EBIX Insurance No. S200004909
AGREEMENT FOR SERVICES
BETWEEN THE
CITY OF SANTA CLARA, CALIFORNIA,
AND
LIFE EXTENSION CLINICS, INC DBA LIFE SCAN WELLNESS CENTERS
PREAMBLE
This Agreement is entered into between the City of Santa Clara, California, a chartered California municipal corporation (City) and Life Extension Clinics, Inc. dba Life Scan Wellness Center, a Florida corporation, (Contractor). City and Contractor may be referred to individually as a "Party" or collectively as the "Parties" or the "Parties to this Agreement."
RECITALS
A. City desires to secure the services more fully described in this Agreement, at Exhibit A, entitled "Scope of Services";
B. Contractor represents that it, and its subcontractors, if any, have the professional qualifications, expertise, necessary licenses and desire to provide certain goods and/or required services of the quality and type which meet objectives and requirements of City; and,
C. The Parties have specified herein the terms and conditions under which such services will be provided and paid for.
The Parties agree as follows:
AGREEMENT TERMS AND CONDITIONS
1. AGREEMENT DOCUMENTS
The documents forming the entire Agreement between City and Contractor shall consist of these Terms and Conditions and the following Exhibits, which are hereby incorporated into this Agreement by this reference:
Exhibit A - Scope of Services
Exhibit B1 - Schedule of Fees
Exhibit B2 - Fee Details
Exhibit C - Insurance Requirements
This Agreement, including the Exhibits set forth above, contains all the agreements, representations and understandings of the Parties, and supersedes Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center Rev. 07-01-18
and replaces any previous agreements, representations and understandings, whether oral or written. In the event of any inconsistency between the provisions of any of the Exhibits and the Terms and Conditions, the Terms and Conditions shall govern and control.
2. TERM OF AGREEMENT
Unless otherwise set forth in this Agreement or unless this paragraph is subsequently modified by a written amendment to this Agreement, the term of this Agreement shall begin on April 7, 2022 and terminate on April 30, 2023.
3. SCOPE OF SERVICES & PERFORMANCE SCHEDULE
Contractor shall perform those Services specified in Exhibit A within the time stated in Exhibit A. Time is of the essence.
4. WARRANTY
Contractor expressly warrants that all materials and services covered by this Agreement shall be fit for the purpose intended, shall be free from defect and shall conform to the specifications, requirements and instructions upon which this Agreement is based. Contractor agrees to promptly replace or correct any incomplete, inaccurate or defective Services at no further cost to City when defects are due to the negligence, errors or omissions of Contractor. If Contractor fails to promptly correct or replace materials or services, City may make corrections or replace materials or services and charge Contractor for the cost incurred by City.
5. QUALIFICATIONS OF CONTRACTOR - STANDARD OF CARE
Contractor represents and maintains that it has the expertise in the professional calling necessary to perform the Services, and its duties and obligations, expressed and implied, contained herein, and City expressly relies upon Contractor's representations regarding its skills and knowledge. Contractor shall perform such Services and duties in conformance to and consistent with the professional standards of a specialist in the same discipline in the State of California.
6. COMPENSATION AND PAYMENT
In consideration for Contractor's complete performance of Services, City shall pay Contractor for all materials provided and Services rendered by Contractor in accordance with Exhibit B1, entitled "SCHEDULE OF FEES" and Exhibit B2, entitled "FEE DETAILS." The maximum compensation of this Agreement is One Hundred Thousand Dollars ($100,000), subject to budget appropriations, which includes all payments that may be authorized for Services and for expenses, supplies, materials and equipment required to perform the Services. All work performed or materials provided in excess of the maximum compensation shall Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center Rev. 07-01-18
be at Contractor's expense. Contractor shall not be entitled to any payment above the maximum compensation under any circumstance.
7. TERMINATION
A. Termination for Convenience. City shall have the right to terminate this Agreement, without cause or penalty, by giving not less than Thirty (30) days' prior written notice to Contractor.
B. Termination for Default. If Contractor fails to perform any of its material obligations under this Agreement, in addition to all other remedies provided by law, City may terminate this Agreement immediately upon written notice to Contractor.
C. Upon termination, each Party shall assist the other in arranging an orderly transfer and close-out of services. As soon as possible following the notice of termination, but no later than ten (10) days after the notice of termination, Contractor will deliver to City all City information or material that Contractor has in its possession.
