2002-304ORDINANCE NO. OO~
AN ORDINANCE ACCEPTING SEALED PROPOSALS AND AWARDING A CONTRACT FOR
DRUG TESTING AND PHYSICALS; PROVIDING FOR THE EXPENDITURE OF FUNDS
THEREFORE; AND PROVIDING AN EFFECTIVE DATE (RFSP 2873-OCCUPATIONAL
HEALTH SERVICES, CONTRACT NURSES, DRUG TESTING, PHYSICALS AWARDED TO
PINNACLE DIAGNOSTICS ACCORDING TO THE ATTACHED FEE SCHEDULES).
WHEREAS, the City has solicited, received and evaluated competitive sealed proposals for
Drug Testing and Physicals in accordance with the procedures of STATE law and City ordinances;
and
WHEREAS, the City Manager or a designated employee has received and reviewed and
recommended that the herein described proposals are the most advantageous to the City considering
the relative importance of price and the other evaluation factors included in the request for proposals;
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. That the items in the following numbered request for proposal for materials,
equipment, supplies or services, shown in the "Request Proposals" on file in the office of the
Purchasing Agent, are hereby accepted and approved as being the most advantageous to the City
considering the relative importance of price and the other evaluation factors included in the request
for proposals.
RFSP
NUMBER CONTRACTOR AMOUNT
2873 Pinnacle Diagnostics Exhibit A
SECTION 2. That by the acceptance and approval of the above numbered items of the
submitted proposals, the City accepts the offer ofthe persons submitting the proposals for such items
and agrees to purchase the materials, equipment, supplies or services in accordance with the terms,
specifications, standards, quantities and for the specified sums contained in the Proposal Invitations,
Proposals, and related documents.
SECTION 3. That should the City and person submitting approved and accepted items
and of the submitted proposals wish to enter into a formal written agreement as a result of the
acceptance, approval, and awarding of the proposals, the City Manager or his designated
representative is hereby authorized to execute the written contract; provided that the written contract
is in accordance with the terms, conditions, specifications, standards, quantities and specified sums
contained in the Proposal and related documents herein approved and accepted.
SECTION 4. That by acceptance and approval of the above numbered items of the submitted
proposals, the City Council hereby authorizes the expenditure of funds therefor in the amount and in
accordance with the approved proposals or pursuant to a written contract made pursuant thereto as
authorized herein.
SECTION 5. That this ordinance shall become effective immediately upon its passage and
approval.
PASSED AND APPROVED this the day of 2002.
&a-
EULINE BROCK, MAYOR
ATTEST:
JENNIFER WALTERS, CITY SECRETARY
BY:
TO LEGAL FORM:
HERBERT L. PR Y, CITY ATTORNEY
BY:
4-ORD-RFSP 2873
EXHIBIT A
Pinnacle Diagnostics Fee Schedule-Physicals
(Fee Per Evaluation/Exam)
Post-Offer Physicals $125
Post-Injury Physicals $125
Executive Physicals $300
Pinnacle Diagnostics Fee Schedule Drug and Alcohol Testing
(Fee Per Test/Collection)
DOT Drug Screen
Non-DOT Drug Screen
After Hour Specimen Collection
Random Testing Specimen Collection
Medical Review Officer Services
Testing of Split Specimen
Alcohol Screening
Preferred Services Provided
$35.00
$30.00
$17.50
No Additional Fee
No Additional Fee
$75.00
$15.00
Local, in house lab, same day
results, split specimens
collected on all drug tests
Pinnacle Drug Testing Contract
SERVICES AGREEMENT
FOR DRUG TESTING AND PHYSICALS
STATE OF TEXAS
COUNTY OF DENTON
HI$ AGREEMENT is made and entered into as of the day of
2002, by and between the City of Denton, Texas, a Texas municipal
corporation, with its principal office at 215 East McKinney Street, Denton, Denton County,
Texas 76201, hereinafter called "CITY" and, Pinnacle Diagnostics and Laboratories, Inc., a
corporation with a clinic located in Denton, Texas, hereinafter called "PINNACLE," acting
herein, by and through their duly authorized representatives.
WITNESSETH, that in consideration of the covenants and agreements herein contained,
the parties hereto do mutually agree as follows:
ARTICLE 1
EMPLOYMENT
The CITY hereby contracts with PINNACLE, as an independent contractor, and that
PINNACLE hereby agrees to perform the services herein in connection with the Project as stated
in the sections to follow, with diligence and in accordance with the highest professional
standards customarily obtained for such services in the State of Texas. The services set out
herein are the following:
Providing drug and alcohol testing both for DOT and non-DOT city employees and
providing physicals for both work related and executive physicals.
ARTICLE 2
SCOPE OF SERVICES
PINNACLE shall perform the following services in a professional manner:
A. PINNACLE shall perform all those services as necessary and as described in CITY'S
request for proposal relating to drug and alcohol testing and physicals attached as Exhibit
"A", PINNACLE's response to proposal attached as Exhibit "B", and Addition to Scope
of Services attached as Exhibit "C" which are attached hereto and made a part hereof as if
written word for word.
B. If there is any conflict between the terms of this Agreement and the exhibits attached to
this Agreement, the terms and conditions of this Agreement will control over the terms
and conditions of the attached exhibits.
Page 1
Pinnacle Drug Testing Contract
ARTICLE 3
PERIOD OF SERVICE
This Agreement shall become effective upon proper execution by the parties, and shall
remain in force for a period of three (3) years. The City has the option of renewing the
agreement for two (2) additional one-year terms upon the same term and conditions by giving
thirty (30) days notice before the expiration of the contract. This Agreement may be sooner
terminated in accordance with the provisions hereof.
ARTICLE 4
COMPENSATION
A. COMPENSATION TERMS:
In consideration for PINNACLE's provision of services for drug testing and physicals the
CITY shall pay to PINNACLE fess set forth as Fee Schedule set out in Exhibit "B".
ARTICLE 5
INDEPENDENT CONTRACTOR
PINNACLE shall provide services to CITY as an independent contractor, not as an
employee of the CITY. PINNACLE shall not have or claim any right arising from employee
status. Nothing in this Agreement shall be interpreted or construed so as to make PINNACLE an
employee, agent, or borrowed servant of the CITY. Nothing in this Agreement shall be
interpreted or construed so as to make the employees of the CITY the servants, agents, or
employees of PINNACLE. CITY and the employees of the CITY shall not be eligible for the
employment benefits, including health and unemployment insurance, and worker's compensation
coverage, which are provided to employees of PINNACLE. The parties agree and acknowledge
that PINNACLE will employ a physician, and nothing in this Agreement shall be interpreted or
construed so as to make the physician an employee, servant or agent of the CITY. CITY and
PINNACLE acknowledge and understand that nothing in this Agreement requires, and shall not
be construed to require (directly or indirectly, explicitly or implicitly) CITY's use of PINNACLE
or any other facility or service related to PINNACLE, or the admission or referral of any persons
or patients treated by CITY to PINNACLE or other facilities related to PINNACLE.
ARTICLE 6
INDEMNITY AGREEMENT
A. PINNACLE covenants and agrees to FULLY INDEMNIFY and HOLD
HARMLESS, the CITY and its elected officials, employees, officers, directors, and
representatives, individually or collectively, from and against any and all costs,
claims, liens, damages, losses, expenses, fees, fines, penalties, proceedings, actions,
demands, causes of action, liability and suits of any kind and nature, including but
not limited to, personal or bodily injury, death and property damage, made upon
the CITY directly or indirectly arising out of, resulting from or related to
PINNACLE's activities under this CONTRACT, including any acts or omissions of
Page 2
Pinnacle Drug Testing Contract
PINNACLE, any agent, officer, director, representative, employee, consultant or
subcontractor of PINNACLE, and their respective officers, agents, employees,
directors and representatives while in the exercise of performance of the rights or
duties under this CONTRACT. The indemnity provided for in this paragraph shall
not apply to any liability resulting from the negligence of CITY, its officers or
employees, in instances where such negligence causes personal injury, death, or
property damage. IN THE EVENT PINNACLE AND CITY ARE FOUND
JOINTLY LIABLE BY A COURT OF COMPETENT JURISDICTION,
LIABILITY SHALL BE APPORTIONED COMPARATIVELY IN
ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS, WITHOUT,
HOWEVER, WAIVING ANY GOVERNMENTAL IMMUNITY AVAILABLE TO
THE CITY UNDER TEXAS LAW AND WITHOUT WAIVING ANY DEFENSES
OF THE PARTIES UNDER TEXAS LAW.
B. The provisions of this INDEMNIFICATION are solely for the benefit of the parties
hereto and not intended to create or grant any rights, contractual or otherwise, to
any other person or entity.
C. PINNACLE shall promptly advise the CITY, in writing of any claim or demand
against the CITY or PINNACLE known to PINNACLE related to or arising out of
PINNACLE'S activities under this CONTRACT.
ARTICTY, 7
INSURANCE
During the performance of the services under this Agreement, PINNACLE shall maintain
the following insurance either as a self insured entity or with an insurance company licensed to
do business in the State of Texas by the State Insurance Commission or any successor agency
that has a rating with Best Rate Carriers of at least an B+ or above and comply with any
additional provisions that were required by the Request for Proposal attached as Exhibit "A":
A. Comprehensive General Liability Insurance with bodily injury limits of not less than
$500,000 for each occurrence and not less than $1,000,000 in the aggregate, and with
property damage limits of not less than $500,000 for each occurrence and not less than
$1,000,000 in the aggregate.
B. Automobile Liability Insurance with bodily injury limits of not less than $500,000 for each
person and not less than $500,000 for each accident and with property damage limits for not
less than $500,000 for each accident.
C. Worker's Compensation Insurance in accordance with statutory requirements, and Employer's
Liability Insurance with limits of not less than $100,000 for each accident.
D. Professional Liability Insurance or appropriate Errors & Omissions Insurance with limits of
not less than $500,000 annual aggregate.
Page 3
Pinnacle Drug Testing Contract
E. Prior to the commencement of any work under this CONTRACT, PINNACLE shall
furnish an original completed certificate(s) of insurance to the CITY's risk manager, which
shall be completed by an agent authorized to bind the named underwriter(s) and their
company to the coverage, limits, and termination provisions shown thereon, and which
shall furnish and contain all required information referenced or indicated thereon. The
original certificate(s) must have the agent's original signature, include the signer's company
affiliation, title and phone number, and be mailed directly from the agent to the CITY. The
CITY shall have no duty to pay or perform under this CONTRACT until such certificate
shall have been delivered to the CITY's risk manager, and no officer or employee, other
than the CITY's risk manager shall have authority to waive this requirement.
