PE PORCH SES
WORK HEALTH SERVICES
Submitted by:
Proactive Work Health Medical Services INC.
DBA Exam Professionals
1894 Commercenter W.
Ste 106, San Bernardino, CA 92408
Proposals
PRE-EMPLOYMENT MEDICAL SCREENING
SERVICE PROVIDER
RFP F-26-1054
City of San Bernardino
Jennifer Broadnax,
Procurement Contract Specialist
[email protected]
1 Proposal Due Date: Thursday, May 21, 2025 03:00PM PST
1. Table of Contents
1. Table of Contents.... ..pg. 2
2. Executive Summary & Location.. ..pg. 3-4
3. Identification of Proposer.. •pg. 5
4. Staffing Resources.. ..pg. 5-9
5. Fiscal Stability 16 ..pg. 10
6. Experience and Technical Competence. ..pg. 10
7. Proposed Method to Accomplish the Work .pg. 11
8. Fee Proposal •pg. 12
9. Insurance ..pg. 12
10. Litigation History. ..pg. 13
11. Other Information.................. ..pg. 13
12. Certification of Proposal.......... ..pg. 13
13. Appendices........... ..pg. 14-15
2 2.Executive Summary
Who we are
Proactive Work Health Services is pleased to submit this proposal to provide comprehensive pre-employment medical screening services for the City of San Bernardino. We are a locally based occupational health provider, operating a fully equipped clinic within the City and specializing in public-sector and POST-compliant medical evaluations.
Our clinic is centrally located at 1894 Commercenter W. Ste 106, San Bernardino, CA 92408, allowing convenient access for City applicants and minimizing hiring delays. We provide rapid appointment availability, experienced California-licensed occupational physicians, and medical clearance reporting within forty-eight (48) hours, ensuring the City's hiring processes remain efficient, compliant, and defensible.
Proactive Work Health Services combines local presence, law-enforcement expertise, streamlined operations, and competitive pricing to deliver exceptional value without compromising quality or regulatory compliance.
Locations:
Yuma, AZ Pomona, CA
1743 W. 24th St. Ste. A, Yuma, AZ 85364 502 S. Garey Ave. Pomona, CA 91766 [email protected] [email protected] Main: 928-459-7277 Main: 909-620-8887
Fax: 928-798-2315 Fax: 909-620-8817
Core Hours: M-F 8am-5pm Core Hours: M-F 8am-5pm
Contact: Rolando Cabrera Contact: Rosemary Franco
Email: [email protected] Email: [email protected] Los Angeles, CA Garden Grove, CA
132 S. Beaudry Ave. Los Angeles, CA 90012 12828 Harbor Blvd. Ste. 200, Garden Grove, CA [email protected] 92840
Main: 213-977-9300 [email protected]
Fax: 213-977-9600 Main: 714-638-7000
24/7 Core Hours: M-F 8am-5pm Fax: 714-638-2800
Contact: Marcos Flores Core Hours: 24/7 Core Hours: M-F 8am-5pm Email: [email protected] Contact: Malcolm Medina Email: [email protected]
Chatsworth, CA
9421 Winnetka Ave. Ste. A, Chatsworth, CA 91311 Lancaster, CA [email protected] 44451 16Th St. W. Ste. 101, Lancaster, CA 93534 Main: 747-444-4090 [email protected]
Fax: 747-444-4094 Main: 661-945-5999
Core Hours: M-F 8am-6pm Fax: 661-948-2897
Contact: Carla Ramos Core Hours: M-F 7:30am-6pm / Sat. 9am-5pm Email: [email protected] After Hours: M-F 6pm-9pm Contact: Carla Ramos
Ontario, CA Email: [email protected]
3 1801 Excise Ave. Ste. 108, Ontario, CA 91761
[email protected]
Main: 909-390-3400 Roseville
Fax: 909-360-8491 151 N. Sunrise Ave. Ste. 1205, Roseville, CA 95661 24/7 Core Hours: M-F 7am-5pm [email protected] After Hours/On-Call: M-F 5pm-7am, Sat & Sun Main: 916-780-0110 Contact: Rosemary Franco Fax: 916-536-7241
Email: [email protected] Core Hours: M-F 8am-5pm Contact: Aisha Willis
Chico Email: [email protected]
564 Rio Lindo Ave. Suite 201, Chico, CA 95926
[email protected] Sacramento, CA
Main: 530-715-8004 8001 Fruitridge Rd Ste. D, Sacramento, CA 95820 Fax: 530-200-8362 [email protected] Core Hours: M-F 8am-5pm Main: 916-387-6929