8. ASSIGNMENT AND SUBCONTRACTING
City and Contractor bind themselves, their successors and assigns to all covenants of this Agreement. This Agreement shall not be assigned or transferred without the prior written approval of City. Contractor shall not hire subcontractors without express written permission from City.
Contractor shall be as fully responsible to City for the acts and omissions of its subcontractors, and of persons either directly or indirectly employed by them, as Contractor is for the acts and omissions of persons directly employed by it.
9. NO THIRD PARTY BENEFICIARY
This Agreement shall not be construed to be an agreement for the benefit of any third party or parties and no third party or parties shall have any claim or right of action under this Agreement for any cause whatsoever.
10. INDEPENDENT CONTRACTOR
Contractor and all person(s) employed by or contracted with Contractor to furnish labor and/or materials under this Agreement are independent contractors and do not act as agent(s) or employee(s) of City. Contractor has full rights to manage its employees in their performance of Services under this Agreement.
11. CONFIDENTIALITY OF MATERIAL
All ideas, memoranda, specifications, plans, manufacturing procedures, data, drawings, descriptions, documents, discussions or other information developed Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center Rev. 07-01-18
or received by or for Contractor and all other written information submitted to Contractor in connection with the performance of this Agreement shall be held confidential by Contractor and shall not, without the prior written consent of City, be used for any purposes other than the performance of the Services nor be disclosed to an entity not connected with performance of the Services. Nothing furnished to Contractor which is otherwise known to Contractor or becomes generally known to the related industry shall be deemed confidential.
12. OWNERSHIP OF MATERIAL
All material, which shall include, but not be limited to, data, sketches, tracings, drawings, plans, diagrams, quantities, estimates, specifications, proposals, tests, maps, calculations, photographs, reports, designs, technology, programming, works of authorship and other material developed, collected, prepared or caused to be prepared under this Agreement shall be the property of City but Contractor may retain and use copies thereof. City shall not be limited in any way or at any time in its use of said material. However, Contractor shall not be responsible for damages resulting from the use of said material for work other than Project, including, but not limited to, the release of this material to third parties.
13. RIGHT OF CITY TO INSPECT RECORDS OF CONTRACTOR
City, through its authorized employees, representatives or agents shall have the right during the term of this Agreement and for four (4) years from the date of final payment for goods or services provided under this Agreement, to audit the books and records of Contractor for the purpose of verifying any and all charges made by Contractor in connection with Contractor compensation under this Agreement, including termination of Contractor. Contractor agrees to maintain sufficient books and records in accordance with generally accepted accounting principles to establish the correctness of all charges submitted to City. Any expenses not so recorded shall be disallowed by City. Contractor shall bear the cost of the audit if the audit determines that there has been a substantial billing deviation in excess of five (5) percent adverse to the City.
Contractor shall submit to City any and all reports concerning its performance under this Agreement that may be requested by City in writing. Contractor agrees to assist City in meeting City's reporting requirements to the State and other agencies with respect to Contractor's Services hereunder.
14. HOLD HARMLESS/INDEMNIFICATION
A To the extent permitted by law, Contractor agrees to protect, defend, hold harmless and indemnify City, its City Council, commissions, officers, employees, volunteers and agents from and against any claim, injury, liability, loss, cost, and/or expense or damage, including all costs and attorney's fees in providing a defense to any such claim or other action, and whether sounding in law, contract, tort, or equity, in any manner Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center Rev. 07-01-18
Page4
arising from, or alleged to arise in whole or in part from, or in any way connected with the Services performed by Contractor pursuant to this Agreement - including claims of any kind by Contractor's employees or persons contracting with Contractor to perform any portion of the Scope of Services - and shall expressly include passive or active negligence by City connected with the Services. However, the obligation to indemnify shall not apply if such liability is ultimately adjudicated to have arisen through the sole active negligence or sole willful misconduct of City; the obligation to defend is not similarly limited.
B. Contractor's obligation to protect, defend, indemnify, and hold harmless in full City and City's employees, shall specifically extend to any and all employment-related claims of any type brought by employees, contractors, subcontractors or other agents of Contractor, against City (either alone, or jointly with Contractor), regardless of venue/jurisdiction in which the claim is brought and the manner of relief sought.
