Contract 2019-66 AGREEMENT BETWEEN THE CITY OF CLERMONT, FLORIDA
AND LIFE SCAN WELLNESS CENTERS FOR
PUBLIC SAFETY PHYSICAL EXAMINATION SERVICES
THIS AGREEMENT, made this a7 day of 4UU {--' 2019, between the City of
Clermont, a Municipal Corporation of the State of Florida(hereinafter referred to as the "CITY"),
685 West Montrose Street, Clermont, Florida and Life Extension Clinics, Inc. d/b/a Life Scan
Wellness Centers (hereinafter referred to as "LIFE SCAN"), 1011 North MacDill Avenue, Tampa,
FL 33607,who,in consideration of the covenants,representations and agreements herein contained,
agree as follows:
1. SCOPE OF SERVICES: LIFE SCAN agrees to furnish all labor, materials, and
equipment to provide job applicant exam and drug and additional testing services as set
forth in the City of Clermont RFP 19-055 and LIFE SCAN's July 18, 2019 response
thereto, which is expressly incorporated and made a part hereof. In the event of conflict,
the terms and conditions of this agreement shall prevail. In accordance therewith, LIFE
SCAN shall provide the services, as set forth in Exhibit "A" attached hereto and
incorporated herein. LIFE SCAN agrees to perform the assigned responsibilities and
duties faithfully, intelligently, and to the best of its ability, and in the best interest of the
CITY during the term of this agreement. All services provided shall be performed in
accordance with this agreement and with any and all applicable law, professional standards,
and guidelines.
2. AUTHORIZATION TO PROVIDE SERVICES: LIFE SCAN shall not be authorized to
provide any services as set forth in Exhibit "A" until such time as LIFE SCAN has
received written authorization from the City Manager or designee to perform the
specific tasks set forth in bid. LIFE SCAN shall provide the services in accordance with
the written request, Notice to Proceed or purchase order. In the event that LIFE SCAN
commences any such services without such authorization, LIFE SCAN expressly
acknowledges that it shall not be entitled to compensation of any kind related to said
services.
3. COMPENSATION: Payments shall be made pursuant to Florida Statute Section 218.70,the
Prompt Payment Act and all CITY Policies promulgated thereby.
a. LIFE SCAN shall be compensated in an amount and in accordance with the
compensation schedule set forth in Exhibit "B", attached hereto and incorporated
herein.
b. As a condition precedent to receiving payment, LIFE SCAN shall have been
authorized to proceed by CITY, shall not be in default of any of the terms and
conditions of this agreement and shall provide to CITY an invoice.The invoice shall
be forwarded to CITY, upon completion of work contemplated herein, and signed
by an authorized representative of LIFE SCAN. The invoice shall include a
statement identifying the period for which it applies or purchase order number and
the sub-tasks or portions thereof, completed by LIFE SCAN in accordance with
Exhibits"A"and "B"hereto.
c. CITY shall pay all valid, approved, and undisputed invoices within thirty
(30) days of receipt from LIFE SCAN. In the event that CITY disputes any
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invoice submitted, it shall advise LIFE SCAN in writing and said invoice shall not
be deemed due and payable under this agreement. Neither the CITY'S review,
approval, or acceptance of nor payment for, any services provided hereunder, shall
be construed to operate as a waiver of any rights under this agreement and LIFE
SCAN shall be liable to CITY for any and all damages to CITY caused by the LIFE
SCAN'S negligent or wrongful performance of any of the services furnished under
this agreement.
The acceptance of final payment by LIFE SCAN shall constitute a waiver of all
claims by LIFE SCAN except those previously made in writing and identified
by LIFE SCAN as unsettled at the time of a request for final payment.
4. TERM.
a. This Agreement shall become effective upon execution by both parties and shall
remain in effect for an initial term of thirty-six (36) months, unless terminated as
provided herein.
b. Prior to, or upon completion, of the initial term of this contract, CITY shall have the
option to renew this contract for four(4)additional twelve(12)month period(s). Prior
to completion of each exercised term, the CITY may consider an adjustment to price
based on changes on the U.S. Bureau of Statistics, Producer Price Index (PPI) for the
most recent twelve (12) month period (see http://www.bls.gov/ppi/#publications PPI
Detailed Reports, Current Edition). It is LIFE SCAN's responsibility to request in
writing any price adjustment under this provision. LIFE SCAN's written request for
adjustment should be submitted sixty (60) days prior to the anniversary date of the
agreement. LIFE SCAN'S adjustment request must clearly substantiate the requested
increase. The written request for adjustment should not be in excess of the relevant
price index change. If no adjustment request is received from LIFE SCAN,CITY will
assume that LIFE SCAN has agreed that the optional term may be exercised without
price adjustment. Any adjustment request received after the commencement of a new
option period shall not be considered. CITY reserves the right to reject any written
price adjustments submitted by LIFE SCAN.