Contact: Aisha Willis Fax: 916-387-6977
Email: [email protected] Core Hours: M-F 8am-5pm Contact: Aisha Willis
Palmdale, CA Email: [email protected]
39251 10th St. W. Palmdale, CA 93551
[email protected]
Main: 661-274-2000 21 San Miguel Ave. Ste. C, Salinas, CA 93901 Fax: 661-349-7099 [email protected]
Core Hours: M-F 8am-5pm Main: 831-256-7673
Contact: Belinda Castor ax: 831-800-858
Email: [email protected] ore Hours: M-F 8am-6pl El Segundo, CA Email: [email protected]
920 N. Nash St. Bldg. A, El Segundo, CA 90245
[email protected] ABC - Freeport, TX
Main: 310-321-5500 1002 ABC Ave. Ste. 400, Freeport, TX 77541 Fax: 310-321-5505 [email protected]
Core Hours: M-F 8am-5pm Main: 979-239-3000
After Hours: M-F 5pm-12am, Sat & Sun 8am-12am Fax: 979-239-3003 Contact: Lani Bravo Core Hours: M-F 7am-5pm
Email: [email protected]
San Bernardino, CA
1950 S. Sunwest Ln. Suite 108 San Bernardino, CA Dallas, TX 92408 1341 W. Mockingbird Ln. Ste. 200W, Dallas, TX
[email protected] 75247
Main: 909-521-8818 [email protected]
Fax: 909-521-9854 Main: 214-630.114
Core Hours: M-F 8am-6pm Fax: 214-637-3820
Contact: Esther Perez
Email: [email protected]
Brazosport - Freeport, TX
1100 N. Brazosport Blvd. Ste. 3, Freeport, TX
77541
[email protected]
Main: 979-705-7565
Fax: 979-358-3010 Fax: 323-584-2282
Core Hours: M-F 7:30am-5pm
Contact: Dorothy Patterson
Email: [email protected] Email: [email protected] Van Nuys, CA
16360 Roscoe Blvd. Ste. 120, Van Nuys, CA 91406
[email protected]
Main: 818-578-0125
Fax: 818-578-0135
Core Hours: M-F 8am-10pm, Sat. and Sun. 8am-
3pm
4 Email: [email protected]
Contact: Carla Ramos
Email: [email protected]
3. Identification of Proposer
• Legal Name: Proactive Work Health Medical Center Inc. DBA Exam Professionals
• Address: 1894 Commercenter W. Ste 106, San Bernardino, CA 92408 • Legal Structure: S Corp
• California Business License No.: 984573
Authorized Contact:
• Name / Title: Esther Duarte Perez, LVN
• Phone: 909-521-8818
• Email: [email protected]
4. Staffing Resources
A. Firm Staffing and Key Personnel
Proactive Work Health Services maintains a dedicated occupational health team consisting of:
• Medical Director (MD/DO) - California-licensed physician experienced in occupational medicine and POST examinations
• Occupational Health Physicians, Advanced Practice Providers & Nurse Practitioners, Physician Assistants experienced in occupational medicine and POST examinations
• Medical Assistants
• Certified Technicians for audiometry, vision, EKG, spirometry, and respirator screenings
• Administrative and Records Personnel
5 We maintain sufficient staffing to respond to variable hiring volumes and provide continuity of service without disruption.
B. Key Personnel Assigned to the City
Three designated individuals will be responsible for coordination, clinical oversight, and reporting.
Esther Duarte Perez, LVN - 1st Coordinator, ensures that the City has direct communication and immediate concerns are addressed with the clinic in all aspects of service.
Bryan Barrera-2nd Coordinator, ensures back up support is provided for any staffing needs to ensure there are no interruptions in the service provided.
Christian Dang PA -3nd Coordinator, ensures Results are sent out and any corrections needed. As well as work closely with Coordinator 1 & 2.
Resume:
Esther Duarte Perez, LVN
San Bernardino, CA | 909-965-9799| [email protected]/
PROFESSIONAL SUMMARY
Occupational medical clinic manager with 12 years of experience leading clinical operations, strengthening team performance, and ensuring quality care through clear communication and attention to detail.
