The URL can be used to link to this page

2014-417• ' , • • ;� i i AN ORDINANCE ACCEPTING COMPETITIVE PROPOSALS AND AWARDING A CONTR.ACT FOR WORKERS' COMPENSATION CLAIMS THIRD PARTY ADMINISTRATION FOR THE CITY OF DENTON; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR; AND PROVIDING AN EFFECTIVE DATE (RFP 5642-AWARDED TO TEXAS POLITICAL SUBDIVISIONS JOINT SELF-INSURANCE FUND IN THE THREE (3) YEARNOT-TO-EXCEED AMOUNT OF $150,000). WHEREAS, the City has solicited, received and tabulated competitive bids for the purchase of necessary materials, equipment, supplies or services in accordance with the procedures of State law and City ordinances; and WHEREAS, the City Manager or a designated employee has reviewed and recommended that the herein described bids are the lowest responsible bids for the materials, equipment, supplies or services as shown in the "Bid Proposals" submitted therefore; and WHEREAS, the City Council has provided in the City Budget for the appropriation of funds to be used for the purchase of the materials, equipment, supplies or services approved and accepted herein; NOW, THEREFORE, THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS: SECTION_1. The numbered items in the following numbered bids for materials, equipment, supplies, or services, shown in the "Bid Proposals" on iile in the office of the City Purchasing Agent, are hereby accepted and approved as being the lowest respansible bids for such items: RF'p VENDOR . '� 5642 Texas Political Subdivisions Joint $150,000 Self-Insurance Fund SECTION 2. By the acceptance and approval of the above numbered items ofthe submitted bids, the City accepts the offer of the persons submitting the bids for such items and agrees to pur- chase the materials, equipment, supplies or services in accordance with the terms, specifications, standards, quantities and for the specified sums contained in the Bid Invitations, Bid Proposals, and related documents. SECTION 3. Shauld the City and the winning bidder(s) wish to enter into a formal written agreement as a result of the acceptance, approval, and awarding of the bids, the City Manager or his designated representative is hereby authorized to execute a written contract in accordance with the terms, conditions, specifications, standards, quantities and specified sums contained in the Bid Proposal and related documents and to extend that contract as determined to be advantageous to the City of Denton. SECTION 4. The City Council of the City of Denton, Texas hereby expressly delegates the authority to take any actions that may be required or permitted to be performed by the City of Denton under RFP 5642 to the City Manager of the City of Denton, Texas, or his designee. SECTION 5. By the acceptance and approval of the above enumerated bids, the City Council hereby authorizes the expenditure of funds therefor in the amount and in accordance with the approved bids. SECTION 6. This ordinance shall become effective immediately upon its passage and approval. ��w�r� ��r� ��]�>��vl�� .��►� �:�', ��{ � �� , `, � W �- � �c� � �� ' �` ` � � � � �_, ,� ,, r � ,� � �� ,�- � r �, � r�- � � � F`� �r ,�.-..... � � � ..... .w�� ..... ....._ ��II � WATTS, MAYOR ATTEST: JENNIFER WALTERS, CITY SECRETARY ��` • `�s��,�`� � `��` �' �� .�� t� r� �� ''�'.�..� �'_, ��f � ,� APPROVED AS TO LEGAL FORM: ANITA BURGESS, CITY ATTORNEY �. � -. �_�� BY. `� �.`��,�°�°�" ' CONTRACT BY AND BETWEEN CITY OF DENTON, TEXAS AND TEXAS POLITICAL SUBDIVISIONS (RFP 5642) s��y' ��` �'��,{r,�' � �' ��, � .... /"►.1�., T1miI� C"�l'�'�`1�AC'"I` i� t�tadc �i�t� ��71er`c�1 irrt�� i��is ��'�<�� ' �,' `� 2��m l�� t�3 b�t�vee�� `i'�.�� l��iiti�s�1 ��.��ciivisicr�i� .1�1�� -aorntit��, w�c��; ��Idi�s� �� 14'��3� ir��is��-k L�1vc�, 3"� ]�l��a�•„ t��[1��, sr� 75"?�4 , i��reirlafi�r° ��.i'��°r�� I.c� �� "Cr��tr°w��ic��°," �ar�� tl�� CITY OF DENTON, TEXAS, a home rule municipal corporation, hereinafter referred to as "City," to be effective upon approval of the Denton City Council and subsequent execution of this Contract by the Denton City Manager or his duly authorized designee. For and in consideration of the covenants and agreements contained herein, and for the mutual benefits to be obtained hereby, the parties agree as follows: SCOPE OF SERVICES Supplier shall provide products and/or services in accordance with the City's document ��a`I' � �f��{2 � �'c��•k�r�" Car��tae��it�� "�'1�it°�i P�riy C;1.�i�z�� c�r��irii�tr�ttit�t� `��°uic�.�, a copy of which is on file at the office of Purchasing Agent and incorporated herein for all purposes. The Contract consists of this written agreement and the following items which are attached hereto and incorporated herein by reference: (a) Special Terms and Conditions (Exhibit "A"); (b) Request for Proposal # 5642 (Exhibit "B" on File at the Office of the Purchasing Agent); (c) City of Denton Standard Terms and Conditions (Exhibit "C"); (d) Insurance Requirements (Exhibit "D"); (e) Form CIQ — Conflict of Interest Questionnaire (Exhibit "E"); ( fl Contractor's Proposal. (Exhibit "F"); (g) TPS Interlocal Agreement (Exhibit "G") These documents make up the Contract documents and what is called for by one shall be as binding as if called for by all. In the event of an inconsistency or conflict in any of the provisions of the Contract documents, the inconsistency or conflict shall be resolved by giving precedence first to the written agreement then to the contract documents in the order in which they are listed above. These documents shall be referred to collectively as "Contract Documents." RFP# 5642 IN WITNESS WHEREOF, the parties of these presents have executed this agreement in the year and day first above written. . r . r r . r CONT CTOR . ,�� BY: � Al.'1� �ORIZED SIGNATURE N );� t c: �� ° � Name: r� � �� . Title: �'� _ �. �� ' • :' ' ��'�� a EMAIL ADDRES�� r 1 � o� ��r �� BY: � � ��. . c,� � "w`" dd �: �-�, `�. �, � �,^^�„� .-�.,��,- _ ��.,�� GEORGE �'. CAMPBELL, CITY MANAGER �a � . �� _. BY ��,��'�� .' E''. r��r'��`��°�� f�� a Date: �,�,, ' ,�"�'� ,� . . � ,r �, � � : � ,r � . :� .•••� � . � ., �• . . ;, . � �. BY: '`� � ' . . . , ., Exhrbit A Special Terms and Conditions Total Contract Amount The contract total for services shall not exceed $150,000. Pricing shall be per Exhibit F attached. Contract Terms The contract term will be one (1) year, effective from date of award. The City and the Supplier shall have the option to renew this contract for an additional two (2) one-year periods. The contract shall commence upon the issuance af a Notice of Award by the City af Denton and shall automatically renew each year, from the date of award by City Council, unless either party notifies the other prior to the scheduled renewal date. At the sole option of the City af Denton, the contract may be further extended as needed, not to exceed a total of six (6) months. Cooperative Purchasin�/Pi��yback Option Cooperative Purchasing Terms as stated in the Main RFP document, Section 8 is removed from this contract. This contract will not be available to other governmental agencies. . . , �, r �, � '` , � � � � These standard Terms and Conditions and the Terms and Conditions, Specifications, Drawings and other requirements included in the City's solicitation are applicable to Contracts/Purchase Orders issued by the City hereinafter referred to as the City or Buyer and the Seller herein after referred to as the Bidder, Cantractor or Supplier. Any deviations must be in writing and signed by a representative of the City's Procurement Department and the Supplier. No Terms and Conditions contained in the Sellers Solicitation Response, Invoice or Statement shall serve to modify the terms set forth herein. If there is a conflict between the provisions on the face of the Contract/Purchase Order these written provisions will take precedence. By submitting an Offer in response to the Solicitation, the Contractor agrees that the Contract shall be governed by the following terms and conditions, unless exceptions are duly noted and fully negotiated. l. CONT CTOR'S OBLIGATIONS. The Contractor shall fully and timely pravide all deliverables described in the Solicitation and in the Contractor's Offer in strict accordance with the terms, covenants, and conditions of the Contract and all applicable Federal, State, and local laws, rules, and regulations. 2. EFFECTIVE DATE/TERM. Unless otherwise specified in the Solicitation, this Contract shall be effective as of the date the contract is signed by the City, and shall continue in effect unti l all obligations are performed in accordance with the Contract. 3. INVOICES: A. The Contractor shall submit separate invoices in duplicate on each purchase order or purchase release after each delivery. If partial shipments or deliveries are authorized by the City, a separate invoice must be sent for each shipment or delivery made. B. Proper Invoices must include a unique invoice number, the purchase order or delivery order number and the master agreement number if applicable, the Department's Name, and the name of the point of contact for the Department. Invoices shall be itemized and transportation charges, if any, shall be listed separately. A copy of the bill of lading and the freight waybill, when applicable, shall be attached to the invoice. The Contractor's name, remittance address and, if applicable, the tax identification number on the invoice must exactly match the information in the Vendor's registration with the City. Unless otherwise instructed in writing, the City may rely on the remittance address specified on the Contractor's invoice. C. Invoices for labor shall include a copy of all time-sheets with trade labor rate and deliverables order number clearly identified. Invoices shall also include a tabulation of work-hours at the appropriate rates and grouped by work order number. Time billed for labor shall be limited to hours actually worked at the work site. D. Unless otherw►se expressly authorized in the Contract, the Contractor shall pass through all Subcontract and other authorized expenses at actual cost without markup. E. Federal excise taxes, State taxes, or City sales taxes must not be included in the invoiced amount. The City will furnish a tax exemption certificate upon request. I' '• .<' 4. PAYMENT: A. All proper invoices need to be sent to Accounts Payable. Approved invoices will be paid within thirty (30) calendar days of the City's receipt of the deliverables or of the invoice being received in Accounts Payable, whichever is later. B. If payment is not timely made, (per paragraph A); interest shall accrue on the unpaid balance at the lesser of the rate specified in Texas Government Code Section 2251.025 or the maximum lawful rate; except, if payment is not timely made for a reason for which the City may withhold payment hereunder, interest shall not accrue until ten (10) calendar days after the grounds for withholding payment have been resolved. C. If partial shipments or deliveries are authorized by the City, the Contractor will be paid for the partial shipment or delivery, as stated above, provided that the invoice matches the shipment or delivery. D. The City may withhold or set off the entire payment or part of any payment otherwise due the Contractor to such extent as may be necessary on account of: i. delivery of defective or non-conforming deliverables by the Contractor; ii. third party claims, which are not covered by the insurance which the Contractor is required to provide, are filed or reasonable evidence indicating probable filing of such claims; iii. failure of the Contractor to pay Subcontractors, or for labor, materials or equipment; iv. damage to the property of the City or the City's agents, employees or contractors, which is not covered by insurance required to be provided by the Contractor; v. reasonable evidence that the Contractor's obligations will not be completed within the time specified in the Contract, and that the unpaid balance would not be adequate to cover actual or liquidated damages for the anticipated delay; vi. failure of the Contractor to submit proper invoices with purchase order number, with all required attachments and supporting documentation; or vii. failure of the Contractor to comply with any material provision of the Contract Documents. E. Notice is hereby given that any awarded Contractor who is in arrears to the City for delinquent taxes, the City may offset indebtedness owed the City through payment withholding. F. Payrnent will be made by check unless the parties mutually agree to payment by credit card or electronic transfer of funds. The Contractor agrees that there shall be no additional charges, surcharges, or penalties to the City for payments made by credit card or electronic funds transfer. G. The awarding or continuation af this contract is dependent upon the availability of funding. The City's payment obligations are payable on(y and solely from funds Appropriated and available for this contract. The absence of Appropriated or other lawfully available funds shall render the Contract null and void to the extent funds are not Appropriated or available and any deliverables delivered but unpaid shall be returned to the Contractor. The City shall provide the Contractor written notice of the failure of the City to make an adequate Appropriation for any f�scal year to pay the amounts due under the Contract, or the reduction of any Appropriation to an amaunt insufficient to permit the City to pay its obligations under the Contract. In the event of none or inadequate appropriation of funds, there will be no penalty nor removal fees charged to the C ity. 5. TRAVEL EXPENSES: All travel, lodging and per diem expenses in connection with the Contract shall be paid by the Contractor, unless otherwise stated in the contract terms. . ' ' • . � � . � RFP# 5642 A. If a DBE/MBE/WBE Program Plan is agreed to and the Contractor has identified Subcontractors, the Contractor is required to submit a Contract Close-Out MBE/WBE Compliance Report to the Purchasing Manager no Iater than the 15th calendar day after completion of all work under the contract. Final payment, retainage, or both may be withheld if the Contractor is not in compliance with the requirements as accepted by the City. B. The making and acceptance of final payment will constitute: i. a waiver of all claims by the City against the Contractor, except claims (1) which have been previously asserted in writing and not yet settled, (2) arising from defective work appearing after final inspection, (3) arising from failure of the Contractor to comply with the Contract or the terms of any warranty specified herein, (4) arising from the Contractor's continuing obligations under the Contract, including but not limited to indemnity and warranty obligations, or (5) arising under the City's right to audit; and ii. a waiver of all claims by the Contractor against the City other than those previously asserted in writing and not yet settled. 7. GHT TO AUDIT: A. The City shall have the right to audit and make copies of the books, records and computations pertaining to the Contract. The Contractor shall retain such books, records, documents and other evidence pertaining to the Contract period and five years thereafter, except if an audit is in progress or audit findings are yet unresolved, in which case records shall be kept until all audit tasks are completed and resolved. These books, records, documents and other evidence shall be available, within ten (10) business days of written request. Further, the Contractor shall also require all Subcontractors, material suppliers, and other payees to retain all baoks, records, documents and other evidence pertaining to the Contract, and to allow the City similar access to those documents. All books and records will be rnade available within a 50 mile radius of the City of Denton. The cost of the audit will be borne by the City unless the audit reveals an overpayment of 1% or greater. If an overpayment of 1% or greater occurs, the reasonable cost of the audit, including any travel costs, must be borne by the Contractor which must be payable within five (5) business days of receipt of an invoice. B. Failure to comply with the provisions of this section shall be a material breach of the Contract and shall constitute, in the City's sole discretion, grounds for termination thereof. Each of the terms "books" "records" "documents" and "other evidence" as used above shall be construed , , , , to include drafts and electronic files, even if such drafts ar electronic files are subsequently used to generate or prepare a final printed document. 8. SUBCONTRACTORS: A. If the Contractor identified Subcontractors in a DBE/MBE/WBE agreed to Plan, the Contractor shall comply with all requirements approved by the City. The Contractor shall not initially employ any Subcontractor except as provided in the Contractor's Plan. The Contractor shall not substitute any Subcontractor identified in the Plan, unless the substitute has been accepted by the City in writing. No acceptance by the City of any Subcontractor shall canstitute a waiver of any rights or remedies of the City with respect to defective deliverables provided by a Subcontractor. If a Plan has been approved, the Contractor is additionally required to submit a monthly Subcontract Awards and Expenditures Report to the Procurement Manager, no later than the tenth calendar day of each month. B. Work performed for the Contractor by a Subcontractor shall be pursuant to a written contract between the Contractor and Subcontractor. The terms of the subcontract may not conflict with the terms of the Contract, and shall contain provisions that: . ., ,, i. require that all deliverables to be provided by the Subcontractor be provided in strict accardance with the provisions, specifications and terms of the Contract; ii. prohibit the Subcontractor from further subcontracting any portion of the Contract without the prior written consent of the City and the Cantractor. The City may require, as a condition to such further subcontracting, that the Subcontractor post a payment bond in form, substance and amount acceptable to the City; iii. require Subcontractors to submit all invoices and applications for payments, including any claims for additional payments, damages or otherwise, to the Contractor in sufficient time to enable the Contractor to include same with its invoice or application for payment to the City in accordance with the terms of the Contract; iv. require that all Subcontractors obtain and maintain, throughout the term of their contract, insurance in the type and amounts specified for the Contractor, with the City being a named insured as its interest shall appear; and v. require that the Subcontractor indemnify and hold the City harmless to the same extent as the Contractor is required to indemnify the City. C. The Contractor shall be fully responsible to the City for all acts and omissions of the Subcontractors just as the Contractor is responsible for the Contractor's own acts and omissions. Nothing in the Contract shall create for the benef�t of any such Subcontractor any contractual relationship between the City and any such Subcantractor, nor shall it create any obligation on the part of the City to pay or to see to the payment of any moneys due any such Subcontractor except as may otherwise be required by law. D. The Contractor shall pay each Subcontractor its appropriate share of payments made to the Contractor not later than ten (l 0) calendar days after receipt of payment from the City. 9. WA NTY-P CE: A. The Contractor warrants the prices quoted in the Offer are no higher than the Contractor's current prices on orders by others for like deliverables under similar terms of purchase. B. The Contractor certifies that the prices in the Offer have been arrived at independently without consultation, communication, or agreement for the purpose of restricting competition, as to any matter relating to such fees with any other Contractor or with any competitor. C. In addition to any other remedy available, the City may deduct from any amounts owed to the Contractor, or otherwise recover, any amounts paid for items in excess of the Contractor's current prices on orders by others for like deliverables under similar terms of purchase. 