5. TERMINATION OF AGREEMENT FOR CAUSE. The CITY shall notify, in
writing, the LIFE SCAN of deficiencies or default in the performance of its duties under
the Agreement. Three separate documented instances of deficiency or failure to perform in
accordance with the specifications contained herein shall constitute cause for termination
for default. It shall be at the CITY'S discretion whether to exercise the right to terminate.
LIFE SCAN shall not be found in default for events arising due to acts of God.
6. TERMINATION BY CITY FOR CONVENIENCE. The performance of work under
this agreement may be terminated for convenience should the City Manager of the CITY
determine it is in the best interest of the CITY. Any such termination shall be effected by
the delivery to the LIFE SCAN of a Notice of Termination specifying the extent to which
performance of work under the agreement is terminated and the date upon which such
termination becomes effective. Upon such termination for convenience, LIFE SCAN shall
be entitled to payment, in accordance with the payment provisions, for undisputed
services rendered up to the termination date and the CITY shall have no other
obligations to LIFE SCAN. LIFE SCAN shall be obligated to continue performance of
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agreement services,in accordance with the agreement,until the termination date and shall have
no further obligation to perform services after the termination date.
7. AUTHORIZED REPRESENTATIVE OF THE CITY. During the term of this
agreement,the City Manager of CITY,or his designee,shall serve as a the CITY representative
authorized to act on behalf of the CITY, as provided by law, with respect to the project.
8. INSURANCE PROVIDED BY LIFE SCAN.
a. Insurance. Except as otherwise specified in this agreement, LIFE SCAN and
all subcontractors of any tier shall be required at their sole cost and expense to
maintain in effect at all times during the performance of the work, insurance
coverage with limits as set forth in RFP 14-006 with insurers and under forms of
policies satisfactory to the CITY. It shall be the responsibility of LIFE SCAN and
all his subcontractors to maintain required insurance coverage and it shall also be
the responsibility of LIFE SCAN to assure and evidence that subcontractors are
adequately insured at all times. Failure of LIFE SCAN and its subcontractors to
maintain adequate coverage shall not relieve LIFE SCAN of any contractual
responsibility or obligation.
b. Upon request, LIFE SCAN and any subcontractors shall furnish to the CITY
such certificates of insurance or endorsements required by the provisions set forth
herein. It shall be the responsibility of LIFE SCAN to maintain adequate insurance
coverage and to assure that subcontractors are adequately insured at all times.
Failure of LIFE SCAN and its subcontractors to maintain adequate coverage shall not
relieve LIFE SCAN of any contractual responsibility or obligation. A verification
form of such insurance policy shall be filed with the City of Clermont within ten
(10) days of the execution of the agreement. The certificate of insurance shall list
the CITY as additional insured with respect to the General Liability coverage.
c. Waivers of Subrogation: LIFE SCAN and its subcontractors shall require their
insurance carrier, with respect to all insurance policies, to waive all rights of
subrogation against the City of Clermont, its Council members, partners, officials,
directors, officers, agents, and employees.
d. Comprehensive General Liability. This insurance shall be an occurrence type
policy written in comprehensive form and shall protect LIFE SCAN and its
subcontractors and the additional insured against any and all claims arising from
bodily injury, sickness, disease or death of any person other than LIFE SCAN'S
employees or damage to property of the CITY or others arising directly or
indirectly from or out of the act of omission of LIFE SCAN or its subcontractors
or their agents, employees or subcontractors.
e. Worker's Compensation Insurance. LIFE SCAN shall take out and maintain
during the life of this agreement, workers compensation insurance for all of
his employees connected with the work of this project and in case any work is sublet,
LIFE SCAN shall require any subcontractor similarly to provide workers
compensation insurance for all of the latter's employees unless such employees are
covered by the protection afforded by the LIFE SCAN. Such insurance shall comply
fully with the Florida Workers Compensation Law. In case any class of employees
engaged in hazardous work under this agreement at the site of the project is not
protected under the workers compensation statute, LIFE SCAN shall provide
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adequate insurance, and cause such subcontractor to provide adequate insurance,
satisfactory to the owner, for the protection of his employees not otherwise protected.