CORE SKILLS
* Clinic Operations & Workflow Management
* Team Leadership & Staff Coordination
* Client Relations & Communication
* Compliance, Quality Assurance & Attention to Detail
PROFESSIONAL EXPERIENCE
Manager - Proactive Work Health Services
San Bernardino, CA | 08/2019 - Current
• Improved clinic operational efficiency through structured workflow management and staff oversight.
• Maintained high standards of regulatory compliance, documentation accuracy, and quality assurance.
6 • Strengthened employer and client relationships through proactive communication and service coordination.
• Supported clinic growth by managing staffing, scheduling, and daily operational demands.
Specialty Coordinator- USHW & Concentra
San Bernardino, CA | 03/2015- 06/2020
• Coordinated occupational specialty services and employer requirements • Facilitated communication between providers, staff, and clients • Ensured accurate documentation, scheduling, and follow-up • Supported regulatory compliance and operational efficiency
EDUCATION
LVN
UEI | Ontario, CA| 2013
CERTIFICATIONS / ADDITIONAL INFORMATION (Optional)
• NIOSH Certification, LVN license, IV&Phlebotomy
• English-Fluent, Spanish-Fluent, Portuguese-Basic (currently learning) Resume:
Bryan Barrera
San Bernardino, CA • 909-333-7448 • [email protected] Professional Summary
Experienced occupational health clinic manager with 12+ years of progressive healthcare experience
leading clinical operations, improving workflow efficiency, and delivering high-quality patient care.
Core Skills
Clinic Operations & Workflow Optimization • Team Leadership & Staff Scheduling • Patient Care &
Clinical Support • Specimen Collection & Processing • Client Relations & Communication
Professional Experience
Manager - Proactive Work Health Services (03/2026 - Present) Head Phlebotomist - Riverside University Health System (03/2020-02/2026) Phlebotomist - San Bernardino County (06/2018 - 09/2019) 7 Medical Assistant - US HealthWorks (06/2015 - 06/2018) Assisted with intake, vitals, drug screens, EKGs, and supported clinic operations.
Education
Phlebotomy Career Training (2022) • Everest College - Medical Assistant (2015) Certifications
Phlebotomy Technician • Medical Assistant • Basic Life Support (BLS) Languages
English (Fluent) • Spanish (Fluent
Resume:
Christina Dang PA-C
Ontario, CA | [email protected]| 909-333-7448
PROFESSIONAL SUMMARY
Experienced Physician Assistant with 6 years of expertise in client services, delivering high-quality patient care while building strong client relationships. Skilled in managing clinical workflows, supporting patient needs, and ensuring efficient, patient-centered service in fast-paced healthcare environments.
CORE SKILLS
• Quality Improvement Initiatives
Conflict Resolution & Problem Solving
Multitasking in High-Volume Environments
PROFESSIONAL EXPERIENCE
Physician Assistant-Proactive Work Health Service Dba Exam Professionals 03/2022-Present
Physician Assistant-Oceana Gastroenterology 08/2020-02/2022
EDUCATION
University of Maryland, Baltimore-PA studies
8 CERTIFICATIONS / ADDITIONAL INFORMATION
PA-C
LANGUAGES
• English-Fluent, Vietnamese Fluent
BIO:
Esther Duarte Perez is an experienced LVN/Manager with 12+ years in Occupational Medicine and Client Services. She is recognized for her exceptional organization, keen attention to detail, and proven ability to navigate complex operational challenges. Esther successfully supports her team, organization, and clients by building effective communication channels that drive quality service and positive outcomes.With a background in Nursing and operational coordination, Esther brings a practical and people-centered approach to her work. She is currently focused on supporting smooth organizational transitions and improving internal processes.
Christina Dang is a dedicated Physician Assistant with over six years of experience delivering high-quality patient care and exceptional client services. She currently practices at Proactive Work Health Services, where she excels in managing clinical workflows and supporting patient-centered care in fast-paced environments. Christina is known for her strong problem-solving abilities, commitment to quality improvement, and effectiveness in high-volume settings. She holds her PA-C certification and is fluent in both English and Vietnamese, allowing her to serve diverse patient populations.
Bryan Barrera is an experienced occupational health professional with over 12 years of healthcare experience. As a Clinic Manager at Proactive Work Health Services, he specializes in improving operations, leading teams, and delivering high-quality patient care. With a strong background in phlebotomy and clinical support, Bryan is known for his efficiency, leadership, and commitment to patient-centered service.
C. Subcontractors
Proactive Work Health Services does not anticipate utilizing subcontractors. All services are provided directly by our medical team.
