AMENDMENT NO. 1 TO AGREEMENT BETWEEN
THE CITY OF HUNTINGTON BEACH AND
WITTMAN ENTERPRISES, LLC
FOR
BILLING SERVICES FOR EMERGENCY PARAMEDIC AND AMBULANCE
SERVICE
THIS AMENDMENT is made and entered into by and between the CITY OF HUNTINGTON BEACH, a California municipal corporation, hereinafter referred to as "City," and WITTMAN ENTERPRISE, LLC, a Limited Liability Corporation, hereinafter referred to as "Consultant."
WHEREAS, City and Consultant are parties to that certain agreement, dated October 21, 2019, entitled "Professional Services Contract Between the City of Huntington Beach and Wittman Enterprises, LLC for Billing Services for Emergency Paramedic and Ambulance Service" which agreement shall hereinafter be referred to as the "Original Agreement"; and
City and Consultant wish to amend the Original Agreement to increase the amount of compensation to be paid to Consultant,
NOW, THEREFORE, it is agreed by City and Consultant as follows:
TERM
The term of the Agreement is extended for one additional year until October 20, 2023.
2. REAFFIRMATION
Except as specifically modified herein, all other terms and conditions for the Original Agreement shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on October 20 - 2022. 22-11930/292844 1
WITTMAN ENTERPRISES, LLC CITY OF HUNTINGTON BEACH, a
municipal corporation of the State of
California
Courin Wettmanof
Corinne Wittman ang
print name
ITS: (circle one) Chairman/President/Vice President Mayor AND
City Clerk
By:_
Walter Imboden INITIATED AND APPROVED:
print name
ITS: (circle one) Secretary/Chief Financial
Officer/Asst. Secretary - Treasurer Fire Chief
REVIEWED AND APPROVED: APPROVED AS TO FORM:
City Manager City Attorney leu
COUNTERPART
22-11930/292844 2
WITTMAN ENTERPRISES, LLC CITY OF HUNTINGTON BEACH, a
municipal corporation of the State of
California
By:_
print name Bakera Deges
ITS: (circle one) Chairman/President/Vice President Mayor AND Gobm Istanislaw
City Clerk: 10/27/228
By:_
INITIATED AND APPROVED:
print name
ITS: (circle one) Secretary/Chief Financial Sna
Officer/Asst. Secretary - Treasurer Fire Chief
REVIEWED AND APPROVED: APPROVED AS TO FORM:
City Manager City Attorney
COUNTERPART
22-11930/292844 2
WITTENT-01 JROTH
'ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDYYYY) 6/24/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. { SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policles may require an endorsement. A statement or his certificate does not confer rights to the certificate holder in lieu of such endorsements)
PRODUCER MANIACT
Vaultari Insurance Services 0 0: 888) 524-0798 FAX, No: (866) 206-8646 PO Box 646
Roseville, CA 95678 AREss: [email protected]
INSURERS) AFFORDING COVERAGE NAIC I
INSURER A : Continental Casualty Company
INSURED INSURER B: National Fire Insurance Company of Hartford Wittman Enterprises LLC INSURER C: Employers Preferred Insurance Company 11093 Sun Center Drive INSURER D: Travelers Casualty Insurance Co of Amer 25658 Rancho Cordova, CA 95670 INSURER E: Obsidian Specialty Insurance Company INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO! INDICATED. VOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERN CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIN
INSR ADDL SUBR
LIR TYPE OF INSURANCE INSD WVD POLICY NUMBER LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE. 2,000,000 ] CLAIMS-MADE X OCCUR B6020067350 7/1/2022 7/1/2023 PREASE TO TACA 1,000,000 MED EXP (Any one person). 10,000
PERSONAL & ADV INJURY 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000 X POLICY L 1 SES _ LOC 4,000,000
$
OTHER: APPROVED AS TO FORM 10,000
AUTOMOBILE LIABILITY OMBINED SINGLE LIMI 1,000,000
a accident $
X ANY AUTO 6020087395. 711/2022 7/1/2023 BODILY INJURY (Per person)
AUTOS ONLY SCHEDULED MICHAELE GATES
AURES ONLY CITY ATTORNEY
CITY OF HUNTINGTON BEACH
A X UMBRELLA LIAB X OCCUR 2,000,000
LEACH OCCURRENCE es es en
EXCESS LIAB CLAIMS-MADE 86020067431 7/1/2022 7/1/2023 2,000,000
AGGREGATE
DED | X RETENTIONS 10,000
$
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N/ A EL. EACH ACCIDENT
EL. DISEASE - EA EMPLOYEE S 1,000,000
es, describe un 1,000,000