F. The CITY reserves the right to review the insurance requirements of this section during the
effective period of this CONTRACT and any extension or renewal hereof and tomodify
insurance coverage and their limits when deemed necessary and prudent by the CITY's risk
manager based upon changes in statutory law, court decisions, or circumstances
surrounding this Contract, but in no instance will the CITY allow modification whereupon
the CITY may incur increased risk.
G. PINNACLE's financial integrity is of interest to the CITY, therefore, subject to
PINNACLE's right to maintain reasonable deductibles in such amounts as are approved by
the CITY, PINNACLE shall obtain and maintain in full force and effect for the duration of
this CONTRACT, and any extension hereof, at PINNACLE's sole expense, insurance
coverage written by companies authorized and admitted to do business in the State of
Texas.
H. The CITY shall be entitled, upon request and without expense, to receive copies of the
policies and all endorsements thereto as they apply to the limits required by the CITY, and
may make a reasonable request for deletion, revision, or modification of particular policy
terms, conditions, limitations or exclusions (except where policy provisions are established
by law or regulation binding upon either of the parties hereto or the underwriter of any
such policies). Upon such request by the CITY, PINNACLE shall exercise reasonable
efforts to accomplish such changes in policy coverage, and shall pay the cost thereof.
I. PINNACLE agrees that with respect to the above required insurance, all insurance
contracts and certificate(s) of insurance will contain the following required provisions.
• Name the CITY and its directors, officers, employees, agents and elected officials as
additional insureds with respects to the operations and activities of, or on behalf of, the
named insured performed under contract with the CITY, with the exception of the workers'
compensation/employers' liability and the professional liability policies.
• PINNACLE's insurance shall be deemed primary with respect to any insurance or
self-insurance carried by the CITY for liability arising out of operations under the contract
with the CITY.
Page 4
Pinnacle Drug Testing Contract
Provide for an endorsement that the "other insurance" clause shall not apply to the CITY
where the CITY is an additional insured on the policy.
• Workers' Compensation/Employers' liability policy will provide a waiver of Subrogation in
favor of the CITY.
PINNACLE shall notify the CITY in the event of any notice of cancellation of any notice
of cancellation, non renewal or material change in coverage and shall give such notices
not less than ten (10) days prior to the change, or ten (10) days for nonpayment of
premium, which notice must be accompanied by a replacement Certificate of Insurance.
All notices shall be given to the CITY, by Certified mail, at the following address:
City of Denton Purchasing Department
901B Texas Street
Denton, Texas 76201
Attn: Tom Shaw
K. If PINNACLE fails to maintain the aforementioned insurance, or fails to secure and
maintain the aforementioned endorsements, the CITY may obtain such insurance and
deduct and retain the amount of the premiums for such insurance from any sums due
under the agreement, however, procuring of said insurance by the CITY is an alternative
to other remedies the CITY may have, and is not the exclusive remedy for failure of
PINNACLE to maintain said insurance or secure such endorsement. In addition to any
other remedies the CITY may have upon PINNACLE's failure to provide and maintain
any insurance or policy endorsements to the extent and within the time required, the
CITY shall have the right to order PINNACLE to stop work hereunder, and/or withhold
any payments(s) which become due to PINNACLE hereunder until PINNACLE
demonstrates compliance with the requirements hereof.
L. Nothing herein contained shall be construed as limiting in any way the extent to which
PINNACLE may be held responsible for payments of damages to persons or property
resulting from PINNACLE's or its subcontractors performance of the work covered by
this CONTRACT.
ARTICLE 8
ARBITRATION AND ALTERNATE DISPUTE RESOLUTION
The parties may agree to settle any disputes under this Agreement by submitting the
dispute to arbitration or other means of alternate dispute resolution, such as mediation. No
arbitration or alternate dispute resolution arising out of or relating to this Agreement, involving
one party's disagreement, may include the other party to the disagreement without the other's
approval.
ARTICLE 9
TERMINATION OF AGREEMENT
Page 5
Pinnacle Drug Testing Contract
A. Notwithstanding any other provision of this Agreement, either party may terminate by
giving thirty (30) days' advance written notice to the other party.
B. This Agreement may be terminated in whole or in part in the event of either party
substantially failing to fulfill its obligations under this Agreement. No such termination
will be affected unless the other party is given (1) written notice (delivered by certified
mail, return receipt requested) of intent to terminate and setting forth the reasons
specifying the non-performance, and not less than thirty (30) calendar days to cure the
failure; and (2) an opportunity for consultation with the terminating party prior to
termination.
C. This Agreement shall terminate automatically upon either party's loss of licensure or
certification, or upon the effective date of any change in statute, ordinance, rule or
regulation or action of governmental authority prohibiting this arrangement or the
services contemplated hereunder.
ARTICLE 10
NOTICES
All notices, communications, and reports required or permitted under this Agreement
shall be personally delivered or mailed to the respective parties by depositing same in the United
States mail to the address shown below, certified mail, return receipt requested, unless otherwise
specified herein. Mailed notices shall be deemed communicated as of three (3) days' mailing:
To PINNACLE:
To CITY:
Pinnacle Diagnostic & Laboratories City of Denton
Dr. Troy Hurst Michael A. Conduff, City Manager
403 W. University Drive 215 E. McKinney
Denton, TX 76201 Denton, Texas 76201
All notices shall be deemed effective upon receipt by the party to whom such notice is
given, or within three (3) days' mailing.
ARTICLE 11
ENTIRE AGREEMENT
This Agreement, consisting of 9 pages and three (3) exhibits constitutes the complete and
final expression of the agreement of the parties, and is intended as a complete and exclusive
statement of the terms of their agreements, and supersedes all prior contemporaneous offers,
promises, representations, negotiations, discussions, communications, and agreements which
may have been made in connection with the subject matter hereof.
Page 6
Pinnacle Drug Testing Contract
ARTICLE 12
SEVERABILITY
If any provision of this Agreement is found or deemed by a court of competent
jurisdiction to be invalid or unenforceable, it shall be considered severable from the remainder of
this Agreement and shall not cause the remainder to be invalid or unenforceable. In such event,
the parties shall reform this Agreement to replace such stricken provision with a valid and
enforceable provision which comes as close as possible to expressing the intention of the stricken
provision.
ARTICLE 13
COMPLIANCE WITH LAWS
PINNACLE shall comply with all federal, state, and local laws, rules, regulations, and
ordinances applicable to the work covered hereunder as they may now read or hereinafter be
amended.
ARTICLE 14
DISCRIMINATION PROHIBITED
In performing the services required hereunder, PINNACLE shall not discriminate against
any person on the basis of race, color, religion, sex, national origin or ancestry, age, or physical
handicap.
ARTICLE 15
PERSONNEL
A. The PINNACLE represents that it has or will secure, at its own expense, all personnel
required to perform all the services required under this Agreement. Such personnel shall
not be employees or officers of, or have any contractual relations with the CITY.
PINNACLE shall inform the CITY of any conflict of interest or potential conflict of
interest that may arise during the term of this Agreement.
B. Except for the services provided by the Director, services required hereunder will be
performed by PINNACLE or under its supervision. All personnel engaged in work shall
be qualified, and shall be authorized and permitted under state and local laws to perform
such services.
ARTICLE 16
ASSIGNABILITY
This Agreement shall apply to, and be binding upon, the parties and their respective
successors and permitted assigns. The parties shall not assign any interest in this Agreement,
and shall not transfer any interest in this Agreement (whether by assignment, novation, or
Page 7
Pinnacle Drug Testing Contract
otherwise) without the prior written consent of the other party. Any assignment attempted
without such consent shall be void.
ARTICLE 17
MODIFICATION
No waiver or modification of this Agreement or of any covenant, condition, or limitation
herein contained shall be valid unless in writing and duly executed by the parry to be charged
therewith, and no evidence of any waiver or modification shall be offered or received in evidence
in any proceeding arising between the parties hereto out of or affecting this Agreement, or the
rights or obligations of the parties hereunder, and unless such waiver or modification is in
writing and duly executed; and the parties further agree that the provisions of this section will not
be waived unless as set forth herein.
ARTICLE 18
MISCELLANEOUS
A. The following exhibits are attached to and made a part of this Agreement: (list exhibits)
1. Exhibit "A" CITY Request for Proposals
2. Exhibit "B" Pinnacle's Response to Request for Proposals
3. Exhibit "C" Addition to Scope of Services
B. Venue of any suit or cause of action under this Agreement shall lie exclusively in Denton
County, Texas. This Agreement shall be construed in accordance with the laws of the
State of Texas.
C. Force Majeure. Neither party shall be in violation of this Agreement if either party is, or
if either party reasonably determines that it is, prevented from performing its obligations
for any reason beyond its control, including without limitation, flood, storm, strikes, acts
of God or the public enemy.
D. The captions of this Agreement are for informational purposes only, and shall not in any
way affect the substantive terms or conditions of this Agreement.
IN WITNESS HEREOF, the City of Denton, Texas has caused this Agreement to be
executed by its duly authorized City Manager, and PINNACLE. has execute greement
through its duly authorized undersigned officer on this the day of
2002.
CITY ENTON, TEXAS
V~L. MANAGER 16
Page 8
Pinnacle Drug Testing Contract
ATTEST:
JENNIFER WALTERS, CITY SECRETARY
BY:
APPROVED AS TO LEGAL FORM:
HERBERT L. PROUTY, CITY ATTORNEY
BY:
PINNACLE DIAGNOSTICS &
LABORAT ORIES
Y~
WITNESS:
BY: L
Page 9
EXHIBIT C
Addition to Scope of Services
In addition to the required services outlined in the Request for Proposal, the following
services will be provided by Pinnacle Diagnostics:
Drug and Alcohol Testing
1. Pinnacle will provide same day test results for non-DOT specimen collections.
2. Pinnacle will ensure collection will take place within thirty (30) minutes of the
applicant/employee arriving for testing.
3. Pinnacle will employee personnel that are certified Breath Alcohol Technicians
and have the instrumentation to conduct breath alcohol tests.
4. Pinnacle will collect split specimens on all tests (DOT and non-DOT).
5. Pinnacle will provide the City hard copies of all test results within 10 business
days.
6. Pinnacle will provide educational and training material to employees when
requested.
7. Pinnacle will work in conjunction with Denton Community Hospital for after-
hour testing. All fees for collection from Denton Community Hospital will be
charged to Pinnacle, at which time, Pinnacle will bill the City of Denton for the
collection fee and testing fee.
Physicals
1. Pinnacle will provide consultation services for employees in order to reduce
workplace injuries, including instruction in proper body mechanics, lifting
techniques, etc.
2. Pinnacle will be able, as needed, to schedule all post-offer physicals within
twenty-four (24) hours of being contacted and can ensure that testing will take
place within thirty (30) minutes of the employee arriving.
