HomeMy WebLinkAbout25L - AGMT - PRE-EMPLOYMENT SRVSREQUEST FOR
COUNCIL ACTION
CITY COUNCIL MEETING DATE:
JUNE 19, 2018
TITLE:
APPROVE AN AGREEMENT WITH
OCCU-MED, LTD. FOR MEDICAL SERVICES
FOR CITY EMPLOYEES AND PRE-EMPLOYMENT
ASSESSMENTS (STRATEGIC PLAN NO. 7,51E)
CITY M N GER
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
APPROVED
❑ As Recommended
❑ As Amended
❑ Ordinance on 15t Reading
❑ Ordinance on 2nd Reading
❑ Implementing Resolution
❑ Set Public Hearing For_
CONTINUED TO
FILE NUMBER
Authorize the City Manager and Clerk of Council to execute an agreement with Occu-Med Ltd.,
subject to non -substantive changes approved by the City Manager and City Attorney, to provide
comprehensive medical services to City employees and pre-employment assessments for
prospective employees for the period of July 1, 2018 through June 30, 2019, in the amount not to
exceed $115,000.
DISCUSSION
Since June 1, 2015, the City has contracted with Occu-Med Ltd. to provide the following medical
services:
• Pre-employment medical examinations and screenings
• Post -exposure medical examinations and screenings
• Fitness for duty examinations
• Department of Motor Vehicle (DMV) Driver's License physical examinations
• Certain Department of Transportation (DOT) related drug and alcohol examinations and
screenings;
• California OSHA (Occupational Safety and Health Act) occupational testing such as periodic
evaluation of respiratory, audio, and chest functions as well as Hepatitis vaccinations and
boosters, as needed.
The current agreement expires on June 30, 2018. Staff is recommending that the City enter into a
one-year agreement with Occu-Med Ltd. to continue comprehensive medical services to City
employees and pre-employment employees per the attached agreement. During this time, the City
will conduct a Request for Proposal (RFP) for such services.
25L-1
Approve an Agreement
with Occu-Med, Ltd.
June 19, 2019
Page 2
STRATEGIC PLAN ALIGNMENT
Approval of item allows the City to meet Goal #7 -Team Santa Ana, Objective #5, (Create a culture
of innovation and efficiency within the organization), Strategy E, (Identify best practices and
opportunities for process improvement and automation across City departments in order to provide
effective and efficient delivery of City services to the community.)
FISCAL IMPACT
Funds are budgeted and available in the various departmental Contractual Services - Professional
accounts (no. 62300). The estimated amount of expenditures in FY 2018-2019 is $115,000.
Human Resources Department
APPROVED AS TO FUNDS AND ACCOUNTS:
Francisco Gutierrez-
Executive
utierrezExecutive Director�"�
Finance and Management Services Agency
Exhibit: 1. Agreement between the City and Occu-Med Ltd.
25L-2
AGREEMENT WITH OCCU-MED
TO PROVIDE MEDICAL SERVICES
THIS AGREEMENT is made and entered into this 19' day of June, 2018 by and between Occu-Med, Ltd.,
a Delaware corporation ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation
organized and existing under the Constitution and laws of the State of California ("City").
RECITALS
A. The City desires to retain a consultant having special skill special skill, knowledge and expertise in
the field of providing a fully comprehensive and legally defensible medical services review
program including, but not limited to: pre-employment assessments, drug tests, fitness for duty
exams, and medical review officer.
B. Consultant represents that Consultant is able and willing to provide such services to the City.
Consultant has been providing these services to the City since 2015.
C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable
in its field and that any services performed by Consultant under this Agreement will be performed
in compliance with such standards as may reasonably be expected from a professional consulting
firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and
conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
Consultant shall organize, schedule, manage, and/or evaluate a comprehensive range of medical
services and examinations, as set forth in Exhibit A.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates
and charges identified in Exhibit B. The total amount to be expended under this Agreement
shall not exceed $100,000.
a. Payment by City shall be made within 45 days (forty-five) days following receipt of proper
invoice evidencing work performed, subject to City accounting procedures. Payment need not
be made for work which fails to meet the standards of performance set forth in the Recitals
which may reasonably be expected by City.
3. TERM
This Agreement shall commence on July 1, 2018 for a one (1) year term, unless terminated earlier
in accordance with Section 15, below.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an independent
contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to
create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise
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discretion or control over the professional manner in which Consultant performs the services which are the
subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in
a manner consistent with all applicable standards and regulations governing such services. Consultant shall
pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes
relating to employees and shall be responsible for all applicable withholding taxes.
5. OWNERSHIP OF MATERIALS
This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse,
or sublicense any and all copyrights, designs, and other intellectual property embodied in plans,
specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any
tangible medium of expression, including but not limited to, physical drawings or data magnetically or
otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under
this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that
City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares
under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any
and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents
& Data which were provided to Consultant by the City. City shall not be limited in any way in its use of
the Documents and Data at any time, provided that any such use not within the purposes intended by this
Agreement shall be at City's sole risk.
6. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall maintain and
shall require its subcontractors, if any, to obtain and maintain insurance as described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial general
liability insurance naming the City, its officers, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection
against claims arising from bodily and personal injury, including death resulting therefrom
and damage to property, resulting from any act or occurrence arising out of Consultant's
operations in the performance of this Agreement, including, without limitation, acts
involving vehicles. The amounts of insurance shall be not less than the following: single
limit coverage applying to bodily and personal injury, including death resulting therefrom,
and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000
in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents,
and representatives as additional insured(s); (b) be primary and not contributory with
respect to insurance or self-insurance programs maintained by the City; and (c) contain
standard separation of insureds provisions.
b. Business automobile liability insurance, or equivalent form, with a combined single limit
of not less than $1,000,000 per occurrence. Such insurance shall include coverage for
owned, hired and non -owned automobiles.
C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of
the Labor Code, Consultant, if Consultant has any employees, is required to be insured
against liability for worker's compensation or to undertake self-insurance. Prior to
commencing the performance of the work under this Agreement, Consultant agrees to
obtain and maintain any employer's liability insurance with limits not less than $1,000,000
per accident.
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d. If Consultant is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and omissions) insurance, with a combined single limit of not
less than $1,000,000 per claim with $2,000,000 in the aggregate.
e. The following requirements apply to the insurance to be provided by Consultant pursuant
to this section:
i. Consultant shall maintain all insurance required above in full force and effect for
the entire period covered by this Agreement.
ii. Certificates of insurance shall be furnished to the City upon execution of this
Agreement and shall be approved by the City.
iii. Certificates and policies shall state that the policies shall not be canceled or
reduced in coverage or changed in any other material aspect without thirty (30)
days prior written notice to the City.
iv. Where the amounts or coverage provided by the certificates of insurance provides
coverage greater than those listed by this Agreement, the amounts provided by the
certificates of insurance shall be incorporated by reference into the Agreement.
V. Consultant shall supply City with a fully executed additional insured endorsement.
f. If Consultant fails or refuses to produce or maintain the insurance required by this section
or fails or refuses to furnish the City with required proof that insurance has been procured
and is in force and paid for, the City shall have the right, at the City's election, to forthwith
terminate this Agreement. Such termination shall not affect Consultant's right to be paid
for its time and materials expended prior to notification of termination. Consultant waives
the right to receive compensation and agrees to indemnify the City for any work performed
prior to approval of insurance by the City.
7. INDEMNIFICATION
Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents,
employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages,
just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including
death, and claims for property damage, which may arise from the negligent operations of the Consultant,
its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services
described in section I of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from
this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just
compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason
of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement.
The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City,
including fees and costs for special counsel to be selected by the City, regarding any action by a third party
challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation,
restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or
effects arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services
are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by
Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness,
or willful misconduct of the Consultant.
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8. INTELLECTUAL PROPERTY INDEMNIFICATION
Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees
against any and all liability, including costs, for infringement of any United States' letters patent, trademark,
or copyright infringement, including costs, contained in the work product or documents provided by
Consultant to the City pursuant to this Agreement.
L' 9 DEV -11 11
Consultant shall keep records and invoices in connection with the work to be performed under this
Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred
under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum
period of three (3) years, or for any longer period required by law, from the date of final payment to
Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant
shall allow a representative of the City to examine, audit, and make transcripts or copies of such records
and any other documents created pursuant to this Agreement during regular business hours. Consultant
shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement
for a period of three (3) years from the date of final payment to Consultant under this Agreement.
10. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such information is
reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or
disclose such information except in the performance of this Agreement, and further agrees to exercise the
same degree of care it uses to protect its own information of like importance, but in no event less than
reasonable care. "Confidential Information" shall include all nonpublic information. Confidential
information includes not only written information, but also information transferred orally, visually,
electronically, or by other means. Confidential information disclosed to either party by any subsidiary
and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and
nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources;
(b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession
of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of
law; or (e) is independently developed by the Consultant without reference to information disclosed by the
City. Consultant shall abide by all appreciable medical privacy laws including, but not limited to, the Health
Insurance Portability and Accountability Act ("HIPAA").
11. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have interests, direct or indirect,
which would conflict in any manner with performance of services specified under this Agreement.
12. DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual
orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the
recruitment, selection, training, utilization, promotion, termination or other employment related activities.
Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal,
state and local laws and regulations.
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13. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and Consultant,
and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict
between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail.
This Agreement may not be modified except by written instrument signed by the City and by an authorized
representative of Consultant. The parties agree that any terns or conditions of any purchase order or other
instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or
obligate Consultant or the City. Each party to this Agreement acknowledges that no representations,
inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting
on behalf of any party, which is not embodied herein.
14. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant
may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of
the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent
shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability
to have any of the services which are the subject to this Agreement performed by City personnel or by other
consultants retained by City.
i[.. I I s1:1u 11M14I (IM
This Agreement may be terminated by the City upon thirty (30) days written notice of termination.
In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all
services performed by Consultant prior to receipt of such notice of termination, subject to the following
conditions:
a. As a condition of such payment, the Executive Director may require Consultant to deliver
to the City all work product(s) completed as of such date, and in such case such work
product shall be the property of the City unless prohibited by law, and Consultant consents
to the City's use thereof for such purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of performance
specified in the Recitals of this Agreement.
No waiver of breach, failure of any condition, or any right or remedy contained in or granted by
the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving
the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a
waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute
a continuing waiver unless the writing so specifies.