10. WAR NTY — SERVICES: The Contractor warrants and represents that all services to be provided the City under the Contract will be fully and timely performed in a good and workmanlike manner in accordance with generally accepted industry standards and practices, the terms, conditions, and covenants of the Contract, and all applicable Federal, State and local laws, rules or regulations. A. The Contractor may not limit, exclude or disclaim the foregoing warranty or any warranty implied by law, and any attempt to do so shall be without force or effect. B. Unless otherwise specified in the Contract, the warranty period shall be at least one year from the Acceptance Date. If during the warranty period, one or more of the above warranties are breached, the Contractor shall promptly upon receipt of demand perform the services again in accordance with abave standard at no additional cost to the City. All costs incidental to such additional performance shall be borne by the Contractor. The City shall endeavor to give the Contractor written notice of the breach of warranty within thirty (30} calendar days of discovery . . ; �, of the breach warranty, but failure to give timely notice shall not impair the City's rights under this section. C. If the Contractor is unable or unwilling to perform its services in accordance with the above standard as required by the City, then in addition to any other available remedy, the City may reduce the amount of services it may be required to purchase under the Contract from the Contractor, and purchase conforming services from other sources. In such event, the Contractor shall pay to the City upon demand the increased cost, if any, incurred by the City to procure such services from another source. 11. ACCEPTANCE OF INCOMPLETE OR NON-CONFORMING DELIVE BLES: If, instead of requiring immediate correction or removal and replacement of defective or non- conforming deliverables, the City prefers to accept it, the City may do so. The Contractor shall pay all claims, casts, losses and damages attributable to the City's evaluation of and determination to accept such defective ar non-conforming deliverables. If any such acceptance occurs prior to final payment, the City may deduct such amounts as are necessary to compensate the City for the diminished value of the defective or non-conforming deliverables. If the acceptance occurs after final payment, such amount will be refunded to the City by the Contractor. 12. RIGHT TO ASSURANCE: Whenever one party to the Contract in good faith has reason to question the other party's intent to perform, demand may be made to the other party for written assurance of the intent to perform. In the event that no assurance is given within the t►me specified after demand is made, the demanding party may treat this failure as an anticipatory repudiation of the Contract. 13. STOP WORK NOTICE: The City may issue an immediate Stop Work Notice in the event the Contractor is observed performing in a manner that is in violation of Federal, State, or local guidelines, or in a manner that is determined by the City to be unsafe to either life or property. Upon notification, the Contractor will cease all work until notified by the City that the violation or unsafe condition has been corrected. The Contractor shall be liable for all costs incurred by the City as a result of the issuance of such Stop Work Notice. 14. DEFAULT: The Cantractor shall be in default under the Contract if the Contractor (a) fails to fully, timely and faithfully perform any of its material obligations under the Contract, (b) fails to provide adequate assurance of performance under Paragraph 24, (c) becomes insolvent or seeks relief under the bankruptcy laws of the United States or (d) makes a material misrepresentation ►n Contractor's Offer, or in any report or deliverable required to be subrnitted by the Contractor to the City. 15. TERMINATION FOR CAUSE: In the event of a default by the Contractor, the City shall have the right to terminate the Contract far cause, by written notice effective ten (10) calendar days, unless otherwise specified, after the date of such notice, unless the Contractor, within such ten (10) day period, cures such default, or provides evidence sufficient to prove to the City's reasonable satisfaction that such default does not, in fact, exist. In addition to any other remedy available under law or in equity, the City shall be entitled ta recover all actual damages, costs, losses and expenses, incurred by the City as a result of the Contractor's default, including, without limitation, cost of cover, reasonable attorneys' fees, court costs, and prejudgment and post judgment interest at the maximum lawful rate. Additionally, in the event of a default by the RFP# 5642 Contractor, the City may remave the Contractor from the City's vendor list for three (3) years and any Offer submitted by the Contractor may be disqualified for up to three (3) years. All rights and remedies under the Contract are cumulative and are not exclusive of any other right or remedy provided by law. 16. TERMINATION WITHOUT CAUSE: The City shall have the right to terminate the Contract, in whole or in part, without cause any time upon thirty (30) calendar days' prior written notice. Upon receipt of a natice of termination, the Contractor shall promptly cease all further work pursuant to the Contract, with such exceptions, if any, specified in the notice of termination. The City shall pay the Contractor, to the extent of funds Appropriated or otherwise legally available for such purposes, for all goods delivered and services performed and obligations incurred prior to the date of termination in accordance with the terms hereof. 17. F UD: Fraudulent statements by the Contractor on any Offer or in any report or deliverable required to be submitted by the Contractor to the City shall be grounds for the termination of the Contract for cause by the City and may result in legal action. 18. DELAYS: A. The City may delay scheduled delivery or other due dates by written notice to the Contractor if the City deems it is in its best interest. If such delay causes an increase in the cost of the work under the Contract, the City and the Contractor shall negotiate an equitable adjustment for costs incurred by the Contractor in the Contract price and execute an amendment to the Contract. The Contractor must assert its right to an adjustment within thirty (30) calendar days from the date of receipt of the notice of delay. Failure to agree on any adjusted price shall be handled under the Dispute Resolution process speci�ed in paragraph 49. However, nothing in this provision shall excuse the Contractor from delaying the delivery as notified. B. Neither party shall be liable for any default or delay in the performance of its obligations under this Contract if, while and to the extent such default or delay is caused by acts of God, fire, riots, civil commotion, labor disruptions, sabotage, sovereign conduct, or any other cause beyond the reasonable control af such Party. In the event of default or delay in contract performance due to any of the foregoing causes, then the time for completion of the services will be extended; provided, however, in such an event, a conference will be held within three (3) business days to establish a mutually agreeable period of time reasonably necessary to overcome the effect of such failure to perform. 19. INDEMNITY: A. Definitions: i. "Indemnified Claims" shall include any and all c(aims, demands, suits, causes of action, judgments and liability of every character, type or description, including all reasonable costs and expenses of litigation, mediation or other alternate dispute resolution mechanism, including attorney and other professional fees for: (1) damage to or loss of the property af any person (including, but not 1►mited ta the City, the Contractor, their respective agents, officers, employees and subcontractors; the officers, agents, and employees of such subcontractors; and third parties}; and/or (2) death, badily injury, illness, disease, worker's compensation, loss of services, or loss of income or wages to any person (including but not 1►mited to the agents, afficers and employees of the City, the Contractar, the Contractor's subcantractors, and third parties}, ii. "Fault" shall include the sale of defective or non-conforming deliverables, negligence, willful misconduct or a ., . : � , • - • -•. .• -• .� �. � ; � , �. �� 'l �'' � � I 1 1 � J � . . � � I ' �, . � � � . � .�; � . . . ; I 1 1 ,, �. .. � � 1 1 ��.:. t� , ;: , ! '�,R � ,�. ;, :, �: • ,'.: ! � !�; ��.:� � •� � :� ! � � ,.... ,, � � .. � �' ■ �, , ,`� � � �1 / L.. � : ;, ,, , ' � • ',. � � ... , �; , .. �.:: ��...; 1 �� ,,. ! �., :....... , ; ! . �:., � .,,.. �,; / .. ... � , ! . , �;. , ...,.. � • �:. , �.. , ';... j: ��; �:, ':: � �'. I� . ,,. , ��:, ��... � t ' . �'. � 1:: � � � � '... / , ♦ � ,.. I �'�: � �.: , ! �� ':� �: 20. INSU NCE: The following insurance requirements are applicable, in addition to the speci�c insurance requirements detailed in EXHIBIT D The successful Contractor shall procure and maintain insurance of the types and in the minimum amounts acceptable to the City. The insurance shall be written by a company licensed to do business in the State of Texas and satisfactory to the City. A. General Requirements: i. The Contractor shall at a minimum carry insurance in the types and amounts indicated and agreed to, as submitted to the City and approved by the City within the procurement process, for the duration of the Contract, including extension options and hold over periods, and during any warranty period. ii. The Contractor shall provide Certifcates of Insurance with the coverage's and endorsements required to the City as verification of coverage prior to contract execution and within fourteen (14) calendar days after written request from the City. Failure to provide the required Certificate of Insurance may subject the Offer to disqualification from consideration for award. The Contractor must also forward a Certificate of Insurance to the City whenever a previously identified policy period has expired, or an extension option or hold over period is exercised, as verification of continuing coverage. iii. The Contractor shall not commence work until the required insurance is obtained and until such insurance has been reviewed by the City. Approval of insurance by the City shall not relieve or decrease the liability of the Contractor hereunder and shall not be construed to be a limitation of liability on the part ofthe Contractor. iv. The Contractor must submit certificates of insurance to the City for all subcontractors prior to the subcontractors commencing work on the project. v. The Contractor's and all subcontractors' insurance coverage shall be written by companies licensed to do business in the State of Texas at the time the policies are issued and shall be written by companies with A.M. Best ratings of A- VII or hetter. The City will accept workers' compensation coverage written by the Texas Workers' Compensation Insurance Fund. vi. All endorsements naming the City as additional insured, waivers, and notices of cancellation endorsements as well as the Certificate of Insurance shall contain the solicitation number and the following information: City of Denton Materials Management Department 901 B Texas Street • •. ,� Denton, Texas 76209 vii. The "other" insurance clause shall not apply to the City where the City is an additional insured shown on any policy. It is intended that policies required in the Contract, covering both the City and the Contractor, shall be considered primary coverage as applicable. viii. If insurance policies are nat written for amounts agreed to with the City, the Contractor shall carry Umbrella or Excess Liability Insurance for any differences in amounts specified. If Excess Liability Insurance is provided, it shall follaw the form of the primary coverage. ix. The City shall be entitled, upon request, at an agreed upon location, and without expense, to review certified capies af policies and endorsements thereto and may make any reasonable requests for deletion or revision or modification of particular policy terms, conditions, limitations, or exclusions except where policy provisions are established by law or regulations binding upon either of the parties hereto or the underwriter on any such palicies. x. The City reserves the right to review the insurance requirements set forth during the effective period of the Contract and to make reasonable adjustments to insurance coverage, 1►mits, and exclusions when deemed necessary and prudent by the City based upon changes in statutory law, court decisions, the claims history of the industry or iinancial condition of the insurance company as well as the Contractor. xi. The Contractor shall not cause any insurance to be canceled nor permit any insurance to lapse during the term of the Contract or as required in the Contract. xii. The Contractor shall be responsible for premiums, deductibles and self-insured retentions, if any, stated in policies. All deductibles or self-insured retentions shall be disclosed on the Certificate of Insurance. xiii. The Contractor shall endeavor to provide the City thirty (30) calendar days' written notice of erosion of the aggregate limits below occurrence limits for all applicable coverage's indicated within the Contract. xiv. The insurance coverage's specified in within the solicitation and requirements are requ►red minimums and are not intended ta limit the responsibility or liability of the Contractor. B. Specific Coverage Requirements: Specific insurance requirernents are contained in the solicitation instrument. 21. CLAIMS: If any claim, demand, suit, or other action is asserted against the Contractor which arises under or concerns the Contract, or which could have a material adverse affect on the Contractor's ability to perform thereunder, the Contractor shall give written notice thereof to the City within ten (10) calendar days after receipt of notice by the Contractor. Such notice to the City shall state the date of notification of any such claim, demand, suit, or other action; the names and addresses of the claimant(s}; the basis thereof; and the name of each person against whom such claim is being asserted. Such natice shall be delivered personally or by mail and shall be sent to the City and to the Denton City Attorney. Personal delivery to the City Attorney shall be to City Hall, 215 East McKinney Street, Denton, Texas 76201. 22. NOTICES: Unless otherwise specified, all notices, requests, or other communications required or appropriate to be given under the Contract shall be in writing and shall be deemed delivered three (3) business days after postmarked if sent by U.S. Postal Service Certified or _ • ; ,, Registered Mail, Return Receipt Requested. Notices delivered by other means shall be deemed delivered upan receipt by the addressee. Routine communications may be made by first class mail, telefax, or other commercially accepted means. Notices to the Contractor shall be sent to the address specified in the Contractor's Offer, or at such other address as a party may notify the other in writing. Notices to the City shall be addressed to the City at 901 B Texas Street, Denton, Texas 76209 and marked to the attention of the Purchasing Manager. 23. RIGHTS TO BID, PROPOSAL AND CONT CTUAL MATE AL: All material submitted by the Contractor to the City shall become property of the City upon receipt. Any part►ons of such material claimed by the Contractor to be proprietary must be clearly marked as such. Determination of the public nature of the material is subject to the Texas Public Information Act, Chapter 552, and Texas Government Code. 24. NO WARRANTY BY CITY AGAINST INFRINGEMENTS: The Contractor represents and warrants to the City that: (i) the Contractor shall provide the City good and indefeasible title to the deliverables and (ii) the deliverables supplied by the Contractor in accordance with the specifications in the Contract will not infringe, directly or contributorily, any patent, trademark, copyright, trade secret, or any other intellectual property right of any kind of any third party; that no claims have been made by any person or entity with respect to the ownership or operation of the deliverables and the Contractor does not know of any valid basis for any such claims. The Contractor shall, at its sole expense, defend, indemnify, and hold the City harmless from and against all liability, damages, and costs (including court costs and reasonable fees of attorneys and other professionals) arising out of or resulting from: (i) any claim that the City's exercise anywhere in the world of the rights associated with the City's' ownership, and if applicable, license rights, and its use of the deliverables infringes the intellectual property rights of any third party; or (ii) the Contractor's breach of any of Contractor's representations or warranties stated in this Contract. In the event of any such claim, the City shall have the right to monitor such claim or at its option engage its own separate counsel to act as co-counsel on the City's behalf. Further, Contractor agrees that the City's specifications regarding the deliverables shall in no way diminish Contractor's warranties or obligations under this paragraph and the City makes no warranty that the production, development, or delivery of such deliverables will not impact such warranties of Contractor. 25. CONFIDENTIALITY: In order to prov►de the deliverables to the City, Contractor may require access to certain of the City's and/or its licensors' coniidential information (including inventions, employee information, trade secrets, confidential know-how, confidential business information, and other information which the City or its licensors consider confidential} (collectively9 66Confidential Information"). Contractor acknowledges and agrees that the Confidential Information is the valuable property of the City and/or its licensors and any unauthorized use, disclosure, dissemination, or other release of the Confidential Information will substantially injure the City and/or its licensors. The Contractor (including its employees, subcontractors, agents, or representatives} agrees that it will maintain the Confidential Information in strict confidence and shall not disclose, disseminate, copy, divulge, recreate, or otherwise use the Confidential Information without the prior written consent of the City or in a manner not expressly permitted under this Agreement, unless the Confidential Information is reQuired to be disclosed by law or an order of any court or other governmental authority with proper jurisdiction, provided the Contractor promptly notifies the City before disclosing such information so as to permit the City reasonable time to seek an appropriate protective order. The • •: ,, Contractor agrees to use protective measures no less stringent than the Contractor uses within its own business to protect its own most valuable information, which protective measures shall under all circumstances be at least reasonable measures to ensure the continued confidentiality of the Confidential Information. 