CITY OF DENTON
RFSP # 2873
EXHIBIT
e a
m
OCCUPATIONAL HEALTH
SERVICES, CONTRACT NURSE,
DRUG TESTING, PHYSICALS
BID OPENING: AUGUST 13, 2002
2PM
Prepared by: City of Denton-Human Resources/Risk Management
Departments
RFSP #
City of Denton, Texas
REQUEST FOR PROPOSALS
FOR OCCUPATIONAL HEALTH SERVICES, CONTRACT NURSE,
DRUG TESTING, PHYSICALS
I. INTRODUCTION
The City of Denton (hereinafter referred to as "CITY") is soliciting proposals from
organizations (hereinafter referred to as "PROPOSER") qualified to perform
OCCUPATIONAL HEALTH SERVICES, CONTRACT NURSE, DRUG TESTING,
and PHYSICALS for the CITY. The scope of the work will encompass all aspects of
CITY operations and requires extensive knowledge and experience. The information
provided in the Request for Proposals (hereinafter referred to as "RFP") is only to be used
for the purpose of preparing a proposal(s) in the areas of occupational health services,
contract nurse services, drug testing, and physicals.
II. GENERAL BACKGROUND
CITY is comprised of 45 divisions and has a workforce of approximately 1300. CITY is
self-funded for its Workers' Compensation program and fully insured for its Employee
Health Benefits program. CITY is subject to and in compliance with Federal Rules and
Regulations regarding DOT (Department of Transportation) drug and alcohol testing.
CITY policy includes drug and alcohol testing in addition to DOT regulations. CITY
conducts approximately 550 Non-DOT drug tests, 45 Non-DOT alcohol tests, 200 DOT
drug tests, and 25 DOT alcohol tests annually. CITY conducts approximately 110 post-
offer physicals annually. CITY provides flu shots, work related vaccinations, exposure
testing, and wellness programs to its employees. CITY averages approximately 125
workers' compensation claims per year.
Currently, CITY uses various vendors to provide drug testing, post-offer and executive
physical services. Previously, all other proposed services were provided in-house
through the City's Occupational Health Program. CITY desires all proposed services to
be contracted to outside vendors. PROPOSER may elect to respond to all or selected
portions of this RFP.
CITY's designated representative during the RFP process shall be CITY's Purchasing
Agent.
The CITY's fiscal year is from October 1 to September 30.
Ill. CONTRACT TERM
The Contract term shall be for a period of three (3) years, beginning on October 1, 2002,
and ending September 30, 2005. It is renewable for two successive one (1) year terms
upon the same terms and conditions unless terminated. Contract shall be reviewed prior
to renewal and changes made by agreeing parties.
2
IV. SCOPE OF SERVICES
This RFP is divided into four sections, Section 1: Occupational Health Services,
Section 2: Contract Nurse Services, Section 3: Drug and Alcohol Testing Services,
and Section 4: Physical Services. PROPOSER may elect to propose on one, multiple, or
all of the following sections of Scopes of Services.
SECTION 1: OCCUPATIONAL HEALTH SERVICES
The CITY provides self-funded Workers' Compensation benefits to its employees in
accordance with Texas Workers' Compensation Commission statutes. The CITY is
requesting proposals for a medical provider, facility, or clinic to function as the primary
or initial source of medical treatment for its injured workers. Services should include, but
are not limited to:
A. Provide initial evaluation and treatment with potential for complete
medical treatment of the injury/illness for all CITY Workers'
Compensation injuries and illnesses
B. Provide work status report to employee and the CITY within 24 hours of
the injury
C. Provide treatment in accordance with Texas Workers' Compensation
guidelines
D. Provide employee with appropriate care, follow-up guidelines, restrictions,
and appointment for next treatment
E. Assign appropriate restrictions based on employee work status, job
description, and CITY light duty guidelines
F. Proactively participate in and promote the CITY's light duty program
G. Effectively communicate with employee, the CITY, and its third party
administrators (TPA)
H. Effectively communicate and coordinate treatment with CITY selected
case managers, peer review doctors, and other cost containment vendors
I. Track employee treatment progress and communicate with employee, the
CITY, and TPA
J. Provide referrals where applicable to specialists, other doctors/medical
providers, and for additional treatment such as work hardening, physical
therapy, pain management, etc. as needed
K. Coordinate and monitor treatment provided by referral provider
L. Provide injury prevention education to employee and/or the City as needed
or requested
M. Provide care in an expeditious manner so as to promote efficiency and
worker production
Preferences
A. Designated doctor to provide care during normal business hours (08:00-
17:00, Monday through Friday, no weekends or holidays)
B. No additional charge for medical treatment after normal business hours
C. 24hrs/day, 7 days/week, 365 days/year availablity
D. Emergency care and after hours fees equal to standard office
visit/treatment fees as set forth in TWCC fee guidelines
SECTION 2: CONTRACT NURSE SERVICES
The CITY is requesting proposals for Contract Nurse Services. A Contract Nurse will
perform occupational health nurse duties on site for CITY employees. Services should
include, but are not limited to:
A. Must headquarter and perform most services from the City of Denton
Employee Health Clinic, located at the City Service Center on Texas
Street, Denton, Texas
B. Contract nurse will work Monday through Friday, no weekends or City
holidays, from 07:00-10:00 a.m. daily for a total of 15 hours per week
C. Occupational Health duties include first aid and minor medical treatment
of both job related and non job related illness or injury
D. On-the-job injury treatment includes:
1. Provide employee with appropriate care, follow-up guidelines,
restrictions and appointment for next treatment
2. Effectively communicate with employee, the City, and its third party
administrators (TPA)
3. Track employee treatment progress and communicate with employee,
the City and TPA
4. Provide referrals where applicable to specialists, other doctors/medical
providers, and for additional treatment such as work hardening,
physical therapy, pain management, etc. as needed
5. Provide limited case management and return to work administration
E. Non job related illness or injury treatment includes:
1. Minor treatment and over-the-counter drug delivery for common
illness
2. Provide feedback to supervisors regarding sick employees
3. Provide medical consultation to employees regarding illness or
medical conditions
F. Track and record all employee traffic in and out of the clinic regardless of
treatment
G. Provide injury prevention education to employee and/or the City as needed
or requested
H. Provide drug screen collection and Breath Alcohol Testing, if requested
I. Provide City required vaccination shots and flu shot delivery
J. Provide record keeping and tracking systems for all shots
K. Advise and train on Wellness issues as needed
L. Perform health assessments or other assigned duties at Employee Health
Fairs
M. Must be a licensed nurse in the state of Texas
Preferences
A. COHN, or other occupational certifications and experience
B. Be available for additional hours at the same hourly rate as needed
C. Administer allergy shots to employees where applicable and authorized by
treating physician
SECTION 3: DRUG AND ALCOHOL TESTING SERVICES
The CITY conducts drug and alcohol testing according to the Department of
Transportation's (DOT) regulations. In addition, drug and alcohol testing is conducted
under CITY policy. All testing should be conducted for the following five (5) drugs:
A.
Marijuana metabolites
B.
Cocaine metabolites
C.
Amphetamines
D.
Opiate metabolites
E.
Phencyclidine (PCP)
Types of Testing Conducted by the CITY
A. Pre-Employment
B. Post-Accident
C. Reasonable Suspicion
D. Follow-Up and Return to Duty
E. Random
Site Specifications
A. Possess all necessary materials, equipment and facilities to provide for the
Collection and refrigerated storage of specimens
B. Employ sufficient personnel, including trained technicians to provide for integrity
And security of records and specimens
C. Execute the chain-of custody procedures established by the Department of
Transportation as well as any procedures established by agreement with the CITY
D. Collection site must be located within Denton city limits
E. Provide all necessary materials needed for collection process
F. Available for collection at least Monday through Friday 8am - 5pm
G. Ensure integrity of other laboratories used, including MRO services
H. Release of test results only to those individuals that have been approved through
The Human Resources department to receive testing information
1. Coordinate and facilitate processes with other collection and laboratory facilities
when an employee requests additional testing at another location
J. Coordinate with other collection and laboratory facilities that may conduct
pre-employment or after-hour testing for the CITY to obtain collected samples
via courier
K. Contact the CITY's Designated Employer Representative (DER) within
twenty- four (24) hours of a collection, either with a confirmed test result or
the status of a pending test
L. Permit the CITY to conduct inspections of the collection facility at any time
without notice
M. Provide written reports of results to the CITY within fourteen (14) days of
collection, unless requested by the CITY that a copy be provided immediately
N. Provisions for obtaining specimens that will allow for individual privacy,
including actual collection procedures as well as reporting procedures
0. Provisions to insure that the collection site will be secure at all times and that
no unauthorized personnel may be permitted in any part of the collection site
where specimens or records are obtained or stored
P. Standardized forms and identification methods approved by the CITY must be
completed accurately at designated times throughout the collection process.
a. For Non-DOT collections, employee must complete a consent form
furnished by the CITY before a collection is made
b. Appropriate identification (a photo ID) must be shown before
proceeding with any collection
c. A minor, defined as under the age of 18, should not be tested without a
legal guardian present
d. Directions for the completion of Chain of Custody forms must be
accurately followed during the collection process
Laboratory Personnel Experience and Expertise
A. The laboratory must maintain an individual who is responsible for the day-to-day
management of the drug and alcohol testing program, including quality control
B. The laboratory must employ sufficient personnel with the necessary training and
experience (including continuing education) to supervise and conduct the work of
the testing facility, including ensuring competency of the staff by documenting
training, reviewing work, and verifying skills
C. Maintain an updated procedures manual that is available to personnel performing
tests
D. Maintain qualified personnel for test validation who review all data and results
and certify that the reports are valid and accurate
E. Ability of personnel to advise the CITY on substance abuse related questions or
issues
F. Employ qualified personnel who is responsible for verifying all confirmatory
positive test results and meets the following qualifications:
a. Licensed physician in the State of Texas
b. Knowledge of substance abuse; and
c. Appropriate medical and/or forensic training in the review of medical
history and biomedical information
Laboratory Requirements
A. Laboratories used for drug screening must be certified by the Substance Abuse
and Mental Health Administration (SAMSHA)
B. Execute rigorous chain of custody procedures to maintain control and
accountability of all specimens
C. Maintain the capability to perform initial and confirmatory tests at the same
facility or coordinate with another laboratory for further testing
D. Conduct the initial screening tests using immunoassay technology that meets the
requirements of the Food and Drug Administration for commercial distribution
E. Conduct confirmatory tests using Gas Chromatography/Mass Spectrometry
(GC/MS) techniques
F. Establish written procedures for instrument set-up and normal operation, a
schedule for checking critical operating characteristics, tolerance limits and
troubleshooting and repair and make available to the CITY the records on
preventative maintenance
G. Permit the CITY to conduct inspections of the laboratory facilities at any time
without notice
H. Maintain and make available to the CITY documentation on all aspects of the
drug testing process as required by Department of Transportation retention
regulations including:
a. Chain of custody documents
b. Quality assurance/quality control records
c. Procedure manuals
d. All test data and reports
Laboratory Procedures
A. Test procedures are to be completed within twenty-four (24) hours to ensure rapid
turnaround of test results. Results or status of testing are to be reported to the
CITY within twenty-four (24) hours.
