoena. This provision shall survive the tennination of this Agreement. VIII. RECORD RETENTION AND AUDIT St. Mary's Occupational Medicine shall maintain records pertaining to the performance of its obligations under this Agreement. Such records shall be maintained for as long as this Agreement is in effect plus three years unless otherwise required by law. St.Mary's Occupational Medicine shall snake its records available for its inspection by City or any other authorized regulatory body or agency at reasonable times upon reasonable notice in a manner consistent with laws and regulations relating to patient confidentiality. St. Mary's Occupational Medicine shall have the right, upon reasonable notice, to audit the records of City to verify the number of EMPLOYEES covered under this Agreement. IX. MISCELLANEOUS A. Assignment This Agreement may not be assigned by either party without the prior written consent of the other. Consent shall not be withheld unreasonably. B. Agreement Modification This Agreement constitutes the entire understanding of the parties hereto and supersedes any and all written or oral agreements, representations or understandings. No modifications, amendments or alterations shall be effective unless evidenced by an instrument in writing signed by both parties. Furthermore,neither this Agreement nor any modifications,amendments,or alterations thereof shall be considered executed by, or binding upon, St. Mary's Occupational Medicine unless and until signed by a duly authorized officer of St. Mary's Occupational Medicine. C. Invalid Provisions Notwithstanding Section IX-B above, any provision of this Agreement which is in violation of any S—i-%S ?euz Wp l F state or federal laws or regulations shall be deemed amended to conform with such laws or regulations,pursuant to the terms of this Agreement, except that if such change will materially and substantially alter the obligations of the parties under this Agreement, any such provision shall be renegotiated by the parties. The invalidity or nonenforceability of any terms or provisions hereof shall in.no way effect the validity or enforceability of any terms or provisions hereof. D. Governing Law This Agreement shall be governed by and construed in accordance with the laws of the state of Missouri,includingbutnot limited to those laws andregulations governing Worlcers`Compensation. Accordingly, City is hereby advised that the premium discount program available to Missouri employers who direct their employees to receive medical services for work related illnesses and/or injuries from St.Mary's Occupational Medicine is dependent upon the status of Missouri statutes and Department of Insurance regulations. The premium discount program is subject to change as required to comply with these laws. For example, the premium discount program may be modified or tenminated if Missouri ceases to require that the rates for Workers' Compensation insurance be set by the Missouri Department of Insurance. In addition, an Employer who repeatedly fails to cooperate w6h Mary's Occupational Medicine may have its premium discount terminated by its insurer. E. Federal Funds To Be Used The majority of work under this agreement will be funded through City of Jefferson budgeted funds. Work in two divisions,Transit and Central Maintenance,maybe funded through the Federal Transit Administration. As a recipient of Federal Transit Administration funds; the following requirements shall be fully considered in preparing bids and performing any work using FTA funds. No Obligation by the Federal Government. (1) The Purchaser and Contractor acknowledge and agree that, notwithstanding any concurrence by the Federal Government in or approval of the solicitation or award of the underlying contract, absent the express written consent by the Federal Government, the Federal Government is not a party to this contract and shall not be subject to any obligations or liabilities to the Purchaser, Contractor, or any other party (whether or not a party to that contract) pertaining to any matter resulting from the underlying contract. (2) The Contractor agrees to include the above clause in each subcontract financed in whole or in part with Federal assistance provided by FTA. It is further agreed that the clause shall not be modified, except to identify the subcontractor who will be subject to its provisions. U:lCmmn I FIIe,%holl Iml.51 SL' ICLL N Khiq.IAGRf:FNIFNT 2111 Zwpl f Program Fraud and False or Fraudulent Statements or Related Acts. (1)The Contractor acknowledges that the provisions of the Program Fraud Civil Remedies Act of 1986, as amended, 31 U.S.C. § 3801 et seq. and U.S. DOT regulations, "Program Fraud Civil Remedies,"49 C.F.R.Part 31,apply to its actions pertaining to this Project.Upon execution of the underlying contract, the Contractor certifies or affirms the truthfulness and accuracy of any statement it has made, it makes, it may make, or causes to be made, pertaining to the underlying contract or the FTA assisted project for which this contract work is being performed. In addition to other penalties that may be applicable, the Contractor further acknowledges that if it snakes, or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification, the Federal Government reserves the right to impose the penalties of the Program Fraud Civil Remedies Act of 1986 on the Contractor to the extent the Federal Government deems appropriate. (2) The Contractor also acknowledges that if it makes, or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification to the Federal Government under a contract connected with a project that is financed in whole or in part with Federal assistance originally awarded by FTA under the authority of 49 U.S.C. § 5307, the Government reserves the right to impose the penalties of 18 U.S.C. § 1001 and 49 U.S.C. § 5307(n)(1) on the Contractor, to the extent the Federal Government deems appropriate. (3) The Contractor agrees to include