17. JURISDICTION - VENUE
This Agreement has been executed and delivered in the State of California and the validity,
interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined
and governed by the laws of the State of California. Both parties further agree that Orange County,
California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection
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with or by reason of this Agreement.
18. PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits,
approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by
the laws and regulations of the United States, the State of California, the City of Santa Ana and all other
governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain
or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for
termination of this Agreement.
19. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature herein below has the power,
authority and right to bind their respective parties to each of the terns of this Agreement,
and shall indemnify City fully, including reasonable costs and attorney's fees, for any
injuries or damages to City in the event that such authority or power is not, in fact, held by
the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth
in the body of this Agreement.
20. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be
in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified
mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this
Section, to the following persons:
To City:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Fax: 714- 647-6956
With courtesy copies to:
Steven Pham
Executive Director, Human Resources
City of Santa Ana
20 Civic Center Plaza (M-24)
P.O. Box 1988
Santa Ana, California 92702
Fax: 714-647-6930
To Consultant:
Occu-Med
Attn: Christopher St. George
2121 West Bullard Avenue
Fresno, CA 93711
Fax: 559-435-7200
Sonia R. Carvalho
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
Fax: 714- 647-6515
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A party may change its address by giving notice in writing to the other party. Thereafter, any
communication shall be addressed and transmitted to the new address. If sent by mail, communication shall
be effective or deemed to have been given three (3) days after it has been deposited in the United States
mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax,
communication shall be effective or deemed to have been given twenty-four (24) hours after the time set
forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above.
For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be
excluded.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above
written.
ATTEST:
Maria D. Huizar
Clerk of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: k" F _
Laura A. Rossini
Senior Assistant City Attorney
RECOMMENDED FOR APPROVAL:
Steven Pham,
Executive Director, Human Resource
CITY OF SANTA ANA
Raul Godinez II
City Manager
CONSULTANT:
By:
Title:
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EXHIBIT A
SCOPE OF SERVICES
25L-10
Exhibit A
City of Santa Ana
Response to Request for Updated Scope of Work
Submitted by:
V
OCCU-MED
May 31, 2018
Corporate HQ - 2121 West Bullard Avenue, Fresno, CA 93711
TAX ID: #522333519
CA Corporate: #C2472806
559.435.7200 - Fax
Contact:
Chris St. George
559.435.2800 x207 - Telephone
cstgeorge@occu-med.com
www.occu-med.com
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City of Santa Ana Response to Request for Updated Scope of Work f 5/31/18
Table of Contents
Page Number
Company Identification COVER PAGE
Organizational and Credentials
Qualifications and Experience of Key Personnel
Scope of Services (Technical Proposal)
Work Plan
Billing/Reporting 15
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City of Santa Ana Response to Request for Updated Scope of Work 1 5/31/18
I. Organizational and Credentials
Occu-Med's founder (now President and CEO of the company) directed a project (which eventually
expended more than $2 million in cash and in-kind contributions) funded by the United States Civil
Service Commission in 1976 "to develop and implement an improved system of physical and medical
standards and procedures for employment." The goals of this project were: a) to ensure workers were
able to safely perform the essential function of their jobs, b) reduce the costs associated with worker
injuries, and c) protecting the rights of the disabled by developing a medically appropriate and legally
defensible methodology for determining what medical conditions, injuries or illnesses allowed for
reasonable accommodation. The Director of this project, Jim Johnson, having spent his previous two
years at the County Supervisors' Association of California ("CSAC") as, among other assignments, staff
to the statewide association of District Personnel Administrators, obtained a secondary grant to expand
this project to include the entire state of California and to form an Advisory Group of representatives
from more than thirty Counties, several Cities and various state and federal agencies enforcing the newly
enacted legislation protecting the employment rights of the handicapped. Based on the original research
conducted then, Occu-Med's methodology for managing employment medical evaluations was born.
Occu-Med has gained a thorough understanding of employment laws and regulations over its 35 years of
providing these services, and we know the importance of having a complete understanding of the physical
and environmental factors that the employee will face in the workplace before a placement
recommendation is made. Occu-Med has both legal and medical staff, and, because we thoroughly
understand medicine, the law and the requirements of the job in question, we are able to confidently
permit placement of applicants and employees who are able to safely perform the essential duties of the
job with or without reasonable accommodation and are able to recommend (just as confidently) the
disqualification of individuals who are unable to safely perform the essential duties of the job (again, with
or without reasonable accommodation). For example, as part of our services we track, monitor and opine
on updates to the Occupational Health and Safety Administration (OSHA) and the Americans with
Disabilities Act Amendments Act of 2008 (ADAAA), Health Insurance Portability and Accountability
Act (HIPAA), the California Fair Employment and Housing Act (FEHA), Peace Officer Standards and
Training (POST) Guidelines and National Fire Protection Associated Guidelines (NFPA) 1582 which
sometimes go unnoticed by Risk Managers and ESH&S personnel, yet it is the employer who will be left
to pay the bill should an applicant be tested inappropriately during a pre -placement medical exam. And
just as importantly we ensure the quality of each clinic, provider, and laboratory in our medical network
including: Joint Commission, State Medical Board and SAMHSA accreditation. We believe it is
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City of Santa Ana Response to Request for Updated Scope of Work 15/31/18
incumbent upon Occu-Med to remain an authority in the relevant legal changes within which such
employment decisions must be made. We have received numerous testimonies from our clients regarding
the quality of our service.
