Sacramento City Council
June 24, 2025

City of Sacramento
City Council - 5PM Report
915 I Street Sacramento, CA 95814
www.cityofsacramento.org
File ID: 2025-01154 6/24/2025
Contract: Cooperative Purchasing Agreement Periodic Physical Exam/Health Screenings and Cancer Screening
File ID: 2025-01154
Location: Citywide
Recommendation: Pass a Motion: 1) approving the use of the City of Modesto cooperative purchase agreement with Life Extensions Clinic DBA Life Scan Wellness Center to provide periodic physical exam/health screenings and cancer screening for Sacramento Fire Department (SFD) sworn personnel through September 25, 2026, for a not-to-exceed amount of $663,975; and 2) authorizing the Interim City Manager, or designee, to execute the cooperative/piggybacking agreement and the cooperative purchase agreement’s Additional Terms and Conditions.

Contact: Tilden Billiter, Deputy Chief, (916) 808-2203, [email protected], Fire Department
Presenter: None
Attachments:
1-Description/Analysis
2-City of Modest RFP 1920-21
3-City of Modesto Contract #203256 and extension
4-PRC003541 City of Modesto Life Extensions Clinic Cooperative/Piggybacking Agreement Additional Federal Terms and Conditions
Description/Analysis
Issue Detail: The Fire Department (SFD) is seeking approval to utilize the cooperative purchasing agreement between the City of Modesto and Life Extensions Clinics to enter into a contract with Life Extensions Clinics, providing periodic physical exams, health screenings, and cancer screening physicals for SFD sworn personnel. Currently, SFD provides entry-level physicals for all its suppression personnel as a condition of pre-employment. SFD also offers periodic physicals and immunizations (typically every other year as funding allows); however, the physicals do not meet the National Fire Protection Association (NFPA) 1582 standards. This contract will support the initial phase of providing an NFPA-compliant program for physicals and cancer screening for existing sworn

File ID: 2025-01154 6/24/2025
personnel. This initial phase will provide SFD with an opportunity to utilize the data and resources gathered during the initial period and work towards identifying a funding strategy for creating an ongoing program for SFD members.

Policy Considerations: None.

Economic Impacts: None.

Environmental Considerations: California Environmental Quality Act (CEQA): Ongoing administrative maintenance activities, such as purchases of supplies, equipment or materials which are not made for purposes of a public construction project, do not constitute a “project” and are exempt from the California Environmental Quality Act (CEQA) CEQA Guidelines, Section 15061(b) (3), 15378(b) (2).

Sustainability: None.

Commission/Committee Action: None.

Rationale for Recommendation: Currently, SFD provides entry-level physicals for all its suppression personnel as a condition of pre-employment. SFD also offers periodic physicals and immunizations (typically every other year as funding allows); however, the physicals do not meet the National Fire Protection Association (NFPA) 1582 standards. This contract will support the initial phase of providing an NFPA-compliant program for physicals and cancer screening for existing sworn personnel.

Financial Considerations: On October 22, 2024, the City Council adopted Resolution 2024-0314 which authorized the City Manager or the City Manager’s designee to accept $1,295,431 from the 2023 Assistance to Firefighter Grant (AFG) program and to transfer the City’s cost share of the grant from the Intergovernmental Transfer (IGT) commitment of General Fund balance in the amount of $129,544 to the 2023 AFG project (G12904000). The purpose of the AFG program is to protect the health and safety of the public and firefighting personnel against fire and fire-related hazards. SFD’s mission is to protect our community through effective and innovative public safety services. This includes the protection of our SFD members.

Sufficient funding is available in the 2023 AFG Project (G12904000) to support the recommended services in the amount of $1,295,431.

Local Business Enterprise (LBE): The minimum LBE participation requirement is waived for the City’s use of cooperative purchase agreements that have been competitively bid, evaluated, and awarded by other governmental agencies that may or may not have similar LBE programs. The use of cooperative purchase agreements saves time, reduces administrative costs, improves efficiency, and helps taxpayer dollars go further.

1 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21FOROCCUPATIONAL MEDICINE SERVICESA PRE-PROPOSAL TELECONFERENCETo be held onTuesday, June 30, 2020 at 1:30 P.M.Participants: Dial 1-408-418-9388Enter Access Code: 969 845 341PROPOSAL OPENING: JULY 28, 2020 at 10:00 A.M.CITY OF MODESTO CONTACT: Kathy Crandall, BuyerE-MAIL ADDRESS: [email protected]: Phone Number (209) 577-5420