26. OWNERSHIP AND USE OF DELIVE BLES: The City shall own all rights, titles, and interests throughout the world in and to the deliverables. A. Patents. As to any patentable subject matter contained in the deliverables, the Contractor agrees to disclose such patentahle subject matter to the City. Further, if requested by the City, the Contractor agrees to assign and, if necessary, cause each of its employees to assign the entire r►ght, title, and interest to specific inventions under such patentable subject matter to the City and to execute, acknowledge, and deliver and, if necessary, cause each of its employees to execute, acknowledge, and deliver an assignment of letters patent, in a farm to be reasonably approved by the City, to the City upan request by the City. B. Copyrights. As to any deliverables containing copyrightable subject matter, the Contractor agrees that upon their creation, such deliverables shall be considered as work made-for-hire by the Contractor for the City and the City shall own all copyrights in and to such deliverables, provided however, that nothing in this Paragraph 38 shall negate the City's sole or joint ownership of any such deliverables arising by virtue of the City's sole or joint authorship of such deliverables. Should by operation of law, such deliverables not be considered works made-for- hire, the Contractor hereby assigns to the City (and agrees to cause each of its employees providing services to the City hereunder to execute, acknowledge, and deliver an assignment to the City ofl all worldwide right, title, and interest in and to such deliverables. With respect to such work made-far-hire, the Contractor agrees to execute, acknowledge, and deliver and cause each of its employees providing services to the City hereunder to execute, acknowledge, and deliver a work-made-for-hire agreement, in a form to be reasonably approved by the City, to the City upon delivery of such deliverables to the City or at such other time as the City may request. C. Additional Assignments. The Contractor further agrees to, and if applicable, cause each of its employees to, execute, acknowledge, and deliver all applications, specifications, oaths, assignments, and all other instruments which the City might reasonably deem necessary in order to apply for and obtain copyright protection, mask work registration, trademark registration and/or protection, letters patent, or any similar rights ►n any and all countries and in order to assign and convey to the City, its successors, assigns and nominees, the sole and exclusive right, title, and interest in and to the deliverables. The Contractor's obligations to execute, acknowledge, and deliver (or cause to be executed, acknowledged, and delivered) instruments or papers such as those described in this Paragraph 38 a., b., and c. shall continue after the termination of this Contract with respect to such deliverables. In the event the City should not seek to obtain copyright protection, mask work registration or patent protection for any of the deliverables, but shauld desire to keep the same secret, the Contractor agrees to treat the same as Confidential Information under the terms of Paragraph 37 above. 27. PUBLICATIONS: All published material and written reports submitted under the Contract must be originally developed material unless otherwise specifically provided in the Contract. When material not originally developed is included in a report in any form, the source shall be identified. 28. ADVERTISING: The Contractor shall not advertise or publish, without the City's prior consent, the fact that the City has entered into the Contract, except to the extent required by law. I, ., . , � . 29. NO CONTINGENT FEES: The Contractor warrants that no person or selling agency has been employed or retained to solicit or secure the Contract upon any agreement or understanding for commission, percentage, brokerage, or contingent fee, excepting bona fide employees of bona fde established commercial or selling agencies maintained by the Contractor for the purpose of securing business. For breach or violation of this warranty, the City shall have the right, in addition to any other remedy available, to cancel the Contract without liability and to deduct from any arnounts owed to the Contractor, or otherwise recover, the full amount of such commission, percentage, brokerage or contingent fee. 30. GRATUITIES: The City may, by written notice to the Contractor, cancel the Contract without liability if it is determined by the City that gratuities were offered or given by the Contractor or any agent or representative of the Contractor to any officer or employee of the City with a view toward securing the Contract or securing favorable treatment with respect to the awarding or amending or the making of any determinations with respect to the performing of such contract. In the event the Contract is canceled by the City pursuant to this provision, the City shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by the Contractor in providing such gratuities. 31. PROHIBITION AGAINST PERSONAL INTEREST IN CONT CTS: No officer, employee, independent consultant, or elected official of the City who is involved in the development, evaluation, or decision-making process of the performance of any solicitation shall have a financial interest, direct or indirect, in the Contract resulting from that solicitation. Any willful violation of this section shall constitute impropriety in office, and any officer or employee guilty thereof shall be subject to disciplinary action up to and including dismissal. Any violation of this provision, with the knowledge, expressed or ►mplied, of the Contractor shall render the Contract voidable by the City. The Contractor shall complete and submit the City's Conflict of Interest Questionnaire (Exhibit E). 32. INDEPENDENT CONT CTOR: The Contract shall not be construed as creating an employer/employee relationship, a partnership, or a joint venture. The Contractor's services shall be those of an independent contractor. The Contractor agrees and understands that the Contract does not grant any rights or privileges established for employees of the City, Texas for the purposes of income tax, withhold►ng, social security taxes, vacation or sick leave benefits, worker's compensation, or any other City employee benefit. The City shall not have supervision and control of the Contractor or any employee of the Contractor, and it is expressly understoad that Contractor shall perform the services hereunder according to the attached specifications at the general direction of the City Manager of the City, Texas, or his designee under this agreement. 33. ASSIGNMENT-DELEGATION: The Contract shall be binding upon and ensure to the benefit of the City and the Contractor and their respective successors and assigns, provided however, that no right or interest in the Contract shall be assigned and no obligation shall be delegated by the Contractor without the prior written cansent of the City. Any attempted assignment or delegation by the Contractor shall be vo►d unless made in conformity with this paragraph. The Contract is not intended to confer rights or benefits on any person, firm or entity not a party hereto; it being the intention of the parties that there are no third party beneficiaries to the Contract. I. ' � �, 34. WAIVER: No claim or right arising out of a breach of the Contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved party. No waiver by either the Contractor or the City of any one or more events of default by the other party shall operate as, or be construed to be, a permanent waiver of any rights or obligations under the Contract, or an express or implied acceptance of any other existing or future default or defaults, whether of a similar or different character. 35. MODIFICATIONS: The Contract can be modified or amended only by a writing signed by both parties. No pre-printed or similar terms on any the Contractor invoice, order or other document shall have any force or effect to change the terms, covenants, and conditions of the Contract. 36. INTE TATION: The Contract is intended by the parties as a final, complete and exclusive statement of the terms of their agreement. No course of prior dealing between the parties or course of performance or usage of the trade shall be relevant to supplement or explain any term used in the Contract. Although the Contract may have been substantially drafted by one party, it is the intent of the parties that all provisions be construed in a manner to be fa►r to both parties, reading no provisions more strictly against one party or the other. Whenever a term defined by the Uniform Commercial Code, as enacted by the State of Texas, is used in the Contract, the UCC definition shall control, unless otherwise defined in the Contract. 37. DISPUTE RESOLUTION: A. If a dispute arises out of or relates to the Contract, or the breach thereof, the parties agree to negotiate prior to prosecuting a suit for damages. However, this section does not prohibit the filing of a lawsuit to toll the running of a statute of limitaiions or ta seek injunctive relief. Either party may make a written request for a meeting between representatives of each party within fourteen (14) calendar days after receipt of the request or such later period as agreed by the parties. Each party shall include, at a minimum, one (1) senior level individual with decision- making authority regarding the dispute. The purpose of this and any subsequent meeting is to attempt in good faith to negatiate a resolution of the dispute. If, within thirty (30) calendar days after such meeting, the parties have not succeeded in negotiating a resolution of the dispute, they will proceed directly to mediation as described below. Negotiation may be waived by a written agreement signed by both parties, in which event the parties may proceed directly to mediation as descrihed below. B. If the efforts to resolve the dispute through negotiation fail, or the parties waive the negotiation process, the parties may select, within thirty (30) calendar days, a mediator trained in mediation skills to assist with resolution of the dispute. Should they choose this option; the City and the Contractor agree to act in goad faith in the selection of the mediator and to give consideration to qualified individuals norninated to act as mediator. Nothing in the Contract prevents the parties from relying on the skills of a person who is trained in the subject matter of the dispute or a contract interpretation expert. If the parties fail to agree on a mediator within thirty (30) calendar days of initiation of the mediation process, the mediator shall be selected by the Denton County Alternative Dispute Resolution Program (DCAP). The parties agree to participate in mediation in good faith for up to thirty (30) calendar days from the date of the first mediation session. The City and the Contractor will share the mediator's fees equally and the parties will bear their own costs of participation such as fees for any consultants or attorneys they may utilize to represent them or otherwise assist them in the mediation. RFP# 5642 38. JU SDICTION AND VENUE: The Contract is made under and shall be governed by the laws of the State of Texas, including, when applicable, the Uniform Commercial Code as adopted in Texas, V.T.C.A., Bus. & Comm. Code, Chapter 1, excluding any rule or principle that would refer to and apply the substantive law of another state or jurisdiction. All issues arising from this Contract shall be resolved in the courts of Denton County, Texas and the parties agree to submit to the exclusive personal jurisdiction of such courts. The foregoing, however, shall not be construed or interpreted to limit or restrict the right or ability of the City to seek and secure injunctive relief from any competent authority as contemplated herein. 39. INVALIDITY: The invalidity, illegality, or unenforceability of any provision of the Contract shall in no way affect the validity or enforceability of any other portion or provision of the Contract. Any void provision shall be deemed severed from the Contract and the balance of the Contract shall be construed and enforced as if the Contract did not contain the particular portion or provision held to be void. The parties further agree to reform the Contract to replace any stricken provision with a valid provision that comes as close as possible to the ►ntent of the stricken provision. The provisions of this section shall not prevent this entire Contract from being void should a provision which is the essence ofthe Cantract be determined to be void. 40. HOLIDAYS: The following holidays are observed by the City: New Year's Day (observed) MLK Day Memorial Day 4th of July Labor Day Thanksgiving Day Day After Thanksgiving Christmas Eve (observed) Christmas Day (observed) New Year's Day (observed) If a Legal Holiday falls on Saturday, it will be observed on the preceding Friday. If a Legal Holiday falls on Sunday, it will be observed on the following Monday. Normal hours of operation shall be between 8:00 am and 5:00 pm, Monday through Friday, excluding City of Denton Holidays. Any scheduled deliveries or work performance not within the normal hours of operation must be approved by the City Manager of Denton, Texas or his authorized designee. 41. SURVIVABILITY OF OBLIGATIONS: All provisions of the Contract that impose continuing obligations on the parties, including but not limited to the warranty, indemnity, and con�dentiality obligations of the parties, shall survive the expiration or termination of the Contract. 42. NON-SUSPENSION OR DEBA ENT CERTIFICATION: The City is prohibited from contracting with or making prime or sub-awards to parties that are suspended or debarred or whose principals are suspended or debarred from Federal, State, or City Contracts. By accepting a Contract with the City, the Vendor certifies that its firm and its principals are not currently suspended or debarred from doing business with the Federal RFP# 5642 Government, as indicated by the General Services Administration List of Parties Excluded from Federal Procurement and Non-Procurement Programs, the State of Texas, or the City. 43. EQUAL OPPORTUNITY A. Equal Employment Opportunity: Na Offeror, or Offeror's agent, shall engage in any discriminatory employment practice. No person shall, on the grounds of race, sex, age, disability, creed, color, genetic testing, or national arigin, be refused the benefits of, or be otherwise subjected to discrimination under any activities resulting from this RFQ. B. Arnericans with Disabilities Act (ADA) Compliance: No Offeror, or Offeror's agent, shall engage in any discriminatory employment practice against ind►viduals with disabilities as defined in the ADA. 44. BUY AMERICAN ACT-SUPPLIES (Applicable to certain federally funded requirements} The following federally funded requirements are applicable, in addition to the specific federally funded requirements. A. Definitions. As used in this paragraph i. "Component" means an article, material, or supp[y incorporated directly into an end product. ii. "Cost of companents" means - (1) For components purchased by the Contractor, the acquisition cost, including transportation costs to the place of ►ncorparation into the end product (whether or not such costs are paid ta a domestic firm), and any appl►cable duty (whether or not a duty-free entry certificate ►s issued); or (2) For components manufactured by the Contractor, all costs associated with the manufacture of the component, including transpartation costs as described in paragraph (1) of this definition, plus allocable overhead costs, but excluding profit. Cost of components does not include any costs associated with the manufacture of the end product. iii. "Domestic end product" means- (1) An unmanufactured end product mined or produced in the United States; or (2) An end product manufactured in the United States, if the cost of its companents mined, produced, or rnanufactured in the United States exceeds 50 percent of the cost of all its components. Components of foreign origin of the same class or kind as those that the agency determines are not mined, produced, or manufactured in sufficient and reasonably available commercial quantities of a satisfactory quality are treated as domestic. Scrap generated, collected, and prepared for processing in the United States is considered domestic. iv. "End product" means those articles, materials, and supplies to be acquired under the contract for public use. v. "Foreign end product" means an end product other than a domestic end product. vi. "United States" means the 50 States, the District of Colurnbia, and outlying areas. B. The Buy American Act (41 U.S.C. l0a - l Od) provides a preference for domestic end products for supplies acquired for use in the United States. C. The City does not maintain a list of foreign articles that will be treated as domestic for this Contract; but will consider for approval foreign articles as domest►c for this product if the articles are on a list approved by another Governmental Agency. The Offeror shall submit documentation with their Offer demonstrating that the article is on an approved Governmental list. D. The Contractor shall deliver only domestic end products except to the extent that it specifed delivery of foreign end products in the provision of the Solicitation entitled "Buy American Act Certificate". RFP#5642 45. GHT TO INFO ATION: The City reserves the right to use any and all information presented in any respanse to this solicitation, whether amended or not, except as prohibited by law. Selection of rejection of the submittal does not affect this right. 46. LICENSE FEES OR T ES: Provided the solicitation requires an awarded contractor or supplier to be licensed by the State of Texas, any and all fees and taxes are the responsibility of the respondent. 47. P VAILING WAGE TES: All respondents will be required to camply with Provision 5159a of "Vernon's Annotated Civil Statutes" of the State of Texas with respect to the payment of prevailing wage rates and prohibiting discrimination in the employment practices. http://www.access.gpo. �ov/davisbacon/tx.htrnl 48. COMPLIANCE WITH ALL STATE, FEDERAL, AND LOCAL LAWS: The contractor or supplier shall comply with all State, Federal, and Local laws and requirements. The Respondent must comply with all applicable laws at all times, including, without limitaiion, the following: (i) §36.02 of the Texas Penal Code, which prohibits bribery; (ii) §36.09 of the Texas Penal Code, which prohibits the offering or conferring of benefits to public servants. The Respondent shall give all notices and comply with all laws and regulations applicable to furnishing and performance ofthe Contract. 49. FEDERAL, STATE, AND LOCAL REQUIREMENTS: Respondent shall demonstrate on-site compliance with the Federal Tax Reform Act of 1986, Section 1706, amending Section 530 of the Revenue Act of of 1978, dealing with issuance of Form W-2's to comrnon law employees. Respondent is responsible for bath federal and State unemployment insurance coverage and standard Worker's Compensation insurance coverage. Respondent shall ensure compliance with all federal and State tax laws and withholding requirements. The City shall not be liable to Respondent or its employees for any Unemployment or Workers' Compensation coverage, or federal or State withholding requirements. Contractor shall indemnify the City and sha(1 pay all costs, penalties, or losses resulting from Respondent's omission or breach of this Section. 50. DRUG F E WORKPLACE: The contractor shall comply with the applicable provisions of the Drug-Free Work Place Act of 1988 (Public Law 100-690, Title V, Subtitle D; 41 U.S.C. 701 ET SEQ.) and maintain a drug-free work environment; and the final rule, government-wide requirements for drug-free work place (grants), issued by the Office of Management and Budget and the Department of Defense (32 CFR Part 280, Subpart F) to implement the provisions of the Drug-Free Work Place Act of 1988 is incorporated by reference and the contractor shall comply with the relevant provisions thereof, including any amendments to the final rule that may hereafter be issued. 