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Agenda 02/09/2016 Item #16E 1 2/9/2016 16.E.1. EXECUTIVE SUMMARY Recommendation to award ITB 15-6474R, "Medical Oversight Physician (Part A) for Collier County and Employment Physicals & Drug Testing (Part B)" to Advance Medical of Naples, LLC. OBJECTIVE: To provide medical oversight for the County's Occupational Health Program. CONSIDERATION: Collier County uses a contracted medical services provider to act as the Medical Oversight physician for the Occupational Health staff, to evaluate designated post job offer candidates, and to provide active employee physical evaluations and required drug testing as needed. The current contract, 11-5699,expires upon full execution of 15-6474R. On October 27,2015,the Procurement Service Division posted formal notice for ITB 15-6474R, a two-part solicitation,to seven hundred and eighty eight(788)vendors;twenty-four(24)notices were downloaded and three(3)bids received. The table below summarizes the bids. Unit of Measure Advance Medical Millennium NCH Part A-Medical Director $10,000 $27,600 $15,000 Part B-Employment Physicals 3,179 $124,083.50 $194,880.58 $195,290.00 and Drug Testing Total 3,179 $134,083.5 $222,480.58 $210,290.00 To evaluate the bids, staff forecasted the estimated cost of service under the new bid using the actual number of tests performed in FY 2014 and the estimated number of new, additional tests now recommended/required for various job positions in the County. Staff designed the program to allow pre-employment physicals performed under the program to also meet the qualifier requirement under the Group Health Plan,thus eliminating duplication and saving money. Based on the estimated first year use of the contract,Advance Medical Center,LLC,was determined to be the lowest,qualified and responsive bidder for Part A and Part B of this solicitation. FISCAL IMPACT: Funds are budgeted annually in the Workers' Compensation (Fund 518) budget and Group Health and Life (Fund 517) budget and department budgets for required physicals and drug tests. Total funds expended are dependent upon the need for services.First year estimated cost for this contract is $134,084;however, actual expenditures are based on number and types of services and tests conducted. LEGAL CONSI ERATIONS: This item is approved as to form and legality, and requires majority vote for Board approval.—CMG RECOMMENDATION: That the Board of County Commissioners awards ITB 15-6474R "Medical Oversight Physician (Part A) for Collier County and Employment Physicals & Drug Testing (Part B)" to Advance Medical Center of Naples, LLC and authorizes the Chairman to execute the attached County Attorney approved agreement. Prepared by: Gary Troy,Occupational Health Nurse Attachments: Attachment A:Bid Tabulation Attachment B:Agreement No. 15-6474R /*"1 Attachment C: Solicitation No. 15-6474R Packet Page-530- 2/9/2016 16.E.1 . COLLIER COUNTY Board of County Commissioners Item Number: 16.16.E.16.E.1. Item Summary: Recommendation to award ITB 15-6474R, "Medical Oversight Physician (Part A) for Collier County and Employment Physicals & Drug Testing (Part B)" to Advance Medical of Naples, LLC in the estimated annual amount of$134,083.50. Meeting Date: 2/9/2016 Prepared By Name: WalkerJeff Title:Division Director-Risk Management,Risk Management 12/30/2015 8:02:57 AM Submitted by Title: Division Director-Risk Management,Risk Management Name: WalkerJeff 12/30/2015 8:02:58 AM Approved B pP By Name: CrouchJason Title:Procurement Specialist,Procurement Services Date: 12/30/2015 4:52:26 PM Name: JohnsonScott Title: Manager-Procurement,Procurement Services Date: 1/3/2016 7:38:52 PM Name: pochopinpat Title: Operations Coordinator,Administrative Services Department Date: 1/5/2016 4:47:47 PM Name: MarkiewiczJoanne Title: Division Director-Procurement Services,Procurement Services Date: 1/7/2016 10:07:58 AM Packet Page -531- 2/9/2016 16.E.1 . Name: GreeneColleen Title:Assistant County Attorney, CAO General Services Date: 1/20/2016 2:59:42 PM Name: PriceLen Title: Department Head-Administrative Svc,Administrative Services Department Date: 1/22/2016 1:38:13 PM Name: GreeneColleen Title: Assistant County Attorney, CAO General Services Date: 1/26/2016 9:14:47 AM Name: WellsLaura Title: Management/Budget Analyst, Senior, Office of Management&Budget Date: 1/26/2016 5:06:37 PM Name: KlatzkowJeff Title: County Attorney, Date: 1/29/2016 8:25:50 AM Name: CasalanguidaNick Title: Deputy County Manager, County Managers Office Date: 1/31/2016 12:51:05 PM Packet Page -532- 1 2/9/2016 16.E.1 . Vendors Salkited:7ge ^t BID TAB 15-6474R Medical Director for Collier County and Employment Physicals&Drug Testing(Part A and Part B) Specs oaxnlozded:as Submittals Received:3 Item Number -.`'.Advance:.Medical : Millennium NCH PART A:Medical Director Services Annual Cost: 0 $ 10,00000 $ 27,600.00 5 11,000.00 Estimated Expected Item Number Part B.Item Description Unit of Measure Volume Price Each Expected Annual Cost Price Each Expected Annual Cost Price Each Expected Annual Cost 1 Pre-Placement Employment Physical ea 121 $ 80.00 5 9,680.00 $ 45.00 5 5,445.00 595.00 $ 11,495.00 2 Pre-Placement Physical W/CDL Physical ea 34 $ 85.00 $ 2,890.00 $ 95.00 $ 3,230.00 $95.00 $ 3,230.00 3 Firefighter Physical ea 70 $ 80.00 $ 5600.00 $ 125.00 $ 8,750.00 $95.00 $ 6,650.00 4 Respirator Medical Clearance Evaluation ea 30 $ .11000 $ : 3,300.00:$ 150.00 $ 4,500.00 $95.00 $ 2,850.00 5 SCUBA DMng Medical Examination and Certification 3 $ 80.00 $.: 240.00 $ 125.00 $ 375.00 $95.00 S 285.00 6 CDL Physical(DOT) ea 4 $ 90.00 $ :.:360.00 $ 125.00 $ 500.00 $95.00 5 380.00 7 Fitness for Duty Examination 9 5 170.00 $` 1,530.00 5 65.00 $ 585.00 $95.OD $ 855.00 8 Asbestos Medical Examinations and Consultations ea 0 $ 150.00 5.... - $ - $95.00 $ - 9 laboratory Work ea 181 $ 1500 $ 4715.00 $ 33.97 $ 6,148.93 $85.00 $ 15,385.00 10 Creatinine ea 186 $ 050 $ ::93.00. S 8.36 $ 1,555.70 $10.00 $ 1,860.00 11 BUN ea 177 $ 0.50 $ -88.50 $ 6.44 5 1,140.59 $10.00 $ 1,770.00 12 TSH Levels Test ea 70 $ `: 10.00 $ 700.00 $ 27.44 5 1,921.08 $38.00 $ 2,660.00 13 C-Reactive Protein ea 70 $ 800 $ 560.00. $ 21.14 $ 1,480.08 $12.00 $ 840.00 14 Heavy Metals Test-Blood Panel Test(Arsenic,Cadmium,Lead,Mercury) ea 89 $ 12500 $ 11,125.00 $ 66.62 $ 5,929.54 $100.00 $ 8,900,00 15 Heavy Metals Test-Blood-Aluminum ea 89 $ "'1800 $ 1,602.00:$ 41.60 $ 3,702.76 $30.00 $ 2,670.00 16 Heavy Metals Test-Blood-Antimony ea 89 $ 89.00.$ 7,921.00.$ 30.76 $ 2,737.28 $89.00 $ 7,921.00 17 Heavy Metals Test-Blood-Bismuth ea 89 $ 81:00 $ 7,209.00 $ 35.87 $ 3,192.25 530.00 5 2,670.00 18 Heavy Metals Test-Blood-Chromium ea 89 $ 2300 $ .2,04700 $ 3112 $ 2,947.68 $30.00 $ 2,670.00 19 Heavy Metals Test-Blood-Copper ea 89 $ 900 $ .801.00$ 20.27 $ 1,803.85 $66.00 $ 5,874.00 20 Heavy Metals Test-Blood-Nickel ea 89 $ ::..7900 $ : 7831.00 $ 9.28 $ 825.56 579.00 $ 7,031.00 21 Heavy Meals Test-Blood-Zinc ea 89 $ :9.00 $ 801.00 $ 18.60 $ 1,655.40 530.00 5 2,670.00 22 HbA1c ea 70 $ :'.8.00 $ 560.00 $ 15.85 $ 1,109.64 $30.00 $ 2,100.00 23 RBC Cholinesterase ea 70 $ -:2700 $ -. : 1,890.00. $ 234.54 $ 16,417.80 $41.00 $ 2,870.00 24 Polychlorinated Biphenyls ea 70 $ '.3580 $ 2,450.00.$ 275.00 $ 19,250.00 $116.00 $ 8,120.00 25 Blood Alcohol Test ea 0 $ "::45.00.$ - $ - $24.00 $ Breath Alcohol Test-(Administered by a Breath Alcohol Technician 26 meeting DOT Qualifications Only) ea 0 $ 4500 $ $ 200.00 $ - $75.00 5 - 27 Arsenic-Urine ea 70 $ .:.1700 $ .1,19800 $ 30.98 $ 2,168.88 549.00 $ 3,430.00 28 Mercury-Urine ea 70 $ 9700 $ '..:. "2,59000 $ 30.98 $ 2,168.88 544.00 $ 3,080.00 29 PPD Testing w/Reading(Induration measurement) ea 31 $ 1000 $ ':310.00 $ 101.22 $ 3,137.82 530.00 $ 930.00 30 Chest x-ray(2-view) ea 75 $ 5000 S .3,750:00.$ 45.00 $ 3,375.00 550.00 $ 3,750.00 31 Chest x-ray(4-view) ea 0 $ 9500,$ $ 64.64 $ - $65.00 $ - 32 Chest CTw/contrast ea 0 $_`. 475.00 $.:.. - $ 273.70 $ - $475.00 $ 33 Chest CT without contrast ea 0 $ 450.00 $': $ 214.96 $ - $405.00 $ - Audiometric Screening Test(pure tone air only)with interpretation 34 (Audiogram)per OSHA's Occupational Noise Exposure Standard-CFR '.. 1910.95. ea 177 $ 1.00 $ 177.00 $ 115.31 $ 20,40952 $50.00 $ 8,850.00 35 Pulmonary Function Test(with interpretation) no 137 $ 30.00 $. 4,110.00 5 76.63 $ 10,498.58 $55.00 $ 7,53500 `, 36 Drug Screen w/MRO-DOT 5 Panel(Collected per DOT Urine Specimen Collection Guidelines-49 CFR Part 40) ea 33 $ 35.00 $ 1,155.00 $ 40.00 $ 1,320.00 $35.00 $ 1,155.00 37 Drug Screen w/MRO-MRS Panel ea 186 $ 26.00. $ 4,836.00 $ 45.00 $ 8,370.00 527.00 $ 5,022.00 38 Drug Screen w/MRO-HR510 Panel no $ 4700 $ -. $ 55.00 $ - $36.00 $ - 38 Hepatitis Panel Test ea $: -80 00 $ 320.00 $ 13.33 $ 53.33 $100.00 $ 400.00 40 Measles,Mumps,Rubella Vaccination(MMR) ea $ 8580 $ $ 99.37 $ - $94.00 $ - 41 MMR Titer ea 4 $ .2500 $ 850.00 $ 58.45 $ 1,987.44 $256.00 $ 8,704.00 42 Mumps Vaccination ea $: ..::7500 $ 5 - $22.00 $ - 43 Mumps Titer ea $. .:45.00 $ • $ - $9200 $ - 44 Measles Vaccination ea $ 75.00 $ -.. $ - $19.00 $ 45 Measles Titer no $ 45.00 $ -. - $ - $82.00 $ - 46 Varicella Vaccination(Price per injection) ea $ 15500 $- - $ - $163.00 $ - 47 Varicella Titer ea 3 $ 1800 $ 612.00 $ 42.07 $ 1,430.45 534.00 $ 1,156.00 48 Hepatitis A Vaccination Series(Price per injection) ea $ '..75.00.$ $ 15533 $ - $35.00 $ - 49 Hepatitis B Vaccination Series(Price per injection) ea 0 $ '45.00..$ 900.00 $ 24656 $ 4,931,28 $40.00 $ 800.00 50 Hepatitis Titer(if previously immunized) ea 8 $ -.16.00 $ 768.00.. 5 24.48 $ 1,175.04 $35.00 $ 1,680.00 51 HIV S&2 Antibody Test ea $ 32.00 $ $ - $15.00 $ - 52 Pre-exposure Rabies Vaccination Series(Price per injection) ea 3 $ '.29800 $ : 3,770.00:$ 314,83 $ 4,092.82 $234.00 $ 3,042.00 53 Rabies Titer(if previously immunized) ea $ 3500 $ 3580 $ 21.04 $ 21.04 $85.00 $ 85.00 54 Tetanus/diphtheria Vaccination ea $ ':.28.00 $ 25280 $ 105.28 $ 94755 $35.00 $ 315.00 55 Tdap Vaccination ea $ 5500 $ - $ - $45.00 $ - 56 ERG-12 Lead(with interpretation and physician confirmation) ea 111 $ :4000 $ 4,440.00 $ 22.00 $ 2,442.00 $50.00 $ 5,550.00 57 Cardiac Stress Test(with interpretation and physician confirmation) ea 109 $`- 13500.$ 14,71580 $ 92.00 $ 10,028.00 $150.00 $ 16,350.00 $8 Echocardiogram(with interpretation and physician confirmation) ea 70 5'. 110.00 $ 7,700.00.. $ 27255 $ 19,07850 $285.00 $ 19,950.00 59 Prostate Exam ea 60 $ 100 $ 60.00 $ 24.50 $ 1,470.24 $25.00 $ 1,500.00 60 PAP Test ea 10 $: 35.00 $s`. 350.00 $ 57.11 $ 571.08 $25.00 $ 250.00 PART B:Employment Physicals&Drug Testing Cost: 61 Totals 3,179 $ 124,08350 $ 194,880.58 $ 195,290.00 62 Total of Part A&Part B $ 134,08350 $ 222,480.58 $ 210,290.00 Advance Medical Millennium NCH Yes No Yes No Yes No 63 Do you have an MRO? x..:. X x Does your Medical Director meet the qualifications outlined in the Scope 64 of Work? x x 0 65 Can you perform all tests as specified In the Scope of Work? x x x 66 Can you perform the Prostate Exam? x x x 67 Can you perform the PAP Test? o - x x Required Submittals Advance Medical Millennium NCH Vendors Check Ust Bid Response Form x x Local Vendor Preference Affidavit x - x Local sTax Receipt Immigration Affidavit Solicitation Substitute W-9 Insurance Statement 0 x Florida Division of Medical Quality Assurance ticensure E-verify x MRO Ucensure x-.. x Opened by:Jason Crouch,Procurement Strategist Witnessed by:Camille Shim-Madnos,Procurement Technklan Pmlect Manager:Gary Troy Packet Page -533- 2/9/2016 16.E.1 . AGREEMENT 15-6474R for "Medical Director for Collier County and Employment Physicals and Drug Testing" THIS AGREEMENT, made and entered into on this day of 2016,by and between Advance Medical of Naples, LLC, authorized to do business in the State of Florida, whose business address is 720 Goodlette Road, N. Suite 500, Naples, FL 34102 (the "Provider") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. CONTRACT TERM. The contract shall be for a one (1) year period, commencing on date of Board of County Commissioners approval and terminating on one (1)year from that date or until all outstanding Purchase Orders issued prior to the expiration of the Agreement period have been completed or terminated,not to exceed six(6) months. The County may, at its discretion and with the consent of the Provider, renew the Agreement under all of the terms and conditions contained in this Agreement for three (3) additional one (1) year periods. The County shall give the Provider written notice of the County's intention to renew the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Provider written notice of the County's intention to extend the Agreement term not less than thirty (30) days prior to the end of the Agreement term then in effect 2. COMMENCEMENT. The Provider shall commence services upon the issuance of Purchase Order. 3. STATEMENT OF WORK. The Provider shall provide Medical Director for the Collier County Occupational Health Program (Part A) and Employment Physicals and Drugs Testing (Part B) services in accordance with Exhibit A, Scope of Services, attached hereto, the terms and conditions of ITB #15-6474R and the Provider's proposal, referred to herein and made an integral part of this Agreement Packet Page-534- 2/9/2016 16.E.1 . This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County Purchasing Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 4. THE CONTRACT SUM. The County shall pay the Provider a not-to-exceed annual amount of Ten Thousand Dollars ($10,000.00), to be billed and paid in the form of monthly lump sum installments for services related to Medical Director of Collier County Occupational Health Program(Part A). For Employment Physicals and Drugs Testing (Part B), the County shall pay the Provider for the services provided to the County, in accordance with the attached Exhibit B - Price Schedule. 4.1. Payment(s) will be made upon receipt of a proper invoice and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". 4.2. Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of contract. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. 5. SALES TAX. Provider shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212,Florida Statutes,Certificate of Exemption#85-8015966531C-2. 6. NOTICES. All notices from the County to the Provider shall be deemed duly served if mailed or faxed to the Provider at the following Address: Advance Medical of Naples, LLC 720 Goodlette Road, N. Suite 500 Naples, FL 34102 Telephone: 239-566-7676 Facsimile: 239-254-3105 All Notices from the Provider to the County shall be deemed duly served if mailed or faxed to the County to: 2 Packet Page-535- CA 2/9/2016 16.E.1 . Collier County Government Center Procurement Services Division 3327 Tamiami Trail, East Naples,Florida 34112 Attention:Joanne Markiewicz, Director,Procurement Services Division Telephone: 239-252-8407 Facsimile: 239-252-6480 The Provider and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Provider or to constitute the Provider as an agent of the County. 8. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Provider. The County will not be obligated to pay for any permits obtained by SubProviders/SubProviders. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Provider. The Provider shall also be solely responsible for payment of any and all taxes levied on the Provider. In addition, the Provider shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Provider agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Provider. 9. NO IMPROPER USE. The Provider will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Provider or if the County or its authorized representative shall deem any conduct on the part of the Provider to be objectionable or improper,the County shall have the right to suspend the contract of the Provider. Should the Provider fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Provider further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 3 Packet Page -536- CA 2/9/2016 16.E.1 . 10. TERMINATION. Should the Provider be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non-performance. In the event that the County terminates this Agreement, Provider's recovery against the County shall be limited to that portion of the Contract Amount earned through the date of termination. The Provider shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Provider agrees that there shall be no discrimination as to race,sex,color,creed or national origin. 12. INSURANCE. The Provider shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of$500,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. n B. Business Auto Liability: Coverage shall have minimum limits of $500,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-Ownership. C. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $500,000 for each accident. D. Medical Professional Liability: Coverage shall have minimum limits of $250,000 Per Occurrence, $750,000 aggregate. E. Medical Malpractice: Coverage shall have minimum limits of $1,000,000 Per Occurrence. Special Requirements: Collier County Government shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Provider during the duration of this Agreement. The Provider shall 4 Packet Page -537- �J 2/9/2016 16.E.1. provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County ten (10) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: ten (10) days prior written notice, or in accordance with policy provisions. Provider shall also notify County, in a like manner, within twenty- four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Provider from its insurer, and nothing contained herein shall relieve Provider of this requirement to provide notice. Provider shall ensure that all subProviders/sub-Providers comply with the same insurance requirements that he is required to meet. 13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Provider shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, whether resulting from any claimed breach of this Agreement by Provider, any statutory or regulatory violations, or from personal injury, property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Provider or anyone employed or utilized by the Provider in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. n This section does not pertain to any incident arising from the sole negligence of Collier County. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Provider, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Provider's obligation to indemnify and defend under this Article 13 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. • 14. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Risk Management Division. 