2 CITY OF MODESTO REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21TABLE OF CONTENTS Page . Notice to Proposers ......................................................................................................................... 3 . City Contacts ...................................................................................................................... 4 . Calendar of Events ............................................................................................................. 4 . Offer and Acceptance ......................................................................................................... 4 Submittal Checklist ............................................................................................................ 5 FORMS . Proposal Acknowledgement (Signature Form) ............................................................... 6 . Pricing Schedule (Signature Form) ............................................................................... 11 . Exceptions, Clarifications, Amendments ......................................................................... 12 . References ........................................................................................................................ 13 . Financial Interest Disclosure (Signature Form) ............................................................. 16 . Support of Local Vendors ................................................................................................ 18 . Company History Statement ............................................................................................ 19 . Minimum Qualifications .................................................................................................. 19 Addenda Acknowledgement ............................................................................................ 20 Technical Specifications and Requirements Proposal Evaluation Criteria ............................................................................................ 21 . Background/Scope of Services ........................................................................................ 25 Required Licenses ............................................................................................................ 29 Insurance Requirements ................................................................................................... 29 General Terms and Conditions . Proposal Submittal ........................................................................................................... 32 . Acceptance/Rejection of Irregular Proposals ................................................................... 32 . Complete Proposal Submittal ........................................................................................... 33 . Compliance / Non-Compliance ........................................................................................ 33 . Pricing Format .................................................................................................................. 33 . Pricing Schedule ............................................................................................................... 34 . Award of Proposal ............................................................................................................ 34 . Evaluation Process ........................................................................................................... 34 . Term of Contract .............................................................................................................. 35 . Termination of Services ................................................................................................... 36 . Electronic Payment .......................................................................................................... 36 . Sample Agreement ........................................................................................................... 44 Physical Examinations Protocol A-P .......................................................................... 58-73 3 . NOTICE TO PROPOSERSNOTICE IS HEREBY GIVEN that the City of Modesto, County of Stanislaus, State of California, will 0 Tenth Street, Suite 6600, Modesto, CA 95354 sealed proposals for the furnishing of Occupational Medicine Services for the City of Modesto, Human Resources Department. All equipment, materials, and supplies shall be furnished F.O.B. City of Modesto. Proposals shall be submitted on the proposal sheet and shall http://www.modestogov.com/257/Contracting-Bid-Opportunities; such proposals shall include all necessary specifications. It is highly recommended all proposal documents be downloaded from the Each proposal Modesto, CA 95354 no later than Tuesday, July 28, 2020 at 10:00 A.M. at which time proposals will be opened and recorded. All proposals shall be available for review following City Council award approval at the Purchasing Division, 1010 Tenth Street, 5th Floor, Suite 5300, Modesto, CA 95354. Proposals will be received only at the address shown above, and prior to the time indicated. Any proposal received at or after said time and/or date, or at a place other than the stated address cannot be considered and will be returned to the proposer unopened. All proposals, whether delivered by an employee of the proposer, U.S. Postal Service, courier or package delivery service must be received and time stamped at the stated address prior to the time s time stamp shall be considered the official timepiece for the purpose of establishing the actual receipt of proposals. The City of Modesto assumes no responsibility for delay in the delivery of the proposal. On the outside of both the proposal envelope and courier envelope, the proposer shall indicate the following: NAME AND ADDRESS OF PROPOSER SPECIFICATION NUMBER 1920-21 OCCUPATIONAL MEDICINE SERVICES PROPOSAL OPENING DATE: JULY 28, 2020 AT 10:00 A.M. MAIL TO: CITY CLERK COURIER TO: CITY CLERK CITY OF MODESTO CITY OF MODESTO P.O. BOX 642 1010 10TH STREET, SUITE 6600 MODESTO, CA 95353 MODESTO, CA 95354 The City reserves the right to reject any or all proposals or to waive any informalities or minor irregularities in a proposal. No proposer may withdraw his/her proposal for a period of one-hundred twenty (120) days after the date set for the opening thereof. 4 CITY CONTACTSAll questions regarding these specifications, terms, and conditions shall be submitted in writing to Kathy Crandall, Buyer, via email at: [email protected] contacts during the proposal process shall be through the Purchasing Division. Attempts by the proposer to contact department representatives may result in disqualification of the proposer from the proposal process.CALENDAR OF EVENTS Event DateProposal Issued June 19, 2020A Pre-Proposal Conference June 30, 2020 at 1:30 P.M. Written Questions Due July 9, 2020Addendum Issued (if required) July 14, 2020Response DueBEFORE10:00 A.M. on Tuesday, July 28, 2020Proposal Award Date December 2020Note: Award date is approximate.Note: Deliver or mail proposals to the referenced address, only, as indicated in the Notice to proposers.It is the responsibility of each proposer to be familiar with all of the specifications, terms and conditions and the site condition (if applicable). The proposer agrees and acknowledges all RFP specifications, terms and conditions and indicates the ability to perform by submission of a proposal. By the submission of a proposal, the proposer certifies that if awarded a contract they will make no claim against the City based upon ignorance of conditions or misunderstanding of the specifications.CALIFORNIA LABOR CODE SECTION 1771.1 (a)1771.1. (a) A PROVIDER or sub PROVIDER shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered PROVIDER to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the PROVIDER is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded.OFFER AND ACCEPTANCE:Seller represents his/her acceptance to provide products and/or services as follows. City's offer to purchase products and/or services is expressly conditioned upon Seller's assent to the terms and conditions set forth in City purchase order documents, specifications, supporting data, and these articles. Seller agrees that Seller's Order Acknowledgement terms and conditions received prior to, during or after order placement by City are hereby rejected. City purchase orders signed by the City's Purchasing Manager or her designated agent and issued to Seller constitutes written notification to Seller of City's rejection of any and all of Seller Order Acknowledgements, counter offers and change to the City's terms and conditions. 10:00 A.M. on Tuesday, July 28, 2020ProposalAward Date
5 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICESSUBMITTAL CHECKLIST PROPOSAL SUBMITTAL CHECKLIST The proposer shall provide a complete proposal before 10:00 A.M. on the bid opening date. Failure to provide all the required documents may cause the bid to be considered non-responsive. COMPLETE PROPOSAL Page No. Proposal Acknowledgement (Signature Form) .................................................................... 6 Pricing Schedule (Signature Form) ............................................................................................ 11 Exceptions, Clarifications, Amendments (if applicable).............................................................. 12 References3 Financial Interest Disclosure Form (Signature Form) ............................................................... 16 Support of Local Vendors (if applicable) ..................................................................................... 18 Company History Statement ........................................................................................................ 19 Minimum Qualifications (Financials, Under Separate, Sealed Cover). Please note, only 1 set of financials need be submitted with your original proposal packet(s) .................................. 19 Addenda Acknowledgement ........................................................................................................ 20 6 PROPOSAL ACKNOWLEDGEMENT REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICES The City is soliciting proposals from qualified proposers to furnish its requirements per the specifications, terms and conditions contained in the above referenced proposal number. This Proposal Acknowledgement must be completed, signed by a responsible officer or employee, dated and submitted with the proposal response. Obligations assumed by such signature must be fulfilled. 1. Preparation of Proposals: (a) All prices and notations must be printed in ink or typewritten. No erasures permitted. Errors may be crossed out and corrections printed in ink or typewritten adjacent and must be initialed in ink by person signing the proposal. (b) Quote price as specified in proposal. No alterations or changes of any kind shall be permitted to the Proposal Form. Responses that do not comply shall be subject to rejection in total. 2. Failure to Submit Proposal: If you are not submitting a proposal but want to remain on the mailing list and receive future proposals, complete, sign and return this Proposal Acknowledgement and state the reason you are not pricing. 3. Taxes and Freight Charges: (a) Unless otherwise required and specified in the RFP, the prices quoted herein do not include Sales, Use or other taxes. (b) No charge for delivery, drayage, express, parcel post packing, cartage, insurance, license fees, permits, costs of bonds, or for any other purpose, except taxes legally payable by City, will be paid by the City unless expressly included and itemized in the proposal. (c) Amount paid for transportation of property to the City is exempt from Federal Transportation Tax. An exemption certificate is not required where the shipping paper shows the consignee as one (1) of the Agencies; as such papers may be accepted by the carrier as proof of the exempt character of the shipment. (d) Articles sold to the Agencies are exempt from certain Federal excise taxes. The Agencies will furnish an exemption certificate. 4. Award: (a) Unless otherwise specified by the proposer or the RFP gives notice of an all-or-none award, the City may accept any item or group of items of any proposal. (b) Proposals are subject to acceptance at any time within thirty (30) days of opening, unless otherwise specified in the RFP. (c) A valid, written purchase order mailed, or otherwise furnished, to the successful proposer within the time for acceptance specified results in a binding contract without further action by either party. The contract shall be interpreted, construed and given effect in all respects according to the laws of the State of California. 5. Patent Indemnity: Proposers who do business with the City shall hold the City, its officers, agents and employees, harmless from liability of any nature or kind, including cost and expenses, for infringement or use of any patent, copyright or other proprietary right, secret process, patented or un-patented invention, article or appliance furnished or used in connection with the contract or purchase order. 6. Samples: Samples of items, when required, shall be furnished free of expense to the City and if not destroyed by test may upon request (made when the sample is furnished), be returned at the proposer 7. Rights and Remedies of Agencies for Default: (a) In the event any item furnished by the proposer in the performance of the contract or purchase order should fail to conform to the specifications therefore or to the sample submitted by the proposer with its proposal, the City may reject the same, and it shall thereupon become the duty of the proposer to reclaim and remove the same forthwith, without expense to the City, and immediately to replace all such rejected items with others conforming to such specifications or samples; provided that should the proposer fail, neglect or refuse so to do the City shall thereupon have the right to purchase in the open market, in lieu thereof, a corresponding quantity of any such items and to deduct from any moneys due or that may there after come due to vendor the difference between the prices named in the contract or purchase order and the actual cost thereof to the City. In the event that the proposer fails to make prompt delivery as specified for any item, the same conditions as to the rights of the City to purchase in the open market and to reimbursement set forth above shall apply, except when delivery is delayed by fire, strike, freight embargo, or Act of God or the government. (b) Cost of inspection or deliveries or offers for delivery, which do not meet specifications, will be borne by the proposer. (c) The rights and remedies of the Agencies provided above shall not be exclusive and are in addition to any other rights and remedies provided by law or under the contract. 8. Discounts: (a) Terms of less than ten (10) days for cash discount will be considered as net. (b) In connection with any discount offered, time will be computed from date of complete, satisfactory delivery of the supplies, equipment or services specified in the RFP, or from date correct invoices are received by the City at the billing address specified, if the latter date is later than the date of delivery. Payment is deemed to be made, for the purpose of earning the 9. California Government Code Section 4552: In submitting a proposal to a public purchasing body, the proposer offers and agrees that if the proposal is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2, commencing with Section 16700, of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the proposer for sale to the purchasing body pursuant to the proposal. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the proposer. 10. No Guarantee or Warranty: The City makes no guarantee or warranty as to the condition, completeness or safety of any material or equipment that may be traded in on this order. 11. Two Proposal Document Requested: Failure to furnish at least proposal document may result in disqualification. THE undersigned acknowledges receipt of the referenced RFP and/or Addenda and offers and agrees to furnish the articles and/or services specified on behalf of the proposer indicated below, in accordance with the specifications, terms and conditions of this RFP and Proposal Acknowledgement, for the pricing indicated on the Pricing Schedule. Firm: Address: City/State/Zip: Signature/Title/Date:
7 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICESPRICING SCHEDULE All time, materials, tax, tools, delivery, travel, licenses and insurance necessary to perform the required work shall be included in bid pricing for pricing schedules and optional services. Proposals must be submitted on the pricing schedule provided. No alterations should be made to the pricing schedule. Any section on page 12. ESTIMATED ANNUAL QTY x UNIT PRICE = EXTENDED PRICE **In case of discrepancy between a unit price and an extended price, the unit price will be presumed to be correct in the reasonable discretion of the City. ** Services Est. Annual Quantity Unit of Issue Unit Price Extended Price Physical Examination Protocol A 33 Each $________/Each $_____________ Physical Examination Protocol B 42 Each $________/Each $_____________ Physical Examination Protocol C 1 Each $________/Each $_____________ Physical Examination Protocol D 2 Each $________/Each $_____________ Physical Examination Protocol E 1 Each $________/Each $_____________ Physical Examination Protocol F 78 Each $________/Each $_____________ Physical Examination Protocol G 8 Each $________/Each $_____________ Physical Examination Protocol H 51 Each $________/Each $_____________ Physical Examination Protocol I 1 Each $________/Each $_____________ Physical Examination Protocol J 9 Each $________/Each $_____________ Physical Examination Protocol K 21 Each $________/Each $_____________ Physical Examination Protocol L 1 Each $________/Each $_____________ Physical Examination Protocol M 6 Each $________/Each $_____________ Physical Examination Protocol N 3 Each $________/Each $_____________ Physical Examination Protocol O 171 Each $________/Each $_____________ Physical Examination Protocol P 44 Each $________/Each $_____________ ANNUAL TOTAL $_____________ 8 REQUIRED ADDITIONAL SERVICES Optional Services Description of Work QuantityUnit of Issue Unit PriceExtended PriceFitness for Duty Examination (including report) 1 Each $________/Each $_____________ DOT Exam and Certificate (including report) 1 Each $________/Each $_____________ DOT Alcohol Screening (including report) 1 Each $________/Each $_____________ DOT Drug Screening (including report) 1 Each $________/Each $_____________ Cal/OSHA Respirator Questionnaire 1 Each $________/Each $_____________ Asbestos Exposure Monitoring 1 Each $________/Each $_____________ Hazardous Waste Remediation Examinations 1 Each $________/Each $_____________ Pesticide Exposure Monitoring 1 Each $________/Each $_____________ Cal/OSHA Aerosol Transmissible Disease Standard Compliance 1 Each $________/Each $_____________ Consultation Services 1 Hourly $________/Each $_____________ Advisor to City (Courtroom Testimony) 1 Hourly $________/Each $_____________ 9 OPTIONAL SERVICES FOR FIREFIGHTER ANNUAL PHYSICALS Optional Services Est. Annual Quantity Unit of Issue Unit Price Extended Price Vision Exam (Titmus) 1 Each $________/Each $_____________ Skin cancer assessment 1 Each $________/Each $_____________ Behavioral Health and Sleep Assessment Screenings 1 Each $________/Each $_____________ Personal Consultation with review of testing results 1 Each $________/Each $_____________ Thyroid Ultrasound 1 Each $________/Each $_____________ Echocardiogram (Heart) Ultrasound 1 Each $________/Each $_____________ Carotid Arteries Ultrasound 1 Each $________/Each $_____________ Liver, Gall Bladder, Spleen, & Kidney & Bladder Ultrasounds 1 Each $________/Each $_____________ Ovaries and Uterus Ultrasounds (Women) 1 Each $________/Each $_____________ Prostate and Testicular Ultrasounds(Men) 1 Each $________/Each $_____________ Hemoccult Test with Digital Rectal Exam 1 Each $________/Each $_____________ Urinalysis 1 Each $________/Each $_____________ Lipid Panel 1 Each $________/Each $_____________ Thyroid Panel TSH with Reflex to T4 1 Each $________/Each $_____________ Testosterone (men) 1 Each $________/Each $_____________ CA-125 (women) 1 Each $________/Each $_____________ Muscular Strength and Endurance Evaluation 1 Each $________/Each $_____________ Aerobic Endurance Evaluation (V02 Max Calc) 1 Each $________/Each $_____________ Flexibility Evaluation 1 Each $________/Each $_____________ Nutrition and Diet Recommendations 1 Each $________/Each $_____________ Personal Fitness Recommendations 1 Each $________/Each $_____________ 10 OPTIONAL SERVICES FOR FIREFIGHTER ANNUAL PHYSICALS Optional Services Est. Annual Quantity Unit of Issue Unit Price Extended Price QuantiFeron Gold TB Blood Test 1 Each $________/Each $_____________ HIV Screening Test 1 Each $________/Each $_____________ TD (Tetanus) Titer 1 Each $________/Each $_____________ TD (Tetanus) Vaccine 1 Each $________/Each $_____________ Varicella Titer 1 Each $________/Each $_____________ Varicella Vaccine 1 Each $________/Each $_____________ Meningococcal Titer 1 Each $________/Each $_____________ Meningococcal Vaccine 1 Each $________/Each $_____________ Hepatitis A Titer 1 Each $________/Each $_____________ Hepatitis A Virus Screening Test 1 Each $________/Each $_____________ Hepatitis B Virus Screening Test 1 Each $________/Each $_____________ Hepatitis C Virus Screening Test 1 Each $________/Each $_____________ MMR 1 Each $________/Each $_____________ MMR Titer 1 Each $________/Each $_____________ Polio Titer 1 Each $________/Each $_____________ Polio Vaccine Booster 1 Each $________/Each $_____________ Testosterone Blood Test 1 Each $________/Each $_____________ C Reactive Blood Test 1 Each $________/Each $_____________ Heavy Metals (Hazmat) 1 Each $________/Each $_____________ Body Weight and Composition (Calipers) 1 Each $________/Each $_____________ Coronary Calcium Score Baseline 1 Each $________/Each $_____________ 11 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICES PRICING SCHEDULE City Business/Delivery License No. __________ Expiration Date: __________ PROVIDER License No. __________ Expiration Date: __________ Stated pricing is subject to (______ %) cash discount if invoice is paid within ______ days after acceptance of service. A City Business License is not required at the time of the bid, however, please note the License No. if proposer should already have one. (See Section 2.12 for further details) Program? Please check one: Yes ____ No ____ Information regarding the program is provided in Section 2.15 Payment. THE undersigned acknowledges receipt of the referenced RFP and/or Addenda and offers and agrees to furnish the articles and/or services specified on behalf of the proposer indicated below, in accordance with the specifications, terms and conditions of this RFP and Proposal Acknowledgement, for the pricing indicated on the Pricing Schedule. Company Name (Proposer): By (Person Submitting Proposal): (Print) By (Person Submitting Proposal): (Signature) Title of Person Submitting Proposal: Business Address (City/State/Zip): Email Address: Telephone Number: Fax Number: Date: Company Name (Proposer):
12 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICESEXCEPTIONS, CLARIFICATIONS, AMENDMENTS List requests for proposal clarifications and exceptions below, if any, sign and submit with your proposal response. This form is not required to be returned, unless an Exception, Clarification, or Amendment is requested by the proposer. Item No. Reference To: Description Page No. Paragraph No.