f. The insurance companies providing coverage must be rated through the A.M.Best rating
guide or internet site at ambest.com. Proof of the carrier's FSC rate(must be a 7 or
better) and proof of the carrier's best rating(must be A- or better)must be submitted
with the Certificate of Insurance. Alternative, LIFE SCAN shall be allowed to self-
insure any of the required coverage's.
g. Insurance Coverage Not Limitation of Liability: The maintenance of insurance
coverage as provided herein shall not be construed to limit nor have the effect of
limiting LIFE SCAN'S liability to CITY under the provision of any clause or
paragraph contained in this agreement.
9. INDEMNIFICATION. LIFE SCAN agrees to hold harmless and indemnify,
including attorney fees, CITY, its officers,employees and agents against any and all claims,
losses,damages or lawsuits for damages or threat thereof, arising from or related to negligent
acts, errors or omissions of LIFE SCAN, its employees, agents, assigns or subcontractors..
10. INDEPENDENT CONTRACTOR. It is agreed by the parties that at all times and for all
purposes within the scope of this agreement, the relationship of LIFE SCAN and CITY
is that of an independent contractor.
11. NOTICES. All notices shall be in writing and sent by United States mail, certified
or registered, with return receipt requested and postage prepaid, or by nationally recognized
overnight courier service to the address of the party set forth below. Any such notice shall be
deemed given when received by the party to whom it is intended.
Life Extension Clinics, Inc. d/b/a Life Scan Wellness Centers
Patricia Johnson, CEO
1011 North MacDill Avenue
Tampa, FL 33607
Darren Gray
City Manager City of Clermont
685 West Montrose Street
Clermont, Florida 34711
12. GENERAL PROVISIONS.
a. Attorneys' Fees. In the event a suit or action is instituted to enforce or interpret
any provision of this agreement, the prevailing party shall be entitled to recover such sum
as the Court may adjudge reasonable as attorneys' fees at trial or on any appeal, in addition
to all other sums provided by law.
b. Waiver. The waiver by CITY of breach of any provision of this agreement shall not
be construed or operate as a waiver of any subsequent breach of such provision or of such
provision itself and shall in no way affect the enforcement of any other provisions of this
agreement.
c. Severability. If any provision of this agreement or the application thereof to any person
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or circumstance is to any extent invalid or unenforceable, such provision, or part thereof,
shall be deleted or modified in such a manner as to make the agreement valid and
enforceable under applicable law, the remainder of this agreement and the application of
such a provision to other persons or circumstances shall be unaffected, and this agreement
shall be valid and enforceable to the fullest extent permitted by applicable law.
d. Amendment. Except for as otherwise provided herein, this agreement may
not be modified or amended except by an agreement in writing signed by both parties.
e. Entire Agreement. This agreement including the documents incorporated by
reference contains the entire understanding of the parties hereto and supersedes all prior and
contemporaneous agreements between the parties with respect to the performance of
services by LIFE SCAN.
f Availability of Funds. The obligations of the City of Clermont under this agreement
are subject to the availability of funds lawfully appropriated for its purpose. All purchases are
contingent upon available City of Clermont funding.
g. Assignment. This agreement is personal to the parties hereto and may not be
assigned by LIFE SCAN, in whole or in part, without the prior written consent of CITY.
h. Venue. The parties agree that the sole and exclusive venue for any cause of action
arising out of this agreement shall be Lake County, Florida.
i. Applicable Law. This agreement and any amendments hereto are executed and
delivered in the State of Florida and shall be governed, interpreted, construed and enforced
in accordance with the laws of the State of Florida.
j. Records. LIFE SCAN expressly understands and acknowledges that any
and all documents related to the services provided herein, may be considered records that
are subject to examination and production in accordance with Florida's Public Records Law,
except to the extent that an exception to the Public Records Law applies. LIFE SCAN
expressly agrees that it will comply with all requirements related to said law and that it
will hold CITY harmless for any such disclosure that is permitted by Florida's Public
Records Law.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement on this 27 day of
'Au 3 u s+ 2019.