9 5. Fiscal Stability
In fulfillment of the requirement for the latest audited financial statements, Proactive has provided the verified Balance Sheet and Adjusted Profit & Loss (P&L) statements from our recent, independent Quality of Earnings (QOE)evaluation conducted by Bakertilly.
A QOE report represents a more rigorous, forward-looking financial validation than a standard backward-looking audit, directly confirming the sustainability and repeatability of our operating cash flows. To protect proprietary corporate operations and client confidentiality, the granular narrative analysis has been omitted, and the primary financial health statements are presented herein. The full underlying 29-page report remains on file and can be reviewed securely upon request.
6. Experience and Technical Competence
A. General Experience
Proactive Work Health Services has extensive experience delivering pre-employment, occupational, and public-safety medical evaluations for municipal and government clients. Our services comply with:
• POST regulations and California Government Code §1031 (f) • Americans with Disabilities Act (ADA)
• California FEHA requirements
• Cal/OSHA, OSHA, CDC, and NIOSH standards
B. Law Enforcement / POST Medical Examinations
10 We routinely conduct POST-compliant medical examinations for law enforcement candidates, including physical examinations for safety-sensitive positions. Our physicians are experienced in evaluating functional capacity, fitness for duty, and work restrictions in a manner that is objective, legally defensible, and consistent with City-approved protocols.
Technical Competence & System Capabilities
- Hardware Capabilities: (Enterprise-grade, multi-core workstations with redundant local servers and cloud-hybrid storage solutions.)
- Clinical Software: HIPAA-compliant EHR and Practice Management platforms featuring end-to-end encryption and automated modules.
C. References & Relevant Projects
Three municipal or public-sector references are provided in the appendices, demonstrating performance, responsiveness, and regulatory compliance.
7. Proposed Method to Accomplish the Work
A. Clinic Location & Accessibility
All examinations are performed at our San Bernardino clinic located at:
1894 Commercenter W. Ste 106, San Bernardino, CA 92408
1950 S. Sunwest Lane, ste 108, San Bernardino CA 92408 (X-Ray Only when needed) The clinic is:
• ADA-compliant and easily accessible
• Professionally staffed and fully equipped for occupational exams • Available Monday through Friday during normal business hours B. Appointment Scheduling & Timeliness
• Examinations scheduled within two (2) working days of City request • Average wait time does not exceed thirty (30) minutes 11 • Multi-component exams completed in a single visit whenever possible C. Examination Services
We provide all services identified in Exhibit A, including but not limited to:
• Post-offer/pre-employment physicals
• Occupational and environmental health exams
• Audiometry, vision, spirometry, EKG, chest x-ray coordination • Respirator medical clearance and N-95 fit testing
• POST-required law enforcement exams
• Proof of immunity verification/TB Screenings/Bloodwork D. Reporting & Communication
• Written summaries within forty-eight (48) hours
• Immediate City notification of delays or inconclusive results • Secure electronic delivery of City-approved clearance forms • Monthly batch submission with invoices
E. Records Management
• HIPAA-compliant medical record storage
• Records maintained at no cost for the contract term
• Transfer of records to the City within two (2) weeks of expiration or termination
8. Fee Proposal
Proactive Work Health Services provides a competitive, cost-effective pricing structure designed to support the City's fiscal objectives while maintaining high clinical standards.
Our pricing:
Is competitive within the San Bernardino County municipal market • Reflects efficiencies achieved through a local clinic location 12 • Includes administrative and reporting services at no additional cost • Is fixed for the initial contract term unless otherwise agreed in writing A completed Vendor Quote Form with unit pricing and hourly rates for additional authorized services is included as a separate attachment.
9. Insurance
Proactive Work Health Services meets or exceeds all insurance requirements outlined in Exhibit B, including general liability, professional liability, employer's liability, automobile liability, and cyber liability. A signed Acknowledgement of Insurance Requirements is included.
10. Litigation History
Proactive Work Health Services has no litigation related to the provision of these services within the past five (5) years.
11. Other Information/ Locations
Demonstrated record of timely service delivery
Consistent compliance with regulatory requirements
Positive community presence within San Bernardino County No conflicts of interest with the City of San Bernardino
12. Certification of Proposal
13 "The undersigned hereby submits its proposal and, by doing so, agrees to furnish services to the City in accordance with the Request for Proposal (RFP), and to be bound by the terms and conditions of the RFP."
