2016-38 American Sign Language Services,INC
3700 Commerce Blvd,Suite 2016
+�) S ERV I ill ES� Kissimmee,FL 34741
� ii Phone (407)518-790o
amerlcan sign language services,inc
Fax-(407)518-7900
www ASLServices corn
i
Onsite
, Interpreting Agreement
Prepared For:
I MR�..;r•"
I
i
Choice of Champions
City of Clermont
6
Professional Interpreting Services Agreement
ASL Services,Inc
INTERPRETING SERVICE AGREEMENT
This Agreement is made between City of Clermont hereafter referred to as (Client) and American Sign Language Services
Coip (ASL Services, Inc) hereafter referred to as (Provider) to provide professional Interpreting services for On-Site
Interpreting Requests
Onsite Interpreting: Interpreterwill appear in person and provide professional interpreting services at the designated
location On-Site interpreting is an optimal choice when a meeting or presentation will require a live interaction with a
Deaf individual or group
AMERICAN SIGN LANGUAGE SERVICES CORP (ASL SERVICES, INC) WILL RENDER THE FOLLOWING
FOR ALL INTERPRETING SERVICES REQUEST:
1 Facilitate all requests for interpreting services
2. Provide a Scheduling Team and/or Dispatcher to be on call to assist in obtaining an On-Site
A Team Member is available 24 hours/day,365 days a year to assist you with your scheduling needs
3 Provide a means to request prescheduled or on-demand interpreting assignments
-b Prescheduled appointments are scheduled requests confirmed with more than 1 business day (25
Hours or more) notice via e-mail, or a call to our scheduling department Confirm prescheduled
appointments with an e-mail confirmation,guarantees an interpreter at your designated start time
and location One weeks' notice is preferred (but not required).
-A= On-Demand appointments are requested with less than 1 business days' (25 Hours or less) notice
These request will be called into our dispatcher paging system (dispatcher will return call within
15 minutes)
.k Our scheduling team and dispatchers can take requests for appointments that are same day, or up
to 18 months in advance.
4. Match your Client's language needs to the appropriate interpreter (i e Spanish-ASL, English Spanish-ASL,
low vision, oral interpreting, physical limitations, gender sensitive etc .) Non- Primary Languages (e g I
Mandarin Chinese, Russian,and German)may require to be prescheduled.
5. Assign qualified interpreters for all on-site interpreting needs. Credentials and/or experience can be
provided for any interpreter upon request Our core group of interpreters has been background checked
and/or fingerprinted for safety purposes All interpreters follow conduct, confidentiality and ethics under
RID CPC Specifications (http://nd org/ethics/code-of-professional-conduct/)
6. Compliance with HIPAA standards of confidentiality (included in RID Code of Professional Conduct) in
regards to patient's private information
7. Hold all aspects of this Agreement private and confidential
Page 2 of 5
Professional Interpreting Services Agreement
ASL Services,Inc
CLIENT RESPONSIBILITIES FOR REQUESTING INTERPRETING SERVICES
American Sign Language Services Corp (ASL Services,Inc)scheduling team is trained to quickly identify the pertinent
information for each request, and match them with the best available interpreter suited for that situation While all
interpreters are qualified to provide interpreting services,we work hard to assign each and everyjob to the Interpreter
who has the most experience in that subject matter
Policies and Procedures:
To Schedule:
4 On-Site:Advanced Requests,(Please give 25 hours or more notice for scheduled requests One weeks'notice
is optimal, but not required) please call 407-518-7900 ext. 309, fax 407-518-7903 or e-mail:
scheduling@aslservices.com. For Same Day/Next Day requests please call the After Hours pager at 407-
931-8050.A scheduling representative will return your call within 15 minutes
Confirmation:
ak E-Mail and Fax requests are monitored during the following business hours
o Monday-Thursday 8 30am -4 30pm EST
o Friday 8 30am-1 OOpm EST
4 You will receive confirmation via e-mail or fax for each request submitted If you do not receive confirmation
within one business day of submitting requests, please call 407-518-7900 ext 309 during business hours, or
407-931-8050 after business hours
4. To confirm your patient/clients upcoming appointment, you can utilize GLOBALVRS, by dialing toll-
free 1-877-326-3877 (24/7/365). By calling this number, you will be connected to a deaf
interpreter. You can then provide the interpreter with the phone number of your deaf patient/client
and confirm the appointment through the VRS call center.