B. Retain all specimens for at least seven (7) calendar days
C. Review and interpret all confirmatory positive tests to certify accuracy
D. When reporting test results, follow DOT standards and guidelines for all possible
result outcomes
E. Review positive results and compare those with the medical information provided
by the employee
a. Examine alternate medical explanations for positive results
b. Identify any results based on scientifically insufficient data
c. Review other relevant biomedical factors
Random Drug and Alcohol Testing
A. Provide on-site collections for random drug testing program
B. Compile list of employees selected for testing using a random selection process
for both DOT and Non-DOT testing
C. List of employees randomly selected will be provided to the Human Resources
department no later than three (3) business days prior to the testing date
D. Total number of random tests conducted each year must equal a minimum of 50%
of all safety-sensitive employees for drugs and 10% for alcohol (percentages
subject to change based on Department of Transportation Regulations)
E. Provide the CITY with results of those who participate in each testing within
twenty-four (24) hours for DOT collections and three (3) business days for Non-
DOT collections
F. Provide an annual compilation of all testing for that calendar year to the Human
Resources department to ensure compliance with DOT and CITY rules and
regulations
Preferences for Service
A. Laboratory personnel are DATIA (Drug and Alcohol Testing Industry
Association) certified
B. Availability of personnel at collection site for after-hour collections 24 hours a
day, seven days a week
C. Provide educational and training material and services to employees (ie. updates
on DOT regulation changes, compliance information, on-site audits of program
requirements)
D. Provide test results the same day as the collection takes place
E. Ability to ensure collection will take place within thirty (30) minutes of employee
arriving for testing
F. Employ personnel that are certified Breath Alcohol Technicians and have the
instrumentation to conduct breath alcohol tests
G. Collect split specimens on Non-DOT samples
H. Referral services to Substance Abuse Professionals
SECTION 4: PHYSICAL SERVICES
The CITY is requesting proposals for Post-Offer and Executive Physical Services. New
employees are required to demonstrate capability to perform the essential functions of
the job. Excecutive level employees are offered a complete physical as an optional
benefit. Services should include, but are not limited to:
Post-Offer Physicals
A. Testing site located within Denton city limits
B. Develop Job Specific Testing for each position being tested, including completing
on-site observations and interviews with supervisors to gather information to
develop tests
C. Provide the City with copies of test criteria developed
D. Provide verbal results to City within twenty-four (24) hours and written results
within five (5) business days
E. Permit the City to conduct inspections of the facility at any time without notice
F. Meet the standards required by the Americans with Disabilities Act (ADA), while
providing a detailed evaluation of an individual's functional capabilities to
perform the essential functions of the job.
G. Comprehensive evaluation including assessments of range of motion, posture,
joint integrity, and strength
H. Cardiovascular assessment including risk profile, blood pressure, heart rate, and
recovery condition
I. Strength evaluation of the back and extremities
J. Risk profile for overuse syndromes
K. Job simulation components, including body mechanics and lifting
L. Employ certified personnel to conduct this testing, including providing
certifications and training documentation
M. Provide baseline statistics to improve efficiency and effectiveness
N. Perform post injury evaluation by matching data with that of the initial post offer
data
0. Availability to provide services Monday through Friday including the ability to
schedule employees within twenty-four (24) hours of being contacted by the City
P. Provide vital statistics including but not limited to medical history, weight,
audiogram, and visual acuity of employees
Preferences
A. Provide consultation services for employees (i.e. instruction in proper body
mechanics and lifting techniques, etc.) in order to reduce workplace injuries
B. Testing can be conducted by appointment and will take place within thirty (30)
minutes of employee arriving at facility
C. Provide any additional optional physical evaluations offered
Executive Physicals
A. Testing site located within Denton city limits
B. Provide a comprehensive physical evaluation including, but not limited to:
a. Medical History
b. Weight and Body Fat Analysis
c. Resting electrocardiogram
d. Cardiac Stress Test
e. Audiogram
f. Visual Acuity
g. CBC, Chem Profile, Lipid Profile, Urinalysis
h. Spirometry
i. Physical Exam
j. Post Exam Consult
C. Provide results to employee within five (5) business days
V. PROPOSALS
The PROPOSER's completed Proposal pages in Attachment "A" of this RFP are the main
source of evaluation for the Proposal. Along with the Proposal pages, Proposals should
include a description of additional support services and/or risk management services that
PROPOSER offers and wants to propose in a written presentation form. All
PROPOSERS are encouraged to include any other information that they feel will enhance
their opportunities to be awarded a Contract.
A Proposal from a PROPOSER for Occupational Health Services, Contract Nurse, Drug
Testing, and/or Physicals should include the following:
A. The location of your offices and hours staffed. Provide the names of
principal owners, partners or officers.
B. CITY would like Proposals to indicate who is primarily responsible for the
management and supervision of CITY contracted program, such as an
account manager. The account manager and the names of all other staff
members assigned to the handling of CITY contracted program should
also be included with an indication of length of service, area of expertise,
licenses and certification, and a brief biography.
C. All proposals should include a list of references (local and public entity
preferred). Along with your references, include a list that is representative
of your clients. References will be contacted as part of the evaluation
process.
VI. PREPARATION OF PROPOSAL
A. PROPOSER is expected to examine this Request for Proposal (RFP)
carefully, understand the terms and conditions for providing the pertinent
services, and respond completely. Failure to respond completely may
result in disqualification. Questions about this RFP shall be directed, in
writing only, to the address provided below, on company letterhead.
B. Verbal questions and explanations are not permitted, other than during any
interviews. It is suggested that any and all questions be sent by Certified
Mail, return receipt requested. No inquiries or questions will be answered
after July 23, 2002 to allow ample time for distribution of answers and/or
any changes. Any questions regarding this RFP may be directed to:
City of Denton Risk Management
Attention: Robert Waggoner, Risk Manager
601 E. Hickory, Suite A
Denton, Texas 76205
Telephone: (940) 349-7836
FAX: (940) 349-7870
C. Failure to respond to all portions of the Section being proposed may result
in the PROPOSER's response being deemed non-responsive. If CITY
deems a Proposal non-responsive, it will be disqualified. An officer or
principal of the PROPOSER must sign proposals, however, an agent if
accompanied by written evidence of authority may sign them.
D. The Proposal response should indicate whether the PROPOSER would be
able to include all or selected portions of the items identified in Part IV
Scope of Services Sections 1,2,3, and/or 4 of this Request for Proposal. If
a Proposal does not identify whether the PROPOSER will include these
items, the PROPOSER may be disqualified.
E. All Proposals should include the PROPOSER's federal tax identification number.
10
VII. SELECTION PROCESS
CITY will conduct a comprehensive evaluation of all Proposals received in response to
this RFP. CITY will establish a Selection Committee comprised of staff members to
perform such evaluation. Each Proposal received will be analyzed to determine overall
responsiveness and qualifications under the RFP; further, the Selection Committee may
select proposing organizations for "in person" presentation. Criteria to be evaluated, not
necessarily in order of priority, may include the items listed below. Final approval of a
selected PROPOSER is subject to the action of CITY's City Council.
SECTION 1: OCCUPATIONAL HEALTH SERVICES
Evaluation Criteria
A. Economic evaluation of the proposed Fee Schedule (10%)
B. Responsiveness to the Request for Proposal (15%)
a. Requested information included and thoroughness of response
b. Understanding and acceptance of the scope of services
c. Acceptance of the RFP and Contract requirements
d. Clarity and conciseness of the response
C. References, background, and experience of the facility and personnel
(25%)
D. Capability to provide services requested in Scope of Services (50%)
a. Timely treatment
b. Record keeping and reporting capability
c. Other resources, including number of employees and accessibility
d. Ability to provide quality medical care
SECTION 2: CONTRACT NURSE SERVICES
Evaluation Criteria
A. Economic evaluation of the Proposed Fee Schedule (15%)
B. Responsiveness to the Request for Proposal (25%)
a. Requested information included and thoroughness of
response
b. Understanding and acceptance of the scope of services
c. Acceptance of the RFP and Contract requirements
d. Clarity and conciseness of the response
C. Capability to provide the services requested in Scope of Services (60%)
a. Background of PROPOSER including professional qualifications
11
b. Relevant experience of the PROPOSER, especially with
municipalities and public entity clients
c. References
SECTION 3: DRUG AND ALCOHOL TESTING SERVICES
Evaluation Criteria
A. Economic evaluation of the proposed Fee Schedule (10%)
B. Responsiveness to the Request for Proposal (10%)
a. Requested information included and thoroughness of response
b. Understanding and acceptance of the scope of services
c. Acceptance of the RFP and Contract requirements
d. Clarity and conciseness of the response
C. Background and experience of the facility and personnel (20%)
D. Ability to provide preferences outlined in request (10%)
E. Capability to provide services requested and information contained in
attachments (50%)
a. Timely testing
b. Recordkeeping and reporting capability
c. Other resources, including number of employees and accessibility
d. References
SECTION 4: PHYSICAL SERVICES
Evaluation Criteria
A. Ability to provide preferences outlined in proposal (5%)
B. Economic evaluation of the proposed Fee Schedule (10%)
C. Responsiveness to the Request for Proposal (15%)
a. Requested information included and thoroughness of response
b. Understanding and acceptance of the scope of services
c. Acceptance of the RFP and Contract requirements
e. Clarity and conciseness of the response
D. Background and experience of the facility and personnel (20%)
F. Capability to provide services requested and information contained in
Attachments (50%)
a. Timely testing
b. Recordkeeping and reporting capability
12
C. Other resources, including number of employees and accessibility
d. References
e. Ability to professionally perform requested services
CITY may accept, within the time specified herein, any Proposal in whole or in part,
whether or not there are negotiations subsequent to its receipt. If subsequent negotiations
are conducted, they shall not constitute a rejection or alternate RFP on the part of CITY.
The Contract will be awarded to the respondent whose Proposal will be most
advantageous to CITY, as determined by the evaluation factor's listed herein and by the
recommendation of the Selection Committee with approval of the City Council.
The CITY encourages participation by Minority or Woman owned Business Enterprises.
VIII. TERMS AND CONDITIONS
Execution of Contract: The services outlined are anticipated to commence October 1,
2002, and CITY and the selected PROPOSER must execute all contracts and agreements
by no more than 14 days after CITY notifies the PROPOSER that it has been selected to
perform the services. CITY's notice will be made in writing. CITY will require the
successful PROPOSER to enter into Contract with the CITY. Contract documents are not
binding on the CITY until approved as to form by the City Attorney.