15. CONFLICT OF INTEREST. Provider represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Provider further represents that no persons having any such interest shall be employed to perform those services. 5 Packet Page-538- 6� 2/9/2016 16.E.1 . 16. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the following component parts, all of which are as fully a part of the contract as if herein set out verbatim: Provider's Proposal, Insurance Certificate(s), Bid #15-6474R Scope of Services, any Addendum/Addenda, Exhibit A, Scope of Services, Exhibit 13- Price Schedule, and Exhibit C, Business Associate Agreement. 17. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 18. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the individual and/or firm for cause. 19. COMPLIANCE WITH LAWS. By executing and entering into this agreement, the Provider is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety (including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes), and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(d) and (3) stated as follows: (2) In addition to other contract requirements provided by law, each public agency contract for services must include a provision that requires the Provider to comply with public records laws, specifically to: (a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the service. (b) Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 6 Packet Page -539- 3 2/9/2016 16.E.1. (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. (d) Meet all requirements for retaining public records and transfer,at no cost, to the public agency all public records in possession of the Provider upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. (3) If a contractor does not comply with a public records request, the public agency shall enforce the contract provisions in accordance with the contract. If Provider observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Provider to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 20. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County .� encourages and agrees to the successful proposer extending the pricing, terms and conditions of this solicitation or resultant contract to other governmental entities at the discretion of the successful proposer. 21. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement • shall remain in effect. 22. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this contract in compliance with the Purchasing Ordinance, as amended, and Purchasing Procedures. 23. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Provider with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement,the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Provider with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at 7 Packet Page -540- (6.1) 2/9/2016 16.E.1 . mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102,Fla. Stat. 24. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 25. KEY PERSONNEL. The Provider personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Provider shall assign as many people as necessary to complete the services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet the required services. The Provider shall not change Key Personnel, including the Medical Director, unless the following conditions are met: (1) Proposed replacements have substantially the same or better qualifications and/or experience; and (2) that the County is notified in writing as far in advance as possible. The Provider shall make commercially reasonable efforts to notify Collier County within seven (7) days of the change. The County retains final approval of proposed replacement personnel. 26. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the ITB 15-6474R, the Provider's Proposal, and/or the County's Board approved Executive Summary, the Contract Documents shall take precedence. 27. ASSIGNMENT. Provider shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Provider does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Provider all of the obligations and responsibilities that Provider has assumed toward the County. s Packet Page -541- 0 2/9/2016 16.E.1 . IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized .—. person or agent, have executed this Agreement on the date and year first written above. BOARD OF COUNTY COMMISSIONERS ATTEST: COLLIER COUNTY,FLORIDA Dwight E. Brock,Clerk of Courts By: By: ,Chairperson Dated: (SEAL) Advance Medical of Naples,LLC Provider By: First Witness Signature TType/print witness nameT TType/print signature and titlet Second Witness TType/print witness nameT .proved as to Form and Legality: Assistant County Attorney Print Name 9 Packet Page -542- 2/9/2016 16.E.1 . EXHIBIT A SCOPE OF SERVICES The services to be provided by the Provider shall include, but are not limited to those listed below. The County shall order services as required, but makes no guarantee as to the quantity,number and type of services that will be ordered or required by this agreement. The services to be provided by the Provider for Medical Director for Collier County (Part A) consist of: Part A: The Provider shall provide Medical Director Services for the Collier County Occupational Health Program as may be required by the Collier County Manager's Agency and its participating agencies, located in Naples, Florida These programs are be available to all Regular, Temporary and Seasonal Employees of the County Manager's Agency of Collier County and its participating agencies, which currently include,but are not limited to: County Attorney, Airport Authority, and Pelican Bay Services. This contract does not include the Collier County Sheriff's Staff and employees nor the Collier County Clerk of the Court's staff as they have separate contracts. The County has a total of approximately one thousand nine hundred and forty (1,940) employees, subject to change. The Provider shall ensure that the physician providing services is a licensed doctor of medicine or osteopathy who has completed residency training in an accredited medical training program and/or is American Boards of Medical Specialties (ABMS) or American Osteopathic Association (AOA) certified, and must possess certification as a Medical Review Officer (MRO). The physician shall be knowledgeable and/or have a background that includes, but is not limited to; Occupational Medicine,OSHA Standards, NFPA 1582 and 1583 Standards, Florida Workers' Compensation Statutes, DOT Agencies - FAA/FTA/FMCA and USCG drug and alcohol testing regulations. In the event that the Provider to provide listed services is unavailable, an on call physician of similar qualifications shall be designated to provide such services. The services to be provided by the Provider also include,but are not limited to the following: 1. Review, recommend&approve standing medical orders &protocols. 2. Provide a written recommendation for an employee or prospective job candidate's ability to wear a respirator based on OSHA's Respiratory Protection Standard - CFR1910.134. 3. Provide services per OSHA's Occupational Noise Exposure Standard-CFR 1910.95. 4. Consult and recommend pre-placement evaluation criteria &findings. 5. Consult on work related injuries &illnesses. 6. Consult on"fitness for duty" evaluations. 10 Packet Page -543- CI)� 2/9/2016 16.E.1 . 7. Medical Review Officer (MRO): review and consultation of drug related tests. Reports and Records: All medical reports shall be the sole property of Collier County and may not be used or reproduced in any form without the explicit written permission of the County. The Provider shall maintain complete records on each individual examined/treated. Such records shall remain confidential in compliance with all HIPPA regulations and will be made available only to the County's representative and/or the individual. No information, record, report or data derived, compiled, obtained, prepared or developed by the Provider from work performed pursuant to the contract may be released, disseminated or disclosed without written consent of the County. All medical reports and records shall be formally transferred to the County by the Provider within five (5)working days after the receipt of a contract termination notice. The services to be provided by the Provider for Employment Physicals and Drug Testing (Part B) consist of: Part B: A comprehensive pre-employment physical and drug testing program to benefit Collier County and reduce liability to the County. This program will ensure the proper placement of employees based upon physical capabilities related to essential functions of n County positions. Also included will be reassessment of appropriate County employees on a designated basis. This program will ensure the health of County employees and potential County employees. The Provider shall ensure that the physician providing and/or overseeing services is a licensed doctor of medicine or osteopathy who has completed residency training in an accredited medical training program and/or is American Boards of Medical Specialties (ABMS) or American Osteopathic. Association (AOA) certified. The physician shall be knowledgeable and/or have a background that includes, but is not limited to; Occupational Medicine, OSHA Standards, NFPA 1582 and 1583 Standards, Florida Workers' Compensation Statutes, DOT Agencies - FAA/FTA/FMCA and USCG drug and alcohol testing regulations. Specific requirements include: 1. The Occupational Medical Services Program will be designed to provide the medical services listed. The Provider shall provide weekend and extended hours of operation and shall be staffed with appropriately trained and qualified medical personnel. 2. Clinical Activities: The following are the activities that shall be required of the Provider. This list includes the core function and major emphasis of clinical activities to be performed. Lab results, medical findings and recommendations shall be reviewed with the examinee. 11 Packet Page -544- b� 2/9/2016 16.E.1 . A. Pre-Placement Employment Physical: A basic occupational and medical history is reviewed with an occupational physical exam. (A Respirator Medical Clearance Evaluation may also be required based on job classification.) The medical determination of ability to work is assessed based on the job classification specifications. A vision exam (near & far acuity, color, depth perception) will be conducted with this physical at no charge. Ancillary tests to determine medical clearance (i.e., drug testing, blood alcohol, CBC, lipid panel) are reimbursed per fee schedule. B. Pre-Placement Physical W/CDL Physical: The candidate's medical history is reviewed. (A Respirator Medical Clearance Evaluation may also be required based on job classification.) The medical examiner, conducts a physical that evaluates the candidate's medical condition for employment and CDL medical certification. The physician completes the pre-employment physical form and the Department of Transportation medical physical form. Laboratory results are reviewed. A vision screen and urine dipstick is conducted at no additional charge. The DOT card is issued. C. Firefighter Physical: A comprehensive medical history review and physical evaluation is conducted in accordance with the recommendations of NFPA 1582. (A Respirator Medical Clearance Evaluation and Fitness Plan per NFPA 1582 Guidelines, is included as part of the physical evaluation.) This physical shall be conducted in a manner that permits the physician to review the findings of all components (labs, tests...etc) of the physical and review those findings and any recommendations with the firefighter candidate / employee. D. Respirator Medical Clearance Evaluation: A respiratory health questionnaire and medical history is reviewed by a physician, nurse practitioner or physician's assistant per the OSHA Standard - CFR 1910.134. The physical examination with interpretation of spirometry and ancillary tests will assess the ability to wear a respirator. A written medical recommendation shall be provided per the OSHA Standard - CFR 1910.134. A vision exam will be included at no charge. Spirometry testing is included. Ancillary tests at the published fee schedule can augment this physical assessment. E. SCUBA Diving Medical Examination and Certification: A medical history is reviewed and a physical examination with required ancillary testing is conducted to determine issuance of a diving certification. F. CDL Physical (DOT): The Department of Transportation Medical Examination Report for commercial driver fitness determination is conducted in accordance with DOT regulations and requirements. A Medical Examiners Certificate (DOT Card) will be issued after successful completion of this physical. G. Fitness for Duty Examination: The selected vendor shall perform any fitness for duty examinations requested by the County Occupational Health Nurse or County Human Resources Department. The fitness for duty examination content shall be determined by the physician based on the job classification requirements. A complete medical report shall be 12 Packet Page -545- 2/9/2016 16.E.1 . forwarded to the County Occupational Health Nurse within one (1) working day of the completion of the examination. H. Asbestos Medical Examinations and Consultations: The selected vendor shall provide medical examinations and consultations following the requirements of the Asbestos Standard CFR 1926.1101. This examination shall include a Respirator Medical Clearance Evaluation. I. Laboratory Work:The following tests shall be performed for an all-inclusive fee: • Comprehensive Metabolic Panel with Lipids • Complete Blood Count(CBC) w/Platelet, Auto Differential • Urinalysis Chemistry • Creatinine • BUN • TSH Levels Test • C-Reactive Protein • Heavy Metals Test- Blood Panel Test(Arsenic,Cadmium, Lead, Mercury) • Heavy Metals Test-Blood- Aluminum • Heavy Metals Test-Antimony • Heavy Metals Test-Blood-Bismuth • Heavy Metals Test-Blood-Chromium • Heavy Metals Test- Blood-Copper • Heavy Metals Test-Blood-Nickel • Heavy Metals Test-Blood Zinc • HbA1c • RBC Cholinesterase • Polychlorinated Biphenyls • Blood Alcohol Test • Breath Alcohol Test - (Administered by a Breath Alcohol Technician meeting DOT Qualifications Only) • Arsenic - Urine • Mercury- Urine • PPD Testing w/Reading (Induration measurement) • Chest x-ray (2-view) • Chest x-ray (4-view) • Chest CT w/contrast • Chest CT without contrast • Audiometric Screening Test (pure tone air only) with interpretation (Audiogram) per OSHA's Occupational Noise Exposure Standard-CFR 1910.95. • Pulmonary Function Test(with interpretation) • Drug Screen w/MRO - DOT 5 Panel (Collected per DOT Urine Specimen Collection Guidelines -49 CFR Part 40) • Drug Screen w/MRO-HRS 5 Panel • Drug Screen w/MRO- HRS 10 Panel 13 Packet Page -546- 0 2/9/2016 16.E1. • Hepatitis Panel Test • Measles, Mumps,Rubella Vaccination (MMR) • MMR Titer • Mumps Vaccination • Mumps Titer • Measles Vaccination • Measles Titer • Varicella Vaccination(Price per injection) • Varicella Titer • Hepatitis A Vaccination Series (Price per injection) • Hepatitis B Vaccination Series (Price per injection) • Hepatitis Titer (if previously immunized) • HIV 1 &2 Antibody Test • Pre-exposure Rabies Vaccination Series (Price per injection) • Rabies Titer(if previously immunized) • Tetanus/diphtheria Vaccination • Tdap Vaccination • EKG-12 Lead (with interpretation and physician confirmation) • Cardiac Stress Test (with interpretation and physician confirmation) • Echocardiogram (with interpretation and physician confirmation) • Prostate Exam • PAP Test J. Medical Services Not Listed: Medical services (labs, tests, immunizations, etc) not listed in this document shall be permitted upon review and authorization by the County Occupational Health Nurse. K. Pre-employment Physical Examinations: Pre-employment examinations will usually be scheduled on short notice. Appointments may be requested for the same day or the following business day. The medical examination and review of the collected medical and occupational history must be performed by a licensed physician, nurse practitioner or physician's assistant, preferably experienced in occupational health. Routine measurements, laboratory specimens and x-rays may be taken by paramedical personnel. Written confirmation of the examination results must be provided to the County Occupational Health Nurse, or designated person, within twenty-four (24) hours. This confirmation must identify any concerns and/or accommodation recommendations. L. Reports and Records: All medical reports shall be the sole property of Collier County and may not be used or reproduced in any form without the explicit written permission of the County. The Provider shall maintain complete records on each individual .-. examined/treated. Such records shall remain confidential in compliance with all HIPPA 14 Packet Page -547- 2/9/2016 16.E.1 . regulations, including Exhibit C "HIPPA Business Associate Agreement," and will be made available only to the County's representative and/or the individual. No information, record, report or data derived, compiled, obtained, prepared or developed by the Provider from work performed pursuant to the contract may be released, disseminated or disclosed without written consent of the County. All medical reports and records shall be formally transferred to the County by the Provider within five (5) working days after the receipt of a contract termination notice. 