Proposal For Occupational Health Services
Submitted by:
AFC Urgent Care of Santa Clarita
Prepared by:
Lupe Hafner, Director of Business Developement
[email protected] 661-714-8158
ofe
american family care
URGENT CARE
19042 Soledad Canyon Road Santa Claria CA 91351
www.afcurgentcare.com/santaclarita 661-251-6300 Option 1 27550 Newhall Ranch Road Suite 203 Valencia CA 91355
www.afcurgentcare.com/valencia 661-251-6300 Option 2
Statement of Project Understanding
AFC Urgent Care (American Family Care) welcomes the opportunity to present this proposal In response to the City of Santa Clarita Board RFP, Occupational Health Services Provider. AFC fully understands this proposal request is for the provision of Occupational Health Services for employees/applicants of the City of Santa Clarita.
As a side note we would like to add that AFC Urgent Care has provided occupational health services to the City of Santa Clarita since 10/2021 with our contract ending 06/2025. We truly value our long-standing reltionship with the City and hope our proposal is deemed acceptable.
Background of Company
AFC Urgent Care (American Family Care) is a health care franchise with close to 300 clinics nationwide that specialises in urgent care, occupational medicine, and non-emergency medicine all individually owned and operated. Our location in Canyon Country opened 07/2012 with our Valencia location opening 05/2021. Former business executives Curtis and Lupe Hafner opened and operate the clinics with Dr. Gian P. Hernandez, President and Medical Director.
Employer Resources:
: Pre employment exams
Drug testing
• DOT physical exams
Audiometric testing
• Vision screening
Respirator medical clearance
Digital X-Rays
• Vaccinations, TB Testing
• Work place injuries
• Return to work exams
Hours of Operation
Monday-Friday 8:00am - 8:00pm
Saturday & Sunday 8:00am - 6:00 pm
Contractor Responsibilities
Both locations can provide all requested services listed in the RFP as demonstrated in our prae orst are placement exams and drug testing corinated with the cry if there are substantial volumes to increase effeciancy in hiring.
NOTICE TO PROPOSERS REGARDING CONTRACTUAL REQUIREMENTS
PROPOSAL # HR-24-25-13
Occupational Health Services
City of Santa Clarita, California
1. SUMMARY OF CONTRACTUAL REQUIRMENTS
a. A contract is required for any service performed on behalf of the City of Santa Clarita (City). b. By submitting a proposal, you have reviewed the sample contract documents contained within this request for proposals and agree to be bound by the requirements set forth. c. Questions and requests for modification of these terms must be negotiated and approved prior to proposal submission and are at the full discretion of the City.
2. SUMMARY OF INDEMNITY AND INSURANCE REQUIREMENTS
a. These are the Indemnity and Insurance Requirements for Contractors providing services or supplies to City of Santa Clarita (City). By agreeing to perform the work or submitting a proposal, you verify that you comply with and agree to be bound by these requirements. If any additional Contract documents are executed, the actual Indemnity language and Insurance Requirements may include additional provisions as deemed appropriate by City's Purchasing Agent.
b. You should check with your Insurance advisors to verify compliance and determine if additional coverage or limits may be needed to adequately insure your obligations under this agreement. These are the minimum required and do not in any way represent or imply that such coverage is sufficient to adequately cover the Contractor's liability under this agreement. The full coverage and limits afforded under Contractor's policies of Insurance shall be available to Buyer and these Insurance Requirements shall not in any way act to reduce coverage that is broader or includes higher limits than those required.
The Insurance obligations under this agreement shall be: 1—all the Insurance coverage and limits carried by or available to the Contractor; or 2-the minimum Insurance requirements shown in this agreement, whichever is greater. Any insurance proceeds in excess of the specified minimum limits and coverage required, which are applicable to a given loss, shall be available to City. c. Contractor shall furnish the City with original Certificates of Insurance including all required amendatory endorsements and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. City reserves the right to require full-certified copies of all Insurance coverage and endorsements.