C. To the extent Contractor is obligated to provide health insurance coverage to its employees pursuant to the Affordable Care Act ("Act") and/or any other similar federal or state law, Contractor warrants that it is meeting its obligations under the Act and will fully indemnify and hold harmless City for any penalties, fines, adverse rulings, or tax payments associated with Contractor's responsibilities under the Act.
15. INSURANCE REQUIREMENTS
During the term of this Agreement, and for any time period set forth in Exhibit C, Contractor shall provide and maintain in full force and effect, at no cost to City, insurance policies as set forth in Exhibit C.
16. WAIVER
Contractor agrees that waiver by City of any one or more of the conditions of performance under this Agreement shall not be construed as waiver(s) of any other condition of performance under this Agreement. Neither City's review, acceptance nor payments for any of the Services required under this Agreement shall be constructed to operate as a waiver of any rights under this Agreement or of any cause of action arising out of the performance of this Agreement.
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center Rev. 07-01-18
17. NOTICES
All notices to the Parties shall, unless otherwise requested in writing, be sent to City addressed as follows :
City of Santa Clara
Attention : Fire Department
1500 Warburton Avenue
Santa Clara, CA 95050
and by e-mail at fire@santaclaraca .gov
And to Contractor addressed as follows :
Life Extension Clinics, Inc. dba Life Scan Wellness Centers Attn : Patricia Johnson
1011 North MacDill Avenue
Tampa, FL 33607
and by e-mail at [email protected]
The workday the e-mail was sent shall control the date notice was deemed given .
An e-mail transm itted after 1 :00 p.m. on a Friday shall be deemed to have been transmitted on the following business day.
18. COMPLIANCE WITH LAWS
Contractor shall comply with all applicable laws and regulations of the federal , state and local government , including but not limited to "The Code of the City of Santa Clara, California" ("SCCC"). In particular , Contractor 's attention is called to the regulations regarding Campaign Contributions (SCCC Chapter 2.130), Lobbying (SCCC Chapter 2.155) , Minimum Wage (SCCC Chapter 3.20), Business Tax Certificate (SCCC section 3.40.060), and Food and Beverage Service Worker Retention (SCCC Chapter 9.60), as such Chapters or Sections may be amended from time to time or renumbered. Additionally Contractor has read and agrees to comply with City's Ethical Standards (http://santaclaraca .gov/home/showdocument?id=58299 ).
19. CONFLICTS OF INTEREST
Contractor certifies that to the best of its knowledge, no City officer , employee or authorized representative has any financial interest in the business of Contractor and that no person associated with Contracto r has any interest, direct or indirect , which could conflict with the faithful performance of this Agreement. Contractor is familiar with the provisions of California Government Code section 87100 and Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center Rev. 07-01-18
following, and certifies that it does not know of any facts which would violate these code provisions. Contractor will advise City if a conflict arises.
20. FAIR EMPLOYMENT
Contractor shall not discriminate against any employee or applicant for employment because of race, sex, color, religion, religious creed, national origin, ancestry, age, gender, marital status, physical disability, mental disability, medical condition, genetic information, sexual orientation, gender expression, gender identity, military and veteran status, or ethnic background, in violation of federal, state or local law.
21. NO USE OF CITY NAME OR EMBLEM
Contractor shall not use City's name, insignia, or emblem, or distribute any information related to services under this Agreement in any magazine, trade paper, newspaper or other medium without express written consent of City.
22. GOVERNING LAW AND VENUE
This Agreement shall be governed and construed in accordance with the statutes and laws of the State of California. The venue of any suit filed by either Party shall be vested in the state courts of the County of Santa Clara, or if appropriate, in the United States District Court, Northern District of California, San Jose, California.
23. SEVERABILITY CLAUSE
In case any one or more of the provisions in this Agreement shall, for any reason, be held invalid, illegal or unenforceable in any respect, it shall not affect the validity of the other provisions, which shall remain in full force and effect.
24. AMENDMENTS
This Agreement may only be modified by a written amendment duly authorized and executed by the Parties to this Agreement.
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center Rev. 07-01-18
25. COUNTERPARTS
This Agreement may be executed in counterparts, each of which shall be deemed to be an original, but both of which shall constitute one and the same instrument.
