Loading...
#15-6474R (Advance Medical of Naples, LLC) amendment THIRD AMENDMENT TO AGREEMENT#15-6474R FOR MEDICAL DIRECTOR FOR COLLIER COUNTY AND EMPLOYMENT PHYSICALS AND DRUG TESTING THIS THIRD AMENDMENT, made and entered into on this 2g+4 day of --5b,,,4.-Ary 2025,by and between Advance F Medical of Naples,LLC(the "Provider")and Collier Countyla political subdivision of the State of Florida, (the "County"): WHEREAS, on February 9, 2016 (Agenda Item 16.E.1), the County entered into an Agreement with the Provider to provide medical oversight for the County's Occupational Health Program; and WHEREAS, on October 15, 2018. the County administratively approved the First Amendment to the Agreement to add two additional testing categories to Exhibit B- Price, Part B to include Pre-Placement Health Screening at a cost of$45.00, and Hepatitis A/B Vaccination at a cost of $110.00; and WHEREAS, on January 14, 2020, the County amended the Agreement to extend the Agreement term an additional five years, beginning on February 9, 2020, and ending on February 8, 2025, and to include Exhibit B-1 containing updated pricing. WHEREAS,the Parties desire to further amend the Agreement to extend the Agreement term one additional year, beginning on February 9, 2025 and ending on February 8, 2026. and to include Exhibit B-1, which contains updated pricing. NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the Parties as follows: 1. The Agreement is hereby extended one additional year from the Agreement end date of February 8, 2025. with a new end date of February 8, 2026. 2. Exhibit B-1 Pricing is hereby incorporated to the Agreement containing revised pricing effective on February 9, 2025. 3. Except as modified through this Amendment, all other terms and conditions of the Agreement shall remain the same. SIGNATURE PAGE TO FOLLOW **Remainder of this page left blank intentionally** Page 1 of 4 Third Amendment to Agreement# 15-6474R CA IN WITNESS WHEREOF,the Parties have executed this Third Amendment by an authorized person or agent on the date and year first written above. A ri EST: Crystal K. Kinzel, Clerk of Courts& BOARD OF COUNTY COMMISSIONERS Comptroller COLLIER COUNTY, FLORIDA ,.,fp• fa"401 -;‘.‘ "'''''•' /2 r, <km4,4L_Ir__ By p : lif,Vt,:aeoitt.00-- .. - s i i ttest as to Chairman's Burt L. Saunders, Chairman Dated: •, ;: A,.> 1,?-0-41.; signature only (SEAL) Provider's Witnesses: PROVIDER: ADVANC MEDICAL OF NAPLES, LLC , 1:411,6)213Y10_1___k _ Irst Witness By: kOr i Signature Anti PLOttifi9d /Type/print witne amels ell try t • kid_th Y 1Typerpritt. signature and titlet ) econd W. ss 116,02_( — /7 t. ). Lotdoida t4) 6 Date /Type/print witness namer rov d as v F an Legality: -"---tv ( Scott R. Teach, Deputy County Attorney „.'--;--------„, ( \ Page 2 of 4 6yvi Third Amendment to Agreement 4 I5-6474R EXHIBIT B-I PRICING (Effective 02109/2025) Annual Cost PART A:Medical Director Services Annual Cost $ 15,000.00 Unit of Pricing PART B:Item Description Physical Exam/Testing Types: Measure Pre-Placement Employment Physical ea $ 125.00 ea $ 1-2400 Firefighter/EMT Physicals preplacement/annual ea $ 150.00 ea $ 120.00 SCUBA Diving Medical Examination and Certification ea $ 100.00 CDL Physical(DOT)annual or preplacement ea $ 140.00 Fitness for Duty Examination ea $ 250.00 ea $ 1-1-400 Laboratory Services: Laborato Work includes the following tests ea $ 52.00 Cbc Chem Lipid UA C eatininc ea $ 240 &UN ea $ 00 TSH Thyroid Stimulating Hormone ea $ 17.00 C Reactive Protein ea $ 14.00 Heavy Metals Test includes following: ea $ 137.00 Arsenic-Blood Cadmium-Blood Lead-Blood