51. RESPONDENT LIABILITY FOR DAMAGE TO GOVERNMENT PROPERTY: The Respondent shall be liable for all damages to government-owned, leased, or occupied property and equipment caused by the Respandent and its employees, agents, subcantractors, and suppliers, including any delivery or cartage campany, in connection with any performance pursuant to the Cantract. The Respondent shall notify the City Procurement Manager in writing of any such damage with►n one (1) calendar day. RFP# 5642 52. FORCE MAJEURE: The City, any Customer, and the Respondent shall not be responsible for performance under the Contract should it be prevented from performance by an act of war, order of legal authority, act of God, ar other unavoidable cause nat attributable to the fault or negligence of the City. In the event of an occurrence under this Section, the Respondent will be excused from any further perfarmance or observance of the requirements so affected for as long as such circumstances prevail and the Respondent continues to use cornmercially reasonable efforts to recommence performance or observance whenever and to whatever extent possible without delay. The Respondent shall immediately notify the City Procurement Manager by telephone (to be confirmed in writing within five (5) calendar days af the inception of such occurrence) and describe at a reasonable level of detail the circumstances causing the non- performance or delay in performance. 53. NON-WAIVER OF GHTS: Failure of a Party to require performance by another Party under the Contract will not affect the right of such Party to require performance in the future. No delay, failure, or waiver of either Party's exercise or partial exercise of any right or remedy under the Contract shall operate to limit, impair, preclude, cancel, waive or otherwise affect such right or remedy. A waiver by a Party of any breach of any term of the Contract will not be construed as a waiver of any continuing or succeeding breach. 54. NO WAIVER OF SOVE IGN IMMUNITY: The Parties expressly agree that no provision of the Contract is in any way intended to constitute a waiver by the City of any immunities from suit or from liabil►ty that the City may have by operation of law. 55. RECORDS RETENTION: The Respondent shall retain all financial records, supporting documents, statistical records, and any other records or books relating to the performances called for in the Contract. The Respondent shall retain all such records for a period of four (4) years after the expiration of the Contract, or until the CPA or State Auditor's Office is satisfied that all audit and litigation matters are resolved, whichever period is longer. The Respondent shall grant access to all baoks, recards and documents pertinent to the Contract to the CPA, the State Auditor of Texas, and any federal governmental entity that has authority to review records due to federal funds being spent under the Contract. � •: ,, Exhibit D INSURANCE REQUIREMENTS AND WORKERS' COMPENSENTATION REQUIREMENTS Upon contract execufion, all insurance requiremenfs shall become contracfual obligations, which fhe successful contractor shall have a duty to maintain throughout fhe course of this contracf. STANDARD PROVISIONS: Without limiting any of the other obligafions or liabilities of fhe Confractor, the Contractor shall provide and mainfain until the contracfed work has been completed and accepted by fhe City of Denton, Owner, the minimum insurance coverage as indicafed hereinaffer. Contractor shall file with the Purchasing Department safisfactory certificates of insurance including any applicable addendum or endorsements, containing the contract number and title of the project. Contracfor may, upon written requesf fo the Purchasing Department, ask for clarification of any insurance requirements at any time; however, Confractor shall not commence any work or deliver any material unfil he or she receives notification fhat the contracf has been accepted, approved, and signed by the City of Denton. All insurance policies proposed or obtained in satisfaction of these requirements shall comply wifh fhe followinq general specifications, and shall be maintained in compliance wifh these general specifications throughout the duration of the Contract, or longer, if so noted: • Each policy shall be issued by a company authorized to do business in the State of Texas with an A.M. Best Company rating of at least A- VII or better. Any deductibles or self-insured retentions shall be declared in the proposal. If requested by the City, the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect to the City, its officials, agents, employees and volunteers; or, the contractor shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. Liability policies shall be endorsed to provide the following: � Name as Additional Insured the City of Denton, its Officials, Agents, Employees and volunteers. � That such insurance is primary to any other insurance available to the Additional Insured with respect to claims covered under the policy and that this insurance applies separately to each insured against whom claim is made or suit is brought. The inclusion of more than one insured shall not operate to increase the insurer's limit of liability. RFP#5642 • Cancellation: City requires 30 day written notice should any of the policies described on the certificate be cancelled or materially changed before the expirafion date. • Should any of the required insurance be provided under a claims made form, Contractor shall maintain such coverage continuously throughout the term of this contract and, without lapse, for a period of three years beyond the contract expiration, such that occurrences arising during the contract term which give rise to claims made after expiration of the contract shall be covered. • Should any of the required insurance be provided under a form of coverage that includes a general annual aggregate limit providing for claims investigation or legal defense costs to be included in the general annual aggregate limit, the Contractor shall either double the occurrence limits or obtain Owners and Contractors Protective Liability Insurance. • Should any required insurance lapse during the contract term, requests for payments originating after such lapse shall not be processed until the City receives satisfactory evidence of reinstated coverage as required by this contract, effective as of the lapse date. If insurance is not reinstated, City may, at its sole option, terminate this agreement effective on the date of the lapse. SPECIFIC ADDITIONAL INSURANCE REQUIREMENTS: All insurance policies proposed or obtained in satisfaction of this Contract shall additionally comply with the following marked specifications, and shall be maintained in compliance wifh these addifional specifications throughout the duration of the Contract, or longer, if so noted: [X] A. General Liability Insurance; General Liability insurance with combined single limits of not less than $1,000,000.00 shall be provided and maintained by the Contractor. The policy shall be written on an occurrence basis either in a single policy or in a combination of underlying and umbrella or excess policies. If the Commercial General Liability form (ISO Form CG 0001 current edition) is used: Coverage A shall include premises, operations, products, and completed operations, independent contractors, contractual liability covering this contract and broad form property damage coverage. • Coverage B shall include personal injury. • Coverage C, medical payments, is not required, If the Comprehensive General Liability form (ISO Form GL 0002 Current Edition and ISO Form GL 0404) is used, it shall include at least: • Bodily injury and Property Damage Liability for premises, operations, RFP# 5642 products and completed operations, independent contractors and property damage resulting from explosion, collapse or underground (XCU) exposures. • Broad form contractual liability (preferably by endorsement) covering this contract, personal injury liability and broad form property damage liability. [ ] Automobile Liability Insurance: Contractor shall provide Commercial Automobile Liability insurance with Combined Single Limits (CSL) of not less than 500 000 either in a single policy or in a combination of basic and umbrella or excess policies. The policy will include bodily injury and property damage liability arising out of the operation, maintenance and use of all automobiles and mobile equipment used in conjunction with this contract. Satisfaction of the above requirement shall be in the form of a policy endorsement for: • any auto, or • all owned hired and non-owned autos. [X] Workers' Compensation Insurance Contractor shall purchase and maintain Workers' Compensation insurance which, in addition to meeting the minimum statutory requirements for issuance of such insurance, has Employer's Liability limits of at least $100,000 for each accident, $100,000 per each employee, and a$500,000 policy limit for occupational disease. The City need not be named as an "Additional Insured" but the insurer shall agree to waive all rights of subrogation against the City, its officials, agents, employees and volunteers for any work perFormed for the City by the Named Insured. For building or construction projects, the Contractor shall comply with the provisions of Attachment 1 in accordance with §406.096 of the Texas Labor Code and rule 28TAC 110.110 of the Texas Workers' Compensation Commission (TWCC). [] Owner's and Contractor's Protective Liability Insurance The Contractor shall obtain, pay for and maintain at all times during the prosecution of the work under this contract, an Owner's and Contractor's Protective Liability insurance policy naming the City as insured for property damage and bodily injury which may arise in the prosecution of the work or Contractor's operations under this contract. Coverage shall be on an "occurrence" basis and the policy shall be issued by the same insurance company that carries the Contractor's liability insurance. Policy limits will be at least $500,000.00 combined bodily injury and property damage per occurrence with a $1,000,000.00 aggregate. [] Fire Damage Legal Liability Insurance Coverage is required if Broad form General Liability is not provided or is unavailable to the contractor or if a contractor leases or rents a portion of a City building. Limits of not less than each occurrence are required. ; •,; •;. r. [X] Professional Liability Insurance Professional liability insurance with limits not less than $500,000.00 per claim with respect to negligent acts, errors or omissions in connection with professional services is required under this Agreement. [ ] Builders' Risk Insurance Builders' Risk Insurance, on an All-Risk form for 100% of the completed value shall be provided. Such policy shall include as "Named Insured" the City of Denton and all subcontractors as their interests may appear. [ ] Commercial Crime Provides coverage for the theft or disappearance of cash or checks, robbery inside/outside the premises, burglary of the premises, and employee fidelity. The employee fidelity portion of this coverage should be written on a"blankeY' basis to cover all employees, including new hires. This type insurance should be required if the contractor has access to City funds. Limits of not less than $ each occurrence are required. [ ] Additional Insurance Other insurance may be required on an individual basis for extra hazardous contracts and specific service agreements. If such additional insurance is required for a specific contract, that requirement will be described in the "Specific Conditions" of the contract specifications. ! .:R . .. � I'.. �. ATTACHMENT 1 [X] Workers' Compensation Coverage for Building or Construction Projects for Governmental Entities A. Definitions: Certificate of coverage ("certificate")-A copy of a certificate of insurance, a certificate of authority to self-insure issued by the commission, or a coverage agreement (TWCC-81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation insurance coverage for the person's or entity's employees providing services on a project, for the duration of the project. Duration of the project - includes the time from the beginning of the work on the project until the contractor's/person's work on the project has been completed and accepted by the governmental entity. Persons providing services on the project ("subcontractor" in §406.096) - includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project, regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees. This includes, without limitation, independent contractors, subcontractors, leasing companies, motor carriers, owner-operators, employees of any such entity, or employees of any entity which furnishes persons to provide services on the project. "Services" include, without limitation, providing, hauling, or delivering equipment or materials, or providing labor, transportation, or other service related to a project. "Services" does not include activities unrelated to the project, such as food/beverage vendors, office supply deliveries, and delivery of portable toilets. B. The contractor shall provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any overage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all employees of the Contractor providing services on the project, for the duration of the project. C. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. D. If the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project, the contractor must, prior to the end of the coverage period, file a new certificate of coverage with the governmental entity showing that coverage has been extended. E. The contractor shall obtain from each person providing services on a project, and provide to the governmental entity: 1. a certificate of coverage, prior to that person beginning work on the project, so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project; and 2, no later than seven days after receipt by the contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project. . , , �, F. The contractor shall retain all required certificates of coverage for the duration of the project and for one year thereafter. G. The contractor shall notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the contractor knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project. H. The contractor shall post on each project site a notice, in the text, form and manner prescribed by the Texas Workers' Compensation Commission, informing all persons providing services on the project that they are required to be covered, and stating how a person may verify coverage and report lack of coverage. I. The contractor shall contractually require each person with whom it contracts to provide services on a project, to: 1. provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all of its employees providing services on the project, for the duration of the project; 2. provide to the contractor, prior to that person beginning work on the project, a certificate of coverage showing that coverage is being provided for all employees of the person providing services on the project, for the duration of the project; 3. provide the contractor, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; 4. obtain from each other person with whom it contracts, and provide to the contractor: a. a certificate of coverage, prior to the other person beginning work on the project; and b. a new certificate of coverage showing extension of coverage, prior to the end of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; 5. retain all required certificates of coverage on file for the duration of the project and for one year thereafter; 6. notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and 7. Contractually require each person with whom it contracts, to perform as required by paragraphs (1) -(7), with the certificates of coverage to be provided to the person for whom they are providing services. 1. By signing this contract or providing or causing to be provided a certificate of RFP# 5642 coverage, the contractor is representing to the governmental entity that all employees of the contractor who will provide services on the project will be covered by workers' compensation coverage for the duration of the project, that the coverage will be based on proper reporting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self-insured, with the commission's Division of Self-Insurance Regulation. Providing false or misleading information may subject the contractor to administrative penalties, criminal penalties, civil penalties, or other civil actions. K. The contractor's failure to comply with any of these provisions is a breach of contract by the contractor which entitles the governmental entity to declare the contract void if the contractor does not remedy the breach within ten days after receipt of notice of breach from the governmental entity. I:� ': .� Exhibit E � � • !. • ! City of Denton RFP for �Vorkers' Compensation Third Party Administration Services 4� :; I�a c�" i` .� 1 �'i " '! 1 CONPZICT OF INTEREST QUESTIONNAIRE FORNI CIQ For vendor or other nerson doine business wtth local covernment�l entitv T6is questionnaire reflects changes inade to the Isrv by Tri.B. 1491, 80th Leg., lZegulnr Session. OFFICE USS O�tLY T'his questionnaire is 6eing �led in accordance with chapter 176 of the Locat Governrctent Code by a person a��g e�r��ed who has e business relationship as defined by Seclian 176.�01(t-a} Fvith a local g�vernmentnl entity and the person meets requ'vements under Section 176.006(a}, By law this questionnaire must be £led with the records administrator of the local government entity not tater than the 7th business day after the date the gerson becomes aware of facts that require the statement to be filed. See Sectian 1T6.006, Local Government Code, f1 person commits nn offense if the person knowingly violates Section 176.006, Lacal Gavernment Code. An offense under this seotion is a Class C mPsdemeanor. � .��.� ......., w.�._..�..� 1 Name oPperson �eha hns a business relaHonshlp vvllh locnl �ove`nmenlal entlty. rc Kas Pm l��ca I�u 6d r vi srvv�.� JS.� � _ . � ...._. 2� � j�� Check thts bos if you sre t"�ing nn updote lo a prevtausly filed quesNannaCee. / '� (Thc law requ7res that }rou Gle an updated comp[eted quastionnaire wiih the appropriatc filing authority not latee shan dte 7'h business day after U�e dale the orisinallv Filed nuestionna've becomes incomotete oc inaccurate.l ....�.. — .. � w._._, - .. _._�_ <i Name of local govemment offlcer with whom filer has z�n �u��s'r�yi�;�ni or business relationsMp. � �. t� �'�° �c�r ,� �; Name of . E�:ce This section, (item 3{ncluding subparts A, B, C& D}, must be completed (or each ofticer with whom Ihe filer has an employment or other buslness relalBonshlp �s deflned by Sec[ion 178.001(i-a}, LaceB Qovernment Code. Attacta additional pages tu khls Form CIQ ae necesssry, �. Is fhe local government offlcer named In thls sectlon recelving or fikely to reaeive taxabl� Income, other than Inveslment {ncome, From tha fller ot the questlonnafre7 Q Yes � No 8. !s the liler of the quesHannaire recelving or likely to receive taxabBe income, olher fhan Investment Income, from or at tha direclion o! the loca! government ofilcer named In lhls section AND the taxable Incom� Is not received frortr the lacal governmental entity4 Yes No C. Is fhe fller af fhls questionnaire empPayed by a corporatlon or o[her buslness entlty wlth respect to which the local governmenP afficer sarves as en olflc�e or director, or holds en ownership of 10 percent or mare7 Yes No D. Descr6be each aitl�Jd1Juv�, or business relaflonshlp. � �u _mm� u _. , ,��,� #�'�� _ -_. _��!'�=._v__ �k�ro�dr�rrraf person tfqin� bku�ie��s� will�ir�e q�svr,rauai�rbSt�9 Dafe �arrSi� � !M :� �� ... . a K�� I' � - 1 w � C� ! � i '.' + '" � '"'`�� .� w �•, � .� � , � � � "'�, �� ' *" � � ** I � ' f � � i� I � ,�' j ,• �t � ( � i� ��.�. � � � -..� . � . � � , � i � � �. ' � , �� ,� �� i � `�� dq�t�� i � " �..... � .�"��''� `�� . r . �= ��=a� ��- � `` � � �� ,. �r !�� i � jt , �a � � �� °y��`J' �. €,.,;;,�' . .,pu g�. `� �_... � ...... � µ�..� �� r' _ , . .'� i � � '�. . . ; ... _„��....---�" TEXAS POL,ITICAL SUBQIVISIONS 14990 tvDMaTRK Lv�DY.,A R° FLOo AL �9 1 7 ! L ( 00) 0013 .TPSPOO .oRG . � �r � : - * . . • �.. . ..r � � � �►' �' � ��1 � �.