The Parties acknowledge and accept the terms and conditions of this Agreement as evidenced by the following signatures of their duly authorized representatives. nta Clara
CITY OF SANTA CLARA, CALIFORNIA
a chartered California municipal corporation
orney
Dated: {.../ "v-/ -z... 2--
~ ~Batra
"CITY"
City Manager
1500 Warburton Avenue
Santa Clara, CA 95050
Telephone: (408) 615-2210
Fax: (408) 241-6771
LIFE EXTENSION CLINICS, INC. OBA LIFE SCAN WELLNESS CENTERS a Florida corporation
Dated: t-ff-==;;ql.:::="-~~~r ~--------
B y (Signature): "=,_,,,c--___,.c..+--'-.......,__-""'-'-,,.Lb"-"'------==:;__J:;______:r-- _ __ _ Name: -'-:..:...:.:....:..:..:..::..C....::.....:c..:...:..:...:,~;L------------ Title: - ---------- ---- - -Pr inc i pa I Place of 1011 N. MacDill Avenue Business Address: Tampa, FL 33607 --~~-------- =------- Em a i I Address : patricia .johnson@lifescanwellne ~ com Telephone : (813) 876-0625
Fax: (813) 876-0653
"CONTRACTOR "
Agreement with Life Extension Clinics , Inc. dba Life Scan Wellness Center Rev. 07-01-18
EXHIBIT A
SCOPE OF SERVICES
The Services to be performed for the City by the Contractor under this Agreement are set forth below.
1. General Information
1.1. Contractor will provide occupational medical services for City staff at various City locations within Santa Clara, 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 and employees 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.
1.2. All reports provided by Contractor 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.
Testing results to be reviewed and discussed with patient by Contractor's physician.
2. Technical Specifications
Contractor will provide occupational medical services including, but not limited to, the following:
2.1. Pre-Employment Physicals (Post Job Offer):
2.1.1. Provide pre-employment physicals for public safety personnel compliant with California Commission on Peace Officer Standards Training (POST) for Police personnel and as recommended by National Fire Protection Association (NFPA) for Fire personnel.
2.1.2. Provide medical clearance reports on pre-employment physicals and "any additional testing (as necessary) "to the City via electronic mail within three (3) business days of the appointment. If information is delayed, the physician's office must proactively contact City staff via telephone or electronic mail to communicate the delay and anticipated completion date.
2.1.3. Provide sufficient staffing availability to schedule appointments within two (2) business days of a request for appointment.
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit A-Scope of Services
Rev. 07-01-18
2.1.4. Maintain sufficient scheduling availability to conduct examinations within ten (10) business days of a request for appointment
2.1.5. 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.
2.1.6. 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.
2.2. Drug and Alcohol Testing
2.2.1. Contractor will provide drug and alcohol testing services for employees of the City 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)
2.2.2. 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.
2.2.3. 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.
2.2.4. Provide results of alcohol testing to the City via electronic mail immediately after completion of testing.
2.2.5. Provide results of drug testing within three (3) business days of the test to the City of Santa Clara via electronic mail. If information is delayed, the physician's office must proactively contact City/Risk Division via telephone or electronic mail to communicate the delay and anticipated completion date.
2.3. Annual & Post-Employment Medical Surveillance
2.3.1. 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:
2.3.1.1. Cal/OSHA Respirator Questionnaire
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit A-Scope of Services
Rev. 07-01-18
2.3.1.2. Asbestos Exposure Monitoring
2.3.1.3. Hazardous Waste Remediation Examinations
2.3.1.4. Pesticide Exposure Monitoring
2.3.1.5. Immunizations (such as Flu, Hepatitis, Measles, Mumps, Rubella, Tetanus, etc.)
2.3.1.6. Cal/OSHA Aerosol Transmissible Disease Standard Compliance
2.4. Annual Physicals
2.4.1. 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) for Police personnel and as recommended by National Fire Protection Association (NFPA) for Fire personnel.