Occu-Med is open Monday -Friday 7am-6pm PT. Occu-Med maintains multiple offices throughout the
United States including one in Denver, CO, Fort Worth, TX and Washington DC. Between the four (4)
offices we maintain an average staff of approximately 60 employees. Correspondence regarding our or
updated Scope of Work can be directed to Christopher St. George at either address listed on our cover
page or by phone at: 559.435.2800 x207.
Qualifications and Experience of Key Personnel/Staffing
Occu-Med's Medical Director is Devonna M. Kaji M.D.
Dr. Kaji graduated Magna Cum Laude from the University of California, Berkeley and the University of
Hawaii, John A. Burns School of Medicine. She received her surgery training at the University of
Southern California and is a Board Certified Urologist. She has served as Professor of Urology and
Assistant Chief of the Department of Urology at the Children's Hospital of Los Angeles, the University of
Southern California and the University of Colorado. Dr. Kaji has served on Occu-Med's Board of
Directors and managed its Medical Advisory Board for more than 30 years, and she has been the
Company's Medical Director for more than 20 years. She has participated in all of the Company's
medical research, having met with the medical specialists and sub -specialists representing 12 separate
body systems who initially formulated Occu-Med's Compendium of Medical Standards. She has
continued to supervise and participate in every medical research meeting addressing the continued
effectiveness and appropriateness of this Compendium of what is now termed Medical Guidelines. Dr.
Kaji supervises all medical specialists currently on retainer to Occu-Med. Further, as Medical Director,
Dr. Kaji oversees all medical aspects of the Company's EXAMQA program.
Occu-Med's internal Team Assigned to the City's account is Team Bailey please find their contact
information listed below:
earn Bailey x 1.559.435.2800
Iristi-fa De-?,u?,u =WWIIII C 1
.� �-,-,u C. u.i7•-
4 1 Occu-Med
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City of Santa Ana Response to Request for Updated Scope of Work 1 5/31/18
II. Scope of Services (Technical Proposal)
Occu-Med contracts with multiple medical providers throughout the Orange County area which will
allow the City's applicants and employees to always attend an appointment close to his or her current job
or home. This service extends beyond the City's immediate geographical area, as Occu-Med has over
5,000 medical providers nationwide, so no matter where the City is recruiting from rest -assured
Occu-Med will have a clinic nearby. Currently, Occu-Med's primary network of clinics for the City of
Santa Ana will consist of:
Gateway Medical Associates Safeway Elevated Health
Anaheim, CA Santa Ana, CA Huntington Beach, CA
Work Plan
A. Pre -Placement Medical Evaluations
PREAMBLE
QA' is the name given to Occu-Med's end-to-end solution for the scheduling and on-going review of all
medical examinations for applicants or employees for jobs with the City. When applicable the same
methodology outlined in this section for scheduling, tracking and reporting the results of the medical
exam will be applied when scheduling annual, surveillance and fitness -for -duty exams as well. This
service includes Occu-Med's review of exams, the further investigation of medical conditions identified
during these exams (through the "RDQA" service --see description), the preparation of letters to applicants
or employees who are determined to be Medically Disqualified for the job for which they applied or
currently work-in, an analysis of Reasonable Accommodation for each individual Medically Disqualified,
and the preparation of periodic (daily, when useful) production / performance / status reports.
Scheduling
Scheduling pre -placement, or periodic medical exams through Occu-Med could not be easier. A City
representative contacts Occu-Med's Exam Scheduling Hotline or submits an Occu-Med Exam
Requisition Form via e-mail, and the necessary medical exam is scheduled the same day as the referral.
Occu-Med within two (2) hours of receipt of your referral will contact your applicant or employee in
order to arrange a medical appointment with him or her. Upon completion of scheduling, your
representative will immediately receive email confirmation of the appointment time and date, which will
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City of Santa Ana Response to Request for Updated Scope of Work G 5/31/18
be scheduled to occur within 2 business days of the referral (or as directed by the City). Normally, the
exam will be scheduled at: one of the local medical providers identified however, with your permission,
exams could be scheduled at an alternative nearby clinic if the preferred clinic is booked out beyond
acceptable time periods or if the applicant lives closer to an alternative clinic. Upon scheduling the
medical exam the applicant is provided in advance all the necessary paperwork in order to complete the
exam successfully. This includes a copy of Occu-Med's GINA compliant medical history forms which
are used in place of the local medical providers' forms. We do this to ensure no inappropriate medical
history questions are solicited as often times, clinic specific forms lack compliance as they are used for
various other types of medical evaluations.
Having scheduled the medical exam, and with knowledge of the length of time required to obtain results
from the medical testing included in the exam (i.e., PPD test for tuberculosis takes 48 to 72 hours for
results), Occu-Med contacts the medical provider to request, or "harvest," the exam at the absolute
earliest time that it should be ready for review. This service has cut exam turnaround time for our clients
in half in almost every case. Thus, eliminating a clinic from "holding" an exam until they have staff that
can fax or email the results. Occu-Med commits to submitting a Medical Exam Summary Report to the
City on the same day the complete medical exam is received (provided it is received before 4:OOPM PT).
EXAMQA
When reviewing an exam Occu-Med combines:
a) a thorough knowledge of the essential physical and environmental components of the jobs in
question;
b) the medical expertise to gather all necessary and appropriate medical information upon which to
base safe placement, return -to -work and fitness -for -duty recommendations; and,
c) extensive knowledge of the legal constraints within which such hiring decisions must be made.
