HomeMy WebLinkAbout461367 WORKWELL OCCUPATIONAL MEDICINE - CONTRACT - FAX QUOTE - 8648 DRUG & ALCOHOL TESTINGOfficial Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 1 of 13
SERVICES AGREEMENT
THIS AGREEMENT made and entered into the day and year set forth below by and
between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter
referred to as the "City" and WORKWELL OCCUPATIONAL MEDICINE, LLC, hereinafter referred
to as "Service Provider".
WITNESSETH:
In consideration of the mutual covenants and obligations herein expressed, it is agreed by
and between the parties hereto as follows:
1. Scope of Services. The Service Provider agrees to provide services in accordance with the
scope of services attached hereto as Exhibit A, consisting of two (2) page(s) and
incorporated herein by this reference. Irrespective of references in Exhibit A to certain
named third parties, Service Provider shall be solely responsible for performance of all
duties hereunder.
2. Contract Period. This Agreement shall commence January 1, 2018, and shall continue in
full force and effect until December 31, 2018, unless sooner terminated as herein provided.
In addition, at the option of the City, the Agreement may be extended for additional one year
periods not to exceed four (4) additional one year periods. Renewals and pricing changes
shall be negotiated by and agreed to by both parties. Written notice of renewal shall be
provided to the Service Provider and mailed no later than thirty (30) days prior to contract
end.
3. Delay. If either party is prevented in whole or in part from performing its obligations by
unforeseeable causes beyond its reasonable control and without its fault or negligence, then
the party so prevented shall be excused from whatever performance is prevented by such
cause. To the extent that the performance is actually prevented, the Service Provider must
provide written notice to the City of such condition within fifteen (15) days from the onset of
such condition.
4. Early Termination by City/Notice. Notwithstanding the time periods contained herein, the
City may terminate this Agreement at any time without cause by providing written notice of
termination to the Service Provider. Such notice shall be delivered at least fifteen (15) days
prior to the termination date contained in said notice unless otherwise agreed in writing by
the parties. All notices provided under this Agreement shall be effective when mailed,
postage prepaid and sent to the following addresses:
Service Provider: City: Copy to:
Workwell Occupational
Medicine, LLC
Attn: Stephen Pottenger
164 Primrose Court
Longmont, CO 80501
City of Fort Collins
Attn: Jane Johnson
PO Box 580
Fort Collins, CO 80522
City of Fort Collins
Attn: Purchasing Dept.
PO Box 580
Fort Collins, CO 80522
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 2 of 13
In the event of early termination by the City, the Service Provider shall be paid for services
rendered to the date of termination, subject only to the satisfactory performance of the
Service Provider's obligations under this Agreement. Such payment shall be the Service
Provider's sole right and remedy for such termination.
5. Contract Sum. The City shall pay the Service Provider for the performance of this Contract,
subject to additions and deletions provided herein, as per the attached Exhibit "B",
consisting of one (1) page(s), and incorporated herein by this reference.
6. City Representative. The City will designate, prior to commencement of the work, its
representative who shall make, within the scope of his or her authority, all necessary and
proper decisions with reference to the services provided under this agreement. All requests
concerning this agreement shall be directed to the City Representative.
7. Independent Service provider. The services to be performed by Service Provider are those
of an independent service provider and not of an employee of the City of Fort Collins. The
City shall not be responsible for withholding any portion of Service Provider's compensation
hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or
for any other purpose.
8. Subcontractors. Service Provider may not subcontract any of the Work set forth in the
Exhibit A, Statement of Work without the prior written consent of the city, which shall not be
unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of
the City), then the following provisions shall apply: (a) the subcontractor must be a reputable,
qualified firm with an established record of successful performance in its respective trade
performing identical or substantially similar work, (b) the subcontractor will be required to
comply with all applicable terms of this Agreement, (c) the subcontract will not create any
contractual relationship between any such subcontractor and the City, nor will it obligate the
City to pay or see to the payment of any subcontractor, and (d) the work of the subcontractor
will be subject to inspection by the City to the same extent as the work of the Service
Provider.
9. Personal Services. It is understood that the City enters into the Agreement based on the
special abilities of the Service Provider and that this Agreement shall be considered as an
agreement for personal services. Accordingly, the Service Provider shall neither assign any
responsibilities nor delegate any duties arising under the Agreement without the prior written
consent of the City.