15 Packet Page-548- off ' 2/9/2016 16.E.1 . EXHIBIT B PRICE SCHEDULE (following this page) 16 Packet Page -549- 2/9/2016 16.E.1 . EXHIBIT B-PRICE I PART A: Medical Director Services Annual Cost Annual Cost $ 10,000.00 PART B:Testing Types Unit of Price Each Measure Pre-Placement Employment Physical ea $ 80.00 Pre-Placement Physical W/CDL Physical ea $ 85.00 Firefighter Physical ea $ 80.00 Respirator Medical Clearance Evaluation ea $ 110.00 SCUBA Diving Medical Examination and Certification ea $ 80.00 CDL Physical (DOT) ea $ 90.00 Fitness for Duty Examination ea $ 170.00 Asbestos Medical Examinations and Consultations ea $ 150.00 Laboratory Work ea $ 15.00 Creatinine ea $ 0.50 BUN ea $ 0.50 TSH Levels Test ea $ 10.00 C-Reactive Protein ea $ 8.00 Heavy Metals Test- Blood Panel Test (Arsenic, Cadmium, ea $ 125.00 Lead, Mercury) Heavy Metals Test-Blood- Aluminum ea $ 18.00 Heavy Metals Test-Blood- Antimony ea $ 89.00 Heavy Metals Test-Blood-Bismuth ea $ 81.00 Heavy Metals Test-Blood- Chromium ea $ 23.00 Heavy Metals Test-Blood-Copper ea $ 9.00 Heavy Metals Test-Blood-Nickel ea $ 79.00 Heavy Metals Test-Blood-Zinc ea $ 9.00 HbA1c ea $ 8.00 RBC Cholinesterase ea $ 27.00 Polychlorinated Biphenyls ea $ 35.00 Blood Alcohol Test ea $ 45.00 Breath Alcohol Test- (Administered by a Breath Alcohol ea $ 45.00 Technician meeting DOT Qualifications Only) Arsenic -Urine ea $ 17.00 Mercury-Urine ea $ 37.00 PPD Testing w/Reading(Induration measurement) ea $ 10.00 Chest x-ray (2-view) ea $ 50.00 Chest x-ray (4-view) ea $ 95.00 Chest CT w/contrast ea $ 475.00 17 Packet Page-550- CD 2/9/2016 16.E.1. Chest CT without contrast ea $ 450.00 Audiometric Screening Test(pure tone air only) with ea $ 1.00 interpretation (Audiogram) per OSHA's Occupational Noise Exposure Standard-CFR 1910.95. Pulmonary Function Test (with interpretation) ea $ 30.00 Drug Screen w/MRO -DOT 5 Panel (Collected per DOT ea $ 35.00 Urine Specimen Collection Guidelines-49 CFR Part 40) Drug Screen w/MRO -HRS 5 Panel ea $ 26.00 Drug Screen w/MRO -HRS 10 Panel ea $ 47.00 Hepatitis Panel Test ea $ 80.00 Measles, Mumps, Rubella Vaccination (MMR) ea $ 85.00 MMR Titer ea $ 25.00 Mumps Vaccination ea $ 75.00 Mumps Titer ea $ 45.00 Measles Vaccination ea $ 75.00 Measles Titer ea $ 45.00 Varicella Vaccination (Price per injection) ea $ 155.00 Varicella Titer ea $ 18.00 Hepatitis A Vaccination Series (Price per injection) ea $ 75.00 Hepatitis B Vaccination Series (Price per injection) ea $ 45.00 Hepatitis Titer(if previously immunized) ea $ 16.00 HIV 1 &2 Antibody Test ea $ 32.00 Pre-exposure Rabies Vaccination Series (Price per injection) ea $ 290.00 Rabies Titer (if previously immunized) ea $ 35.00 Tetanus/diphtheria Vaccination ea $ 28.00 Tdap Vaccination ea $ 55.00 EKG-12 Lead (with interpretation and physician ea $ 40.00 confirmation) Cardiac Stress Test (with interpretation and physician ea $ 135.00 confirmation) Echocardiogram(with interpretation and physician ea $ 110.00 confirmation) Prostate Exam ea $ 1.00 PAP Test ea $ 35.00 18 Packet Page -551- 2/9/2016 16.E.1 . EXHIBIT C Business Associate Agreement (following this page) 19 Packet Page-552- U 2/9/2016 16.E.1 . HIPAA BUSINESS ASSOCIATE AGREEMENT THIS HIPAA BUSINESS ASSOCIATE AGREEMENT ("Agreement") is made by and between Collier County, Florida (hereinafter referred to as "Client") and Advance Medical of Naples, LLC (hereinafter referred to as "AM N").This Agreement is effective as of the date signed by Client. RECITALS WHEREAS, Client is a "covered entity"within the meaning of 45 CFR § 160.103; WHEREAS, AMN provides accounting, consulting, or other services to Client and, in connection therewith, Client wishes to disclose "protected health information" within the meaning of 45 CFR § 160.103 to AMN and AMN wishes to receive protected health information and, on behalf of Client, create, maintain, or transmit protected health information (collectively, "Client's PHI"); WHEREAS, AMN is a "business associate" within the meaning of 45 CFR § 160.103; WHEREAS, Client and AMN intend to protect the privacy and provide for the security of Client's PHI in compliance with the Health Insurance Portability and Accountability Act of 1996, the Health Information Technology for Economic and Clinical Health Act of 2009, and the regulations and policy guidance thereunder("HIPAA Rules"); WHEREAS, the HIPAA Rules require that Client receive adequate assurances that AMN will comply with certain obligations with respect to Client's PHI and, accordingly, the parties hereto desire to enter into this Agreement for the purpose of setting forth in writing the terms and conditions for the use, disclosure, and safeguarding of Client's PHI, including provisions required by the HIPAA Rules as the same may be amended from time to time; NOW, THEREFORE, in consideration of the foregoing recitals and mutual covenants herein contained and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged,the parties agree as follows: TERMS OF AGREEMENT 1. Obligations and Activities of AMN. a. Permitted and Required Uses and Disclosures. AMN shall not use or disclose Client's PHI except as permitted or required by this Agreement or as required by law. Specifically, AMN agrees as follows: i. AMN may only use or disclose Client's PHI as necessary to perform the services set forth in the service agreement, if any, between Client and AMN, to perform functions, activities, or services for, or on behalf of, Client as requested by Client from time to time, or as required by law. Page 1 of 8 EXHIBIT C-Contract#15-6474R "Medical Director for Collier County and Employment Physicals and Drug Testing" Packet Page -553- Ca 2/9/2016 16.E.1 . ii. AMN shall use or disclose only the "Minimum Necessary" amount of information, as such term is defined in the HIPAA Rules, required to conduct the authorized activities herein, except that AMN will limit disclosures to a limited data set as set forth in 45 CFR § 164.514(e)(2) as required by the HIPAA Rules, iii. AMN may not use or disclose Client's PHI in a manner that would violate Subpart E of 45 CFR Part 164 if done by Client, except that AMN may use or disclose Client's PHI for the proper management and administration of AMN or to carry out the legal responsibilities of AMN, provided the use or disclosures are required by law or AMN obtains reasonable assurances from the person to whom the information is disclosed that Client's PHI will remain confidential and used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and the person notifies AMN of any instances of which it is aware in which the confidentiality of Client's PHI has been breached. iv. AMN may use Client's PHI to provide "data aggregation services" relating to the health care operations of Client within the meaning of 45 CFR § 164.501. v. AMN shall not disclose Client's PHI in a manner that would violate any restriction thereof which has been duly communicated to AMN. vi. Except as permitted by the HIPAA Rules, AMN shall not directly or indirectly receive remuneration in exchange for any of Client's PHI unless authorized in writing by Client. b. Safeguards. AMN shall use appropriate safeguards, and comply with Subpart C of 45 CFR Part 164 with respect to electronic protected health information,to prevent use or disclosure of Client's PHI other than as provided in this Agreement. i. Administrative Safeguards. AMN shall implement all required administrative safeguards pursuant to 45 CFR § 164.308 as such are made applicable to business associates pursuant to the HIPAA Rules. Additionally, AMN shall either implement or properly document the reasons for non- implementation of all administrative safeguards of 45 CFR § 164.308 that are designated as "addressable" as such are made applicable to business associates pursuant to the HIPAA Rules. ii. Physical Safeguards. AMN shall implement all required physical safeguards pursuant to 45 CFR § 164.310 as such are made applicable to business associates pursuant to the HIPAA Rules. Additionally, AMN shall either implement or properly document the reasons for non-implementation of all Page 2 of 8 EXHIBIT C-Contract#15-6474R "Medical Director for Collier County and Employment Physicals and Drug Testing" Packet Page -554- 2/9/2016 16.E.1. physical safeguards of 45 CFR § 164.310 that are designated as "addressable" as such are made applicable to business associates pursuant to the HIPAA Rules. iii. Technical Safeguards. AMN shall implement all required technical safeguards pursuant to 45 CFR § 164.312 as such are made applicable to business associates pursuant to the HIPAA Rules. Additionally, AMN shall either implement or properly document the reasons for non-implementation of all technical safeguards of 45 CFR§ 164.312 that are designated as "addressable" as such are made applicable to business associates pursuant to the HIPAA Rules. c. Reporting of Disclosures. AMN shall report to Client any use or disclosure of Client's PHI not provided for by this Agreement of which AMN becomes aware, including any acquisition, access, use or disclosure (i.e., "breach") of "unsecured protected health information," within the meaning of 45 CFR § 164.403, and any security incident of which AMN becomes aware. AMN shall make such report to Client without unreasonable delay and in no case later than sixty (60) calendar days following discovery of the breach. AMN's notice to Client shall include all information needed by Client to provide notice to affected individuals and otherwise satisfy the requirements of 45 CFR § 164.410. d. AMN's Subcontractors. AMN may disclose Client's PHI to one or more subcontractors and may allow its subcontractors to create, receive, maintain, or transmit Client's PHI on behalf of AMN. AMN shall obtain satisfactory assurances from any such subcontractor that it will appropriately safeguard Client's PHI in accordance with 45 CFR § 164.314(a) and shall ensure that the subcontractor agrees in writing to the same or more stringent restrictions, conditions, and requirements that apply to AMN with respect to Client's PHI. Upon AMN contracting with a subcontractor regarding Client's PHI,AMN shall provide Client written notice of such executed agreement. e. Satisfying Requests for Access. AMN shall make available to Client Client's PHI in a "designated record set," within the meaning of 45 CFR § 164.501, as Client may require to satisfy its obligations to respond to a request for access pursuant to 45 CFR § 164.524. If AMN receives a request for access directly from an individual or an individual's designee, AMN shall forward such request within five (5) calendar days to Client for Client to fulfill. f. Satisfying Requests for Amendment. AMN shall make any amendments to Client's PHI in a designated record set, as Client may require to satisfy its obligations to respond to a request for amendment pursuant to 45 CFR § 164.526. If AMN receives a request for amendment directly from an individual or an individual's designee, AMN shall forward such request within ten (10) calendar days to Client for Client to fulfill. g. Internal Practices. AMN shall make its internal practices, books and records relating to the use and disclosure of Client's PHI available to the Secretary of the Page 3 of 8 ••■•, EXHIBIT C-Contract#15-6474R"Medical Director for Collier County and Employment Physicals and Drug Testing" Packet Page -555- 2/9/2016 16.E.1 . United States Department of Health and Human Services or his or her designee for purposes of determining compliance with the HIPAA Rules. h. Accounting. AMN shall document disclosures of Client's PHI and information related to such disclosures and otherwise maintain and make available the information required to provide an accounting of disclosures to the Client as necessary to permit the Client to respond to a request for an accounting pursuant to 45 CFR § 164.528. If AMN receives a request for an accounting directly from an individual or an individual's designee, AMN shall forward such request within ten (10) calendar days to Client for Client to fulfill. Policies and Procedures; Documentation. AMN shall develop appropriate policies and procedures relating to its compliance with the administrative, physical, and technical safeguards set forth in Section 1.b. and shall document, retain, and update such policies and procedures as required by 45 CFR§ 164.316. j. Compliance as if Covered Entity.To the extent AMN is to carry out one or more of the obligations imposed on the Client as a "covered entity" under Subpart E of 45 CFR Part 164, AMN shall comply with the requirements of said Subpart E that apply to the Client in the performance of such obligations. 2. Client Obligations. Client shall provide notice to AMN of any of the following: a. Any limitations in the notice of privacy practices of Client under 45 CFR § 164.520, as well as any changes to such limitations, to the extent that such limitation may affect AMN's use or disclosure of Client's PHI. b. Any changes in, or revocation of, the permission by an individual to use or disclose his or her protected health information, to the extent that such changes may affect AMN's use or disclosure of Client's PHI. c. Any restriction on the use or disclosure of protected health information that Client has agreed to or is required to abide by under 45 CFR § 164.522, to the extent that such restriction may affect AMN's use or disclosure of Client's PHI. d. Client shall not request AMN to use or disclose Client's PHI in any manner that would not be permissible under the HIPAA Rules if done by Client, except that Client may request AMN to provide to Client "data aggregation services" relating to the health care operations of the Client within the meaning of 45 CFR § 164.501, as permitted by 45 CFR § 164.504(e)(2)(i)(B). 3. Termination of Agreement. Termination shall be in accordance with terms and conditions as set forth in Section 11, Agreement#15-6474R. Page 4 of 8 EXHIBIT C-Contract#15-6474R "Medical Director for Collier County '1 and Employment Physicals and Drug Testing" Packet Page -556- 2/9/2016 16.E.1 . 4. Treatment of Client's PHI after Termination. Upon termination of this Agreement for any reason, AMN,with respect to Client's PHI, shall: a. Retain only that portion of Client's PHI which is necessary for AMN to continue its proper management and administration or to carry out its legal responsibilities; b. Return to Client or, if agreed to by Client, destroy remaining Client's PHI that AMN still maintains in any form and retain no copies of such Client's PHI; c. Continue to use appropriate safeguards and comply with Subpart C of 45 CFR Part 164 with respect to electronic protected health information to prevent use or disclosure of Client's PHI, other than as provided for in this Section, for as long as AMN retains any Client's PHI; d. Not use or disclose Client's PHI retained by AMN other than for the purposes for which Client's PHI was retained and subject to the same conditions, as set forth in Section 2, which applied prior to termination; e. Return to Client or, if agreed to by Client, destroy remaining Client's PHI retained by AMN when it is no longer needed by AMN for its proper management and administration or to carry out its legal responsibilities and retain no copies of such �-� Client's PHI; f. Obtain or ensure the destruction of any Client's PHI created, received, or maintained by any of AMN's subcontractors; and g. Within thirty (30) calendar days after termination or expiration of this Agreement, certify in a written statement signed by a senior officer of AMN, that all Client's PHI has been returned or disposed of as required above. If the parties mutually agree that return or destruction is not feasible, this Agreement shall continue to apply to Client's PHI and, without limitation to the foregoing, the obligations of AMN under this Agreement shall survive the termination of this Agreement with respect to any Client's PHI retained by AMN. AMN shall limit further use and disclosure of Client's PHI to those purposes that make the return or destruction of Client's PHI infeasible. 5. Amendment to Comply with Law. The parties acknowledge that state and federal laws relating to electronic data security and privacy are rapidly evolving and that amendment of this Agreement may be required to provide for procedures to ensure compliance with such developments. The parties agree to promptly enter into negotiations concerning the terms of an amendment to this Agreement embodying written assurances consistent with the HIPAA Rules or other applicable law upon the written request of either party. Page 5of8 EXHIBIT C-Contract#15-6474R"Medical Director for Collier County and Employment Physicals and Drug Testing" Packet Page -557- 2/9/2016 16.E.1 . 6. No Third Party Beneficiaries. Nothing expressed or implied in this Agreement is intended to confer, nor shall anything herein confer, upon any person other than Client, AMN, and their respective successors or assigns, any rights, remedies, obligations, or liabilities whatsoever. 7. Indemnification.This section shall be in accordance with terms and conditions as set forth in Section 13, Agreement#15-6474R. 8. Interpretation. This Agreement shall be interpreted in a reasonable manner as necessary to implement and comply with the HIPAA Rules. The parties agree that any ambiguity in this Agreement shall be resolved in favor of a meaning that complies and is consistent with the HIPAA Rules. There shall be no presumption for or against either party, by reason of one of the parties causing this Agreement to be drafted,with respect to the interpretation or enforcement of this Agreement. 9. Notices. All notices and other communications required or permitted hereunder or necessary or convenient in connection herewith shall be in writing and shall be deemed to have been given when hand delivered or mailed by registered or certified mail, as follows (provided that notice of change of address shall be deemed given only when received): If to Client,to: Collier County Government Center 3311 Tamiami Trail E. Naples, Florida 34112 Attn:Jeff Walker, Risk Management Director Telephone no: 239-252-8461 Facsimile no: 239-252-8048 If to AMN,to: Advance Medical of Naples, LLC 720 Goodlette-Frank Road N, Suite 500 Naples, Florida 34102 Attention: Patricia Jackson Telephone no: 239-566-7676 Facsimile no: 239-254-3105 or to such other names or addresses as Client or AMN, as the case may be, shall designate by notice to the other in the manner specified in this Section 9. 10. Survival. The obligations contained in this Agreement which by their nature or context survive or are expressly intended to survive the expiration or termination of this Agreement will so survive and continue in full force and effect. Without limiting the Page 6 of 8 .—. EXHIBIT C-Contract#15-6474R"Medical Director for Collier County and Employment Physicals and Drug Testing" t4 Packet Page -558- 2/9/2016 16.E.1. generality of the foregoing, Sections 2, 4, and 7 shall survive the termination of this Agreement. 11. Severability. If any provision of this Agreement is determined by a court of competent jurisdiction to be invalid, illegal, or unenforceable, the remaining provisions of this Agreement shall remain in full force, if the essential terms and conditions of this Agreement for each party remain valid, binding, and enforceable. 12. Entire Agreement. This Agreement constitutes the entire agreement between the parties on the matters contained herein. 