This aspect of our services means that Occu-Med and its medical review staff review all completed
medical exams and it is Occu-Med's recommendation that is made to the City regarding an applicant or
employees safe placement. This process ensures that pertinent aspects regarding a placement decision are
considered and not just those in the examining physician's purview. For Conditional Qualifications (CQ),
an Employment Agreement accompanies each such report. For Recommended Delayed for Qualification
(RDQ), RDQA is initiated with the applicant, and the City is simply notified that the process has begun.
This eliminates the possibility of disclosure of protected personal medical information that may be
undesirable for the City to have received. For each Disqualification (DQ), an appropriate medical -legal
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report is submitted documenting the specific justifications for the disqualification and informing the City
of the requirement of a consideration of Reasonable Accommodation (a process in which we encourage
the City to involve us). Periodic performance reports, addressing both clinic turnaround statistics and
EXAMQA results, are available upon request.
Details regarding Occu-Med's qualification recommendations are as follows:
Occu-Med's Qualification Recommendations and Reports
Medically Qualified — Applicant is an immediate safe placement.
Conditionally Qualified - Applicant may be placed immediately but has work restrictions or
accommodation as outlined on the medical restrictions and/or reasonable accommodations page of the
report. The specific restrictions or accommodations are always included as part of the Conditionally
Qualified Medical Exam Summary Report.
Recommendation Delayed for Qualification — Applicant will be required to submit further information
regarding one or more medical conditions before being placed. This process is facilitated by Occu-Med
via RDQA. The applicant is contacted on the day that he/she becomes delayed and informed that he or
she has 10 business days to complete the request for additional medical information (extensions of the
timeframe can be granted at the City's discretion).
Medically Disqualified — Applicant has been deemed medically unsuited for this job class and will not be
1p aced. Occu-Med's report outlining relevant issues will be attached. The City must consider Reasonable
Accommodation for this Medical Disqualification and must determine whether such an accommodation is
feasible.
Recommendation Delayed for Qualification — RDQA
The RDQA process is one of the most elegant and sophisticated services associated with the Occu-Med
Program.
When the Occu-Med recommendation is that a decision be delayed until certain medical information can
be further explored (that is, when the applicant is classified as "Recommendation Delayed for
Qualification"—or "RDQ"—under Occu-Med terminology), Occu-Med will submit that report as well as
an additional report when the requested additional information is received and Occu-Med is able to offer a
conclusive placement recommendation. Since the law permits making "further medical inquiry" into
medical conditions that could pose a direct threat of injury from the performance of the job's essential
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duties, it is necessary to notify the applicant of the specific findings as well as the information that will be
necessary to submit in order to be cleared for the job. Since City staff may not have the time or the
medical expertise to contact each of these applicants to describe in detail the medical findings and to
answer their questions about the medical information needed for clearance to be approved, Occu-Med
staff communicates directly with these applicants. Further, there is also a growing fear by employers that
they may be receiving medical information about job applicants from medical examinations in violation
of state and federal laws relating to such information (specifically, when the medical condition being
investigated more fully pursuant to an "RDQ" designation is found to be benign in relation to the job's
essential duties). For these reasons Occu-Med has developed—and will institute as part of this contract—
a service designated as "RDQA." Under RDQA Occu-Med corresponds directly with job applicants to
discuss the medical findings, to answer any questions about the medical condition or the process being
employed, and to describe any medical records or documentation required for clearance. Applicants will
have five (5) days to respond to Occu-Med and ten (10) days to provide further information unless the
City dictates the application of different time requirements. The City's staff will simply be notified that
such a review has been initiated, and the City will be informed on a periodic basis (as directed) on the
status of each RDQ. Then, when the requested information is submitted, Occu-Med will prepare the
appropriate clearance report.
Occu-Portal
At the request of the City results will also be made available via an online web -based portal known as the
Occu-Portal.
Occu-Med will provide personnel, designated as authorized by the City, with access to the Occu-Med
Portal. This web -based tool will permit designated the City's personnel to access real-time statuses of
individuals referred to Occu-Med for evaluation. Additional tutorial information regarding utilizing
Occu-Med's vendor portal will also be made available online should new users need training on the site.
Occu-Med will also provide to the City, at its convenience, a telephonic or face-to-face walk-through of
our portal features so that the City can customize which fields it wishes to have appear on the portal.
Occu-Med will create vendor logins for six (6) City personnel, and more can be added at the City's
convenience. Login access will be emailed by Occu-Med to the designated City representatives. It will
be incumbent upon the City to notify Occu-Med should a representative change or no longer require
access. Occu-Med's web -based portal utilizes individualized logins for each client contact and protects
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data transmission by utilizing a 128 -bit SSL security certificate. If the City desires to utilize this service a
nominal monthly charge per user will be applied (see Exhibit Q.
As part of Occu-Med's services Occu-Med serves as the custodian of records for all medical records for
our clients. Occu-Med maintains this information in a HIPAA compliant softcopy that is available to the
City with a one (1) -business day request.
