HomeMy WebLinkAbout461367 WORKWELL OCCUPATIONAL MEDICINE - CONTRACT - RFP - 7438 MEDICAL PROVIDER - WORKERS COMPENSATION & DOAmendment #01
Services Agreement between The City of Fort Collins
and Workwell Occupational Medicine LLC
This Amendment (“Amendment”) is entered into by and between Workwell Occupational Medicine LLC
(the “Service Provider”) and the City of Fort Collins, Colorado (the “City”).
WHEREAS, Service Provider and the City have mutually entered into a Service Agreement
commencing on February 1, 2013; and
WHEREAS, the City desires to amend the Scope of Work to change the personnel requirement for
initial treatment of injuries; and
WHEREAS, the Service Provider agreed to the personnel requirements change for initial treatment of
injuries;
NOW, THEREFORE, in consideration of the foregoing recitals and the mutual promises herein
contained, the parties agree as follows:
1. Exhibit A, Scope of Work. Paragraph 11 of the Scope of Work shall be amended as follows:
From: “City employees shall initially be treated only by Level II accredited physicians for treatment of
injury. Impairment ratings may only be completed by Level II accredited physicians. DOT medical exams
must be completed by a medical examiner licensed, certified and/or registered in accordance with applicable
State and or Federal laws and regulations.”
To: “City employees may initially be treated by physician, PA or RN for treatment of injury.
However, follow up care for lost time, modified or restricted work duty must be performed by a Level II
accredited physician. Impairment ratings may only be completed by Level II accredited physicians. DOT
medical exams must be completed by a medical examiner licensed, certified and/or registered in
accordance with applicable State of Colorado and or Federal laws and regulations.”
2. Exhibit A, Scope of Work. Add a new Paragraph 19 as follows:
“Billing for services shall provide separate itemized monthly invoices for Workers Compensation,
Drug & Alcohol Testing, Medical Monitoring and DOT/CDL medical exams.”
Except as expressly amended by this Amendment, all other terms and conditions of the Agreement shall
remain in full force and effect. In the event of a conflict between the terms of the Agreement and
Amendment #01, Amendment #01 shall prevail.
IN WITNESS WHEREOF, the parties have executed this Agreement the day and year shown.
CITY OF FORT COLLINS:
By:
Gerry Paul
Director of Purchasing & Risk Management
Date: _____________________
WORKWELL OCCUPATIONAL MEDICINE LLC
By:
Stephen G. Pottenger
Chief Executive Officer
Date: _________________________
DocuSign Envelope ID: 645F3B5B-455D-45C1-82BB-3498A2C1760A
3/31/2015 3/31/2015