the above two clauses in each subcontract financed in whole or in part with Federal assistance provided by FTA. It is further agreed that the clauses shall not be modified, except to identify the subcontractor who will be subject to the provisions. Access to Records The following access to records requirements apply to this Contract: 1. Where the Purchaser is not a State but a local government and is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 C. F. R. 18.36(l),the Contractor agrees to provide the Purchaser,the FTA Administrator,the Comptroller General of the United States or any of their authorized representatives access to any books, documents, papers and records of the Contractor which are directly pertinent to this contract for the purposes of malting audits, examinations, excerpts and transcriptions. Contractor also agrees, pursuant to 49 C. F. R. 633.17 to provide the FTA Administrator or his authorized representatives including any PMO Contractor access to Contractor's records and construction sites pertaining to a major capital project, defined at 49 U.S.C. 5302(a)l, which is receiving federal financial assistance through the programs described at 49 U.S.C. 5307, 5309 or 5311. 2. Where the Purchaser is a State and is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 C.F.R. 633.17, Contractor agrees to provide the Purchaser, the FTA Administrator or his authorized representatives, including any PMO Contractor, access to the LCICa,,=o 5—X11\51%1¢ '.,1AGREENIENT1UI_'.wpd 8 t ` Contractor's records and construction sites pertaining to a major capital project, defined at 49 U.S.C. 5302(a)l, which is receiving federal financial assistance through the programs described at 49 U.S.C. 5307, 5309 or 5311. By definition, a major capital project excludes contracts of less than the simplified acquisition threshold currently set at $100,000. 3. Where the Purchaser enters into a negotiated contract for other than a small purchase or under the simplified acquisition threshold and is an institution of higher education, a hospital or other non-profit organization and is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 C.F.R. 19.48,Contractor agrees to provide the Purchaser,FTA Administrator, the Comptroller General of the United States or any of their duly authorized representatives with access to any books, documents, papers and record of the Contractor which are directly pertinent to this contract for the purposes of making audits, examinations, excerpts and transcriptions. 4. Where any Purchaser which is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 U.S.C. 5325(x) enters into a contract for a capital project or improvement (defined at 49 U.S.C. 5302(a)1)through other than competitive bidding,the Contractor shall snake available records related to the contract to the Purchaser, the Secretary of Transportation and the Comptroller General or any authorized officer or employee of any of them for the purposes of conducting an audit and inspection. 5. The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed. 6. The Contractor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three years after the date of tennination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case Contractor agrees to maintain same until the Purchaser, the FTA Administrator, the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. Reference 49 CFR 18.39(I)(1.1). 7. FTA does not require the inclusion of these requirements in subcontracts. Federal Changes The contractor shall at all times comply with all applicable FTA regulations,policies,procedures and directives, including without limitation those listed directly or by reference in the Agreement (Form FTA MA(10) dated October, 2003)between Purchaser and FTA, as they may be amended or promulgated from time to time during the term of this contract. Contractor's failure to so comply shall constitute a material breach of this contract. Civil Rights R G:iCoirn no Fi a Twl—ional S�rviicsL51 Maly'+`AGREGNIGNT?III?.u(KS 9 The following requirements apply to the underlying contract: (1)Nondiscrimination-In accordance with Title VI of the Civil Rights Act,as amended,42 U.S.C. § 2000d, section 303 of the Age Discrimination Act of 1975, as amended, 42 U.S.C. § 6102, section 202 of the Americans with Disabilities Act of 1990,42 U.S.C. § 12132,and Federal transit law at 49 U.S.C. § 5332, the Contractor agrees that it will not discriminate against any employee or applicant for employment because of race, color, creed, national origin, sex, age, or disability. In addition,the Contractor agrees to comply with applicable Federal impleinentingregulations and other implementing requirements FTA may issue. (2) Equal Em llooyment Opportunity-The following equal employment opportunity requirements apply to the underlying contract: (a)Race.Color,Creed.National Origin,Sex-In accordance with Title VII of the Civil Rights Act, as amended, 42 U.S.C. § 2000e, and Federal transit laws at 49 U.S.C. § 5332, the Contractor agrees to comply with all applicable equal employment opportunity requirements of U.S.Department of Labor(U.S.DOL)regulations,"Office ofFederal Contract Compliance Programs,Equal Employment Opportunity,Department of Labor,"41 C.F.R.Parts 60 et sec., (which implement Executive Order No. 11246, "Equal Employment Opportunity," as amended by Executive Order No. 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," 42 U.S.C. § 2000e note), and with any applicable Federal statutes, executive orders, regulations, and Federal policies that may in the future affect construction activities undertaken in the course of the Project. The Contractor agrees to take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, creed, national origin, sex, or age. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or tenmination; rates of pay or other Banns of compensation; and selection for training, including apprenticeship. In addition, the Contractor agrees to comply with any implementing requirements FTA may issue. (b)Age-In accordance with section 4 of the Age Discrimination in Employment Act of 1967, as amended, 29 U.S.C. § § 623 and Federal transit law at 49 U.S.C. § 5332, the Contractor agrees to refrain from discrimination against present and prospective employees for reason ofage.In addition,the Contractor agrees to comply with any implementing requirements FTA may issue. (c) Disabilities - In accordance with section 102 of the Americans with Disabilities Act, as amended,42 U.S.C. § 12112,the Contractor agrees that it will comply with the requirements of U.S. Equal Employment Opportunity Commission, "Regulations to Implement the Equal Employment Provisions of the Americans with Disabilities Act," 29 C.F.R. Part 1630, L41Cnntrxl FJsIF'mlis.innnl Srvic55E hlnry'.,U1{;ItGkhlkNT?III?upd 10 S S pertaining to employment of persons with disabilities. In addition, the Contractor agrees to comply with any implementing requirements FTA may issue. (3)The Contractor also agrees to include these requirements in each subcontract financed in whole or in part with Federal assistance provided by FTA, modified only if necessary to identify the affected parties. Termination of Contract 1. Termination for Convenience (General Provision) The (Recipient) may terminate this contract, in whole or in part, at any time by written notice to the Contractor when it is in the Government's best interest.The Contractor shall be paid its costs,including contract close-out costs, and profit on work performed up to the time of termination. The Contractor shall promptly submit its termination claim to (Recipient) to be paid the Contractor. If the Contractor has any property in its possession belonging to the(Recipient),the Contractor will account for the same, and dispose of it in the manner the(Recipient) directs. 2. Termination for Default[Breach or Cause] (General Provision)If the Contractor does not deliver supplies in accordance with the contract delivery schedule, or, if the contract is for services, the Contractor fails to perform in the manner called for in the contract, or if the Contractor fails to comply with any other provisions of the contract, the (Recipient) may terminate this contract for default. Termination shall be effected by serving a notice of tennination on the contractor setting forth the manner in which the Contractor is in default. The contractor will only be paid the contract price for supplies delivered and accepted, or services performed in accordance with the manner of perfonmance set forth in the contract. If it is later detennined by the(Recipient)that the Contractor had an excusable reason for not performing, such as a strike,fire,or flood, events which are not the fault of or are beyond the control of the Contractor, the (Recipient), after setting up a new delivery of performance schedule,may allow the Contractor to continue work,or treat the termination as a tennination for convenience. 3. Opportunity to Cure(General Provision)The(Recipient)in its sole discretion may,in the case of a termination for breach or default,allow the Contractor[an appropriately short period of time]in which to cure the defect. In such case,the notice oftermination will state the tune period in which cure is permitted and other appropriate conditions If Contractor fails to remedy to (Recipient)'s satisfaction the breach or default of any of the terns, covenants, or conditions of this Contract within [ten (10) days] after receipt by Contractor of written notice from(Recipient)setting forth the nature of said breach or default, (Recipient) shall have the right to tenninate the Contract without any further obligation to ... ..... ........ . U:1c,,mma nit, 'mf,io-nnl s—i—\sl Niau',1Acn.ENIENT 2012.wNl Contractor. Any such termination for default shall not in any way operate to preclude (Recipient) from also pursuing all available remedies against Contractor and its sureties for said breach or default. 4. Waiver of Remedies for any Breach In the event that (Recipient) elects to waive its remedies for any breach by Contractor of any covenant, term or condition of this Contract, such waiver by(Recipient) shall not limit(Recipient)'s remedies for any succeeding breach of that or of any other term, covenant, or condition of this Contract_ 5. Termination for Convenience (Professional or Transit Service Contracts) The (Recipient), by written notice, may tenninate this contract, in whole or in part, when it is in the Government's interest. If this contract is terminated,the Recipient shall be liable only for payment under the payment provisions of this contract for services rendered before the effective date of ten-nination. 6. Termination for Default(Supplies and Service) If the Contractor fails to deliver supplies or to perform the services within the time specified in this contract or any extension or if the Contractor fails to comply with any other provisions of this contract, the (Recipient) may tenninate this contract for default. The (Recipient) shall tenninate by delivering to the Contractor a Notice of Tennination specifying the nature of the default. The Contractor will only be paid the contract price for supplies delivered and accepted, or services performed in accordance with the manner or perfonnance set forth in this contract. If, after termination for failure to fulfill contract obligations, it is determined that the Contractor was not in default,the rights and obligations of the parties shall be the same as if the termination had been issued for the convenience of the Recipient. 