13. Non-Waiver. No failure or delay in exercising any right or remedy under this Agreement and no course of dealing between the parties operates as a waiver or estoppel of any right, remedy, or condition. A waiver made in writing on one occasion is effective only in that instance and only for the purpose that it is given and is not to be construed as a waiver on any future occasion. (signature page to follow) Page 7 of 8 EXHIBIT C-Contract#15.6474R "Medical Director for Collier County and Employment Physicals and Drug Testing" Packet Page -559- U`� 2/9/2016 16.E.1 . IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be signed as of the date first set forth above. COVERED ENTITY: BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA By: Jeff Walker, Director of Risk Management BUSINESS ASSOCIATE: Advance Medical of Naples, LLC First Witness By: By: Print Name Patricia Jackson Second Witness By: Print Name .proved as to Form and Legality: 4 ssistant County Attorney Page 8 of 8 EXHIBIT C-Contract#15-6474R"Medical Director for Collier County and Employment Physicals and Drug Testing" Packet Page -560- 2/9/2016 16.E.1 . Co ler County Administrative Services Departnent Procurement Services Division INVITATION TO BID Date: October 27, 2015 From: Jason Crouch, Procurement Strategist (239) 252-8949 (Telephone) (239) 252-6594 (FAX) jasoncrouch @colliergov.net (Email) To: Prospective Vendors Subject: Solicitation: ITB 15-6474R Medical Director for Collier County and Employment Physicals and Drug Testing As requested by Risk Management, the Collier County Board of County Commissioners Purchasing Department has issued this ITB for the purpose of obtaining fair and competitive responses. Please refer to the Public Notice included in this document for the opening date and time and any applicable pre-ITB conference. All questions regarding this ITB must be submitted online on the Collier County Purchasing Department Online Bidding System website: www.colliergov.net/bid. All responses to questions will be posted on the website with electronic notification to all prospective vendors. We look forward to your participation in Collier County's competitive procurement process. cc: Gary Troy; Jeff Walker Note: All ITB responses submitted must include one (1) original labeled MASTER, along with one (1) exact duplicate copies, including all required forms. • Prca cement SeNtes Denson•332T Tamiami Trail East•Naples,Fonda 34112-1901•235-252-8907•WON.co liiergavnettprocurementse.•vicas #15-6474R 1 Packet Page -561- 2/9/2016 16.E.1 . Invitation to Bid Index Public Notice 3 Exhibit I: Scope of Work, Specifications and Response Format 4 Exhibit III: Standard Purchase Order Terms and Conditions 17 Exhibit IV: Additional ITB Terms and Conditions 20 Attachment 1: Vendor Submittal -Vendor's Non-Response Statement 28 Attachment 2: Vendor's Check List 29 Attachment 3: Vendor Submittal - Bid Response Form 30 Attachment 4: Vendor Submittal—Local Vendor Preference Affidavit 32 Attachment 5: Vendor Submittal—Immigration Affidavit 33 Attachment 6: Vendor Substitute W—9 34 Attachment 7: Vendor Submittal - Insurance and Bonding Requirements 35 #15-6474R Packet Page -562- 2 2/9/2016 16.E.1. CIL Comity Administrative Services Department Procurement Services Division Public Notice Sealed bid responses for Solicitation 15-6474R Medical Director for Collier County and Employment Physicals and Drug Testing, will be received electronically or manually at the Collier County Government, Purchasing Department, 3327 Tamiami Trail E, Naples, FL 34112 until 3 PM. Collier County local time on November 9, 2015. Solicitation responses received after the stated time and date will not be accepted. Solicitation 15-6474R Medical Director for Collier County and Employment Physicals & Drug Testing All questions regarding this ITB must be submitted online on the Collier County Purchasing Department Online Bidding System website: www.colliergov.net/bid. All responses to questions will be posted on the website with electronic notification to all prospective vendors. All solicitation responses must be made on the official ITB response form included and only available for download from the Collier County Purchasing Department Online Bidding System website noted herein. ITB Documents obtained from sources other than Collier County Purchasing may not be accurate or current. Collier County encourages vendors to utilize recycled paper on all manual bid response submittals. Collier County does not discriminate based on age, race, color, sex, religion, national origin, disability or marital status. BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA BY: /s/Joanne Markiewicz Director, Procurement Services Division Publicly posted on the Collier County Purchasing Department website: www.colliergov.net/purchasing and in the lobby of the Purchasing Building on October 27, 2015. #15-6474R 3 Packet Page -563- 2/9/2016 16.E.1 . Exhibit I: Scope of Work, Specifications and Response Format As requested by the Collier County Risk Management Division (hereinafter, the "Division or Department"), the Collier County Board of County Commissioners Procurement Services Division (hereinafter, "County") has issued this Invitation to Bid (hereinafter, "ITB")with the intent of obtaining bids from interested and qualified firms in accordance with the terms, conditions and specifications stated or attached. The Vendor, at a minimum, must achieve the requirements of the Scope of Work and specifications stated. The results of this solicitation may be used by other County departments once awarded according to the Board of County Commissioners Purchasing Policy. Brief Description of Purchase The County is interested in receiving quotes from qualified vendors to provide Medical Director Services and pre-employment and periodic physicals for County employees. The County shall award a contract for both services to one vendor who provides the overall lowest, qualified and responsive bid for services identified in Part A and Part B of this solicitation, as described in the Detailed Scope of Work section below. Background The Bidder shall provide occupational medical services on an "as-needed" basis as may be required by the Collier County Manager's Agency and its participating agencies, located in Naples, Florida. This program will be available to all Regular, Temporary and Seasonal Employees of the County Manager's Agency of Collier County and its participating agencies, which currently include, but are not limited to: County Attorney, Airport Authority, and Pelican Bay Services. This contract does not include the Collier County Sheriff's Staff and employees nor the Collier County Clerk of the Court's staff as they have separate contracts. The location of the facility proposed to provide the occupational medical services will be one of the factors considered during the evaluation process. The County prefers the medical facility to be located within ten (10) miles from the Collier County Government Center, 3301 E. Tamiami Trail, Naples, Florida, with satellite facilities to be provided in areas within Lee or Collier County. The Bidder must provide all services listed in this Scope of Services. The County does not guarantee a specific quantity of work. Detailed Scope of Work Part A: The Consultant shall provide Medical Director Services for the Collier County Occupational Health Program as may be required by the Collier County Manager's Agency and its participating agencies, located in Naples, Florida These programs are be available to all Regular, Temporary and Seasonal Employees of the County Manager's Agency of Collier County and its participating agencies, which currently include, but are not limited to: County Attorney, Airport Authority, and Pelican Bay Services. This contract does not include the Collier County Sheriff's Staff and employees nor the Collier County Clerk of the Court's staff as they have separate contracts. The County has a total of approximately one thousand nine hundred and forty (1,940) employees. #15-6474R Packet Page -564- 4 2/9/2016 16.E.1 . The Consultant shall ensure that the physician providing services is a licensed doctor of medicine or osteopathy who has completed residency training in an accredited medical training program and/or is American Boards of Medical Specialties (ABMS) or American Osteopathic Association (AOA) certified, and must possess certification as a Medical Review Officer(MRO) at time of bid opening. The physician shall be knowledgeable and/or have a background that includes, but is not limited to; Occupational Medicine, OSHA Standards, NFPA 1582 and 1583 Standards, Florida Workers' Compensation Statutes, DOT Agencies - FAA/FTA/FMCA and USCG drug and alcohol testing regulations. In the event that the physician awarded to provide listed services is unavailable, an on call physician of similar qualifications shall be designated to provide such services. *The Consultant must provide all services listed in this Scope of Services. The County does not guarantee a specific quantity of work. Services provided in respect to this solicitation and resulting contract shall be billed monthly, unless otherwise directed by Department staff. Services to be provided include, but are not limited to the following: 1. Review, recommend & approve standing medical orders & protocols. 2. Provide a written recommendation for an employee or prospective job candidate's ability to wear a respirator based on OSHA's Respiratory Protection Standard - CFR1910.134. 3. Provide services per OSHA's Occupational Noise Exposure Standard - CFR 1910.95. 4. Consult and recommend pre-placement evaluation criteria &findings. 5. Consult on work related injuries & illnesses. 6. Consult on "fitness for duty" evaluations. 7. Medical Review Officer(MRO): review and consultation of drug related tests. Reports and Records: All medical reports shall be the sole property of Collier County and may not be used or reproduced in any form without the explicit written permission of the County. The Consultant shall maintain complete records on each individual examined/treated. Such records shall remain confidential in compliance with all HIPPA regulations and will be made available only to the County's representative and/or the individual. No information, record, report or data derived, compiled, obtained, prepared or developed by the Consultant from work performed pursuant to the contract may be released, disseminated or disclosed without written consent of the County. All medical reports and records shall be formally transferred to the County by the Consultant within five (5)working days after the receipt of a contract termination notice. Part B: A comprehensive pre-employment physical and drug testing program to benefit Collier County and reduce liability to the County. This program will ensure the proper placement of employees based upon physical capabilities related to essential functions of County positions. Also included will be reassessment of appropriate County employees on a designated basis. This program will ensure the health of County employees and potential County employees. The Consultant shall ensure that the physician providing and/or overseeing services is a licensed doctor of medicine or osteopathy who has completed residency training in an accredited medical training program and/or is American Boards of Medical Specialties (ABMS) or American Osteopathic Association (AOA) certified. The physician shall be knowledgeable and/or have a background that includes, but is not limited to; Occupational Medicine, OSHA Standards, NFPA #15-6474R 5 Packet Page -565- 2/9/2016 16.E.1 . 1582 and 1583 Standards, Florida Workers' Compensation Statutes, DOT Agencies - FAA/FTA/FMCA and USCG drug and alcohol testing regulations Specific requirements include: 1. The Occupational Medical Services Program will be designed to provide the medical services listed. The awarded Consultant shall provide weekend and extended hours of operation and shall be staffed with appropriately trained and qualified medical personnel. 2. Clinical Activities: The following are the activities that shall be required of the successful Bidder. This list includes the core function and major emphasis of clinical activities to be performed. Lab results, medical findings and recommendations shall be reviewed with the examinee. A. Pre-Placement Employment Physical: A basic occupational and medical history is reviewed with an occupational physical exam. (A Respirator Medical Clearance Evaluation may also be required based on job classification.) The medical determination of ability to work is assessed based on the job classification specifications. A vision exam (near&far acuity, color, depth perception)will be conducted with this physical at no charge. Ancillary tests to determine medical clearance (i.e., drug testing, blood alcohol, CBC, lipid panel) are reimbursed per fee schedule. B. Pre-Placement Physical W/CDL Physical: The candidate's medical history is reviewed. (A Respirator Medical Clearance Evaluation may also be required based on job classification.) The medical examiner, conducts a physical that evaluates the candidate's medical condition for employment and CDL medical certification. The physician completes the pre-employment physical form and the Department of Transportation medical physical form. Laboratory results are reviewed. A vision screen and urine dipstick is conducted at no additional charge. The DOT card is issued. C. Firefighter Physical: A comprehensive medical history review and physical evaluation is conducted in accordance with the recommendations of NFPA 1582. (A Respirator Medical Clearance Evaluation and Fitness Plan per NFPA 1582 Guidelines, is included as part of the physical evaluation.)This physical shall be conducted in a manner that permits the physician to review the findings of all components (labs, tests...etc)of the physical and review those findings and any recommendations with the firefighter candidate/employee. D. Respirator Medical Clearance Evaluation: A respiratory health questionnaire and medical history is reviewed by a physician, nurse practitioner or physician's assistant per the OSHA Standard —CFR 1910.134. The physical examination with interpretation of spirometry and ancillary tests will assess the ability to wear a respirator. A written medical recommendation shall be provided per the OSHA Standard - CFR 1910.134. A vision exam will be included at no charge. Spirometry testing is included. Ancillary tests at the published fee schedule can augment this physical assessment. E. SCUBA Diving Medical Examination and Certification: A medical history is reviewed and a physical examination with required ancillary testing is conducted to determine issuance of a diving certification. F. CDL Physical (DOT): The Department of Transportation Medical Examination Report for commercial driver fitness determination is conducted in accordance with DOT regulations and requirements. A Medical Examiners Certificate (DOT Card)will be issued after successful completion of this physical. #15-647'4R 6 Packet Page -566- 2/9/2016 16.E.1 . G. Fitness for Duty Examination: The selected vendor shall perform any fitness for duty examinations requested by the County Occupational Health Nurse or County Human Resources Department. The fitness for duty examination content shall be determined by the physician based on the job classification requirements. A complete medical report shall be forwarded to the County Occupational Health Nurse within one (1) working day of the completion of the examination. H. Asbestos Medical Examinations and Consultations: The selected vendor shall provide medical examinations and consultations following the requirements of the Asbestos Standard CFR 1926.1101. This examination shall include a Respirator Medical Clearance Evaluation. I. Laboratory Work: The following tests shall be performed for an all-inclusive fee: • Comprehensive Metabolic Panel with Lipids • Complete Blood Count (CBC)w/Platelet, Auto Differential • Urinalysis Chemistry • Creatinine • BUN • TSH Levels Test • C-Reactive Protein • Heavy Metals Test— Blood Panel Test (Arsenic, Cadmium, Lead, Mercury) • Heavy Metals Test-Blood-Aluminum • Heavy Metals Test-Antimony • Heavy Metals Test-Blood-Bismuth • Heavy Metals Test-Blood-Chromium • Heavy Metals Test- Blood-Copper • Heavy Metals Test-Blood- Nickel • Heavy Metals Test-Blood Zinc • HbA1c • RBC Cholinesterase • Polychlorinated Biphenyls • Blood Alcohol Test • Breath Alcohol Test—(Administered by a Breath Alcohol Technician meeting DOT Qualifications Only) • Arsenic- Urine • Mercury- Urine • PPD Testing w/Reading (Induration measurement) • Chest x-ray (2-view) • Chest x-ray (4-view) • Chest CT w/contrast • Chest CT without contrast • Audiometric Screening Test (pure tone air only) with interpretation (Audiogram) per OSHA's Occupational Noise Exposure Standard - CFR 1910.95. • Pulmonary Function Test (with interpretation) • Drug Screen w/MRO— DOT 5 Panel (Collected per DOT Urine Specimen Collection Guidelines—49 CFR Part 40) • Drug Screen w/MRO— HRS 5 Panel • Drug Screen w/MRO— HRS 10 Panel • Hepatitis Panel Test • Measles, Mumps, Rubella Vaccination (MMR) • MMR Titer • Mumps Vaccination • Mumps Titer • Measles Vaccination #15-6474R 7 Packet Page -567- 2/9/2016 16.E.1 . • Measles Titer • Varicella Vaccination (Price per injection) r` • Varicella Titer • Hepatitis A Vaccination Series (Price per injection) • Hepatitis B Vaccination Series (Price per injection) • Hepatitis Titer(if previously immunized) • HIV 1 & 2 Antibody Test • Pre-exposure Rabies Vaccination Series (Price per injection) • Rabies Titer(if previously immunized) • Tetanus/diphtheria Vaccination • Tdap Vaccination • EKG - 12 Lead (with interpretation and physician confirmation) • Cardiac Stress Test (with interpretation and physician confirmation) • Echocardiogram (with interpretation and physician confirmation) • Prostate Exam • PAP Test J. Medical Services Not Listed: Medical services (labs, tests, immunizations, etc) not listed in this document shall be permitted upon review and authorization by the County Occupational Health Nurse. K. Pre-employment Physical Examinations: Pre-employment examinations will usually be scheduled on short notice. Appointments may be requested for the same day or the following business day. The medical examination and review of the collected medical and occupational history must be performed by a licensed physician, nurse practitioner or physician's assistant, preferably experienced in occupational health. Routine measurements, laboratory specimens and x-rays may be taken by paramedical personnel. Written confirmation of the examination results must be provided to the County Occupational Health Nurse, or designated person, within twenty-four (24) hours. This confirmation must identify any concerns and/or accommodation recommendations. L. Reports and Records: All medical reports shall