�r`�0 ('t RFP 5642 .�,� ��"��' �� f � � Exhibit F . •' ' •' �I• Section 1 Coversheet Section 2 Pricing Sheet — Exhibit 1 Section 3 Solicitation Checklist Section 4 Attachment A— Business Overview Questionnaire Section 5 Attachment B — Exception Form Section 6 Attachment C— Safety Recard Questionnaire (not applicable) Section 7 Attachment D — Reference Form Section 8 Attachment E— Conflict of Interest Questionnaire Form Section 9 Attachment F — Acknowledgment Sectian 10 Sample Statistical Data & Loss Reports Propaser can provide monthly f,...�---.� F 5642 Exhibit F _ � � � � � � ,� ; �� . ,. .- • - - - � R,� . �� • � '� �� .,,; � ., n . � � ,; . �� .z "" Item UOM Product DQSC�Egtfon Fve pet Clalm Allooated Expenses 6 C f 7 fiect�rsi� 1-��&srr� aqdMml�t�i�tutfs�� arev9a�a - P�f ��u�a�r f'rP�lrrg Ci�eti�r� -' � .��. .. g I 1 EA 4�'ark�rs�,e�rr��a��s�sP�j-�H Ia��nk S 35 00 . ��.._ �� .._ -____ g i 2 EA WorkmsCompmnsatlon-Madioal Onty g yys o❑ .� ��_ . _ � .� 10I 3 EA 4lorkarsComporrsatlon-Indamnity s �c�[100 ��.v _�_____.�... __ . 11 ��tEars 2 - �t��ms �d�sEr�slr�ti�sra ��ul�es - Flat Fe� �rdoi�sg �pt�ait a�. _.� �_�� _.�._ - � �d �aaa��r�1 �� fipc�on S 29 �00 �� a s...�. __ .�. , � .� ...�... � � 13 6 MO l��r�nr� C�en�a��tl�n FI��d I�I�nth9y F��1aat��n � � 41 ��k� � _ _ _. � 34 i` Not la oeae,d 30 LT & 80 MO annually. Ovorago wlll ba ahaopvd,t por elaim u:�in r�tas. ---- 1�!"Flat annual foo for oliims handling, preauth and blll ra4few $64,400 Fee per Clalm Flat Monthly Fee Flat� n�nual F � .�.�....�._...m�..�... - -- n_.� Seotion 9-Addltional Fees � ediaat Cost ( Indioate lf Inofuded In Iee per olalm, Flat Fre per month, flat fee por l.ar or an �� j addltional or s.parur f•rj � �_ .� a e ....� �.�. ................__,..�. .. - 17 ! 6 ?�� sr�r �F�r'm ��l�� C3a�rr �easrx {�,re�rr t�m� f�� 8150 LT & ffi50 M0 S 6.000.00 S 1� i 7 DataConvarsPon I�r9,� K�i�a� f��i � S 4.900,00 _� ___... .�..__ 1� � 8 ' On-Llne CartYpur�r ��e�rf��$ #�esa�u��d� �..�.�.e..m_mq�_��.�._ �.� ��...., w_.._._m.. ..,� 2t9 i 9 �Ih�1�� r�tvtv� �cd �c��ulc^.�a [PnoludetlJ ��_ . - � � 21 � 10 Annual Adminlstratlon Fsa p■cl.dad i. (�] flat f..] $ 3.500,00 22 I 11 � AttertdfnS17171NaatIn9�E.,o.�a...�x.,r...s,..,..,.� ..� � �.,._:�. - _ ._ ,..w _....._ �.._.,mm.. - — ..� 23 � 12 5ubrog�tionior Wor�±ra�"�:ompsn:atlon" [22.5%) --- �..._._. ��wY..�......_._ 24 13 ��rra-�Pi �rs¢� E�nnu�llye ��nr r�l�itn� S150LT & S50Mq - - _ _._. ... � ___ 25 ! t+ Monthiy data Fsed to ClR�`: RMI$ (inoludrdl _....._��.. � � .._ ...._..__..— _ 26 Y 46 � iDl �Df Fllinps �inoluded} �._.. -- �... .�� _ �..... . . - _�.—�--- 2i ,. 16 $eotlon111�eportin4(�ra�sludwil _ � .�.e. .. _ �,,° 28 17 h��li��l Cost �flsn#�ls7m��r�t �.__._....��e.m.� . ��A.A.. ..�. _. ,.........�..�.,...___---- _ 29 : 1e BIII Audlts [p�r �c�61, all ty�>esl S 8.50 S 13,000,00 o� _.. � �...�. . a�. ..._ 30 19 FfaldSerubeslfnvfst�gw�i�n �g�..a'�.a�s��a$pw�� S __�m. ��.. _„ - -. -- 31 ' 20 N��dfaatC�s�M �y�qrrnar� S �. �.... _ . _m._. . _ _.�. � 32 ; 21 Vooatlonal Casv Manac�mment S _ _ . �. . _� �..�..e.�. �. -- - �_._._. 33 22 l!'t€6ize�P�xnFSevas�w �rr.a�.r�,,...e.a.�t..�r��,r<�a,y t 145,00 . _ __ 34 i 29 Rrha6111tatlon SoN6ovs [■•ad rore irfor.aeio■' ' - - - - _ . - __ . ,....m... 35 � 24 Us� of PPO Networks �i�i�RA In T�aa�� _� � ��.._.__.� - - - 36 I 26 ' Certlfiad Nawork Faos (per olalm aoovso foo) S 275,00 _..... _ ..., m� _ . _ _ ....m.... 37 Srotlon i- Addltlonal Faes Not Includ�d in S+otlon 3 38 � 26 ��acsa�sor6e�d�n(p�ct�rQ�w1 S 140.00 S 12.DOD.00 — __.._..e.�_.__.. _. ��_ w- �..�.,.� _ .n 39 � 27 Loss Conteol S i05A, 0. J - -- - —�- •-- - ..___ 40 I 28 " 22.5% of reooverv. onlv If a r�ooveru Bs made. � I [�1 42 ' 30 43 � 91 �. . .._. _.. �� , . _� �, �_ �,� .. 32 w �� e.� � � _... _.,..� �,�.. ._ _ ._ __�.�. _�__ _ , f _..,,..�.. - q5 '$QOtion 6- Alternate Proposal For Llablliy Clalms - 4� 33 LfabilitvClaims �� _. � __.. _ ai , ant T b�t !Paym�ntttrmsfortheCf2yaFDtnwnar�typfn{ly3tidays. P{*asrindiuu2h��dditionaldiscountext�ndadtoeachmanthlylnvoic�thstis 4$ ��,�€d within cha�im�r p�sr��9 indicatad balow. _ _ ___ _ . 44 ; Payment 7erms Utsoount 7G 50 � lnvoioe PsEd in 20 davs -- - �.,. Si ; ! Involo. P+�id Pn 15 days i� � ► ►i ��acir�� Sh�C �s�:��r�r� Data �� _ .. ._._ . _ Ready � ��. __ � 3 5642 L�7iil±7(1� f . !, ; : *. ` �'. , � . i• , � � � � . . ,� � � w; �, �� • a ,��.�;: � Ft�d�i�:��° �:tlripSaG'� � t'E� e�� 9,sM ff'rnv�si�at�.s �ratll°i Fte��f�w 1�i�+it � �� 5��: t�� t�"a�rkJ'�`��Sn3ez�1 9��^vl�u+ �,��raitil 4 —ic�sitrris°w�l 13reb+�an�S �rid 3 ��t�r�yls�is�� r�� I:�tkaisia: �— i"° I`iy Set� �oa�� f�[fi� _ �� . Rtwi�w xl�G�ar� � T��, w;�r1 t�rtani �aatCc�a � . . ........ __. �w�r �h�t _ m... m .. n.. �.� ..�..� .._—_____.____ � �`��r�:r�:t ��orrebil aidY�?r�� ...._..._..� ___._ _ ......_.......� 50l kcdr,�s�� t `Ir�� 1�� .�. . — �. --��..�........_ ,�t�t��.t�5��t ,�1� i3usirr�ai tiverview Oue�tionnaire _ _ _ �. _�_ .. � _. �. __ � �. ____ wd �. ... unune @ios� �I ' r� t� tt�rraltmum �ra��1 i�lc�tfl��s ( cti 3i �t�ii lo ��gr�,��c � �1��4i��cr�critcria �._��..��.sv ., A� . ._ . �. _ .�._w ebt`achra�e�t � - Ea�oe�d'aoai ��ra�t �ii�c ent 1� - ��fercn F� _ �. _..� �. ...�,.,.� . _ � _ _ A ch nt b: — i��rrl�l9cr. ��9 �s��8r��t t aiae ir� F� ....�.��..,� ___..._._... __.......m .................__._.___ r�tlt��arra�r�t �°` = hck-no�af�.l�r�t�a�t 9SPQ3¢l� ��4.`$s1tl�'..3C�CA0 �0%W Fl11d �.ti5.9 ��Qfd.4 PCQ�SC!' C,�S9 piPA! 613� Bi74f1BhS}` ...... .. _. . . . ._,.. _.. . m�_ ITMM Ona (11 nne� l�ub rs�s+�ac s�art bv �utho d offlcar `n lhe e��E�;a•�& ��`i lotv . . _,.. �_...� �� _.� ._.a.m.�� w�.w�....._ v.. �,. . ....— . ,. `�iar��s {� } �� ,f� � i�� ai i�, :��l,r�bl�vE��r� _�—__. � _�. . ...�_. � St tronic ��b�z�ExsEa� �sf �apo c v�� co ttor ry devi�� or �r��@ Qm �ks:+ci�4��1�'+��c��t�rr s�� l��tI�+n 1�� _ _ rt" B il pricin� st�ex e xhab�; {) to ,� 3d��crcvofctenton,com _.....� ..ee � � _ _ — __.. _...._ i� r �, t t r � a � t� 1!0 ��°��: :f��T�i « t_� {� � � � ,,�. ir, �. ;��`�,k . .- � , , . r, . Exhibit F � � J �°�'�n '�R ��"" � � � � � , ,rK� : �' " � � r � � ' i r � , r. ! • ' � I: .��it!'��"�� I !.' � � r �. �' . � Ai ., 4 , a 4. `T Payer #: ?5-1)31607 5, ate stabl�shed: 19�3 . � - � �; �, '� � i�- � � �: � � � •, • �� . P"Iea�� pro�ide � det�iled listin� c�i all pr�ducis and/c�r servic�s iha� ymur ccsr�pa�y provid�s. ��J� ��"�`��° � r�� `:��ra�,�� °�:��;�� '��s�� `��.��% i�a�� °��,r�.�' ��ra��,��i:�� .�� :��:��t�� a�t�� zr��ta�:� �� s�$ ��t�°��, ��t��;�� :�.�°�:, �.��i �.�ii��-��r�� ;� �c�;��:�tr�ti�� `�� ;��°-�`��c�� r��r��z:�ix. ��:��° ��zi�li��x��.�� c�f° ��r��xc�� ;r�� ;� c��r�tr�� c:c��.� ��1°�� :��r��i��tif �Ri�i��;, ��r:�� i�� $z��:��2�� l�i ��# �,��"�,�� 1��a� �c��tz°c��., ��i��i ��ti�� °�� '��:��c;�� e�c�t��c�� ° ;��f��r ��,e��. i ' • � ! -! f', �__ + "• ,, � � 3 �' � ♦ � -" � " ' # ' ' ' � ! Y, ; r ,':�� t �': ! � 0 Exhibit F -� • � r - r�� •-�- • � - • � . r- �- - -� _ . • - 11 � - �_ _� � . -� � • - r ,., # • � , - • . • � � � - . � � - � ;- � • � � • -�r -� - � - , � - - - -� � - �- � i t��,..�. I � � � -� . � -- - � ' �* , • , � � � � - - � � � . � �; '� ' � �' ! �. — .!R i t �i . � i.�°��, .� — � — �. • ��,.. ��. ! — f..:' i ...:1 � " � ��.- — � �,.. ' �' ��' _ � �� N �' i R 1' R � / ! • " * � . ' � . ! ,, * ! ', � � _ 1' ' _ ! * . � 1 � — � f 1 �; 11 - ... � — � ..��.... — � -. .. * ......... � � - ,.... � ^ � ': M M ' � #.. � - r• � ��- r �- � �- - r � . _ r • �- - .� � � • - �' �' '- �� * � t,- � '* � , , �,� 1��,� �a+��a.9.�� a,�,:.. ��"��$ .�t:t, �rk7i.Y:�" '� a'��i'�,',s 4�4�°�.�.�4;i Iv':Y.,��'.=,a�,. �.. , * �� :. . � � � .. � ' � .',, � � .:. � qe (�y'-�,.� €� x'' �.�s£'i a ".�ti�. .-��s��'-i4�., a°':€ s &;�d;,.�... � .�t �:'��'i. �` �+,%1 ^ 1 1 �,��- ' ! � 1. ' 1 M ' t - �; � - I'e ,� ��s� ; , + . Exhibit F f�`�.¢c.r z�_ . �.�y�x'f � � ` � ��j.. w� „4 �_�. mw , .� �.,. � �z.: , ,. �, �' �.. ,'�� '��r�rr��l� �l�i�i�:� r�� lY�s�v fit°ir� ,�� tl�� n'i�tii��w��a � ��i��t�� t��t� ��a ��.�rcaa� ;�; i�t�9��tiioa�; �ta��i� 5 t�[' 1:?� �tl't^�:�i�r��;�� N�� i��; �11.��c�iti�r�ti$�1 Ka��t�`1��ai� ��rt�v la�: ��_:�� '�� °�� ,�� — -�- � �� ' �� . ��a � � � �, � � � �—;��.;�� .�..��,� � � � �,. ,_ `�� Y�.:.:fi� ,� .� ,., �_�.,;�_ .,:` � ud„�<� G r_�� a. „ ..,� � .�� £_�.t ,.,, � � a_ �� t -�2 � .�� t �� .a_wi v _if.�;�., ,.r.i.... �a�V B�� - �. -� , fi �`" �'..s�.v�d��.,�.�i,.�n,.n ;tis. . 'v i _ .,.s ,G =� �._e. r _ � �„a��.:':a' ��.�Y�„ .x:,...��..�a,.,�t,_ . . ..^s: . w''y'� . s..�:;"' ._ .., s. .. `;._ . ° o.�r� ;� a v-.: � ._ :. ;`�'' �� « � . :..1-�r .t.y �,. �.,,a��e �.t. f;��,, "r�.,a>ot�3 ,.3 �_,�,�t�.. �.�.,.C,, .c..�.. � ... �ch ,V, s„_�=�. , _�� .?.. . ..�rs..... � � � �. ,�'tr, n.� . e�_�.;i�;� e. � ��.f_ ., ��_,_ =ti, <<�.� e �, sr� a_. �;�I + ��s � �,a._ . ��:> � ,..s,,. . . :.�,.�=�U` �_ . �E�#,:, .�, .�.. �� t u s s °.s'. " ✓,..:.s * 4. %,...rx.vte s�i 5..:, i�r.,f.�S�¢cii._ i3 � . -. -.�..r'£ .. >s . a.� � S_t�°,', �e�c.s° a, �. ��. s�'�.,Cu.�,�. r ae.�.��.> 4;Y,€;.,.e. �^�=.=f�� m � �, ?' � <.�_ ,_.s..a_,s � s� ., r...t,._:,�.,« 3i`.fit.�. _ ..a t _ �:2..x._ _w..�<x,"S. ° _ �,. .� ar aer . �¢ �.�s.t. �_;�� h, ,�", is, ecn� `c.�;. ,�_�}xasEen fe ._�..,:> ,., .,.�`'�,.. ..xY:zA Fsi ��..SL.r-".�'9 .,'+ ...?.�.,.,'�� _.,� :"v�e�t. .st, �s^,J...`J4 p ..... .i t,.s.t�'..crae„t _r+. x;.��.es(..,.°Pt+.ot.��.,,�'� rye°'i ��rA �rr..:,.�t ��b.. l�'i3H..s_r,,.ft�ier.e. 4�,��i�it3_ i....ir4..= #�n.*..e�':v.el�i.� ... .. . . h� , , L. t `(y.sx.� ,_. ��' �`sY`ti,;.,Fe +� ..� r 9,... .._ 4 „, ._.. .r,. ,..5s:.r ,..s. _st . = s.x...s...t. �vY,� ......_�t_F -.!.3 :��".ri � -.s4s. w....4 S� C _ ..r.e.. x_..di.e_ i _SC.d "��b-,. .r��k�i '✓Ys 3i '� r4.�£ ,.x.vF 3 r.e_b �,�Klwk ..�..�. r.., x�i sL sx.i�'r. k'_F,A_e ss.wz�. 4..,r4l�:�s. _._kL=-."9_s...�v�+�.�` Lrs.xkh s.n.� c"�',.v .�_¢.. ki3e. �.e.§f�'+w0.-'c,z}4> n i. 1 ``�,� �+'FV�, ,_�.r. a��.=�P� s__ ..,;�'da.,P,;� 4u�� S.r. ..�-� �,.��"`h., � ,�„�" �T 3:� �«�»'#',z ...�... ..,..a�.r..,t� ,_sc. „r...�`; �.r vfa €.5f. _' �' +_' �.. a .-.x�} .- e_ �. ..� s s.a� �. c'"L i.�. . �� ;,,6 �. �z�.xv-.. ..t...�'-_ ,��.� _...::.. ,�A�1¢�� _x ., '�.. . . U..r.�t.. ,..., .,,+., � l..�wv�,`. �. ,..,.. .. .� ..... _ . . , '.i� � a�s�'' � °' :� y 't .. 1 }f '�} ' 1 b �' � ; ,tM ��'� A,. J � ,...:.�s< <..�.... .�� Y� .... �_ s x .. `��r�x �,.�r .,,x:.s<'a ��e .,_, ,..��y�' �. , w wFr.c.�.U�.� r< �p s . t.�+C't.�. . Cx ... .. _.e.__.!.. . a" �_h.� � .7 '�5 r s� ,,s d Lr �. a� ��°_ ; ;>- � �k . ._ .. ... � . �'va=�, . ..u,.�.: �,..:._=.;`x,.e -:3 � #� ,..� ,a„'?�? �:.s.''�r...c,s. �,e. i v>�a�i�� sa:�.=.`'v, _ ii'�,_�. . -,.x ,.a� .....:.... ....fi..i_4, ,h.r�,-��e=_�J n��° € '� �` -, s� �.. � a R; � ' c fi.: =e'�'r'Sz.+.t�.,., u �' a ..� scuF..a� .t�..o-f , ...u�.'�.A.:'. e. . .,�.� � T �f�.,.�,r_ � t �=�a��= F. � ,_ ..,. ,�s � �u . 4: — �VYY_,.=a Yits �. +.i:..�) ,...3.�;�s°_9.w.�x. ..tt�.e4.x l.,a�..�..e_6n..��..a_`f x w*, s�...,.i„ ....s.�ts erYf:"S.n_ dnw,-. .. �.ti_�'�,,, 3aiit� -,J ,=..�.aW k.x,.... i.: � ' � '`.,5 , . a f ( _ . $�=t 3 ' �b �S��k..ur,<x -.u.+.� ��-i '� .,<, s.as & n �,. -�y..�.Fw 4.._ t..u�,...,.. .�..._: ),.., r' : - S, a 4 .. °sxu .`4�'w t_ f. z..-.wt..s '�.'"� �'�, �,„ � � . � _s a n � r c..�� e=,, k.> �.�.:�:�.,�°a ns..�:, ..��;.� �..b''r �� .x�,� a,a,J._',sa��-..: C.xi �.fi._., < :..f ,�.,,. r�.a �,.:�4. a.e� . ..>ia.t,..� ..a. . �b w?✓� rw,w .. ..W . . �� -,.., ,n� a, _ � y.. n�"�..s_aa,..rU:, ��._�,« �. . �.v �r x.� 'v.�..��.. �.4�. � �.,(...�,`,':..�h�.'�..E .,,a,..rs.4�h s.n.s=��. �'� ,..it=.,a �_..z:• sc�.'s, �. a,�i� t"tw� v.. ?.,,: ; ��-- � � ,-: ' � " �''i;"� , F, �,._� n 1,,. . - _ � �; C :�� o;,�z � �.,,. f� � wsE.�e �� ,�, . �, �. �.4v;°u � -,'��..,i_'�.r§ e',.''r.cs'�9�",�� £' x-..r�`!Q`;_�.,�.�..4;- � zF.o�i��%�t .� "�.' r�.�.e.x.. ..� 3�.�k *�'rt.:" v.�...e v4 Y�; >..w...C�. s „ x .. ,. « .. `� �, • � ,,;� , .-� .;� e .. ,� �-�r � �:p-�- �ra ,_y �, ..�'-,:,�.' � :a�_ ,. . ��.?� �.:.a, �. �"� ; v f.WS=xi.0 �r_�....r:f.,.:�>_�S :. E5 ,�.�.,.��..�.n .. ; _,1..�,� _ 5�- ,,r .. � .��.� ro'Yb, ��` ti_.. � �. � . _. . .,.,�� a�. _ `�" �� "° t,t,.;:,cs�� c;.,.a_.. W�-,,..x.�.., st.� ,.i... �anVt `�,°;� w-�,u �s.ss§- a .+x.....�:., . ,��_�..! � �',� , m � , �.�s 6��r .5....:,vea_� .....� c. ,.te „ d , x✓ . ._. _ u �... ._. °Y�I __. . �.z�.�a.�z� �sd� „ ..,...t � �ia�=J � n�-�`�.i '� .-; :,wt�. ��.�.�� ..,� x�.,� 7-ytrv�a,.,.t�e .�i._ s.P% ..< <a.'zi�..., wn...�...:.r..3 .��.� ?b, �.c.6.E,.i t,.. ...s. ,s,H,. �,..`>�; ..,..s. z'�, wY"s"; rxi„c..4. a',dw ,. .�..�.,��'��.,; ... , .„, , r., .., ��? .a,e,t.��; s - „ z z_�.., �� ¢ �.Qa .... ��lr��.� _.=u;.��.� ,� � �" ,�, �,.. ., ��„ �s ,,.., �,`". ?,�,�� x. .�,�cs ��rT.,�._.c,�3..,��: f �'s -�, � � u �.� _-, ,Y y . _ , ' � s,�,. _n�..�E.r�u.;� � ��n 6 ��,�,,4.� .:�.� x s..�.��< �� .,,.v.�=� e�s ,U�;:; , .��34a _�1�.,�.L�. � .. .x��.c;�Yi ,,,, _.,�-�� , �:::� �; n , �.., ;.�;.-! a.:,�: .. . , ,. , r, . . 4 ;; `" � w„ , s � � ? a'�'s r :-� y Yi't:,t ..rs.,� s::�,..+. .,x,.: ,_"`� .. _. . x ,s, w,"� .,..:.5...,,.,�.ss. E.,�� ..t� ,.:.. a:...sw,4w;.. _. . . . � � � „ ,✓ .� .. n , F ° � : �r�tr�„ >' '� $ � � ? " � � , , fs�r.s� - �.s:.a.,�.1�,�.� .a. _ ...,r i��r. .. ..,�,L� _ ,.��I�,. ,. _( ��.�„ „.,�, ..... '� P.._ .� �. _, , . �. F.;nt4'�� V_„ .. .._�. ..xa.�,a �.�' ��. „... _ �� . � .�awx�a,�h fl�y.€.s m .z�_ __�� ,.�..<,. K �_s. 1 �., �4xs_,�s .� '�:s ,,J�i'�� '�t �_ r,a.x e _ _�.F'-,�° #"vr�'�.� � .��, tt..- ".'{F sx:�t� ��"� �.�' �� r-� n � " 't�. � _..' , . ,- , s , Y+. ' � ' *r '..; z . � fs i t c., '', +. �. :, x ..,. Ab�f . x r .,r ; . s fx , a , w 5.+.7 � Y � r :± i # - . . ' �.....r3 ,. �.i�r.a-,xs...., ka_ 4-� ,. �it v,�.rweerx b, �x,. . �:y�. s a r� .�-¢s .r^'"^— _ ... ..... ....... ... .... ..... ._... ___. ._. _ ... ... .... ... ' 5642 7 Exhibit F ��, `�� .� ��a ��z��,�� :��P ��C �� °�a ��.� �� s��, ��.� �� r�' ��"i"$ �.� �P�� s �, �7�°�:��;� �-��r��:r. �"�� i��x�� :�� g �1cs�� °��p� ��c:°.��°�° �:�f ��.�i�� p �� :�s��.�� . �s��;t�:��:� �� .a��m�;��tr�.�°��;��°� �F�� .�i�.�.��s ��,� �.��. ��.� ��"�. ��'�� a��,�;�� :� �� .�_��-�� .��;�� ;�� "�°� �c��,��'��`� �� F��°�;� ��c��r��:�� °��'�':�� .�� 1�� , ��:�� cs�a�� f��° ��a�� ' �� p��:��.�•:�� s�.��:�c::g� ��.� �t��t �;��-� ��.��r°�ta�� :::h�� °. �:'�� tr��b��.��. ��a:� �€��, �'i�� <�4� �� w,"z��y�� :;� �°�a��z,� �� .�W�i�a� �;�.�, ��°� ��%��a�r,�� "��z� '�`T�� ` �s��I t�� F��;�4�: ��:��;�€:�� :�i�::�� °�s ��'�° �a��a�°�;y�.��o �� :��.�: ��¥�� :,c�r�:��.� ��i=:��e , �...��.�i�; � ��.��.� � ��,�.�.��:� �.��c.��a� �� '��_�� °�;�: ��iG�¥��r � , 5642 .�� . � 1 . �� ,�� .�'. . � Tj •'J �('t ; �_ � t �� 1��i�% 1,fi�"} �� 1 �,� �: , � 4 4%. Exhibit F i � � � �catt ��,�,�s x �i�� +saa �w,��r,�;�F- 1`c�r tr�. Cery �° kt�r�te+�, urd �;r��awr��;r �� 5�� i'r' : �� c�� 'r��cd b� ( diu+��z ��'�� Jri ��^�r � tr�rn "��a�an Te�^�9 Ua;e�r��rt� cc�t ��rfit ��u�eral }� ra �a er ��;� icr sa tY� "Brr� �� ^ �n�3.y�,��r��t��a�'�i�sk�� r�e�d��r�r,cr�tr��i��^?{,l li`r�'_3� air� rc�<r Fce�Id�tC��p �z". &3�rtn�lfv j !�'Srlx � tw�,s �a �cirei�•� G�i�� I�"��s,�i td�c� �±� �:� 4 F9� sy t�� .� r�l� e�rrer' �aarN3ba� u, �`��, 5sg.r + Fo,� `� . , �� c7rn�n^��e:�tr;€'�e�x.��ac.��c.�`u�f2hc�°�.ka,Cf�a��e'�.�.�ew,��y:uncr�#,�tnae`ier��srv;,e�.'��4��!d>s.P4��icar„�h.'_s' 1 ir�r�� cru liro�4r� �� trr.�� "�'r�� I&c aa �t �� "��fi�a•��,c� �+�si�+i�ar�� r� �rd�t i^r°G a� �";.i1 ei b�� i"��c�. �`�t�'vz�` � � ;'. � � f,�l`.',�A� �.�bFv �� A��1t,t1 P�r !hw ��v�.�^i@ c�� ir�u�.i�i �51 �':� li� 1�+"��,. a:r� d�� 3��c^.�:1 �s �w��.�nt� ��n;�r, �C7d7� � � �c�tt �rsd �Si€ �w�d�. �yr��t�, h aa��c s�r. �r r�s�d�s 9� 4�� e9ty � �� . .. ....... � � ' � '� . .. . ... ........r �__° ___ __ ____ .__ .... —... .. ,,..... ._.__...._. .,. ........... .. � � � � ��c�—�d��° � i,',;� ' Archi� Krsas�tx e� D9s°r�tor �? pss�s �ta� e�@ �� T"� Grc*�ta �asasr:y. F� �3ter�� Flc��ut �I�sg� at�9 " `tc.A�k at�h �.�r;sr�ra�i`r. �6n�i 9��,� s�r; t �tus`�av�: ��.rt�r�n�nd Ir �;nwt��..:}�er��rc„I �y�� 'si f�1d �qa�r�ii�s �aad � sr��c3,.e� rr��aaau�!�rw r� �r�,�� P� rrt��p�.�j ��Pi� s+�ff�,�a�u. ��e�h i� r� ��t�erer �r �A 4� d�f �',,�" � � � [a�r•zer�r� n� vrFC 4?�,y� � ��a�,�y �q��°��at�1 E�i�#r i¢.. �Fd Y� ��. �;� i�v iwk c«d�c �a�d ° �bCc �f8�ia��. 6� �� ' , �v�s �ICCt�� a� 7� c �� _; �a��^.��J �� r�a;�� a� 2� ��h � � Wi k.�s w �� .�rvtl�r. ��,e� Nha�� r�. ��. �s�i� �� N�s u � t�. �, � ��a� � �4 { �.,id�°i'°�' x@L"��::�'d1, 3�n:.a ?'��""�C� �.a �.s I'"i�.�v+' Lir �i,i�! u��151"i�g,iYlytiWt# 4r� �"�{C�.�d1PITM`�,i �'+Ci`11�u"�m ��P {�x �,�•�.�`� f 4bi�Y � t �r�v�wr�der,* �,t��a� L?3�s�r ��^„� �G�w I�f� Pab�� or �r�� r � �Kd!�U�iF�rs �st�r� �il�r��a�s �Pr�1� ��' � ,�� CU�arar��Yp i�s s��IA 19 � �'r� �eu.i(�7�r �r d r,e�YhP t� �b .'�4 �da� At,�.,sr� � ar�9 i.s �s da��"Cy ensr9t:�r !�+' �Y�� f �.°�vrvl �@ii3st�; �c, iru,�,� �� +�r � ��2eWi bY� V �r� � ,. � r�rrs��r v�� i�c�� a _Sd'� �.r� �n� ��•�'ie �� a�t�t+�:u�*i�� Vr,r:,,�� "'� �f �}i�!q1 Y��:ir�e�s �Eifi�r��3, esr� ir, �a Carr��r �r�,m:rr r�i P�� :r�: �F Y�:q�,, :�.h��i� ��i�k da�ryr.�,:n: � t �ASS��ea9in� i��ry,� tF�� T�S � d�f 1" �c �n 2 6� �d his w�ea 9�asr9t�. 6� 4Fir�� hf � " � �, 7 �s 3� b� �� i� d 1"r�a�� °� #°�v�^� �s �s� �9�e�tar �f Eos�p�ar��r �cr�*E*x r,�� ;��w e�:��,�r�r_r� ?e�i..'i�-�p�� ar,;�=i�e��r:+ Svr;s�` (� rict, �� vWjcw°�d w� ��r�s� a�t td�Cv�o �iCy �° �'c vs �r �t i �wc� r.a^ � N an+� �� c �:�<, ee�� c �� ,` � p �� ` i� � lec��a�� Ld �, i �� L�� , f 1��.�h �r�ta �� r�e� l��s� �r_r•k�i�ar�� ir p��i�.rg , . �`� I s�c,errk�l� �x•i�� €� c¢rc •uirsa��r� }��s��s a ��, �ra� ��s'1 �- �ar �€�F �� fr tr>>W r, �tn� �§}v�r� �c�1� �tott�.s..�` � �' a 1 �ro��erg i'erny�R�. �;t �k� W��3 1;r��Iy �ui°t�`rkcd �:i€- pr��"e ,c.� �a�c� �rw�r�� :Tnnt ha�i¢� d�s(�a�a#i� � � ��t' �""��i.*I�� Sr�st�3 1?iik �nt'�.��r. Efl��3a��r�e ic�C,ik� a?�[�:al ��: �vu� e^� t„��rr�et:s�'t6� �I�}s.S#. �� ccnx��c�� t?� rk�l,;«�I ,�� r,�� i�� . �rr,.#a.� �F;c�al�.� c.��• � r.,�^-� ��c v�� ICC4� 4� tPa� 3P� � d af'C � � �t�2 �' ��4�es dn �' ple. ,�#" �'`� � � <,. t d �" �t �� 1��'��,�, � `� �! Er �P "R�y" �J�i#t is �ay�r �� ta�ckri�6�, e �sEtf�s� t� h�ld xBr�:� 2�Il9. � as � �^ �1� df �� , � �h�res� i1nPw�r�rPy„ �rsd � C�S��s+J P�s�Sie �sca�sus�a�ri. 6k�� i� �ih� 6� �m�i� �fi�s ir� �a�s ba�na��s^n sa� �'� , ��c� ��d fG�r� L�at ��. f�f� av �ae�k�d R� �5 �a��°d �� iss 2 . Q�e�y hs� t �ai�c, "C�r�. h�� riod�r� mr^�d �rsc gr�dc9�t�! F4� r��sc4�s !r� �#�kd�t� ��1,, � ,° , � ,¶ �'i l } ��fi� �� , L�la� 9fiut c�r � C�d�ctnr af 6�# n R�saur�� n� ��s� RF� sv@ As� fi� �1y ot i�s�b�c�. � � y" ��,ti� � �� 4i��„�a�'�"��m.�� °�t:'F �u�.� �t��Ya f�6�Et�.n �.�Ik�Gys. ��e�iwi°or,,� ia� �' r��'�. a:�f�l+^�€P �; +�SEi[�is fr €"'S�.�rrs.�. 'S€'t�rrs s��r; �• � �' Tr„��cn€e T.��i°ocr �" ��rrv,.rle� ui�arp E_.. r,�dw �a�ws�ir�g 4}�cp :�rse.�5�„rx ir �is� a��r��rr�:�� fa�e� c��n�^,;� ' " �:.�spergr�� ; a�1��r�, ��lf�x��rr• i.s:lts5 i;c��s h�rv �r��tt;� wiaes 8�� Gat�r, r,t ��C��k ra� FiSG� t4�'�k.y;�t*��. d'tir�d�rma+c��^ ir� l.�„,i. ��s r�°r�:� F�as,� hM1:;rc�a` r,+� �f�icr, s1�� tr�•t� r,� ltcr ��wi°€�� gc;ratr�,�i fos � a�:+�� •, ,; ,� �� _ ......... . . �.,.., .�._. .. , ,..,.._........ I n�,.._,v_ � 5642 `•-�_r.w.� � Exhibit F i� ��", i _ � � ��, � � , _u� , '�� ;; , � � s,.� �-� �� 4'� '�a�'i �� Pr � tf 1��{ h` _...�,.^'"�.".„.... 5�i42 �.. �� a , . � �� t �� ;, � � �.. , , � . �� , � �.. �: �� a�� °�� 6ts, ��:y�+�am tr? CP��a� k:��K�,f v°� �>3fir��, e,r�� plAc T��Yur° ��c�r4#y �"��P�w�l �t��eu�ts� �i�friet !n 20l� �'�ir�„� � I� ��e�� if zrrvie� � tN�re� �n.�� a��r�fi�FS �!'�� 4*r �eirv�� ire sr�r�f n� i�ra C�� fla� 8A44. �'ar� M�� a ��ts � c�w�9 d�r-��9��a �i r� rr t'�^r�srf�r��a�s4 �w^�i� pBtnui'�e� �"�scx€rc�� t ��nff Ps��' .#°��,•� �kS��aC,t'r� 5�r ��rzti j�. P�dc �k � i��. sr �,� �r�;l �,ta3�. a�^�9 r�1�i�r�t �,m-esY�as�tsn+�l i tlorte. ras w��E n4 �rr.�m�rwa�s t,.��4 aa.rb, �r•� g�z�rs��sl�r €,��§��r�i4a�� a'�r y+�� t�� -f'F� $�;a^d cE � S [�8 ?a��. f [I � . ,`t }I �� " � � �1�Yi��L' � J � �x�o�rtl� �da�t�� k�rrdol H h b E� dae D9r��or �E� �t 1°VS, 9it dg � farmer ��r�ra9 ��n�e9 arad Comrca4 d w�f iha �° ts¢�rtenerr4 af Y� . for Chl�$ rAdneletP�Pa�tiv� Offfeces^ a� 61a� Cdty mS . �ton R e, E �e° Exxe¢a4ivt bi�ct��° �t' i�ri+� 1�sai.