Extension: If the provider has performed in a manner satisfactory to the City of Denton,
the City manager or his/her designee may extend the contract by one-year periods for up
to two (2) additional years beginning at the conclusion of the initial three (3) year
contract by the signing of an extension agreement.
Preference will be given to a provider with any rate guarantees not to exceed 25% overall.
Termination: The contract shall be subject to termination under any of the following
conditions:
A. Notwithstanding any other provision of this Agreement, either party may
terminate by giving thirty (30) days advance notice to the other party.
B. This Agreement may be terminated in whole or in part in the event of either party
substantially failing to fulfill its obligation under this agreement. No such
termination will be affected unless the terminating party gives the other party
written notice (which is to be sent by certified U.S. mail return receipt requested)
of intent to terminate and sets forth the reason for termination that specify the
non-performance. The terminating party, by such notice, must also give the other
party an opportunity for consultation with the terminating party prior to
termination.
C. If the agreement is terminated prior to the completion of services to be provided
hereunder, the Provider shall immediatley cease all services and shall render a
final bill for services within thirty (30) days after the date of the termination. The
City shall pay the Provider for all services properly rendered and satisfactorly
performed and for reimbursable expenses of termination incurred prior to the
13
termination date. Should the City subsequently contract with a new Provder for
the continuation of services, if applicable and where provided by law, the Provider
shall turn over all documents prepared or furnished by the Provider pursuant to
this Agreement to the City on or before the date of the termination, but may
maintain copies of such information for its use.
Submission of Proposals: Four (4) typed and bound copies of the Proposal shall be
enclosed in a sealed envelope with the notation "OCCUPATIONAL HEALTH
SERVICES, PHYSICALS, DRUG TESTING, and CONTRACT NURSE" clearly
marked on the envelope. All Proposals are due in the Purchasing Department at the
City of Denton no later than 2:00 PM CST on August 13, 2002. Any Proposal
received at the location below after that time shall not be considered.
Please mail or deliver your Proposal to:
City of Denton Purchasing Department
901B Texas Street
Denton, Texas 76201
ATTN: Tom Shaw
All provisions in PROPOSER's Proposal, including any estimated or projected costs,
shall remain valid for ninety (90) days following the deadline date for submissions or if a
Proposal is selected, throughout the entire term of the Contract.
All Proposals become property of CITY upon receipt and will not be returned. Proposals
submitted will clearly identify trade secrets or information deemed confidential by the
PROPOSER by typing the word "CONFIDENTIAL" in bold fourteen (14) point font
on the bottom margin and indicate what information is protected. However, all
PROPOSERS are hereby notified that any Proposals submitted to CITY may be subject to
disclosure, either in whole or part, under the Texas Public Information Act.
Withdrawal of Proposal
Submitted proposals may be withdrawn prior to the proposal due date.
Restrictions on Communication
After the RFP has been issued, PROPOSER is prohibited from communicating with
CITY staff regarding the RFP or Proposals, with the following exceptions:
- The selection committee during any finalist interviews.
CITY shall not schedule meetings with representatives of any PROPOSER to discuss
Proposals, and PROPOSER should not contact CITY employees to explain, clarify or
discuss their Proposals before an award has been made except as set out in this section.
Violation of this provision may lead to disqualification from this process.
14
CITY reserves the right to contact any PROPOSER for clarification after responses are
opened and/or to further negotiate with any PROPOSER if CITY so desires.
Independent Contractor - It is expressly understood and agreed that PROPOSER and
all persons designated by it to provide services in connection with this RFP, is and shall
be deemed to be an independent contractor, responsible for its respective acts or
omissions, and that CITY shall in no way be responsible for any acts or omissions by the
PROPOSER. Neither party hereto has authority neither to bind the other nor to hold out
to third party that it has the authority to bind the other.
IX. INSURANCE & INDEMNITY PROVISIONS
A. Prior to the commencement of any work under this CONTRACT,
CONTRACTOR shall furnish an original completed certificate(s) of
insurance to the CITY's risk manager, which shall be completed by an
agent authorized to bind the named underwriter(s) and their company to
the coverage, limits, and termination provisions shown thereon, and which
shall furnish and contain all required information referenced or indicated
thereon. The original certificate(s) must have the agent's original signature,
include the signer's company affiliation, title and phone number, and be
mailed directly from the agent to the CITY. The CITY shall have no duty
to pay or perform under this CONTRACT until such certificate shall have
been delivered to the CITY's risk manager, and no officer or employee,
other than the CITY's risk manager shall have authority to waive this
requirement.
B. The CITY reserves the right to review the insurance requirements of this
section during the effective period of this CONTRACT and any extension
or renewal hereof and to modify insurance coverage and their limits when
deemed necessary and prudent by the CITY's risk manager based upon
changes in statutory law, court decisions, or circumstances surrounding
this Contract, but in no instance will the CITY allow modification
whereupon the CITY may incur increased risk.
C. CONTRACTOR's financial integrity is of interest to the CITY, therefore,
subject to CONTRACTOR's right to maintain reasonable deductibles in
such amounts as are approved by the CITY, CONTRACTOR shall obtain
and maintain in full force and effect for the duration of this CONTRACT,
and any extension hereof, at CONTRACTOR's sole expense, insurance
coverage written by companies authorized and admitted to do business in
the State of Texas. Requirements are addressed in Attachment C.
D. The CITY shall be entitled, upon request and without expense, to receive
copies of the policies and all endorsements thereto as they apply to the
limits required by. the CITY, and may make a reasonable request for
deletion, revision, or modification of particular policy terms, conditions,
limitations or exclusions (except where policy provisions are established
by law or regulation binding upon either of the parties hereto or the
15
underwriter of any such policies). Upon such request by the CITY, the
CONTRACTOR shall exercise reasonable efforts to accomplish such
changes in policy coverage, and shall pay the cost thereof.
E. CONTRACTOR agrees that with respect to the above required insurance,
all insurance contracts and certificate(s) of insurance will contain the
following required provisions.
• Name the CITY and its directors, officers, employees, agents and
elected officials as additional insureds with respects to the
operations and activities of, or on behalf of, the named insured
performed under contract with the CITY, with the exception of the
workers' compensation/employers' liability and the professional
liability policies.
• The CONTRACTOR's insurance shall be deemed primary with
respect to any insurance or self-insurance carried by the CITY for
liability arising out of operations under the contract with the CITY.
• Provide for an endorsement that the "other insurance" clause shall
not apply to the CITY where the CITY is an additional insured on
the policy.
• Workers' Compensation/Employers' liability policy will provide a
waiver of Subrogation in favor of the CITY.
F. CONTRACTOR shall notify the CITY in the event of any notice of
cancellation of any notice of cancellation, non renewal or material change
in coverage and shall give such notices not less than ten (10) days prior to
the change, or ten (10) days for nonpayment of premium, which notice
must be accompanied by a replacement Certificate of Insurance. All
notices shall be given to the CITY, by Certified mail, at the following
address:
City of Denton Purchasing Department
901B Texas Street
Denton, Texas 76201
Attn: Tom Shaw
G. If CONTRACTOR fails to maintain the aforementioned insurance, or fails
to secure and maintain the aforementioned endorsements, the CITY may
obtain such insurance and deduct and retain the amount of the premiums
for such insurance from any sums due under the agreement, however,
procuring of said insurance by the CITY is an alternative to other remedies
the CITY may have, and is not the exclusive remedy for failure of
CONTRACTOR to maintain said insurance or secure such endorsement.
In addition to any other remedies the CITY may have upon
CONTRACTOR's failure to provide and maintain any insurance or policy
16
endorsements to the extent and within the time required, the CITY shall
have the right to order CONTRACTOR to stop work hereunder, and/or
withhold any payments(s) which become due to CONTRACTOR
hereunder until CONTRACTOR demonstrates compliance with the
requirements hereof.
H. Nothing herein contained shall be construed as limiting in any way the
extent to which CONTRACTOR may be held responsible for payments of
damages to persons or property resulting from CONTRACTOR's or its
subcontractors performance of the work covered by this CONTRACT.
I. CONTRACTOR covenants and agrees to FULLY INDEMNIFY and
HOLD HARMLESS, the CITY and its elected officials, employees,
officers, directors, and representatives, individually or collectively,
from and against any and all costs, claims, liens, damages, losses,
expenses, fees, fines, penalties, proceedings, actions, demands, causes
of action, liability and suits of any kind and nature, including but not
limited to, personal or bodily injury, death and property damage,
made upon the CITY directly or indirectly arising out of, resulting
from or related to CONTRACTOR's activities under this
CONTRACT, including any acts or omissions of CONTRACTOR,
any agent, officer, director, representative, employee, consultant or
subcontractor of CONTRACTOR, and their respective officers,
agents, employees, directors and representatives while in the exercise
of performance of the rights or duties under this CONTRACT. The
indemnity provided for in this paragraph shall not apply to any
liability resulting from the negligence of CITY, its officers or
employees, in instances where such negligence causes personal injury,
death, or property damage. IN THE EVENT CONTRACTOR AND
CITY ARE FOUND JOINTLY LIABLE BY A COURT OF
COMPETENT JURISDICTION, LIABILITY SHALL BE
APPORTIONED COMPARATIVELY IN ACCORDANCE WITH
THE LAWS OF THE STATE OF TEXAS, WITHOUT, HOWEVER,
WAIVING ANY GOVERNMENTAL IMMUNITY AVAILABLE TO
THE CITY UNDER TEXAS LAW AND WITHOUT WAIVING ANY
DEFENSES OF THE PARTIES UNDER TEXAS LAW.
J. The provisions of this INDEMNIFICATION are solely for the benefit
of the parties hereto and not intended to create or grant any rights,
contractual or otherwise, to any other person or entity.
K. CONTRACTOR shall promptly advise the CITY, in writing of any
claim or demand against the CITY or CONTRACTOR known to
CONTRACTOR related to or arising out of CONTRACTOR'S
activities under this CONTRACT.
X. SCHEDULE OF EVENTS
17
RFP Mailouts July 5, 2002
Proposals Due August 13, 2002 2PM
Contract Award City Council - September 17, 2002
Start Date October 1, 2002
XI. RESERVATION OF RIGHTS
CITY reserves the right to:
• Reject any and all Proposals received.
• Issue a subsequent RFP
• Cancel the entire RFP
• Remedy technical errors in the RFP process
• Negotiate with any, all or none of the respondents to the RFP
• Accept the written Proposal as an offer
• Waive informalities and irregularities
• Accept one or more Proposals
This RFP does not commit CITY to enter into a Contract, nor does it obligate it to pay
any costs incurred in preparation and submission of Proposals or in anticipation of a
Contract.