Daniel Pesci
Authorized Signature: _
Daniel Pesci
Printed Name / Title:
2026-05-20
Date:
13. Appendices
County of Yuba
Tiffany Manuel
HR Director/Risk Manager
Phone: 530-749-7860
Email: [email protected]
Antelope Valley Medical Center
Nancy Emerson, Integration Manager
5121 Van Nuys Blvd, Sherman Oaks, CA 91403
Phone: 661-234-8089
Email: [email protected]
Palmdale School District
Frances Ufondu
Chief Business Officer
District Contracts Office
Phone: 661-789-6519
Email: [email protected]
14 Address: 39139 10th Street East, Palmdale, CA 93550
Fiscal Stability:
SECTION IV
Balance Sheet Overview
Basis of presentation
Balance Sheets, Roported
The adjacent table presents the balance sheets at the Historical Balance Shoet Dates. The balance sheets are presented on a roported Dec-22 Dec-23 Dec-24 bass and are not adjusted to include the impact of adjustments lo EBITDA Asssts:
ecking savin; (30) 10304
counts recervat 19.665 19 665 Checknalszvingz. Reflects cash held in operating accounts. Management represented there was no restricted cash at Dec-24 As our due diligence procedures we obtained and tead the bank reconcliations at the Histoncal Balance Shee! Dates and reconcied Prepaids 20%
bank balances to the inserral reported thai balances
Fuxed antets, net
Diner asse 110311020 230% • Proas. Represenis the bolance for prepad maurance and consirucion wok for new lcations teing adoeud Toet me and squy
Accounte payable 817 Sher surent asset Represents the balance for (0) the captaization of transaction costs pertaning to acquistions. (a) loans recervat 733 rtaining to shareholders and third-parbes. (il) security deposits, and ilvi employee loans and advances, to name a ti Creca carc 245 280
1.000 1.74 1.254 •Enou assets, net. Represents the balance for i) furniture and equipment. (il) aufomobiles. (if) compuler assets. (l) leasercid l curtent labil 2,663 2233 2,010 mprovetients, and (v) medical equipment. net of corresponding accumulated depreciation
23.934 22 447
toe eiier and egut 26,598 24,680 28.07 nang ire daes enta the balance tor() te captizaion of expenses relaing to ER develogrnen, (t) ecury depos, ane () Liabilities and equity:
Payment arms from venese ar be enu ana alle yalace dung the Cormpays normal course of fusiness operatons Typal Sepii exd Represonts the credt card balance pertaning to purchases pranly lor ofice supies and other miscelareous Buanes» •Siner sutrent abiltes Represents the balance for (i) vancus linas of credf. (*) loan payablos, and (ia) intercompany payatles
SECTION II
Adjusted P&L Summary
Pro Forma Adjusted Income Statement Basis of presentation % of revenue The adjacent table presents the pro forma adjusted P&L for the Histancal Period, including adjustments to pro forma adjusted EBITDA as described in Section II. Expenses are presented based on natural spend type 2/354 27.700 28521
•Revenye: Reprosents revenue generated trom services provided such as hoaith asseasments. screenings, minor work-related nunes, and physical therapy treatment. Overall fevenue incheased ovet fe riistoncal peroo due to increasud fares beirg chargeo to Payrol experises 14,014 13.04% 17.136 ayors We oblened the historicai billing and colection detail on a claim level from multiple EMR systems and analyzed charges and
2.055 colections based on the date of service in order to calculate net revenue on an accrual basis.
Conit al and anturaine 1.0% 1.46 1 10830
50 • Expenses:
Outsources clam managemen, 59 s B830 • Paytull expanses, Reproserts payrol and payrcll related expenses relating to (i) Physicians. (W) Nurse Practlioners (t) her medical protessionais. (N) G&A employees, and (v) Independent contractors. included within the expense row is (l salonies. iei bonus iu bavo lxes (il oro coners Pasros excenses Tave icoased rouricul te mistorca Per 7,257 primarily driven by headcount and increased revenue as medical professionals are partially compensated based un 2 percentage of colections.