Cancellation:
American Sign Language Services Corp incurs the cost of interpreters once they are booked for an assignment,for
this reason,any assignments canceled or rescheduled with less than 25 hours'notice,will be billed in full
No Show:
Nk Standard wait time for the interpreter is 20 minutes per hourscheduled
Solicitation:
rok You agree not to attempt to solicit, hire, subcontract,or in any way employ or directly utilize the services of any of
the professional interpreters that American Sign Language Services Corp provides for up to two years from the most
recent dates of service
Penalty of solicitation of services is$1,000 00 per occurrence
Confidentiality:
,k American Sign Language Services Corp falls under Title H(Administrative Simplification) of HIPAA ASL Services,Inc
employees have been HIPAA trained and certified
Page 3 of 5
Professional Interpreting Services Agreement
ASL Services,Inc
PRICING: ON-SITE INTERPRETING
AMERICAN SIGN LANGUAGE SERVICES CORP (ASL SERVICES, INC.) PROFESSIONAL ON-SITE
INTERPRETING FEES
$85 00 Per hour with a 2 (two) hour minimum for Pre-Scheduled Services (7 00am- 5 OOpm) Request must
be submitted minimum 1 business day to be considered Pre-Scheduled _
$55 00 1 Flat Rate applicable for On-Demand requests
$10 00 i Additional per hour for evening requests(5pm-7am), and weekends
SPECIAL SERVICE FEES
• Trilingual (proficient in English/Spanish/Sign Language)
• Tactile(interpreter for the Deaf and Blind)
.$15 00/hr • Foreign Sign Language/Deaf Interpreter
• Mexican Sign Language (LSM)
Travel & Mileage I See Below Notations
FEDERAL HOLIDAYS ARE BILLED AT 1.5 TIMES APPLICABLE RATE
Please Note: All efforts to meet same week requests will be made but are not guaranteed until an e-mail confirmation
has been received
nk Teamed Assignments:Two(2)Interpreters may be scheduled as needed by provider due to the following factors
o Duration of assignment (Typically assignments of more than three hours)
o Assignment intensity
o Special needs e g Tactile Interpreting (Deaf/Blind)
https//drivegoogle com/fila/d/OB3DKvZMf/FLdVzZpaUtraW5xZG8/view
-I' Travel & Mileage Fees:Travel Fees will be billed at the hourly rate dependent on the interpreter's travel
time to and from the location of service. Fees are waived for jobs preformed in Orange&Osceola Counties
in Florida
I hereby agree to the on-site interpreting rates for professional interpreting services rendered by American Sign Language
Services Corp (ASL Services,Inc,) I am a designated representative that has authority to approve these services I agree to
keep this agreement confidential,and will not release information contained within to any third party All terms of this
agreement are legally bound by the laws established by the state of Florida This agreement will automatically renew each
year,and stay in effect until new service rates are provided during agreement renewal
Printed Name. -barren Pn G(0\ Title C 't-( rn(, act p4
Signature .� , A Date: u C (
ASLS Rep Iv , wr
Printed Name 01, Com/ OS Title C00
ASLS Rep
Signature 'Aj Date 1-/—( -/&
Page 4of5
Professional Interpreting Services Agreement
ASL Services,Inc
BILLING REMITTANCE INFORMATION
` Billing: '
f
NI. In accordance with the Americans with Disabilities Act(www ada gov),your company is directly responsible
for payment whether or not your company is able to submit It to insurance or a third party Your company
is therefore responsible for providing American Sign .3uages Corp with full billing information
ir
Acceptance of Rates, Terms and Services (Initial) - G �
Company Legal Name 0_41...k pT 0.-ler Mara.
Company Representative Name and Title \(t .ckA A �f d Rowe.` 1L C er
Email Address L CY r 00 .D C.,1 eir MOY\ L. org
Phone Number SS 2.—21-1` — 7 33 1
Physical Billing Address 1 AS UD•(1\a3n`irOSe��'.)Gt.'M._,r-1-i --gL-7
Check the method of payment that best matches your company needs:
❑ I wish to receive the invoice via EMAIL(PDF Document, prints as an original)
Invoice Remittance E-Mail Address
NI I wish to receive the invoice via Postage Mail
Additional Notes that should be implemented on all invoices for your organization
i e Weekly Botched Invoices or invoices requiring special documentation at time of remittance
I
•
Authorized Provider Initials
Authorized Client Initials
I
Date: 4/7/ 1 I
Page 5of5