City of Clermont Life Extension Clinics, Inc.
d/b/a Life Scan Wellness Centers
ey . i�
Gail L. Ash, Mayor Patricia Joh, o•, CEO
Date: -2 - 17-2019 Date: ` •
Attest: /Air
Tracy Ackroyd, City Clerk Corp. Se 1 7Officer
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EXHIBIT A
SECTION — B
STATEMENT OF WORK
The City of Clermont seeks to establish a contract for pre-employment, annual and fit for
duty medical examination services for general and police officer and firefighter personnel,
as well as vaccines, drug and alcohol screens, and other services as needed. The City
may award more than one contract to fulfill the needs of these services. The city has
approximately eighty-one (81) police officer positions and eighty-one (81) firefighter
positions that require pre-employment and annual physicals, approximately 25
classifications of positions (encompassing ninety-five (95) employees) that fall under
Department of Transportation (DOT) pre-employment physical and drug/alcohol testing
requirements, and forty-eight (48) non-DOT positions that require pre-employment
physicals and Drug Free Workplace drug/alcohol testing.
The city's physical examination process is designed to examine candidates and/or
existing employees to determine their ability to perform the job duties and discover any
existing medical conditions that may create hazards to the individual or others in a
particular work assignment.
The medical requirements followed for this RFP vary by job classification:
• Firefighter examinations are based on the National Fire Protection Association
(NFPA) 1582 guidelines and an in-depth consideration of essential functions.
These essential functions are what employees are expected to perform at
emergency incidents and are derived from the performance objectives stated in
NFPA 1001 , Standard for Firefighting Professional Qualifications. When making
an assessment of the company's ability to perform the job, the factors physicians
need to take into consideration include, but are not limited to:
a) Operating both as a member of a team and independently at incidents of
uncertain duration.
b) Spending extensive time outside exposed to the elements.
c) Tolerating extreme fluctuations in temperature while performing duties.
Firefighters are often required to perform physically demanding work in hot (up
to 400°F), humid (up to 100%) atmospheres while wearing equipment that
significantly impairs body-cooling mechanisms.
d) Experiencing frequent transition from hot to cold and from humid to dry
atmospheres.
e) Working in wet or muddy areas.
f) Performing a variety of tasks on slippery, hazardous surfaces such as on
rooftops or from ladders.
g) Working in areas where sustaining traumatic or thermal injuries is possible.
RFP No: 19-055
Page 9 of 42
SECTION — B
STATEMENT OF WORK
h) Facing exposure to carcinogenic dusts, such as asbestos, toxic substances
such as hydrogen cyanide, acids, carbon monoxide, or organic solvents, either
through inhalation or skin contact.
i) Facing exposure to infectious agents such as Hepatitis or HIV.
j) Wearing personal protective equipment (PPE) that weighs approximately 60
pounds while performing firefighting tasks.
k) Performing physically demanding work while wearing positive-pressure
breathing equipment.
I) Performing complex tasks during life-threatening emergencies.
m) Working for long periods of time requiring sustained physical activity and
intense concentration.
n) Facing life-or-death decisions during emergency conditions.
o) Being exposed to grotesque sights and smells associated with major trauma
and burn victims.
p) Making rapid transitions from rest to near-maximal exertion without warm-up
periods.
q) Operating in environments of high noise, poor visibility, limited mobility, at
heights, and in enclosed or confined spaces.
r) Using manual and power tools in the performance of duties.
s) Relying on senses of sight, hearing, smell, and touch to help determine the
nature of the emergency, to maintain personal safety, and to make critical
decisions in a confused, chaotic, and potentially life threatening environment
throughout the duration of the operation.
t) Additional job requirements include: Moderate to heavy work for extended
periods of duration with limited rest and rehabilitation. Must be able to walk,
stand, and lift 50+ lbs., run, jump, leap, climb, stoop, reach, bend, and
carry/push/pull 50+ lbs. Must have good hand/finger dexterity and hand/eye
coordination. Must have acceptable eyesight, hearing and speech. Must be
able to wear protective clothing and equipment of 60 lbs. or more and work in
extremely dangerous and stressful situations.
• Police Officers examinations are based upon an officer's ability to perform the job
duties of a police officer. Job description to be provided upon implementation.
• Department of Transportation (DOT) "safety sensitive" pre-employment physical
examinations are performed in adherence with established federal guidelines.