3. INDEMNIFICATION
a. To the fullest extent permitted by law, CONSULTANT shall defend (with legal counsel reasonably acceptable to CITY), indemnify and hold harmless CITY and its officers, agents, departments, officials, representatives and employees (collectively "Indemnitees") from and against any and all claims, loss, cost, damage, injury (including, without limitation, economic harm, injury to or death of an employee of CONSULTANT or its subconsultants), expense and liability of every kind, nature and description that arise from or relate to (including, without limitation, incidental and consequential damages, court costs, attorneys' fees, litigation expenses and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation) that arise from or relate to, directly or indirectly, in whole or in part, from: (1) CONSULTANT's performance of Services under this Agreement, or any part thereof; (2) any negligent act or omission of CONSULTANT, any subconsultant, anyone directly or indirectly employed by them, or anyone that they control; (3) any actual or alleged infringement of the patent rights, copyright, trade secret, trade name, trademark, service mark or any other intellectual or proprietary right of any person or persons in consequence of the use by CITY, or any other Indemnitee, of articles or Services to be supplied in the performance of this Agreement; or (4) any breach of this Agreement (collectively "Liabilities"). Such obligations to defend, hold harmless and indemnify any Indemnitee shall not apply to the extent such Liabilities are caused by the sole negligence or willful misconduct of such Indemnitee, but shall apply to all other Liabilities. The foregoing shall be subject to the limitations of California Civil Code section 2782.8 as to any design professional services performed by CONSULTANT and in particular the limitation on CONSULTANT's duty to defend whereby such duty only arises for claims relating to the negligence, recklessness or willful misconduct of CONSULTANT as well as the limitation on the cost to defend whereby CONSULTANT will only bear such cost in proportion to CONSULTANT's proportionate percentage of fault (except as otherwise provided in section 2782.8). b. The foregoing indemnification provisions will not reduce or affect other rights or obligations which would otherwise exist in favor of the CITY and other Indemnitees. c. CONSULTANT shall place in its subconsulting agreements and cause its subconsultants to agree to indemnities and insurance obligations in favor of CITY and other Indemnitees in the exact form and substance of those contained in this Agreement.
4. INSURANCE
a. Before commencing performance under this Agreement, and at all other times this Agreement is effective, CONSULTANT will procure and maintain the following types of insurance with coverage limits complying, at a minimum, with the limits set forth below:
Type of Insurance Limits
Commercial general liability: $1,000,000
Professional liability $1,000,000
Business automobile liability $1,000,000
Workers compensation Statutory requirement
b. Commercial general liability insurance will meet or exceed the requirements of ISO-CGL Form No. CG 00 01 11 85 or 88. The amount of insurance set forth above will be a combined single limit per occurrence for bodily injury, personal injury, and property damage for the policy coverage. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 01 06 92, including symbol 1 (Any Auto). Liability policies will be endorsed to name CITY, its officials, and employees as "additional insureds" under said insurance coverage and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by CITY will be excess thereto. Such endorsement must be reflected on ISO Form No. CG 20 10 11 85 or 88, or equivalent. Such insurance will be on an "occurrence," not a "claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to CITY.
c. Professional liability coverage will be on an "occurrence basis" if such coverage is available, or on a "claims made" basis if not available. When coverage is provided on a "claims made basis," CONSULTANT will continue to renew the insurance for a period of at least three (3) years after this Agreement expires or is terminated. Such insurance will have the same coverage and limits as the policy that was in effect during the term of this Agreement, and will cover CONSULTANT for all claims made by CITY arising out of any errors or omissions of CONSULTANT, or its officers, employees or agents during the time this Agreement was in effect.
d. CONSULTANT will furnish to CITY duly authenticated Certificates of Insurance evidencing maintenance of the insurance required under this Agreement, including endorsements, and such other evidence of insurance or copies of policies as may be reasonably required by CITY from time to time. Insurance must be placed with California-admitted insurers with (other than workers compensation) a current A.M. Best Company Rating of at least "A:VII."
e. Waiver of Subrogation: The insurers) agree to waive all rights of subrogation against CITY, its elected or appointed officers, officials, agents, volunteers and employees for losses paid under the terms of the workers compensation policy which arise from work performed by CONSULTANT for CITY. f. Should CONSULTANT, for any reason, fail to obtain and maintain the insurance required by this Agreement, CITY may obtain such coverage at CONSULTANT's expense and deduct the cost of such insurance from payments due to CONSULTANT. under this Agreement or terminate pursuant to TERMINATION section. In the alternative, should CONSULTANT fail to meet any of the insurance requirements under this Agreement, City may terminate this Agreement immediately with no penalty. g. Should CONSULTANT'S insurance required by this Agreement be cancelled at any point prior to expiration of the policy, CONSULTANT must notify City within 24 hours of receipt of notice of cancellation.
Furthermore, CONSULTANT must obtain replacement coverage that meets all contractual requirements within 10 days of the prior insurer's issuance of notice of cancellation. CONSULTANT must ensure that there is no lapse in coverage.
h. The CITY shall be entitled to any coverage in excess of the minimums required herein.
