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Home My WebLink About01-01-2012 to 12-31-2013 OCCUPATIONAL— Ora —Sits Health Health Solution Solutions THIS AGREEMENT, is between OCCUPATIONAL HEALTH SOLUTIONS, LLC, a Kentucky Company (hereinafter referred to as "OHS ") and City of Jeffersonville, (hereinafter referred to as the "Company"). WHEREAS, OILS is in business of providing health risk assessment and wellness services to the Client located in Indiana. NOW THEREFORE, in consideration of the convenants contained herein along with other good and valuable consideration, the parties agree as follows: 1. PROFESSIONAL SERVICES All personnel and contract vendors providing health and wellntss services to the Company will be qualified to perform such functions as deemed essential. These individuals are employees of OHS except for contract vendors. 2. OUALIFICATIONS AND CERTIFICATIONS All personnel and contract vendors providing health and wellness services to the Company will be fully qualified and meet OHS, state and federal guidelines of liccnsurc and/or certification for the provision of such services. Copies of personnel credentials will be made available to the Company upon request, and will be kept on file with OHS. 3. RATE SCHEDULE Health risk assessments and wellness program managem nt will be provided by OHS according to the following rates based on actual participants of the health screening program See (Attached program details for all pricing) Blood profiles will include: Total Cholesterol, HDL, LDL, Triglycerides and Glucose levels and will be performed by a medical professional that specializes in blood draws. The professionals may include: R.N. "s, Phlebotomists, Medical'l'echs and other qualified professionals. 80% Participation Rule- OHS will bill for a minimum of 80% of the participants scheduled by the company on each scheduled day. Example the schedule has 100 names and only 70 participate, we will bill the Company for 80. Travel which requires overnight or > 1 br. outside of Louisville will be charged for hotel, mileage (a,.40 /mi. & meals. TB1) and billed with invoice. 4. BILLING PROCEDURE We will detail the days and numbers of participants on each day. Payment for wellness program services rendered by OHS are due and payable upon receipt of the invoice. . I a Contract (Page 2) 5. RULES AND REGULATIONS OHS personnel and vendors will observe rules and regulations as set by the Company and will act in a manner consistent with other Company personnel. OHS will not give any medical advice or prescribe any medications. Our role is to provide health education services to the employer and employee. This is a voluntary program for all participants 6. CONFIDENTIALITY The personal information that is shared will remain just that, personal. Employee confidentiality must be respected by both the employer and Occupational Health Solutions (OHS). OHS will not send or disclose any individual medical information without proper authorization from individuals. No individual health information will be shared with anyone at Cite of Jeffersonville. All programs and services are HIPAA compliant. 7. ORIENTATION The Company will provide to OHS personnel (Dave Berkemeier) a short period of orientation explaining thc rules and regulations of the Company's work areas. I.E. policies and procedures, emergency procedures... 8. INSURANCE Throughout the teen of this agreement, OHS will maintain in their own name insurance coverage of at least $1,000,000 per person and S2,000,000 per oecummce covering each for all acts or omissions which may give rise to liability for services undcr this agreement. OHS shall provide the Company with a current certificate of insurance if needed. OHS dots not carry liability insurance related to blood draw occurrences. All blood draw professionals will carry individual liability insurance policies and OHS will maintain appropriate professional liability insurance coverage. 9. WORKERS' COMPENSATION OHS shall comply with the Statc Worker's Compensation Law and provide for the payment of worker's compensation to its employers in thc manner and to the extent required by such law. 10. CIVIL RIGHTS ACT OHS agrees that they will comply with all laws, including but not limited to, Civil Rights Act of 1964 (P.L. 88 -352) providing that no person in the United Stales shall, on the Bounds of race, color, creed, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination as a result of this contract. 11. EFFECTIVE DATE This agreement shall become effective on 01-01 -2012 and continue until 12 -31 -2013 at which time the contract is automatically renewed on a year to year basis if notice of termination is not given. 12. TERMINATION This agreement may be terminated by either party upon written notice. This agreement may be terminated without cause or for any reason upon 60 days written notice of termination to the party at the other party's principle address. xer Contract (Page 3) 13. NOTICES Any notice required or permitted to bc given shall be in writing and shall be effective if sent by certified mail: to OHS at: and the Company at: OCCUPATIONAL HEALTH SOLUTIONS, LLC CITY OP JEFFERSONVILLE 9005 RESERVE DRIVE 500 QUARTERMASTER COURT PROSPECT, KY 40059 JEItbRSONVILLE, IN 47130 14. INDEMNIFICATION As a Company, I do hereby waive, release and forever discharge (OHS - provider of health screening services) and its officers, agents, employees, representatives, executors, and all others from any and all responsibilities or liability from injuries or damages resulting from Company participation in any voluntary health activities. I also understand that fitness activities involve a risk of injury and even death, and that the Company and all participants are voluntarily participating in these activities. 15. ENTIRE AGREEMENT This agreement constitutes the entire agreement between the parties. The provisions hcrcin shall bc to the benefit of and shall be binding upon the parties hereto. This agreement may only be modified by written agreement executed by all parties. In Witness whereof, the undersigned have executed this agreement as of the day and year first written above. OCCUPATIONAL HEALTH SOLUTIONS CI s y FFS t 9).-a CLL.. / � � % i Y Signature Signature / David Eerkemeier 171 S / `, C's 1 r :5 Pr Name Name C/ President r g Title Tide _11,2.3-2ri11 11 -23 -2011 Date Date Please fax the signed contract to Occupational Health Solutions ® 502426 -1177 You can e-mail the signed contract to davehdhealthyworksite.com Once OHS receives the signed contract we will coordinate logistics and timeline for implementing the on -site testing dates and times. Company Contact Phone Number E -mail