18
ATTACHMENT A
CITY OF DENTON, TEXAS
PROPOSAL FORM
OCCUPATIONAL HEALTH SERVICES, CONTRACT NURSE SERVICES, DRUG
TESTING, and PHYSICALS
Organization Name:
Address of Service Office
Telephone No.:
Office Hours:
Principal Contact for This
PRICING
(City) (State) (zip)
Fax No.:
Date Established:
CITY is requesting proposals with pricing submitted either as per service provided or as a flat
annual fee depending upon the Section or Sections of this RFP the PROPOSER is responding to.
A PROPOSER may choose to propose on a Section both as a flat annual fee or as per service
provided. Each Proposer will provide pricing that reflects the total bottom line fee for Section
proposed. All expected or anticipated costs and expenses will be projected by the Proposer and
included in the fee quoted.
COMPANY QUALIFICATIONS
(Note: If a national or regional company, respond only for the local branch/office that would
handle CITY's program.)
Principal Owner/Owners/Partners and Officers
2. Date Founded/Opened
3. Total number of full time employees
Number of public entity clients:
% of total clientele
4. Number of municipal clients: % of total
clientele
6. Total number of clients:
19
7. List four (4) references, public entity clients preferred, including address,
telephone number and contact person. Please indicate length of relationship:
b.
C.
d.
8. Please furnish the following information regarding the personnel at this location
that will provide services to CITY, and their experience.
Name:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
Name:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
Name:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
20
Licenses, professional designations and/or degrees earned:
Name:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
Name:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
21
9. Attach an Organizational Chart for the specified location where services will be
provided specifying supervisor/management positions/titles/reporting relationships.
10. Provide information regarding any ongoing training that your employees servicing the
CITY will be required to satisfactorily complete. Indicate if CITY personnel may
attend this training and at what cost, if any.
11. Has anyone filed any complaint with Texas Workers' Compensation Commission
concerning your organization? [ ]Yes [ ]No (if applicable)
If "yes", please explain:
12. Describe your documentation procedure for handling customer complaints
13. Will you subcontract any portion of the services you propose to furnish?
[ ] Yes [ ] No If "yes", give full details below.
14. Do we have your permission to request an investigation of your firm's financial
condition, reputation, etc.?
[ ] Yes [ ] No.
15. Does your organization or do persons within your organization currently have
claims or litigation against the CITY? [ ] Yes [ ] No. If "yes", please explain.
22
16. Please attach a copy of all licenses and permits you are required to hold in order to
perform the services proposed.
MISCELLANEOUS
Have you completed and attached Attachments [ ] Yes [ ] No
2.. Federal tax ID number:
I affirm that the information provided herein is correct and that pricing information contained in
this document shall remain a valid offer for 90 days following the deadline date for submission
or if a Proposal is selected, throughout the entire tern of the Contract.
By:
(Authorized Officer)
Type Name and Title
Date
23
ATTACHMENT B
FEESCHEDULE
Seperate sheet/format may be used, but this or seperate fee schedule must be completed and
returned. Failure to complete could result in rejection of proposal.
Occupational Health
Services
Fee per Service
Annual Flat Fee
$(Attach pricing sheet,
TWCC Fee Guidelines, or
simply state that fees will
not exceed TWCC
fee guidelines)
$
Additional Services
$
$
(list)
Fee per Hour
Annual Flat Fee
Contract Nurse
$
$
Additional Services
$
$
(list)
Drug and Alcohol Testing
Cost per Test (DOT)
Cost per Test (Non-DOT)
Drug sample collection and
lab testing for original
$
$
sample, including random
selection processes
MRO services for drug
$
$
testing
Testing of split specimen
$
$
Drug and alcohol sample
$
$
collection after normal
business hours
Preferred Services
Cost Itemization
EBT alcohol testing,
$
$
including random selection
processes
Substance Abuse
$
Professional Services
Educational Training for
$
Employees
Optional Services Provided
$
(Drug testing costs should include all supplies, collection materials, equipment, and
administrative activities as outlined in the scope of service)
24
Physicals
Cost per Test
Post Offer Physical Exam
$
Post Injury Test
$
Functional Capacity Evaluation
$
Executive Physical
$
Optional Services Provided
$
25
ATTACHMENT C
INSURANCE REQUIREMENTS
CONTRACTOR shall procure and maintain for the duration of the contract, insurance against
claims for injuries to persons or damages to property which may arise from or in connection with
the performance of the work hereunder by the CONTRACTOR, its agents, representatives,
employees or subcontractors. The cost of such insurance shall be included in the Contractor's
proposal.
A. Minimum Scope of Insurance
Coverage shall be at least as broad as:
1. ISO Form Number GL 0002 (Ed 1/72) covering Comprehensive General Liability and
ISO Form Number GL 0404 covering Broad Form Comprehensive General Liability;
or ISO Commercial General Liability coverage ("occurrence" Form CG 0001).
"Claims made" form is unacceptable except for professional liability.
2. Workers' Compensation insurance as required by the Labor Code of the State of
Texas, including Employers' Liability Insurance.
3. Professional Liability (required for Occupational Health Services, Contract Nurse,
and Physicals).
4. Auto Liability (required for Contract Nurse and Drug Testing).
B. Minimum Limits of Insurance
CONTRACTOR shall maintain limits not less than:
1. Commercial General Liability: $500,000 per occurrence for bodily injury, personal
injury and property damage. $1,000,000 Aggregate Policy will include coverage for
a) Premises - Operations; b) Broad Form Contractual Liability; c) Products and
Completed Operations; d) Use of Contractors and Subcontractors; e) Personal Injury;
f) Broad Form Property Damage.
2. Workers' Compensation and Employer's Liability: Workers' Compensation limits as
required by the Labor Code of the State of Texas and Statutory Employer's Liability
Limits.
3. Professional Liability $500,000.
4. Auto Liability $500,000 to include coverage for any auto or all owned, hired, and
non-owned auto.
C. Deductibles and Self-Insured Retentions
Any deductible or self-insured retentions must be declared to and approved by the City.
26
D. Other Insurance Provisions
The policies are to contain, or be endorsed to contain the following provisions:
1. General and Auto Liability.
a. The City, its officers, officials, employees, Boards and Commissions and
volunteers are to be added as "Additional Insureds" as respects liability arising out
of activities performed by or on behalf of the vendor, products and completed
operations of the vendor, premises owned, occupied or used by the
CONTRACTOR. The coverage shall contain no special limitations on the scope
of protection afforded to the City, its officers, officials, employees or volunteers.
It is understood that the business auto policy under 'Who is an Insured"
automatically provides liability coverage in favor of the City.
b. The CONTRACTOR's insurance coverage shall be primary insurance as respects
the City, its officers, officials, employees and volunteers. Any insurance or
self-insurance maintained by the City, its officials, employees or volunteers shall
be excess of the consultant's insurance and shall not contribute with it.
c. Any failure to comply with reporting provisions of the policy shall not affect
coverage provided to the City, its officers, officials, employees, Boards and
Commissions or volunteers.
d. The CONTRACTOR's insurance shall apply separately to each insured against
who claim is made or suit is brought, except with respect to the limits of the
insured's liability.
2. Workers' Compensation and Employer's Liability Coverage - The insurer shall agree
to waive all rights of subrogation against the City, its officers, officials, employees
and volunteers for losses arising from work performed by the CONTRACTOR for the
City.
3. All Coverages - Each insurance policy required by this clause shall be endorsed to
state that coverage shall not be suspended, voided, canceled or non-renewed by either
party, reduced in coverage or in limits except after ten (10) days prior written notice
by certified mail return receipt requested, has been given to the City.
E. Acceptability of Insurers
The City prefers that Insurance be placed with insurers with an A.M. Best's rating of no
less than B+:VI, or, A or better by Standard & Poors. This requirement will be waived for
workers' compensation coverage only for those CONTRACTOR whose workers'
compensation coverage is placed with companies who participate in the State of Texas
Workers' Compensation Assigned Risk Pool. Professional Liability carriers will need to
be approved by the Risk Manager.
27
F. Verification of Coverage
Contractor shall furnish the City with certificates of insurance effecting coverage
required. The certificates for each insurance policy are to be signed by a person
authorized by that insurer to bind coverage on its behalf. The certificates are to be on
forms approved by the City and are to be received and approved by the City before work
commences. The City reserves the right to require complete, certified copies of all
required insurance policies, at any time.
28
t
RFSP #
2873
Occupational Health
EXHIBIT
a
6
E
2
Services, Contract Nurse,
._D-rug _ T-e-ati-n-g P"eals.
For
City oT ' Denton
403 W. University Drive • Denton, Texas 76201 • 940.898.1787 • Toll Free 877.257.5227
A Brief Overview
Pinnacle Diagnostic & Laboratories, Inc., specializes in D.O.T. and non-
D.O.T. drug testing, management of random drug testing programs, job-
specific physicals (WorkSTEPS) and breath alcohol tests. Criminal
background checks are also available.
Drug screening has become a necessity for businesses everywhere and a
reduction in the turnaround time of the results means real dollar savings for
clients who want to keep employees productive on the payroll, rather than
waiting for test results. Since we collect specimens and process drug tests
on-site in Denton, Texas, utilizing state of the art testing equipment, we are
able to get a report to you by 9:00 a.m. the next business day if specimens
are in our office by 6:00 p.m.
Our random testing management program removes the employer from the
liability related to the selection process. Our computer makes the random
selections for the employer, and each candidate receives notification of the
random test from our office on our letterhead.
It is the mission of Pinnacle Diagnostic & Laboratories to provide you with
the highest quality of employment testing available at a competitive price
and in a timely and efficient manner. It is our goal to help keep your
business competitive through the reduction of work related injuries/accidents
and the costs associated with those injuries/accidents.
403 W. University Drive 0 Denton, Texas 76201 • 940.898.1787 • Toll Free 877.257.5227
COMPLIANCE & QUALITY
We realize that the timeliness and quality of drug testing equates to the.
quality- and safety of your workplace. Our vision and mission is to provide
you with fast and high quality drug testing. Therefore, we have developed
the following procedures to insure that timeliness and quality remain high:
1. Pinnacle Diagnostic & Laboratories uses the latest in laboratory
technology, the AXSYM system. In most cases drug test results will be
available in 24 hours or less. This is true for all pre-employment, reasonable
cause, random and post-accident testing.
2. Our staff will respond quickly to your testing needs. Tracey Horner is
our coordinator and account manager." She will be happy to meet with you
to review, discuss or assist you in developing your drug testing policies and
procedures.
3. We believe it is our obligation to win your loyalty and provide you with
exceptional service. Our integrity and ethics are beyond reproach.
Pinnacle Diagnostic & Laboratories testing procedures are fully accredited
by thZC Inspection ands re ion of abora ories o e
College of American Pathologists (CAP) and the U.S. Departmen lth
and Human Services Substance Abuse and Mental Health Serv'
Administration (HHS/SAMHSA). All laboratory personnel e _AT
certified as well as certified Breath Alcohol Technicians.