RFP No: 19-055
Page 10 of 42
SECTION — B
STATEMENT OF WORK
1 — POLICE OFFICER AND FIREFIGHTER ANNUAL PHYSICAL EXAMINATION
REQUIREMENTS
A comprehensive medical examination (A through J) to include a health risk assessment,
a complete medical history review to determine any health conditions that would prevent,
or could be aggravated by, performing the duties of the position, including but not limited
to, the ability to carry equipment, wear protective equipment/clothing and meet the
physical and psychological demands of the police officer and firefighter position. This
medical history shall also include any significant changes, job-related exposures/injuries
and new symptoms since the previous physical. Annual exams shall include the
following:
a) Physical Examination (NFPA 1582 Compliant for firefighters)
• Hands-on Physical
• Vital Signs
• Clinical Breast Examination
b) Cardiac Assessment
• Echocardiogram
• Resting EKG
• Abdominal Aorta Ultrasound
• Carotid Artery Ultrasound
• Cardiac Stress Test: with VO2 max calculation (stress test treadmill
electrocardiograms will be supervised by a Physician, Clinical Exercise
Physiologist, PA, MSN, or NP)
c) Cancer and Disease Assessment
• Skin Cancer Screening
• DRE for lower intestinal masses (test optional to the employee)
• Hemoccult Test for Colon Cancer Screening
• Prostate Ultrasound (MEN ONLY).
• Testicular Ultrasound (MEN ONLY)
• Thyroid Ultrasound
• Liver, Pancreas, Gall Bladder, Bladder, Spleen, and Kidney Ultrasound
• Pelvic Ultrasound (WOMEN ONLY) ***Not necessary for post total
hysterectomy
• Osteoporosis Risk Assessment (based on age and risk factors)
d) Pulmonary Function Test for respirator use
e) Lab tests
• Urinalysis
• Total lipid profile
RFP No: 19-055
Page 11 of 42
SECTION — B
STATEMENT OF WORK
• Complete blood count
• Comprehensive metabolic panel
• Thyroid stimulating hormone (TSH)
• CA-125 Ovarian Cancer blood test (WOMEN ONLY)
• Testosterone (MEN ONLY)
• Prostate Specific Antigen (PSA) blood test (MEN ONLY)
• Diabetes test (Glucose and Hemoglobin A1C)
f) TITMUS Vision Test
• Visual acuity corrected vision shall be to at least 20/30 Snellen in each eye.
• Color vision
• Depth perception
• Peripheral vision — Visual field performance shall be 140 in the horizontal
meridian combined.
• Night blindness —A history of night blindness should be evaluated to determine
employee's capacity to perform essential tasks at night or in dark or low
settings.
g) Hearing Exam
• Audiometric Exam
h) Personal Consultation
• Consultation with Physician, PA, MSN, or NP, to review test results and receive
recommendations for medical interventions and counseling for disease
management.
i) Behavioral modification recommendations for:
• Tobacco cessation
• Stress management
• Diet and nutrition plan
• Healthy heart
• Diabetes management
• Healthy mind, healthy body information
j) Fitness Evaluations
• Fitness and agility evaluation
• Muscular strength evaluation
• Muscular endurance evaluation
• Cardiovascular aerobic endurance evaluation
• Resistance evaluation
• Stretching/Flexibility evaluation
• Body composition analysis
RFP No: 19-055
Page 12 of 42
SECTION — B
STATEMENT OF WORK
• Exercise prescription
• Nutritional analysis
• Weight management goals
k) Additional Test Services (Priced separately on Tab I, Cost of Services)
• Chest x-ray: Optional annually, required a minimum every five (5) years
• Respirator Fit Testing (SCBA Face piece fit test/ N-95 respirators)
• Hepatitis C Test
• Hepatitis B Test (antigen)
• Hepatitis B Titer (antibody)
• Hepatitis B Vaccine (3 per series)
• Hepatitis A Test (antigen)
• Hepatitis A Titer (antibody)
• Hepatitis A Vaccine (2 per series)
• Purified Protein Derivative (PPD) Test
• Tetanus
• Tuberculosis screening, annually by QuantiFERON — TB Gold In-Tube Test
(QFT-GIT)
2 — JOB APPLICANT EXAMINATIONS (ADDITIONAL SERVICES)
Job applicant examinations or pre-employment tests are required of police officer and
firefighter positions and certain general positions. Examination results shall be
communicated within 3-4 business days. The types of job applicant medical examination
and specific tests are as follows (Priced separately on Tab I, Cost of Services):
a) Physical Examination — appointments to be scheduled within 72 hours
a) Pre-employment drug screens
b) Random, Reasonable Suspicion, and Post Accident Drug Screens
c) Height, Weight and Blood Pressure Recorded
d) Blood Chemical Profile:
e) Complete Blood Count (CBC)
f) Lipid Panel
g) Comprehensive Metabolic Panel
h) Thyroid Stimulating Hormone (TSH)
i) Urinalysis
j) EKG at rest— or Stress EKG if recommended by physician
k) Stress EKG
RFP No. 19-055
Page 13 of 42
SECTION — B
STATEMENT OF WORK
I) PPD — or chest x-ray if a positive reactor
m) Chest X-Ray (2 view)
n) Vision Test (Snellen and Ishihara Color)
o) Audiometric Test
p) Pulmonary Function Test (PFT)
3 — DRUG TESTING (ADDITIONAL SERVICES)
The following is a list of all drugs for which the City tests all job applicants and employees
(Priced separately on Tab I, Cost of Services).