SCRIPTION OF OPERATIONS be E.L. DISEASE - POLICY LIMIT $ TE&O / Professional L 107019103 1/1/2022 1/1/2023 Agg/Occ 2,000,000 E Cyber Liability PLM-CB-SLKAHXFUM 11/7/2021 11/7/2022 Aggregate/Limit 2,000,000 Phe Cly or untington saco, is oiler, dies ted or appointed ofeis, employees, agents and volunteers will be named as Additional Insured with respects to General Liability per attached endorsement form number SB146932F,
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Huntington Beach THE EXPIRATION DATE ACCORDANCE WITH THE POLICY PROVISIONS E WILL BE DELIVERED IN 2000 Main Street
Huntington Beach, CA 92648
AUTHORIZED REPRESENTATIVE
ACORD 25(2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
PROFESSIONAL SERVICES CONTRACT BETWEEN
THE CITY OF HUNTINGTON BEACH AND
WITTMAN ENTERPRISES, LLC
FOR
BILLING SERVICES FOR EMERGENCY PARAMEDIC AND AMBULANCE SERVICE THIS AGREEMENT ("Agreement") is made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and WITTMAN ENTERPRISES, LLC, a Limited Liability Corporation hereinafter referred to as "CONSULTANT."
WHEREAS, CITY desires to engage the services of a consultant to provide billing services for emergency paramedic and ambulance services; and
Pursuant to documentation on file in the office of the City Clerk, the provisions of the Huntington Beach Municipal Code, Chapter 3.03, relating to procurement of professional service contracts have been complied with; and
CONSULTANT has been selected to perform these services, NOW, THEREFORE, it is agreed by CITY and CONSULTANT as follows:
SCOPE OF SERVICES
CONSULTANT shall provide all services as described in Exhibit "A," which is attached hereto and incorporated into this Agreement by this reference. These services shall sometimes hereinafter be referred to as the "PROJECT."
CONSULTANT hereby designates Corinne Wittman-Wong who shall represent it and be its sole contact and agent in all consultations with CITY during the performance of this Agreement.
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CITY STAFF ASSISTANCE
CITY shall assign a staff coordinator to work directly with CONSULTANT in the performance of this Agreement.
TERM; TIME OF PERFORMANCE
Time is of the essence of this Agreement. The services of CONSULTANT are to commence on October 21, 2019 (the "Commencement Date"). This Agreement shall automatically terminate three (3) years from the Commencement Date, unless extended or sooner terminated as provided herein. All tasks specified in Exhibit "A" shall be completed no later than three (3) years from the Commencement Date. The time for performance of the tasks identified in Exhibit "A" are generally to be shown in Exhibit "A." This schedule may be amended to benefit the PROJECT if mutually agreed to in writing by CITY and CONSULTANT.
In the event the Commencement Date precedes the Effective Date, CONSULTANT shall be bound by all terms and conditions as provided herein.
COMPENSATION
In consideration of the performance of the services described herein, CITY agrees to pay CONSULTANT on a time and materials basis at the rates specified in Exhibit "B," which is attached hereto and incorporated by reference into this Agreement, a fee, including all costs and expenses, not to exceed One Million Eighty Thousand Dollars ($1,080,000).
EXTRA WORK
In the event CITY requires additional services not included in Exhibit "A" or changes in the scope of services described in Exhibit "A," CONSULTANT will undertake such work only after receiving written authorization from CITY. Additional compensation for such extra work shall be allowed only if the prior written approval of CITY is obtained. 19-8011/215114
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6. METHOD OF PAYMENT
CONSULTANT shall be paid pursuant to the terms of Exhibit "B."
DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS
CONSULTANT agrees that title to all materials prepared hereunder, including, without limitation, all original drawings, designs, reports, both field and office notices, calculations, computer code, language, data or programs, maps, memoranda, letters and other documents, shall belong to CITY, and CONSULTANT shall turn these materials over to CITY upon expiration or termination of this Agreement or upon PROJECT completion, whichever shall occur first. These materials may be used by CITY as it sees fit.