be the sole property of Collier County and may not be used or reproduced in any form without the explicit written permission of the County. The successful Bidder shall maintain complete records on each individual examined/treated. Such records shall remain confidential in compliance with all HIPPA regulations and will be made available only to the County's representative and/or the individual. No information, record, report or data derived, compiled, obtained, prepared or developed by the selected Bidder from work performed pursuant to the contract may be released, disseminated or disclosed without written consent of the County. All medical reports and records shall be formally transferred to the County by the successful Bidder within five (5)working days after the receipt of a contract termination notice. #15-6474R 8 Packet Page-568- 2/9/2016 16.E.1 . Award Criteria ITB award criteria is as follows: • All questions on the Bid document shall be answered as to price(s), time requirements, and required document submissions. • Award shall be based upon the responses to all questions on the Bid Response Page(s). • Further consideration may include but not be limited to, references, completeness of bid response and past performances on other County bids/projects. • Prices will be read in public exactly as input on the electronic bid response form or written on the manually submitted Bid Response Page(s)at the time of the bid opening; however, should an error in calculations occur whenever unit pricing and price extensions are requested, the unit price shall prevail. Mathematical miscalculations may be corrected by the County to reflect the proper response. • The County's Purchasing Department reserves the right to clarify a vendor's proposal prior to the award of the solicitation. • It is the intent of Collier County to award to the lowest responsive vendor(s) in accordance with the following methodology: The County shall award a single contract for both services to one (1) vendor who provides the overall lowest responsive bid for services identified in Part A and Part B of this solicitation. • Collier County reserves the right to select one (1), or more than one (1) vendor, however, it is the intent to select a single vendor to whom award shall be recommended. • The County reserves the right to issue a formal contract or standard County Purchase Order for the award of this solicitation. Term of Contract The contract term, if an award(s) is/are made is intended to be for one (1) year with three (3) one (1)year renewal options. Prices shall remain firm for the initial term of this contract. Requests for consideration of a price adjustment must be made prior to the contract anniversary date, in writing, to the Procurement Director. Price adjustments are dependent upon the consumer price index (CPI) over the past twelve (12) months, budget availability and program manager approval. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing structure. #15-6474R 9 Packet Page -569- 2/9/2016 16.E.1 . Projected Timetable Event Date Issue Solicitation Notice October 27, 2015 Last Date for Receipt of Written Questions November 4, 2015 at 5 PM, Naples Local Time Solicitation Deadline Date and Time November 9, 2015 at 3 PM, Naples Local Anticipated Evaluation of Submittals November 9-10, 2015 Anticipated Board of County Commissioner's Contract December 8, 2015 As'royal Date _ Vendor Required Documents • Attachment 2: Vendor's Check List • Attachment 3: Vendor Bid Response Form • Attachment 4: Local Vendor Preference • Attachment 5: Immigration Law Affidavit • Attachment 6: Vendor Substitute W-9 • Attachment 7: Insurance and Bonding Requirement • Additional Attachment: Respective medical license(s) and all related certification(s), including MRO certificate, #15-6474R 10 Packet Page -570- 2/9/2016 16.E.1 . Exhibit II: General Bid Instructions s-. 1. Purpose/Objective As requested by the Collier County departments or divisions identified in Exhibit 1, the Collier County Board of County Commissioners Purchasing Department (hereinafter, the County) has issued this Invitation to Bid (hereinafter, the "ITB", or"Bid")with the sole purpose and intent of obtaining bid responses from interested and qualified firms in accordance with the terms, conditions, and specifications stated and/or attached herein/hereto. The successful vendor will hereinafter be referred to as the "Vendor." All bids must be submitted on the Bid form furnished by the County noted in Attachments 2, 3, 4, 5, 6, and 7 of this ITB. No bid will be considered unless the Bid form is properly signed. Vendor is responsible to read and follow the instructions very carefully, as any misinterpretation or failure to comply with these instructions could lead to the bid submitted as being rejected as non-responsive. 2. Pricing Vendors must provide unit prices using the unit of measured specified by the County. All prices will remain firm for initial term of this contract. After award by the Board of County Commissioners, prices may only be adjusted as outlined in Exhibit I: Term of Contract. 3. Alternate Bid Pricing In the event that alternate pricing is requested, it is an expressed requirement of the bid to provide pricing for all alternates as listed. The omission of a response or a no-bid or lack of a submitted price will be the basis for the rejection of the submitted bid response. All bids responses received without pricing for all alternates as listed will be considered technically non-responsive and will not be considered for award. 4. Equal Product Manufacturer's name, brand name and/or model number are used in these specifications for the purpose of establishing minimum requirements of level of quality, standards of performance and/or design required, and is in no way intended to prohibit the bidding of other manufacturer's items of equal or similar material. An equal or similar product may be bid, provided that the product is found to be equal or similar in quality, standard of performance, design, etc. to the item specified. Where an equal or similar is bid, the Bid must be accompanied with two (2) complete sets of factory information sheets (specifications, brochures, etc.) and test results, if applicable, of unit bid as equal or similar. Equal product samples, if required for evaluation, and at no cost to the County, must be submitted with Bid. Unless otherwise directed in the solicitation, the bid will not be considered unless samples are delivered to specified address by bid due date. The County shall be sole judge of equality or similarity, and its decision shall be final in the best interest. #15-6474R 11 Packet Page -571- 2/9/2016 16.E.1 . 5. Discounts Any discounts or terms must be shown on the Bid form. Such discounts, if any, may be considered in the award of tie bids. In no instance should payment terms less than fifteen (15) calendar days be offered. 6. Exceptions Vendors taking exception to any part or section of these specifications shall indicate such exceptions on a separate sheet entitled "EXCEPTIONS TO SPECIFICATIONS." Failure to indicate any exceptions to the specifications shall be interpreted as the Vendors intent to fully comply with the specifications as written. The County, at its sole discretion, shall determine if the exceptions are material in nature, and if the Vendor's exceptions may be declared grounds for rejection of bid proposal. 7. Addenda The County reserves the right to formally amend and/or clarify the requirements of the bid specifications where it deems necessary. Any such addendum/clarification shall be in writing and shall be distributed electronically to all parties who received the original bid specifications prior to the deadline for submission of Bids. All changes to this ITB will be conveyed electronically through a notice of addendum or questions and answers to all vendors registered under the applicable commodity code(s) at the time when the original ITB was released, as well as those vendors who downloaded the ITB document. Additionally, all addendums are posted on the Collier County Purchasing Department Online Bidding System website: www.colliergov.net/bid. Before submitting a bid response, please make sure that you have read all, understood clearly and complied completely with any changes stated in the addenda as failure to do so may result in the rejection of your submittal. 8. Bid Submission For electronic submissions... All electronic bids shall be submitted online via the Collier County Purchasing Department Online Bidding System: www.colliergov.net/bid. For paper submissions... All paper bids shall be submitted to the County Procurement Director, Collier County Government, Procurement Services Division, 3327 Tamiami Trail E, Naples, FL 34112, by the date and time as stated in the Legal Notice. The County assumes no responsibility for bid responses received after the due date and time, or at any office or location other than that specified herein, whether due to mail delays, courier mistakes, mishandling, inclement weather or any other reason. Late bid responses shall be returned unopened, and shall not be considered for award. Vendors must submit one (1) paper copy clearly labeled "Master," and one (1) compact disks (CD's) with one copy of the proposal on each CD in Word, Excel or PDF. List the Solicitation Number and Title on the outside of the box or envelope. All bids sent by courier service must have the bid number and title on the outside of the courier packet. Vendors who wish to receive copies of bids after the bid opening may view and download same from the Collier County Purchasing Department Internet bid site. #15-6474R 12 Packet Page -572- 2/9/2016 16.E.1. 9. Questions If the vendor should be of the opinion that the meaning of any part of the Bid Document is doubtful, obscure or contains errors or omissions it should report such opinion to the Procurement Strategist before the bid opening date. Direct questions related to this ITB only to the Collier County Purchasing Department Internet website: www.colliergov.net/bid. Questions will not be answered after the date noted on the ITB. Vendors must clearly understand that the only official answer or position of the County will be the one stated on the Collier County Purchasing Department Online Bidding System website. For general questions, please call the referenced Procurement Strategist identified in the Public Notice. 10. Protests Any prospective vendor/ proposer who desires to protest any aspect(s) or provision(s) of the solicitation (including the form of the solicitation documents or procedures) shall file their protest with the Procurement Director prior to the time of the bid opening strictly in accordance with the County's then-current procurement ordinance and policies. 11. Rejection and Waiver The County reserves the right to reject any and all bids, to waive defects in the form of bid, also to select the bid that best meets the requirements of the County. Vendors whose bids, past performance or current status do not reflect the capability, integrity or reliability to fully and in good faith perform the requirements denoted may be rejected as non- responsive. Bids that do not meet all necessary requirements of this solicitation or fail to provide all required information, documents or materials may be rejected as non-responsive. 12. Local Vendor Preference (LVP) The County is using the Competitive Sealed Quotation methodology of source selection for this procurement, as authorized by Ordinance Number 2013-69 establishing and adopting the Collier County Purchasing Ordinance. Local business means the vendor has a current Business Tax Receipt issued by the Collier County Tax Collector for at least one year prior to bid or proposal submission to do business within Collier County, and that identifies the business with a permanent physical business address located within the limits of Collier County from which the vendor's staff operates and performs business in an area zoned for the conduct of such business. A Post Office Box or a facility that receives mail, or a non-permanent structure such as a construction trailer, storage shed, or other non-permanent structure shall not be used for the purpose of establishing said physical address. In addition to the foregoing, a vendor shall not be considered a "local business" unless it contributes to the economic development and well-being of Collier County in a verifiable and measurable way. This may include, but not be limited to, the retention and expansion of employment opportunities, support and increase to the County's tax base, and residency of employees and principals of the business within Collier County. Vendors shall affirm in writing their compliance with the foregoing at the time of submitting their bid or proposal to be eligible for consideration as a "local business" under this section. A vendor who misrepresents the Local �-. Preference status of its firm in a proposal or bid submitted to the County will lose the privilege to claim Local Preference status for a period of up to one year. #15-6474R 13 Packet Page-573- 2/9/2016 16.E.1 . Under this solicitation, bidders desiring to receive local preference will be invited and required to affirmatively state and provide documentation as set forth in the solicitation in support of their status as a local business. Any bidder who fails to submit sufficient documentation with their bid offer shall not be granted local preference consideration for the purposes of that specific contract award. Except where federal or state law, or any other funding source, mandates to the contrary, Collier County and its agencies and instrumentalities, will give preference to local businesses in the following manner. Competitive bid (local price match option). Each formal competitive bid solicitation shall clearly identify how the price order of the bids received will be evaluated and determined. When a qualified and responsive, non-local business submits the lowest price bid, and the bid submitted by one or more qualified and responsive local businesses is within ten percent of the price submitted by the non-local business, then the local business with the apparent lowest bid offer (i.e., the lowest local bidder) shall have the opportunity to submit an offer to match the price(s), less one (1)dollar, offered by the overall lowest, qualified and responsive bidder. In such instances, staff shall first verify if the lowest non-local bidder and the lowest local bidder are in fact qualified and responsive bidders. Next, the Purchasing Department shall determine if the lowest local bidder meets the requirements of Fla. Stat. Sec.287.087 (Preferences to businesses with drug-free workplace programs). If the lowest local bidder meets the requirements of Fla. Stat. Sec. 287.087, the Purchasing Department shall invite the lowest local bidder to submit a matching offer, less one (1) dollar, within five (5) business days thereafter. If the lowest local bidder submits an offer that fully matches the lowest bid, less one (1) dollar, from the lowest non-local bidder tendered previously, then award shall be made to the local bidder. If the lowest local bidder declines or is unable to match the lowest non-local bid price(s), then award will be made to the lowest overall qualified and responsive bidder. If the lowest local bidder does not meet the requirement of Fla. Stat. Sec 287.087, and the lowest non-local bidder does, award will be made to the bidder that meets the requirements of the reference state law. Bidder must complete and submit with their bid response the Affidavit for Claiming Status as a Local Business which is included as part of this solicitation. Failure on the part of a Bidder to submit this Affidavit with their bid response will preclude said Bidder from being considered for local preference on this solicitation. A Bidder who misrepresents the Local Preference status of its firm in a bid submitted to the County will lose the privilege to claim Local Preference status for a period of up to one (1) year. The County may, as it deems necessary, conduct discussions with responsible bidders determined to be in contention for being selected for award for the purpose of clarification to assure full understanding of, and responsiveness to solicitation requirements. 13. Immigration Affidavit Certification Statutes and executive orders require employers to abide by the immigration laws of the United States and to employ only individuals who are eligible to work in the United States. The Employment Eligibility Verification System (E-Verify) operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA), provides an Internet-based means of verifying employment eligibility of workers in the United States; it is not a substitute for any other employment eligibility verification requirements. The program will be used for Collier County formal Invitations to Bid (ITB) and Request for Proposals (RFP) including professional services and construction services. #15-6474R 14 Packet Page-574- 2/9/2016 16.E.1 . Exceptions to the program: • Commodity based procurement where no services are provided. • Where the requirement for the affidavit is waived by the Board of County Commissioners Vendors/ Bidders are required to enroll in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Vendors are also required to provide the Collier County Purchasing Department an executed affidavit certifying they shall comply with the E-Verify Program. The affidavit is attached to the solicitation documents. If the BidderNendor does not comply with providing both the acceptable E-Verify evidence and the executed affidavit the bidder's /vendor's proposal may be deemed non-responsive. Additionally, vendors shall require all subcontracted vendors to use the E-Verify system for all purchases not covered under the "Exceptions to the program" clause above. For additional information regarding the Employment Eligibility Verification System (E-Verify) program visit the following website: http://www.dhs.gov/E-Verify. It shall be the vendor's responsibility to familiarize themselves with all rules and regulations governing this program. Vendor acknowledges, and without exception or stipulation, any firm(s) receiving an award shall be fully responsible for complying with the provisions of the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended and with the provisions contained within this affidavit. Failure by the awarded firm(s)to comply with the laws referenced herein or the provisions of this affidavit shall constitute a breach of the award agreement and the County shall have the discretion to unilaterally terminate said agreement immediately. 