b) Alcohol
c) Amphetamines
d) Cannabinoids
e) Cocaine
f) Phencyclidine
g) Opiates
h) Methaqualone
i) Barbiturates
j) Benzodiazpines
k) Methadone
I) Propoxyphene
m) Random, Reasonable Suspicion and Post Accident Drug Screens for both CDL
and non-CDL positions (perform Blood and Breath Alcohol Test as required).
4 — MINIMUM QUALIFICATIONS
a) Personnel Requirements
• Respondent physician and/or medical director shall be board certified with
experience in occupational medicine health care to Police, Fire, Rescue and
EMS Agencies with a minimum of five (5) year experience. Sonographer
personnel shall be a registered diagnostic medical sonographer. Respondent
shall provide a detailed biography of the provider(s).
• Successful respondent Project Manager and/or Supervisors shall have
excellent communications skills, be capable of directing and coordinating with
RFP No: 19-055
Page 14 of 42
SECTION — B
STATEMENT OF WORK
the designated City staff, develop a detail staffing plan that ensures an
adequate number of full and/or part-time staffing is trained, experienced, and
licensed in all areas of the project, and ensure that the available personnel
meet performance criteria and adhere to strict safety and security measures.
The staffing plan shall include duties and responsibilities for each assigned
position and staffing method to be used. The staffing plan is to be submitted
with the proposal response.
• Successful respondent Project Manager and/or Supervisors shall constantly
use their experience and training to properly guide the program.
• Successful respondent shall provide an adequate number of personnel
specifically trained, experienced and licensed in all areas of the project.
• Provide other qualified licensed professionals as needed.
• The City reserves the right to direct successful respondent to rearrange work
schedules or annual work plan to meet the immediate needs of the City. This
shall include weekend work and staffing.
• Successful respondent shall have the capability of being mobile so as to
perform the exams at various locations throughout the City for police officer and
firefighter positions.
b) Maintenance
• Awarded respondent shall be required to perform maintenance, sanitize and
clean equipment as per manufacturer's recommendation in order to provide
continuous optimum operating standard. In the event equipment becomes
inoperable and cannot be replaced and/or repaired within a reasonable time
frame, the City reserves the right to obtain an alternative provider.
c) Reporting
• A copy of the complete examination and test results must be provided to the
employee either in person or via U.S. Mail within thirty (30) days of the exam.
A Fit-for-Duty exam report stating whether the employee is medically fit to
perform the essential duties of the position and provide results of Hepatitis
titers/screenings, must be provided to the city for each employee within
fourteen (14) days of the exam. If the employee is found to be unfit for duty,
the city must be notified by phone within 24 hours of the exam and provided a
written notification within three (3) days of any test that reveal conditions that
could place the employee or team in immediate danger by continuing
unrestricted duty. The final evaluation will be reviewed and signed by a license
Physician, NP, MSN, or PA. The respondent shall develop samples of
RFP No: 19-055
Page 15 of 42
SECTION — B
STATEMENT OF WORK
reporting and are to be submitted with the response. The City reserves the
right to request, modify or alternate reports throughout the term of the contract
agreement.
d) Mobile Testing
• The successful respondent will be responsible for performing these physicals
at various sites around the City covering multiple shifts.
• If not utilizing their own mobile units to provide the physicals, the successful
respondent may utilize City owned sites, if available, as a project location.