2.5. Additionally, the City's Fire Department reserves the option to request the optional services below:
2.5.1. Vision Exam (Titmus) Skin cancer assessment
2.5.2. Behavioral Health and Sleep Assessment Screenings
2.5.3. Personal Consultation with review of testing results
2.5.4. Thyroid Ultrasound
2.5.5. Echocardiogram (Heart) Ultrasound
2.5.6. Carotid Arteries Ultrasound
2.5.7. Liver, Gall Bladder, Spleen, & Kidney & Bladder Ultrasounds
2.5.8. Ovaries and Uterus Ultrasounds (Women)
2.5.9. Prostate and Testicular Ultrasound (Men)
2.5.10. Hemoccult Test with Digital Rectal Exam (fecal occult blood testing)
2.5.11. Urinalysis
2.5.12. Lipid Panel
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit A-Scope of Services
Rev. 07-01-18
2.5.13. Thyroid Panel TSH with Reflex to T4
2.5.14. Testosterone (men)
2.5.15. CA-125 (women)
2.5.16. Muscular Strength and Endurance Evaluation
2.5.17. Aerobic Endurance Evaluation (V02 Max Cale)
2.5.18. Flexibility Evaluation
2.5.19. Nutrition and Diet Recommendations
2.5.20. Personal Fitness Recommendations QuantiFeron Gold TB Blood Test
2.5.21. HIV Screening Test
2.5.22. TD (Tetanus) Titer
2.5.23. TD (Tetanus) Vaccine
2.5.24. Varicella Titer
2.5.25. Varicella Vaccine
2.5.26. Meningococcal Titer
2.5.27. Meningococcal Vaccine
2.5.28. Hepatitis A Titer
2.5.29. Hepatitis A Virus Screening Test
2.5.30. Hepatitis B Virus Screening Test
2.5.31. Hepatitis C Virus Screening Test
2.5.32. MMR (Measles, Mumps and rubella)
2.5.33. MMR Titer (is a blood test that checks for immunity)
2.5.34. Polio Titer (test is used to check immunity to Polio_ Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit A-Scope of Services Page4
Rev. 07-01-18
2.5.35. Polio Vaccine Booster (Adults who completed the polio vaccine series as children and are traveling to areas with increased risk of polio should receive a one-time booster close of vaccine (IPV).)
2.5.36. Testosterone Blood Test
2.5.37. C Reactive Blood Test (Heavy Metals) (Hazmat The level of C reactive protein (CRP), which can Be measured in your blood, increases when there's inflammation in your body.)
2.5.38. Body Weight and Composition (Calipers)
2.5.39. Coronary Calcium Score Baseline
2.6. Billing and Reports
2.6.1. 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.
2.6.2. Provide a monthly explanation and summary of charges incurred in a format established by the City in its sole discretion.
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit A-Scope of Services
Rev. 07-01-18
EXHIBIT 81
SCHEDULE OF FEES
1. MAXIMUM COMPENSATION
1.1. The maximum amount payable for all services provided under this Agreement shall not exceed One Hundred Thousand Dollars ($100,000), during the term of the Agreement. No additional services will be performed unless both Parties execute an amendment outlining the services requested and the compensation agreed for such services.
1.2. All payments are based upon City's acceptance of Contractor's performance of services specified in Exhibit A, Scope of Services. City shall have no obligation to pay unless Contractor has successfully completed the work for which payment is due.
2. FEES
2.1. City will pay Contractor the fee specified below for annual physicals:
Services Fee
Public Safety Annual Physical $700/Each
2.2. See Exhibit B2 (Fee Details) for specific details of the services included in the Public Safety Annual Physical.
2.3. The City may request as needed the optional services specified in Section 2 of Exhibit B2 (Fee Details).
3. PRICING
3.1. Pricing shall be fixed for the term of the Agreement.
4. INVOICING REQUIREMENTS
4.1. Contractor will invoice the City on a monthly basis for services provided by Contractor during the preceding month on an invoice and in a format approved by the City, including supporting narrative documentation, and is subject to verification and approval by City.