�rs�rtit �'a�uE�r sr^.��, n# A6�uyrrr^s, i 3i�a @�.a�shi tk9C� '��6U9l� en irofue�n� a�aalatna°� law, �rrod hc hat ar�r�rcrJ an tW�c 6ors�d� a� �s��r� prap�rey m�e� caasuell'�� Be�vrcra ��esx IIf� I ero � Olc�med ro9ofe�d adenB�xa�t+°�xe�€�� Ir� ��r��r��i �x ��'nYdnl�lr�a�buri rri n avai,9ter�" eomp�n��F9oea 7f d�uee f , Pa o 4�+a� Laeuls& �4�� lJn9wt�d4y Bn : hv�v�por^t a¢sd �o �r�a l6raCv¢r�a35�+ Sch�al of , llisr.l+sr^;ve°i#r�r� C�+r•�e�lorx �'tian.c°a RasK�rir �a�� e�� tlk�,e. Und rftfeg blresPor 4or TPS, My, li�Er� wr�i� Fc�rr�arPy r§��ls4�n+ Vlc�: Px��y r+f ,�rr #�F� vlzn r.o�vr-.a�g� ;��e,e�,x�rF=' 6or Avtzanl Rfsk. and keslslant V�ee Fs €s3�� nt nf L��ea°wr,tar,� �c�i :�,;a� �ti�,��° ��Satr�a��;m€nf �sf �e�4t-,. Tr�, Irv both of 4hose peelitoro sha 6oc��:�i ara srr,�c�.v�*itln� c��7d nacu^kcrlr,g i'&1e 7P5 p r. Prior to t , sh¢ wa+ a Supervlsor of �o erclaf ualty Underrdrftteg far Employers C�ualty Com�ny whe'�e worked on Yhe T�S T�56 acsaurtts. . Ruehle ha� a 8achelor oF Eusi sy Adminlst lan r from thc Unfv IYy of T¢x�s In �rlPngton. � ,kj � � � i 4- a4cti �lai � t�r 5t�ve � K� d ¢ssu$t6-Vdaae 6 �lal � 1, 7'�d� 4nc9udcs cxgscrl�nce wtfBs �eraY d Intea°e��ior�! �ask rot d�pa�°tmteaos. Tr�ur �ro�der�, `Pp� �parm?to¢� and 5alf Ioaaur�vac¢ p�, Flan Ants'� 0 6 aw izatiar�! sksBes all�w €�r sa,�ee�aFuf eommundc�ti��,a weth n0i p�rtr�v to th� �1 . Yn addtta�re. h� E� � e w6�h all Wa w� �p9B t9 {� A� 6tlA I 9ea �psnl�h. Ft� gna t�d fa�m ��i 7��taF� U' a of . A4�� 6n Y491 w�h a ketssr mfi �rhp. �nvlr�aaen�eatml 9 os��e a�u�9 . �16�r Bes � S! . �eN°k.� Pn � An �ff9 �1; � r, ' «.. xa �:� r.., +, u_ � �� " � Rie d � lMe� P�Y �ia°cs8or f�o° �5� h�� rnare 4fA 28 y� af ¢xpeei�s� � n L Da��vee�t�or�Caro d C u9��e. Insludtng 1� y� �6reh La At al L �na�� Careopany a�ed a� r��eM a y��c^� a�mt9� � Y Campus�y, bd&s �ro�a�ths dess8+�d� rt�k ausa�a P, �xposae� fd�.estBEfis� , �y�e�ne � Fy o e ca �¢ea�lysts, a��e re t manpB�y tr�9ntr�g. arad perfor t rsa e�t E�r peabBPc caeo�e' o �hred n clmr of ala�htt��B�e�B �rs�t r4rg #r�m C9n�v�r�i9� of °fexae �6 ��78� fF� � � �; �• �• i� +,� w + � �� , . � ,�. ti,., �� i_,.r�:�<� ��„{�;.rr 7� � � �., ��, � _��.3� � ., .. , " wf,}�_, EE e., ,1;.. "i �.:� .�.� ��,�,�.. �...�..,.._*-? „•.�_a � .��Ir�.. s�....�.�,; � �., ti..E.,.�sep.. ,k€;, e.,� �?�� ^� ;�� ,.�f .€;e �. w.t.u.�..�i� t,<.. ` +' H. - � ;4:4.. i,r, :.��.'- 4 �..^,.ce,. '�` �, s � .,��" ��.. ,s..,,..., �..�v,:. ..�.. fii,_.�u:��t,.t.,� s.s...,.s t...a. .�..,.�...d➢ �a'a3�.a .�..�..��.,� a�.... .$ a .��aT:.�t.e�3� s�T �,.t�„� ...�,. � w s�;.s �,��33«.�¢.,.�. n� %�*r�..rr �.�n, ,s.�.x3- { -,=�=��i�� .€..-.3.. � ..... ,'��fi� , s �. �:._n�.�:: �..� , � . _ � , . . �a :�r �-�.,� �"a �at ,, ��'/ ��.,�� , r. ��U �3.c,�.�:7 `��..w<.A, ,. �. ,. ,,, ,.?- ��'..;'i �..f.._s:�� .x'. .'��:.�a��.,. ` �._,_ �.£s ,.",' �,'.,, w T� � y ` ,� � _ 5y _ t ( q� ��.,;"i 6i- >�, �.�e. s.xi�.��. �� ., ro s�" ' �.j.�, , p� � � �. r� .x. .afi �saf:,,31 - YYia..i3� v..� 34.,,�.�.c3.+.�+s. �.tt S b. (�.y.. i.3 Y s i�,si.. J. °.K t p3;=s@��u�✓id e_L.� � yy . ... . . F ._ - ' ' i��.?��``` ��,xx`s� �a.��,-ax t z ` �.? .�`..Y� ,..�e _.., C�,.t,..��k. nE.�"a �E,� G,.��c'�' Yr �'� �., x_ �3i,�� .,,...aw�x,. � �, s „ ..a .A,.� y ' � `.` . ,., ._ . �., _s_Y �_�°�� .a��: .w� a�f.�s.�� °r_�,j s�_=.t=firti.��,. rr�_.. .:n .� m�`�� e.x � �� z4 �,,,fi.� .,'� . w��. $�� %��...� � �.=.t.. � v ,�� 6� . ac�.,a�.; . � �.�.�:��,��' � '� �- �..ra�,-�'. . � ��-. �, .��.-� "-. �5€� ' � -�' � . Wt.,a z, -�3. �c ...E �. j .. ,. ��k .c.:..,. .�,,.a. ..� ,�" }s �.�.s.a�,.��. .<r.b�4 - .�_�,. f.�=,.;b �..��.��;, �,��,..'.�,.� s��,�� ... , .: � .. � _ , - t t _.r<.»� , �e� � t „>.°,: � .xu ,.n�� ,�.v.. ,.�t� 5n�'4'� ��. ,�€ `� �9,E��.F4.,�. r_r ��r« "?��,,�_� ��e. �a� ��„��__ �"i ��. ,< � »��..r�..roc"rr..,y {-- ��.:�,.�.,� �4 s��SA`a.°�.� ,rd �=.'�:�9"'�.� ��i':,�:.5 _..�.. �.__�",,. x ib��,�� ,�. ,�. ,�n,«..,_k.t z �cs�_, s. _ �.°� :ii. s r ti..;;� �..h',:; x s,.�?.i... ��— � s ^ � , s a s - � � °� � ` r ' �' ' y � s', s . a 3 .:, i..,a�_Y :e.f .d; .,.P>Y ?1Y...F�. .s,� , . Es.i, �s.s x . ..�.�s,�.{ �.�,..,..� r.,<l.c.�a .s.�� na.... �.i_i_� ,. . .�y�,'w ,_.. ._a.i'a � ,� , � u��.�, �� _� , .� � �� _-� � s ��R,.., , . �:c ,a � a. �;�� a��` �. �� : >�� Ff= s:�;w � ; ... �'S r�� .a� ' �s . �z.t.e it � =.a,� et�.;i:: �.cr �*� e.':y i.�,[.��.�.�: ; �,��.� ��_;9 � ,.4�� , `; n,��; h .,��a �➢�fi� ..".�,,.�s�: � „_dl �ad�wt•.. ,� - i�,z:.ts . � ;ha..4s:� ��-., ��. aF. e.'; n. �.'.,�ir x,�..,. .� ..r.ss...�"_�_F i.��.:: �...� .. :..w _ _,x_... ,.�§ :.�..; .��i..., � �.�� ..: r � . � � „... �.,+,,.,;.�� . k.�,.=,��v ��j„� .,. ��t �L:�, «... , k,' ,s,�.s':�^S ��., ":�a�a.. �:' x�..�„�,��. i�a,.�.x� �, .��rt,,,.,v:s "9�� _ �.- s, ��,.� �. , :-;�� -, . _ ;; , � . r , ..3 . .. ., - , i .r. `,> U,. . ..... � i,..� '� _ t , s..a �, s.�;- :. S u i, .� r „ y,� s, ,_,... s,�,,, . bP cn�...... . �".is�.w v'Y�.., < . 4.e�E��ss�6�.:�.� ,:l ,..r.� . s�,�..,w., x; *�=,.E4.�v,a ,�y � s �"'� =3" v:t �',4 ,� _�°.,�� #_=�v;J 3 l�.::,um s,3 0,. t.-;�; � e.��,. ''�'� a .. �,� @.a,.�_+_:FS_�.,y a��.� ��, xi,...� `u�: . �.'i.�� w�.. 43 �=.,,.a�. w.. . ta_ � �z - , .- _ .. _ .. - _ �w.c� ,_AcG..wt �� .� .�y : .n�.�. .=.�..rF.< ��.:�. '`.�_ , ,F�c�� b#.. �_�� ,_� ��:�,,_ .,_ �a z . �,. � _��}' 'ttx>rf�a �v�' e� .r.i��s�G'�;� 3.,. � �st. G � �R �., �Y �'s _ ��,f��"�� a,,.w�� vdr ";`��fi„ s .� ,,;"� . , . � ..�f,.,�',�:�. `w� ,J�;, 3. 6.._ � � � ,. �t >_��. „f� _t? ,. ,.. „;4 is ��... t £.,.�..i¢ � �. .s.�f�°, i ��t�; .� � �'.#�tt7iiti � i ��-ro� �°��€a'p��:a �Y`�x��; f"�➢�9:uf:;�V ��s�s.tlb�i��.cs�� 95��' �c$�u'�y� �b'��%a�;;; i�f�c;�: V��4� �:arro�u9�u�uk �3V��c11, 3,<� ��a�€;e f9aV1:��, "1"��eas ?52�+1_......�. {�c��aty) �S��t�� t�Il�� "Pcfl��a�u�a�u� �fcs.:�?`L-3� V-b3Cr � �'��x I°��s.. ��iCi- �Q�'�-C(�51 ��.'�'ts��° I-��tgd��. �;3�.1��Grtf-5g�9� .R�t-&� � Pri�cipal �o�tact far'I"his Proposal: . . .1. ,;� �.l �, �< i'ItI�IN� The CIT'Y �s �equesting pr�posals with the ccast disiributed c�n aa l. Per fil�lclairn b�s�s with a rnaximilaa� not io �xce�d cost; andlor 2. F'lat mc�nthly fee (re�ardless of ntimb�� of clairns); and(or 3. l�iat annizal fe� (r�gardless c�f �tiember of clalrns}. R , .� � i � r � - i � . _ � , � .; . ' � ' i . a ....... - ♦ � ...., �1 ' „ � .... _ . ...... � _, �: CL.AIMS �MI1�II�T`�A'I'I�I� �'lease answer th� followin� qiresti�ns regarding y�ur abil�ty eo admi�iist�r workers' comp�nsatii�n fc�r th� �I°TY, Answers t� alt qtdestis�ns, e�ce�at (tern �, SFdOI€Ili ��JjJLy l0 l{l� 5/7LC8�C C�L&607IS ClGb�fldS�dl1� IiiC�f1011 1{2�! YV6t4ll� LiCtGt��l� pr�cess CPiY cladms shauld y�c� be selecteci. �t) P.4iVY �}`U.�L,IFI�A'TI�NS (Nmtee If � national or re�ior�al campany, resp�nd o f€�r the local branch/c�ffice that would handle ��T°Y`s ac�ount.} a. F�ra��1 6��rIC?a�r�e�s��¢��b-� ��ad C3�%ee¢�� [2�y��c1�Y 1��;�4°�u �,�€ec�iiu,�; V'� � �:;,.� 2. ilaie �'oi�ncied/Cip�n�d I 983 :�. Toial nurnber crifull kern� ecxaploye�s 23 . �'�'� % of total 4v�rk�rs. • �r, � r � - c. 'C�Caf nt`rrtbe�� f rnanagers aa�d execartives wha hav� left the cosaapany within ihe past l2 monthse 1 , " ,°�...� .% �f rnanagers/ex�cutives �mployed. 4. htunaber esf public entity clients: 10`1 l0(} °fu oi tota] client�le. } 5642 �4 Exhibit F 5. "Pot�l n��reiber af r.lients: I i1� g 6. L'sst c�f' fattr (4} sirnilar-sizecl, err I�orger, 'i'exas pubiic entity clients, includin� acldress, tel�phone nc�rrib�r° �arrd cantact persc�n. P(e�cse inclic�te le�lgth of rel�tionship: a.C'ity aF l.ubback, [.eisa I luteheso�r (I�irector �F IZ�I} �� SC)6-776-22'1"J — 5 years� _� � �,.'�'.,; E>P �;si�lx _1�1 �'.E.�kr'c;rv �J=� (6?11, :� ��r E� t� ?'i�i1 �� }�.�ar,, i,(.�t°,� �:t� ('C3Ctli?1ECir.,,, [�.[in, �,.jt�'•t:t, �)��.C)E9 ��'`9 �� .�;3�,} �� ui;s �>cst7-� I�'1 I"t `��t:`9„ � �.tt, ;�T .`+�1<��r;Ic r, �1,:, ;'tn ,��1 .el <�€�t.E�1'r',EB�' �.� r:�r:li�r<�i��r} .�:> >"� '��'.)��— `' ,=c° �r`: 7. Lisk Che ttir�e (3) rr�osC recent'Cexsts public enCity clients that did riot r-�new their oo�ttrac[s I'or yaui° services, inc(uciang ¢ici�ress, te��hc�r�e nurnber aeiti contact person. a.��ledin£t Couitty, Cyuthi�t lv}` (�:�unCy �C're.i5ure�} (U? 8_�0-741-61 10.__ Pr.larll ��iC �.,:?.[. ��:rf°J,(tCt; ��i�r!:�c)�''�)1`>-��f i ,-,,_ a,�i.�'t'lCli �)„"at�"; I��U�..�. �,>IIE,c�I'IIIi,�iC�..tit� . s�(,_;-��.-� .�E�?,; �. Elow rryany claims processin� Icrcdtion� cic�es your firirr espeeat� in'['�x1s? 'i_ r„ 9, Vdhich cinirrrs proezssin� lac�iti�� will be ass�e�ated with Che �ITY"s aec€��n�? 1449f7 Laridmark E3tv1, 3"r F'Ic�or C�allas, Tcras 75254 iQ. F'lease inciicate the siz� c�F the claims process%n� location in the f'o1lc�win� terrr�s: �laY•kers' C.verdp. �a. t�tt�xbe�° �f' acs:€�un[b scrveci 3 b. A.verage n�arr7be�� of clai�ns opei7Ed eac�� m�nth c. Average n«mber caf cllims hai�dPed by an �djidster per m�nth d. Average number esf ctaims I�,:' ) prc�cessed eacFi rnanth �. IYt�n�ber of� p�iblic �rit�ties this ofii�e har�dles 1 l, Ple�is� furnrsh the fc�ilowin� inf`ormation r�garcling the n«mber �f' ��ersonr�ei at tfa�s Pocat°son only, �nd their experiea3ce. �"1e�se classify each employee in c�nly ane �f the ,�csb cate��[°ies listed �elow �o that the tc�tafl �rri11 be the total ntrrriber oF ernployees �ssi�ned to the tocatic�n that wi11 provide services to ttie CIT`1'. �'Iease choase the j�b categary that best cle�cribes the fi�nction af the emp(csyees invo(vetl. If all caGe�ories are in�tieqttate tt� descr�be the function of an employ�E or n g�°caup of'erripl�syees, please creeite �nt3 descrihe yc�ur own c�t�gc�i-y, _ __ �J� � 15 5642 ��.�. ,� Exhibit F ��^'^# +•r��' soscAr�wxr �� CC ;� ii y ,. ! g �w n� M.'G a; ,-�43 .7AS�e� � n �� tl a.r �°�y A 6,,,..i'�t�4_.�.,�._...,. �'.m'kt �at+GL! .».7*�a...�...?.?i..°.= �"'�,...�4w..,� ,,,,,,,� �a^ea�.'S��'+�. ..� .,�,i.......n......� p�eg�Dremf�caU�damrdkeo�� _. ....:............................x..l,...,.,..,_..._ � � C � ) _,m._.m.�� 1. .�.,�,,.�, R' 'C �4� � rWSm f `a5 tytopss �t l.r.c�stcom 4 �'cooae4 a�cJ ......................_.m..._,1.....__....._.._ C�eteProfisda�4o E ) i0Ye0L5 a 5 � S� i6 z � A rt . � �. w �:�: � .... M f S"w - a. =� , .. �, �: -. �Cears of employtnent with your firm tc __ Years of experrence in insuranc� inditstry. l3 _._ ...,..._ .. � �..`— ............._.�. Years of experience in v✓orkers' compensation claims adrninistration: I"s �'r�s��€�s��.S �€_;��.��a.� rir�.cifssr €4��gr��;� ��r��e�"� ��±€;i��°� o�` ��r��s, ��,rvi.��:�.s,n��1 ��s�a�,rc.�<, �.,,.�; � � ;i.�� -Sr.:��.-� I3, Piease Purnish the %(lowing inFarcnation regarding the i"exas DepartmeYtt of Insurance hearing professional that would handle this account. i�a�a��:a `�°ta�rt 1.,,ii,,. Years of eri�ploymenC writh your firm; Cunningham � � � I,.; �'euesr�4�expeCfence i�t iirsur�uice i��rr�tf�"..� ,. _,_,.,,� Xenrs of T�xas Workers' �odnpensation experience ,,,,,, ,,,� Years of h�arin� experience .,.n_ .............�__ . ._ __ f'rofessionat destgnations and/or degrees earned . .� . � � + ' - . � �� ► * �, ,. � . r . ., . s�', ♦ ^ 1, �., ' • . ;: f .. .. , � � � 1� 5642 `'�....–..�.- Exhibit F � � �=-� n � t�� j ��, �� .� t, � Indreate ynur slantlai°cls f`nr ctrtiaus t'ssrgnmentlw°orklc';id £or each 6tdjuster. , , ;1vs�i,r=� 4 r t, I<,a� ° r<t�. �` .,.1 r�f,,� ,. I�, !,; t:, � t � i ',, . 16. �"crct�gsstrc ycm��r ��c•tssa�l �cr°F�,rr�r;ts�s;� f�r th� �2 2notitl�s �rrdi�� °�wa�l��a° 31, �,@33 k�a stand�r°d, (if yc�� strs; �a�f�:ct�a:i. ws; rt�ny as� fc��- su��a�rt for t41es�; f'tgur�s.} G�'6��im ,�u�litq I�im�� ieen pesfarrned by �vC_`E �s1d "4�Villis. L��rCh claim au�f'tts shc�vveci T�'S �, ,r��,� i.. .r�,�:�,, ..,. �� ,-�;�,°. — 17. Provitle th� following statisties regarding yottr operation as of �2��ernber 319 2013: �. r r a r � •► �r � a � � � �,.i M, � 18. Provid� informati�n regarding any ongoin� training that the emp(oyees servicing this account will be r�qtiired ta satisfactorily complete, Indicate if CI'T1' personnel may atterrd this training and ai what cost, if any. __ � 17 5842 Exhibit F ; .�� ,.Z'a,`�t�, ., �;� � ;L:,�ti. . � .. �., l�wj, .,�.x,� ,.��„Y� �d�}��i' ,t) �.�,1(.,..,Y�.. ��.. �l �.�a,. ��t�,�,J ?>:;:',�... fi �'°� �..:��° � ,.r�,t��rr. , .tr,r?J �t,G_�li.� ir. di{ _ �,s(.. fl4, �hesci°ib� !he workff�w �a�' c1�ir�s pr�se�iCesl byy tl�� I°fl"i' f�r �flan�lir��. '[`he �ity'U c��iA�s w's11 in7rr�cdiatei� be ,se[�s� by t�d�i�1�. C:l�irns kvifi �e zzssi�?ned tc� the hs�nr�i i��; ,, . , � � � sk ,�K _�, � ,+� .,� E�, �,�� v :q. �a��a ,.t� i.�,:;. � � .�-�s � t ...�. � � � �-�•= —�.�.�. _. � 21. If yes, h�w would this be acc€�rnpl�shed? f�on-C;ity clai�ris Gvould be trailsFemrF:c1 to �ttather acijuster 22, Descrzbe yaur screening arid �'allUw-up sysiem fc�r th� #'altow°sn�: :a ;��.�.��r �' >�r�s: �.��.�r�� ..� .�r:n � ..�, ��" �'� �, � I t �� ° ., _ ,. �n, wF .m -,, za� n� Q.,��F,k .'+ u.l:.ita .... 3 ,,.i� t, v ,�vJ-:;: r aa,� �,.i�p,l4;.;� �.�.. . �{'7"`li .r �., tiY�i`',"?y �.,a4,�` r1 ..1 .�?,1.,.2 , c.� . "i1.: �r' , LG1�.;�8-� 1� '1".;Vt t a€( � : t","3 1 ,':�:;'., �. s...�,,,.�:`�s.,. .�...fi$a��, aa,a. +,<,.F�`*=, A�. _ _ €:-,.�:Ys,. �i'��' 3Cldtil (� 4 , �!�. .;ji,..r. J....� �. , i,.._ �d"�r t�. I� a ;ci� .3 ..t. �. .�y:t�,.. , ��54'_ �'�.,�,'�+..Dt rF$�v'.i... . �'-t. v,a r v.... iai � ., -y'ir:l�., ., ..-1>i`;: .�y .t.r„�- � sf:�• ......... �. �3cbpi�c�Ce cl�itr�s �id�d. a�;ai��t �I'TY's rn�jt�a° rn�:dic�al pld�� or cath�r is�sL�r�r�� c�res�rs: t�(1 cl�ims wiil ka� i�a�(exed ta c:he� k faz� c(id[�licat� cl�i�z�ss. d, 5eleciic�n of° physici�n Por irideper�dent rrteclic�f �xam; ��' .a..zs. � v�1.� �., ..� ..r� �.,. � 1 r;r.,�z� t+��. d�,=irr r . a.s:ii..l , , .. ...,. .� �.i��.S �'�t � ;' ��v�,.,va�.�. �. Peer revie�w or trttier rneans of repoa�ting st�spec�ed rr�edica! rrialp�actice, ___ r �, �� ,,i z�..,.., � a. �.. ,.,. �„ .i�?��: �;c � :..<a., � ,�.�:� ��i.� ,� ..ticx .�,r�..; ,G.r i ,.�.x, xi,�y r�;', ,��r,�.tt, f. CPverpayHnenC c�f' benefits ....�.. a�. ..''� I.ti. ;�,Y.,.Iw �;,'t d.}r.t�. �,...�r�,C !.4 .:.�t,r, �..r,;.��„'ai .:�.,. ��.LT.S;.:t'�r.�r�.�.,'.'v�� .-�� _...,�r.. �..ali1�..CCr�i -`e ��,.� .�., , r'J ,.,b�.��.� '� r= �i/c rr�,.1.=.-. �.,.., . ,.. �.� ,. �"c "..;. C� ., ,..�.... %y . �'�";. _�.__ _.... ...... ...... ....... _ ..., .. F .... 5642 ��,W,.� � Exhibit F 23, Describe your qtiality control program and attach yoitr written internal control procedteres. The CITY minimum required standards are indicated in Attachments B�c C, Can yot� camply with the CITY's minimum standards? a} , �,v:. ,� ,,_,., � . �.,� ,,..,. �,. , ., ,. ..,. �'�.�:.:.t�,� , x.� �,_,.,.�.-:� W�, t�. �.,.... �,.> , �, .. v.tr,.. . � . .. E. �. .�.";� .�..e, � .. �. �.4,. , . ., .. �� . .. ..� � .�� E .. ,�.� �..� . .� c� . . �.� ,..,. '�, E, .�...w. � ....., ._....� . �.E, .H .. �. w � .�.. ..�.�..� v .,. �. ; � ,_ .....w. ...... ,�s, � � �4 ��_... �. . , ,� .�,. , � . �,:�t .� .�.. ,E,<<...., , ., .�,,.... , �,�._ ,�. =� t,..� ., ,., 1� .. .....� . t . ,. . � , �, ,...� W � �..� , <<�, �r. � 4, , � , , t . � > �.. �. .,, . E ? e 1,, �. . .�,� . . W, � � .,�, ,E:=�. :. .,t . �, . t .��,a .. .� , c. .4 , �. .. .,. E1. .fi �. 6... xC ..< < ..E c . �., .,....�.. . ; r�: . , �. .. ,.. . E...� W.,, .. ( < <<i..., �. , ., ..,� , b,. ,� E �. � 4 �.E. < ..�C. .W c. <.,. � � . . ..<E .,, � ., r �. �� .,< C. .s..� e < <t �L.. � � �a{�§ . ..... .t., , f`.,.�,<.e. .. .... ,. � �...�, �.E ..� c.,� �.�... .� .�E. t u't'° C..c.....}..w. v.. �t,�. ..�....'1�'�,i .c.v,..�.... W�„ ...W v.,.�t€, e.� �1'e . �„ .,..�..,,� e �.. f. ,..t}..... E.. '�k."...,s,... c.s ..,a...,.< u, �. .. < .., e . � .. ..s ..� . <<. '?F, ., , w. ..,.<. � n ,� . .<. �.o. .. ) <.. . .� .. . .e � `-i.. . <.. 4 ,.. , .. � i.y .� .�.< <� + ; ,..�. <, .. �... , . �.. ��.,.,C , �.x„ E,. .. ..... t"f , < .... . .�, .�.d .��., . ,., <,.. ..<,,. ,.C:,: � �, i.ix .,i. - 'w � ' _ .. . . . .e .�.. �..c <.. . F ..�r �t.<..4 }.,, c. n � � Y,..bs. i � ,�.. . <., .2.. fC . � E E J. . .t .� 1� r ... �. ., . ., ,� c#� �E �E, � . 3�°s. �..�.. � . E s . , � t .� . � . ��, . < .u....... , �., �.<� . ,�,.c�.�, ... �, .. v 4✓r. ., �., . , < �;it _ .s.,. . Ue t,< <. }v . . ,:`✓ .,. 1 :'.. ,�.., � .. ��, . <<. . uc.< . < .W: J t,.� .> .�. . . .�.., . .�. �... ... v. E..E. , ..,� h� .E. >, . f `; ., .. .«WS .� � . "i i.i �` k.t� ., �%<�.s .. , , c.ai� , a W E �z.. <<, ,�''* , <<<,E. , t,.�.�'? ��wb.�. �F .. . �'tiC=.. ��e, F , ..� ,E < , �, E F .. ... i, «. �,� � , � � ��.. .,L �,r E,. ..�:�>. < ...� �,� .,,< « < � :.�. o... ,.. a .�,E. �.E,.,.<��. . ��, .. , i„ << . .,�, c .�.., . ...<. ._ ..�.F, , ..�... x�..s..... .iE,...�... Et', �'. < < , W�,.... �,. �.,<< .,. � w r., F. �.�, ...E. , s�. E�w �.. .W �..,E .W,., E... ,:; ..�„ .. :�. .. E.�.. . .�., . .., � � E,.� , �E v�. .. . .c.... . .� � t. E,�,. �.e,Ea .... . � ... . <d ..e „ > . €.. .t . �. ...<. �.�.�. C �.. �,'f�< < ... C. W.cv. ^� .� rf , .. .t � . " n ir hW 4 s. :. �.<. ... , t ..� ,. c tEw v.� .., t. �.�.E.iC ,.�,5,...=�ot �.�' ,a.,,�,... � . � . �,. � m.� .,� ... .�. < < W � .. , ., . e,� .W. . �,. ��<. . ., ..�. . < < . „.rtA E . ..��. « . �' „ � . .ts .�. .� t ,r <<k9 ... C, . � Y�i�f,,:. ..., .. <<t.,�, ...., , ..v .E. .... .W v �x< t«e t . o.... , �...��. .. , C,.c, 6.. , E sE.,��'v.. . ... .. �... E. > t .. �. .« ., � .u,.. ... .s�...� .. .. e.t� . ,�r. .�, c,E .,,<<. e., . , .....t..�...� �, ,Y;WA� E�..�. ..c„ , �..��E , .., W,.. ... � E,.<. ,� ,<<. . t, , s.. , , . �.. �.? .t.� c.0 �.,,«, .. S E.,, :;S•::te >� t, .., r .,F ,Yt:.<'�... ,.4.., ,. ,..�. .. �< < E.< .. , �, r; u.z .,, .�<<. ., � .. ..tFC. .., .c, u .,. v�. ��. E ,. �, <<;")% � ..... .�. ..,�....,_..s�.,.� T�G `.`:% � ''� , ... � _:�� , i �i"`, � �.� , c <., r. �-< .. , r r ^, � .. E E �+ t. �. , . E.. c.;'l� y—=-�`w 5642 19 � Exhibit F � 5642 v . �,.. .C�c. � , .l. I ,. .��4ffi i. ,.> P�C .., J.�.7�1, �i..u, i��i:�7 .�� ..�'�+t5 . .o r.�. . �.� , ,. . ..c.51 _ J..wr I;.,.,, � tu, ..s � r SY ,?, ,,r, .,. � e�rwti'i,:[: .., _. �f..�l.i. �9; .1 ..,� 1 �i.l, r:Yzt r , � a"s t� t �5�',,..i: f ., rrr,'z;. ,� . .�:r. � , ��r i. .,,,� ;',_. , � w _�?.� . .) �v i:.; � , �'1 `. _.,�f r_�i��:r1I? , , c. '_° l,rl�,?, �,�Y.�J"srl�u i�bZ�ri �°..,a. `r;11 r'e<< �,rNL�1r,.,_s5. 7'��H .§,w .�.:,� r,,,.;`•�,�.�: — a �u ,? ,� ... r4,� r>f .,, w!'uJ t. w�2; �cl..u�l.'°�; 1F .., trlb � t£'=i1„t��. .. .�a t:t�� 7, t.�ri'!i;? ��;w�f". riryt� r J ..,, "'�4v,. �„„ ,rii. ��a� 1� 17�� ` �"!. lr�.� u.t',�. c...l.,�+ ir, ,. �. J.e.. "�t�.". i., ,J �. +#_sll� �;" z:Y€., .,, ..i. �l^,� � � ;;� I 7 T ; . , fl l.t,•`°° � (v li' 1'�3' c ,1 „� , , .�;; 1..� G3t, r,.,,EYwrl,i> {; J.,;�;s „1, , .:�,r.<<;:, if7r...o-° :,.(1 .r.t� ';, i, .,.."�, !Cl ) . rr r .� .;i; ,v. �,14 ...,e �.�.!'J�. ,t.w ..,��J�,.t , r�: ..� ri> >l�.g.,l_, ii,��,� U _.t. 4.� ,r4 , �w �" i ... U�>;.L� . b. <+.G:+� i , f., <'X1.F. .1. x.: ...� ,.� '� v ?�r. .'1�i r I., 1 __c. r ,, � 1� i`. Jll. .1.4'2 .,, ..,C,a.� ;,ir �' -.`: ��.I � �,,•�.il:# ,{ .� .. , 7. �.. <, .,.,. ! .; �".1�. „ �„ Ct-t� �' i,% . . El�:: 1? ,,. c�l � � .. . .u. � �,Z`=, C�r� _ ._1i�,.f t1 � .:2?I,,_,, _,. �. 5�i: _ �� , . , � �:, r i ri<<.. �r.c 4,�,��-� �, . .,. r. iri:.�tAi. �, =x =a7 ,1 ..<fi r.�� ,Y.+ ,Ji �„ i ..__. , � � .�%� � �t. �{M r-� r ir��, ;:l h (+t„!... ,7 ° lf� l .0 .�c..�._ l i t,,�t7+.: ....7 i � ..��e �� ., t�� ,.�., r. :?i.. �. �t-w.,,. �,) ti:,,..1 , „ -�rr , t? rr . .,. .7, ,,, 14;�,,,.,,. S ,. :rl 1 � 1�.C;, "1 u,..t'Y . .:�ti; ., �„ i}; ,..,. ✓Y l l�&.� w., f I< < l'�. .,4,.,,..., ., t..�:�I1 1 "7�i."...1 . . .;°r.� rf, �('i�„ i �,Ir � , i� :€)r ,� . r:'.t�; , �wb. ..>�T1,.� , .,a f�' ,� . ir� ,�;k� r� f . i� �. C,� :i;t,�� e . �w+ �. , t „�. . iwl, ! z�t...� rt-t�'i . �.i � , i.� � �`,�wt�, �i�„r..�. .. . 'Ih;,. �1,V �?� ! . . 37� .. ; � r.�, «, r : z i.i;,�u:. „f,l,. :➢:,rl .l r'Y!. ��7E� . � 4�1� ..Y.f 1� , <., � � . .�-,� r„ _l<t {rE.° .7. � rc�Er 1 ie; .:1�1 7 ., �xi .i<<;�; t�( �), izt�1 , . :::'�., (,t .:4� .,,f� Yr t, _. ..`�.t��.. �r'r l�': .,., , �� CI',.ti`. .' I� ,! G ='Y , �,. . i: Ctfir, � C .1"lt? ( . . ,yi�� 'wy".lY ,� t ,.. ,.. �,.rrY .i� . �... , ��.`.. � =vt1G , .6�a. 7 v ,a.