Company Name (Proposer):
13 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICES REFERENCES All proposers must provide a list of five (5) current or former clients in the area provided below, identifying prior experience with the same type of services requested by the City under Scope of Work. References shall have similar volume and requirements to those outlined in these specifications, terms and conditions. unacceptable. performance record on services similar to that described in this proposal. The City reserves the right to contact references other than those provided in the response and to use the information gained from them in the award process. Company Name: Address: City, State, Zip Code: Contact Person: Email Address: Telephone Number: Type of Business: Date of Service: Annual Contract Value $ Company Name: Address: City, State, Zip Code: Contact Person: Email Address: Telephone Number: Type of Business: Date of Service: Annual Contract Value $ Company Name: Address: City, State, Zip Code Contact Person: Email Address: Telephone Number: Type of Business: Date of Service: Annual Contract Value $ 14 Company Name:Address:City, State, Zip CodeContact Person:Email Address:Telephone Number:Type of Business:Date of Service:Annual Contract Value $Company Name:Address:City, State, Zip CodeContact Person:Email Address:Telephone Number:Type of Business:Date of Service:Annual Contract Value $ Company Name (Proposer):
15 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICESFINANCIAL INTEREST DISCLOSUREREQUIRED DISCLOSURE BEGINNING THE COUNCIL MEETING OF JANUARY 7, 2003The ordinance requiring financial interest disclosure by all parties having a direct or indirect interest of $2,000 or more (except for certain publicly traded companies) will be effective at the Council meeting of January 7, 2003. This means that any Council action on a contract, agreement or development right must be accompanied by a FINANCIAL INTEREST DISCLOSURE FORM listing by name all parties that have a material financial interest in the agreement, contract or development right.PLEASE NOTE, any Council action that requires a FINANCIAL INTEREST DISCLOSURE cannot be considered by the City Council until the required reporting is made. That means that Agenda Items without the DISCLOSURE will be removed from the Council Agenda.FinDisclosure12-19 16 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICESFINANCIAL INTEREST DISCLOSURE FORMAll persons included within the meaning of either of the following tests have a material financial interest in an agreement, or application for development rights, submitted for approval or disapproval by the City Council, and shall be identified by the applicant, by name. on page 13.Tests of Materiality:1. Whether it is foreseeable to a reasonable person that the value of their interest in propertyavailable for use by an applicant, or their interest in the applicant itself, may increase ordecrease by an amount greater than $2,000.00 as a direct or indirect result of Counciln for development rights.2.applicant may increase or decrease by a sum greater than $2,000.00 as a direct or indirectresult of Council action on the agreement or application for development rights.It is the legal obligation of all applicants for approval of an agreement or of an application for development rights to verify in writing, under penalty of perjury, that the identity of each person having a material financial interest in the agreement or application or development rights is true, correct and complete. The applicant understands that this information is provided under penalty of perjury, and that intentionally supplying misinformation or deception may result in either invalidation of the agreement or application, or criminal prosecution for misdemeanor violation of the Modesto Municipal Code, or both. Negligent provision of misinformation shall be grounds for invalidation. In accordance with the Modesto Municipal Code, each applicant has a continuing obligation to maintain the truth, accuracy and completeness of the financial interest disclosure information provided below until after final consideration by the City Council of any matter arising out of or relating to the agreement or application.By signing this document, I agree to the information contained within.COMPANY NAME: ______________________________________________________________________________________ATURE):____________________________________________________________________DATE:Applicable Names:(See attached list)Questions concerning the application of either test to particular facts should be resolved in advance of Council action by agreement with the department head recommending approval of its agreement/application.DIRECTOR 17 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICESFINANCIAL INTEREST DISCLOSURECOMPANY NAME: __________________________________________NAMESSignature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:Signature / Print:
18 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICESUPPORT OF LOCAL VENDORSREQUEST FOR DECLARATIONofLOCAL BUSINESSShould the proposer that submits the lowest responsive proposal or quote and would otherwise normally qualify to receive the proposal pursuant to Sections 8-3.203 and 8-3.204 of the Modesto Municipal Code (MMC) not be a local business as defined herein, the lowest proposal or quote submitted by a localbusiness that is within five percent (5%) of the lowest proposal or quote, whether or not that proposer isthe second lowest proposer, may be deemed to be the lowest proposer if the local proposer agrees toreduce its proposal to match the proposal or quote of the lowest proposer in writing within five (5)business days after notification by City Purchasing staff, provided that said local proposer is deemed tobe a responsible proposer as determined by the Purchasing Manager.To qualify as a local proposer, the proposer must have a physical business location within the City ofModesto and a current City of Modesto business license. This document is only required should the proposer request to be considered for the Support of Local Vendor preference, and meets the criteria noted above.I declare I am a local business per the above criteria SUPPORT OF LOCAL VENDORSDECLARATION OF ELIGIBILITYCompany Name:Street Address:Telephone Number:Business License Number:Under penalty of perjury, The Undersigned declares that the foregoing information is true and correct:Print/Type Name:Title:Signature:Date:
19 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICE COMPANY HISTORY STATEMENT Your company shall have been in business for a minimum of three (3) continuous years (immediately prior to the time of the RFP submittal date) providing the types of services requested in this RFP. The company history statement shall be prepared on company letterhead and provided with the proposal submittal. MINUMUM QUALIFICATIONS Minimum Qualifications are mandatory for proposal consideration, and at a minimum shall include the following: Financial Stability (Provided in a sealed separate envelope): prepared Financial Statements (Income Statement and Balance Sheet). These statements, if un-audited, shall be accompanied by a cover letter that states the name and title of the preparer, the basis of the financial statement presentation (cash or accrual) and whether these statements have been prepared in accordance with Generally Accepted Accounting Principles for the most recent fiscal year end of the opinion and notes to the financial statements. period that ended at least eight (8) months before the required date of submittal, if such inability exists. One complete set of Financial Statements shall be submitted in a sealed separate envelope filed with the (original proposal document), marked with the following: FINANCIAL STATEMENTS NAME AND ADDRESS OF PROPOSER SPECIFICATION NO. 1920-21 OCCUPATIONAL MEDICINE SERVICES PROPOSAL OPENING DATE: JULY 28, 2020 AT 10:00 A.M. 20 ADDENDA ACKNOWLEDGEMENT The proposer shall check the RFP listing on the City or PlanetBid website, periodically, and in any event, no later than the day prior to proposal opening to obtain any addenda information. The changes identified in the addenda modify this request for proposal and specifications. The addenda now become a part of this request for proposal and specifications. Signing the Proposal on the signature portion thereof, the proposer is acknowledging that the proposer has confirmed that he or she has received all addenda issued for this request for proposal and specifications, and has included costs for such in the proposal submitted. Failure to list and acknowledge all addenda numbers may cause the bid to be considered non-responsive. Do not attach any of the addenda to this sheet nor include them with the proposal. This document is only required to be returned should addenda have been issued. The Proposal is submitted with respect to the changes to the request for bid and specifications included in addenda numbers: LIST ALL ADDENDA NUMBERS: ____________________________________________________ Company Name (Proposer):
21 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICES Most of the material needed to present a comprehensive proposal can be placed into one of the sections listed. Responses should be complete and detailed. However, if relevant information needs to be EVALUATION All proposals submitted will be reviewed by a City of Modesto evaluation committee. At the completion of the proposal review, finalists may be asked to provide an in-depth presentation and product demonstration in Modesto. Whether or not a presentation shall be performed is wholly within the discretion of the evaluation committee. The committee will select the proposal which best fulfills the committee. No single factor will determine the final award decision. Overall responsiveness to the Request for Proposals is an important factor in the evaluation process. EVALUATION CRITERIA 1. REFERENCES 2. BACKGROUND OF FIRM 3. QUALIFICATIONS AND EXPERIENCE OF PERSONNEL 4. LEVEL & QUALITY OF SERVICE 5. COST 22 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICESCOMPANY HISTORY STATEMENT Your company shall have been in business for a minimum of three (3) continuous years (immediately prior to the time of the RFP submittal date) providing the types of services requested herein. The company history statement shall be prepared on company letterhead and provided with the proposal submittal. 23 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21 OCCUPATIONAL MEDICINE SERVICESDETAILED FULL SCOPE OF SERVICE and legally defensible cost-effective solutions to medical evaluation needs, as related to the full scope of services defined in this RFP document. Except as specifically defined herein, all terms shall be interpreted according to best practice and understanding. 24 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICES QUALIFICATIONS AND EXPERIENCE OF PERSONNEL 1 Identify the key personnel from your firm who would be assigned to this account. Include a description of their qualifications, current job functions (including other accounts to which they are committed), proposed roles on the account team, and office locations(s). Designate a principal of the firm who would be ultimately responsible for the relationship and an Account Manager who would provide day-to-day direction of the required work. Furnish resumes for all key personnel. 2 If more than two (2) people will be assigned to the City, include an organization chart that clearly delineates communication and reporting relationships among the staff. 25 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICES TECHNICAL SPECIFICATIONS AND GENERAL REQUIREMENTSBACKGROUND/SCOPE OF SERVICESProposer shall describe in detail their firm, its affiliations, history, etc.Include any additional information that will assist the City in evaluating your proposal.1. Furnish background information about your firm, including date of founding, legal form (i.e. sole proprietorship, partnership, LLC, corporation/state or incorporation), number and location of offices, number of employees, days/hours of operation and other pertinent contractually. 2.to the City. Specifically highlight those qualifications that distinguish you from your competitors.3. Identify all lost or terminated contracts within the past three (3) years. For each contract, the reasons for the end of your working relationship.4. If your organization is a subsidiary or division of a parent firm, provide similar background information on the parent firm and identify any other affiliated companies.1.1 SCOPE OF SERVICESThe City of Modesto is seeking to enter into an agreement for medical services with a physician or medical group to provide various necessary medical services for City applicants for appointments at a physical location within the City limits of Modesto, CA. The City seeks to utilize the best combination of options available to implement a legally-defensible medical evaluation program to improve program efficiency, effectiveness and fiscal accountability. Additionally, the service provider must screen applicants andemployees to properly evaluate and determine whether the physical capabilities and work-related safety requirements of the job, as well as the essential job functions, can be performed by an individual.All reports provided by the physician or medical group in correlation with the scope of services described below must be legible and easy to read, preferably electronically generated. Reports must clearly and concisely provide necessary information. Facility testing results to be reviewed and discussed with patient by facility physician. The selected physician or medical group shall provide services, including, but not limited to, the following criteria. 26 1.2 TECHNICAL SPECIFICATIONS 1.2.1 Pre-Employment Physicals (post job offer): Provide specific physical examinations for job candidates based on the proposed job description and City requirements A all exams should be conducted in compliance with the Genetic Information Nondiscrimination Act of 2008 (GINA). Job descriptions are provided at www.modestogov.com/346. All testing requiring interpretation must be discussed with the employee by a physician at the location where the testing was conducted. Provide pre-employment physicals for public safety personnel compliant with California Commission on Peace Officer Standards Training (POST) and National Fire Protection Association (NFPA) standards. Physical exam component requirements are listed in Along with a list of City positions that will require that type of examination. Provide medical clearance reports on pre- of the City staff via telephone or electronic mail to communicate the delay and anticipated completion date. Provide sufficient staffing availability to schedule appointments within two (2) business days of a request for appointment. Maintain sufficient scheduling availability to conduct examinations within ten (10) business days of a request for appointment The City will also consider proposals for the analysis of the physical requirements of certain positions in support of physical ability testing. Resulting evaluation criteria must be validated and legally defensible. As an advisor to the City, the provider may be called upon to testify in court or in other grievance proceedings relating to his/her recommendations to the City. 1.2.2 Drug and Alcohol Testing Provide drug and alcohol testing services for employees of the City of Modesto subject to such testing because of safety sensitive duties, post-accident, or as a result of reasonable suspicion testing request. Maintain sufficient availability to provide immediate response to drug and alcohol requests when required by DOT regulations (i.e., must be able to take walk-ins) Alcohol testing procedures must be compliant with 49CFR Part 40 and must be conducted by a certified Breath Alcohol Technician using an evidential breath testing device approved by the Federal Motor Carrier Safety Administration. Drug testing procedures must be compliant with 49CFR Part 40. Drug testing must be conducted using a split sample urine specimen and must be done in compliance of DOT Standards. Provide results of alcohol testing to the City of Modesto via electronic mail immediately after completion of testing. Provide results of drug testing within three (3) business days of the test to the City of proactively contact City/Risk Division via telephone or electronic mail to communicate the delay and anticipated completion date. 27 1.2.3 DOT Commercial Driver Physical Examinations Provide DOT compliant physical exams. DOT exams must be performed by a provider Provide results of exam within three (3) business days of the exam via electronic mail. If telephone or electronic mail to communicate the delay and anticipated completion date. Provide sufficient staffing availability to schedule appointments within two (2) business days of a request for appointment. Maintain sufficient scheduling availability to conduct examinations within ten (10) business days of a request for appointment. 1.2.4 Fitness for Duty Examinations Proviapplicable job description as needed. Provide results of the exam to the City of Modesto within two (2) business days of the appointment. If information is delayed, the physCity, Risk Division via telephone or electronic mail to communicate the delay and anticipated completion date. Provide sufficient staffing availability to schedule appointments within three (3) business days of a request for appointment. Maintain sufficient scheduling availability to conduct examinations within ten (10) business days of a request for appointment. 1.2.5 Consultation Services Conduct an analysis and evaluation of the current pre-employment placement medical evaluation process and make recommendations for improvement. Analyze current job class specifications and make recommendations for developing job profiles taking into consideration factors such as delineated physical abilities, physical working conEvaluation process. Provide a written outline of the administrative and procedural requirements and provide training to Human Resources personnel in administration procedures. 1.2.6 Annual & Post-Employment Medical Surveillance Provide medical surveillance services as requested by the City for those employees, or prior employees, with occupational exposures covered by local, state, or federal regulations. This may include, but is not limited to: 1. Cal/OSHA Respirator Questionnaire 2. Asbestos Exposure Monitoring 3. Hazardous Waste Remediation Examinations 4. Pesticide Exposure Monitoring 5. Immunizations (such as Flu, Hepatitis, Measles, Mumps, Rubella, Tetanus, etc.) 28 6. Cal/OSHA Aerosol Transmissible Disease Standard Compliance1.2.7 Annual PhysicalsProvide annual physicals for public safety personnel, as requested by the City, and in compliance with California Commission on Police Officer Standards and Training (POST) and National Fire Protection Association (NFPA) standards and recommendations. Physical examination protocols for Fire and Police can be found in Exhibit D. 1.2.8 Additionally City of Modesto Fire Department reserves the option to request the additional services below, as listed in Exhibit C Optional Services: Vision Exam (Titmus)Skin cancer assessmentBehavioral Health and Sleep Assessment ScreeningsPersonal Consultation with review of testing resultsThyroid UltrasoundEchocardiogram (Heart) UltrasoundCarotid Arteries UltrasoundLiver, Gall Bladder, Spleen, & Kidney & Bladder UltrasoundsOvaries and Uterus Ultrasounds (Women)Prostate and Testicular Ultrasound (Men)Hemoccult Test with Digital Rectal Exam (fecal occult blood testingUrinalysisLipid PanelThyroid Panel TSH with Reflex to T4Testosterone (men)CA-125 (women)Muscular Strength and Endurance EvaluationAerobic Endurance Evaluation (V02 Max Calc)Flexibility EvaluationNutrition and Diet RecommendationsPersonal Fitness Recommendations QuantiFeron Gold TB Blood TestHIV Screening TestTD (Tetanus) TiterTD (Tetanus) VaccineVaricella TiterVaricella VaccineMeningococcal TiterMeningococcal VaccineHepatitis A TiterHepatitis A Virus Screening TestHepatitis B Virus Screening TestHepatitis C Virus Screening TestMMR (Measles, Mumps and rubella)MMR Titer (is a blood test that checks for immunity)Polio Titer (test is used to check for immunity to Polio)MMR Titer(is a blood test that checks for immunity)Polio Titer(test is used to check for immunity to Polio) Provide annual physicals for public safety personnel, as requested by the City, and in compliance with California Commission on Police Officer Standards and Training (POST) and National Fire Protection Association (NFPA) standards and recommendations.Physical examination protocols for Fire and Police can be found in recommendations.Physical examination protocols for Fire and Police can be found in Exhibit D. 29 Polio Vaccine Booster(Adults who completed the polio vaccine series as children and are traveling to areas with increase risk of polio should receive a one-time booster close of vaccine (IPV).Testosterone Blood TestC Reactive Blood Test (Heavy Metals (HazmatThe level ofC-reactiveprotein (CRP), which can Be measured in yourblood, increases when there's inflammation in your body. Body Weight and Composition (Calipers)Coronary Calcium Score Baseline1.2.9 Billing and Reports1. Provide quarterly electronic activity reports, in a format established by the City in its sole discretion, of the nature and the number of examinations conducted, including but not limited to results and final depositions.2. Provide a monthly explanation and summary of charges incurred in a format established by the City in its sole discretion.1.3 REQUIRED LICENSESPrior to beginning any service that shall be furnished under this specification, the bidder shall secure the appropriate Business/Delivery license from the City of Modesto. Business/Delivery license information may be obtained by calling (209) 577-5389.If the bidder is furnishing any labor or service including installation or maintenance, the bidder shall possess the appropriate California PROVIDER's license(s) at the time the proposal is submitted. A contract shall not be awarded to a bidder that does not possess the appropriate PROVIDER's license(s). The appropriate PROVIDER's license(s) is that specified in this request, or if not specified, that which is otherwise required by law, and qualifies the PROVIDER to do business in the State of California.1.4 INSURANCEThe PROVIDER shall provide, at its own expense, and maintain at all times the following insurance with insurance companies licensed in the State of California and shall provide evidence of such insurance to the CITY as may be required by the City Clerk of the CITY. The policies or certificates thereof shall provide that, thirty (30) days prior to cancellation or material change in the policy, notices of same shall be given to the Risk Manager of the CITY via PINS Advantage Insurance Program, for all of the following stated insurance policies.A. Workers' Compensation - in compliance with the statutes of the State of California, plus employer's liability with a minimum limit of liability of $1,000,000.B. General Liability - insurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. The insurance shall indicate on the certificate of insurance the following coverage and indicate the policy aggregate limit applying to: premises and operations; broad form contractual; independent PROVIDERsand sub PROVIDERs; products and completed operations.

