HomeMy WebLinkAboutCORRESPONDENCE - RFP - P1097 HEALTH RISK ASSESSMENT LIFESTYLE MANAGEMENT (24)NOTE To participate in the RFP process vendors need to sign and return this
Business Associate Agreement
BUSINESS ASSOCIATE AGREEMENT - SECURITY STANDARDS
This agreement is entered into between
and the City of Fort Collins
(Business Associate)
Business Associate agrees that it will implement policies and procedures to ensure that its creation
receipt maintenance or transmission of electronic protected health information ( ePHI ) on behalf of
the City of Fort Collins complies with the applicable administrative physical and technical
safeguards required to protect the confidentiality and integnty of ePH 1 under the Security Standards
45 CFR Part 164
Business Associate agrees that it will ensure that agents or subcontractors agree to implement the
applicable administrative physical and technical safeguards required to protect the confidentiality
and integrity of ePHI under the Security Standards 45 CFR Part 164
Business Associate agrees that it will report security violations to the Cityof Fort Collins Security
Manager
a
PRINT NAME
TITLE
Please return to
City of Fort Collins
Attn Purchasing-RFP
P O Box 580
Ft Collins CO 80522-0580
-or fax back to (970) 221 6707
Date