10. Acceptance Not Waiver. The City's approval or acceptance of, or payment for any of the
services shall not be construed to operate as a waiver of any rights or benefits provided to
the City under this Agreement or cause of action arising out of performance of this
Agreement.
11. Warranty.
a. Service Provider warrants that all work performed hereunder shall be performed with the
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 3 of 13
highest degree of competence and care in accordance with accepted standards for work
of a similar nature.
b. Unless otherwise provided in the Agreement, all materials and equipment incorporated
into any work shall be new and, where not specified, of the most suitable grade of their
respective kinds for their intended use, and all workmanship shall be acceptable to City.
c. Service Provider warrants all equipment, materials, labor and other work, provided under
this Agreement, except City-furnished materials, equipment and labor, against defects
and nonconformances in design, materials and workmanship/workwomanship for a
period beginning with the start of the work and ending twelve (12) months from and after
final acceptance under the Agreement, regardless whether the same were furnished or
performed by Service Provider or by any of its subcontractors of any tier. Upon receipt
of written notice from City of any such defect or nonconformances, the affected item or
part thereof shall be redesigned, repaired or replaced by Service Provider in a manner
and at a time acceptable to City.
12. Default. Each and every term and condition hereof shall be deemed to be a material element
of this Agreement. In the event either party should fail or refuse to perform according to the
terms of this agreement, such party may be declared in default thereof.
13. Remedies. In the event a party has been declared in default, such defaulting party shall be
allowed a period of ten (10) days within which to cure said default. In the event the default
remains uncorrected, the party declaring default may elect to (a) terminate the Agreement
and seek damages; (b) treat the Agreement as continuing and require specific performance;
or (c) avail himself of any other remedy at law or equity. If the non-defaulting party
commences legal or equitable actions against the defaulting party, the defaulting party shall
be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees
and costs incurred because of the default.
14. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire
agreement between the parties and shall be binding upon said parties, their officers,
employees, agents and assigns and shall inure to the benefit of the respective survivors,
heirs, personal representatives, successors and assigns of said parties.
15. Indemnity/Insurance.
a. The Service Provider agrees to indemnify and save harmless the City, its officers, agents
and employees against and from any and all actions, suits, claims, demands or liability
of any character whatsoever brought or asserted for injuries to or death of any person
or persons, or damages to property arising out of, result from or occurring in connection
with the performance of any service hereunder.
b. The Service Provider shall take all necessary precautions in performing the work
hereunder to prevent injury to persons and property.
c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider
shall provide and maintain insurance coverage naming the City as an additional insured
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 4 of 13
under this Agreement of the type and with the limits specified within Exhibit C, consisting
of one (1) page, attached hereto and incorporated herein by this reference. The Service
Provider before commencing services hereunder, shall deliver to the City's Purchasing
Director, P. O. Box 580, Fort Collins, Colorado 80522, one copy of a certificate
evidencing the insurance coverage required from an insurance company acceptable to
the City.
16. Entire Agreement. This Agreement, along with all Exhibits and other documents
incorporated herein, shall constitute the entire Agreement of the parties. Covenants or
representations not contained in this Agreement shall not be binding on the parties.
17. Law/Severability. The laws of the State of Colorado shall govern the construction
interpretation, execution and enforcement of this Agreement. In the event any provision of
this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction,
such holding shall not invalidate or render unenforceable any other provision of this
Agreement.
18. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et.
seq., Service Provider represents and agrees that:
a. As of the date of this Agreement:
1. Service Provider does not knowingly employ or contract with an illegal alien who will
perform work under this Agreement; and
2. Service Provider will participate in either the e-Verify program created in Public Law
208, 104th Congress, as amended, and expanded in Public Law 156, 108th
Congress, as amended, administered by the United States Department of Homeland
Security (the “e-Verify Program”) or the Department Program (the “Department
Program”), an employment verification program established pursuant to Section 8-
17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired
employees to perform work under this Agreement.
b. Service Provider shall not knowingly employ or contract with an illegal alien to perform
work under this Agreement or knowingly enter into a contract with a subcontractor that
knowingly employs or contracts with an illegal alien to perform work under this
Agreement.