The AXSYM system in our facility is maintained and calibrated on a regular
basis to ensure accurate testing. A procedures manual is available for
inspection.
Pinnacle Diagnostic & Laboratories
Pinnacle Diagnostic & Laboratories is a one-call provider for all employee
screening needs. We are a local walk-in laboratory and physical facility that.
is open Monday through Thursday from 8:00 a.m. until 6:00 p.m. and Friday
from 8:00 a.m. until 5:00 p.m. Our primary location is 403 W. University
Drive. We also offer collections and physicals at the TA Truck Stop on I-35
at Highway 77. The hours for this facility are from 6:00 a.m. until 6:00 p.m.
Saturday through Sunday. Any testing needed outside of the above hours is
collected by Denton Community Hospital. All documentation is done by
our office and results are delivered within 24 hours from collection (GC/MS
confirmation may require an additional 24 hours). Results can be
telephoned, faxed or mailed to a designated recipient established by the City.
Because we have one centralized location, you get quick answers to any
questions with a single call. When it comes to the drug testing process, we
are fast, flexible and accurate.
Pinnacle Diagnostic & Laboratories is equipped to implement pre-
employment, reasonable suspicion, random, post-accident and return to duty
drug screening. All necessary materials and equipment are provided by our
facility. There are no extra fees associated with on-site collections or
establishing and maintaining a random testing plan. The City is welcome to
conduct inspections of the collection facility at any time; no notice is
required.
Outline of Drug Testing Procedures
All collections are performed following the guidelines set forth in the
"Urine Specimen Collection Handbook for Federal Workplace Drug Testing
Programs" published by the Substance Abuse and MentalHealth Services
Administration. A chain of custody for each specimen to be tested will be
established and maintained through the testing of the specimen. This chain
of custody will be finalized and approved by the City. No unauthorized
personnel are permitted in any part of the collection site where specimens
and records are obtained or stored. Split specimen procedures will be
adhered to with specimens labeled as such. Every effort is made to
minimize the number of persons handling the specimens.
Procedures for collecting urine specimens will allow for individual privacy
unless there is reason to believe that a particular individual may adulterate
the specimen. When an individual arrives at the collection site, the
collection site person will request photo identification (usually a driver's
license) and the social security card of the individual. If the identity of the
individual cannot be established, the collection will not occur. A consent
form is also signed at this time. Minors, those under the age of 18, are not
tested without a legal guardian present. All employees will be tested within
thirty minutes of arrival on site. Individuals will be asked to remove any
unnecessary outer clothing (coats, jackets) that might conceal an adulterant.
The collection site technician will secure any personal belongings such as a
purse or briefcase; the individual may retain his or her wallet.
The individual shall urinate into a collection container and provide at least
60 ml of urine. The collection site person will pour 30 ml of urine into one
container to be used as the primary specimen. The remainder will be stored
until the results are ready. If the test result of the primary specimen is
positive, the employee may request the split specimen be tested by a
different certified laboratory. This request will be honored if made within
seventy-two (72) hours of the employee having been notified of a positive
test result. The split specimens will be retained for seven calendar days.
Positive, results are always compared with medical information provided by
the employee. Any alternate medical explanations for positive results are
considered. Dr. Troy M. Hurst and Dr. J.R. Baber provide MRO services. If
a second opinion is needed, Dr. Gregory Gleim or Dr. Hal Miller are
avail-able e or consult.
Testing results are released only to those individuals that have been
approved through the Human Resources department to receive the results.
DOT standards and guidelines are used when reporting results. Results are
delivered within 24 hours from collection (GC/MS confirmation may require
an additional 24 hours). Results can be telephoned, faxed or mailed to a
designated recipient established by the City.
Random Drug Testing
Our random testing management program removes the employer from the
liability related to the selection process. Our computer makes the random
selections for the employer for both DOT and non-DOT testing. Each
candidate can receive notification of the random test from our office on our
letterhead or the employee list can be submitted to the Human Resources
department for notification three days prior to. the testing date. The total
number of random tests is determined by the City. Currently DOT
regulations require a minimum of 50% of all safety-sensitive employees for
drug testing and 10% for alcohol' testing.
All collection procedures outlined above are followed. Results are delivered
within 24 hours from collection (GC/MS confirmation may require an .
additional 24 hours). Results can be telephoned, faxed or mailed to a
designated recipient established by the City. An annual compilation report
is also provided to ensure compliance with DOT and City rules and
regulations.
Adulterated Specimens
Individuals attempting to interfere with, mask or dilute urine specimens
containing drugs do so by adulterating or substituting the urine sample.
Specimen adulteration can occur by either internal or external means.
Internal adulteration refers to substances that are ingested either purposefully
o~owmgTluc may m uence t e rug resu t. xterna a ulteration
refers.to the addition of a substance into the urine by the donor during or
immediately following urination into a collection container. Many of these
substances are easily detected because of physical properties such as color or
odor. Other substances may not be detected without additional analysis.
Our testing protocol identifies adulterants that interfere with the testing
process allowing you to make informed personnel decisions.
Confidentiality
Pinnacle Diagnostic & Laboratories maintains a high standard of
confidentiality with all testing. The. strictest guidelines are followed
concerning persons with AIDS and HIV infection. Our personnel are trained
in integrity and security aspects of specimens as well as records. Referrals
are available to Substance Abuse Professionals if needed.
WorkSTEPS Defined
WorkSTEPS is a comprehensive physical testing program developed by
Larry Feeler, P.T. in 1986. Mr. Feeler marketed the program to industry in
West Texas, primarily in the Odessa/Midland area until 1993 when
WorkSTEPS, Inc. was formed and the program was then marketed to free
standing physical therapy clinics and hospitals throughout Texas and
Oklahoma.
The testing program is the most comprehensive program of its kind. Today
there are more than 226 WorkSTEPS providers in 32 states that provide pre-
employment testing to over 650 companies. There are over 175,000
employment tests in the WorkSTEPS test database.
Each Post Offer Comprehensive Test (POCT) gives the employer a pass or
fail report on each prospective employee tested. The POCT effectively
screens out those individuals who ate physically incapable of safely
performing the job they are being hired. to perform. It virtually eliminates
Worker's Comp fraud and establishes a baseline on each individual tested.
If a tested employee becomes injured on the job, a baseline on that employee
has already been established from his/her pre-employment test. As a result,
a comprehensive rehab program can be developed specifically for the
injured party that zeroes in on the degree of injury. Speculation about the
extent of injury is eliminated, and the injured employee is rehabbed more
etely an' ache opportunity to return to work quicker, luither
comp! reducing the costs related to Workers Comp injuries and claims.
The average employer realizes a reduction in injuries, claims and expenses
by as much as 50% or more the first year the program is implemented.
Outline of Physical Testing Procedures
WorkSTEPS testing is performed at the 403 W. University Drive location.
All testing is conducted by appointment with a waiting time of no more than
thirty minutes after employee arrival.
Job specific testing for each position being tested is developed from a
database of over 175,000 tests. On-site observations and/or interviews may
also be used to develop tests. Copies of testing criteria can be provided to
the City upon request. The comprehensive evaluation includes. range of
motion, posture, joint integrity, strength (back and extremities),
cardiovascular risks profile, blood pressure, heart rate, recovery condition as
well as job simulation components. Vital statistics such as medical history,
weight; hearing and visual acuity are included. Body and lifting mechanics
are studied and a risk profile for overuse syndromes is developed.
All testing meets the standards set forth by the Americans with Disabilities
Act. A detailed evaluation of an individual's functional capabilities to
perform the essential functions of the job is assessed by a certified
technician. Training documentation and certifications are available upon
request and the City is welcome to conduct inspections of the facility at any
time without prior notice. Verbal testing results are available within 24
hours and written results are mailed within two business days. Consultations
services for employees are provided to instruct in proper body mechanics
and lifting techniques if deficiencies are found.
Post-Injury Physicals
Post-injury physicals are offered to assess the extent of employee injury.
These results are compared to the initial pre-employment physical. Return
to work physicals to assess employment readiness are also available.
Executive Physicals
Executive physicals 'are available at the 403 W. University Drive site
Monday through Friday from 8:00 a.m. until 5:00 p.m. This evaluation
includes:
Medical History
Weight and Body Fat Analysis
Resting Electrocardiogram
Cardiac Stress Test
Audiogram
Visual Acuity
CBC, Chem Profile, Lipid Profile, Urinalysis
Spirometry
Physical Exam
A post exam consult is provided to the employee at the time the physical is
completed. Written results are provided to the employee within two
business days. .
Cost-Effectiveness of Pinnacle Diagnostic & Labs
Most test results are available within 45 minutes to two. hours. Priority
testing is always available within 30 to 45 minutes (i.e., police or firefighter
accident). he employee can re urnto work the same ay i the cTrug screen
is negative. Since our facility offers both drug testing and pre-employment
physicals, if the employee cannot pass the drug screen, the physical does not
have to be performed (or paid for).
Collection Site: Pinnacle Diagnostics
403 W. University Dr.
Denton, TX 76201
Hours: Monday - Thursday 8am to 6pm
Friday- 8am to 5pm
Phone: (877) 257-5227 (Toll Free)
(940) 898-1787 (Office)
(940) 323-8666 (fax)
Contacts:
Dr. Troy Hurst- Director of Occupational/Industrial Medicine
Tracey Horner- Operations Manager
Collection Site #2: Pinnacle Diagnostics
Denton Travel Center
6420 N. 1-35W
Denton, TX 76207
Hours: Sunday - Saturday 6am to 6pm
Phone: (800) 426-9060 (Toll Free)
(940) 382-7718
(940)-38Z-7690
Contact: Tracey Horner @ (940) 898-1787
After Hours Collection Site: Denton Community Hospital
207 N. Bonnie Brae
Denton, TX 76201
(940) 898-7192
Contact: Sheri Sager
Any questions regarding invoicing, drug test results, physical results,
and the reporting of these results should be directed to Tracey at
(940) 898-1787. If Tracey is not available Dr. Hurst will also be able
to help answer your questions.
403 W. University Drive , Denton, Texas 76201 • 940.898.1787 • Toll Free 877.257.5227
Organizational Chart
ATTACHMENT. A
CITY OF DENTON, TEXAS
PROPOSAL FORM
OCCUPATIONAL HEALTH SERVICES., CONTRACT NURSE SERVICES, DRUG
TESTING, and PHYSICALS.
Organization Name: Pinnacle Diagnostics
Address of Service Office: 403 w. University Dr. Denton, Tx 76201
(City) (State) . (zip)
Telephone No.: 940)898-1787 FaxNo.: 940) 323-8666
Office Hours: M-Th 8-6 F 8-5 Date Established: . 1997
Principal Contact for This Proposal: Troy Hurst
PRICING
CITY is requesting proposals with pricing submitted either as per service provided or as a flat
annual fee depending upon the Section or Sections of this RFP the PROPOSER is responding to.