7. Termination for Convenience of Default (Cost-Type Contracts) The (Recipient) may tenninate this contract, or any portion of it, by serving a notice or termination on the Contractor. The notice shall state whether the termination is for convenience of the (Recipient) or for the default of the Contractor. If the termination is for default, the notice shall state the manner in which the contractor has failed to perform the requirements of the contract. The Contractor shall account for any property in its possession paid for from funds received from the(Recipient),or property supplied to the Contractor by the(Recipient).If the termination is for default, the (Recipient) may fix the fee, if the contract provides for a fee, to be paid the contractor in proportion to the value,if any, of work performed up to the time of tern-iination.The Contractor shall promptly submit its termination claim to the(Recipient) and the parties shall negotiate the tenmination settlement to be paid the Contractor. If the termination is for the convenience of the (Recipient), the Contractor shall be paid its . . . . . . .......................... ................................................... ............................................. ............................................... ........................................... uaCu na fik,\Pmlc,,innm 5—'i—Sl Maq%' AGREEMENT 2012,.;N! 12 contract close-out costs,and a fee,if the contract provided for payment of a fee, in proportion to the work performed up to the time of termination. If, after serving a notice of termination for default, the (Recipient) deter-nines that the Contractor has an excusable reason for not performing, such as strike, fire, flood, events which are not the fault of and are beyond the control of the contractor, the (Recipient), after setting up a new work schedule, may allow the Contractor to continue work, or treat the termination as a termination for convenience. Disadvantaged Business Enterprise To the extent required by Federal law, regulation, or directive, the Recipient agrees to take the following measures to facilitate participation by disadvantaged business enterprises(DBE)in the Project: (1) The Recipient agrees and assures that it will comply with TEA-21 § 1101(b), 23 U.S.C. § 101 note, and U.S. DOT regulations, "Participation by Disadvantaged Business Enterprises in Department of Transportation Financial Assistance Programs," 49 C.F.R. Part 26. (2) The Recipient agrees and assures that it shall not discriminate on the basis of race, color, sex,or national origin in the award and performance of any third party contract,or subagreement supported with Federal assistance derived from U.S. DOT or in the administration of its DBE program and will comply with the requirements of 49 C.F.R. Part 26. The Recipient agrees to take all necessary and reasonable steps set forth in 49 C.F.R.Part 26 to ensure nondiscrimination in the award and administration of all third party contracts and subagreements supported with Federal assistance derived from U.S. DOT. As required by 49 C.F.R. Part 26 and approved by U.S.DOT,the Recipient's DBE program is incorporated by reference and made part of the Grant Agreement or Cooperative Agreement. The Recipient agrees that implementation of this DBE program is a legal obligation, and that failure to carry out its terms shall be treated as a violation of the Grant Agreement or Cooperative Agreement. Upon notification by U.S. DOT to the Recipient of its failure to implement its approved DBE program, U.S. DOT may impose sanctions as provided for under 49 C.F.R. Part 26 and may, in appropriate cases,refer the matter for enforcement under 18 U.S.C. § 1001, and/or the Program. Fraud Civil Remedies Act, 31 U.S.C. §§ 3801 et seq. Incorporation of FTA Terms The Recipient and contractor certify that terns in FTA C 4220.1E which replaces FTA C4220.1 D will be incorporated into contracts and sub-contracts. Debarment and Suspension This contract is a covered transaction for purposes of 49 CFR Part 29. As such, the contractor is required to verify that none of the contractor, its principals, as defined at 49 CFR 29.995, or affiliates, as defined at 49 CFR 29.905, are excluded or disqualified as defined at 49 CFR 29.940 and 29.945. The contractor is required to comply with 49 CFR 29, Subpart C and must include the requirement to comply with 49 CFR 29, Subpart C in any lower tier covered transaction it enters into. By signing and submitting its bid or proposal, the bidder or proposer certifies as follows: The certification in this clause is a material representation of fact relied upon by the City of Jefferson. It if is later determined that the bidder or proposer knowingly rendered an erroneous certification,in addition to remedies available to the City of Jefferson,the Federal Government may pursue available remedies,including but not limited to suspension and/or debarment. The bidder or proposer agrees to comply with the requirements of 49 CFR 29, Subpart C while this offer is valid and throughout the period of any contract that may arise from this offer. The bidder or proposer further agrees to include a provision requiring such compliance in its Iower tier covered transactions. Davis Bacon and Copeland Anti-Kickback Acts (1) Minimum wages-(1)All laborers and mechanics employed or working upon the site of the work(or under the United States Housing Act of 1937 or under the Housing Act of 1949 in the construction or development of the project), will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account(except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR part 3)), the full amount of wages and bona fide fringe benefits(or cash equivalents thereof)due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which maybe alleged to exist between the contractor and such laborers and mechanics. Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis-Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or iechanics, subject to the provisions of paragraph (1)(iv) of this section;also,regular contributions made or costs incurred for more than a weekly period (but not less oven than quarterly)underpians,funds,or programs which cover the particular weekly period,are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to ................................. ................................... ............................. ...................................... ............................. U.To llml FftA'.AL,niuual S-L1'SI hlnrySlAGIiEEhIGNT?nl'-.wpJ 14 skill, except as provided in 29 CFR Part 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided, That the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination(including any additional classifications and wage rates conformed under paragraph (1)(ii) of this section) and the Davis-Bacon poster (WH-1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. (ii)(A)The contracting officer shall require that any class of laborers or mechanics,including helpers,which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (1) Except with respect to helpers as defined as 29 CFR 5.2(n)(4), the work to be performed by the classification requested is not performedbya classification in the wage determination; and (2) The classification is utilized in the area by the construction industry; and (3) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination; and (4) With respect to helpers as defined in 29 CFR 5.2(n)(4), such a classification prevails in the area in which the work is performed. (B)If the contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, DC 20210. The Administrator, or an authorized representative, will approve, modify,or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (C)In the event the contractor,the laborers or mechanics to be employed in the classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation ofthe contracting officer,to the Administrator for IJ:1Cantrxl Fi1�1Pntc,sxinnl5—i-AS1'Aa','.,4AGREEhIENT2III2.wpd 15 determination.The Administrator,or an authorized representative,will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (D) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs (a)(1)(ii) (B) or©) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. (iii) Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. (iv)If the contractor does not make payments to a trustee or other third person,the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, That the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis-Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. (v)(A) The contracting officer shall require that any class of laborers or mechanics which is not listed in the wage detennination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefor only when the following criteria have been met: (1) The work to be performed by the classification requested is not performed by a classification in the wage detennination; and (2) The classification is utilized in the area by the construction industry; and (3) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage detennination. (B) If the contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate),a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, Washington, DC 20210. The Administrator, or an authorized UdGmirua Pi1 iPm%�sfnioal timid St Nluy AGREEME=NT?6I'_.eTd 16 representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (C) In the event the contractor, the laborers or mechanics to be employed in the classification or their representatives,and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer,to the Administrator for determination. The Administrator,or an authorized representative, will issue a determination with 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (D) The wage rate(including fringe benefits where appropriate) determined pursuant to paragraphs (a)(1)(v) (B) or ( C) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. (2) Withholding- The City of Jefferson shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld from the contractor under this contract or any other Federal contract with the same prime contractor, or any other federally-assisted contract subject to Davis-Bacon prevailing wage requirements,which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work(or under the United States Housing Act of 1937 or under the Housing Act of 1949 in the construction or development of the project), all or part of the wages required by the contract,the City of Jefferson may,aver written notice to the contractor, sponsor,applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. (3) Payrolls and basic records - (I) Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work(or under the United States Housing Act of 1937,or under the Housing Act of 1949,in the construction or development of the project). Such records shall contain the name, address, and social security number of each such worker,his or her correct classification,hourly rates of wages paid(including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section I(b)(2)(B) of the Davis-Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. U:T fl.ct 17 Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(l)(iv)that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in section 1(b)(2)(B)of the Davis-Bacon Act,the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing silldmefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. (ii)(A)The contractor shall submit weekly for each week in which any contract work is perfonned a copy of all payrolls to the City of Jefferson for transmission to the Federal Transit Administration. The payrolls submitted shall set out accurately and completelyall of the information required to be maintained under section 5.5(a)(3)(I) of Regulations, 29 CFR part 5. This information may be submitted in any form desired. Optional Form WH-347 is available for this purpose and maybe purchased from the Superintendent of Documents (Federal Stock Number 029-005-00014-1), U.S. Government Printing Office, Washington, DC 20402. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. (B) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (1) That the payroll for the payroll period contains the information required to be maintained under section 5.5(a)(3)(I) of Regulations, 29 CFR part 5 and that such information is correct and complete; (2) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations, 29 CFR part 3; (3) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work perfonned, as specified in the applicable wage determination incorporated into the contract. (C) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH-347 shall satisfy the requirement for submission of the U:iCnntrwt fiiusll`rnlrsnion:d 5­n SE%I u}''.1V GREEKIENT 2012..IaI 18 t "Statement of Compliance" required by paragraph (a)(3)(ii)(B) of this section. (D) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United States Code. (iii)The contractor or subcontractor shall make the records required under paragraph (a)(3)(I) of this section available for inspection, copying, or transcription by authorized representatives of the Federal Transit Administration or the Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, the Federal agency may, after written notice to the contractor, sponsor, applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds. Furthennore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. (4) Apprentices and trainees-(1)Apprentices-Apprentices will be permitted to work at less than the predetermined rate for the work they perfonmed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Bureau of Apprenticeship and Training, or with a State Apprenticeship Agency recognized by the Bureau, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Bureau of Apprenticeship and Training or a State Apprenticeship Agency (where appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio pennitted to the contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage detennination forthe classification ofwork actuallyperforined.In addition,any apprentice perfonning work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage detennination for the work actually performed. Where a contractor is perfonning construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. UACu axi Fil,T fe-onul Scrviocs45i Mmu,'MGtEEMENT'_III?.xN 19 Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage detennination for the applicable classification.If the Administrator ofthe Wage and Hour Division of the U.S. Department of Labor determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Bureau of Apprenticeship and Training, or a State Apprenticeship Agency recognized by the Bureau, withdraws approval of an apprenticeship program,the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work perfonned until an acceptable program is approved. (ii) Trainees - Except as provided in 29 CPR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration.Theratio of trainees to journeymen on the job site shall not be greater than pennitted under the plan approved by the Employment and Training Administration.Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage detennination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any trainee perforining work on the job site in excess of the ratio perinitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program,the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (iii) Equal employment op ortunity - The utilization of apprentices, trainees and journeymen under this part shall be in confonnity with the equal employment .................... opportunity.requirements of Executive.Order.1.1246, as amended, and 29 CFR part UX,wiract Fk-nfll—ioaal SmiLLMSI M1*'41GR1-E%1FNT2W2—Pc1 20 30. (5) Compliance with Copeland Act requirements-The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract. (6) Subcontracts - The contractor or subcontractor shall insert in any subcontracts the clauses contained in 29 CFR 5.5(a)(1) through (l 0) and such other clauses as the Federal Transit Administration may by appropriate instructions require, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. (7) Contract termination: debarment-A breach of the contract clauses in 29 CFR 5.5 maybe grounds for termination of the contract,and for debannent as a contractor and a subcontractor as provided in 29 CFR 5.12. (8) Compliance with Davis-Bacon and Related Act requirements - All rulings and interpretations of the Davis-Bacon and Related Acts contained in 29 CFR parts 1, 3, and 5 are herein incorporated by reference in this contract. (9) Disputes concerning labor standards-Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR parts 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contracting agency, the U.S. Department of Labor, or the employees or their representatives. (10) Certification of eligibility-(1)By entering into this contract,the contractor certifies that neither it (nor he or she) nor any person or fine who has an interest in the contractor's firm is a person or firm ineligible to be awarded Govermnent contracts by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1). (ii)No part of this contract shall be subcontracted to any person or firm ineligible for award of a Govermnent contract by virtue of section 3(a)of the Davis-Bacon Act or 29 CFR 5.12(a)(1). (iii)The penalty for making false statements is prescribed in the U.S.Criminal Code, 18 U.S.C. 1001_ Contract Work Hours and Safety Standards if%O)Oncl FIIL�TnoI'­in11al tierviocs451'slary AGRPI`LN L`NT 2W2,wjx1 21 (1) Overtime requirements-No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. (2) Violation; liability for unpaid wages; liquidated damages - In the event of any violation of the clause set forth in paragraph(1)of this section the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph(1) of this section, in the sum of$1 a for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (1) of this section. (3) Withholding for unpaid wages and liquidated damages -The(write in the name of the grantee) shall upon its own action or upon written request of an authorized representative of the Department ofLabor withhold or cause to be withheld,from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federal I y-assisted contract subject to the Contract Work Hours and Safety