B. DOT MANDATED ALCOHOL AND DRUG TESTING SERVICES
Drug screening at many clinics is "hit or miss." Additionally, if a Medical Review Officer (MRO) is ever
required, that service is subject to a separate fee. And, finally, many issues that arise are beyond the
experience of the clinic to address (i.e., dilute negative tests and shy bladder). Occu-Med has developed a
national program that manages all such drug screening issues for its clients, including assisting in the
development of drug screening programs and procedures, pursuant to CFR Title 49 Part 40. Further, due
to our national purchasing power, we are able to offer attractive pricing with no add-on charges for MRO
services. Further, we are readily available to address any issues in this area that arise this service will be
substituted for the clinic's typical program, ensuring compliance for the DOT drug screen program.
Urine Collections
Occu-Med along with selected medical clinics on our network are able to provide the City a
comprehensive solution for collecting DOT urine drug screens and BAT in compliance with CFR Title
49, PART 40.
Collection sites where the DOT collections can be performed are located in Occu-Med clinic network and
available throughout the City and Orange County, and more will be added based on where the City
identifies the need to have locations for post -accident and after-hours testing.
Only Certified Specimen Collectors having received the CFR Title 49, PART 40.213 Training will be
used for these collections.
All urine results will be sent to MEDTOX Laboratories for confirmation. Medtox is SAMHSA certified
(Federal Register/Vol. 79, No. 27/Monday, February 10, 2014/Notices), and is able to conduct
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confirmatory tests using the split -specimen regulations and MRO confirmation. These results are
typically available within 48-72 hours, with up to 72 additional hours needed if MRO confirmation is
required pursuant to a DOT requirements for a positive finding using GCMS confirmation. When MRO
confirmation is required the City will be notified of the delay.
Breath Alcohol Collections
For BAT confirmation only EBTs on the NHTSA CPL for evidential devices that meet the requirements
of CFR Title 49, PART § 40.231 (b) will be used to conduct alcohol confirmation. These results will be
immediately available to the City.
C. COMERCIAL DRIVER PHYSICAL EXAMINATIONS
Pursuant to 49 CFR § 391.41 Department of Transportation Physical Qualifications and Examination of
Drivers Motor Carrier Safety Regulations, a DMV medical exam will be administered. A Department of
Motor Vehicles Medical Examiners Certificate per 49 CFR 391.41-49 will be prepared by the examining
medical provider and will be given to the employee with a copy emailed by Occu-Med to the City's
Human Resources Department. Pursuant to the May 19, 2014 revisions to the Federal Motor Carrier
Safety Regulations Occu-Med will ensure all medical providers conducting DOT exams are certified on
the National Registry.
As required, Occu-Med will also schedule ancillary required commercial driver components including but
not limited to: DMV DL 51 Medical Examination Report requirements and Audiometric baseline per
CCR Title 8 § 5097 (audiogram an to assess hearing between 500hz-6000hz). Information will be
recorded in accordance with CCR Title 8 § 5097.
D. FITNESS -FOR -DUTY EXAMS
Intensive Return -To -Work Program (IRTW)
Occu-Med, through its Fitness -For -Duty (FFD) and Intensive Return -To -Work (IRTW) Programs,
focuses on delivering employer -oriented analysis regarding injured or disabled employees. Occu-Med has
been an industry leader in employee health solutions for over 36 years, and, through its IRTW division, its
medical and legal expertise is concentrated to provide employers with a valuable perspective on
evaluating whether or not an employee, as a result of an injury or medical condition, can continue to
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perform the essential functions of a job with or without reasonable accommodation
Occu-Med's IRTW Program will provide the City an effective method of managing the possible return to
work of employees who require a medical leave of absence due to injury or medical conditions, as well as
an Americans With Disabilities (ADA) and Fair Employment and Housing Act (FEHA)-compliant
reasonable accommodation forum for engaging such employees. Occu-Med's IRTW Program is currently
in use by hundreds of municipalities, water agencies and fire districts. Occu-Med is uniquely positioned
to assist the City with human resources matters involving complex medical cases that require a prompt
and discerning assessment of the medical factors that may constitute a contraindication to an employee's
performing one or more of the essential functions of the his/her job.
Occu-Med's expert staff guarantees the quality and timeliness of its reports. Our experts range from
physicians, nurses, and physical therapists to legal and human resource professionals. It is through our
expert staff that a quality and consistent service is rendered. Occu-Med's staff and consulting physicians
as well as other medical providers represent a considerable breadth in various medical fields including:
Cardiology, Internal Medicine, Occupational Medicine, Family Practice, Urology, Optometry,
Orthopaedic, Rheumatology, Gastroenterology, Neurology, Toxicology, Pathology, Psychiatry and
Psychology, as well as a consulting audiologist. Our staff and consulting medical providers ensure that
our recommendations are medically appropriate and employer oriented. Additionally, by maintaining
legal staff, our clients can be confident that our recommendations are also legally defensible.
Occu-Med's IRTW Program is ready to be implemented immediately as a turnkey model to the City. The
program is designed to provide the client with the information necessary to make an informed decision
regarding any employee's ability to safely perform the essential functions of his or her job by means of a
legally defensible recommendation. The IRTW Program strategically applies Occu-Med's medical and
legal expertise in order to render medical analysis and recommendations regarding the facts of an
evaluation while considering the applicable laws and regulations. Thus, we also render legally defensible
recommendations throughout the reasonable accommodation process.