c. Service Provider is prohibited from using the e-Verify Program or Department Program
procedures to undertake pre-employment screening of job applicants while this
Agreement is being performed.
d. If Service Provider obtains actual knowledge that a subcontractor performing work under
this Agreement knowingly employs or contracts with an illegal alien, Service Provider
shall:
1. Notify such subcontractor and the City within three days that Service Provider has
actual knowledge that the subcontractor is employing or contracting with an illegal
alien; and
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 5 of 13
2. Terminate the subcontract with the subcontractor if within three days of receiving the
notice required pursuant to this section the subcontractor does not cease employing
or contracting with the illegal alien; except that Service Provider shall not terminate
the contract with the subcontractor if during such three days the subcontractor
provides information to establish that the subcontractor has not knowingly employed
or contracted with an illegal alien.
e. Service Provider shall comply with any reasonable request by the Colorado Department
of Labor and Employment (the “Department”) made in the course of an investigation that
the Department undertakes or is undertaking pursuant to the authority established in
Subsection 8-17.5-102 (5), C.R.S.
f. If Service Provider violates any provision of this Agreement pertaining to the duties
imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If
this Agreement is so terminated, Service Provider shall be liable for actual and
consequential damages to the City arising out of Service Provider’s violation of
Subsection 8-17.5-102, C.R.S.
g. The City will notify the Office of the Secretary of State if Service Provider violates this
provision of this Agreement and the City terminates the Agreement for such breach.
19. Confidentiality of Participant Records
a. Access to Participant Information. Service Provider acknowledges and agrees that in
the course of performing its duties under this Agreement, Service Provider and/or their
agents may acquire or obtain access to or knowledge of health records or other personal
and confidential information regarding employees.
b. Safeguard of Information. Service Provider and their agents will safeguard all health
records and other personal and confidential information to ensure that the information is
not improperly disclosed and to comply with any applicable law, rule or regulation,
including, but not limited to, regulations promulgated by the United States Department
of Health and Human Services, pursuant to the Health Insurance Portability and
Accountability Act of 1996 (“HIPAA”) as the same may be amended from time to time
(collectively the “HIPAA Regulations”), the Health Information Technology for Economic
and Clinical Health (HITECH) Act, and other federal and state regulations governing the
confidentiality of health information, including without limitation mental health, substance
abuse and HIV-related information. Individual electronic medical record information is
the property of Service Provider, subject to each employee’s rights to his/her individual
medical information.
c. Granting of Access. Service Provider will afford access to employee’s health records or
personal and confidential information to other persons only as allowed or required by
law or regulation. Service Provider shall not grant access to patient records, patient
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 6 of 13
information, and other personal and confidential data to any individual or to the City.
20. Confidentiality of Business Information
a. Restriction of Use; Confidentiality. Each of the Parties agrees not to use any
Confidential Information (as defined below) for any purpose other than to accomplish
the intent of this Agreement. No other rights or licenses to trademarks, inventions,
copyrights, or patents are implied or granted under this Agreement. Confidential
Information supplied shall not be reproduced in any form except as required to
accomplish the intent of this Agreement. Each Party agrees to keep all such Confidential
Information confidential and, at a minimum, treat this Confidential Information in the
same confidential manner it would treat its own most confidential information, and shall
not disclose it to others or use it for any purpose except as required to accomplish the
intent of this Agreement.
b. Confidential Information. For purposes of this provision, the term “Confidential
Information” shall mean any business practices, methods of doing business, or written
or electronic materials relating to its business and shall also include without limitation
any written material of the type that is proprietary, including, without limitation, software
programs, technical information, patent applications, patent disclosures, prototypes,
samples, business apparatus, forms of reports, know-how, and other materials marked
“confidential”, or confidential information disclosed verbally if set forth in a writing which
is provided to the recipient within 15 days of verbal disclosure thereof. Confidential
Information shall not, however, include information that recipient can establish (i) was
publicly known and made generally available in the public domain prior to the time of
disclosure to recipient; (ii) becomes publicly known and made generally available after
disclosure to recipient through no action or inaction of recipient or its affiliates; or (iii) is
in the possession of recipient, without confidentiality restrictions, at the time of disclosure
as shown by recipient’s files and records immediately prior to the time of disclosure.