HOLD HARMLESS
A. CONSULTANT hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents and volunteers from and against any and all claims, damages, losses, expenses, judgments, demands and defense costs (including, without limitation, costs and fees of litigation of every nature or liability of any kind or nature) arising out of or in connection with CONSULTANT's (or CONSULTANT's subcontractors, if any) negligent (or alleged negligent) performance of this Agreement or its failure to comply with any of its obligations contained in this Agreement by CONSULTANT, its officers, agents or employees except such loss or damage which was caused by the sole negligence or willful misconduct of CITY. CONSULTANT will conduct all defense at its sole cost and expense and CITY shall approve selection of CONSULTANT's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as limitation upon the amount of indemnification to be provided by CONSULTANT. 19-8011/215114
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B. To the extent that CONSULTANT performs "Design Professional Services" within the meaning of Civil Code Section 2782.8, then the following Hold Harmless provision applies in place of subsection A above:
"CONSULTANT hereby agrees to protect, defend, indemnify and hold harmless CITY and its officers, elected or appointed officials, employees, agents and volunteers, from and against any and all claims, damages, losses, expenses, demands and defense costs (including, without limitation, costs and fees of litigation of every nature or liability of any kind or nature) to the extent that the claims against CONSULTANT arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of CONSULTANT. In no event shall the cost to defend charged to CONSULTANT exceed CONSULTANT's proportionate percentage of fault. However, notwithstanding the previous sentence, in the event one or more other defendants to the claims and/or litigation is unable to pay its share of defense costs due to bankruptcy or dissolution of the business, CONSULTANT shall meet and confer with CITY and other defendants regarding unpaid defense costs. The duty to indemnify, including the duty and the cost to defend, is limited as provided in California Civil Code Section 2782.8.
Regardless of whether subparagraph A or B applies, CITY shall be reimbursed by CONSULTANT for all costs and attorney's fees incurred by CITY in enforcing this obligation.
This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONSULTANT.
PROFESSIONAL LIABILITY INSURANCE
CONSULTANT shall obtain and furnish to CITY a professional liability insurance policy covering the work performed by it hereunder. This policy shall provide coverage for CONSULTANT's professional liability in an amount not less than One Million Dollars 19-8011/215114
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($1,000,000.00) per occurrence and in the aggregate. The above-mentioned insurance shall not contain a self-insured retention without the express written consent of CITY; however an insurance policy "deductible" of Ten Thousand Dollars ($10,000.00) or less is permitted. A claims-made policy shall be acceptable if the policy further provides that:
A. The policy retroactive date coincides with or precedes the initiation of the scope of work (including subsequent policies purchased as renewals or replacements).
B. CONSULTANT shall notify CITY of circumstances or incidents that might give rise to future claims.
CONSULTANT will make every effort to maintain similar insurance during the required extended period of coverage following PROJECT completion. If insurance is terminated for any reason, CONSULTANT agrees to purchase an extended reporting provision of at least two (2) years to report claims arising from work performed in connection with this Agreement.
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 effect 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.
10. CERTIFICATE OF INSURANCE
Prior to commencing performance of the work hereunder, CONSULTANT shall furnish to CITY a certificate of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverage as required by this Agreement; the certificate shall:
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A. provide the name and policy number of each carrier and policy; B. state that the policy is currently in force; and
C. shall promise that such policy shall not be suspended, voided or canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice; however, ten (10) days' prior written notice in the event of cancellation for nonpayment of premium.
CONSULTANT shall maintain the foregoing insurance coverage in force until the work under this Agreement is fully completed and accepted by CITY.
The requirement for carrying the foregoing insurance coverage shall not derogate from CONSULTANT's defense, hold harmless and indemnification obligations as set forth in this Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of the policy of insurance. CONSULTANT shall pay, in a prompt and timely manner, the premiums on the insurance hereinabove required.
11. INDEPENDENT CONTRACTOR
CONSULTANT is, and shall be, acting at all times in the performance of this Agreement as an independent contractor herein and not as an employee of CITY. CONSULTANT shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONSULTANT and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services to be performed hereunder.
12. TERMINATION OF AGREEMENT
All work required hereunder shall be performed in a good and workmanlike manner.
CITY may terminate CONSULTANT's services hereunder at any time with or without cause, and whether or not the PROJECT is fully complete. Any termination of this Agreement by CITY shall 19-8011/215114
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be made in writing, notice of which shall be delivered to CONSULTANT as provided herein. In the event of termination, all finished and unfinished documents, exhibits, report, and evidence shall, at the option of CITY, become its property and shall be promptly delivered to it by CONSULTANT.