14. Lobbying All firms are hereby placed on NOTICE that the County Commission does not wish to be lobbied either individually or collectively about a project for which a firm has submitted a bid. Firms and their agents are not to contact members of the County Commission for such purposes as meetings of introduction, luncheons, dinners, etc. During the bidding process, from bid opening to final Board approval, no firm or its agent shall contact any other employee of Collier County with the exception of the Purchasing Department. 15. Certificate of Authority to Conduct Business in the State of Florida (Florida Statute 607.1501) In order to be considered for award, firms must be registered with the Florida Department of State Divisions of Corporations in accordance with the requirements of Florida Statute 607.1501 and provide a certificate of authority (www.sunbiz.org/search.html) prior to execution of a contract. A copy of the document may be submitted with the solicitation response and the document number shall be identified. Firms who do not provide the certificate of authority at the time of response shall be required to provide same within five (5) days upon notification of selection for award. If the firm cannot provide the document within the referenced timeframe, the County reserves the right to award to another firm. 16. General Information #15-6474R 15 Packet Page-575- 2/9/2016 16.E.1 . When it is deemed by the County that a bid cannot be awarded as originally intended, the County reserves the right to award this bid through an approach which is the best interest of the County. Alternate bids will not be considered unless authorized by the ITB. In case of identical bids tying as low bid, the County shall ask vendors to submit certification that they have a drug-free workplace in accordance with Section 287.087 Florida Statutes. Should all vendors provide said certification; the County will give local vendor preference. 17. Bid Award Process Award of contract will be made by the Board of County Commissioners in public session. Award shall be made in a manner consistent with the County's Purchasing Policy. Award recommendations will be posted outside the offices of the Purchasing Department as well as on the Collier County Purchasing Department website on Wednesdays and Thursdays prior to the County Commission meetings. Any actual or prospective respondent who desires to formally protest the recommended contract award must file a notice of intent to protest with the Procurement Director within two (2) calendar days (excluding weekends and County holidays) of the date that the recommended award is posted. Upon filing of said notice, the protesting party will have five (5) days to file a formal protest and will be given instructions as to the form and content requirements of the formal protest. A copy of the "Protest Policy" is available at the office of the Procurement Director. #15-6474R 16 Packet Page -576- 2/9/2016 16.E.1. Exhibit III: Standard Purchase Order Terms and Conditions 1. Offer delivery; provided that risk of loss prior to This offer is subject to cancellation by the actual receipt of the goods by the COUNTY COUNTY without notice if not accepted by nonetheless remain with VENDOR. VENDOR within fourteen (14)days of issuance. b) No charges will be paid by the COUNTY for packing, crating or cartage unless otherwise 2. Acceptance and Confirmation specifically stated in this Purchase Order. This Purchase Order (including all documents Unless otherwise provided in Purchase attached to or referenced therein) constitutes Order, no invoices shall be issued nor the entire agreement between the parties, unless payments made prior to delivery. Unless otherwise specifically noted by the COUNTY on freight and other charges are itemized, any the face of this Purchase Order. Each delivery of discount will be taken on the full amount of goods and/or services received by the COUNTY invoice. from VENDOR shall be deemed to be upon the c) All shipments of goods scheduled on the terms and conditions contained in this Purchase same day via the same route must be Order. consolidated. Each shipping container must be consecutively numbered and marked to No additional terms may be added and Purchase show this Purchase Order number. The Order may not be changed except by written container and Purchase Order numbers must instrument executed by the COUNTY. VENDOR be indicated on bill of lading. Packing slips is deemed to be on notice that the COUNTY must show Purchase Order number and objects to any additional or different terms and must be included on each package of less conditions contained in any acknowledgment, than container load (LCL) shipments and/or invoice or other communication from VENDOR, with each car load of equipment. The notwithstanding the COUNTY'S acceptance or COUNTY reserves the right to refuse or payment for any delivery of goods and/or return any shipment or equipment at services, or any similar act by VENDOR. VENDOR'S expense that is not marked with Purchase Order numbers. VENDOR agrees 3. Inspection to declare to the carrier the value of any All goods and/or services delivered hereunder shipment made under this Purchase Order shall be received subject to the COUNTY'S and the full invoice value of such shipment. inspection and approval and payment therefore d) All invoices must contain the Purchase Order shall not constitute acceptance. All payments are number and any other specific information as subject to adjustment for shortage or rejection. identified on the Purchase Order. Discounts All defective or nonconforming goods will be of prompt payment will be computed from the returned pursuant to VENDOR'S instruction at date of receipt of goods or from date of VENDOR'S expense. receipt of invoices, whichever is later. Payment will be made upon receipt of a To the extent that a purchase order requires a proper invoice and in compliance with series of performances by VENDOR, the Chapter 218, Fla. Stats., otherwise known as COUNTY prospectively reserves the right to the "Local Government Prompt Payment cancel the entire remainder of the Purchase Act," and, pursuant to the Board of County Order if goods and/or services provided early in Commissioners Purchasing Policy. the term of the Purchase Order are non-conforming or otherwise rejected by the 5. Time Is Of the Essence COUNTY. Time for delivery of goods or performance of services under this Purchase Order is of the 4. Shipping and Invoices essence. Failure of VENDOR to meet delivery a) All goods are FOB destination and must be schedules or deliver within a reasonable time, as suitably packed and prepared to secure the interpreted by the COUNTY in its sole judgment, lowest transportation rates and to comply shall entitle the COUNTY to seek all remedies with all carrier regulations. Risk of loss of available to it at law or in equity. VENDOR any goods sold hereunder shall transfer to agrees to reimburse the COUNTY for any the COUNTY at the time and place of expenses incurred in enforcing its rights. #15-6474R 17 Packet Page -577- 2/9/2016 16.E.1 . VENDOR further agrees that undiscovered VENDOR shall indemnify and hold harmless the delivery of nonconforming goods and/or services COUNTY from any and all claims, including r\ is not a waiver of the COUNTY'S right to insist claims of negligence, costs and expenses, upon further compliance with all specifications. including but not limited to attorneys'fees, arising from, caused by or related to the injury or death 6. Changes of any person (including but not limited to The COUNTY may at any time and by written employees and agents of VENDOR in the notice make changes to drawings and performance of their duties or otherwise), or specifications, shipping instructions, quantities damage to property (including property of the and delivery schedules within the general scope COUNTY or other persons), which arise out of or of this Purchase Order. Should any such change are incident to the goods and/or services to be increase or decrease the cost of, or the time provided hereunder. required for performance of the Purchase Order, an equitable adjustment in the price and/or 11. Warranty of Non-Infringement delivery schedule will be negotiated by the VENDOR represents and warrants that all goods COUNTY and VENDOR. Notwithstanding the sold or services performed under this Purchase foregoing, VENDOR has an affirmative obligation Order are: a) in compliance with applicable laws; to give notice if the changes will decrease costs. b) do not infringe any patent, trademark, Any claims for adjustment by VENDOR must be copyright or trade secret; and c) do not constitute made within thirty (30) days from the date the unfair competition. change is ordered or within such additional period of time as may be agreed upon by the VENDOR shall indemnify and hold harmless the parties. COUNTY from and against any and all claims, including claims of negligence, costs and 7. Warranties expense, including but not limited to attorneys' VENDOR expressly warrants that the goods fees, which arise from any claim, suit or and/or services covered by this Purchase Order proceeding alleging that the COUNTY'S use of will conform to the specifications, drawings, the goods and/or services provided under this samples or other descriptions furnished or Purchase Order are inconsistent with VENDOR'S specified by the COUNTY, and will be of representations and warranties in section 11 (a). satisfactory material and quality production, free from defects and sufficient for the purpose If any claim which arises from VENDOR'S breach intended. Goods shall be delivered free from any of section 11 (a) has occurred, or is likely to security interest or other lien, encumbrance or occur, VENDOR may, at the COUNTY'S option, claim of any third party. These warranties shall procure for the COUNTY the right to continue survive inspection, acceptance, passage of title using the goods or services, or replace or modify and payment by the COUNTY. the goods or services so that they become non-infringing, (without any material degradation 8. Statutory Conformity in performance, quality, functionality or additional Goods and services provided pursuant to this cost to the COUNTY). Purchase Order, and their production and transportation shall conform to all applicable 12. Insurance Requirements laws, including but not limited to the Occupational The VENDOR, at its sole expense, shall provide Health and Safety Act, the Federal commercial insurance of such type and with such Transportation Act and the Fair Labor Standards terms and limits as may be reasonably Act, as well as any law or regulation noted on the associated with the Purchase Order. Providing face of the Purchase Order. and maintaining adequate insurance coverage is a material obligation of the VENDOR. All 9. Advertising insurance policies shall be executed through No VENDOR providing goods and services to the insurers authorized or eligible to write policies in COUNTY shall advertise the fact that it has the State of Florida. contracted with the COUNTY for goods and/or services, or appropriate or make use of the 13. Compliance with Laws COUNTY'S name or other identifying marks or In fulfilling the terms of this Purchase Order, property without the prior written consent of the VENDOR agrees that it will comply with all COUNTY'S Purchasing Department. federal, state, and local laws, rules, codes, and ordinances that are applicable to the conduct of its business. By way of non-exhaustive example, 10. Indemnification this shall include the American with Disabilities Act and all prohibitions against discrimination on #15-6474R 18 Packet Page-578- 2/9/2016 16.E.1. the basis of race, religion, sex creed, national conditions of this Purchase Order, provided that origin, handicap, marital status, or veterans' COUNTY has provided VENDOR with notice of status. Further, VENDOR acknowledges and such breach and VENDOR has failed to cure without exception or stipulation shall be fully within 10 days of receipt of such notice. responsible for complying with the provisions of the Immigration Reform and Control Act of 1986 19. General as located at 8 U.S.C. 1324, et seq. and a) This Purchase Order shall be governed by regulations relating thereto, as either may be the laws of the State of Florida. The venue amended. Failure by the awarded firm(s) to for any action brought to specifically enforce comply with the laws referenced herein shall any of the terms and conditions of this constitute a breach of the award agreement and Purchase Order shall be the Twentieth the County shall have the discretion to Judicial Circuit in and for Collier County, unilaterally terminate said agreement Florida immediately. Any breach of this provision may b) Failure of the COUNTY to act immediately in be regarded by the COUNTY as a material and response to a breach of this Purchase Order substantial breach of the contract arising from by VENDOR shall not constitute a waiver of this Purchase Order. breach. Waiver of the COUNTY by any default by VENDOR hereunder shall not be 14. Force Majeure deemed a waiver of any subsequent default Neither the COUNTY nor VENDOR shall be by VENDOR. responsible for any delay or failure in c) All notices under this Purchase Order shall performance resulting from any cause beyond be sent to the respective addresses on the their control, including, but without limitation to face page by certified mail, return receipt war, strikes, civil disturbances and acts of nature. requested, by overnight courier service, or by When VENDOR has knowledge of any actual or personal delivery and will be deemed potential force majeure or other conditions which effective upon receipt. Postage, delivery and will delay or threatens to delay timely other charges shall be paid by the sender. A performance of this Purchase Order, VENDOR party may change its address for notice by shall immediately give notice thereof, including all written notice complying with the relevant information with respects to what steps requirements of this section. VENDOR is taking to complete delivery of the d) The Vendor agrees to reimbursement of any goods and/or services to the COUNTY. travel expenses that may be associated with this Purchase Order in accordance with 15. Assignment Florida Statute Chapter 112.061, Per Diem VENDOR may not assign this Purchase Order, and Travel Expenses for Public Officers, nor any money due or to become due without the employees and authorized persons. prior written consent of the COUNTY. Any e) In the event of any conflict between or assignment made without such consent shall be among the terms of any Contract Documents deemed void. related to this Purchase Order, the terms of the Contract Documents shall take 16. Taxes precedence over the terms of the Purchase Goods and services procured subject to this Order. To the extent any terms and for Purchase Order are exempt from Florida sales conditions of this Purchase Order duplicate and use tax on real property, transient rental or overlap the Terms and Conditions of the property rented, tangible personal purchased or Contract Documents, the provisions of the rented, or services purchased (Florida Statutes, Terms and/or Conditions that are most Chapter 212), and from federal excise tax. favorable to the County and/or provide the greatest protection to the County shall 17. Annual Appropriations govern. The COUNTY'S performance and obligation to pay under this Purchase Order shall be contingent upon an annual appropriation of funds. 18. Termination This Purchase Order may be terminated at any time by the COUNTY upon 30 days prior written notice to the VENDOR. This Purchase Order may be terminated immediately by the COUNTY for breach by VENDOR of the terms and #15-6474R 19 Packet Page -579- 2/9/2016 16.E.1 . Exhibit IV: Additional ITB Terms and Conditions n 1. Additional Items and/or Services During the contract term, Collier County reserves the right to add related items and/or services upon negotiation of a satisfactory price by the Project Manager and Vendor. 2. Conflict of Interest Vendor shall provide a list of any businesses and/or organizations to which the firm has any affiliation or obligations within the past five (5) years; whether paid or donated, which could be construed by the County as a conflict of interest. Disclosure of any potential or actual conflict of interest is subject to County staff review and does not in and of itself disqualify a firm from consideration. These disclosures are intended to identify and or preclude conflict of interest situations during contract selection and execution. 3. Vendor Performance Evaluation Collier County has implemented a Vendor Performance Evaluation System for all contracts awarded in excess of$25,000. To this end, vendors will be evaluated on their performance upon completion/termination of agreement. 4. Deductions for Non-Performance The County reserves the right to deduct a portion of any invoice for goods not delivered, or services not performed in accordance with requirements, including required timeframe. The County may also deduct, or chargeback the Vendor the costs necessary to correct the deficiencies directly related to the Vendor's non-performance. 5. Offer Extended to Other Governmental Entities Collier County encourages and agrees to the successful vendor extending the pricing, terms and conditions of this solicitation or resultant contract to other governmental entities at the discretion of the successful vendor. 6. Environmental Health and Safety All Vendors and Sub vendors performing service for Collier County are required and shall comply with all Occupational Safety and Health Administration (OSHA), State and County Safety and Occupational Health Standards and any other applicable rules and regulations. Vendors and Sub vendors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site. All firewall penetrations must be protected in order to meet Fire Codes. Collier County Government has authorized OSHA representatives to enter any Collier County facility, property and/or right-of-way for the purpose of inspection of any Vendor's work operations. This provision is non-negotiable by any department and/or Vendor. All new electrical installations shall incorporate NFPA 70E Short Circuit Protective Device Coordination and Arc Flash Studies where relevant as determined by the engineer. All electrical installations shall be labeled with appropriate NFPA 70E arch flash boundary and PPE Protective labels. #15-6474R 20 Packet Page -580- 2/9/2016 16.E.1. 