Pro Forms Adused Rovnus by Sate M General & adminsttalir. Represents expenses primaniy pertaring to (i) insurance, consising of general Sabilty a aloracsce insurance. fl bank and postoll services feos. tal accounting and professonal fees. (Iv) dues and subscriptiol software exponses, and (v) office suppliea. General & administrative expenses have increased over the Histor od. primariy driven by increased collection service fees, marketing spend and cleaning services expens 4,.602
180210100
•Luneye el de ramer asat pansany spears partinemen nt Serie Atl nata enete Staling and dane. increases lo tent expense
atherz, Represents expenses pertaining to (i) taxes including cty, franchise, property, accitional payoll taxes (i) travel stainment, (i) automobiles, (ie) repa and mantenance, and (v) legal fees Expenses in FY23 are higher due lo ad PWS payruli tares
15 Audit trail
Details
FILE NAME DRAFT PROPOSAL - City San bernardino .doc - 5/20/26, 3:20 PM STATUS Signed
2026/05/20
STATUS TIMESTAMP
23:06:50 UTC
Activity
[email protected] sent a signature request to: 2026/05/20 SENT • Daniel Pesci ([email protected]) 22:20:57 UTC 2026/05/20
Signed by Daniel Pesci ([email protected])
SIGNED 23:06:50 UTC
2026/05/20
This document has been signed by all signers and is complete 23:06:50 UTC
COMPLETED
The email address indicated above for each signer may be associated with a Google account, and may either be the primary email address or secondary email address associated with that account.
ACKNOWLEDGEMENT OF INSURANCE REQUIREMENTS
VENDOR NAME: PHONE: Proactive Work Health Medical Services INC DBA Exam Professionals ADDRESS: 1894 Commercenter W. Ste 106, San Bernardino, CA 92408 The Proposer shall demonstrate the willingness and ability to provide the required insurance coverage as set forth in the City requirements within ten (10) calendar days of notification of selection for contract award. The insurance requirements are detailed below:
RFP F-26-1054
PRE-EMPLOYMENT MEDICAL SCREENING SERVICES
MINIMUM INSURANCE REQUIREMENTS
COVERAGE TYPE MINIMUM POLICY LIMITS
Commercial General Liability $2,000,000 per occurrence/$4,000,000 aggregate for bodily injury, personal
injury, and property damage
Automobile Liability $1,000,000 per occurrence for bodily injury and property damage
Employer's Liability $1,000,000 per occurrence
Professional Liability $1,000,000 per claim and aggregate (errors and omissions)
Cyber Liability (IF APPLICABLE) $1,000,000 per occurrence and aggregate By signing below, the Proposer acknowledges that they have reviewed the City's insurance requirements and confirm their ability to meet these requirements within the specified timeframe. 5/20126
SUBMITTED BY: DATE: luthorized Representative Signature
VENDOR QUOTE FORM
VENDOR NAME: PHONE: Proactive Work Health Medical Service INC. DBA Exam Professionals ADDRESS: 1894 Commercenter W. Ste 106, San Bernardino, CA 92408 The undersigned, hereby declare that they have carefully examined the location of the proposed work, familiarized themselves with the local conditions affecting the cost of the work, and have read and examined the terms and conditions for the following Project:
RFP F-26-1054
PRE-EMPLOYMENT MEDICAL SCREENING SERVICES
The undersigned, hereby propose to furnish all labor, materials, equipment, tools, transportation, and services, and to discharge all duties and obligations necessary and required to perform and complete the Project in strict accordance with the Vendor Price Quote for the ELECTRONICALLY SUBMITTED TOTAL VENDOR QUOTE PRICE.
ITEM NO. DESCRIPTION QUANTITY UNIT COST TOTAL AMOUNT
1 - Basic physical (with Medical History Review) $85.00 (discount for Bundles available)
- Bloodwork (Lead/ZPP/Glucose) $110.00 (lead/zpp).
$110.00 (lead/zpp).
- Audiogram $50.00
- N-95 Mask fit testing $50.00
Chest X-ray (1 View) $85.00
EKG $70.00
TB Skin Test $40.00
TB Risk Assessment $15.00
Hep B Titer $55.00
Vaccine $120.00 each vaccine x3 $120.00 $360.00
MMR Titer $100.00
Vaccine $175.00 each for vaccine $175.00 $175.00
- Tap Vaccine $120.00
- Respiratory Questionnaire $75.00
$75.00 for questionnaire and PFT
Spirometry/PFT
TOTAL VENDOR QUOTE $1,390.00
Total Number of Additional Pages: 1 of 2
Should the proposer be requested to perform additional finance related services, please list the proposed positions and hourly rate:
PERSONNEL SPECIFY TITLE & POSITION ASSIGNED HOURLY RATE Staff Manager (or similar) Bryan Barrera $30
Staff Associate (or similar) CHristina Dang $70
I hereby declare under penalty of perjury that the foregoing is true and correct. 5/20/26
SUBMITTED BY:
TITLE: Manager
PRINT NAME: Esther Duarte Perez, LVN
CONTRACTOR LICENSE NO:__ (If Applicable)
CLASSIFICATION: DIR REGISTRATION NO: —
!