Polio Vaccine BoosterTestosterone Blood TestC Reactive Blood Test(Heavy Metals (HazmatCoronary Calcium Score Baselinesecure the appropriate Business/Delivery license from the City of Modesto. appropriate California PROVIDER 30 C. Automobile Liability insurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. This insurance shall cover any automobile for bodily injury and property damage. D. Professional Liability (Errors and Omissions) insurance with a minimum limit of $1,000,000 per claim and policy 2,000,000 aggregate. If coverage is on a claim made basis it shall be maintained for at least three (3) years following completion of the work. E. Professional Services (including architects, engineers, consultants, councilors, attorneys, accountants) F. Waiver of Subrogation G. Additional Insured Status-endorsement If at any time any of said policies shall be unsatisfactory to the CITY, as to form or substance or if a company issuing such policy shall be unsatisfactory to the CITY, the PROVIDER shall promptly obtain a new policy, submit the same to Risk Management via PINS for approval and submit a certificate thereof as hereinabove provided. Upon failure of the PROVIDER to furnish, deliver or maintain such insurance and certificates as above provided, this Agreement, at the election of the CITY, may be forthwith declared suspended, or terminated. Failure of the PROVIDER to obtain and/or maintain any required insurance shall not relieve the PROVIDER from any liability under this Agreement, nor shall the insurance requirements be construed to conflict with or otherwise limit the obligations of the PROVIDER concerning indemnification. The CITY, its agents, officers, officials, employees, and volunteers shall be named as an additional insured on all insurance policies required herein, except Workers' Compensation. The Workers' Compensation insurer shall agree to waive all rights of subrogation against the CITY, its agents, officers, officials, employees, and volunteers for losses arising from work performed by PROVIDER for the CITY. The PROVIDER's insurance policy(ies) shall include a provision that the coverage is primary as respects the CITY; shall include no special limitations to coverage provided to additional insured; and, shall be placed with insurer(s) with acceptable Best's rating of A:VII or with approval of the Risk Manager. For any claims related to this project, the PROVIDERinsurance as respects the Entity, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the Entity, its officers, officials, employees, or volunteers shall be excess of the PROVIDER PROPOSER CONFERENCE A Non-Mandatory Proposal Teleconference is scheduled for June 30, 2020 at 1:30pm. , Participants: Dial 1-408-418-9388 Enter Access Code: 969 845 341 31 The City recommends that each company attending limit the number of representatives to two (2) individuals.Persons attending the bidder conference assume all risks of damage or loss to person and property and specifically release the City of Modesto from liability therefore. 32 REQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICES GENERAL REQUIREMENTS2.1 PROPOSAL SUBMITTALProposer shouldigned original proposal documents, plus six (6) copies of the signed original proposal document and One (1) electronic copy submitted via USB. The original proposal document shall be clearly marked.Photocopies do not constitute an original proposal document.DOCUMENT MAY RESULT IN DISQUALIFICATION. It is the responsibility of the proposers to identify information in their proposal responses that they consider confidential under the California Public Records Act. To the extent that the City agrees with that designation, such information will be held in confidence whenever possible. All other information will be considered public.All costs associated with the preparation of this proposal shall be borne by the proposer.All exceptions taken to these specifications shall be specifically and clearly identified on the Exceptions, Clarifications, and Amendments Form. Failure to comply with this provision is grounds for proposal rejection. Exceptions taken shall not affect the overall performance and quality of the services required by the City. The Purchasing Manager or her designated agent shall make the final decision regarding the acceptability of the services with exceptions.Proposal shall be made in the format specified below. All requested exhibits shall be submitted with the completed Proposal and in the designated format. No oral, telegraph, telephone, facsimile or electronic proposals will be accepted. Failure to comply with all requirements may result in proposal rejection.2.1.1 PROPOSAL PREPARATIONProposal shall be submitted in a three-ring binder with section tabs (A through Z as needed) with responses in the order described below. In those instances where specific questions are asked, each question shall be repeated in the proposal with the response following the question. Extraneous or marketing information shall not be included.elevant section of the proposal. In this case, proposer may offer an alternative equivalent service.2.1.2 ACCEPTANCE/REJECTION OF IRREGULAR PROPOSALSA contract shall be awarded to the proposer whose proposal most closely satisfies the needs of the City and is deemed the most advantageous to the City. The City reserves the right to reject any or all proposals or to waive any informalities or minor irregularities in a proposal.

Proposer shouldigned original proposal documents, six ( igned original proposal documents, igned original proposal documents, ) copies of the signed original proposal document and One (plussix (6) copies of the signed original proposal document and One (1) electronic copy 33 2.1.3 COMPLETE PROPOSAL SUBMITTALThe following documents constitute the makeup of a complete proposal submittal:Proposal Acknowledgement (Signature Form)Pricing Schedule (Signature Form)Exceptions, Clarifications, AmendmentsReferencesFinancial Interest Disclosure (Signature Form)Support of Local Vendor (if applicable)Company History StatementMinimum Qualifications (Financials) Failure to furnish any of these documents may result in disqualification.2.1.4 PROPOSAL PREPARATIONProposals shall be prepared in the order listed in Section 2.1.3 Complete Proposal Submittal.Proposals should be tabbed with dividers. Tabbed dividers shall be clearly marked indicating the appropriate document. 2.2 COMPLIANCEProposers are required to sign, Proposal Acknowledgement Form and Financial Interest Discfull compliance with all requirements of Proposal No. 1920-21, and any addendum to such Proposal. The Proposer guarantees that the offered equipment, material or services meet all safety requirements applicable in accordance with Cal-OSHA regulations and any other rule or regulation required by the City of Modesto.2.3 NON-COMPLIANCEIf you cannot comply with a specification requirement, note as an addendum on the Exceptions, Clarifications, Amendments form, your exception, and your recommendation. The Purchasing Manager will evaluate your recommendation. If after evaluation it is determined that the Proposer is not in compliance with the specification, the Proposal may be rejected.2.4 PRICING FORMATAll labor initial background checks, drug-screening, licenses, insurance and equipment to perform the services shall be included in the proposed pricing,Unless otherwise stated, the Proposer agrees that, in the event of a price decline, the benefit of such lower pricing shall be extended to the City.