4.2. City will pay Contractor within thirty (30) days of City's receipt of an approved invoice.
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit 81-Schedule of Fees
Rev. 07-01-18
EXHIBIT 82
FEE DETAILS
1. The following services are included in the public safety annual physicals:
Public Safety Annual Physical $700/Each
Description: Fee
Medical & Occupational/Environmental Questionnaire Included Comprehensive Hands-On Physical Exam Included
Vital Signs: Height, Weight, Blood Pressure, Pulse Included Sleep Disorder Evaluation, Epworth Sleep Scale Included Back Health Evaluation Included
Urinalysis Included
Audiomam Included
Titmus Occupational Vision with Peripheral, Depth
Perception, and Color Included
Breast Exam with Self-Exam education Included
Personal Consultation with review of testinQ results Included Laboratorv Tests:
Comprehensive Metabolic Panel, Blood Chemistry Included Complete Blood Count, HematoloQy Panel Included
Hemoccult Stool Test for Colon Cancer Screening Included Total Lipid Panel Included
Thyroid Test TSH Included
Glucose Included
Hemoglobin A 1 C Included
PSA (Prostate cancer marker, Men) Included
Testosterone (Men) Included
Ultrasound Screenings (Early Detection of Heart
Disease and Cancer):
Echocardiogram (Heart Ultrasound) Included
Carotid Arteries Ultrasound Included
Aorta and Aortic Valve Ultrasounds Included
Liver Ultrasound Included
Gall Bladder Ultrasound Included
Kidneys Ultrasound Included
Spleen Ultrasound Included
Bladder Ultrasound Included
Thyroid Ultrasound Included
Prostate Ultrasound Included
Testicular Ultrasound Included
Ovaries and Uterus Ultrasounds Included
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit 82-Fee Details Page 1 Rev. 07-01-18
Description: Fee
Cardiopulmonary Testing
Cardiac Stress Test (Treadmill with 12 lead, sub-
maximal, Bruce Protocol) Included
EKG, 12 Lead Included
Spirometry, PFT Lun!=) Capacity Included
OSHA Respirator Medical Clearance Included
Fitness Evaluations per NFPA 1583-IAFF/IAFC
Wellness Fitness Initiative :
Fitness tests for muscular strenqth & endurance Included Sit and Reach , Plankinq, Grip Strenqth, Included
Sit Up Test, Wall Sit, Flexibility Included
VO2 Max Cale for Aerobic Capacity Included
Body Weight and Composition Included
Personal Fitness Rx Included
Personal Wellness Plan with recommendations Included
2. The following are optional services provided by Contractor :
Optional Tests Available Fee Per
Test
Chest X-Ray, 2 view with radiologist review $80.00
Lumbar X-Rav, 2 view with radioloqist review $80 .00
Hazmat Cholinestrese $81.00
Hazmat Heavy Metals $81.00
Hepatitis A Screeninq Test $60 .00
Hepatitis A Titer $38.00
Hepatitis B Screeninq Test $60.00
Hepatitis B Titer $38.00
Hepatitis C Screening Test $60.00
HIV Test, Gen 4 $29.00
PPD TB Skin Test $29.00
QuantiFeron TB Blood Test $72.00
Tdap (Tetanus, Diphtheria , Pertussis) Titer $32 .00
Tdap (Tetanus, Diphtheria , Pertussis) Vaccine, single dose $86.00 MMR Booster $86.00
MMR Titer $86.00
Varicella Vaccine $24.00
Varicella Titer $128.00
Polio Booster $33.00
Polio Titer $64.00
OSHA Respirator Mask Fit Testinq (Portacount) $44.00
Drug Screen, I CUP $51.00
Druq Rescreen with confirmation $58.00
Medical Review Officer (MRO) as indicated/secondary $117 .00 review Agreement with Life Extension Clinics , Inc. dba Life Scan Wellness Center/Exhibit B2-Fee Details Page/ 2- Rev. 07-01-18
Optional Tests Available Fee Per
Test
Phlebotomist (Blood Draw) Fee $22.00
Cardiac Calcium Scorinq $150 .00
Covid-19 Antibody Test $100.00
Agreement with Life Extension Clinics, Inc. dba Life Scan Wellness Center/Exhibit 82-Fee Details PageJ' 3 Rev. 07-01-18
EXHIBIT C
INSURANCE REQUIREMENTS
Without limiting the Contractor's indemnification of the City, and prior to commencing any of the Services required under this Agreement, the Contractor shall provide and maintain in full force and effect during the period of performance of the Agreement following acceptance by the City, at its sole cost and expense, the following insurance policies from insurance companies authorized to do business in the State of California.