13. ASSIGNMENT AND DELEGATION
This Agreement is a personal service contract and the work hereunder shall not be assigned, delegated or subcontracted by CONSULTANT to any other person or entity without the prior express written consent of CITY. If an assignment, delegation or subcontract is approved, all approved assignees, delegates and subconsultants must satisfy the insurance requirements as set forth in Sections 9 and 10 hereinabove.
14. COPYRIGHTS/PATENTS
CITY shall own all rights to any patent or copyright on any work, item or material produced as a result of this Agreement.
15. CITY EMPLOYEES AND OFFICIALS
CONSULTANT shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the applicable provisions of the California Government Code.
16. NOTICES
Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONSULTANT's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below. CITY and CONSULTANT may designate different addresses to which subsequent notices, certificates or 19-8011/215114
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other communications will be sent by notifying the other party via personal delivery, a reputable overnight carrier or U. S. certified mail-return receipt requested:
TO CITY: TO CONSULTANT:
City of Huntington Beach Wittman Enterprises, LLC
ATTN: Fire Chief ATTN: Corinne Wittman-Wong, CEO
2000 Main Street 11093 Sun Center Drive
Huntington Beach, CA 92648 Rancho Cordova, CA 95670
17. CONSENT
is required under this Agreement, its
When CITY's consent/approval
consent/approval for one transaction or event shall not be deemed to be a consent/approval to any subsequent occurrence of the same or any other transaction or event.
18. MODIFICATION
No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties.
19. SECTION HEADINGS
The titles, captions, section, paragraph and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of matters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement.
20. INTERPRETATION OF THIS AGREEMENT
The language of all parts of this Agreement shall in all cases be construed as a If any
whole, according to its fair meaning, and not strictly for or against any of the parties. provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining 19-8011/215114
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covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law.
21. DUPLICATE ORIGINAL
The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it.
22. IMMIGRATION
CONSULTANT shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the United States Code regarding employment verification.
23. LEGAL SERVICES SUBCONTRACTING PROHIBITED
CONSULTANT and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONSULTANT understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for 19-8011/215114
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CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONSULTANT.
24. ATTORNEY'S FEES
In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees, such that the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party.
25. SURVIVAL
Terms and conditions of this Agreement, which by their sense and context survive the expiration or termination of this Agreement, shall so survive.
26. GOVERNING LAW
This Agreement shall be governed and construed in accordance with the laws of the State of California.
27. SIGNATORIES
Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully 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.
28. ENTIRETY
The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiation, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this 19-8011/215114
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Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, factor circumstance not expressly set forth in this Agreement. This Agreement, and the attached exhibits, contain the entire agreement between the parties respecting the subject matter of this Agreement, and supersede all prior understandings and agreements whether oral or in writing between the parties respecting the subject matter hereof.
29. EFFECTIVE DATE
This Agreement shall be effective on the date of its approval by the City Council.
This Agreement shall expire when terminated as provided herein. 19-8011/215114
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IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers.
CONSULTANT, CITY OF HUNTINGTON BEACH, a
municipal corporation of the State of
WITTMAN ENTERPRISES, LLC California
Was shank
Imboden Kin Istanishaw
print name
ITS: (circle one) Chairman/President/Y ice President City Clerk 10/35/19 8
AND INITIATED AND APPROVED
By. Kathy SHua
Kathryn S. Garcia Fire Chief
print name
ITS: (circle one) Secretary/Chief Financial Officer/Asst.
Secretary - Treasurer
REVIEWED AND APPROVED:
City Manager
City Attorney
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EXHIBIT "A"
A. STATEMENT OF WORK: (Narrative of work to be performed) Wittman Enterprises, LL will conduct emergency paramedic and ambulance billing services for the City of Huntington Beach.
B. CONSULTANT'S DUTIES AND RESPONSIBILITIES:
Private Billing
Wittman Enterprises, LLC to prepare all invoices and follow-up mailings. Initial invoicing with both English and Spanish instructions will be on 8 X 11 billings and will be placed in envelopes, sealed and mailed, postage prepaid. Initial invoicing occurs within three (4) days of receipt of transport tickets. Toll Free 800 telephone number provided to patients. An initial telephone call will also be made at this time to elicit any insurance information from the patient or patient'S family. If we receive no answer on this call, Wittman's will send an inquiry letter in addition to the initial invoice. The standard bill schedule is as follows:
Private Bill Schedule
1. Invoice Immediately
2. Statement 30 days
3. Past Due 20 days
4. Final Demand 10 days
Medicare, Medicaid, Medi-Medi
Wittman Enterprises, LLC to prepare all invoices and electronically convey to Medicare and Medicaid/Medi-Cal fiscal intermediaries.