Section 2.1.3 Complete Proposal Submittal.
34 2.5 PRICING SCHEDULE Proposers shall use the Pricing Schedule Form to present their proposed pricing. No other form or format shall be accepted. 2.6 AWARD OF PROPOSAL Proposals shall be evaluated by a committee and will be ranked in accordance with the RFP section The committee shall recommend award to the proposer(s) who, in its opinion, has submitted a proposal that best serves the overall interests of the City, and attains the highest overall point score. Award may not necessarily be made to the proposer with the lowest price. The City reserves the right to decline to award a contract if it is determined that the proposed pricing is not competitively priced based on similar contracts with public agencies within the State of California. the right to award a contract to the Contracts may be awarded to more than one company in order to provide for backup, or in PROVIDER could be awarded a specific job only if the primary PROVIDER is unable to perform the service, or if the primary PROVIDER is unable to complete the specific job within the time frame required by the City, and finally, if the primary PROVIDER is unable to maintain acceptable quality standards required by the City. 2.7 EVALUATION PROCESS Proposals shall be evaluated using a three (3) step process: Level 1 Minimum Qualifications Review: The City shall perform an initial responsiveness review to determine compliance and shall notify disqualified Proposers. Proposers that do not d non-responsive and/or/non-responsible to this RFP and will receive no further consideration. Level 2 Proposal Content and Cost Ratings: Proposals that meet Level 1 Minimum posal Evaluation evaluated as part of Level 2 evaluation process. Level 3 Short List (Oral Presentations): At the sole discretion of the Evaluation Committee, a Level 1 and Level 2 rankings. If the Evaluation Committee chooses, these proposers would be proposals shall be completed upon the conclusion of presentations. 35 2.8 TERM OF CONTRACT The term of the contract shall be for a period of two (2) years with three (1) one-year extension options at the sole discretion of City, for a total of up to five (5) years. 1. Pricing shall remain firm for the first two (2) years of any contract, which may be awarded pursuant to this RFP. 2. Price increases for subsequent contract years three, four and five, shall not exceed the Consumer Price Index (CPI) for West Urban Area in any one contract year, and shall be negotiated through the Purchasing Division. Requests for price increases shall be submitted by PROVIDER(s) in writing, at least sixty (60) days prior to the annual anniversary date of the contract to be effective for the subsequent year. pursuant to this RFP. 2.9 QUANTITIES The successful Proposer shall be required to provide whatever quantities may be required during the contract term. No minimum or maximum is guaranteed or implied. 2.10 FUNDING All annual extensions are based upon continuous funding for that purpose by the City Council. Failure to fund any annual extension shall result in an immediate termination of the agreement without redress. 2.11 INSPECTION AND ACCEPTANCE Whenever the product or service provided by the supplier has been delivered to delivery point, the designated agent shall make the final inspection and acceptance. If upon initial inspection the product or service is found to be defective in its construction or deficient in any of the requirements of this specification, the supplier shall remedy or remove said product in an acceptable manner at the supplier's expense. No compensation shall be allowed for such correction of product, labor, or transportation of product. 2.12 CITY BUSINESS LICENSE Prior to beginning any service, that shall be furnished under this specification and proposal, the Proposer shall secure the appropriate Business license from the City of Modesto. Business license information may be obtained by calling (209) 577-5389. 2.13 SUPPORT OF LOCAL VENDORS Should the bidder that submits the lowest responsive bid or quote and would otherwise normally qualify to receive the bid pursuant to Sections 8-3.203 and 8-3.204 of the Modesto Municipal Code (MMC) not be a local business as defined herein, the lowest bid or quote submitted by a local business that is within five percent (5%) of the lowest bid or quote, whether or not that bidder is the second lowest bidder, may be deemed to be the lowest bidder if the local bidder agrees to reduce its bid to match the bid or quote of the lowest bidder in writing within five (5) business days after notification by City Purchasing staff, 36 provided that said local bidder is deemed to be a responsible bidder as determined by the Purchasing Manager.To qualify as a local bidder, the bidder must have a physical business location within the City of Modesto and a current City of Modesto business license. 2.14 TERMINATION OF SERVICESThe City reserves the right to discontinue services with the provider upon failure to meet contractual expectations and/or obligations, as recommended by the site supervisor or his/her agent. Cancellation of services shall be determined by the collaborative efforts of the Purchasing Manager, or designee, and using department after reviewing the incident(s) of failure to perform. without the knowledge or consent of the provider.The City may terminate the agreement at any time with or without cause.2.15 ELECTRONIC PAYMENTElectronic Payment Method:The City of Modesto provides an Epay Program which involves payment of invoices by a secure Visa account number assigned to the supplier after award of bid or contract. Notification of payments and required invoice information isated Accounts Receivable contact by email remittance advice at time of payment. During the evaluation process preference may be shown to proposers that agree to accept Epay for payment of invoices. Please indicate on the Pricing Schedule whether or not your company Invoice to: City of ModestoAttn: Accounts PayableP.O. Box 642Modesto, CA 95353Email to:[email protected] OTHER GOVERNMENT/PUBLICLY FUNDED AGENCIESIf mutually agreeable to all parties, the issuance of any resultant contract/purchase order referencing these specifications and modified by mutual agreement between all parties may be extended to other government or publicly funded agencies. It shall be understood that all terms and conditions as specified herein shall apply.2.17 NON-DISCRIMINATIONA. During the performance of this contract, PROVIDER and its sub PROVIDERs shall not unlawfully discriminate against any employee or applicant for employment because of race, color, ancestry, religion, sex, national origin, marital status, age, medical condition (cancerrelated), physical handicap (including AIDS), or sexual orientation. Equal employment opportunity extends, but is not limited to recruitment, compensation, benefits, layoff, termination, and all other conditions of employment. PROVIDER and sub PROVIDERs shall ensure that the evaluation and treatment of their employees and applicants for employment are OTHER GOVERNMENT/PUBLICLY FUNDED AGENCIESIf mutually agreeable to all parties, the issuance of any resultant contract/purchase order referencing these specifications and modified by mutual agreement between all parties may be extended to other government or publicly funded agencies. It shall be understood that all terms and conditions as specified herein shall apply. 37 free of such discrimination. PROVIDER and sub PROVIDERs shall comply with the provisions of the Fair Employment and Housing Act (Government Code, Section 12900 et seq.) and the applicable regulations promulgated thereunder (California Administrative Code, Title 2, Section 7285.0 et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing Government Code, Section 12900, set forth in Chapter 5 of Division 4 of Title 2 of the California Administrative Code are incorporated into this contract by reference and made a part hereof as if set forth in full. B. PROVIDER and its sub PROVIDERs shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. C. PROVIDER shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to perform work under the contract. D. PROVIDER shall permit access by representatives of the Department of Fair Employment and Housing and the City upon reasonable notice at any time during the normal business hours, but in no case less than twenty-four (24) hours notice, to such of its books, records, accounts, other sources of information and its facilities as said Department or City shall require to ascertain compliance with this clause. 2.18 NON-DISCRIMINATION OF THE HANDICAPPED: CERTIFICATION OF PROPOSER REGARDING NON-DISCRIMINATION OF THE HANDICAPPED By executing this agreement, the Proposer hereby certifies that he/she is in compliance with the Americans with Disabilities Act of 1990, the applicable administrative requirements promulgated in response thereto, and any other applicable Federal laws and regulations relating to handicap discrimination and participation, and will continue to do so for at least the duration of the agreement and any extensions thereof. 2.19 DRUG FREE WORKPLACE Proposer/PROVIDER certifies that he/she is in compliance with Sections 8350 - 8355 of Chapter 5.5 of the Government Code, Drug Free Workplace Act. Every person or organization awarded a contract/purchase order or grant for the procurement of any property or service from any state agency (city) shall certify to the contracting or granting agency that it will provide a drug free workplace. 2.20 HOLD HARMLESS AGREEMENT The PROVIDER shall hold the CITY, its agents, officers, employees, and volunteers, harmless from and save, defend and indemnify them against any and all claims, losses, liabilities and damages from every cause, including but not limited to injury to person or property or wrongful death, with the indemnity to include reasonable attorney's fees, and all costs and expenses, arising directly or indirectly out of any act or omission of PROVIDER, whether or not the act or omission arises from the sole negligence or other liability of CITY, or its agents, officers, employees, or volunteers relating to or during the performance of its obligations under the Agreement. 2.21 ASSIGNMENT OF RIGHTS PROVIDER offers and agrees, and will require all sub PROVIDERS and suppliers to agree, to assign to the CITY all rights, title, and interest in and to all causes of action it and they 38 may have under Section 4 of the Clayton Act (15 United States code, Section 15) or under the Cartwright Act (Business and Professions Code, Section 16700 et seq.), arising from the purchase of goods, services, or materials pursuant to this contract or any subcontract. The assignment made by PROVIDER and all assignments made by sub PROVIDERs and suppliers shall be made and become effective at the time the CITY renders final payment to PROVIDER, without further acknowledgment by the parties (Government Code, Sections 4550-4554). 2.22 CITY PROCESS/PROCEDURE APPROVALS CITY approval of any process or procedure shall not relieve the proposer of his/her responsibility to furnish the required items and service meeting all specifications contained herein. 2.23 PROPOSAL/SELLER REPRESENTATION The proposer/seller represents that: A. He/She has had an opportunity to examine and has examined any and all of the documents, including specifications, any resultant purchase order and supporting data, and that he/she has, from the information contained in such documents, specifications, and data, fully acquainted him/her with all conditions relevant to the work. B. He/She has made all reasonable investigations essential to a full understanding of the difficulties, which may be encountered in performing the work. C. He/She will complete the work for the compensation stated above. D. He/She assumes full and complete responsibility for all conditions relevant to the work and all risks in connection therewith. E. In addition, thereto, the proposer/seller represents that he/she is fully qualified to do the work in accordance with the terms of any Purchase Order issued within the time specified in it. F. Anything mentioned in the specifications and not in the Purchase Order, or mentioned in the Purchase Order and not mentioned in the specifications, shall be of like effect as if shown or mentioned in both. In case of difference between the specifications and the Purchase Order, the Purchase Order shall govern. 2.24 FAILURE TO PERFORM SATISFACTORY It is agreed and understood that if the PROVIDER fails to perform the work as specified herein, CITY's representative may (1) consent to accept such unsatisfactory service with an appropriate adjustment in contract price, based on established cost factors, (2) have such required work done by CITY forces or otherwise, and charge the cost thereof to the PROVIDER, or (3) recommend termination of contract between said PROVIDER and the City of Modesto. Those discrepancies and deficiencies in the work that remains uncorrected after the date set for correction may be the necessary justification for a billing adjustment in the month following the occurrence. Unless otherwise negotiated, billing adjustments for this incomplete or uncorrected work shall be permanent retention of 100% of the estimated monthly cost for the work not corrected or completed. 2.25 PROVIDER'S RESPONSIBILITY FOR DAMAGES 39 If PROVIDER damages any property belonging to the CITY, the CITY may either retain from the money due to PROVIDER an amount sufficient to repair the damage or require PROVIDER to repair the damage to the satisfaction of the CITY at PROVIDER's expense. 2.26 LABOR FORCE AND SUPERVISION PROVIDER shall provide sufficient labor at all times to carry out the project properly and shall ensure that fully experienced competent licensed workers who are skilled in the type of work required are employed. PROVIDER shall ensure that supervision is provided at all times while any work under this contract is being performed. If, in the judgment of the CITY, any person is incompetent or disorderly, PROVIDER shall promptly remove such person from the work for the duration of the contract. 2.27 PROTEST AND APPEAL PROCEDURES Potential offerors, bidders, PROVIDERs, and sub PROVIDERs wishing to protest or appeal a procurement or contracting decision by the City of Modesto must follow the procedures provided by the section. Protests or appeals which are not submitted in accordance with these procedures will not be reviewed. DEFINITIONS For the purposes of this procedure: "Days" means working days in which City Hall is open for business, excluding holidays and weekends. Modesto. "Interested Party" means an actual or prospective bidder or offeror, or any PROVIDER or sub PROVIDER identified by name in any bid or proposal. "Bid" includes the term "offer" or "proposal" as used in the context of formal, informal, or negotiated procurements. an Announced Decision, the date noted will begin the time that an Interested Party may lodge a protest . Procurements valued at $50,000 or less normally will not have an Announced Decision. A. PROTEST PROCEDURES 1. Any interested party may lodge a written protest to an Announced Decision with the City of Modesto's Purchasing Manager no later than ten (10) days after the Announced Decision. 2. The protest shall be delivered or sent by registered mail and postmarked by the deadline, or protest will be automatically rejected. Protestors who choose to be represented by legal counsel are responsible for the associated expenses. 3. The protest shall be accompanied by a certified or cashier's check in the amount of $300.00, (EXCEPT FOR PROTESTS OF FEDERALLY FUNDED PROJECTS) or in such other sum as the City may establish, made payable to the Clerk of the City of Modesto. Protests filed without the requisite fee will be rejected without any additional review. 40 4. The protest filed with the Purchasing Manager shall: a. Include the name, address, and business telephone number of the protestor; b. Identify the project under protest by name, Request for Bid (RFB)/Request for Proposal (RFP) number, and bid/RFP date; c. Contain a concise statement of the grounds for protest; d. Include all supporting documentation, if any. Documentation submitted after filing deadline will not be reviewed. All protests shall either be delivered to: Attn: Purchasing Manager 1010 Tenth St. Suite 6600 Modesto CA 95354 Or mailed to: Attn: Purchasing Manager PO Box 642 Modesto CA 95353 B. PROTEST REVIEW (ANNOUNCED DECISION) 1. Protest to Purchasing Manager Upon receipt of a complete and timely protest, the Purchasing Manager shall review all the submitted materials and shall create and retain a written record of the review. The Purchasing Manager shall respond at least generally to each material issue raised in the protest not later than ten (10) days after receipt of the protest. Notice of the Purchasing Manager's decision may be given by letter mailed through U.S. Postal Service. 