The General Liability policy shall be primary insurance as to the City of Santa Clara so that any other coverage held by the City shall not contribute to any loss under Contractor's insurance. The minimum coverages, provisions and endorsements are as follows:
A. COMMERCIAL GENERAL LIABILITY INSURANCE
1. Commercial General Liability Insurance policy which provides coverage at least as broad as Insurance Services Office form CG 00 01. Policy limits are subject to review, but shall in no event be less than, the following:
$1,000,000 Each Occurrence
$2,000,000 General Aggregate
$2,000,000 Products/Completed Operations Aggregate
$1,000,000 Personal Injury
2. Exact structure and layering of the coverage shall be left to the discretion of Contractor; however, any excess or umbrella policies used to meet the required limits shall be at least as broad as the underlying coverage and shall otherwise follow form.
3. The following provisions shall apply to the Commercial Liability policy as well as any umbrella policy maintained by the Contractor to comply with the insurance requirements of this Agreement:
a. Coverage shall be on a "pay on behalf' basis with defense costs payable in addition to policy limits;
b. There shall be no cross liability exclusion which precludes coverage for claims or suits by one insured against another; and c. Coverage shall apply separately to each insured against whom a claim is made or a suit is brought, except with respect to the limits of liability.
B. BUSINESS AUTOMOBILE LIABILITY INSURANCE
Business automobile liability insurance policy which provides coverage at least as broad as ISO form CA 00 01 with policy limits a minimum limit of not less than one million dollars ($1,000,000) each accident using, or providing coverage at Agreement with Life Extension Clinics, dba Life Scan Wellness Centers/Exhibit C-lnsurance Requirements Page 1
Rev. 07-01-18
least as broad as, Insurance Services Office form CA 00 01. Liability coverage shall apply to all owned (if any), non-owned and hired autos.
In the event that the Work being performed under this Agreement involves transporting of hazardous or regulated substances, hazardous or regulated wastes and/or hazardous or regulated materials, Contractor and/or its subcontractors involved in such activities shall provide coverage with a limit of one million dollars ($1,000,000) per accident covering transportation of such materials by the addition to the Business Auto Coverage Policy of Environmental Impairment Endorsement MCS90 or Insurance Services Office endorsement form CA 99 48, which amends the pollution exclusion in the standard Business Automobile Policy to cover pollutants that are in or upon, being transported or towed by, being loaded onto, or being unloaded from a covered auto.
C. WORKERS' COMPENSATION
1. Workers' Compensation Insurance Policy as required by statute and employer's liability with limits of at least one million dollars ($1,000,000) policy limit Bodily Injury by disease, one million dollars ($1,000,000) each accident/Bodily Injury and one million dollars ($1,000,000) each employee Bodily Injury by disease.
2. The indemnification and hold harmless obligations of Contractor included in this Agreement shall not be limited in any way by any limitation on the amount or type of damage, compensation or benefit payable by or for Contractor or any subcontractor under any Workers' Compensation Act(s), Disability Benefits Act(s) or other employee benefits act(s).
3. This policy must include a Waiver of Subrogation in favor of the City of Santa Clara, its City Council, commissions, officers, employees, volunteers and agents.
D. PROFESSIONAL LIABILITY
Professional Liability or Errors and Omissions Insurance as appropriate shall be written on a policy form coverage specifically designed to protect against negligent acts, errors or omissions of the Contractor. Covered services as designated in the policy must specifically include work performed under this agreement. Coverage shall be in an amount of not less than one million dollars ($1,000,000) per claim or two million dollars ($2,000,000) aggregate. Any coverage containing a deductible or self-retention must first be approved in writing by the City Attorney's Office.
E. COMPLIANCE WITH REQUIREMENTS
All of the following clauses and/or endorsements, or similar provisions, must be part of each commercial general liability policy, and each umbrella or excess policy.
Agreement with Life Extension Clinics, dba Life Scan Wellness Centers/Exhibit C-lnsurance Requirements
Rev. 07-01-18
Page2
1. Additional Insureds. City of Santa Clara, its City Council, commissions, officers, employees, volunteers and agents are hereby added as additional insureds in respect to liability arising out of Contractor's work for City, using Insurance Services Office (ISO) Endorsement CG 20 10 11 85, or the combination of CG 20 10 03 97 and CG 20 37 10 01, or its equivalent.