A PROPOSER may choose to propose on a Section both' as a flat annual fee or as per service
provided. Each Proposer will provide pricing that reflects the total bottom line fee for Section
proposed. All expected or anticipated costs and expenses will be projected by the Proposer and
included in the fee quoted.
COMPANY QUALIFICATIONS
(Note: If a national or regional company, respond 2nly_for the local branch/office that would
handle CITY's program.)
1. Principal Owner/Owners/Partners and Officers -may-Hurst '-e e'
2. Date Founded/Opened 10/97
3. Total number of full time employees 8
3. Number 98$public entity clients: 49 % of total clientele
4.1 Number of muV pal clients: 1 % of total
clientele
6. Total number of clients: 50
19
7. List four (4) references, public entity clients preferred, including address,
telephone number and contact person. Please indicate length of relationship:
a Denton County 401 W. Hickory 4516
Denton, TX 76201 940) 349-3085 Michelle Gray-1 year
b. Child Protective Services 3730 McKinney
Denton, TX 76208 940) 387-8544 Debra Pohlman-1 year
C. Redi-Mix 1445 MacArthur Blvd. #136 .
Carrollton, TX 75007 972). 242-4550 Sandi McInnish-3 years
City Of Denton 601E. Hickory #A
Denton, TX 76205 940) 349-8344 Carla Romine-3 years
8. Please furnish the following information regarding the personnel at this location
that will provide services to CITY, and their experience.
Troy Hurst
Years of employment with your organization: .8
Years of experience in industry: 7
Years of experience perfoming work relevant to Service Proposed: 7
Licenses, professional designations and/or degrees earned: D . C.
Name: Nicholas Stratsso
1
Years of employment-with your organizatiom
Years of experience in industry: 19
Years of experience perfoming work relevant to Service Proposed: 3
Licenses, professional designations and/or degrees earned: n . c .
Tracey Horner
Years of employment with your organization: 1
Years of experience in industry: 1
Years of experience perfoming work relevant to Service Proposed: 1
Licenses, professional designations and/or degrees earned:
20
Name:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
Years of employment with your organization:
Years of experience in industry:
Years of experience perfoming work relevant to Service Proposed:
Licenses, professional designations and/or degrees earned:
21
9. Attach an Organizational Chart for the specified location where services will be
provided specifying supervisor/management positions/titles/reporting relationships.
10. Provide information regarding any ongoing training that your employees servicing the
CITY will be required to satisfactor ily complete. Indicate if CITY personnel may
attend this training and at what cost, if any.
All employees servicing the CITY will be required to annually
attend OSEA and WorkSTEPS seminars as well as complete any
required training to be certified for DOT collections. All
seminars will be open to any CITY employees who wish to attend.
Prices will vary by seminar.
11. Has anyone filed any. complaint
concerning your organization? .
If "yes", please explain:
12. Describe your documentation procedure for handling customer complaints
Because we are locally awned. and operated, we try to handle any
complaints. race to race Wlth the client. - However,, 1 a is not
a feasible solution toany,situation we will ask the client to please
submit a written comp]ai.nt an the pro em wi a an e to the
best of curability.
13. Will you subcontract any portion of the services you propose to furnish?
[ Yes [ ] No If "yes", give full details below.
MRO services -for DOT drug tests, to. Dr.. James Baber, M.D. because
he is certified by NIDA.. DOT drug test to Quest, because they
are a federally regulated laboratory.
14. Do we have your permission to request an. investigation of your firm's financial
condition, reputation, etc.?
[ Yes[ ] No.
15. Does your organization or do persons within your organization currently have claims
or litigation against the CITY? [ ] Yes [xkNo. If "yes", please explain.
with Texas Workers' Compensation Commission
]Yes [x]No (if applicable)
22
16. Please attach a copy of all licenses and permits you are required to hold in order to
perform the services proposed.
MISCELLANEOUS
1. Have you completed and attached Attachments. [X] Yes [ ] No
2.. Federal tax ID number: 75-2 7 9 5115
I affirm that the information provided herein is correct and that pricing information contained in
this document shall remain a valid offer for 90 days following the deadline date for submission
or if a Proposal is selected, throughout the entire term of the Cpptract.
Dr. Troy Hurst -Director of Occupational/
Industrial Medicine
Type Name.and Title
Date
23
0
ATTACHMENT B
FEESCHEDULE
Seperate sheet/format may be used, but this or seperate fee schedule must be completed and
returned. Failure to complete could result in rejection of proposal.
Occupational Health
Services
Fee per Service
Annual Flat Fee
$(Attach pricing sheet,
TWCC Fee Guidelines, or
simply state that fees will
not exceed TWCC
fee guidelines)
$
Additional Services.
$
$
(list)
Fee per Hour
Annual Flat Fee
Contract Nurse
$
$
Additional Services
$
$
(list)
Drug and Alcohol Testing
Cost per Test (DOT)
Cost per Test (Non-DOT)
Drug sample collection and,
lab testing for original
$ 35
$ 30
sample, including random
selection processes
MRO services for drug
$ . inc.
$ inc.
testing
Testing of split specimen
75
$ _ -75
Drug and alcohol sample
$ Equivalent to
$ Equivalent to
collection after normal
what the hospital
what the hospital
business hours
charges
charges
Preferred Services
Cost Itemization
EBT alcohol testing,
$ 15
$ 15
including random selection
processes
Substance Abuse
$ n/a
n/a
Professional Services
Educational Training for
$ i
Employees
nc.
inc.
Optional Services Provided
$ 70 (hair analysis)
$70 (hair analysis)
(Drug testing costs should include all supplies, collection materials, equipment, and
administrative activities as outlined in the scope of service)
24
Physicals
Cost per Test
Post Offer Physical Exam
$ 125
Post Injury Test
$ 125
Functional Capacity Evaluation
$ 43 per 15 min.. (TWCC
guideli
Executive Physical
$ 300
Optional Services Provided
$
ies)
25
w
s
A
It --u
w ~U
1 C
k
/
w
~y .--t - G
~6
' 1 Jr
11
Y
yrr
1y
l}~
~
fyywy~~
+
11
♦w
iy
~i
y
.y
t3 1
.M~
A
u w ~
~
m G
is
1
Fireman's Fund Insurance Company
National
Chiropractic
Council
Declarations to G9aians-Blade Professional ]Liability Policy
Named ImurediCertificate Holder:
Cortifioatc No:
Master Policy Held By:
Policv tio:
Professional Services:
Exclusions:
Limitations:
Territory:
Individual Deductible per claim:
Endorscmcnt(s):
Lu its of Liability:
Total Annual Premium:
Premium Based On:
Payment Term : Plan Type:
Lapse Dates:
Retroacdw Date:
Policy Period:
Troy Michael Hurst, D.C.
132098.3326
National Chiropractic Council
395.03-NCC (H0694) - Elite
Chiropractic
As stated in Section V of Endorsement to Policv
None
Tx
;gone'
Chiropractic (FF0694)
51,000,000 00 Each Claim/ S3,000,000,00 .kggregate
S985.00
Annual Reporting Period
Quarterly: Q3-4
None
1%2'98
From: 7 201 To: 72:02
(All dates are at 12:01 a.m. Fit address of Named Insured as stated herein. This Declarations page covers one year
policy period ending on Expiration Date,)
Countersigned by:
(DWSPC AN Al iighra Raearvad, Pw,. Aug~[ Zi, 2000 Page. t of 2 1400034
. .'.'.is;vnr2.n: FY'+"e'ACC.'Yrrs'arn;pr.~.
DECLARATIDNS RENEWAL DECLARATION
SPECIAL FORS} CUSTOMIZER POLICY NO. 0"49.761270 07731
t. The insured
TROY HURST OBA NOR-TEX REHAB C PAIN CLINIC
Mailing g Address 403 W UNIVERSITY DR
DENTON TX 76201
LOCATION OF INSURED PREMISES
403 W UNIVERSITY OR DENTON TX 76201
MASONRY OFFICE BUILDING
2. Policy Period From JUL 31s 2002 To JUL 319 2063
BEGINNING AND ENDING 12 01 A.M.• STANDARD TIME AT THE ADDRESS OF THE
INSURED STATED ABOVE
3. The insured is AN INDIVIDUAL
.4. Additional Interests
This policy also covers the interests of any of the following when Indicated by an "X" and named below.
The Mortgagee, under The Loss Payee, under Other
Coverage A - Part One X Coverage A - Part Two
The Additional Insured for Leased Premises, under The Vendorunder
Coverage B - Part One Coverage B - Part One
Name **PLEASE REFER TO THE ATTACHED NOTICE.**
Address
5. Policy Coverage provided
This policy applies to each of the Coverages and Parts shown below. Under Coverage A, Coverage Is provided only for property at the Insured
Premises for which a specific limit of liability Is shown. .
- -
COVERAGE A- Business Property
Part
Buildings
Limits of Liability
One
The Property Insurance
Adjustment Condition IS NOT applicable to this policy
$
Two
-
Business REPLACEMENT COST
Contents
-
.150#000
$
-
DEDUCTIBLE. $ 250. Applicable to each adjusted loss.
COVERAGE B - Business Uabllity -
Part
TRIO -
- UmIts of Liability
One
Comprehensive Liability -
-
$ lp00040QO Each Accidental
Event
Fire and Specified Peril Legal Liability
- -
EachAccidental
$ 501 000 Event
Advertising Injury Liability
$ 100,000.
Two
Medical Payments
$ $5,000 Each Person
25,000 Each Accident
~6. Optional Coverages
The following optional coverages, If any, are provided under this policy.
T.
Loc. No.
Coverage
Part
. Title - -
001 001
001DU1
A
B
4
XTERIOR BLDG. GLASS
DDITIONAL INSURED
Annual Premium for the Policy and Optional Coverages $ 1'006. DO-
B. Endorsements: The following endorsements amend this policy.
N
-U55513As BU5575 A-1• BU57 40-l tb U5756-PBU5576-1 * BU5728
7 L
O) W
H
b
a~.
a
0
V
N
V
V
cn
E-74
O
U ~
W ~
a"
U
w N
V
0
a~
:
911/2
WN
U
U
1--1
4)
4-1
0
U
v
10
MO
F~4
N
U
O
U
M~
W
w
U
0
0
cv
0
c~
ti
a~
y
a
°
G
o.
a
a
U
E
oa
O
v
v
V
.ti
W
'N
of
v
O
~N
o~
.~a
Cl ~
O
V
u
y
4
44
0
N
H.1
Z~ m
V y
v
C
. N
O
O
N
NH
C3
0
3
~o
a~
c~
~ o
01 0
U