2. Appeal to Deputy City Manager The Purchasing Manager's decision may be appealed in writing to the City of Modesto's Deputy City Manager(s) no later than ten (10) days after the date of the Purchasing e initial protest to the Purchasing Manager. The Deputy City Manager shall not be permitted to review any newly raised issues. The Deputy City Manager shall review the appeal, accompanying supporting documents, if any, and the written record of the protest review by the Purchasing Manager. A written record of the Deputy City Manager's review shall be created and maintained. The Deputy City Manager shall give notice of his or her decision to the protestor within ten (10) days after receipt of appeal. All protest appeals shall either be delivered to: Attn: Deputy City Manager 41 1010 Tenth St. Suite 6600Modesto CA 95354 Or mailed to: Attn: Deputy City Manager PO Box 642 Modesto CA 95353 3. Appeal to City Council Any protestor seeking to appeal to the decision of the Deputy City Manager may appeal in writing to the City Council by filing with the City Clerk a written notice of such appeal not later than fifteen (15) business days after the date of the Deputy City Manager's decision. The City Clerk will calendar the protest for Council hearing and give notice of the time and place of the hearing as provided in Modesto Municipal Code Sections 1-4.01 through 1-4.05. The City Council is the highest authority of the City of Modesto. It is possible that the City Council may reverse the decision of any City staff member at the hearing, or provide other direction to staff. In such cases, staff cannot reverse a City Council decision. All protests shall either be delivered to: Attn: City Council 1010 Tenth St. Suite 6600 Modesto CA 95354 Or mailed to: Attn: City Council PO Box 642 Modesto CA 95353 C. PROTESTS OF PROCUREMENTS EXCEEDING $250,000.00 Interested parties protesting procurements exceeding $250,000.00 shall comply with the procedures contained herein, except that in lieu of appeal to the Deputy City Manager, a protestor may request that the protest be heard and decided at an administrative hearing. A written request for administrative hearing shall be accompanied by a certified or cashier's check in the amount of $1,500.00, (EXCEPT FOR PROTESTS OF FEDERALLY FUNDED PROJECTS; Refer to Purchasing Procedures Manual for the Transit Division and Federal Transit Administration Funded Purchases, Chapter 14) payable to the City of Modesto, and shall be received by the Purchasing Manager not later than fifteen (15) days after dispatch of the Purchasing Manager's decision. The request for hearing shall include the specific grounds of the appeal. 42 The City of Modesto shall select and engage an impartial and qualified person to act as hearing officer in the pending protest. The protestor shall have the right to twice reject the selected hearing officer, provided that the City is notified of such rejection within three (3) days of notice to protestor of the name of the hearing officer. The protest shall be heard not later than twenty (20) days after receipt of protestor's request for hearing and the selection of a hearing officer. Protests not heard in a timely manner shall be deemed withdrawn, unless the City and the protestor mutually agree otherwise in writing. The impartial hearing officer shall be deemed a withdrawal of the protest. The costs of the hearing officer and expenses of the protest shall be borne by the protestor. The sums deposited with the request for hearing shall be credited to the costs of the hearing officer and other hearing expenses. The decision of the hearing officer shall be deemed as the final decision of the City, and no other appeal to City Staff or body shall be permitted. D. PROCUREMENTS OBTAINED WITH FEDERAL FUNDS 1. If the protested procurement involves federal funds, e.g., from the Federal Transit Administration (FTA) of the United States, the Deputy City Manager, City Council, or hearing officer shall give notice, accompanying their respective decisions, to the protestor that he or she has the right to appeal to the appropriate federal agency, for which an agency name, contact (where available) and address shall be provided by City staff. Such an appeal shall be filed with the appropriate agency within seven (7) business days of the dispatch or rejection notices to the protestor. Federal agencies may entertain protests alleging that the City has failed to adopt written protest procedures or has failed to follow such procedures. Appeals to the Federal Transit Administration (FTA) shall comply with FTA Circular 4220.1E and the amendments and supplements thereto. Additional information regarding protesting procurements obtained with Federal Funds can be found in the Purchasing Procedures Manual for the Transit Division and Federal Transit Administration Funded Purchases, Chapter 14. 2. The City Council is the highest authority of the City of Modesto. It is possible that the City Council may reverse the decision of any City staff member at the hearing before Council on the procurement at hand. In such cases, no internal appeal is possible since staff may in no case reverse a City Council decision. In such an event, a disappointed transit bidder or a contract involving expenditures of Federal funds shall have the right to appeal the City Council decision directly to the Federal Transit Administration. 2.28 PAYMENT Paper Payment Method: All invoices shall be paid in full within thirty (30) days after completion and acceptance of the goods/services. 2.29 SAMPLE ANNUAL AGREEMENT Please review the Sample Annual Agreement. This Agreement may be modified and subject to change. 43 Please review the Sample Annual Agreement. This Agreement may be modified and subject to change. 2.30 INDEMNITY The vendor shall hold the City, its agents, officers, employees, and volunteers, harmless from and save, defend and indemnify them against any and all claims, losses, liabilities, judgments or damages from every cause, including but not limited to injury to person or property or wrongful death, including reasonable costs and expenses of defense of any judicial or administrative action, arising directly or indirectly out of any negligent or intentional act or omission of Vendor, or its agents, officers, employees, or volunteers relating to or during the performance of obligation to defend, indemnify, and hold the City, its agents, officers, and employees harmless under the provisions of this paragraph is not limited to or restricted by any requirement in this Agreement for Vendor to procure and maintain a policy of insurance. In the indemnity clause contained herein Vendor agrees to defend, indemnify and hold City harmless from the negligence of its employees, among other risks. With reference to the foregoing, the parties agree that all risk of loss, including but not limited to damages, property losses and defense of third-- party suits, arising out of or relating to the operation the provisions contained in Indemnity. 44 SAMPLE AGREEMENTREQUEST FOR PROPOSAL AND SPECIFICATIONS NO.1920-21OCCUPATIONAL MEDICINE SERVICESThis Agreement, made and entered into in the City of Modesto, State of California, this ____ day of _________, 2020, by and between the City of Modesto, a municipal corporation of the State of California, hereinafter called CITY, and (enter Provider name), hereinafter called PROVIDER,W I T N E S S E T H:WHEREAS, the Modesto City Council adopted Resolution No____________ (Will be applied after council meeting) authorizing the award of proposal and contract for the furnishing of Occupational Medicine Services to PROVIDER, hereof, andWHEREAS, the PROVIDER provided a responsive and responsible submittal to RFP 1920-21, Occupational Medicine Services that best meets CITY needs, andWHEREAS, PROVIDER e-of-, andNOW, THEREFORE, the parties hereto mutually agree as follows:1. THE WORK.a. PROVIDER shall furnish Occupational Medicine Services and insurance necessary to furnish Occupational Medicine Services, in strict accordance with the conditions of the complete Contract. b. PROVIDER shall do and perform the service in a professional and businesslike manner under the direction of and to the satisfaction of the CITY.c. PROVIDER shall perform its duties under this Agreement in accordance with the standard(s) of care prevailing in its industry.d. PROVIDER shall maintain proper insurance with the CITY for the duration of the contract. 45 e. PROVIDER shall maintain a CITY business license for the duration of the contract.f. PROVIDER shall furnish the services defined for the contracted rates as shown in Exhibit C, not to exceed $ annually:Base Rate shall be defined as the rate of pay, which shall be paid to PROVIDER. 2. CITY CONTACT: City Contact:Kathy Crandall, Buyer Ph: 209-577-5420Changes of a contractual or business nature shall be affected only by written change to the contract, issued by the City of Modesto, Purchasing Division.3. TERM OF CONTRACT:The term of the contract shall be for a period of two (2) years, with three (3) one-yearextension options.Year 1: January 1, 2021 through December 31, 2021Year 2: January 1, 2022 through December 31, 2022Year 3: January 1, 2023 through December 31, 2023 Year 4: January 1, 2024 through December 31, 2024 Year 5: January 1, 2025 through December 31, 2025Pricing as set forth in Exhibit C shall remain firm for the first two (2) years of the contract. Pricing shall remain firm for the first five (2) years of the contract.Price increases for subsequent contract years, three, four and five, shall not exceed the Consumer Price Index (CPI) for West Urban Area in any one contract year, and shall be negotiated through the Purchasing Division. Requests for price increases shall be submitted by PROVIDER in writing, sixty (60) days prior to the annual anniversary date of the contract to be effective for the subsequent year.4. LIABILITY INSURANCE:The Provider shall provide, at its own expense, and maintain at all times the following insurance with insurance companies licensed in the State of California and shall provide evidence of such insurance to the CITY as may be required by the City Clerk of the CITY. The 46 policies or certificates thereof shall provide that, thirty (30) days prior to cancellation or material change in the policy, notices of same shall be given to the Risk Manager of the CITY via PINS Advantage Insurance Program, for all of the following stated insurance policies.A. Workers' Compensation - in compliance with the statutes of the State of California, plus employer's liability with a minimum limit of liability of $1,000,000.B. General Liability - insurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. The insurance shall indicate on the certificate of insurance the following coverage and indicate the policy aggregate limit applying to: premises and operations; broad form contractual; independent PROVIDERs and sub PROVIDERs; products and completed operations.C. Automobile Liabilityinsurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. This insurance shall cover any automobile for bodily injury and property damage. D. Professional Liability (Errors and Omissions)insurance with a minimum limit of $1,000,000 per claim and policy 2,000,000 aggregate. If coverage is on a claims made basis it shall be maintained for at least three (3) years following completion of the work.E. Professional Services (including architects, engineers, consultants, councilors, attorneys, accountants)F. Waiver of Subrogation G. Additional Insured Status-endorsement. If at any time any of said policies shall be unsatisfactory to CITY, as to form or substance, or if a company issuing such policy shall be unsatisfactory to CITY, provider shall promptly obtain a new policy, submit the same to Risk Manager of CITY for approval and submit a certificate thereof as herein above provided. Upon failure of PROVIDER to furnish, deliver or maintain such insurance and certificates as above provided, this Agreement, at the election of CITY, may be forthwith declared suspended, or terminated. Failure of PROVIDER to obtain and/or maintain any required insurance shall not relieve PROVIDER from any liability under this Agreement, nor shall the insurance requirements be construed to conflict with or otherwise limit the obligations of PROVIDER concerning indemnification. CITY, and its agents, officers, employees, and volunteers shall be named as an additional insured on all insurance policies CITY, its agents, officers, employees, and volunteers for losses arising from work performed by 47 PROVIDER for CITYinsurance policy(ies) shall include a provision that the coverage is primary as respects CITY; shall include no special limitations to coverage provided to with approval of the Risk Manager of CITY. The PROVIDER must deliver certificates evidencing existence of the insurance to the City prior to the time contract is signed. PROVIDER agrees to provide CITY with a separate endorsement evidencing proof as stated above. Every endorsement shall identify the policy number. PROVIDER shall provide CITY with separate an endorsement evidencing proof bility insurance policy. In addition, PROVIDER shall provide CITY with a Workers Compensation subrogation waiver by way of a separate endorsement. All endorsements referenced above must include the applicable policy number.For any claims related to this project, the insurance coverage shall be primary insurance as respects the Entity, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the Entity, its officers, officials, employees, or volunteers shall be excess of the insurance and shall not contribute with it.PROVIDER further agrees that the amount of insurance required may from time to PROVIDER agrees to file a new insurance certificate w5. PAYMENT:PROVIDER shall invoice CITY weekly. All invoices shall be paid in full within thirty (30) days after completion and acceptance of the service by the City, and receipt of a properly prepared invoice in duplicate, subject to cash discounts allowed and stated in this proposal document. 48 Invoice to: City of ModestoAttn: Accounts PayableP.O. Box 642Modesto, CA 95353 PROVIDER shall establish a separate billing account number for each CITY department and/or division. At a minimum invoices shall state the following:City department/division name and addressBilling periodService hours worked day and weekUnit price, extended price, sales tax and total 6. INDEMNITY:The PROVIDER shall hold the CITY, its agents, officers, employees, and volunteers, harmless from and save, defend and indemnify them against any and all claims, losses, liabilities, judgments or damages from every cause, including but not limited to injury to person or property or wrongful death, including reasonable costs and expenses of defense of any judicial or administrative action, arising directly or indirectly out of any negligent or intentional act or omission of PROVIDER, or its agents, officers, employees, or volunteers relating to or during the performance of its obligations under this Agreement.obligation to defend, indemnify, and hold the CITY, its agents, officers, and employees harmless under the provisions of this paragraph is not limited to or restricted by any requirement in this Agreement for PROVIDER to procure and maintain a policy of insurance.In the indemnity clause contained herein PROVIDER agrees to defend, indemnify and hold CITY harmless from the negligence of its employees, among other risks. With reference to the foregoing, the parties agree that all risk of loss, including but not limited to damages, property losses and defense of third-party suits, arising out of or relating to the operation of CITY owned vehicles by employees is apportioned to PROVIDER in accordance with the provisions contained in Indemnity 6.7. ARBITRATION:
49 Any dispute or claim arising or related to this Agreement, its performance, breach, or interpretation (including issues about its validity or enforceability), shall be exclusively, (except as approved below) resolved by final binding arbitration before the American Arbitration Association (AAA), utilizing its Commercial Arbitration Rules. One Arbitrator shall be selected using AAA procedures. The Arbitrator shall use all reasonable efforts to minimize discovery and to complete the arbitration proceedings as expeditiously as possible. The Arbitrator shall render a written decision punitive, incidental, consequential, treble or other multiple or exemplary damages, and the parties hereby agree to waive and not seek such damages. Either party may seek judicial relief to compel the other party to comply with the provisions of this Section, or injunctive or other equitable relief to protect its intellectual property rights, provided (unless prohibited by applicable law) that the remainder of the dispute or claim is submitted to arbitration. The arbitration shall be held in Modesto California; both parties give their irrevocable consent to jurisdiction of courts of or in the State of California, as well as processes of the AAA in California. Awards shall be final, binding and non-appealable (except on the minimal grounds required under the Federal Arbitration Act or other applicable law). All awards may be filed with one or more courts, state, federal or foreign having jurisdiction over the party against whom such award is rendered or its property, as a basis of judgment and of the issuance of execution for its collection. 8. GOVERNING LAW:This Agreement shall be deemed made in, governed by, performed in, and construed and enforced in accordance with the laws of the State of California, U.S.A., without giving effect to its conflicts of laws provisions or principles. 