Standards Act,which is held by the same prime contractor,such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph (2) of this section. (4) Subcontracts - The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraphs (1) through (4) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1) through (4) of this section. Energy Conservation Requirements The contractor agrees to comply with mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act. ..... .. ..... ..... U:1Gnunr7 fi6Wn,1'a if 15wi—Si hlar S',1GREEMLNT 2013w1ai 22 Prompt Payment Claus The prime contractor agrees to pay each subcontractor under this prime contract for satisfactory performance of its contract no later than thirty days from receipt of each payment the prime contract receives from City of Jefferson, Missouri. The prime contractor agrees further to return retainage payments to each subcontractor within thirty days after the subcontractors work is satisfactorily completed. Any delay or postponement or postponement of payment from the above referenced time frame any occur only for good cause following written approval of the City of Jefferson, Missouri. The clause applies to both DBE and non-DBE subcontracts. F. Reserved Right Of City The City reserves the right to obtain services elsewhere. G. Notice Any notice required pursuant to this Agreement shall be given in writing personally delivered or sent by certified or registered mail, return receipt requested, to the party as follows: St. Mary's Occupational Medicine City of Jefferson ATTN: Amy--Selir-eeder,Shell Ick 1-,b, e h ATTN: Human Resources Director Marketing Assistant/Office Assistant 320 East McCarty Street St. Mary's Occupational Medicine 54-- Jefferson City, MO 65101 3�? -C-arntry Ek�b-Dries f� f ut ter;-t .sf Jefferson City, MO 65109 ATTN: City Counselor 320 East McCarty Street Jefferson City, MO 65101 IN WITNESS WHEREOF, the parties have executed this Agreement as of the day and year set below. CITY OF JEFFERSON, MISSOURI ST. MARY'S OCCUPATIONAL MEDICINE Mayor Title: ATTEST: ATTEST: ... . . . . ........................ ............................................. ................................................ ............................................... ........................................ U:1Cunlrx'I Fil.,T. ......ppl Semr,,1S1 Miley AGREEb1ENT?III1.1 l 23 �^✓,����` '��/��!" i�i�:�l �rl �_i f.U;� ! t��_/7 �i�/i ;' E�f d'u� /1 City Clerk Titled r° APPROVED AS TO FORM: hii6rim City Counselor L1;t{1mtrwl tihhPrs+Eun�i���nl S�niucat5l hl:vry'.L1GFtfiChlLN'I'?01�.w1 24 CITY OF JEFFERSON AMENDMENT ST. MARY'S OCCUPATIONAL MEDICINE PAYOR AGREEMENT WHEREAS, the City of Jefferson, Missouri, a municipal corporation, with offices at 320 East McCarty, Jefferson City, Missouri, 65101, hereinafter designated "City," entered into a Contract with St. Mary's Occupational Medicine, a worker's compensation program hereinafter referred to as "St. Mary's Occupational Medicine ", on January 1, 2012; and WHEREAS, the Contract included coverage for certain medical expenses incurred by employees work related illnesses and/or injuries; and WHEREAS, both parties wish to extend the agreement for the first of three additional one -year renewal periods as stipulated in Item VI. of the agreement dated January 1, 2012. NOW, THEREFORE, be it agreed by the parties that the agreement is hereby renewed for the first of the three additional one -year periods to end December 31, 2014. IN TESTIMONY WHEREOF, the parties have hereunto set their hands and seals this _ day of October, 2013. CITY OF JEFFERSON, MISSOURI ST. MARY'S OCCUPATIONAL MEDICINE Mayor ATTEST: r.7/0010/27/a/ y Clerk APPROVED AS TO FORM: City Counselor nmrndmrnl 201 ,1.ncpd luta. &,]2•1 Title: ATTES 114Lietelett. ?St Occupational r\/ec icine City of Jefferson /St. Mary's Occupational Medicine Fee Schedule Effective 8/7/2013-12/31/2014 • DOT(old code D0016 —new code DOT) $65 • Non DOT (old codePRE1 -- new code0CM05) $35 • Vision (old code 99172- new code eye exam) $ 38 O Pulmonary Function Test(old code 94010- -new code 904020 -PFT) $48 9 Exercise Stress Test (old code 93105 CAR48- new code exercise stress -City of Jeff) $406 • Venipuncture(36415) $ 21 © Total Cholesterol (old code 82465- new code Lab01330) $ 26 • Lipids(old code 80061 - new code Lab01042) $55 0 Complete Blood Count(old code 850025- new code Lab 02029) $31 0 Comprehensive Metabolic Panel(old code 80053- new code Lab01669) $40,75 TSH panel (old code 84443- new code Lab01160)$73 • Urinalysis(old code 81003- new codeLab90730) $21 • Immunization Admin Fee(90471) $35 Tetanus(old code 90718- new code IMM76) $46 O Tdap (old code 90715- new code IMM61)$ 65 O Hep A vaccine(old code 90632- new code IMM24) $96 each ® Hep 8 vaccine(old code 90746- new code IMM28) $100 each Rabies vaccine (old code 90675- new code IMM9) $250 each • Return to work (old code €RTA/- ---new code OCM10) $75 • Drug Screen Collection(99001) $15 O BAT(82075) $35 • BAT confirmation(82075) $15 • Respirator Questionnaire(OCM8) $25 o Deposition Fee(DEP01) $306 per hour • Medical Testimony Fee (99075) $515 per hour 25 i 1 West Edgewood Dr., Ste F Jefferson City, MO 65109 573.634.4133 LetHealingBegin.com A Member of SSM Health Care an equal opportunity/affirmative ac:,on emotaver - lerviceS provided on a non-discriminatory basis GV..tu f6t-c0 CITY OF JEFFERSON AMENDMENT ST. MARY'S OCCUPATIONAL MEDICINE PAYOR AGREEMENT WHEREAS, the City of Jefferson, Missouri, a municipal corporation, with offices at 320 East McCarty, Jefferson City, Missouri, 65101, hereinafter designated "City," entered into a Contract with St. Mary's Occupational Medicine, a worker's compensation program hereinafter referred to as "St. Mary's Occupational Medicine", on January 1, 2012, amended on October 31, 2013, and October 6, 2014; and WHEREAS, the Contract included coverage for certain medical expenses incurred by employees work-related illnesses and/or injuries; and WIiEREAS,= both -parties wish -to extend --the agreement -for the third --of -three- additional- one-year-- - renewal periods as stipulated in Item VI. of the agreement dated January 1, 2012, amended on October 31, 2013, and October 6, 2014. NOW, THEREFORE, be it agreed by the parties that the agreement is hereby renewed for the third and final of three additional one-year periods to end December 31, 2016. IN TESTIMONY WHEREOF, the parties have hereunto set their hands and seals this I day of September, 2015. CITY OF JEFFERSON, MISSOURI Mayor ATTEST: -; 1ty Cler _ - " APPROVED .AS TO.