Nothing in this Agreement shall be deemed to prohibit recipient from disclosing any
Confidential Information that is (i) required by law to be disclosed, including, without
limitation, any and all such Confidential Records the Client is required to publicly disclose
under the Colorado Open Records Act (CRS §24-72-200.1, et. seq.) or (ii) pursuant to
the written consent of the disclosing Party.
21. Special Provisions. Special provisions or conditions relating to the services to be performed
pursuant to this Agreement are set forth in Exhibit D - Confidentiality, consisting of one (1)
page, attached hereto and incorporated herein by this reference.
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 7 of 13
THE CITY OF FORT COLLINS, COLORADO
By:
Gerry Paul
Purchasing Director
DATE:
ATTEST:
APPROVED AS TO FORM:
WORKWELL OCCUPATIONAL MEDICINE, LLC
By:
Printed:
Title:
CORPORATE PRESIDENT OR VICE PRESIDENT
Date:
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Stephen Pottenger
CEO/Member
12/22/2017
Assistant City Attorney
12/23/2017
City Clerk
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 8 of 13
EXHIBIT A
SCOPE OF SERVICES
Objective
Service Provider will to provide drug and alcohol testing and other screening services as
needed.
A. Services to Be Provided
These tests will include Non-DOT and DOT (FMCSA and FTA) tests. They will include
Pre-employment, Random, Reasonable Suspicion, Post-Accident, Return-to-Duty, and
Follow-up. All samples will be tested by a SAMSHA approved and regulated laboratory.
Samples will be picked up daily (Monday through Friday).
Service Provider will provide a dedicated representative (please provide representative’s
name, phone number and email information) to the City and promptly update the City if
this information changes. The dedicated representative will be the City’s contact for
information and issue resolution during the term of this agreement.
Collection sites will provide all sample containers and other sample gathering supplies.
Supply Custody and Control forms for drug and alcohol testing.
The collection protocol for standard urine collection shall follow all DOT guidelines. This
protocol should be posted in the collection facility for the donor’s information.
Causes for observed collections are: adulterated sample, out of range temperature, and
request from the City of Fort Collins.
Negative results will be provided through eScreen. Positive results require review by
eScreen’s designated Medical Review Officer (MRO) with the City’s Designated
Employer Representative (DER).
The testing site(s) and their agents will safeguard Participants’ health records and other
personal and confidential information to ensure that the information is not improperly
disclosed and to comply with any applicable law, rule or regulation, including, but not
limited to, regulations promulgated by the United States Department of Health and
Human Services, pursuant to the Health Insurance Portability and Accountability Act of
1996 (“HIPAA”) as the same may be amended from time to time (collectively the “HIPAA
Regulations”), the Health Information Technology for Economic and Clinical Health
(HITECH) Act, and other federal and state regulations governing the confidentiality of
health information.
B. Certification and Documentation Requirements
All collectors must be certified Federal Drug and Breath Alcohol collectors and will
provide certifications for all collectors to the City of Fort Collins annually.
Provide retention of records for five years as stipulated in 49CFR 382.401 and 655.71.
1. Records of driver alcohol test results indication and alcohol concentration of 0.00
or greater;
2. Records of driver verified positive controlled substance test results;
3. Documentation of refusals to take required alcohol and/or controlled substances
tests.
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 9 of 13
C. Records Retention
1. Maintain records concerning the collection process and test results for at least 5
years for a positive test and at least one year for a negative test.
2. Maintain records for a minimum of one year for negative and canceled controlled
substance test results.
3. Assure that all non-negative urine specimens are retained by the drug testing
laboratory for a minimum of one year.
4. Assure all test results are forwarded directly to the MRO for disposition to the
City of Fort Collins DER.
5. Submit at least monthly invoices to eScreen and the City DER reflecting fees for
drug and alcohol tests. Include the testing date, name of employee, type of test
given. Vender shall provide phone number and email address of billing contact
and keep the City updated if this information changes.
6. State after hours testing availability and fees.
D. Deliverables
All test results will be reported to City DER through the eScreen website. The City has
two DERs.