9. COMMENCEMENT AND COMPLETION OF THE WORK:The work contemplated herein shall be commenced as shown in Section 3. Work shall not commence until the contract administrator receives and has on file:Proofs of insurance (approved by Risk Management); 50 Executed Agreement;a. Resolution No. ____________ d made a part hereof;b. Scope-of-Work, 10. TERMINATION OF SERVICES:a. The CITY reserves the right to discontinue service with the PROVIDER upon failure to meet contractual expectations and/or obligations, as recommended by the Purchasing Manager, or his designee, in conjunction with the using departments. The CITY reserves the right to review the service performance at any time with or without the knowledge or consent of the PROVIDER. Cancellation of services shall be determined by the collaborative efforts of the Purchasing Manager, or his or her designee, and using departments, after reviewing the incident(s) of failure to perform. b. Either party may terminate the contract in its unilateral discretion for any or no reason by providing at least ninety (90) days written notice to the other of its desire to terminate.11. COMPLIANCE WITH ALL LAWS: PROVIDER hereby agrees that PROVIDER and its sub PROVIDERs, if any, in the performance of the work described, designated and shown upon the plans herein referred to, will comply with all federal, state, county and municipal laws, rules and regulations which may be applicable to the work herein contracted for, whether now in existence or hereafter adopted.12. CONTRACT DOCUMENTS:The complete contract between the parties hereto consists of this agreement, and all exhibits, and the following documents which are incorporated herein by this reference:a. Resolution No. 2020-__________;b. Scope-of-Work;c. Insurance Certificates, 51 d. City of Modesto Standard Specifications and General Provisions. These documents include important legal requirements, procedures and restrictions and should be reviewed by PROVIDER. They are available for review during normal business hours in the Department of Finance, Purchasing Division. All documents specified above are intended to operate so that any work called for in any one and not mentioned in the other, or vice versa, is to be executed the same as if mentioned in all said documents.13. NOTICES:Any notice, payment or instrument required or permitted by this Contract to be given or delivered to either party shall be deemed to have been received when personally delivered, or one calendar week following deposit of the same in any United States Post Office, registered or certified mail, postage prepaid, addressed as follows:PROVIDER: Contact Name (or designee)Company NameCompany AddressCity, State, zipCompany Phone #Contact emailCITY: City of ModestoPurchasing DivisionP.O. Box 642Modesto, CA 95353Each party may change its address for delivery of notice by delivering written notice of such change of address to the other party. 14. SIGNATOR(IES) FOR PROVIDER:The undersigned signator(ies) for PROVIDER warrant(s) and represent(s) that he/she/they is/are legally competent to execute the contract and has/have full authority to execute this contract.15. ASSIGNMENT:Neither this agreement nor any portion thereof shall be subcontracted or assigned without the written consent of the CITY in each and every instance. 52 16. MISCELLANEOUS:Time is of the essence in every provision of this contract.IN WITNESS WHEREOF, the CITY OF MODESTO, a municipal corporation, has authorized the execution of this Agreement in duplicate by its City Manager and attested by its City Clerk under authority of Resolution No. _________, adopted by the Council of the City of Modesto on the _____________-day of _____________________, 2019 and _____________________has caused this Agreement to be duly executed.CITY OF MODESTO,Company NameA municipal corporationBy:__________________________ By:_________________________________JOSEPH P. LOPEZ (Signature)CITY ManagerBy:_________________________________ (Name & Title)ATTEST: Date:_______________________________By:______________________ By:_________________________________STEPHANIE LOPEZ (Signature)CITY Clerk 53 _________________________________(SEAL) (Name & Title)Date:_______________________________APPROVED AS TO FORM:By:_________________________________JOSE M. SANCHEZCity AttorneyBy:_____________________________CHRISTINA D. ALGERCity Human Resources Manager, (Risk)Signature RequirementsCorporation: 1.Signature of two (2) officersor 2.Signature of one (1) officer plus the corporate seal. Partnership: Signature of one partnerSole Proprietorship: Signature of proprietor 54 PRICING SCHEDULEREQUEST FOR PROPOSAL AND SPECIFICATIONS NO. 1920-21OCCUPATIONAL MEDICINE SERVICESAll time, materials, tax, tools, delivery, travel, licenses and insurance necessary to perform the required work shall be included in bid pricing for Pricing Schedules and Optional Services. ESTIMATED ANNUAL QTY x UNIT PRICE = EXTENDED PRICE **In case of discrepancy between a unit price and an extended price, the unit price will be presumed to be correct, in the reasonable discretion of the City. **ServicesEst. Annual QuantityUnit of IssueUnit PriceExtended PricePhysical Examination Protocol A 33 Each $________/Each $_____________Physical Examination Protocol B 42 Each $________/Each $_____________Physical Examination Protocol C 1 Each $________/Each $_____________Physical Examination Protocol D 2 Each $________/Each $_____________Physical Examination Protocol E 1 Each $________/Each $_____________Physical Examination Protocol F 78 Each $________/Each $_____________Physical ExaminationProtocol G8Each$________/Each$_____________Physical ExaminationProtocol H51Each$________/Each$_____________Physical ExaminationProtocol I1Each$________/Each$_____________Physical ExaminationProtocol J9Each$________/Each$_____________Physical ExaminationProtocol K21Each$________/Each$_____________Physical ExaminationProtocol L1Each$________/Each$_____________Physical ExaminationProtocol M6Each$________/Each$_____________Physical ExaminationProtocol N3Each$________/Each$_____________Physical ExaminationProtocol O171Each$________/Each$_____________Physical ExaminationProtocol P44Each$________/Each$_____________ANNUAL TOTAL$_____________ 55 REQUIRED ADDITIONAL SERVICES Optional ServicesDescription of WorkQuantityUnit of IssueUnit PriceExtended PriceFitness for Duty Examination (including report) 1 Each $________/Each $_____________DOT Exam and Certificate (including report) 1 Each $________/Each $_____________DOT Alcohol Screening (including report) 1 Each $________/Each $_____________DOT Drug Screening (including report) 1 Each $________/Each $_____________Cal/OSHA Respirator Questionnaire 1 Each $________/Each $_____________Asbestos Exposure Monitoring 1 Each $________/Each $_____________Hazardous Waste Remediation Examinations 1 Each $________/Each $_____________Pesticide Exposure Monitoring 1 Each $________/Each $_____________Cal/OSHA Aerosol Transmissible Disease Standard Compliance 1 Each $________/Each $_____________Consultation Services 1 Hourly $________/Each $_____________Advisor to City (Courtroom Testimony) 1 Hourly $________/Each $_____________ 56 OPTIONAL SERVICES FOR FIREFIGHTER ANNUAL PHYSICALSOptional ServicesEst. Annual QuantityUnit of IssueUnit PriceExtended PriceVision Exam (Titmus) 1 Each $________/Each $_____________Skin cancer assessment 1 Each $________/Each $_____________Behavioral Health and Sleep Assessment Screenings 1 Each $________/Each $_____________Personal Consultation with review of testing results 1 Each $________/Each $_____________Thyroid Ultrasound 1 Each $________/Each $_____________Echocardiogram (Heart) Ultrasound 1 Each $________/Each $_____________Carotid Arteries Ultrasound 1 Each $________/Each $_____________Liver, Gall Bladder, Spleen, & Kidney & Bladder Ultrasounds 1 Each $________/Each $_____________Ovaries and Uterus Ultrasounds (Women) 1 Each $________/Each $_____________Prostate and Testicular Ultrasounds(Men) 1 Each $________/Each $_____________Hemoccult Test with Digital Rectal Exam 1 Each $________/Each $_____________Urinalysis 1 Each $________/Each $_____________Lipid Panel1Each$________/Each$_____________Thyroid Panel TSH with Reflex to T41Each$________/Each$_____________Testosterone (men)1Each$________/Each$_____________CA-125 (women)1Each$________/Each$_____________Muscular Strength and Endurance Evaluation1Each$________/Each$_____________Aerobic Endurance Evaluation (V02 Max Calc)1Each$________/Each$_____________Flexibility Evaluation1Each$________/Each$_____________Nutrition and Diet Recommendations1Each$________/Each$_____________Personal Fitness Recommendations1Each$________/Each$_____________ 57 OPTIONAL SERVICES FOR FIREFIGHTER ANNUAL PHYSICALSOptional ServicesEst. Annual QuantityUnit of IssueUnit PriceExtended PriceQuantiFeron Gold TB Blood Test 1 Each $________/Each $_____________HIV Screening Test 1 Each $________/Each $_____________TD (Tetanus) Titer 1 Each $________/Each $_____________TD (Tetanus) Vaccine 1 Each $________/Each $_____________Varicella Titer 1 Each $________/Each $_____________Varicella Vaccine 1 Each $________/Each $_____________Meningococcal Titer 1 Each $________/Each $_____________Meningococcal Vaccine 1 Each $________/Each $_____________Hepatitis A Titer 1 Each $________/Each $_____________Hepatitis A Virus Screening Test 1 Each $________/Each $_____________Hepatitis B Virus Screening Test 1 Each $________/Each $_____________Hepatitis C Virus Screening Test 1 Each $________/Each $_____________MMR 1 Each $________/Each $_____________MMR Titer 1 Each $________/Each $_____________Polio Titer 1 Each $________/Each $_____________Polio Vaccine Booster1Each$________/Each$_____________Testosterone Blood Test1Each$________/Each$_____________C Reactive Blood Test1Each$________/Each$_____________Heavy Metals (Hazmat)1Each$________/Each$_____________Body Weight and Composition (Calipers)1Each$________/Each$_____________Coronary Calcium Score Baseline1Each$________/Each$_____________ 58 EXHIBIT A Physical Examination Protocol ATo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Job classifications covered: Administrative Office Assistant I/II/III/Senior; Business Analyst; Buyer/Assistant Buyer/Senior Buyer; Community Development Program Specialist I/II/Senior, Financial Analyst I/II/III/Senior, Housing and Urban Development Supervisor, Human Resources Analyst I/II/Senior, Infrastructure Financing Program Supervisor, Transit Analyst 59 Physical Examination Protocol B To be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-n, Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Blood Specimen: Glucose Job classifications covered: Account Clerk I/II; Account Technician; Administrative Analyst I/II; Assistant/Associate Land Surveyor; Associate Civil/Traffic Engineer; Background Investigator; Code Enforcement Officer NPU II; Compost Facility Supervisor; Custodian I/II; Director of Human Resources; Economic Development Marketing Specialist; Environmental Compliance Inspector Flex/I/II; Executive Assistant; Facilities Manager; Homeless Management Information Systems (HMIS) Program Coordinator/Technician; Integrated Waste Specialist; Lab Analyst Flex/I/II/III/Supervisor; Operations Manager (Fleet Services); Operations Supervisor; Parking Services Crewleader/Supervisor; Parks Planning & Development Manager; Parks Project Coordinator; Police Assistant; Police Services Worker Technical/Administrative; Purchasing Manager; Senior Civil Engineer; Senior Systems Technician; Service Worker; Software Analyst I/II/Senior; Solid Waste Enforcement Officer/Supervisor; Storeskeeper/Senior Storeskeeper; Streets Manager; Survey Party Chief; Systems Engineer I/II/Senior; Traffic Operations Engineer 60 Physical Examination Protocol CTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information DOT Exam and Certificate Blood Specimen: Chemistry Profile 23 or Comprehensive Metabolic Panel Urinalysis: DOT Drug Screen Job classifications covered: Operations Crewleader 61 Physical Examination Protocol DTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-on PhysicDipstick Urinalysis, Sight screening Authorization for Release of Medical Information OSHA Respirator Questionnaire and Clearance Pulmonary Function Test Blood Specimen: Glucose Job classifications covered: Housing Rehabilitation Specialist I/II; Police Evidence & Property Technician Flex/I/II 62 Physical Examination Protocol ETo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information PPD (TB) Skin Test Job classifications covered: Engineering Intern 63 Physical Examination Protocol FTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information PPD (TB) Skin Test Blood Specimen: Glucose Job classifications covered: Administrative Services Technician I/II; After School Program Leader/Specialist; Events Attendant; Events Coordinator; Exhibits Coordinator; Police Cadet; Police Clerk I/II; Police Community Service Officer Flex/I/II; Recreation Coordinator; Recreation Leader III; Recreation Specialist; Systems Technician I/II 64 Physical Examination Protocol GTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram with Headset Blood Specimen: Glucose Job classifications covered: Airport Manager; Assistant/Associate Engineer; Building Inspector; Building Maintenance Specialist/Technician; Construction Inspector; Cross Connection Specialist; Environmental Services Supervisor; Production Technician; Traffic Operations Technician; Traffic Striping Crewleader; Water Conservation Specialist 65 Physical Examination Protocol HTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram with Headset Blood Specimen: Glucose Hepatitis B Vaccination (Optional) Job classifications covered: Garage Attendant/Lead; Groundskeeper/Head Groundskeeper; Service and Maintenance Aide 66 Physical Examination Protocol ITo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram DOT Exam and Certificate Blood Specimen: Chemistry Profile 23 or Comprehensive Metabolic Panel Urinalysis: DOT Drug Screen Job classifications covered: Operations Crewleader (Forestry; Electrician Crewleader; Operations Crewleader (Compost); Water Meter Technician; Welder/Fabricator 67 Physical Examination Protocol JTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram with Headset OSHA Respirator Questionnaire and Clearance Pulmonary Function Test Blood Specimen: Glucose Job classifications covered: Electrical & Instrumentation Technician; Electrical Supervisor Utilities; Instrumentation Technician; Maintenance Worker I; Plant Maintenance Supervisor; Police Identification Technician Flex/I/II 68 Physical Examination Protocol KTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands- Range of Motion, Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram with Headset OSHA Respiratory Questionnaire and Clearance Pulmonary Function Test DOT Exam and Certificate Blood Specimen: Chemistry Profile 23 or Comprehensive Metabolic Panel Urinalysis: DOT Drug Screen Job classifications covered: Electrician Assistant I/II/III; Electrician Traffic & Buildings; Electrician Utilities (Wastewater); Equipment Service Technician; Heavy Equipment Mechanic/Crewleader; Maintenance Worker II; Parks Maintenance Mechanic/Crewleader; Tree Trimmer/Crewleader; Utilities Plant Operator Trainee/I/II/Senior/Supervisor; Utilities Services Worker I/II/III/Senior 69 Physical Examination Protocol LTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram with Headset PPD (TB) Skin Test Blood Specimen: Glucose Job classifications covered: Emergency Medical Services Coordinator; Fire Prevention Inspector; Police Range and Training Center Coordinator 70 Physical Examination Protocol MTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-otion, Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram with Headset PPD (TB) Skin Test OSHA Respirator Questionnaire and Clearance Pulmonary Function Test Blood Specimen: Glucose Hepatitis B Vaccination (Optional) Job classifications covered: Class Specialty Instructor; Police Animal Control Officer II/Supervisor; Pool Site Coordinator; Recreation Instructor; Lifeguard I/II; Engineering Assistant I/II 71 Physical Examination Protocol NTo be used for pre-employment or annual physicals as requested Except as specifically defined herein, all terms shall be interpreted according to common practice and understanding. Occupational Medical History Questionnaire Problem-oriented written medical history and interview to verify questionnaire General Physical Examination: Vital Signs, Hands-Dipstick Urinalysis, Sight screening Authorization for Release of Medical Information Audiogram with Headset PPD (TB) Skin Test OSHA Respirator Questionnaire and Clearance Pulmonary Function Test DOT Exam and Certificate Blood Specimen: Chemistry Profile 23 or Comprehensive Metabolic Panel Urinalysis: DOT Drug Screen Hepatitis B Vaccination (Optional) Job classifications covered: Airport Maintenance Worker; Equipment Mechanic; Equipment Operator/Senior; Plant Mechanic Trainee/I/II/Senior 72 Physical Examination Protocol OTo be used for pre-employment or annual physicals as requestedExcept as specifically defined herein, all terms shall be interpreted according to common practice andunderstanding.Occupational Medical History QuestionnaireProblem-oriented written medical history and interview to verify questionnaireNFPA-1582 Compliant General Physical Examination: Vital Signs, Hands-Range of Motion, Dipstick Urinalysis, Sight screeningAuthorization for Release of Medical InformationAudiogram with HeadsetPPD (TB) Skin TestChest X-Ray (PA & LAT)OSHA Respiratory Questionnaire and ClearancePulmonary Function TestTreadmill Stress Test (Bruce Protocol 12 METS; 85% Max Predicted Heart Rate)Blood Specimen: CBC; SMA 25; T4; HDL; LDL; VLDL; HDEL/Total Cholesterol RatioUrinalysis: Gross and MicroscopicJob classifications covered: Firefighter/Trainee; Fire Engineer; Fire Captain/Special Assignment; Fire Battalion Chief; Fire Division Chief; Fire Chief Physical Examination Protocol OTo be used for pre-employment or annual physicals as requested 73 Physical Examination Protocol PTo be used for pre-employment or annual physicals as requestedExcept as specifically defined herein, all terms shall be interpreted according to common practice andunderstanding.Occupational Medical History QuestionnaireProblem-oriented written medical history and interview to verify questionnaireGeneral Physical Examination: Vital Signs, Hands-ation, Range of Motion, Dipstick Urinalysis, Sight screeningAuthorization for Release of Medical InformationAudiogram with HeadsetPPD (TB) Skin TestChest X-Ray (PA)OSHA Respiratory Questionnaire and ClearancePulmonary Function TestTreadmill Stress Test (Bruce Protocol 12 METS; 85% Max Predicted Heart Rate)Blood Specimen: CBC; SMA 25; T4; HDL; LDL; VLDL; HDEL/Total Cholesterol RatioUrinalysis: Gross and MicroscopicHepatitis B Titer ScreeningHepatitis B Vaccine (Optional)Job classifications covered: Police Officer Flex/Recruit/Trainee; Police Detective; Police Sergeant; Police Lieutenant; Police Captain; Assistant Chief of Police; Chief of Police; Police Reserve Level I/II/; Police Reserve Sergeant/Lieutenant Physical Examination Protocol PTo be used for pre-employment or annual physicals as requested

