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Home My WebLink AboutKORT - PROFESSIOAL SERVICES Kowr The Best In Rehab. WORKSTRATEGIES Keeping America on the Job! January 29, 2018 Kim Calabro, HR City of Jeffersonville 500 Quartermaster Court, Room 336 Jeffersonville, Indiana 47130 Re: Letter of Agreement between the City of Jeffersonville, 500 Quartermaster Court, Room 336, Jeffersonville, Indiana 47130 and Kentucky Orthopedic Rehabilitation, LLC for and on behalf of itself and its subsidiaries and affiliates d/b/a KORT, (KORT)effective January 29, 2018. Dear Ms.Kim Calabro: Please accept this Letter of Agreement, documenting the agreed upon term and rate for Service(s) from the KORT WorkStrategies Program that will be provided at the City of Jeffersonville located at 500 Quartermaster Court, Room 336, Jeffersonville, Indiana 47130. The terms of this Letter of Agreement will be in effect for one (1) year with automatic renewals for additional one (1) year periods unless it is earlier terminated as provided herein. Either party may terminate this Agreement at any time, without cause, by giving sixty(60) days prior written notice to the other party. Both parties agree that KORT will provide on-site ergonomic education and individual assessments (for those interested employees) provided at a rate of$120.00/hour or visit according to service and proposal to the City of Jeffersonville during any one year period that this Letter of Agreement is in effect. Both parties must approve any additional WorkStrategies Services. The City of Jeffersonville will be invoiced on a monthly basis (or as discussed). Payment is due within 30 days of receipt of invoice. The City of Jeffersonville and KORT agree to comply with all Indiana state laws and regulations governing this client/provider arrangement. All invoices pertaining to WorkStrategies Program services delivered to Company employees will be mailed to: The City of Jeffersonville Attn. Ms. Kim Calabro, Human Resources 500 Quartermaster Court Jeffersonville, Indiana 47130 kcalabro@cityofj eff.net Any questions pertaining to this Agreement can be directed to: Lisa M. Stumler,KORT-WorkStrategies Marketing Rep at 502-387-1154. Thank you for giving us this opportunity to serve your employees. Sincerely, Jason Chambers, CEO Kentucky Orthopedic Rehabilitation, LLC 13201 Magisterial Drive Louisville, KY 40223 Acknowledged and Agreed to: By: Title: CAI or Company esorq—va\pv\c, , eb 1'� a° 4CRD CERTIFICATE OF LIABILITY INSURANCE I DATW D/YY) 113/2 1/3/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A.CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL-INSURED:the pollcy(Ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer ri hts to the certificate holder In lieu of such endorsements. R00uCER SelectMed Unit -he Graham CompanyNAME; PHONE -�aX�" -he Graham Building • 215-567-8300 (No,No):215-405-271.1 AL Penn Square West ADDR'Ess: SELECTMED UNIT@g<ahamco.cam 'hiladelphia PA 19102- IN$URER(S)AFFORDING COVERAGE NAIC■ INSURER A:Libe Mutual Fire Ins.Co. 23035 ISUREO SELEMED-01 LibertyINSURER El: • .. , 42404 (entucky Orthopedic Rehabilitation, LLC '/o Select Medical Co orat€on 31127 1716 Old GettysburgRoad INSURER D:American Guarantee fi Liability 20247 Mechanicsburg PA 17055 , Assurance Company,Ltd. ■* e :OVERAGES CERTIFICATE NUMBER:1528189295 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ SR rADDL t:11aR POLICY EFF POLICY EXP TR. TYPE OF INSURANCE _Wan wvn POLICY NUMEIER. IMMIDDIYYYYI IMM/PA/YYYY1 - - LIMITS COMMERCIAL DENERAL LIABILITY EACH OCCURRENCE 17•MAGETORENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ - PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: _GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS•COMP/OP AGG S OTHER: _ S A AUTOMOBILE LIABILITY A$ $ 1.509047-037 4/112017 4/1nals 3 [EUMIT $ ,LEe. ccddentl 2,000,000 . _ X ANY AUTO BODILY INJURY(Par person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERT{OAMAt3E $ AUTOS ONLY �. AUTOS ONLY (Per=dent) $ E UMBRELLA LIAR X OCCUR 0001448016 12/31/2017 12/31/2018 EACH OCCURRENCE $26,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $28,000 000 DED RETENTION$ 1-24"- L B wORKERSCOMPENSATION WA7-036-609047.017 411/2017 4/1/2018 X I gff -UTE I 8 AND EMPLOYERS'UABIUTY YIN WC 7.830••609047.O27 4/1/2017 4/1/2018 - ANYPRQPRIETORIPARTNERIEXEGUTIVE - El.EACH ACCIDENT $1,000,000 OFEICERJMEMBEREXCLUDED7 I N/A (Mandatory In NH) E.L,DISEASE•EA EMPLOYEE $1,000,000 it yes describe under DESCRIPTION OF 4PERATLON sI E.L.DISEASE-POLICY LIMIT $1,000,000 _ ,C Excess Genafal/ProresslonsI LIeD, NMU 208.5248455.14 12/31/2017 12/31/2018 Sae Below 0 Property ZMD541783712 12/31/2017 12/31/2018 See Below •—•----s DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additlanal Remarks Schedule,may be attached If more space la rewired) EXCEEXCESS COMMERCIAL GENERAL LIABILITY COVERAGE(CGL)-$10M Each Occurrence/$10M Aggregate Limit Excess of$2M Self-Insured Retention; EXCESS PROFESSIONAL LIABILITY COVERAGE(PL)-$7M Each Clalm/$7M Aggregate Limit Excess of$5M Self-Insured Retention:Both Coverages are subject to a$10M Policy Aggregate Limit. PROPERTY COVERAGE: $5,000,000 Limit for Unnamed/Unscheduled Locations; Specified Limits for Scheduled Locations. RE: 13201 Magisterial Drive,Louisville,KY 40223 CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN " ACCORDANCE WITH THE POLICY PROVISIONS. Kentucky Orthopedic Rehabilitation, LLC, d/b/a KORT 13201 Magisterial Drive - -- Louisville 40223 AUTHORIZED REPRESENTATIVE 071968.2015 ACORD CORPORATION. All rights reserved.