Should the successful respondent use the City owned facilities, they shall be
responsible for all public utilities, phone lines, insurance, mobile vehicle and or
portable equipment capability. The successful respondent shall also be
responsible for maintaining all City supplied facilities in a neat, clean and
functional manner, and will be responsible for any damages beyond normal
wear and tear, and/or vandalism. The successful respondent shall be
responsible for the compliance to all Federal, State and local statutes and
regulations pursuant to the sage and proper storage of all regulated
substances, materials, and equipment at the successful respondent sole
expense. The successful respondent shall be responsible for transport of all
equipment, fuel, materials, and supplies to and from the site.
e) Comprehensive Safety and Security Program
• Safety and security is a prime consideration to City staff. A variety of
emergencies may occur that would adversely affect, endanger or
inconvenience City personnel or its information; the successful respondent
shall design a comprehensive safety and security program in accordance with
the Health Insurance Portability and Accountability Act (HIPPA) that conforms
to the validity of a test and/or results. The safety and security plan is to be
submitted with the response. The safety and security program should address
at a minimum, but not be limited to, the following:
1. Processes and procedures for employee safety and security.
2. Processes and procedures for facilities and equipment security.
3. Emergency Preparedness Plan.
4. Safety equipment.
5. Coordination and reporting to the City's Human Resources Department
regarding accidents and/or damages.
6. Records confidentiality procedures.
RFP No: 19-055
Page 16 of 42
SECTION — B
STATEMENT OF WORK
7. Testing safety and accuracy.
f) Subcontracting
• Subcontracting and/or assigning of any and/or all portions of this subsequent
agreement are subject to City review and approval. The successful respondent
shall perform required services through its own employees or subcontractors.
The successful respondent shall include the subcontractor's name, location,
equipment and personnel with their response.
g) Medical Laboratory
• The Medical Laboratory shall meet all equipment, location and personnel
requirements as established by the Department of Transportation regulations
(49 CFR 40, 59, FR 4300, as amended), Florida Drug Free Workplace Florida
Statutes 440.102 requirements, and be properly licensed. The successful
respondent shall provide a facility and certified technicians to collect blood and
urine specimens.
h) Medical Review Officer
• The Medical Review Officer must meet all requirements as established by the
Department of Transportation regulations (49 CFR 40, 59, FR 4300, as
amended), Florida Drug Free Workplace Florida Statutes 440.102
requirements, and be properly licensed.
END OF SECTION — B
RFP No: 19-055
Page 17 of 42
EXHIBIT B
SECTION — C
RESPONSE FORMAT
Annual Physical Examination Requirements Price per Service
(Section B, 1A — 1J)
Police Officer or Firefighter Physical Examination $ 395.00
Additional Test Services, (Section B, 1K) Price per Service
Ex Chest x-ray: Optional annually, required a minimum $ 63.00
every five (5) years
Respirator Fit Testing (SCBA Face piece fit test/ N-95 $ 35.00
respirators) *QUANTITATIVE with PORTACOUNT
see below
Hepatitis C Test $ 50.00
Hepatitis B Test (antigen) $ 50.00
Hepatitis B Titer (antibody) $ 25.00
Hepatitis B Vaccine (3 per series) $ 210.00 ($70 each)
Hepatitis A Test (antigen) $ 30.00
Hepatitis A Titer (antibody) $ 25.00
Hepatitis A Vaccine (2 per series) $ 140.00 ($70 each)
PPD Test $ 12.00
Tetanus $ 25.00
Tuberculosis screening, annually by QuantiFERON — TB $ 63.00
Gold In-Tube Test (QFT-GIT)
RFP No: 19-055
Page 21 of 42
SECTION — C
RESPONSE FORMAT
Additional Services: Job Applicant Examinations for
Price per Service
Fire, Police, and General Employee — (Section B, 2)
Physical Examination - appointments to be scheduled within $ $0.00
72 hours
Pre-employment drug screens $ 35.00
Height, Weight and Blood Pressure Recorded $ included
Blood Chemical Profile: $
1. Complete Blood Count (CBC) $ 15.00
2. Lipid Panel $ 15.00
3. Comprehensive Metabolic Panel $ 15.00
4. Thyroid Stimulating Hormone (TSH) $ 25.00
Urinalysis $ included
EKG at rest — or Stress EKG of recommended by physician) $ 35.00
Stress EKG (includes Resting EKG and Stress EKG) $ 175.00
Purified Protein Derivative (PPD) — or chest x-ray if a $ 10.00
positive reactor
Chest X-Ray (2 view) $ 60.00
Vision Test (Snellen and Ishihara Color) $ 15.00
Audiometric Test $ 22.00
Pulmonary Function Test (PFT) $ 22.00
Other exams as recommended for police officers and $ NO ADDITIONAL
firefighters CHARGE
Pre-Employment in our Standard Life Scan Wellness:
Hemoglobin AIC & Glucose, PSA, CA125
(women)Testosterone (men), Hemoccult $ NO ADDITIONAL
Fitness Evaluations for Public Safety Candidates are also CHARGE
included. This can also be included for Non Public Safety
RFP No: 19-055
Page 22 of 42
SECTION — C
RESPONSE FORMAT
HAZMAT Blood Tests
Heavy Metals and Cholinesterase
Other Available Tests Recommended for Public Safety:
• Coronary CT Calcification Scoring with Lung CT every
5+ years (replaces chest X-Ray)
• Expanded Cancer Blood Markers that correlate with our
current Life Scan Wellness Pubic Safety Evaluations
• Nutritional Evaluation with Clinical Assessment
* OSHA Respirator Mask Fit testing: We utilize a quantitative method for mask fit testing
using the PortaCount equipment which is the gold standard for both N95 and SCBA.