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 10 of 13
EXHIBIT B
FEE SCHEDULE
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 11 of 13
EXHIBIT C
INSURANCE REQUIREMENTS
1. The Service Provider will provide, from insurance companies acceptable to the City, the
insurance coverage designated hereinafter and pay all costs. Before commencing work
under this bid, the Service Provider shall furnish the City with certificates of insurance
showing the type, amount, class of operations covered, effective dates and date of
expiration of policies, and containing substantially the following statement:
“The insurance evidenced by this Certificate will not reduce coverage or limits and
will not be cancelled, except after thirty (30) days written notice has been received
by the City of Fort Collins.”
In case of the breach of any provision of the Insurance Requirements, the City, at its
option, may take out and maintain, at the expense of the Service Provider, such
insurance as the City may deem proper and may deduct the cost of such insurance from
any monies which may be due or become due the Service Provider under this
Agreement. The City, its officers, agents and employees shall be named as additional
insureds on the Service Provider 's general liability and automobile liability insurance
policies for any claims arising out of work performed under this Agreement.
2. Insurance coverages shall be as follows:
A. Workers' Compensation & Employer's Liability. The Service Provider shall
maintain during the life of this Agreement for all of the Service Provider's
employees engaged in work performed under this agreement:
1. Workers' Compensation insurance with statutory limits as required by
Colorado law.
2. Employer's Liability insurance with limits of $100,000 per accident,
$500,000 disease aggregate, and $100,000 disease each employee.
B. Commercial General & Vehicle Liability. The Service Provider shall maintain
during the life of this Agreement such commercial general liability and automobile
liability insurance as will provide coverage for damage claims of personal injury,
including accidental death, as well as for claims for property damage, which may
arise directly or indirectly from the performance of work under this Agreement.
Coverage for property damage shall be on a "broad form" basis. The amount of
insurance for each coverage, Commercial General and Vehicle, shall not be less
than $1,000,000 combined single limits for bodily injury and property damage.
In the event any work is performed by a subcontractor, the Service Provider shall
be responsible for any liability directly or indirectly arising out of the work
performed under this Agreement by a subcontractor, which liability is not covered
by the subcontractor's insurance.
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 12 of 13
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F
Official Purchasing Document
Last updated 10/2017
Services Agreement - Workwell
RFQ 8648 – Drug & Alcohol Testing Page 13 of 13
EXHIBIT D
CONFIDENTIALITY
IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to
this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been
informed that the City has established policies and procedures with regard to the handling of
confidential information and other sensitive materials.
In consideration of access to certain information, data and material (hereinafter individually and
collectively, regardless of nature, referred to as “information”) that are the property of and/or relate
to the City or its employees, customers or suppliers, which access is related to the performance
of services that the Service Provider has agreed to perform, the Service Provider hereby
acknowledges and agrees as follows:
That information that has or will come into its possession or knowledge in connection with the
performance of services for the City may be confidential and/or proprietary. The Service Provider
agrees to treat as confidential (a) all information that is owned by the City, or that relates to the
business of the City, or that is used by the City in carrying on business, and (b) all information
that is proprietary to a third party (including but not limited to customers and suppliers of the City).
The Service Provider shall not disclose any such information to any person not having a legitimate
need-to-know for purposes authorized by the City. Further, the Service Provider shall not use
such information to obtain any economic or other benefit for itself, or any third party, except as
specifically authorized by the City.
The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have
no obligation under this Agreement with respect to information and material that (a) becomes
generally known to the public by publication or some means other than a breach of duty of this
Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the
request for such disclosure is proper and the disclosure does not exceed that which is required.
In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this
Agreement to anyone to whom it is required to make such disclosure and shall promptly advise
the City in writing of each such disclosure.
In the event that the Service Provider ceases to perform services for the City, or the City so
requests for any reason, the Service Provider shall promptly return to the City any and all
information described hereinabove, including all copies, notes and/or summaries (handwritten or
mechanically produced) thereof, in its possession or control or as to which it otherwise has
access.
The Service Provider understands and agrees that the City’s remedies at law for a breach of the
Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that
the City shall, in the event of any such breach, be entitled to seek equitable relief (including without
limitation preliminary and permanent injunctive relief and specific performance) in addition to all
other remedies provided hereunder or available at law.
DocuSign Envelope ID: 93D77A88-599E-4277-8B9C-046754BFB24F