<°i. , r�i :6'�.r ��:`�7 �, ., �r,, c , .e;�.,ir,. !,�r. , . E� ( 1 i�� sr;`� C,t.i,. �1.71.,. �:-'. , , `'�.� Y,.. ..x'l.� .,�r, lYl i , ;,��'C, r ,'.l�r�'.�_;f ,. �..'vt .,, �'.� � ., � i I,X,. ,� �, ,➢, .._ .,.� H,ll7.,. ,ti.,.., �x:3 ,5., l.' 7�1,. .,.._.fa,.,:➢�✓,Y ,.�}.e[;' .,,1::!: l! i�`� C, ��°�t. 7�Yi i' 1�., 1. .,u r. ,..v �t,c<,cC?. o.z'trFs�,l.f�.,.,a. 7..�`�IE?�.:.. ..:rYk If�:.'.r<.CiI,.?��tl.��..�:„w,S ...�1�,,....�. ,�titi,'.. 7 ''"Y71 .,i,�'��° �W cY��bi. � J. K4'i ?_ .c�l X�r1 , 11 �, i . ,. Cs . � ,. .ai.. �,., !`. z': . ,�r ;1'..�T' ?....rt�. ( ;,ir1 I, .rt..s r.; �d ,.��°��; Cit , tti..,, . ',?r ..� ... ... � ,, A� ... ,.��.� ,t i� .(.i .71.._'i.`, C i ., � ,.-.. ..[ l.'. ,:.17 1 i�.iFr . i�°L . x"1L; t.l';id'e �� _.. J�C€'iu�.0 ' :;tE.! �7, , rtt. -�., l�` �`r+'�3UYL�.Zs'�t .slJ .,� i��. ., vIC7 r� C'r=',I. . �..,Ja. s% ...,.C��-�, ) � Ci?z ,..,.; i:; .. . �?�� ..,_�i ::.;4.� r i.i�.`: ',., i�r3�i', r..,',.,, t� ., I:f? ' �_„ . ;;�rii�i �1.. 1 .�,3P' L, ,i YIU�s' . .�,� � . �E. ...;!;i ...,.. '��i)' ! ; :, llir:, ts'? i rt',,7yI,`' x r,';C r � „�2',�'}'?. F t.. ,.... �-.::ti�l i, a et l��.-.. , .Y .�. �I 5...<. .. ?_:.,..1 F" 1"`, ,. l'. .,,� 'c.0 i. ,,.. �.Fo,.11, s r �C�� ,wi�. � ,�: � , '�� . ,,\ „4[;.'...!'7 .�. Erl ��., ., .., i'(".t, CIi��P�="1 i 1, . !)::i li ., „G ,l , )* EJY" t .:'lr ':�'.� , r�t., fIC?��.t fL. ,.�F��„ ! '�;[ „�C,,. ��.� , ., ,..., Y 1 „I, ,�4 ti.( 7�: Cif.. 1 .I � !"Pi? ,? , . ".bY C�. �,G�€J�).,� ,s,7J#r1,,tY;,. YYr t . 1 .t, _. , .".�fi � ., .�� C�., �.,. .,:R�', <- Y ,.,�.��;,I:k..,1 (�. . ,l � ,.C.., , n�...� .7, iw1Y;.. _ .,,i,t:[ .�, 17_, ,.t iir;'[V ..1�. 4-„�i",4`�I�r , ill r� , . i �, , ..tic",t�i { (1?'[, , � 7.3i„ „ . .:.f� ii � €G , «, .,.�4i. ., U.-�; . �, �",t'Y,r,., u. . r. i�� ; ��°its7i „ , _`� Vx< !c.71�,! ��:. r,rl.! �itr u� a � ,. I�I: � f � .�_.,,. .. <,:fr , i,.,".:4Y P ., 'J2, , p.:S�:rC:.� . ,,. , ... ,�isi 7 ,.I �� l `, , a..�U.�,��zi,', �� . I.,;�.;s� . : ...� ( , , ...�`w 1 _,.r . ;;%-brt,,.,1, � 1,:6„t i�' .��, ]rl...� t.r. €� . . �:_,+z.� .., i" ( i I:.; r „r{,.,., .,di�F i5t 1.�, � �r'r', �� ,`, ��1.'., ". C, ;'fi., , �Pi',,, r7l ,�=r ,?, �„ �,t'�1 ,s ..' ;.Y i �� i7 `€#-r t, i,�'7i? �U., i). Ci'.�. r�v .,�:'�',.' `._ i',...,.I ,.ii Y;:L�` . ..l.ti,"l, .. #?, ....,°i( � ,[,.�, fi;. t,t. %i�:��ct� '.`1tii� . ...f., � � i fl , r -, ...h 4,' � ZQ Exhibit F `L� • 5642 ``��_��..� ; � �i :;l�tr,i U'1 lf".. � i� ' i �l�v° �'C=C r„ ; i�, °: I�,�� j �'� � ,did" fi� �f i`4','�; ;?'ti J �� .' l �:1:15�?I� . , �„ .;?-.'(:` ,? ."'3L;71.?f,. ':;t e`s )''.I:, , a°7� 1',`4i„I �.�7,. ;if.� l�it... a� ,i'7, � �!� , ,,., x ., l�",)_ �i y-?.3G,` �.. i � t:. .', v �i� � �. ,,;. � r �, �.. �l°� ir r , .,', > e..,�� ' .� �� ,,,,,�'r� <e,, 1 ., ..,, . .,., .� , li . .�I _ �t �;r" °r�� G��,r� i,,�` �.., i, I,�,�t�'.u> >1 � t z- fi<a�r�, ° I��v.: I rt�,�P��, . f�';� .! l �'..,. � � r`ir ,.it. .'�, >>31g 'C'� .,: �"I�.` 7 i. ��.;. ; , � � ;� l ,✓� ; . .. #1 lf 1 . ..$rt'. 1 ; f.T i� . C:' ' , I � -z' l [.� , ., l _ ,.., .. . 1. , t ".. , ? . �r. 7' - _ „ �, . ri, Ci_ � . '� ,. � �. :1 ,. . J .=1 .,, �'1,i .,, �t. I � , .` ` .,. . ? . �., , l :,. ,.�,;i � rs � .'1� i� ;al �i 1� . �dfJ ::. l: ��.. ; 1 t ._ , �� . . ,,�� ` � ' E:' �i � ^ : f � �fl .. ,;,., .i lr E �"- <, ., .,. . 'l�, �'. ��..., .. P.� _ �, ?`,. , . . . „ - , . _ , . , , . 1 a , ,�, „ .; �f .'L„' . ., ..", ,.. �,: . _ 1 . ,. i � :f:' a , ,. �„ _ . �`I ' �lrs ,�� . . .) -. � ,. , 1:.,, f' a ., l �l ' �. ?, f�I ','�, �l� f ; ' 1 � �t„ � ;.P . . 1 . �I I�. .S c. .� . %7' � < << � , .. l� l , .�` . . .. �� „ ;i ,'� � f .-=d5. ..sl�l= It,�.:]]'., 1�.-.�1'�; � ��.rl ".��::i-„ .i°..°r ,.,..a_ r,� �; r'�� ,�r?'<;el�ll� :Ie �, 1 ,....,_. , r:t ��-�. r �� 1� e�� : t .; �:��r . ,. •r .. . " �; �^ .[ I,.a� rfi ,.,� .. , i' �i �,�� .� � I , . ,�, i :;», e:�l. '1 ra.,, i��.<, ,� f t;, ,i , r;s,.. te�� ,rl < Iar�' r? !i. `°'€�T I1 ["�J+., 1'��.1-. `,t, „l;^' .,.( �< :'°�i.,'� �,I , ..., . „� .., t;l� tI t .. `� i , ;, ]i ;<i, '�� 1G�t , �r�!� �,: � =ct r , �_ �U1.i. �°,> .�1� `» f r lr,''JC i , . c __ 1 t .- �_,,. . f G , .,�, r,. _,. r„�=''r �� .%I^� :i, ,�', ':�, t, . '�tx. � . _ _ �, `L,1.. . W, �'��1 �f�.��b , c,��3� .., „3�,£.t�.., .',�1 i� :t`� ,J��J:1"LC„ ... I�d�i._ s: 'E, t � �� , �>z.� i r t� ��. .i,.i°S,�' . � r�,. ,:�<< 71� � .� si .:'.f � �ti.]< r tr,�� o �r, r.� � �t ,�. r_,< '�9r . I°c :.., . 1 ... ..,, g �,i ' i�..?C i'I � � t � i' 1� :I� , ,`f St�lz,� 9. , .'= I`-,; 1i,..�. ., ::f 1 f.E .6; , _ 1`' -. i n . �_ r . � r z ;� , zc, , �,i ��: r.� a , : ,. ��r5 �. � . ' i �:,: . _ I . �� << !n 1� �� J�t,..�r.,.1:ar.'�., .'f;r,n�. i .,..�°ii , ?I � . .. '1 � r:";��. ., .�71'41' S.�),,l:t .?�, t�.,a� ?,� �,.,,aa�i" �.�E,f` ::1. .'�a 'I l.i:J.ld4t�`.,_1?. 3 ,,, ., 1..,.� ., .;�?<" "ii' _:14. is �� ? ,,. , . �it :t ,'l„ .�. .., 4 . „ ^� �� .1;1G ., , . .� i�� `I 7�_ 1.� _. _. ... , r._ :l ni�. 'I 3��. ,. .i� ,,, J . .-,. i �] ,,.,� , f,'L 'J , _„ � ��). „ � _. . . ]�� .. . .�,�' S'� . ,.i "s,-l.: ,, i�i .ic'�'� .,. i i . "?`" f, , ;'�l 1 '1:,' .l-,`f �; .�, , , , . i: . . . . , . :T:'. ]' � , . , . .. ., _ . .. .. .. . . . ,. 11,?��_ r 1 ,'-;i .��,. , _ . �,.t'-,� , lr;.. .�.�,�a I ... �r„r,li� ,.i ..�,t , , ., . . ,.�, n, � r � ,. a . , „ r . . �F,,:}I ,. �: . ,7.J` i' -� �� ,., � ,.� . ��'. �. �,IJ,a� ?r. . i� . .r;�� .. .. �, � ,� �,,` t?' , .:'C_ , a .'? a,C, t.. „f tC ( ..;'i. . . � 1. I `Il�' . , � I��,' . ) , . � If.:f�. ,.11 ,�f,a'°t �IY,.EI . .� ,.1. -11<�. , `"„:l . 4... f� � I,.;� ,_�, .,... ?.t',,. , lf'.l" ., (, ,,,.,,.., ?[ , , , 1 , ., ,a�� . ;.<,,:�:�r s,.#'=� ., t�.l.,;i��t ;;t.��. 7. ..-�, � f�l:r , �.t' r��'r , .. .1�.`i�.,.`�, ;i��l,. �..-"f .,fJ,.<<<il'�'t':71�iJ_�'i,�11 1.�=.::U cl;`r.e�f�, �'�1 �r ,. ��'. , ':1,._ ..;1 .ri <, . i � ,��„n,�7 �.? I , _`-�` ., ( �Z'. 'i � >> ., ?tLt �C �,. � �, , � � r r � . , °�:. . . . �,f : ? -1� �;�i :�?.�e ,., r�ra ,1.: !.,�_ as i�. d„ .� . , . � 4�n`�� L � i` f ��,�: �, r)u ; it, i , 1 �».� e _�.ti.l' i �i�. . ,. �.,i , �. � r,`r �:f� �-a �,�,�1 . �:s ,.x� . 1�. <rl . r�rr . , .'l� t� ?"��;. , .. ,;�, �,� � i i,�s. 1' . .., ;=`( . ,?��` f'+l.,,f, �ii „ j . , -f ,, , ',ll „� I1 ' , . � ;,1' .C:" _ � „I?a'; ��„1,`;' _ . €,L?i�-�. ��;"�< I., � _.� . -,;ili��X.��. t.�, .'�� ,(�._. , . _..<. 1 i�..'rC ,ii . _.��1� �i�,:� u�a�tr ts ':,r., �}�: �4 . , �t. r �.f � . , v � ,.''. �� :si 1, �.''t t ..,�.., � � t,� i. �. ? "t. � t . 1 ,��'n 7 i ,. I. � .a .,1; , i i -i � ,. � t�,'� �a zf, � � � ..0 J ,, �i � .�,.�t �i .. � � ,;, �:� �<t u �� , �,t � ,�� t?.,. , , ... C, . ..'t�, r � . , ti .i 'l,"�, ��i. f ,�1� . iz .ii..t {I ill� �. ,;`� �1i :�t '.� 1'��, 'f ". ,41, Si �� ,7��I,` z �,'�i� �.�.I�' . . �4 f .' a'u� sr i � i:_ [ °. f ,,. . �. ,�xz� �.�-,. r,7.:, <I�' r .�t .: �> > '1�:, . .f ,�r '°it . r; l � . , Z1 � �i� �,�'�� , � ,.� , .w , � , .�r�.� u �x.. �� t .�. _ . _ �;� , <<<. .v , _ ��_� �� .. .�.. ..,, k � �, „ .. x.. , _.�� .�„ ... ,.� .,.s .., ...�.. �v ,, �:, r ., „ E , .,. .� ,., ._. . .... , , _,�. .ti.. t<.�.u,., ti ,, .� .� , . ,..E .. ,� _. � . .� .,�> ._ ,.r.z . , ,,,.,.., ..� ., ,.r< � �.�r , � .�, � G . a . ,�, .s. _ _ . , .. t u� , � , w. 3` w , t . , .u, .,� . �, ._ ,. .. ,...,�r. . � .., � t, . ,. _., , ,. � �, „ , .� . , v ,C u _<. t„ .' Js: r .,. _ � .,c �.� ,.� U, u . �, .�, , F..� .. ,., u . .,,ti u ... ,,. .2 .: J , _. �i � .. - .. ..,..J,...,u .:� ,... .E....t �`°>'� w,.�,�r ,.t�,.o- � ,.� �,c,,, ,.._, . ,.,.x. ., __� . .. u,,.., f ,� .. �., „_ .. .,..� . , .; .�. f , �„u� .sE ..; . ,. , �.,. k, .,.�. � a., _ . � .,, . _. .. . ,�w,,,.,, .,�._ 4 ..,,,.. _ , . � _,�.. �,., u,. J� ., e';� � � �,� ., �,.., ,,, �,. U ... .,,,. . ,,. �... c. .,. e, c" ., , ,. .. . .. . . .. .. . ... �.r '1x._ u,. � . � z . �� u t,� . , <w „ .�� ,,�. � � . M , s.. u � u., �; }, , .� _. � . . � _ ,.. G ,�,V'. u , w .., _ .... , _ , � ... .z� . ,'� .. .,i,. _,, �, ,. ,.. .., , u_ ., ,.. .., r , .,.... U, . ,.r, _,. r,i . . � �. ,c .. .. r,. .�; Y ., ., ....u, . , <L.. J C, . „ , .., .. c. . , c .. -., ..€. , ... .� , .. „ �t� . . .. .._ .. c. . .. 1 � ... . . , _ .., .. , , , _, �.,. a .�,X td. C� „ �, . ,.c � ., _. . . Y �"Y„ . „ .z. ,.,, .L" ..,.. � �. �� ,...,.,, _ �. . ...,. .. �, � ,. a .�n" ,. „ .. _ t . �,..,., .�... z :.,.c :. . _t._.r 7.. „. .ca ,3, �r .., ,. .. , ..., , ,.. _ , �,,.. � . ,. � � �. u .., . r. . . .. � , , s ._ t��= .,�. .. ., � r , iy , �. .W,. . �. I . t, . �. �,.. . ,� ., . . ,u, . ,. . : < <. . �. .u.. . , I ' ° � � ' .. v. �,, Y . �.,.. , w,.. �,.... s. .� .. ' a � ,.,, �„r, , �.. :';� �, ;.�a ;-� , � . ,�,. .,_ . ti..,; �_ . ... .�.. � -,.c, „ �c ,ti: ; , . ... ., ... � ,.a G , c :?` �`. ;..£�, , ,..... , -..c .. s . .t, ,`�.� .b. „ .. _,.,.. ` Gi ,.. , [., i , w .......... . .. � , .. _, *x�. .. __, e, u . ,s ._ . „ w. .. � . _ ..; . . .,, , .� � ., .. ,_. <',v _ e . :r" ,.. ,_... °'., ,�� . .. �_, u:rf , �_,. . , . �_ . . u �. . .,,u,. .,,,. , ., t ., , t. �, . .. , ,, ,,. E, ....,'l f �.� .. .v.... . .. . X,,'.,�E. _w rl c r ..... .4r'4:� wc . . << . . ... y, ,.., ...�>� . , �_ .. .. .... . ... � e , eF. fad3. ,. ,,. ,., ,... .r� � .t�. ,, .�atc , ,,, �. ,,, JC ...,.x ,... .. . � , ,. ,t,.,.z ,_ ., E,"',`V . _. .....,,d , u �.e, .;r? ti� ,. .s. , , ,,., . . . .�. , j�f t �. .?�� u,.. . � .i�iv.., .. o . .. 'G'i: . � d r.. . . ,..s ,�,w, �.. � .,_.,. a .l.r Y,.v.,,,.. I<.w L `.,.v` .,.... n, �:, ;:. :' ; �: , r�..� t , ', , . _EC ., c.. .... .�. . ... r.r . < < .r., , . ,.c c. . c .c, , r., ., , . , . .�.c . ., .,. �.-. , ... , .. � , �::� .� ,+., . ., ., ;�..,.., ., uc.s. , .c ,.. r. .�,.... �, c ._ , . ., t., �;�..: ,_, � ,c,. .� .: F c_. ( 3r � , . ,. ,.k�u ,r ..c .,.� v ..� . +.,.i ,�... .. „ .. .. . .. , .,., _ �, r �, .-. :r . ,, r.. .s .E.... �f,"+.7 ,,..... .,. r .. , , .. ="� ... . ... ., s .. . ..,� ,. ;.-.l.` ..� ...i.; � ,: ,..✓;-.t.�. .r ., ., t..� . ,.�„ ,t ..�. �., � , . ,.. ,. .,.c. . .. . ,.r , .. �, v., . �. , i� d ,o . ,.. . rc,.., . _ � . . x...,,.,. 1�. , .,r : �..,, �., ,.. , ..s.., _. , „ '.,aa . ..�, { e, ,., . . . , .�.. t%< < �u. . ,..- 24, �-Ias anyone filed 1ny coanplaint with the 'Texas I3epartrn�nt af Ins«rance crsncernin� yanr organizat�s�n? [ ]�es [ ]�V� � � If "y�s", plet�se expi�'tn: 25. Describe your docciment�tion procedua°e for hantJling customec complain . �, ,,,. F . � � . �. . .�f ,,. E. , . .� �,..�.. ., , ��.E . .. 26. �);,4>;��-��;;: y'�a�.� �ysis°�P� �'skr r�.�.��.��:a; �€;d�°�,t,��;� c;��l�. � f�ir �E.,S z1.t. Ei:'sS4ttt ,., :,Y i+, .o �.d: �?".'sb,:;. e., �,., ! .�-�.c„ d., t ,.�? ..3S�.I1C`,t�5 raJ�.i��S. � l� t��., ;�, . . k. .w.�..�.€�.E,w� . y. ,, r..,:,� LVi.rl�t: t'+ tli3ii 2'1, F3esci•ibe yaur interaa�l �uc]it pr�sceduees fae the c(airns cafF'ic�, T��clude tk�e fz'equency csf tt�e etti�dits, �vi�c� a�e;3f��.°trr� t;�et�, � r�c9 ��,��:at ��g•�t��e��;�° �sf cl<s,tn:� �:r�. ��a�at�:�1. , w... — ,._�._.__. �! �a �,�.�, �, � ' ti,. . �. �E4 E _ ,.. �. . . ... M1� =;.w, k�v c:l�tl .?.al. !'s by , �,a �.- it;lts �-3 `.i<: �: ,) � �~�c;�r E'r��e!�t�v ric�€�� y�;�su ci��ry ;:y.�der�� ti��% �:l�zi�;�s ,�,�5��•r�€.,�cz�y g�c,a•;�c�:r��;� �� €°�,v%e � ��,e�� c;i�za�a�s? J' e}1 .v< ce b .�, ;. .� , ..�:.�r a�,. b p a .e.. t � Ii�.�t.� �,'st�a �'�sv L..,.* 1 .'�e.4;�`i °.€ �`.,,� �,.�i° . , �F-.:i,vb�`..V ...... 29. [-�aw �s•e t°eser•ves est�blishecl and mcsr�it�red? �_ . .. . � �, . �. <«. � . � , . �. . .� ,._, „ . .. .., � �� 3Q. i��,�t a?°� a',��c��t�:�J €�x�,�,*,.�s�r� �s�c>��at<�r�:,' �nci <a�aµjt�stc��i'� _ _ ................. �ti�.��csai;; z xt,a. ..,,,...? e ��e >uc°c' �;� thc si?.��, : J�.,ts, a.s �k.?, �.., �.� t�.° ��tr� ��..� � ,<a: , �k,. tis'r��s. 31, �7s��;ri�sc, �c:r�tr��+��ts��l ca�st'a.s��.� :'��° �:ac ,c��r.•� fa�llsa��ir;�; c;��l�'i��Ptisr�,. �F �[��:, ira"stial. c;�.��xtr<ac:d��l ��;�s:�L¢;.��t. ,.m_____w. �k`�'I� t' .1.: c��< <: .'.i> iE:�:.x:`� S ,c.Ll�,' R,�r �:,£_s:.:ltia � st�i'S K�_�� !�[T�oi.?.z. ,,,v, 5a�[.+. r dti.v,ti3 �„-.14��{)�:: -3ii. _...�.'°___.... 32, V1til1 ycs�� subccac�tr�tct 7ny partic�n �af the services y€�� propose t€� fl�r°nish (thrs incl«des but is stot limit�si tes rrt�ciical c�se mana�ernerit, bill r°eviewlatbciit, pharxnacy marl�gernent, I�Il��„ �ar�vate invest`r�;atcsr}? [� Yes [) CYc� If "yes"', �ive ft�ll details below. i0�tanagecl `'a�e. ll�(�}� _ ._ Suhro;;atic�n: (li�!( F'ha�inacy Benefit i�rt�r�tigerneut: �!�[oderil i°vleclic��l � _..._._._._ 33. [7c� yau c�ffer �ccess t� a cei°t�fieei rriedical netwc�rk? C 1�es []@ia lf' "yes", �rve dei�tils bel�su, inclLtc�iri� �ny fees tc� access. �-- 5642 23 Exhibit F �'hr�:r�.t�P�° �i`�riC�'� ��iJ`� 1�`�tr� :.i �;1,:. •�, .. � + • - . � ;_ , - 35. I7o we have yaur permission ta requesk an investig�tion of your firrn's iinancial canditi�n, reput�tian, �ta? [ ] Yes [ ] No, 36. Daes your firm, at cto persmns within yot`r firrra, curr�ntly have claicrrs or liti�ation against the CITY? . �� . - � . , 37. Is yo�ir firm, ar are persons within your firm, ctarrentty invotved in outsCanding ctaims or litigation which wo�tld have bearing on yot�r bid? (]Yes [ j Ncr If "yes", pfease explain, 3�. P�ease attach a c�py of a(1 ticertses and permits you are requir�d to obtain in order to adrriinister c[aims in Texas. �-�� , : 24 5642 Exhibit F � TlF��1° .15��7 � ^�� „t �, rp� :�.�'^ ,�y'��N�^.�.. p d x�� .. ��.«..........v.a ��MIF' � �, 3 516 � �i�IC'� `�0��[."T �C10 , � « � �� ,�r,,,, � ,�� r1 at � �, � � ' � — -, � , ,� � s. . ri4, ' � �„- �� !. � �, a i �V � � x i , r � s M � k I� 1°E s°r1�9 t�F��F �vitn � � � � � � ,, �� ; ;, ,;t � , ,,�k, �, �� t 5642 25 ��....�..� -"" Exhibit F 39, Is y€�ur farsi� audit�d by an atits°rde independent a�ad�tc�r? X I'ese as �n lnd�pend�nt e�tity, Yes, as a part of parei3t co�porai%nn. C�ia (if ncs4, �xpla�n below). 40. I-Ias Fidelity �ond ssr �rrors �c Ornissions caverage ever b�en ref'us�d, ��r�-renewed, �r canceled? C l'�'�s []�t� If "yes" please explafn b�ls�w. 4l. Is your F�ren cdirrentiy approv�d �s a'�`h�rd F'arty Administ�•ator t'or any �nstir��ce c�rri�r? [, Yes [] tv� lf "y�s", please furrtish th� i�ft�ri��tii€�rs reyuesteti Gela�v: I�11me of Lnsure�� L°rn�s af insiirince Administered Ama�tint of Atfthoritv 42. EIas any ynsurance cornparey ever• w�thda�awn its authority? []l'cs [] I'da If "yes", please explain. __ _ 43. I-Ias �ny principai or emp6oyee of your firm ever been acetised ar c�nvicted of mishandlin� car misappropi•i�ting Funds? C l Yes � J i�d�. IF "yes" pEease explai�7, ._. _...... �� _ ... w� � �_ - �w__ I1��L7�8r1rt�E Please �ns�uer the follca�ving c�ta�sti�ns re�ardia�g y�«r �"�r�n: lm � pl�ye� Fid�li�y �r�da iJnderwriter; 'I'ravelers �ar��@ fimc��tnt: �5{�CI,C7C1C7 Term: �rom: C73I I 6! I 4 'i"s�: 031 i E,( I 5 —... i�C3liCy I`7i?iilbei� I O?5�3021 _._..... _ ---- 2. Pc•o�`ession�al L�abiliiy �c�v�r��e: Inse�rec; C}��bb Li��b�liGy I.imit: �3,t�t�[a,�likdl 'I'errn; F'rom: 0�/0 I/ l'! __ '�`o; t�51C) I l 1 1' Pcrla�y 1Vurr�ber; �234-4 I �67 .._-- *List any claitns pending against yo`i 3. �c�mrnerci�tl �i�ner�l Liability Insurance: L.iabi[°rty Lirnii; �2,00O,OOQ 'Perm: F�ro�n: 10/01(I '�cro; ��1tJl!!5 - `°� 5642 2b �� , , �, �iusiness Autorn�bile L.i�bility; I,iabilrty i�irr�it� �1,000,000 t'til... . , .M.M.___ T'�rr�t, F'r�m: lO1Ql/l<s� _�, .- .... "�'o; t�ld�l'i � I'oii�y Ntarnb�r, f�'�� .�. �. 5, �lc�rke�s' �arnpensation L,ia6ilityLirnit: �. �� :� s 'Cerm; �rorn: I C}l0 I ! I =_ �_ ._ 'To; ! Ol0 l / I 4 _m. Poiicy Number; HQ633_ 1 � � � � � � �� ,� ',' t Are the fees proposed in fee schedule for life of this claim or for life of Contract pricing? Life of the Claim [ ] L e of Co sct 'ci [] Explain: . IV�ISC�I�L.��C?LTS 1. �iave y�u cc�mplet�d and �ttached Atiachrnents [] Yes [] I�Io 2. Eias th� req�rested supp�ri documentation in Sectaan V, b�en a¢tached to this 1'ropos�l F�rm? [ l Y�s [ ] t��a 3. F'edea°al t�� Ii� ni�anber: �,,,.w-w-. 5642 27 Cffi� � �� ;� ,,. 'r�� :: � �t �k i ;ti � ' � �a} � � ,. ti„ �„7 .�r� �� , L ,f,�. ,��r ,�{ j�'' �. �%, �� 't t i�{ �-- �i�� `� i$ City of Denton f�r Warkers" Campensst'ron Third Party.4dministration Sarvlces 1 1 t ; / : , � Any �xceptions taken to thls sokicitation must be itemized on the lines below. Additional pages may be added as needed. Tf there are no excepttons, pEease slgn where fndicated at Ihe bottom af the page. item # Description i Y�� c�c��,�� m �t�a`'�r� �� .�, 2�r�� '��- ..__. � ' `� . i �`�.'��5��44��°��«��`��tli9��:.... — �i��''��°1�,� Sign€�tur� �omp�ay �ate I ► `r Nk 'c ► x� M�:, � . . ,. t. f11 ,�`;��° � �,� �,- �y � � � � Exhibit F �� ,+,. � , `,. , c�r { }, , 5642 �.�. "� .; � l� l=� Lr__�� City of Denton RFP for Workers' Compensation Third Party Administratian Services . ; . l ; � !1 . � . Pleasa tist three (3) C3avernmentreferences, other than the �ity oFDenton, who can verify the quslity af service your company provides. The Ci[y prefers custamers of similer size �nd soope of work ta this solicitatian. � �- _ ::. � _.,. -.. -__...�_ . ._ �.. E]FERENCE O � �� „�. o , � ,... GOVE12nT�2�NT/COMPANYNAMB: C�� d((j �.kbbOG� LacAT�oN; ib�� f3'� �i� �� a"C K�� i---- _ �w. ___ .. corr°rACS P�RSOrr T$: Le� �__� " F a�� ^, n`� r� �-w° �, 2� sw w�.�+�<��- - '1� P�Ya :N'L�n�,� ��: 8 � � -° 7? 4�-'�'�.°7 `� _ .. . . —__ . — _ ... _.. —____ SCOPE OP WC? ; ` G _..... _.� �_ ,,, �. ,. _. _.. - —. � � , �. . _._ caN cT PE�oD: __ i ol��,�� y-�o%�{� s s t n ce x oe r ��E� cavE rrrtca rr : ci t t,ocaTioN: �a� �Jm � a�rt�� , �� 't 0+�� = d. e . . .................... carrrACr p� orr x ° b��i �a t, ci� s+G J�. _ �. ��.,_ � � _� rsLEPxorr� : �'t2. r ° �y / _..__. ..... _ ..w ScoPE OF wo : L ...._._.... . ._. - CQNTRACI`PERIOD, Ii1�01�1`i .10��1�t i _ �ina�. �q�fr_ .p . �_�.� � �� ...�� .-....� _a .�. .�_. REFERENCE THI2EE GovE rr�crco rr : �.,��, �� a��,�e� �ocA°riorr: t t � q R�1 s¢ �[� �r.� �� 'i��..�. �4�.� —. . ___ -- - CONTACT P SON TT : _. ��'_. _ � �_ d ► `3� ._�.� — 'TP,I�PFIONE NUNIBEIt; �0 3�� Wo °' f! 0 t _ _ _ _ . -..._ �.. „ - w , SCQPEOPWO ° ` p'� _.__....m..-. . __ _ .__w � �__� _ corrr crP� oa: lolo,laK-eo/vrlr s o� �. ts�cr �� m � i��n�� ,� �, '�: �� :: .� � A =:�r� .,c►,:�^�� • ►�►� . � . � ��r�t.�� The undersig�aed a�re�s 4hys suUmission b�cornes the proper�y of Ghe �iiy oi �enton �iter the officlal open�ng. The uardecsigned i�ft'ie€t�� M�4 ta,3� fiintE€��t�i��ed 1�1t�AS�1� ��d�tt �hr. ipe�,i�ic�dio�, draw'sn�s, exhibiCS a�d �tl�ua• r��r��sazesass; t9b� loc�l cond°stiotss ��3ee �eSa�ch P�aG �v��I¢ �� Co fi�c yn.rla��s��:i: ��tisf€�� himsel� of the condikions o@ �1�1svC.i'y, 1��aril�rr�r aza� sforage oPa�rateri.ols a��c� etqui}lerw•r�a; ��xirl sAll o33�s� r�«Yt€�:� d��t �y�fl l�e xeqa�red%r th� work b�f�re,�ub¢nist�iz� � t°e��j�s��. `The und�rsigned agcees„ if t]tis sub�aa�ss°son is �ecepted, to iurnista arty and �11 Items/services a�poat whtch prices are mffereda at the price(s� and upere the terms and condit�ons cont�lned �n the specifica6ion, °P4Y� p�r9ad 8°or accept�nce �f ttus s�sbmiss°son wall be 120 calendar days unles� u different per9od °rs noted. T'he und�rsigned �ffirrns th�t B.hey are duly author�zed ta erxecat� k�sia cc,r�t��et, �t�at �iiis s�bmissn�a has not beest prepared ln collusYOn �va[ta Any other respmnd�at, n�r aray employe� +�t YB!s� �i[v ��: a7�x�tzara, aaatc! tiz:�G th� contenG� af th�s stzbmassion havc mot been ca asnicated to nny �Yh�r tespond�¢at mr C{� azsy �eie�kcayt�. rsf a.hz�. �'.icy c�� i�+ent�� prioc to eh� �cc�ptance af tliis satbmissi€sn. Respondent hereby �ssigns to �e Csty �ny and a�l claims for overcharg�s assoctaced wdth �as contsact whach �r�se under the �nN�r�sst I�ws o� the iJ�tited States, � 5 LT5�,4 Sectian l et s� ., and which arise ua�der the antitrust lsawrs of tin� St�te of 'I'exas, Tex. �us. 3e C�m, �ode, Stction 15.01, t�. �'ha `tatd�tsigned afF'u°�ns th�Y they h�ve read and do understand the sp�cificafi�ns, al1 exbibifs and �ttachenents con2ssined 9n this solicitation package. The dersagned �gc' th�t the solicatation p�ck�ge posted en the w�bsite �re the o4iacia! spectfi�ations and shall n�t alt�r th� electroruc capy of the sp�cafic�tl�ns asidlor pr°scing sheet (�xhibiY 1�, cvithout cle�r�y adentlfy4ng ehunges. '�he sia�C...�i��A�d �guci;rst�ar�c�� tScs;y^ wrfl 1� r�s3t4��ssible for s�oaiCorietg the �aty ai I)entoax chasin� �ebsit� �t: �i.1.