-FQ- RML; , City Counselor ST. MARY'S OCCUPATIONAL MEDICINE nw, v Title: ATTEST - Notary Pab11c, NotaTry Seal ._ State of Missouri Callaway County. Commission # 14632077 My Commission Expires December 14, 2018 CITY OF JEFFERSON RENEWAL TO OCCUPATIONAL MEDICINE PAYOR AGREEMENT WHEREAS,the City of Jefferson,Missouri,a municipal corporation,with offices at 320 East McCarty,Jefferson City,Missouri,65101,hereinafter designated "City,"entered into a contract with SSM Regional Health Services,a Missouri nonprofit corporation,doing business as SSM Health Medical Group -Occupational Medicine,with offices at 2511 W.Edgewood Drive,Jefferson City,Missouri,65109,hereinafter referred to as "Contractor,"on February 6,2017;and WHEREAS,the contract was for healthcare services for work related illnesses and/or injuries;and WHEREAS,both parties wish to extend the agreement for the first of two additional one-year renewal periods as stipulated in Paragraph VI.A.of the agreement dated February 6,2017;and NOW,THEREFORE,be it agreed by the parties that the agreement is hereby renewed for the first of the two additional one-year periods to end January 31,2019. CITY OF JEFFERSON,MISSOURI 'jAMd. Mayor Date:_[2r/Z3//-7 ATTEST: huJm^m^^ APPROVED AS TO FORM: SSM HEALTH MEDICAL GROUP - OCCUPATIONALMEDICINE Title: Date:I Title: H^t'^'UU^f^WS ^^WAS ixs&-flV>teajc a\ ATTEST:l^nuh,Wu^^ CITY OF JEFFERSON RENEWAL TO OCCUPATIONAL MEDICINE PAYOR AGREEMENT WHEREAS, the City of Jefferson, Missouri, a municipal corporation, with offices at 320 East McCarty, Jefferson City, Missouri, 65101, hereinafter designated "City," entered into a contract with SSM Regional Health Services, a Missouri nonprofit corporation, doing business as SSM Health Medical Group - Occupational Medicine, with offices at 2511 W. Edgewood Drive, Jefferson City, Missouri, 65109, hereinafter referred to as "Contractor," on February 6, 2017 and renewed on January 4, 2018; and WHEREAS, the contract was for healthcare services for work related illnesses and/or injuries; and WHEREAS, both parties wish to extend the agreement for the second of two additional one-year renewal periods as stipulated in Paragraph VI.A. of the agreement dated February 6, 2017; and NOW, THEREFORE, be it agreed by the parties that the agreement is hereby renewed for the second of the two additional one-year periods to end January 31, 2020. CITY OF JEFFERSON,MISSOURI SSM HEALTH MEDICAL GROUP— OCCUPATIONAL MEDICINE • � idiJi! Carrie Tergin, Mayor Title: ..- - .N1"-d,- Date: II- 0..p- g' Date: 00l‘8 55Y ATTEST: ATTEST: (9'360 2.03-12. ily Donal w son, City Clerk Title: tu g_VOLILQ) 1/63-\AAA() APPROVED AS TO FORM: 4/ Ryan oe an, City Counselor ii . SSMHeaftih Medical Group OCCUPATIONAL MEDICINE 2019 Fee Schedule Select Physicals and Most Common Services Price ❑ Pre- Employment Physical 1 $35.00 Includes Height, Weight, Blood Pressure, Pulse, Medical History and Physical ❑ Pre-Employment Physical 2 $65.00 Includes Height, Weight, Blood Pressure, Pulse, Medical History and Physical, and Vision ❑ DOT Physical - Includes urinalysis $65.00 ❑ Audiogram - In sound proof certified booth $35.00 ❑ Vision Testing - Including Titmus and Ishiara $38.00 ❑ Pulmonary Function Testing $48.00 ❑ Treadmill Stress Testing $510.00 ❑ Respirator Questionnaire $25.00 ❑ TB testing $25.00 ❑ Urinalysis (dip) $21.00 ❑ Deposition Fee (per hour) $306.00 ❑ Medical Testimony Fee (per hour) $515.00 ❑ Functional Capacity Evaluation (Audrain) $70.00 Select Drug and Alcohol Testing Services Price ❑ DOT (Department of Transportation) 5 panel urine drug screen* $35.00 Utilizing our lab and MRO* ❑ Non-DOT 5 panel rapid drug test* $30.00 (cocaine, amphetamine, phencyclidine, marijuana, opiates) ❑ Non-DOT 10 panel rapid drug test* $35.00 (methamphetamine, cocaine, marijuana, amphetamine, opiates, oxycodone, benzodiazepines, barbiturates, propoxyphene, phencyclidine) ❑ *MRO (Medical Review Officer) fee $45.00 (applies to all positive and confirmed negative drug screens) ❑ Specimen Collection only — Hair or Urine $15.00 (utilizing your lab and MRO) ❑ Breath Alcohol Testing $35.00 (an additional $15.00 fee applies to positive BAT confirmation) ❑ Drug Screen $50.00 (On site fee (min. 10 employees) 0-3 hours/each additional hour$25.00) ❑ Drug Screen Randomization Program $100 (Yearly Maintenance Fee $50.00) Set Up Page 1 of 2 Reviewed June 19, 2018 • V„,/13- SSMHeaft5h Medical Group OCCUPATIONAL MEDICINE 2019 Fee Schedule Select Bloodwork and Titers Price ❑ CMP (comprehensive metabolic panel) $41.00 ❑ CBC (complete blood count) $31.00 ❑ Lipid panel $55.00 ❑ TSH (Thyroid stimulating hormone) $73.00 ❑ Rabies Immune Status $85.00 ❑ Hepatitis B surface antigen $85.00 ❑ HIV $105.00 ❑ Hepatitis C $54.00 ❑ Reticulocyte Count $58.00 ❑ PSA (prostate specific antigen) $66.00 ❑ Lead (occupational) $84.00 ❑ Arsenic $160.00 ❑ Mercury $135.00 ❑ Zinc $90.00 ❑ Cadmium $125.00 ❑ Venipuncture Fee $21.00 (charged each time blood is drawn) Select Immunizations Price ❑ Influenza $35.00 ❑ Hepatitis B vaccine $100.00 (series is 3 injections, booster is linjection) each ❑ Hepatitis A Vaccine $96.00 (series is 2 injections) each ❑ TDAP (tetanus, diphtheria, and pertussis) $65.00 ❑ TD (tetanus, diphtheria) $46.00 ❑ Rabies Vaccination $410.00 (pre-exposure series is 3 injections, post-exposure is 4 injections) each ❑ Administration Fee $35.00 (applies each time a vaccine is administered) Page 2 of 2 Reviewed June 19, 2018