The evaluation begins with an assessment of the factors causing the need for the evaluation. This process
is formally started by the submission of the requisition form. The requisition form requests the employee's
contact information, a job description and other peripheral information pertinent to the employee's
situation. The goals are to reduce risk through obtaining specific medical information to determine
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whether or not a pertinent medical condition, injury, or medication being prescribed will affect the
employee's ability to safely perform one or more of the essential functions of the job and to save time by
eliminating costly delays.
Obtain Medical Information
Next, Occu-Med selects the appropriate physician to provide the needed medical information (this can be
the treating physician or an independent specialist). Occu-Med contacts the employee by issuing an
Individualized Assessment/Reasonable Accommodation Letter. The Individualized
Assessment/Reasonable Accommodation Letter will introduce Occu-Med to the employee as the City's
healthcare and human resources consultant and will explain that the IRTW Evaluation is an ADA/FEHA
compliant reasonable accommodation process. Additionally, the letter will inform the employee of the
necessary steps and information required to complete the IRTW Evaluation. The letter, to be made
available to the appropriate physician or physicians designated, requests the specific, appropriate medical
information that will be necessary to determine whether the employee continues to be an appropriate
placement in the job, with or without restrictions. When such medical information is submitted, our
medical staff evaluates it in conjunction with the essential functions of the employee's job to determine
whether a contraindication to job performance exists.
Recommendation
Occu-Med delivers a recommendation to the City through verbal communication followed by a legally
defensible written report outlining the specific process that occurred and how the recommendation was
determined (all while protecting the confidentiality of all medical information that is not job related nor
consistent with business necessity). The recommendation specifically advises the client of whether
Occu-Med recommends that an employee should be returned to work or not returned to work.
Occu-Med's recommendation is outlined in each report and is determined by the evaluation of the medical
information submitted in conjunction with the review of the essential functions of the job class.
The aforementioned qualifications are explained in each report along with the specifics of the case. For
example, sometimes the recommendation is that the employee be retained in or returned to the job with
work accommodations or restrictions. In this case, Occu-Med will provide the requested restrictions or
accommodations to the client, and the client must then identify the necessary accommodations or
restrictions that are reasonable, if any. Thus, the City's obligation to reasonable accommodation of the
employee is met. Job assessment is completed and the employee can be returned to work in the same
job if the recommended accommodations are indeed reasonable.
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In the event that the restrictions or accommodations aren't reasonable, the client must then determine if an
alternate job, for which the employee is otherwise qualified (retains the necessary knowledge, skills and
abilities), exists and is presently vacant, allowing the employee to return to work with the City under a
new job title. If alternative job placement is not available, the client now has legally defensible
documentation to justify that the proposed accommodations are unreasonable. Occu-Med's report (Med-
Legal Analysis) integrates the functional limitations of the employee and the legal and practical
ramifications regarding the agency's ability to accommodate the employee's restrictions or
the legally appropriate path for terminating the employee. Occu-Med considers all the relevant factors of
the case before rendering a medically appropriate and legally defensible job suitability recommendation.
In cases where the employee is unresponsive to Occu-Med's correspondence a report documenting the
attempts to contact the employee and the employee's failure to engage in the reasonable accommodation
process will be provided to the City. With the City's approval, a Notification of Medical Disqualification
(Failure to Engage in the Reasonable Accommodation Process) letter will be sent to explain to the
employee that his or her lack of response to the Individualized Assessment/Reasonable Accommodation
invitation constitutes his or her failure to engage in the reasonable accommodation process. This letter
may also be used in the case that the employee's medical condition is a contraindication to job placement
and no reasonable accommodation could be made. Occu-Med's IRTW Report and recommendation will
allow the City to make an informed, legally defensible decision as to whether or not an employee should
be returned to work.
E. Occu-VAX
Occu-VAX is the scheduling and coordination, immunization record management and the on-going
management of all immunization and chemoprophylaxis treatments for applicants and employees for jobs.
This service includes an individualized evaluation of each applicant / employee to assess the
appropriateness and necessity for administering the immunization and chemoprophylaxis treatments
outlined in the specific Occu-VAX Profile prior to and, when appropriate, during employment.
Scheduling and Coordination: Upon completion of the medical evaluation or concurrently by
requirement or request from a designated City employee, Occu-Med will promptly contact applicants /
employees to: a) assess the appropriateness and necessity for receiving immunization and
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chemoprophylaxis treatments, and b) schedule and coordinate the administration of those immunization
and chemoprophylaxis treatments deemed appropriate and necessary prior to and during employment.
Immunization Record Management: Applicants and employees will be given an immunization record
(documentation of immunization history) upon completion of: a) initial administration of immunization
and chemoprophylaxis treatments; or b) an assessment concluding that no immunization or
chemoprophylaxis treatments are necessary. Immunization records for all applicants and employees
evaluated will be maintained electronically by Occu-Med. In the event an applicant for employee
declines an immunization Occu-Med will obtain the appropriate declination from the individual.
On -Going Immunization Management: All immunization and chemoprophylaxis treatments
recommended by NFPA, POST or the CDC will be managed by Occu-Med. This service includes
tracking to assure compliance with the CDC, in addition to other applicable guidelines; notification of
employees and designated supervisory personnel of all periodic follow-ups associated with immunization
and chemoprophylaxis treatments; and, upon request, preparation and provision of customized tracking
reports documenting any aspect of the immunization and chemoprophylaxis treatment program.