•
1 1 •
•
RFP No: 19-055
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SECTION — C
RESPONSE FORMAT
Additional Services: Drug Testing for Fire, Police, and Price per Employee
General Employee — (Section B, 3)
Random, Reasonable Suspicion and Post Accident Drug DOT Drug Test $50.00
Screens for both CDL and non-CDL positions including Non DOT Drug Test: $40.00
MRO review and consultation as needed. Alcohol BAT: $60.00
Drug Rescreen: $45.00
MRO Review: $50.00
Random, Reasonable Suspicion and Post Accident Breath
or Blood Alcohol Test as required including MRO review and Alcohol Blood: $80.00
consultation as needed MRO Review $50.00
After-hours drug and alcohol testing services $ NOT AVAILABLE
Other Services as needed Price per Employee
Medical Fitness for Duty evaluation $ To be determined
based on needs.
Psychological Fitness for Duty evaluation $ NOT AVAILABLE
Post Exposure services — exposure hotline, surveillance and
$ NOT AVAILABLE
source testing
MRO Consultation outside of drug test result review (e.g., $ 100.00
review of prescription drug disclosures)
TAB J — Signed Addenda (if applicable) and Requested Forms.
i. Signed addenda
ii. Conflict of Interest (Section F)
iii. Drug-Free Workplace (Section G)
iv. Public Entity Crimes (Section H)
v. Supplemental Questionnaire (Section I)
vi. Signature Page (Section J)
RFP No: 19-055
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SECTION - C
RESPONSE FORMAT
END OF SECTION - C
RFP No: 19-055
Page 25 of 42
SECTION —J
SIGNATURE PAGE
By signing this section the respondent certifies that:
1. It satisfies all legal requirements (as an entity) to do business with the City.
2. The undersigned respondent acknowledges that award of a contract may be
contingent upon a determination by the City and that the respondent has the
capacity and capability to successfully perform the contract.
3. The proposer hereby certifies that it understands all requirements of this
solicitation, and that the undersigned individual is duly authorized to execute this
proposal document and any contract(s) and/or other transactions required by
award of this solicitation.
Purchasing Agreements with Other Government Agencies
This section is optional and will not affect contract award. If the City of Clermont awarded
your company, would your company sell under the same terms and conditions, for the
same price, to other governmental agencies in the State of Florida? Each governmental
agency desiring to accept to utilize this contract shall be responsible for its own purchases
and shall be liable only for materials or services ordered and received by it. Niki ❑
No (Check one)
By signing below,the respondent agrees to all terms,conditions, and specifications as stated in this solicitation,and is
acting in an authorized capacity to execute this response. The respondent also certifies that it can and will provide and
make available,at a minimum,the items set forth in this solicitation.
Respondent Information and Signature
Company Name (print): Life Extension Clinics, Inc. D/B/A Life Scan Wellness Centers
Street Address: 1011 North MacDill Ave Tampa, FL 33607
Mailing Address(if different):
Telephone: 813-876-0625
P Fax: 813-876-0653
Email: Patricia.Johnson@lifescanwellness.com Payment Terms: % days, net
FEIN: 59 28 I Professional. License No.:
Signature: a°7-1?-(TP / Date: 7'4, 1
Print Name: Patrici. •ohn Title: CEO
Does the respondent accept payment using the City's MASTERCARD? ❑ Yes 0 No
END OF SECTION J
RFP No: 19-055
Page 42 of 42