City of San Bernardino
Business Registration Certificate
This Business Registration Certificate does not indicate the legal operation of this business at this location.
Other approvals by other City departments may be required. This certificate is issued without verification that the certificate is subject to or exempt from licensing by the State of California. It is the responsibility of each business owner to obtain and pay for a renewal registration certificate regardless of whether or not such business owner has received a renewal notice from the city. Any failure to receive such notice, for any reasor., shall not affect the applicability of penalties of non-payment or late payment.
Annual renewal notices: Renewal notices will be mailed on the first business day of the month that the account expires.
However, if your business is required to report gross receipts; the business must still include all the gross receipts for the previous 12 months from the expiration date. If you do not receive your annual renewal notice, please contact our office at (909)384-5302 ог (909)384-5035.
POST IN A CONSPICUOUS PLACE
Account Number: 953530
Business Class: PHYSICIAN Expiration Date: 8/31/2026
Notes:
Business Name: DOT EXAM PROFESSIONALS
Business Location: 1894 COMMERCENTER STE 106
Owner, Firm or EXAM PROFESSIONAL INC
Corporation:
BUSINESS REGISTRATION CERTIFICATE NON TRANSFERABLE
CITY OF SAN BERNARDINO BUSINESS REGISTRATION
P.O. BOX 1318
SAN BERNARDINO, CA 92402-1318 ACCT NO. 953530
DATE PAID 10/14/2025
SB1186 $4.00
PEN $1,213.74
525A $2,427.47
BALANCE $ 0.00
1894 COMMERCENTER W STE 106
SAN BERNARDINO, CA, 92408-3310
County of Yuba - Master Services Agreement
Role of the Firm
• Proactive Work Health Services serves as an independent contractor providing occupational health and employee medical services, medical testing, staffing, and related support services to the County of Yuba.
Dollar Value of Services and Fees
Contract value not to exceed $75,000.
Pricing governed by Statements of Work and fee schedules.
Sample fees include:
Occupational exam: $135
Audiogram: $76
Respirator fit test: $90
Flu vaccine: $40
Description of Services and Staffing
Services include:
• Occupational medical examinations
• Drug testing
• Respirator fit testing
• Audiograms
Vaccinations
• Laboratory testing
• Mobile and onsite occupational health services
Staffing Terms:
Contractor provides staffing based on best efforts and approved Statements of Work. • Long-term staffing arrangements may be billed year-round.
Duration of Services
Contract term: November 1, 2025 - October 31, 2027.
Relationship to the Client
• Proactive Work Health Services acts as an independent contractor and retains control over staffing and service delivery.
• Relationship governed through Master Services Agreement and Statements of Work.
Contact Information
• Proactive Work Health Services
Nancy Emerson, Integration Manager
5121 Van Nuys Blvd, Sherman Oaks, CA 91403
Phone: 661-234-8089
Email: [email protected]
County of Yuba
• Tiffany Manuel
HR Director/Risk Manager
Phone: 530-749-7860
Email: HR@ Yuba.gov
Antelope Valley Medical Center - Service
Agreement Renewal
Role of the Firm
• Proactive Work Health Medical Center, Inc. provides employee health services to Antelope Valley Medical Center.
Dollar Value of Services and Fees
• Hospital reimburses Clinic $59,494 per month for Hospital Employee Health services.
Description of Services and Staffing
Agreement relates to continued provision of Hospital Employee Health services under the existing service agreement. Specific staffing details are not listed in the amendment document.
Duration of Services
Original agreement extended for three additional years.
New expiration date: April 30, 2028.
Relationship to the Client
Proactive Work Health Medical Center functions as the Clinic/service provider for Antelope Valley Medical Center under a continuing service agreement.
Contact Information
Antelope Valley Medical Center
• Edward Mirzabegian
Chief Executive Officer
Proactive Work Health Medical Center, Inc.
• Daniel Pesci
Administrator, Chief Executive Officer
Palmdale School District - Agreement for
Services
Role of the Firm
• Proactive Work Health Medical Center DBA Proactive Work Health Services is contracted as an independent contractor to provide employee medical testing and physical services for the Palmdale School District Human Resources department.
