1092-Company Care Letter of AgrCompany Care
Provider Letter of Agreement
This Agreement, effective the 18 day of September 20 Ol b
and between Company Care (herein referred to as "Provider") and _Gifu of Sanford. (herein
referred to as "Client"), is as follows:
1. Scone of Services• Provider shall perform the series listed on Attachment A. Client
shall pay Provider in accordance with the fees set forth in Attachment A.
2. Tenn: The term of this Agreement shall be for the period October 1. 2001 to
September 30, 2004
3. Changes: Any changes to this Agreement shall be made by mutual written consent
of both Parties.
4. Compensation Client will pay Provider for services rendered within thirty (30) days
of the date of invoice. Client will be billed according to the information supplied by
the Client and attached hereto as Attachment B.
5. Termination: This contract may be terminated by either party, at any time, upon
sixty (60) days prior written notice.
6. Insurance and Indemnification: Provider shall maintain, at its sole cost and
expense, professional liability insurance with an insurer satisfactory to Client, with
minimum limits of $1,000.000.00 per occurrence, $3,000.000.00 in the aggregate and
shall at the request of Client, provide written evidence of said insurance coverage. In
the event said coverage is changed materially, Provider shall, within ten (10) days of
such material change, notify Client in writing. Provider shall indemnify, defend and
save Client harmless from and against any and all losses, claims, damages,
liabilities, and expenses (including, without limitation to, reasonable attorney's fees)
based upon, arising out of, or attributable to any acts or omissions arising from
Provider's performance hereunder.
7. Licensure/Compliance• Provider warrants and represents that it is licensed to
Perform the services provided under this Agreement and shall maintain all such
licenses for the duration of the Agreement. In addition, Provider represents that the
services provided hereunder are in compliance with any and all applicable Federal
and State statutes, laws and/or regulations.
8. Resolutions of Dispute. the event a dispute between Client and Provider, or any
affiliated provider, arises out of or is related to this Agreement, the Parties shall meet
and negotiate in good faith to attempt to resolve this dispute. If, after at least thirty
(30) days following the date one party sent written notice of the dispute to the other
party, the dispute is not resolved, and if any party wishes to pursue the dispute, it
shall be submitted to binding arbitration in accordance with the rules then in effect of
the National Health Lawyers Association (the "NHLA "). In no event may arbitration
be initiated more than one (1) year following the sending of written notice of the
dispute. The arbitrator shall have no authority to award any punitive or exemplary
damages. Any arbitration proceeding under this agreement shall be conducted in
Orlando, FL. or in such other location agreed to by the parties. Any award entered
into by the arbitrator shall be final and binding on the parties and may be entered as
a judgment in any court having jurisdiction. If the dispute pertains to a matter which
is generally administered by certain Client procedures, such as credentialing or a
quality assessment plan, the procedures set forth in that plan must be fully exhausted
before either party may evoke its right to arbitration under this Section.
9. Hold Harmless and Indemnl — Wjon• Each party shall be responsible for any and
all claims, liabilities, damages or judgments, which may arise as a result of their own
negligence or intentional wrongdoing. Each party shall hold harmless and indemnify
the other party against any such claims, liabilities, damages or judgments. which may
be asserted against, imposed on or incurred by the other party.
10. Assionment: Provider shall not assign this Agreement without prior written consent
of Client.
11. Governing Law: This Agreement shall be governed by and construed in accordance
with laws of the State of Florida.
12. Indeuendent Contractor For all purposes hereunder, the relationship of Client and
Provider is solely that of independent contractors and this Letter of Agreement does
not create a partnership, joint venture or other association between Provider and
Client Provider's employees and agents shall be considered to be under exclusive
management and control of Provider.
13. Notices: Any and all notices sent pursuant to this Agreement shall be given in
writing, via certified mail or overnight courier and shall be delivered to the following
addresses:
To Provider: Central Florida Regional Hospital To Client: City of Sanford
Company Care 300 N. Park Avenue
1401 W. Seminole Blvd. P.O. Box 1788
Sanford, Fl 32771 Sanford, FI 32772 -1788
(407) 302 -7322 (407) 330 -5628
IN WITNESS WHEREOF, The Parties have set their hands the date and year first written above.
Company Care Providers
d✓
Ashley Jo
Chief Financial fficer
Central Florida Regional Hospital
Client /p
//lY
Jo A. enaro
an Resources Director
City of Sanford
/ ��' /� C 4 e" �-
Diane D. Dickinson
Company Care
Account Representative
CENTRAL FLORIDA REGIONAL HOSPITAL
COMPANY CARE
Letter of Agreement — Attachment A
List of Services and Prices
Fees for Services — City agrees to pay vendor within 30 days of receipt of a complete and
correct invoice for services rendered.
Test
Breathalyzer /Alcohol Test
NIDA 5 Panel Drug Screen
AHCA 5 Panel Drug Screen
AHCA 8 Panel Drug Screen
AHCA Blood/Alcohol Screen
Chain of Custody Nicotine Screening
Cost
$15.00 Screen $25.00 Confirmation
$40.00
$40.00
$40.00
$40.00
$20.00
`j
CENTRAL FLORIDA REGIONAL HOSPITAL
COMPANY CARE
LETTER OF AGREEMENT
ATTACHMENT B
COMPANY: City of Sanford
MAILING ADDRESS: P.O. Box 1788, Sanford, FL 32772
BUSINESS ADDRESS: 300 N. Park Ave, Sanford, FL 32772
TELEPHONE: 407 - 330 -5628 FAX: 407 - 330 -5606
CONTACT PERSON: Joe Denaro or Sabrina Benton
WORKERS' COMPENSATION CARRIER: N/A
GROUP HEALTH CARRIER: N/A
DRUG FREE WORKPLACE: Yes
SPECIAL AGREEMENTS: Drug Screen & Alcohol Testing on request per
List of Services
BILLS TO BE SENT TO: City of Sanford