2. Primary and non-contributing. The General Liability policy provided by Contractor shall contain language or be endorsed to contain wording making it primary insurance as respects to, and not requiring contribution from, any other insurance which the indemnities may possess, including any self-insurance or self-insured retention they may have. Any other insurance indemnities may possess shall be considered excess insurance only and shall not be called upon to contribute with Contractor's insurance.
3. Cancellation.
a. Each insurance policy shall contain language or be endorsed to reflect that no cancellation or modification of the coverage provided due to non-payment of premiums shall be effective until written notice has been given to City at least ten (10) days prior to the effective date of such modification or cancellation. In the event of non-renewal, written notice shall be given at least ten (10) days prior to the effective date of non-renewal.
b. Each insurance policy shall contain language or be endorsed to reflect that no cancellation or modification of the coverage provided for any cause save and except non-payment of premiums shall be effective until written notice has been given to City at least thirty (30) days prior to the effective date of such modification or cancellation. In the event of non-renewal, written notice shall be given at least thirty (30) days prior to the effective date of non renewal.
F. ADDITIONAL INSURANCE RELATED PROVISIONS
Contractor and City agree as follows:
1. Contractor agrees to ensure that subcontractors, and any other party involved with the Services, who is brought onto or involved in the performance of the Services by Contractor, provide the same minimum insurance coverage required of Contractor, except as with respect to limits. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this Agreement. Contractor agrees Agreement with Life Extension Clinics, dba Life Scan Wellness Centers/Exhibit C-lnsurance Requirements Page 3
Rev. 07-01-18
that upon request by City, all agreements with, and insurance compliance documents provided by, such subcontractors and others engaged in the project will be submitted to City for review .
2. Contractor agrees to be responsible for ensuring that no contract used by any party involved in any way with the project reserves the right to charge City or Contractor for the cost of additional insurance coverage required by this Agreement. Any such provisions are to be deleted with reference to City. It is not the intent of City to reimburse any third party for the cost of complying with these requirements . There shall be no recourse against City for payment of premiums or other amounts with respect thereto.
3. The City reserves the right to withhold payments from the Contractor in the event of material noncompliance with the insurance requirements set forth in this Agreement.
G. EVIDENCE OF COVERAGE
Prior to commencement of any Services under this Agreement , Contractor , and each and every subcontractor (of every tier) shall, at its sole cost and expense , provide and maintain not less than the minimum insurance coverage with the endorsements and deductibles indicated in this Agreement. Such insurance coverage shall be maintained with insurers, and under forms of policies, satisfactory to City and as described in this Agreement. Contractor shall file with the City all certificates and endorsements for the required insurance policies for City's approval as to adequacy of the insurance protection .
H. EVIDENCE OF COMPLIANCE
Contractor or its insurance broker shall provide the required proof of insurance compliance , consisting of Insurance Services Office (ISO) endorsement forms or their equivalent and the ACORD form 25-S certificate of insurance (or its equivalent), evidencing all required coverage shall be delivered to City, or its representative as set forth below, at or prior to execution of this Agreement.
Upon City's request , Contractor shall submit to City copies of the actual insurance policies or renewals or replacements . Unless otherwise required by the terms of this Agreement , all certificates, endorsements , coverage verifications and other items required to be delivered to City pursuant to this Agreement shall be emailed to:
ctsantaclara@ebix .com
or mailed to:
EBIX Inc.
City of Santa Clara Fire Department
P.O. Box 100085- S2
Duluth , GA 30096
Agreement with Life Extension Clinics, dba Life Scan Wellness Centers/Exhibit C-lnsurance Requirements
Rev. 07-01-18
Page4
Telephone number: 951-766-2280
Fax number: 770-325-0409
I. QUALIFYING INSURERS
All of the insurance companies providing insurance for Contractor shall have, and provide written proof of, an A. M. Best rating of at least A minus 6 (A- VI) or shall be an insurance company of equal financial stability that is approved by the City or its insurance compliance representatives.
Agreement with Life Extension Clinics, dba Life Scan Wellness Centers/Exhibit C-lnsurance Requirements
Rev. 07-01-18
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Name: Life Extension Clinics dba Life Scan Wellness Cent A Account Number: S200004909
Address: 1011 North MacDill Avenue, Tampa, FL, 33607
Status: ComRliant with minor/exRiring deficiencies.
The following deficiencies are according to last validation on :04/13/2022 Deficiencies Information
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