Dollar Value of Services and Fees
• Total contract amount not to exceed $10,000.
• Sample fee schedule listed in Appendix A:
Audio Test: $50
TB Test: S40
TB Risk Assessment: $15
• Titmus Vision Test: $55
Basic Physical Exam: $85
Fit for Duty Exam: $95
Description of Services and Staffing
Services provided:
• Employee medical testing
Employee physical examinations
Fit-for-duty evaluations
TB screening/testing
• Vision testing
Staffing/Operational Notes:
• Contractor is specially trained and experienced in providing the services. • Contractor employees will not have contact with students during services. • Contractor must comply with:
• Fingerprinting/background check requirements
• Tuberculosis certification requirements
• Insurance and confidentiality requirements
Duration of Services
• Contract term: July 1, 2025 - June 30, 2026.
Relationship to the Client
Proactive Work Health Services acts as an independent contractor and is not considered an employee, agent, or partner of the District.
District may terminate the agreement with 30 days written notice.
Payment is made after completion of services and submission of invoice.
Contact Information
Proactive Work Health Medical Center DBA Proactive Work Health Services Monika Covarrubias
Client Services Manager
Phone: 818-574-3007
Email: [email protected]
Address: PO BOX 17130, Los Angeles, CA 90017
Palmdale School District
• Frances Ufondu
Chief Business Officer
District Contracts Office
Phone: 661-789-6519
Email: [email protected]
Address: 39139 10th Street East, Palmdale, CA 93550
6. Physical exams must be able to occur within two (2) working days of being requested to do so by the City. Applicants/Employees should wait no longer than thirty (30) minutes from the time of actual appointment, before services are begun.
7. Contractor shall maintain examination centers located within San Bernardino or San Bernardino County and convenient to the City. The City will consider proposals whose facilities are not in close proximity to the City. The Contractor shall provide services during normal business hours Monday-Friday, City holidays excluded.
Location of services shall be handicapped-accessible and shall conform to all applicable federal, state, and local safety disability laws.
A. Contractor must provide:
i. California-licensed examining physicians, clinicians and professionals who are experienced in occupational medicine and familiar with state and federal laws. Providers must indicate in their proposal which, if any, physicians and/or support staff are located at a location different from the examining facility;
ii. All appropriate support staff, such as licensed nurses, medical technicians, and administrative staff;
ili. Necessary facilities, equipment, supplies and materials.
Bidders must acknowledge all requirements of previous section, including all categories and sub-points.
Please Sign and Acknowledge Here:
5/20/26
Esther Duarte Perez
If Bidder can provide additional services that are related to the services above, but not mentioned in this section, please list the additional services and detail how they will be beneficial to the city
ISSUANCE DATE
PHYSICIAN ASSISTANT BOARD
SEPTEMBER 8, 2020
LICENSING DETAILS FOR: 58496
EXPIRATION DATE
NAME: DANG, CHRISTINA NGOC
LICENSE TYPE: PHYSICIAN ASSISTANT JULY 31, 2028
PRIMARY STATUS: LICENSE RENEWED & CURRENT CURRENT DATE / TIME SCHOOL NAME: ANNE ARUNDEL COMMUNITY COLLEGE
MAY 20, 2026
GRADUATION YEAR: 2020 7:18:45 PM
ADDRESS OF RECORD
1056 DORAL CT
ONTARIO CA 91761-6857
SAN BERNARDINO COUNTY
PUBLIC RECORD ACTIONS
› ADMINISTRATIVE DISCIPLINARY ACTIONS (NO RECORDS)
› COURT ORDER (NO RECORDS)
› MISDEMEANOR CONVICTION (NO RECORDS)
› FELONY CONVICTION (NO RECORDS)
› MALPRACTICE JUDGMENT (NO RECORDS)
› PROBATIONARY LICENSE (NO RECORDS)
› HOSPITAL DISCIPLINARY ACTION (NO RECORDS)
› LICENSE ISSUED WITH PUBLIC LETTER OF REPRIMAND (NO RECORDS) › ADMINISTRATIVE CITATION ISSUED (NO RECORDS)
› ADMINISTRATIVE ACTION TAKEN BY OTHER STATE OR FEDERAL GOVERNMENT (NO RECORDS)
ARBITRATION AWARD (NO RECORDS)
PUBLIC DOCUMENTS
DOCUMENTS (NO RECORDS)