All secondary and coinsurance billing transferred to the appropriate secondary pay source and promptly billed to that source.
III. Workers' Compensation and Private Insurance
Wittman Enterprises, LLC to bill private insurance, supplemental insurance, secondary insurance and Workers' Compensation billed according to specific requirements. Electronic billing of insurance companies is performed where appropriate. Any correspondence for additional information or follow up necessary to secure insurance payments will be performed by Wittman Enterprises, LLC.
Delinquent Claim Handling
Patients with claims aging over 45 days will be contacted by telephone for payment arrangements.
Telephone follow up will continue until payment in full is received or account is dismissed by the City to an outside collection agency.
Wittman Enterprises, LLC will utilize installment billing as allowed by the City in cases of financial hardship.
EXHIBIT A
Receipts Processing
Wittman Enterprises, LLC will receive direct payment, posting and depositing cash receipts within one (1) day of receipt. Bank deposit receipt will be emailed to the City. Wittman Enterprises, LLC shall have no access to the proceeds of the receipts. All funds are under the exclusive control of the City of Huntington Beach.
Reports
Monthly, Wittman Enterprises, LLC will perform accurate month end close procedures that will result in the following reports:
Monthly Ticket Survey
Monthly Sales Journal
Monthly Cash Receipts Journal
Monthly Receivables Aging
Management A/R Analysis
Statistical Reports customized to client needs
Provider Responsibilities
• Submit necessary transport information, including pay source information and patient condition, to Wittman Enterprises, LLC for billing purposes.
• Forward to Wittman Enterprises, LLC all necessary information relating to patient transports services, payments and patient eligibility.
• Notify Wittman Enterprises, LLC of any accounts that require special attention. • Obtain signature of patient or guardian.
• Provide patient's Social Security Number
Source Documents
Wittman Enterprises, LLC will retain all source documents including attachments for six (6) years.
When service contracted is terminated, all source documents are returned to Provider at the Provider's expense.
C. CITY'S DUTIES AND RESPONSIBILITIES:
In a timely manner, the City will provide accurate documentation to the vendor so that they can conduct emergency paramedic and ambulance billing services. The City will provide vendor with supplemental documents as required from various sources to assist in completing billing services.
D. WORK PROGRAM/PROJECT SCHEDULE:
To be determined.
EXHIBIT A
EXHIBIT "B"
Payment Schedule (Fixed Fee Payment)
1. CONSULTANT shall be entitled to monthly progress payments toward the fixed fee set forth herein in accordance with the following progress and payment schedules.
Delivery of work product: A copy of every memorandum, letter, report, calculation and other documentation prepared by CONSULTANT shall be submitted to CITY to demonstrate progress toward completion of tasks. In the event CITY rejects or has comments on any such product, CITY shall identify specific requirements for satisfactory completion.
3. CONSULTANT shall submit to CITY an invoice for each monthly progress payment due. Such invoice shall:
A) Reference this Agreement;
B) Describe the services performed;
C) Show the total amount of the payment due;
D) Include a certification by a principal member of CONSULTANT's firm that the work has been performed in accordance with the provisions of this Agreement; For all payments include an estimate of the percentage of work completed.
Upon submission of any such invoice, if CITY is satisfied that CONSULTANT is making satisfactory progress toward completion of tasks in accordance with this Agreement, CITY shall approve the invoice, in which event payment shall be made within thirty (30) days of receipt of the invoice by CITY. Such approval shall not be unreasonably withheld. If CITY does not approve an invoice, CITY shall notify CONSULTANT in writing of the reasons for non-approval and the schedule of performance set forth in Exhibit "A" may at the option of CITY be suspended until the parties agree that past performance by CONSULTANT is in, or has been brought into compliance, or until this Agreement has expired or is terminated as provided herein.
Any billings for extra work or additional services authorized in advance and in writing by CITY shall be invoiced separately to CITY. Such invoice shall contain all of the information required above, and in addition shall list the hours expended and hourly rate charged for such time.
Such invoices shall be approved by CITY if the work performed is in accordance with the extra work or additional services requested, and if CITY is satisfied that the statement of hours worked and costs incurred is accurate. Such approval shall not be unreasonably withheld. Any dispute between the parties concerning payment of such an invoice shall be treated as separate and apart from the ongoing performance of the remainder of this Agreement.