Mercury-Blood Heavy Metals Test-Blood-Aluminum ea $ 35.00 Heavy Metals Test-Blood-Antimony ea $ 152.00 Heavy Metals Test-Blood-Bismuth ea $ 152.00 Heavy Metals Test-Blood-Chromium ea $ 61.00 Heavy Metals Test-Blood-Copper ea $ 20.00 Heavy Metals Test-Blood-Nickel ea $ 145.00 Heavy Metals Test-Blood-Zinc ea $ 22.00 HbA1c ea $ 18.00 RBCCholinesterase ea $ 52.00 Arsenic Urine ea $ 8-7 00 Mere y---Urine ea $ 5&0O Page 3 of 4 Third Amendment to Agreement ft 15-6474R PolychbrinatedEiphemyls ea 189-00 Hep#�tis6 Surface une status) ea $ 32.08 Mn&«m Titer includes the following en $ 7110 Measles . Mumps Rubeob Rabies Titer(if previously immunized) ea $ 152.00 VariceUa Titer(if previously immunized nr active disease) ea $ 32.00 ea $ i6.0A H|V1&J Antibody Test ea $ 32,00 PAP Test w/HPV ea $ 165.00 PSA1T0--tal ea $ 22.00 Q�qtife on Gold(TB) ea $ 108.00 Drug Screening Services Blood Alcohol Test ea $ 50.00 Breath Alcohol Test—(AdministeredbyaBreathAJcohxdTechnidan meeting DOT Oma|iMcadonsOnly) | ea $ 40.80 Drug Screen wYyWRO — DOT S Panel (Collected per DOT Urine Spednne-n Collection Guidelines—49[FR Part 4O) ea $ WOO _ Drug Screen w/K4RO—HRS5Panel ea $ 45.00 Drug Screen w/K4R0—HnS1OPanel ea . $ BlUD . Vaccines~ - ~ Measles,Mumps,Rubella Vaccination(K4mK) ea $ 120M VahceUa Vaccination(Price per injection) ea $ 220�00 ea $ 44�00 Hepatitis 8 Vaccination Series(Price per injection) ea $ 75.00 Twi vaccine combined ea $ 135.00 _ Pre-exposure Rabies Vaccination Series(Price per injection) ea 685�00 Tetanus/diphthe,iaVaccinatiun ea $ S8OO� � TdapVaccinadon ea $ 68�0O ' ` ` Diagnostic Testing ^ � Chest x-ray(2view) ea $ 75{0 Chest x-ray(4~view) ea $ 90.00 Sigrnoidoscopy ea $ 400.00 | Chest[T without contrast ea 350.00 PPD Testing w/Readin0(induration measurement) ea 2110 Audiometric Screening Test(per OSHA) ea $ 1I00 Pulmonary Function Test(with interpretation) ea $ 45�00 � [KG 12 Lead(with interpretation and physician confirmation) ea $ 47.00 Cardiac Stress Test(with interpretation and physician confirmation) ea g 175.00 Echocardiogram(with interpretation and physician confirmation) ea $ 265.00 Prostate Exam ea 8.00 Page 4of4 Third Amendment/o Agreement# 15'6474K ��� AFFIDAVIT REGARDING LABOR AND SERVICES Effective July 1, 2024, pursuant to § 787.06(13), Florida Statutes, when a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services. Nongovernmental Entity's Name: Advance Medical of Naples, LLC Address: 720 Goodlette Frank Road North, Suite 500, Naples, FL 34102 Phone Number: 239.566.7676 Authorized Representative's Name: Gregory E. Leach Authorized Representative's Title: MD, MBA, Owner Email Address: Iraymond©advmednaples.com AFFIDAVIT Gregory E. Leach (Name of Authorized Representative), as authorized representative attest that Advance Medical of Naples, LLC (Name of Nongovernmental Entity) does not use coercion for labor or services as defined in § 787.06, Florida Statutes. Under p a perj , I declare that I have read the foregoing Affidavit and that the facts stated in it are true. 1/9/2025 ( ign ure o auth epresentative Date STATE OF Florida COUNTY OF Collier Sworn to (or affirmed) and subscribed before me, by means of II physical presence or ❑ online notarization this 9th day of January , 20 , byGregory E. Leach (Name of Affiant), who produced his Florida Driver's License as identificati ( • sift' ` AUDREY M.DENIHAN _*: *` MY COMMISSION#NH 374928 Notary Pu is not required when digital) •.* P?`' EXPIRES:May11,2027 1/9/2025 Commission Expires Personally Known ® OR Produced Identification 1=1 Type of Identification Produced: Florida Drivers License