7. Florida Wood Products The Vendor/Contractor agrees to comply with Florida Statute 255.20 to provide lumber, timber and other forest products produced and manufactured in the State of Florida as long as the price, fitness and quality are equal. 8. Public Records Compliance The Vendor/Contractor agrees to comply with the Florida Public Records Law Chapter 119 (including specifically those contractual requirements at F.S. § 119.0701(2) (a)-(d) and (3)), ordinances, codes, rules, regulations and requirements of any governmental agencies. 9. Standards of Conduct The Vendor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Vendor shall supply competent employees who are physically capable of performing their employment duties. The County may require the Vendor to remove an employee it deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment on Collier County projects is not in the best interest of the County. 10. Licenses The Vendor is required to possess the correct professional and other licenses, and any other authorizations necessary to perform the required work pursuant to all applicable Federal, State and Local Law, Statute, Ordinances, and rules and regulations of any kind. Additionally, copies of all the required licenses must be submitted with the bid response indicating that the entity bidding, as well as the team assigned to the County account, is properly licensed to perform the activities or work included in the ITB documents. Failure on the part of any vendor to supply this documentation with their bid response may be grounds for deeming vendor non-responsive. A Vendor with an office within Collier County is required to have an occupational license. All State Certified contractors who may need to pull Collier County permits or call in inspections must complete a Collier County Contractor License registration form and submit the required fee. After registering the license/registration will need to be renewed thereafter to remain "active" in Collier County. Questions regarding professional licenses should be directed to Contractor Licensing, Community Development and Environmental Services at (239) 252-2431, 252-2432 or 252-2909. Questions regarding required Business Tax Receipt (formerly known as Occupational Licenses) should be directed to the Tax Collector's Office at (239)252-2477. 11. Protection of Property The Vendor shall ensure that the service is performed in such manner as to not damage any property. In the event damage occurs to any property as a direct result of the Vendor or their Sub vendor in the performance of the required service, the Vendor shall repair/replace, to the County's satisfaction, damaged property at no additional cost to the County. If the damage caused by the Vendor or their Sub vendor has to be repaired/replaced by the County, the cost of such work will be deducted from the monies due the Vendor. #15-6474R 21 Packet Page-581- 2/9/2016 16.E.1 . The County's project manager, shall coordinate with the Vendor/Contractor the return of any surplus assets, including materials, supplies, and equipment associated with the scope or work. 12. Prohibition of Gifts to County Employees No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, the current Collier County Ethics Ordinance and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the individual and/or firm for cause. 13. Invoice and Payments Payments are made in accordance with the Local Government Prompt Payment Act, Chapter 218, Florida Statutes. Vendor's invoices must include: • Purchase Order Number • Description and quantities of the goods or services provided per instructions on the County's purchase order or contract. Invoices shall be sent to: Board of County Commissioners Clerk's Finance Department ATTN: Accounts Payable 3299 Tamiami Trail E Ste 700 Naples FL 34112 Or emailed to: bccapclerk(a�collierclerk.com. Collier County, in its sole discretion, will determine the method of payment for goods and/or services as part of this agreement. Payment methods include: • Traditional —payment by check, wire transfer or other cash equivalent. • Standard — payment by purchasing card. Collier County's Purchasing Card Program is supported by standard bank credit suppliers (i.e. VISA and MasterCard), and as such, is cognizant of the Rules for VISA Merchants and MasterCard Merchant Rules. The County may not accept any additional surcharges (credit card transaction fees) as a result of using the County's credit card for transactions relating to this solicitation. The County will entertain bids clearly stating pricing for standard payment methods. An additional separate discounted price for traditional payments may be provided at the initial bid submittal if it is clearly marked as an "Additional Cash Discount." Upon execution of the Contract and completion of each month's work, payment requests may be submitted to the Project Manager on a monthly basis by the Contractor for services rendered for that prior month. Services beyond sixty (60) days from current monthly invoice will not be considered for payment without prior approval from the Project manager. All invoices should be submitted within the fiscal year the work was performed. (County's fiscal year is October 1 - September 30.) Invoices submitted after the close of the fiscal year will not be accepted (or processed for payment) unless specifically authorized by the Project Manager. #15-6474R 22 Packet Page -582- 2/9/2016 16.E.1 . Payments will be made for articles and/or services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of contract. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of"laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this agreement. In instances where the successful contractor may owe debts (including, but not limited to taxes or other fees)to Collier County and the contractor has not satisfied nor made arrangement to satisfy these debts, the County reserves the right to off-set the amount owed to the County by applying the amount owed to the vendor or contractor for services performed of for materials delivered in association with a contract. Invoices shall not reflect sales tax. After review and approval, the invoice will be transmitted to the Finance Division for payment. Payment will be made upon receipt of proper invoice and in compliance with Chapter 218 Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." Collier County reserves the right to withhold and/or reduce an appropriate amount of any payment for work not performed or for unsatisfactory performance of Contractual requirements. 14. Survivability Bids (ITBs/RFPs): The Consultant/ContractorNendor agrees that any Work Order/Purchase Order that extends beyond the expiration date of Solicitation 15-6474R resultant of this solicitation will survive and remain subject to the terms and conditions of that Agreement until the completion or termination of any Work Order/Purchase Order. 15. Insurance Requirements Solicitation 15-6474R Medical Director for Collier County and Employment Physicals & Drug Testing The Vendor shall at its own expense, carry and maintain insurance coverage from responsible companies duly authorized to do business in the State of Florida as set forth in Insurance and Bonding Requirements Attachment of this solicitation. The Vendor shall procure and maintain property insurance upon the entire project, if required, to the full insurable value of the scope of work. The County and the Vendor waive against each other and the County's separate Vendors, Contractors, Design Consultant, Subcontractors agents and employees of each and all of them, all damages covered by property insurance provided herein, except such rights as they may have to the proceeds of such insurance. The Vendor and County shall, where appropriate, require similar waivers of subrogation from the County's separate Vendors, Design Consultants and Subcontractors and shall require each of them to include similar waivers in their contracts. Collier County shall be responsible for purchasing and maintaining, its own liability insurance. Certificates issued as a result of the award of this solicitation must identify "For any and all work performed on behalf of Collier County." The General Liability Policy provided by Vendor to meet the requirements of this solicitation shall name Collier County, Florida, as an additional insured as to the operations of Vendor under this solicitation and shall contain a severability of interests provisions. #15-6474R 23 Packet Page-583- 2/9/2016 16.E.1. Collier County Board of County Commissioners shall be named as the Certificate Holder. The "Certificate Holder" should read as follows: Collier County Board of County Commissioners Naples, Florida The amounts and types of insurance coverage shall conform to the minimum requirements set forth in the Insurance and Bonding Requirements Attachment, with the use of Insurance Services Office (ISO)forms and endorsements or their equivalents. If Vendor has any self-insured retentions or deductibles under any of the below listed minimum required coverage, Vendor must identify on the Certificate of Insurance the nature and amount of such self- insured retentions or deductibles and provide satisfactory evidence of financial responsibility for such obligations. All self-insured retentions or deductibles will be Vendor's sole responsibility. Coverage(s) shall be maintained without interruption from the date of commencement of the Work until the date of completion and acceptance of the scope of work by the County or as specified in this solicitation, whichever is longer. The Vendor and/or its insurance carrier shall provide 30 days written notice to the County of policy cancellation or non-renewal on the part of the insurance carrier or the Vendor. The Vendor shall also notify the County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Vendor from its insurer and nothing contained herein shall relieve Vendor of this requirement to provide notice. In the event of a reduction in the aggregate limit of any policy to be provided by Vendor hereunder, Vendor shall immediately take steps to have the aggregate limit reinstated to the full extent permitted under such policy. Should at any time the Vendor not maintain the insurance coverage(s) required herein, the County may terminate the Agreement or at its sole discretion shall be authorized to purchase such coverage(s) and charge the Vendor for such coverage(s) purchased. If Vendor fails to reimburse the County for such costs within thirty (30) days after demand, the County has the right to offset these costs from any amount due Vendor under this Agreement or any other agreement between the County and Vendor. The County shall be under no obligation to purchase such insurance, nor shall it be responsible for the coverage(s) purchased or the insurance company or companies used. The decision of the County to purchase such insurance coverage(s) shall in no way be construed to be a waiver of any of its rights under the Contract Documents. If the initial or any subsequently issued Certificate of Insurance expires prior to the completion of the scope of work, the Vendor shall furnish to the County renewal or replacement Certificate(s) of Insurance not later than ten (10) calendar days after the expiration date on the certificate. Failure of the Vendor to provide the County with such renewal certificate(s) shall be considered justification for the County to terminate any and all contracts. 15. Collier County Information Technology Requirements All vendor access will be done via VPN access only. All access must comply with current published County Manager Agency (CMA) policies. Current policies that apply are CMAs 5402, 5403 and 5405. These policies will be available upon request from the Information Technology Department. All vendors will be required to adhere to IT policies for access to the County network. Vendors are required to notify the County in writing twenty-four (24) hours in advance as to when access to the network is planned. Included in this request must be a detailed work plan with actions that will be taken at the time of access. The County IT Department has developed a Technical Architecture Requirements Document that is #15-6474R 24 Packet Page-584- 2/9/2016 16.E.1 . required to be filled out and submitted with your bid response. This document can be found on the Collier County Purchasing Department website: www.colliergov.net/purchasinq. On the left hand side of the menu, click on CC Technical Requirements. If this document is not submitted with your bid response, your bid response may be deemed non-responsive. 16. Security and Background Checks If required, Vendor/Contractor/ Proposer shall be responsible for the costs of providing background checks by the Collier County Facilities Management Department, and drug testing for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four (4)years. 17. Maintenance of Traffic Policy For all projects that are conducted within a Collier County Right-of-Way, the Vendor shall provide and erect Traffic Control Devices as prescribed in the current edition of the Manual On Uniform Traffic Control Devices (MUTCD), where applicable on local roadways and as prescribed in the Florida Department of Transportation's Design Standards (DS)on state roadways. These projects shall also comply with Collier County's Maintenance of Traffic Policy, #5807, incorporated herein by reference. Copies are available through the Risk Management and/or Purchasing Departments and are available on-line at colliergov.net/purchasing. The Vendor will be responsible for obtaining copies of all required manuals, MUTCD, FDOT Roadway &Traffic Design Standards Indexes, or other related documents, so to become familiar .-� with their requirements. Strict adherence to the requirements of the Maintenance of Traffic ("MOT") policy will be enforced under this Contract. All costs associated with the Maintenance of Traffic shall be included on the line item on the bid page. If MOT is required, MOT is to be provided within ten (10) days of receipt of Notice of Award. 18. Debris Vendor shall be responsible for the removal and disposal of all debris from the site and the cleaning of the affected areas. Vendor shall keep the premises free of debris and unusable materials resulting from their work and as work progresses; or upon the request of the County's representative, shall remove and dispose such debris and materials from the property. The Vendor shall leave all affected areas as they were prior to beginning work. 19. Direct Material Purchase The County reserves the right to require Vendor to assign some or all of its agreements with material suppliers directly to the County. Any such goods and/or materials purchased by the County pursuant to such an assignment of a material supply agreement shall be referred to as "County Furnished Materials" and the responsibilities of both the County and the Vendor relating to said materials shall be governed by the terms and conditions of this solicitation. Additionally, the County at its sole option may choose to purchase some or all of the goods and/or materials from other suppliers. In either instance the County may require the following information from the Vendor: • Required quantities of material. #15-6474R 25 Packet Page-585- 2/9/2016 16.E.1 . • Specifications relating to goods and/or materials required for job including brand and/or model number or type if applicable • Pricing and availability of goods and/or materials provided under Vendor's agreements with material suppliers 20. Grant Compliance The purchase of any goods and/or services that are funded through Federal Grant Appropriations, the State of Florida, or any other public or private foundations shall be subject to the compliance and reporting requirements of the granting agency. 21. Equipment Vendor shall have available and in good working condition, the necessary equipment to perform the required service. If required, the Vendor shall supply a list of equipment and an hourly rate for each. Hourly rates will commence once equipment arrives at the service site. In the event that additional specialized and/or heavy equipment (backhoe, crane, mudhog, etc.) is needed, the Project Manager must be notified in advance for approval. The reimbursement of additional equipment expense shall be at cost and will commence once equipment arrives at the service site. The County reserves the right to request and obtain documentation of the Vendor's cost, and to withhold payments until documentation is provided. The scope of these specifications is to ensure the delivery of a complete unit ready for operation. Omission of any essential detail from these specifications does not relieve the Vendor from furnishing a complete unit. All equipment must be new and of current manufacture in production at the time of ITB opening, and carry standard warranties. At the time of delivery, at least two (2) complete shop repair manuals and parts lists must be furnished with each type of equipment. Vendor must service all equipment prior to delivery and/or acceptance by the County. 22. Storage Tank Installation and Closure Requirements The contractor shall ensure compliance with all NFPA regulations: specifically 110 & 30/30A; FDEP chapter 62 regulations: specifically 761, 762, 777, and 780; 376 & 403 Florida Statutes; and STI, UL, PEI, ASME, NACE, NLPA, NIST &API referenced standards pertaining to the storage of hazardous materials and petroleum products. The contractor shall notify the Solid & Hazardous Waste Management Department (SHWMD) prior to the installation, removal, or maintenance of any storage tank, including day tanks for generators, storing /will be storing petroleum products or hazardous materials. The contractor shall provide a 10 day and 48 hour notice to SHWMD 239-252-2508 prior to commencement. The contractor shall provide the plans pertaining to the storage tank systems containing hazardous materials / petroleum products to the SHWMD prior to plans submittal to a permitting entity and then SHWMD must approve the plans prior to contractor's submittal for permitting. 23. 62-761.300 Applicability 1) General Requirements: a) Underground storage tank systems: The requirements of this Chapter, unless specified otherwise, apply to owners and operators of facilities, or owners and operators of UST #15-6474R 26 Packet Page -586- 2/9/2016 16.E.1. systems with individual storage tank capacities greater than110 gallons that contain or contained: �• i) Vehicular fuel, subject to Chapter 17-61, F.A.C., after May 21, 1984 ii) Pollutants or hazardous substances after December 10, 1990; or iii) Regulated substances in unmaintained storage tank systems. b) This rule is applicable to non-residential facilities. Under 40 C.F.R. 280, residential tanks greater than 1100 gallons containing motor fuels are subject to Federal UST rules (advisory information only-not required by this Chapter). 