Exhibit B
EXHIBIT B
PAYMENT SCHEDULE
CITY OF HUNTINGTON BEACH PROFESSIONAL SERVICES AGREEMENT
WITTMAN ENTERPRISES, LLC
FOR
EMS BILLING SERVICES
I. Fees
A. Percentage of Net Collections 3.90% of net collected revenue B. Monthly Reports Included
Net Collections are the dollars eligible for collection after adjusting for Medicare and Medi-Cal write Boling sCilsted fered ter i the nt dollars collected min as any refund by tayor a pastes and. indicated above.
1 Exhibit B
PROFESSIONAL SERVICES CONTRACT BETWEEN
THE CITY OF HUNTINGTON BEACH AND
WITTMAN ENTERPRISES, LLC
FOR
BILLING SERVICES FOR EMERGENCY PARAMEDIC AND AMBULANCE SERVICE Table of Contents
1 1 Scope of Services...
City Staff Assistance. .2
2 3 Term; Time of Performance.......
Compensation .2
4 5 Extra Work.
6 Method of Payment...
7 Disposition of Plans, Estimates and Other Documents
8 Hold Harmless .........
9 Professional Liability Insurance.
10 Certificate of Insurance..
11 Independent Contractor..
12 Termination of Agreement
13 Assignment and Delegation
14 Copyrights/Patents
15 City Employees and Officials
16 Notices..
17 Consent
18 Modification
19 Section Headings
20 Interpretation of this Agreement..
21 Duplicate Original
22 Immigration.
23 Legal Services Subcontracting Prohibited
10 24 Attorney's Fees
10 25 Survival..
.10
26 Governing Law....
:........10
27 Signatories.........
..........10
28 Entirety.............
29 Effective Date........ ...........11
WITTENT-01 JMAHNCKE
ACORD® DATE (MM/DDYYYY)
CERTIFICATE OF LIABILITY INSURANCE 9/18/2019
HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI
ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
PRODUCER
1: 259-6900 A No: (866) 206-8646
INSURERS) AFFORDING COVERAGE NAIC #
INSURER A : National Fire Insurance Company of Hartford INSURED INSURER B: Continental Insurance Company.
Wittman Enterprises LLC INSURER G: Continental Casualty Company 11093 Sun Center Drive INSURER D: State Compensation Insurance Fund Rancho Cordova, CA 95670 INSURER E: AXIS Surplus Insurance Company INSURER F: Travelers Casualty Insurance Co of Amer
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIN
INSR ADDL SUBR OLICY EXF
TYPE OF INSURANCE NSD WVD POLICY NUMBER LIMITS
LTR
A COMMERCIAL GENERAL LIABILITY 2,000,000
X EACH OCCURRENCE
CLAIMS-MADE X OCCUR B6020067350 7/1/2019 7/1/2020 300,000 X
MED EXP (Any one person 10,000
PERSONAL & ADV INJURY 2,000,000
GENERAL AGGREGATE 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X 4,000,000
POLICY LOC
10,000
OTHER:
1,000,000
AUTOMOBILE LIABILITY
X ANY AUTO B6020067395 7/1/2019 71/2020 BODILY INJURY (Per person) AUTOS ONLY APPROVED AS TO FORM BODILY INJURY (Per accident) s
AUTES ONLY AUTOS ONLY
cott Feda
X By:- 2,000,000
X UMBRELLA LIAB OCCUR MICHAEL B. GATES EACH OCCURRENCE
CITY ABFORIBY431 7/1/2019 711/2020 2,000,000
EXCESS LIAB CLAIMS-MADE _AGGREGATE
X RETENTION S 1OjQ0O OF HUNTINGTON BEACH
DED
D X STATUTE T TERH
YIN 9161868-2019 711/2019 7/1/2020 E.L. EACH ACCIDENT 1,000,000 NI A 1,000,000
E.L. DISEASE - EA EMPLOYEE S 1,000,000
DESCRIPTION OF OPERATIONS below 11772019 Egregater our MiT 3 E Cyber Liability P00100004271101 11/712018 1,000,000
F Professional Liab 107019103 1/1/2019 1/1/2020 Each Claim/Agg 2,000,000 The Cly of uninton beach, is or ers, ested or apied orcas, pay, my dea and runes we lamed as Aditional insured with rospects to General Liability per attached endorsement form number SB146932F.
CERTIFICATE HOLDER CANCELLATION
City of Huntington Beach
2000 Main Street
Huntington Beach, CA 92648
AUTHORIZED REPRESENTATIVE
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