��a=t1��KU,citsr!,Le_..��i� ��irnta;icCex.�rr�n Pia��c^.-"��'7 Ca �nsure �h�y h�v� darvtilos�d�d and si�ned all �ddeadum(s) requared for subtr�ission wiYh th�ir respons�. I ce ° y ttlst T h�ve rsaade no wwillful �airar��rw;s��i�Eir��BS iaz �lxls �a��.��,�ei��„ �,t��' Pi;dk��: I v�ktkshcl� ' arm�Eion in my statem�nts and answ�ss to qitestions, I�m .�+v��•�a �tat th� f�a9'�rrrn�Gtit�xe �iv�n �ry r�r� sst th�s �3i�� -��siu at w111 b� fnvestigaced, wtth sny fuPl permiss§on, snd 6haC �ny inisxu�+z��er�fntic��:� �z ckntisalr�rsa r�x«�y ca�r�s� nty s�s�t�rlis�i��n i+a E,e �ejected. ,, , : ,+. . �r+t � � ♦ .r r ,�, . � � � �r r '. � s + '. .. t: .� � , ��. ! � 1, � , � L� : �� Jil.e,,il�' + � * tk; � ,'� , _ . , * r I8t°P ��% - �81R ��CUP[l�llt "�� ._ ' 32 5642 A�TT'�i�� D�t � I#I� k� l� �d i at ! 4 i � �1 SA�r��tazr� , _,,..��-'�� '�:,' _.— IJ�te i1��0:�1� .. _ _ �rame _ 1 �Pr` ...,..... b. f b ___ _ �...__ — `T��te _ r��"a'��.��r��...�t�•,�k'�r�. FaxNo. 4��" ��3" ��r � � � � � � �. �,, t �,<', ` t� .'. � � ; `� , :.� �:_ ,�, � � 4` .` li �' �c ,s " �:r -: .�. 'i ,�1, , `� � �� - �,. -,, g�nr9_re—., �— � � I � �� ,� r -__-z,_.._.� . ...t... �nu � �... u ir;, a ar _ z... j.,. �� _.,_ g C�u-uY-�ta _ r' Y ��y jf�i sl t t....,_.. � p� ? n 'F��. . .. �..; ji.....��:°a�'�.u.�. _.._.. .. � a _. � �v,�m>9.";t:✓t. �� ._,....a..—.1,.� '.;." * .. �;',. , � � tPS �rnptoy� L��s e�t�nc� �mm �, �s=eF4P � 4st �u lq Y i�NfiuF�.txP ann . ,�,-,.. _j'"'"� .......�.. � ba�wiae _ J�,_ m � � tv�s�rdw �� n�mavd m v�nse r�� ,t +� r��re� � a__.. _ .m._._ fQ6 .. %7 .. 7J�� 0.�i 6.W 0�93 �� %P,�@.P4 � &�!4 � 56313M� .. .. �:.,e.m.,�w,w,w ,...,,._..�.,......:« ...—,.� aM�.ru�awa _. 2a.�.� � aao � antm.m . � '.... �st am ��§ a� ��I . �.,_. ,.., ...w, ....... . ._ - dk1U2�6•fl4Ytl�{0 %7&iel IQW 111L15f 0.� �. 2Y�&4� 1.l0 �,99A8Y LLOP Ey°AdS1F 1�466 �7CE. 3iAd&O8 � 141�(4M I 768@.ffim....... d•�+.'� � • liP.Yl � &�.49. ��1 .. ..,�� n~•�..6iL8�8� 16�7�dd AA�!$ES .,.. A79L� �7L79P5� '.,— 9A8 �� 2f�Yf � � . 76W�AIB�NY9PeHO� �� .�..w.�v,.��3! ��.. 7,1sLR ' 4 �� St �4 .---. � j � 33 5642 Exhibit F � ` — — _ — a �� t. � .e ,,.u, �. v.,.a d�a� ,�.. ��.� � ��F� �,.. i�",� ; , ��`�$��, ,''�, � , ,, , � �,, : , �t��^ � � l�' �` � e� "� ° �� . s � t °°, � ... ,9.% u-:_ - r �; , a� k �. .��i � _. . ; . , " +, . � _ __ °° �s'i. y , :. ?. ,^, , ' �........ . .. .. :..: ., .. ... _ .... y � ' ry�.q; �; -�y'� ..'..�• CPek I •�,•..� N I_:y Eef CM Y 7f PatICYSlBr �� ., s '� .5.� ,3 t � i� �' � ,,. 'GIfY1D G�9P x � Ulrim tl V�.fl Ya�Fk� I��µ . , =�t. k � dG8t1& P.__. _.• 61&rzdtlf Y..e... _ .... ....._.. .,.� .................. .�I...,. �,..,.,.,e...,., m� ._._....,.,.. ....,,, � � d 3 �t ' _. c, lt:• ,,� UBuPnkdU J YastlnkESt I 'FL&hWSPfi � IftEBiUaH�l '� CNk � .. ' `` S _ 5Y ` Y{ i' ry L�1, ��t� �� J� �, �P �,°�- �� , j; ��, d.�. a� o,�,��`t� , : �'�.M1��E� �e ��,6�,,�'�.�,,�-.,.� . rit6�t'��.,..... ` seran e..e„��ib . . . . _:_._w... ��t�4� CaflaR.�a� � G.rBt�.. ... .. !"4YU C�IGe.4m�?uba__� h CnAmWs:t++� �rz� . "t e< 1 . , .,.."' 4 , '�} `� �°: � � �-• . • � : �nl:�. Dakm 0 D 1 �,�e``�``�� . � ' Y �� 3tl�.d ZP,tlh � ! I I . , �4`iY � '�Y� }�• .' { -� .. � .w. ..... .� ., �. � , q � � � , tl` t` �y` �� t r� i 5 t s ��. ¢'i...'' 9yc�s„ I R rnnea.:J ��,.....,� � d � M^ Kd.e.+ I P �P.x. tl � GLrd4mRU'a I __ �u� � ; i � . . ....,,... .. .... ..... ,. ........._, . _ j „ _ 4�11��°.��,�,4��`��.� �`�. �� Ittti""�'t��` � � , � �5 t � � � t�' , �� , � k 4 t � S o ° " tiG = {:C.il._ �} ��=:.-� _ii. ;. Y � r y i� _ t S� �'�� e. , t,'� , �� t - . _ _.d - �_ � s � r' ` �-. .. :"'-. •.. -- .� �,'.` . . . : � . _ ___�._ � . _ ti �_l . .. . . _ . _ ,. _, . ._ . Cshs�.:w-+s��Htcuwa.ars nw�tn 8uadu�bca.� j ...,.,w "azmaa� ��, � I�i�xa�ersc�r,u_ ____. z fi, ku ,.. �.-.,«a.,,. � �.�.....-_ 5642 __.. �.� � � �3[� ' - � � � ,� �; � �; � ' - � � � ' ! . M i � �;,,��?_ . <<,,� � � �. Exhibit G . , � � ; ` � � I, R 1 ., � :.� .:' .:, iR ♦ '�. ,�� ! ..��. � � '�. � � � � R � 1 � 1 �1 11', 1 This Interlocal Agreement entered into by and between the Texas Political Subdivisions Workers' Compensation Joint Self-Insurance Fund (hereinafter referred to as "Fund"} and the undersigned political subdivision of the State of Texas (hereinafter referred ta as "Fund Member") is for the purpose of providing the statutory benefts prescribed by Chapter 504 of the Texas Labor Code for employees of political subdivisions. � ► The undersigned Fund Member, in consideration of the adoption of a plan of self-insurance as authorized by Chapter 504 of the Texas Labor Cade, to provide Workers' Compensation benefits at a minimum cost, and in further consideration of other political subdivisions executing similar Interlocal agreements, does hereby agree to become a member of the Fund. The conditions of membership agreed upon by and between the parties are as follows: 1. Definition of terms used in this Interlocal Agreement. a. Allocated Loss Expense -- the costs incurred in processing claims, including but not limited to court and State Workers' Compensation Board costs, expenses for investigation and adjustment of claims, legal expenses, cost containment services (such as PPO discaunts, rehabilitation services, medical management services}, costs in protection and pursuit of subrogation/recovery rights, and similar expenses chargeable to a particular claim (excluding ordinary overhead expenses of the Fund and/or its designee such as salaries and other fixed expenses, which shall be deemed unallocated expenses). b. Board -- the Board of Trustees of the Texas Pol►tical Subdivisions Warkers' Compensation Joint Self-Insurance Fund. c, Employee - references the definition af "employee" in Chapter 504 of the Texas Labor Code. For the purpose of the coverage afforded under this Interlocal Agreement, any full-time, salaried elected official who appears on the regular payrolls of the Fund Member will be considered an employee of the Fund Member. The Fund Member may extend statutory coverage to certain volunteers (individuals who do not meet the full definition of employee) by specific Supplement to the Interlocal Agreement. RFP 5642 Exhibit G d. Fund Year — January 1 through December 31. Thrs does not affect or alter the Fund Member's effective date. e. Loss -- the sums actually paid or payable by the Fund in the settlement or satisfaction of any claim or suit for which a Fund member is liable either by adjudication or settlement made with the written consent of the Fund. 2. This Interlocal Agreement shall commence at 12:01 a.m. on the date shown as "effective date" on the signatory page of this Agreement, and shall remain in force and effect until terminated as hereinafter provided. This Agreement may be terminated by (a) mutual consent or by (b) either party giving sixty (60) days prior written notice of termination to the other party or (c) as otherwise specified in this Interlocal Agreement or the Bylaws of the Fund. 3, The Fund Member must be a political subdivision of the State of Texas and will be bound by the provisions of Chapter 504 of the Texas Labor Code as amended. 4. The newly enrolling Fund Member who has not previously been a member of this Fund or the Fund Member who has not previously operated under this Cash Flow plan, agrees to pay the Fund, on or before the inception date of this Interlocal Agreement, an initial payment of one (1) month's estimated Claims Administration Fee, and the total Field Service Fee (if any), Administrative Services Fees, Loss Control Services Fees, or other charges as set forth in Exhibit A attached hereto. On or before the commencement of the third month after the inception date of this Interlocal Agreement, the Fund Member agrees to pay an amount equal to the actual Claims Administration Fees of the first month of inembership plus any other associated Claims Administration Fee. On or before the commencement of the fourth month of this Interlocal Agreement, a similar payment based upon the actual Claims Administration Fees of the second month shall be paid to the Fund, with subsequent month(y payments to be paid each and every month thereafter, based on the actual Claims Adrninistration Fees and applicable charges. The actual Claims Administration Fees of the Fund Member are those fees paid by the Fund on behalf of the Fund Member in the month which is two months prior to the billing month. However, the Fund and the Fund Member may agree to a different payment plan. The Fund Member who was a member of this Fund immediately prior to the inception date of this Interlocal Agreement and has operated under this Cash Flow plan agrees to pay the Fund for those services described in this Agreement and the charges listed in Exhibit A attached hereto. Included in this biiling will be an amount equal to the actual Claims Administration Fees of the Fund Member plus any other associated Claims Administration Fee as set forth in Exhibit A. I:�y1.�:i� Exhibit G 6. The Fund will invoice the Fund Member monthly for these amounts due and the payment by the Fund Member is due in the office of the Fund and/or its designee on or before the beginning of the month. In the event the Fund Member fails ar refuses to make the payments of charges as herein provided, the Fund reserves the right to terminate such Fund Member by giving ten (10) days written notice and to collect any and all outstanding charges or other required payments which were incurred priar to the date af the Interlocal Agreement termination. 7, It is further agreed that the Fund Memher will create on or before the inception date of this Interlocal Agreement a loss deposit with the Fund equal to a minimum of two months estimated paid losses. This deposit will be adjusted periodically to accurately reflect realistic monthly loss payments and/or timely invoice payments. 8. The Fund Member agrees to pay any Division of Workers' Compensation maintenance tax that may be imposed and the Fund agrees to file the necessary tax forms with the Internal Revenue Service. 9. Any party hereto paying for the performance of governmental functions or services shall make payments therefore from current revenues available to the paying party. 10. After termination of this Agreernent, the Fund will continue to handle claims with an accident date occurring during the term of this Agreement until such claims are ultimately and finally disposed of and ciosed, and the Fund Member will pay the Fund each and every month, until all claims handled by the Fund are disposed of, the monthly Claims Administration Fee calculated as described herein, and the monthly reimbursement of paid Losses on behalf of the Fund Member as is determined herein. The Fund Member also agrees ta maintain with the Fund the loss deposit as determined herein. Upon expiration of this contract the Fund and/or its designee will have the exclusive right and obligation to adjust claims which occurred during the Agreement Period. 11. In the event the Fund Member fails or refuses to make any required payment on a timely basis as described herein, the Fund reserves the right, by giving ten (10} days written notice, to cease all payments on behalf of the Fund Member. In such event, the Fund will notify the Division of Workers' Compensation of this action. The Fund Member agrees to pay the Fund all charges and other required payments which were incurred prior to the date of notification. 12. After termination of this Agreement, the Fund is not obligated to provide any of the services as described herein except for Claims Administration services as described in Paragraph 10 above. 13. Loss control services will be supplied by the Fund and/or its designee to Fund Members to assist them in following a plan of loss control that may result in reduced losses. The loss control services provided are, however, optional with the Fund Member. If the Fund � Exhibit G Member elects this service, its election shall be indicated on Exhibit A. The Fund Member agrees that it will cooperate in instituting any and all reasonable loss control recammendations for the purpose of eliminating or minimizing hazards that would contribute to losses. The Fund and/or its designee shall provide all of its standard services, or as modified for the individual Fund Member. 14. The Fund and/or its designee, agrees on behalf of the Fund Member to pay all Losses and Allocated Loss Expenses, except as otherwise provided herein, to handle any and all cla►ms after notice of injury has been given, to prepare all required Division of Workers' Compensation forms, and to provide a defense. The Fund Member hereby appoints the Fund and/or its designee as its agent to act in all matters pertaining to processing and handling of workers' compensation claims and shall cooperate fully in supplying any information needed. The Fund Member does hereby agree that any suit brought by one of its employees pursuant to the provisions of Chapter 504 of the Texas Labor Code shall be defended in the name of the Fund Member by the counsel selected by the Fund and/or its designee, on behalf af and at the expense of the Fund as necessary for the prosecution of any litigation. Full cooperation by the Fund Member shall be extended to supply any information needed ar helpful in such defense. The Fund and/or its designee shall conduct all negotiations with the injured employee and/or his Representative at all hearings and conferences, and negotiate within authority previously granted by the Fund. If a personal appearance by a representative or a co-employee is necessary, the expense of this appearance will be paid by the Fund Member. All decisions on individual claims shal( be made by the Fund and/or its designee, which includes the decision to appeal or not to appeal a Division of Workers' Compensation final ruling and decision. However, any Fund Member shall have the right in any claim involving one of its employees, to consult with the Fund on any decision made by the Fund and/or its designee. Notwithstanding any provisions of this paragraph, all reports and filings required by the Texas Workers' Compensation Act and the Division of Workers' Compensation of any employer will be the responsibility of the Fund Member. It is further understood that this Agreement does not cover discrimination suits under Chapter 451 of the Texas Labor Code. 15. The Fund Member does hereby agree that any suit brought by one of its employees pursuant to the provisions of Chapter 504 of the Texas Labor Code shall be defended in the name of the Fund Member by counsel selected by the Fund and/or its designee and approved by the Fund Member on behalf of and at the expense of the Fund Member as necessary for the prosecution of any litigation. Full cooperation by the Fund Member shall be extended to supply any information needed or helpful in such defense. 16. The Fund Member will be solely responsible for future benefits payable and for funding its net reserve. The Fund Member agrees to hold the Fund harmless from any and all claims (including, but not limited to attorney's fees and costs) that may be asserted against the Fund for the non-payments of any claim due to the failure of the Fund Member to maintain adequate reserves for the payment of claims. RFP 5642 Exhibit G 17, The Fund agrees that all Fund transactions will be audited annually by a certified public accounting firm. 18. As the administrators of the Fund, the Board shall primarily and constantly keep foremost in its deliberations and decisions in operating the Fund that each of the participating Fund Members is a"self-insured." At least annually, the Fund and/or its designee shall carefully review, study and consider the actual claims or loss experience (including reserves for future claims payments) of each of the Fund Members in order to maintain as nearly as possible an equitable and reasanable administration of the Fund as applied to each Fund Member. 19. The Fund Member agrees that it will appaint a Workers' Compensation Coordinator of department head rank or greater, and that the Fund and/or its designee shall not be required ta contact any other individual except this person. Any notice to or any agreements with the Workers' Compensation Coordinator shall be binding upon the Fund Member. The Fund Member may change the Coordinator by giving written notice to the Fund. 20. The Fund Member acknowledges that it has received a copy of the Bylaws of the Fund, and it agrees to abide by these Bylaws and any amendments thereto and any and all policies and procedures of the Fund. 21. The Fund Member shall have the right to appeal any decision or recommendation of the Fund and/or its designee to the Board whose determination will be final. Any appeal shall be made in writing to the Fund Secretary within 60 days of decision or recommendation of the Fund and/or its designee. 22, The Fund Member shall take no action to release, discharge or impair its right to seek recovery of any amounts paid under this Agreement from any person or entity legally responsible for the bodily injury, sickness or disease, or death for which such payment is made. Furthermore, the Fund Member shall not assign such rights without the express, written approval of the Fund. 23. This Interlocal Agreement, together with all the Amendments, Supplements and other attachments hereto, constitutes the entire agreement between the parties and supersedes all previous Interlocal Agreements, promises, representations, understandings and negotiations, whether written or oral, between the parties with respect to the subject matter hereof. 24. If any portion of this Interlocal Agreement shal( be declared illegal or held unenforceable for any reason, the remaining partions shall continue in full force and effect. 25. It is the intent of the Parties that the Fund and/or its designee and the Fund Member each shall bear responsibility for any of its own negligence or its own error or omission, including, but not limited to, claims alleging violations of the Texas Insurance Code, the r��a Exhibit G Deceptive Trade Practices and Consumer Protection Act, and the common law duty of good faith, 26. The Fund and/or its designee shall not be held accountable for any increased cost or expense to the Fund Member involving payments of claims, under any contention by the Fund Member that a claim service, risk management service, loss control service, or administrative service could have been handled differently. 27. The Fund Member agrees to timely provide all necessary information to the Fund and/or its designee and to timely execute atl necessary documents as may be needed or required for the administration of the Fund. 28. Periodically each Fund Member will be provided a computer printout containing a statement of claims cumulative for said Fund Member by Effective Date of that Fund Member. 1: 1 ' 1': 1 :;' � °, �.� .�� , � , _ �k � , � .. � ��'�` �� . ., . ��' _� �_ � � � w- �� ...��. �`�L� � � � �" ��'� ,�.- ��.,....��..�. . .� ,� w Fund �:mb rName Si��tiri°� c f`Authorized t�fi�i��l � � ,._ �� _ � "� � . .� .� � � � ,� �",� �"..%'�� ° � t��'��°�� Dat Type Na �� , r � f�� . Title a ' 1 : ' 1 � O 1 /O 1 /2015 H0712 Effective Date of Agreement Contract Number Signature of Fund Secretary Date i:»�7:�� Exhibit G ,� i � =1 � , !;� . �, � � � , � � , . . . r ► : �u ► - - ". _ � It is mutually agreed that the fees payable for services under this Interlocal Agreement shall be based on the fallowing schedule: Basis of Char�es I Administrative Service Fee Includes: General Administrative Claims Management Review Field Service Fee I TOTAL ANNUAL SERVICE FEE Flat Estimated Annual Contribution $ _ Included Included Included $ T__.._ Loss Control Services are available as needed at a cost of $125 per hour plus actual expenses, 14-H0712 Contract Number City of Denton Fund Member Authorized Official Date ra��7:��a 3anuary 1, 2015 Effective Date Texas Political Subdivision Workers' Compensation Jaint Self-Insurance Fund ' �� _,�-��,,,.�m� ; ��", >��,�. � � �:,�.. ��.-.. � � ,< Signature of Fund Secretary November 13, 2014 Date