Occu-VAXis a dynamic service that any employer can access, from including a Hepatitis B Titer as part
of a pre -placement evaluation so that Hepatitis immunity can be immediately documented, or providing
on-site flu immunizations during the flu season. Should the City elect to incorporate Occu-VAX a medical
records management fee would be applied.
OSHA Respirator Medical Evaluation Questionnaire review pursuant to CCR Title 8 § 5144.
Occu-Med will administer OSHA Respirator Medical Evaluation Questionnaire pursuant to CCR Title 8 §
5144 to the applicant once the referral is received. Occu-Med can either use the City's form, or the
Cal/OSHA form. These forms will be provided to the applicant electronically. Once returned to
Occu-Med the OSHA Respirator Medical Evaluation Questionnaire is reviewed by one of our physicians
or other licensed health care professional (PLHCP). When necessary, the applicant or employee will
undergo a Pulmonary Function Test Occu-Med requires that three (3) blows be taken with the best result
becoming the medical record.
Additional Annual Physicals
Based on coordination with the City Occu-Med is able to provide those physical and associated medical
exam components as well. These physicals would be scheduled and coordinated much the same way as
described in the Pre -Employment Physical Exam section of the document. Occu-Med and the City would
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need to coordinate on the appropriate reporting channel for results in order to ensure only information that
is job related and is consistent with business necessity will be shared with the City. Occu-Med is
prepared to expertly advise the City on the matter.
F. BILLING AND REPORTING
Occu-Med maintains a database of all exams that we review, and we have done so for the City's
evaluations since 2015, Occu-Med has regularly provided the City with an annual report documenting the
results of our work. Clinic performance reports documenting accuracy and turnaround times for exams
are also available to our clients upon request. Occu-Med will work with the City to establish what
specific information the City wishes to receive in each report.
As documented in our May 1, 2018 correspondence to the City Occu-Med is able to maintain our fees at
the current rate for the 1 -year extension to our contract (fee schedule enclosed).
EXAMQA Report Fee
Our EXAMQA services consists of our customary review fee which includes the following:
• Scheduling of each medical exam
• Tracking each medical exam for applicant/employee attendance
• Harvesting all medical exam results from the clinic
• Occu-Med Medical Network allowing City applicants to be seen anywhere in the United States
• Review and evaluation of completed medical examinations with results sent to you on the same
day that the exam is received
• Written reports for each review undertaken for each applicant
• Employment Agreements for any employees placed with accommodations
• Additional reviews for applicants with medical or physical conditions requiring further testing or
submission of additional information
• Explanation (by telephone and by letter) to prospective employees of additional medical
information necessary for job clearance
• Submission of legally defensible hiring recommendations
• Assistance with reasonable accommodation recommendations
• Consultation relative to pre -placement, retum-to-work, and fitness -for -duty issues
• RDQA services
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Assurance of excellent clinic performance issues, as needed
• Periodic reports documenting the results of Occu-Med's work
QAzfees that the City would pay directly to the medical clinic, but without all the hassle of dealing with
"MEDICAL BILLING INVOICES" Occu-Med began its Clinic Bill Review service in 2006 as part of its
service to ITT, a company charged with deploying employees to Iraq, Kuwait, Qatar and Afghanistan for
various major federal projects in that region. We have evaluated more over 100,000 clinic invoices for
pre -placement exams over this span of time and have been absolutely appalled at our findings: a) more
than 92% of these clinic invoices were initially submitted with inaccuracies (wrong charges for tests not
performed, charges for unnecessary testing performed, duplicate billings); and b) much worse is the fact
that nearly all of the incorrect invoices were inaccurate in favor of the clinic.
Occu-Med requires the submission of an accurate invoice for payment—at which point we immediately
submit payment to the clinic. We submit our invoice to the City as a single fee (as negotiated) for an
exam— as the City's request our invoice will also include a list of itemized charges, however, the charges
will always add up to the pre -agreed negotiated fee. Clients have informed us that this "bill review"
service alone has literally saved days of staff time. Another client, upon learning of this billing trend,
audited the previous year's invoices and was able to obtain a refund of more than $3,000 for exams
performed.
On the first day of each month, Occu-Med will submit an invoice to the City for the prior month's
medical services and examinations. Our invoices will be itemized by the date of service, name of person
examined, type of physical performed, itemized charges for each type of physical (if applicable), a
subtotal for each person examined, and a total of charges for the month being billed.
Our knowledge of the precise medical exam components that are of value for each specific job class
(eliminating useless, improper and overly expensive medical tests), our ability to negotiate fair and
reasonable charges from providers for medical exams, our national buying power for laboratory services
(blood chemistry panels and urine drug screens), and our careful auditing of clinic and laboratory charges
allow us to offer a vastly expanded array of services to our clients for fees typically charged by their
medical provider for just the medical examination and laboratory charges.
Occu-Med will in -turn be able to continue to submit clear and straightforward monthly invoices to the
City. This stands in contrast to the amorphous and often incorrect invoices typically submitted by clinics.
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INSURANCE
Occu-Med provided the necessary insurance information to the City in our May 2, 2018 correspondence
(also attached herein).
Thank you for the opportunity to provide the City an updated Scope of Work, we look forward to hearing
from you.
Proposal Respectfully Submitted By:
Christopher St. George
Business Development Director
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EXHIBIT B
COMPENSATION (RATES)
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