24. 62-762.301, F.A.C. Applicability 1) General Requirements: a) Aboveground storage tank systems: The requirements of this chapter, unless specified otherwise, apply to owners and operators of facilities, or owners and operators of aboveground stationary storage tank systems with individual storage tank capacities greater than 550 gallons that contain or contained: Vehicular fuel, subject to Chapter 17- 61, F.A.C., after May 21, 1984 (1) Vehicular fuel, subject to Chapter 17-61, F.A.C., after May 21, 1984; (2) Pollutants after March 12, 1991; or (3) Pollutants in unmaintained storage tank systems. b) Aboveground compression vessels and hazardous substance storage tank systems: Owners and operators of compression vessels and hazardous substance storage tanks with capacities of greater than 110 gallons containing hazardous substances are only required to comply with subsections 62-762.401(1)-(2), F.A.C. c) Aboveground mineral acid storage tank systems: Owners and operators of facilities, or owners and operators of aboveground mineral acid storage tank systems with capacities of greater than 110 gallons containing mineral acids are only required to comply with Rule 62- 762.891, F.A.C. 25. Definitions 62-761.200(11) and 62-762.201(16), F.A.C.: "County" means a locally administered program under contract with the Department to perform compliance verification activities at facilities with storage tank systems. 62-761.200(48) and 62-762.201(62), F.A.C.: "Pollutants" includes any"product" as defined in Section 377.19(11), F.S., pesticides, ammonia, chlorine and derivatives thereof, excluding liquefied petroleum gas. 62-761.200(51) and 62-762.201(65), F.A.C.: "Product' as defined in Section 377.19(11), F.S., means any commodity made from oil or gas and includes refined crude oil, crude tops, topped crude, processed crude petroleum, residue from crude petroleum, cracking stock, uncracked fuel oil, fuel oil, treated crude oil, residuum, gas oil, casing head gasoline, natural gas gasoline, naphtha, distillate, condensate, gasoline, used oil, kerosene, benzene, wash oil, blended gasoline, lubricating oil, blends or mixtures of oil with one or more liquid products or byproducts derived from oil or gas, and blends or mixtures of two or more liquid products or byproducts derived from oil or gas, whether hereinabove enumerated or not. 62-761(73) and 62-762(84), F.A.C.: "Vehicular fuel" means a petroleum product used to fuel motor vehicles, including aircraft, watercraft and vehicles used on and off roads and rails. #15-6474R 27 Packet Page-587- 2/9/2016 16.E.1 . Co Ater County Adnvnittrative Services Department Procurement Services Division Attachment 1: Vendor Submittal -Vendor's Non-Response Statement The sole intent of the Collier County Purchasing Department is to issue solicitations that are clear, concise and openly competitive. Therefore, we are interested in ascertaining reasons why prospective Vendors did not wish to respond to this ITB. If your firm is not responding to this ITB, please indicate the reason(s) by checking any appropriate item(s) listed below and return this form via email or fax to the Procurement Strategist listed on the first page or mail to: Collier County Purchasing Department, 3327 Tamiami Trail East, Naples, Florida 34112. We are not responding to this ITB for the following reason(s): Solicitation: ITB 15-6474R Medical Director for Collier County and Employment Physicals & Drug Testing ❑ Services requested not available through our company. ❑ Our firm could not meet specifications/scope of work. ❑ Specifications/scope of work not clearly understood (too vague, rigid, etc.) ❑ Project is too small. ❑ Insufficient time allowed for preparation of response. ❑ Incorrect address used. Please correct mailing address: ❑ Other reason(s): Firm's Complete Legal Name Address City, State, Zip Telephone Number FAX Number Signature/Title Type Name of Signature Date: • #15-6474R 28 Packet Page -588- 2/9/2016 16.E.1 . Collier County v Administrative Sal/ices Department Procurement Services C}l e can Attachment 2: Vendor's Check List IMPORTANT: THIS SHEET MUST BE SIGNED BY VENDOR. Please read carefully, sign in the spaces indicated and return with bid. Vendor should check off each of the following items as the necessary action is completed: 1. The Bid has been signed. 2. The Bid prices offered have been reviewed. 3. The price extensions and totals have been checked. 4. The payment terms have been indicated. 5. Any required drawings, descriptive literature, etc. have been included. 6. Any delivery information required is included. 7. If required, the amount of bid bond has been checked, and the bid bond or cashiers check has been included. 8. Addendum have been signed and included, if applicable. 9. Affidavit for Claiming Status as a Local Business, if applicable. 10. Immigration Affidavit and company's E-Verify profile page or memorandum of understanding. 11. Copies of licenses, equipment lists, subcontractors or any other information as noted in this ITB. 12. The mailing envelope must be addressed to: Procurement Director Collier County Government Purchasing Department 3327 Tamiami Trail E Naples FL 34112 The mailing envelope must be sealed and marked with: • Solicitation: : ITB 15-6474R Medical Director for Collier County and Employment Physicals & Drug Testing • Opening Date: November 9, 2015 13. The bid will be mailed or delivered in time to be received no later than the specified opening date and time. (Otherwise bid cannot be considered.) 14. If submitting a manual bid, include any addenda (initialed and dated noting understanding and receipt). If submitting bid electronically, bidder will need to download all related documents on www.colliergov.net/bid. The system will date and time stamp when the addendum files were downloaded. ALL COURIER DELIVERED BIDS MUST HAVE THE BID NUMBER AND TITLE ON THE OUTSIDE OF THE COURIER PACKET. Company Name Signature & Title Date #15-6474R 29 Packet Page -589- 2/9/2016 16.E.1 . Co icr County �. Administrative services Department Procurement Services Division Attachment 3: Vendor Submittal - Bid Response Form FROM: Board of County Commissioners Collier County Government Center Naples, Florida 34112 RE: Solicitation: ITB 15-6474R Medical Director for Collier County and Employment Physicals & Drug Testing Dear Commissioners: The undersigned, as Vendor, hereby declares that the specifications have been fully examined and the Vendor is fully informed in regard to all conditions pertaining to the work to be performed for as per the scope of work. The Vendor further declares that the only persons, company or parties interested in this Bid or the Contract to be entered into as principals are named herein; that this Bid is made without connection with any other person, company or companies submitting a Bid; and it is all respects fair and in good faith, without collusion or fraud. The Vendor proposes and agrees if this bid is accepted, to comply with the requirements in full and in accordance with the terms, conditions and specifications denoted herein. The Vendor agrees to provide the following: *** SEE FOLLOWING PAGES ** * Any discounts or terms must be shown on the Bid Response Form. Such discounts, if any, will be considered and computed in the tabulation of the bids. In no instance should terms for less than fifteen (15) days payment be offered. Prompt Payment Terms: % Days; Net_ Days Bid Response Form is electronic. Please input your prices online. n Bid Response is as follows: Note: If you choose to bid manually, please submit an ORIGINAL and ONE COPY of your bid response pages. The undersigned do agree that should this Bid be accepted, to execute a formal contract, if required, and present the formal contract to the County Procurement Director for approval within fifteen (15) days after being notified of an award. #15-6474R 30 Packet Page -590- 2/9/2016 16.E.1 . IN WITNESS WHEREOF, WE have hereunto subscribed our names on this day of , 2015 in the County of , in the State of Firm's Complete Legal Name Address City, State, Zip Florida Certificate of Authority Document Number Federal Tax Identification Number CCR #or CAGE Code Telephone Number FAX Number Signature/Title Type Name of Signature Date Additional Contact Information Send Payments To: (REQUIRED ONLY if different from above) Firm's Complete Legal Name Address City, State, Zip Contact Name Telephone Number FAX Number Email Address #15-6474R 31 Packet Page -591- 2/9/2016 16.E.1. Cater County Administrative Services Department /"■ Procurement Services Division Attachment 4: Vendor Submittal — Local Vendor Preference Affidavit Solicitation: ITB 15-6474R Medical Director for Collier County and Employment Physicals &Drug Testing (Check Appropriate Boxes Below) State of Florida(Select County if Vendor is described as a Local Business ❑ Collier County ❑ Lee County Vendor affirms that it is a local business as defined by the Purchasing Policy of the Collier County Board of County Commissioners and the Regulations Thereto. As defined in Section XI of the Collier County Purchasing Policy: Local business means the vendor has a current Business Tax Receipt issued by the Collier County Tax Collector for at least one year prior to bid or proposal submission to do business within Collier County, and that identifies the business with a permanent physical business address located within the limits of Collier County from which the vendor's staff operates and performs business in an area zoned for the conduct of such business. A Post Office Box or a facility that receives mail, or a non-permanent structure such as a construction trailer, storage shed, or other non-permanent structure shall not be used for the purpose of establishing said physical address. In addition to the foregoing, a vendor shall not be considered a "local business"unless it contributes to the economic development and well-being of Collier County in a verifiable and measurable way.This may include, but not be limited to,the retention and expansion of employment opportunities, support and increase to the County's tax base, and residency of employees and principals of the business within Collier County.Vendors shall affirm in writing their compliance with the foregoing at the time of submitting their bid or proposal to be eligible for consideration as a"local business" under this section.A vendor who misrepresents the Local Preference status of its firm in a proposal or bid submitted to the County will lose the privilege to claim Local Preference status for a period of up to one year under this section. Vendor must complete the following information: Year Business Established in ['Collier County or❑ Lee County: Number of Employees (Including Owner(s)or Corporate Officers): Number of Employees Living in ❑ Collier County or❑ Lee (Including Owner(s)or Corporate Officers): If requested by the County,vendor will be required to provide documentation substantiating the information given in this affidavit. Failure to do so will result in vendor's submission being deemed not applicable. Vendor Name: Date: Address in Collier or Lee County: Signature: Title: STATE OF FLORIDA ❑ COLLIER COUNTY ❑ LEE COUNTY Sworn to and Subscribed Before Me, a Notary Public,for the above State and County, on this Day of , 20 Notary Public My Commission Expires: (AFFIX OFFICIAL SEAL) #15-6474R 32 Packet Page-592- 2/9/2016 16.E.1 . Co -ter County Administrative Services Department Procurement Services Division Attachment 5:Vendor Submittal—Immigration Affidavit Solicitation: ITB 15-6474R Medical Director for Collier County and Employment Physicals& Drug Testing This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal Invitations to Bid (ITB's)and Request for Proposals (RFP)submittals. Further, Vendors/ Bidders are required to enroll in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Failure to include this Affidavit and acceptable evidence of enrollment in the E-Verify program, may deem the Vendor/ Bidder's proposal as non-responsive. Collier County will not intentionally award County contracts to any vendor who knowingly employs unauthorized alien workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e)of the Immigration and Nationality Act("INA"). Collier County may consider the employment by any vendor of unauthorized aliens a violation of Section 274A(e)of the INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A(e)of the INA shall be grounds for unilateral termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act and subsequent Amendment(s))and agrees to comply with the provisions of the Memorandum of Understanding with E- Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify), operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the .-. Vendor's/Bidder's proposal. Company Name Print Name Title Signature Date State of County of The foregoing instrument was signed and acknowledged before me this day of ,20_,by who has produced as identification. (Print or Type Name) (Type of Identification and Number) Notary Public Signature Printed Name of Notary Public Notary Commission Number/Expiration The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of this affidavit to interrogatories hereinafter made. #15-6474R 33 Packet Page-593- 2/9/2016 16.E.1 . colter Camay Administrative Services Department Procurement Services Division Attachment 6: Vendor Substitute W—9 Request for Taxpayer Identification Number and Certification In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following information for tax reporting purposes from individuals and companies who do business with the County (including social security numbers if used by the individual or company for tax reporting purposes). Florida Statute 119.071(5) require that the county notify you in writing of the reason for collecting this information, which will be used for no other purpose than herein stated. Please complete all information that applies to your business and return with your quote or proposal. 1. General Information (provide all information) Taxpayer Name (as shown on income tax return) Business Name (if different from taxpayer name) • Address City State Zip Telephone FAX Email Order Information Remit/Payment Information Address Address City State Zip City State Zip FAX FAX Email Email 2. Company Status (check only one) _Individual/Sole Proprietor _Corporation Partnership _Tax Exempt(Federal income tax-exempt entity Limited Liability Company under Internal Revenue Service guidelines IRC 501 (c)3) Enter the tax classification (D=Disregarded Entity, C=Corporation, P=Partnership) 3. Taxpayer Identification Number(for tax reporting purposes only) Federal Tax Identification Number(TIN) (Vendors who do not have a TIN,will be required to provide a social security number prior to an award of the contract.) 4. Sign and Date Form Certification: Under penalties of perjury, I certify that the information shown on this form is correct to my knowledge. Signature Date Title Phone Number #15-6474R 34 Packet Page -594- 2/9/2016 16.E.1. Cofer County Adminatrdtive Services Department Procurement 5ertiices Dw sion Attachment 7: Vendor Submittal - Insurance and Bonding Requirements Insurance/Bond Type Required Limits 1. ® Worker's Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government Compensation Statutory Limits and Requirements 2. ® Employer's Liability $500,000 single limit per occurrence 3. ® Commercial General Bodily Injury and Property Damage Liability(Occurrence Form) patterned after the current $500,000 single limit per occurrence, $2,000,000 aggregate for Bodily Injury ISO form Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. 4. ® Indemnification To the maximum extent permitted by Florida law, the ContractorNendor/Consultant shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys'fees and paralegals'fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the ContractorNendor/Consultant or anyone employed or utilized by the ContractorNendor/Consultant in the performance of this Agreement. 4. ®Automobile Liability $ 500,000 Each Occurrence; Bodily Injury& Property Damage, Owned/Non-owned/Hired;Automobile Included 5. ® Other insurance as ® Medical Professional Liability $250,000 Per Occurrence, noted: $750,000 in the aggregate ® Medical Malpractice $ 1,000,000 Per Occurrence 6. ❑ Bid bond Shall be submitted with proposal response in the form of certified funds, cashiers'check or an irrevocable letter of credit, a cash bond posted with the County Clerk, or proposal bond in a sum equal to 5% of the cost proposal. All checks shall be made payable to the Collier County Board of County Commissioners on a bank or trust company located in the State of Florida and insured by the Federal Deposit Insurance Corporation. 7. ❑ Performance and For projects in excess of$200,000, bonds shall be submitted with the Payment Bonds executed contract by Proposers receiving award, and written for 100% of the Contract award amount, the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner; provided, however, the surety shall be rated as"A-"or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5%of the reported policy holders' surplus, all as reported in the most current Best Key Rating Guide, published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New York 10038. #15-6474R 35 Packet Page-595- 2/9/2016 16.E.1 . 8. ® Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Vendor shall provide County with certificates of insurance meeting the required insurance provisions. 9. ® Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability where required. 10. ® The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The Certificates of Insurance must state the Contract Number, or Project Number, or specific Project description, or must read: For any and all work performed on behalf of Collier County. 11. ® Thirty (30) Days Cancellation Notice required. Ljb 9/25/2015 Vendor's Insurance Statement We understand the insurance requirements of these specifications and that the evidence of insurability may be required within five (5) days of the award of this solicitation. Name of Firm Date Vendor Signature Print Name Insurance Agency _ Agent Name _ Telephone Number #15-6474R 36 Packet Page -596-