I have read and understand the above requirements and agree to be bound by them for any work performed for the City.
Authorized Signature: Date: 10/31/2024
Printed Name: Apryl Basaez
DESIGNATION OF SUBCONTRACTORS/SUBCONSULTANTS
PROPOSAL # HR-24-25-13
Occupational Health Services
City of Santa Clarita, California
isted below are the names and locations of the places of business of each subcontractor, supplier, and vendor who will perform work or labor send see is. ease a dor a set need greater of the prime contractor total bid. if no subcontractor will bel Subcontractor DIR Registration No. Dollar Value of Work NA
Location and Place of Business
Bid Schedule Item No's: Description of Work
License No. Exp. Date: / / Phone (
Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business
Bid Schedule Item No's: Description of Work
License No. Exp. Date: / / Phone ()
Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business
Bid Schedule Item No's: Description of Work
License No. Exp. Date: Phone ()
VOTE: A contractor or subcontractor shall not be qualified to propose on, be listed in a proposal, subject to the requirements of Section 4104 c he Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registere
REFERENCES
PROPOSAL # HR-24-25-13
Occupational Health Services
City of Santa Clarita, California
he following are the names, addresses, and telephone numbers of three public agencies for which propose las performed work of a similar scope and size within the past 3 years. If the instructions on this form conflic with the references requested in the scope of work, the scope of work shall govern. Complete this form out accordingly. Fill out this form completely and upload it with your proposal.
1. Quantum Staffing 25020 Avenue Stafford Valencia, CA 91355 Name and Address of Owner / Agency
Chaney 661-257-8740
Name and Telephone Number of Person Familiar with Project No amount set Occupational Services
Open/Ongoing
Contract Amount Type of Work Date Completed
Gothic Landscape, Inc. 27413 Tourney Road Valencia, CA 91355
2. Name and Address of Owner / Agency
Bladie Gutierrez 661-857-3231
Name and Telephone Number of Person Familiar with Project No amount set Occupational Medicine Open/Ongoing
Contract Amount Type of Work Date Completed
Select Painting & Construction
33305 Barber Road Santa Clarita CA 91390
Name and Address of Owner / Agency
Lotte Frank 800-493-8724
Name and Telephone Number of Person Familiar with Project Occupational Medicine, Work Comp Open/Ongoing
No Amount Set
Contract Amount Type of Work Date Completed
ACKNOWLEDGEMENT & ACCEPTANCE OF SCOPE OF WORK
PROPOSAL# HR-24-25-13
Occupational Health Services
City of Santa Clarita, California
By providing the three (3) required signatures below, the Contractor acknowledges full understanding, complete agreement to, and accepts in its entirety, all Scope of Work for the Occupational Health Services The Contractor will be expected to perform maintenance practices and uphold the standards herein to the established Scope of Work throughout the length of the contract. *Supervisor's Signature: _Date: 10/31/2024
Apryl Basaez, Managing Director
*Estimator's Signature: Date: (0/31/2021
Apryl Basaez, Managing Director
*Owner's Signature: Date: 10/31/2024
Gian P. Hernandez, D.O.
*All three signatures required
CITY OF SANTA CLARITA DISCLOSURE STATEMENT
PROPOSAL# HR-24-25-13
Occupational Health Services
City of Santa Clarita, California
The following information must be disclosed:
1. List the names of all persons having a financial interest in the Request for Proposals.
Gian P Hernandez, D.O. sole shareholder.
SC Medical, Inc. DBA AFC Urgent Care Santa Clarita,
DBA AFC Urgent Care Valenic:
2. f any person identified pursuant to No. 1 above is a corporation or partnership, list the names of al individuals owning more than ten percent of the shares in the corporation or owning any partnership interest in the partnership.
Gian P. Hernandez, D.O.
President, Medical Director
3. If any person identified pursuant to No. 1 above is a non-profit organization or a trust, list the names of any persons serving as a director of the non-profit organization or as a trustee or beneficiary or trustor of the trust.
For Profit
4. Has the offeror had more than $250.00 worth of business transacted with any member of the City of Santa Clarita staff, boards, commissions, committees, and Council within the past twelve months? If yes, please indicate the person(s) with whom you have conducted business.
No
NOTE: Attach additional pages as necessary.
Apryl Basaez, Managing Director
Print or Type Name of Offeror
10/31/2024
Date