City of Modesto
Purchasing Division
1010 Tenth Street, Suite 5300
P.O. Box 642
Modesto, CA 95354

DATE: April 8, 2025

TO: Patricia Johnson, Life Scan Wellness Center

VIA EMAIL: [email protected]

FROM: Jess Benavidez, Assistant Buyer

SUBJECT: Year 5 Extension for Annual Agreement 203256

Dear Patricia Johnson,

As you are aware, the existing agreement with Life Scan Wellness Center to provide Occupational Medicine Services to the City of Modesto was set to expire on June 30, 2025. The City would like to extend the existing agreement utilizing the 5th year extension option through June 30, 2026. During this extension, all terms and conditions of the existing agreement would remain the same.

Should you have any questions regarding this extension, please feel free to contact me at (209) 577-5412.

Please signify your acceptance of this twelve (12) month extension by signing and returning this letter.

Respectfully Yours,

Jess Benavidez
Assistant Buyer
City of Modesto

Print Name and Title Signature and Date

Phone: (209) 577-5405 • Fax: (209) 544-8821 www.modestogov.com Hearing & Speech Impaired Only TDD: (209) 526-9211

Jess Benavidez
2025-04-11Todd LeDuc
Document Ref: 98E3S-LTYCQ-AJNIK-MGCHE Page 1 of 1
REF. NUMBER
98E3S-LTYCQ-AJNIK-MGCHE

DOCUMENT COMPLETED BY ALL PARTIES ON
11 APR 2025 16:02:38 UTC

SIGNER TIMESTAMP SIGNATURE

TODD LEDUC
EMAIL
[email protected]
SENT
11 APR 2025 16:00:37 UTC
VIEWED
11 APR 2025 16:02:11 UTC
SIGNED
11 APR 2025 16:02:38 UTC

IP ADDRESS

99.45.224.116

LOCATION

BOCA RATON, UNITED STATES

RECIPIENT VERIFICATION

EMAIL VERIFIED
11 APR 2025 16:02:11 UTC
Signed with PandaDoc PAGE 1 OF 1

Life Scan Wellness Centers Quote:Department: Santa Clara Fire DepartmentCity and State:Santa Clara, CAContact: Date: 12/9/24 Number of Physicals: TBDPublic Safety Physical Exam (NFPA 1582 compliant)Protocol O (Fire) Protocol P (Police)Medical & Occupational/Environmental Questionnaire Included IncludedComprehensive Hands-On Physical Exam Included IncludedVital Signs: Height, Weight, Blood Pressure, Pulse Included IncludedBeahvioral Health Screenings (i.e. Epworth, PHQ-9 etc.) Included IncludedBack Health Evaluation Included IncludedUrinalysis Included IncludedAudiogram Included IncludedTitmus Occupational Vision Included IncludedBreast Exam with Self-Exam education Included IncludedPersonal Consultation with review of testing results Included IncludedLaboratory Tests: Comprehensive Metabolic Panel, Blood Chemistry Included IncludedComplete Blood Count, Hematology Panel Included IncludedHemoccult Stool Test for Colon Cancer Screening Included IncludedTotal Lipid Panel Included IncludedThyroid Test TSH Included IncludedGlucose Included IncludedHemoglobin A1C Included IncludedMen: PSA (Prostate cancer marker) and Testosterone Included IncludedWomen: CA-125 Included IncludedUltrasound Screenings (Early Detection of Heart Disease and Cancer):Echocardiogram (Heart Ultrasound) Included IncludedCarotid Arteries Ultrasound Included IncludedAorta and Aortic Valve Ultrasounds Included IncludedLiver Ultrasound Included IncludedGall Bladder Ultrasound Included IncludedKidneys Ultrasound Included IncludedSpleen Ultrasound Included IncludedBladder Ultrasound Included IncludedThyroid Ultrasound Included IncludedMen: Prostate and Testicular Ultrasounds Included IncludedWomen: Ovaries and Uterus Ultrasounds Included IncludedCardiopulmonary TestingCardiac Stress Test (Treadmill with 12 lead, sub-maximal) Included IncludedEKG, 12 Lead Included Included Effective July 1, 2025 - June 30, 2026Effective July 1, 2025 - June 30, 2026

Spirometry, PFT with OSHA Respirator Medical Clearance Included IncludedFitness Evaluations per NFPA 1583Fitness tests for muscular strength & endurance Included IncludedVO2 Max Calc for Aerobic Capacity Included IncludedBody Weight and Composition Included IncludedPersonal Fitness Rx Included IncludedLIFE SCAN PUBLIC SAFETY PHYSICAL EXAM BASIC COST Each$830.77 $870.76Mandatory LifeScan NFPA Proprietary EMR System with Behavioral Health AssessmentsTotal Life Scan Wellness Center Cost per physical$855.77 $895.76OPTIONAL TESTS AVAILABLELine-Item COST Line-Item COSTChest X-Ray, 2 view with radiologist review ( included) $91.06 $91.06Lumbar X-Ray, 2 view with radiologist review $103.76 $103.76Hazmat Cholinesterase $84.41 $84.41Hazmat Heavy Metals $84.41 $84.41Hepatitis A Screening Test $62.19 $62.19Hepatitis A Titer $39.98 $39.98Hepatitis B Screening Test $62.19 $62.19Hepatitis B Titer $45.53 $45.53Hepatitis C Screening Test $62.19 $62.19HIV Test, Gen 4 $29.99 $29.99PPD TB Skin Test Included IncludedQuantiFeron Gold TB Blood Test $74.41 $74.41Tdap (Tetanus, Diphtheria, Pertussis) Titer $33.32 $33.32MMR Booster $88.85 $88.85MMR Titer $33.32 $33.32Varicella Titer $22.22 $22.22Varicella Vaccine $133.28 $133.28Polio Booster $66.64 $66.64Polio Titer $33.32 $33.32OSHA Respirator Mask Fit Testing (PortaCount) $65.64 $65.64Drug Screen, I CUP $65.64 $65.64Drug Rescreen with confirmation $74.12 $74.12Medical Review Officer (MRO) as indicated/secondary review $150.35 $150.35C Reactive Blood Test $44.43 $44.43Phlebotomist (Blood Draw) Fee Included IncludedLabs Drawn without Appointment $100.00 $100.00Form Fee - Add'l forms needing to be filled out by APRN (per form) $50.00 $50.00Secure Wifi if not provided by department (per week) $50.00 $50.00Minimum 45 appointments: +A69:C83Pricing subject to annual increase. Pricing is based on 9 patients per day, 45 per week. All scheduled appointments will be billed.

Proprietary EMR and Data Storage, Enhanced Data Dashboards, Administrative Management, Patient and Client Portals$25.00 $25.00

SIGNATURES
The parties have signed this Contract, effective as of the day and year first stated above.

CONTRACTOR
Under penalty of perjury, I certify that the information provided here is correct.

S. �1gnature: ---------­Todd J. LeDuc (May 19, 202514:21 EDT) Title: CEO
Additional Signature (if required):

Title:

CITY OF SACRAMENTO
A Municipal Corporation
APPROVED AS TO FORM:

Signature: _b 'P. µ.,,/2 Gary Lindsey (May 20, 202514:05 PDT) Title: Senior Deputy City Attorney
Reviewed By:

Signature: �Ibo
Ashley Aslin (May 20, 2025 14:11 PDT)
Title: Contract and Compliance Specialist
Approved By:

Signature: __________________